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BioMed Research International 2024To evaluate the enamel bonding ability and orthodontic adhesive resin degree of conversion using the experimental bracket design. . Thirteen bovine teeth were used in...
OBJECTIVE
To evaluate the enamel bonding ability and orthodontic adhesive resin degree of conversion using the experimental bracket design. . Thirteen bovine teeth were used in the study. The experimental bracket was modified with a translucent region in the center of its body. After enamel etching, Orthocem orthodontic adhesive (FGM, Joinville, Brazil) was applied on the bracket base for bonding. The groups were divided as follows ( = 10 per group): (1) control (CB) with standard brackets and (2) spot bracket (SB) with experimental brackets featuring a 0.8 mm translucent region at the center using carbide bur. Shear bond strength (SBS) was evaluated after 24 hours in a universal testing machine and adhesive remnant index (ARI). The degree of conversion (DC) was analyzed using Raman spectroscopy ( = 3 per group). Data were then analyzed using Student's -test and Mann-Whitney statistical methods.
RESULTS
The SB group exhibited a higher mean SBS (10.33 MPa) compared to the CB Group (8.77 MPa). However, there was no statistical difference between the groups ( = 0.376). Both SB and CB groups had a mean ARI score of 1. Raman analysis revealed a higher degree of conversion in the SB group (49.3%) compared to the CB group (25.9%).
CONCLUSIONS
The experimental support showed a higher degree of adhesive conversion, although there was no significant increase in bond strength.
Topics: Orthodontic Brackets; Animals; Cattle; Dental Bonding; Dental Enamel; Composite Resins; Shear Strength; Polymerization; Materials Testing; Dental Cements; Resin Cements
PubMed: 38884017
DOI: 10.1155/2024/7457900 -
Cureus May 2024A well-aligned dentition is more conducive to periodontal health, which is necessary for successful orthodontic therapy. Maintaining good dental hygiene is crucial for...
A well-aligned dentition is more conducive to periodontal health, which is necessary for successful orthodontic therapy. Maintaining good dental hygiene is crucial for effective treatment, and patient cooperation, education, motivation, and attitude are all important components. Orthodontists must routinely check in with their patients to see whether they are maintaining their oral hygiene and if they are using any additional assistance. Negligence on the part of the patient may be the cause of poor treatment outcomes. This study aims to show how patient education can affect treatment outcomes and the development of a functional, aesthetically pleasing, and healthy dentition. Aim This study aims to investigate awareness, attitude, and periodontal health knowledge among orthodontic patients. Objectives The study explores the level of awareness and knowledge regarding periodontal health among orthodontic patients, examining its correlation with factors such as age, attitude, and duration of orthodontic treatment. Additionally, it aims to gauge the extent of education received by orthodontic patients regarding proper oral hygiene practices and the potential repercussions of neglecting them. Methods A questionnaire-based study with a cross-sectional design was performed in Jeddah, Saudi Arabia. A total of 428 participants were randomly selected from several private orthodontic clinics and hospitals. The participants in the study were individuals currently undergoing treatment with fixed orthodontic appliances. Information was gathered using a self-administered questionnaire. Results The patients undergoing orthodontic treatment have a moderate understanding of periodontal disease about dental plaque. The level of awareness of periodontal health was 41%, and the level of knowledge about periodontal health was 51%. When it came to periodontal health, adult orthodontic patients had a positive attitude toward fixed orthodontic treatment (mean score = 0.75). Subjects' attitudes regarding fixed orthodontic treatment were significantly impacted by the patient's consistency with his/her dental checkups (p value = 0.02). Conclusion The patients' periodontal health awareness was moderate, while their periodontal health knowledge was fair. Orthodontic patient's awareness levels, as well as knowledge levels, showed significant differences in age and duration but not sex. Results showed no significant difference among the attitude levels of orthodontic patients and age, sex, and duration.
PubMed: 38882991
DOI: 10.7759/cureus.60335 -
Journal of Pharmacy & Bioallied Sciences Apr 2024To compare the patient acceptance between fixed orthodontic appliances and clear aligners. An electronic search was completed in PubMed, Cochrane Database, Web of... (Review)
Review
To compare the patient acceptance between fixed orthodontic appliances and clear aligners. An electronic search was completed in PubMed, Cochrane Database, Web of Science, Scopus, Lilacs, Google Scholar, and Open Grey databases without any restrictions until August 23. All comparative study types contrasting patient perception between clear aligners and fixed appliances were included. After removal of duplicates, exclusion by title and abstract, and reading the full text, only eight articles were included. The studies used an observational questionnaire study design. Of the observational studies, one was retrospective and three prospective, one online survey, and the other three cross sectional. Though the response varied in terms of patient preference and acceptance, it was found that clear aligners have a positive impact with respect to quality of life, tolerance, and improved confidence. However, there is not enough evidence to make a final conclusion about treatment outcomes.
