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International Journal of Environmental... Apr 2023Early-stage dental demineralization, called white spots (WS), get their name from the characteristic colour that enamel takes on due to the acid attack of salivary... (Review)
Review
Early-stage dental demineralization, called white spots (WS), get their name from the characteristic colour that enamel takes on due to the acid attack of salivary cariogenic bacteria. They are often associated with fixed orthodontic therapy (FOT) and, if left untreated, evolve into caries with repercussions on oral health and dental aesthetics. This review aims to identify the most effective prophylaxis strategies to prevent WS during FOT. The search for the reviewed studies was conducted on the Pubmed, Scopus, and Web of Science databases, selecting English-only articles published in the 5 years from January 2018 to January 2023. The keywords used were "WS" and "fixed orthodontic*", using "AND" as the Boolean operator. A total of 16 studies were included for qualitative analysis. Prevention begins with maintaining proper oral hygiene; fluoride in toothpaste, mouthwashes, gels, varnishes, and sealants can be added to prophylaxis and used regularly. Using a laser in combination with fluoride helps prevent the occurrence of WS and assists in the repair processes of initial lesions. Further studies are needed to establish international guidelines for preventing WS in orthodontically treated patients.
Topics: Humans; Cariostatic Agents; Dental Care; Dental Caries; Fluorides; Mouthwashes; Orthodontics
PubMed: 37107890
DOI: 10.3390/ijerph20085608 -
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 -
Journal of Zhejiang University.... Sep 2023Over the past decade, dramatic progress has been made in dental research areas involving laser therapy. The photobiomodulatory effect of laser light regulates the... (Review)
Review
Over the past decade, dramatic progress has been made in dental research areas involving laser therapy. The photobiomodulatory effect of laser light regulates the behavior of periodontal tissues and promotes damaged tissues to heal faster. Additionally, photobiomodulation therapy (PBMT), a non-invasive treatment, when applied in orthodontics, contributes to alleviating pain and reducing inflammation induced by orthodontic forces, along with improving tissue healing processes. Moreover, PBMT is attracting more attention as a possible approach to prevent the incidence of orthodontically induced inflammatory root resorption (OIIRR) during orthodontic treatment (OT) due to its capacity to modulate inflammatory, apoptotic, and anti-antioxidant responses. However, a systematic review revealed that PBMT has only a moderate grade of evidence-based effectiveness during orthodontic tooth movement (OTM) in relation to OIIRR, casting doubt on its beneficial effects. In PBMT-assisted orthodontics, delivering sufficient energy to the tooth root to achieve optimal stimulation is challenging due to the exponential attenuation of light penetration in periodontal tissues. The penetration of light to the root surface is another crucial unknown factor. Both the penetration depth and distribution of light in periodontal tissues are unknown. Thus, advanced approaches specific to orthodontic application of PBMT need to be established to overcome these limitations. This review explores possibilities for improving the application and effectiveness of PBMT during OTM. The aim was to investigate the current evidence related to the underlying mechanisms of action of PBMT on various periodontal tissues and cells, with a special focus on immunomodulatory effects during OTM.
Topics: Humans; Inflammation; Low-Level Light Therapy; Orthodontics; Root Resorption; Tooth Movement Techniques
PubMed: 37961799
DOI: 10.1631/jzus.B2200706 -
The Journal of Clinical Pediatric... Jan 2023A great emphasis is currently given to the early correction of malocclusions to prevent further complications if left untreated. Interceptive orthodontics not only... (Review)
Review
A great emphasis is currently given to the early correction of malocclusions to prevent further complications if left untreated. Interceptive orthodontics not only simplifies but also eliminates the need for later procedures. The 2 × 4 appliance is an orthodontic treatment modality applied during the mixed dentition period, particularly for malpositioned permanent upper incisors. This scoping review was aimed to examine the breadth and depth of the published literature on this clinical topic, as well as knowledge gaps, about this fixed appliance during mixed dentition, for the correction of incipient anterior malocclusions (incisor crowdings, midline diastemas, or crossbites). PubMed, Cochrane Library, Google Scholar, Dentistry & Oral Sciences Source, and two grey literature databases were explored; under a structured PICO question (Patient, Intervention, Comparison, Outcome) and eligibility criteria, for relevant clinical trials, observational studies, and case reports/series (in English or Spanish), using different searching terms. Titles and abstracts were screened. Full-text articles were critically reviewed for bias risk and a data charting table was constructed. 161 references were identified, after which 115 titles remained after removing duplicates. After the abstract screening, 18 potential full-text articles were reviewed. Finally, 16 studies were included, according to the performed critical appraisal. The 2 × 4 appliance is suitable for mixed dentition patients with mild or severe malocclusions, particularly when removable appliance usage is a critical problem.
