This study compared the anchorage provided by the Nance appliance (NA) and fixed frontal bite plane (FBP) during intra-arch distal molar movement over 6 months in 40 patients. Both groups experienced approximately 1.4-1.9mm of anterior movement of the maxillary central incisors, with no significant difference between groups. Distal molar movement was 1.7-1.8mm in both groups. The overbite decreased more in the FBP group. Neither appliance provided fully stable anchorage. A second treatment phase is recommended to correct anchorage loss after distal molar movement.
Malposition of unerupted mandibular second premolar in children with palatall...EdwardHAngle
Objective: To test the hypotheses that (1) the distal angulation of unerupted mandibular premolar
(MnP2) is significantly greater in children with palatally displaced canines (PDC) than in those in
a control sample; and (2) delayed tooth formation is significantly more frequent in children with
both malposed MnP2 and PDC than in children with PDC only.
Materials and Methods: We examined retrospectively panoramic radiographs from 43 patients
with PDC who had no previous orthodontics. A control sample consisted of age- and sex-matched
patients. The distal angle formed between the long axis of MnP2 and the tangent to the inferior
border was measured. Dental age was evaluated using the Koch classification.
Results: A significant difference was observed between the mean inclination of the right side
MnP2 in the PDC group (75.4 degrees) and that of the control group (85.8 degrees). This difference
was highly statistically significant (P < .0001). The same evaluation was carried out for the
left side, with similar results. The average dental age was found to be delayed in patients who
showed both abnormalities (malposed MnP2 and PDC) compared with patients who showed the
PDC anomaly only.
Conclusion: Both hypotheses are retained. Statistically, PDC and MnP2 malposition are significantly
associated suggesting a common genetic etiology, despite taking place on opposite jaws.
While the presence of PDC or MnP2 anomaly has been associated with a delay in tooth formation,
we find the presence of both anomalies to show a more profound delay. Our findings suggest a
delay in tooth formation as a possible common genetic mechanism for these 2 malposition anomalies.
Mandibular arch form the relationship between dental and basal anatomyEdwardHAngle
We investigated mandibular dental arch form at the levels of both the clinically relevant application points of the orthodontic bracket and the underlying anatomic structure of the apical base. The correlation of both forms was evaluated and examined to determine whether the basal arch could be used to derive a standardized clinical arch form.
Three dimensional changes of the naso-maxillary complex following rapid maxil...EdwardHAngle
Rapid maxillary expansion (RME) was performed on 30 patients to correct transverse deficiencies. Computed tomography scans were taken before and after RME to assess volumetric changes in the naso-maxillary complex (NMC). Following RME, the total volume of the NMC increased 12% on average. The maxillary volume increased 10.6% and the nasal volume increased 17%. The maxillary contribution to the total volume increase was 69.75% while the nasal contribution was 30.25%. All linear, angular, and volumetric measurements of the maxilla and dentition showed statistically significant increases following RME, indicating expansion at both the skeletal and dental levels.
Effects of rapid palatal expansion on the sagittal and vertical dimensions of...EdwardHAngle
The purpose of this study was to use cone-beam computed tomography imaging to examine the skeletal and dental changes in the sagittal and vertical dimensions after rapid palatal expansion.
Commercially available archwire forms compared with normal dental arch forms ...EdwardHAngle
This study compared the widths of 20 commercially available preformed archwires to the widths of natural dental arches in 30 subjects with ideal occlusions. The study found that the preformed archwires were significantly narrower than the natural dental arches at both the canine and molar levels. Specifically, 14 archwires fell within 1 standard deviation of the mean canine width, but only 7 fell within 1 standard deviation of the mean molar width. The variations in current preformed archwire forms do not entirely correspond to the diversity of normal arch forms.
Role of polycystin 1 in bone remodeling- orthodontic tooth movement study in ...EdwardHAngle
Objective: To test the hypothesis that polycystin-1 (PC1) is involved in orthodontic tooth movement as a mechanical sensor.
Materials and Methods: The response to force application was compared between three mutant and four wild-type 7-week-old mice. The mutant mice were PC1/Wnt1-cre, lacking PC1 in the craniofacial region. An orthodontic closed coil spring was bonded between the incisor and the left first molar, applying 20 g of force for 4 days. Micro–computed tomography, hematoxylin and eosin staining, and tartrate-resistent acid phosphatase (TRAP) staining were used to study the differences in tooth movement among the groups.
Results: In the wild-type mice the bonded molar moved mesially, and the periodontal ligament (PDL) was compressed in the compression side. The compression side showed a hyalinized zone, and osteoclasts were identified there using TRAP staining. In the mutant mice, the molar did not move, the incisor tipped palatally, and there was slight widening of the PDL in the tension area. Osteoclasts were not seen on the bone surface or on the compression side. Osteoclasts were only observed on the other side of the bone—in the bone marrow.
Conclusions: These results suggest a difference in tooth movement and osteoclast activity between PC1 mutant mice and wild-type mice in response to orthodontic force. The impaired tooth movement and the lack of osteoclasts on the bone surface in the mutant working side may be related to lack of signal from the PDL due to PC1 deficiency.
Purpose: To assess the amount of dental and skeletal expansion and stability after surgically assisted
rapid maxillary expansion (SARPE).
Patients and Methods: Data from 20 patients enrolled in this prospective study were collected before
treatment, at maximum expansion, at the removal of the expander 6 months later, before any second
surgical phase, and at the end of orthodontic treatment, using posteroanterior cephalograms and dental
casts.
Results: With SARPE, the mean maximum expansion at the first molar was 7.48 1.39 mm, and the
mean relapse during postsurgical orthodontics was 2.22 1.39 mm (30%). At maximum, a 3.49 1.37
mm skeletal expansion was obtained, and this expansion was stable, such that the average net expansion
was 67% skeletal.
Conclusion: Clinicians should anticipate a loss of about one third of the transverse dental expansion
obtained with SARPE, although the skeletal expansion is quite stable. The amount of postsurgical relapse
with SARPE appears quite similar to the changes in dental-arch dimensions after nonsurgical rapid palatal
expansion, and also quite similar to dental-arch changes after segmental maxillary osteotomy for
expansion.
Transverse growth of the maxilla and mandible in untreated girls with low, av...EdwardHAngle
The purpose of this study was to investigate maxillary and mandibular transverse growth in
untreated female subjects with low, average, and high mandibular plane angles longitudinally from ages 6 to 18.
Malposition of unerupted mandibular second premolar in children with palatall...EdwardHAngle
Objective: To test the hypotheses that (1) the distal angulation of unerupted mandibular premolar
(MnP2) is significantly greater in children with palatally displaced canines (PDC) than in those in
a control sample; and (2) delayed tooth formation is significantly more frequent in children with
both malposed MnP2 and PDC than in children with PDC only.
Materials and Methods: We examined retrospectively panoramic radiographs from 43 patients
with PDC who had no previous orthodontics. A control sample consisted of age- and sex-matched
patients. The distal angle formed between the long axis of MnP2 and the tangent to the inferior
border was measured. Dental age was evaluated using the Koch classification.
Results: A significant difference was observed between the mean inclination of the right side
MnP2 in the PDC group (75.4 degrees) and that of the control group (85.8 degrees). This difference
was highly statistically significant (P < .0001). The same evaluation was carried out for the
left side, with similar results. The average dental age was found to be delayed in patients who
showed both abnormalities (malposed MnP2 and PDC) compared with patients who showed the
PDC anomaly only.
Conclusion: Both hypotheses are retained. Statistically, PDC and MnP2 malposition are significantly
associated suggesting a common genetic etiology, despite taking place on opposite jaws.
While the presence of PDC or MnP2 anomaly has been associated with a delay in tooth formation,
we find the presence of both anomalies to show a more profound delay. Our findings suggest a
delay in tooth formation as a possible common genetic mechanism for these 2 malposition anomalies.
Mandibular arch form the relationship between dental and basal anatomyEdwardHAngle
We investigated mandibular dental arch form at the levels of both the clinically relevant application points of the orthodontic bracket and the underlying anatomic structure of the apical base. The correlation of both forms was evaluated and examined to determine whether the basal arch could be used to derive a standardized clinical arch form.
Three dimensional changes of the naso-maxillary complex following rapid maxil...EdwardHAngle
Rapid maxillary expansion (RME) was performed on 30 patients to correct transverse deficiencies. Computed tomography scans were taken before and after RME to assess volumetric changes in the naso-maxillary complex (NMC). Following RME, the total volume of the NMC increased 12% on average. The maxillary volume increased 10.6% and the nasal volume increased 17%. The maxillary contribution to the total volume increase was 69.75% while the nasal contribution was 30.25%. All linear, angular, and volumetric measurements of the maxilla and dentition showed statistically significant increases following RME, indicating expansion at both the skeletal and dental levels.
Effects of rapid palatal expansion on the sagittal and vertical dimensions of...EdwardHAngle
The purpose of this study was to use cone-beam computed tomography imaging to examine the skeletal and dental changes in the sagittal and vertical dimensions after rapid palatal expansion.
