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BMC Oral Health Jul 2023To assess the possibility of extrusion of a maxillary central incisor with the use of buccal and lingual pressure columns in the absence of attachments, and to evaluate...
OBJECTIVE
To assess the possibility of extrusion of a maxillary central incisor with the use of buccal and lingual pressure columns in the absence of attachments, and to evaluate the forces and moments experienced by the teeth using both thermoformed and 3D-printed clear aligners.
MATERIALS AND METHODS
A three-axis force and moment sensor (Aidin Robotics, Anyang, South Korea) was used to measure the forces and moments during extrusion of an upper left central incisor (UL1) and any forces experienced by the upper right central incisor (UR1) using thermoformed aligners and 3D-printed aligners. For the thermoformed aligners, the materials used were ATMOS® (American Orthodontics, Sheboygan, WI) and Zendura FLX® (Bay Materials LLC, Fremont, CA). 3D-printed aligners were fabricated using TC-85 clear photocurable resin (Graphy Inc., Seoul, South Korea). For each material type, three conditions were tested: Group 1: No attachment or pressure columns (control); Group 2: Attachment only; and Group 3: Pressure columns only. Each group was planned for 0.5 mm of extrusion on the UL1.
RESULTS
All force readings collected demonstrated statistically significant differences when compared by materials and when compared by groups, with a P value of < 0.001. In the absence of attachment or pressure columns (Group 1), ATMOS® and TC-85 groups exerted extrusive force on the UL1. However, significantly lower forces and moments were exerted by the TC-85 group in comparison to the ATMOS® and Zendura FLX® groups. In the presence of attachment (Group 2), all three ATMOS®, Zendura FLX® and TC-85 groups exerted extrusive force on the UL1, with the TA group showing different directions of faciolingual force, mesiodistal force and faciolingual inclination on the UR1 when compared to the other two thermoformed groups. Whereas in the presence of pressure columns (Group 3), only the TC-85 3D-printed aligner group exerted extrusive force. Thermoformed aligners generated significantly higher mean forces and moments than 3D-printed aligners. Significant levels of unintended forces and moments were present in all groups.
CONCLUSIONS
Force levels generated during extrusion with clear aligners are significantly lower with those 3D-printed using TC-85 than with those thermoformed using ATMOS® or Zendura FLX®. Attachments consistently generated extrusive forces, and may be an effective adjunct in achieving extrusion of incisors. Extrusion may be achieved without the use of attachments by utilizing pressure columns in 3D-printed aligners using TC-85. While different strategies can generate extrusive forces, there are significant unintended forces and moments.
Topics: Humans; Incisor; Orthodontic Appliance Design; Tooth Movement Techniques; Research Design; Orthodontic Appliances, Removable
PubMed: 37461004
DOI: 10.1186/s12903-023-03136-2 -
International Journal For Numerical... Jan 2024The incidence of oral malocclusion is increasing and is seriously damaging the oral health of human beings. The Kitchon root-controlled auxiliary archwire is an...
The incidence of oral malocclusion is increasing and is seriously damaging the oral health of human beings. The Kitchon root-controlled auxiliary archwire is an individualized orthodontic arch. It is used clinically for the treatment of tooth-lingual tilt/root-lip tilt phenomenon of the central incisors. However, the bending parameters of the Kitchon root-controlled auxiliary archwire used in different patients are based on the clinical experience of the dentists. Therefore, this orthodontic treatment has a high risk and unpredictability. In this paper, the loading performance and orthodontic process of Kitchon root-controlled auxiliary archwire are analyzed. And the prediction model of support resistance and correction torque are established. The bending parameters of the Kitchon root-controlled auxiliary archwire, as well as the effect of the bending parameters on the support resistance and the correction torque, are all quantified. And the prediction models for the support resistance and the correction torque are calculated separately. The correlation coefficients of calculated data and experimental data are ξ > .97 and ξ > .96, respectively; the correlation coefficients of simulated data and experimental data are ξ > .96 and ξ > .96, respectively. The accuracy and reliability of the established prediction models are verified. It provides an effective theoretical guide for dentists to safely and efficiently perform root-controlled rotation orthodontic treatment on patients' central incisors.
Topics: Humans; Torque; Orthodontic Wires; Reproducibility of Results; Tooth; Mechanical Phenomena
PubMed: 37899669
DOI: 10.1002/cnm.3789 -
BMC Oral Health Feb 2024Our meta-analysis aimed to evaluate the efficacy of applying Herbst and Twin Block appliances in the treatment of Class II malocclusion among children. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Our meta-analysis aimed to evaluate the efficacy of applying Herbst and Twin Block appliances in the treatment of Class II malocclusion among children.
