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The Journal of Contemporary Dental... Jul 2020This literature review aims to update the evidence for prevention of white spot lesion (WSL) using orthodontic sealants among patients with fixed orthodontic appliances. (Review)
Review
AIM
This literature review aims to update the evidence for prevention of white spot lesion (WSL) using orthodontic sealants among patients with fixed orthodontic appliances.
BACKGROUND
As a major issue among orthodontists, prolonged treatment duration increases the risk of plaque development around orthodontic brackets and bands. In consequence, this can lead to heightened risk for caries development and higher possibility of WSL development around fixed orthodontic brackets.
RESULTS
Increased prevalence of WSLs generally occurs during orthodontic treatment. This review explored various products of orthodontic sealants used to prevent WSL. Orthodontic sealants do not require patient compliance and thus will further lessen the burden among orthodontists as well as support enamel surface for a long period of time during treatment. Certain factors, however, are considered important in the efficacy of these sealants, such as antibacterial activity, color stability, resistance to acid and brush abrasion, and their effect on shear bond strength (SBS).
CONCLUSION
The review showed that the use of orthodontic sealants in preventing WSLs during and after fixed orthodontic treatment is significantly effective. However, the bioactive glass is deemed more effective against WSL development due to its ability to immediately repair enamel surface, low cytotoxicity, and high biocompatibility. Moreover, clinical studies on bioactive glass are still needed to determine its acceptability among patients with fixed orthodontic appliance.
CLINICAL SIGNIFICANCE
Development of WSL around the orthodontic brackets during treatment is a difficult task among orthodontists. As such, this review explored various strategies to effectively combat WSL development for good oral health and esthetics during orthodontic treatment.
Topics: Dental Caries; Dental Materials; Esthetics, Dental; Humans; Orthodontic Brackets; Orthodontics
PubMed: 33020368
DOI: No ID Found -
Brazilian Dental Journal 2020The aim of this study was to analyze the influence of orthodontic bracket type (metallic or ceramic) and mouthguard on biomechanical response during impact....
The aim of this study was to analyze the influence of orthodontic bracket type (metallic or ceramic) and mouthguard on biomechanical response during impact. Two-dimensional plane-strain models of a patient with increased positive overjet of the maxillary central incisor was created based on a CT scan, simulating the periodontal ligament, bone support, gingival tissue, orthodontic brackets (metallic or ceramic) and mouthguard. A nonlinear dynamic impact finite element analysis was performed in which a steel object hit the model at 1 m/s. Stress distributions (Von Mises and Modified Von Mises) and strain were evaluated. Stress distributions were affected by the bracket presence and type. Models with metallic and ceramic bracket had higher stresses over a larger buccal enamel impact area. Models with ceramic brackets generated higher stresses than the metallic brackets. Mouthguards reduced the stress and strain values regardless of bracket type. Mouthguard shock absorption were 88.37% and 89.27% for the metallic and ceramic bracket, respectively. Orthodontic bracket presence and type influenced the stress and strain generated during an impact. Ceramic brackets generated higher stresses than metallic brackets. Mouthguards substantially reduced impact stress and strain peaks, regardless of bracket type.
Topics: Ceramics; Dental Stress Analysis; Finite Element Analysis; Humans; Incisor; Materials Testing; Mouth Protectors; Orthodontic Appliance Design; Orthodontic Brackets; Stress, Mechanical
PubMed: 33146339
DOI: 10.1590/0103-6440202002818 -
The Angle Orthodontist May 2022To test a new concept in bracket design-the tip and torque adjustable bracket (TTAB)-to identify its integral ability to change both tip and torque.
OBJECTIVES
To test a new concept in bracket design-the tip and torque adjustable bracket (TTAB)-to identify its integral ability to change both tip and torque.
MATERIALS AND METHODS
The newly designed TTAB underwent independent testing using the orthodontic measurement and simulation system. The TTAB incorporated Roth tip and torque prescription values, with the unique quality of the bracket to enhance or reduce the innate prescribed values of tip (by either +10° or -10°) and torque (by either +7.5° or -7.5°). The TTAB was tested using both the incorporated standard Roth prescription on the rate of canine retraction (sliding mechanics), using 0.018-inch stainless-steel (SS) arch wire, and with alteration of tip values (-10° and +10°). Similarly, frictional measurements and torque evaluations using 0.019 × 0.025-inch SS arch wire were undertaken with the standard prescription and altered torque (+7.5° and -7.5°). In addition, a number of control investigations were performed. Differences were analyzed using analysis of variance.
