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Baumer C, Schmidtmann I, Ohlendorf D, Ferrari Peron P, Wehrbein H, Erbe C. Orthodontists' instructions for oral hygiene in patients with removable and fixed orthodontic appliances. Int J Dent Hyg 2024; 22:329-336. [PMID: 37845796 DOI: 10.1111/idh.12763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/01/2023] [Accepted: 09/03/2023] [Indexed: 10/18/2023]
Abstract
INTRODUCTION The aim of this questionnaire-based survey was to evaluate information on frequencies, instructions and products relating to oral hygiene (OH) in orthodontic practices. METHODS Using a computer-generated randomization list, 1000 orthodontists were selected and sent a questionnaire. The size and number of inhabitants of the federal states of Germany were considered. The federal states with the highest return rate (Baden-Wuerttemberg [BW], Bavaria [B], Hesse [H], Lower Saxony [LS], Nordrhein-Westphalia [NRW]) were considered and differences between the 16 federal states were divided into North, South, East and Central Germany. RESULTS The response rate of the questionnaires was 52.4%. The majority (53.8%) worked in one practice alone. Most (59.1%) have been orthodontists for 5-25 years. For vestibular multibracket appliances (MBA) in BW, B, H and LS over 90% recommended interdental brushes (IDB). In NRW 91.4% recommend fluoride gel. In B and H more than 80% chose electric toothbrush (ETB), in BW, LS and NRW more than 80% manual toothbrush (MTB). For lingual MBA (LMBA) in BW, H, LS and NRW with approximately 50% each fluoride gel, IDB and MTB were chosen. In B fluoride gel, IDB and ETB. For removable apparatus (RA), five federal states recommended MTB (>80%) and ETB (BW, B, H > 80%; NRW > 70%; LS > 60%). CONCLUSION Electric toothbrushes are recommended for the use with all appliances, only with removable appliances manual toothbrushes are favoured. For vestibular MBA it is strongly advised to use IDB additionally.
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Affiliation(s)
- Christina Baumer
- Department of Orthodontics, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Irene Schmidtmann
- Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany
| | - Daniela Ohlendorf
- Social Medicine and Environmental Medicine, Institute of Occupational Medicine, Goethe-University, Frankfurt am Main, Germany
| | - Priscila Ferrari Peron
- Department of Orthodontics, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Heinrich Wehrbein
- Department of Orthodontics, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Christina Erbe
- Department of Orthodontics, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
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Erbe C, Zanders-Grote L, Wagner Y, Schmidtmann I, Lang NP, Wehrbein H. Randomized multicenter study on the plaque removal efficacy of 2 interdental brushes around the base of orthodontic brackets. Am J Orthod Dentofacial Orthop 2023; 164:466-475. [PMID: 37480898 DOI: 10.1016/j.ajodo.2023.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/01/2023] [Accepted: 06/01/2023] [Indexed: 07/24/2023]
Abstract
INTRODUCTION The objective of this multicenter study was to analyze the efficacy of cleaning 2 interdental brushes (IDBs) around brackets in patients with fixed orthodontic appliances. METHODS The study design was a multicenter, randomized, examiner-blinded crossover study with 3 interventions, the first of which was a baseline intervention. This study included 20 patients (12 females, 8 males) aged 12-18 years with fixed orthodontic devices examined at the Department of Orthodontics, University Medical Center of the Johannes Gutenberg University Mainz, and the Children's Dental Clinic St. Gallen. The outcome was a conventional, cylindrically shaped IDB (IDBG-S [IB]; Top Caredent GmbH, Schönau, Germany) was examined in comparison with an innovative waist-shaped IDB (Circum, CDB-8 [CB]; Top Caredent GmbH). The participants did not use the IDB themselves. The brushing procedure was performed professionally by 1 operator (C.E.). Each buccal tooth surface with a bracket was split into 8 areas, the main areas being 1 and 8. These main areas, which were difficult for toothbrushes to reach, were mesial (area 1) and distal (area 8) of the bracket edges in the gingival direction. Plaque index (PI) scores were assessed at 2 examinations before and after the cleaning procedure on 8 tooth surfaces in the area with orthodontic brackets. A computer-generated program randomly allocated the IDB sequence to the participants. Examiners (L.Z.-G. and Y.W.) assessing the outcomes were blinded to the intervention and the randomized allocation of participants to the different IDBs. RESULTS Both IDBs showed a plaque removal effect (CB, 0.68 [interquartile range, 0.63-0.77]; IB, 0.43 [interquartile range, 0.33-0.55]). The difference between the 2 IDB was statistically significant (P = 0.002). In particular, the CB yielded a higher plaque removal efficacy (CB effect, 0.68; IB effect, 0.21) at the main areas 1 and 8, which were difficult to reach. Ten participants were randomized to each sequence, and all 20 completed the study. No side effects or adverse events were reported or observed. CONCLUSION The waist-shaped brush head of the CB significantly enhanced plaque reduction in total and particularly in problem areas. REGISTRATION This trial was registered at the German Clinical Trials Registry (no. DRKS00014088; https://www.drks.de/drks_web/navigate.xxdo?navigationId=trial.HTML&TRIAL_ID=DRKS00014088) PROTOCOL: The protocol was not published before trial commencement. FUNDING This study was supported by the manufacturer Top Caredent GmbH, Schönau, Germany, which provided all interdental brushes used in this study.
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Affiliation(s)
- Christina Erbe
- Department of Orthodontics, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
| | - Lisa Zanders-Grote
- Department of Orthodontics, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | | | - Irene Schmidtmann
- Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Niklaus P Lang
- Clinic of Dental Medicine, University of Zurich, Zurich, Switzerland; Clinic of Dental Medicine, University of Bern, Bern, Switzerland
| | - Heinrich Wehrbein
- Department of Orthodontics, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
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Farook FF, Alrumi A, Aldalaan K, Ababneh K, Alshammari A, Al-Khamees AA, Albalawi F. The efficacy of manual toothbrushes in patients with fixed orthodontic appliances: a randomized clinical trial. BMC Oral Health 2023; 23:315. [PMID: 37221525 DOI: 10.1186/s12903-023-03035-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 05/12/2023] [Indexed: 05/25/2023] Open
Abstract
OBJECTIVE This study aims to evaluate three types of manual toothbrushes [Cross action (CA), Flat trim (FT), and orthodontic type (OT)] in terms of efficacy in plaque removal in patients undergoing fixed orthodontic treatment. BACKGROUND Manual toothbrushes are an essential part of oral hygiene for primary prevention. Plaque control, however, can be influenced by a number of individual and material-related factors. Individual factors include the presence of fixed orthodontic appliances on tooth surfaces, such as brackets and bands, which create difficulties with oral hygiene and lead to plaque formation. The evidence for the effectiveness of advanced bristle designs (multilevel, criss-cross) of the manual toothbrush alone in removing plaque in patients undergoing orthodontic therapy is limited. METHODS The experiment followed the Consolidated Standards of Reporting Trials (CONSORT) guidelines. This was a three treatment, three-period crossover clinical trial with a single brushing exercise. Thirty subjects were randomized to one of the three treatment sequences of different bristle designs: (CA, FT, and OT). The primary outcome measure was the difference in the plaque scores (baseline minus post-brushing) at each study period, as determined by the Turesky-Modified Quigley-Hein Plaque Index. RESULTS Of the thirty-four subjects enrolled in the study, thirty of the subjects met the inclusion criteria and completed all three periods of the study. The mean age was 19.5 ± 1.52 years, with a range of 18-23 years. The differences between treatments in plaque score reduction after brushing were statistically significant (p-value < .001). The treatment differences were statistically significant (p-value < .001) favoring the FT toothbrush over the OT and CA types of toothbrush designs. On the contrary, the difference between the OT and CA types was not statistically significant. CONCLUSIONS Plaque was significantly removed by the conventional FT toothbrush after a single brushing compared to the OT and CA types.
