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Dental Press Journal of Orthodontics 2023Technology-enhanced simulations seem to be effective in dentistry, as they can support dental students to improve competencies in simulated environments. However,... (Review)
Review
INTRODUCTION
Technology-enhanced simulations seem to be effective in dentistry, as they can support dental students to improve competencies in simulated environments. However, implementation of this technology in orthodontic education has not been reviewed.
OBJECTIVE
This scoping review aimed to comprehensively summarize the use of technology-enhanced simulations in orthodontic practice.
METHODS
A systematic search was conducted to identify literature on technology-enhanced simulation-based learning in orthodontic education published from 2000 to 2021. The search was conducted up to September 2021 to identify articles from Scopus, Embase, PubMed, ProQuest Dissertations & Theses Global, Google Scholar and the reference lists of identified articles.
RESULTS
The search identified 177 articles. Following the inclusion and exclusion criteria, 16 articles of 14 digital simulators were included in this review. The findings demonstrated an increasing use of technology-enhanced simulations in orthodontic education. They were designed in several formats, including three-dimensional virtual format, augmented reality, virtual reality, automaton, haptic, and scenario-based simulations. These simulations were implemented in varied areas of orthodontics including diagnosis and treatment planning, bracket positioning, orthodontic procedures, facial landmark, removable appliance and cephalometric tracing. Most included articles demonstrated the development process without outcome evaluation. Six studies provided outcome evaluations at reaction or learning levels. None of them provide the evaluation at behaviour and results levels.
CONCLUSION
Insufficient evidence has been generated to demonstrate the effectiveness of technology-enhanced simulations in orthodontic education. However, high-fidelity computer-based simulations together with robust design research should be required to confirm educational impact in orthodontic education.
Topics: Humans; Learning; Computer Simulation; Clinical Competence
PubMed: 37466506
DOI: 10.1590/2177-6709.28.3.e2321354.oar -
Journal of Dentistry Mar 2024The article reviewed novel orthodontic devices and materials with bioactive capacities in recent years and elaborated on their properties, aiming to provide guidance... (Review)
Review
OBJECTIVE
The article reviewed novel orthodontic devices and materials with bioactive capacities in recent years and elaborated on their properties, aiming to provide guidance and reference for future scientific research and clinical applications.
DATA, SOURCES AND STUDY SELECTION
Researches on remineralization, protein repellent, antimicrobial activity and multifunctional novel bioactive orthodontic devices and materials were included. The search of articles was carried out in Web of Science, PubMed, Medline and Scopus.
CONCLUSIONS
The new generation of orthodontic devices and materials with bioactive capacities has broad application prospects. However, most of the current studies are limited to in vitro studies and cannot explore the true effects of various bioactive devices and materials applied in oral environments. More research, especially in vivo researches, is needed to assist in clinical application.
CLINICAL SIGNIFICANCE
Enamel demineralization (ED) is a common complication in orthodontic treatments. Prolonged ED can lead to dental caries, impacting both the aesthetics and health of teeth. It is of great significance to develop antibacterial orthodontic devices and materials that can inhibit bacterial accumulation and prevent ED. However, materials with only preventive effect may fall short of addressing actual needs. Hence, the development of novel bioactive orthodontic materials with remineralizing abilities is imperative. The article reviewed the recent advancements in bioactive orthodontic devices and materials, offering guidance and serving as a reference for future scientific research and clinical applications.
Topics: Humans; Dental Caries; Esthetics, Dental; Dental Enamel; Tooth Demineralization; Orthodontic Brackets
PubMed: 38253119
DOI: 10.1016/j.jdent.2024.104844 -
International Orthodontics Dec 2023Re-mineralizing surface pretreatment is essential for both controlling and preventing white spot lesion (WSL) throughout the time of fixed orthodontic treatment. It is... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Re-mineralizing surface pretreatment is essential for both controlling and preventing white spot lesion (WSL) throughout the time of fixed orthodontic treatment. It is also important that the re-mineralizing have no negative impact on the bonding between the bracket, adhesive, and enamel. Therefore, this review is aimed to investigate the orthodontic brackets' shear bond strength after re-mineralizing surface treatment of enamel.
MATERIAL AND METHODOLOGY
The review was conducted following the PRISMA 2020 guidelines. In-vitro experimental studies measuring shear bond strength (SBS) of orthodontic brackets on both demineralized and intact enamel following re-mineralizing surface treatment were included. Database search was done in PubMed, Scopus, and Science Direct during July 2023. Methodological quality of the studies was assessed according to the guidelines for the reporting of pre-clinical in-vitro studies. Both qualitative and quantitative analyses of the included studies were done.
RESULTS
Matching the inclusion criteria, 46 and 37 studies were selected for qualitative and quantitative analysis respectively. On intact enamel re-mineralizing agents had no negative impact on the brackets' SBS. On the contrary, they seemed to enhance the bond strength remarkably on the demineralized enamel.
DISCUSSION
Re-mineralizing surface pretreatment is crucial prior to fixed orthodontic treatment as it did not reduce the bond strength. Although, it cannot be judged depending solely on the in-vitro results with high heterogeneity. Clinical evidence is required to support the statement.
