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Brazilian Journal of Biology = Revista... 2022Nanoparticles (NPs) are insoluble particles with a diameter of fewer than 100 nanometers. Two main methods have been utilized in orthodontic therapy to avoid microbial... (Review)
Review
Nanoparticles (NPs) are insoluble particles with a diameter of fewer than 100 nanometers. Two main methods have been utilized in orthodontic therapy to avoid microbial adherence or enamel demineralization. Certain NPs are included in orthodontic adhesives or acrylic resins (fluorohydroxyapatite, fluorapatite, hydroxyapatite, SiO2, TiO2, silver, nanofillers), and NPs (i.e., a thin layer of nitrogen-doped TiO2 on the bracket surfaces) are coated on the surfaces of orthodontic equipment. Although using NPs in orthodontics may open up modern facilities, prior research looked at antibacterial or physical characteristics for a limited period of time, ranging from one day to several weeks, and the limits of in vitro studies must be understood. The long-term effectiveness of nanotechnology-based orthodontic materials has not yet been conclusively confirmed and needs further study, as well as potential safety concerns (toxic effects) associated with NP size.
Topics: Anti-Bacterial Agents; Orthodontic Brackets; Orthodontics; Silicon Dioxide; Titanium
PubMed: 35195179
DOI: 10.1590/1519-6984.257070 -
Systematic Reviews Jul 2023Systematic reviews that assess the benefits of interventions often do not completely capture all dimensions of the adverse effects. This cross-sectional study (part 1 of...
BACKGROUND
Systematic reviews that assess the benefits of interventions often do not completely capture all dimensions of the adverse effects. This cross-sectional study (part 1 of 2 studies) assessed whether adverse effects were sought, whether the findings on these effects were reported, and what types of adverse effects were identified in systematic reviews of orthodontic interventions.
METHODS
Systematic reviews of orthodontic interventions on human patients of any health status, sex, age, and demographics, and socio-economic status, in any type of setting assessing any type of adverse effect scored at any endpoint or timing were eligible. The Cochrane Database of Systematic Reviews and 5 leading orthodontic journals were manually searched for eligible reviews between August 1 2009 and July 31 2021. Study selection and data extraction was conducted by two researchers independently. Prevalence proportions were calculated for four outcomes on seeking and reporting of adverse effects of orthodontic interventions. Univariable logistic regression models were used to determine the association between each one of these outcomes and the journal in which the systematic review was published using the eligible Cochrane reviews as reference.
RESULTS
Ninety-eight eligible systematic reviews were identified. 35.7% (35/98) of reviews defined seeking of adverse effects as a research objective, 85.7% (84/98) sought adverse effects, 84.7% (83/98) reported findings related to adverse effects, and 90.8% (89/98) considered or discussed potential adverse effects in the review. Reviews in the journal Orthodontics and Craniofacial Research compared with Cochrane reviews had approximately 7 times the odds (OR 7.20, 95% CI 1.08 to 47.96) to define seeking of adverse effects in the research objectives. Five of the 12 categories of adverse effects accounted for 83.1% (162/195) of all adverse effects sought and reported.
CONCLUSIONS
Although the majority of included reviews sought and reported adverse effects of orthodontic interventions, end-users of these reviews should beware that these findings do not give the complete spectrum on these effects and that they could be jeopardized by the risk of non-systematically assessing and reporting of adverse effects in these reviews and in the primary studies that feed them. Much research is ahead such as developing core outcome sets on adverse effects of interventions for both primary studies and systematic reviews.
Topics: Humans; Cross-Sectional Studies; Systematic Reviews as Topic; Drug-Related Side Effects and Adverse Reactions; Iatrogenic Disease; Orthodontics
PubMed: 37400925
DOI: 10.1186/s13643-023-02273-7 -
Revue Medicale de Liege May 2020An increasing number of adult patients are seeking orthodontic treatment and several surgical and non-surgical methods have been developed to reduce the overall...
