An approach to rotational relapse

doi:10.1016/0002-9416(81)90198-6

American Journal of Orthodontics

Volume 80, Issue 1, July 1981, Pages 83-91

https://doi.org/10.1016/0002-9416(81)90198-6 Get rights and content

Abstract

The tendency of rotated teeth to relapse after treatment following retention is partially because of the supra-alveolar fibers which are stretched during rotational correction. Early treatment, overrotation, a long retention period, and proper contouring of contact points have been used to reduce relapse. With several surgical methods, it has been shown that releasing the tension in the periodontal fibers by severing the supracrestal and transseptal fibers significantly reduced relapse tendencies following rotation. This study was designed to test a simple surgical method (Vanarsdall) and to examine the effect of transsecting supra-alveolar fibers in orthodontically rotated teeth. Twelve cases in which a tooth and its antimere were rotated in excess of 10 degress prior to orthodontic treatment were chosen for this study. One of the two rotated teeth was chosen for the gingival fibrotomy, while its antimere was retained by conventional orthodontic means and served as a control. The incision was made at a 45-degree angle to the long axis of the tooth, on the labial and lingual aspects of each tooth, 2 months prior to debanding. A significant decrease in the amount of relapse up to 30 days following removal of appliances in the fibrotomy group as compared to the control group (0.42 degrees and 5.75 degrees, respectively) suggests that the procedure be considered for overcoming rotational relapse.

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There are more references available in the full text version of this article.

Cited by (18)

