-
Journal of Orthodontic Science 2023This study aims to identify the motivations behind orthodontic re-treatment in Saudi Arabia.
OBJECTIVE
This study aims to identify the motivations behind orthodontic re-treatment in Saudi Arabia.
MATERIALS AND METHODS
This is a cross-sectional study performed through a patient questionnaire. The questionnaire elicited data on the respondents' socio-demographic data, type of previous orthodontic treatment, retention, satisfaction level, and reasons for undergoing orthodontic re-treatment.
RESULTS
Four hundred and nineteen responses were received during the study period from June to July 2022. The result showed a pre-dominant female predilection (83, 29%), with the majority belonging to the 21-25 age group (47.26%). Most participants had had one previous orthodontic treatment (77%), with an active treatment time of approximately 1-3 years (55.85%). There was no significant difference between the satisfaction of outcomes after the initial treatment and at the time of the survey. Most participants received retention appliances (69.45%) and were informed about the importance of appliances. The type of retention was mainly removable retainers (47.5%). Around one-third of the sample (31.98%) were interested in seeking orthodontic re-treatment, with self-motivation as the primary drive and improving the smile as the predominant reason.
CONCLUSION
The study's findings show that a large portion of the population is seeking orthodontic re-treatment, which must be considered. Self-motivation was a driving force rather than external motivation. The most common reason for seeking orthodontic re-treatment was to improve their smile and the increased esthetic demand.
PubMed: 37881663
DOI: 10.4103/jos.jos_116_22 -
Journal of Orofacial Orthopedics =... Oct 2023This study aimed to evaluate the effects of lower premolar extraction on posttreatment stability one year following fixed orthodontic treatment with passive...
PURPOSE
This study aimed to evaluate the effects of lower premolar extraction on posttreatment stability one year following fixed orthodontic treatment with passive self-ligating brackets (Damon system, Ormco, Orange, CA, USA).
METHODS
All patients were treated with fixed orthodontic appliances using passive self-ligating brackets (Damon). For retention, removable Hawley retainers were used. Two groups of patients were included in the study. Each group consisted of 23 patients: group Ex consisted of 10 male and 13 female patients (13.4 ± 1.6 years old) with extraction of lower first premolars and group NonEx consisted of 11 male and 12 female patients (13.4 ± 3.9 years old) without dental extractions. The patients' dental models and photographs were assessed at T0 (pretreatment), T1 (the end of active orthodontic treatment: 3.3 ± 1.0 years in the Ex and 2.3 ± 0.8 years in the NonEx group) and at T2 (1 year posttreatment). All lower casts were scanned and the following dental parameters were recorded and compared between the two groups: intercanine width (ICW), anterior arch width (AAW), intermolar width (IMW), Little's irregularity index (LII) and gingival recessions.
RESULTS
An increase in ICW (group Ex: 1.20 ± 2.51 mm and group NonEx: 0.84 ± 1.48 mm) by the end of active treatment (T1; P < 0.05), as well as a relapse regarding the ICW (group Ex: -0.1 ± 0.47 mm and group NonEx: -67% ± 0.38 mm) one year post-treatment (T2) were recorded in the samples. Relapse in the non-extraction group was statistically and clinically significant, whereas ICW values remained relatively stable in the extraction group during the posttreatment period (T1-T2). The irregularity index decreased during treatment (group Ex: -8.79 ± 6.36 mm and group NonEx: -5.24 ± 2.99 mm) and relapsed in both groups (group Ex: 0.57 ± 90 mm and group NonEx: 0.27 ± 0.53). The rate of relapse in LII was correlated to the relapse rate of ICW. A reduction of IMW was recorded in the Ex group (-1.89 ± 1.82 mm) during active treatment (P < 0.05), which remained stable 1 year posttreatment. AAW increased in both groups (group Ex: 2.77 ± 1.77 mm and group NonEx: 1.77 ± 2.04 mm) throughout active treatment and remained stable at T2.
CONCLUSION
Intergroup comparison revealed that ICW remained stable 1 year posttreatment in the Ex group, whereas high relapse of ICW was recorded in the NonEx group. Furthermore, risk of a relapse of LII appears to be higher in cases with a relapse of the ICW.
PubMed: 37847251
DOI: 10.1007/s00056-023-00501-2 -
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 -
American Journal of Orthodontics and... Feb 2024This study performed a 3-dimensional analysis of tooth movement during orthodontic retention to assess the effectiveness of double retention (fixed and removable) in...
INTRODUCTION
This study performed a 3-dimensional analysis of tooth movement during orthodontic retention to assess the effectiveness of double retention (fixed and removable) in preventing undesired tooth movement.