An increasing number of adult patients are seeking orthodontic treatment and several surgical and non-surgical methods have been developed to reduce the overall treatment time. Two randomized controlled clinical trials, performed in our University Hospital, demonstrated that the piezocision surgery - minimally invasive corticotomies - decreased the overall orthodontic treatment time by 43 % - effect during 4 to 6 months after the surgery - without any further clinical and radiological adverse effects. In addition, the use of a custom-made orthodontic system - brackets and arches - optimized the acceleration in the fine-tuning phase of orthodontic treatment. Finally, the combination of the two techniques is therefore relevant to maximize the reduction of the orthodontic treatment time. Fundamentally, our preclinical studies in rats have highlighted the biological phenomena underlying piezocision with an important bone demineralization and osteoclast recruitment associated with a predominant expression of the RANKL-OPG duo.
Topics: Adult; Animals; Humans; Orthodontics; Piezosurgery; Radiography; Randomized Controlled Trials as Topic; Rats; Tooth Movement Techniques
PubMed: 32496696
DOI: No ID Found -
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 -
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 -
American Journal of Orthodontics and... Jan 2022A key goal of orthodontic treatment with fixed appliances is alignment of the dentition, and this remains a commonly selected outcome in clinical studies investigating... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
A key goal of orthodontic treatment with fixed appliances is alignment of the dentition, and this remains a commonly selected outcome in clinical studies investigating orthodontic tooth movement. This systematic review has evaluated treatment duration to achieve alignment of the mandibular dentition using fixed appliances.
METHODS
Systematic literature searches without restrictions were undertaken in 9 databases for randomized clinical trials (RCTs) assessing duration and rate of tooth alignment using fixed appliances with or without treatment adjuncts published up to January 2021. After duplicate study selection, data extraction, and risk of bias assessment according to Cochrane, random-effects meta-analyses of aggregate data, and individual patient data were conducted.
RESULTS
Thirty-five trials were included with 2258 participants (39% male; mean age 17.8 years), giving a pooled duration to achieve whole-arch alignment of the mandibular dentition of 263.0 days (4 trials; 95% confidence interval [CI], 186.7-339.4 days) and incisor alignment in the mandibular arch of 100.7 days (9 trials; 95% CI, 84.1-117.4 days). Surgical-assisted orthodontics was associated with reduced duration of incisor alignment: mean difference of 44.3 days less (4 trials; 95% CI, 20.0-68.9 days; P <0.001; high quality of evidence), whereas subgroup and meta-regression analyses indicated significant effects of baseline crowding and premolar extractions. Individual patient data analysis from 3 RCTs indicated that for each additional participant age year, whole-arch alignment of the mandibular dentition took 13.7 days longer (3 trials; 95% CI, 7.7-17.7 days; P <0.001) and for each additional mm of irregularity, 17.5 days more were needed (2 trials; 95% CI, 9.8-25.2 days; P <0.001).
CONCLUSIONS
Patient and treatment-related characteristics can significantly affect the duration of tooth alignment and should be taken into account both clinically and when designing trial outcomes. Future research studies investigating rates of orthodontic tooth alignment would benefit from adequate sample sizes and a more consistent methodology in outcome assessment. Data in this systematic review provides a basis for appropriate trial design for future RCTs investigating the rate of orthodontic tooth alignment with fixed appliances.
Topics: Adolescent; Female; Humans; Male; Orthodontic Appliances, Fixed; Tooth Movement Techniques
PubMed: 34794862
DOI: 10.1016/j.ajodo.2021.06.016 -
BMC Oral Health Jun 2023Controlling the 3D movement of central incisors during tooth extraction cases with clear aligners is important but challenging in invisible orthodontic treatment. This...
BACKGROUND
Controlling the 3D movement of central incisors during tooth extraction cases with clear aligners is important but challenging in invisible orthodontic treatment. This study aimed to explore the biomechanical effects of central incisors in tooth extraction cases with clear aligners under different power ridge design schemes and propose appropriate advice for orthodontic clinic.