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Affiliation(s)
- Fathima Fazrina Farook
- College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, 11426, Saudi Arabia.
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
- Department of Dental Services, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.
| | - Abdulmajeed Alrumi
- College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, 11426, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Department of Dentistry, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Khaled Aldalaan
- College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, 11426, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Department of Dental Services, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Khansa Ababneh
- College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, 11426, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Department of Dental Services, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Abdulsalam Alshammari
- College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, 11426, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Department of Dental Services, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Amani Abdullah Al-Khamees
- Department of Dental Services, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
- College of Dentistry , Majmaah University, Al Majma'ah, Saudi Arabia
| | - Farraj Albalawi
- College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, 11426, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Department of Dental Services, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
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Mahjoub DT, AlJabri RK, Bifari NE, Najjar RS. Oral hygiene awareness and practice in orthodontic patients in Makkah city: A cross sectional study. J Orthod Sci 2023; 12:32. [PMID: 37351389 PMCID: PMC10282541 DOI: 10.4103/jos.jos_115_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/27/2022] [Accepted: 01/20/2023] [Indexed: 06/24/2023] Open
Abstract
OBJECTIVES To evaluate the level of oral hygiene awareness and practice among orthodontic patients that have fixed appliances and investigate the differences in awareness as per age, gender, and education qualification. MATERIALS AND METHODS A cross-sectional study with 250 patients was included. A questionnaire was used to collect information regarding the patient's oral hygiene. RESULTS The level of awareness and oral hygiene practice was significantly higher among females, with a consistent stepwise increase toward older ages. Also, increased with higher education level, longer duration since getting the appliance, and receiving instructions from the orthodontist. CONCLUSIONS Oral hygiene instructions received by the orthodontist play an important role in the patient's awareness level. Also, many predictors have a significant effect on the patient's cooperation in practicing oral hygiene measures.
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Affiliation(s)
- Dalal Tariq Mahjoub
- Consultant Orthodontist, King Abdulaziz Hospital, Makkah, Kingdom of Saudi Arabia
| | | | | | - Rahaf S. Najjar
- Pediatric Dentist Specialist, King Abdulaziz Hospital, Makkah, Kingdom of Saudi Arabia
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Kumar A, Singh J, Sinha P, Vaman Kini V, Champaneri HR, Mishra SK, Tiwari A, Singh R. The Efficacy of the Three Types of Plaque Control Methods During Fixed Orthodontic Treatment: A Randomized Controlled Trial. Cureus 2023; 15:e38231. [PMID: 37261166 PMCID: PMC10226844 DOI: 10.7759/cureus.38231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 04/27/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND When intraoral orthodontic devices are used, it becomes significantly more difficult to remove plaque effectively. Dentists and orthodontic specialists can come up with more effective preventive strategies while patients are undergoing fixed orthodontic work if they have a deeper understanding of the present scenario. In addition, individuals will become more aware of the importance of good dental hygiene habits as a result of this. OBJECTIVE To assess and compare the effectiveness of a manual toothbrush, machine-driven toothbrush, and conventional mechanical toothbrush coupled with mouth rinse in removing plaque and maintaining gingival health in patients undergoing fixed orthodontic treatment. METHODS AND MATERIALS In this research, a total of 222 individuals who met the eligibility and exclusion requirements were randomly selected and offered their written consent. There were a total of 74 participants for each of the three different categories. Category A used a physically driven toothbrush. Category B used a motorized toothbrush. Category C used a physically driven toothbrush together with mouthwash containing 0.2% chlorhexidine gluconate. All study participants were assessed at baseline, one-month follow-up, and two-month follow-up to document the preliminary information, including that of the modified papillary bleeding index (MPBI) by Muhlemann, plaque index (PI) introduced by Silness and Loe, and gingival index (GI) introduced by Loe and Silness. RESULTS In this study, the mean PI scores at the one-month and two-month follow-ups were minimum in Category C, while it was maximum in Category A at the two-month follow-up. The mean GI scores at the two-month follow-up were minimum in Category C, while it was maximum in Category A at the two-month follow-up. The mean MPBI scores at the two-month follow-up were minimum in Category C, while it was maximum in Category A. It was observed that participants in this trial who only used a typical mechanical brush experienced an increase in PI and GI scores after one and two months of follow-up. At the one-month and two-month follow-ups, it was noted that the values of PI, GI, and MPBI significantly decreased in the study participants using automated toothbrushes as well as in study participants using manual toothbrushes in conjunction with chlorhexidine mouthwash as compared to baseline values. However, when the three categories were compared, it was found that the research participants utilizing both a manual toothbrush and 0.2% chlorhexidine experienced the highest decreases in PI, GI, and MPBI values. CONCLUSION The reduction in the scores of PI, GI, and MPBI was maximum in orthodontic patients after two months when they apply manual toothbrushing along with 0.2% chlorhexidine.