Commercially available archwire forms compared with normal dental arch forms ...EdwardHAngle
This study compared the widths of 20 commercially available preformed archwires to the widths of natural dental arches in 30 subjects with ideal occlusions. The study found that the preformed archwires were significantly narrower than the natural dental arches at both the canine and molar levels. Specifically, 14 archwires fell within 1 standard deviation of the mean canine width, but only 7 fell within 1 standard deviation of the mean molar width. The variations in current preformed archwire forms do not entirely correspond to the diversity of normal arch forms.
Role of polycystin 1 in bone remodeling- orthodontic tooth movement study in ...EdwardHAngle
Objective: To test the hypothesis that polycystin-1 (PC1) is involved in orthodontic tooth movement as a mechanical sensor.
Materials and Methods: The response to force application was compared between three mutant and four wild-type 7-week-old mice. The mutant mice were PC1/Wnt1-cre, lacking PC1 in the craniofacial region. An orthodontic closed coil spring was bonded between the incisor and the left first molar, applying 20 g of force for 4 days. Micro–computed tomography, hematoxylin and eosin staining, and tartrate-resistent acid phosphatase (TRAP) staining were used to study the differences in tooth movement among the groups.
Results: In the wild-type mice the bonded molar moved mesially, and the periodontal ligament (PDL) was compressed in the compression side. The compression side showed a hyalinized zone, and osteoclasts were identified there using TRAP staining. In the mutant mice, the molar did not move, the incisor tipped palatally, and there was slight widening of the PDL in the tension area. Osteoclasts were not seen on the bone surface or on the compression side. Osteoclasts were only observed on the other side of the bone—in the bone marrow.
Conclusions: These results suggest a difference in tooth movement and osteoclast activity between PC1 mutant mice and wild-type mice in response to orthodontic force. The impaired tooth movement and the lack of osteoclasts on the bone surface in the mutant working side may be related to lack of signal from the PDL due to PC1 deficiency.
Purpose: To assess the amount of dental and skeletal expansion and stability after surgically assisted
rapid maxillary expansion (SARPE).
Patients and Methods: Data from 20 patients enrolled in this prospective study were collected before
treatment, at maximum expansion, at the removal of the expander 6 months later, before any second
surgical phase, and at the end of orthodontic treatment, using posteroanterior cephalograms and dental
casts.
Results: With SARPE, the mean maximum expansion at the first molar was 7.48 1.39 mm, and the
mean relapse during postsurgical orthodontics was 2.22 1.39 mm (30%). At maximum, a 3.49 1.37
mm skeletal expansion was obtained, and this expansion was stable, such that the average net expansion
was 67% skeletal.
Conclusion: Clinicians should anticipate a loss of about one third of the transverse dental expansion
obtained with SARPE, although the skeletal expansion is quite stable. The amount of postsurgical relapse
with SARPE appears quite similar to the changes in dental-arch dimensions after nonsurgical rapid palatal
expansion, and also quite similar to dental-arch changes after segmental maxillary osteotomy for
expansion.
Transverse growth of the maxilla and mandible in untreated girls with low, av...EdwardHAngle
The purpose of this study was to investigate maxillary and mandibular transverse growth in
untreated female subjects with low, average, and high mandibular plane angles longitudinally from ages 6 to 18.
Influence of common fixed retainers on the diagnostic quality of cranial magn...EdwardHAngle
Introduction: Orthodontists are often asked to remove fixed retainers before magnetic resonance imaging
(MRI). This study was undertaken to assess the effects of 2 commonly used fixed retainers on MRI distortion
and whether they should be removed. Methods: MRI scans were performed on a dry skull with Twistflex (Dentaurum,
Ispringen, Germany) and Ortho Flex Tech (Reliance Orthodontic Products, Itasca, Ill) retainers. Two
neuroradiologists independently ranked the distortions. The influence of the fixed retainers' alloys, their distance
to the area of diagnosis, location, strength of the magnetic field, and the spin-echo sequence were examined.
Statistical analysis included kappa and Pearson chi-square tests. Results: Ortho Flex Tech retainers caused
no distortion. Twistflex retainers caused distortion in 46% of the tests in areas close to the retainer (tongue
and jaws). Maxillary fixed retainers and the combination of maxillary and mandibular fixed retainers further
increased the distortion. Greater distortion was observed with 3-T magnetic fields and T1-weighted spin-echo
sequences. Conclusions: Removal of the Ortho Flex Tech retainer is unnecessary before MRI. Removal of
the Twistflex should be considered if the MRI scans are performed to diagnose areas close to the fixed retainers,
when 3-T magnetic fields and T1-weighted sequences are used, and when both maxillary and mandibular fixed
retainers are present.
Short term and long-term stability of surgically assisted rapid palatal expan...Dr Sylvain Chamberland
Introduction: The purpose of this article is to present further longitudinal data for short-term and long-term
stability, following up our previous article in the surgery literature with a larger sample and 2 years of stability
data. Methods: Data from 38 patients enrolled in this prospective study were collected before treatment, at maximum
expansion, at removal of the expander 6 months later, before any second surgical phase, at the end of
orthodontic treatment, and at the 2-year follow-up, by using posteroanterior cephalograms and dental casts.
Results: With surgically assisted rapid palatal expansion (SARPE), the mean maximum expansion at the first
molar was 7.60 6 1.57 mm, and the mean relapse was 1.83 6 1.83 mm (24%). Modest relapse after completion
of treatment was not statistically significant for all teeth except for the maxillary first molar (0.99 6 1.1 mm). A
significant relationship (P-.0001) was observed between the amount of relapse after SARPE and the posttreatment
observation. At maximum, a skeletal expansion of 3.58 6 1.63 mm was obtained, and this was stable.
Conclusions: Skeletal changes with SARPE were modest but stable. Relapse in dental expansion was almost
totally attributed to lingual movement of the posterior teeth; 64% of the patients had more than 2 mm of dental
changes. Phase 2 surgery did not affect dental relapse.
Orthodontic movement using pulsating force induced peizoelctricityEdwardHAngle
Pulsating forces were applied to a patient's maxillary molar to induce piezoelectricity and accelerate tooth movement. Piezoelectricity generates charges when bone deforms under mechanical stress, inducing microcurrents that may stimulate bone remodeling. A device applied 30 oz peak (20 oz average) pulsating forces at 0.7 Hz to the test tooth, and 18 oz continuous force to the control tooth. Over 180 hours, the pulsed tooth moved 0.056 inches, more than the control. Mobility was also lower for the pulsed tooth. Precise measurements showed pulsating forces may achieve faster, less painful orthodontic tooth movement through piezoelectric effects.
Relationship between dental arch width and vertical facial morphology in unt...EdwardHAngle
The objectives of this study were to investigate if a relationship exists between dental arch width and the vertical facial pattern determined by the steepness of the mandibular plane, and to examine the differences in dental arch widths between male and female untreated adults. Lateral cephalograms and dental casts were obtained from 185 untreated Caucasians and measurements of arch width and mandibular plane angle were taken. The results showed that male arch widths were significantly larger than females and that as the mandibular plane angle increased, arch width decreased for both males and females. It was concluded that dental arch width is associated with gender and facial vertical morphology.
Effects of bonded rapid palatal expansion on the transverse dimensions of the...EdwardHAngle
The purpose of this study was to examine the maxillary response on the transverse dimensions to rapid palatal expansion (RPE) by using cone-beam computed tomography (CBCT).
Gingival recession—can orthodontics be a cure? evidence from a case presentationEdwardHAngle
A 35-year-old woman presented with severe gingival recession and a unilateral Class II malocclusion. Her treatment plan involved orthodontic correction of the malocclusion using brackets that torqued roots more onto the bone. It also involved changing her dental hygiene methods to use an oscillating toothbrush gently. After 28 months of orthodontic treatment, her malocclusion was corrected and her gingival recession improved without needing grafting. Three months later, her teeth had settled well into their new positions.
The Christensen prosthesis system is used to treat temporomandibular joint (TMJ) disorders through either hemiarthroplasty or total joint replacement. Studies have found that the Christensen fossa-eminence prosthesis for hemiarthroplasty provides better results than the total joint replacement. Additionally, customized total joint prostheses like the TMJ Concepts system lead to improved outcomes over the off-the-shelf Christensen prosthesis in terms of incisal opening, pain, function, and diet. The Christensen prosthesis can also effectively treat rheumatoid-induced TMJ disorders, improving pain, function, and satisfaction for most patients.
