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Application of occlusal indices in orthodontic practice  [PDF]
?or?evi? Jelena,??epan Ivana,Gli?i? Branislav
Stomatolo?ki Glasnik Srbije , 2009, DOI: 10.2298/sgs0904176d
Abstract: Introduction. Occlusal indices were designed to improve diagnostic criteria and to enable an objective assessment of malocclusion severity. The aim of this study was to present the most frequently used occlusal indices in orthodontic practice and to determine their reliability when applied to dental models. Material and Methods. Three occlusal indices were selected for analysis: the Index of Orthodontic Treatment Need (IOTN), the Peer Assessment Rating Index (PAR) and the Index of Complexity, Outcome and Need (ICON). Twenty dental models of patients referred to Department of Orthodontics, School of Dentistry, Belgrade, with malocclusions of different type and severity were used in this study. All dental models were measured by three afore mentioned indices twice, two months apart, in order to determine intraexaminer reliability. Results. The results showed that three indices had good reliability. Weighted Kappa was calculated for IOTN (0.72 and 0.79 for the aesthetic and the dental health component, respectively) and root mean square error was calculated for PAR and ICON (2.1 and 4.5, respectively). There was no statistically significant difference in scores between two measurements of these two indices (p<0.01). Conclusion. Application of occlusal indices enables orthodontists to determine priorities in patient care, planning of orthodontic service, monitoring and promotion of standards. Occlusal indices are reliable diagnostic criteria.
Orthodontic Management of Occlusal Prematurity in Early Mixed Dentition  [PDF]
Maen Mahfouz, Yara Mahfouz
Open Journal of Stomatology (OJST) , 2015, DOI: 10.4236/ojst.2015.52006
Abstract: Premature contact is one of the most well-known occlusion disorders and can interfere mandibular movement remarkably. The masticatory system has ability to respond with the wide range of adaptive modalities. These adaptations can be functional, structural and/or behavioral. Therefore, this system, like any biological system, cannot be viewed as a rigid and immutable. This paper presents a clinical case which is demonstrating orthodontic management of occlusal prematurity in early mixed dentition by using a protrusive arch wire.
Occlusal trauma can not be compared to orthodontic movement or Occlusal trauma in orthodontic practice and V-shaped recession  [cached]
Alberto Consolaro
Dental Press Journal of Orthodontics , 2012,
Abstract: The mechanisms of tissue changes induced by occlusal trauma are in no way comparable to orthodontic movement. In both events the primary cause is of a physical nature, but the forces delivered to dental tissues exhibit completely different characteristics in terms of intensity, duration, direction, distribution, frequency and form of uptake by periodontal tissues. Consequently, the tissue effects induced by occlusal trauma are different from orthodontic movement. It can be argued that occlusal trauma generates a pathological tissue injury in an attempt to adapt to new excessive functional demands. Orthodontic movement, in turn,performs physiological periodontal bone remodeling to change the position of the teeth in a well-planned manner, eventually restoring normalcy. Os mecanismos das altera es teciduais induzidas pelo trauma oclusal n o s o minimamente comparáveis aos do movimento ortod ntico. Embora ambos os eventos tenham uma causa primária de natureza física, essas for as aplicadas sobre os tecidos dentários têm características completamente distintas na intensidade, tempo, dire o, distribui o, frequência e forma de absor o pelos tecidos periodontais. Por consequência, os efeitos teciduais induzidos no trauma oclusal s o diferentes do movimento ortod ntico. Pode-se afirmar que o trauma oclusal gera uma les o tecidual de natureza patológica, na tentativa de se adaptar a novas demandas funcionais excessivas. Por sua vez, o movimento ortod ntico utiliza-se da remodela o óssea periodontal fisiológica para mudar o dente de posi o, de forma planejada e com posterior restabelecimento da normalidade.