METHODS
Databases, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), China VIP Database (VIP), and Wanfang were thoroughly searched from inception to August 9, 2023. The outcomes included skeletal, dental, and soft tissue changes. The weighted mean difference (WMD) was used as the effect indicator, and the effect size was expressed with a 95% confidence interval (CI). The heterogeneity of each outcome effect size was tested, and the heterogeneity statistic I ≥ 50% was analyzed by the random-effect model, otherwise, the fixed-effect model was conducted. Sensitivity analysis was performed.
RESULTS
A total of 12 studies involving 574 patients were included in this meta-analysis. Herbst appliance had a statistically significant increase in mandibular body length (WMD: 1.44, 95% CI: 0.93 to 1.96, P < 0.001) compared with the Twin Block appliance. More increases in angle and distance of L1 to mandibular plane (MP) were found in the Herbst appliance compared with the Twin Block appliance. Significant and greater improvements in molar relationship (WMD: 0.79, 95% CI: 0.28 to 1.29, P = 0.002), posterior facial height (WMD: -1.23, 95% CI: -2.08 to -0.38, P = 0.005), convexity angle (WMD: -1.89, 95% CI: -3.12 to -0.66, P = 0.003), and Sella-Nasion plane angle (U1 to SN) (WMD: 3.34, 95% CI: 2.25 to 4.43, P < 0.001) were achieved in the Twin Block appliance. Herbst and Twin Block appliances produced similar effects in the skeletal and dentoalveolar changes including Sella-Nasion-point A (SNA), Sella-Nasion-point B, point A-Nasion-point B (ANB), overjet, and overbite.
CONCLUSION
As the findings revealed both Herbst and Twin Block appliances contributed successfully to the correction of Class II malocclusion. Compared with the Twin Block appliance, the Herbst appliance may have more advantages in mandibular bone movement. Twin Block therapy resulted in more improvement in the aesthetics of the face.
Topics: Child; Humans; Cephalometry; Orthodontics, Corrective; Malocclusion, Angle Class II; Orthodontic Appliances, Functional; Mandible
PubMed: 38409017
DOI: 10.1186/s12903-024-04027-w -
Postgraduate orthodontic education: An international perspective on content and satisfaction levels.Journal of the World Federation of... Dec 2023There is significant international variation in the postgraduate orthodontic training. The aim of this study was to obtain information relating to the design, content,...
BACKGROUND
There is significant international variation in the postgraduate orthodontic training. The aim of this study was to obtain information relating to the design, content, and delivery of formal postgraduate orthodontic training internationally. Moreover, we aimed to evaluate the perception of orthodontists towards their training as well as identifying factors associated with an improved level of satisfaction.
METHODS
A 42-question survey was sent to orthodontists worldwide via SurveyMonkey. The survey was circulated on orthodontic Facebook groups and through other digital channels including Instagram.
RESULTS
A total of 168 respondents completed all sections of the questionnaire. The vast majority believed programme length was appropriate (n = 150; 89%). Most respondents were confident with their research skills and in their ability to diagnose and treatment plan. Social media was frequently accessed by the respondents for the purposes of orthodontic education (n = 83; 49%). A high proportion (n = 70; 42%) did not treat any clear aligner cases during postgraduate training with many having experience using Invisalign only. The majority of respondents across the regions had training in buccal miniscrew insertions. Exposure to three-dimensional printing during residency was limited.
CONCLUSIONS
The study offers an overview of the structure, content, and modes of delivery in orthodontic postgraduate training internationally. While satisfaction levels are good, there is a disparity in terms of exposure to certain techniques internationally. Further training in the modern diagnostic approaches and mechanics may improve satisfaction with postgraduate training.
Topics: Humans; Orthodontics; Orthodontists; Internship and Residency; Orthodontic Appliances, Removable; Internationality
PubMed: 37739847
DOI: 10.1016/j.ejwf.2023.08.004 -
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 -
Journal of Pharmacy & Bioallied Sciences Feb 2024Orthodontic treatment is a common dental procedure aimed at correcting malocclusions and improving dental aesthetics. However, one of the potential side effects of...
BACKGROUND
Orthodontic treatment is a common dental procedure aimed at correcting malocclusions and improving dental aesthetics. However, one of the potential side effects of orthodontic treatment is root resorption, which can lead to permanent damage to the tooth's root structure.
MATERIALS AND METHODS
In this comparative study, 60 orthodontic patients were divided into three groups, each receiving a different orthodontic treatment approach: Group A-conventional fixed orthodontic appliances, Group B-self-ligating orthodontic appliances, and Group C-clear aligners. Digital radiographs were taken before and after treatment to assess root resorption. The extent of root resorption was quantified using a standardized measurement scale.
