4 research outputs found
Perceived Effects of Orthognathic Surgery versus Orthodontic Camouflage Treatment of Convex Facial Profile Patients.
No full textIncreased facial profile convexity has a common occurrence in the population and is a primary reason for seeking orthodontic treatment. The present study aimed to compare the perceived changes in facial profile appearance between patients treated with combined orthognathic/orthodontic treatment versus only orthodontic camouflage treatment. For this reason, 18 pairs of before- and after-treatment facial profile photos per treatment group (n = 36 patients) were presented to four types of assessors (surgeons, orthodontists, patients, laypeople). Ratings were recorded on 100 mm visual analogue scales depicted in previously validated questionnaires. All rater groups identified minor positive changes in the facial profile appearance after exclusively orthodontic treatment, in contrast to substantial positive changes (14% to 18%) following combined orthodontic and orthognathic surgery. The differences between the two treatment approaches were slightly larger in the lower face and the chin than in the lips. The combined orthodontic and orthognathic surgery interventions were efficient in improving the facial appearance of patients with convex profile, whereas orthodontic treatment alone was not. Given the significant influence of facial aesthetics on various life aspects and its pivotal role in treatment demand and patient satisfaction, healthcare providers should take these findings into account when consulting adult patients with a convex facial profile
Positional guidelines for orthodontic mini-implant placement in the anterior alveolar region: a systematic review
No full textPURPOSE
To investigate the adequacy of potential sites for insertion of orthodontic mini-implants (OMIs) in the anterior alveolar region (delimited by the first premolars) through a systematic review of studies that used computed tomography (CT) or cone beam CT (CBCT) to assess anatomical hard tissue parameters, such as bone thickness, available space, and bone density.
MATERIALS AND METHODS
MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews were searched to identify all relevant papers published between 1980 and September 2011. An extensive search strategy was performed that included the key words "computerized (computed) tomography" and "mini-implants." Information was extracted from the eligible articles for three anatomical areas: maxillary anterior buccal, maxillary anterior palatal, and mandibular anterior buccal. Quantitative data obtained for each anatomical variable under study were evaluated qualitatively with a scoring system.
RESULTS
Of the 790 articles identified by the search, 8 were eligible to be included in the study. The most favorable area for OMI insertion in the anterior maxilla (buccally and palatally) and mandible is between the canine and the first premolar. The best alternative area in the maxilla (buccally) and the mandible is between the lateral incisor and the canine, while in the maxillary palatal area it is between the central incisors or between the lateral incisor and the canine.
CONCLUSIONS
Although there is considerable heterogeneity among studies, there is a good level of agreement regarding the optimal site for OMI placement in the anterior region among investigations of anatomical hard tissue parameters based on CT or CBCT scans. In this context, the area between the lateral incisor and the first premolar is the most favorable. However, interroot distance seems to be a critical factor that should be evaluated carefully
Aesthetic Impact of Orthognathic Surgery vs. Orthodontic Camouflage in Class II Division 1 Patients with Convex Facial Profile: A Follow-Up Using Combined Frontal and Profile Views
No full textBackground/Objectives: A previous study evaluating convex facial profiles at rest demonstrated that combined orthodontic and orthognathic surgical treatment is more effective in enhancing facial aesthetics compared to orthodontic camouflage alone. The present follow-up study aimed to reassess these findings by incorporating both profile and frontal facial views in the aesthetic evaluation. Methods: This retrospective cohort study sample included 36 consecutively selected patients with convex facial profiles and Class II Division 1 malocclusion. Two groups of 18 non-growing patients with similar characteristics were compared. Group A was treated with orthodontics and orthognathic surgery, whereas Group B was treated with orthodontics exclusively. Pre- and post-treatment profile and frontal facial photographs were simultaneously presented to orthodontists, oral and maxillofacial surgeons, convex profile patients, and laypeople, asking them to assess changes in facial appearance. Results: Significant positive changes in facial appearance were perceived for Group A, in contrast to no changes for Group B, with a difference of 17/100 visual analogue scale (VAS) units. The rater groups demonstrated a high degree of consistency (ICC > 0.88). Multivariate analysis revealed significant differences in perceived changes between the two treatment groups (F = 14.63, p < 0.001, Pillai’s Trace = 0.36, and partial η2 = 0.36), with no significant effects from the rater group (p > 0.05). Similar results are evident when only profile photos were rated (p > 0.05). Conclusions: The combined orthodontic and orthognathic surgery approach effectively enhances facial appearance in convex profile cases, whereas orthodontic treatment alone does not result in significant changes. These findings should be clearly communicated during patient consultations and considered in treatment planning
Facial esthetic outcome of functional followed by fixed orthodontic treatment of class II division 1 patients
No full textObjectives: To assess the perceived facial changes in class II division 1, convex profile patients treated with functional followed by fixed orthodontic appliances. Subjects and methods: The study sample consisted of 36 pairs of pre- and post-treatment photographs (frontal and profile, at rest) of 12 patients treated with activator, 12 with twin-block, and 12 controls with normal profiles, treated without functional appliances. All photographs were presented in pairs to 10 orthodontists, 10 patients, 10 parents, and 10 laypersons. Visual analog scale (VAS) ratings of changes in facial appearance were assessed. Results: The patient groups were similar in sex distributions, age, and treatment duration. The different rater groups showed strong to excellent agreement. There were no significant differences among treatment groups (F = 0.91; P = 0.526; Wilks lambda = 0.93), raters (F = 1.68; P = 0.054; Wilks lambda = 0.83), and when testing the combined effect of treatment and rater on the results (F = 0.72; P = 0.866; Wilks lambda = 0.85). The raters detected slightly more positive changes in the activator and twin-block groups, compared to the control group, regarding the lower face and the lips, but these findings did not reach significance. Furthermore, their magnitude hardly exceeded 1/20th of the total VAS length. Limitations: Retrospective study design. Conclusions: The perceived facial changes of convex profile patients treated with functional, followed by fixed orthodontic appliances, did not differ from those observed in normal profile patients, when full-face frontal and profile photos were simultaneously assessed. Consequently, professionals should be skeptical regarding the improvement of a patient’s facial appearance when this treatment option is used. © 2019, The Author(s)
