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Dirk Wiechmann - One of the best experts on this subject based on the ideXlab platform.

  • class ii correction by maxillary en masse distalization using a completely customized Lingual Appliance and a novel mini screw anchorage concept preliminary results
    Head & Face Medicine, 2021
    Co-Authors: Frauke Beyling, Rainer Schwestkapolly, Hansjoachim Helms, Elisabeth Klang, Eva Niehoff, Dirk Wiechmann
    Abstract:

    The aim of the study was to evaluate the efficacy of a novel en masse distalization method in the maxillary arch in combination with a completely customized Lingual Appliance (CCLA; WIN, DW Lingual Systems, Germany). Therefore, we tested the null-hypothesis of a significant deviation from an Angle-Class I canine relationship and a normal overjet defined by an individual target set-up after dentoalveolar compensation in Angle Class II subjects. This retrospective study included 23 patients, (m/f 3/20, mean age 29.6 years (min/max, 13.6/50.9 years)), with inclusion criteria of an Angle Class II occlusion of more than half a cusp prior to en masse distalization and treatment completed consecutively with a CCLA in combination with a mini-screw (MS) anchorage for uni- or bilateral maxillary distalization (12 bilateral situations, totalling 35). Plaster casts taken prior to (T0) and following CCLA treatment (T3) were compared with the treatment plan / set-up (TxP, with a Class I canine relationship and a normal overjet as the treatment objective). MSs were placed following levelling and aligning (T1) and removed at the end of en masse distalization at T2. Statistical analysis was carried out using Schuirmann’s TOST [two one-sided tests] equivalence test, based on a one-sample t-test with α = 0.025 on each side (total α = 0.05). Ninety-seven percent of planned correction of the canine relationship was achieved (mean 3.6 of 3.7 mm) and also 97 % of the planned overjet correction (mean 3.1 of 3.2 mm), with a statistically significant equivalence (p < 0.0001) for canine relationship and overjet between the individual treatment plan (set-up) and the final outcome. Adverse effects were limited to the loss of n = 2 of 35 mini-screws. However, in each instance, the treatment was completed, as scheduled, without replacing them. Accordingly, the null-hypothesis was rejected. The technique presented allows for a predictable correction of an Angle-Class II malocclusion via dentoalveolar compensation with maxillary en masse distalization.

  • Class II correction by maxillary en masse distalization using a completely customized Lingual Appliance and a novel mini-screw anchorage concept – preliminary results
    'Springer Science and Business Media LLC', 2021
    Co-Authors: Frauke Beyling, Hansjoachim Helms, Rainer Schwestka-polly, Elisabeth Klang, Eva Niehoff, Dirk Wiechmann
    Abstract:

    Abstract Background The aim of the study was to evaluate the efficacy of a novel en masse distalization method in the maxillary arch in combination with a completely customized Lingual Appliance (CCLA; WIN, DW Lingual Systems, Germany). Therefore, we tested the null-hypothesis of a significant deviation from an Angle-Class I canine relationship and a normal overjet defined by an individual target set-up after dentoalveolar compensation in Angle Class II subjects. Methods This retrospective study included 23 patients, (m/f 3/20, mean age 29.6 years (min/max, 13.6/50.9 years)), with inclusion criteria of an Angle Class II occlusion of more than half a cusp prior to en masse distalization and treatment completed consecutively with a CCLA in combination with a mini-screw (MS) anchorage for uni- or bilateral maxillary distalization (12 bilateral situations, totalling 35). Plaster casts taken prior to (T0) and following CCLA treatment (T3) were compared with the treatment plan / set-up (TxP, with a Class I canine relationship and a normal overjet as the treatment objective). MSs were placed following levelling and aligning (T1) and removed at the end of en masse distalization at T2. Statistical analysis was carried out using Schuirmann’s TOST [two one-sided tests] equivalence test, based on a one-sample t-test with α = 0.025 on each side (total α = 0.05). Results Ninety-seven percent of planned correction of the canine relationship was achieved (mean 3.6 of 3.7 mm) and also 97 % of the planned overjet correction (mean 3.1 of 3.2 mm), with a statistically significant equivalence (p 

