The aim of this study was to develop a psychometric instrument for assessment of orthodontic-specific aspects of quality of life. The study subjects, 194 young adults aged 18-30 years, were interviewed using a pool of 23 items dealing with the psychosocial impact of dental aesthetics. Self- and interviewer-rating of the dental aesthetic appearance of each subject were carried out using the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN). Additionally, the Perception of Occlusion Scale and a modification of the Dental Aesthetic Index (DAI) were applied. Factorial analyses identified four measures within the item pool, namely Dental Self-Confidence, Social Impact, Psychological Impact, and Aesthetic Concern. The factor structure was confirmed in an independent sample of 83 subjects aged 18-33 years. The reliabilities of the factor analysis-derived scales were between alpha (alpha) 0.85 and 0.91. They differed between respondents with varying severity of malocclusion, as assessed by subject and interviewer ratings. The results suggest that the proposed instrument, termed the 'Psychosocial Impact of Dental Aesthetics Questionnaire' (PIDAQ), meets the criteria of factorial stability across samples and criterion-related validity and reliability, and might be a promising tool for further research and clinical application in orthodontics.
These findings confirm that ossification of the midpalatal suture is not a valid reason for the increased transversal resistance encountered during rapid palatal expansion in younger subjects (< or = 25 years) as well as in many older persons.
This paper presents the Orthosystem (Institute Straumann, Waldenburg/ Switzerland), a new endosseous orthodontic implant anchor system for palatal anchorage. The Orthosystem may replace compliance dependent extraoral anchoring aids for orthodontics and makes a bonding of well aligned mandibular dentition and it's use with class II elastics unnecessary. The fixture is designed for a one-stage application. It consists of an implant of pure titanium with a surface-treated, screw-shaped endosseous part of 3.3 mm diameter and lengths of 4 and 6 mm. Above the polished transmucosal neck follows as abutment where transpalatal arches made of rigid orthodontic wires (0.032 x 0.032 inch) are fixed by means of a clamp-cap. 6 patients with an angle class II malocclusion were implanted with the 6 mm fixture in the proximal midsagittal region of the palate during a pilot study. The treatment goal was extraction of the first maxillary premolars with subsequent retraction of the frontal dentition under maximal anchorage of the lateral teeth. For the implantation a simple surgical procedure of 10 min length was required while no further invasive action are needed until explantation. This way the strain on the patients was reduced to a minimum. They are now at varying stages of active treatment and the most advanced case is demonstrated here. The clinical and radiological findings after 12 months of treatment comprising 3 months of healing revealed no implant mobility or dislocation, favourable periimplant soft tissue conditions, and no marked mesial movement of the implant supported teeth. The frontal dentition was retracted by 8 mm with space closure occurring in a relatively short treatment period.
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