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American Journal of Orthodontics and... Aug 2020Patients may express views about their orthodontic care by posting publicly available reviews on the Internet. This study analyzed online reviews of orthodontists with... (Review)
Review
INTRODUCTION
Patients may express views about their orthodontic care by posting publicly available reviews on the Internet. This study analyzed online reviews of orthodontists with an emphasis on the types and frequency of complaints expressed in negative reviews.
METHODS
A random sample of 10.6% of the American Association of Orthodontists membership was evaluated to identify members practicing in a North American office that is limited to orthodontics and has an online presence. Information regarding those orthodontists and their offices was collected. For offices with Google and/or Yelp reviews, all negative (1- or 2-star) reviews were saved for content analysis. If an office posted a response to a negative review, those responses were also collected for analysis.
RESULTS
Of the 807 eligible orthodontists, 92.4% had reviews on Google and/or Yelp. Average ratings of orthodontists were very positive (ie, 4- and 5-star reviews constituted >97% of Google reviews and >88% of Yelp reviews), yielding an average orthodontist rating of 4.72 on Google and 4.42 on Yelp. However, approximately half of those orthodontists (50.9%) also had at least 1 negative review. The 3 most frequently mentioned categories of complaints were regarding quality of care and/or service, interpersonal interactions, and money and/or financial issues. An analysis of the specific kinds of complaints is described. Orthodontists posting responses to negative reviews had significantly better average ratings than those who did not, but this association does not demonstrate a causal relationship.
CONCLUSIONS
Understanding the complaints orthodontic patients express in online reviews may suggest strategies to improve patient satisfaction and an orthodontist's online reputation.
Topics: Humans; Orthodontics; Orthodontists; Patient Satisfaction
PubMed: 32746975
DOI: 10.1016/j.ajodo.2020.02.005 -
European Journal of Orthodontics Sep 2023The application of orthodontic forces causes root resorption of variable severity with potentially severe clinical ramifications.
BACKGROUND
The application of orthodontic forces causes root resorption of variable severity with potentially severe clinical ramifications.
OBJECTIVE
To systematically review reports on the pathophysiological mechanisms of orthodontically induced inflammatory root resorption (OIIRR) and the associated risk factors based on in vitro, experimental, and in vivo studies.
SEARCH METHODS
We undertook an electronic search of four databases and a separate hand-search.
SELECTION CRITERIA
Studies reporting on the effect of orthodontic forces with/without the addition of potential risk factors on OIIRR, including (1) gene expression in in-vitro studies, the incidence root resorption in (2) animal studies, and (3) human studies.
DATA COLLECTION AND ANALYSIS
Potential hits underwent a two-step selection, data extraction, quality assessment, and systematic appraisal performed by duplicate examiners.
RESULTS
One hundred and eighteen articles met the eligibility criteria. Studies varied considerably in methodology, reporting of results, and variable risk of bias judgements.In summary, the variable evidence identified supports the notion that the application of orthodontic forces leads to (1) characteristic alterations of molecular expression profiles in vitro, (2) an increased rate of OIIRR in animal models, as well as (3) in human studies. Importantly, the additional presence of risk factors such as malocclusion, previous trauma, and medications like corticosteroids increased the severity of OIIRR, whilst other factors decreased its severity, including oral contraceptives, baicalin, and high caffeine.
CONCLUSIONS
Based on the systematically reviewed evidence, OIIRR seems to be an inevitable consequence of the application of orthodontic forces-with different risk factors modifying its severity. Our review has identified several molecular mechanisms that can help explain this link between orthodontic forces and OIIRR. Nevertheless, it must be noted that the available eligible literature was in part significantly confounded by bias and was characterized by substantial methodological heterogeneity, suggesting that the results of this systematic review should be interpreted with caution.
REGISTRATION
PROSPERO (CRD42021243431).
Topics: Animals; Humans; Root Resorption; Risk Factors; Malocclusion; Tooth Movement Techniques
PubMed: 37366151
DOI: 10.1093/ejo/cjad011 -
European Journal of Dental Education :... Aug 2022The electronic dental model (e-model) is an example of a digital 3-dimensional technology to support inquiry-based learning in undergraduate dental education. As student...