METHODS
One hundred randomly selected patients were included at the initiation of double orthodontic retention with fixed retainers and vacuum-formed splints (recommended to be worn 22 h/d) in both arches. Intraoral scans were performed directly (T0), 1 month (n = 88), 3 months (T2) (n = 78), and 6 months (T3) (n = 66) after retainer bonding. Nine reference points were marked on each tooth in every patient. Subsequent scans were superimposed, and point displacement was calculated. Statistical analysis was performed using the R statistical software (version 4.2.2; R Core Team, Vienna, Austria).
RESULTS
Sample size calculation determined at least 55 patients were needed. The total dropout between T0 and T3 was 34 patients (did not show up for appointment). The median absolute displacement value of a single point between T0 and T3 was 0.015 mm. The most stable teeth were mandibular central incisors, whereas the least stable were mandibular molars. Most tooth displacements occurred between T0 and T2, then slowed down significantly.
CONCLUSIONS
Double orthodontic retention prevents major tooth displacements in most patients during the first 6 months of retention; however, larger, unpredictable single-tooth displacement may occur in individual patients.
Topics: Humans; Orthodontic Retainers; Tooth Movement Techniques; Malocclusion; Incisor; Orthodontic Appliances, Fixed; Orthodontic Appliance Design
PubMed: 37815779
DOI: 10.1016/j.ajodo.2023.07.018 -
Journal of Dental Sciences Oct 2023Polyetheretherketone (PEEK) is known for its strength, flexibility, biocompatibility, and potential as a replacement for metals in dental appliances; however,...
BACKGROUND/PURPOSE
Polyetheretherketone (PEEK) is known for its strength, flexibility, biocompatibility, and potential as a replacement for metals in dental appliances; however, uncertainty remains about the mechanical characteristics and dimensions of PEEK-made orthodontic fixed lingual retainers (FLRs). This study aimed to determine the optimal shape of PEEK-made orthodontic FLRs using the finite element method (FEM) and the three-point bending test (TPBT).
MATERIALS AND METHODS
Seventy-five three-dimensional PEEK rod-shaped models were created, which included five thicknesses (0.4, 0.6, 0.8, 1.0, and 1.2 mm), five widths (0.7, 0.9, 1.1, 1.3, and 1.5 mm), and three cross-sectional shapes (rectangular, oval, and hemielliptical). A 0.9-mm (0.036-inch) stainless steel wire (SSW) was used as a control and the FEM was used to determine six optimal dimensions among the PEEK models. The selected models were then fabricated and subjected, along with the SSW, to the experimental TPBT to assess their mechanical responses against lingual and biting pressures.
RESULTS
The FEM analysis revealed that Von Mises stresses on the PEEK models decreased with an increase in width and thickness. Six optimal shapes of PEEK models were chosen based on acceptable lingual and biting stresses as well as patient comfort compared to the SSW. Furthermore, PEEK models showed significantly lower deformation during the 3.1-mm deflection test than did the SSW, while no notable differences were observed among different sizes of PEEK models. The hemielliptical PEEK model with a thickness of 1.0 mm and width of 1.5 mm was found to be mechanically robust enough to withstand lingual forces, while none of the PEEK models, including the SSW, were able to resist biting forces.
CONCLUSION
Within the limitations of this study, PEEK-made orthodontic FLRs with a hemielliptical cross-sectional shape and a thickness-to-width ratio of 1.0:1.5 would be suitable for use as orthodontic FLRs.
PubMed: 37799918
DOI: 10.1016/j.jds.2023.05.026 -
Orthodontics & Craniofacial Research Apr 2024To evaluate stability outcomes and failure rates associated with four types of lingual retainers: (1) dead-soft wire, (2) multistrand stainless steel (SS) wire, (3)...
OBJECTIVE
To evaluate stability outcomes and failure rates associated with four types of lingual retainers: (1) dead-soft wire, (2) multistrand stainless steel (SS) wire, (3) CAD/CAM nitinol, and (4) connected bonding pads (CBPs) after 3 years of retention.
METHODS
This study enrolled 96 patients (66 females, 30 males) with a median age of 19 years with four types of lingual retainers: (1) 0.016 × 0.022-inch dead-soft wire, (2) 0.0215-inch five-strand SS wire, (3) 0.014 × 0.014-inch CAD/CAM nitinol wire, and (4) CBPs. The irregularity index, intercanine distances, and arch lengths were obtained and used to evaluate mandibular stability. Failure rates were also assessed during this study. Data were statistically analysed.
RESULTS
Irregularity increased, whereas intercanine width and arch length decreased after 3 years of retention. The greatest irregularity was associated with the CBPs and the least with the CAD/CAM retainers. Changes in stability measurements were significantly higher in the dead-soft wire and CBPs than those in the CAD/CAM nitinol and multistrand SS wires. Parallel to these changes, the frequency of failure yielded similar results with the same significance between the groups. The failure rate of CBPs, in contrast to the CAD/CAM nitinol and multistrand SS wires, was significantly higher in the right quadrant (P < .05).
CONCLUSION
After taking the 3-year results into consideration, CAD/CAM nitinol and multistrand SS wires were found to be more successful than the others in maintaining mandibular stability. The most failures were observed with CBPs after 3 years of retention.
