Evaluation of different incisor intrusion mechanics used in orthodontic treatments

Abstract

Aim: The purpose of this study is to determine the usage prevalence of four different incisor intrusion arch mechanics used in the orthodontic treatment and to reveal the relationship of these mechanics with dental malocclusion type, treatment type, jaw applied, amount of intrusion, arch wire material and arch wire size used. Methods: A total of 403 patients, 136 Angle Class I (mean age: 15.24±2.11 years), 134 Angle Class II (mean age: 14.35±2.62 years), 133 Angle Class III (mean age: 16.12±3.01 years) patients with orthodontic treatment were included in this retrospective study. The analysis of the procedures applied to the patients during the treatment was carried out using interactive computer software used in the orthodontics clinic. In the study, the second order step, Quiros, Jarabak and intrusion added retraction arches and intrusion processes were examined. Pearson Chi-Square and Fisher's Exact tests were used for statistical evaluation of the categorical data. Results: When the relationship between preferred intrusion mechanics is evaluated according to the amount of intrusion; the most preferred mechanics for 0.5-1 mm intrusion is step bending, the most preferred mechanics for 2 mm intrusion is the Jarabak intrusion arch, and for 3 mm intrusion, Quiros and Jarabak intrusion mechanics are used in equal numbers has been determined. When the usage prevalence of intrusion mechanics applied to the lower or upper jaw was evaluated, it was determined that step bending was applied to the upper jaw statistically significantly more than other mechanics. Conclusion: The second order step bending is preferred for intrusions up to 1 mm, which is the most used intrusion amount in the clinic. A greater number of intrusions have been made in the upper jaw and 0.016 x 0.022 -inch stainless steel wire is the most preferred material for all mechanics. The amount of intrusion should be determined according to the individual characteristics of the patient, treatment objectives and aesthetic expectations.

Keywords

• Orthodontics
• Deep bite
• Intrusion

Ortodontik tedavilerde kullanılan farklı kesici diş intrüzyon mekaniklerinin değerlendirilmesi

Abstract

Amaç: Bu çalışmanın amacı, ortodontik tedavilerde kullanılan dört farklı kesici diş intrüzyon mekaniğinin kullanım yaygınlıklarının belirlenmesi ve bu mekaniklerin dental maloklüzyon tipi, ortodontik tedavi tipi, uygulandığı çene, intrüzyon miktarı ve kullanılan ark teli materyali ve boyutu ile ilişkilerinin değerlendirilmesidir. Yöntem: Retrospektif olarak gerçekleştirilen bu çalışmaya daha önceden ortodontik tedavi görmüş olan 136 Angle Sınıf I (ortalama yaş: 15.24 ± 2.11 yıl), 134 Angle Sınıf II (ortalama yaş: 14.35 ± 2.62 yıl), 133 Angle Sınıf III (ortalama yaş: 16.12 ± 3.01 yıl) molar ilişkiye sahip olan toplam 403 hasta dahil edilmiştir. Hastalara tedavi sırasında uygulanan işlemlerin analizi çalışmanın gerçekleştirildiği ortodonti kliniğinde kullanılan interaktif bilgisayar yazılımı kullanılarak gerçekleştirilmiştir. Bu yazılım kullanılarak ikinci düzen step bükümleri, Quiros intrüzyon arkı, Jarabak intrüzyon arkı ve intrüzyon ilave edilmiş retraksiyon arkları ile intrüzyon uygulanan işlemler incelenmiştir. Elde edilen kategorik verilerin istatistiksel değerlendirilmesi amacıyla Pearson Ki-Kare ve Fisher’s Exact testleri kullanılmıştır. Bulgular: İntrüzyon miktarına göre tercih edilen intrüzyon mekaniği arasındaki ilişki değerlendirildiğinde kesici dişlere 0.5 mm ve 1 mm intrüzyon uygulamak için en fazla tercih edilen seçeneğin step bükümü olduğu, 2 mm intrüzyon uygulamak için ise en fazla tercih edilen seçeneğin Jarabak intrüzyon arkı olduğu belirlenmiştir. Kesici dişlerde 3 mm intrüzyon elde etmek için kullanılan mekanikler değerlendirildiğinde Quiros ve Jarabak intrüzyon arklarının eşit sayıda kullanıldığı tespit edilmiştir. Alt veya üst çeneye uygulanan intrüzyon mekaniklerinin kullanım yaygınlığı değerlendirildiğinde step bükümünün diğer mekaniklere kıyasla üst çenede istatistiksel olarak anlamlı derecede daha fazla uygulandığı belirlenmiştir. Sonuç: Klinikte en fazla kullanılan intrüzyon miktarı olan 1 mm’ye kadar olan intrüzyonlar için ikinci düzen step bükümü tercih edilmektedir. Üst çenede daha fazla sayıda intrüzyon işlemi yapılmış olup tüm mekanikler için 0.016 x 0.022 inç boyutunda paslanmaz çelik tel en fazla tercih edilen materyaldir. İntrüzyon miktarı hastanın bireysel özelliklerine, tedavi hedeflerine ve estetik beklentilere göre belirlenmelidir.

