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Scientific Reports Nov 2023The objective of this study was to compare and evaluate the changes in periodontal pathogens and periodontal status within 6 months of wearing three orthodontic...
The objective of this study was to compare and evaluate the changes in periodontal pathogens and periodontal status within 6 months of wearing three orthodontic retainers, namely, vacuum-formed retainer (VFR), Hawley retainer (HR), and lingual fixed retainer (LR). In total, 48 patients who underwent orthodontic treatment with ordinary metal brackets were divided into VFR, HR, and LR groups (n = 16 per group). Saliva samples were collected at the time of debonding (T0) and after 1 month (T1), 3 months (T2), and 6 months (T3). Porphyromonas gingivalis (Pg) and Aggregatibacter actinomycetemcomitans (Aa) were quantitatively analyzed using real-time PCR. Gingival index (GI), plaque index (PLI), and probing depth (PD) were measured at the four time points to evaluate changes in periodontal state. SPSS20.0 software was used to analyze the data, and P < 0.05 was considered statistically significant. The trial was registered at the Chinese Clinical Trial Registry (ChiCTR2300073704), the registration was retrospective. Compared to baseline (T0) values, Pg, Aa, GI, PLI, and PD were significantly decreased in all three groups 1 month after wearing the retainer (p < 0.05). Significant differences were observed in Aa at T3 among the three groups, whereby the HR group exhibited significantly better results compared to the VFR and LR groups (p < 0.05). Differences were found among the three groups' Porphyromonas gingivalis at T3, and the HR group was significantly better than the VFR and LR groups (P < 0.05). From T1 to T2, GI, PLI, and PD of the three groups tended to be stable, however differences were observed at T3, with the PLI and PD of the HR group being the lowest among the three groups (p < 0.05). Regardless of the type of retainer used, the periodontal condition of patients was significantly improved after removal of the metal brackets. After 6 months of retainer use, the Hawley retainer was superior to vacuum-formed retainer and lingual fixed retainer with regard to Pg, Aa, and periodontal clinical parameters.
Topics: Humans; Orthodontic Retainers; Retrospective Studies; Porphyromonas gingivalis; Orthodontic Appliances, Fixed; Gingival Diseases
PubMed: 38001102
DOI: 10.1038/s41598-023-46922-2 -
Journal of Indian Prosthodontic Society 2023
Topics: Esthetics, Dental; Denture, Partial, Removable; Orthodontic Retainers
PubMed: 37929370
DOI: 10.4103/jips.jips_90_23 -
Progress in Orthodontics Nov 2023Alveolar bone defects, particularly palatal bone dehiscence (PBD) and labial bone fenestration (LBF), occur frequently as a result of retraction of the maxillary...
BACKGROUND
Alveolar bone defects, particularly palatal bone dehiscence (PBD) and labial bone fenestration (LBF), occur frequently as a result of retraction of the maxillary anterior teeth. The study aims to explore the long-term bone remodeling of maxillary anterior teeth in adult patients with post-orthodontic treatment PBD and LBF.
MATERIALS AND METHODS
The study includes 24 adult patients with maxillary protrusion (8 males, 16 females) who were treated with extraction of four first premolars and had alveolar bone defects (PBD or LBF) in maxillary anterior teeth following orthodontic treatment. Cone-beam computed tomography imaging measurements were obtained before (T1), after (T2) orthodontic treatment, and after at least 1-year removable thermoplastic retainer retention (T3). The maxillary anterior teeth with PBD or LBF at T2 were divided into the PBD or LBF groups, respectively. The labial and palatal alveolar bone height (ABH), alveolar bone thickness (ABT), and movement of maxillary anterior teeth were measured during retraction (T2-T1) and retention (T3-T2) periods.
RESULTS
The incidence of PBD and LBF in maxillary anterior teeth significantly increased after orthodontic treatment and decreased during the retention period. In the PBD group, the palatal ABH of all maxillary anterior teeth significantly increased from T1 to T2 but decreased from T2 to T3. The ABT of the maxillary central incisor and canine significantly increased on the palatal side and decreased on the labial side during the retention period. In the LBF group, the labial ABT of the maxillary central incisor at the apical level showed a significant decrease from T1 to T2, followed by an increase from T2 to T3. In both groups, the maxillary central incisor showed significant labial movement, with a relative intrusion during the retention period.
CONCLUSION
For adult patients with maxillary protrusion, the alveolar bone defect of maxillary anterior teeth caused by orthodontic retraction significantly improved during the retention period, indicating good long-term bone remodeling. Our findings suggest that a combination of spontaneous reorientation of maxillary anterior teeth and bone remodeling contributed to alveolar bone covering in these patients.
Topics: Male; Female; Humans; Adult; Follow-Up Studies; Prospective Studies; Incisor; Cone-Beam Computed Tomography; Maxilla; Bone Remodeling
PubMed: 37926789
DOI: 10.1186/s40510-023-00489-w -
The Angle Orthodontist Nov 2023To investigate the post-treatment stability of anterior open bite (AOB) cases treated with upper and lower extrusion arches in adults.
OBJECTIVES
To investigate the post-treatment stability of anterior open bite (AOB) cases treated with upper and lower extrusion arches in adults.
MATERIALS AND METHODS
23 patients with AOB were treated with extrusion arches and evaluated for dentoskeletal changes using lateral cephalometric radiographs before treatment (T0), after treatment (T1), and 12 months post-treatment (T2). Patients received bondable tongue spurs and vacuum-formed retainers as post-treatment retention/stability measures for 12 months. Post-treatment stability was further assessed qualitatively by the Photographic Openbite Severity Index.
RESULTS
All the cases showed positive overlap between the anterior teeth at the end of orthodontic treatment, and 20 of 23 treated patients attended the recall visit after 12 months. A total of 85% of the cases maintained positive overlap at least 1 year post-treatment, 10% showed edge-to-edge bite, and only 5% showed no overbite.
CONCLUSIONS
Treatment of AOB in adults with extrusion arches proved to be stable 1 year post-treatment. Changes in the overbite after 1 year of follow-up were not significant.
Topics: Humans; Adult; Open Bite; Follow-Up Studies; Tooth; Malocclusion, Angle Class II; Overbite; Cephalometry
PubMed: 37922388
DOI: 10.2319/030623-155.1 -
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 -
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 -
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 -
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