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Abu Arqub S, Al-Moghrabi D, Allareddy V, Upadhyay M, Vaid N, Yadav S. Content analysis of AI-generated (ChatGPT) responses concerning orthodontic clear aligners. Angle Orthod 2024; 94:263-272. [PMID: 38195060 PMCID: PMC11050467 DOI: 10.2319/071123-484.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 11/01/2023] [Indexed: 01/11/2024] Open
Abstract
OBJECTIVES To assess the accuracy of ChatGPT answers concerning orthodontic clear aligners. MATERIALS AND METHODS A cross-sectional content analysis of ChatGPT generated responses to queries related to clear aligner treatment (CAT) was undertaken. A total of 111 questions were generated by three orthodontists based on a set of predefined domains and subdomains. The artificial intelligence (AI)-generated (ChatGPT) answers were extracted and their accuracy was determined independently by five orthodontists. The accuracy of answers was assessed using a prepiloted four-point scale scoring rubric. Descriptive statistics were performed. RESULTS The total mean accuracy score for the entire set was 2.6 ± 1.1. It was noted that 58% of the AI-generated answers were scored as objectively true, 18% were selected facts, 9% were minimal facts, and 15% were false. False claims included the ability of CAT to reduce the need for orthognathic surgery (4.0 ± 0.0), improve airway function (3.8 ± 0.5), achieve root parallelism (3.6 ± 0.5), alleviate sleep apnea (3.8 ± 0.5), and produce more stable results compared to fixed appliances (3.8 ± 0.5). CONCLUSIONS The overall level of accuracy of ChatGPT responses to questions concerning CAT was suboptimal and lacked citations to relevant literature. Ability of the software to offer current and precise information was limited. Therefore, clinicians and patients must be mindful of false claims and relevant facts omitted in the answers generated by ChatGPT.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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AlMoharib HS, Alqasem A, Almusfer G, Aldosari MA, Almadhoon HW. The effectiveness of water jet flossing and interdental flossing for oral hygiene in orthodontic patients with fixed appliances: a randomized clinical trial. BMC Oral Health 2024; 24:498. [PMID: 38678246 DOI: 10.1186/s12903-024-04166-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 03/19/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Orthodontic treatment presents challenges with plaque accumulation around brackets, archwires, and elastics, leading to retained plaque and gingival inflammation. Conventional toothbrushing may not be enough, requiring additional oral hygiene aids like interproximal brushes, dental flosses, and water flossers. Limited research exists on comparing water flossing and interdental flossing in orthodontic patients. Therefore, this study aims to assess their effectiveness in maintaining oral hygiene during active orthodontic treatment. METHODS A single-blind, randomized, parallel clinical study recruited orthodontic patients with full-mouth brackets and archwires. Thirty participants were randomly assigned to either water jet flossing or interdental flossing groups. All participants were instructed to brush twice daily with a provided toothbrush and toothpaste and use the assigned intervention once daily at night. Clinical measures, including the Gingival Bleeding Index (BI), Plaque Index (PI), and Gingival Index (GI), were recorded at baseline and day 14. Descriptive statistics and statistical tests were performed using SPSS software. RESULTS The water jet flossing group demonstrated a slightly higher, albeit non-significant, benefit in plaque removal (median difference of 6.79%%, P = 0.279) and bleeding reduction (median difference of 5.21%%, P = 0.172) compared to the interdental flossing group after two weeks. Both groups showed significant reductions in gingival bleeding index and plaque index from baseline to the 2-week follow-up. The interdental flossing group had median mean percentage differences of 16.13%% (plaque index) and 23.57% (gingival bleeding index), while the water jet flossing group had median percentage differences of 21.87% (plaque index) and 32.29% (gingival bleeding index). No significant changes in gingival index grades were observed in either group. CONCLUSION Both water jet flossing and interdental flossing were effective in reducing plaque accumulation and gingival bleeding among orthodontic patients. While no significant differences were found between the two methods, water jet flossing showed a potential advantage. Further research is needed to validate its effectiveness, assess long-term impact, and understand its benefits for orthodontic patients.
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Affiliation(s)
- Hani S AlMoharib
- Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Afyaa Alqasem
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
| | - Ghaida Almusfer
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad A Aldosari
- Orthodontics and Pediatric Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Namura Y, Pullisaar H, Holm HV, Syverud M, Mulic A, Vandevska-Radunovic V. Elemental composition, corrosion resistance and mechanical properties of computer-aided design and computer-aided manufacturing fixed retainers versus conventional fixed retainers. J Oral Sci 2024; 66:107-110. [PMID: 38403676 DOI: 10.2334/josnusd.23-0303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
PURPOSE To investigate the elemental composition, corrosion resistance, and mechanical properties of computer-aided design and computer-aided manufacturing (CAD-CAM) retainers versus conventional fixed retainers (FRs). METHODS Eight different retainer wires were investigated. Energy dispersive X-ray spectroscopy was used to determine the elemental composition. Leakage was analysed according to ISO 10271:2020 guidelines. Hardness was tested using the Vickers method with a load of 0.3 kg. The tensile force and tensile strength were evaluated. Multiple comparisons among wires of hardness, tensile force, and strength were conducted using the Welch t-test, with Bonferroni correction. RESULTS Nickel was present in all wires. The CAD-CAM-FR wire, which contained more nickel than the other wires, had no measurable leakage. The gold-plated wires had the highest total leakage, but did not exceed the ISO standard limit. The hardness of the stainless-steel twisted wires was the highest and that of the CAD-CAM-FR wire was the lowest. The tensile strength of the CAD-CAM-FR wire was significantly lower than that of the other wires and similar to the other twisted-wire retainers. CONCLUSION The CAD-CAM-FR wire is likely to have high corrosion resistance and flexibility due to its low hardness.
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Affiliation(s)
- Yasuhiro Namura
- Department of Orthodontics, Nihon University School of Dentistry
| | - Helen Pullisaar
- Section of Orthodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo
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Alhamwi AM, Burhan AS, Idris MI, Nawaya FR. Duration of orthodontic treatment with clear aligners versus fixed appliances in crowding cases: a systematic review. Clin Oral Investig 2024; 28:249. [PMID: 38607436 DOI: 10.1007/s00784-024-05629-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 03/20/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVE To critically appraise and assess the currently observed evidence about the difference in orthodontic treatment duration between clear aligners and fixed appliances in crowding cases. MATERIALS AND METHODS An electronic search without limitations was conducted from inception to June 2023 covering nine databases: The Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Scopus, Web of Science, Google Scholar, Trip, CINAHL via EBSCO, EMBASE via OVID and ProQuest. Randomized controlled trials (RCTs) and matched non-randomized studies were included in this systematic review. Risk of Bias was assessed via Cochrane's tool (RoB 2) for RCTs and ROBINS-I tool for non-randomized studies. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework was employed to evaluate the overall quality of evidence. RESULTS Out of the 3537 articles initially identified, ten eligible studies were included in this systematic review; six were RCTs. Only one study offered extraction-based treatment, while the other nine adopted non-extraction treatments. According to the GRADE, there is low evidence that treatment duration in mild to moderate crowding cases with clear aligners is similar to that in fixed orthodontic appliances. Meta-analysis was not administered due to high inconsistency. CONCLUSIONS Based on currently available information, there was no significant difference in the treatment duration between the CA and FA groups in mild to moderate crowding cases. Further well-performed RCTs, especially in severe cases, are required. CLINICAL RELEVANCE Time efficiency is an essential outcome measure for clinical orthodontic practice. While the type of appliance used is a critical determinant of treatment duration, orthodontists should be aware of other factors that can significantly impact treatment time, such as patient and treatment-related factors.
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Affiliation(s)
- Ahmad Marwan Alhamwi
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Al Mazzeh Street, Damascus, Syria.
| | - Ahmad Sharafeddin Burhan
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Al Mazzeh Street, Damascus, Syria
| | - Mohammad Ibrahim Idris
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Al Mazzeh Street, Damascus, Syria
| | - Fehmieh Rafik Nawaya
- Department of Pediatric Dentistry, Faculty of Dentistry, Syrian Private University, Damascus, Syria
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Kusaibati AM, Sultan K, Hajeer MY, Gkantidis N. Digital setup accuracy for moderate crowding correction with fixed orthodontic appliances: a prospective study. Prog Orthod 2024; 25:13. [PMID: 38584176 PMCID: PMC10999400 DOI: 10.1186/s40510-024-00513-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/08/2024] [Indexed: 04/09/2024] Open
Abstract
OBJECTIVES To evaluate the accuracy of a semi-automatic 3D digital setup process in predicting the orthodontic treatment outcome achieved by labial fixed appliances. SUBJECTS AND METHODS Twenty-five adult patients (18 to 24 years old) with class I malocclusion and moderate crowding were prospectively enrolled and received treatment on both jaws through the straight-wire technique. Prior to treatment commencement, a semi-automatic digital setup simulating the predicted treatment outcome was performed for each patient through Orthoanalyzer software (3Shape®, Copenhagen, Denmark) to obtain the prediction model. This was compared to the final outcome model through 3D superimposition methods. Metric variables and inspection of color-coded distance maps were used to detect how accurately the digital setup predicts the actual treatment outcome. RESULTS The mean absolute distances (MAD) between the superimposed dental arches of the predicted and the final models were: 0.77 ± 0.13 mm following superimposition on the palate, 0.52 ± 0.06 mm following superimposition on the maxillary dental arch, and 0.55 ± 0.15 mm following superimposition on the mandibular dental arch. The MAD at the palatal reference area was 0.09 ± 0.04 mm. Visualization of color-coded distance maps indicated that the digital setup accurately predicted the final teeth position in a few cases. Almost half of the cases had posteriorly wider upper and lower dental arches and palatally/lingually positioned or inclined anterior teeth, whereas the rest still showed errors within 2-3 mm, distributed over the entire dental arches with no distinct pattern. CONCLUSIONS The accuracy of semi-automatic prediction of the labial fixed appliance treatment outcome in Class I cases with moderate crowding is not yet sufficient. While average measures showed deviations less than 1 mm, examination of individual color-coded distance maps revealed significant disparities between the simulated and the actual results.
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Affiliation(s)
| | - Kinda Sultan
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus, Syria
| | - Mohammad Younis Hajeer
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus, Syria
| | - Nikolaos Gkantidis
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland.