PubMed: 38882823
DOI: 10.4103/jpbs.jpbs_1172_23 -
Journal of Pharmacy & Bioallied Sciences Apr 2024Class II malocclusions are a common orthodontic problem, often requiring comprehensive treatment to achieve proper occlusion and facial harmony. Early orthodontic...
BACKGROUND
Class II malocclusions are a common orthodontic problem, often requiring comprehensive treatment to achieve proper occlusion and facial harmony. Early orthodontic intervention in the mixed dentition phase has been advocated to address these issues.
MATERIALS AND METHODS
A retrospective analysis was conducted on a cohort of 150 patients with class II malocclusions who underwent early orthodontic treatment between the ages of 7 and 10 years. The treatment included fixed or removable appliances, headgear, and functional appliances, depending on individual needs. Records of their initial malocclusion severity, treatment modalities, and long-term follow-up data (mean follow-up duration of 10 years) were collected and analyzed. Stability was assessed by evaluating overjet and overbite changes from post-treatment to the long-term follow-up.
RESULTS
The initial mean overjet and overbite values were 8.5 mm and 4.0 mm, respectively. Following early orthodontic intervention, these values were significantly reduced to 3.0 mm and 1.5 mm, respectively ( < 0.001). At the long-term follow-up, the mean overjet and overbite remained stable at 3.2 mm and 1.6 mm, respectively. Analysis revealed that 85% of patients maintained their corrected class II occlusion within clinically acceptable limits, while 15% experienced minor relapse requiring minimal additional treatment.
CONCLUSION
Early orthodontic treatment in class II malocclusions can lead to significant improvements in overjet and overbite, and these corrections tend to remain stable over the long term.
PubMed: 38882812
DOI: 10.4103/jpbs.jpbs_1171_23 -
Journal of Pharmacy & Bioallied Sciences Apr 2024Orthodontic treatment often spans several months or even years, which can be burdensome for patients. Biomodulation techniques have emerged as potential strategies to...
BACKGROUND
Orthodontic treatment often spans several months or even years, which can be burdensome for patients. Biomodulation techniques have emerged as potential strategies to expedite orthodontic tooth movement.
MATERIALS AND METHODS
A randomized clinical trial was conducted with a sample of 60 orthodontic patients, aged 12-30 years, requiring fixed appliance therapy. Patients were randomly assigned to either the biomodulation group ( = 30) or the control group ( = 30). The biomodulation group received low-level laser therapy (LLLT) along with traditional orthodontic treatment, while the control group received conventional orthodontic treatment without LLLT. Treatment duration, pain perception, and orthodontic tooth movement were assessed during the study period.
RESULTS
The results demonstrated a significant reduction in treatment duration in the biomodulation group compared to the control group. The biomodulation group exhibited a 30% reduction in overall treatment time, with an average treatment duration of 8.4 months, while the control group required an average of 12 months ( < 0.001). Pain perception during orthodontic adjustments was lower in the biomodulation group. Additionally, biomodulation was associated with a statistically significant increase in the rate of tooth movement, as evidenced by a 20% reduction in the time required to achieve desired tooth alignment ( < 0.01).
CONCLUSION
Biomodulation through low-level laser therapy represents a promising adjunct to traditional orthodontic treatment, significantly accelerating tooth movement and reducing treatment duration.
PubMed: 38882742
DOI: 10.4103/jpbs.jpbs_1143_23 -
Progress in Orthodontics Jun 2024Metallic and elastomeric ligatures are widely used in orthodontics to secure the archwire within the bracket slots, but elastomeric ligatures have traditionally been... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Metallic and elastomeric ligatures are widely used in orthodontics to secure the archwire within the bracket slots, but elastomeric ligatures have traditionally been associated with increased microbial colonization, which could adversely affect periodontal health.
AIM
This systematic review compares the periodontal effects of elastomeric and steel ligatures used for orthodontic fixed appliances.
METHODS
Unrestricted literature search of 7 databases (MEDLINE, Scopus, Web of Science, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and Virtual Health Library) up to July 2023 were performed for randomized / non-randomized clinical studies on humans comparing the two ligation methods during fixed-appliance therapy. After duplicate study selection, data extraction, and risk-of-bias assessment with the Risk of Bias (RoB) 2 or the Risk Of Bias In Non-randomized Studies - of Interventions (ROBINS-I) tool, random-effects meta-analyses of Mean Differences (MD) or Standardized Mean Differences (SMD) and their 95% confidence intervals (CIs) were carried out, followed by assessment of certainty of existing evidence with the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach.
