No abstract available.
Orthodontists ; History, 21st Century

The “surgery-first” approach, defined as a team approach between surgeons and orthodontists for orthognathic surgery without preoperative orthodontic treatment, is aimed at dental decompensation. A brief historical background and indications for the surgery-first approach are reviewed. Considering the complicated mechanism of postoperative orthodontic treatment, the proper selection of patients is a vital component of successful surgery-first approach.
Humans ; Orthodontics ; Orthodontists ; Orthognathic Surgery ; Surgeons

OBJECTIVE: Treating Class II subdivision malocclusion with asymmetry has been a challenge for orthodontists because of the complicated characteristics of asymmetry. This study aimed to explore the characteristics of dental and skeletal asymmetry in Class II subdivision malocclusion, and to assess the relationship between the condyle-glenoid fossa and first molar. METHODS: Cone-beam computed tomographic images of 32 patients with Class II subdivision malocclusion were three-dimensionally reconstructed using the Mimics software. Forty-five anatomic landmarks on the reconstructed structures were selected and 27 linear and angular measurements were performed. Paired-samples t-tests were used to compare the average differences between the Class I and Class II sides; Pearson correlation coefficient (r) was used for analyzing the linear association. RESULTS: The faciolingual crown angulation of the mandibular first molar (p < 0.05), sagittal position of the maxillary and mandibular first molars (p < 0.01), condylar head height (p < 0.01), condylar process height (p < 0.05), and angle of the posterior wall of the articular tubercle and coronal position of the glenoid fossa (p < 0.01) were significantly different between the two sides. The morphology and position of the condyle-glenoid fossa significantly correlated with the three-dimensional changes in the first molar. CONCLUSIONS: Asymmetry in the sagittal position of the maxillary and mandibular first molars between the two sides and significant lingual inclination of the mandibular first molar on the Class II side were the dental characteristics of Class II subdivision malocclusion. Condylar morphology and glenoid fossa position asymmetries were the major components of skeletal asymmetry and were well correlated with the three-dimensional position of the first molar.
Anatomic Landmarks ; Cone-Beam Computed Tomography ; Crowns ; Head ; Humans ; Malocclusion* ; Molar ; Orthodontists ; Temporomandibular Joint*

OBJECTIVE: The purpose of this study was to clarify the effects of continuous force application for extrusive tipping movement and occlusal interference on periapical root resorption in the rat mandibular first molar. METHODS: We constructed an appliance comprising a titanium screw implant with a cobalt-chromium post as the anchorage unit and a nickel-titanium closed coil spring (50 cN) as the active unit. Force was applied on the mandibular left first molar of rats for 8 (n = 10) and 15 days (n = 10; experimental groups), with the tooth in occlusion. Five rats were included as a non-treated control group to examine the body effect of the appliance. Active root resorption lacunae, identified using tartrate-resistant acid phosphatase, were evaluated in terms of the length, depth, and area. RESULTS: The rat mandibular first molars were mesially tipped and extruded in the occlusal direction. This mesio-occlusal tipping movement and occlusion resulted in the formation of a compression zone and active root resorption lacunae in the distoapical third of the distal roots. However, there was no significant difference in the amount of root resorption between the two experimental groups. The control group did not exhibit any active root resorption lacunae. CONCLUSIONS: Periapical root resorption was induced by continuous extrusive tipping force and occlusal interference in rat mandibular molars. These data suggest that we orthodontists had better take care not to induce occlusal interference during our orthodontic treatment.
Acid Phosphatase ; Animals ; Molar* ; Orthodontists ; Rats* ; Root Resorption* ; Titanium ; Tooth ; Tooth Movement

BACKGROUND: The present study aimed to determine whether laypeople and professionals rate the facial appearance of individuals with repaired complete unilateral or bilateral cleft lip and palate (UCLP, BCLP) similarly based on viewing full facial images. METHODS: The study followed a cross-sectional analytical design where five young patients aged 10 to 14 years, who had completed all stages of their unilateral or bilateral cleft lip and palate treatment (bilateral: three, unilateral: two), were evaluated by two groups. The assessment was done by laypeople and 97 qualified professionals (33 orthodontists, 32 plastic surgeons, and 32 oral and maxillofacial surgeons). Professionals were not involved in any stage of the patients’ treatment. RESULTS: The facial appearance assessment of the professional groups on different facial aesthetics was significantly lower than that of laypeople, and they had higher perceived need for further treatment. On the other hand, laypeople had higher aesthetic ratings and lower perceived need for further treatment. Differences were also observed between the assessments of the professional groups. Participants who had lower aesthetic assessments of the repair tended to report a higher influence of cleft lip and palate on social activities and professional life. CONCLUSION: Differences in perception exist between healthcare professionals and laypeople. The discrepancies between the professional groups could be attributed to different treatment modalities and protocols.
Cleft Lip ; Delivery of Health Care ; Esthetics ; Hand ; Humans ; Orthodontists ; Palate ; Plastics ; Surgeons

