International journal of orthodontics (Milwaukee, Wis.)

To evaluate the acceptability of different intra-oral and extra-oral orthodontic appliances, to rank orthodontic appliances from the most to the least attractive and to investigate the factors that may affect the acceptance of orthodontic treatment. A random sample of 800 students (schoolchildren and university students) were invited to participate in this study and a total of 688 students were included (86%). A self-administrated structured questionnaire was constructed for the purpose of this study. More than one-half in each age group (53%) claimed that they would accept to have orthodontic treatment. Acceptance of the different orthodontic appliances was affected by gender, age and type of school. Removable appliance was reported as the most acceptable and facemask was reported as the least acceptable orthodontic appliances. Majority of subjects ranked ceramic and facemask appliances as the most and the least attractive orthodontic appliances, respectively. The predictor variables for the acceptance of orthodontic treatment were perceived demand for orthodontic treatment, perceived positive effect of orthodontic treatment and expected benefits from orthodontic treatment. Removable appliance was the most acceptable orthodontic appliance whereas ceramic appliance was ranked as the most attractive one. Facemask was the least acceptable and the least attractive option.
The Nickel Titanium (NiTi) closed coil springs serve as an efficient force delivery system in orthodontic space closure mechanics. The closed coil springs with the eyelets come in various lengths to broaden its force characteristics for an expedient space closure. However, at a certain point of time of progressive space closure, the coil spring can be expanded no further for an adequate force delivery. In such situations, the clinician prefers to replace the existing spring with another short length spring. The present article describes a simple conservative technique for progressively re-activating the same NiTi closed coil spring for complete space closure.
-Diagrammatic representation of landmarks and linear variables used to obtain tongue, soft palate, and upper airway measurements. Tongue length (TGL) was measured as the distance from the tip of the tongue (TT) to the base of the epiglottis (Eb). Tongue height (TGH) was defined as the maximum perpendicular distance from the plane TT-Eb to the dorsum of the tongue. The soft palate length (PNS-P) was measured from the posterior nasal spine (PNS) to the inferior tip of the soft palate (P), and the soft palate thickness (MPT) was measured on the line perpendicular to the PNS-P line. The superior posterior airway space (SPAS) was measured between the posterior pharyngeal wall and the posterior border of the soft palate on a line parallel to Go-B through the midpoint of PNS-P. The middle airway space (MAS) was measured between the posterior pharyngeal wall and the dorsum of the tongue on a line parallel to Go-B through the tip of the soft palate (P). The inferior airway space (IAS) was defined as the width of the pharynx measured between the posterior pharyngeal wall and the dorsum of the tongue on a line joining gonion (Go) to the supramentale (B). 1, TGL; 2, TGH; 3, PNS-P; 4, MPT; 5, SPAS; 6, MAS; 7, IAS.
-Diagrammatic representation of landmarks and contours used to identify tongue, soft palate, nasopharynx, oropharynx, and hypopharynx crosssectional areas. The tongue area is the area outlined by the dorsum of the tongue surface and the lines that connect TT (the centre of the lead disc attached to the border between the ventral and dorsal surfaces of the tongue tip), RGN (retrognathion), H (anteriorsuperior point of the hyoid), and Eb. The soft palate area is defined by the outline of the soft palate that starts and ends at PNS through P. The nasopharynx is outlined by a line between R (the point on the posterior pharyngeal wall constructed by the line from PNS to the cross-sectional point of the cranial base and the lateral pterygoid plate) and PNS, an extension of the palatal plane to the posterior pharyngeal wall, and the posterior pharyngeal wall. The oropharynx is outlined by the inferior surface of the tongue, a line parallel to the palatal plane through point Et (the most superior point of the epiglottis), and the posterior pharyngeal wall. The hypopharynx is outlined by the inferior border of the oropharynx, the posterior surface of the epiglottis, a line parallel to the palatal plane through point C4 (the most inferior and anterior point on the fourth cervical vertebrae), and the posterior pharyngeal wall. For the measurement of the cross-sectional areas, the tongue, soft palate, and pharyngeal area outlines were quantified by reading the drawn sheets on a personal computer via a flat-bed scanner. A custommade program developed by Sano et al. (2007) computed the cross-sectional area of each soft tissue from the reproduced image. 1, Tongue; 2, Soft Palate; 3, NASO; 4, ORO; 5, HYPO.