RESULTS
A total of 11 studies (3 randomized / 8 non-randomized) with 354 patients (mean age 14.7 years and 42% male) were included. No statistically significant differences were seen for plaque index (5 studies; SMD = 0.48; 95% CI = -0.03 to 1.00; P = 0.07), gingival index (2 studies; MD = 0.01; 95% CI = -0.14 to 0.16; P = 0.89), probing pocket depth (2 studies; MD = 0; 95% CI = -0.17 to 0.16; P = 0.97), or Streptococcus mutans counts (4 studies; SMD = 0.40; 95% CI=-0.41 to 1.20; P = 0.21). Elastomeric ligatures were associated with moderately increased total bacterial load (3 studies; SMD = 0.43; 95% CI = 0.10 to 0.76; P = 0.03). Confidence in these estimates was low in all instances due to the inclusion of non-randomized studies with high risk of bias.
CONCLUSIONS
Existing low quality evidence indicates that ligature method does not seem to influence the periodontal health during fixed treatment, even if elastomeric ligatures are associated with a moderate increase of bacterial load.
REGISTRATION
PROSPERO (CRD42023444383).
Topics: Humans; Elastomers; Orthodontic Appliances, Fixed; Steel; Periodontal Index; Orthodontic Brackets; Ligation
PubMed: 38880839
DOI: 10.1186/s40510-024-00520-8 -
BMC Oral Health Jun 2024to evaluate the predictability of expansion achieved in patients in early mixed dentition treated with Clear Aligners (CA), analyzing the efficiency of the expansion at... (Comparative Study)
Comparative Study
BACKGROUND
to evaluate the predictability of expansion achieved in patients in early mixed dentition treated with Clear Aligners (CA), analyzing the efficiency of the expansion at the end of the first set of aligners and at the end of the therapy in the upper and lower arch.
METHODS
36 patients (20 F, 16 M; mean age 8.3 ± 1.5 years) were selected retrospectively from the Department of Orthodontics of the Hospital of Rome "Tor Vergata". All subjects were treated with CA with no other auxiliaries than attachments. For each patient a standardized sequential expansion protocol was planned for both arches. Digital dental casts were created at three observation periods from an intraoral scanner: prior to treatment (T0), at the end of the first set of aligners (T1), at the end of treatment (T2). The 3D models in planned position determined by the first Clincheck (CC) were obtained for comparison with T1 and T2. Six linear transversal measurements were used to evaluate the dimensional changes and the predictability of expansion movements, comparing T1-CC and T2-CC.
RESULTS
a statistically significant increase within the pre-treatment and the final outcomes for all the variables examined was found. In the upper arch, the greatest level of predictability was detected at the level of the first (46.44%) and second deciduous molar width (44.95%) at T1. The analysis of T2-CC changes showed a significant increase in the percentage of predictability of expansion at the level of the first permanent molars, at mesial (54.86%) and distal (58.92%) width. In the lower arch, a higher percentage of predictability than the upper arch was reported at T1-CC and T2-CC, with the greatest values at the level of second (T1-CC: 48.70%; T2-CC: 75.32%) and first deciduous molar width (T1-CC: 45.71%; T2-CC: 72.75%).
CONCLUSIONS
CA can induce significant transversal increments. The predictability of expansion is variable, but it did not exceed the 50% during the first set of aligners. It was necessary to apply refinement set to achieve a good predictability for expansion of about 70%. The expansion in the lower arch was observed to be more predictable than in the upper arch.
Topics: Humans; Dentition, Mixed; Retrospective Studies; Female; Child; Male; Models, Dental; Dental Arch; Palatal Expansion Technique; Orthodontic Appliance Design; Imaging, Three-Dimensional; Tooth Movement Techniques; Maxilla; Mandible; Orthodontic Appliances, Removable; Forecasting; Cephalometry; Malocclusion; Treatment Outcome
PubMed: 38879479
DOI: 10.1186/s12903-024-04435-y -
Dental Clinics of North America Jul 2024The use of mandibular repositioning devices (MRDs) in the management of patients with obstructive sleep apnea (OSA) has gained extensive recognition with relevant... (Review)
Review
The use of mandibular repositioning devices (MRDs) in the management of patients with obstructive sleep apnea (OSA) has gained extensive recognition with relevant clinical evidence of its effectiveness. MRDs are designed to advance and hold the mandible in a protrusive position to widen the upper airway and promote air circulation. This review of the MRD aims to provide an evidence-based update on the optimal design features of an MRD, an analysis of the variety of appliances available, and the current understanding of the action mechanism.
