Comparison of treatment outcomes between skeletal anchorage and extraoral anchorage in adults with maxillary dentoalveolar protrusion

Yao, Chung-Chen Jane; Lai, Eddie Hsiang-Hua; Chang, Jenny Zwei-Chieng; Chen, Ing; Chen, Yi-Jane

doi:10.1016/j.ajodo.2006.12.022

Cited by 118 publications

(108 citation statements)

References 15 publications

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“…[1][2][3][4] Typical orthodontic treatment includes extraction of the bimaxillary premolars and anterior tooth retraction, with maximum anchorage achieved through the placement of miniscrews, which enable the practitioners to achieve maximum anterior tooth retraction without undesirable movements of the posterior teeth. Despite the fact that the relationship between maximum anchorage and tooth displacement is well recognized, 5,6 retrospective upper airway analysis after retraction of the large incisors remains to be established. The upper airway plays an important role in respiration, swallowing, and pronunciation.…”

Section: Introductionmentioning

confidence: 99%

Effect of large incisor retraction on upper airway morphology in adult bimaxillary protrusion patients

Chen

Liu

Wang

et al. 2012

The Angle Orthodontist

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Objective: To evaluate, using multislice computed tomography (MSCT), the morphologic changes in the upper airway after large incisor retraction in adult bimaxillary protrusion patients. Materials and Methods: Thirty adult patients with bimaxillary protrusion had four first premolars extracted, and then miniscrews were placed to provide anchorage. A CT scan was performed before incisor retraction and again posttreatment. Three-dimensional (3D) reconstruction of the pre-(T1) and post-(T2) CT data was used to assess for morphological changes of the upper airway. A paired t-test was used to compare changes from T1 to T2. The relationship among the three variables (upper incisor retraction amount, upper airway size, and hyoid position) was analyzed by Pearson correlation coefficient. Results: The amounts of upper incisor retraction at the incisal edge and apex were 7.64 6 1.68 mm and 3.91 6 2.10 mm, respectively. The hyoid was retracted 2.96 6 0.54 mm and 9.87 6 2.92 mm, respectively, in the horizontal and vertical directions. No significant difference was observed in the mean cross-sectional area of the nasopharynx (P . .05) between T1 and T2, while significant differences between T1 and T2 were found in the mean cross-sectional areas of the palatopharynx, glossopharynx, and hypopharynx (P , .05); these mean cross-sectional areas were decreased by 21.02% 6 7.89%, 25.18% 6 13.51%, and 38.19% 6 5.51%, respectively. The largest change in the cross-sectional area is always noted in the hypopharynx. There was a significant correlation among the retraction distance of the upper incisor at its edge, the retraction distance of the hyoid in the horizontal direction, and the decrease of the hypopharynx. Conclusion: Large incisor retraction leads to narrowing of the upper airway in adult bimaxillary protrusion patients. (Angle Orthod. 2012;82:964-970.)

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Section: Introductionmentioning

confidence: 99%

Effect of large incisor retraction on upper airway morphology in adult bimaxillary protrusion patients

Chen

Liu

Wang

et al. 2012

The Angle Orthodontist

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“…However, little is known about alveolar bone adaptation during incisor retraction and intrusion, especially in adult patients with maximum anchorage. Despite the fact that the relationship between maximum anchorage and tooth displacement has been well-recognized Yao et al, 2008;Liu et al, 2011), retrospective alveolar bone loss assessment remains to be established. Meikle (1980) and Fuhrmann (1996;2002) discovered that retraction of the upper anterior tooth might induce dehiscence, even fenestration in the cortical plate.…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional evaluation of upper anterior alveolar bone dehiscence after incisor retraction and intrusion in adult patients with bimaxillary protrusion malocclusion

