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BMC Oral Health May 2019To examine: (I) the current evidence of the impact of fixed orthodontic appliances on the development of halitosis in patients undergoing orthodontic treatment, and (II)...
OBJECTIVE
To examine: (I) the current evidence of the impact of fixed orthodontic appliances on the development of halitosis in patients undergoing orthodontic treatment, and (II) the influence of different orthodontic bracket systems on halitosis.
MATERIAL AND METHODS
Three electronic databases (PubMed, Scopus, and Cochrane Library) were searched prior to March 15, 2018. The review was systematically conducted and reported according to the Cochrane Handbook and the PRISMA statement. Only Randomised Clinical Trials (RCTs) were considered. Selected full-text papers were independently assessed by four investigators and any disagreements were resolved by consensus. The Cochrane Handbook was used to grade the risk of bias and the quality of evidence was rated according to GRADE.
RESULTS
Out of 363 identified studies, three RCTs on halitosis and fixed orthodontic appliances met the inclusion criteria. The risk of bias in the three studies was rated as high and the quality of evidence was rated as very low.
CONCLUSIONS/CLINICAL IMPLICATIONS
There is a lack of scientific evidence that subjects with fixed orthodontic appliances develop halitosis during treatment. Additional well-conducted RCTs with extended periods of assessment are needed as well as consensus concerning cut-off values for the diagnosis of halitosis.
Topics: Halitosis; Humans; Orthodontic Appliances; Orthodontic Appliances, Fixed; Orthodontic Brackets; Randomized Controlled Trials as Topic
PubMed: 31046726
DOI: 10.1186/s12903-019-0761-1 -
BMC Oral Health Oct 2020Conventional brackets are often used during orthodontic therapy of patients with malocclusion. The complex construction of such brackets greatly inhibits oral hygiene,...
BACKGROUND
Conventional brackets are often used during orthodontic therapy of patients with malocclusion. The complex construction of such brackets greatly inhibits oral hygiene, which predisposes to increased carriage of microbiota. Orthodontic brackets could act as reservoir of yeast and predispose to oral candidosis. The aim of this study was to assess Candida prevalence and the role of oral hygiene during fixed appliance therapy. A further aim was to characterize the isolated yeasts according to their ability to form biofilms.
METHODS
Seventeen participants (average age 17 ± 7 years) were monitored by taking oral rinses and elastomeric ligature samples, and by evaluating the approximal plaque index (API) and gingival bleeding index (GBI) before and after placement of the orthodontic conventional brackets for 12 weeks. Isolated yeasts were counted and biofilm formation was evaluated.
RESULTS
One hundred and sixteen samples (67 oral rinses and 49 orthodontic elastomers) were collected. Ten patients (58.8% subjects) were Candida-carriers (two were colonized after bracket placement) and C. albicans was the most common species. The average number of yeasts in the oral cavity showed some fluctuation during the study, but in general had an upward trend (adj. R2 = 0.7967, p = 0.07025). A correlation was found between median number of yeasts and the periodontal indices (API, GBI). The average API values decreased in the Candida-carriers (adj. R = 0.95; p = 0.01709), while average GBI values increased in the noncarriers (adj. R = 0.92; p = 0.0256).
CONCLUSIONS
Treatment with orthodontic appliances promotes Candida yeast colonization, which is variable over time in terms of strain and species, with dominance of C. albicans, and without increased biofilm-forming activity. The API value decreases over time in carriers, and the GBI value increases in uncolonized patients, which may have predictive significance for the development of oral candidiasis during orthodontic treatment.
Topics: Adolescent; Adult; Candida; Child; Dental Plaque Index; Humans; Oral Hygiene; Orthodontic Brackets; Periodontal Index; Prevalence; Young Adult
PubMed: 33036600
DOI: 10.1186/s12903-020-01267-4 -
Journal of Applied Oral Science :... 2021Pain is a problem during bracket removal, and more comfortable treatment is needed. This study examined the association of pain with the removal force required for...
OBJECTIVE
Pain is a problem during bracket removal, and more comfortable treatment is needed. This study examined the association of pain with the removal force required for ceramic brackets, compared with metal and plastic brackets, to determine which removal method resulted in less pain and discomfort.
METHODOLOGY
81 subjects (mean age, 25.1 years; 25 males and 56 females) were enrolled, from whom 1,235 brackets (407 ceramic, 432 plastic, and 396 metal) were removed. Measured teeth were distinguished at six segments. Pain was measured with a visual analogue scale (VAS) during the removal of each bracket. An additional grip was placed on the grips of debonding pliers with right-angled beaks; a mini loading cell sensor pinched by the grips was used to measure removal force during debonding. VAS and force values were statistically analyzed. The Kruskal-Wallis test followed by the Mann-Whitney U test with Bonferroni correction were performed for multiple comparisons; multiple regression analysis was also performed.