  • quality of occlusal outcome following space closure in cases of lower second premolar aplasia using Lingual orthodontic molar mesialization without maxillary counterbalancing extraction
    Head & Face Medicine, 2018
    Co-Authors: Elisabeth Klang, Frauke Beyling, Michael Knosel, Dirk Wiechmann
    Abstract:

    Controlled space closure in cases of isolated lower second premolar aplasia (ILSPA) without maxillary counterbalancing extraction is challenging. Anterior anchorage loss may occur during space closure resulting in compromised occlusal results in terms of an absence of proper canine guidance during laterotrusive mandible movements. In order to evaluate the effectiveness of Herbst telescope anchorage in combination with double-cable, pull mechanics and a completely customized Lingual Appliance for orthodontic space management in cases of ILSPA, we tested the null hypothesis that there is a significant deterioration in the sagittal canine relationship towards an Angle-Class-II occlusion expressed as a loss of anterior anchorage following space closure with molar mesialization. Twenty-five consecutively de-bonded subjects (female / male 17 / 8; aged at T0 (start of MB Tx) 12.3 to 20.6 years; mean age 15.0 / SD 1.7 years) were included in this retrospective analysis using the inclusion criteria of least of one lower second premolar aplasia; completed treatment with a totally customized Lingual Appliance (CCLA) in combination with Herbst telescopes. Exclusion criteria were the absence of counterbalancing maxillary extractions, as well as additional tooth aplasia other than lower second premolars. A total of 33 single, lower premolar aplasia space closures (right / left sided 17 / 16) were assessed using plaster casts and intra-oral photographs scaled to the plaster casts, at bonding (T0), Herbst insertion (T1), following gap closure (T2) and de-bonding (T3). Parallelism of roots was controlled by panoramic x-rays at T3. The mean aplasia space at T0 was 7.5 mm (SD 2.6). Complete space closure was achieved in all 33 situations. The null hypothesis was rejected. There was a significant improvement in the initial canine relationships (mean 3.5 mm distal occlusion at T0) to a mean 0.1 mm at T3. When evaluated against the individual treatment plan, the following amounts of planned improvements were achieved: space closure 100%, canine relationship 97.5%, overjet 93.9%, overbite 96.4%, parallel roots in space closure site 93.9%. Herbst telescope anchorage in combination with double-cable pull mechanics and a CCLA for orthodontic space closure can deliver predictable, high-quality treatment results.

  • Quality of occlusal outcome following space closure in cases of lower second premolar aplasia using Lingual orthodontic molar mesialization without maxillary counterbalancing extraction
    Head & Face Medicine, 2018
    Co-Authors: Elisabeth Klang, Frauke Beyling, Michael Knosel, Dirk Wiechmann
    Abstract:

    Background Controlled space closure in cases of isolated lower second premolar aplasia (ILSPA) without maxillary counterbalancing extraction is challenging. Anterior anchorage loss may occur during space closure resulting in compromised occlusal results in terms of an absence of proper canine guidance during laterotrusive mandible movements. In order to evaluate the effectiveness of Herbst telescope anchorage in combination with double-cable, pull mechanics and a completely customized Lingual Appliance for orthodontic space management in cases of ILSPA, we tested the null hypothesis that there is a significant deterioration in the sagittal canine relationship towards an Angle-Class-II occlusion expressed as a loss of anterior anchorage following space closure with molar mesialization. Methods Twenty-five consecutively de-bonded subjects (female / male 17 / 8; aged at T0 (start of MB Tx) 12.3 to 20.6 years; mean age 15.0 / SD 1.7 years) were included in this retrospective analysis using the inclusion criteria of least of one lower second premolar aplasia; completed treatment with a totally customized Lingual Appliance (CCLA) in combination with Herbst telescopes. Exclusion criteria were the absence of counterbalancing maxillary extractions, as well as additional tooth aplasia other than lower second premolars. A total of 33 single, lower premolar aplasia space closures (right / left sided 17 / 16) were assessed using plaster casts and intra-oral photographs scaled to the plaster casts, at bonding (T0), Herbst insertion (T1), following gap closure (T2) and de-bonding (T3). Parallelism of roots was controlled by panoramic x-rays at T3. Results The mean aplasia space at T0 was 7.5 mm (SD 2.6). Complete space closure was achieved in all 33 situations. The null hypothesis was rejected. There was a significant improvement in the initial canine relationships (mean 3.5 mm distal occlusion at T0) to a mean 0.1 mm at T3. When evaluated against the individual treatment plan, the following amounts of planned improvements were achieved: space closure 100%, canine relationship 97.5%, overjet 93.9%, overbite 96.4%, parallel roots in space closure site 93.9%. Conclusion Herbst telescope anchorage in combination with double-cable pull mechanics and a CCLA for orthodontic space closure can deliver predictable, high-quality treatment results.

