Wolters, C.B. (2019) Het effect van een kortere herstelperiode dan aanbevolen op het behandelsucces van de getraumatiseerde maxillaire incisief na orthodontische behandeling. thesis, Dentistry.
Full text available on request.Abstract
PURPOSE There are no available guidelines for the orthodontic treatment of traumatic injuries. Much research has been done in the hope of uncovering an optimal treatment procedure and come with recommendations for observation periods based on clinical expertise and case reports. The apparent ideal treatment remains a topic of debate, the literature has reported on treatment success in a way that deviates from recommendations made over the course of the observation period. The main purpose of this research is to present the current recommendations and to form one overarching recommendation. Clinical cases whereby orthodontic treatment is given following dental trauma, are assayed onto this recommendation to answer the final question whether orthodontic treatment of maxillary central incisors can be started earlier than recommended without changing treatment outcomes. METHODS As part of the literature review, the electronic database MEDLINE-PubMed was utilised in search for recommendations, where 3 recommendations were included. An overarching recommendation regarding the observation period was developed per category of dental trauma (mild/moderate/severe). Different orthodontic treatments of maxillary central incisors were also searched, 80 elements from case reports were included. The treatment outcome (successful/with complications/failed) was determined per element on the basis of different outcome variables (pulp necrosis, root resorption, ankylosis and marginal bone loss). Treatment outcomes from case studies were compared to this observation period (short/longer than recommended) with help of frequency tables and the Fisher Exact Test. Next to the observation period, remaining independent variables (age, gender, degree of root development, single or combined dental trauma, category of dental trauma and treatment duration) were tested for the effect with regards to the occurrence of complications through a logistic regression analysis. RESULTS For the categories mild, moderate and severe dental trauma, the observation period was 3, 6 and 12 months respectively. In total, 68,8 % of all treated traumatic incisors were treated before recommended (n=55). The treatment outcome was successful for 27,3 % of the cases (n=15), 60 % successful with complications (n=33) and 12,7 % of the cases failed (n=9). In the group with a longer observation period than recommended, the percentages were 48 % (n=12), 44 % (n=11) and 8 % (n=8) respectively. Differences in treatment outcome between shorter and longer observation periods were insignificant (p>0,05). Moreover, a significant effect does not seem to exist for any of the independent variables (p>0,05). CONCLUSION Recommendations found in the research literature are divergent and have low evidential value. After analysing results from case reports, it can be concluded that successful treatment outcomes after orthodontic treatments of maxillary central incisors are possible. No significant difference in treatment outcome can be demonstrated between earlier or later than recommended observation periods.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Janssen, drs. K.I. |
| Faculty: | Medical Sciences |
| Date Deposited: | 24 Nov 2021 09:13 |
| Last Modified: | 24 Nov 2021 09:13 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2865 |
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