Background
Among the recent modalities introduced to accelerate orthodontic tooth movement (OTM) is micro-osteoperforations (MOPs), in other words, bone puncturing. The aim of this split-mouth trial was to investigate the effects of MOPs on the rate of OTM.
Methods
Eighteen patients requiring bilateral first premolar extraction and upper canine retraction with maximum anchorage were enrolled in this study. Immediately before canine retraction, three MOPs were randomly allocated to either the right or left sides. MOPs were performed using a mini-screw (1.8 mm diameter, 8 mm length) distal to the canine. Canine retraction continued for 4 months. Data were collected from monthly digital models, in addition to pre- and post-retraction maxillary CBCT images
.
The
primary outcomes
were the rate of canine retraction per month and the total distance moved by the canines. The
secondary outcomes
were the effect of MOPs on anchorage loss, canine root resorption, and pain.
Results
The mean rate of canine retraction in both sides was 0.99 ± 0.3 mm/month. The total distance moved by the canine cusp tip was greater in the MOP than the control side (mean difference 0.06 ± 0.7 mm), which was statistically insignificant (
P
> 0.05(. The total distances moved by the canine center and apex were significantly greater in the MOP than the control side (mean difference 0.37 ± 0.63 mm (
P
< 0.05) and 0.47 ± 0.56 mm (
P
< 0.01) respectively). Insignificant differences were detected regarding anchorage loss and root resorption between both sides (
P
> 0.05). Mild to moderate pain was experienced following the MOP procedure, which rapidly faded away within 1 week.
Conclusions
Micro-osteoperforations were not able to accelerate the rate of canine retraction; however, it seemed to facilitate root movement.
Objective
This study evaluated the dimensional and positional osseous temporomandibular joint features in normodivergent facial patterns with and without temporomandibular disorders.
Methods
A total of 165 adult patients were divided into two groups: group 1 (n = 79 patients; 158 joints): temporomandibular disorders patients and group 2 (n = 86 patients; 172 joints): non-temporomandibular disorders patients. Three-dimensional positional and dimensional temporomandibular joint characteristics, including glenoid fossa, mandibular condyles, and joint spaces, were assessed by cone beam computed tomography.
Results
The glenoid fossa positions in the three orthogonal planes and height showed statistical significance between the two studied groups. The temporomandibular disorders patients showed higher horizontal and vertical condyle inclinations while anteroposterior inclination was less, and the condyle was positioned more superior, anterior, and lateral in the glenoid fossa. The condyle width and length showed no significance between the two groups, while condyle height was smaller in temporomandibular disorders patients. Anterior and medial joint spaces increased while the superior and posterior joint spaces reduced in temporomandibular disorders patients.
Conclusion
There were significant differences between the patients with and without temporomandibular joint disorders in terms of mandibular fossa positions and height as well as condylar positions and inclinations in horizontal and vertical planes together with reduced condylar height and reduced posterior and superior joint spaces in the temporomandibular disorders patients.
Clinical relevance
The temporomandibular disorder is a multifactorial disorder in which one of these factors is the dimensional and positional characteristics of the temporomandibular joints; including or excluding this factor requires a comprehensive three-dimensional investigation of patients with TMD compared to the normal group under the condition that the facial pattern is average as a confounding factor.
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