Topics: Humans; Resin Cements; Orthodontic Brackets; Dental Enamel; Shear Strength; Dental Bonding; Materials Testing; Surface Properties; Dental Stress Analysis
PubMed: 37647675
DOI: 10.1016/j.ortho.2023.100807 -
European Journal of Orthodontics Sep 2023To evaluate the effect of high-fluoride mouth rinse and high-fluoride toothpaste on the development of demineralized lesions (DLs) during orthodontic treatment. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To evaluate the effect of high-fluoride mouth rinse and high-fluoride toothpaste on the development of demineralized lesions (DLs) during orthodontic treatment.
TRIAL DESIGN
Three-armed parallel-group randomized controlled trial.
METHODS
The trial was performed with 270 adolescent orthodontic patients. Randomization was performed in blocks of 30, enrolling the patients into one of the following groups: the fluoride mouth rinse (FMR) group receiving 0.2% sodium fluoride (NaF) mouth rinse plus 1450 ppm fluoride (F) toothpaste; high-fluoride toothpaste (HFT) group receiving 5000 ppm F toothpaste; and the Control (CTR) group receiving 1450 ppm F toothpaste. Inclusion criteria were patients scheduled for treatment in both arches with fixed appliances and age between 12 and 20 years. The primary outcome variable was the proportion of participants with at least one new demineralized lesion as assessed on digital photos taken before and after treatment, analysed by a blinded clinician. The analysis included all teeth or teeth in the aesthetic zone, i.e. all central incisors, lateral incisors, and canines. A random sample of 30 participants was assessed to check intra- and inter-reliability. For pairwise comparison between groups, Fisher's non-parametric permutation test was used for continuous variables. Blinding was employed during the caries registration and data analysis.
RECRUITMENT
October 2010 to December 2012.
RESULTS
In total, 270 patients were randomized, of which 22 were excluded during treatment. Therefore, 248 participants were included in the study. The number of patients with an increase of ≥1 DL, including only central- and lateral incisors and canines, during orthodontic treatment, was significantly lower in the HFT group, 51/85 60%, compared to the CTR group, 64/82 78%, RR 0.77 (CI 0.62; 0.95), P = .01 and in the FMR group, 47/81 58%, compared to the CTR group, RR 0.74 (CI 0.60; 0.92), P < .01.
CONCLUSIONS
To prevent demineralized lesions in the aesthetic zone, high-fluoride mouth rinse and high-fluoride toothpaste may be recommended.
LIMITATIONS
The protocol was not registered, and the present study did not use a double-blinded design.
Topics: Adolescent; Humans; Child; Young Adult; Adult; Fluorides; Toothpastes; Mouthwashes; Reproducibility of Results; Esthetics, Dental; Dental Caries; Sodium Fluoride; Cariostatic Agents
PubMed: 37524332
DOI: 10.1093/ejo/cjad044 -
Journal of the World Federation of... Apr 2024Aligner orthodontics has gained significant popularity as an alternative to traditional braces because of its aesthetic appeal and comfort. The biomechanical principles... (Review)
Review
Aligner orthodontics has gained significant popularity as an alternative to traditional braces because of its aesthetic appeal and comfort. The biomechanical principles that underlie aligner orthodontics play a crucial role in achieving successful outcomes. The biomechanics of aligner orthodontics revolve around controlled force application, tooth movement, and tissue response. Efficient biomechanics in aligner orthodontics involves consideration of attachment design and optimized force systems. Attachments are tooth-colored shapes bonded to teeth, aiding in torque, rotation, and extrusion movements. Optimized force systems ensure that forces are directed along the desired movement path, reducing unnecessary strain on surrounding tissues. Understanding and manipulating the biomechanics of aligner orthodontics is essential for orthodontists to achieve optimal treatment outcomes. This approach requires careful treatment planning, considering the mechanics required for each patient's specific malocclusion. As aligner orthodontics continues to evolve, advances in material science and treatment planning software contribute to refining biomechanical strategies, enhancing treatment efficiency, and expanding the scope of cases that can be successfully treated with aligners.
Topics: Humans; Biomechanical Phenomena; Orthodontic Brackets; Esthetics, Dental; Orthodontics; Malocclusion
PubMed: 38228450
DOI: 10.1016/j.ejwf.2023.12.005 -
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 -
Cureus Nov 2023Superelastic materials have gained popularity due to their ability to maintain a constant force over a prolonged period during orthodontic treatment. However, high...
BACKGROUND
Superelastic materials have gained popularity due to their ability to maintain a constant force over a prolonged period during orthodontic treatment. However, high hysteresis and frictional properties had limited the use of superelastics as archwire material that demanded the need for improved superelastic orthodontic archwires with enhanced mechanical properties.
AIM
The present study aimed to investigate the differences in mechanical properties and frictional resistance of improved superelastic orthodontic archwires against conventional archwires and to evaluate their potential implications in clinical orthodontic practice.