Guo

Zhang

Liu

et al. 2011

J. Zhejiang Univ. Sci. B

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Abstract:Objective: The purpose of this study was to evaluate three-dimensional (3D) dehiscence of upper anterior alveolar bone during incisor retraction and intrusion in adult patients with maximum anchorage. Methods: Twenty adult patients with bimaxillary dentoalveolar protrusion had the four first premolars extracted. Miniscrews were placed to provide maximum anchorage for upper incisor retraction and intrusion. A computed tomography (CT) scan was performed after placement of the miniscrews and treatment. The 3D reconstructions of pre-and post-CT data were used to assess the dehiscence of upper anterior alveolar bone. Results: The amounts of upper incisor retraction at the edge and apex were (7.64±1.68) and (3.91±2.10) mm, respectively, and (1.34±0.74) mm of upper central incisor intrusion. Upper alveolar bone height losses at labial alveolar ridge crest (LAC) and palatal alveolar ridge crest (PAC) were 0.543 and 2.612 mm, respectively, and the percentages were (6.49±3.54)% and (27.42±9.77)%, respectively. The shape deformations of LAC-labial cortex bending point (LBP) and PAC-palatal cortex bending point (PBP) were (15.37±5.20)° and (6.43±3.27)°, respectively. Conclusions: Thus, for adult patients with bimaxillary protrusion, mechanobiological response of anterior alveolus should be taken into account during incisor retraction and intrusion. Pursuit of maximum anchorage might lead to upper anterior alveolar bone loss.

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“…Although theoretically this makes sense, some studies have shown mesialization of the anchorage unit. 3,4 In contrast, other studies have suggested distalization of the posterior anchorage unit, which may or may not be favorable. 5,6 Lastly, intrusion of the anterior segment often occurs during retraction with skeletal-based anchorage.…”

Section: Introductionmentioning

confidence: 96%

Initial forces experienced by the anterior and posterior teeth during dental-anchored or skeletal-anchored en masse retraction in vitro

Lee

Heo

El‐Bialy

et al. 2016

The Angle Orthodontist

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Objective: To investigate initial forces acting on teeth around the arch during en masse retraction using an in vitro Orthodontic SIMulator (OSIM). Materials and Methods: The OSIM was used to represent the full maxillary arch in a case wherein both first premolars had been extracted. Dental and skeletal anchorage to a posted archwire and skeletal anchorage to a 10-mm power arm were all simulated. A 0.019 3 0.025-inch stainless steel archwire was used in all cases, and 15-mm light nickel-titanium springs were activated to approximately 150 g on both sides of the arch. A sample size of n¼40 springs were tested for each of the three groups. Multivariate analysis of variance (a ¼ 0.05) was used to determine differences between treatment groups. Results: In the anterior segment, it was found that skeletal anchorage with power arms generated the largest retraction force (P , .001). The largest vertical forces on the unit were generated using skeletal anchorage, followed by skeletal anchorage with power arms, and finally dental anchorage. Power arms were found to generate larger intrusive forces on the lateral incisors and extrusive forces on the canines than on other groups. For the posterior anchorage unit, dental anchorage generated the largest protraction and palatal forces. Negligible forces were measured for both skeletal anchorage groups. Vertical forces on the posterior unit were minimal in all cases (,0.1 N). Conclusions: All retraction methods produced sufficient forces to retract the anterior teeth during en masse retraction. Skeletal anchorage reduced forces on the posterior teeth but introduced greater vertical forces on the anterior teeth. (Angle Orthod. 2017;87:549-555)

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Comparison of treatment outcomes between skeletal anchorage and extraoral anchorage in adults with maxillary dentoalveolar protrusion

Cited by 118 publications

References 15 publications

Effect of large incisor retraction on upper airway morphology in adult bimaxillary protrusion patients

Effect of large incisor retraction on upper airway morphology in adult bimaxillary protrusion patients

Three-dimensional evaluation of upper anterior alveolar bone dehiscence after incisor retraction and intrusion in adult patients with bimaxillary protrusion malocclusion

Initial forces experienced by the anterior and posterior teeth during dental-anchored or skeletal-anchored en masse retraction in vitro

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