RESULTS
The results indicated that Group A exhibited an average root resorption of 0.2 mm, Group B showed an average root resorption of 0.1 mm, and Group C had the lowest average root resorption of 0.05 mm. These findings suggest that clear aligners resulted in significantly less root resorption compared to conventional fixed orthodontic appliances and self-ligating orthodontic appliances ( < 0.05).
CONCLUSION
This comparative study highlights the differential effects of various orthodontic mechanics on root resorption. Clear aligners demonstrated the least amount of root resorption when compared to conventional fixed orthodontic appliances and self-ligating orthodontic appliances.
PubMed: 38595390
DOI: 10.4103/jpbs.jpbs_1022_23 -
Archives of Oral Biology Aug 2024The effectiveness of supragingival dental biofilm control during orthodontic treatment and changes in the bacterial profile were analyzed. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
The effectiveness of supragingival dental biofilm control during orthodontic treatment and changes in the bacterial profile were analyzed.
DESIGN
Sixty-four participants aged 12-22 years (57% female) were included in the study. Participants underwent orthodontic treatment with fixed appliances and were randomly assigned to one of the three groups, which during a period of one month: (I) used chlorhexidine digluconate (CHX), (II) used high concentration of fluoride (F) gel and (III) performed standard oral hygiene. The plaque and gingivitis index, pH of biofilm and white spot lesions (WSL) were assessed. Changes of the bacteria in the biofilm were analyzed by the quantitative polymerase chain reaction RESULTS: Increase in the plaque index, pH of biofilm, and WSL was observed during orthodontic treatment with standard oral hygiene. Large interindividual variability was present, and the effects of one-month use of fluorides and CHX on clinical parameters were not significant. Despite standard hygiene the abundance of studied biofilm bacteria increased - the most Streptoccocus mutans (14.2x) and S. salivarius (3.3x), moderate Veillonella parvula (3x) and the least S. sobrinus (2.3x) and Agregatibacter actinomycetemcomitans (1.9x). The use of CHX reduced S. sobrinus (2.2x) and A. actinomycetemcomitans (1.9x). Fluoride use reduced A. actinomycetemcomitans (1.3x) and S. sobrinus (1.2x). Fluorides better controlled S. mutans than CHX.
CONCLUSION
Bacterial biomass in supragingival biofilm increased during treatment with metal orthodontic appliances, with greater increase in cariogenic bacteria than periopathogens. Fluoride controlled S. mutans, while CHX S. sobrinus and A. actinomycetemcomitans.
Topics: Humans; Biofilms; Female; Adolescent; Chlorhexidine; Child; Male; Orthodontic Appliances, Fixed; Young Adult; Fluorides; Dental Plaque Index; Oral Hygiene; Dental Plaque; Hydrogen-Ion Concentration; Streptococcus mutans; Gingivitis; Anti-Infective Agents, Local; Polymerase Chain Reaction; Dental Caries
PubMed: 38701663
DOI: 10.1016/j.archoralbio.2024.105984 -
Orthodontics & Craniofacial Research Dec 2023To determine the effect of common beverages and accelerated aging on the colour stability of filled resins, which could potentially be used for fabrication of 3D-printed...
OBJECTIVE
To determine the effect of common beverages and accelerated aging on the colour stability of filled resins, which could potentially be used for fabrication of 3D-printed orthodontic brackets.
MATERIALS AND METHODS
GR-17.1 (shades A1, A2, and A3), and GR-10 Guide resins (pro3dure medical, Eden Prairie, MN) were printed on an Asiga MAX UV printer into discs 2 mm thick, with a diameter of 10 mm, and then post-print processed as per manufacturer's instructions. Discs were immersed in 5 mL of coffee, tea, red wine, or distilled water for 7 days. Another group was subjected to accelerated aging in accordance with ISO Standard 4892-2. Ten samples were produced per resin, per treatment condition. Colour measurements were taken on the discs before and after treatment using a spectrophotometer against white and black reference tiles to assess colour and translucency differences with the CIEDE2000 colour difference formula.
RESULTS
While initial colour of the printed resin discs was acceptable, all resin groups underwent significant colour change during the experiment. Red wine and coffee produced the greatest colour and translucency change, followed by tea, with accelerated aging producing the least change in colour and translucency.
CONCLUSION
The 3D-printed resins tested underwent significant changes in colour and translucency following exposure to endogenous and exogenous sources of staining, which may affect their acceptability for fabrication of aesthetic orthodontic brackets.
