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Marzal R, Albaladejo A, Curto A. A pilot study analyzing the influence of the material and the size of the orthodontic archwire on the level of pain and anxiety in adult patients in treatment with brackets: A prospective triple-blind randomized clinical trial. J Clin Exp Dent 2024; 16:e440-e447. [PMID: 38725824 PMCID: PMC11078505 DOI: 10.4317/jced.61428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 02/26/2024] [Indexed: 05/12/2024] Open
Abstract
Background The objective was to investigate the influence of the material and dimensions of the orthodontic archwire on the pain and anxiety in adult patients in orthodontic treatment with brackets. Material and Methods A randomized prospective triple-blind clinical pilot study was conducted at the Dental Clinic of the University of Salamanca. The study sample comprised 30 adult patients who started orthodontic treatment with brackets. This sample was divided into two groups: the NiTi group (n=15) and Cu-NiTi group (n=15). Pain was analyzed with a visual analogue scale (VAS) and anxiety with the State-Trait Anxiety Inventory (STAI). Anxiety was assessed at the start of treatment (T0) and after one month (T1). Pain was analyzed at the start of treatment (T0), at different time points at the start (T01), and after 4 (T02), 24 (T03), and 48 hours (T04); these measurements were also recorded one month after starting orthodontic treatment (T11, T12, T13, and T14). Results The mean age of patients was 31.3 (± 6.05) years old. The highest level of pain, at the beginning of treatment, was observed after 48 hours (5.57 ± 1.72) and at one month after starting treatment at 24 hours (5.13 ± 1.89), with no significant differences between the two groups. When analyzing anxiety, no differences were observed between groups; the anxiety levels were higher one month after starting treatment compared to the start. Regarding the correlation between pain and anxiety, the NiTi group showed a greater direct relationship (<0.05) between these two variables at the start of treatment in the anxiety trait in relation to pain at T02 and T03 and after a month in T12, T13, and T14. Conclusions In the sample studied, there was no significant influence of the size or material of the orthodontic archwire on pain and anxiety levels. Key words:Orthodontics, Brackets, Archwire, Pain, Anxiety, NiTi, Cu-NiTi.
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Affiliation(s)
- Raquel Marzal
- Postgraduate Student in Orthodontics, Faculty of Medicine, University of Salamanca, Spain. Alfonso X el Sabio Avenue. 37007. Salamanca. Spain
| | - Alberto Albaladejo
- DDS, Full Professor in Orthodontics, Faculty of Medicine, University of Salamanca, Spain. Alfonso X el Sabio Avenue. 37007. Salamanca. Spain
| | - Adrián Curto
- DDS, Professor in Pediatric Dentistry, Faculty of Medicine, University of Salamanca. Alfonso X el Sabio Avenue. 37007. Salamanca. Spain
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Baxi S, Tripathi AA, Bhatia V, Prasad Dubey M, Kumar P, Bagde H. Self-Ligating Bracket Systems: A Comprehensive Review. Cureus 2023; 15:e44834. [PMID: 37809259 PMCID: PMC10559757 DOI: 10.7759/cureus.44834] [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: 08/16/2023] [Accepted: 09/04/2023] [Indexed: 10/10/2023] Open
Abstract
Currently, ligature-free bracket technologies, including self-ligating brackets (SLBs), are all the rage in orthodontics. Self-ligating mechanisms have been shown to be more effective and less time-consuming in orthodontic treatment than traditional appliances due to their enhanced frictional properties. Crucial to the success of the multi-band/bracket method is the transmission of forces and moments from the bracket to the archwire. Advances in bracket design and ligation techniques are constantly being made to better distribute loads and increase the efficiency of leveling.
