The purpose of the present study was to determine whether a force of 20 cN can be biologically active for tooth movement and to examine the pain intensity during the application of light (20 cN) or heavy (200 cN) continuous forces for 7 days. In the first experiment, a force of 20 cN was applied to eight canines in five volunteers. The mean tooth movement during 10 weeks was 2.4 mm. In the second experiment, two forces of 20 or 200 cN were applied to maxillary premolars in 12 male subjects (aged 24-31 years) to measure pain intensity for 7 days. Spontaneous and biting pain were recorded every 2-4 hours on a 100 mm visual analogue scale (VAS). Wilcoxon signed-rank test was used for statistical analysis. Comparing the VAS score at force initiation with the other time points, there was no significant difference in spontaneous pain for either group, or in biting pain for the light-force group. However, biting pain in the heavy-force group during the time period from 6 to 156 hours was significantly (P < 0.05) greater than that at force initiation. Comparing the VAS scores between the light- and heavy-force group, VAS scores for biting pain in the heavy-force group during the time period from 8 to 100 hours was significantly (P < 0.05) greater than that in the light-force group. A force of 20 cN can move teeth, but pain intensity while biting may be greater approximately 8 hours to 5 days following the application of heavy continuous force compared with light force.
We performed an orthodontic treatment combined with mandibular distraction osteogenesis in a 15-year-old patient who wanted a correction of a chin deficiency and a protruding upper lip. The patient had an Angle Class II division 1 malocclusion with mandibular retrusion, a low mandibular plane angle, and scissors bite. First, a quad-helix appliance was applied to the mandibular dentition to correct the scissors bite in the bilateral premolar region. Later, a preadjusted edgewise appliance was applied to the maxillary and mandibular teeth. After 3 days, a mandibular distraction osteogenesis was performed. During and after the distraction, the open bite between the upper and lower dental arches was corrected using up and down elastics. The total treatment time with the edgewise appliance was 14 months. A skeletal Class I apical base relationship, good facial profile, and optimum intercuspation of the teeth were achieved with the treatment. The jaw-movement pattern on the frontal view did not change during gum chewing. However, the maximum gap without pain increased. The electromyographic (EMG) activity of the masseter and anterior temporalis muscles, and maximum occlusal force increased. The present case report suggests that an orthodontic treatment combined with mandibular distraction osteogenesis in a patient with mandibular retrusion in the late growth period might be effective for improving stomatognathic function.
This longitudinal study aimed to clarify the relationship of oral health in infancy with that in adulthood among participants who were the subjects of the oral health promotion project (OHPP) conducted in Miyako Island, Okinawa Prefecture, Japan, since 1984. Twenty-seven subjects, around 35 years of age, were examined for dental caries, periodontal diseases (community periodontal index), dental plaque, occlusion, and bite-force and compared with those at 4 and 13–15 years of age. The dental caries status and maximum bite force in adulthood was significantly reflected for those at 4 and 13–15 years of age (p < 0.05). CPI in adulthood was related to the dental caries status at 4 and 13–15 years of age but not to the gingival score at 4 years of age, and it was weakly related to the gingival score at 13–15 years (r = 0.264, p > 0.05). Most of the normal occlusion at 4 years of age became normal permanent occlusion in adulthood (88.9%). Most of the cases involving the discrepancy factor retained the same condition in both the deciduous and permanent dentitions (83.3%) (p < 0.001). Those who participated in the OHPP soon after birth showed significantly fewer DMFT (p < 0.05) compared with those who did not. This study revealed that oral health at 4 years of age was related to that in adulthood, suggesting that fostering good oral health soon after birth is of great importance.
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