A variety of problems involving the masticatory system can be partially attributed to parafunctional habits such as bruxism. These include occlusal trauma, abfractions, tooth migration, as well as temporomandibular dysfunction. Since bruxism is considered a contributing factor to the above-mentioned dental problems, it is essential to consider parafunctional habits in the diagnosis and treatment planning before doing any occlusal reconstruction. However, the problem lies in the lack or absence of a simple device or gauge useful to be able to diagnose and evaluate the occlusal schemes in the patient's grinding pattern. In this study, we have developed a very simple device (BruxChecker) for evaluating the grinding patterns in sleep bruxism. Using the BruxChecker, it was possible to visualize real or actual interferences during sleep bruxism. Therefore, examination of the grinding pattern using this device is necessary and crucial for making the proper treatment plan for each patient.
Objective: To investigate patient discomfort during archwire engagement and disengagement in patients treated with self-ligating and conventional brackets using a split-mouth design. Materials and Methods: Eighteen consecutive patients (15 female, 3 male; age: 22.2 6 6.4 years) who requested treatment with fixed orthodontic appliances were randomly assigned for bonding with SmartClip self-ligating brackets on one side of the dentition and conventional standard edgewise brackets on the other. During the course of treatment, patients rated the discomfort experienced during every archwire engagement and disengagement using a numeric rating scale. Results were evaluated for round and rectangular nickel titanium and rectangular stainless steel, titanium molybdenum, and Elgiloy archwires. Patients also rated their overall experience retrospectively for both bracket systems. Results: Regardless of archwire type, disengagement was rated as being significantly more painful on the SmartClip side (P 5 .027). For rigid, rectangular archwires, engagement and disengagement were rated as being significantly more painful on the SmartClip side (P 5 .031; P 5 .004). Retrospective ratings favored conventional brackets beyond ratings recorded during treatment. Conclusion: Engagement and disengagement of rigid rectangular archwires caused more pain with SmartClip self-ligating brackets than with conventional ones. Careful archwire manipulation and patience during full alignment are essential for limiting chairside pain. Low pain levels will help ensure treatment satisfaction and compliance. (Angle Orthod. 2013;83:292-297.)
Morphometric shape analyses corroborated current evidence that self-ligating brackets were no more effective than conventional brackets with steel ligatures after 6-month initial alignment. From months 6-9 treatment with ß-titanium reverse-curve wires on 0.022-inch ligature-less brackets resulted in similar tooth positions as accomplished by Elgiloy multiloop wires on 0.018-inch steel-ligature-tied brackets.
In this pilot study, asymmetric reciprocal torque represented a treatment option for midline corrections of approximately 2-4 mm and improvement in the chin position without mesiodistal tooth movement or extraction.
Zusammenfassung
In der vorliegenden Studie wurde ein selbstligierender mit einem konventionellen Brackettyp auf die Effektivit?t der Zahnbewegung w?hrend der Nivellierungsphase verglichen. Dabei wurden beide Brackettypen simultan verwendet, n?mlich zuf?llig in der linken und rechten Gebissh?lfte.
21 Patienten (4 m?nnliche und 17 weibliche) im Alter von 11 bis 36 Jahren mit ann?hernd symmetrischer Malokklusion nahmen teil. Von diesen Patienten wurden Ober- und Unterkiefermodelle zu 2 verschiedenen Zeitpunkten angefertigt (t? Anfangszustand vor Behandlung und t1 Zustand nach Nivellierung). Um einen direkten Vergleich der beiden Bracketsysteme innerhalb eines Individuums zu bewerkstelligen, kam das Split-Mouth-Design zum Einsatz. Die Patienten hatten jeweils im 1. und 4. Quadranten sowie im 2. und 3. den gleichen Brackettyp, SmartClip? (3M Unitek, Monrovia, California, USA; = SLB) bzw. Standard Edgewise (American Orthodontics, Sheboygan, Wisconsin, USA; = KLB).
Die Kiefermodelle wurden mithilfe des 3D-Digitalisierungsger?tes MicroScribe? G2X (Immersion, San Jose, USA) vermessen. Die Auswertung der 3-D-Koordinaten jedes Zahnes erfolgte mittels geometrisch morphometrischer Analyse, Hauptkomponentenanalyse und Prokrustes-Analyse.
Obwohl das Ausma? an Zahnbewegung zwischen KLB und SLB unterschiedlich ausfiel und auf der KLB-Seite deutlicher ausgepr?gter war, zeigten sich keine statistisch signifikanten Unterschiede (p >0,1) zwischen den linken und rechten Zahnbogenh?lften in den ersten 6 Monaten festsitzender Kieferorthop?die.
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