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Affiliation(s)
- Shalabh Baxi
- Department of Orthodontics, Government Dental College, Raipur, IND
| | - Anand A Tripathi
- Department Of Orthodontics, Saraswati Dhanwantari Dental College and Hospital, Parbhani, IND
| | - Virag Bhatia
- Department of Orthodontics, Government College of Dentistry, Indore, IND
| | - Mangleshwar Prasad Dubey
- Department of Orthodontics, Guru Gobind Singh College of Dental Sciences and Research Centre, Burhanpur, IND
| | - Pratiksha Kumar
- Department of Oral Pathology and Microbiology, Government College of Dentistry, Indore, IND
| | - Hiroj Bagde
- Department of Periodontology, Rama Dental College and Research Centre, Kanpur, IND
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Al-Ibrahim HM, Hajeer MY, Burhan AS, Haj Hamed Y, Alkhouri I, Zinah E. Assessment of Dentoalveolar Changes Following Leveling and Alignment of Severely Crowded Upper Anterior Teeth Using Self-Ligating Brackets Alone or With Flapless Piezocision Compared to Traditional Brackets: A Randomized Controlled Clinical Trial. Cureus 2023; 15:e35733. [PMID: 36875255 PMCID: PMC9984186 DOI: 10.7759/cureus.35733] [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] [Accepted: 03/03/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction Dental crowding is one of the most common types of malocclusions. It can be treated with or without extraction, depending on the severity of the crowding. Extraction-based orthodontic treatments are the preferred treatment option in cases of severe crowding, but they take longer than non-extraction cases. Objective This study aimed to evaluate the dentoalveolar changes following the orthodontic treatment of severely crowded maxillary anterior teeth in adults using self-ligating brackets alone or combined with flapless piezocision. Materials and methods The participants in this study were 63 patients (46 females and 17 males; mean age SD: 19.71 ± 2.74 years) who attended the Department of Orthodontics at the University of Damascus from January 2020 to December 2021. The participants were divided into three groups at random: Group (1): traditional brackets group, Group (2): self-ligating brackets group; and Group (3): self-ligating brackets with flapless piezocision group. Little's Irregularity Index (LII) was measured at five assessment times: before the onset of orthodontic treatment (T0), after one month (T1), after two months (T2), after three months (T3), and at the end of the leveling and alignment phase (T4). The intercanine width (lingual), the intercanine width (cusp), and the canine rotation angle were measured at two assessment times: before the onset of orthodontic treatment (T0) and at the end of the leveling and alignment phase (T4). Results The three studied groups had statistically significant differences in terms of LII during the first three months, and the most significant improvement of LII was in the self-ligating brackets with the piezocision group (P < 0.001). In addition, the intercanine width (cusp) at the end of the leveling and aligning phase revealed greater mean values in both self-ligating brackets groups compared to the traditional brackets group, and the differences were statistically significant (P < 0.001). Otherwise, no statistically significant differences were found at the end of the leveling and aligning phase in the intercanine width (lingual) or the canine rotation angle between the three studied groups (P > 0.05). Conclusion Using self-ligating brackets with flapless piezocision revealed more significant results concerning LII as compared to other groups. Thus, combining these two acceleration methods could get more effective results in aligning severely crowded teeth. Self-ligating brackets, whether used alone or with flapless piezocision, resulted in greater intercanine width at the cusp level. The type of brackets (traditional or self-ligating) did not affect the canine rotation angle.
