Three-dimensional evaluation of maxillary molar distalization with skeletal anchorage

Detalhes bibliográficos
Autor(a) principal: Souza, Lorena Vilanova Freitas de
Data de Publicação: 2020
Tipo de documento: Tese
Idioma: eng
Título da fonte: Biblioteca Digital de Teses e Dissertações da USP
Texto Completo: https://www.teses.usp.br/teses/disponiveis/25/25144/tde-25102021-182737/
Resumo: Introduction: This study aimed to evaluate the changes after maxillary molar distalization with direct skeletal anchorage, based on cephalometric superimposition of digital dental models evaluations and finite element analysis (FEA). Methods: The sample included 23 patients (9 males, 11 females; mean age 13.21 ±1.54 years) treated with the miniscrew anchored Cantilever and 26 patients treated by the First Class skeletally anchored First Class. Lateral cephalograms before and after molar distalization were evaluated with the Dolphin software. Superimposition of digital dental models using an open-source software was performed in Cantilever sample. FEA was performed to comparisons between buccal and palatal distalizing methods with skeletal anchorage. Results: In Cantilever sample, all maxillary teeth showed distal movement and palatal (incisors) or distal (posterior teeth) angulation showing statistically significance for the maxillary first premolar and maxillary first and second molars. The vertical changes were minimal. The first and second molars showed crown distal rotation of 19.31 ± 5.71º and 10.17 ± 3.84º, respectively. There was increase in intermolar distance. When Cantilever with direct skeletal anchorage was compared to First Class with indirect anchorage, the maxillary incisor showed palatal inclination (0.75 ± 2.57º) in the Cantilever group, and labial inclination (2.85 ± 3.53º) and protrusion (1.41 ± 1.40mm) in the First Class group. The maxillary first premolar showed distal angulation (4.15 ± 4.87º) and distal movement (1.09 ± 1.54mm) in the Cantilever group and mesial angulation (11.20 ± 24.19º) and mesial movement (2.62 ± 2.08mm) in the First Class group. Regarding FEA, tipping movements were predominant in first and second molars with both modalities, due to the higher displacements values at coronal levels than at apical regions. In the palatal appliance the palatal root showed slight greater displacement than in cantilever appliance, especially regarding distal movement. Conclusions: The miniscrew anchored cantilever was effective for maxillary molar distalization with minimal side effects. Three-dimensional displacement was observed for all teeth. Distal movement was progressively greater from anterior to posterior teeth. Both Cantilever and First Class appliances corrected the Class II molar relationship with similar molar distal angulation. Indirect anchorage does not provide absence of anchorage loss. The FEA showed predominantly tipping movements in both distalization methods and the von mises stress showed different patterns between appliances.
id USP_977bba975c96ec8bf8e349af4d43c784
oai_identifier_str oai:teses.usp.br:tde-25102021-182737
network_acronym_str USP
network_name_str Biblioteca Digital de Teses e Dissertações da USP
repository_id_str 2721
spelling Three-dimensional evaluation of maxillary molar distalization with skeletal anchorageAvaliação tridimensional da distalização de molares superiores com ancoragem esqueléticaAngle Class II MalocclusionAparelhos ortodônticosCefalometriaCephalometryDental modelsMá oclusão de Classe IIModelos dentáriosOrthodontic appliancesIntroduction: This study aimed to evaluate the changes after maxillary molar distalization with direct skeletal anchorage, based on cephalometric superimposition of digital dental models evaluations and finite element analysis (FEA). Methods: The sample included 23 patients (9 males, 11 females; mean age 13.21 ±1.54 years) treated with the miniscrew anchored Cantilever and 26 patients treated by the First Class skeletally anchored First Class. Lateral cephalograms before and after molar distalization were evaluated with the Dolphin software. Superimposition of digital dental models using an open-source software was performed in Cantilever sample. FEA was performed to comparisons between buccal and palatal distalizing methods with skeletal anchorage. Results: In Cantilever sample, all maxillary teeth showed distal movement and palatal (incisors) or distal (posterior teeth) angulation showing statistically significance for the maxillary first premolar and maxillary first and second molars. The vertical changes were minimal. The first and second molars showed crown distal rotation of 19.31 ± 5.71º and 10.17 ± 3.84º, respectively. There was increase in intermolar distance. When Cantilever with direct skeletal anchorage was compared to First Class with indirect anchorage, the maxillary incisor showed palatal inclination (0.75 ± 2.57º) in the Cantilever group, and labial inclination (2.85 ± 3.53º) and protrusion (1.41 ± 1.40mm) in the First Class group. The maxillary first premolar showed distal angulation (4.15 ± 4.87º) and distal movement (1.09 ± 1.54mm) in the Cantilever group and mesial angulation (11.20 ± 24.19º) and mesial movement (2.62 ± 2.08mm) in the First Class group. Regarding FEA, tipping movements were predominant in first and second molars with both modalities, due to the higher displacements values at coronal levels than at apical regions. In the palatal appliance the palatal root showed slight greater displacement than in cantilever appliance, especially regarding distal movement. Conclusions: The miniscrew anchored cantilever was effective for maxillary molar distalization with minimal side effects. Three-dimensional displacement was observed for all teeth. Distal movement was progressively greater from anterior to posterior teeth. Both Cantilever and First Class appliances corrected the Class II molar relationship with similar molar distal angulation. Indirect anchorage does not provide absence of anchorage loss. The FEA showed predominantly tipping movements in both distalization methods and the von mises stress showed different patterns between appliances.Introdução: Este estudo teve como objetivo avaliar as alterações após distalização dos molares superiores com ancoragem esquelética direta, a partir da avaliação cefalométrica e de modelos digitais e da análise de elementos finitos (AEF). Métodos: A amostra incluiu 23 pacientes (9 homens, 11 mulheres; idade média de 13,21 ± 1,54 anos) tratados com o Cantilever ancorado diretamente em mini-implante e 26 pacientes tratados com aparelho First Class com ancoragem esquelética indireta. Telerradiografias laterais foram avaliadas antes e após a distalização do molar com o software Dolphin Imaging. A sobreposição de modelos digitais utilizando um software aberto foi realizada na amostra do Cantilever. A AEF foi realizada para comparações entre os métodos de distalização por vestibular e por palatino, ambos com ancoragem esquelética. Resultados: Na amostra do Cantilever, todos os dentes superiores apresentaram movimento distal e inclinação para palatino (incisivos) ou mesioangulação (dentes posteriores), sendo estatisticamente significante a alteração ocorrida no primeiro pré-molar superior e no primeiro e segundo molar superior. As mudanças verticais foram mínimas. O primeiro e o segundo molares apresentaram rotação vestibulodistal da coroa de 19,31 ± 5,71º e 10,17 ± 3,84º, respectivamente. Houve aumento da distância intermolar. Quando o Cantilever com ancoragem esquelética direta foi comparado ao First Class ancoragem indireta, o incisivo superior apresentou inclinação palatalina (0,75 ± 2,57º) no grupo Cantilever, e inclinação vestibular (2,85 ± 3,53º) e protrusão (1,41 ± 1,40 mm) no grupo do First Class. O primeiro pré-molar superior apresentou angulação distal (4,15 ± 4,87º) e movimento distal (1,09 ± 1,54mm) no grupo Cantilever e angulação mesial (11,20 ± 24,19º) e movimento mesial (2,62 ± 2,08mm) no grupo do First Class. Em relação à AEF, os movimentos de inclinação foram predominantes no primeiro e no segundo molar em ambos os métodos de distalização, uma vez que maiores valores de deslocamento foram encontrados no nível coronal que nas regiões apicais. No aparelho de distalização por palatino, a raiz palatina apresentou deslocamento ligeiramente maior do que no aparelho por vestibular, principalmente em relação ao movimento distal. Conclusões: O Cantilever ancorado a mini-implante foi eficaz para a distalização dos molares superiores com poucos efeitos colaterais. Deslocamento tridimensional foi observado para todos os dentes após distalização. O movimento distal foi progressivamente maior dos dentes anteriores para os posteriores. Os aparelhos Cantilever e First Class corrigiram a relação molar de Classe II com angulação distal molar semelhante, porém ancoragem indireta não promove absoluta ancoragem. A AEF mostrou movimentos predominantemente de inclinação nos dois métodos de distalização e o Von Misses Stress mostrou padrões diferentes entre os aparelhos.Biblioteca Digitais de Teses e Dissertações da USPHenriques, Jose Fernando CastanhaSouza, Lorena Vilanova Freitas de2020-11-23info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisapplication/pdfhttps://www.teses.usp.br/teses/disponiveis/25/25144/tde-25102021-182737/reponame:Biblioteca Digital de Teses e Dissertações da USPinstname:Universidade de São Paulo (USP)instacron:USPLiberar o conteúdo para acesso público.info:eu-repo/semantics/openAccesseng2024-08-02T16:51:02Zoai:teses.usp.br:tde-25102021-182737Biblioteca Digital de Teses e Dissertaçõeshttp://www.teses.usp.br/PUBhttp://www.teses.usp.br/cgi-bin/mtd2br.plvirginia@if.usp.br|| atendimento@aguia.usp.br||virginia@if.usp.bropendoar:27212024-08-02T16:51:02Biblioteca Digital de Teses e Dissertações da USP - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv Three-dimensional evaluation of maxillary molar distalization with skeletal anchorage
Avaliação tridimensional da distalização de molares superiores com ancoragem esquelética
title Three-dimensional evaluation of maxillary molar distalization with skeletal anchorage
spellingShingle Three-dimensional evaluation of maxillary molar distalization with skeletal anchorage
Souza, Lorena Vilanova Freitas de
Angle Class II Malocclusion
Aparelhos ortodônticos
