Browsing School, Graduate by Subject "Malocclusion"
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Dental and Skeletal Changes seen on CBCT with Damon Self-ligating Bracket System vs. Conventional Bracket SystemIntroduction: This research investigated changes in arch width and arch length through a CBCT analysis of patients treated with either Damon or Conventional brackets. Methods: Pre-treatment and post-alignment CBCT files were collected for borderline extraction patients treated through non-extraction therapy (17 Damon, 13 Conventional). Measurements were made for the canine, premolars, and first molars to evaluate dental arch width (inter-occlusal dimension: IOD, inter-apical dimension: IAD), skeletal arch width (inter-buccal/lingual alveolar crests: IBACD, ILACD), angulation, and arch length changes. Results: IOD increased for all teeth, with similar overall expansion in both groups. Damon cases showed tipping of all teeth except the mandibular canine. The arch length increased for both treatment modalities in both jaws. IBACD decreased for teeth, which translated. Conclusion: The claim that moderate to severe crowding can be resolved through translation of the posterior dentition without AP expansion of the dental arch was not supported by this study.
An In-Depth Analysis of Borderline Class I Malocclusions in Caucasian Patients at the University of MarylandProblem: To determine if a group of experienced clinicians determines there to be equal numbers of extraction and nonextraction treatments planned when evaluating borderline Class I malocclusions in Caucasian patients, and second, to determine the variables that are most important in the diagnosis and evidence-based treatment planning of these cases. Methods: All Caucasian patients treated in the University of Maryland, Baltimore Orthodontic Graduate Clinic having completed initial orthodontic records over a three-year period were evaluated for the presence of a borderline Class I Malocclusion. Of the initial 180 subjects, 15 were statistically determined to be borderline and were subsequently subjected to analysis by 11 orthodontic faculty members. The cases were then evaluated for those variables determined to be indicative of borderline Class I malocclusions in Caucasian patients based on stepwise forward logistic regression. Results: There was no significant difference between the treatment plan recommended and the 50/50 treatment expected for borderline cases (X2=0.055, p = 0.8153), although extraction treatment was slightly more likely to be chosen by those surveyed (50.9%) than non-extraction treatment (49.1%). As determined through logistic regression, the four most significant variables were the mandibular intercanine measurement and maxillary crowding, (both study model variables), followed by the cephalometric Z-angle and the upper lip to E-plane measurement. Conclusions: The results of the first stage of this study, which evaluated the percentage of extraction and non-extraction cases planned by faculty members when evaluating borderline Class I malocclusions in Caucasian patients, found that there was no significant difference in the percentage of extraction and non- extraction treatments planned The most common extraction pattern was the extraction of all four first bicuspids (44.1%). The results of the second stage of the study identified cephalometric and study model variables that were indicators of borderline Class I malocclusions in Caucasian patients. The four variables with the highest B value significance levels were identified through logistic regression to be the mandibular intercanine width and maxillary arch crowding, followed by the Z-angle and the upper lip to E-plane measurement.
The Effect of Malocclusion Severity and Treatment Duration on Patient Satisfaction with Clear Aligner TherapyObjective: Determine if a patient’s initial malocclusion and treatment duration influenced satisfaction with clear aligner (Invisalign®) therapy. Methods: Thirty-three orthodontic patients treated with clear aligners responded to a satisfaction questionnaire containing twenty-one questions relating to their satisfaction with treatment, approximately two years after completing treatment. Overjet, overbite, and maxillary and mandibular anterior crowding/spacing were measured to determine the initial severity of their malocclusion. Logistic regression analyses with satisfaction factors as the dependent variable were used to quantify associations between patient satisfaction regarding both the initial severity of malocclusion and treatment duration. Results: Overall, patients were satisfied with aligner treatment. However, no significant associations were observed between patient satisfaction and either the initial severity of the malocclusion or treatment duration. Conclusion: The current study does not find that initial malocclusion or treatment duration significantly affects patient satisfaction. Patient satisfaction with clear aligner therapy is generally very high, and multi-factorial.