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Affiliation(s)
- Amit Kumar
- Department of Orthodontics and Dentofacial Orthopaedics, Dr. B.R. Ambedkar Institute of Dental Sciences and Hospital, Patna, IND
| | - Jaideep Singh
- Department of Orthodontics and Dentofacial Orthopaedics, Maharana Pratap Dental College, Kanpur, IND
| | - Pallavi Sinha
- Department of Oral Medicine and Radiology, New Horizon Dental College and Research Institute, Chhattisgarh, IND
| | - Vineet Vaman Kini
- Department of Periodontics, MGM Dental College and Hospital, Navi Mumbai, IND
| | - Harshal R Champaneri
- Department of Periodontics, Vaidik Dental College and Research Centre, Daman, IND
| | - Shashank Kumar Mishra
- Department of Conservative Dentistry and Endodontics, Triveni Institute of Dental Sciences, Hospital and Research Center, Bilaspur, IND
| | - Anushree Tiwari
- Clinical Quality and Value, American Academy of Orthopaedic Surgeons, Rosemont, USA
| | - Ramanpal Singh
- Department of Oral Medicine and Radiology, New Horizon Dental College and Research Institute, Chhattisgarh, IND
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Di Spirito F, Amato A, Di Palo MP, Cannatà D, Giordano F, D’Ambrosio F, Martina S. Periodontal Management in Periodontally Healthy Orthodontic Patients with Fixed Appliances: An Umbrella Review of Self-Care Instructions and Evidence-Based Recommendations. Dent J (Basel) 2023; 11:dj11020035. [PMID: 36826180 PMCID: PMC9954872 DOI: 10.3390/dj11020035] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 01/17/2023] [Accepted: 01/28/2023] [Indexed: 02/04/2023] Open
Abstract
The present umbrella review aimed to characterize periodontal self-care instructions, prescriptions, and motivational methods; evaluate the associated periodontal outcomes; and provide integrated, evidence-based recommendations for periodontal self-care in periodontally healthy orthodontic patients with fixed appliances. The presently applied study protocol was developed in advance, compliant with the PRISMA statement, and registered on PROSPERO (CRD42022367204). Systematic reviews published in English without date restrictions were electronically searched until 21 November 2022 across the PROSPERO Register and Cochrane Library, Web of Science (Core Collection), Scopus, and MED-LINE/PubMed databases. The study quality assessment was conducted through the AMSTAR 2 tool. Seventeen systematic reviews were included. Powered and manual toothbrushes showed no significant differences in biofilm accumulation, although some evidence revealed significant improvements in inflammatory, bleeding, and periodontal pocket depth values in the short term with powered toothbrushes. Chlorhexidine mouthwashes, but no gels, varnishes, or pastes, controlled better biofilm accumulation and gingival inflammation as adjuncts to toothbrushing, although only for a limited period. Organic products, such as aloe vera and chamomile, proved their antimicrobial properties, and herbal-based mouthwashes seemed comparable to CHX without its side effects. Motivational methods also showed beneficial effects on periodontal biofilm control and inflammation, while no evidence supported probiotics administration.
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Affiliation(s)
- Federica Di Spirito
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
- Correspondence:
| | - Alessandra Amato
- Department of Neuroscience, Reproductive Science and Dentistry, University of Naples Federico II, 80138 Naples, Italy
| | - Maria Pia Di Palo
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Davide Cannatà
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Francesco Giordano
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Francesco D’Ambrosio
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Stefano Martina
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
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Toshniwal SH, Reche A, Bajaj P, Maloo LM. Status Quo in Mechanical Plaque Control Then and Now: A Review. Cureus 2022; 14:e28613. [PMID: 36185936 PMCID: PMC9523496 DOI: 10.7759/cureus.28613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Abstract
There are various kinds of dental diseases, of which dental caries and disease of periodontal origin are the most common. A very strong connection has been proven between oral inflammation and general health of an individual. Dental Biofilm is the main cause for gingivitis and periodontitis. Dental plaque may also be referred to as microbial plaque that consists of highly organized structures of different microbiotas attached to the hard tooth structure, which may be bound by salivary glycoproteins. Plaque control is a term that refers to removal of already formed or the control of formation of this microbial biofilm. There have been various methods practiced for plaque control; they are broadly classified into mechanical methods and chemical plaque control methods. Mechanical plaque control further includes many other methods such as manual toothbrushes and smart toothbrushes, which includes power-driven toothbrushes, sonic and ultrasonic toothbrushes, solar-powered toothbrushes (ionic toothbrushes), disposable toothbrushes, and laser toothbrushes; this also includes interdental cleaning aids. Continuous advancements with the integration of technology have been made in the field of mechanical plaque control to improve its quality.
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Al Shammari A, Farook FF, Fallatah A, Aldosari S, Ababneh KT, Aleissa BM. A Randomized Clinical Study of the Plaque Removal Efficacy of a Novel Manual Toothbrush With Micro-Pulse Bristles on Fixed Orthodontic Patients. Cureus 2022; 14:e28453. [PMID: 36176832 PMCID: PMC9510717 DOI: 10.7759/cureus.28453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2022] [Indexed: 11/05/2022] Open
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Akama Y, Nagamatsu Y, Ikeda H, Nakao-Kuroishi K, Kometani-Gunjigake K, Kawamoto T, Shimizu H. Applicability of neutral electrolyzed water for cleaning contaminated fixed orthodontic appliances. Am J Orthod Dentofacial Orthop 2022; 161:e507-e523. [PMID: 35337704 DOI: 10.1016/j.ajodo.2022.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 02/01/2022] [Accepted: 02/01/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION We investigated whether water jet washing with neutral electrolyzed water (NW) can be an easy and safe self-performed cleaning method for oral environments of fixed orthodontic appliance-wearing patients. In line with this, we examined the bactericidal effects and dissolution behaviors of metal elements released from appliances. METHODS A metal or resin bracket ligated with a metal wire and metal bracket adhered to an apatite-pellet were used as specimens. The bacteria and plaque removal effects of the 30 seconds of NW (30, 100 ppm) jet washing for contaminated specimens were examined via an agar-plate method and the observation of the residual plaque, comparing with other treatments (brushing and flow washing), those treatments with tap water (TW), and flow washings with commercial mouthwashes, Listerine Total Care + (LS) and ConCool F (CC). The amounts of metal released from metal specimens during the 1-week immersion in NW were analyzed and compared with those in TW, LS, and CC. RESULTS NW jet washing produced larger decreases of surviving bacteria than the treatments with TW and CC (P <0.05) and equal or larger decreases than the treatment with LS (P <0.05). NW jet washing yielded the highest plaque removal level. The amounts of nickel and chromium released from metal specimens after the 1-week immersion in NW (30 ppm) were less than or equal to those with LS. CONCLUSIONS NW jet washing could be applicable for cleaning fixed orthodontic appliances because of its higher bactericidal effects than the treatments with commercial mouthwashes, inducing no or a slight metal release in actual usage time.