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Souza GLN, de Campos França E, de Araújo Lombardi M, da Costa GC, da Rocha NB, Abreu LG. Impact of treament with orthodontic aligners on the oral health-related quality of life. BMC Oral Health 2024; 24:419. [PMID: 38580945 PMCID: PMC10996220 DOI: 10.1186/s12903-024-04183-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 03/26/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND There is an increasing interest in information on the effects of orthodontic aligners on the oral health-related quality of life (OHRQoL) of people. AIM To compare the impact of orthodontic aligners versus conventional fixed appliances on OHRQoL, using a validated tool and controlling for sociodemographic and clinical variables. METHOD Sixty-one individuals participated in this study. Group 1 (G1) consisted of 33 individuals under treatment with orthodontic aligners and Group 2 (G2) comprised 28 individuals under treatment with conventional fixed appliances. OHRQoL was evaluated with the Oral Health Impact Profile (OHIP-14) in which 14 items are distributed across seven dimensions: functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap. The higher the score, the more negative is the perception of the individual regarding his/her OHRQoL. Descriptive statistics, Mann-Whitney test, and Poisson regression were performed. Effect Size (ES) and Minimal Clinically Important Difference (MCID) were also determined. RESULTS Participants' mean age was 30.69 years. Individuals in G1 had a significantly lower score for physical pain and the total score of OHIP-14 compared to individuals in G2 (p < 0.05). The ES was large (ES = 0.74) for physical pain and moderate (ES = 0.46) for the total score. The ES was moderate for physical disability (ES = 0.50). The difference between groups for physical pain (1.30) and for physical disability (0.90) was greater than the MCID (0.87 and 0.88, respectively). Poisson regression showed that G2 individuals showed a score for physical pain 1.39 times higher than those of G1 in the adjusted model (OR = 1.39, [1.03-1.89], p = 0.031). CONCLUSION Those under treatment with orthodontic aligners have a more positive perception of OHRQoL compared to those wearing fixed appliances.
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Affiliation(s)
- Gabriela Luiza Nunes Souza
- Department of Pediatric Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | | | - Najara Barbosa da Rocha
- Department of Social and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lucas Guimarães Abreu
- Department of Pediatric Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, Pampulha, Belo Horizonte, 6627, MG, Brazil.
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Song JH, Lee JH, Joo BH, Choi YJ, Chung CJ, Kim KH. Treatment outcome comparison of Invisalign vs fixed appliance treatment in first premolar extraction patients. Am J Orthod Dentofacial Orthop 2024; 165:399-413. [PMID: 38142394 DOI: 10.1016/j.ajodo.2023.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 10/01/2023] [Accepted: 10/01/2023] [Indexed: 12/25/2023]
Abstract
INTRODUCTION In this study, we compared the dentitional changes after Invisalign and conventional orthodontic treatment with 4 first premolar extractions. METHODS This retrospective study included 57 patients whose orthodontic treatment involved the extraction of 4 first premolars because of bialveolar protrusion. A total of 27 patients were treated with Invisalign (mean age, 25.5 ± 5.2 years) and 30 patients with the fixed appliance (mean age, 24.4 ± 5.8 years). The angular and linear changes of the maxillary and mandibular central incisors, second premolars, first molars, and second molars were measured from the recordings on the basis of the lateral cephalograms taken before and after treatment. The angular changes of the canines and second premolars were measured using panoramic radiographs. RESULTS The overbite and interincisal angle increased significantly in the Invisalign group compared with in the conventional fixed appliance group (P <0.05). The maxillary central incisors showed increased lingual tipping in the Invisalign group (P <0.05), whereas there was no statistically significant difference in the angular change of the mandibular incisors between groups (P >0.05). The maxillary first and second molars showed mesial tipping in the Invisalign group (P <0.05). The maxillary second premolars, first and second molars, and the mandibular second molars showed mesial movement in the Invisalign group (P <0.05). CONCLUSIONS The Invisalign group showed more statistically significant lingual tipping of the maxillary central incisors, distal tipping of the maxillary canines, and mesial tipping of the maxillary first and second molars after maximum retraction of the anterior teeth compared with the fixed appliance group.
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Affiliation(s)
- Ji-Hye Song
- Department of Orthodontics, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, South Korea
| | - Ji-Hyun Lee
- Department of Orthodontics, Gangnam Severance Dental Hospital, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, South Korea
| | - Bo-Hoon Joo
- The Institute of Clear Aligner Center of The STAR 28 Dental Group, Seoul, South Korea
| | - Yoon Jeong Choi
- Department of Orthodontics, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, South Korea
| | - Chooryung J Chung
- Department of Orthodontics, Gangnam Severance Dental Hospital, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, South Korea
| | - Kyung-Ho Kim
- Department of Orthodontics, Gangnam Severance Dental Hospital, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, South Korea.
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Pullisaar H, Cattaneo PM, Gera A, Sankiewicz M, Bilińska M, Vandevska-Radunovic V, Cornelis MA. Stability, survival, patient satisfaction, and cost-minimization of CAD/CAM versus conventional multistranded fixed retainers in orthodontic patients: a 2-year follow-up of a two-centre randomized controlled trial. Eur J Orthod 2024; 46:cjae006. [PMID: 38394353 PMCID: PMC10888518 DOI: 10.1093/ejo/cjae006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
BACKGROUND CAD/CAM (computer-aided design/computer-aided manufacturing) fixed retainers (FRs) as an alternative to multistranded FRs to maintain orthodontic treatment outcome. OBJECTIVES The primary aim was to compare CAD/CAM versus conventional multistranded FRs in terms of stability until 2 years. Secondary outcomes were failure rates, patient satisfaction, and cost-minimization. TRIAL DESIGN 2-arm parallel, two-centre randomized controlled trial. METHODS Patients were randomized to CAD/CAM or conventional FRs in both arches, in a 1:1 ratio and blocks of four. Allocation concealment was secured by using sequentially numbered envelopes. Patients were blinded. FRs were bonded at the end of treatment, and patients were recalled after 12 and 24 months. First-time retainer failures were recorded and digital impressions were taken. Arch widths and lengths, as well as Little's Irregularity Index (LII), were measured. Additionally, patients answered satisfaction questionnaires. Linear mixed models were applied for measurements and patient satisfaction. Survival analyses were estimated with Kaplan-Meier curves, along with Cox-regression modelling. Cost-minimization analysis was undertaken. RESULTS One hundred and eighty-one patients were randomized (98 in Centre 1, and 83 in Centre 2): 90 in CAD/CAM and 91 in conventional group. One hundred and fifty three patients attended T24 follow-up. There were no significant differences in LII and arch dimensions between groups for failure-free patients. Within 24 months, 34% maxillary CAD/CAM FRs and 38% maxillary conventional FRs failed, along with 42% mandibular CAD/CAM FRs and 40% mandibular conventional FRs, with no significant difference in survival between groups (hazard ratios conventional to CAD/CAM: maxillary arch: 1.20 [P = 0.46], mandibular arch: 0.98 [P = 0.94]). There were no significant differences in patient satisfaction between groups. No harms were observed. Cost-minimization analysis showed that CAD/CAM FRs were slightly cheaper than conventional FRs. CONCLUSIONS There were no clinically significant differences in LII, arch widths, and lengths between CAD/CAM and conventional FRs after 24 months. There were no differences in failures and patient satisfaction between groups. CAD/CAM FRs were slightly cheaper than conventional FRs. TRIAL REGISTRATION ClinicalTrials.gov NCT04389879.
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Affiliation(s)
- Helen Pullisaar
- Department of Orthodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Geitmyrsveien 69/71, Oslo 0455, Norway
| | - Paolo M Cattaneo
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Boulevard 9, 8000 Aarhus C, Denmark
| | - Arwa Gera
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Boulevard 9, 8000 Aarhus C, Denmark
| | - Monika Sankiewicz
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Boulevard 9, 8000 Aarhus C, Denmark
| | - Małgorzata Bilińska
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Boulevard 9, 8000 Aarhus C, Denmark
| | - Vaska Vandevska-Radunovic
- Department of Orthodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Geitmyrsveien 69/71, Oslo 0455, Norway
| | - Marie A Cornelis
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Boulevard 9, 8000 Aarhus C, Denmark
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Guo Z, Zhang R, Guo C, Li X, Jin Z, Liu Q. A retrospective study of alveolar bone remodelling after anterior retraction in orthodontic tooth extraction cases with clear aligners and fixed appliances. Orthod Craniofac Res 2024; 27:220-227. [PMID: 37578004 DOI: 10.1111/ocr.12705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 07/24/2023] [Accepted: 08/03/2023] [Indexed: 08/15/2023]
Abstract
OBJECTIVES To evaluate alveolar bone dimensions and its relationship with tooth movement (retraction, intrusion and torque) during orthodontic treatment with fixed appliance and clear aligners. METHODS Thirty-two patients were included in this retrospective clinical study. Cone beam computed tomography (CBCT) was collected before and after treatment to measure the volume of dehiscence and fenestrations in the maxillary anterior region, anterior alveolar bone thickness and height and degree of tooth movement. Rank-sum tests were used to compare the differences in alveolar bone defect volumes between clear aligners and fixed appliance, multiple linear regression analysis was used for study evaluation, and kappa statistics were used to assess internal consistency and test-retest reliability. RESULTS Post-operatively, most alveolar bone defects occurred on the labial side. The incidence of bone fenestration was 23.96% in the clear aligner group and 26.18% in the fixed appliance group, which was higher than the incidence of bone dehiscence (5.21%). The labial bone height decreased by 0.272 mm, and the palatal bone height increased by 0.617 mm for every 1 mm downward intrusion of the anterior tooth apex in the fixed appliance group. In the clear aligner group, there was no significant change in the labial bone height, and the palatal bone height decreased by 0.447 mm for every 1 mm of anterior tooth retraction coronally. CONCLUSIONS In the fixed appliance group, anterior tooth intrusion and retraction may have led to alveolar bone resorption by its compression at the cervical level. This study provides a three-dimensional tooth movement evaluation method by using CBCT.
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Affiliation(s)
- Ziyu Guo
- Department of Orthodontics, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Ruijie Zhang
- Department of Orthodontics, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Changgang Guo
- Department of Orthodontics, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Xin Li
- Department of Orthodontics, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Zuolin Jin
- Department of Orthodontics, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Qian Liu
- Department of Orthodontics, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, China
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Malhi G. Clear aligners vs fixed appliances: which treatment option presents a higher incidence of white spot lesions, plaque accumulation and salivary caries-associated bacteria? Evid Based Dent 2024; 25:21-22. [PMID: 38195742 DOI: 10.1038/s41432-023-00961-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 12/12/2023] [Indexed: 01/11/2024]
Abstract
DATA SOURCES Multiple databases were searched electronically in order to find relevant studies for the meta-analysis. These included: MEDLINE, Scopus, Embase, Google Scholar, Clinical trial registry, OpenGrey and ProQuest. Two independent reviewers were used to assess the certainty of evidence and risk of bias. STUDY SELECTION The eligibility criteria for the studies were as follows: randomized controlled trials and non-randomized studies that compared the incidence and severity of white spot lesions, plaque accumulation and salivary caries-associated bacteria between clear aligners and conventional fixed appliances in patients undergoing orthodontic treatment. In total, 14 studies met the criteria, with 8 of the studies deemed suitable for meta-analysis. DATA EXTRACTION AND SYNTHESIS Two independent reviewers carried out data extraction with a form composed of the following subheadings: Study information, Population, Intervention and control, Outcomes. The risk of bias was assessed using the ROBINS-I tool and a revised version of ROB-2, the Cochrane risk of bias tool. GRADEpro GDT software was used to assess the quality of evidence. To calculate the size of the effect of the different treatment options, the mean and standard deviation were extracted from all included studies. Heterogeneity was assessed using chi square and I2 tests, with a p value below 10% being indicative of significant heterogeneity for the chi square and a value greater than 50% being indicative of significant heterogeneity for the I2 tests. RESULTS With regards to plaque accumulation, the effect size was measured at 3 time points: 3 months, 6 months and 12 months. At all the time points assessed within the 8 studies included in the meta-analysis, the effect size was greater for clear aligners. With regards to white spot lesions, 4 studies were available to assess the incidence of white spot lesions. Three studies reported a lower risk of developing white spot lesions in clear aligners, where one study reported no difference. As all 4 studies used different methodologies, a meta-analysis was not possible. With regards to salivary caries-associated bacteria, 2 studies reported a higher concentration of bacteria in conventional fixed appliances. Meta-analysis was not performed due to lack of studies. CONCLUSIONS Based on the evidence presented, clear aligners appear to be associated with less plaque accumulation and less salivary caries-associated bacteria when compared with conventional fixed appliances. Therefore, this could be related to the reduced incidence of white spot lesions in clear aligners.