INTRODUCTION
The electronic dental model (e-model) is an example of a digital 3-dimensional technology to support inquiry-based learning in undergraduate dental education. As student perceptions of and engagement with e-models vary, it is uncertain whether these perceptions have implications for their learning processes and outcomes.
MATERIALS AND METHODS
Third-year dental students (N = 40) completed a questionnaire to identify their perceptions of and preferences for model modalities. They were divided into three groups based on their preference: Preferring plaster models (Group 1); Preferring e-models (Group 2); No preference (Group 3). Students from three groups (N = 9) attended a hands-on digital occlusion evaluation workshop, and then completed a case-based diagnostic evaluation test using digital occlusion evaluation software. Camtasia Studio™ recorded real-time and on-screen data of the number of mouse-clicks and time spent.
RESULTS
Students reported positive feedbacks on the use of e-models, and 72.5% of the students preferred combination use of e-models and plaster models. After attending the hands-on digital dental occlusion evaluation workshop, Group 2 scored higher on the diagnostic evaluation test (p < .05) and registered more mouse-clicks than Group 1 when evaluating the arch symmetry (p < .05). Group 2 registered fewer mouse-clicks than Group 3 during tooth size measurement (p < .05). There was no significant difference regarding the time used to answer the knowledge questions amongst the three groups.
CONCLUSION
Undergraduate dental students indicated a generally high acceptance of e-models for their learning in orthodontics, and more prefer a blended approach. Students preferring e-models presented higher performance outcomes, which supports cognitive load theory regarding prior exposure to simulation-based environments.
Topics: Education, Dental; Educational Measurement; Humans; Learning; Orthodontics; Students
PubMed: 34528742
DOI: 10.1111/eje.12718 -
Journal of Orofacial Orthopedics =... Jan 2022Gummetal® (Maruemu Works, Osaka, Japan), a new orthodontic wire material successfully used in clinical applications since 2006, is biocompatible and exhibits...
OBJECTIVES
Gummetal® (Maruemu Works, Osaka, Japan), a new orthodontic wire material successfully used in clinical applications since 2006, is biocompatible and exhibits exceptionally high elasticity, nonlinear elastic behavior, plasticity and strength. Systematic comparisons of friction behavior are lacking; thus, the friction of Gummetal® in the binding modus was compared to commonly used low friction wires.
MATERIALS AND METHODS
In vivo tests were run with Gummetal®, CoCr (cobalt-chromium Elgiloy®, Rocky Mountain Orthodontics, Denver, CO, USA), β‑Ti (β-Titanium TMA®, Ormco, Orange, CA, USA), NiTi (nickel-titanium, NiTi-SE, Dentalline, Birkenfeld, Germany), and stainless steel (SS; Ref. 251-925, 3M Unitek, Monrovia, CA, USA) [dimensions: 0.014 inch (0.35 mm), 0.016 inch (0.40 mm), 0.016 × 0.022 inch (0.40 × 0.56 mm), and 0.019 × 0.025 inch (0.48 × 0.64 mm)-β-Ti not available in the dimension 0.014 inch]. These were combined with Discovery® (Dentaurum, Ispringen, Germany), Micro Sprint® (Forestadent, Pforzheim, Germany), Clarity™ (3M Unitek), and Inspire Ice™ (Ormco) and slots in the dimension 0.022 inch (0.56 mm) and, except for the 0.019 × 0.025 inch wires, in the dimension 0.018 inch (0.46 mm). They were ligated with a 0.010 inch (0.25 mm) steel ligature (Smile Dental, Ratingen, Germany). Brackets were angulated by applying a moment of force of 10 Nmm against the wire, which was pulled through the slot at 0.2 mm/s.
RESULTS
In 660 tests using 132 bracket-wire combinations, friction loss for Gummetal® was comparable to and, in a few combinations with Micro Sprint®, significantly lower (p < 0.05) than SS and CoCr. The friction for Gummetal® was significantly lower (p < 0.05) than NiTi, and β‑Ti. In some bracket-wire combinations, lower friction was found with round wires compared to rectangular wires, except for the combination with Inspire Ice™, which was higher but not significant. Slot size did not have a significant effect on friction in most combinations.