RESULTS
The rate of observed tooth movement for the TTAB with its prescribed baseline values was comparable to that of the control brackets. Importantly, the alteration of TTAB tip to -10° and +10° significantly (P < .001) increased and reduced, respectively, the rates of canine retraction. In the alteration of torque, at +7.5° and -7.5°, the bracket delivered a moment of +9.3 (2.8) Nmm and -11.9 (3.8) Nmm, respectively, to the lateral incisor (P < .001).
CONCLUSIONS
This in vitro study demonstrates a new concept in preadjusted edgewise bracket design, offering adjustable tip and torque, with the potential for expanded clinical scope.
Topics: Dental Stress Analysis; Materials Testing; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Stainless Steel; Torque
PubMed: 35061018
DOI: 10.2319/061421-474.1 -
BioMed Research International 2021To compare the orthodontic bracket debonding force and assess the bracket failure pattern clinically between different teeth by a validated prototype debonding device. ....
OBJECTIVE
To compare the orthodontic bracket debonding force and assess the bracket failure pattern clinically between different teeth by a validated prototype debonding device. . Thirteen (13) patients at the end of comprehensive fixed orthodontic treatment, awaiting for bracket removal, were selected from the list. A total of 260 brackets from the central incisor to the second premolar in both jaws were debonded by a single clinician using a validated prototype debonding device equipped with a force sensitive resistor (FSR). Mean bracket debonding forces were specified to ten (10) groups of teeth. Following debonding, Intraoral microphotographs of the teeth were taken by the same clinician to assess the bracket failure pattern using a 4-point scale of adhesive remnant index (ARI). Statistical analysis included one-way ANOVA with post hoc Tukey HSD and independent sample -test to compare in vivo bracket debonding force, Cohen's kappa (), and a nonparametric Kruskal-Wallis test for the reliability and the assessment of ARI scoring.
RESULTS
A significant difference ( < 0.001) of mean debonding force was found between different types of teeth in vivo. Clinically, ARI scores were not significantly different ( = 0.921) between different groups, but overall higher scores were predominant.
CONCLUSION
Bracket debonding force should be measured on the same tooth from the same arch as the significant difference of mean debonding force exists between similar teeth of the upper and lower arches. The insignificant bracket failure pattern with higher ARI scores confirms less enamel damage irrespective of tooth types.
Topics: Adult; Dental Cements; Device Removal; Equipment Failure; Humans; Mechanical Phenomena; Orthodontic Brackets; Tooth; Young Adult
PubMed: 33959664
DOI: 10.1155/2021/6663683 -
Clinical Oral Investigations Jan 2024We aimed to develop a tool for virtual orthodontic bracket removal based on deep learning algorithms for feature extraction from bonded teeth and to demonstrate its...
OBJECTIVE
We aimed to develop a tool for virtual orthodontic bracket removal based on deep learning algorithms for feature extraction from bonded teeth and to demonstrate its application in a bracket position assessment scenario.
MATERIALS AND METHODS
Our segmentation network for virtual bracket removal was trained using dataset A, containing 978 bonded teeth, 20 original teeth, and 20 brackets generated by scanners. The accuracy and segmentation time of the network were tested by dataset B, which included an additional 118 bonded teeth without knowing the original tooth morphology. This tool was then applied for bracket position assessment. The clinical crown center, bracket center, and orientations of separated teeth and brackets were extracted for analyzing the linear distribution and angular deviation of bonded brackets.
RESULTS
This tool performed virtual bracket removal in 2.9 ms per tooth with accuracies of 98.93% and 97.42% (P < 0.01) in datasets A and B, respectively. The tooth surface and bracket characteristics were extracted and used to evaluate the results of manually bonded brackets by 49 orthodontists. Personal preferences for bracket angulation and bracket distribution were displayed graphically and tabularly.
CONCLUSIONS
The tool's efficiency and precision are satisfactory, and it can be operated without original tooth data. It can be used to display the bonding deviation in the bracket position assessment scenario.
