ORTHODONTICS IN NEWS

OrthoAccel™ Technologies has just received official clearance from the Korean Food and Drug Administration (KFDA) to begin commercial sales of its AcceleDent™ orthodontic device in South Korea.

“I’m extremely gratified by this news,” says Mr. Sung-ku Hong, CEO of Inno DMC, the exclusive South Korean distributor. “AcceleDent™ is an important advancement in orthodontic care and I’m certain it will be welcomed by Korean orthodontists and their patients.”

Michael K. Lowe, CEO of OrthoAccel® Technologies, adds, “We’ve been eager to open the South Korean market since first entering into a distribution agreement with Inno DMC back in 2010. This is an exciting step, marking the company’s first movement into the Asia Pacific region.”

AcceleDent™ is a lightweight, hands-free appliance used at home to speed up the rate of orthodontic treatment. It’s used 20 minutes a day by biting gently on the mouthpiece to hold it in place. Patients are then free to engage in normal activities, like reading, texting, or watching TV, during the treatment. Sales of AcceleDent™ have increased rapidly since it received FDA clearance in November, 2011.

The addition of the South Korean market continues a trend that has seen OrthoAccel® expand into over 20 international markets as well as the United States.

SOURCE OrthoAccel Technologies, Inc.

Young adolescents and teens with fixed orthodontic appliances who chew gum report significantly less pain and impact of their braces than their peers who do not chew gum, report researchers from Sheffield in the UK.

Specifically, 11-18 year-olds who were randomly assigned to chew gum (CG group) reported significantly lower total impact scores (TIS) – indicating the impact of the braces on their diet, function, and social situations – and visual analog scores (VAS) – indicating teeth pain – at 24 hours after bonding/separator and archwire appointments than those assigned to not chew gum (NG group).

Furthermore, gum chewing had no significant effect on appliance breakages, says the research team in Orthodontics and Craniofacial Research.

“It has been shown that fixed orthodontic appliances lead to a deterioration in both adolescent and adult oral health-related quality of life, particularly in the first month after placement,” explain Philip Benson and colleagues from the University of Sheffield.

They add that the act of chewing has been recommended to increase blood flow into and around the periodontal membrane, restoring lymphatic circulation and preventing, or relieving, inflammation and edema.

A total of 28 patients with braces in the NG group were specifically asked not to chew gum throughout the study while the 29 in the CG group received chewing gum to use when required after orthodontic appointments. Patients reported TIS and VAS scores at 24 hours and 1 week after their appointments.

Both measures were significantly lower in the CG than the NG group at 24 hours after appointments, with mean TIS and VAS scores of 73 versus 89, and 20 mm versus 45 mm, respectively. These remained lower among CG patients than NG patients after 1 week, but were not significantly different.

First-time band failures occurred equally in both groups, at a median of 11 (4.4%; NG=4, CG=7) and 15 (6.3%; NG=7, CG=8) at 24 hours and 1 week, and there was no significant difference in the rate of bracket failures and wire and other problems by patient group either.

“The results suggest that when placing a fixed appliance, young people can be advised to use a sugar-free chewing gum when required to relieve discomfort without this having a detrimental effect on their treatment,” conclude Benson et al.

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Society could save millions of crowns each year if more children were fitted with fixed braces. This is shown in unique studies performed by Sofia Petrén, a dentist and orthodontic specialist at the Section for Orthodontics at Malmö University.

Calculations indicate that at least ten percent of all eight- and nine-year-olds in Sweden have so-called crossbite.

This means that the children’s upper and lower jaws are different in width and do not line up against each other when they bite their jaws together. If this problem is not corrected, the children can experience pain in the jaw, facial muscles, and jaw joints. Their face can also become asymmetrical.

In randomized studies, Sofia Petrén investigated four methods of treatment: fixed appliance (Quad Helix), removable appliance (expansion plate), composite construction on the molars of the lower jaw, and no action in the hope that the problem will straighten itself out. A total of 70 children were involved in the four groups.

The results show that neither the composite construction nor no action has any effect on crossbite. The other two treatments are effective, both in the short and long term, but the fixed appliance yielded clearly superior results.

“The fixed braces entail that the children are treated 24 hours a day. The removable plate means that the children need the help of their parents, and it happens that they forget it sometimes, which affects the outcome of treatment,” says Sofia Petrén.

There’s a big difference in the cost of the various treatment methods, both direct and indirect, according to Sofia Petrén, who arrived at these results in her dissertation Correction of Unilateral Posterior Crossbite in the Mixed Dentition, submitted to the Faculty of Dentistry at Malmö University.

The fixed appliance is also the cheapest. Sofia Petrén compared the costs, both direct and indirect, and found that society could save SEK 32 million per year if all children with unilateral crossbite were treated with fixed braces. Part of the difference is due to the fact that children who are treated with removable appliances sometimes need to be treated again because the treatment failed.

But even if all treatments with removable appliances were successful, the annual cost would still be more than SEK 12 million compared with fixed braces.

“Today both treatments are equally common in clinics, but I maintain we should use the method that works best, has a lasting effect, and is most cost-effective.”

Even though braces have been used for more than 100 years, the scientific evidence for different treatments is very patchy, something that SBU, the Swedish Council on Health Technology Assessment, drew attention to in a 2005 report.

Sofia Petrén’s dissertation fills a major gap in our knowledge that will probably lead to changes in treatment routines. The finding that children’s bite problems do not sort themselves out spontaneously means that county councils that postpone treatment to save money will be facing even higher costs in the long run.

“When children are treated in their teens, the treatment is more complicated and costly,” says Sofia Petrén, who wants to study how children’s quality of life is affected during and after treatment.

 

Metal Braces

High-powered computers and advanced robotics continue to move forward in the field of orthodontics. An example of one of the new companies entering this field is SureSmile. They offer a system which combines three-dimensional computer imaging, exotic alloys and robotics. The company is claiming to reduce orthodontic treatment time, not move teeth any faster, but by moving teeth more efficiently. The technology is new and there is little research to validate their claim so far. Dr. Newhart is part of national study club that is working with the technology to test its uses, advantages and limitations. The technology is currently more expensive than conventional orthodontic because the technology is new.

 

Metal Braces

The procedure starts with a scanning of the teeth. This can be accomplished by a cone beam scanner or by handheld scanner. The 3D image information is fed to a computer for further refinement. The location and tension needed for the brackets and wire is fed into the computer by Dr. Newhart and the information is sent by Internet to the Sure Smile facility.

 

Metal Braces

Now the robots come in. The orthodontic wire is gripped by two robotic pincers, which heats and bends the wire into a pattern that will guide the teeth into their preferred position. The wire, similar to Dr. Newhart’s proprietary Time-Release™ archwire, remembers its shape and is stiff when it is warm, but is highly flexible when cool – properties that are the reverse of most metals.

Even if the wire is purposely bent out of proper shape, once it is put in warm water, it springs back into its predetermined form and is ready to use. In the mouth, natural body heat keeps the wire firm and supplies tension to move the teeth.