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Affiliation(s)
- Govind Malhi
- Oral Maxillofacial Surgery and Orthodontic Department, Victoria Hospital, Kirkcaldy, Scotland, UK.
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Kanizaj Ugrin S, Špalj S. Comparison of efficacy of thermoplastic retainer with round and rectangular bonded lingual wire retainer in the mandible two years after orthodontic treatment: a randomised controlled trial. Clin Oral Investig 2024; 28:183. [PMID: 38424224 DOI: 10.1007/s00784-024-05572-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 02/21/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVE To analyse three protocols in maintaining the stability of orthodontic therapy results and their effect on gingival health. MATERIALS AND METHODS Sixty-six subjects (pre-therapeutic age 11-18 years; 68% female) randomly allocated into three retention groups of equal size were analysed. The first group had a 0.673 × 0.268 mm (0.027 × 0.011 inches) rectangular braided steel retention wire bonded to the lingual surfaces of all mandibular teeth from canine to canine, and the second group had a 0.406 mm (0.016 inches) round twisted steel wire. The third group was the control, without wires, and only with vacuum-formed retainers. All three groups had vacuum-formed removable retainers in the maxilla. The frequency of wire detachment/breakage/loss of retainer, the occurrence of crowding of mandibular incisors, and changes in intercanine width and gingival health were monitored. RESULTS Incidence and severity of relapse differed between groups (p = 0.001 and 0.049) being most common in the removable retainer group (incidence 68.2%; severity 0.7 ± 1.0 mm), followed by the round wire group (36.4%; 0.5 ± 1.2 mm) and rectangular wire group (13.6%; 0.1 ± 0.1 mm). The intercanine width decreased more without a bonded retainer (incidence 68.2%; severity 0.5 ± 0.7 mm) and with the round wire more (45.5%; 0.5 ± 0.7 mm) than with the rectangular (27.3%; 0.1 ± 0.3 mm). The difference was significant for incidence (p = 0.025), but not severity. Detaching of the wires/breakage/loss of retainer was similar. There were no significant differences in the accumulation of biofilm, calculus and gingivitis between appliances. CONCLUSION A rectangular wire is the most effective in retention, and the impact of retention appliances on gingival health is similar. TRIAL REGISTRATION ClinicalTrials.gov, NCT05121220. Registered 02 October 2021 - Retrospectively registered. CLINICAL RELEVANCE Studying guidelines for reducing relapse, proper use of materials and appliances, the behavior of retention wires according to their profile in the retention phase, and possibilities of maintaining oral health will contribute to improving the stability of orthodontic therapy results.
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Affiliation(s)
- Silvija Kanizaj Ugrin
- Orthodontic Clinic Orthonova, Zagreb, Croatia.
- School of Dental Medicine, University of Zagreb, Zagreb, Croatia.
| | - Stjepan Špalj
- Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
- Faculty of Dental Medicine and Health, J. J. Strossmayer University of Osijek, Osijek, Croatia
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Pinheiro IS, Guedes CRS, Apolinário AB, Faria FRD, Mota Júnior SL, Phiton MM, Campos MJDS, Vitral RWF. Civil liability of orthodontists and aligner manufacturers in the treatment with orthodontic aligners. Dental Press J Orthod 2024; 29:e24spe1. [PMID: 38359315 PMCID: PMC10871073 DOI: 10.1590/2177-6709.29.1.e24spe1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 01/03/2024] [Indexed: 02/17/2024] Open
Abstract
INTRODUCTION The use of clear aligners as an alternative to fixed orthodontic appliances has become popular due to the aesthetic demands of adult patients seeking orthodontic treatment. However, orthodontists' lack of knowledge about the legal consequences of their activities, and the lack of solid scientific evidence raise concerns regarding civil liability in this type of treatment. Marketing campaigns of manufacturing companies often exaggerate promises of results, and ignore the lack of scientific evidence. Patients, as consumers, are protected by the Consumer Protection Code, whereas orthodontists are considered treatment providers. Therefore, they can be held liable for damage caused to patients, whether by subjective or objective fault. OBJECTIVE This article aims to identify the civil responsibilities of orthodontists and aligner manufacturing companies, by means of a literature review, providing basic legal guidance to help professionals protect themselves from possible lawsuits related to treatment with orthodontic aligners. CONCLUSIONS The study highlights the importance of knowledge of legal notions in treatments with orthodontic aligners by orthodontists, who should legally safeguard themselves through individual written contracts, avoiding obligation of results. In addition, in cases of legal claims, it is possible that the manufacturing companies are jointly and severally liable for possible damages claimed by the patient.
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Affiliation(s)
- Isabela Sales Pinheiro
- Universidade Federal de Juiz de Fora, Faculdade de Odontologia, Programa de Pós-Graduação em Odontologia (Juiz de Fora/MG, Brazil)
| | - Cleverson Raymundo Sbarzi Guedes
- Universidade Federal de Juiz de Fora, Faculdade de Odontologia, Programa de Pós-Graduação em Odontologia (Juiz de Fora/MG, Brazil)
| | - Analina Braga Apolinário
- Universidade Federal de Juiz de Fora, Faculdade de Odontologia, Programa de Pós-Graduação em Odontologia (Juiz de Fora/MG, Brazil)
| | - Fernanda Ramos de Faria
- Universidade Federal de Juiz de Fora, Faculdade de Odontologia, Programa de Pós-Graduação em Odontologia (Juiz de Fora/MG, Brazil)
| | - Sergio Luiz Mota Júnior
- Universidade Federal de Juiz de Fora, Faculdade de Odontologia, Programa de Pós-Graduação em Odontologia (Juiz de Fora/MG, Brazil)
| | - Matheus Melo Phiton
- Universidade Estadual do Sudoeste da Bahia, Departamento de Saúde (Jequié/BA, Brazil)
| | - Marcio José da Silva Campos
- Universidade Federal de Juiz de Fora, Faculdade de Odontologia, Departamento de Odontologia Social e Infantil (Juiz de Fora/MG, Brazil)
| | - Robert Willer Farinazzo Vitral
- Universidade Federal de Juiz de Fora, Faculdade de Odontologia, Departamento de Odontologia Social e Infantil (Juiz de Fora/MG, Brazil)
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Jedliński M, Tandecka K, Grocholewicz K, Janiszewska-Olszowska J. Three-dimensional microanalysis of tooth movement during the first 6 months of orthodontic double retention. Am J Orthod Dentofacial Orthop 2024; 165:143-160. [PMID: 37815779 DOI: 10.1016/j.ajodo.2023.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 07/01/2023] [Accepted: 07/01/2023] [Indexed: 10/11/2023]
Abstract
INTRODUCTION This study performed a 3-dimensional analysis of tooth movement during orthodontic retention to assess the effectiveness of double retention (fixed and removable) in preventing undesired tooth movement. METHODS One hundred randomly selected patients were included at the initiation of double orthodontic retention with fixed retainers and vacuum-formed splints (recommended to be worn 22 h/d) in both arches. Intraoral scans were performed directly (T0), 1 month (n = 88), 3 months (T2) (n = 78), and 6 months (T3) (n = 66) after retainer bonding. Nine reference points were marked on each tooth in every patient. Subsequent scans were superimposed, and point displacement was calculated. Statistical analysis was performed using the R statistical software (version 4.2.2; R Core Team, Vienna, Austria). RESULTS Sample size calculation determined at least 55 patients were needed. The total dropout between T0 and T3 was 34 patients (did not show up for appointment). The median absolute displacement value of a single point between T0 and T3 was 0.015 mm. The most stable teeth were mandibular central incisors, whereas the least stable were mandibular molars. Most tooth displacements occurred between T0 and T2, then slowed down significantly. CONCLUSIONS Double orthodontic retention prevents major tooth displacements in most patients during the first 6 months of retention; however, larger, unpredictable single-tooth displacement may occur in individual patients.
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Affiliation(s)
- Maciej Jedliński
- Department of Interdisciplinary Dentistry, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, Szczecin, Poland.
| | - Katarzyna Tandecka
- Faculty of Mechanical Engineering Koszalin, Koszalin University of Technology, Koszalin, Poland
| | - Katarzyna Grocholewicz
- Department of Interdisciplinary Dentistry, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Joanna Janiszewska-Olszowska
- Department of Interdisciplinary Dentistry, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, Szczecin, Poland
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Wang M, Chen J, Wang Z, Wang Y, Zhang Y, Feng Q, Wei F. Salivary microbiomes vary among orthodontic appliances and associate with clinical periodontal parameters. Orthod Craniofac Res 2024; 27:174-184. [PMID: 37985447 DOI: 10.1111/ocr.12733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVE To investigate the salivary bacterial communities during the first 6-month orthodontic treatment with Clear Aligners (CA) and Fixed Appliances (FA), and its correlation with clinical periodontal parameters. MATERIALS AND METHODS Saliva and periodontal parameters were sampled from individuals wearing CA or FA before treatment (T0), and after 3- (T3) and 6-month (T6) treatments. Salivary bacterial communities characterized based on the 16S rRNA V3-V4 region were compared between FA and CA and correlated with clinical periodontal parameters. RESULTS Probing Depth (PD) significantly increased at T6 in the FA group versus T0, whereas it remained stable in the CA group. The Shannon and Pielou indices were significantly higher in the FA group and significantly positively correlated with periodontal inflammation parameters. β-diversity analysis revealed distinct communities between the FA group and CA group at T6. The relative abundances of 3 genera and 15 species were significantly higher in the FA group. Among the above appliance-type related taxa, bacterial genera Selenomonas, Stomatobaculum, Olsenella and Faecalicoccus and bacterial species Selenomonas_sputigena, Dialister_invisus, Olsenella_profus, Prevotella_buccae, Cryptobacterium_curtum and Clostridium_spiroforme were significantly positively associated with periodontal parameters. CONCLUSIONS Orthodontic treatments trigger appliance-related salivary bacterial communities, highlighting the importance of developing appliance-orientated periodontal strategies during orthodontic treatments. Salivary bacterial communities harboured by patients wearing FA possess higher bacterial parameters which were associated with increasing PD, PI and Gingival Index.