Topics: Humans; Dentition, Mixed; Malocclusion; Orthodontic Appliances, Fixed; Orthodontics, Interceptive; Incisor
PubMed: 36627214
DOI: 10.22514/jocpd.2022.033 -
Progress in Orthodontics Jul 2021This scoping review aims to provide an overview of the existing evidence on the use of artificial intelligence (AI) and machine learning (ML) in orthodontics, its... (Review)
Review
INTRODUCTION
This scoping review aims to provide an overview of the existing evidence on the use of artificial intelligence (AI) and machine learning (ML) in orthodontics, its translation into clinical practice, and what limitations do exist that have precluded their envisioned application.
METHODS
A scoping review of the literature was carried out following the PRISMA-ScR guidelines. PubMed was searched until July 2020.
RESULTS
Sixty-two articles fulfilled the inclusion criteria. A total of 43 out of the 62 studies (69.35%) were published this last decade. The majority of these studies were from the USA (11), followed by South Korea (9) and China (7). The number of studies published in non-orthodontic journals (36) was more extensive than in orthodontic journals (26). Artificial Neural Networks (ANNs) were found to be the most commonly utilized AI/ML algorithm (13 studies), followed by Convolutional Neural Networks (CNNs), Support Vector Machine (SVM) (9 studies each), and regression (8 studies). The most commonly studied domains were diagnosis and treatment planning-either broad-based or specific (33), automated anatomic landmark detection and/or analyses (19), assessment of growth and development (4), and evaluation of treatment outcomes (2). The different characteristics and distribution of these studies have been displayed and elucidated upon therein.
CONCLUSION
This scoping review suggests that there has been an exponential increase in the number of studies involving various orthodontic applications of AI and ML. The most commonly studied domains were diagnosis and treatment planning, automated anatomic landmark detection and/or analyses, and growth and development assessment.
Topics: Algorithms; Artificial Intelligence; China; Humans; Machine Learning; Orthodontics
PubMed: 34219198
DOI: 10.1186/s40510-021-00361-9 -
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 -
Journal of Healthcare Engineering 2021White teeth can make people full of confidence and satisfy the concept of modern life from the love of beauty. Due to the fusion of computer-aided design and teeth,...
White teeth can make people full of confidence and satisfy the concept of modern life from the love of beauty. Due to the fusion of computer-aided design and teeth, invisible orthodontics has become the focus of research. Invisible orthodontic treatment technology can predict the results of orthodontics. How to automatically calculate the position and posture of the teeth in the middle stage of orthodontics is the key point of the treatment technology. In order to solve this problem, this article is divided into two parts to start research. Aiming at the problem of tooth orthodontic path planning, quaternion is used to define the tooth posture, combined with the initial posture and target posture of the tooth. A two-stage method is given to plan a collision-free path for the orthodontic tooth. In the first stage, the quaternion spherical linear interpolation and position linear interpolation are used to obtain the intermediate posture of the tooth during orthodontics, and the initial value of the orthodontic stage is obtained, and the obtained intermediate posture is used as a sampling node to apply to the next stage. In the second phase, considering the problem of orthodontic collision and interference, a scheme for calculating the priority of orthodontics is proposed, and the random node expansion part in the RRT (Rapid-exploration Random Tree) algorithm is improved. The initial value of the orthodontic phase is used to calculate the initial value of the iteration. Finally, a path with no collision and the least number of orthodontic stages is searched from the random tree of each tooth node. The experimental results and analysis show that this method can quickly and effectively solve the orthodontic path of teeth, and it is used clinically. The clasp-free invisible correction technology pushes the molars far away to leave gaps for treating patients with mild to moderate overcrowding. The treatment time should be reduced by at least 30%; the stability of the gaps and the long-term healing effect of the treatment provide a reference.
Topics: Humans; Molar; Orthodontics; Tongue; Tooth Movement Techniques; Wearable Electronic Devices
PubMed: 34221298
DOI: 10.1155/2021/4979681 -
American Journal of Orthodontics and... Jul 2023This study aimed to determine adaptations orthodontists made during the coronavirus disease 2019 pandemic to maintain safety and determine which adaptations will remain...
INTRODUCTION
This study aimed to determine adaptations orthodontists made during the coronavirus disease 2019 pandemic to maintain safety and determine which adaptations will remain after the pandemic.
METHODS
An original 34-question survey was sent by mail to a randomized selection of practicing orthodontic specialists (n = 1000). Questions included the changes made during the pandemic in 4 categories (infection control, social distancing, appliance type, and teleorthodontics) and whether those changes will remain postpandemic.