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Affiliation(s)
- Yasuhiko Akama
- Division of Orofacial Functions and Orthodontics, Department of Health Promotion, Kyushu Dental University, Kitakyushu, Japan; Division of Biomaterials, Department of Oral Functions, Kyushu Dental University, Kitakyushu, Japan
| | - Yuki Nagamatsu
- Division of Biomaterials, Department of Oral Functions, Kyushu Dental University, Kitakyushu, Japan.
| | - Hiroshi Ikeda
- Division of Biomaterials, Department of Oral Functions, Kyushu Dental University, Kitakyushu, Japan
| | - Kayoko Nakao-Kuroishi
- Division of Orofacial Functions and Orthodontics, Department of Health Promotion, Kyushu Dental University, Kitakyushu, Japan
| | - Kaori Kometani-Gunjigake
- Division of Orofacial Functions and Orthodontics, Department of Health Promotion, Kyushu Dental University, Kitakyushu, Japan
| | - Tatsuo Kawamoto
- Division of Orofacial Functions and Orthodontics, Department of Health Promotion, Kyushu Dental University, Kitakyushu, Japan
| | - Hiroshi Shimizu
- Division of Biomaterials, Department of Oral Functions, Kyushu Dental University, Kitakyushu, Japan
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Narayanan P, Thiruvenkatachari B, DiBiase AT. Role of the general dental practitioner in managing the risks of orthodontic treatment. Br Dent J 2021; 231:682-688. [PMID: 34893726 DOI: 10.1038/s41415-021-3713-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 05/13/2021] [Indexed: 11/09/2022]
Abstract
The aim of this article is to outline the potential risks in orthodontic treatment and the general dental practitioner's role in reducing and managing such risks. The success of orthodontic treatment largely depends on patient understanding of the risk/benefit implications of the orthodontic treatment and all of the potential consequences involved in such treatment. A perfect blend of good case selection, sound clinical judgement and, more importantly, a patient's clear understanding of the potential risks involved and the treatment implications help minimise and manage potential hazards that occur during the course of the treatment.
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Affiliation(s)
- Prashanth Narayanan
- Associate Dentist, West Park Dental Practice, Crownhill Rd, Higher St Budeaux, Plymouth, PL5 2QT, UK
| | - Badri Thiruvenkatachari
- Honorary Senior Lecturer, School of Dentistry, Coupland 3 Building, University of Manchester, Higher Cambridge Street, Manchester, M13 9PL, UK
| | - Andrew T DiBiase
- Consultant Orthodontist, Maxillofacial Unit William Harvey Hospital, East Kent University Foundation NHS Trust, Kennington Rd, Willesborough, Ashford, TN24 0LZ, UK; Professor in Orthodontics, Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research, Chennai, 600100, India.
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Effectiveness of a Selective Etching Technique in Reducing White Spots Formation around Lingual Brackets: A Prospective Cohort Clinical Study. COATINGS 2021. [DOI: 10.3390/coatings11050572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The risk of developing white spot lesions (WSLs) after orthodontic treatment with lingual brackets is generally considered lower than with labial ones, even if plaque accumulation is frequently higher due to the increased difficulty level in oral hygiene maintenance. In this prospective clinical study, selective enamel etching technique effectiveness in reducing plaque accumulation and WSLs was tested. Thirty patients were bonded with a split-mouth approach: two randomly selected opposite quadrants were used as the test sides, using customized plastic etching guides, and the other two as control sides, applying traditional direct etching methods. The plaque presence around the braces was recorded after 1, 3, 6, and 12 months according to a lingual plaque accumulation index (LPAI), as was the presence of WSLs. PAI measured values were significantly higher in the control sides during the observation period. Test and control sides differed significantly for new WSL onset only after 12 months of treatment. Therefore, the present research demonstrated that this guided enamel etching technique allowed for significant reduction in plaque accumulation around the lingual brackets and reduced onset of white spots after one year of treatment.
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Marçal FF, Mota de Paulo JP, Barreto LG, de Carvalho Guerra LM, Silva PGDB. Effectiveness of orthodontic toothbrush versus conventional toothbrush on plaque and gingival index reduction: A systematic review and meta-analysis. Int J Dent Hyg 2021; 20:87-99. [PMID: 33971076 DOI: 10.1111/idh.12511] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 04/21/2021] [Accepted: 05/02/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE In orthodontic patients submitted to oral hygiene instruction, what is the efficacy of orthodontic toothbrush (O-TB) versus conventional toothbrush (C-TB) on plaque and gingival index reduction in randomized and non-randomized controlled clinical trials? METHODS Electronic database search was performed on PubMed, ClinicalTrials.gov, Cochrane Library and Google Scholar. Database research, study selection, data extraction and ROBINS-I and Risk of Bias Tool 2.0 analysis were conducted by two independently examiners in duplicate. Two different meta-analyses were performed for plaque index and gingival index, followed by the analysis of overall quality of the evidence using GRADE. RESULTS A total of 158 studies were identified for screening; six articles were included in qualitative synthesis, and of those, three were subjected to a quantitative synthesis (meta-analysis). Three non-randomized studies presented an overall 'low', 'moderate' and 'high' risk of bias for each one of the articles, and the three randomized clinical trials presented 'low risk' for two articles and 'some concerns' quality for the other one. The overall strength of evidence was ranked 'very low' quality for plaque index and gingival index subgroups. CONCLUSIONS Gingival bleeding is not modified by orthodontic design toothbrush, but there is circumstantial scientific evidence for recommending the use of an O-TB instead a C-TB based on the analysis of plaque index control. Although major plaque removal of the O-TB was validated by meta-analysis, this improvement is not completely clarified which calls for further clinical studies to assess the effects of using an O-TB compared with a C-TB.
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Affiliation(s)
- Felipe Franco Marçal
- Department of Dentistry, Centro Universitário Christus, Fortaleza, Ceará, Brazil
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Daneshkazemi P, Sadeghian S, Khodaei M. Shear bond strength of orthodontic brackets on intact and demineralized enamel after application of resin infiltrant, fluoride varnish and casein phosphopeptide-amorphous calcium phosphate remineralizing agents: in-vitro study. Int Orthod 2021; 19:259-268. [PMID: 33775598 DOI: 10.1016/j.ortho.2021.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/06/2021] [Accepted: 03/08/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To evaluate the effects of remineralizing agents on the shear bond strength (SBS) of orthodontic brackets bonded to intact and demineralized enamel. MATERIAL AND METHODS In this in-vitro study, 160 human premolars were divided into 8 groups, including group 1 with intact enamel as the positive control, group 2 with demineralized enamel as the negative control, groups 3-5 treated with fluoride varnish, Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) and resin infiltrant on intact enamel, and groups 6-8 treated with the same agents on demineralized enamel. Brackets were bonded using the conventional method, and the samples were thermocycled. SBS of the brackets was measured using a universal testing machine, and the adhesive remnant index (ARI) was assessed. Data were analysed with one-way ANOVA and post hoc statistical test at the significance level of 0.05. RESULTS SBS of the brackets in all groups with intact enamel was higher than that of their counterparts on demineralized enamel, which was only significantly different between groups 1 and 2 (P-value<0.001). SBS values of groups 7 and 8 were not significantly different from group 1 (P-value=1), yet the application of fluoride varnish on both intact (P-value=0.091) and demineralized enamel (P-value<0.001) created less SBS than in group 1. CONCLUSIONS All pre-treatment methods increased SBS of the brackets bonded to demineralized enamel, yet only the resin infiltrant and CPP-ACP produced SBS similar to that of intact enamel. Also, the use of fluoride varnish on intact enamel significantly reduced SBS.
