{"title":"Treatment acceptance in adult patients with anterior open bite: A National Dental Practice-Based Research Network study","authors":"","doi":"10.1016/j.ajodo.2024.06.007","DOIUrl":"10.1016/j.ajodo.2024.06.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Orthodontists have many techniques to treat anterior open bites<span> and must involve patients in making treatment decisions. This study aimed to investigate orthodontic treatment plan acceptance by United States adults with anterior open bites and to identify associations between treatment acceptance and patient demographics and dentofacial characteristics.</span></div></div><div><h3>Methods</h3><div><span>A prospective, observational cohort study enrolled the patients of 91 orthodontic providers. A total of 345 adults were included in the sample. Provider personal and practice demographics were captured. Patient demographics, treatment goals, dentofacial characteristics, and reasons for not accepting the recommended plans were recorded. Adjusted regression models were used to identify associations between </span>patient characteristics and the likelihood of accepting the most highly recommended plan.</div></div><div><h3>Results</h3><div>Approximately 78% of patients accepted the most highly recommended treatment plan. 60% of the patients who were recommended surgical plans accepted them. Patients with a history of orthodontics and a concave profile were more likely to accept the most highly recommended plan. Insurance coverage for orthognathic surgery was associated with a higher acceptance rate for surgery. Severe crowding was associated with a lower acceptance of surgery. The most common reasons for declining the recommended plan were not wanting jaw surgery and considering the treatment to be too invasive, risky, and/or costly.</div></div><div><h3>Conclusions</h3><div>Patient acceptance is less common at higher levels of invasiveness of treatment. Prior orthodontic treatment, concave profile, and insurance coverage for surgery were associated with accepting treatment. Most patients accepted a surgical plan when it was the most recommended option.</div></div>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Does planned molar intrusion with aligners assist with closure of anterior open bite?","authors":"","doi":"10.1016/j.ajodo.2024.04.016","DOIUrl":"10.1016/j.ajodo.2024.04.016","url":null,"abstract":"<div><h3>Introduction</h3><div><span>This study aimed to determine whether prescribed molar intrusion, with or without virtual occlusal bite-blocks (BB), resulted in actual molar intrusion and assisted with anterior </span>open bite<span> (AOB) correction in adult patients treated with Invisalign clear aligners (Align Technology, Santa Clara, Calif).</span></div></div><div><h3>Methods</h3><div><span><span><span>A retrospective study was conducted with 36 adult patients with AOB. Subjects were divided into 2 treatment groups: planned molar intrusion (PMI) and no-PMI (No-PMI). PMI was obtained from the tooth movement tables in the ClinCheck software. Patients with PMI were further categorized by the presence or absence of virtual posterior BB (PMI-BB and PMI-No BB, respectively). Treatment success was determined on the basis of positive vertical </span>incisor overlap in posttreatment </span>cephalograms<span>. Treatment changes were assessed using pretreatment and posttreatment cephalometric radiographs (Welch 2-sample </span></span><em>t</em> test, 95% confidence interval, <em>P =</em> 0.05). Finally, treatment stability was assessed at least 1-year posttreatment using the Photographic Open Bite Severity Index (POSI).</div></div><div><h3>Results</h3><div>There were 15 patients with No-PMI and 21 without PMI (total n = 36). The mean overbite change was 2.5 ± 1.0 mm for No-PMI and 3.2 ± 1.8 mm for patients with PMI (<em>P =</em> 0.12). All patients had positive vertical incisor overlap in posttreatment cephalograms, indicating 100% treatment success. Open bites were corrected primarily by incisor retroclination and extrusion in both treatment groups. The average measured molar intrusion for the PMI group was 0.71 mm greater than the change for the No-PMI group, but the difference was not statistically significant after controlling for potentially confounding variables (<em>P =</em> 0.074). A total of 14 patients from the original sample were assessed for stability using the POSI analysis. Of those, 12 (85.7%) had a POSI score of 0.</div></div><div><h3>Conclusions</h3><div>Regardless of whether the molar intrusion was planned or not, the modality of AOB correction with Invisalign clear aligners was primarily incisor extrusion and retroclination. Overall, aligners are an effective appliance for the treatment of adult AOB. Based on our limited sample, treatment stability was similar to that reported for fixed appliances.