RESULTS
Forces in the upper and lower anterior segments were significantly smaller (p<0.05) than those in the other segments. Pain tended to be greater in the upper and lower anterior segments than in the posterior segments. In all segments, the removal force was greater for metal brackets than for plastic or ceramic brackets. Ceramic brackets caused significantly greater pain than plastic brackets for the upper and lower anterior segments. Debonding force was involved in the brackets, following adjustments for pain, upper left segment, age, and sex.
CONCLUSIONS
Pain and discomfort are likely to occur during bracket debonding.
Topics: Adult; Animals; Ceramics; Dental Debonding; Humans; Orthodontic Brackets; Pain
PubMed: 34320118
DOI: 10.1590/1678-7757-2020-0879 -
Journal of Orofacial Orthopedics =... Sep 2019In vitro testing of archwires in a multibracket model may provide estimates of force-moment (F/M) systems applied to individual teeth in a realistic geometry. Such...
OBJECTIVE
In vitro testing of archwires in a multibracket model may provide estimates of force-moment (F/M) systems applied to individual teeth in a realistic geometry. Such investigations have mostly been performed by continuous wire deflection, leading to frictional forces biasing the pure deflection forces. Aim of this study was to quantify this bias and the pure deflection forces for leveling archwires.
MATERIALS AND METHODS
Three nickel-titanium (NiTi) and two multistranded wires were tested in a three-bracket model simulating vertical movement of an upper incisor with a typical interbracket distance of 8 mm (intercenter). To determine pure deflection forces, the middle bracket was first leveled incrementally from its vertical malposition to neutral position with repeated wire insertion at each step (so-called "static leveling mode"). For comparison, forces at the middle bracket were also determined during dynamic leveling with or without ligation of the wire at the lateral brackets by either elastic, tight or loose steel ligatures.
RESULTS
The dynamic mode resulted in significantly lower mean leveling forces for all the tested wires (ANOVA [analysis of variance], p < 0.01) compared to the static mode. Expressed in numbers, dynamic wire unloading resulted in mean force underestimation of 53 ± 9% (loose steel ligatures), 56 ± 11% (elastic ligatures) or 91 ± 29% (tight steel ligatures).
CONCLUSIONS
Orthodontic tooth movement is quasi-static. This concerns the initial hyalinization phase in particular. Thus, especially static testing of archwires provides valid reference data for the peak forces exerted directly after clinical insertion of a leveling wire. In dynamic wire testing, significant underestimation of actual forces exerted on individual teeth may occur due to experimental friction, which might considerably differ from that occurring during clinical therapy. This aspect has to be taken into account in the interpretation of published stiffness values for orthodontic wires, and in the selection of the appropriate archwire for leveling of the present tooth malposition, respectively.
Topics: Dental Stress Analysis; Friction; Materials Testing; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Titanium; Tooth Movement Techniques
PubMed: 31410493
DOI: 10.1007/s00056-019-00187-5 -
Medicina (Kaunas, Lithuania) Feb 2021The aim of this study was to evaluate the influence of friction on design of the type of bracket, patients' perception of pain and the impact on their oral... (Randomized Controlled Trial)
Randomized Controlled Trial
The aim of this study was to evaluate the influence of friction on design of the type of bracket, patients' perception of pain and the impact on their oral health-related quality of life. A randomized clinical trial was carried out with 90 patients (62.2% women and 37.8% men) with three kinds of fixed multi-bracket appliances: Conventional (GC), fixed multi-bracket low friction (GS) and self-ligating (GA). The VAS (Visual Analogue Scale) was used to determine pain during the first seven days of treatment at different points in time. The patients were also given the OHIP-14 (Oral Health Impact Profile) questionnaire to analyse their oral health-related quality of life (OHRQoL) after the first 30 days of treatment. The ANOVA test was used for the analysis of the variables and the post hoc Bonferroni test for the comparison between groups. Maximum pain was observed between one and two days after the start of treatment. The GC group showed the greatest degree of pain, with maximum values (4.5 ± 2.0) at 24 h. The self-ligation brackets show lower impact on patients' oral health-related quality of life (0.8 ± 2.2, < 0.01). Friction in the type of bracket influences pain and the Oral Health-Related Quality of Life of patients who use multi-bracket fixed orthodontics.
Topics: Friction; Humans; Materials Testing; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Quality of Life
PubMed: 33671217
DOI: 10.3390/medicina57020171 -
The Angle Orthodontist May 2022To evaluate the transfer accuracy of 3D-printed indirect bonding trays constructed using a fully digital workflow in vivo.
OBJECTIVES
To evaluate the transfer accuracy of 3D-printed indirect bonding trays constructed using a fully digital workflow in vivo.