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Affiliation(s)
- Pedram Daneshkazemi
- Department of orthodontics, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Sousan Sadeghian
- Department of orthodontics, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran.
| | - Mohammad Khodaei
- Department of Material Science and engineering, Golpayegan university of technology, Golpayegan, Iran
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Boes H, Brüstle S, Danesh G, Zimmer S, Bizhang M. Comparative in vitro study of the cleaning efficacy of AirFloss ultra and I-Prox Sulcus brushes in an orthodontic phantom model. Sci Rep 2021; 11:1921. [PMID: 33479418 PMCID: PMC7820349 DOI: 10.1038/s41598-021-81603-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 01/07/2021] [Indexed: 11/09/2022] Open
Abstract
Preventing biofilm-related risks such as gingivitis and white spot lesions during orthodontic treatments is very challenging. The cleaning efficiencies of AirFloss Ultra and I-Prox P sulcus brushes were evaluated using an orthodontic phantom model. After attaching brackets onto black-coated maxillary KaVo teeth, a plaque substitute was applied. The evaluated tooth surfaces were divided into two areas. Cleaning was performed with an AirFloss Ultra with two (A-2) or four (A-4) sprays or an I-Prox P for two (I-2) or four (I-4) seconds. Images before and after cleaning were digitally subtracted, and the percentage of fully cleaned surfaces was determined (Adobe Photoshop CS5, ImageJ). Statistical analysis was performed by ANOVA and post hoc tests with Bonferroni correction (SPSS 25, p < 0.05). The mean values of total cleaning efficacy were 26.87% for I-2, 43.73% for I-4, 34.93%, for A-2 and 56.78% for A-4. The efficacy was significantly higher for A-4 than for A-2, I-4, and I-2. There were significant differences between the four groups. Repeated cleaning led to an improved result. Within the study limitations, the AirFloss Ultra with four sprays proved to be more efficient than the sulcus brush I-Prox P for cleaning.
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Affiliation(s)
- Hanna Boes
- Department of Operative and Preventive Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Str. 50, 58455, Witten, Germany.
| | - Sören Brüstle
- Department of Operative and Preventive Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Str. 50, 58455, Witten, Germany
| | - Gholamreza Danesh
- Department of Orthodontics, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Stefan Zimmer
- Department of Operative and Preventive Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Str. 50, 58455, Witten, Germany
| | - Mozhgan Bizhang
- Department of Operative and Preventive Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Str. 50, 58455, Witten, Germany
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Klaus K, Glanz T, Glanz AG, Ganss C, Ruf S. Comparison of Quantitative light-induced fluorescence-digital (QLF-D) images and images of disclosed plaque for planimetric quantification of dental plaque in multibracket appliance patients. Sci Rep 2020; 10:4478. [PMID: 32161288 PMCID: PMC7066241 DOI: 10.1038/s41598-020-61454-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 02/27/2020] [Indexed: 11/17/2022] Open
Abstract
The purpose of the present cross-sectional clinical study was to check the ability of plaque detection and quantification by QLF-D against conventional digital photographs of disclosed plaque in multibracket appliance (MB) patients. 20 patients were included according to the following criteria: (1) upper and lower jaw treated by MB appliance, (2) patients being 16 years of age or older, (3) all central and lateral incisors as well as canines in situ, (4) absence of developmental defects, carious lesions, surface fillings, prosthetic restorations or recessions greater than 1/3 of root length in central/lateral incisors and canines as well as (5) declaration of consent. QLF-D and conventional photographs were analyzed planimetrically regarding plaque coverage on buccal and oral surfaces of central/lateral incisors and canines. The conventional photographs of stained plaque served as gold standard. On average, in QLF-D pictures 20.7% ± 17.4 of the tooth surfaces were covered with plaque, while the conventional photographs of disclosed plaque presented a mean plaque-covered area of 36.2% ± 23.5. The Bland-Altman plot for both imaging modalities showed a very large inconsistent scattering with both negative and positive deviations. The method discrepancy increased with increasing plaque coverage, thus indicating a systematic method error. On average, the deviation of the methods from the optimal line of accordance was -15.5%. In patients wearing MB appliances, there was no clinical significant agreement regarding the plaque-covered tooth surface depicted by QLF-D respectively conventional images of disclosed plaque. Due to the large method discrepancy, QLF-D is currently not reliable for precise plaque quantification in MB patients.
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Affiliation(s)
- Katharina Klaus
- Department of Orthodontics, Justus-Liebig-University Gießen, Germany (Schlangenzahl 14, 35392, Gießen, Germany.
