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Current clinical trends and evidence. EOS. Ravindra Nanda. Episode 79. April 8th 2021

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Hosted by
Farooq Ahmed

Current clinical trends and evidence Ravindra Nanda European Orthodontic Society webinar

 

Join me as i summarise Professor Ravi Nanda’s lecture, looking at 4 aspects of the field of orthodontics

  1. ·       Variation in appliances
  2. ·       Example of trends and evidence: Class 2 correction
  3. ·       Personality based orthodontics
  4. ·       Future

 

 

Various appliances

·      No consensus bracket type / prescription

o   Can’t due to confounding factors: alveolar bone, size and shape crown, ligation method

o   Bracket slot size: 0.18 better torque with lower dimension wire, 022 between sliding mechanics with large dimension archwire, wide range of control Detterline 2010

·      Wire interaction and biological response

 

To move forward, conformity on how force is being delivered to the tooth to deliver movement

 

Trends

Ravi is the editor in chief of Progress in Orthodontics

·      Most popular Downloads

o   TADS, Aligners, Expansion, Space closure

 

 

Class 2 correction

·      Well researched area

·      5 x Systematic reviews all show mandible does not grow

o   However companies still make claims of changing mandible

Class 2 elastics Vs motion appliance

Class 2 correction with elastics 2012 Janson SR

·      No difference in class 2 elastics Vs fixed functional appliance

·      Biomechanics

o   Not retracting upper anterior teeth backwards

o   Distally tip upper molar, then need biomechanics to upright molar, then retract upper anterior teeth into the space

·      Motion appliance Yin 2019

o   Claims skeletal changes including condylar remodelling

o   Uses class 2 elastics and sectional fixed appliances / VFR lower arch

o   No significant skeletal change

o   Same as  class 2 elastics

o   Still being promoted by manufacturers

 

·      Clinical tip: Use of biomechanics: Simple method for class 2 molar correction

o   Class 2 lever

o   Tip molar, create space

o   Close space with class 2 elastic

 

 

 

 

 

Accelerate tooth movement

Evidence:

·      Propel – MOP: Alikhani 2013 New York

·      28 days

·      40-50% faster tooth movement

Longer studies

·      Systematic review no difference with MOP Santos 2020

Still being discussed and used, however no advantage

 

New topic skeletal expansion

New topic bone borne expansion adults mid-palatal suture

·      Evidence being presented with CBCT, imagery – appropriate measures / research

·      No long term studies but the literature is going in this direction

·      Example of new treatment, progressing in a ideal way in literature

 

Going forwards

·      Informed about timing of treatment

·      Enhance OTM

·      Biological profile – what will respond better, less evasive, shorter, precise

·      Personilsed orthodontics – knowing the biological, molecular cause of malocclusion

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