Incorporation of Zirconium Oxide Nanoparticles in Adhesive Resin for Bonding of Brackets to Enamel Conditioned with Er,Cr:YSGG, Photodynamic Therapy, and Phosphoric Acid

Objective: To evaluate the effect of enamel conditioning methods, that is, total-etch and rinse (TER), Er,Cr:YSGG (ECYL), and photodynamic therapy (PDT) on the shear bond strength (SBS) of orthodontic metallic brackets bonded using Zirconium oxide experimental adhesive (ZOEA). Methods: Sixty human incisor buccal surfaces were cleaned and allocated into three groups based on the method of enamel surface treatment, that is, TER using 37% phosphoric acid gel, methylene blue photosensitizer activated by PDT and ECYL (n = 20 each). Each group was further divided into two subgroups (n = 10) based on the type of adhesive, that is, ZOEA and experimental adhesive (EA). Metallic brackets were seated using composite resin. Samples were placed in a universal testing machine for SBS and failure mode using the ARI index. One-way analysis of variance and post hoc Tukey were used for multiple comparisons. ARI was presented in percentages in different investigated groups. Results: TER+ZOEA (17.16 ± 0.41 MPa) displayed the highest bond integrity. However, group PDT+EA (11.34 ± 0.25 MPa) demonstrated the lowest bond scores. The intergroup comparison revealed that the TER system displayed significantly higher SBS values than the PDT and ECYL groups (p < 0.05). The intragroup comparison revealed that enamel conditioned with TER and brackets bonded with ZOEA and EA displayed comparable bond integrity (p > 0.05). Conclusions: Enamel conditioned with TER bonded to a metallic bracket displayed better bond strength than PDT and ECYL. Zirconium oxide nanoparticles incorporated in adhesive have proved to be promising in improving the bond integrity of adhesive.

Effect of ten different biomarkers in the gingival crevicular fluid of obese and non-obese undergoing fixed orthodontic treatment

OBJECTIVE

The aim of this study is to evaluate the effect of ten proinflammatory cytokines in GCF of participants with raised body mass index (BMI) compared to non-obese subjects undergoing fixed orthodontic treatment.

PATIENTS AND METHODS

In the cross-sectional cohort, subjects were shortlisted through the purposive sampling method with the same age and gender and similar characteristics (cohort). For inclusion and exclusion, predefined criteria were followed. In all included participants obese and non-obese collection of GCF was made from mandibular canine to canine. Identification of inflammatory mediators (MPO and CRP) leptin, adiponectin, and resistin (pg/mL). Bone remodeling biomarkers RANKL (pg/mL) and tissue remodeling biomarkers MMP8, MMP9, TIMP1, and MMP8/TIMP1, MMP9/TIMP1 ratio were collected and blinded by the investigator. Normal distribution of data i.e., age, BMI, the flow rate of GCF, indices plaque and gingival, and uWMS were compared using a t-test. Non-normality biomarker data were evaluated using Mann-Whitney U-test. To assess the relationship between the concentration of GCF biomarkers and plaque and gingival indices Pearson and Spearman correlation coefficients were used.

RESULTS

The total number of participants included was 44. In the obese and non-obese groups, the male/female ratio was the same i.e., (n=11 each). The mean age of participants in the obese group was (25.7±1.55 years), whereas the non-obese group was (26.1±1.29 years). In obese the mean BMI was (33.6±2.1 kg/m2) whereas in non-obese (22.9±1.9 kg/m2) (p<0.02). Among the levels of biomarkers adiponectin (p<0.006) and leptin (p<0.028) demonstrated a significant difference between obese and non-obese participants. Also, a significant difference was noted between obese and non-obese in tissue remodeling biomarker MMP9 (p<0.03).

CONCLUSIONS

A surge in the level of the biomarkers, i.e., MMP9, leptin, and adiponectin in the gingival crevicular fluid is found in obese undergoing fixed orthodontic treatment.

Periodontal, Microbiological, and Proinflammatory Cytokines Levels in Fixed Orthodontics Patients Treated with Photodynamic Therapy Adjunct to Full Mouth Scaling

Objective: To assess the efficiency of photodynamic therapy (PDT) adjunct to full mouth scaling (FMS) in improving periodontal, microbiological, and proinflammatory cytokines levels in patients undergoing fixed orthodontics treatment (FOT). Materials and methods: The study recruited 60 teenage patients who were undergoing FOT. All the patients were arbitrarily divided into two groups: Group 1, FMS +PDT and Group 2, FMS alone. Plaque scores (PS), bleeding on probing (BOP), and probing depth (PD) were assessed. Levels of biomarkers interleukin (IL)-6 and tumor necrosis factor-alpha (TNF-α) using enzyme-linked immunosorbent assay were evaluated. Samples were collected from gingival plaque for estimation of Prevotella intermedia and Porphyromonas gingivalis load. All measurements were completed at three intervals baseline, 4th week, and 8th week. Post Hoc corrections and intergroup comparisons were examined using Student's t-test and Bonferroni correction. To find differences between repeated follow-ups, analysis of variance (ANOVA) multiple rank tests were used. Results: At baseline, all the gingival parameters displayed comparable outcomes between patients of Group 1 and Group 2 (p > 0.05). However, at 4 and 8 weeks of follow-up, PS and BOP among tested groups exhibited significantly lower values than baseline (p < 0.001). At 8 weeks, there was a significant difference in PS between the two groups tested. Moreover, at 4 and 8 weeks, BOP revealed a significant difference between the groups. PD remains comparable with baseline at follow-up visits (p > 0.05). A significant decrease in IL-6 and TNF-α levels was observed in both investigated groups at 4 and 8 weeks of baseline. Moreover, it was identified that P. intermedia and P. gingivalis were reduced significantly at 4 weeks. Moreover, a significant difference existed between both Group 1 and Group 2 at 4 and 8 weeks of recall visit (p < 0.05). Conclusions: The use of photodynamic treatment adjuvant to FMS aids in improving periodontal parameters and cytokines levels.

Applications of artificial intelligence and machine learning in orthodontics

Over the past two decades, artificial intelligence (AI) and machine learning (ML) have undergone considerable development. There have been various applications in medicine and dentistry. Their application in orthodontics has progressed slowly, despite promising results. The available literature pertaining to the orthodontic applications of AI and ML has not been adequately synthesized and reviewed. This review article provides orthodontists with an overview of AI and ML, along with their applications. It describes state-of-the-art applications in the areas of orthodontic diagnosis, treatment planning, growth evaluations, and in the prediction of treatment outcomes. AI and ML are powerful tools that can be utilized to overcome some of the clinical problems that orthodontists face daily. With the availability of more data, better AI and ML systems should be expected to be developed that will help orthodontists practice more efficiently and improve the quality of care.