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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 -
The Angle Orthodontist May 2020To evaluate the effects of adhesive precoated (APC) flash-free brackets on enamel demineralization and periodontal status in patients during fixed orthodontic treatment. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
To evaluate the effects of adhesive precoated (APC) flash-free brackets on enamel demineralization and periodontal status in patients during fixed orthodontic treatment.
MATERIALS AND METHODS
Thirty patients, age 12 to 18 years, who had Angle Class I or Class II malocclusion with mild to moderate crowding in the permanent dentition were selected for this study. APC flash-free and conventional ceramic brackets were bonded for a split-mouth study design. The quadrant allocation was randomized. Demineralization records were obtained immediately after bonding (T0), 1 month after bonding (T1), and 6 months after bonding (T2). Clinical periodontal measurements, including gingival index, plaque index, and bleeding upon probing, were obtained before bonding (T0) and at the same time points (T1 and T2). Data were analyzed using Mann-Whitney U and Friedman tests to compare parameters between groups and times.
RESULTS
Demineralization values decreased on most sides of the brackets for both groups between T0 and T1. In the conventional group, there was significantly higher demineralization on more sides compared with flash-free brackets between T1 and T2. With one exception, the decreased values were found in the incisal/occlusal sides of all brackets at T2. All periodontal parameters showed significant increases after 6 months of treatment in both groups. Intergroup comparison showed no significant differences in demineralization or periodontal measurements at any of the time points.
CONCLUSIONS
The effects of APC flash-free and conventional brackets on enamel demineralization and periodontal health did not differ from each other.
Topics: Adolescent; Child; Dental Bonding; Dental Cements; Dental Enamel; Dental Plaque Index; Humans; Orthodontic Brackets; Tooth Demineralization
PubMed: 33378441
DOI: 10.2319/80819-518.1 -
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 -
European Journal of Paediatric Dentistry Dec 2023This is a frequently asked question. The answer depends on various factors, with cooperation being among the most essential. As a parent, you must ask yourself if you...
This is a frequently asked question. The answer depends on various factors, with cooperation being among the most essential. As a parent, you must ask yourself if you can rely on your child to wear aligners correctly for most of the day. If the answer to this question is yes, then clear aligners may be a better choice than traditional braces. There are three major benefits of clear aligners in children: 1. Greater comfort, aligners are less voluminous than traditional braces and more likely to prevent irritation, mouth ulcers and other discomfort that derives from the movement of the orthodontic wire or braces. 2. Better hygiene, as their removal during meals and tooth cleaning manoeuvres makes home oral hygiene easier. 3. Better aesthetics, thanks to the transparency of the plastic replacing the metal. However, a certain degree of caution is advised to those who are considering this treatment option. Although aligners allow us to start resolving certain tooth malpositions (which can cause periodontal and aesthetic problems or increase the severity of damage in the event of trauma), and to improve alignment and minor crowding at an early age, it must not be forgotten that the intervening period for changing the definitive position of individual teeth is still the period of permanent teeth. It is important to consider whether a child has a dental or skeletal problem. In cases where a child's problem is exclusively dental, the aligner may be one of the tools used. In cases of skeletal problems, the literature advises against the aligner, as it is not the right instrument at this stage of development. The literature in some cases refers to aligners as the universal remedy, valid for every malocclusion, presenting them as a panacea for all orthodontic problems of very young patients. It is necessary to remain open to the innovations that the market offers us and that can improve our daily clinic, and aligners can be a valid support in this regard, but, as dentists, we should always keep a critical and open eye on treatments with an evidence-based rationale. As with all other orthodontic appliances, aligners must be evaluated on a case-by-case basis, keeping in mind that they are one of the tools in the hands of the clinician. When the clinical situation makes it possible and when both the child's requirements and the parent's expectations are fulfilled, it is certainly worth considering clear aligners as a viable route in the family-child's orthodontic treatment, making it as simple and convenient as possible. Lastly, we should remember the concept of efficiency regarding an orthodontic treatment, which depends on its cost/benefit ratio, with the former being understood in a biological sense and in terms of its impact on the life of the patient and their family with respect to duration, cooperation required, discomfort induced by the equipment used and frequency of check-ups. The latter should obviously be considered in terms of results obtained in relation to the pre-established treatment goals. A consideration that we should always keep in mind: let us never forget that is the orthodontist who treats the patient, not the appliance!