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Affiliation(s)
- Heba M Al-Ibrahim
- Department of Orthodontics, University of Damascus Faculty of Dentistry, Damascus, SYR
| | - Mohammad Y Hajeer
- Department of Orthodontics, University of Damascus Faculty of Dentistry, Damascus, SYR
| | - Ahmad S Burhan
- Department of Orthodontics, University of Damascus Faculty of Dentistry, Damascus, SYR
| | - Yaser Haj Hamed
- Department of Orthodontics, Appolonia Pediatric Dentistry Center, Dubai, ARE
| | - Issam Alkhouri
- Department of Oral and Maxillofacial Surgery, University of Damascus Faculty of Dentistry, Damascus, SYR
| | - Eiad Zinah
- Department of Dental Public Health, University College London, London, GBR
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Muacevic A, Adler JR, Burhan AS, Sultan K, Ajaj MA, Mahaini L. The Efficacy of Accelerating Orthodontic Tooth Movement by Combining Self-Ligating Brackets With One or More Acceleration Methods: A Systematic Review. Cureus 2022; 14:e32879. [PMID: 36578856 PMCID: PMC9788653 DOI: 10.7759/cureus.32879] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2022] [Indexed: 12/25/2022] Open
Abstract
This review aimed to evaluate the effectiveness of using one or more acceleration methods with self-ligating brackets to accelerate orthodontic tooth movement in adults and the associated effects of these interventions. An electronic search of the following databases (PubMed, Scopus, Google Scholar, EMBASE) was performed (From January 1990 to November 2021). ClinicalTrials.gov and the International Clinical Trials Registry Platform were also electronically searched to find any unpublished studies and ongoing trials. The selected randomized controlled trials (RCTs) involved adult patients treated using self-ligating brackets combined with one or more acceleration methods compared with self-ligating brackets or conditional brackets alone. The risk of bias was assessed using Cochrane's risk of bias tool. A total of seven RCTs and one controlled clinical trial (CCT) were included in this review. Combining self-ligating brackets with flapless corticotomy, low-level laser therapy (LLLT), and infrared light accelerated orthodontic movement by 43% and 50% for surgical methods, 20-50% for LLLT, and 22% for infrared light. Regarding side effects on periodontal tissues, neither flapless corticotomy nor low-frequency vibrational forces caused any damage. Combining self-ligating brackets and flapless corticotomy, low-level laser, or infrared light effectively accelerated orthodontic movement by 20% to 50 %. In contrast, the combination of self-ligating brackets with vibrational forces did not affect speeding tooth movement. The acceleration methods did not have any side effects on the periodontal tissues, but the available evidence was insufficient. There is a need for further primary research regarding the effectiveness of combining self-ligating brackets with acceleration methods and the possible untoward side effects.
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Al-Ibrahim HM, Hajeer MY, Burhan AS, Alkhouri I, Latifeh Y. Evaluation of Patient-Centered Outcomes Associated With the Acceleration of Upper Incisor Decrowding Using Self-Ligating Brackets With or Without Piezocision in Comparison With Traditional Brackets: A Three-Arm Randomized Controlled Trial. Cureus 2022; 14:e26467. [PMID: 35785015 PMCID: PMC9249031 DOI: 10.7759/cureus.26467] [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: 06/30/2022] [Indexed: 11/05/2022] Open
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Wazwaz F, Seehra J, Carpenter GH, Ireland AJ, Papageorgiou SN, Cobourne MT. Duration of tooth alignment with fixed appliances: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop 2021; 161:20-36. [PMID: 34794862 DOI: 10.1016/j.ajodo.2021.06.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 06/01/2021] [Accepted: 06/01/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION A key goal of orthodontic treatment with fixed appliances is alignment of the dentition, and this remains a commonly selected outcome in clinical studies investigating orthodontic tooth movement. This systematic review has evaluated treatment duration to achieve alignment of the mandibular dentition using fixed appliances. METHODS Systematic literature searches without restrictions were undertaken in 9 databases for randomized clinical trials (RCTs) assessing duration and rate of tooth alignment using fixed appliances with or without treatment adjuncts published up to January 2021. After duplicate study selection, data extraction, and risk of bias assessment according to Cochrane, random-effects meta-analyses of aggregate data, and individual patient data were conducted. RESULTS Thirty-five trials were included with 2258 participants (39% male; mean age 17.8 years), giving a pooled duration to achieve whole-arch alignment of the mandibular dentition of 263.0 days (4 trials; 95% confidence interval [CI], 186.7-339.4 days) and incisor alignment in the mandibular arch of 100.7 days (9 trials; 95% CI, 84.1-117.4 days). Surgical-assisted orthodontics was associated with reduced duration of incisor alignment: mean difference of 44.3 days less (4 trials; 95% CI, 20.0-68.9 days; P <0.001; high quality of evidence), whereas subgroup and meta-regression analyses indicated significant effects of baseline crowding and premolar extractions. Individual patient data analysis from 3 RCTs indicated that for each additional participant age year, whole-arch alignment of the mandibular dentition took 13.7 days longer (3 trials; 95% CI, 7.7-17.7 days; P <0.001) and for each additional mm of irregularity, 17.5 days more were needed (2 trials; 95% CI, 9.8-25.2 days; P <0.001). CONCLUSIONS Patient and treatment-related characteristics can significantly affect the duration of tooth alignment and should be taken into account both clinically and when designing trial outcomes. Future research studies investigating rates of orthodontic tooth alignment would benefit from adequate sample sizes and a more consistent methodology in outcome assessment. Data in this systematic review provides a basis for appropriate trial design for future RCTs investigating the rate of orthodontic tooth alignment with fixed appliances.