  • single tooth torque correction in the lower frontal area by a completely customized Lingual Appliance
    Head & Face Medicine, 2017
    Co-Authors: Collin Jacobs, Dirk Wiechmann, Milena Katzorke, Heiner Wehrbein, Rainer Schwestkapolly
    Abstract:

    Aim of this study was to analyze the efficacy and precision of the completely customized Lingual Appliance (CCLA) regarding the single tooth torque correction. The study also examined external apical root resorptions as possible side effects of torque correction and the changings of the periodontal situation. A case series of three patients were included. The patients showed a single tooth torque problem with a gingival recession and were treated with the CCLA. Plaster casts before and after treatment and plaster casts of the set up were scanned and superimposed. Deviations between the two plaster casts were analyzed at different points of interest. Changes of the gingival recession were compared before and after treatment. Relative root resorptions were measured by the orthopantomograms. Treatment times were assessed by the records of the patients. Results were presented descriptively. The mean change of the most apical part of the root reached by the orthodontic treatment was 1.8 ± 0.3 mm. The largest deviation between set up and final model was measured on the occlusal surface of the tooth 36 with 0.8 mm. Most measurement points showed a deviation of 0.5 mm or less. The depths of the gingival recession showed a significant reduction of 4.7 mm. The widths of the gingival recession were reduced by 1.1 mm. The average relative root resorption of the corrected teeth was 2.7 ± 1.5%. The average treatment time was 13.8 ± 4.5 months. This is the first study showing that the CCLA with its high precision is very effective in correcting single tooth torque problems. Orthodontic torque correction resulted in a significant reduction of gingival recessions and caused only negligible root resorptions.

Rainer Schwestkapolly - One of the best experts on this subject based on the ideXlab platform.

  • objective treatment outcome assessment of a completely customized Lingual Appliance a retrospective study
    International Orthodontics, 2021
    Co-Authors: Fawzi M Alqatami, Ons Alouini, Michael Knosel, Hansjoachim Helms, Rainer Schwestkapolly
    Abstract:

    OBJECTIVE To assess the outcome quality of subjects treated with a completely customized Lingual Appliance (CCLA) in a postgraduate university program, using the ABO Objective Grading System (OGS), by testing the null-hypothesis of a significant proportion of post-treatment cases exceeding an adjusted 'exam failure' threshold value of OGS=24. MATERIALS AND METHODS This retrospective single-arm study included 66 consecutively debonded CCLA cases (m/f 19/47; mean age: 25.1±9 years) treated at Hannover Medical School (MHH, Hannover, Germany). The discrepancy index (DI) was assessed on initial plaster casts. The OGS of the cast-radiograph evaluation was scored for both set-up and post-treatment casts, including the seven components of alignment/rotation, marginal ridges, buccoLingual inclination, overjet, occlusal contacts, occlusal relationships and interproximal contacts, to parameterize differences between those. RESULTS DI score distribution (≥20, <20) was 25 (37.9%)/41 (62.1%) subjects. Mean initial DI was 17.3±8.5. Mean set-up OGS was 10.4±4.4 (min-max: 3-21), mean final OGS was 17.7±5.9 (min-max: 7-33), and the difference 7.3 (post-treatment - set-up) was statistically significant (p<0.0001; 95% CI [5.8, 8.7]). The null-hypothesis was rejected: A statistically significant proportion of the final casts (n=58; 87.8%) scored below OGS=24 by exact binomial test (P<0.0001; 95% CI [77.5%, 94.6%]). The rate of a final OGS score<24 was not significantly different (P=0.98) between both DI (≥20, <20) groups. CONCLUSIONS The outcome quality of the CCLA treatment in this postgraduate university setting was high and therefore sufficient for a vast majority of treated cases to pass the ABO-OGS clinical examination.

