| 1. |
- Bazargani, Farhan, 1969-, et al.
(författare)
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Three-dimensional Analysis of Effects of Rapid Maxillary Expansion on Facial Sutures and Bones : A systematic review
- 2013
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Ingår i: Angle orthodontist. - : The EH Angle Education and Research Foundation Inc. - 0003-3219 .- 1945-7103. ; 83:6, s. 1074-1082
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Forskningsöversikt (refereegranskat)abstract
- Objective: To evaluate the evidence on three-dimensional immediate effects of rapid maxillary expansion (RME) treatment on growing patients as assessed by computed tomography/cone beam computed tomography (CT/CBCT) imaging. Materials and Methods: The published literature was searched through the PubMed, Embase, and Cochrane Library electronic databases from January 1966 to December 2012. The inclusion criteria consisted of randomized controlled trials, prospective controlled studies, and prospective case-series. Two reviewers extracted the data independently and assessed the quality of the studies. Results: The search strategy resulted in 73 abstracts or full-text articles, of which 10 met the inclusion criteria. When treating posterior crossbites with a RME device, the existing evidence points out that the midpalatal suture opening is around 20%-50% of the total screw expansion. There seems to be no consistent evidence on whether the midpalatal sutural opening is parallel or triangular. The effect on the nasal cavity dimensions after RME seems to be apparent and indicates an enlargement between 17% and 33% of the total screw expansion. Circummaxillary sutures, particularly the zygomaticomaxillary and frontomaxillary sutures and also spheno-occipital synchondrosis, appear to be affected by the maxillary expansion. Overall, however, the changes were small and the evidence not conclusive. Conclusions: CT imaging proved to be a useful tool for assessment of treatment effects in all three dimensions. The majority of the articles were judged to be of low quality, and therefore, no evidence-based conclusions could to be drawn from these studies.
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| 2. |
- Feldmann, Ingalill, et al.
(författare)
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Anchorage capacity of osseointegrated and conventional anchorage systems : a randomized controlled trial.
- 2008
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Ingår i: American Journal of Orthodontics and Dentofacial Orthopedics. - : Elsevier BV. - 0889-5406 .- 1097-6752. ; 133:3, s. 339.e19-28
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Our aim in this investigation was to evaluate and compare orthodontic anchorage capacity of 4 anchorage systems during leveling/aligning and space closure after maxillary premolar extractions. METHODS: One hundred twenty patients (60 girls, 60 boys; mean age, 14.3 years; SD 1.73) were recruited and randomized into 4 anchorage systems: Onplant (Nobel Biocare, Gothenburg, Sweden), Orthosystem implant (Institut Straumann AG, Basel, Switzerland), headgear, and transpalatal bar. The main outcome measures were cephalometric analysis of maxillary first molar and incisor movement, sagittal growth changes of the maxilla, and treatment time. The results were also analyzed on an intention-to-treat basis. RESULTS: The maxillary molars were stable during the leveling/aligning in the Onplant, Orthosystem implant, and headgear groups, but the transpalatal bar group had anchorage loss (mean, 1.0 mm; P <.001). During the space-closure phase, the molars were still stable in the Onplant and Orthosystem groups, whereas the headgear and transpalatal bar groups had anchorage loss (means, 1.6 and 1.0 mm, respectively; P <.001). Thus, the Onplant and the Orthosystem implant groups had significantly higher success rates for anchorage than did the headgear and transpalatal bar groups. Compared with the Orthosystem implant, there were more technical problems with the Onplant. CONCLUSIONS: If maximum anchorage is required, the Orthosystem implant is the system of choice.
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| 3. |
- Feldmann, Ingalill, et al.
(författare)
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Orthodontic anchorage : a systematic review.
- 2006
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Ingår i: Angle Orthod. - 0003-3219 .- 1945-7103. ; 76:3, s. 493-501
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this systematic review was to examine, in an evidence-based way, what kind of orthodontic anchorage systems/applications are evaluated and their effectiveness. A literature survey from the Pub Med and Cochrane databases covering the period from January 1966 to December 2004 was performed. Randomized controlled trials (RCT), prospective and retrospective controlled studies, and clinical trials comparing at least two anchorage situations were included. Two reviewers selected and extracted the data independently and also assessed the quality of the retrieved studies. The search strategy resulted in 494 articles, of which 14 met the inclusion criteria. Two main anchorage situations were identified: anchorage of molars during space closure after premolar extractions and anchorage loss in the incisor or premolar region (or both) during molar distalization. Because of contradictory results and the vast heterogeneity in study methods, the scientific evidence was too weak to evaluate anchorage efficiency during space closure. Intraoral molar distalization leads to anchorage loss in various amounts depending on the choice of distalization unit. Most of the studies had serious problems with small sample size, confounding factors, lack of method error analysis, and no blinding in measurements. To obtain reliable scientific evidence, controlled RCT's with sufficient sample sizes are needed to determine which anchorage system is the most effective in the respective anchorage situation. Further studies should also consider patient acceptance and cost analysis as well as implants as anchorage.