CONCLUSION
The low friction associated with Gummetal® wires during arch-guided tooth movement will be a valuable addition to the armamentarium of orthodontists.
Topics: Dental Alloys; Dental Stress Analysis; Friction; Materials Testing; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Titanium
PubMed: 34228140
DOI: 10.1007/s00056-021-00317-y -
JDR Clinical and Translational Research Apr 2022There has been little research to explore how adults financially value private orthodontic treatment and whether they have preferences for different attributes of...
INTRODUCTION
There has been little research to explore how adults financially value private orthodontic treatment and whether they have preferences for different attributes of treatment. This study used a discrete choice experiment and aimed to determine whether the recognized skill level of the dental professional and the type of orthodontic appliance influence the values that the public places on private adult orthodontic treatment.
METHODS
In total, 206 adult patients or the parents/guardians of children attending general dental practices in the northeast of England were recruited to complete a discrete choice experiment. Three attributes were included: the type of dental professional providing treatment, the type of orthodontic appliance, and cost. Also collected were demographic and orthodontic history characteristics. Results were analyzed with conditional logistic regression and elicited marginal willingness to pay (MWTP).
RESULTS
Participants value the training and expertise of the dental professional providing private orthodontic treatment greater than the type of orthodontic appliance. MWTP for orthodontic treatment increased in conjunction with the recognized skill level of the dental professional. Participants were willing to pay more for aesthetic appliances over a fixed metal appliance.
CONCLUSIONS
Participants value the training and expertise of the dental professional providing private adult orthodontic treatment greater than the type of orthodontic appliance. These preferences concur with other discrete choice experiments undertaken in medical specialties that included attributes focusing on the qualification, skill, or expertise of the health care professional. MWTP for orthodontic treatment increased in conjunction with the recognized skill level of the dental professional. Participants were willing to pay more for aesthetic appliances than metal fixed appliances. The cost of orthodontics is significant, and adults appreciate the importance of having options and making choices. The results of this study suggest that patients are willing to pay more for orthodontic services provided by clinicians with higher levels of formal training. In a competitive market where the public appears to prefer the provider over treatment modality, there is an incentive for clinicians to optimize their knowledge and skills to deliver the high-quality orthodontic treatment that patients are demanding. Orthodontic clinicians should be mindful of the demand for the different adult orthodontic appliances and tailor their skill sets accordingly.
Topics: Adult; Child; Dental Care; Esthetics, Dental; Health Personnel; Humans; Orthodontic Appliances; Orthodontics
PubMed: 33955299
DOI: 10.1177/23800844211012670 -
Clinical and Experimental Dental... Oct 2019The accuracy of the information incorporated into brackets is a determining factor for the efficacy of torque applied to teeth. The aim of this study was to compare the...
OBJECTIVE
The accuracy of the information incorporated into brackets is a determining factor for the efficacy of torque applied to teeth. The aim of this study was to compare the dimensions of a bracket's slots with the nominal values announced by the manufacturer.
MATERIALS AND METHODS
A total of 730 maxillary right central brackets manufactured by seven companies (Dentsply Gac, American Orthodontics, Rocky Mountain Orthodontics, GC Orthodontics, 3M Unitek, and Dentaurum) were studied. The sample included 0.018 × 0.025 and 0.022 × 0.028 in., metal and ceramic, conventional and self-ligating brackets. Images were obtained with an Olympus BX51 optical microscope. Slot dimensions were measured at the base and at the face on both mesial and distal sides using ImageJ software. Data were analyzed using Wilcoxon, sign tests, two- and three-way ANOVA, and Tukey's tests. Intraclass correlation coefficient was employed to assess the intraobserver and interobserver variability. The threshold for statistical significance was ≤ .05.
RESULTS
Statistical analysis showed that the slot dimensions of 90% to 97% of studied brackets were significantly different from nominal values. In general, slot size was oversized, with a face size larger than the base size. Comparison between mesial and distal sides showed that up to 45% of the brackets were significantly asymmetrical. The manufacturer had a significant effect for base and face widths ( = .0001) and for length ( = .003).
