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  • 1.
    Bayat, Jari Taghavi
    et al.
    Karolinska Inst, Dept Dent Med, Div Orthodont, SE-14104 Huddinge, Sweden.
    Huggare, Jan
    Karolinska Inst, Dept Dent Med, Div Orthodont, SE-14104 Huddinge, Sweden.
    Mohlin, Bengt
    Univ Gothenburg, Sahlgrenska Acad, Inst Odontol, Dept Orthodont, Gothenburg, Sweden.
    Akrami, Nazar
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Determinants of orthodontic treatment need and demand: a cross-sectional path model study2017In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 39, no 1, p. 85-91Article in journal (Refereed)
    Abstract [en]

    Objectives: To put forward a model predicting orthodontic treatment need and demand. Furthermore, to explore how much of the variance in treatment demand could be explained by a set of self-assessed measures, and how these measures relate to professionally assessed treatment need. Subjects and methods: One hundred and fifty adolescents, aged 13 years, completed a questionnaire which included a set of self-assessed measures dealing with self-esteem, such as dental and global self-esteem, various aspects of malocclusion, such as perceived malocclusion and perceived functional limitation, and treatment demand. Treatment need was assessed by Dental Health Component of the Index of Orthodontic Treatment Need grading. Path analysis was used to examine the relations between the measures and if they could predict treatment need and demand. Results: The measures proved to be reliable and inter-correlated. Path analysis revealed that the proposed model had good fit to the data, providing a test of the unique effect of all included measures on treatment need and demand. The model explained 33% of the variance in treatment demand and 22% of the variance in treatment need. Limitations: The specific age group could affect the generalizability of the findings. Moreover, although showing good fit to data, the final model is based on a combination of theoretical reasoning and semi-explorative approach. Conclusions: The proposed model displays the unique effect of each included measure on treatment need and demand, explaining a large proportion of the variance in perceived treatment demand and professionally assessed treatment need. The model would hopefully lead to improved and more cost-efficient predictions of treatment need and demand.

  • 2.
    Björksved, Margitha
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Department of Orthodontics, Public Dental Health Service, Eskilstuna, Sweden;Department of Orthodontics, Postgraduate Dental Education Center, Örebro, Sweden.
    Arnrup, Kristina
    Dental Research Department, Public Dental Service, Region Örebro County, Örebro, Sweden;School of Health Sciences, Örebro University, Örebro, Sweden.
    Lindsten, Rune
    Department of Orthodontics, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Magnusson, Anders
    Department of Orthodontics, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Sundell, Anna Lena
    Department of Paediatric Dentistry, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Gustafsson, Annika
    Department of Paediatric Dentistry, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Bazargani, Farhan
    Department of Orthodontics, Postgraduate Dental Education Center, Örebro, Sweden;School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Closed vs open surgical exposure of palatally displaced canines: surgery time, postoperative complications, and patients' perceptions2018In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 40, no 6, p. 626-635Article in journal (Refereed)
    Abstract [en]

    Background: Closed and open surgical techniques are two different main approaches to surgical exposure of palatally displaced canines (PDCs). Because there is insufficient evidence to support one technique over the other, there is a need for randomized controlled trials.

    Objectives: To compare surgery time, complications and patients' perceptions between closed and open surgical techniques in PDCs.

    Trial design: The trial was a multicentre, randomized, controlled trial with two parallel groups randomly allocated in a 1:1 ratio.

    Material and methods: Study participants were 119 consecutive patients from 3 orthodontic centres, with PDCs planned for surgical exposure, randomly allocated according to a computer-generated randomization list, using concealed allocation. Full-thickness mucoperiosteal flap was raised, and bone covering the canine was removed in both interventions. In closed exposure, an attachment with a chain was bonded to the canine and the flap was sutured back with the chain penetrating the mucosa. In open exposure, a window of tissue around the tooth was removed and glass ionomer cement placed on the canine crown, to prevent gingival overgrowth during spontaneous eruption. Patient perceptions were assessed with two questionnaires, for the evening on the day of operation and 7 days post-surgery.