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Affiliation(s)
- Fidaa Wazwaz
- Department of Orthodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Centre for Craniofacial Development and Regeneration, King's College London, London, United Kingdom
| | - Jadbinder Seehra
- Department of Orthodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Centre for Craniofacial Development and Regeneration, King's College London, London, United Kingdom
| | - Guy H Carpenter
- Department of Mucosal Biology, Faculty of Dentistry, Oral and Craniofacial Sciences, Centre for Host Disease, King's College London, London, United Kingdom
| | - Anthony J Ireland
- Department of Orthodontics, University of Bristol Dental School, London, United Kingdom
| | - Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Martyn T Cobourne
- Department of Orthodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Centre for Craniofacial Development and Regeneration, King's College London, London, United Kingdom.
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Leveling and alignment time and the periodontal status in patients with severe upper crowding treated by corticotomy-assisted self-ligating brackets in comparison with conventional or self-ligating brackets only: a 3-arm randomized controlled clinical trial. J World Fed Orthod 2021; 11:3-11. [PMID: 34688577 DOI: 10.1016/j.ejwf.2021.09.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/21/2021] [Accepted: 09/21/2021] [Indexed: 12/17/2022]
Abstract
INTRODUCTION The lengthy period of time required is one of the main reasons patients refuse orthodontic treatment. In addition, treatment may have negative effects on periodontal tissues. OBJECTIVE This study aimed to evaluate the overall time needed for leveling and alignment and the periodontal indices in adult patients with severe crowding. Patients were treated using either self-ligating brackets associated with flapless corticotomy (SLBs + FC group), self-ligating brackets alone (SLBs group), or conventional brackets (CBs group) alone. MATERIALS AND METHODS A total of 57 adult patients (10 male patients, 47 female patients) referred to the Department of Orthodontics, the University of Damascus Dental School from August 2018 to March 2019, were enrolled in this trial. The patients were randomly allocated to 1 of 3 groups: CBs (mean age: 19.62 ± 2.42 years), SLBs (mean age: 19.98 ± 2.84 years), or SLBs + FC (mean age: 20.67 ± 2.59 years). The overall alignment time for the upper anterior teeth was calculated. The following periodontal parameters were measured at 5 assessment times: plaque index, gingival index, papillary bleeding index, and probing depth. RESULTS The average leveling and alignment time was 81.89 ± 9.49 days, 123 ± 10.69 days, and 165.25 ± 13.05 days for the SLBs + FC group, the SLBs group, and the CBs group, respectively. A significant reduction in the overall alignment duration was found in the SLBs + FC group by 50%, and in the SLBs group by 25%, compared to the control group, with a statistically significant difference among the 3 groups (P < 0.001). There were statistically significant differences in the periodontal indices (except probing depth) after 1 month, with values greater in the SLBs + FC group (P < 0.05). CONCLUSIONS Using self-ligating brackets in combination with flapless corticotomy may be effective in accelerating upper dental decrowding in adult patients, with a reduction of 50% of the normal treatment time using traditional brackets. Using self-ligating brackets alone reduced treatment time by 25%. The adjunctive flapless corticotomy did not cause clinically negative effects on the periodontal tissues.
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