The effect of vibration on the rate of leveling and alignmentEdwardHAngle
This study evaluated the effects of vibration therapy using an AcceleDent device on the rate of orthodontic leveling and alignment in the mandibular arch. The study found that patients who used the AcceleDent device for 20 minutes per day experienced faster leveling and alignment times compared to control groups. For leveling, the AcceleDent group achieved the desired outcome in an average of 160 days, which was 48 and 55 days faster than the study and pre-study control groups respectively. For alignment, the AcceleDent group achieved the desired outcome in an average of 93 days, which was 27 and 38 days faster than the study and pre-study control groups, though the differences for alignment were not
jornal club on Tissue Engineering for Lateral Ridge Augmentation withRecombi...Shilpa Shiv
JC on Tissue Engineering for Lateral Ridge Augmentation withRecombinant Human Bone Morphogenetic Protein 2Combination Therapy: A Case Report. IJPRD 2015.
Comparison of corticotomy facilitated vs standard tooth-movement techniques i...Dr. Carlos Joel Sequeira.
1) The study compared the effects of a corticotomy-facilitated (CF) technique to a standard tooth movement (S) technique in accelerating orthodontic tooth movement in dogs.
2) The maxillary first premolars were distalized using miniscrews and nickel-titanium coil springs on both the right (CF) and left (S) sides of the maxilla.
3) Tooth movement was significantly faster with the CF technique, which involved corticotomy cuts and perforations, doubling the rate of tooth movement compared to the standard technique.
This document describes a case study of using titanium screw anchorage to successfully treat a 31-year-old female patient with a severe anterior open bite of 7 mm. Mini screws were implanted in the maxilla and mandible to provide anchorage for intruding the upper and lower first molars by 3 mm each over 19 months of active treatment. This led to a counterclockwise rotation of the mandible which corrected the open bite and improved her retrognathic facial profile. The results suggest titanium screws are useful for intruding molars and treating anterior open bites in adult patients.
Technique for Placement of Oxidized Titanium Implants by Oded BahatOded Bahat
This study evaluated 290 tapered, oxidized titanium implants placed in compromised bone in 126 patients over 3 years. The implants had a 99.3% survival rate after 3 years of loading. Marginal bone levels around the implants remained stable over the 3-year period. By using a customized osteotomy technique that minimized bone removal and tapered implants with an oxidized surface, the implants provided reliable support for fixed dental prostheses in grafted and ungrafted compromised bone.
Subjective classification and objective analysis of the mandibular dental arc...EdwardHAngle
Our objective was to evaluate the relationship between subjective classification of dental-arch shape, objective analyses via arch-width measurements, and the fitting with the fourth-order polynomial equation.
Journal Club On Pre-extractive Interradicular Implant Bed Preparation: Case P...Shilpa Shiv
Journal Club On Pre-extractive Interradicular Implant Bed Preparation: Case Presentations of a Novel Approach to Immediate Implant Placement at Multirooted Molar Sites, IJPRD 2013.
This document describes a technique for selectively intruding overerupted molars in adult patients using a combination of selective alveolar corticotomies and a modified full-coverage maxillary splint with nickel-titanium springs. Two case reports are presented where this approach successfully intruded overerupted maxillary molars within 2.5-4 months without side effects. The technique aims to take advantage of the regional acceleratory phenomenon caused by corticotomies to increase orthodontic treatment efficiency for adult patients who require molar intrusion.
The document discusses factors related to stability and retention in class II division 1 malocclusions. It covers 3 main topics: 1) The relationship between stability and extraction patterns, finding that nonextraction and premolar extraction have similar long-term stability. 2) The relationship between treatment mechanics and stability, finding stability with functional appliances, Herbst, Twin Force Bite Corrector. 3) Surgical vs conventional treatment, finding functional appliances and surgery have similar stable results, though surgery has more vertical relapse. Relapse is multifactorial and can be reduced by ensuring proper occlusion, avoiding overcorrection of lower incisors, and continued retention as needed.
New insights on age related association between nasopharyngeal airway clearan...EdwardHAngle
This document summarizes a study that evaluated the relationship between adenoid hypertrophy (enlarged adenoids) and facial morphology in children. The study examined 200 children referred for suspected adenoid obstruction, dividing them into two age groups and four subgroups based on facial divergence. Measurements were made from lateral cephalograms to assess airway clearance and facial morphology. Results found smaller airway measurements and more divergent facial patterns in children aged 6 and under and those with severe facial divergence. The findings suggest earlier airway clearance may be needed in severely affected young children to prevent irreversible facial changes.
Angular changes and their rates in concurrence to developmental stages of the...EdwardHAngle
In the early developmental stage of the mandibular second premolar (MnP2), it is not unusual to find the tooth extremely angulated to the lower border of the mandible, as seen in the panoramic roentgenogram. On eruption, the tooth, in most cases, is close to being upright. However, impaction or other types of malocclusions due to its ectopic eruption are not rare.
This randomized controlled study compared clinical outcomes of flapless implant surgery to traditional flap implant placement. 24 patients received implants in the maxillary anterior or premolar region, with 12 receiving flapless implants and 12 receiving traditional flap implants. Both groups had high success rates of around 92% after 15 months. The flapless group had slightly higher plaque scores initially but scores were similar after 15 months. The flapless group experienced less loss of keratinized gingiva. While both groups reported satisfaction, the flapless approach may provide benefits such as reduced treatment time and discomfort. Larger studies are still needed to confirm these results.
This finite element analysis compared the stress distribution of two implant-supported prosthesis systems - one with implants placed in a straight line (straight system) and one with angled implants creating an offset (angled system). Both systems had three implants supporting a metal-ceramic prosthesis in the posterior mandible. Vertical and horizontal loads were applied. The results found that the peak stresses occurred at the neck of the mesial implant in the straight system and the distal implant in the angled system, but the values were similar between systems. There was no significant difference found in stress concentration between the two systems.
This study analyzed the position and angulation of 300 maxillary central incisors using cone beam imaging to provide data to help clinicians achieve good esthetic results for immediate dental implants. The thickness of buccal and palatal bone and apical bone height were measured. Incisors were classified according to their position (buccal, midline, palatal) and angulation (toward buccal, anterior to A point, parallel to alveolus). Most incisors were positioned buccally. Recommendations for implant placement based on tooth classification aim to maintain adequate buccal bone thickness and prevent complications.
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offering a wide range of dental certified courses in different formats.for more details please visit
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Influence of common fixed retainers on the diagnostic quality of cranial magn...EdwardHAngle
Introduction: Orthodontists are often asked to remove fixed retainers before magnetic resonance imaging
(MRI). This study was undertaken to assess the effects of 2 commonly used fixed retainers on MRI distortion
and whether they should be removed. Methods: MRI scans were performed on a dry skull with Twistflex (Dentaurum,
Ispringen, Germany) and Ortho Flex Tech (Reliance Orthodontic Products, Itasca, Ill) retainers. Two
neuroradiologists independently ranked the distortions. The influence of the fixed retainers' alloys, their distance
to the area of diagnosis, location, strength of the magnetic field, and the spin-echo sequence were examined.
Statistical analysis included kappa and Pearson chi-square tests. Results: Ortho Flex Tech retainers caused
no distortion. Twistflex retainers caused distortion in 46% of the tests in areas close to the retainer (tongue
and jaws). Maxillary fixed retainers and the combination of maxillary and mandibular fixed retainers further
increased the distortion. Greater distortion was observed with 3-T magnetic fields and T1-weighted spin-echo
sequences. Conclusions: Removal of the Ortho Flex Tech retainer is unnecessary before MRI. Removal of
the Twistflex should be considered if the MRI scans are performed to diagnose areas close to the fixed retainers,
when 3-T magnetic fields and T1-weighted sequences are used, and when both maxillary and mandibular fixed
retainers are present.
Short term and long-term stability of surgically assisted rapid palatal expan...Dr Sylvain Chamberland
Introduction: The purpose of this article is to present further longitudinal data for short-term and long-term
stability, following up our previous article in the surgery literature with a larger sample and 2 years of stability
data. Methods: Data from 38 patients enrolled in this prospective study were collected before treatment, at maximum
expansion, at removal of the expander 6 months later, before any second surgical phase, at the end of
orthodontic treatment, and at the 2-year follow-up, by using posteroanterior cephalograms and dental casts.
Results: With surgically assisted rapid palatal expansion (SARPE), the mean maximum expansion at the first
molar was 7.60 6 1.57 mm, and the mean relapse was 1.83 6 1.83 mm (24%). Modest relapse after completion
of treatment was not statistically significant for all teeth except for the maxillary first molar (0.99 6 1.1 mm). A
significant relationship (P-.0001) was observed between the amount of relapse after SARPE and the posttreatment
observation. At maximum, a skeletal expansion of 3.58 6 1.63 mm was obtained, and this was stable.
Conclusions: Skeletal changes with SARPE were modest but stable. Relapse in dental expansion was almost
totally attributed to lingual movement of the posterior teeth; 64% of the patients had more than 2 mm of dental
changes. Phase 2 surgery did not affect dental relapse.