| | - Tabea Glanz
- Private Practice, Lüdenscheid, Germany (Dr. Arndt Himmen, Freiherr-vom-Stein-Str. 24, 58511, Lüdenscheid, Germany
| | - Alexander Georg Glanz
- Private Orthodontic Practice, Zweibrücken, Germany (Dr. Michael Wagner, Poststr. 5, 66482, Zweibrücken, Germany
| | - Carolina Ganss
- Department of Conservative and Preventive Dentistry, Justus-Liebig-University Gießen, Germany (Schlangenzahl 14, 35392, Gießen, Germany
| | - Sabine Ruf
- Department of Orthodontics, Justus-Liebig-University Gießen, Germany (Schlangenzahl 14, 35392, Gießen, Germany
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Aljohani SR, Alsaggaf DH. Adherence to Dietary Advice and Oral Hygiene Practices Among Orthodontic Patients. Patient Prefer Adherence 2020; 14:1991-2000. [PMID: 33116442 PMCID: PMC7586054 DOI: 10.2147/ppa.s277034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 10/06/2020] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Adherence to dietary advice and proper oral hygiene practices during orthodontic treatment are critical to maintaining good oral health and achieving successful treatment results. Thus, understanding patients' habits and practices before, during, and after orthodontic treatment is needed to ensure better oral health-related behavior among these patients. PURPOSE To investigate sugar-related dietary habits, visits to dental hygienists and dentists, and oral hygiene practices among patients during orthodontic treatment and after treatment compared to patients before treatment. METHODS A cross-sectional self-administered survey collected data from 375 patients (aged 10 years and older) from the Orthodontic Department at King Abdulaziz University Dental Hospital, Jeddah, Saudi Arabia. Patients were grouped according to their history of receiving orthodontic treatment into: patients before orthodontic treatment, patients during treatment, and patients after treatment. The survey assessed sugar-related dietary habits, frequency of visits to hygienists and dentists, and oral hygiene practices. RESULTS Patients during orthodontic treatment and those after treatment were less likely to eat sticky food compared to patients before treatment (OR=0.4, 95% CI=0.2-0.9 and OR=0.5, 95% CI=0.3-0.9, respectively). No significant differences were found in the odds of dental visits among the groups. Compared to patients before orthodontic treatment, patients during treatment and patients after treatment had higher odds of tooth brushing twice or more per day (OR=4.8, 95% CI=1.7-14.3, and OR=4.0, 95% CI=1.2-13.6, respectively) and were more likely to brush for an adequate time (OR=2.6, 95% CI=1.6-4.4 and OR=1.9, 95% CI=1.0-3.5, respectively). Moreover, the likelihood of flossing once daily was higher in patients during treatment and in patients after treatment relative to those before treatment. However, only patients during orthodontic treatment used interdental brushes more than patients before treatment. CONCLUSION Patients' oral health-related behavior seems to improve during and after orthodontic treatment. The findings of this study suggest that orthodontists can play a role in improving oral hygiene practices among their patients. More reinforcement of dietary instructions and periodic dental and hygiene visits is needed during orthodontic follow-up appointments.
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Affiliation(s)
- Salha R Aljohani
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
- Correspondence: Salha R AljohaniDepartment of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Alsulemaneya, PO Box 80209, Jeddah21589, Saudi ArabiaTel +966 504684941Fax +966 12 692 1262 Email
| | - Doaa H Alsaggaf
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Sawai DS, Singh P, Tushar, Dogra M, Sultana R, Khan SA. Perception, awareness, and practice among patients seeking orthodontic treatment toward maintenance of periodontal health and factors affecting the same among patients visiting dental clinics in Patna. J Family Med Prim Care 2019; 8:3695-3699. [PMID: 31803675 PMCID: PMC6881928 DOI: 10.4103/jfmpc.jfmpc_773_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 09/16/2019] [Accepted: 09/26/2019] [Indexed: 11/04/2022] Open
Abstract
Background During the orthodontic treatment, maintenance of periodontal health is of utmost importance; hence, this study was conducted to explore the perception and awareness of patients seeking orthodontic treatment toward maintenance of periodontal health and factors affecting the same. Materials and Methods It was a cross-sectional descriptive questionnaire study conducted among134 patients seeking orthodontic treatment from 16 private clinics in Patna. The study was conducted in the month of June 2019. The city was divided into four directions east, west, north, and south and four clinics were selected from each directions randomly. A close-ended questionnaire was prepared consists of demographic details and questions regarding their perception, awareness, and practice to maintain periodontal health from the start of orthodontic treatment. Results Majority of study participants {74 (55.22%)} were between the age group of 11 and 15 years. Among all study participants, females {81 (60.45%)} were more than males. It was determined that 112 (83.58%) of patients were using tooth brush and tooth paste/powder for cleaning teeth. There was moderate awareness, negative perception, and fair practice of majority of study participants seeking orthodontic treatment toward maintenance of periodontal health. Awareness of study participants was significantly (P-value ≤ 0.05*) associated with practice. Conclusion There was moderate awareness, negative perception, and fair practice of majority of study participants seeking orthodontic treatment toward maintenance of periodontal health. Education of study participants was significantly associated with awareness and practice regarding maintenance of periodontal health. There is further need to educate the orthodontic patients toward maintenance of periodontal health.
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Affiliation(s)
- Devashish Singh Sawai
- Department of Dentistry, Govt Doon Medical College and Hospital, Dehardun, Uttrakhand, India
| | - Puja Singh
- Department of Periodontology and Implantology, Buddha Institute of Dental Sciences and Hospital, Patna, Bihar, India
| | - Tushar
- Department of Prosthodontics and Crown and Bridge, Buddha Institute of Dental Sciences and Hospital, Patna, Bihar, India
| | - Mehak Dogra
- Department of Pedodontics and Preventive Dentistry, Private Practitioner, Jammu and Kashmir, India
| | - Rafat Sultana
- Department of Periodontology and Implantology, Private Practitioner, Patna, Bihar, India
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Self-Reported Changes in Oral Hygiene Habits among Adolescents Receiving Orthodontic Treatment. Dent J (Basel) 2019; 7:dj7040096. [PMID: 31581420 PMCID: PMC6960564 DOI: 10.3390/dj7040096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/24/2019] [Accepted: 09/26/2019] [Indexed: 11/16/2022] Open
Abstract
The prevalence of malocclusion and a need for orthodontic treatment is high. Orthodontic appliances increase biofilm accumulation by expanding plaque retention sites. The aim of this study was to investigate the self-reported changes in oral hygiene habits among adolescents receiving orthodontic treatment. A cross-sectional study of 291 patients aged 10–17 years (mean (M) = 12.98; standard deviation (SD) = 2.36) was conducted in the Department of Orthodontics, Lithuanian University of Medical Sciences (LSMU) Hospital (Kaunas, Lithuania) during the fall semester (October–January) of the 2017/2018 study year. An anonymous self-administered questionnaire covered background information, experience of orthodontic treatment, oral hygiene habits and the seeking of professional dental care. Statistical data analysis was performed using SPSS version 22. To establish relationships between categorical variables, Chi-squared tests (χ2) were used. A p-value ≤ 0.05 was set to indicate statistically significant difference. The univariate logistic regression analysis evaluated the probability of an event given a certain risk indicator, including odds ratio (OR) and its confidence interval (95% CI). Associations were found between the usage of auxiliary measures (OR = 1.797 (1.118–2.887), p = 0.015), tongue cleaning (OR = 1.712 (1.059–2.767), p = 0.028), mouth rinsing after meals (OR = 1.707 (1.048–2.781), p = 0.032) and experience of orthodontic treatment, respectively. More orthodontic patients underwent professional oral hygiene regularly than non-orthodontic patients (p = 0.024). More patients with fixed orthodontic appliances reported significantly changed oral hygiene habits, while more orthodontic patients with removable appliances did not change their oral hygiene habits.