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Affiliation(s)
- Mengqiao Wang
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China
| | - Jitian Chen
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China
| | - Ziyao Wang
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China
| | - Yihua Wang
- Department of Microbiome, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China
| | - Yue Zhang
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China
| | - Qiang Feng
- Department of Microbiome, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China
| | - Fulan Wei
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China
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Xia Q, Wang W, Wang C, Feng G, Wang C, Song J, Fan Y. Comparative assessment of orthodontic clear aligner versus fixed appliance for anterior retraction: a finite element study. BMC Oral Health 2024; 24:80. [PMID: 38218801 PMCID: PMC10787995 DOI: 10.1186/s12903-023-03704-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/22/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND The aim of this study is to conduct a comparative evaluation of different designs of clear aligners and examine the disparities between clear aligners and fixed appliances. METHODS 3D digital models were created, consisting of a maxillary dentition without first premolars, maxilla, periodontal ligaments, attachments, micro-implant, 3D printed lingual retractor, brackets, archwire and clear aligner. The study involved the creation of five design models for clear aligner maxillary anterior internal retraction and one design model for fixed appliance maxillary anterior internal retraction, which were subsequently subjected to finite element analysis. These design models included: (1) Model C0 Control, (2) Model C1 Posterior Micro-implant, (3) Model C2 Anterior Micro-implant, (4) Model C3 Palatal Plate, (5) Model C4 Lingual Retractor, and (6) Model F0 Fixed Appliance. RESULTS In the clear aligner models, a consistent pattern of tooth movement was observed. Notably, among all tested models, the modified clear aligner Model C3 exhibited the smallest differences in sagittal displacement of the crown-root of the central incisor, vertical displacement of the central incisor, sagittal displacement of the second premolar and second molar, as well as vertical displacement of posterior teeth. However, distinct variations in tooth movement trends were observed between the clear aligner models and the fixed appliance model. Furthermore, compared to the fixed appliance model, significant increases in tooth displacement were achieved with the use of clear aligner models. CONCLUSIONS In the clear aligner models, the movement trend of the teeth remained consistent, but there were variations in the amount of tooth displacement. Overall, the Model C3 exhibited better torque control and provided greater protection for posterior anchorage teeth compared to the other four clear aligner models. On the other hand, the fixed appliance model provides superior anterior torque control and better protection of the posterior anchorage teeth compared to clear aligner models. The clear aligner approach and the fixed appliance approach still exhibit a disparity; nevertheless, this study offers a developmental direction and establishes a theoretical foundation for future non-invasive, aesthetically pleasing, comfortable, and efficient modalities of clear aligner treatment.
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Affiliation(s)
- Qian Xia
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Weixu Wang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Chunjuan Wang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Ge Feng
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Chao Wang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.
- Key Laboratory of Biomechanics and Mechanobiology, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, State Key Laboratory of Virtual Reality Technology and Systems, Ministry of Education, Beihang University, No.37, Xueyuan Road, Beijing, 100083, China.
| | - Jinlin Song
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
| | - Yubo Fan
- Key Laboratory of Biomechanics and Mechanobiology, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, State Key Laboratory of Virtual Reality Technology and Systems, Ministry of Education, Beihang University, No.37, Xueyuan Road, Beijing, 100083, China
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Austro-Martinez MD, Nicolás-Silvente AI, Requena MA, Carazo-Austro M, Alarcón JA. Stability of class II correction with the Austro Repositioner associated with multi-brackets fixed appliances in dolichofacial patients. BMC Oral Health 2024; 24:44. [PMID: 38191391 PMCID: PMC10773075 DOI: 10.1186/s12903-023-03692-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 11/21/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND The purposes of the present study were to evaluate the changes produced by the Austro Repositioner, and to assess the stability of Class II malocclusion treatment with the Austro Repositioner associated with fixed appliances and its capacity to control the vertical dimension in dolichofacial patients. METHODS A group of patients with Class II malocclusion due to mandibular retrognathism and a dolichofacial growth pattern treated with the Austro Repositioner combined with fixed appliances were compared to a matched untreated control group of subjects with Class II malocclusion. Evaluations were made on the basis of lateral cephalograms taken at T1 (initial records), T2 (end of treatment), and T3 (1 year after treatment). Statistical comparisons were performed with paired- and two-sample t tests. RESULTS The experimental (treated) group comprised 30 patients, 14 boys and 16 girls, and the control group comprised 30 subjects (15 boys and 15 girls) with similar ages at T1, T2 and T3. In the treated group, a significant decrease in the ANB angle was found (- 3.79 ± 1.46; p < 0.001). No significant differences were found in the maxillary skeletal measurements. In contrast, the SNB angle showed a significant increase of 3.77 ± 1.49 in the treated group compared with a nonsignificant increase of 0.77 ± 1.55 in the control group (p = 0.002). Vertical changes showed a significant decrease in the FMA angle (- 3.36 ± 1.62), while the lower anterior facial height distance and the overbite increased significantly in the treated group, reflecting a change in vertical dimensions after treatment. No significant changes were observed in either the treated or control group during the one-year posttreatment period; thus, the treatment results remained stable. CONCLUSIONS The Austro Repositioner combined with fixed appliances could be considered an optimal treatment modality in Class II dolichofacial patients.
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Affiliation(s)
- María Dolores Austro-Martinez
- Department of Restorative Dentistry, School of Dentistry, CEIR Campus Mare Nostrum, University of Murcia, Murcia, 30008, Spain
| | - Ana I Nicolás-Silvente
- Department of Dental Pathology and Therapeutics, School of Dentistry, CEIR Campus Mare Nostrum, University of Murcia, Murcia, 30008, Spain
| | | | - Marta Carazo-Austro
- Undergraduate student, Faculty of Odontology, University of Granada, Granada, 18071, Spain
| | - José Antonio Alarcón
- Department of Stomatology, Section of Orthodontics, Faculty of Odontology, University of Granada, Granada, 18071, Spain.
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Sapata DM, Oliveira E Silva CD, Pascotto RC, Poleti TMFF, Arai MSI, Ramos AL. Periodontal indexes of two types of 3 x 3 retainers: 0.032-in SS V-loop versus 0.0215-in SS coaxial - a randomized crossover trial. Dental Press J Orthod 2024; 28:e2323175. [PMID: 38198390 PMCID: PMC10773445 DOI: 10.1590/2177-6709.28.6.e2323175.oar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 10/24/2023] [Indexed: 01/12/2024] Open
Abstract
OBJECTIVE This randomized crossover trial evaluated periodontal indexes of two types of 3 x 3 retainers (a modified 0.032-in SS V-loop retainer and a conventional 0.0215-in SS coaxial wire retainer) after bonded for six months. Also, bonded failure rate, and a questionnaire about comfort, ease of cleaning and overall preference were recorded. MATERIAL AND METHODS 15 patients were enrolled in this study who used both retainers for six months each, having a 15-day wash-out interval between each bonded retainer usage. The following periodontal index were recorded: Plaque Index (PI), Calculus Index (CI) and Gingival Index (GI). Patients answered a questionnaire to assess comfort, ease of cleaning and overall retainer-type preference. Rate of bonding failure was also evaluated. RESULTS V-Loop retainer showed higher PI (P<0.05) as compared to conventional 0.0215-in coaxial wire retainer. However, CI and GI presented no statistically significant differences between both types of retainers. The conventional 0.0215-in coaxial wire retainer was chosen as the most comfortable (p<0.05), although no statistically significant differences were found for all other questionnaire answers. Bonding failure events were more observed in the 3x3 V-Loop retainer (p<0.002), as compared to the conventional 0.0215-in coaxial retainer. CONCLUSION V-Loop retainer showed higher PI (p<0.05), higher bonding failure rate and less comfortable, as compared to conventional 0.0215-in coaxial wire.
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Affiliation(s)
- Diogo Marques Sapata
- Universidade Estadual de Maringá, Departamento de Odontologia (Maringá/PR, Brazil)
| | | | | | | | | | - Adilson Luiz Ramos
- Universidade Estadual de Maringá, Departamento de Odontologia (Maringá/PR, Brazil)
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Tran G, Rucker R, Foley P, Bankhead B, Adel SM, Kim KB. Relapse and failure rates between CAD/CAM and conventional fixed retainers: a 2-year follow-up of a randomized controlled clinical trial. Eur J Orthod 2024; 46:cjad079. [PMID: 38168815 DOI: 10.1093/ejo/cjad079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
BACKGROUND Retention has been always considered a major challenge in orthodontics. Recently computer-aided design/computer-aided manufacturing (CAD/CAM) fixed retainers (FRs) have been introduced as a marked development in retainer technology, offering potential advantages. OBJECTIVE The objective of this study was to compare the differences in relapse and failure rates in patients treated with FRs using CAD/CAM technology, lab-based technique, and chairside method. TRIAL DESIGN A double-blinded, prospective, randomized controlled clinical trial was conducted over a 2-year period at a single centre. METHODS INTERVENTIONS These patients were divided into three groups: CAD/CAM group with multistranded Stainless Steel wires (CAD/CAM, n = 14), lab group with the same multistranded wires (lab, n = 15), and a chairside group with Stainless Steel Ortho-FlexTech wires (chairside, n = 14). OUTCOMES Inter-canine width (ICW) and Little's irregularity index were digitally measured from scans at the orthodontic debonding (T1), 6-month retention (T2), 1-year retention (T3), and 2-year retention (T4) visits. All forms of failure were documented and analyzed. RANDOMIZATION Participants were randomly assigned to the three groups using online randomization software (randomization.com) by a statistician who was not involved in the study. BLINDING Patients were blinded in terms of the FR group to which they were each randomly assigned. The principal investigator was blinded upon data analysis since patients' records were coded to minimize observer and measurement bias. RESULTS Initially 81 patients were assessed for eligibility. Seventy-five patients were randomly allocated into the three study groups. After 2-year follow-up, 43 patients came back for the follow-up and were analyzed. The CAD/CAM group showed significantly less reduction in ICW compared to the chairside group at all time intervals (P < .05) and compared to the lab group at 6 months (P = .038). In terms of LII, the CAD/CAM group exhibited significantly less change than the chairside and lab groups at all time intervals (P < .05). The CAD/CAM group had the lowest failure rate (21.4%), followed by chairside group (28.6%) and then lab group (33.3%), however the differences were insignificant. No harms were observed in the current study. CONCLUSION Within 2 years of fixed retention, CAD/CAM FRs showed significantly less relapse than lab-based and chairside FRs. However, there was no significant difference in failure rates among the groups. TRIAL REGISTRATION NCT05915273.