  • class ii correction by maxillary en masse distalization using a completely customized Lingual Appliance and a novel mini screw anchorage concept preliminary results
    Head & Face Medicine, 2021
    Co-Authors: Frauke Beyling, Rainer Schwestkapolly, Hansjoachim Helms, Elisabeth Klang, Eva Niehoff, Dirk Wiechmann
    Abstract:

    The aim of the study was to evaluate the efficacy of a novel en masse distalization method in the maxillary arch in combination with a completely customized Lingual Appliance (CCLA; WIN, DW Lingual Systems, Germany). Therefore, we tested the null-hypothesis of a significant deviation from an Angle-Class I canine relationship and a normal overjet defined by an individual target set-up after dentoalveolar compensation in Angle Class II subjects. This retrospective study included 23 patients, (m/f 3/20, mean age 29.6 years (min/max, 13.6/50.9 years)), with inclusion criteria of an Angle Class II occlusion of more than half a cusp prior to en masse distalization and treatment completed consecutively with a CCLA in combination with a mini-screw (MS) anchorage for uni- or bilateral maxillary distalization (12 bilateral situations, totalling 35). Plaster casts taken prior to (T0) and following CCLA treatment (T3) were compared with the treatment plan / set-up (TxP, with a Class I canine relationship and a normal overjet as the treatment objective). MSs were placed following levelling and aligning (T1) and removed at the end of en masse distalization at T2. Statistical analysis was carried out using Schuirmann’s TOST [two one-sided tests] equivalence test, based on a one-sample t-test with α = 0.025 on each side (total α = 0.05). Ninety-seven percent of planned correction of the canine relationship was achieved (mean 3.6 of 3.7 mm) and also 97 % of the planned overjet correction (mean 3.1 of 3.2 mm), with a statistically significant equivalence (p < 0.0001) for canine relationship and overjet between the individual treatment plan (set-up) and the final outcome. Adverse effects were limited to the loss of n = 2 of 35 mini-screws. However, in each instance, the treatment was completed, as scheduled, without replacing them. Accordingly, the null-hypothesis was rejected. The technique presented allows for a predictable correction of an Angle-Class II malocclusion via dentoalveolar compensation with maxillary en masse distalization.

  • single tooth torque correction in the lower frontal area by a completely customized Lingual Appliance
    Head & Face Medicine, 2017
    Co-Authors: Collin Jacobs, Dirk Wiechmann, Milena Katzorke, Heiner Wehrbein, Rainer Schwestkapolly
    Abstract:

    Aim of this study was to analyze the efficacy and precision of the completely customized Lingual Appliance (CCLA) regarding the single tooth torque correction. The study also examined external apical root resorptions as possible side effects of torque correction and the changings of the periodontal situation. A case series of three patients were included. The patients showed a single tooth torque problem with a gingival recession and were treated with the CCLA. Plaster casts before and after treatment and plaster casts of the set up were scanned and superimposed. Deviations between the two plaster casts were analyzed at different points of interest. Changes of the gingival recession were compared before and after treatment. Relative root resorptions were measured by the orthopantomograms. Treatment times were assessed by the records of the patients. Results were presented descriptively. The mean change of the most apical part of the root reached by the orthodontic treatment was 1.8 ± 0.3 mm. The largest deviation between set up and final model was measured on the occlusal surface of the tooth 36 with 0.8 mm. Most measurement points showed a deviation of 0.5 mm or less. The depths of the gingival recession showed a significant reduction of 4.7 mm. The widths of the gingival recession were reduced by 1.1 mm. The average relative root resorption of the corrected teeth was 2.7 ± 1.5%. The average treatment time was 13.8 ± 4.5 months. This is the first study showing that the CCLA with its high precision is very effective in correcting single tooth torque problems. Orthodontic torque correction resulted in a significant reduction of gingival recessions and caused only negligible root resorptions.