Keywords

• Ortodonti
• Derin kapanış
• İntrüzyon

References

1. 1. Huang GJ, Bates SB, Ehlert AA, Whiting DP, Chen SS-H, Bollen A-M. Stability of deep-bite correction: A systematic review. Journal of the World Federation of Orthodontists. 2012;1(3):e89-e96.
2. 2. Proffit WR, White RP, Sarver DM. Contemporary treatment of dentofacial deformity, Chapter 1: Mosby St. Louis; 2003. 22 p.
3. 3. Gelgör İE, Karaman İA, Ercan E. Prevalence of malocclusion among adolescents in central anatolia. European Journal of Dentistry. 2007;1(03):125-131.
4. 4. Lewis P. Correction of deep anterior overbite A report of three cases. American Journal of Orthodontics and Dentofacial Orthopedics. 1987;91(4):342-345.
5. 5. Proffit WR, White RP, Sarver DM. Contemporary treatment of dentofacial deformity Chapter 14: Mosby St. Louis; 2003. 436 p.
6. 6. Varlık SK, Alpakan ÖO, Türköz Ç. Deepbite correction with incisor intrusion in adults: A long-term cephalometric study. American Journal of Orthodontics and Dentofacial Orthopedics. 2013;144(3):414-419.
7. 7. Burstone CJ, editor Biomechanics of deep overbite correction. Seminars in orthodontics; 2001: Elsevier.
8. 8. Nanda R, Kuhlberg A. Management of deep overbite malocclusion. Biomechanics and esthetic strategies in clinical orthodontics: Elsevier; 2005. p. 131-55.