Cefalometria
Cephalometry
Dental models
Má oclusão de Classe II
Modelos dentários
Orthodontic appliances
title_short Three-dimensional evaluation of maxillary molar distalization with skeletal anchorage
title_full Three-dimensional evaluation of maxillary molar distalization with skeletal anchorage
title_fullStr Three-dimensional evaluation of maxillary molar distalization with skeletal anchorage
title_full_unstemmed Three-dimensional evaluation of maxillary molar distalization with skeletal anchorage
title_sort Three-dimensional evaluation of maxillary molar distalization with skeletal anchorage
author Souza, Lorena Vilanova Freitas de
author_facet Souza, Lorena Vilanova Freitas de
author_role author
dc.contributor.none.fl_str_mv Henriques, Jose Fernando Castanha
dc.contributor.author.fl_str_mv Souza, Lorena Vilanova Freitas de
dc.subject.por.fl_str_mv Angle Class II Malocclusion
Aparelhos ortodônticos
Cefalometria
Cephalometry
Dental models
Má oclusão de Classe II
Modelos dentários
Orthodontic appliances
topic Angle Class II Malocclusion
Aparelhos ortodônticos
Cefalometria
Cephalometry
Dental models
Má oclusão de Classe II
Modelos dentários
Orthodontic appliances
description Introduction: This study aimed to evaluate the changes after maxillary molar distalization with direct skeletal anchorage, based on cephalometric superimposition of digital dental models evaluations and finite element analysis (FEA). Methods: The sample included 23 patients (9 males, 11 females; mean age 13.21 ±1.54 years) treated with the miniscrew anchored Cantilever and 26 patients treated by the First Class skeletally anchored First Class. Lateral cephalograms before and after molar distalization were evaluated with the Dolphin software. Superimposition of digital dental models using an open-source software was performed in Cantilever sample. FEA was performed to comparisons between buccal and palatal distalizing methods with skeletal anchorage. Results: In Cantilever sample, all maxillary teeth showed distal movement and palatal (incisors) or distal (posterior teeth) angulation showing statistically significance for the maxillary first premolar and maxillary first and second molars. The vertical changes were minimal. The first and second molars showed crown distal rotation of 19.31 ± 5.71º and 10.17 ± 3.84º, respectively. There was increase in intermolar distance. When Cantilever with direct skeletal anchorage was compared to First Class with indirect anchorage, the maxillary incisor showed palatal inclination (0.75 ± 2.57º) in the Cantilever group, and labial inclination (2.85 ± 3.53º) and protrusion (1.41 ± 1.40mm) in the First Class group. The maxillary first premolar showed distal angulation (4.15 ± 4.87º) and distal movement (1.09 ± 1.54mm) in the Cantilever group and mesial angulation (11.20 ± 24.19º) and mesial movement (2.62 ± 2.08mm) in the First Class group. Regarding FEA, tipping movements were predominant in first and second molars with both modalities, due to the higher displacements values at coronal levels than at apical regions. In the palatal appliance the palatal root showed slight greater displacement than in cantilever appliance, especially regarding distal movement. Conclusions: The miniscrew anchored cantilever was effective for maxillary molar distalization with minimal side effects. Three-dimensional displacement was observed for all teeth. Distal movement was progressively greater from anterior to posterior teeth. Both Cantilever and First Class appliances corrected the Class II molar relationship with similar molar distal angulation. Indirect anchorage does not provide absence of anchorage loss. The FEA showed predominantly tipping movements in both distalization methods and the von mises stress showed different patterns between appliances.
publishDate 2020
dc.date.none.fl_str_mv 2020-11-23
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/doctoralThesis
format doctoralThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.teses.usp.br/teses/disponiveis/25/25144/tde-25102021-182737/
url https://www.teses.usp.br/teses/disponiveis/25/25144/tde-25102021-182737/
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv
dc.rights.driver.fl_str_mv Liberar o conteúdo para acesso público.
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Liberar o conteúdo para acesso público.
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.coverage.none.fl_str_mv
dc.publisher.none.fl_str_mv Biblioteca Digitais de Teses e Dissertações da USP
publisher.none.fl_str_mv Biblioteca Digitais de Teses e Dissertações da USP
dc.source.none.fl_str_mv
reponame:Biblioteca Digital de Teses e Dissertações da USP
instname:Universidade de São Paulo (USP)
instacron:USP
instname_str Universidade de São Paulo (USP)
instacron_str USP
institution USP
reponame_str Biblioteca Digital de Teses e Dissertações da USP
collection Biblioteca Digital de Teses e Dissertações da USP
repository.name.fl_str_mv Biblioteca Digital de Teses e Dissertações da USP - Universidade de São Paulo (USP)
repository.mail.fl_str_mv virginia@if.usp.br|| atendimento@aguia.usp.br||virginia@if.usp.br
_version_ 1815257344573964288