Topics: Humans; Sleep Apnea, Obstructive; Mandibular Advancement; Orthodontic Appliance Design
PubMed: 38879283
DOI: 10.1016/j.cden.2024.02.005 -
Dental Clinics of North America Jul 2024Obstructive sleep apnea (OSA) can affect children and adults, and, if left untreated, could have a major impact on the general and overall well-being of the patient.... (Review)
Review
Obstructive sleep apnea (OSA) can affect children and adults, and, if left untreated, could have a major impact on the general and overall well-being of the patient. Dental health care providers and orthodontists have an interdisciplinary role in screening patients at risk for OSA and make a referral to establish a definitive diagnosis by a sleep physician. The gold standard of diagnostic testing is polysomnography. The adeno-tonsillar hypertrophy is the primary cause of sleep apnea in children; therefore, adeno-tonsillectomy must be the first line of treatment. Post adeno-tonsillectomy, if there is residual OSA due to underlying skeletal discrepancy, the patient may be referred to an orthodontist for appropriate management. Currently the evidence in the literature for prophylactic growth modification in children to prevent OSA is weak. In adults, the gold standard for managing OSA is Positive Airway Pressure (PAP) therapy; however, adherence to this treatment is rather low. The oral appliance (OA) therapy is an alternate for PAP intolerant patients and for mild to moderate OSA patients. The OA therapy has to be administered by a qualified dentist or orthodontist after careful examination of dental and periodontal health as well as any pre-existing joint conditions. The OA therapy could cause OA-associated malocclusion and patients have to be made aware of prior to initiating treatment. In patients with severe OSA, surgical maxilla-mandibular advancement (MMA) is highly effective.
Topics: Humans; Sleep Apnea, Obstructive; Child; Adult; Patient Care Team; Orthodontists; Polysomnography; Tonsillectomy; Adenoidectomy; Mass Screening; Professional Role; Orthodontic Appliances
PubMed: 38879281
DOI: 10.1016/j.cden.2024.03.005 -
Evidence-based Dentistry Jun 2024Systematic review and meta-analysis of randomized clinical trials (RCTs), non-randomized studies of intervention (NRSIs), cohort and cross-sectional studies. The...
DESIGN
Systematic review and meta-analysis of randomized clinical trials (RCTs), non-randomized studies of intervention (NRSIs), cohort and cross-sectional studies. The systematic review was registered in advance on PROSPERO, and was conducted following the Cochrane Handbook of Systematic Reviews of Interventions and PRISMA checklist.
DATA SOURCES
An electronic search in three databases (PubMed, Scopus, and Embase) was conducted by two authors to evaluate studies published from 1990 until May 2023.
STUDY SELECTION
The review question was defined in PICOS format as follows: Population (P), subjects with permanent dentition who having/had orthodontic therapy; Exposure (E), orthodontic therapy with fixed orthodontic appliance; Comparison/Control (C), no orthodontic treatment or intervention; Outcome (O), assessing incidence and/or prevalence of initial caries lesions (ICLs) at subject and teeth levels was the primary outcome, whereas evaluating the influence of demographics and treatment-related variables were secondary outcomes; studies (S), randomized clinical trials, non-randomized clinical studies, cohort and cross-sectional studies.
DATA ANALYSIS
Meta-analysis was conducted of three or more included studies had comparable findings. The following factors were calculated for each study; sample size, number of patients with ICLs, number of teeth with ICLs, number of teeth affected per patient, and number of surfaces affected. Statistical heterogeneity of effects among studies was assessed by means of the Cochran's test was used to evaluate the statistical heterogeneity of effects in the included studies. Funnel plot approach was used to assess publication bias, whereas Begg's and Egger's correlation test were used to identify asymmetry. Meta-analysis was conducted using a random effects model owing to high methodological and clinical heterogeneity. A descriptive analysis was presented when the meta-analyses appeared inappropriate. Statistical significance level was set at p < 0.05 for all statistical analyses.
RESULTS
21 studies were included in the qualitative synthesis (systematic review); 11 RCTs; 7 NRSIs, and 3 observation studies. Of the included studies, 19 studies were analyzed in the quantitative synthesis (meta-analysis). In regard to the prevalence rate of ICLs; 57% of patients had ICLs, with a mean of 2.24 lesions per patient and 22% of surfaces were affected. In regard to the incidence rate; 48% of patients developed new ICLs, with a mean of 2.29 new lesions per patient, and 15% of surfaces became affected. Both prevalence and incidence rates were positively associated with the duration of the orthodontic therapy (P = 0.01 and P < 0.01, respectively), illustrating an elevation in the ICLs numbers as the treatment duration (number of months) increases. There was no association between patients' age and ICLs numbers.
CONCLUSIONS
Orthodontic therapy using fixed appliances can increase the risk of accumulating plaque and developing caries lesion. However, other risk factors may play a role in developing ICLs; thus, controlling for these factors is paramount to better evaluate the true influence of orthodontic therapy on the ICLs development. Implementing caries preventive measures during orthodontic treatment may be needed to minimize the potential risks.
PubMed: 38871996
DOI: 10.1038/s41432-024-01029-z