Research Article - (2022) Volume 9, Issue 9
Received: Mar 03, 2022, Manuscript No. JEBMH-22-51464; Editor assigned: Mar 07, 2022, Pre QC No. JEBMH-22-51464; Reviewed: Mar 21, 2022, QC No. JEBMH-22-51464; Revised: May 02, 2022, Manuscript No. JEBMH-22-51464; Published: May 17, 2022, DOI: 10.18410/jebmh/2022/09.9.16
Citation: Rithanya P, Felicita SA. Need for Adjunct Orthodontics in Young Patients Reporting To the Dental Outpatient Department. J Evid Based Med Healthc 2022;9(9):15.
Introduction
Adjunct orthodontics is the tooth movement carried out to facilitate other dental procedures necessary to control the disease, restore function or enhance the appearance of the tooth and the surrounding tissues. It can facilitate treatment in necessary ways such as contemporary prosthodontics, rehabilitation of hypodontia as an adjunct therapy to periodontitis, surgical adjunctive procedure for accelerating any orthodontic treatment.
Aim
Aim of the present study was to assess and analyses the need for adjunct orthodontics in patients reporting to the dental outpatient department in a university setting.
Materials and Method
Data collection was done using a patient management system. It is a recording system of all the data related to the medical and dental history of the patients and the treatment done in Saveetha dental college. The inclusive criteria for the present study included distal tipping, mesial tipping, migration and supraeruption and the exclusive criteria included patients name, age and gender. The overall data was filtered and only the inclusive criteria mentioned above were finally taken for evaluation. The collected data is analyzed using SPSS IBM (Chi square test).
Results and Conclusion
In the present study, it was found that 7 % of the cases from the overall study population reported with supraeruption, 12 % reported with distal tipping, 16 % were found to be migration, 25 % of mesial tipping and 40 % of the cases were found to be with no individual tooth abnormalities. It can be concluded that there are limited studies based on adjunct therapies in orthodontics. Further studies are further needed to introduce better treatment modalities.
Orthodontic treatment is based on tooth movement, which is performed by the periodontal ligament which unites the tooth root and the alveolar bone. Force applied on the tooth produces stress on the periodontal ligament with areas of traction or stretching that induces bone resorption and formation that further result in tooth movement.1 Therefore, for this process to occur efficiently a healthy periodontium is essential to avoid any compromise to the tooth supporting tissues.2 Orthodontic treatment may contribute to the periodontal health, because they align the teeth and favour in balancing the occlusion.3 However, fixed appliances may increase the supragingival biofilm and deteriorate the periodontal health.4 Bacteria in the supragingival or the subgingival biofilm may affect the orthodontic treatment which should be controlled by adequate oral hygiene.5 Maintenance of periodontal health is essential to treat malocclusion and crowding in the dental arch. Orthodontic treatment produces root parallelism which adequately distributes occlusal forces and corrects any vertical bone defects.6 Adjunct orthodontics involves alignment of crowded anterior teeth, tooth uprighting, coronal positioning before any restorations, prosthesis after forced eruption, reduction of the inter proximal distance or any distance between the roots, fixed or removable appliances.7 Range of surgical and non - surgical techniques have received increasing attention in recent years to reduce the duration and course of the orthodontic treatment. Various techniques have been used however, in relation to the effectiveness of the procedures and possible adverse effects that are related. Interdisciplinary esthetics is a contemporary modality of treatment causing outcomes in the field of restorative dentistry. An adjunct approach to rehabilitation of congenitally missing anterior teeth with orthodontic intervention throws light on the integrated treatment modality.8Adjunctive procedures carried out as part treatment plan include cases of hypodontia or any missing teeth, mesial migration of maxillary canines, maintaining adequate space, restoring the lip fullness, achieving stable and functional occlusion and restoring anterior esthetics. Incorporation of NiTi open coil springs was carried out to vitalize the canines bilaterally. Our team has extensive knowledge and research experience that has translate into high quality publications.9-28 Aim of the present study was to assess and analyses the need for adjunct orthodontics in patients reporting to the dental outpatient department in a university setting.
Sampling
Samples for the present study were collected from March 2020 to March 2021. The samples were collected from the patient management system. A total of 25,0000 patients were screened out of which a total of 500 to 700 cases were collected. The inclusive criteria for the study involved migration, supraeruption, mesial tipping and distal tipping. Whereas the exclusive criteria involved the patients age, gender and name.
