Skeletal open bite correction with rapid molar intruder appliance in growing individuals
ABSTRACT To determine the dentofacial effects of a fixed functional appliance, the rapid molar intruder (RMI).
One control group (n = 10) and two study groups (n = 10 each) were formed. The first experimental group consisted of growing children in the mixed dentition period who received RMI therapy alone. The second experimental group consisted of growing children in the early permanent dentition period who received both RMI and fixed appliance (edgewise) therapy together. Mean changes for the measurements for each group were evaluated by the Wilcoxon signed rank test. Comparisons of the mean changes between the groups were made by the Kruskal-Wallis test.
Open bite correction was achieved by counterclockwise rotation of the mandible as a consequence of redirecting growth in both treatment groups. The ANB angle decreased significantly (P < .05). Significant decreases were also noted for vertical skeletal characteristics in both treatment groups (P < .05). Molar intrusion was statistically significant for both maxillary and mandibular first molars (P < .05) in both treatment groups.
The RMI appliance provided effective bite closure and favorable dentofacial changes for nonsurgical open bite treatment in growing patients. It was concluded that this method could be regarded as a safe and noncompliance alternative for early intervention of skeletal open bite correction.
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ABSTRACT: Orthodontic forces for tooth intrusion ought to be continuous and low, which may be achieved with the help of osseointegrated implants. The aims of this study were to describe a method to intrude supererupted maxillary molars using interarch intrusion mechanics (a bite plane appliance) with implants and to assess anchor implant stability through resonance frequency analysis (RFA; Osstell, Mentor version 2, Integration Diagnostics AB, Göteborg, Sweden) in comparison with nonanchorage control implants during orthodontic intrusion. A 48-year-old female patient was treated with implants (36 and 37 regions, Brånemark Implant System, MkIII TiUNite, Nobel Biocare AB, Göteborg, Sweden; lengths, 13 and 10 mm; diameter, 5 mm) serving as orthodontic anchorage for intrusion of supraerupted teeth in the maxilla (teeth 26 and 27) using a bite plane appliance. The force of intrusion applied was individual discontinuous bite force in the present case. The control implants were in the sites 45, 46, and 47 with healing abutments out of loading. Stability of both the anchorage and control implants was assessed by RFA from the commencement of orthodontic intrusion (7 months after the first-stage surgery) to the end of the study (19 months after the first-stage surgery). Marginal bone height measurements of both implants were performed on radiographs at the same time. The treatment was completed without complications or abnormalities of the intruded teeth or the opposite anchorage implants. However, implant stability quotient values of the anchored implants obviously changed during the initial 4 months after commencement of intrusion compared with control implants. In the present case, an intrusion of 2.2 mm was achieved in 12 months. The present method made it possible to intrude molars successfully. However, further studies with more cases are needed to clarify the reliability of the method and determine how to control the bite forces applied as orthodontic load.Clinical Implant Dentistry and Related Research 01/2009; 12(1):48-54. DOI:10.1111/j.1708-8208.2008.00129.x · 3.59 Impact Factor
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ABSTRACT: Anterior open-bite (AOB) treatment is considered challenging because of difficulties in determining and addressing etiologic factors and the potential for relapse in the vertical dimension after treatment. In this review, we compiled evidence on the long-term stability of the major therapeutic interventions for correcting AOB. Our objective was to review and compile evidence for the stability of surgical and nonsurgical therapies for AOB malocclusion. Our data sources were PubMed, EMBASE, Cochrane Library, limited gray literature search, and hand searching. A search was performed of the electronic health literature on the stability of AOB after treatment. Hand searching of major orthodontic journals and limited gray literature searching was also performed, and all pertinent abstracts were reviewed for inclusion. Full articles were retrieved for abstracts or titles that met the initial inclusion criteria or lacked sufficient detail for immediate exclusion. Studies accepted for analysis were reviewed and their relevant data retrieved for pooling. The long-term stability estimates were pooled into nonsurgical and surgical groups, and summary statistics were generated. One hundred five abstracts met the initial search criteria, and 21 articles were included in final analyses. Rejected articles failed to exhibit follow-up times of 12 months or more, did not include measurements of overbite (OB), or did not meet inclusion criteria. All included articles were divided into a surgical group (SX) with a mean age of 23.3 years and a nonsurgical group (NSX) with a mean age of 16.4 years. All studies were case series. Random-effects statistical models were used to pool the mean OB measures before and after treatment and also at the long-term follow-up. The pretreatment adjusted means of OB were -2.8 mm for the SX and -2.5 mm for the NSX. AOB closures up to +1.6 mm (SX) and +1.4 mm (NSX) were achieved. Relapse in the SX group during the mean 3.5 years of follow-up reduced the OB to +1.3 mm; the NSX group relapsed to +0.8 mm in the mean 3.2 years of follow-up. Pooled results indicated reasonable stability of both the SX (82%) and NSX (75%) treatments of AOB measured by positive OB at 12 or more months after the treatment interventions. In the included case series publications, success of both the SX and NSX treatments of AOB appeared to be greater than 75%. Because the SX and the NSX were examined in different studies and applied to different clinical populations, no direct assessment of comparative effectiveness was possible. The pooled results should be viewed with caution because of the lack of within-study control groups and the variability among studies.American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 02/2011; 139(2):154-69. DOI:10.1016/j.ajodo.2010.10.019 · 1.38 Impact Factor
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ABSTRACT: The aim of this retrospective study was to quantitatively evaluate the treatment effects of intrusion of overerupted maxillary molars using miniscrew implant anchorage and to investigate the apical root resorption after molar intrusion. The subjects included 30 patients whose average ages were 35.5±9.0 years. All patients had received intrusion treatments for overerupted maxillary molars with miniscrew anchorage. There were 38 maxillary first molars and 26 maxillary second molars to be intruded. Two miniscrews were inserted in the buccal and palatal alveolar bone mesial to the overerupted molar. Force of 100-150 g was applied by the elastic chains between screw head and attachment on each side. Lateral cephalograms and panoramic radiographs taken before and after intrusion were used to evaluate dental changes and root resorption of molars. Only 6 of the 128 miniscrews failed. The first and second molars were significantly intruded by averages of 3.4 mm and 3.1 mm respectively (P<0.001). The average intrusion time was more than 6 months. The crown of the molars mesially tilted by averages of 3.1 degrees and 3.3 degrees (P<0.001) for first and second molars. The amounts of root resorption were 0.2-0.4 mm on average. The intrusion treatment of overerupted molars with miniscrew anchorages could be used as an efficient and reliable method to recover lost restoration space for prosthesis. Radiographically speaking, root resorption of molars was not clinically significant after application of intrusive forces of 200 to 300 g.Journal of Huazhong University of Science and Technology 10/2013; 33(5):780-5. DOI:10.1007/s11596-013-1197-5 · 0.83 Impact Factor