    Blinding: It was not possible to blind either patients or care providers to the interventions. The outcome assessors were blinded and were unaware of patients' intervention group.

    Results: Seventy-five girls and 44 boys, mean age 13.4 years (SD 1.46) participated in the study and got either of the interventions (closed exposure, n = 60; open exposure, n = 59). Surgery time did not differ significantly between the interventions. Complications though were more severe in bilateral cases and the patients experienced more pain and impairment in the open group.

    Conclusion: There were no statistically significant differences regarding surgery time between the groups. Postoperative complications were similar between the groups in unilateral PDCs, but more common in the open group in bilateral cases. More patients in the open group experienced pain and impairment compared to the closed group.

    Trial registration: Trial registration: ClinicalTrials.gov, ID: NCT02186548 and Researchweb.org, ID: 127201.

  • 3.
    Feldmann, Ingalill
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Research and Development, Gävleborg.
    List, Thomas
    Bondemark, Lars
    Orthodontic anchoring techniques and its influence on pain, discomfort, and jaw function--a randomized controlled trial.2012In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 34, no 1, p. 102-8Article in journal (Refereed)
    Abstract [en]

    The aim of this trial was to evaluate and compare perceived pain, discomfort, and jaw function impairment between orthodontic treatments combined with skeletal anchorage and treatment using conventional anchorage with headgear or transpalatal bar. A total of 120 adolescent patients in order to start orthodontic treatment were consecutively recruited and randomized into three groups with different anchorage. Group A underwent installation of a skeletal anchorage (Onplant or Orthosystem implant), group B received headgear, and group C a transpalatal bar. Questionnaires were used to assess pain intensity, discomfort, analgesic consumption, and jaw function impairment from baseline to the end of treatment. Pain scores overall peaked on day 2 and were almost back to baseline on day 7. The site with the highest pain scores during treatment was incisors in contact but with no differences between groups. Pain intensity from molars was significantly less in the skeletal anchorage group A compared to the transpalatal bar group C the first 4 days in treatment and with no sign differences compared to headgear. The results confirm that there were very few significant differences between patients' perceptions of skeletal and conventional anchorage systems during orthodontic treatment. Consequently, these new appliances were well accepted by the patients in a long time perspective and can thus be recommended.

  • 4.
    Ganzer, Niels
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Publ Dent Serv Reg Gavleborg, Dept Orthodont, Box 57, SE-80102 Gavle, Sweden.
    Feldmann, Ingalill
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Publ Dent Serv Reg Gavleborg, Dept Orthodont, Box 57, SE-80102 Gavle, Sweden.
    Liv, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Bondemark, Lars
    Malmo Univ, Fac Odontol, Dept Orthodont, SE-20506 Malmo, Sweden..
    A novel method for superimposition and measurements on maxillary digital 3D models-studies on validity and reliability2018In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 40, no 1, p. 45-51Article in journal (Refereed)
    Abstract [en]

    Background: Serial 3D models can be used to analyze changes, but correct superimposition is crucial before measurements can be assessed. Earlier studies show that every palatal structure changes due to growth or treatment. Here, we describe a new method that uses an algorithm-based analysis to perform superimpositions and measurements in maxillary 3D models. This method can be used to identify deformations. In a second step, only unchanged areas are used for superimposition.

    Objectives: This study investigates the validity and reliability of this novel method.

    Methods: Digital 3D models from 16 cases were modified by an independent 3D engineer to simulate space closure and growth. True values for tooth movements were available as reference. Measurements and repeated measurements were performed by four observers.

    Results: The total tooth movement had an absolute mean error of 0.0225 mm (SD 0.03). The intraclass correlation coefficient (ICC) was 0.9996. Rotational measurements had an absolute mean error of 0.0291 degrees (SD 0.04 degrees) and an ICC of 0.9999.