CLINICAL SIGNIFICANCE
With the aid of this tool, unnecessary bracket removal can be avoided when evaluating bracket positions and modifying treatment plans. It has the potential to produce retainers and orthodontic devices prior to tooth debonding.
Topics: Orthodontic Brackets; Deep Learning; Dental Bonding; Dental Debonding; Microscopy, Electron, Scanning
PubMed: 38280038
DOI: 10.1007/s00784-023-05440-1 -
BMC Oral Health Jul 2022Before the magnetic resonance imaging (MRI) examination fixed orthodontic devices, such as brackets and wires, cause challenges not only for the orthodontist but also...
BACKGROUND
Before the magnetic resonance imaging (MRI) examination fixed orthodontic devices, such as brackets and wires, cause challenges not only for the orthodontist but also for the radiologist. Essentially, the MRI-safe scan of the fixed orthodontic tools requires a proper guideline in clinical practice. Therefore, this systematic review aimed to examine all aspects of MRI-safe scan, including artifact, thermal, and debonding effects, to identify any existing gaps in knowledge in this regard and develop an evidence-based protocol.
METHODS
The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement was used in this study. The clinical question in "PIO" format was: "Does MRI examination influence the temperature of the orthodontic devices, the size of artifacts, and the debonding force in patients who have fixed orthodontic bracket and/or wire?" The search process was carried out in PubMed, PubMed Central, Scopus, and Google Scholar databases. The search resulted in 1310 articles. After selection according to the eligibility criteria, 18 studies were analyzed by two reviewers. The risk of bias was determined using the Quality In Prognosis Studies tool.
RESULTS
Out of the eligible 18 studies, 10 articles examined the heating effect, 6 were about the debonding effect, and 11 measured the size of artifact regarding brackets and wires. Considering the quality assessment, the overall levels of evidence were high and medium. The published studies showed that heating and debonding effects during MRI exposure were not hazardous for patients. As some wires revealed higher temperature changes, it is suggested to remove the wire or insert a spacer between the appliances and the oral mucosa. Based on the material, ceramic and plastic brackets caused no relevant artifact and were MRI-safe. Stainless steel brackets and wires resulted in susceptibility artifacts in the orofacial region and could cause distortion in the frontal lobe, orbits, and pituitary gland. The retainer wires showed no relevant artifact.
CONCLUSIONS
In conclusion, the thermal and debonding effects of the fixed orthodontic brackets and wires were irrelevant or resoluble; however, the size of the artifacts was clinically relevant and determined most significantly the feasibility of fixed brackets and wires in MRI examination.
Topics: Artifacts; Humans; Magnetic Resonance Imaging; Orthodontic Brackets; Orthodontic Wires; Stainless Steel
PubMed: 35854295
DOI: 10.1186/s12903-022-02317-9 -
British Dental Journal May 2020
Topics: Braces; Equipment Design; Orthodontic Appliances, Fixed; Orthodontic Brackets
PubMed: 32444722
DOI: 10.1038/s41415-020-1684-6 -
The Angle Orthodontist Jan 2021The purpose of this cohort study was to evaluate the effect of self-ligating brackets (SB) and other related factors that influence orthodontic treatment time. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
The purpose of this cohort study was to evaluate the effect of self-ligating brackets (SB) and other related factors that influence orthodontic treatment time.
MATERIALS AND METHODS
This was a two-armed prospective study. Consecutively treated patients who were recruited from a private practice were enrolled and asked to choose between SB and conventional brackets (CB). If the patient did not have a preference, that patient was randomly allocated. An identical archwire sequence was used, and all patients were treated by a single orthodontist. Treatment duration, number of bracket failures, poor oral hygiene, poor elastic wear, whether or not to orthodontic mini-implants (OMI) were used, OMI failure, extraction, American Board of Orthodontics Discrepancy Index, and arch length discrepancy were measured and statistically analyzed using t-tests, correlation analysis, and analysis of covariance (ANCOVA). Stepwise regression analysis was conducted to generate an equation to predict treatment duration.
RESULTS
A total of 134 patients with an average age of 22.73 years were included. The average treatment duration was 28.63 months. ANCOVA showed no significant difference in treatment duration between CB and SB. Stepwise regression analysis could explain 64.6% of the variance in treatment duration using five variables.
CONCLUSIONS
SB did not exhibit a significant reduction in treatment time as compared with CB. Patient cooperation, extractions, and malocclusion severity had a significant impact on treatment duration.
