-
Clinics and Practice Sep 2023(1) Context and Objective: Wire syndrome (WS) refers to dental displacements which can be qualified as aberrant, unexpected, unexplained, or excessive of teeth still...
(1) Context and Objective: Wire syndrome (WS) refers to dental displacements which can be qualified as aberrant, unexpected, unexplained, or excessive of teeth still contained by an intact orthodontic retainer wire without detachment or fracture, leading to evolving aesthetic and/or functional consequences, both dental and periodontal. The clinical diagnosis of WS in severe cases is often easy. On the other hand, emerging cases must be detected early to stop this evolutionary process as soon as possible, as well as to effectively manage unwanted dental displacements and associated dento-periodontal tissue repercussions. The aim of this retrospective study was to understand the challenges and importance of early diagnosis, highlight the clinical gradient of WS, and clarify the key elements of diagnosis for many practitioners confronted with this type of problem. (2) Materials and Methods: Three cases of increasing complexity were described: the history of wire syndrome, a description of the key elements of its diagnosis, and the final diagnosis itself. (3) Results: Different types and locations of wire syndrome have been observed, from early form to terminal wire syndrome. The three main stages of the clinical gradient are described as follows. In the first case, wire syndrome starting on tooth 41, called the "X-effect" type, was suspected. X-effect wire syndrome on 21, X-effect wire syndrome on 41, and Twist-effect wire syndrome on 33 were diagnosed in the second case, which can be classified as an intermediate case. In the extreme clinical situation of the last case, severe and terminal wire syndrome on tooth 41, the X-effect type, was observed. (4) Conclusions: This case series presents the main stages of the clinical gradient of WS. Although in the case of early WS it is very difficult to identify and/or differentiate it from movements related to a classical relapse phenomenon, the diagnosis of terminal WS is very easy. The challenge for the practitioner is therefore to detect WS as early as possible to stop the iatrogenic process and propose a personalized treatment depending on the severity of clinical signs. The earlier WS is detected, the less invasive the treatment.
PubMed: 37736934
DOI: 10.3390/clinpract13050098 -
BMC Oral Health Feb 2024Aim of this randomized clinical controlled trial was to evaluate the influence of fixed orthodontic steel retainers on gingival health and recessions of mandibular... (Randomized Controlled Trial)
Randomized Controlled Trial
Influence of fixed orthodontic steel retainers on gingival health and recessions of mandibular anterior teeth in an intact periodontium - a randomized, clinical controlled trial.
OBJECTIVE
Aim of this randomized clinical controlled trial was to evaluate the influence of fixed orthodontic steel retainers on gingival health and recessions of mandibular anterior teeth.
MATERIALS AND METHODS
After end of the orthodontic treatment, patients were randomly assigned into the test (fixed steel retainer) or control group (modified removable vacuum-formed retainer). Periodontal parameters (periodontal probing depth: PPD; recession: REC; bleeding on probing: BOP) as well as plaque and gingival index were assessed on mandibular anterior teeth directly before attaching/handing over the retainer (baseline: BL), 6 and 12 months after orthodontic treatment.
RESULTS
37 patients (test: n = 15, mean age: 16.1±4.2 years; control: n = 17, mean age: 17.1±5.4 years) completed the study. REC and PPD failed to show significant pairwise differences. The number of patients showing gingival health in the area of the mandibular anterior teeth (test: BL n = 10, 6 months n = 9, 12 months n = 11; control: BL n = 10, 6 months n = 16, 12 months n = 15) revealed a significant difference for the intra-group comparison between BL and 6 months in the control group (p = 0.043). The inter-group comparisons failed to show significant differences.
CONCLUSION
Young orthodontically treated patients with fixed steel retainers show in 73.3% healthy gingival conditions after one year which are comparable to the control group (88.2%). Gingival recessions were in a clinically non-relevant range at any time of the examination.
CLINICAL TRIAL NUMBER
DRKS00016710.
Topics: Humans; Child; Adolescent; Young Adult; Adult; Steel; Gingiva; Periodontium; Gingival Diseases; Gingival Recession; Orthodontic Appliance Design
PubMed: 38355505
DOI: 10.1186/s12903-024-03998-0 -
European Journal of Orthodontics Nov 2023To systematically assess the scientific literature for the prevalence of failure rate of fixed orthodontic bonded retainer (FOBR). (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To systematically assess the scientific literature for the prevalence of failure rate of fixed orthodontic bonded retainer (FOBR).
METHOD
Randomized clinical trials (RCTs) and prospective non-RCTs involving participants who had FOBR fitted were included. The Cochrane Central Register of Controlled Trials, Web of science, MEDLINE, and EMBASE via OVID were searched from inception to January 2023. Risk of bias was assessed using the Cochrane RoB 2 and Newcastle-Ottawa tools. The main outcome was the failure rate of FOBRs. The secondary outcome was to identify factors that can influence the failure of FOBR. Meta-analyses and sensitivity analyses were undertaken using Revman, version5.4. A random-effects model was used. Quality assessment using Grading of Recommendations Assessment, Development, and Evaluation.