    Limitations: Serial models need to be taken with a moderate interval (1 to 2 years). Obvious changed areas in the palate need to be cropped before processing the models.

    Conclusion: The tested method is valid and reliable with excellent accuracy and precision even when changes through growth or orthodontic treatment occur.

  • 5.
    Ganzer, Niels
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Publ Dent Hlth Serv, Dept Orthodont, Gävle, Sweden.
    Feldmann, Ingalill
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Publ Dent Hlth Serv, Dept Orthodont, Gävle, Sweden.
    Petren, Sofia
    Malmö Univ, Fac Odontol, Dept Orthodont, Malmö, Sweden.
    Bondemark, Lars
    Malmö Univ, Fac Odontol, Dept Orthodont, Malmö, Sweden.
    A cost-effectiveness analysis of anchorage reinforcement with miniscrews and molar blocks in adolescents: a randomized controlled trial2019In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 41, no 2, p. 180-187Article in journal (Refereed)
    Abstract [en]

    Objective: To analyse cost-effectiveness of anchorage reinforcement with buccal miniscrews and with molar blocks. We hypothesized that anchorage with miniscrews is more cost-effective than anchorage with molar blocks.

    Trial design: A single-centre, two-arm parallel-group randomized controlled trial.

    Methods: Adolescents (age 11–19 years) in need of treatment with fixed appliance, premolar extractions, and en masse retraction were recruited from one Public Dental Health specialist centre. The intervention arm received anchorage reinforcement with buccal miniscrews during space closure. The active comparator received anchorage reinforcement with molar blocks during levelling/alignment and space closure. The primary outcome measure was societal costs defined as the sum of direct and indirect costs. Randomization was conducted as simple randomization stratified on gender. The patients, caregivers, and outcome assessors were not blinded.

    Results: Eighty patients were randomized into two groups. The trial is completed. All patients were included in the intention-to-treat analysis. The median societal costs for the miniscrew group were €4681 and for the molar block group were €3609. The median of the difference was €825 (95% confidence interval (CI) 431–1267). This difference was mainly caused by significantly higher direct costs consisting of material and chair time costs. Differences in chair time costs were related to longer treatment duration. No serious harms were detected, one screw fractured during insertion and three screws were lost during treatment.

    Generalizability and limitations: The monetary variables are calculated based on a number of local factors and assumptions and cannot necessarily be transferred to other countries. Variables such as chair time, number of appointments, and treatment duration are generalizable. Owing to the study protocol, the benefit of miniscrews as a stable anchorage has not been fully utilized.

    Conclusions: When only moderate anchorage reinforcement is needed, miniscrews are less cost-effective than molar blocks. The initial hypothesis was rejected. Miniscrews provide better anchorage reinforcement at a higher price. They should be used in cases where anchorage loss cannot be accepted.