Evaluation of agreement and correlation of three occlusal indices in an assessment of orthodontic treatment need  [PDF]
?or?evi? Jelena,??epan Ivana,Gli?i? Branislav
Vojnosanitetski Pregled , 2011, DOI: 10.2298/vsp1102125d
Abstract: Background/Aim. Occlusal indices are quantitative diagnostic indicators of malocclusion severity, orthodontic treatment need, complexity and outcome. The aim of this study was to determine correlations and agreement among three occlusal indices: the Index of Orthodontic Treatment Need (IOTN), the Peer Assessment Rating Index (PAR) and the Index of Complexity, Outcome and Need (ICON) in evaluating orthodontic treatment need. Methods. A total eighty study models of patients referred to the Department of Orthodontics, School of Dentistry, Belgrade, were assessed in this retrospective study. Malocclusions of various types and severity in the permanent dentition were included. Results. The Aesthetic and the Dental Health Component of IOTN determined orthodontic treatment need in 25% and 51% of the patients, respectively. PAR determined orthodontic treatment need in 59% and ICON in 53% of patients. The Aesthetic Component of IOTN and ICON had the highest correlation (Spearman's correlation coefficient 0.95, p < 0.01). Correlations between indices were 0.44 to 0.61 with statistical significance (p < 0.01). The agreement between indices, calculated using Kappa statistics, was 0.22 to 0.63. Conclusion. The most critical in malocclusion assessment was PAR. The Aesthetic Component of IOTN and ICON correlated highly (p < 0.01). Correlations between other pairs of indices were moderate (p < 0.01). The Aesthetic Component of IOTN and ICON had substantial agreement, whereas agreement between other indices was fair or moderate. ICON could replace PAR and IOTN. Application of occlusal indices enables objective evaluation of orthodontic treatment need and easier determination of the treatment priorities.
Assessment of the quality of completed orthodontic treatments, by defined occlusal criteria  [PDF]
Aucher A,Perreau T
Pratiques et Organisation des Soins , 2008,
Abstract: Aims: Six regions were measured to assess the rate of completed orthodontic treatment presenting at least one of the six occlusal criteria defined by the reference frame and a residual dysmorphosis after being reimbursed by the public health insurance.Methods: The method was descriptive and included a cross-sectional study of patients who had completed their orthodontic treatment inMay 2003 for a period of at least 12 months. The cross-sectional study included both regional and cross regional representations. Each representation was obtained by a random stratified sample given to each region. The findings taken from each examined patients enabled an assessment of the occlusal state of the completed treatment based on the reference frame. Thus it was possible to measure their success rates.Results: 2,130 recipients agreed to be examined. According to the reference frame criteria, the rate of completed orthodontic treatments presenting at least one residual dysmorphosis was set at 31.7 % (± 1.9 %). This rate was significantly higher in patients who did not ask for retention (39 %), underwent extractions (41.1 %) or suffered from inadequate dental hygiene (41.3 %). On average treatments presenting at least one residual dysmorphosis lasted longer and their costs were reimbursed on a longer period than the others. On average each treatment lasted three years and medical costs were born by health insurance for a period of nine quarters.Conclusion: More than one quarter of the completed orthodontic treatments presented at least one residual dysmorphosis defined by the reference frame. This assessment draws attention to the possible pathological consequences of these residual dysmorphosis, and alsoraises the question of the justification and validity of some of the costs of these treatments incurred by society. Prat Organ Soins 2008;39(2):103-112
Evaluation of the Articulation Following Orthodontic Treatment Utilizing Sam II Articulator and T-scan Occlusal Analyser Before and After Occlusal Adjustment  [PDF]
Gokhan Oncag,Munire Ece Sabah,Servet Dogan,Ahmet Saracoglu
Journal of Medical Sciences , 2002,
Abstract: The aim of orthodontic treatment has been expanded to include the ideal skeletal and functional relationship. This study was conducted on 9 girls and 11 boys (total 20) between 13-15 years of age. The patients were evaluated 6 months after the completion of retention, with the T-Scan occlusal analyser and semi adjustable SAM II articulator, following non extraction treatment with Straight Wire Roth technique. The number and localisation, the sequence and amount of premature contacts were evaluated qualitative and quantitatively in this study. Result indicates there was a significant increase in the number of contacts after occlusal adjustment with both SAM II articulator and T-scan occlusal analyser. However, there was a significant level of difference between the sensitivity of the two methods ( p<0.001).