METHODS
A series of Finite Element models was constructed to simulate anterior teeth retraction or no retraction with different power ridge designs. These models all consisted of maxillary dentition with extracted first premolars, alveolar bone, periodontal ligaments and clear aligner. And the biomechanical effects were analysed and compared in each model.
RESULTS
For the model of anterior teeth retraction without power ridge and for the model of anterior teeth no retraction with a single power ridge, the central incisors exhibited crown lingual inclination and relative extrusion. For the model of anterior teeth no retraction with double power ridges, the central incisors tended to have crown labial inclination and relative intrusion. For the model of anterior tooth retraction with double power ridges, the central incisors exhibited a similar trend to the first kind of model, but as the depth of the power ridge increased, there was a gradual decrease in crown retraction value and an increase in crown extrusion value. The simulated results showed that von-Mises stress concentration was observed in the cervical and apical regions of the periodontal ligaments of the central incisors. The clear aligner connection areas of adjacent teeth and power ridge areas also exhibited von-Mises stress concentration and the addition of power ridge caused the clear aligner to spread out on the labial and lingual sides.
CONCLUSIONS
The central incisors are prone to losing torque and extruding in tooth extraction cases. Double power ridges have a certain root torque effect when there are no auxiliary designs, but they still cannot rescue tooth inclination during tooth retraction period. For tooth translation, it may be a better clinical procedure to change the one-step aligner design to two-step process: tilting retraction and root control.
Topics: Humans; Incisor; Orthodontic Wires; Cuspid; Maxilla; Tooth Extraction; Orthodontic Appliances, Removable; Tooth Movement Techniques; Finite Element Analysis
PubMed: 37349701
DOI: 10.1186/s12903-023-03106-8 -
Dental Press Journal of Orthodontics 2023The aim of this prospective clinical study was to compare the clinical outcomes of three different fixed lingual retainers, in terms of effects on periodontal health and... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
The aim of this prospective clinical study was to compare the clinical outcomes of three different fixed lingual retainers, in terms of effects on periodontal health and success rate.
METHODS
Forty five patients aged 13 to 25 years were randomly assigned into three groups, using bonded upper and lower lingual retainers. The study groups were as follows: Group 1- Bond-A-Braid®, Group 2- everStick® ORTHO, Group 3- Super-Splint. The follow-up appointments were performed two weeks (Baseline=T0), one month (T1), three months (T2), and six months (T3) after the application of retainers. Plaque Index (PI), Gingival Index (GI), Probing Depth (PD), Bleeding in Probing (BOP) and Retainer Failure were assessed at each appointment.
RESULTS
The everStick Ortho group showed significantly lower PI values on the upper-lower lingual side after three (p=0.008) and six (p=0.001) months. The everStick Ortho group had significantly lower upper lingual (GI) levels after six months, and lower lingual side levels after one month. The Super-Splint group showed significantly lower PD values on the upper lingual side after six months. The everStick Ortho group presented significantly lower BOP levels after six months on the upper lingual side. No significant differences between the groups (p>0.05) in terms of retainer failure were found.
CONCLUSIONS
The everStick Ortho group presented better results in terms of periodontal health. The failure rates of the retainers were similar.
Topics: Humans; Orthodontic Retainers; Prospective Studies; Periodontal Index; Orthodontic Appliances, Fixed; Orthodontic Appliance Design
PubMed: 36790247
DOI: 10.1590/2177-6709.27.6.e222154.oar -
European Journal of Orthodontics Jun 2020Social media are one of the most common and easily accessible ways of gaining information about orthodontic treatment.
BACKGROUND
Social media are one of the most common and easily accessible ways of gaining information about orthodontic treatment.
OBJECTIVE
The main objective of this study was to systematically search the literature and determine the various aspects of the interrelationship between social media and orthodontics from the patient's perspective.