    Trial registration: NCT02644811

  • 6.
    Isacsson, Göran
    et al.
    Västmanland Cty Hosp, Dept Orofacial Pain & Jaw Funct, Västerås, Sweden.
    Nohlert, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Fransson, Anette M C
    Örebro Univ, Publ Dent Serv, Dent Res, Dept Orthodont, Örebro, Region Örebro C, Sweden; Örebro Univ, Fac Med & Hlth, Örebro, Sweden; Örebro Univ, Publ Dent Serv, Dept Dent Sleep Med, Örebro, Region Örebro C, Sweden.
    Bornefalk Hermansson, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Wiman Eriksson, Eva
    Örebro Univ, Publ Dent Serv, Dept Dent Sleep Med, Örebro, Region Örebro C, Sweden.
    Ortlieb, Eva
    Örebro Univ, Publ Dent Serv, Dept Dent Sleep Med, Örebro, Region Örebro C, Sweden.
    Trepp, Livia
    Örebro Univ, Publ Dent Serv, Dept Dent Sleep Med, Örebro, Region Örebro C, Sweden.
    Avdelius, Anna
    Malmö Univ, Dept Orofacial Pain & Jaw Funct, Malmö, Sweden.
    Sturebrand, Magnus
    Västmanland Cty Hosp, Dept Orofacial Pain & Jaw Funct, Västerås, Sweden.
    Fodor, Clara
    Västmanland Cty Hosp, Dept Orofacial Pain & Jaw Funct, Västerås, Sweden.
    List, Thomas
    Malmö Univ, Dept Orofacial Pain & Jaw Funct, Malmö, Sweden.
    Schumann, Mohamad
    Västmanland Cty Hosp, Dept Orofacial Pain & Jaw Funct, Västerås, Sweden.
    Tegelberg, Åke
    Örebro Univ, Publ Dent Serv, Dept Dent Sleep Med, Örebro, Region Örebro C, Sweden; Malmö Univ, Dept Orofacial Pain & Jaw Funct, Malmö, Sweden.
    Use of bibloc and monobloc oral appliances in obstructive sleep apnoea: a multicentre, randomized, blinded, parallel-group equivalence trial2019In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 41, no 1, p. 80-88Article in journal (Refereed)
    Abstract [en]

    Background: The clinical benefit of bibloc over monobloc appliances in treating obstructive sleep apnoea (OSA) has not been evaluated in randomized trials. We hypothesized that the two types of appliances are equally effective in treating OSA.

    Objective: To compare the efficacy of monobloc versus bibloc appliances in a short-term perspective.

    Patients and methods: In this multicentre, randomized, blinded, controlled, parallel-group equivalence trial, patients with OSA were randomly assigned to use either a bibloc or a monobloc appliance. One-night respiratory polygraphy without respiratory support was performed at baseline, and participants were re-examined with the appliance in place at short-term follow-up. The primary outcome was the change in the apnoea–hypopnea index (AHI). An independent person prepared a randomization list and sealed envelopes. Evaluating dentist and the biomedical analysts who evaluated the polygraphy were blinded to the choice of therapy.

    Results: Of 302 patients, 146 were randomly assigned to use the bibloc and 156 the monobloc device; 123 and 139 patients, respectively, were analysed as per protocol. The mean changes in AHI were −13.8 (95% confidence interval −16.1 to −11.5) in the bibloc group and −12.5 (−14.8 to −10.3) in the monobloc group. The difference of −1.3 (−4.5 to 1.9) was significant within the equivalence interval (P = 0.011; the greater of the two P values) and was confirmed by the intention-to-treat analysis (P = 0.001). The adverse events were of mild character and were experienced by similar percentages of patients in both groups (39 and 40 per cent for the bibloc and monobloc group, respectively).

    Limitations: The study shows short-term results with a median time from commencing treatment to the evaluation visit of 56 days and long-term data on efficacy and harm are needed to be fully conclusive.

    Conclusion: In a short-term perspective, both appliances were equivalent in terms of their positive effects for treating OSA and caused adverse events of similar magnitude.

    Trial registration: Registered with ClinicalTrials.gov (#NCT02148510).

  • 7. Jäderberg, Sylvia
    et al.
    Feldmann, Ingalill
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Engström, Christer
    Removable thermoplastic appliances as orthodontic retainers: a prospective study of different wear regimens2012In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 34, no 4, p. 475-479Article in journal (Refereed)
    Abstract [en]

    The aim of this prospective study was to evaluate and compare stability after 6 months of Essix retainer use. Patients' perceptions of wearing the retainer were also evaluated. A total of 69 patients, 53 girls and 16 boys [mean age 15.7 years, standard deviation (SD) 1.96], were included in the study and randomized into two groups with different wear regimens; full-time wear for 3 months and thereafter at night (group A) compared to full-time wear for 1 week and thereafter at night only (group B). Sixty patients completed the study and thus, group A comprised 30 maxillary retainers and 18 mandibular retainers and group B 30 maxillary and 18 mandibular retainers. Little's irregularity index (LII), overjet, and overbite were measured at debond (T(1)) and after 6 months (T(2)). Differences within and between groups were analysed with a Mann-Whitney test. At T(2), all patients completed a questionnaire in order to evaluate their experience of wearing an Essix retainer and how they complied with the given instructions.