Study of the number of occlusal contacts in maximum intercuspation before orthodontic treatment in subjects with Angle Class I and Class II Division 1 malocclusion
Watanabe-Kanno, Gustavo Adolfo;Abr?o, Jorge;
Dental Press Journal of Orthodontics , 2012, DOI: 10.1590/S2176-94512012000100017
Abstract: objective: define and compare numbers and types of occlusal contacts in maximum intercuspation. methods: the study consisted of clinical and photographic analysis of occlusal contacts in maximum intercuspation. twenty-six caucasian brazilian subjects were selected before orthodontic treatment, 20 males and 6 females, with ages ranging between 12 and 18 years. the subjects were diagnosed and grouped as follows: 13 with angle class i malocclusion and 13 with angle class ii division 1 malocclusion. after analysis, the occlusal contacts were classified according to the established criteria as: tripodism, bipodism, monopodism (respectively, three, two or one contact point with the slope of the fossa); cuspid to a marginal ridge; cuspid to two marginal ridges; cuspid tip to opposite inclined plane; surface to surface; and edge to edge. results: the mean number of occlusal contacts per subject in class i malocclusion was 43.38 and for class ii division 1 malocclusion it was 44.38, this difference was not statistically significant (p>0.05). conclusions: there is a variety of factors that influence the number of occlusal contacts between a class i and a class ii, division 1 malocclusion. there is no standardization of occlusal contact type according to the studied malocclusions. a proper selection of occlusal contact types such as cuspid to fossa or cuspid to marginal ridge and its location in the teeth should be individually defined according to the demands of each case. the existence of an adequate occlusal contact leads to a correct distribution of forces, promoting periodontal health.
Efectividad del ajuste oclusal en pacientes de alta de ortodoncia Effectiveness of occlusal adjustment in patients with orthodontic discharge  [cached]
Amitis Ruiseco Palomares,Orlando L. Rodríguez Calzadilla,Gladys Ota?o Laffitte
Revista Cubana de Estomatolog?-a , 2006,
Abstract: El tratamiento ortodóncico tiene como objetivo llegar a un punto óptimo oclusal, estético y funcional. Con frecuencia son introducidas interferencias que a largo plazo pueden provocar disturbios del sistema estomatognático; una técnica de ajuste oclusal puede ser útil para estabilizar la función y garantizar la salud de este. Se seleccionó una muestra constituida por 14 pacientes con más de 6 meses de alta ortodóncica, diagnosticados con interferencias oclusales en una investigación previa. A cada uno de ellos se les realizó un ajuste oclusal por tallado selectivo, y pasados 6 meses, se procedió a la evaluación de la oclusión para la detección de posibles interferencias, analizándolas durante los diferentes movimientos mandibulares, tanto en las áreas de trabajo como de no trabajo, así como por grupos dentarios. Para ello se les realizó el análisis funcional de la oclusión en boca, completándose el estudio con el montaje de los modelos en el articulador semiajustable Dentatus ARL mediante el uso del arco facial. El estudio reveló que a la mayoría de los pacientes se les reestableció una oclusión funcional, lo que demuestra la efectividad del tratamiento, que el mayor porcentaje de interferencias después del ajuste fueron en el área de no trabajo y durante los movimientos de lateralidad, además de que el grupo molar fue el de mayor cantidad de interferencias, tanto antes como después del tratamiento oclusal. The orthodontic treatment is aimed at reaching an occlusal, aesthetic, and functional optimal point. The frequently introduced interferences may cause disorders of the stomathognatic system, and an occlusal adjustment technique may be useful to stabilize the function and to gurantee its health. A sample of 14 patients with more than 6 months of orthodontic discharge that were diagnosed occlusal interferences in a previous research was selected. Each of them underwent occlusal adjustment by selective grinding, and after 6 months the occlusion was evaluated to detect possible interferences during the different mandibular movements in the working and non-working areas, as well as by tooth groups. To this end, the functional analysis of buccal occlusion was made. The study was completed with the assembly of the models in the semiadjustable articulator Dentatus ARL by using the facial arch. The study revealed that most of the patients recovered the functional occlusion, which showed the efficiency of the treatment, that the highest percentage of interferences after the adjustment were in the non-working area and during the laterality movements, and that t
Optimizing Maxillary Aesthetics of a Severe Compromised Tooth through Orthodontic Movement and Dental Implants  [PDF]
Rafael Scaf de Molon,Erica Dorigatti de Avila,Joni Augusto Cirelli,Mauricio de Almeida Cardoso,Leopoldino Capelozza-Filho,Luiz Antonio Borelli Barros