RESULTS
Thirty-four studies (25 RCTs and 9 prospective clinical studies) (3484 participants) were included in this review. The overall failure rate of bonded retainers, after excluding high-risk studies, was 35.22% (95% confidence interval [CI] 27.46-42.98). The failure rate is increased with the duration of follow up; with short-term follow-up rate 24.18% (95% CI 20.16-28.21), medium-term follow up 40.09% (95% CI 30.92-49.26), and long-term follow up 53.85% (95% CI 40.31-67.39). There is a low level of evidence to suggest there is no statistically significant difference in the failure rate of fixed retainers using direct versus indirect bonding methods, using liquid resin versus without liquid resin, and fibre-reinforced composite retainers compared to multi-stranded stainless steel retainers.
DISCUSSION
There is low-quality evidence to suggest that the failure rate of FOBR is relatively high. There is a need for high-quality, well-reported clinical studies to assess factors that can influence the failure rate of FOBR.
REGISTRATION
CRD42021190910.
Topics: Humans; Prevalence; Orthodontic Appliances, Fixed; Prospective Studies; Orthodontic Retainers; Stainless Steel
PubMed: 37824794
DOI: 10.1093/ejo/cjad047 -
Cureus Dec 2023The present systematic review was done to assess the available literatures on changes in the number of occlusal contacts (NOC), occlusal contact surface areas, and... (Review)
Review
The present systematic review was done to assess the available literatures on changes in the number of occlusal contacts (NOC), occlusal contact surface areas, and occlusal force distribution (OFD) with vacuum-formed retainers (VFRs) or clear overlay retainers during retention and to compare them with other retainers. Six electronic databases (Web of Science, Scopus, PubMed, Cochrane Library, Lilacs, and Google Scholar) were searched. Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) reporting on occlusal contact changes with VFRs were included. A total of nine articles were included in this review: three RCTs, five prospective controlled trials (PCTs), and one CCT. The Cochrane risk of bias tool and ROBINS-I tool were used for risk of bias assessment. The three RCTs showed moderate risk of bias, and out of five CCTs, four showed low risk of bias, and one showed moderate risk of bias. One CCT showed a low risk of bias in the ROBINS-I tool. Two out of four studies reported improved occlusal surface area (OSA) with VFRs when assessed at the end of six months and 12 months; one out of four studies reported improved NOC; and one study reported a decrease in OFD anteriorly and an increase in OFD posteriorly after two months of retention. On comparison between the groups, the other retainer groups showed more NOCs compared to VFRs. The limited available evidence suggests an increase in OSA and no change in NOCs and OFD with VFRs during retention. No significant differences between VFRs and other retainers for OSA and OFD were noted, and more NOCs were noted for other retainer groups.
PubMed: 38239549
DOI: 10.7759/cureus.50751 -
Journal, Genetic Engineering &... Mar 2024Orthodontic relapse is a frequent problem that many patients experience. Although orthodontic therapy has advanced, recurrence rates can still reach 90%. We undertook a...
BACKGROUND
Orthodontic relapse is a frequent problem that many patients experience. Although orthodontic therapy has advanced, recurrence rates can still reach 90%. We undertook a study to look at the possibilities of laser bio-stimulation and stem cells because they have showed promising outcomes in lowering recurrence rates.
OBJECTIVES
Our objective was to analyze the effects of Low-level laser therapy (LLLT) and Mesenchymal stem cells (MSC) alone and collectively on the rate of orthodontic relapse in rats radiographically and histologically.
METHODS
Rat maxillary central incisors were moved distally for two weeks. One week later, the incisors were retained. Animals (n = 40) were split into four groups. Control group (C); laser treatment Group (L), Bone marrow mesenchymal stem cells Group (BMSCs) and combination of Stem cells and laser-irradiation group (BMSCs-L). Removed retainer permitted relapse. Before stem cell application or laser irradiation, each animal underwent two CBCT scans. Rat maxillae were stained with Hx&E, Masson trichrome, and tartrate-resistant acid phosphatase antibody for histology, histochemistry, and immunohistochemistry.
RESULTS AND CONCLUSIONS
LLLT could reduce the relapse tendency, as shown by increased bone density and enhanced remodeling of hetero-formed periodontal ligament (PDL). Furthermore, the transfer of BMMSCs on the pressure side had positive effects on PDL remodeling and decreased, but did not inhibit, the relapse rate. Finally, the synergistic effects of the application of LLLT and BMMSC were better than the control but still moderate and long-lasting.