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19
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Influence of enamel sealing with a light-cured filled sealant before bracket bonding on the bond failure rate during fixed orthodontic therapy. J Orofac Orthop 2019; 80:136-143. [PMID: 30972424 DOI: 10.1007/s00056-019-00174-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 03/06/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE Fluoride-containing adhesives for enamel sealing are commonly used for the prevention of white spot lesions during fixed orthodontic treatment. Thus, we examined whether enamel sealing with L.E.D. ProSeal® (Reliance Orthodontic Products Inc., Itasca, IL, USA) before bracket bonding increases the rate of bond failure during orthodontic treatment. METHODS In 20 adolescents (11-16 years, 10 male/10 female) at the start of fixed therapy, self-ligating SmartClip™SL3 metal brackets (3M Unitek, Monovia, CA, USA) were bonded to cleaned and conditioned (40% H3PO4, 30 s) buccal enamel surfaces of all permanent teeth except molars using Transbond™ XT (3M Unitek). In a split-mouth design, either L.E.D. ProSeal® (1st/3rd quadrant) or Clinpro™ XT Varnish (2nd/4th quadrant; 3M Unitek) was applied to enamel surfaces before (ProSeal®) or after (Clinpro™ XT Varnish) bracket bonding (200 teeth each; light curing: 20 s, Ortholux™ Luminous, 3M Unitek). Cumulative bond failure as total number of teeth with bracket detachment since start of therapy was documented every 3 months for a total of 12 months. RESULTS Cumulative bond failure was higher for enamel sealing before bonding from 6 months onward reaching significance at 12 months (34/200) compared to sealing after bonding (24/200): p = 0.038; Cramér's V = 0.488; odds ratio (OR) = 1.5; relative risk (RR) = 1.4. The higher loss rate was limited to the lower arch, but evident within 3 months reaching significance at 9 and 12 months (p = 0.019/0.011, V = 0.636/0.630; OR = 1.7/1.75, RR = 1.5/1.6). In general, cumulative bond failure at 12 months was higher in the lower arch, but this was only significant for teeth sealed before bonding (p = 0.001, V = 0.303, OR = 3.4, RR = 2.8). CONCLUSIONS Enamel sealing with L.E.D. ProSeal® should be performed after bracket bonding to prevent increased bond failure and bracket loss in the lower dental arch.
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20
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Alhaija ESA, Al-Saif EM, Taani DQ. Periodontal health knowledge and awareness among subjects with fixed orthodontic appliance. Dental Press J Orthod 2018; 23:40.e1-40.e9. [PMID: 30427500 PMCID: PMC6266317 DOI: 10.1590/2177-6709.23.5.40.e1-9.onl] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Accepted: 02/21/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To report on periodontal health knowledge and awareness among orthodontic patients and to investigate the effect of age, attitude and duration of orthodontic treatment on periodontal health awareness among orthodontic patients. METHODS A total of 297 orthodontics patient (90 males, 207 females) with mean age of 17.7 ± 5.0 years (older then 18 years = 119, 18 years or younger = 178) were included in this study. Subjects were currently wearing upper and lower fixed orthodontic appliances for an mean period of 12.55 ± 10.86 months (less than or equal to 18 months = 231, more than 18 months = 66). Data was collected through a self-administered questionnaire (demographic characteristics, subjects' awareness toward their periodontal health, periodontal knowledge among orthodontic patient and patients' attitude toward orthodontic treatment regarding periodontal health) and clinical periodontal examination. RESULTS Periodontal knowledge was poor among orthodontic patients in relation to dental plaque. Only 24 subjects (8%) correctly answered knowledge-related questions. Adult orthodontic patients reported negative attitude toward fixed orthodontic treatment in respect to periodontal health (p<0.001). Duration of orthodontic treatment negatively affected subjects' attitude toward fixed orthodontic treatment (p<0.01). The majority of subjects were in the high level of awareness group (64%). Orthodontic patients' awareness toward their periodontal health during fixed orthodontic treatment was affected by attitude scores (p=0.005), number of teeth with gingival recession (p=0.041), Gingival Index (p=0.000), duration of treatment (p=0.047) and age (p=0.008). CONCLUSIONS Periodontal health knowledge among orthodontic patients was poor. Orthodontic patients' awareness of their periodontal health was moderate and was affected by age, attitude and duration of orthodontic treatment.
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Affiliation(s)
- Elham S Abu Alhaija
- Jordan University of Science and Technology, Faculty of Dentistry, Department of Preventive Dentistry (Irbid, Jordan)
| | - Eman M Al-Saif
- Jordan University of Science and Technology, Faculty of Dentistry, Department of Preventive Dentistry (Irbid, Jordan)
| | - Dafi Q Taani
- Jordan University of Science and Technology, Faculty of Dentistry, Department of Preventive Dentistry (Irbid, Jordan)
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Cunha LDD, Peruzzo DC, Costa LA, Pereira ALP, Benatti BB. Effect of a single-tufted toothbrush on the control of dental biofilm in orthodontic patients: A randomized clinical trial. Int J Dent Hyg 2018; 16:512-518. [PMID: 30129268 DOI: 10.1111/idh.12360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 05/28/2018] [Accepted: 07/08/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To compare the effect of a single-tufted toothbrush combined or not with a conventional toothbrush to control dental biofilm in healthy orthodontic patients. MATERIALS AND METHODS Twenty orthodontic patients were randomly assigned to receive three different treatments: Group 1-conventional toothbrush; Group 2-single-tufted toothbrush and Group 3-combination of single-tufted and conventional toothbrushes. Stained plaque index (SPI), visible plaque index (VPI) and gingival bleeding index (GBI) were recorded. The data were analysed by Kolmogorov-Smirnov test. Wilcoxon test was used for intragroup comparison and Friedman test for the intergroup comparison (α = 5%). RESULTS Intragroup analysis showed that VPI and SPI significantly decreased (P < 0.05) after 72 hour in Group 3. Anterior and posterior teeth did not show any significant statistical differences after 72 hour (P > 0.05), but VPI values in the labial surfaces were different to Group 3 (P < 0.05) in comparison with the other groups after 72 hour. Group 3 showed a statistically significant reduction (P < 0.05) for SPI in the interproximal surfaces when compared with Group 1. CONCLUSION The combination of single-tufted and conventional toothbrushes was effective for controlling dental biofilm formation in orthodontic patients.