Case Reports in Dentistry , 2014, DOI: 10.1155/2014/103808
Abstract: Treatment of severe compromised tooth in the maxillary anterior area still poses great challenge to the clinicians. Several treatment modalities have been proposed to restore the function and aesthetics in teeth with advanced periodontal disease. The present study aims to report a case of traumatic injury of a left-maxillary central incisor with ridge preservation, orthodontic movement, and implant therapy. A 45-year-old woman underwent the proposed treatment for her left central incisor: basic periodontal therapy, xenogenous bone graft, and guided bone regeneration (GBR). Six months after the graft procedure, orthodontic movement by means of alignment and leveling was made and a coronal displacement of the gingival margin and vertical bone apposition could be observed after 13 months of active movement. Afterwards, a dental implant was placed followed by a connective tissue graft and immediate provisionalization of the crown. In conclusion, orthodontic movement was effective to improve the gingival tissue and alveolar bone prior to implant placement favoring the aesthetic results. Six years postoperatively, the results revealed height and width alveolar bone gain indicating that the treatment proposed was able to restore all the functional and aesthetic parameters. 1. Introduction Single implant therapy is a predictable treatment and has high success rates, at least when adequate bone volume is present. However, severe compromised tooth in the maxillary aesthetic region poses a great challenge to implant therapy. A correct diagnosis, absence of systemic conditions such as diabetes mellitus [1], an adequate treatment plan, improvement of surgical techniques, and multidisciplinary team planning play an important role in the success of complex cases [2]. According to Savi et al. [3] to achieve an adequate aesthetic result in anterior upper regions with dental implants, favorable periodontal tissue and bone conditions should be present. There are several treatment options to restore the aesthetic and function of a compromised anterior tooth. Different treatment modalities to hard and soft tissue formation at the site of tooth extraction are used, including forced orthodontic eruption [4, 5], ridge augmentation by means of bone and connective tissue graft [2], guided bone regeneration (GBR), immediate or delayed implant placement, and a combination of those [6]. Implant therapy can be complex due to numerous local anatomic or traumatic factors resulting in aesthetic commitment in the maxilla. These factors involve thin gingival biotype, thin buccal bone
Effect of occlusal adjustments on the periodontal status of patients with periodontitis after orthodontic treatment

- , 2017, DOI: 10.7518/gjkq.2017.01.010
Abstract: 摘要: 目的观察咬合调整对牙周病患者正畸治疗前后牙周状况改变的影响。方法选择成人牙周病正畸患者47例,按照正畸治疗中是否进行咬合调整分为观察组和对照组,对所有患者正畸治疗前、后及治疗后6个月随访时进行牙周状况的检查评估,并作统计学分析。结果观察组患者在治疗后及随访时的牙周探诊深度(PD)、临床附着丧失(CAL)、出血指数(BI)均较治疗前有明显降低,牙齿松动度(TM)也较治疗前有明显减小,而在随访时与治疗后相比较,PD和CAL的变化也有统计学意义(P<0.05),松动度也有明显减小。对照组患者治疗后的PD、BI及随访时的BI均较治疗前有明显降低,随访时的牙齿松动度较治疗前明显减低,与治疗后比较也有明显变化。组间同期比较,观察组在随访时的PD和CAL与对照组有明显差异,在治疗后及随访时的TM也与对照组间存在明显差异。结论在牙周炎错患者的正畸治疗中,及时进行咬合调整,能去除病理性因素,消除咬合创伤,恢复咬合平衡,有利于牙周组织的改建及修复。
Abstract: Objective To observe the changes in occlusal adjustments on periodontal status of patients with periodontal disease before and after orthodontic treatment. Methods Forty-seven cases of adult orthodontic patients periodontal were selected and divided into two groups according to whether occlusal adjustment, named observation group and control group. The periodontal status of all the patients was evaluated during the first visit. After 6 and 12 months, the periodontal status of the patients was evaluated again. The changes in the periodontal status were recorded, and statistical analysis was performed. Results Periodontal probing depth(PD), clinical attachment loss(CAL), and bleeding index(BI) observed after six months of the treatment, were significantly lower than those before treatment(P<0.05). Tooth loose degrees(TM) also significantly reduced compared to that before treatment. PD and CAL changes of the group six months after treatment compared with treatment was completed, were also lower. The degree of looseness was significantly reduced. PD, BI of the group 6 months after treatment decreased than those before treatment and the control group. The tooth mobility of 6 months after treatment was significantly lower than that before treatment and just after treatment. The PD, CAL and TM of the observed group are statistically different from those in the control group. Conclusion Occlusal adjustment for the malocclusion patients with periodontitis in the cause of orthodontic therapy, which helped to remove pathological factors, eliminate occlusal trauma, and build the occlusal balance, showed effectiveness in treatment of reconstruction and repair of periodontal tissues.
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