Comparison of 2 different wear protocols of vacuum-formed retainers with respect to the conventional parameters and 3-dimensional superimpositional analysis
2023, American Journal of Orthodontics and Dentofacial Orthopedics
This study aimed to compare the effectiveness of 2 different wear protocols of vacuum-formed retainers (VFR) in terms of angular and linear displacement of teeth using 3-dimensional (3D) superimpositional analysis and conventional model parameters.
The study was conducted on 2 groups, each consisting of 17 patients randomly assigned to the part-time group or full-time group of VFR wearing after a nonextraction treatment. While conventional model measurements were assessed on 3D dental casts, 3D tooth movements were evaluated by digitally superimposed scans of casts acquired at 4-time points (debonding and 1, 3, and 6 months after debonding). Regarding conventional parameters, the difference between time-dependent changes among the groups was tested using the nonparametric Brunner-Langer and parametric linear mixed models. Considering 3D measurements, comparisons of groups were made using the Student t tests.
There were no significant intergroup differences regarding conventional model parameters at any time (P >0.05). Significant intergroup differences were observed regarding angular and linear relapses in the labiolingual direction for maxillary and mandibular incisors, as well as the rotational relapses for maxillary left canine and mandibular right lateral incisor, which were greater in the part-time group in the first month and at the end of 6 months (P <0.05).
Conventional model parameters appear to play a debatable role in evaluating the effectiveness of a retainer wear regimen. Three-dimensional analysis of tooth movements revealed that part-time VFR wear was less effective in retaining labiolingual and rotational tooth movements for the first month after debonding.
Comparison of conventional and laser-aided fiberotomy in relapse tendency of rotated tooth: A randomized controlled clinical trial
2019, International Orthodontics
Citation Excerpt :
In 1970 Edwards introduced circumferential supracrestal fiberotomy (CSF) as a procedure to transect supraalveolar (gingival and transsepetal) fibers for reducing relapse after rotational movements [2,3]. Other animal and clinical studies also showed that CSF is an effective procedure for reduction of relapse [2,4–7]. CSF is a simple method and patient referral to a periodontist is not necessary unless gingival recession is a worrying factor [8].
The aim of the present study was to compare the tendency of mandibular incisor rotation relapse after conventional circumferential supracrestal fiberotomy (CSF) with Er,Cr:YSGG laser-aided CSF.
In this three-arm parallel study, the patients with one lower incisor rotation greater than 30 degrees before treatment were selected. The patients were randomly assigned to three groups in a 1:1:1 ratio. Rotational relapse tendency was measured on a digitized model one month after arch wire removal. Probing depth, clinical crown height and pain levels were also measured.
A total of 46 patients were recruited. Relapse tendency in conventional CSF and laser-aided CSF groups were 5.09 ± 1.59° and 4.87 ± 2.08°, respectively, and significantly lower than 11.28 ± 2.93° in the control group (P < 0.001). Relapse tendency was not different between the conventional CSF and laser CSF groups. Probing depth, clinical crown height, and experienced pain levels exhibited negligible differences.
Er,Cr:YSGG laser-aided CSF in one month was as effective in reducing rotational relapse tendency of mandibular incisor teeth as conventional CSF.
La présente étude a eu pour but de comparer la tendance à la récidive de la rotation des incisives mandibulaires après une fibrotomie circonférentielle supracrestale classique (CSF) et après une CSF assistée au laser Er,Cr:YSGG.
Dans cette étude à trois bras parallèles, les patients ayant une rotation incisive mandibulaire supérieure à 30 degrés avant le traitement ont été sélectionnés. Les patients ont été répartis au hasard en trois groupes dans un rapport de 1:1:1. La propension à la récidive de la rotation a été mesurée sur un modèle numérisé un mois après l’enlèvement de l’arc orthodontique. La profondeur de sondage, la hauteur de la couronne clinique et les niveaux de douleur ont également été mesurés.
Au total, 46 patients ont été recrutés. La tendance à la récidive dans les groupes de CSF classique et de CSF assistée par laser était de 5,09 ± 1,59° et 4,87 ± 2,08°, respectivement, et significativement inférieure à 11,28 ± 2,93° dans le groupe témoin (p < 0,001). La tendance à la récidive n’était pas différente entre les groupes de CSF classique et de CSF au laser. La profondeur du sondage, la hauteur clinique de la couronne et les niveaux de douleur observés présentaient des différences négligeables.
En un mois, la CSF assistée au laser Er,Cr:YSGG a été aussi efficace pour réduire la tendance à la récidive rotationnelle des incisives mandibulaires que la CSF classique.
Effect of low-level laser irradiation on the rate and short-term stability of rotational tooth movement in dogs
2015, American Journal of Orthodontics and Dentofacial Orthopedics
Citation Excerpt :
Furthermore, because of the high output power of the laser used in this study (200 MW) and to avoid the range of inhibitory doses during the rotational dental movement (Arndt-Schultz law: weak stimuli will increase physiologic processes, and strong stimuli will inhibit physiologic activity), irradiation was performed only from the buccal side of the root and on 2 points. In line with other studies investigating dental rotations, our measurement method also evaluated the status of the teeth related to the constant reference line.11,18,33-35 The reference line was determined to cross the most prominent cusp tip of the mandibular second premolars.
Low-level laser therapy (LLLT) has many biostimulative effects such as acceleration of mesiodistal orthodontic tooth movement. However, its effects on the extent and short-term stability of rotational tooth movement have not been researched. The purpose of this study was to investigate the effect of low-level laser irradiation during rotational tooth movement on the rate of movement and the amount of relapse in dogs.