CLINICAL SIGNIFICANCE
Based on the improved relapse rate as proven in the present study, the Application of both LLLT and stem cells can be adopted to reduce the relapse tendency either lonely or collectively.
PubMed: 38494247
DOI: 10.1016/j.jgeb.2023.100331 -
BMC Oral Health Aug 2023Retainer is a necessary procedure when orthodontic treatment complete to avoid relapse due to periodontal fiber elasticity and to allow for alveolar bone regeneration....
A comparative study of CAD/CAM fabricated polyether ether ketone and fiber-glass reinforcement composites versus metal lingual retainers under vertical load (an in vitro study).
BACKGROUND
Retainer is a necessary procedure when orthodontic treatment complete to avoid relapse due to periodontal fiber elasticity and to allow for alveolar bone regeneration. Compare the influence of vertical force on the failure of three fixed retainers: CAD/CAM polyether ether ketone (PEEK), CAD/CAM fiber glass reinforced composites (FRCs), and lingual retainer wire "Bond-A-Braid™".
MATERIALS AND METHODS
One hundred and eight maxillary first premolars teeth were randomly allocated to three groups: Group A (CAD/CAM PEEK), Group B (CAD/CAM FRC), and Group C (lingual retainer wire " Bond-A-Braid™"). These retainers were bonded using Assure Plus Bonding Resin and GO TO Paste. For each specimen, a loading cycling and thermocycling machine was used. The failure debonding forces were measured on the interproximal segments using a universal testing machine with a cross-head speed of 1 mm/min. The adhesive remnant index (ARI) was calculated after identifying types of failure with a stereomicroscope at (X 20) magnification.
RESULTS
Group B and group C showed the highest failure bonding forces, with a mean of 209.67 ± 16.15 and 86.81 ± 4.59 N, respectively. However, Group A had a statistically significant lower bond failure force, with a mean value of 45.73 ± 4.48 N. At baseline, there was a statistically significant difference in connector retainer displacement between the three studied groups (p < .001). The ARI score was not statistically significant (p < .001) between the three study groups; for groups A and B, the ARI was predominantly score 3, and group C showed a mixed score of 2 and 3. The failure mode of retainers was investigated using an optical stereomicroscope. In group B, there was a cohesive breakdown in the retainer, and groups A and C exhibited failures primarily in the adhesive at the retainer interface.
CONCLUSION
All groups differed significantly, with group A having the lowest debonding force and group B having the highest. Furthermore, there was not a substantial variation in ARI, but there was a significant difference in connector retainer displacement and the types of failure amongst the three groups.
Topics: Humans; Research Design; Benzophenones; Ketones; Ethers
PubMed: 37605187
DOI: 10.1186/s12903-023-03268-5 -
Medicine Apr 2024This paper demonstrates a digital manufacturing technique of a removable orthodontic appliance from an intraoral scan. An intraoral scan was made for the maxillary and...
This paper demonstrates a digital manufacturing technique of a removable orthodontic appliance from an intraoral scan. An intraoral scan was made for the maxillary and mandibular arches. 3Shape Orthodontics Appliance Designer produced the virtual Hawley retainer, consisting of alloy components (Adam Clasps and Fitted Labial bow) and a base plate. The base plate design was modified to adapt to inserting the alloy components, which were combined using cold-cured acrylic. The finished Hawley retainer was assessed intraorally. The described technique emphasizes the design specifications of digitally designed and manufactured removable orthodontic appliances. A combination of additive and subtractive techniques was successfully employed to manufacture the alloy components and base plate. This novel method provides an alternative approach to manufacturing removable appliances with computer-aided design (CAD)/computer-aided manufacturing (CAM) technologies. The described process offers a precursor to digital manufacturing of other developed designs of dental appliances.
Topics: Humans; Printing, Three-Dimensional; Computer-Aided Design; Orthodontic Appliance Design; Polymers; Benzophenones; Polyethylene Terephthalates; Ketones; Alloys; Orthodontic Appliances, Removable
PubMed: 38669369
DOI: 10.1097/MD.0000000000038004 -
Dental Materials Journal Sep 2023The use of fixed retainers in the lower arch is frequent; however, its presence increases the accumulation of biofilm and dental calculus. The objective of this research...
The use of fixed retainers in the lower arch is frequent; however, its presence increases the accumulation of biofilm and dental calculus. The objective of this research was to evaluate, in vitro, the accumulation of Streptococcus mutans (S. mutans) in 3 designs of fixed retainers. Nine models were reproduced in heat-cured acrylic resin and divided into groups: straight retainer (SR), retainer with vertical strap (RVS), retainer with horizontal strap (RHS). The accumulation of S. mutans was assessed using the MTT assay (3-4,5-dimethyl-thiazol-2-yl-2,5-diphenyltetrazolium bromide) and then measured using an automated reader. The RHS group showed less biofilm accumulation compared to the other groups (p<0.05). The distance between the tooth surface and the retainer showed a strong negative correlation with biofilm accumulation (rs=-0.79, p=0.00037). The RHS showed significantly less accumulation of S. mutans due to the distance between the retainer and the tooth surface. This research provides relevant data for a future randomized clinical trial.
