Aim: The study aimed to evaluate to which extent self-reported symptomatology, age, and sex are predictors of titanium and nickel allergic sensitization in patients in treatment with fixed orthodontic appliances. Methods: The study analyzed 228 subjects aged 11–45 years (median 18, interquartile range 16–22); 68% of them were females, and 52% were adolescents. The allergic sensitization testing included epicutaneous patch test to titanium, titanium dioxide, titanium oxalate, titanium nitride, and nickel sulfate. The questionnaire on symptoms potentially linked to titanium and nickel sensitization was used. Results: Prevalence of the allergic sensitization to titanium in patients undergoing orthodontic treatment was 4% (2% only to titanium without nickel) while to nickel 14% (12% nickel without titanium). Hypersensitivity to both metals at the same time was present in 2% of subjects. Sensitization to nickel was more common in females than in males (17 vs. 8%) and much more common in adults than in adolescents with small effect size (20 vs. 8%; p = 0.013). Sensitization to titanium was more common in females than in males (6 vs. 1%) with no difference in age. Multiple logistic regression analysis revealed that adult age increases the odds for being sensitized to nickel for 2.4 × (95% CI 1.1–5.6; p = 0.044) while watery eyes for 3.7 × (95% CI 1.2–11.1; p = 0.022). None of the symptoms were significant predictors of titanium sensitization. Conclusion: Allergic sensitization to titanium and nickel are not very frequent in orthodontic patients, and self-reported symptomatology is a weak predictor of those sensitizations.
To analyze craniofacial growth during adolescence from the ages of 12 to 21 years and its relation to late mandibular incisor crowding. The study included 61 orthodontically untreated subjects (49% males). Lateral cephalograms were used to assess the jaw growth and inclination of the incisors. Little’s Irregularity Index and the anterior mandibular dental arch depth of mandibular dentition were measured. A reduction of the skeletal class angle (ANB) was observed in both genders, although it was significant only in males (η2=0.188; p=0.015). The growth of the mandible was more prominent compared to that of the maxilla, and it was more prominent in males than in females. The skeletal vertical dimension, however, demonstrated a significant reduction in both genders (η2=0.527-0.593, p<0.001). The mandibular incisors tended to retrocline in both genders, while the maxillary ones tended to procline in males, and slightly retrocline in females. A decrease in the mandibular dental arch depth occurred in both genders (η2=0.259; p<0.05). An increase in the irregularity of incisors for 1.8±1.7 mm on average (95% CI 1.3-2.2; η2=0.520; p<0.001) was observed in both genders. A logistic regression revealed that less sagittal growth of maxilla (increase of SNA angle ≤2°) and reduction of convexity in skeletal sagittal interjaw relationship (reduction of ANB ≥1°) were significant predictors of the occurrence of crowding (Δ Little Irregularity Index ≥1mm) yielding odds ratios of 4.9 and 4.8. The differential growth of the maxilla and mandible is related to the occurrence of late crowding, mostly in smaller amounts in maxillary sagittal growth compared to the mandible.
The objective of this study was to investigate the relationship between the absence, presence and dynamics of mandibular third molar development and the occurrence and amount of late mandibular incisor crowding. Dental plaster casts and panoramic radiographs of 72 orthodontically untreated subjects from the Nittedal growth study, Norway were analyzed. The subjects were recalled for a checkup at 12, 15, 18 and 21 years of age. Mandibular incisor crowding was assessed using Little’s irregularity index and dental maturation of the third molars by the Cameriere’s index. The majority of the subjects (64%) had ≥1 mm increase in irregularity; 22% experienced an increase of 0.1–0.9 mm and 14% had unchanged or decreased irregularity. Incisor irregularity increased with age, regardless of absence or presence of third molars. The amount of change in incisor irregularity from 12 to 21 years did not differ significantly between subjects with hypodontia of third molars, extraction and those with third molars present. No differences were observed between erupted, unerupted or impacted third molars. No correlation was found between the amount of change in irregularity and maturation of the third molars. In conclusion, occurrence and amount of mandibular late incisor crowding is not significantly influenced by the presence of mandibular third molars or their development dynamics.
3 June 2021 in Orthodontics & Craniofacial Research
The aim was to analyze the changes in mandibular dental arch shape during adolescence and assess its relation to late mandibular incisor crowding. Longitudinal study included 68 orthodontically untreated subjects (49% female) and analyzed their data for the ages of 12, 15, 18 and 21 years. Measurements included anterior arch depth, intercanine, interpremolar/anterior and intermolar/posterior width, Little's Irregularity and Bolton's index and the ratio between anterior arch depth and width. Males had significantly greater posterior widths than females at any age (p < 0.05). The anterior arch depth continuously decreased (p < 0.05), while width increased after the age of 18 years. Mandibular incisor crowding increased during all investigated periods (p < 0.05). The increase of intercanine width at 12-21 years of age reduced the risk for mandibular incisor crowding in the same period by 74% (OR: 0.265: 95% CI 0.076-0.931; p = 0.045). The shape of mandibular dental arch continues to change during adolescence becoming more squared while mandibular incisor crowding increases. The increase in mandibular intercanine width reduces the risk of crowding.