    Differences in LII during T(1)-T(2) were 0.44 and 0.49 mm for group A and B, respectively, but with no significant difference between the groups. There were also no significant changes in overjet and overbite within or between the groups during T(1)-T(2). According to the responses to the questionnaire, the retainer was well tolerated by the patients. It was therefore concluded that the Essix retainer is sufficient for maintaining the results after orthodontic treatment and that night-time wear is adequate.

  • 8.
    Löfstrand Tideström, Britta
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Thilander, Birgit
    Ahlqvist-Rastad, Jane
    Jakobsson, Olafur
    Hultcrantz, Elisabeth
    Breathing obstruction in relation to craniofacial and dental arch morphology in 4-year-old children1999In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 21, no 4, p. 323-332Article in journal (Refereed)
    Abstract [en]

    The prevalence of breathing obstruction was determined in a cohort of 4-year-old children. Craniofacial morphology was studied in obstructed children and compared with data from a control group of 4-year-old children with ideal occlusion. Dental arch morphology was compared in obstructed and non-obstructed children in the group. Parents of 95.5 per cent of the study base of 644 children answered a questionnaire concerning their child's nocturnal behaviour and related questions. The 48 children who, based on parental report, snored every night or stopped breathing when snoring (the 'snoring group'), showed a higher rate of disturbed sleep, mouth-breathing, and a history of throat infections as compared with the rest of the cohort. These children were examined by both an orthodontist and an otorhinolaryngologist and, when indicated, they were also monitored in a sleep laboratory. Twenty-eight of the children were diagnosed as having a breathing obstruction (4.3 per cent of the cohort) and six children (0.9 per cent) had sleep apnoea (mean apnoea-hypopnoea index of 17.3), using the same definition as that for adults. Cephalometric values among the obstructed children differed from those of a Swedish sample of the same age with ideal occlusion. Thy had a smaller cranial base angle and a lower ratio of posterior/anterior total face height. Small, but not significant differences were seen for NSL-ML and NL-ML. Compared with 48 asymptomatic children from the same cohort, the obstructed children had a narrower maxilla, a deeper palatal height, and a shorter lower dental arch. In addition, the prevalence of lateral crossbite was significantly higher among the obstructed children.

  • 9.
    Pegelow, Marie
    et al.
    Dental Medicine, Division of Orthodontics and Pediatric Dentistry, Section for Jaw Orthopaedics, Karolinska Institutet, Stockholm .
    Alqadi, Nadia
    Karsten, Agneta Linder-Aronson
    The prevalence of various dental characteristics in the primary and mixed dentition in patients born with non-syndromic unilateral cleft lip with or without cleft palate2012In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 34, no 5, p. 561-570Article in journal (Refereed)
    Abstract [en]

    This retrospective study was carried out on consecutively collected dental casts, x-rays, and photos of 129 Swedish children who had been born with non-syndromic unilateral (U) cleft lip (CL), cleft lip and alveolus (CLA), or cleft lip and palate (CLP). The following dental characteristics were investigated in the primary and permanent dentitions: 1. the presence, eruption, position, and shape of the lateral incisor; 2. the prevalence of rotation and enamel hypoplasia of the permanent central incisor; 3. the occurrence of hypodontia outside the cleft region; and 4. the transition from the primary to the succeeding permanent lateral incisor in the cleft region. Patients with clefts involving the palate (UCLP) exhibited a high frequency of hypodontia. In patients with clefts, which did not include the palate, malformed lateral incisors were a common finding. In the primary and permanent dentition, the lateral incisor had erupted distal to the cleft in 31.8 and 24.8 per cent of the UCLA and UCLP patients, respectively. No significant pattern was seen regarding the transition from the primary to the succeeding permanent lateral incisor (P = 0.15). The central incisor was rotated in 55 per cent of the patients and this positional deviation was particularly frequent in cases where the lateral incisor was missing in the premaxilla (P < 0.05). Hypodontia outside the cleft region was recorded in 15.5 per cent of the patients. Patients with UCLP had more often crossbite than patients with a UCL or a UCLA phenotype (P < 0.001).