The aim of this study was to assess the upper airway soft-tissue structures in Class IIJapanese children following activator treatment by means of cephalometric analysis. A lateral cephalometric radiograph was taken of each patient at Ti (prior to the placement of the activator; mean age: 11 years, 5 months) and T2 (after 1 year of activator treatment; mean age: 12 years, 5 months). Tracings of the lateral cephalometric radiographs were made on acetate paper, and several soft-tissue points and contours of the tongue, soft palate, hyoid, and pharynx were digitised. The sizes of the oropharynx and hypopharynx were significantly smaller in Class II patients than in Class I patients. Moreover, significant differences were observed in the sizes of the tongue and soft palate between Class I and II patients at the age of 12. In terms of the ratio of change relative to the initial values between the 2 skeletal patterns, the width and dimension of the pharyngeal airway in Class II patients showed considerable increases after activator use. The pharyngeal airway soft tissue structures of Class I patients using the activator exceeded normal growth after 1 year. This finding suggests that correction ofskeletal Class II discrepancies by the activator in orthodontic treatment could reduce the risk of respiratory problems, such as severe snoring, obstructive sleep apnoea, and excessive daytime sleepiness in the future.
The objective was to determine which bracket adhesive removal method was the most effective. Four different techniques were investigated: adhesive removing pliers, 12-fluted carbide, white stone, and Sof-Lex discs. Scanning electron microscopy was used for microanalysis and photographing. Sof-Lex discs was the best removal method, similar to the negative control.
Anchorage is a major concern in adult mutilated dentition. However, with the explosive development of Temporary Anchorage Devices (TADs) newer avenues in orthodontic treatment philosophy have opened up. Mini-screws are found to be stable during such treatments, demonstrating that they could provide absolute anchorage for tooth movement. The present article describes a simple, yet effective technique for simultaneous molar uprighting and distalization, using direct skeletal anchorage using a mini-screw supported assembly in a 38 years old male patient as part of adjunctive adult orthodontics with mutilated dentition.
The following case report represents one of the applications of Fiber Reinforced Composites (FRC) in adjunctive orthodontics. In the case, a severely rotated centeral incisor was derotated using FRC as a mean for posterior anchorage control.
Transforce lingual appliances are designed to be used in conjunction with conventional fixed appliances. Lingual arch development is normally followed by bonded fixed appliances to detail the occlusion. Alternatively Transforce appliance treatment is an efficient method of preparing complex malocclusions prior to a finishing stage with invisible appliances. This approach is ideal for adult treatment, using light continuous forces for arch development with appliances that are comfortable to wear. Sagittal and Transverse appliances are designed for arch development in a range of sizes for contracted arches. They can be used to treat all classes of malocclusion and are pre-adjusted fixed/removable devices for non-compliance treatment. Force modules with nickel titanium coil springs enclosed in a tube deliver a gentle, biocompatible continuous force with a long range of action. They are excellent for mixed dentition and ideal for adult arch development. There are multiple sizes for upper and lower arch development and a sizing chart may be placed over a study model for correct selection, eliminating the need for laboratory work.
Facial soft tissue cephalometric parameters are specific to each society. These measurements should be considered during planning treatment for orthodontic patients. We establish lateral cephalometric facial soft tissue norms in adolescent boys and girls with normal occlusion in Mashhad in the northeast of Iran, and compare them with those of other societies.