MATERIALS AND METHODS
Twenty-three consecutive patients had their incisors, canines, and premolars bonded using fully digitally designed and 3D-printed transfer trays. Intraoral scans were taken to capture final bracket positioning on teeth after bonding. Digital models of postbonding scans were superimposed on those of corresponding virtual bracket setups, and bracket positioning differences were quantified. A total of 363 brackets were evaluated. One-tailed t-tests were used to determine whether bracket positioning differences were within the limit of 0.5 mm in mesiodistal, buccolingual, and occlusogingival dimensions, and within 2° for torque, tip, and rotation.
RESULTS
Mean bracket positioning differences were 0.10 mm, 0.10 mm, and 0.18 mm for mesiodistal, buccolingual, and occlusogingival measurements, respectively, with frequencies of bracket positioning within the 0.5-mm limit ranging from 96.4% to 100%. Mean differences were significantly within the acceptable limit for all linear dimensions. Mean differences were 2.55°, 2.01°, and 2.47° for torque, tip, and rotation, respectively, with frequencies within the 2°-limit ranging from 46.0% to 57.0%. Mean differences for all angular dimensions were outside the acceptable limit; however, this may have been due to limitations of scan data.
CONCLUSIONS
Indirect bonding using 3D-printed trays transfers planned bracket position from the digital setup to the patient's dentition with a high positional accuracy in mesiodistal, buccolingual, and occlusogingival dimensions. Questions remain regarding the transfer accuracy for torque, tip, and rotation.
Topics: Dental Bonding; Humans; Models, Dental; Orthodontic Brackets; Printing, Three-Dimensional
PubMed: 35006236
DOI: 10.2319/073021-596.1 -
Journal of the Mechanical Behavior of... Feb 2021Orthodontic archwire rotation around its long axis, known as third-order torque, is utilised to correct tooth rotational misalignments moving the tooth root closer to or...
Orthodontic archwire rotation around its long axis, known as third-order torque, is utilised to correct tooth rotational misalignments moving the tooth root closer to or away from the cheek through engagement with an orthodontic bracket. Studying the behaviour of archwire and brackets during an applied rotation can aid in better understanding and appreciating the mechanics of third-order torque, potentially allowing for more effective orthodontic treatment protocols. Mechanically characterising archwire behaviour during third-order torque application is a complex task due to their physical scale and geometries. An advanced measurement technique was needed to address these constraints. A three-dimensional (3D) non-contact optical method using a digital image correlation (DIC) system was developed. An orthodontic torque simulator (OTS) was used to apply and measure third-order torque with 0.483 × 0.635 mm (0.019″ x 0.025″) rectangular archwires in tandem with a 3D DIC system, whereby surface deformations and strains could be computed using correlation algorithms. The 3D DIC system was implemented to enable third-order torque experimentation with the OTS while imaging the archwire and bracket surfaces. The 3D DIC system's ability to measure 3D archwire deformations and strains was verified using a finite element model, where comparisons between 3D DIC measurements and calculated results from the model were made to ensure the measurement capabilities of 3D DIC in the context of third-order torque. The 3D DIC system was then used to compare archwire behaviour between stainless steel (SS) and titanium molybdenum alloy (TMA) archwires to study potential clinical differences in archwire behaviour, in which the archwires were rotated with a custom SS rigid dowel (RD) as well as commercial Damon Q orthodontic brackets. The quantification of third-order torque and archwire deformations and strains led to the conclusion that SS archwires led to larger torque magnitudes compared to TMA archwires. The RD resulted in larger archwire strains compared to Damon Q brackets. The 3D DIC system provides a non-contact measurement technique that can further be used with third-order torque experimentation with the OTS.
Topics: Dental Alloys; Dental Stress Analysis; Materials Testing; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Stainless Steel; Surface Properties; Titanium; Torque
PubMed: 33221162
DOI: 10.1016/j.jmbbm.2020.104196 -
Journal of Orofacial Orthopedics =... Mar 2015The purpose of this study was to quantify artifacts caused by different bracket systems in cone-beam computed tomography (CBCT) and multislice computed tomography (MSCT)... (Comparative Study)
Comparative Study
OBJECTIVES
The purpose of this study was to quantify artifacts caused by different bracket systems in cone-beam computed tomography (CBCT) and multislice computed tomography (MSCT) scans.
METHODS
Orthodontic brackets of four different systems were consecutively bonded to the surface of a residual molar on a human cadaveric mandible. One MSCT system and three CBCT units were used to scan each of the four bonded brackets, in addition to obtaining a blank reference scan of the tooth surface. All datasets were registered to the reference dataset using visualization software (Analyze 11.0® by AnalyzeDirect). Artifact-related reductions in image quality were expressed in percent of theoretical maximum standard deviations (SD) obtained for the gray values of the adjacent voxels, with higher percentages correlating more pronounced artifacts.