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Affiliation(s)
- Giau Tran
- Department of Orthodontics, Saint Louis University, Saint Louis, MO 63104, USA
| | - Ryan Rucker
- Department of Orthodontics, Saint Louis University, Saint Louis, MO 63104, USA
| | - Patrick Foley
- Department of Orthodontics, Saint Louis University, Saint Louis, MO 63104, USA
| | - Brent Bankhead
- Department of Orthodontics, Saint Louis University, Saint Louis, MO 63104, USA
| | - Samar M Adel
- Department of Orthodontics, Saint Louis University, Saint Louis, MO 63104, USA
- Department of Orthodontics, Faculty of Dentistry, Alexandria University, Alexandria 21526, Egypt
| | - Ki Beom Kim
- Department of Orthodontics, Saint Louis University, Saint Louis, MO 63104, USA
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Bock NC, von Bremen J, Klaus K, Schulz-Weidner N, Ganss C, Ruf S. White spot lesions after fixed appliance treatment-Can we expect spontaneous long-term (≥15 years) improvement? Eur J Orthod 2024; 46:cjad070. [PMID: 38128566 DOI: 10.1093/ejo/cjad070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
OBJECTIVE To investigate the extent to which post-orthodontic white spot lesions (WSLs) change in appearance over a period of ≥15 years and whether an association with caries data exists. SUBJECTS AND METHODS Seventy-two patients treated with a Herbst-Multibracket appliance at age 14.0 ± 2.7 years for 20.1 ± 5.1 months who attended a recall 18.3 ± 2.9 years post-treatment. Post-treatment (T1) intraoral photographs were assessed by a panel of five dentists using a modified version of the WSL-Index by Gorelick. For affected incisors, photographs from before treatment (T0) and recall (T3) were evaluated. In addition, the WSL-Change Index by Pancherz and Muehlich was assessed for all adequately visible incisors considering T1, T2 (if available), and T3. Radiographic (T0, T1, and T2-if available) and clinical (T3) MFT data were used. RESULTS 37.5% of the patients exhibited WSLs on ≥ 1 incisor at T1; in total, 81 incisors (14.9%) were affected. At T3, 48% of the WSLs had improved. The modified WSL-Index decreased from 1.2 ± 0.4 to 0.8 ± 0.6 (P < .001), with a score 0 in 28% of the previously affected incisors. When comparing T2 vs. T3, additional improvement after T2 occurred in 11% of the teeth. While no difference existed at T0, the MFT values at T1, T2, and T3 were higher (P ≤ .05) in patients with WSLs at T1 than in those without. LIMITATIONS The homogeneity of the subjects was limited and no patient-reported outcome was assessed. CONCLUSIONS Long-term, post-orthodontic WSLs showed spontaneous full recovery in 28% and improvement in 48% of the teeth. Patients affected with WSLs exhibited higher post-treatment MFT values.
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Affiliation(s)
| | - Julia von Bremen
- Department of Orthodontics, University of Giessen, Giessen, Germany
| | - Katharina Klaus
- Department of Orthodontics, University of Giessen, Giessen, Germany
| | | | - Carolina Ganss
- Department of Operative Dentistry, Endodontology, and Paediatric Dentistry, University of Marburg, Marburg, Germany
| | - Sabine Ruf
- Department of Orthodontics, University of Giessen, Giessen, Germany
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21
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Receive expert insight on lingual braces. Br Dent J 2024; 236:66. [PMID: 38225335 DOI: 10.1038/s41415-024-6744-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
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22
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Moda LB, Bastos RTDRM, Flores-Mir C, Normando D. Patients' perception of orthodontic retainers: a systematic review. Eur J Orthod 2024; 46:cjad068. [PMID: 38071751 DOI: 10.1093/ejo/cjad068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
BACKGROUND Orthodontic retainers are widely used to prevent relapses after orthodontic treatment; however, evidence about patients' perceptions of retainers is lacking. OBJECTIVE To assess patients' perception of orthodontic retainers. SEARCH METHODS PubMed, Web of Science, Scopus, LILACS, LIVIVO, Cochrane Library, and gray literature (Google Scholar) were searched without date or language restrictions. A manual search of the reference lists of the included articles was also performed. SELECTION CRITERIA Studies comparing patients' perceptions of wearing orthodontic retainers were included. DATA COLLECTION AND ANALYSIS According to the study design, the risk of bias (RoB) assessment was performed using RoB 2.0 or ROBINS-I. The level of evidence was assessed through the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) tool. RESULTS Seventeen studies met the eligibility criteria. After the RoB assessment, 12 randomized controlled trials presented a high RoB, and 4 non-randomized controlled trials presented a moderate RoB. The certainty of evidence was classified as very low for the four assessed outcomes. The studies generally reported an initial temporary negative impact of orthodontic retainers. Different esthetic, functional, and ease-of-use advantages are reported using removable and fixed retainers. A quantitative analysis was not performed due to the considerable clinical and methodological heterogeneity among the studies. CONCLUSION The current evidence, although very limited, suggests that orthodontic retainers have an initial negative impact related to discomfort and functional limitations, but they seem to regress over time. There is a preference for thermoplastic over Hawley-type retainers. However, thermoplastic retainers cause different functional difficulties, and bonded retainers present the advantage of affecting speech function less than orthodontic removable retainers, although they can facilitate oral hygiene problems. REGISTRATION PROSPERO (CRD42022306665).
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Affiliation(s)
- Larissa Barbosa Moda
- Graduate Program in Dentistry, Dental School, Federal University of Pará, UFPA - Belém, Pará, Brazil
| | | | - Carlos Flores-Mir
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - David Normando
- Department of Orthodontics, Dental School, Federal University of Pará, UFPA - Belém, Pará, Brazil
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Tyler D, Kang J, Goh HH. Effectiveness of Waterpik ® for oral hygiene maintenance in orthodontic fixed appliance patients: A randomised controlled trial. J Orthod 2023; 50:367-377. [PMID: 37203873 PMCID: PMC10693741 DOI: 10.1177/14653125231173708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 04/11/2023] [Accepted: 04/17/2023] [Indexed: 05/20/2023]
Abstract
OBJECTIVE To establish whether the use of a WaterPik® alongside a manual toothbrush (WaterPik® + MTB) is more effective for maintaining oral hygiene compared to the use of a manual toothbrush alone (MTB) in patients wearing fixed orthodontic appliances. DESIGN A single-centre, two-arm, parallel-group, single-blind, randomised controlled clinical trial with a 1:1 allocation ratio. SETTING Orthodontic department at York Hospital, York Teaching Hospitals NHS Foundation Trust, UK. PARTICIPANTS A total of 40 fit and well participants, aged 10-20 years, being treated with upper and lower fixed orthodontic appliances. METHODS Participants were randomly allocated, using stratified block randomisation, to the control group (MTB) or intervention group '(Waterpik® + MTB)'. Plaque, gingival and interdental bleeding indices were recorded at baseline, 8 weeks, 32 weeks and 56 weeks. A generalised linear mixed model was used to assess differences between groups. RESULTS An interim analysis of results was performed with 40 patients recruited and 85% of data collected. The overall mean differences between the groups were as follows: plaque index = 0.199 (P = 0.88, 95% confidence interval [CI] -0.24 to 0.27); gingival index = -0.008 (P = 0.94, 95% CI -0.22 to 0.20); and interdental bleeding index = 5.60 (P = 0.563, 95% CI -13.22 to 24.42). No statistical difference between the two groups was found for any variable. The trial was stopped at this point. CONCLUSIONS In terms of oral hygiene, our study did not find evidence to support the claim of benefit of using a Waterpik® in addition to a manual toothbrush for patients wearing fixed orthodontic appliances.
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Affiliation(s)
- Daniel Tyler
- Department of Orthodontics, Leeds Dental Institute, University of Leeds, Leeds, UK
| | - Jing Kang
- Department of in Biostatistics, University of Leeds, Leeds, UK
| | - Hock Hoe Goh
- Department of Orthodontics, York Hospital, York, UK
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Jaber ST, Hajeer MY, Burhan AS, Alam MK, Al-Ibrahim HM. Treatment effectiveness of young adults using clear aligners versus buccal fixed appliances in class I malocclusion with first premolar extraction using the ABO-Objective Grading System: A randomized controlled clinical trial. Int Orthod 2023; 21:100817. [PMID: 37837842 DOI: 10.1016/j.ortho.2023.100817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 09/18/2023] [Accepted: 09/25/2023] [Indexed: 10/16/2023]
Abstract
OBJECTIVE To compare the effectiveness of the clear aligners with the traditional fixed appliances in the treatment of premolars extraction complex cases using the American Board of Orthodontics Objective Grading System (ABO-OGS). MATERIAL AND METHODS A single-centre, 2-parallel groups RCT with two arms. Forty severe crowding patients (14 males, 26 females; mean age: 21.40±2.42) who required four first premolars extraction were included and randomly allocated into two treatment groups: clear aligners therapy group (CAT), and fixed appliances therapy group (FAT). Cases complexities were measured on pre-treatment records using the Discrepancy index (DI). Post-treatment records were evaluated using the American Board of Orthodontics Objective Grading System (ABO-OGS). Two sample t-tests and Fisher's Exact tests were used to test for significant differences between the two groups. The statistical significance was set at P < 0.006 using Bonferroni's correction. RESULTS For the DI, the mean scores were 32.25 (± 4.33) in the CAT group and 33 (± 7.92) in the FAT group. In the CAT group, the total OGS score ranged between 6-33 points with an average of 17.50(± 7.41), whereas the total score in the FAT group went between 4-30 points with an average of 12.89 (± 6.31) with no significant differences between the two groups (P=0.05). When comparison of the successful cases between the two groups was made, 11 cases received passing scores, and 9 cases received failing scores in the CAT group. Whereas in the FAT group, 17 cases received passing scores, and 3 received a failing score. No statistically significant differences were found in the passing rates between of the CAT and FAT groups (P = 0.421). CONCLUSIONS According to the ABO-OGS total scores, there was no significant difference between the clear aligners and fixed appliances in the treatment of class I severe crowding cases with first premolars extraction in young adults. There were no differences between the two techniques in the OGS components scores except for the occlusal contacts, which were significantly better with the fixed appliances. When comparing the number of successful and failed cases between the two groups, no significant differences were noted, with the fixed appliances having a 30% higher success rate than the clear aligners, which must be considered clinically when choosing between these two techniques in the complex orthodontic cases treatment.
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Affiliation(s)
- Samer T Jaber
- Department of Orthodontics, Faculty of Dentistry, Al-Wataniya Private University, Hama, Syria
| | - Mohammad Y Hajeer
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus, Syria.
| | - Ahmad S Burhan
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus, Syria
| | - Mohammad Khursheed Alam
- Orthodontic Division, Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia
| | - Heba M Al-Ibrahim
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus, Syria
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Carlucci A, Lombardo L, Barbara L, Cremonini F, Palone M. Treatment of skeletal Class III malocclusion in adolescents using miniscrew-supported orthopedic and fixed orthodontic appliances. J Clin Orthod 2023; 57:735-746. [PMID: 38346253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Affiliation(s)
| | - Luca Lombardo
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - Lorenza Barbara
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | | | - Mario Palone
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy.
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Hakami Z. Comparison of sleep quality between clear aligner and fixed appliance orthodontic therapies. J World Fed Orthod 2023; 12:245-250. [PMID: 37839985 DOI: 10.1016/j.ejwf.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 09/08/2023] [Accepted: 09/18/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Although available evidence suggests that orthodontic appliances can impact quality of life, there is limited information on the impact of orthodontic appliances on sleep quality. This study aimed to compare sleep quality between patients undergoing orthodontic treatments using conventional fixed appliances and clear aligners. METHODS Adult patients attending clinics in Saudi Arabia participated in this cross-sectional study. Sleep quality was assessed using the validated Arabic version of the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Statistical significance was determined using inferential analysis, with a P < 0.05 considered statistically significant. RESULTS There were 69 patients included in the study. The average age of a patient (33.12 ± 8.1) who received the clear aligner was significantly higher than those who received the fixed appliance (27.7 ± 5.9) (P < 0.05). The variation in the average score of ESS because of the education level was found to be statistically significant (P < 0.05). No significant difference was observed between the mean average ESS and PSQI global scores across the two orthodontic treatment groups. The average sleep latency scores were significantly higher in females than males when analyzing the PSQI component score across sex (P < 0.05). In education, ESS, PSQI global, habitual sleep efficiency, the use of sleep medication, and daytime dysfunction had a positive, weak, but significant correlation. CONCLUSIONS Overall, this study concluded that regardless of the orthodontic appliances used, there was no statistically significant difference in sleep quality during the treatment.