Topics: Streptococcus mutans; Acrylic Resins; Orthodontic Appliances, Fixed; Orthodontic Appliance Design; Biofilms; Orthodontic Retainers
PubMed: 37423720
DOI: 10.4012/dmj.2023-003 -
BMC Oral Health Jun 2024Clinicians often utilize both flowable and packable composites concurrently in bonding fixed retainers. Thus, this study aimed to assess the synergistic effect of these...
BACKGROUND
Clinicians often utilize both flowable and packable composites concurrently in bonding fixed retainers. Thus, this study aimed to assess the synergistic effect of these composites in the bonding process.
METHODS
This in vitro study divided specimens into three groups: flowable composite (nano-hybrid, Tetric N-Flow, Ivoclar Vivadent), packable composite (nano-hybrid, Tetric N-ceram, Ivoclar Vivadent), and combined use of flowable and packable composite. Shear bond strength (SBS), adhesive remnant index (ARI), and wire pull-out resistance were compared among the groups. Statistical analyses were conducted using ANOVA and Tukey tests to compare study groups. Additionally, Chi-square and Kruskal-Wallis tests were employed to analyze the ARI index among the groups.
RESULTS
ANOVA results indicated no statistically significant differences among test groups (P = 0.129) regarding SBS. However, a significant difference existed between flowable and packable composite groups (P = 0.01) regarding ARI scores. Among the study groups, flowable composite exhibited the highest frequencies of ARI scores of 1 and 2, whereas packable composite showed the highest frequency of ARI scores of 0. The combined group had higher frequencies of ARI scores of 0 and 1 compared to the flowable composite. The wire pull-out test revealed that the combined application of flowable and packable composite resulted in significantly lower detachments compared to the packable composite alone (P = 0.008). However, no significant differences were observed in the comparisons between the flowable-packable (P = 0.522) and combined-flowable (P = 0.128) groups.
CONCLUSION
The combined use of flowable and packable composites for fixed retainers demonstrated adequate shear bond strength and ideal ARI scores, suggesting it as a suitable adhesive system for bonding orthodontic fixed retainers.
Topics: Composite Resins; Orthodontic Retainers; In Vitro Techniques; Shear Strength; Materials Testing; Dental Bonding; Dental Stress Analysis; Humans
PubMed: 38858745
DOI: 10.1186/s12903-024-04437-w -
BMC Oral Health Dec 2023To compare force degradation of elastomeric chains and NiTi coil springs in vivo and in vitro, and evaluate the effects of pre-stretched and reused elastomeric chains in...
OBJECTIVE
To compare force degradation of elastomeric chains and NiTi coil springs in vivo and in vitro, and evaluate the effects of pre-stretched and reused elastomeric chains in the oral cavity during the time.
METHODS
In the in vitro groups, 4-unit elastomeric chains and NiTi coil springs with an initial force of 200 g were placed in dry air and artificial saliva. The volunteers wore clear retainers which were used to hold the sample of 4-unit chains, pre-stretched 4-unit chains, and NiTi coil springs with the initial force of 200 g in the in vivo groups. After the first 4 weeks, 4-unit specimens were stretched to 200 g again for another 4 weeks in vivo. The force value and the percentage of force degradation were recorded at each measurement time interval in the in vivo and in vitro groups.
RESULTS
The force degradation of elastomeric chains was greatest within the initial 4 hours, followed by a more stable phase after 1 week. The average force degradation of 4-unit elastomeric chains after 4 weeks was in vivo (64.8%) > artificial saliva (55.0%) > dry air (46.42%) (P < 0.05). The force degradation of NiTi coil springs in vivo (15.36%) or in artificial saliva (15.8%) was greater than in dry air (7.6%) (P < 0.05). NiTi coil springs presented a gentler force decay than elastomeric chains during the period (P < 0.05). In vivo, the force degradation of pre-stretched and reused elastomeric chains decreased less than the regular style(P < 0.05).
CONCLUSION
The force degradation of the elastomeric chains and NiTi coil springs varied in different environments. NiTi coil springs presented a gentler force decay than elastomeric chains during the period. Orthodontists should consider the force degradation characteristics of orthodontic accessories in clinical practice.
Topics: Humans; Saliva, Artificial; Nickel; Titanium; Elasticity; Orthodontic Appliances; Materials Testing; Orthodontic Wires
PubMed: 38097980
DOI: 10.1186/s12903-023-03737-x