  • 10. Rizell, S.
    et al.
    Barrenas, M. -L
    Andlin-Sobocki, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Stecksen-Blicks, C.
    Kjellberg, H.
    Turner syndrome isochromosome karyotype correlates with decreased dental crown width2012In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 34, no 2, p. 213-218Article in journal (Refereed)
    Abstract [en]

    The aim of this project was to study possible influences of Turner syndrome (TS) karyotype and the number of X chromosomes with intact short arm (p-arm) on dental crown width. Primary and permanent mesio-distal crown width was measured on plaster casts from 112 TS females. The influence on crown width of four karyotypes: 1. monosomy (45,X), 2. mosaic (45,X/46,XX), 3. isochromosome, and 4. other, and the number of intact X chromosomal p-arms were investigated. In comparisons between karyotypes, statistically significant differences were found for isochromosome karyotype maxillary second premolars, canines, laterals, mandibular first premolars, and canines, indicating that this karyotype was the most divergent as shown by the most reduced crown width. When each karyotype group were compared versus controls, all teeth in the isochromosome group were significantly smaller than controls (P < 0.01-0.001). The 45,X/46,XX karyotype expressed fewer and smaller differences from controls, while 45,X individuals seemed to display an intermediate tooth width compared with 45,X/46,XX and isochromosomes. No significant difference in crown width was found comparing the groups with one or two intact X chromosomal p-arms. Both primary and permanent teeth proved to have a significantly smaller crown width in the entire group of TS females compared to healthy females. We conclude that the isochromosome group deviates most from other karyotypes and controls, exhibiting the smallest dental crown width, while individuals with 45,X/46,XX mosaicism seemed to have a less affected crown width. An influence of the number of intact p-arms on crown width could not be demonstrated in this study.

  • 11. Rizell, Sara
    et al.
    Barrenas, Marie-Louise
    Andlin-Sobocki, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Stecksen-Blicks, Christina
    Kjellberg, Heidrun
    Palatal height and dental arch dimensions in Turner syndrome karyotypes2013In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 35, no 6, p. 841-847Article in journal (Refereed)
    Abstract [en]

    The aim of this project was to study the impact from Turner syndrome (TS) karyotype and age on dental arch morphology and palatal height and to compare the variables in TS with reference data from non-TS females with normal occlusion. Plaster casts from 76 females with TS (6-50 years) were analysed with respect to dentoalveolar arch dimensions and palatal height. The TS females were divided into the karyotype categories: i) 45, X ii) 45, X/46, XX iii) isochromosome, and iv) other. The 45, X/46, XX karyotype exhibited fewer statistically significant variables differing from the reference group compared with other karyotypes. TS females showed increased dentoalveolar depths, decreased maxillary but increased mandibular width, decreased posterior segments, and decreased mandibular circumference compared with the reference group. In opposition to previous reports, the palatal height did not differ compared with non-TS females. Age had an impact on nine of the variables. We conclude that the present dental arch deviations are reflecting the high frequency of malocclusions reported in TS and the subsequent need for orthodontic treatment, which might possibly be lower in the 45, X/46, XX karyotype. The palatal height did not differ from the reference group, but instead the narrow maxilla might contribute to an illusion of a higher palate. We therefore suggest using the nomination 'narrow palatal vault' instead of the commonly used term 'high palatal vault'.