Cephalometric superimposition  
This article describes the treatment of a young adult male with a concave profile, skeletal class III malocclusion because of a prognathic mandible and proclined upper incisors. The therapy included stages: 1. Pre-surgical orthodontics involving leveling and aligning of upper and lower arches, protraction of lower molars and retraction of upper incisors; 2. Surgical phase involving BSSO with mandibular setback and 3. Post-surgical orthodontics for finishing and detailing. The treatment lasted 23 months and improved facial esthetics significantly The treatment resulted in a functional occlusion with a lack of lateral cuspid guidance that could be accepted considering the difficulty of the case. Over jet and overbite are within norms.
Adult expansion has always been a controversy. We will focus on three clinical cases with non-surgical adult expansion. These cases show the possibilities of improving smile esthetics without compromising function.
There is currently great demand among adult patients for aesthetic solutions. In the great majority of cases, patients present with serious oral problems in their mouths, such as over-crowding, ageneses, edentulous spaces from old extractions, periodontal problems, etc. In the face of all these problems we need interdisciplinary strategies that will help us carry out the complex and imaginative treatments that these cases require. In this article we are going to describe the interdisciplinary treatment that we provided to two adult patients. 1--On a 25 year old male patient with significant upper maxillary crowding with transversal constriction and absence of the upper right lateral incisor; through correction of the over-crowding, the maxillary constriction and rehabilitation with an implant-supported fixed prosthesis in the edentulous space, we will treat and correct this case. 2--A 29 year old male patient with agenesis of the superior canines and edentulous gap in the inferior dental arch.
Anterior open bite is often caused by a downward rotation of the mandible and/or by excessive eruption of the posterior teeth. In such cases, it is difficult to establish absolute anchorage for molar intrusion by traditional orthodontic mechanics. This is a case report of successful treatment of a severe anterior open bite using miniscrew anchorage. A female patient of 20 yrs presented with symmetrical frontal facial appearance, increased anterior facial height, convex profile and incompetent lips. Dentally, she had lost both mandibular first molars due to caries and both maxillary first molars were extruded. She had class II canine relationship, 5 mm overjet, 5 mm anterior open bite, 3 mm mandibular midline diastema and a spacing of 2 mm in the maxillary arch. The treatment objectives were to correct the anterior open bite and establish ideal overjet and overbite and to restore the mandibular first molars with fixed prosthesis. Titanium miniscrews (1.3 mm diameter and 9 mm length) were implanted bilaterally in the maxillary arch between the second premolar and the first molar, and an intrusion force was applied with NiTi closed coil springs for 8 months. After molar intrusion, the same screws were used for en masse retraction of the entire dentition (third molars were extracted) for 4 months. The results showed that, after an active treatment of 20 months, the maxillary molars were intruded about 4 mm each and good occlusion was achieved. In conclusion, the miniscrews were very useful in the non-surgical management of adult anterior open bite cases.
Skeletal Anterior open bite abnormality in adults is probably the most difficult to correct in orthodontics just behind Skeletal Class III abnormality. Literature research shows various techniques to correct this problem, often via orthognathic surgery, but it was difficult to find in the literatures a simplified non-surgical technique. This author propose, a simplified, non-surgical technique to correct skeletal anterior open bite in adults using non-ligating, frictionless brackets and vertical elastics. Some indications and contra-indications will be discussed
These two cases have been chosen to illustrate the very considerable potential for change once the cranial lesions have been identified and their correction is planned as part of treatment.
Adult orthopedic and orthodontic treatment requires a more circumspect sensibility in diagnosis, technology selection, reasons for treatment, and patient goals. Many adults present with asymmetries of the dental arches, the cranium, and the entire body. The use of the Advanced Lightwire Functional (ALF) appliance for adult orthopedic treatment will be shown. The appliance construction, application, rational, indications for use, and the results of adding this appliance to an adult treatment regimen will be explored.
Unlabelled: The purpose of this article was to analyze the various factors responsible for iatrogenic damage to a patient in an orthodontic practice and to advise precautions to prevent such damage. Methods: All case reports describing iatrogenic damage published in all orthodontic journals indexed on PubMed and the related articles of all these case reports published in any journal. Conclusions: Good preventive practices can reduce and even completely eliminate the damage produced by the orthodontic operator.