Topics: Adult; Cohort Studies; Dental Implants; Humans; Orthodontic Anchorage Procedures; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Prospective Studies; Young Adult
PubMed: 33289803
DOI: 10.2319/050220-379.1 -
Journal of Biomechanics May 2021So far, no practicable procedure exists to quantify the orthodontic loads applied to teeth in vivo. Dentists therefore rely on experience and simplified mechanical...
So far, no practicable procedure exists to quantify the orthodontic loads applied to teeth in vivo. Dentists therefore rely on experience and simplified mechanical in-vitro experiments comprising deflection of orthodontic wires. Predicting the mechanical behaviour of orthodontic wires during clinical therapy requires understanding of the different contact states at multi-bracket-wire interfaces. This study experimentally investigates the effect of different bracket-wire contact configurations in a three-bracket setup and uses two numerical approaches to analyse and complement the experimental data. Commonly used round stainless-steel wires (diameter: 0.012″ and 0.016″) and titanium-molybdenum alloy wires (diameter: 0.016″ and 0.018″) were tested. All six force-moment components were measured separately for each of the three brackets. The results indicate that a specific sequence of distinct bracket-wire contact configurations occurs. Several transitions between configurations caused substantial changes of effective wire stiffness (EWS), which were consistent among experimental and numerical methods. The lowest EWS was observed for the configuration in which the wire touched only one wing of the lateral brackets. Taking this stiffness as 100%, the transition to a configuration in which the wire touched two opposing wings of the lateral brackets resulted in an increase of EWS of 300% ± 10%. This increase was independent of the wire type. Additional contacts resulted in further increases of stiffness beyond 400%. The results of this combined experimental and numerical study are important for providing a fundamental understanding of multi-bracket-wire contact configurations and have important implications for clinical therapy.
Topics: Dental Alloys; Dental Stress Analysis; Friction; Materials Testing; Orthodontic Brackets; Orthodontic Wires; Stainless Steel; Titanium
PubMed: 33894471
DOI: 10.1016/j.jbiomech.2021.110401 -
Dental Press Journal of Orthodontics 2022Many patients wearing orthodontic appliances request alterations in the shade of their teeth during orthodontic treatment.
INTRODUCTION
Many patients wearing orthodontic appliances request alterations in the shade of their teeth during orthodontic treatment.
OBJECTIVE
This study aimed to evaluate the efficacy of different products for bleaching and whitening under orthodontic brackets.
METHODS
Seventy bovine incisors were randomly divided into five groups (n = 14): C) non-whitening toothpaste (control); WTsi) hydrated silica whitening toothpaste; WThp) 2% hydrogen peroxide whitening toothpaste; OB) in-office bleaching; and HB) at-home bleaching. Two buccal surface areas were evaluated using the Easyshade spectrophotometer: under the metal bracket (experimental) and around the bracket (control). The paired t-test, ANOVA, and Tukey tests were applied for statistical analysis.
RESULTS
Intragroup comparisons showed that in groups C, WThp and HB, there were statistically significant differences in the enamel color changes (ΔEab) between under and around the bracket areas (C - under bracket = 7.97 ± 2.35, around bracket = 2.86 ± 0.81, p< 0.01; WThp - under bracket = 4.69 ± 2.98, around bracket = 2.05 ± 1.41, p< 0.01; HB - under bracket = 7.41 ± 2.89, around bracket: 9.86 ± 3.32, p= 0.02). Groups WTsi, OB and HB presented similar perception of tooth whiteness (ΔWID) between the tested areas. Intergroup comparisons demonstrated that under the bracket area, the color change (ΔEab) was similar for all groups, except WThp (C = 7.97 ± 2.35; WTsi = 8.54 ± 3.63; WThp = 4.69 ± 2.98; OB = 9.31 ± 4.32; HB = 7.41 ± 2.89; p< 0.01).
CONCLUSIONS
The dental color changes were effective for the products tested in groups WTsi, OB and HB in the presence of metallic orthodontic brackets.
Topics: Animals; Cattle; Color; Dental Enamel; Hydrogen Peroxide; Orthodontic Brackets; Tooth Bleaching; Tooth Bleaching Agents; Toothpastes
PubMed: 36350943
DOI: 10.1590/2177-6709.27.5.e2220325.oar