  • therapeutic accuracy of the completely customized Lingual Appliance win a retrospective cohort study
    Journal of Orofacial Orthopedics-fortschritte Der Kieferorthopadie, 2017
    Co-Authors: Alexander Pauls, Rainer Schwestkapolly, Manuel Nienkemper, Dirk Wiechmann
    Abstract:

    The aim of this retrospective cohort study was to assess the accuracy of the completely customized Lingual Appliance WIN (DW Lingual Systems, Bad Essen, Germany) employing a three-dimensional (3D) comparison between the setup and the final result. The setup and final models of 20 consecutively debonded patients (40 jaws; 7 males, 13 females; mean age 15.76 ± 4.45 years) with various malocclusions of a private practice specialized in orthodontics were digitalized using a 3D scanner. The 3D models of the setup and the final model of each jaw were then digitally matched using the best fit algorithm and segmented into single teeth. After placing individual coordinate systems, the homologous teeth of the setup and the final model were matched to be able to calculate the exact deviations of all rotational and translational components. The t test for unpaired samples, Kruskal–Wallis tests, U tests, and ANOVA with Duncan post hoc test were applied statistically. Regarding the incisors, the angle discrepancies between the setup and the final result appeared to be less than 3° (torque 2.96°; tip 2.04°; rotation 2.00°). The translations showed mean values less than 0.3 mm (mesiodistal 0.16 mm; buccoLingual 0.15 mm; vertical 0.29 mm). Slightly higher values could be measured in the lateral segments regarding rotations (torque 5.18°; tip 3.10°; rotation 3.70°) as well as regarding translations (mesiodistal 0.26 mm; buccoLingual 0.64 mm; vertical 0.36 mm). Using the completely customized Lingual Appliance WIN, it is possible to achieve the final result predicted by the setup with a high accuracy.

  • clinical complications during treatment with a modified herbst Appliance in combination with a Lingual Appliance
    Head & Face Medicine, 2015
    Co-Authors: Dirk Wiechmann, Rainer Schwestkapolly, Hansjoachim Helms, Michael Knosel
    Abstract:

    To assess the types and frequencies of clinical complications experienced when using a modified Lingual Herbst Appliance and to compare these with those associated with conventional Herbst Appliances reported in the literature. Treatment records for 35 consecutive subjects treated during the observation period from October 2013 to August 2014 who received a combination of a Lingual Appliance and a modified Herbst Appliance (WIN, DW LingualSystems) were assessed for complications linked to Herbst treatment phase. Complications were analyzed descriptively, and complication-free intervals were calculated using Kaplan-Meier plots. To enable a comparison with data reported in the literature, the cumulative treatment time for all subjects was divided by the total number of complications. 71.4 % of Herbst treatments were free from complications (n = 25). Complications were seen on 13 occasions (8 instances of Herbst attachment loosening, 5 L-Pin fractures). Most of these complications could be fixed chair side utilizing simple clinical measures. Considering all complications as identical statistical events, the percentage of treatments free from complications would be 88 % for 100 days, 70 % for 200 days and 56.8 % for 300 days. For severe complications, the averaged complication-free treatment interval was found to be 27.8 months. In terms of clinical sturdiness, and taking into consideration the step-wise mode of activation used here as well as the differences in the design of the various Herbst Appliances, the WIN-Herbst Appliance was found to be superior to comparable vestibular Herbst Appliances, as well as the banded Herbst Appliance belonging to the preceding generation of customized Lingual systems. Success in treatment of non-compliant Angle Class II correction is considered to have better predictability using the modified anchorage strategy of the WIN-Herbst Appliance.

X U Baohua - One of the best experts on this subject based on the ideXlab platform.