Topics: Humans; Orthodontic Appliances, Fixed; Orthodontic Brackets; Dental Care
PubMed: 38015116
DOI: 10.23804/ejpd.2023.24.04.01 -
The Angle Orthodontist Jul 2015To measure the slot dimensions of an entire series of metal orthodontic brackets.
OBJECTIVE
To measure the slot dimensions of an entire series of metal orthodontic brackets.
MATERIALS AND METHODS
Ten bracket series approximating five complete sets of brackets each were imaged and measured. Descriptive statistics were generated.
RESULTS
Slot dimension varied significantly from series to series as well as within the series themselves. About one-third of the brackets would not accommodate a full-size wire, and 15% to 20% are 0.001 inches or larger than the nominal advertised size.
CONCLUSION
The clinician is unlikely to have on hand complete sets (upper and lower 5-5) of ideal brackets and should both expect and be able to be accommodate tooth movement through wire bending in three planes of space to overcome any bracket deficiencies.
Topics: Humans; Image Processing, Computer-Assisted; Materials Testing; Microscopy; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Surface Properties
PubMed: 25264581
DOI: 10.2319/042814-307.1 -
Brazilian Oral Research 2015This study aims at comparing conventional and nickel-free metal bracket surface characteristics with elemental composition by scanning electron microscopy (SEM), using... (Comparative Study)
Comparative Study
This study aims at comparing conventional and nickel-free metal bracket surface characteristics with elemental composition by scanning electron microscopy (SEM), using energy dispersive spectroscopy (EDS). The sample consisted of 40 lower incisor brackets divided into four groups: ABZ = conventional brackets, Kirium Abzil 3M® (n = 10); RL = conventional brackets, Roth Light Morelli® (n = 10); NF = nickel-free brackets, Nickel-Free Morelli® (n = 10); and RM = nickel-free brackets, Roth Max Morelli® (n = 10). Qualitative evaluation of the bracket surface was performed using SEM, whereby surface features were described and compared. The elemental composition was analyzed by EDS. According to surface analysis, groups ABZ and RL showed a homogeneous surface, with better finishing, whereas the surfaces in groups NF and RM were rougher. The chemical components with the highest percentage were Fe, Cr and C. Groups NF and MR showed no nickel in their composition. In conclusion, the bracket surface of the ABZ and RL groups was more homogeneous, with grooves and pores, whereas the surfaces in groups NF and RM showed numerous flaws, cracks, pores and grooves. The chemical composition analysis confirmed that the nickel-free brackets had no Ni in their composition, as confirmed by the manufacturer's specifications, and were therefore safe to use in patients with a medical history of allergy to this metal.
Topics: Alloys; Analysis of Variance; Corrosion; Materials Testing; Metals; Microscopy, Electron, Scanning; Nickel; Orthodontic Brackets; Reference Values; Spectrometry, X-Ray Emission; Statistics, Nonparametric; Surface Properties
PubMed: 25590508
DOI: 10.1590/1807-3107BOR-2015.vol29.0022 -
The Angle Orthodontist Sep 2023To quantify the amount of residual monomer released from orthodontic adhesives used in the indirect bonding technique and compare it to a direct bonding composite resin.
OBJECTIVES
To quantify the amount of residual monomer released from orthodontic adhesives used in the indirect bonding technique and compare it to a direct bonding composite resin.
MATERIALS AND METHODS
Five hundred stainless steel orthodontic brackets were bonded on bovine incisors using five groups of bonding resins: Transbond XT (TXT), Transbond Supreme LV (SLV), Sondhi Rapid-Set (SRS), Transbond IDB (IDB), and Custom I.Q. (CIQ). Liquid samples were gathered on the first, seventh, 21st, and 35th days. Residual monomer release was measured from the liquid samples with a liquid chromatography device. In addition, the amount and shape of the adhesive between the tooth surface and the bracket base was evaluated using obtained electron microscopy images. The data were analyzed using analysis of variance, and a Tukey post-hoc test was applied.
