Stability of occlusal outcome during long-term retention: the time-dependent variation of the American Board of Orthodontics index

Abstract

Summary Background The aim of this retrospective cohort study was to assess long-term occlusal changes at debond and a median of 8 years afterwards (in retention) with the American Board of Orthodontics (ABO) objective grading system and identify risk factors. Materials and method Fifty patients (median age: 14.3 years at debond; 60% female) treated with fixed appliances (25 with and 25 without premolar extractions) were included. The occlusal outcome was assessed with the ABO tool and analyzed statistically at 5%. Results Extraction treatment was associated with better occlusal outcome than non-extraction treatment (34.2 versus 40.9 points; P = 0.009). In retention, ABO scores improved by 7.4 points, while patients with worse debond finishing improved more afterwards (P = 0.001). Alignment/rotations deteriorated in 58% of the cases and occlusal relationships in 38% of the cases. Marginal ridges improved more for extraction than non-extraction patients (28% versus 0%; P = 0.001). Occlusal relationships improved more for cases that ‘passed’ the ABO requirements at debond than failed cases (64% versus 28%; P = 0.02). Furthermore, patients with worse debond ABO scores were more likely to deteriorate at alignment/rotations in retention. Finally, the proportion of cases passing the ABO requirements improved considerably between debond (28%) and in retention (54%) as half (47%) of the cases that had failed the ABO requirements at debond passed them in retention. Conclusions Considerable long-term occlusal changes are seen post-debond, which mostly favour improved settling. Extraction treatment and higher finishing quality at debond significantly influenced the chance for improvement. However, setting a cut-off score to denote treatment excellence showed considerable instability through time.

Incisor and profile alterations in extraction cases treated with standard Edgewise and pre-adjusted appliances: A controlled before-and-after study

“…Included patients in this study complied with the following patient eligibility criteria: (1) any age, sex, ethnicity, race, or Angle's molar classification; (2) full complement of teeth excluding the third molars; (3) no prior orthodontic therapy; (4) no dentofacial deformities and clefts; and (5) complete pre-and post-treatment data. In addition, they fulfilled the following treatment-related inclusion criteria: (1) comprehensive treatment with labial fixed appliances in both arches; (2) bilateral extraction of upper first or second premolars (with/without extraction of lower premolars); (3) retraction during treatment of the upper incisors as seen through superimposition of lateral cephalograms on the nasal line; (4) no temporary anchorage devices; (5) no orthognathic surgery; (6) no dental trauma; and (7) no impacted canines. Patients from the two university clinics were selected randomly from the archives of patients treated by postgraduate orthodontic residents in the past 10 years under the direct supervision of university faculty and presented in the orthodontic specialization boards of each country.…”

“…For example, finishing orthodontic treatment to an ideal occlusal standard, as proposed by the American Board of Orthodontists (ABO) [2] , seems to be associated with a more balanced activation of anterior tempo-ralis muscle and improved patient-reported chewing ability compared with worse finished occlusions [3] . In addition, long-term changes in the occlusion of orthodontically treated patients seem to be more favorable in terms of improved settling and reduced tendency for anterior crowding relapse [4] as the finishing quality of orthodontic treatment increases [5] . Such evidence highlights the importance that well-finished postorthodontic occlusion plays and the care with which orthodontists should strive to achieve optimal results.…”

Occlusal outcome after orthodontic treatment with preadjusted straight-wire and standard edgewise appliances

“…Furthermore, clinical data indicated that treatment outcomes fulfilling the standards of the ABO-OGS led to a balanced anterior temporalis activation and improved chewing function as reported by patients [ 19 ]. Finally, ABO-OGS is able to detect fine changes that occur in the occlusion postdebonding [ 20 , 21 ] and evidence supports that better finishing quality with ABO-OGS leads to better long-term outcomes [ 22 ].…”

Finishing and detailing in straight wire orthodontics – beginning of the end

“…The total number of deductions are subtracted from 24 to give the occlusal relationships score. 23 Angst et al 24 reported significant long term changes after debonding and suggested a higher finishing quality at debonding to achieve improved settling of the occlusion.…”