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Affiliation(s)
- Zaki Hakami
- Division of Orthodontics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia.
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Paglia L, Marzo G. Aligners, can my child use them too? Eur J Paediatr Dent 2023; 24:259. [PMID: 38015116 DOI: 10.23804/ejpd.2023.24.04.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
This is a frequently asked question. The answer depends on various factors, with cooperation being among the most essential. As a parent, you must ask yourself if you can rely on your child to wear aligners correctly for most of the day. If the answer to this question is yes, then clear aligners may be a better choice than traditional braces. There are three major benefits of clear aligners in children: 1. Greater comfort, aligners are less voluminous than traditional braces and more likely to prevent irritation, mouth ulcers and other discomfort that derives from the movement of the orthodontic wire or braces. 2. Better hygiene, as their removal during meals and tooth cleaning manoeuvres makes home oral hygiene easier. 3. Better aesthetics, thanks to the transparency of the plastic replacing the metal. However, a certain degree of caution is advised to those who are considering this treatment option. Although aligners allow us to start resolving certain tooth malpositions (which can cause periodontal and aesthetic problems or increase the severity of damage in the event of trauma), and to improve alignment and minor crowding at an early age, it must not be forgotten that the intervening period for changing the definitive position of individual teeth is still the period of permanent teeth. It is important to consider whether a child has a dental or skeletal problem. In cases where a child's problem is exclusively dental, the aligner may be one of the tools used. In cases of skeletal problems, the literature advises against the aligner, as it is not the right instrument at this stage of development. The literature in some cases refers to aligners as the universal remedy, valid for every malocclusion, presenting them as a panacea for all orthodontic problems of very young patients. It is necessary to remain open to the innovations that the market offers us and that can improve our daily clinic, and aligners can be a valid support in this regard, but, as dentists, we should always keep a critical and open eye on treatments with an evidence-based rationale. As with all other orthodontic appliances, aligners must be evaluated on a case-by-case basis, keeping in mind that they are one of the tools in the hands of the clinician. When the clinical situation makes it possible and when both the child's requirements and the parent's expectations are fulfilled, it is certainly worth considering clear aligners as a viable route in the family-child's orthodontic treatment, making it as simple and convenient as possible. Lastly, we should remember the concept of efficiency regarding an orthodontic treatment, which depends on its cost/benefit ratio, with the former being understood in a biological sense and in terms of its impact on the life of the patient and their family with respect to duration, cooperation required, discomfort induced by the equipment used and frequency of check-ups. The latter should obviously be considered in terms of results obtained in relation to the pre-established treatment goals. A consideration that we should always keep in mind: let us never forget that is the orthodontist who treats the patient, not the appliance!
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Affiliation(s)
- L Paglia
- Editor in chief European Journal of Paediatric Dentistry
| | - G Marzo
- Director of the Postgraduate School in Orthodontics University of L'Aquila
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Johal A, Shagmani M, Alfuraih O, Arad I. Long-term comparison of the efficacy of manual versus powered tooth brushing in adolescent orthodontic patients: a single-centre, parallel design randomized clinical trial. Eur J Orthod 2023; 45:808-817. [PMID: 37708303 PMCID: PMC10803043 DOI: 10.1093/ejo/cjad042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
BACKGROUND AND OBJECTIVES To-date, there is no evidence comparing the long-term efficacy of powered and manual toothbrushes in adolescents undergoing fixed appliance treatment. The trial compared the efficacy of manual versus powered toothbrush in controlling plaque and gingival health in patients undergoing fixed treatment in respect of both the short- and long-term. TRIAL DESIGN This was a randomized, parallel, controlled single-blind clinical trial, undertaken in a hospital setting, for which the consolidated standards of reporting trials guidelines were followed. METHODS Ninety-two adolescent participants planned to undergo fixed appliance therapy, were randomly assigned to either a manual or powered toothbrush, with allocation concealment. The outcome measures were plaque and gingival indices and bleeding on probing, assessed at baseline (prior to fixed appliance), one-, six- and 12-months. RESULTS The final sample included 84 participants, aged 12-18 (M=14.1, SD=1.93) years, with 40 (47%) were using a manual and 44 (52%) a powered toothbrush. The intervention (powered vs. manual toothbrush) itself appeared insignificant with regards to the gingival index (GI) (95%CI -0.1 - 0.03; P=0.26), plaque index (PI) (95%CI -0.13 - 0.14; P=0.93) and bleeding on probing (BoP) (95%CI -0.03 - 0.03; P=0.98) at any of the time points assessed. However, periodontal health indicators and plaque control significantly worsened (p<0.01), over the 12-month follow-up period, following placement of the fixed appliances placement. CONCLUSION Whilst no differences were found between manual and powered toothbrushes in controlling plaque and gingival health, in participants undergoing fixed orthodontic treatment, both were suboptimal and highlighted the need for greater patient support and monitoring. TRIAL REGISTRATION DETAILS https://doi.org/10.1186/ISRCTN74268923 Trial funding: Colgate-Palmolive (USA).
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Affiliation(s)
- Ama Johal
- Department of Oral Bioengineering, Institute of Dentistry, Queen Mary University of London, Turner Street, Whitechapel, London E1 2AD, UK
| | - Muftah Shagmani
- Department of Oral Bioengineering, Institute of Dentistry, Queen Mary University of London, Turner Street, Whitechapel, London E1 2AD, UK
| | - Omar Alfuraih
- Department of Oral Bioengineering, Institute of Dentistry, Queen Mary University of London, Turner Street, Whitechapel, London E1 2AD, UK
| | - Ian Arad
- Department of Oral Bioengineering, Institute of Dentistry, Queen Mary University of London, Turner Street, Whitechapel, London E1 2AD, UK
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Hasan NM, Yassir YA. Evaluation of failure rate of molar tubes with a modified bonding technique: a randomized clinical trial. Eur J Orthod 2023; 45:764-772. [PMID: 37467348 DOI: 10.1093/ejo/cjad029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
BACKGROUND During orthodontic therapy, bond failure of molar tubes may delay treatment. With the high failure rate of molar tubes, alternative bonding techniques were tested to improve bond strength. OBJECTIVES To compare the failure rates of molar tubes bonded with conventional and alternative bonding techniques by adding a layer of compomer adhesive at the molar/tube interface. TRIAL DESIGN Single-centre, single-blinded, split-mouth, randomized clinical trial. METHODS Patients aged 12 years or older, who required fixed appliance orthodontic treatment without extraction and with no occlusal interference were eligible to participate. They were allocated randomly using a simple non-stratified split-mouth design with a 1:1 allocation ratio. Blinding was only possible for the patients and data analysts. Molar tubes bonded with the modified bonding technique had an additional layer of compomer at the occlusal molar/tube interface. The patients were followed-up for nine months. Outcome measures included the survival time of molar tubes and the number of molar tubes debonded. The bond failure of molar tubes was analyzed using Kaplan-Meier and Cox regression analysis (P < 0.05). RESULTS Thirty patients were recruited, randomized, and analyzed (mean age 20.33 years). The failure rate of molar tubes bonded with the modified bonding technique was 4.2 per cent and that of molar tubes bonded with the conventional bonding technique was 6.7 per cent. This difference was not statistically significant (P > 0.05). The dental arch and molar type were found to be as significant predictors for molar tube failure rate. No harm was detected during treatment. LIMITATIONS The effect of compomer to reduce enamel demineralization was not tested. CONCLUSIONS AND IMPLICATIONS The modified bonding technique did not significantly reduce the failure rate of molar tubes. The molar tubes bonded on the upper arch and second molars are more susceptible to debond. REGISTRATION The trial was registered with ClinicalTrials.gov on 21 May 2022 (Registration number: NCT05391386). FUNDING This research did not receive any funding.
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Affiliation(s)
- Nawar M Hasan
- Department of Orthodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Yassir A Yassir
- Department of Orthodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq
- School of Dentistry, University of Dundee, Dundee, UK
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Aye ST, Liu S, Byrne E, El-Angbawi A. The prevalence of the failure of fixed orthodontic bonded retainers: a systematic review and meta-analysis. Eur J Orthod 2023; 45:645-661. [PMID: 37824794 PMCID: PMC10687514 DOI: 10.1093/ejo/cjad047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
OBJECTIVES To systematically assess the scientific literature for the prevalence of failure rate of fixed orthodontic bonded retainer (FOBR). METHOD Randomized clinical trials (RCTs) and prospective non-RCTs involving participants who had FOBR fitted were included. The Cochrane Central Register of Controlled Trials, Web of science, MEDLINE, and EMBASE via OVID were searched from inception to January 2023. Risk of bias was assessed using the Cochrane RoB 2 and Newcastle-Ottawa tools. The main outcome was the failure rate of FOBRs. The secondary outcome was to identify factors that can influence the failure of FOBR. Meta-analyses and sensitivity analyses were undertaken using Revman, version5.4. A random-effects model was used. Quality assessment using Grading of Recommendations Assessment, Development, and Evaluation. RESULTS Thirty-four studies (25 RCTs and 9 prospective clinical studies) (3484 participants) were included in this review. The overall failure rate of bonded retainers, after excluding high-risk studies, was 35.22% (95% confidence interval [CI] 27.46-42.98). The failure rate is increased with the duration of follow up; with short-term follow-up rate 24.18% (95% CI 20.16-28.21), medium-term follow up 40.09% (95% CI 30.92-49.26), and long-term follow up 53.85% (95% CI 40.31-67.39). There is a low level of evidence to suggest there is no statistically significant difference in the failure rate of fixed retainers using direct versus indirect bonding methods, using liquid resin versus without liquid resin, and fibre-reinforced composite retainers compared to multi-stranded stainless steel retainers. DISCUSSION There is low-quality evidence to suggest that the failure rate of FOBR is relatively high. There is a need for high-quality, well-reported clinical studies to assess factors that can influence the failure rate of FOBR. REGISTRATION CRD42021190910.