RESULTS
Hydroxyethylmethacrylate and bisphenol A-glycidyl methacrylate monomers were released by all study groups. Urethane-dimethacrylate was released from the TXT, SLV, IDB, and CIQ groups. Triethylene glycol dimethacrylate was released from TXT, SLV, IDB, and SRS groups. The amount of total monomer release was higher in chemically cured adhesives than in light-cured adhesives. Among the chemically cured adhesives, premix adhesives had the highest amount of total monomer release. The light-cured adhesives had less thickness.
CONCLUSIONS
Light-curing adhesives have significantly less monomer release than chemically polymerized adhesives.
Topics: Animals; Cattle; Dental Cements; Dental Bonding; Bisphenol A-Glycidyl Methacrylate; Composite Resins; Resin Cements; Orthodontic Brackets; Adhesives; Materials Testing
PubMed: 37212680
DOI: 10.2319/122322-864.1 -
The Angle Orthodontist Nov 2016To compare microleakage under 3M Unitek's APC Flash-Free Adhesive Coated System bracket and the APC PLUS Adhesive Coated System bracket after thermal cycling.
OBJECTIVE
To compare microleakage under 3M Unitek's APC Flash-Free Adhesive Coated System bracket and the APC PLUS Adhesive Coated System bracket after thermal cycling.
MATERIALS AND METHODS
Forty freshly extracted human maxillary premolars were randomly divided into two groups and bonded with either a Flash-Free bracket or a PLUS bracket. After bonding, the samples were incubated in a water bath at 37°C for 24 hours and thermocycled for 5000 cycles between 5°C and 50°C. All teeth were immersed in a 2% methylene blue solution for 24 hours, embedded in acrylic and sectioned in a buccolingual direction at approximately the center of the bracket. Microleakage was observed at the enamel-adhesive interface from the occlusal and gingival margins of the bracket base. Statistical analysis was conducted using the Mann-Whitney U-test.
RESULTS
The median microleakage was higher in the Flash-Free group, but the difference between the two groups was not statistically significant (P > .05).
CONCLUSION
In a laboratory setting, there is no significant difference between the extent of microleakage under the APC Flash-Free Adhesive Coated System bracket and the APC PLUS Adhesive Coated System bracket after thermal cycling.
Topics: Ceramics; Composite Resins; Dental Bonding; Dental Leakage; Humans; Materials Testing; Orthodontic Brackets; Random Allocation; Resin Cements
PubMed: 27182779
DOI: 10.2319/021016-115.1 -
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 -
Clinical and Experimental Dental... Aug 2023Orthodontic treatment improves both masticatory function and the aspects of facial esthetics through the correct alignment of the teeth. If oral hygiene is neglected... (Randomized Controlled Trial)
Randomized Controlled Trial
The efficacy of the dental Water Jet, orthodontic, and conventional toothbrushes in plaque removal around orthodontic braces in adolescents: A randomized controlled trial.
OBJECTIVES
Orthodontic treatment improves both masticatory function and the aspects of facial esthetics through the correct alignment of the teeth. If oral hygiene is neglected during fixed orthodontic treatment, it may lead to plaque accumulation and gingivitis. The aim of this randomized controlled trial was to evaluate the effectiveness of the dental Water Jet (DWJ), and orthodontic toothbrush (O-TH) in removing dental plaque around the orthodontic braces compared to conventional toothbrush (C-TH) in adolescents.
MATERIALS AND METHODS
This was a three-arm, double-blind, and parallel-group randomized active-controlled trial. Forty-five patients were randomly allocated into three groups: DWJ, the O-TH, and the C-TH (control group). The primary outcome measure was dental plaque accumulation change from the baseline (t ) to post-cleaning (t ), and plaque scores were recorded using the Orthodontic Plaque Index (OPI). The current clinical trial was registered and approved by Australian New Zealand Clinical Trials Registry (ACTRN12623000524695).
RESULTS
A statistically significant difference was noted in the OPI scores between different time points in the DWJ group, the O-TH group, and the C-TH group (p < .05). However, no significant difference was noted between the groups after the cleaning procedure (p > .05).
CONCLUSION
The level of oral hygiene was not satisfactory in patients undergoing fixed orthodontic treatment. In addition, the efficacy of the DWJ was not superior to O-TH nor to C-TH in plaque removal.
Topics: Humans; Adolescent; Orthodontic Brackets; Dental Plaque; Water; Single-Blind Method; Australia
PubMed: 37424367
DOI: 10.1002/cre2.752