RESULTS
The use of personal protective equipment increased during the pandemic, with a significant decrease anticipated after the pandemic. The most common aerosol modification during the pandemic and predicted after the pandemic was using an assistant with high-volume suction (61% and 49%, respectively; P = 0.0013). Ninety-six percent of orthodontists changed their waiting room protocol during the pandemic, but only 23% plan to continue that practice (P <0.0001). Forty-two percent of orthodontists increased clear aligners during the pandemic in response to patient demand (91%). The use of teleorthodontics increased from 8% to 68% during the pandemic and is expected to decrease significantly postpandemic. Virtual appointments are anticipated to be used for screening and consultations of new patients and monitoring active patients in clear aligners but not fixed appliances.
CONCLUSIONS
The specialty recommended patient safety modifications during the coronavirus disease 2019 pandemic. Postpandemic, enhanced personal protective equipment is expected to decrease, and high-volume suction will likely be continued for aerosol-producing procedures. Teleorthodontics will likely remain in limited use.
Topics: Humans; Orthodontics; COVID-19; Orthodontists; Referral and Consultation; Orthodontic Appliances, Fixed; Surveys and Questionnaires
PubMed: 36841666
DOI: 10.1016/j.ajodo.2022.10.027 -
Dental Materials Journal Aug 2023Adhesion of the most common dental biofilm bacteria to alloys used in orthodontics in relation to surface characteristics was analyzed. Streptococcus mutans (S. mutans),...
Adhesion of the most common dental biofilm bacteria to alloys used in orthodontics in relation to surface characteristics was analyzed. Streptococcus mutans (S. mutans), Streptococcus oralis (S. oralis), Veillonella parvula (V. parvula), and Aggregatibacter actinomycetemcomitans (A. actynomicetemcomitans) were incubated for 4 h with nickel-titanium (NiTi) and stainless-steel (SS) wires. The surface roughness and free energy of the alloys, as well as the hydrophobicity of the alloys and bacteria, were assessed. NiTi had higher surface free energy and rougher (p<0.001) and more hydrophilic surfaces than SS (p<0.001). The hydrophobic properties of the bacteria decreased in the following order: V. parvula>S. oralis>S. mutans>A. actynomicetemcomitans. Bacterial adhesion generally increased over time, though this pattern was influenced by the type of alloy and the bacteria present (p<0.001). In a multiple linear regression, the principal predictor of adhesion was bacterial hydrophobicity (p<0.001), followed by time (p<0.001); alloy surface characteristics had a low influence.
Topics: Dental Alloys; Orthodontic Wires; Surface Properties; Orthodontic Appliances; Alloys; Streptococcus mutans; Titanium; Stainless Steel
PubMed: 37271541
DOI: 10.4012/dmj.2022-235 -
BMC Oral Health Nov 2023This study aimed to compare the pain intensity and impacts on oral health-related quality of life (OHRQoL) between orthodontic patients treated with clear aligners (CAs)... (Meta-Analysis)
Meta-Analysis
Comparison of pain intensity and impacts on oral health-related quality of life between orthodontic patients treated with clear aligners and fixed appliances: a systematic review and meta-analysis.
OBJECTIVE
This study aimed to compare the pain intensity and impacts on oral health-related quality of life (OHRQoL) between orthodontic patients treated with clear aligners (CAs) and fixed appliances (FAs).
METHODS
A systematic search was conducted up to December 2022 using PubMed, Web of Science, Cochrane Central Register of Controlled Trials, and Embase. Randomized controlled trials (RCTs) and prospective non-randomized controlled trials (non-RCTs) comparing pain intensity or OHRQoL between patients treated with CAs and FAs were included. The risk of bias (RoB) of individual studies was evaluated using the Cochrane RoB tool 2.0 and ROBINS-I tool for RCTs and non-RCTs, respectively. Further, meta-analyses were separately conducted for each included study using the total oral health impact profile (OHIP)-14 and visual analog scale (VAS) scores to evaluate OHRQoL and pain intensity, respectively.
RESULTS
Overall, 12 studies (5 RCTs and 7 non-RCTs) were included in the study. Subgroup analyses conducted according to the total OHIP-14 scores revealed that patients treated with CAs had higher OHRQoL at 1 week, 1 month, and 6 months of the treatment. Meanwhile, subgroup analyses conducted according to the VAS scores revealed that pain levels were lower in the CA group only at 3 and 4 days of the treatment.
CONCLUSIONS
Patients treated with clear aligners had higher OHRQoL than those treated with fixed appliances during orthodontic treatment. However, OHRQoL appeared to be similar between the two groups at the end of the treatment. Moreover, patients treated with clear aligners experienced lesser pain than those treated with fixed appliances on the third and fourth day after the initial treatment. The difference in pain intensity between the two treatment modalities was not noted at other time points.
Topics: Humans; Pain Measurement; Orthodontic Appliances, Fixed; Pain; Quality of Life; Orthodontic Appliances, Removable; Orthodontic Appliances
PubMed: 38001455
DOI: 10.1186/s12903-023-03681-w