Orthodontic movement using pulsating force induced peizoelctricityEdwardHAngle
Pulsating forces were applied to a patient's maxillary molar to induce piezoelectricity and accelerate tooth movement. Piezoelectricity generates charges when bone deforms under mechanical stress, inducing microcurrents that may stimulate bone remodeling. A device applied 30 oz peak (20 oz average) pulsating forces at 0.7 Hz to the test tooth, and 18 oz continuous force to the control tooth. Over 180 hours, the pulsed tooth moved 0.056 inches, more than the control. Mobility was also lower for the pulsed tooth. Precise measurements showed pulsating forces may achieve faster, less painful orthodontic tooth movement through piezoelectric effects.
Relationship between dental arch width and vertical facial morphology in unt...EdwardHAngle
The objectives of this study were to investigate if a relationship exists between dental arch width and the vertical facial pattern determined by the steepness of the mandibular plane, and to examine the differences in dental arch widths between male and female untreated adults. Lateral cephalograms and dental casts were obtained from 185 untreated Caucasians and measurements of arch width and mandibular plane angle were taken. The results showed that male arch widths were significantly larger than females and that as the mandibular plane angle increased, arch width decreased for both males and females. It was concluded that dental arch width is associated with gender and facial vertical morphology.
Effects of bonded rapid palatal expansion on the transverse dimensions of the...EdwardHAngle
The purpose of this study was to examine the maxillary response on the transverse dimensions to rapid palatal expansion (RPE) by using cone-beam computed tomography (CBCT).
Gingival recession—can orthodontics be a cure? evidence from a case presentationEdwardHAngle
A 35-year-old woman presented with severe gingival recession and a unilateral Class II malocclusion. Her treatment plan involved orthodontic correction of the malocclusion using brackets that torqued roots more onto the bone. It also involved changing her dental hygiene methods to use an oscillating toothbrush gently. After 28 months of orthodontic treatment, her malocclusion was corrected and her gingival recession improved without needing grafting. Three months later, her teeth had settled well into their new positions.
The Christensen prosthesis system is used to treat temporomandibular joint (TMJ) disorders through either hemiarthroplasty or total joint replacement. Studies have found that the Christensen fossa-eminence prosthesis for hemiarthroplasty provides better results than the total joint replacement. Additionally, customized total joint prostheses like the TMJ Concepts system lead to improved outcomes over the off-the-shelf Christensen prosthesis in terms of incisal opening, pain, function, and diet. The Christensen prosthesis can also effectively treat rheumatoid-induced TMJ disorders, improving pain, function, and satisfaction for most patients.
The effect of vibration on the rate of leveling and alignmentEdwardHAngle
This study evaluated the effects of vibration therapy using an AcceleDent device on the rate of orthodontic leveling and alignment in the mandibular arch. The study found that patients who used the AcceleDent device for 20 minutes per day experienced faster leveling and alignment times compared to control groups. For leveling, the AcceleDent group achieved the desired outcome in an average of 160 days, which was 48 and 55 days faster than the study and pre-study control groups respectively. For alignment, the AcceleDent group achieved the desired outcome in an average of 93 days, which was 27 and 38 days faster than the study and pre-study control groups, though the differences for alignment were not
jornal club on Tissue Engineering for Lateral Ridge Augmentation withRecombi...Shilpa Shiv
JC on Tissue Engineering for Lateral Ridge Augmentation withRecombinant Human Bone Morphogenetic Protein 2Combination Therapy: A Case Report. IJPRD 2015.
Comparison of corticotomy facilitated vs standard tooth-movement techniques i...Dr. Carlos Joel Sequeira.
1) The study compared the effects of a corticotomy-facilitated (CF) technique to a standard tooth movement (S) technique in accelerating orthodontic tooth movement in dogs.
2) The maxillary first premolars were distalized using miniscrews and nickel-titanium coil springs on both the right (CF) and left (S) sides of the maxilla.
3) Tooth movement was significantly faster with the CF technique, which involved corticotomy cuts and perforations, doubling the rate of tooth movement compared to the standard technique.
This document describes a case study of using titanium screw anchorage to successfully treat a 31-year-old female patient with a severe anterior open bite of 7 mm. Mini screws were implanted in the maxilla and mandible to provide anchorage for intruding the upper and lower first molars by 3 mm each over 19 months of active treatment. This led to a counterclockwise rotation of the mandible which corrected the open bite and improved her retrognathic facial profile. The results suggest titanium screws are useful for intruding molars and treating anterior open bites in adult patients.
Technique for Placement of Oxidized Titanium Implants by Oded BahatOded Bahat
This study evaluated 290 tapered, oxidized titanium implants placed in compromised bone in 126 patients over 3 years. The implants had a 99.3% survival rate after 3 years of loading. Marginal bone levels around the implants remained stable over the 3-year period. By using a customized osteotomy technique that minimized bone removal and tapered implants with an oxidized surface, the implants provided reliable support for fixed dental prostheses in grafted and ungrafted compromised bone.
Subjective classification and objective analysis of the mandibular dental arc...EdwardHAngle
Our objective was to evaluate the relationship between subjective classification of dental-arch shape, objective analyses via arch-width measurements, and the fitting with the fourth-order polynomial equation.
Journal Club On Pre-extractive Interradicular Implant Bed Preparation: Case P...Shilpa Shiv
Journal Club On Pre-extractive Interradicular Implant Bed Preparation: Case Presentations of a Novel Approach to Immediate Implant Placement at Multirooted Molar Sites, IJPRD 2013.
This document describes a technique for selectively intruding overerupted molars in adult patients using a combination of selective alveolar corticotomies and a modified full-coverage maxillary splint with nickel-titanium springs. Two case reports are presented where this approach successfully intruded overerupted maxillary molars within 2.5-4 months without side effects. The technique aims to take advantage of the regional acceleratory phenomenon caused by corticotomies to increase orthodontic treatment efficiency for adult patients who require molar intrusion.
The document discusses factors related to stability and retention in class II division 1 malocclusions. It covers 3 main topics: 1) The relationship between stability and extraction patterns, finding that nonextraction and premolar extraction have similar long-term stability. 2) The relationship between treatment mechanics and stability, finding stability with functional appliances, Herbst, Twin Force Bite Corrector. 3) Surgical vs conventional treatment, finding functional appliances and surgery have similar stable results, though surgery has more vertical relapse. Relapse is multifactorial and can be reduced by ensuring proper occlusion, avoiding overcorrection of lower incisors, and continued retention as needed.
New insights on age related association between nasopharyngeal airway clearan...EdwardHAngle
This document summarizes a study that evaluated the relationship between adenoid hypertrophy (enlarged adenoids) and facial morphology in children. The study examined 200 children referred for suspected adenoid obstruction, dividing them into two age groups and four subgroups based on facial divergence. Measurements were made from lateral cephalograms to assess airway clearance and facial morphology. Results found smaller airway measurements and more divergent facial patterns in children aged 6 and under and those with severe facial divergence. The findings suggest earlier airway clearance may be needed in severely affected young children to prevent irreversible facial changes.
Angular changes and their rates in concurrence to developmental stages of the...EdwardHAngle
In the early developmental stage of the mandibular second premolar (MnP2), it is not unusual to find the tooth extremely angulated to the lower border of the mandible, as seen in the panoramic roentgenogram. On eruption, the tooth, in most cases, is close to being upright. However, impaction or other types of malocclusions due to its ectopic eruption are not rare.
This randomized controlled study compared clinical outcomes of flapless implant surgery to traditional flap implant placement. 24 patients received implants in the maxillary anterior or premolar region, with 12 receiving flapless implants and 12 receiving traditional flap implants. Both groups had high success rates of around 92% after 15 months. The flapless group had slightly higher plaque scores initially but scores were similar after 15 months. The flapless group experienced less loss of keratinized gingiva. While both groups reported satisfaction, the flapless approach may provide benefits such as reduced treatment time and discomfort. Larger studies are still needed to confirm these results.
This finite element analysis compared the stress distribution of two implant-supported prosthesis systems - one with implants placed in a straight line (straight system) and one with angled implants creating an offset (angled system). Both systems had three implants supporting a metal-ceramic prosthesis in the posterior mandible. Vertical and horizontal loads were applied. The results found that the peak stresses occurred at the neck of the mesial implant in the straight system and the distal implant in the angled system, but the values were similar between systems. There was no significant difference found in stress concentration between the two systems.
This study analyzed the position and angulation of 300 maxillary central incisors using cone beam imaging to provide data to help clinicians achieve good esthetic results for immediate dental implants. The thickness of buccal and palatal bone and apical bone height were measured. Incisors were classified according to their position (buccal, midline, palatal) and angulation (toward buccal, anterior to A point, parallel to alveolus). Most incisors were positioned buccally. Recommendations for implant placement based on tooth classification aim to maintain adequate buccal bone thickness and prevent complications.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Dental and Skeletal changes after intraoral molar distalization with sectiona...Maen Dawodi
Dental and Skeletal changes after intraoral molar distalization with sectional jig
The present study as conducted on 10 subjects to evaluate dental and skeletal changes after intraoral molar distalization. The maxillary molars were distalized with a sectional jig assembly. Sentalloy open coil springs were used to exert 150gm of force for a period of 12 weeks . A modified Nance appliance was the main source of anchorage. The pre-and postdistalization records included dental study casts clinical photographs and cephalograms.