Topics: Adolescent; Female; Humans; Male; Young Adult; Alloys; Dental Bonding; Follow-Up Studies; Mandible; Orthodontic Appliance Design; Orthodontic Retainers; Stainless Steel; Randomized Controlled Trials as Topic
PubMed: 37786933
DOI: 10.1111/ocr.12714 -
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 -
Journal of Orofacial Orthopedics =... Sep 2023The aim of this study was to show a possible correlation between the mean wear time of Hawley retainers and long-term mandibular arch stability as assessed via wear...
PURPOSE
The aim of this study was to show a possible correlation between the mean wear time of Hawley retainers and long-term mandibular arch stability as assessed via wear time analysis with microsensors.
METHODS
This longitudinal retrospective study comprised 47 subjects (mean age 16.30 ± 1.06 years) having been treated with a nonextraction protocol and presenting moderate crowding at pretreatment. For retention, all patients were instructed to use a mandibular Hawley retainer for 12 months, and wear time was documented every 3 months during a posttreatment period of 6 months using TheraMon software. These individuals were divided into two groups. Those who adhered to a wear time equal to or more than 12 h/day (group 1A; N = 17) and those who complied for less than 12 h/day (group 2A; N = 30) were compared with respect to changes of the mandibular arch during the first 6 months of retention. Furthermore, a subgroup of 28 patients who completed a 12-month follow-up period were again divided into two groups: the individuals in group 1B (N = 12) adhered to a wear time equal to or more than 8 h/day, while those in group 2B (N = 16) complied for less than 8 h/day. Little's Irregularity Index, intercanine and intermolar widths, arch length, overjet, and overbite were measured on mandibular models taken at pretreatment (T0) and posttreatment (T1), as well as 6 months (T2) and 12 months (T3) after debonding. Pearson correlation test, independent samples t‑test, and Mann-Whitney U test were used for statistical evaluation.
RESULTS
From T1 to T2, group 1A and group 2A showed a significant relapse in intermolar width with a difference in the median value of 0.38 mm (p = 0.019). At the complete 12-month follow-up, the increase in Little's irregularity score was significantly greater in group 2B (2.54 ± 1.29 mm) than in group 1B (1.32 ± 1.03 mm; p = 0.012). The established wear time measurements showed significant negative correlations with the Little's irregularity score and overjet changes between T1 and T3 (p < 0.05).
CONCLUSIONS
The results emphasized that the use of a retainer should not fall below a level of at least 8 h/day.
PubMed: 37731053
DOI: 10.1007/s00056-023-00495-x -
Frontiers in Dentistry 2023Due to their aesthetic appeal and translucent properties, clear thermoplastic retainers have become increasingly popular. However, ensuring their proper maintenance and...
Due to their aesthetic appeal and translucent properties, clear thermoplastic retainers have become increasingly popular. However, ensuring their proper maintenance and cleaning is a significant challenge. It is essential to prevent any negative impact of cleaning solutions on the translucency and color consistency of retainers. Therefore, this study aimed to assess the effect of different cleaning solutions on the light transmission (translucency) rate of two distinct types of clear thermoplastic sheets. Two different clear thermoplastic sheets (Erkodent, Shodental), and five disinfectant solutions including chlorhexidine, Listerine, hydrogen peroxide, GUM whitening, and acid acetic served as the study materials and distilled water was used as control. The samples in each group (N=12) were immersed in the respective solutions for 15 minutes, twice a week and their light transmittance was measured using spectrophotometry after one and three months. Statistical analysis was conducted using two-way analysis of variance, with the significance level set at P<0.05 Light transmittance decreased from baseline to 3 months for all study groups. After three months, the lowest translucency was related to retainers manufactured with Erkodent sheets, cleaned with GUM whitening (74.11±10.72%). The highest translucency after this period was found in retainers prepared with Shodental sheets immersed in Listerine mouthwash (88±1.55%). Only retainers treated with hydrogen peroxide showed significant difference between the thermoplastic sheets, which was higher in Erkodent (P<0.05). Our findings indicated that among the studied solutions, cleaning translucent retainers with Listerine mouthwash twice a week has the least effect on light transmission.
PubMed: 37724249
DOI: 10.18502/fid.v20i30.13348 -
Folia Medica Aug 2023The main goal of orthodontic retention is to keep the teeth in their corrected positions. Fixed or removable retainers are the most common types of retainers used during...
The main goal of orthodontic retention is to keep the teeth in their corrected positions. Fixed or removable retainers are the most common types of retainers used during the retention phase. For the maxilla, various types of retainers have been described, including the vacuum-formed retainers and Hawley retainers. Fixed retainers are used for the lower jaw.
Topics: Orthodontic Retainers; Mandible; Orthodontic Appliances, Fixed
PubMed: 37655385
DOI: 10.3897/folmed.65.e85525