MATERIALS AND METHODS
A total of 45 samples with 15 in each category respectively from low hysteresis superelastic archwire (L&H Titan; Tomy Inc., Tokyo, Japan), nickel-titanium (NiTi) archwires (Ormco, Brea, CA, USA) and NiTi with copper (CuNiTi) archwires (Ormco) of equal diameter (0.016 x .022 inches) and length (10 cm) were randomly assigned in combination among metal and ceramic orthodontic brackets group. The frictional properties of the archwires were measured using a universal testing machine (Instron, Norwood, MA, USA) equipped with a custom-made jig. The load-displacement data were recorded, and other mechanical properties that included tensile strength, compressive strength and deflective force at 4mm were also evaluated. The data were analysed using independent Student t-tests to compare the mean frictional resistance of the three archwires followed by analysis of variance (ANOVA) to evaluate differences between the means with p-value of less than 0.05 considered as statistically significant.
RESULTS
The improved superelastic wires had the least frictional resistance among the three archwires tested. Further intergroup comparison to evaluate differences between the frictional resistance means among the three archwire categories with two orthodontic brackets groups revealed a significant difference at p<.05. Pairwise comparison also showed significant differences with higher frictional resistance between metal brackets and low hysteresis superelastic archwire category than ceramic brackets and NiTi with copper archwires (.0003) and ceramic brackets with NiTi archwires category (.003) respectively. The lowest deflective force at 4mm with better tensile and compressive strength was seen with the improved superelastic wires.
CONCLUSION
The results of this study suggest that low hysteresis superelastic archwires have lower frictional forces when combined with metal orthodontic brackets compared with ceramic orthodontic brackets. Better tensile strength with least compressive strength and deflective forces at 4mm of testing among low hysteresis L&H Titan superelastic archwire than CuNiTi and NiTi archwires was observed making them potentially advantageous for orthodontic applications.
PubMed: 38060728
DOI: 10.7759/cureus.48334 -
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 -
Journal of Orofacial Orthopedics =... Oct 2023To evaluate force loss due to friction (FR) with an emphasis on esthetic brackets and their design differences during simulated canine retraction.
OBJECTIVES
To evaluate force loss due to friction (FR) with an emphasis on esthetic brackets and their design differences during simulated canine retraction.
MATERIALS AND METHODS
The tested brackets were round and sharp-cornered conventional-ligating brackets and round-cornered self-ligating brackets. The tested archwires were stainless steel (0.018 × 0.025″ and 0.019 × 0.025″, and 0.018″) archwires. A total of 90 bracket-archwire combinations in 9 equally-sized groups (n = 10) were analyzed. Canine retraction was experimentally simulated in a biomechanical set-up utilizing the custom-made orthodontic measurement and simulation system (OMSS) using a NiTi coil spring that delivered a constant force of 1 N. The simulated retraction path was up to 4 mm. FR was compared among groups using the Welch t‑test. Significance level (α) was set to 0.05.
RESULTS
The round-cornered conventional-ligating bracket exhibited the least FR (28.6 ± 5.4%), while there were no significant differences in FR between the round-cornered conventional-ligating bracket and the round-cornered self-ligating bracket with 0.018″ stainless steel wires. However, the round-cornered self-ligating bracket exhibited the least FR (34.9 ± 5.1% and 39.3 ± 4.6%) with 0.018 × 0.025″ and 0.019 × 0.025″ stainless steel archwires, respectively. The sharp-cornered conventional-ligating bracket showed the highest FR of 72.4 ± 3.0% among the bracket systems tested in this study.
CONCLUSIONS
The round-cornered conventional-ligating bracket showed less FR when compared to sharp-cornered conventional-ligating bracket. Conversely, the round-cornered conventional-ligating bracket exhibited greater FR when compared to the round-cornered self-ligating bracket, with an exception with respect to the 0.018″ wire. In general, FR increased with increased wire dimension.
PubMed: 36441190
DOI: 10.1007/s00056-022-00433-3 -
Materials (Basel, Switzerland) Oct 2023Successful orthodontic therapy, apart from a proper treatment plan, depends on optimal bracket-enamel adhesion. Among numerous factors affecting adhesion, the type of...
Successful orthodontic therapy, apart from a proper treatment plan, depends on optimal bracket-enamel adhesion. Among numerous factors affecting adhesion, the type of bracket and preparation of the tooth's surface are crucial. The aim of this study was to compare the shear bond strength (SBS) of metal and ceramic brackets to the enamel's surface using direct bonding. Forty extracted human premolars were divided into four groups according to the etching method (etch-and-rinse and self-etch) and bracket type. The SBS and adhesive remnant index (ARI) were determined. The ceramic brackets achieved the highest SBS values both in the self-etch (SE) and etch-and-rinse (ER) protocols. Higher SBS values for ceramic and metallic brackets were found in the ER protocol. In all tested groups, the achieved SBS value was satisfactory to withstand orthodontic and occlusal forces. There was no significant difference in the ARI score between study groups ( = 0.71). The fracture occurred between the bracket base and adhesive material in both types of brackets, which decreased the risk of enamel damage during debonding.
PubMed: 37895679
DOI: 10.3390/ma16206697