Data Collection
The data collected is further stored in excel sheets and transferred to SPSS IBM software for analysis. Chi square test was performed. The collected data was further analyzed and tabulated.
From the results of the present study it was found that about 100 % of the female population was involved in the study. A higher ratio was seen among the 28 years (patients visiting the dental care for any orthodontic diagnosis), followed by the 25 years old, 26 and 29 years old and finally the 30 years old individuals. Among the orthodontic diagnosis reported the most common were, mesial tipping among them, followed by migration, distal tipping and supraeruption.
Adjunct procedures to prosthetic rehabilitation in treating cases of hypodontia or missing teeth depend on factors such as degree of edentulous span, alignment of teeth and the amount of space, type of space and the skeletal relation. In previous studies, it was seen that migrations of about 23.9 % was due to any carious defect or any early extraction of the deciduous molars. Tipped and rotated teeth were the most among other dental anomalies. Tipped teeth were found to be about 30 % in the previous studies, whereas rotated teeth were found to be about 45 %. Tipped teeth were mostly seen in the posterior region and were frequently associated with early extraction of the deciduous molars. On the other hand, rotated teeth were seen frequently both in the anterior and posterior teeth and were known to be associated with crowding of teeth. Crowding was the most common dental anomaly and was recorded about 52.1 % of the population. It was reported a lesser percentage of mild crowding, and 17 % were seen with moderate to severe crowding. Occlusal development was negatively influenced due to mesial migration of the permanent molars (25 %) which in turn causes deviation and rotation of teeth. Previous studies reported most of the supernumerary teeth were found to be mesiodens (1.8 %) and others were paramolars and distomolars. And were commonly seen in the lower arch. Infraocclusion of the first and the second molars were found to be 2 % prevalent among the mixed dentition.29 And 0.3 % of permanent molars in the previous researches were found to be in infraocclusion. Different modalities of prosthetic rehabilitation ranges from restoring esthetics with removable dentures to making implant supported prosthesis. Formulating a treatment plan depends on various factors such as tooth size relationship, severity of malocclusion size and the esthetics of canines. Adjunct orthodontic techniques such as distalization of canine to a region to create adequate space and bone volume for the placement of dental implants have been routinely advocated by various authors.30 Osseointegrated implants can be a diversity treatment option to restore the esthetics with splinting of the prosthesis. The need for any orthodontic treatment has been presented in the literature by means of different indices. The range of the malocclusion trait may reflect the need and the demand for any orthodontic treatment depending on the individual cases. As the need for orthodontic treatment is different among every individual, there are several levels of orthodontic treatment based on socio - economic status and or other ethnic differences. Any orthodontic treatment should be understood as a relative concept and not expressed as a single figure. Prevention and early orthodontic treatment are still being controversial when it comes to cost effectiveness, functional and psycho local benefits. Studies even reported that early diagnosis and treatment of caries and other dental anomalies helps in correcting malocclusion of about 45% - 70 % of the cases. Treatment options in restoring anterior esthetics range from space regaining or closures using adjunct therapies in orthodontics and restoring arch esthetics with fixed tooth supported or implant supported prosthesis. Orthodontic treatment of adults with periodontal disease should be conducted in association with other specialties to achieve good results. Crowding or any rotation may complicate the oral hygiene of the patients, thereby increasing the risk of periodontal disease.31 Extraction of first premolar and canines moved distally into the extraction space, incisor alignment facilitated brushing. Thus adjunct therapy in the field of orthodontics helps facilitate and improve periodontal health in many individuals.
In the present study, it was found that 7 % of the cases from the overall study population reported with supraeruption, 12 % reported with distal tipping, 16 % were found to be migration, 25 % of mesial tipping and 40 % of the cases were found to be with no individual tooth abnormalities. It can be concluded that there is limited research concerning the effect of adjunct therapy in the field of orthodontics and further studies has to be carried out to improve the treatment plan and for the better treatment outcomes.
The authors would like to thank the study participants for their participation and kind cooperation throughout the study.
The authors declare that the present study was funded by:
The authors declare that there were no conflicts of interest in the present study.
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