Karpitsaris Nikolaos is a postgraduate student, currently final year resident at the department of Orthodontics, Marmara University of Istanbul. He graduated from Aristotle university of Thessaloniki and worked in dental clinics in Greece and Germany as a general dentist before choosing the path of Orthodontics. He believes that a perfect smile is the prettiest thing you can wear. His main interests include lingual orthodontics, orthognathic surgeries and modern treatment modalities.
Statement of the Problem: In recent years, the percentage of adult orthodontic patients has arisen. Adult patients prefer lingual braces more than the labial ones due to esthetic reasons. Lingual appliances can be comparable with labial appliances.\r\n\r\nAim: Among patients receiving lingual and labial orthodontic treatment, we aim to investigate the: changes related to “oral health related quality of life”, changes related to “self-esteem” and oral impacts during treatment.\r\n\r\nCase: A pair of female adults (twins) were referred to our clinic with same chief complaints of minor crowding and unesthetic smile. They had no medical history. Examination revealed skeletal Class I relationship, normal profile and minor crowding in both arches. One of them underwent orthodontic treatment with buccal fixed orthodontic appliances. The other had orthodontic treatment with 2D lingual fixed orthodontic appliances.\r\n\r\nMaterials and Methods: Our case is based on questionnaires being delivered to the patient at every appointment. Three proven and valid questionnaires were delivered: Ohip-14, Rosenberg Self-Esteem Scale, VAS. Their answers were used to quantify the differences between the two different treatment modalities throughout treatment.\r\n\r\nResult: Esthetically pleasing and ideal dental and skeletal occlusion was achieved in both cases. The patient with the lingual treatment showed better response regarding his quality of life and psychology. \r\n\r\nConclusion: This case shows a successful orthodontic treatment plan in both methods, with the lingual treatment playing a truly important role in the patient’s everyday life and psychology.
Jeong Min Lee qualified with an Integrated Masters and bachelor’s in dental surgery from Leeds Dental Institute in 2016. She completed Foundation Training and wanted to continue her training in a hospital setting and underwent an Oral & Maxillofacial surgery post as a Dental Core Trainee 1. This year she is currently a Restorative Dental Core Trainee 2 at Bart’s Hospital, London. During this first three years of her career she has completed her MFDS diploma with the Royal College of Physicians and Surgeons Glasgow and completed some surgical and restorative courses.
Case Description: A 60-year-old partially dentate man presented with generalized moderate tooth wear affecting both arches due to a combination of chronic alcohol intake, diet related factors and parafunctional habit. The patient reported a history of increasing sensitivity to cold and wanted to improve overall dental appearance as they appeared clinically short. He had a shortened dental arch (SDA) in the upper arch with a minimally restored lower dentition, both exhibiting signs of interproximal and occlusal enamel wear with cervical abrasion. He had edge-to-edge class III occlusion with loss of occlusal vertical dimension (OVD) but there was sufficient freeway space and no dento-alveolar compensation due to relatively rapid rate of tooth wear. He had adequate inter-arch space for restoration replacement and a new OVD of 3mm was decided after articulation in retruded contact position. \r\n\r\nTreatment outcome: Direct composite build ups were carried out on upper and lower 4-4s and a hard-occlusal splint was made post-operatively. He was very satisfied with the overall aesthetics and immediate reduction in sensitivity. 3 weeks later, he had adjusted well to the new occlusion. \r\n\r\nDiscussion: The main aim of the treatment was to identify risk factors and introduce preventative regime tailored to patient’s need in order to prevent future caries and minimize further tooth wear. It is therefore important to review the patient every 6 months to monitor wear facets and review alcohol intake in order to increase the longevity of the restorations. Survival rate of these composites can be predicted as moderate to long term as 8 occluding unit allows a stable occlusion and sufficient enamel and clinical height gave maximum surface area for bonding which increases overall durability. Minimally invasive technique was the preferred choice over indirect restorations due to the patient having moderate wear only.