Topics: Coffee; Color; Tea; Orthodontic Brackets; Esthetics, Dental; Printing, Three-Dimensional; Materials Testing; Surface Properties
PubMed: 37089069
DOI: 10.1111/ocr.12665 -
Cureus Mar 2024The purpose of orthodontic therapy is to correct malocclusion and produce a stable outcome that endures over time. Long-term stability can be difficult to achieve, and... (Review)
Review
The purpose of orthodontic therapy is to correct malocclusion and produce a stable outcome that endures over time. Long-term stability can be difficult to achieve, and many patients relapse after treatment, particularly in instances of open bite relapse (OBR). This systematic review aimed to analyze different types of management strategies for OBR and conduct a meta-analysis to find the best method of dealing with relapse. A comprehensive search was carried out across six major online databases using relevant keywords pertaining to our study, including "open bite relapse," "orthodontic retention," "orthodontic surgery," "orthodontic appliance," "orthodontic management," "orthodontic treatment," "orofacial myofunctional therapy (OMT)," "skeletal anchorage," and "treatment follow-up period." Eleven studies were selected after the application of relevant inclusion and exclusion strategies. The mean follow-up period of treatment for the studies ranged from six months to 4.5 years. Of all the management strategies assessed, OMT was found to be the least effective for OBR management. Surgical management modalities, such as mandibular repositioning and molar intrusion using skeletal anchorage, in conjunction with the usage of orthodontic appliances, were found to be noticeably effective, especially in the cases of participants who were <18 years of age. However, when utilized on a singular basis, either of them was found to be lacking the desired effect. The overall odds ratio (OR) of 0.48 (0.37, 0.64) and risk ratio (RR) of 0.62 (0.51, 0.74) were obtained after the meta-analysis of the different interventions for OBR, indicating statistical significance. There were only 11 studies included in the study, so it's possible that not all management strategies for OBR were fully understood. The limited number of studies may also have affected the generalizability of the findings. Although statistical differences were obtained to a certain degree, more clinical trials are needed to assess the effect of such surgical modalities as a viable management tool for OBR, since these represent a significant limiting factor in terms of the overall cost of the treatment placed upon the patient. Prior to the start of the research, registration was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. The research protocol was created to meet the goals and was properly filed with the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42023401991).
PubMed: 38623106
DOI: 10.7759/cureus.56285 -
European Journal of Orthodontics Jul 2023Recent advances in orthodontics offer appealing tools to monitor compliance and designate protocols to enhance it.
BACKGROUND
Recent advances in orthodontics offer appealing tools to monitor compliance and designate protocols to enhance it.
OBJECTIVE
This systematic review of systematic reviews (SRs) aimed to assess the effectiveness of digitized communication methods and sensor-based devices that track compliance in orthodontic patients.
SEARCH METHODS
Five electronic databases (PubMed, Web of Science, MEDLINE, PsycINFO, and EMBASE) were searched from database inception up to 4 December 2022.
SELECTION CRITERIA
SRs using digitized systems and sensor-based technologies to monitor and/or improve compliance with orthodontic treatment or during an active retention phase were included.
DATA COLLECTION AND ANALYSIS
Study selection, data extraction, and risk of bias assessment using the AMSTAR 2 tool were performed independently by two review authors. A qualitative synthesis of outcomes from moderate- and high-quality SRs was provided, and evidence was graded in accordance with a scale of statements.
RESULTS
A total of 846 unique citations were retrieved. After study selection, 18 SRs met the inclusion criteria, and 9 moderate- and high-quality reviews were further integrated into the qualitative synthesis. Digitized communication methods were found to be effective in improving compliance with oral hygiene practices and adherence to orthodontic appointments. Monitoring removable appliance wear with microsensors revealed sub-optimal levels of compliance with wear instructions of intra-oral and extra-oral appliances. One review discussed the informational value of social media platforms and their importance in guiding the decision-making process to seek orthodontic treatment and compliance-related experiences.
LIMITATIONS
The variability in the quality of included SRs and the limited number of primary studies on certain outcomes present as limitations within this overview.
CONCLUSIONS
The integration of tele-orthodontics and sensor-based technologies to improve and monitor compliance within orthodontic practices is promising. There is sufficient evidence that establishing communication channels with orthodontic patients through reminders and audiovisual systems positively impact their oral hygiene practices throughout orthodontic treatment. However, understanding the informational value of social media as communication channels between clinicians and their patients, and their overall effect on modulating compliance is still insufficient.
REGISTRATION
CRD42022331346.
Topics: Humans; Appointments and Schedules; Communication; Orthodontics; Patient Compliance; Systematic Reviews as Topic
PubMed: 37132630
DOI: 10.1093/ejo/cjad004