9. 9. Şenışık NE, Türkkahraman H. Treatment effects of intrusion arches and mini-implant systems in deepbite patients. American Journal of Orthodontics and Dentofacial Orthopedics. 2012;141(6):723-733.
10. 10. Preston CB, Maggard MB, Lampasso J, Chalabi O. Long-term effectiveness of the continuous and the sectional archwire techniques in leveling the curve of Spee. American Journal of Orthodontics and Dentofacial Orthopedics. 2008;133(4):550-555.
11. 11. Nanda R. Correction of deep overbite in adults. Dental Clinics of North America. 1997;41(1):67-87.
12. 12. Öztürk T, Gül Amuk N. Methods for intrusion of anterior teeth in patients with deep bite. Turkiye Klinikleri Journal of Dental Sciences. 2020;26(1):94-103.
13. 13. Ceylan İ, Eröz ÜB. The effects of overbite on the maxillary and mandibular morphology. The Angle Orthodontist. 2001;71(2):110-115.
14. 14. Chen Y-J, Yao C-CJ, Chang H-F. Nonsurgical correction of skeletal deep overbite and class II division 2 malocclusion in an adult patient. American Journal of Orthodontics and Dentofacial Orthopedics. 2004;126(3):371-378.
15. 15. McNamara J, editor Histologic and Cephalometric Responses to Increased Vertical Dimension in Mature Face. Journal of Dental Research; 1974: Amer Assoc Dental Research 1619 Duke St, Alexandrıa, Va 22314.
16. 16. Björk A. Prediction of mandibular growth rotation. American Journal of Orthodontics. 1969;55(6):585-599.
17. 17. Ng J, Major PW, Heo G, Flores-Mir C. True incisor intrusion attained during orthodontic treatment: a systematic review and meta-analysis. American Journal of Orthodontics and Dentofacial Orthopedics. 2005;128(2):212-219.
18. 18. Batenhorst K, Bowers G, Williams Jr J. Tissue changes resulting from facial tipping and extrusion of incisors in monkeys. Journal of Periodontology. 1974;45(9):660-668.
19. 19. Steiner GG, Pearson J, Ainamo J. Changes of the marginal periodontium as a result of labial tooth movement in monkeys. Journal of Periodontology. 1981;52(6):314-320.
20. 20. Burstone CR. Deep overbite correction by intrusion. American Journal of Orthodontics and Dentofacial Orthopedics. 1977;72(1):1-22.
21. 21. Sunita S, Nivedita S, Pritam M, Snigdha G, Baratam S, Shuvesa S. Orthodontic Intrusion: An Insight. International Journal of Oral Health and Medical Research. 2017;6(3):137-140.
22. 22. Dave ML, Sinclair PM. A comparison of the Ricketts and Tweed-type arch leveling techniques. American Journal of Orthodontics and Dentofacial Orthopedics. 1989;95(1):72-78.
23. 23. Dermaut LR, Bulcke MMV. Evaluation of intrusive mechanics of the type “segmented arch” on a macerated human skull using the laser reflection technique and holographic interferometry. American Journal of Orthodontics. 1986;89(3):251-263.
24. 24. Jarabak JR, Fizzell JA. Technique and treatment with light-wire edgewise applications. 1: Mosby; 1972.
25. 25. Quiros OJ. ed. Ortodoncia nueva generación. Caracas: Amolca; Venezuela. 2003: 290-300.
26. 26. Nanda R, Marzban R, Kuhlberg A. The Connecticut intrusion arch. Journal of Clinical Orthodontics. 1998;32(12):708-715.
27. 27. RM R. Dr. Robert M. Ricketts on early treatment (part 2). Journal of Clinical Orthodontics. 1979;13(1):23-38.
28. 28. Martins DR, Tibola D, Janson G, Torres Maria FR. Effects of intrusion combined with anterior retraction on apical root resorption. The European Journal of Orthodontics. 2012;34(2):170-175.
29. 29. Ülger G, Arun T, Sayınsu K, Isik F. The role of cervical headgear and lower utility arch in the control of the vertical dimension. American Journal of Orthodontics and Dentofacial Orthopedics. 2006;130(4):492-501.
30. 30. Ülgen M. Ortodontik tedavi prensipleri. 1993:ss.352-371.
31. 31. Yanez EE. 1001 Tips for orthodontics and it’s secrets, Chapter 4. Amolca Publishing; 2013.
32. 32. Tosun Y. Sabit Ortodontik Apareylerin Biyomekanik Prensipleri, Bölüm 2. Ege Üniversitesi Basımevi. 1999.
33. 33. Dentarium. Orthodontics Catalogue 2016/2017. 447 p.
34. 34. El-Dawlatly MM, Fayed MMS, Mostafa YA. Deep overbite malocclusion: analysis of the underlying components. American Journal of Orthodontics and Dentofacial Orthopedics. 2012;142(4):473-480.