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| 4. |
- Feldmann, Ingalill, et al.
(författare)
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Orthodontic anchoring techniques and its influence on pain, discomfort, and jaw function--a randomized controlled trial.
- 2012
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Ingår i: European Journal of Orthodontics. - : Oxford University Press (OUP). - 0141-5387 .- 1460-2210. ; 34:1, s. 102-8
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this trial was to evaluate and compare perceived pain, discomfort, and jaw function impairment between orthodontic treatments combined with skeletal anchorage and treatment using conventional anchorage with headgear or transpalatal bar. A total of 120 adolescent patients in order to start orthodontic treatment were consecutively recruited and randomized into three groups with different anchorage. Group A underwent installation of a skeletal anchorage (Onplant or Orthosystem implant), group B received headgear, and group C a transpalatal bar. Questionnaires were used to assess pain intensity, discomfort, analgesic consumption, and jaw function impairment from baseline to the end of treatment. Pain scores overall peaked on day 2 and were almost back to baseline on day 7. The site with the highest pain scores during treatment was incisors in contact but with no differences between groups. Pain intensity from molars was significantly less in the skeletal anchorage group A compared to the transpalatal bar group C the first 4 days in treatment and with no sign differences compared to headgear. The results confirm that there were very few significant differences between patients' perceptions of skeletal and conventional anchorage systems during orthodontic treatment. Consequently, these new appliances were well accepted by the patients in a long time perspective and can thus be recommended.
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| 5. |
- Feldmann, Ingalill, et al.
(författare)
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Pain intensity and discomfort following surgical placement of orthodontic anchoring units and premolar extraction : a randomized controlled trial
- 2007
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Ingår i: Angle orthodontist. - : The Angle Orthodontist (EH Angle Education & Research Foundation). - 0003-3219 .- 1945-7103. ; 77:4, s. 578-585
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate and compare perceived pain intensity and discomfort between the placement of two different orthodontic anchoring units designed for osseointegration and premolar extraction in adolescent patients. MATERIALS AND METHODS: A total of 120 adolescent patients (60 girls and 60 boys) were recruited and randomized into three groups. Group A underwent installation of an onplant, group B installation of an Orthosystem implant, and group C premolar extraction. Pain intensity and discomfort, analgesic consumption, limitations in daily activities, and functional jaw impairment were evaluated the first evening and one week after the intervention. RESULTS: Pain intensity following surgical installation of an onplant was comparable to the pain intensity experienced after premolar extraction, but there was significantly less pain after surgical installation of an Orthosystem implant compared to installation of an onplant (P = .002) or premolar extraction (P = .007). The protective, vacuum-formed stent caused great discomfort, even more discomfort than the surgical sites following installation of the onplant or the Orthosystem implant. CONCLUSION: The Orthosystem implant was better tolerated than the onplant in terms of pain intensity, discomfort, and analgesic consumption and was, therefore, the anchorage system of choice in a short-term perspective.
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| 6. |
- Feldmann, Ingalill, et al.
(författare)
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Reliability of a questionnaire assessing experiences of adolescents in orthodontic treatment
- 2007
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Ingår i: Angle orthodontist. - 0003-3219 .- 1945-7103. ; 77:2, s. 311-317
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate the reliability of a questionnaire that assessed the expectations and experiences of adolescent patients about orthodontic treatment. MATERIALS AND METHODS: The study included two groups of patients: 30 consecutive patients (19 girls and 11 boys, mean age 14.6 years, SD 2.3 years) naive to orthodontic treatment, and 30 consecutive adolescent patients (17 girls and 13 boys, mean age 15.1 years, SD 2.0 years) in active orthodontic treatment with fixed appliances in both jaws. A questionnaire comprising 46 items was developed, based upon focus group interviews and previous established questionnaires. The questionnaire covered the following domains: Treatment motivation; treatment expectations; pain and discomfort from teeth, jaws, and face; functional jaw impairment; and questionnaire validity. Internal consistency as well as temporal stability with the test-retest method was investigated. RESULTS: A majority of the questions exhibited acceptable test-retest reliability, and composite scores yielded excellent reliability for all domains. Internal consistency was acceptable and good face validity was found for all domains. CONCLUSION: The questionnaire can be recommended for use in the assessment of expectations and experiences of orthodontic treatment.
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| 7. |
- Feldmann, Ingalill, et al.
(författare)
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The significance of anchorage in orthodontics
- 2015
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Ingår i: Skeletal Anchorage in Orthodontic Treatment of Class II Malocclusion. - : Elsevier. - 9780723438342 - 9780723436492 ; , s. 22-28
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Bokkapitel (refereegranskat)
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| 8. |
- Ganzer, Niels, et al.