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Affiliation(s)
- Su Thae Aye
- Division of Dentistry, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Shiyao Liu
- Division of Dentistry, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Emer Byrne
- University Dental Hospital of Manchester, MFT NHS Trust, UK
| | - Ahmed El-Angbawi
- Division of Dentistry, Faculty of Biology, Medicine and Health, University of Manchester, UK
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Naraghi S, Ganzer N, Bondemark L, Sonesson M. Stability of maxillary anterior teeth during retention and 1 year after removal of retention-an RCT on adolescents retained with two different bonded retainers and a vacuum-formed retainer. Eur J Orthod 2023; 45:629-636. [PMID: 37119264 PMCID: PMC10687510 DOI: 10.1093/ejo/cjad020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
BACKGROUND Maxillary bonded and removable retainers maintain teeth in correct positions following orthodontic treatment. There is insufficient evidence regarding the capacity of the retention methods to stabilize the maxillary teeth both during and after retention. OBJECTIVE To evaluate retention capacity and 1-year post-retention changes in the irregularity of maxillary anterior teeth and single anterior tooth contact point discrepancy (CPD) of two bonded and one removable retention method. TRIAL DESIGN Three-arm parallel group single-centre randomized controlled trial. METHODS Ninety adolescent patients treated with fixed orthodontic appliances were enrolled. After gaining informed consent, the patients were randomized in blocks of 30 by an independent person into one of three groups: A) bonded retainer 13-23; B) bonded retainer 12-22; and C) removable vacuum-formed retainer. The primary outcomes were changes in Little's irregularity index (LII) and single CPD measured on digitalized casts before retention (T1), after 2 years of retention (T2), and 1-year post-retention (T3). BLINDING The digital casts were blinded for the outcome assessor. RESULTS Data on all 90 patients were analysed according to intention-to-treat principles. Changes in LII during retention were 0.3 mm in group A, 0.6 mm in group B, and 1.0 mm in group C. No significant differences between the groups were seen (P > 0.05). Changes during post-retention were 1.1 mm in group A, 0.5 mm in group B, and 0.4 mm in group C. Group A showed more significant changes than groups B and C (P = 0.003). During the whole post-treatment period, no significant differences were shown between the groups (P > 0.05). CPD did not differ significantly between the groups at any point. HARMS Three patients showed changes of LII over 3 mm or CPD over 2 mm during the post-retention period, and two accepted to be realigned. LIMITATIONS The trial was a single-centre study evaluating 1-year post-retention changes. CONCLUSIONS The changes were clinically insignificant during and after the retention period. Thus, all three methods showed equal retention capacity. TRIAL REGISTRATION www.clinicaltrials.com (NCT04616755).
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Affiliation(s)
- Sasan Naraghi
- Orthodontic Clinic, Public Dental Health, Växjö, Sweden
| | - Niels Ganzer
- Division of Orthodontics and Paediatric Dentistry, Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
- Orthodontic Clinic, Public Dental Health, Gävle, Sweden
- Centre for Research and Development Uppsala University/ Region Gävleborg, Gävle, Sweden
| | - Lars Bondemark
- Department of Orthodontics, Faculty of Odontology, Malmő University, Malmő, Sweden
| | - Mikael Sonesson
- Department of Orthodontics, Faculty of Odontology, Malmő University, Malmő, Sweden
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Li B, Lu C, Yao X, Wu X, Wu G, Zeng X. Effects of three orthodontic retainers on periodontal pathogens and periodontal parameters. Sci Rep 2023; 13:20709. [PMID: 38001102 PMCID: PMC10673872 DOI: 10.1038/s41598-023-46922-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
The objective of this study was to compare and evaluate the changes in periodontal pathogens and periodontal status within 6 months of wearing three orthodontic retainers, namely, vacuum-formed retainer (VFR), Hawley retainer (HR), and lingual fixed retainer (LR). In total, 48 patients who underwent orthodontic treatment with ordinary metal brackets were divided into VFR, HR, and LR groups (n = 16 per group). Saliva samples were collected at the time of debonding (T0) and after 1 month (T1), 3 months (T2), and 6 months (T3). Porphyromonas gingivalis (Pg) and Aggregatibacter actinomycetemcomitans (Aa) were quantitatively analyzed using real-time PCR. Gingival index (GI), plaque index (PLI), and probing depth (PD) were measured at the four time points to evaluate changes in periodontal state. SPSS20.0 software was used to analyze the data, and P < 0.05 was considered statistically significant. The trial was registered at the Chinese Clinical Trial Registry (ChiCTR2300073704), the registration was retrospective. Compared to baseline (T0) values, Pg, Aa, GI, PLI, and PD were significantly decreased in all three groups 1 month after wearing the retainer (p < 0.05). Significant differences were observed in Aa at T3 among the three groups, whereby the HR group exhibited significantly better results compared to the VFR and LR groups (p < 0.05). Differences were found among the three groups' Porphyromonas gingivalis at T3, and the HR group was significantly better than the VFR and LR groups (P < 0.05). From T1 to T2, GI, PLI, and PD of the three groups tended to be stable, however differences were observed at T3, with the PLI and PD of the HR group being the lowest among the three groups (p < 0.05). Regardless of the type of retainer used, the periodontal condition of patients was significantly improved after removal of the metal brackets. After 6 months of retainer use, the Hawley retainer was superior to vacuum-formed retainer and lingual fixed retainer with regard to Pg, Aa, and periodontal clinical parameters.
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Affiliation(s)
- Bowen Li
- Institute of Oral Science, Department of Stomatology, Longgang Otorhinolaryngology Hospital, Shenzhen, 518172, People's Republic of China
| | - Cailian Lu
- Department of Stomatology, The First Hospital of Shanxi Medical University, Taiyuan, 030001, People's Republic of China
| | - Xinhui Yao
- Institute of Oral Science, Department of Stomatology, Longgang Otorhinolaryngology Hospital, Shenzhen, 518172, People's Republic of China
| | - Xiaojun Wu
- Institute of Oral Science, Department of Stomatology, Longgang Otorhinolaryngology Hospital, Shenzhen, 518172, People's Republic of China
| | - Guilin Wu
- Institute of Oral Science, Department of Stomatology, Longgang Otorhinolaryngology Hospital, Shenzhen, 518172, People's Republic of China
| | - Xiantao Zeng
- Institute of Oral Science, Department of Stomatology, Longgang Otorhinolaryngology Hospital, Shenzhen, 518172, People's Republic of China.
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Alvarado-Lorenzo A, Antonio-Zancajo L, Baptista H, Colino Gallardo P, Albaladejo-Martinez A, Garcovich D, Alcon S. Comparative analysis of periodontal pain and quality of life in patients with fixed multibracket appliances and aligners (Invisalign®): longitudinal clinical study. BMC Oral Health 2023; 23:850. [PMID: 37951878 PMCID: PMC10638788 DOI: 10.1186/s12903-023-03565-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 10/23/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUNDS The aim of this longitudinal clinical study is to analyse and compare according to location, degree and type, the pain presented by patients during their first year of treatment, as well as the quality of oral life after the placement of two types of orthodontic appliances: conventional brackets and removable Invisalign ® aligners. METHODS The sample consisted of 140 patients grouped into 2 study groups of 70 patients each. The first group (brackets group- BG), with fixed multibracket appliances, using the MBT technique and a 0.022" slot. The second group (invisaling group- IG), in treatment with removable aligners (IG), using the Invisalign ® system. They were providen with a questionnare where they had to record the degree (mild, moderate or intense), the type and location of the pain monthly during the first year of treatment. The second form was the Spanish version of the OHIP-14, oral quality of life questionnaire, which was provided the twelfth month after the start of treatment. RESULTS In both groups, we found that the most frequent location of pain occurred during the first phase: mandibular for the IG group and maxillary in the BG group. Throughout the whole analysis, the intensity was mild-moderate with lower values in the conventional brackets' group. The BG group reported acute pain while the IG group reported sensitive pain during the first month; later both reported sensitive pain. CONCLUSIONS There are differences in terms of periodontal pain in its degree, location, and type according to the different orthodontic techniques used. TRIAL REGISTRATION The study was approved by the bioethics committee of the University of Salamanca (USAL_20/516).
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Affiliation(s)
| | | | - Hugo Baptista
- Department of Oral Surgery, Universidad de Salamanca, Salamanca, 37007, Spain
| | | | | | - Daniele Garcovich
- Department of Dentistry, Universidad Europea de Valencia, Valencia, 46010, Spain
| | - Silvia Alcon
- Department of Oral Surgery, Universidad de Salamanca, Salamanca, 37007, Spain
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Shi X, Wu B, Cao D, Liu J, Qian X, Liu M, Tang M, Yin C, Liu L, Yan B. Effect of socioeconomic and malocclusion-related factors on duration of orthodontic treatment by fixed appliance: A retrospective study. Orthod Craniofac Res 2023; 26:650-659. [PMID: 37036602 DOI: 10.1111/ocr.12661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 02/16/2023] [Accepted: 03/21/2023] [Indexed: 04/11/2023]
Abstract
OBJECTIVES The aims of this study were to evaluate the effect of related factors that influence orthodontic treatment time and to identify the predictors of orthodontic treatment duration in a Chinese population. MATERIALS AND METHODS Information for 29 sociodemographic, malocclusion and orthodontic treatment characteristics was collected. Patients were divided into two groups: the duration ≤24 months group and duration >24 months group. The treatment dates of the initial visit and end of orthodontic treatment were obtained to calculate duration. The data were subjected to univariate and multivariate logistic regression modelling to quantify the association between characteristics and the treatment duration; odds ratios (ORs) and 95% confidence intervals (95% CIs) are reported. RESULTS Of 2120 patients, 704 patients (mean age, 15.9 ± 6.0 years) were included. Age, extraction, Bolton ratio (overall), rotated teeth, overjet and crowding (lower arch) were predictors for duration. The nomogram based on predictive factors exhibited strong discrimination ability, with concordance indices of 0.755 (95% CI = 0.712-0.798) in the training cohort model and 0.717 (95% CI = 0.647-0.787) in the validation cohort model. The calibration curves for the training and validation cohorts showed that the probabilities of the nomogram agreed well with actual probabilities. CONCLUSIONS Young age, non-extraction and severe crowding (lower arch) can increase the chance of durations of ≤24 months. Rotated teeth, excessive overjet and Bolton ratio (overall) can increase the chance of durations of >24 months.
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Affiliation(s)
- Xueming Shi
- Department of Orthodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Bin Wu
- College of Mechanical and Electronic Engineering, Nanjing Forestry University, Nanjing, China
| | - Dan Cao
- Department of Orthodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Jingjing Liu
- Department of Orthodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Xinyao Qian
- Department of Orthodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Mao Liu
- Department of Orthodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Miaoning Tang
- Department of Orthodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Cheng Yin
- Department of Orthodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Luwei Liu
- Department of Orthodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Bin Yan
- Department of Orthodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
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Robertson L, Owen B, Heo G, Carey JP, Major PW, Romanyk DL. The in vitro biomechanics of anterior arch expansion using fixed lingual appliances with coil springs or archwire stops. Orthod Craniofac Res 2023; 26:531-538. [PMID: 36807468 DOI: 10.1111/ocr.12640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/30/2023] [Accepted: 02/12/2023] [Indexed: 02/22/2023]
Abstract
INTRODUCTION The presented study investigates differences in the biomechanics of straight and mushroom fixed lingual appliances when implementing coil springs and stops for anterior arch expansion. MATERIALS AND METHODS An in vitro orthodontic simulator was used to measure three-dimensional forces and moments on each tooth of a simulated maxillary arch. Mushroom and straight archwire forms of 0.016″ NiTi round archwire were considered, using 0.010″ × 0.030″ NiTi open coils and 0.016″-0.018″ archwire stops (n = 44 per group). Teeth in the anterior dental arch were moved from a neutral to crowded position to replicate anterior crowding of central and lateral incisors. Forces and moments of interest for lateral incisors and first premolars were compared using repeated measures mixed multivariate analysis of variance (α = 0.05). RESULTS Three comparisons between straight versus mushroom archwires and two comparisons of coil springs vs. stops were not statistically significant. Overall, it was found that the use of a straight lingual archwire produced larger differences in forces and moments between using stops and coil springs than when using a mushroom archwire. Using stops produced larger forces and moments for both types of archwires as compared to using coil springs. The largest expansion forces were produced using straight archwires with stops, exceeding 3.0 N of force. Straight archwires with coil springs produced the lowest expansion forces on lateral incisors, just exceeding 1.5 N. CONCLUSIONS The findings of this study have elucidated significant differences in the biomechanics of transverse arch expansion using straight or mushroom fixed lingual appliances with coil springs or stops.
