Objective
To compare the three-dimensional (3-D) movement of maxillary teeth in response to three common miniscrew anchorage systems in extraction patients with maxillary dentoalveolar protrusion.
Materials and methods
The study employed a randomized controlled single-blinded design with three arms. Thirty extraction patients who required maximum anchorage to retract maxillary anterior teeth were included and randomly allocated into three treatment groups: space closure with direct miniscrew anchorage and low crimpable hooks (DL group), indirect miniscrew anchorage and low crimpable hooks (IL group), and direct miniscrew anchorage and high crimpable hooks (DH group). Cone beam computed tomography (CBCT) images of all included patients were obtained immediately before (T0) and after (T1) space closure. The outcomes were 3-D positional changes of maxillary central incisor, lateral incisor, canine, second premolar, and first molar. The repeated measures analysis of variance with post hoc LSD test was used to evaluate differences among groups.
Results
A significant intrusion (− 1.34 mm; 95% CI, − 1.60 mm, 1.08 mm) and buccal (− 6.92°; 95% CI, − 8.67°, − 5.13°) and distal (4.90°; 95% CI, 3.75°, 6.04°) inclination of the maxillary first molars were observed in the DL group, compared to the other two groups. The mesial movement (− 0.40 mm; 95% CI, − 0.83 mm, − 0.03 mm) of the maxillary first molars was found in the IL group, while the DL (0.44 mm; 95% CI, 0.15 mm, 0.73 mm) and IL (0.62 mm; 95% CI, 0.28 mm, 0.96 mm) groups exhibited distal movement. In the DH group, the lingual inclination changes of maxillary central incisor (5.04°; 95% CI, 2.82°, 7.26°) were significantly lower, which is indicative of good lingual root torque control of the maxillary anterior teeth.
Conclusion
Three miniscrew anchorage systems produced significantly different 3-D maxillary tooth movement. The maxillary first molars were significantly buccally and distally inclined and intruded in patients using direct miniscrew anchorages with low crimpable hooks. Direct miniscrew anchorages with high crimpable hooks could help to achieve better lingual root torque control of the maxillary incisors.
Trial registration The trial was registered at www.chictr.org.cn (ChiCTR1900026960). Registered 27 October 2019.
(1) Background: Asians tend to have a regressive midface. Midface augmentation is an effective treatment, and various materials have been used as fillers for this purpose. Bio-Oss bone powder has a strong positive effect on promoting new bone regeneration, and has been used in the dental field for over 30 years. However, it has not been used and reported as a filler in midface augmentation. (2) Objective: To evaluate the safety and efficacy of midface augmentation using Bio-Oss bone powder in treating midface retrusion and resulting nasolabial folds, and to develop a predictive model for patient satisfaction. (3) Methods: 85 patients underwent midface augmentation through an intraoral approach with Bio-Oss. Treatment efficacy was assessed by blinded investigators. The data on safety were collected from patient interviews at each follow-up visit. A questionnaire was used for investigating patient satisfaction. The influencing factors of satisfaction were analyzed by univariate and multivariate analysis. A nomogram to predict the risk of dissatisfaction was built based on significant factors with R software. Results: Compared to baseline, there was a significant improvement (p < 0.001) in Wrinkle Severity (4) Rating Scale scores at week 24, with a mean decrease of 0.52 ± 0.57. The aesthetic improvement rate evaluated by the Global Aesthetic Improvement Scale was 92.9%. Four mild treatment-related adverse events were noted. The majority of patients were satisfied overall. A nomogram with good prediction performance was plotted. (5) Conclusions: This new procedure yielded safe and satisfactory aesthetic results. A nomogram with good test performance and discriminative ability was established for predicting patient satisfaction.
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