PURPOSE: The aim of this study was to assess the esthetic outcome of maxillary anterior single implants by comparing the esthetic perception of dental professionals and patients. MATERIALS AND METHODS: Twenty-three patients with single implants in the esthetic zone were enrolled in this study. Dentists of four different dental specialties (Three orthodontists, three oral surgeons, three prosthodontists, and three periodontists) evaluated the pink esthetic score (PES)/white esthetic score (WES) for 23 implant-supported single restorations. The satisfactions of the patients on the esthetic outcome of the treatment have been evaluated according to the visual analog scale (VAS). RESULTS: The mean total PES/WES was 12.26 ± 4.76. The mean PES was 6.45 ± 2.78 and mean WES was 5.80 ± 2.82. There was a statistically significant difference among the different specialties for WES (P<.01) and Total PES/WES (P<.01). Prosthodontists were found to have assigned poorer ratings among the other specialties, while oral surgeons gave the higher ratings than periodontists, orthodontists, and prosthodontists. CONCLUSION: Prosthodontists seemed to be stricter when assessing aesthetic outcome among other specialties. Moreover, a clear correlation existed between dentists' and patients' esthetic perception, thereby providing rationales for involving patients in the treatment plan to achieve higher levels of patient satisfaction.
Dental Implants, Single-Tooth ; Dentists ; Humans ; Oral and Maxillofacial Surgeons ; Orthodontists ; Patient Satisfaction ; Specialization* ; Specialties, Dental ; Visual Analog Scale

BACKGROUND: The aim of this report is to present a new reference for aesthetic mandible surgery using three-dimensional cone-beam computed tomography-based treatment planning for orthognathic surgery which can be implemented in surgical planning and perioperative procedure. METHODS: To make an objective standard for evaluating aesthetic mandibular outline, we make an aesthetic scoring criteria with consideration of asymmetry, broad mandibular border line, and prominent mandibular angle. Two maxillofacial surgeons and two orthodontists rated their aesthetical evaluation from 1 to 5. Experimental group consisting of 47 female and 38 male patients who had rotational orthognathic two-jaw surgery from 2010 to 2011 were chosen according to aesthetic scoring done by two maxillofacial surgeons and two orthodontists. A high aesthetic score (≥16) means the facial contour is symmetric, with no broad and narrow aesthetic mandible frontal profiles. Control A group consisted of ten female and ten male patients who had no orthognathic surgery experience and low aesthetic score (≤10). Control B group consisted of ten female and ten male patients who had no orthognathic surgery experience and had anaesthetic mandibular frontal profile and a high aesthetic score (≥16). The three-dimensional image of the patient was taken from dental cone-beam CT (DCT) scanning (experimental group and control A group: 6 months DCT after surgery, control B group: 1st visit DCT). Each DCT was reformatted to reorient the 3D image using 3D analyzing program (OnDemand3D, cybermed Inc, CA, USA). After selection of 12 landmarks and the construction of reoriented horizontal, vertical, and coronal reference lines, 15 measurements were taken in 3D analysis of frontal mandibular morphology. Afterwards, horizontal and vertical linear measurements and angular measurements, linear ratio were obtained. RESULTS: Mean Go’(Rt)-Me’-Go’(Lt) angular measurement was 100.74 ± 2.14 in female patients and 105.37 ± 3.62 in male patients. These showed significant difference with control A group in both genders. Ratio of Go’(Rt),Go’(Lt)-Me’ length to some linear measurements (ratio of Me’-Cd’RtCd’Lt to Me’-Go’(Rt)Go’(Lt), ratio of Me’-Go’ to Me’-Go’(Rt)Go’(Lt), ratio of Go’(Rt)-Go’(Lt) to Me’-Go’(Rt)Go’(Lt)) showed significant difference with control A group in both genders. CONCLUSION: This study was intended to find some standard measurement of mandible frontal view in 3D analysis of aesthetic patient. So, these potential measurement value may be helpful for orthognathic treatment planning to have more aesthetic and perspective outcomes.
Cone-Beam Computed Tomography ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Mandible ; Oral and Maxillofacial Surgeons ; Orthodontists ; Orthognathic Surgery

OBJECTIVES: In this study, a clinical decision support system was developed to help general practitioners assess the need for orthodontic treatment in patients with permanent dentition. METHODS: We chose a Bayesian network (BN) as the underlying model for assessing the need for orthodontic treatment. One thousand permanent dentition patient data sets chosen from a hospital record system were prepared in which one data element represented one participant with information for all variables and their stated need for orthodontic treatment. To evaluate the system, we compared the assessment results based on the judgements of two orthodontists to those recommended by the decision support system. RESULTS: In a BN decision support model, each variable is modelled as a node, and the causal relationship between two variables may be represented as a directed arc. For each node, a conditional probability table is supplied that represents the probabilities of each value of this node, given the conditions of its parents. There was a high degree of agreement between the two orthodontists (kappa value = 0.894) in their diagnoses and their judgements regarding the need for orthodontic treatment. Also, there was a high degree of agreement between the decision support system and orthodontists A (kappa value = 1.00) and B (kappa value = 0.894). CONCLUSIONS: The study was the first testing phase in which the results generated by the proposed system were compared with those suggested by expert orthodontists. The system delivered promising results; it showed a high degree of accuracy in classifying patients into groups needing and not needing orthodontic treatment.
Artificial Intelligence ; Dataset ; Decision Support Systems, Clinical ; Decision Support Techniques ; Dental Informatics ; Dentition, Permanent ; Diagnosis ; General Practitioners ; Hospital Records ; Humans ; Machine Learning ; Malocclusion ; Orthodontists ; Parents