(författare)
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A cost-effectiveness analysis of anchorage reinforcement with miniscrews and molar blocks in adolescents : a randomized controlled trial
- 2019
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Ingår i: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 41:2, s. 180-187
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To analyse cost-effectiveness of anchorage reinforcement with buccal miniscrews and with molar blocks. We hypothesized that anchorage with miniscrews is more cost-effective than anchorage with molar blocks. Trial design: A single-centre, two-arm parallel-group randomized controlled trial. Methods: Adolescents (age 11–19 years) in need of treatment with fixed appliance, premolar extractions, and en masse retraction were recruited from one Public Dental Health specialist centre. The intervention arm received anchorage reinforcement with buccal miniscrews during space closure. The active comparator received anchorage reinforcement with molar blocks during levelling/alignment and space closure. The primary outcome measure was societal costs defined as the sum of direct and indirect costs. Randomization was conducted as simple randomization stratified on gender. The patients, caregivers, and outcome assessors were not blinded. Results: Eighty patients were randomized into two groups. The trial is completed. All patients were included in the intention-to-treat analysis. The median societal costs for the miniscrew group were €4681 and for the molar block group were €3609. The median of the difference was €825 (95% confidence interval (CI) 431–1267). This difference was mainly caused by significantly higher direct costs consisting of material and chair time costs. Differences in chair time costs were related to longer treatment duration. No serious harms were detected, one screw fractured during insertion and three screws were lost during treatment. Generalizability and limitations: The monetary variables are calculated based on a number of local factors and assumptions and cannot necessarily be transferred to other countries. Variables such as chair time, number of appointments, and treatment duration are generalizable. Owing to the study protocol, the benefit of miniscrews as a stable anchorage has not been fully utilized. Conclusions: When only moderate anchorage reinforcement is needed, miniscrews are less cost-effective than molar blocks. The initial hypothesis was rejected. Miniscrews provide better anchorage reinforcement at a higher price. They should be used in cases where anchorage loss cannot be accepted. Trial registration: NCT02644811
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| 9. |
- Ganzer, Niels, et al.
(författare)
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A novel method for superimposition and measurements on maxillary digital 3D models-studies on validity and reliability
- 2018
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Ingår i: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 40:1, s. 45-51
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Tidskriftsartikel (refereegranskat)abstract
- Background: Serial 3D models can be used to analyze changes, but correct superimposition is crucial before measurements can be assessed. Earlier studies show that every palatal structure changes due to growth or treatment. Here, we describe a new method that uses an algorithm-based analysis to perform superimpositions and measurements in maxillary 3D models. This method can be used to identify deformations. In a second step, only unchanged areas are used for superimposition. Objectives: This study investigates the validity and reliability of this novel method. Methods: Digital 3D models from 16 cases were modified by an independent 3D engineer to simulate space closure and growth. True values for tooth movements were available as reference. Measurements and repeated measurements were performed by four observers. Results: The total tooth movement had an absolute mean error of 0.0225 mm (SD 0.03). The intraclass correlation coefficient (ICC) was 0.9996. Rotational measurements had an absolute mean error of 0.0291 degrees (SD 0.04 degrees) and an ICC of 0.9999. Limitations: Serial models need to be taken with a moderate interval (1 to 2 years). Obvious changed areas in the palate need to be cropped before processing the models. Conclusion: The tested method is valid and reliable with excellent accuracy and precision even when changes through growth or orthodontic treatment occur.
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| 10. |
- Ganzer, Niels, et al.
(författare)
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Anchorage reinforcement with miniscrews and molar blocks in adolescents : A randomized controlled trial
- 2018
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Ingår i: American Journal of Orthodontics and Dentofacial Orthopedics. - : Elsevier. - 0889-5406 .- 1097-6752. ; 154:6, s. 758-767
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Anchorage can be reinforced in many ways. Due to the variety of anchorage concepts, only a few general conclusions can be drawn. Therefore, more research is needed to investigate specific concepts with specific indications. The objective of this trial was to compare the anchorage capacities of miniscrews and molar blocks. Methods: This randomized controlled trial was conducted on 2 parallel arms. The trial was conducted at the Public Dental Service Orthodontic Clinic in Gavle, Sweden. Participants were adolescents who needed orthodontic treatment with a fixed appliance, extraction of the maxillary first premolars, and anchorage reinforcement. In group A, miniscrews were used as direct anchorage during space closure. In group B, molar blocks were used as anchorage reinforcement during leveling and alignment and space closure. The primary outcome was loss of anchorage assessed as maxillary first molar movement. Random allocation was maintained with a simple randomization stratified by sex. The observer was blinded to the allocations during the measurements. Results: Forty participants each were randomized to groups A and B. Results were analyzed on an intention-to-treat basis, meaning that all participants, successful or not, were included in the analysis. Group A showed a mean anchorage loss of 1.2 mm during leveling and alignment. During space closure with miniscrews, no significant anchorage loss was found. Group B showed mean anchorage losses of 1.4 mm during leveling and alignment and 2.4 mm during space closure. No serious harms were detected. The first molar rotation, torque, and tipping showed different characteristics during the treatment phases. Conclusion: Miniscrews can be recommended for anchorage reinforcement. Depending on the need for anchorage reinforcement, miniscrews can be inserted at the beginning of treatment or when space closure starts. Molar blocks cannot be recommended for anchorage reinforcement. Protocol: The protocol was published after trial commencement.
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