CONCLUSION
This study shows that a large proportion of measured brackets displays dimensional inaccuracies when compared with stated values. Clinically, the slot oversize and the divergence of slot walls cause an increase of wire-slot play, inducing a loss of torque control. Practitioners cannot fully trust the precision of used appliances and should be aware that adjustments could be needed in the finishing stages of the treatment.
Topics: Humans; Materials Testing; Orthodontic Appliance Design; Orthodontic Brackets
PubMed: 31687187
DOI: 10.1002/cre2.219 -
Dental Press Journal of Orthodontics 2020The aim of this study was to evaluate the attractiveness of different types of esthetic orthodontic wires by laypeople and dentists.
OBJECTIVE
The aim of this study was to evaluate the attractiveness of different types of esthetic orthodontic wires by laypeople and dentists.
METHODS
Five different types of orthodontic wires were evaluated: three esthetic wires (Teflon-coated, epoxy resin-coated and rhodium-coated wires), and two metallic wires (stainless steel and NiTi), as control. Monocrystalline ceramic brackets were installed in the maxillary arch of a patient presenting good dental alignment. The five evaluated wires were attached to the orthodontic appliance with an esthetic silicone elastic and photographed. The photographs were evaluated by 163 individuals, 110 dentists and 53 laypeople. The data were statistically evaluated by two-way ANOVA and one-way ANOVA, followed by Tukey tests.
RESULTS
There was a statistically significant difference in the attractiveness among the wires evaluated; the most esthetic was the rhodium-coated wire, followed by the epoxy resin-coated wire and, finally, the Teflon-coated wire, with no significant difference from the stainless steel and NiTi control archwires. There was no significant difference between the groups of evaluators.
CONCLUSION
The most attractive was the rhodium-coated wire, followed by the epoxy resin-coated wire and, finally, the least attractive wire was the Teflon-coated wire, without statistically significant difference to the stainless steel and NiTi wires, used as control.
Topics: Dental Alloys; Esthetics, Dental; Humans; Materials Testing; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Stainless Steel; Surface Properties; Titanium
PubMed: 33503122
DOI: 10.1590/2177-6709.25.6.027-032.oar -
Dental Press Journal of Orthodontics 2022To evaluate, in-vitro, the change in crown inclination that occurs during orthodontic leveling and alignment using different archwire-bracket-ligation combinations.
OBJECTIVE
To evaluate, in-vitro, the change in crown inclination that occurs during orthodontic leveling and alignment using different archwire-bracket-ligation combinations.
MATERIALS AND METHODS
Four archwire types were tested: (1) 0.012-in stainless steel and (2) 0.0155-in stainless steel multi-stranded, (3) 0.012-in nitinol Orthonol® and (4) 0.012-in nitinol Thermalloy®. Combinations with five types of 0.022-in slot orthodontic brackets were tested: SmartClipTM and Time3® self-ligating brackets, Mini-Taurus® and Victory SeriesTM conventional brackets, and Synergy® conventional-low friction bracket. Conventional brackets were ligated with both stainless steel and elastomeric ligatures. The simulated malocclusion comprised 2.0mm gingival and 2.0mm labial displacements of a maxillary right central incisor. Rotation around the Y-axis (representing labio-palatal inclination) was measured for the different archwire-bracket-ligation combinations.
RESULTS
The largest rotation was measured whith Orthonol® and Thermalloy® wires when combined with SmartClipTM brackets (8.07±0.24º and 8.06±0.26º, respectively) and with Synergy® brackets ligated with stainless steel ligatures (8.03±0.49º and 8.0±0.37º, respectively). The lower rotation was recorded when Thermalloy®, multi-stranded, and Orthonol® wires were ligated with elastomeric rings to Mini-Taurus® brackets (1.53±0.18º, 1.65± 0.23º and 1.70±0.28º, respectively) and to Victory SeriesTM brackets (1.68± 0.78º, 2.92± 1.40º and 1.74±0.46º, respectively).