  • a clinical study of protruding cases by using Lingual Appliance and mini screw anchorage
    Chinese Journal of Orthodontics, 2013
    Co-Authors: W U Guanying, M A Lili, Lin Yang, X U Baohua
    Abstract:

    Objective To study the dentofacial changes of protruding cases after treatment by using Lingual Appliance and mini screw anchorage.Methods 20 randomly selected protruding cases were treated by Lingual Appliance and mini screw anchorage.In order to evaluate the effect of the treatment,the stability of mini screw anchorage were observed and cephalometrics were done.The traditional Lingual bracket and the base of the individual Lingual bracket were integrated.The manufactured individual Lingual brackets were used to treat the patients.The patients included 68 Class I,27 Class Ⅱ and 9 Class Ⅲ cases.Various kinds of malocclusions were included,such as protrusion,open bite,deep bite,cross bite,crowding and impaction.Results The success rate of mini screw anchorage is 97.5 ％.The upper first molars moved mesially an average of 0.23 mm.The central incisors moved distally an average of 5.31 mm.The angle of U1-Sn was 99.4°after Lingual orthodontic treatment.Conclusions The anchorage of molars can be controlled effectively by Lingual Appliance with micro-implant.Also the torque of anterior teeth can be controlled effectively and get good results. Key words: Lingual orthodontics;  Mini screw;  Anchorage;  Torque

  • a computer aided design and manufacture system for customized Lingual Appliance
    Chinese Journal of Orthodontics, 2012
    Co-Authors: M A Lili, X U Baohua
    Abstract:

    Objective To establish a computer-aided system to design and manufacture customized Lingual Appliance. Methods The system consisted of the data collection module,the software design module and the manufacture module. The digital bracket was manufactured using rapid prototyping technology.Results The customized Lingual Appliance matched the patient's teeth very well. Conclusions The computer-aided design and manufacture system could simplify laboratory procedures and improve the accuracy of Lingual bracket placement. Key words: CAD/CAM;  Customized;  Lingual Appliance

  • nrsing cooperation of personalized bonding for Lingual Appliance
    Nursing Practice and Research, 2012
    Co-Authors: X U Baohua
    Abstract:

    To investigate the personalized Lingual Appliance care in the clinical application of the process of bonding methods,pay attention to issues and the importance of psychological care.With the patient before the operation of adequate communication,good psychological care,and patients to establish friendly relationship of trust with the church how to treat patients,the entire operation of proficiency in operation in each step,quickly and accurately with the doctors,to improve work efficiency.

Robert B Lawson - One of the best experts on this subject based on the ideXlab platform.

M A Lili - One of the best experts on this subject based on the ideXlab platform.

  • a clinical study of protruding cases by using Lingual Appliance and mini screw anchorage
    Chinese Journal of Orthodontics, 2013
    Co-Authors: W U Guanying, M A Lili, Lin Yang, X U Baohua
    Abstract:

    Objective To study the dentofacial changes of protruding cases after treatment by using Lingual Appliance and mini screw anchorage.Methods 20 randomly selected protruding cases were treated by Lingual Appliance and mini screw anchorage.In order to evaluate the effect of the treatment,the stability of mini screw anchorage were observed and cephalometrics were done.The traditional Lingual bracket and the base of the individual Lingual bracket were integrated.The manufactured individual Lingual brackets were used to treat the patients.The patients included 68 Class I,27 Class Ⅱ and 9 Class Ⅲ cases.Various kinds of malocclusions were included,such as protrusion,open bite,deep bite,cross bite,crowding and impaction.Results The success rate of mini screw anchorage is 97.5 ％.The upper first molars moved mesially an average of 0.23 mm.The central incisors moved distally an average of 5.31 mm.The angle of U1-Sn was 99.4°after Lingual orthodontic treatment.Conclusions The anchorage of molars can be controlled effectively by Lingual Appliance with micro-implant.Also the torque of anterior teeth can be controlled effectively and get good results. Key words: Lingual orthodontics;  Mini screw;  Anchorage;  Torque

  • a computer aided design and manufacture system for customized Lingual Appliance
    Chinese Journal of Orthodontics, 2012
    Co-Authors: M A Lili, X U Baohua
    Abstract:

    Objective To establish a computer-aided system to design and manufacture customized Lingual Appliance. Methods The system consisted of the data collection module,the software design module and the manufacture module. The digital bracket was manufactured using rapid prototyping technology.Results The customized Lingual Appliance matched the patient's teeth very well. Conclusions The computer-aided design and manufacture system could simplify laboratory procedures and improve the accuracy of Lingual bracket placement. Key words: CAD/CAM;  Customized;  Lingual Appliance