A total of 665 readings recorded from lateral cephalograms and dental casts were subjected to statistical analysis . The mean distal movements of the 1st molar was 2.78mm, which was highly significant (p<0.001). It moved distally at the rate of 0.86mm/month. There was clinically some distal tipping (3.50degree) and distopalatal rotation (2.40 degree). These changes were statistically significant. This was the result of molar extrusion
(AJODO 1998 Vol 114: 319-27)
Class II malocclusion with mild to moderate space deficiency in the upper jaw can be treated in many different ways. One possibility is to distalize the maxillary 1st molars and to create space in the buccal segments for retraction of cuspids and anterior teeth.
Conventionally, extraoral traction has been used successfully for the correction of Class II malocclusion by restraining the forward growth of the maxilla, threby correcting the skeletal discrepancy.
These extraoral appliances are also capable of distalizing the maxillary molars to correct the dental discrepancies. These methods require considerable patient compliance. The forces exerted by this appliance are intermittent and hence require a prolonged treatment time.
In recent years , intraoral techniques have been found to be successful for maxillary molar distalization. Gianelly et al. reported distalization of maxillary molars using repelling magnet along with modified Nance appliance for anchorage control .He reported a rate of molar movement of 0.75 to 1mm./month.
Gianelly et al. also used Japanese Niti open coil spring in continuous arch wires and reported a mean molar movement of 1 to 1.5mm/month.
A cone-beam computed tomography evaluation of buccal bone thickness following...AlyOsman4
This study used CBCT imaging to evaluate changes in buccal bone thickness and dental dimensions following rapid maxillary expansion (RME) therapy. CBCT scans were taken before (T1), immediately after (T2), and 2-3 years post-expansion (T3) for 24 patients who underwent RME. The results showed significant increases in maxillary molar and premolar widths from T1 to T2 and T1 to T3. Evaluation of buccal bone thickness found non-significant decreases from T1 to T2 and non-significant increases from T2 to T3. While RME resulted in dental changes, it did not appear to have significant deleterious effects on buccal bone thickness
Immediate effects of rapid maxillary expansion with haas-type and hyrax-type ...Dr. Carlos Joel Sequeira.
This randomized clinical trial evaluated and compared the immediate effects of rapid maxillary expansion (RME) using Haas-type and hyrax-type expanders through cone-beam computed tomography (CBCT) scans. 33 subjects were randomly assigned to either the Haas or hyrax group. Both groups underwent RME with 4 quarter turns of initial activation followed by 2 quarter turns per day until 8mm of expansion was reached. CBCT scans were taken before and after expansion. Measurements showed that both appliances significantly increased maxillary transverse dimensions, with greater skeletal than dental expansion. The hyrax group demonstrated greater orthopedic effects and less tipping of maxillary molars compared to the Haas group, but the differences were less
Clinical assessment
Radiographs
Clinical assessment
Radiographs
Clinical assessment
Radiographs
Clinical assessment
Radiographs
Clinical assessment
Radiographs every 2-3 years
This study placed 2,261 implants in 467 patients using angled abutments ranging from 0 to 45 degrees. Over an average observation period of 28.8 months, the estimated 5-year survival rate was greater than 98.6%. Statistical analysis showed no significant difference in survival rates between implants with abutments angled 0-15 degrees and 20-45 degrees. Good esthetic and functional outcomes were observed.
A magnetic resonance imaging studyof the temporomandibular joint and the disc...Abu-Hussein Muhamad
Causative correction of skeletal malocclusions is achieved through bite–jumping by various means. Numerous animal experiments yielded evidence of rebuilt temporomandibular structures after mandibular protrusion. However, the mode and extent of structural and/or topographic changes of the disco-condylar relation after functional orthopaedic treatment is still an issue at stake. A problem exists in defining the physiologic (centric) position of the condyles and the proper disco-condylar relation which is tentatively determined by various methods particularly in MRI studies. Despite the high resolution provided, the results have to be interpreted with caution, as osseous resorption and apposition can not be assessed by visual evidence. In this article a prospective study is presented which proves the effectiveness of the “Wuerzburg concept“, i.e. bionator plus extraoral traction and up-and-down elastics, and its impact on the temporomandibular joint. The underlying reactions are studied by means of MR images obtained from sucessfully treated patients.
A magnetic resonance imaging studyof the temporomandibular joint and the disc...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This case report summarizes the effects of headgear-activator therapy on 10 patients with Class II malocclusions. Key findings include:
1) Five of the 10 cases showed distal movement of the lower first molars, which has not been previously reported.
2) Growth stimulation of the mandible was observed in some patients, with mandibular growth above average compared to a control group.
3) Abnormal oral functions, like tongue thrusting and lip biting, were eliminated in all patients.
4) The headgear-activator appliance was considered an effective tool for controlling vertical growth problems and Class II malocclusions in growing mixed-dentition patients.
omfs journal club ppt on bone ridge augmentationAkhil Sankar
This is a journal club to start with for new omfs pgs . This is correctly criticized and cross-checked ppt. Also, it is a relevant topic in day to day preactise
En masse retraction and two step retraction of maxillary /certified fixed ort...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
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This document discusses various methods and appliances for distalizing maxillary molars, including removable and fixed options. Removable appliances discussed include extraoral traction using headgear as well as removable appliances with finger springs or sliding jigs. Fixed appliances discussed include intramaxillary devices like Wilson's 3D appliance as well as intermaxillary appliances like Herbst or Jasper Jumper. Factors like the presence of second molars, skeletal pattern, and growth prognosis must be considered when determining whether molar distalization is indicated.
Article teixeira effects of micro-osteoperforationCentric Learning
1. The study examined the effect of micro-osteoperforations (MOPs) on the rate of tooth movement in 20 patients undergoing orthodontic treatment.
2. The experimental group received MOPs on one side of the maxilla prior to canine retraction, while the control group did not receive MOPs.
3. MOPs significantly increased the rate of tooth movement by 2.3-fold and increased inflammatory marker levels. Patients did not report significant pain from the procedure.
Effects on the dental arch form using a /certified fixed orthodontic courses ...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
This study evaluated external root resorption (ERR) in root-filled teeth (RFT) and vital pulp teeth (VPT) after orthodontic treatment. The study assessed 69 patients who underwent either non-extraction or extraction orthodontic treatment. Pre- and post-treatment panoramic radiographs were used to measure root and crown lengths and areas to determine the amount of ERR. The results found that ERR was significantly higher in VPT compared to RFT. Additionally, the amount of ERR increased with longer treatment duration. However, the modality of treatment (extraction vs. non-extraction) did not significantly affect the amount of ERR in RFT. The study concluded that RFT are more resistant to ERR
This document describes the orthodontic treatment of a 31-year-old female patient with a gummy smile. To correct the gummy smile, the orthodontist intruded the entire maxillary dentition rather than just the anterior teeth. A midpalatal absolute anchorage system and modified lingual arch were used to achieve posterosuperior movement of the maxillary dentition over 18 months. This corrected the gummy smile and crowding. Follow-up after 21 months showed the results were stable despite the patient not wearing a maxillary retainer as prescribed.
Diagnosis and conservative treatment of skeletaldentalid
A man, aged 28 years 9 months, came for an orthodontic consultation for a skeletal Class III malocclusion
(ANB angle, 3) with a modest asymmetric Class II and Class III molar relationship, complicated by an anterior
crossbite, a deepbite, and 12 mm of asymmetric maxillary crowding. Despite the severity of the malocclusion
(Discrepancy Index, 37), the patient desired noninvasive camouflage treatment. The 3-Ring diagnosis showed
that treatment without extractions or orthognathic surgery was a viable approach. Arch length analysis indicated
that differential interproximal enamel reduction could resolve the crowding and midline discrepancy, but a
miniscrew in the infrazygomatic crest was needed to retract the right buccal segment. The patient accepted
the complex, staged treatment plan with the understanding that it would require about 3.5 years. Fixed appliance
treatment with passive self-ligating brackets, early light short elastics, bite turbos, interproximal enamel
reduction, and infrazygomatic crest retraction opened the vertical dimension of the occlusion, improved the
ANB angle by 2, and achieved excellent alignment, as evidenced by a Cast Radiograph Evaluation score of
28 and a Pink and White dental esthetic score of 3. (
This study evaluated the effect of maxillary advancement of less than 6 mm versus 6 mm or more on soft tissue changes in 53 patients treated for Class III malocclusion. For advancements under 6 mm, there were no significant changes in the nasolabial angle but significant changes in lip and chin positions. For advancements of 6 mm or more, submental and nasolabial soft tissues significantly improved, indicating better aesthetics. The degree of maxillary advancement significantly impacts soft tissue changes and should be considered in treatment planning.