Controlling the eruption and development of dentitions is fundamental for a good oral health. The early diagnosis and adequate treatment of occasional developmental disorders are essential to achieve occlusal, functional and esthetic harmony. Abnormality is the term used for classification of alterations and is the most common developmental anomaly in humans. Even though several factors causing tooth malformations have been identified, many are still partially understood, thus requiring a more thorough study. Anyway, the available knowledge provides bases to attempt the early diagnosis of tooth abnormalities, to allow the adoption of preventive and effective therapeutic approaches.
What are the orthodontic treatment possibilities, limitations and risks inherent in patients with periodontal disorders, particularly active periodontal disease? This case report describes the interface between orthodontics, periodontics and restorative dentistry in the management of a 25-year-old young man with generalized aggressive periodontitis.
Facial aging is a dynamic process involving the aging of soft tissue and bony structures. The shape, size, and volume of the bones of the face have all been shown to change. The cosmetic community has focused on soft tissue changes, particularly changes in the skin and loss of fat volume. However, the bony components of the face are also important for overall facial 3D contour. "The bones of the face retain the capacity for remodeling at any age." Dentofacial orthopedics is the area of dentistry concerned with the supervision, guidance, and correction of the growing and mature orofacial structures. This includes conditions that require movement of the teeth or correction of malrelationships and malformations of related structures by the adjustment of relationships between and among teeth and facial bones by the application of forces or the stimulation and redirection of functional forces within the craniofacial complex. The use of intraoral appliances for this treatment is customary. Since we now recognize that the bony midface undergoes a process of bony resorption and volume loss with increasing age it should be of interest to the dental and cosmetic surgery community that we can show an increase in midface volume and significant bony remodeling with the use of a functional orthopedic orthodontic appliance.
Upper airway obstruction is associated with many dental and skeletal malocclusions. Recognizing and removing the problems at an early age is encouraged. However, the malocclusions caused by upper airway obstruction can be addressed and corrected at different stages of dentitions using various types of appliances and orthodontic techniques. This article reports several cases, which were treated with the help of medical experts and otolaryngologists.
Mean and Standard Deviation of studied variables and their changes during treatment with Faramand functional appliance
Post treatment photographs of frontal, profile and intra oral view of the patient. 
Changes of all variables in immediately after Treatment and at least 2 years after Treatment.
Unlabelled: Because stability is known as the fundamental key of the successful outcome of orthodontics treatment, this study investigated the stability of tongue, hyoid bone and airway dimensions at least two years after active treatment with Faramand functional appliance in patients with class II div 1 malocclusion. Conclusion: The present findings indicate that treatment with functional appliance has the potential to increase pharyngeal airway dimensions and changes in tongue and hyoid position. Importantly, these achieved changes seemed to be maintained in long-term, up to 4 years on average.
Figure 2a and 2b
Specific characteristics of a sidebend cranial strain result from displacement of the skull base, i.e. the sphenoid and occiput. Sidebend strain has skeletal, facial and dental consequences which are described in this patient example. An asymmetric occlusion is commonly seen in conjunction with sidebend strain, where the posterior occlusion is more Class II on the sidebend side and more Class I on the opposite side. By addressing the cranial base problem with A.L.F. appliances, this case example demonstrates an effective means of restoring facial, structural balance, and correcting the malocclusion that accompanies the sidebend strain.
The aim of this study is to report five cases of children treated with an interceptive technique utilizing ALF (Advanced Light Force) functional orthodontic appliances in anterior and/or posterior cross bites in primary and early mixed dentition.
Top-cited authors
Mario Vedovello Filho
  • Centro Universitário Hermínio Ometto (UNIARARAS)
Silvia A. S. Vedovello
  • Centro Universitário Hermínio Ometto (UNIARARAS)
German Ramirez-Yanez
  • University of Manitoba
Abdolreza Jamilian
  • Islamic Azad University