  • 12. Rizell, Sara
    et al.
    Barrenäs, Marie-Louise
    Andlin-Sobocki, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Stecksén-Blicks, Christina
    Kjellberg, Heidrun
    45,X/46,XX karyotype mitigates the aberrant craniofacial morphology in Turner syndrome2013In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 35, no 4, p. 467-474Article in journal (Refereed)
    Abstract [en]

    The aim of this project was to study the impact on craniofacial morphology from Turner syndrome (TS) karyotype, number of intact X chromosomal p-arms, and age as well as to compare craniofacial morphology in TS with healthy females. Lateral radiographs from 108 females with TS, ranging from 5.4 to 61.6 years, were analysed. The TS females were divided into four karyotype groups: 1. monosomy (45,X), 2. mosaic (45,X/46,XX), 3. isochromosome, and 4. other, as well as according to the number of intact X chromosomal p-arms. The karyotype was found to have an impact on craniofacial growth, where the mosaic group, with presence of 46,XX cell lines, seems to exhibit less mandibular retrognathism as well as fewer statistically significant differences compared to the reference group than the 45,X karyotype. Isochromosomes had more significant differences versus the reference group than 45,X/46,XX but fewer than 45,X. To our knowledge, this is the first time the 45,X/46,XX and isochromosome karyotypes are divided into separate groups studying craniofacial morphology. Impact from p-arm was found on both maxillary and mandibular length. Compared to healthy females, TS expressed a shorter posterior and flattened cranial base, retrognathic, short and posteriorly rotated maxilla and mandible, increased height of ramus, and relatively shorter posterior facial height. The impact of age was found mainly on mandibular morphology since mandibular retrognathism and length were more discrepant in older TS females than younger.

  • 13.
    Taghavi Bayat, Jari
    et al.
    Karolinska Inst, Div Orthodont, Dept Dent Med, SE-14104 Huddinge, Sweden.
    Huggare, Jan
    Karolinska Inst, Div Orthodont, Dept Dent Med, SE-14104 Huddinge, Sweden.
    Mohlin, Bengt
    Univ Gothenburg, Sahlgrenska Acad, Inst Odontol, Dept Orthodont, Gothenburg, Sweden.
    Akrami, Nazar
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Predicting orthodontic treatment need: reliability and validity of the Demand for Orthodontic Treatment Questionnaire2017In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 39, no 3, p. 326-333Article in journal (Refereed)
    Abstract [en]

    Objectives: To identify key measures in predicting orthodontic treatment need and to propose a self-assessment instrument that improves treatment need assessment.Subjects and methods: The study included 150 randomly selected 13-year-olds. A set of measures linked to a previous study on daily life impact of malocclusion was processed, resulting in an instrument, the Demand for Orthodontic Treatment Questionnaire (DOTQ), which was analysed regarding dimensionality, reliability and validity. Dental Health Component of the Index of Orthodontic Treatment Need (IOTN-DHC) grading, representing professionally assessed treatment need, were collected from dental records. The instrument’s ability to predict treatment need was tested by randomly splitting the dataset into two subgroups, using multiple regression to predict DHC in one of the groups and the prediction equation to calculate predicted DHC in the other. The outcomes were then correlated to detect the predictive power of the DOTQ, and thereby the validity of the prediction.Results: The DOTQ-measures were reliable and highly inter-correlated. A high, significant correlation was found between assessed and predicted treatment need for the subgroups (r = 0.59 and 0.49), confirming the validity of the prediction. Independent variables (the measures) explained 47 per cent (R = 0.69) of the variance in treatment need. Four measures contributed significantly to the prediction, with Treatment Demand being the most powerful predictor.Limitations: The age group and response rate may raise some questions regarding the generalizability of the findings.Conclusions: The DOTQ is able to predict treatment need as assessed by orthodontic consultants. Its incorporation in the treatment need assessment process will acknowledge patients’ self-perceived impact of malocclusion.

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