Jakobsen, Lise Bjørnåvold; Steinsund, Christine(Master thesis; Mastergradsoppgave, Jun-2011)
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Abstract:
In this thesis we wanted to find out; "Are there guidelines on the use of behaviour guidance techniques in dentistry to prevent the need of General Anesthesia".
Det finnes ulike oppfatninger angående ortodontisk behandling av tenner som er tidligere rotfylt eller tidligere traumatisert. Noen mener at det finnes mer risiko for resorpsjon ved ortodontisk forflytning av slike tenner enn levende "friske" tenner. Det første målet med dette litteraturstudiet var å se om det finnes vitenskapelige bevis for eventuell risiko for resorpsjon ved ortodontisk forflytning av rotfylte/tidligere traumatiserte tenner. Det andre målet var å finne ut hva praktiserende tannleger mener om temaet. 23 artikler var samlet inn gjennom PubMed og veiledere, samt 6 bøker var valgt fra det Helse- og Naturvitenskapelige Biblioteket ved UiT. Et spørreskjema med påstander ang ortodontisk forflytning av rotfylte tenner og tidligere traumatiserte tenner var delt ut til tannleger/spesialister på Studentklinikken og TkNN. Antall spørreskjema utdelt var 41,og 21 var besvart. Resultatene fra litteraturen var at rotfylte tenner (hvis godt renset og tettet) kan forflyttes med samme sikkerhet som vitale tenner. Når det gjelder tenner med tidligere historie av trauma, så sa mesteparten av litteraturen at det er noe større risiko for resorpsjon ved ortodontisk behandling av slike tenner. Besvarelsene av spørreskjema viste at meningen er delt (50/50) ang mer risiko for resorpsjon av rotfylte tenner. Derimot var de fleste deltakere (95%) enige om at det er mer risikabelt å forflytte tenner med tidligere trauma enn tenner uten trauma. Hovedkonklusjonen er at på grunn av lite tilgjengelige artikler og ingen RCT-studier (randomiserte kontrollerte studier) angående tema diskutert i denne masteroppgaven, trengs det mer forskning for å gjøre opp en sikker mening. Større antall deltakere i spørreundersøkelsen er også ønskelig for å føre resultatene over på allmenheten av praktiserende tannleger i Norge.
There are many possible causes to external apical root resorption (EARR) as a sequela of orthodontic treatment with fixed appliance. This literature review examines root morphology, age, commonly affected teeth, magnitude of force, continuous versus interrupted forces and duration of treatment, in order to evaluate if root resorption can be predicted. Qualitative analysis of a range of studies in this area has been made. All of the contributing factors above had a connection to root resorption of varying extents. It is therefore essential for a clinician to be aware of these factors, to be able to estimate the risk of root resorption individually for each patient.Abnormal root morphology may increase the risk of root resorption. This is specially valid for pipette-shaped roots. Maxillary incisors seem to be the teeth most likely to suffer from EARR. From the root resorption point of view orthodontic treatment should begin as early as possible since there is less risk of root resorption in young and developing teeth. Light orthodontic forces seem to present a smaller risk of resorption than heavy forces. If initial resorption is detected, a pause in treatment of two-three months should be considered. With sustained quality, treatment duration should always be as short as possible.
The aim of this study was to assess orthodontic treatment outcome and quality of documentation in patients with different types of anterior crossbite, who had received and finished treatment at the student clinic in Tromsø in the period between 2008 and 2010.
A total of 34 subjects fulfilled the inclusion criteria and were enrolled in the study. Existing pre and post treatment records from all subjects, was collected and supplemented by recalling of subjects. The definition of the treatment being successful was that positive overjet was achieved in all four incisors.
The treatment was successful in 68 % of the patients included in the study, and the treatment tended to be more successful in patients with only single incisors in crossbite. Important determining parameters for the treatment outcome were the duration of active treatment and patient compliance. The treatment success rate was significantly higher in subjects who were treated 8 months or less as compared to subjects who had longer treatments.
Our results suggest that 2 out of 3 anterior crossbites were successfully corrected in the student clinic in Tromsø, and longer treatment time seemed to affect the treatment success negatively. The common lack of post-treatment documentation calls for considerable improvement.