Management of posttraumatic malocclusion caused by condylar process fractureDr. SHEETAL KAPSE
This study evaluated the treatment of 21 patients with post-traumatic malocclusions caused by condylar process fractures. For asymmetric malocclusions from unilateral fractures (n=15), patients underwent unilateral or bilateral mandibular ramus osteotomies. For anterior open bites from bilateral fractures (n=6), patients underwent either Le Fort I osteotomies (n=5) or bilateral ramus osteotomies (n=1). All patients had stable dental and skeletal results after 1+ years except one treated with bilateral ramus osteotomies. The authors conclude that osteotomies of the affected jaw are effective for treating post-traumatic malocclusions from condylar fractures.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
1. Angle Orthodontist, Vol 75, No 3, 2005437
Original Article
Anchorage Provided During Intra-arch Distal Molar
Movement: A Comparison Between the Nance Appliance and a
Fixed Frontal Bite Plane
Lars Bondemarka
; Johan Thorne´usb
Abstract: The aim of this retrospective study was to evaluate and compare the anchorage provided with
the Nance appliance (NA) and the fixed frontal bite plane (FBP) during intra-arch distal molar movement.
After a sample size calculation, 20 patients were recruited and randomly selected for each group from
patients who fulfilled the following criteria: use of an intra-arch Ni-Ti coil appliance with either NA or
FBP to provide anchorage during a six-month molar distalization period, no orthodontic treatment before
molar distalization, and first and second maxillary molars in occlusion. The outcome measures assessed
were anchorage loss, ie, anterior movement of maxillary central incisors, distal movement of maxillary
molars, and bite opening effect. The mean age in the NA group was 14.7 years (SD 1.09) and in the FBP
group 15.0 years (SD 0.99). The data revealed that the maxillary central incisors moved anteriorly 1.4
mm in the NA group and 1.9 mm in the FBP group. The difference in anchorage loss was not significant.
The mean amount of molar distalization within the maxilla was 1.7 mm in the NA group and 1.8 mm in
the FBP group. In both groups, the overbite was significantly reduced and the overbite was decreased
significantly more in the FBP group. Because neither the NA nor FBP provided stable anchorage, a second
treatment phase is recommended to reverse the anchorage loss after distal molar movement. If molar
distalization is planned in deep bite cases, the FBP is the anchorage system of choice. (Angle Orthod 2005;
75:437–443.)
Key Words: Anchorage; Distal molar movement; Intraoral appliance
INTRODUCTION
A common strategy to correct a Class II dental maloc-
clusion or to create space in the maxillary arch by a non-
extraction protocol is to move the maxillary molars distally
in the initial stages of treatment, and thereby gain space to
convert the Class II molar relationship to a Class I. The
molars are then held in place whereas the premolars, ca-
nines and incisors are retracted.
Traditionally, extraoral traction and extraoral traction in
combination with removable appliances have been used for
distal molar movement.1–3
However, these treatments are
highly dependent on patient cooperation and, therefore, var-
ious intra-arch devices have been introduced, which have
a
Head and Associate Professor, Department of Orthodontics, Fac-
ulty of Odontology, Malmo¨ University, Malmo¨, Sweden.
b
Consultant, Specialist in Orthodontics, Orthodontic Clinic, Na-
tional Health Service, Blekinge County Council, Karlskrona, Sweden.
Corresponding author: Lars Bondemark, DDS, Odont Dr, Depart-
ment of Orthodontics, Faculty of Odontology, Malmo¨ University, Carl
Gustavs va¨g 34, SE-20506 Malmo¨, Sweden
(e-mail: lars.bondemark@od.mah.se)
Accepted: November 2004. Submitted: October 2004.
᭧ 2005 by The EH Angle Education and Research Foundation, Inc.
almost eliminated reliance on the patient. These techniques
include Wilson arches,4,5
Hilgers pendulum appliances,6–8
repelling magnets, and superelastic coils.9–16
Most of the
intra-arch devices use palatal anchorage such as a Nance
appliance (NA), but a fixed acrylic frontal bite plane (FBP)
can also be used.17
Despite the anchorage arrangement, it
has been reported that anchorage loss still occurs, resulting
in increased overjet up to two mm during the distal molar
movement.5,7,8,10,13,17
Because loss of orthodontic anchorage may lead to pro-
longed treatment time and less predictable treatment result,
it is of great concern to analyze different anchorage sys-
tems. In the literature, few articles exist comparing the abil-
ity of different anchorage systems to resist tooth move-
ments, and no study has yet compared different anchorage
approaches during intra-arch distal molar movement.
Therefore, the aim of this retrospective study was to ana-
lyze and compare the anchorage provided with NA and
FBP during intra-arch distal molar movement.
MATERIALS AND METHODS
On the basis of an alpha significance level of 0.05 and a
beta of 0.1, the sample size for each group was calculated
2. 438 BONDEMARK, THORNE´ US
Angle Orthodontist, Vol 75, No 3, 2005
FIGURE 1. Occlusal view of the intra-arch Ni-Ti coil appliance provided with a Nance button as anchorage.
to achieve 90% power to detect a clinically meaningful dif-
ference of 1.5 mm (Ϯ1.0 mm) in anchorage loss between
the NA and the FBP groups. The sample size calculation
showed that 10 patients in each group were needed, and to
increase the power even more, it was determined to select
20 patients for each group.
The patients were from one Orthodontic Clinic at Na-
tional Health Service, County Council Skane, Hassleholm,
Sweden, and 20 patients were randomly selected (through
a random table) for each group from among 87 patients
who fulfilled the following criteria: (1) used an intra-arch
Ni-Ti coil appliance with either NA or FBP to provide an-
chorage during a six-month molar distalization period; (2)
a nonextraction treatment plan; (3) no orthodontic treatment
before molar distalization; (4) both first and second max-
illary molars in occlusion; as well as those cases with mild
(2–3 mm) Class II molar relation with the aim to achieve
Class I molar relation or cases with normal occlusion with
the aim to increase the arch perimeter (or both).
One experienced orthodontic specialist had treated all the
patients. In the NA group, there were six boys and 14 girls
(mean age of 14.7 years, SD 1.09) and in the FBP group
five boys and 15 girls (mean age of 15.0 years, SD 0.99).
In the NA group, there were 17 mild Class II and three
Class I, whereas in the FBP group, there were 18 mild Class
II and two Class I. In both groups, maxillary third molars
were present in the alveolar bone on both the right and left
sides in 16 of the 20 patients.
The main outcome measures to be assessed on cephalo-
grams were:
• Anchorage loss, ie, anterior movement and proclination
of maxillary central incisors.
• Distal movement and distal tipping of maxillary first per-
manent molars.
In addition, the bite opening effect and the skeletal sag-
ittal position changes of the maxilla and mandible also were
measured.
Design of the intra-arch appliance provided with
a Nance button as anchorage
The lingual intra-arch Ni-Ti coil appliance is shown in
Figure 1. The appliance consisted of bands placed bilater-
ally on the maxillary first molars and second premolars. A
tube, 1.1 mm in diameter and approximately 10 mm in
length, was soldered on the lingual side of the molar band.
A 0.9-mm lingual archwire that united a Nance acrylic but-
ton was soldered on to the lingual side to the second pre-
molar band. The lingual archwire also provided two distal
pistons that passed bilaterally through the palatal tubes of
the maxillary molar bands. The tubes and pistons were re-
quired to be parallel in both the occlusal and sagittal views.
A Ni-Ti coil (GAC Int Inc, Central Islip, NY), 0.3 mm in
diameter, with a lumen of 1.1 mm, and cut to 10 to 14 mm
in length, was inserted on the distal piston and compressed
to half its length, when the molar band with its lingual tube
was adapted to the distal piston of the lingual archwire.
When the coil was compressed, two forces were produced,
one distally directed to move the molars distally and a re-
ciprocal mesially directed force against which the Nance
3. 439ANCHORAGE DURING MOLAR DISTALIZATION
Angle Orthodontist, Vol 75, No 3, 2005
FIGURE 2. Occlusal view of the intra-arch Ni-Ti coil appliance provided with a fixed acrylic frontal bite plane as anchorage. Note that the bite
plane was extended to the palatal vault to improve anchorage.
button provided anchorage. All appliances in the NA group
were made by one orthodontic technician and efforts had
been made to construct the Nance button with equal size
and dimension for all patients.
Design of the intra-arch appliance provided with
a fixed acrylic frontal bite plane as anchorage
The design was similar to the intra-arch appliance de-
scribed above, but a fixed acrylic frontal bite plane (Figure
2) replaced the Nance button. Compared with an ordinary
frontal bite plane, the bite plane in this study was extended
to the palatal vault to increase or improve the anchorage
against the reciprocal mesially directed force. Also in the
FBP group, all appliances were made by one orthodontic
technician and efforts had been made to construct the fron-
tal bite planes with equal size and dimension for all pa-
tients.