</div></div>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141545517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Concerns about the conclusion that clear aligner mandibular advancement provides better vertical control in growing patients with Class II","authors":"","doi":"10.1016/j.ajodo.2024.07.012","DOIUrl":"10.1016/j.ajodo.2024.07.012","url":null,"abstract":"","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Directory: AAO Officers and Organizations","authors":"","doi":"10.1016/S0889-5406(24)00376-7","DOIUrl":"10.1016/S0889-5406(24)00376-7","url":null,"abstract":"","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Patients’ perceptions matter: Risk communication and psychosocial factors in orthodontics","authors":"","doi":"10.1016/j.ajodo.2024.06.011","DOIUrl":"10.1016/j.ajodo.2024.06.011","url":null,"abstract":"<div><h3>Introduction</h3><div><span>Effective risk communication is essential for achieving patient-centered oral health care, but the limited understanding of patients’ subjective perceptions of orthodontic-related risks hinders this process. This study aimed to investigate adults’ awareness, concerns, and risk-avoidance behaviors about long-term </span>orthodontic<span> risks, exploring their relationship with psychosocial factors.</span></div></div><div><h3>Methods</h3><div><span>We included 498 adult patients (mean age, 27.3 ± 6.8 years; women, 75.5%) during their initial visits to the orthodontic department at a hospital in Chengdu, China. Participants’ understanding of orthodontic risks was gauged before and after exposure to the Oral Health Education Comics (OHEC), a specifically designed digital tool. Concurrently, we used logistic regression models to investigate the associations between patients’ depression, anxiety, self-esteem, </span>perfectionism, and dentofacial esthetics with risk perceptions.</div></div><div><h3>Results</h3><div><span>Approximately 79.5% of participants initially reported low awareness of orthodontic risks, with most knowledge from online sources. Notably, the percentage of participants with high awareness increased to 64.8% after OHEC. The negative facial soft-tissue change was most concerning for participants: 53.4% showed high concerns, and 28.1% showed high avoidance. Furthermore, linear regression indicated positive associations between depression (</span><em>β</em> = 0.42 [95% confidence interval {CI}, 0.07-0.77]) and anxiety (<em>β</em> = 0.76 [95% CI, 0.35-1.18]) with orthodontic risk concerns, whereas risk avoidance was positively associated with depression (<em>β</em> = 0.62 [95% CI, 0.27-0.97]), anxiety (<em>β</em> = 1.09 [95% CI, 0.68-1.50]), and perfectionism (<em>β</em> = 0.24 [95% CI, 0.02-0.46]).</div></div><div><h3>Conclusions</h3><div>Findings emphasize the imperative of streamlined risk communication in orthodontics. By incorporating comprehensible tools such as OHEC and integrating psychosocial evaluations, more refined patient-practitioner communication and psychosomatic-based dental care can be achieved.</div></div>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The American Board of Orthodontics: A brief history and update of the orthodontic certification process","authors":"","doi":"10.1016/j.ajodo.2024.07.001","DOIUrl":"10.1016/j.ajodo.2024.07.001","url":null,"abstract":"<div><div>The American Board of Orthodontics (ABO) has updated its clinical examination process to remove barriers to the case-based examination and to distinguish board-certified orthodontists from uncertified dental practitioners who provide orthodontic care. In 2017, the ABO took the bold step of adopting a new clinical examination format (a scenario-based examination), thereby, addressing the challenges that were inherent in the former case-based examination format. The coronavirus disease 2019 pandemic forced the scenario-based clinical examination scheduled for July 2020 to be canceled. This caused the ABO to regroup and adapt the scenario-based clinical examination to a format that could be administered worldwide in a testing center environment, eliminating the need to travel to St Louis, Missouri. The ABO-written examination remained unaltered.</div><div>Since the scenario-based format was adopted, 63% of the AAO members are now board-certified, and the trend is upward. In support of our mission to elevate the quality of orthodontics through certification, education, and professional collaboration, the ABO is responsible for certifying orthodontists in a fair, reliable, and valid manner. This requires continuous evaluation and review of our certification process to ensure that our examination reliably evaluates the ability of orthodontists to provide the highest level of patient care.