Evaluation of the effectiveness of the platelet-rich plasma compared to the injectable platelet-rich fibrin on the rate of maxillary canine retraction: a three-arm randomized controlled trial

BACKGROUND

Blood-derived materials have been used recently to accelerate orthodontic tooth movement, but there are conflicting reports on their effectiveness.

OBJECTIVE

To evaluate the potential effect of local injection of platelet-rich plasma (PRP) and injectable platelet-rich fibrin (i-PRF) on the rate of orthodontic tooth movement.

TRIAL DESIGN

A single-center, three-arm, parallel-group randomized controlled trial.

MATERIALS AND METHODS

The sample consisted of 60 patients aged between 18 and 25 years (mean age: 21.1 ± 2.2 years) with Class II division 1 malocclusion requiring anterior retraction. Using a computer-generated list of random numbers, patients were assigned to three groups of canine retraction: (i) assisted with PRP injection (PRP group), (ii) assisted with i-PRF group, and (iii) conventional treatment with no injections (Cont. group). In the interventional groups, injections were done immediately and at 8 weeks after the onset of canine. Transpalatal arches (TPAs) were used to reinforce anchorage. The upper canines were distalized on 0.019 × 0.025-inch stainless archwires using coil springs with a force of 150 g. The primary outcome was the amount of canine retraction, whereas the secondary outcomes were canine rotation and anchoring loss. Assessment was done at five-time points: the beginning of tooth movement (T0) and at 4, 8, 12, and 16 weeks following T0 on three-dimensional superimposed digital models.

RESULTS

Sixty patients were randomized and included in this study (20 patients in each group), there were no dropouts. The rate of canine retraction was faster in the experimental groups. The PRP group showed a significantly slower movement in the second and fourth months than the i-PRF group while in the first and third months, there were nonsignificant differences between the two experimental groups.

LIMITATIONS

Blinding was not possible during the clinical stage of this trial.

CONCLUSIONS

PRP and i-PRF were found to be effective in accelerating orthodontic tooth movement during canine retraction. However, the effect of i-PRF was longer than that of PRP.

TRIAL REGISTRATION

ClinicalTrials.gov (ID: NCT05335824).

A Novel Method to Accelerate Orthodontic Tooth Movement Using Low-Intensity Direct Electrical Current in Patients Requiring en-Masse Retraction of the Upper Anterior Teeth: A Preliminary Clinical Report

BACKGROUND

Shortening the duration of orthodontic treatment by speeding up the rate of tooth movement has become an essential goal for both orthodontists and patients. This preliminary report aimed to investigate the safety and effectiveness of a new intraoral removable electrical device in accelerating the en-masse retraction of the upper anterior teeth using low-intensity direct electrical current.

METHODS

This prospective preliminary interventional clinical study was conducted at the Department of Orthodontics, Faculty of Dentistry, Damascus University, Syria, between March 2019 and February 2020. The sample consisted of six patients (four females and two males; mean age: 19.55 ± 0.89 years) whose initial diagnosis was class II division I malocclusion, and their treatment plan suggested the extraction of upper first premolars followed by en-masse retraction. The electrical stimulation was applied on the maxillary anterior region during the en-masse retraction phase using a specially fabricated removable device that was designed by two coauthors of this manuscript (RIS, MYH). Patients were asked to wear their own electrical devices inside their mouths for five hours daily. The primary outcomes were the en-masse retraction rate and duration. The secondary outcomes were safety and patient acceptance.

RESULTS

The average total retraction rate during the treatment period was 0.97±0.06 mm/month. The total amount of retraction achieved during follow-up was 5.65 ± 0.85 mm, which was about 91.86% of the space resulting from the extraction of the upper first premolars. The mean treatment duration to complete the en-masse retraction was 5.66±0.81 months. No side effects of the electrical stimulation were found during the follow-up.

CONCLUSIONS

Low-intensity direct electrical current could be an effective method to accelerate orthodontic movement. The electrical accelerating device used in this study effectively increased the en-masse retraction rate of the upper anterior teeth without any side effects and with high patient acceptance.

Treatment of Moderately Crowded Teeth Using Lingual Fixed Appliance Prepared by a Modified HIRO® Technique: A Case Report and Method Description

There are various manual laboratory methods available for indirect positioning and bonding of lingual brackets. The manual setup has limitations because of its complicated laboratory procedures and requires time and specialized laboratory equipment. In addition, the manual method is also prone to human errors. In this case report, a description of a new method of laboratory preparation for the indirect bonding of lingual brackets is given by merging recent advances in digital dentistry with some of the ordinary manual steps in this field. Therefore, the well-known HIRO® technique has been modified by using the three-dimensional (3D) virtual setup instead of the traditional manual setup. This method does not require the use of any specialized laboratory equipment, and it is also cost-effective for patients who cannot afford fully customized lingual appliances. In this modified technique, 3Shape Ortho Analyzer™ software (3Shape, Copenhagen, Denmark) and a 3D printer (Prusa® i3 mk3; Prusa Research, Prague, Czech Republic) were used to align the teeth three-dimensionally into their desired positions and to produce the final working printed model on which lingual brackets were placed, and transfer caps were fabricated for clinical use.