SEARCH METHODS
Electronic database searches of published and unpublished literature were performed. The reference lists of all eligible articles were hand-searched for additional studies.
SELECTION CRITERIA
Randomized clinical trials (RCTs), prospective, retrospective, and cross-sectional studies were included.
DATA COLLECTION AND ANALYSIS
Study selection, data extraction, and risk of bias assessment were performed individually and in duplicate by the first two authors.
RESULTS
One RCT, three retrospective, and four cross-sectional studies were deemed as eligible for inclusion in this review. The studies included patient's statements in social media or results from questionnaires given to patients. The social media reported were with order of frequency: Twitter, YouTube, Facebook, Google+, Pinterest, and Instagram. The feelings the patients expressed seemed to be more positive than negative: enthusiasm, self-esteem and pleasure, excitement about the aesthetic result, excitement after braces removal but also antipathy, annoyances, reduced self-esteem, and impatience for removing mechanisms. In addition, one study referred to bullying through Twitter.
LIMITATIONS
The high amount of heterogeneity precluded a valid interpretation of the results through pooled estimates.
CONCLUSIONS AND IMPLICATIONS
This systematic review demonstrated that information about orthodontics, how the patient feels, and other psychosocial facets are spread through social media. It is intuitive that research relating to the effects and impact of orthodontic interventions should account not only for the physical impacts of treatment but also to encompass patient-centered outcomes.
REGISTRATION
The protocol of this study was not registered in publicly assessable database.
CONFLICTS OF INTEREST
None to declare.
Topics: Dental Care; Esthetics, Dental; Humans; Orthodontics; Retrospective Studies; Social Media
PubMed: 31107943
DOI: 10.1093/ejo/cjz029 -
Medicina (Kaunas, Lithuania) Mar 2023: Orthodontic tooth movement (OTM) requires bone remodeling resulting from complex processes of aseptic inflammation. Recent studies have confirmed close interaction...
: Orthodontic tooth movement (OTM) requires bone remodeling resulting from complex processes of aseptic inflammation. Recent studies have confirmed close interaction between the immune and skeletal systems. In addition, various orthodontic appliances including fixed systems affect the sublingual microbial composition, and the likelihood of developing inflammatory reactions of the gums is high, especially early in the treatment period. It is known that these systems have both positive and negative effects on the humoral and cellular immune responses. The main aim of the study was to evaluate the influence of self-ligating and conventional brackets on the salivary concentrations of cytokines (IL-6, osteoprotegerin (OPG), TNF-alpha, and IFN-gamma) and cortisol as a marker of stress. : Forty patients were analyzed at baseline (T0) and 2 months (T2) after fixing self-ligating (Ormco Damond Q) and conventional brackets (Ormco Mini Diamond). Salivary cytokine and cortisol concentrations were evaluated by commercial ELISA kits. : Outcomes of our study showed that after two months of treatment with either of these brackets, IFN-gamma and IL-6 levels did not change. However, TNF-alpha decreased with self-ligating brackets (13.36 to 8.32, = 0.002). The self-ligating bracket system also affects OPG concentration and cortisol levels 2 months after orthodontic activation. The level of OPG in the group of self-ligating brackets decreased significantly (8.55 to 2.72, = 0.003). Cortisol concentration was significantly higher in the self-ligation group (25.72 to 48.45, = 0.001) due to the effect of sustained strength movements. : Thus, the use of self-ligating and conventional brackets has a different effect on the concentration of cortisol and cytokines (OPG and TNF-alpha) in saliva 2 months after their fixation. Further longitudinal studies are necessary to explore why OPG levels are decreased in case of self-ligating cases and how OPG levels are related to clinical improvement.
Topics: Humans; Hydrocortisone; Orthodontic Wires; Orthodontic Brackets; Cytokines; Tumor Necrosis Factor-alpha; Interleukin-6
PubMed: 36984567
DOI: 10.3390/medicina59030566