RESULTS
Both the SD percentages for three defined line profiles and their mean values were almost invariably higher with the MSCT system than with the CBCT units. Looking into the individual SD percentages, two of the CBCT units (Pax Zenith 3D® and Picasso Trio®; both Vatech) produced higher values than the MSCT system (SOMATOM Definition AS+®; Siemens) in some line profiles. The titanium bracket, in particular, was associated with marked differences between the two scanner technologies, as the mean artifact intensities from this bracket were particularly high with the MSCT unit and relatively low with the CBCT units. The artifact intensities observed with the other three bracket systems varied widely depending on which scanner was used.
CONCLUSION
Different artifact intensities were noted depending on the composition of the bracket system and on the scanner technology (MSCT/CBCT). While the artifacts manifested themselves differently with different scanners, their adverse effects were comparable. However, given the variable severity of the artifacts observed depending on the materials scanned and the scanners used, a blanket recommendation for or against MSCT or CBCT units cannot be given on the basis of this study.
Topics: Artifacts; Cadaver; Cone-Beam Computed Tomography; Humans; Molar, Third; Multidetector Computed Tomography; Orthodontic Brackets; Phantoms, Imaging; Radiographic Image Interpretation, Computer-Assisted; Radiography, Dental; Reproducibility of Results; Sensitivity and Specificity
PubMed: 25744093
DOI: 10.1007/s00056-014-0278-9 -
The Journal of Contemporary Dental... Sep 2021The aim of the study was to develop a method which can help us achieve precise and accurate direct bonding (DB).
AIM
The aim of the study was to develop a method which can help us achieve precise and accurate direct bonding (DB).
BACKGROUND
Proper and accurate bracket position during orthodontic bonding is one of the main concerns for the clinician. Proper bonding reduces the effort to achieve good finishing by minimizing the wire bending. Unwanted tooth movements like unplanned tip, torque, and rotation are minimized, so the treatment time is shortened. Commonly used techniques for bonding brackets to teeth are DB and indirect bonding (IDB).
TECHNIQUE
A new technique involving the innovative use of tooth-shaped stickers was suggested to combine the advantages of both the methods.
CONCLUSION
There was an accuracy in horizontal, vertical, and axial positioning of the brackets using this method.
CLINICAL SIGNIFICANCE
We found this as an effective method to achieve ideal bracket position by eliminating subjective bias and standardizing the bonding procedure, thus achieving better results in a shorter time by eliminating bonding errors.
Topics: Dental Bonding; Models, Dental; Orthodontic Brackets; Tooth; Tooth Movement Techniques
PubMed: 35000956
DOI: No ID Found -
BMC Oral Health Sep 2023Orthodontic treatment is associated with numerous adverse side effects, such as enamel discoloration, demineralization or even caries. The presence of microleakage...
BACKGROUND
Orthodontic treatment is associated with numerous adverse side effects, such as enamel discoloration, demineralization or even caries. The presence of microleakage between the enamel and the adhesive and between the adhesive and the base of the orthodontic bracket allows penetration of the bacteria, molecules, and liquids into the enamel and can lead to unpleasant "white spot lesions" or secondary caries beneath and around the brackets. The aim of this in vitro study was to evaluate microleakage in five adhesive systems commonly used in orthodontic practice for bonding brackets.
METHODS
One hundred extracted premolars were divided into five groups of twenty teeth. Stainless steel Legend medium metal brackets were bonded to teeth using five adhesive systems: resin-reinforced glass ionomer cement GC Fuji Ortho LC (GCF) and composite materials Light Bond (LB), Transbond XT (TB), Trulock™ Light Activated Adhesive (TL), and GC Ortho Connect (GCO). The specimens were subjected to thermal cycling, stained with 2% methylene blue, sectioned with low-speed diamond saw Isomet and evaluated under a digital microscope. Microleakage was detected at the enamel-adhesive and adhesive-bracket interfaces from occlusal and gingival margins. Statistical analysis was performed using generalized linear mixed models with beta error distribution.
RESULTS
Microleakage was observed in all materials, with GCF showing the highest amount of microleakage. Composite materials GCO, TB, and LB exhibited the lowest amount of microleakage with no statistical difference between them, while TL showed a statistically significantly higher amount of microleakage (p < 0.001). The enamel-adhesive interface had more microleakage in all composite materials (GCO, LB, TB, and TL) than the adhesive bracket-interface (p < 0.001). The highest amount of microleakage occurred in the gingival region in all materials.
CONCLUSION
Composite materials showed better adhesive properties than a resin-reinforced glass ionomer cement. The presence of microleakage at the enamel-adhesive interface facilitates the penetration of various substances into enamel surfaces, causing enamel demineralization and the development of dental caries.
Topics: Humans; Orthodontic Brackets; Dental Caries; Research Design; Dental Enamel; Glass Ionomer Cements
PubMed: 37670283
DOI: 10.1186/s12903-023-03368-2