Data collection
Lateral head radiographs in centric occlusion were ob-
tained at the start and after completion of the molar distal-
ization. The measuring points, reference lines, and mea-
surements used were based on those defined and described
by Bjo¨rk18
and Pancherz.19
Dental and skeletal changes as
well as dental changes within the maxilla and mandible
were obtained by the Pancherz analysis.19
Measurements were made to the nearest 0.5 mm or 0.5Њ.
Images of bilateral structures were bisected. No correction
was made for linear enlargement (10%). Changes in the
different measuring points during the treatment were cal-
culated as the difference in the after-minus-before position.
The cephalograms were scored and coded by an inde-
pendent person, and the examiner conducting the measure-
ment analysis of the cephalograms was unaware of the
group to which the patient had been allocated.
Statistical analysis
The arithmetic mean and standard deviation (SD) were
calculated for each variable. Differences in means within
samples/groups were tested by paired t-tests and between
samples and groups by unpaired t-tests after F-tests for
equal and unequal variances. Differences with probabilities
of less than 5% (P Ͻ .05) were considered statistically sig-
nificant.
Error of the method
Ten randomly selected cephalograms were traced on two
separate occasions. No significant mean differences be-
tween the two series of records were found by using paired
t-tests. The method error20
did not exceed 0.7 mm and 0.9Њ
for the different measurements used except the variables,
inclination of lower incisors and first maxillary molar in-
clination, where the error was 1.5Њ and 1.4Њ, respectively.
RESULTS
No significant difference in treatment effects was found
between girls and boys, and consequently, the data for girls
and boys were pooled and analyzed together.
4. 440 BONDEMARK, THORNE´ US
Angle Orthodontist, Vol 75, No 3, 2005
FIGURE 3. The Nance appliance group (N ϭ 20). Skeletal and den-
tal mean changes (in mm) and standard deviations contributing to
alterations in sagittal movements of incisors and molars in the max-
illa. The average forward movement of the incisors was 1.9 mm (SD
1.19) and the mean distal molar movement within the maxilla was
1.7 mm (SD 1.20). *P Ͻ .05; **P Ͻ .01; ***P Ͻ .001.
FIGURE 4. The frontal bite plane group (N ϭ 20). Skeletal and den-
tal mean changes (in mm) and standard deviations contributing to
alterations in sagittal movements of incisors and molars in the max-
illa. The average forward movement of the incisors was 1.4 mm (SD
1.16) and the mean distal molar movement within the maxilla was
1.8 mm (SD 1.02). *P Ͻ .05; **P Ͻ .01; ***P Ͻ .001.
In the NA group, the anchorage loss, ie, the average an-
terior movement within the maxilla of maxillary incisors
and proclination of the incisors, was 1.9 mm and 3.3Њ, re-
spectively. The corresponding anchorage loss in the FBP
group was 1.4 mm and 4.0Њ (Figures 3 and 4; Table 1). The
difference in anchorage loss between the groups was not
significant (Table 1). The mean overjet was increased 1.2
mm in the NA and 0.4 mm in the FBP group. Significantly
more proclination and anterior movement of the mandibular
incisors was the reason for the smaller increase in overjet
in the FBP group (Table 1).
In both groups, the overbite was significantly reduced,
and the overbite was decreased significantly more in the
FBP group, 2.4 vs 1.1 mm (Table 1). The decrease in over-
bite was mainly because of overeruption of mandibular and
maxillary molars (Table 1).
The mandibular plane angle tilted posteriorly in both
groups as well as the maxillary plane angle in the NA group
(Table 1).
The mean amount of distal molar movement within the
maxilla was almost equal in both groups, 1.7 mm (SD 1.20)
in the NA group vs 1.8 mm (SD 1.02) in the FBP group
(Figures 3 and 4; Table 1). The amount of average distal
molar tipping was small and with no significant difference
between the groups (Table 1).
The ratio of molar vs incisor movement within the max-
illa was 1.7/1.9 (0.89) for the NA group and 1.8/1.4 (1.28)
for the FBP group, indicating more effective distal molar
movement in the FBP group, although no statistically sig-
nificant difference was found between the groups. From
Table 1, it can also be determined that the molar relation
in both groups was corrected not only by distal molar
movement of maxillary molars but also by mesial move-
ment of mandibular molars.
During the molar distalization, small sagittal skeletal
changes occurred in the maxilla and mandible (Table 1).
DISCUSSION
The most significant findings of this study were that the
anchorage systems did not provide stable anchorage during
intra-arch molar distalization and no difference in provided
anchorage was found between the NA and the FBP. The
anchorage loss found in the two groups in this study was
at an equal level as reported in previous case series, when
first and second maxillary molars during six months were
simultaneously moved distally.5,7,8,10,13,17
In most instances, the anchorage loss, ie, forward move-
ment of the incisors, can be corrected with modest inter-
vention. It has been shown that forward movement of the
maxillary incisors associated with distal molar movement
was totally reversed and eliminated by subsequent multi-
bracket appliance and intermaxillary Class II elastics.21
However, in a case with retroclined maxillary incisors, for
example a Class II division 2 occlusion, the reciprocal ef-
fect of forces can be used for proclination of the incisors.
On the other hand, if stable or absolute anchorage is de-
sired, anchorage systems using onplants or osseointegrated
mini screws conceivably can be used. These systems have
shown promising results in respect to achieving stable an-
chorage during the molar distalization procedure.22,23
Both appliances used in this study were made by one
laboratory technician who had instructions to design and
construct the Nance button as well as the frontal bite plane
with equal size and dimension for all patients in the NA
group and FBP group, respectively. In this respect, the pro-
vided anchorage was equal for all patients in each group.
Of course, it is relevant that small differences in size and
design could exist in few patients because of difference in
palatal anatomy; however, this was not deemed to be of
decisive importance for the outcome of the anchorage.
5. 441ANCHORAGE DURING MOLAR DISTALIZATION
Angle Orthodontist, Vol 75, No 3, 2005
TABLE 1. Changes in Cephalometric Variables Within and Between the Two Groups After Distal Movement of Maxillary Molars. Changes
Were Calculated as the Difference After-Minus-Before Positiona
NA (N ϭ 20)
Mean SD
FBP (N ϭ 20)
Mean SD
Group Difference
P value
Skeletal sagittal variables (mm)
Maxillary base, A-OLp 0.5* 1.03 0.5 1.12 NS
Mandibular base, Pg-OLp 0.7** 0.92 Ϫ0.2 1.90 NS
Skeletal ϩ dental sagittal variables (mm)
Overjet 1.2** 1.66 0.4 1.30 NS
Maxillary incisor position, Is-OLp 2.4*** 1.22 1.9*** 1.38 NS
Mandibular incisor position, Ii-OLp 1.2** 1.42 1.6*** 1.64 NS
Maxillary molar position, Ms-OLp Ϫ1.2*** 0.88 Ϫ1.3*** 1.08 NS
Mandibular molar position, Mi-OLp 0.6** 0.91 0.4 1.76 NS
Dental sagittal variables within the maxilla and mandible
Maxillary incisor, Is-OLp (d) minus A-OLp (d) 1.9*** 1.19 1.4*** 1.16 NS
Mandibular incisor, Ii-OLp (d) minus Pg-OLp (d) 0.5 1.32 1.7*** 1.75 *
Maxillary molar, Ms-OLp (d) minus A-OLp (d) Ϫ1.7*** 1.20 Ϫ1.8*** 1.02 NS
Mandibular molar, Mi-OLp (d) minus Pg-OLp Ϫ0.1 0.64 0.6** 0.89 **
Sagittal variables (Њ)
Maxillary incisor inclination, ILs/NSL 3.3*** 3.62 4.0*** 2.73 NS
Mandibular incisor inclination, ILi/ML Ϫ0.2 4.11 3.7*** 3.56 **
Maxillary first molar inclination, M1s/NSL Ϫ4.0** 5.39 Ϫ1.9 4.98 NS
Vertical variables (mm)
Overbite Ϫ1.1*** 1.18 Ϫ2.4*** 1.18 **
Maxillary incisor position, Is-NL 0.2 0.77 Ϫ0.5 1.12 *
Maxillary molar position, Ms-NL 0.8** 1.25 1.0*** 0.66 NS
Mandibular incisor position, Ii-ML 1.2*** 0.71 0.6 1.90 NS
Mandibular molar position, Mi-ML 0.3 1.55 1.4*** 1.12 *
Vertical variables (Њ)
Mandibular inclination, NSL/ML 0.6* 1.05 0.6* 0.96 NS
Maxillary inclination, NSL/NL 0.9** 1.14 Ϫ0.2 1.21 *
Occlusal plane inclination, OL/NSL Ϫ1.6*** 1.42 Ϫ2.2*** 1.61 NS
a
NA indicates Nance appliance; FBP, frontal bite plane; and NS, not significant.
* P Ͻ .05; ** P Ͻ .01; *** P Ͻ .001.