CONCLUSIONS
All archwire-bracket-ligation combinations produced lingual crown inclination; however, lower changes were observed when the conventional brackets were ligated with elastomeric rings. The multi-stranded archwire produced less rotation with nearly every bracket-ligation combination, compared to the other archwires. The effect of the archwire-bracket-ligation combination on tooth inclination during leveling and alignment should be considered during planning treatment mechanics.
Topics: Crowns; Dental Alloys; Orthodontic Appliance Design; Orthodontic Wires; Oxygen Isotopes; Stainless Steel; Stress, Mechanical; Surface Properties; Titanium; Tooth Movement Techniques
PubMed: 35792791
DOI: 10.1590/2177-6709.27.3.e2220489.oar -
International Journal of Environmental... May 2022Orthodontic retention is the final important stage of orthodontic treatment, the aim of which is to consolidate the functional and aesthetic position of teeth. Among...
UNLABELLED
Orthodontic retention is the final important stage of orthodontic treatment, the aim of which is to consolidate the functional and aesthetic position of teeth. Among adults, fixed retainers made of different types of wires are the most common. The aim of this study was to analyse the mechanical properties of a new generation of fixed orthodontic retainers-printed by 3D printers.
MATERIALS AND METHODS
The study was conducted using samples made of Nextdent MFH C&B N1 resin in the form of cuboid bars with nominal dimensions of width b = 3 mm, thickness d = 0.8 mm; 1 mm; 1.2 mm, length l = 30 mm for each type. The influence of the thickness of the retainers on their strength under loaded conditions was evaluated. Flexural strength, elastic properties, deflection, and creep were compared. The samples were aged in an artificial saliva bath at 37 ± 1 °C during the strength tests.
RESULTS
It was shown that differences in the thickness of the samples affected their elastic and strength properties. The highest average flexural modulus, the highest deflection, creep, and strength was characteristic of the samples with the highest thickness (1.2 mm). Samples with an average thickness of 1 mm had the lowest modulus of elasticity.
CONCLUSIONS
The mechanical properties of 3D printed retainers show that they can be an alternative to metal retainers and the procedure of making new retainers, especially when patients have aesthetic requirements or allergies to metals.
Topics: Adult; Aged; Humans; Orthodontic Appliances, Fixed; Orthodontic Retainers; Printing, Three-Dimensional
PubMed: 35565167
DOI: 10.3390/ijerph19095775 -
Journal of Orthodontics Mar 2022To identify the number of companies providing Do-It-Yourself (DIY) orthodontics and explore information available on websites for DIY brace providers operating in the UK.
OBJECTIVE
To identify the number of companies providing Do-It-Yourself (DIY) orthodontics and explore information available on websites for DIY brace providers operating in the UK.
DESIGN
Web search and review of websites providing DIY braces.
SETTING
Leeds, UK.
METHODS
A Web search was completed in November 2020 and April 2021 of all companies providing DIY braces for UK consumers. Each website was evaluated, and the following data collected: name; year started operating; costs; process; involvement of a dental professional; average 'treatment' length; retention; consent process; information on risks and benefits; aligner material; social media presence; age suitability; and consumer ratings on Trustpilot. Quality of website information was assessed via the DISCERN tool.
RESULTS
Seven DIY orthodontic companies were operating in the UK. Websites reviewed revealed the following: product costs were in the range of £799-£1599, 'treatment' length quotes were in the range of 4-12 months; Trustpilot reviews were in the range of 1.6-4.8 stars; and websites claimed their aligners were suitable for individuals with an age range of 12-18 years. Quality of content regarding risks described on websites varied, and there was limited information regarding involvement of a dental professional. Quality of websites information scored 'poor' or 'very poor' on the DISCERN scoring.
CONCLUSIONS
There has been an increase in the number of DIY orthodontic companies operating in the UK over the last three years. There is a need to determine whether these products constitute dental treatment in their own right. If so, it is crucial to ensure these are regulated appropriately with adequate information available to satisfy informed consent and have greater transparency over dental professional involvement to safeguard the public.
Topics: Adolescent; Child; Dental Care; Humans; Internet; Orthodontic Appliances, Fixed; Orthodontic Brackets; Orthodontics; United Kingdom
PubMed: 34096369
DOI: 10.1177/14653125211021607