In this interventional study, fixed orthodontic appliances were used to rotate both mandibular lateral incisors in 8 dogs. Sixteen teeth were divided into 2 groups: the experimental group with LLLT during orthodontic force application, and a control group with orthodontic couple force application only. In the first group, the gallium-aluminum-arsenide diode laser (810 nm, 200 mw, 10 seconds, 2 J/session, 32 J/cm²/point) was emitted on 2 points at the buccal side of the roots on days 0, 1, 2, 3, 4, 7, 14, 21, and 28 during 4 weeks of movement, and the amount of relapse was then observed for 3 months. The extent of rotational movement was measured on dental casts, and the statistical analysis was carried out with t tests.
There was no significant difference between the LLLT group and the control group on the amount of rotational tooth movement (P = 0.66). The mean percentages of relapse after 1 week, 1 month, and 3 months were 33.02%, 53.44%, and 60.64% in the LLLT group and 54.22%, 68.74%, and 73.92% in the control group, respectively. This demonstrates significant differences between these groups at all studied times (P ≤0.05). This difference was greatest in the first week and then decreased until the end of the third month. The greatest percentage of relapse in both groups was registered in the first week after tooth movement.
The total energy dose of the laser used in this study could not accelerate rotational tooth movement, but it did effectively reduce the relapse tendency in teeth rotated by orthodontic movements.
Effectiveness of Er:YAG laser-aided fiberotomy and low-level laser therapy in alleviating relapse of rotated incisors
2014, American Journal of Orthodontics and Dentofacial Orthopedics
In this study, we compared the effectiveness of laser-aided circumferential supracrestal fiberotomy (CSF) and low-level laser therapy (LLLT) with conventional CSF in reducing relapse of corrected rotations.
The study included 24 patients who were at the finishing stage of orthodontic treatment and had at least 1 maxillary incisor with 30° to 70° of rotation before starting therapy. The subjects were divided into 4 groups by treatment: conventional CSF, Er:YAG laser-aided CSF, LLLT, and control. After alginate impressions were taken, the archwire was sectioned from the experimental incisors, and they were allowed to relapse. The second impression was taken 1 month later, and the degree and percentage of relapse were calculated in photographs taken from the dental models. Gingival recession, pocket depth, and pain were also measured in the CSF groups.
The mean percentages of relapse were 9.7% in the conventional CSF, 12.7% in the Er:YAG laser-aided CSF, 11.7% in the LLLT, and 27.8% in the control groups. Relapse was significantly greater in the control than the experimental groups (P <0.05), which were not statistically different from each other. The changes in sulcus depth and gingival recession were small and not significantly different among the CSF groups (P >0.05), but pain intensity was greater in subjects who underwent conventional CSF (P = 0.003).
Er:YAG laser-aided CSF proved to be an effective alternative to conventional CSF in reducing rotational relapse. LLLT with excessively high energy density was also as effective as the CSF procedures in alleviating relapse, at least in the short term.
A quantitative comparison of collagen phagocytosis in periodontal ligament and transseptal ligament of the rat periodontium
1984, American Journal of Orthodontics
The phagocytosis of collagen within soft connective tissues can be used as an index of collagen turnover and remodeling. The objective of this study was to compare the levels of collagen phagocytosis in periodontal and transseptal ligaments in the rat in order to provide an indication of the relative collagenturnover activities within these two tissues. Periodontal and transseptal ligaments from two rats were examined by the techniques of electron microscope stereology. Parameters quantitated included cytoplasm (CC), extracellular collagen (ECC), and intracellular or phagocytosed collagen (ICC). The results indicated that the cells of the transseptal ligament have significantly more ICC than those of periodontal ligament. This suggests that the transseptal ligament in the rat may have a high rate of collagen turnover. There seems to be an increasing body of evidence, including the present results, that the transseptal ligament region of gingiva has a high level of collagen turnover. It seems likely, therefore, that, unless there are marked species differences in collagen turnover, slow remodeling of the transseptal ligament is not responsible for orthodontic relapse. Why relapse of rotated teeth can be reduced by surgical severing or removal of the transseptal tissue remains to be determined.
Orthodontic management of mandibular canine-incisor transposition
1983, American Journal of Orthodontics
This article presents five cases of an unusual dental anomaly—transposition of mandibular canine and lateral incisor. While every one of the presented cases had its individual characteristics, there are certain common traits. For instance, deciduous canines are usually retained, and the anomaly is found concurrent with other dental problems, such as congenital absence of teeth or peg-shaped lateral incisors. Many transposition cases also have a severe arch length discrepancy, which in itself may be an etiologic factor. In two of our cases orthodontic management included extraction of the transposed lateral incisor, whereas in the remaining three cases teeth were left in their transposed positions. On the basis of the longitudinal records of one of our cases, we speculate that there are early signs of transposition in the making, signs which should be recognized and which could possibly make transposition preventable.

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^∗: Postgraduate Student, Orthodontic Department.

^∗∗: Associate Professor, Orthodontic Department.

^∗∗∗: Professor and Chairman, Orthodontic Department.

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Original articleAn approach to rotational relapse

Abstract

Am. J. Orthod.

Am. J. Orthod.

Int. J. Orthod.

Am. J. Orthod.

Retention and avoidance of posttreatment relapse

Am. J. Orthod.

Transseptal fibers and relapse following bodily retraction of teeth; a histologic study

Am. J. Orthod.

Clinical experiments with circumferential supracrestal fiberotomy

Am. J. Orthod.

Irregularities of teeth and their treatment

Dent. Cosmos

Tooth alignment and retention

Dent. Survey

Original article
An approach to rotational relapse