</div></div>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How environmentally friendly is the disposal of clear aligners? A gas chromatography-mass spectrometry study.","authors":"Elbe Peter, J Monisha, V P Sylas, Suja Ani George","doi":"10.1016/j.ajodo.2024.08.011","DOIUrl":"https://doi.org/10.1016/j.ajodo.2024.08.011","url":null,"abstract":"<p><strong>Introduction: </strong>Used clear aligner trays are often indiscriminately disposed of with general plastic waste and incinerated. This study aimed to analyze the smoke composition from incinerating 2 common aligner materials: glycol-modified polyethylene terephthalate (PET-G) and polyurethane.</p><p><strong>Methods: </strong>Each of the 2 materials in triplets was thermoformed. The thermoformed trays were shredded and subjected individually to open-fire combustion, ignited using a methane torch, in a specially designed combustion chamber. The resultant smoke was collected and analyzed using gas chromatography-mass spectrometry to study its in-depth composition.</p><p><strong>Results: </strong>A total of 20 peaks, corresponding to 20 compounds, were identified from each of the 2 material samples. O-xylene (21.06%) showed the maximum concentration in the PET-G sample, whereas 1,4-dimethyl-1,3-cyclohexadiene in polyurethane (18.88%). The first peak in the PET-G sample corresponded to benzene with a relative concentration of 5.18%. Four compounds were common to both samples: 1,4-dimethyl-1,3-cyclohexadiene; 1,3-cyclohexadiene, 2,3-dimethyl-; 1-hydroxymethly-4-methylenecyclohexane; and cyclohexanemethanol, 4-methylene-.</p><p><strong>Conclusions: </strong>Benzene, a group 1 carcinogen, was identified in the PET-G smoke sample, whereas tetrahydrofuran, a suspected carcinogen, was found in the polyurethane sample. Some compounds were hazardous, whereas most were skin, eye, and respiratory irritants. Possible mitigation strategies include proper case selection, efficient manufacturing, direct 3-dimensional printing, and developing biodegradable materials. Clinicians can set up 'used aligner collection points' to ensure responsible disposal. Proper disposal guidelines and stringent regulations are the need of the hour.</p>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A card laid is a card played","authors":"","doi":"10.1016/j.ajodo.2024.07.004","DOIUrl":"10.1016/j.ajodo.2024.07.004","url":null,"abstract":"","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"October 2024","authors":"","doi":"10.1016/j.ajodo.2024.08.004","DOIUrl":"10.1016/j.ajodo.2024.08.004","url":null,"abstract":"","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effects of curing lights on polymerization shrinkage of composite attachments in clear aligner treatment: A microcomputed tomography study.","authors":"Irmak Ocak, Muge Aksu","doi":"10.1016/j.ajodo.2024.08.012","DOIUrl":"https://doi.org/10.1016/j.ajodo.2024.08.012","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate the polymerization shrinkage of composite attachments and changes in attachment templates during bonding in clear aligner treatments.</p><p><strong>Methods: </strong>A total of 24 extracted teeth were divided into 4 groups, and plaster models were digitized. Attachment templates were produced with beveled attachments on premolars and rectangular attachments on molars. Polymerizations used a halogen curing light (800 milliwatts per square centimeter [mW/cm<sup>2</sup>] for 20 seconds) and light-emitting diode (LED) curing light in 3 modes (1000 mW/cm<sup>2</sup> for 20 seconds, 1000 mW/cm<sup>2</sup> for 10 seconds, and 3200 mW/cm<sup>2</sup> for 3 seconds). The curing distance was 5 mm, and temperature changes were recorded with a thermal camera. Microcomputed tomography scanning measured volumetric and linear attachments before and after polymerization. Statistical analyses employed a 1-way analysis of variance with Bonferroni corrected Tukey post-hoc for multiple comparisons and the Kruskal-Wallis test for temperature change.</p><p><strong>Results: </strong>Significant differences (P <0.001) were found in temperature among curing lights. The highest temperature was in the LED unit-extra mode, and the lowest was in the halogen curing unit. The LED unit for 20 seconds caused the highest temperature change. A significant difference (P = 0.048) in occlusal attachment length was found between the LED unit for 20 seconds and the LED unit-extra mode. Polymerization resulted in increased attachment template thickness across all groups, with significant changes noted in the halogen unit, LED unit for 20 seconds, and LED unit-extra mode.</p><p><strong>Conclusions: </strong>Temperature generated during polymerization varied between halogen and LED curing lights. Significant differences were found in attachment length at the occlusal level and template thickness postpolymerization. Preferences in attachment bonding protocols may affect the clinical precision of clear aligner treatments.</p>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}