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Aids for mechanical cleaning of teeth with fixed braces. Hippokratia 2018. [DOI: 10.1002/14651858.cd012931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Öz AA, Yazicioğlu S, Arici N, Akdeniz BS, Murat N, Arıcı S. Assessment of the Confidence of the Adhesive Remnant Index Score With Different Methods. Turk J Orthod 2013. [DOI: 10.13076/tjo-d-13-00003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Zingler S, Pritsch M, Wrede DJ, Ludwig B, Bister D, Kneist S, Lux CJ. A randomized clinical trial comparing the impact of different oral hygiene protocols and sealant applications on plaque, gingival, and caries index scores. Eur J Orthod 2013; 36:150-63. [DOI: 10.1093/ejo/cjt043] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Nassar PO, Bombardelli CG, Walker CS, Neves KV, Tonet K, Nishi RN, Bombonatti R, Nassar CA. Periodontal evaluation of different toothbrushing techniques in patients with fixed orthodontic appliances. Dental Press J Orthod 2013; 18:76-80. [DOI: 10.1590/s2176-94512013000100017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION: Plaque control is the major consensus during orthodontic treatment to prevent the occurrence of cavities and periodontal inflammation. The mechanic resource of greater effectiveness and frequent use in this control is the oral hygiene. The tooth brushing techniques most used in orthodontic patients are: Ramfjord's method, Modified Stillman technique and Bass method. OBJECTIVE: Since control studies evaluating the effectiveness of usual tooth brushing techniques do not show clear advantage, the objective of this study was to evaluate the effectiveness of three brushing methods, through periodontal clinical parameters of patients with fixed orthodontic appliances. METHODS: Thirty patients were selected, with ages between 14 and 22 years old, with fixed orthodontic appliances. After basic periodontal treatment the following factors were evaluated: 1 - Plaque index and 2 - Gingival index and each patient was randomly included in one of the three selected groups according to the brushing technique: Group 1 - Scrubbing technique; Group 2 - Modified Stillman technique and Group 3 - Bass technique. Patients were evaluated for 9 months. RESULTS: The results showed a significant reduction of clinical parameters by the end of this period, however there was a very significant reduction of Gingival index on group 3 (13.6%) when compared to the other groups. CONCLUSION: Thus, it can be suggested that the Bass technique can be effective on the reduction of periodontal clinical parameters of Plaque index and Gingival index in patients with fixed orthodontic appliances.
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Dalessandri D, Dalessandri M, Bonetti S, Visconti L, Paganelli C. Effectiveness of an indirect bonding technique in reducing plaque accumulation around braces. Angle Orthod 2012; 82:313-318. [PMID: 21848408 PMCID: PMC8867932 DOI: 10.2319/041811-273.1] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Accepted: 07/01/2011] [Indexed: 07/29/2023] Open
Abstract
OBJECTIVE To evaluate if the use of an indirect braces bonding protocol for localized enamel etching and adhesive application could help reduce plaque accumulation and demineralization around the brackets compared with a conventional direct-bonding technique. MATERIALS AND METHODS Thirty patients were bonded with a split-mouth approach: two randomly selected opposite quadrants were used as the test sides and the other two as control sides. During the first 6 months, the plaque presence around the braces was recorded monthly according to a plaque accumulation index (PAI), as was the presence of demineralization. PAI values were measured at each of the four bracket sides for every bonded tooth. Analysis of variance was used to identify significant differences between different bracket margins and between test and control sides. RESULTS Test and control sides differed significantly for PAI measurements from t(1) (1 month after bonding) to t(4) (4 months after bonding), with the highest value of significance (P < .001) at t(1) but with no significant differences from t(5) to t(7) (treatment end). Considering whole-mouth results, different bracket margin PAI scores did not differ significantly. PAI scores were higher at t(1) and progressively decreased during the treatment. At debonding, the onset of 21 new white spots was recorded overall for the control sides and eight new white spots for the test sides. CONCLUSION Especially during the first 4 months after brackets placement, this indirect bonding protocol allowed for significant reduction in plaque accumulation around the braces and reduced onset of white spots during the orthodontic treatment.
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Affiliation(s)
- Domenico Dalessandri
- Department of Orthodontics, School of Dentistry, University of Brescia, Brescia, Italy.
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Evaluation of a prevention programme efficiency for patients with fixed orthodontic appliances. VOJNOSANIT PREGL 2011; 68:214-9. [PMID: 21524003 DOI: 10.2298/vsp1103214m] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIM Orthodontic treatment enables the establishment of functional occlusion and improvement of oral health, however, it increases the risk of periodontal disease development. The aim of this paper was to examine the efficiency of the applied programme for the prevention of gingivitis in children undergoing the fixed orthodontic appliance therapy and to determine the most efficient devices and techniques for maintaining oral hygiene during orthodontic treatment. METHODS The study included 80 patients of both genders--60 patients comprised the experimental group and 20 patients comprised the control group. All of them were patients of the Clinic for Orthodontics at the School of Dentistry in Belgrade, aged between 13 and 18. The Silness-Löe Plaque Index (PI) was utilised for the assessment of oral hygiene quality and Silness-Löe Gingival Index (GI) and Mühlemann Papilla Bleeding Index (PBI) were utilised for the assessment of gingival state. Checkups were conducted as a single-blind study at the beginning and after the first, the third and the sixth month of the preventive and prophylactic programme. RESULTS During the observed period, a statistically significant change in PI, GI and PBI values was noticed (p < 0.005), as well as the difference in the dynamics of value changes during the periods between the observed groups. CONCLUSION The preventive programme, applied to children undergoing the fixed orthodontic appliance therapy, had a positive effect both on oral hygiene quality and gingival state. The values of the examined parameters of the patients from the experimental group were significantly lower in comparison with those of the patients from the control group. The most efficient combination of devices for oral hygiene during orthodontic treatment was: a Curaprox CP5460 toothbrush, CD Ortho 60 orthodontic toothbrush and Curaprox CPS 14 interdental brush.
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Talic NF. Adverse effects of orthodontic treatment: A clinical perspective. Saudi Dent J 2011; 23:55-9. [PMID: 24151415 DOI: 10.1016/j.sdentj.2011.01.003] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2010] [Revised: 04/05/2010] [Accepted: 06/14/2010] [Indexed: 11/28/2022] Open
Abstract
Orthodontic treatment is associated with a number of adverse effects, such as root resorption, pain, pulpal changes, periodontal disease, and temporomandibular dysfunction (TMD). Orthodontists should be aware of these effects and associated risk factors. Risk factors linked to root resorption include the duration of treatment, length, and shape of the root, trauma history, habits, and genetic predisposition.
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Affiliation(s)
- Nabeel F Talic
- Department of Pediatric Dentistry and Orthodontics, Orthodontic Division, King Saud University, Riyadh, Saudi Arabia
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Bock NC, von Bremen J, Kraft M, Ruf S. Plaque control effectiveness and handling of interdental brushes during multibracket treatment—a randomized clinical trial. Eur J Orthod 2009; 32:408-13. [DOI: 10.1093/ejo/cjp088] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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