Effect of the leukotriene receptor antagonist montelukast on orthodontic tooth movement

Asthma is a chronic inflammatory disease, and its prevalence is relatively high among children. Optimal management of asthma often requires long-term pharmacotherapy; however, the effects of these medications on orthodontic treatment is uncertain. We evaluated the effects of the leukotriene LTD₄ receptor antagonist montelukast on orthodontic tooth movement in an animal model. Eight mongrel dogs were given montelukast for periods up to 4 weeks. An orthodontic force of 150-200 g was applied to move the second and fourth premolars toward the site of the extracted third premolar. The distance between premolars was measured at baseline and at weeks 1, 2, and 4. Histological examination with hematoxylin-eosin staining was used to evaluate osteoclast activity. A slight delay in orthodontic movement and decreased osteoclast activity were observed in the montelukast-treated group, as compared with untreated controls. However, the differences were not statistically significant (P > 0.05). Our findings suggest that montelukast use will not interfere with orthodontic treatment of asthma patients. However, these findings require confirmation in clinical studies.

An evaluation of two types of nickel-titanium wires in terms of micromorphology and nickel ions' release following oral environment exposure

Background

This study aimed to compare superelastic and heat-activated nickel-titanium orthodontic wires’ surface morphology and potential release of nickel ions following exposure to oral environment conditions.

Methods

Twenty-four 20-mm-length distal cuts of superelastic (NiTi Force I®) and 24 20-mm-length distal cuts of heat-activated (Therma-Ti Lite®) nickel-titanium wires (American Orthodontics, Sheboygan, WI, USA) were divided into two equal groups: 12 wire segments left unused and 12 segments passively exposed to oral environment for 1 month. Scanning electron microscopy and atomic force microscopy were used to analyze surface morphology of the wires which were then immersed in artificial saliva for 1 month to determine potential nickel ions’ release by means of atomic absorption spectrophotometer.

Results

Heat-activated nickel-titanium (NiTi) wires were rougher than superelastic wires, and both types of wires released almost the same amount of Ni ions. After clinical exposure, more surface roughness was recorded for superelastic NiTi wires and heat-activated NiTi wires. However, retrieved superelastic NiTi wires released less Ni ions in artificial saliva after clinical exposure, and the same result was recorded regarding heat-activated wires.

Conclusions

Both types of NiTi wires were obviously affected by oral environment conditions; their surface roughness significantly increased while the amount of the released Ni ions significantly declined.

Maxillary dental arch changes following the leveling and alignment stage with lingual and labial orthodontic appliances: a preliminary report of a randomized controlled trial

BACKGROUND

No randomized controlled trial has tried to compare transverse dental arch changes between the lingual and labial orthodontic fixed appliances in the early stage of treatment.

OBJECTIVE

To compare upper dental arch changes between lingual and labial fixed orthodontic appliances after leveling and alignment.

DESIGN, SETTING

Parallel-groups randomized controlled trial on patients with class I moderate crowding teeth treated at the University of Al-Baath Dental School in Hamah, Syria.

PARTICIPANTS

About 102 patients with crowded teeth and class I malocclusion were evaluated and 58 patients fulflled the inclusion criteria. Randomization was performed using computer generated tables; allocation was concealed using sequentially numbered opaque and sealed envelopes. About 52 participants were analyzed (mean age 21.5 ± 3.2 years). They were randomly distributed into two groups with 26 patients in each (1:1 allocation ratio).

INTERVENTION

Lingual vs labial fixed orthodontic appliances were used.

MAIN OUTCOME MEASURE

Intercanine width, interpremolar width, intermolar width, and arch length were measured on study models before brackets' placement (T1), at the end of leveling and alignment stage (T2).

RESULTS

Statistically significant increase was detected in the intercanine width in the lingual group (1.99 mm, p < 0.001) and in the labial group (1.22 mm, p < 0.001). The interpremolar width had a significant decrease in the lingual group (-0.70 mm, p < 0.001), whereas there was a significant increase in this width in the labial group (1.73 mm, p < 0.001). A significant decrease in intermolar width was detected in the lingual group (-0.79 mm, p < 0.001) whereas a significant increase was observed in the labial group (0.81 mm, p < 0.001). The differences between the two groups were significant for all comparisons (p < 0.001).

CONCLUSION

The labial appliance produced a significant increase in all horizontal transverse arch dimensions, whereas in the lingual appliance group the intercanine width increased significantly in conjunction with a significant narrowing of posterior segments.

FUNDING

The University of Al-Baath Postgraduate Research Budget (UBDS-00786223-PG).

Speech performance and oral impairments with lingual and labial orthodontic appliances in the first stage of fixed treatment

OBJECTIVES

To compare (1) speech performance based on an auditive analysis and sonagraphy and (2) levels of oral impairment between fixed lingual and labial orthodontic appliances.

MATERIALS AND METHODS

Thirty-four patients with Class I division 1 malocclusion and moderate crowding of upper teeth were distributed randomly into two groups. Seventeen patients in group A (mean age: 20.6 years; standard deviation [SD]: 2.9 years) were treated with fixed lingual appliances (Stealth®, AO, Sheboygan, Wisc), whereas 17 patients in group B (mean age: 21.8 years; SD: 3.3 years) were treated with conventional fixed labial appliances. Speech performance was tested using spectrographic analysis of fricative /s/ sound before, immediately after (T1), 1 month after, and 3 months after bracket placement. The levels of oral impairment were assessed using standardized questionnaires.

RESULTS

A significant deterioration in articulation was recorded at all assessment times in group A but only at T1 in group B. Significant intergroup differences were recorded at all assessment times (P < .001). Speech difficulties were significantly higher in the lingual brackets group after 1 month of bracket placement (P < .001). Soft tissue irritation and chewing difficulty were significantly higher in the lingual appliance group after 24 hours of bracket placement (P < .001).

CONCLUSIONS

The lingual appliance is more problematic than the labial one in terms of speech articulation. Although patients with both appliances suffered from different degrees of oral impairment, patients with lingual appliances had more untoward effects, particularly during the first month of treatment.