An advantage with the FBP is that a pronounced bite
opening effect can be combined with the molar distalization
procedure. The bite opening achieved was primarily a result
of dental changes. After the FBP was inserted, maxillary
and mandibular molar heights increased. Similar findings
of overeruption of the lateral segments in bite plane therapy
have been reported earlier.24
Moreover, the frontal bite plane
made an inclined plane for the mandibular incisors that re-
sulted in an anterior tipping of the mandibular incisors with
a subsequent mesial drift of mandibular premolars and mo-
lars. This was the main explanation for smaller increases in
overjet found in the FBP group compared with the NA
group.
Furthermore, because only the incisors and cuspids were
in occlusion in the mandibular arch in the FBP group, lat-
eral occlusal forces were eliminated. This means that the
maxillary molars could move distally independent of these
forces. Therefore, it is reasonable to claim that there was a
possibility for the molars in the FBP group to move distally
more easily and conceivably to a greater extent than in the
NA group, but this was not found in this study. However,
if the ratio of molar vs incisor movement within the maxilla
is calculated, the distal molar movement seems to be a little
bit more effective in the FBP group although no statistically
significant difference was found between the groups.
Overall, the amount of distal molar movement was at the
same level as could be expected when first and second max-
illary molars simultaneously are moved distally.25
It is also
relevant to consider that correction of the molar relationship
occurs not only by distal movement of the maxillary molars
but also by spontaneous mesial movement of the mandib-
ular molars and forward growth of the mandible. It can also
be pointed out that 16 of the 20 patients in each group had
maxillary third molars present in the alveolar bone, and this
was regarded to be of minor importance in the outcome of
the distal molar movement and anchorage loss.
The Pancherz method was used as the superimposition
method and also to detect dental and skeletal changes as
well as dental changes within the maxilla and mandible.
This method is well known and has been proven to be re-
liable, especially for assessment of patients in groups.26
In any scientific study, it is important that the power is
6. 442 BONDEMARK, THORNE´ US
Angle Orthodontist, Vol 75, No 3, 2005
high. The sample size calculation revealed that a sample
size of 10 patients per group was sufficient. Because 20
patients per group were analyzed in this study, it can be
stressed that the power was sufficiently high to reveal re-
liable results. When the power was calculated, a clinical
meaningful difference in anchorage loss was set at 1.5 mm.
It can be claimed that this difference is rather high, but the
intention with the study was to carry out an investigation
that primarily revealed clinical significance, not a statistical
significance only. In this study, a difference of 0.5 mm (SD
0.59) in anchorage loss was found. This difference was of
no clinical or statistical significance. Hypothetically, if a
post hoc power analysis is made, the result will be that 29
patients are needed for each group. However and impor-
tantly, the difference of 0.5 mm is still of no clinical sig-
nificance.
Because the patients in each group were selected ran-
domly among patients who fulfilled the preset criteria, char-
acterized for instance as only successful treatments, selec-
tion bias was avoided in the study. Furthermore, the reli-
ability and the methodological soundness were increased
even more because the measurement analysis of the ceph-
alograms was performed in a blinded manner, ie, the ex-
aminer was unaware of the anchorage system that had been
used. Thus, the risk of measurements being affected by the
researcher was low.
On the other hand, from an evidence-based view it can
be argued that the scientific evidence drawn from results or
conclusions of a retrospective study can only be classified
or ranked as low. However, even if a randomized controlled
trial is the gold standard and shall rule, it has been claimed
that sound methodology in well-designed prospective or
retrospective studies shall not be ignored when assessing
scientific literature.27
CONCLUSIONS
• The NA and FBP did not provide stable anchorage during
the molar distalization, instead an anchorage loss could
be found, ie, anterior movement of the maxillary incisors,
of 1.9 and 1.4 mm, respectively;
• The difference in anchorage loss between the NA and the
FBP was not significant;
• The mean amount of distal molar movement within the
maxilla was almost equal in both groups, 1.7 mm in the
NA group vs 1.8 mm in the FBP group;
• In both groups, the overbite was significantly reduced,
and the overbite was decreased significantly more in the
FBP group;
• Because none of the NA and FBP provided stable an-
chorage, a second treatment phase with multibracket tech-
nique and Class II elastics is recommended to reverse the
anchorage loss after distal molar movement;
• If molar distalization is planned in deep bite cases, the
FBP is the anchorage system of choice.
REFERENCES
1. Graber TM. Extraoral force—facts and fallacies. Am J Orthod.
1955;41:490–505.
2. Wieslander L. Early or late cervical traction therapy of Class II
malocclusion in the mixed dentition. Am J Orthod. 1975;67:432–
439.
3. Cetlin NM, TenHoeve A. Nonextraction treatment. J Clin Orthod.
1983;17:396–413.
4. Wilson RC. Modular orthodontic systems. Part 1. J Clin Orthod.
1978;12:259–278.
5. Muse DS, Fillman MJ, Emmerson WJ, Mitchell RD. Molar and
incisor changes with Wilson rapid molar distalization. Am J Or-
thod Dentofacial Orthop. 1993;104:556–565.
6. Hilgers JJ. The pendulum appliance for Class II non-compliance
therapy. J Clin Orthod. 1992;26:706–714.
7. Gosh J, Nanda RS. Evaluation of an intraoral maxillary molar
distalization technique. Am J Orthod Dentofacial Orthop. 1996;
110:639–646.
8. Byloff FK, Darendeliler MA. Distal molar movement using the
pendulum appliance. Part 1: clinical and radiological evaluation.
Angle Orthod. 1997;67:249–260.
9. Jones R, White J. Rapid Class II molar correction with an open
coil jig. J Clin Orthod. 1992;26:661–664.
10. Bondemark L, Kurol J. Distalization of maxillary first and second
molars simultaneously with repelling magnets. Eur J Orthod.
1992;14:264–272.
11. Carano A, Testa M. The distal jet for upper molar distalization.
J Clin Orthod. 1996;30:374–380.
12. Gianelly AA. Distal movement of the maxillary molars. Am J
Orthod Dentofacial Orthop. 1998;114:66–72.
13. Gulati S, Kharbanda OP, Parkash H. Dental and skeletal changes
after intraoral molar distalization with sectional jig assembly. Am
J Orthod Dentofacial Orthop. 1998;114:319–327.
14. Bondemark L. A comparative analysis of distal maxillary molar
movement produced by a new lingual intra-arch Ni-Ti coil ap-
pliance and a magnetic appliance. Eur J Orthod. 2000;22:683–
695.
15. Papadopoulos MA, Mavropoulos A, Karamouzos A. Cephalo-
metric changes following simultaneous fist and second maxillary
molar distalization using a non-compliance intraoral appliance. J
Orofac Orthop. 2004;65:123–136.
16. Fortini A, Lupoli M, Giuntoli F, Franchi L. Dentoskeletal effects
induced by rapid molar distalization with the first class appliance.
Am J Orthod Dentofacial Orthop. 2004;125:697–705.
17. Bondemark L, Kurol J, Bernhold M. Repelling magnets versus
superelastic nickel-titanium coils in simultaneous distal move-
ment of maxillary first and second molars. Angle Orthod. 1994;
64:189–198.
18. Bjo¨rk A. The relationship of the jaws to the cranium. In: Lund-
stro¨m A, ed. Introduction to Orthodontics. New York, NY: Mc-
Graw-Hill; 1960:104–140.
19. Pancherz H. The mechanism of Class II correction in Herbst ap-
pliance treatment. A cephalometric investigation. Am J Orthod.
1982;82:104–113.
20. Dahlberg G. Statistical Methods for Medical and Biological Stu-
dents. London: Allen and Unwin; 1940:122–132.
21. Bondemark L, Kurol J. Class II correction with magnets and su-
perelastic coils followed by straight-wire mechanotherapy. J Or-
ofac Orthop. 1998;59:127–138.
22. Bondemark L, Feldmann I, Feldmann H. Distal molar movement
with an intra-arch device provided with the Onplant system for
absolute anchorage. World J Orthod. 2002;3:117–124.
23. Park HS, Kwon TG, Sung JH. Nonextraction treatment with mi-
croscrew implants. Angle Orthod. 2004;74:539–549.
24. Forsberg CM, Hellsing E. The effect of a lingual arch appliance
7. 443ANCHORAGE DURING MOLAR DISTALIZATION
Angle Orthodontist, Vol 75, No 3, 2005
with anterior bite plane in deep overbite correction. Eur J Orthod.
1984;6:107–115.
25. Atherton GJ, Glenny AM, O’Brien KD. Development and use of
a taxonomy to carry out a systematic review of the literature on
methods described to effect distal movement of maxillary molars.
J Orthod. 2002;29:211–216.
26. You QL, Hagg U. A comparison of three superimposition meth-
ods. Eur J Orthod. 1999;21:717–725.
27. Ioannidis JP, Haidich AB, Pappa M, Pantazis N, Kokori SI, Tek-
tonidou MG, Contopoulos-Ioannidis DG, Lau J. Comparison of
evidence of treatment effects in randomized and non randomized
studies. JAMA. 2001;286:821–830.