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Affiliation(s)
- Lindsay Robertson
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | | | - Gieson Heo
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Jason P Carey
- Department of Mechanical Engineering, Faculty of Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Paul W Major
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Dan L Romanyk
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Department of Mechanical Engineering, Faculty of Engineering, University of Alberta, Edmonton, Alberta, Canada
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Tee SHM, Shahid S, Al-Moghrabi D, Fleming PS. An assessment of the impact of adhesive coverage and wire type on fixed retainer failures and force propagation along two types of orthodontic retainer wires: an in vitro study. Angle Orthod 2023; 93:712-720. [PMID: 37246952 PMCID: PMC10633805 DOI: 10.2319/110722-765.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 04/01/2023] [Indexed: 05/30/2023] Open
Abstract
OBJECTIVES To evaluate the force required to promote the failure of fixed orthodontic retainers with different adhesive (composite) coverage and to assess the presence and extent of force propagation with two different orthodontic retainer wires. MATERIALS AND METHODS Ortho-FlexTech and Ortho-Care Perform (0.0175 inches), each of 15-cm length, were bonded on acrylic blocks with different adhesive surface diameters (2 mm, 3 mm, 4 mm, and 5 mm). The samples (n = 160) were subjected to a tensile pull-out test, and debonding force was recorded. Fixed retainers using two different wires and 4-mm adhesive diameter were bonded on acrylic bases resembling a maxillary dental arch (n = 72). The retainers were loaded occluso-apically until the first sign of failure while being video recorded. Individual frames of the recordings were extracted and compared. A force propagation scoring index was developed to quantify the extent of force transmission under load. RESULTS A 4-mm adhesive surface diameter required the highest debonding force for both retainer wires with significant differences compared with 2 mm (P < .001; 95% confidence interval [CI]: 8.69, 21.69) and 3 mm (P = .026; 95% CI: 0.60, 13.59). Force propagation scores were significantly higher for Ortho-Care Perform. CONCLUSIONS Based on this laboratory-based assessment, consideration should be given to the fabrication of maxillary fixed retainers using a minimum of 4-mm diameter composite coverage on each tooth. Force appeared to propagate more readily with Ortho-Care Perform than with a flexible chain alternative. This may risk stress accumulation at the terminal ends with potential for associated unwanted tooth movement in the presence of intact fixed retainers.
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Affiliation(s)
- Selena H. M. Tee
- Corresponding author: Dr Selena Hui Ming Tee, Institute of Dentistry, Queen Mary University of London, The Royal London Dental Hospital, Department of Orthodontics, Turner Street, London E1 1FR, UK (e-mail: )
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Khan MR, Shaikh AB. A technique to facilitate impressions in patients with fixed orthodontic appliances. J Prosthet Dent 2023; 130:802-803. [PMID: 35940951 DOI: 10.1016/j.prosdent.2022.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/21/2022] [Accepted: 06/21/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Mehboob R Khan
- Assistant Professor, Department of Prosthodontics, Dr Rajesh R. Kambe Dental College and Hospital, Akola, Maharashtra, India.
| | - Ahzam B Shaikh
- Assistant Professor, Department of Prosthodontics, Dr Rajesh R. Kambe Dental College and Hospital, Akola, Maharashtra, India
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Chou B, Nickel JC, Choi D, Garfinkle JS, Freedman HM, Iwasaki LR. Outcome assessment of orthodontic clear aligner vs fixed appliance treatment in adolescents with moderate to severe malocclusions. Angle Orthod 2023; 93:644-651. [PMID: 37407511 PMCID: PMC10633795 DOI: 10.2319/020923-94.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/01/2023] [Indexed: 07/07/2023] Open
Abstract
OBJECTIVE To compare the efficacy and efficiency of treatment with clear aligners (CAT) vs fixed appliances (FAT) in adolescents with Class I and II moderate to severe malocclusions. MATERIALS AND METHODS One operator's (Garfinkle) cases from 2014 to 2019, started at age 12-18 years, with pre- and posttreatment records were identified and used according to an institutional review board-approved protocol. Records were measured by two calibrated, blinded investigators, aided by software (OrthoCAD [Cadent, Fairview, N.J.], Dolphin Imaging & Management Solutions [Chatsworth, Calif]). Discrepancy index (DI) and cast radiograph evaluation (CRE) scores, treatment duration, number of scheduled and emergency visits, and reported appliance and interarch elastic wear compliance were compared between groups using Wilcoxon rank sum and Fisher's exact tests. Cephalometric superimpositions were completed to evaluate craniofacial growth and dental changes. RESULTS Records from 72 cases met the criteria and were included. For the 47 CAT and 25 FAT cases, mean DI (21 ± 5 and 24 ± 8, respectively; P = .20) and CRE (35 ± 10 and 34 ± 9, respectively; P = .90) scores were not significantly different. Other case attributes and reported appliance and interarch elastic wear compliance were also not significantly different. CAT vs FAT cases had significantly smaller treatment durations (24 ± 6 vs 27 ± 5 months; P = .01) and visit numbers (16 ± 5 vs 24 ± 4; P < .01), but emergency visit numbers were not significantly different (2 ± 2 vs 3 ± 2; P = .08). CONCLUSIONS In adolescents with Class I and II malocclusions and moderate to severe DI scores, on average, CAT vs FAT cases were completed 3 months faster with eight fewer visits, but treatment efficacy was not significantly different.
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Affiliation(s)
- Byron Chou
- Corresponding author: Dr Byron Chou, Division of Orthodontics, Department of Oral and Craniofacial Sciences, School of Dentistry, Oregon Health & Science University, SD-ORTH 2730 S Moody Ave., Portland OR, 97201-5042, USA (e-mail: )
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Wierichs RJ, Selzner H, Bourouni S, Kalimeri E, Seremidi K, Meyer-Lückel H, Kloukos D. Masking-efficacy and caries arrestment after resin infiltration or fluoridation of initial caries lesions in adolescents during orthodontic treatment-A randomised controlled trial. J Dent 2023; 138:104713. [PMID: 37730095 DOI: 10.1016/j.jdent.2023.104713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/14/2023] [Accepted: 09/17/2023] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVES The aim of this randomised, controlled, split-mouth trial was to assess the masking results in initial caries lesions (ICL) that were either resin infiltrated or fluoridated during treatment with fixed orthodontic appliances. METHODS Adolescent patients (age range:12-18years) with fixed orthodontic appliances who had developed ICL [ICDAS 1 or 2 (International Caries Detection and Assessment System)] during orthodontic treatment were consecutively recruited and randomly assigned to either resin infiltration with up to 3 etching procedures (Group:Inf) or to 3-monthly application of a fluoride varnish (Group:FV). Both interventions were performed according to the manufacturer's recommendations. Primary and secondary outcomes (ΔE, ICDAS, DIAGNOdent) included the evaluation of the appearance of the ICL before (T0), 1 week after (T1) treatment and at the last appointment before debonding (T2). RESULTS Fifteen patients (8females, 7males) with 57ICL were included. Mean (SD) observation time at the last appointment before debonding was 0.5 (0.3) years. At T0 FV and Inf did not differ significantly in ΔE (median ΔE0,FV(25th/75th percentiles):11.6 (8.7/20.3): ΔE0,Inf:15.1 (11.4/19.5); pT0 = 0.135), ICDAS (pT0 = 0.920) and DD (pT0 = 0.367). At T1 and T2 ΔE values (pT1<0.001, pT2<0.001), ICDAS scores (pT1<0.001, pT2<0.001) and DIAGNOdent values (pT1 = <0.001, pT2 = <0.001) for Inf were significantly reduced whereas ΔE values (pT1 = 0.382, pT2 = 0.072) and ICDAS scores (pT1 = 0.268, pT2<0.001) for FV remained unchanged. CONCLUSIONS Resin infiltration effectively masked ICL during treatment with fixed orthodontic appliances both immediately after application and at the last appointment before debonding. Furthermore, the visual appearance of fluoridated lesions was not as satisfactory as that of the infiltrated ones at both T1 and T2. CLINICAL SIGNIFICANCE Resin infiltration effectively masked ICL during treatment with fixed orthodontic appliances both immediately after application and at the last appointment before debonding. Furthermore, the visual appearance of fluoridated lesions was not as satisfactory as that of the infiltrated ones immediately after first application as well as half a year after application. TRIAL REGISTRATION German Clinical Trials Register (DRKS-ID: DRKS00011797).
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Affiliation(s)
- Richard Johannes Wierichs
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, Bern 3010, Switzerland.
| | - Hannah Selzner
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, Bern 3010, Switzerland
| | - Sotiria Bourouni
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, Bern 3010, Switzerland
| | - Elena Kalimeri
- Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force & VA General Hospital, Athens, Greece
| | - Kyriaki Seremidi
- Department of Paediatric Dentistry, Athens School of Dentistry, National and Kapodistrian University of Athens, Greece
| | - Hendrik Meyer-Lückel
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, Bern 3010, Switzerland
| | - Dimitrios Kloukos
- Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force & VA General Hospital, Athens, Greece; Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, Switzerland
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Mu C, Sun B, Gong Z, Wei Y, Chen L, Zhang W, Wu H, Zhao B. The tooth movement efficiency of different orthodontic thermoplastics for clear aligners: study protocol for a randomized controlled clinical trial. Trials 2023; 24:684. [PMID: 37872599 PMCID: PMC10594683 DOI: 10.1186/s13063-023-07736-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/16/2023] [Indexed: 10/25/2023] Open
Abstract
INTRODUCTION With regard to the esthetics and comfort of orthodontic treatment, the requirement for removable clear aligners (CAs) is increasing. Unlike conventional fixed orthodontic appliances, CAs were made of thermoplastic film by thermoforming on the personalized dental models. The construction of orthodontic thermoplastic is a critical factor for orthodontic tooth movement (OTM). Polyethylene terephthalate glycol-modified (PETG) and thermoplastic polyurethane (TPU) are the most commonly orthodontic thermoplastics; however, the evidence of the differences between different orthodontic thermoplastic are limited to vitro environment and the evidence in vivo environment is not available. Therefore, this trial aims to provide reliable evidence for orthodontists' personalized treatment plans whether the two most commonly used orthodontic thermoplastics of PETG and TPU have differences in the efficiency of OTM. METHODS AND ANALYSIS This randomized controlled clinical study will recruit 44 orthodontic patients for orthodontic treatment. All the subjects will be randomized into two groups (PETG and TPU, n = 22 for each group). In the first stage (M0 to M1), clear aligners will be made of two orthodontic thermoplastics and move the maxillary first or second premolars 2 mm. In the second stage, patients will take the standard orthodontic treatments. The primary outcome will be the efficiency of clear aligners made of different materials on the digital models. The secondary outcome will be the efficiency of clear aligners made of different materials on the cone-beam computed tomography (CBCT). The efficiency will be calculated through the superimposition of the digital models and CBCT. DISCUSSION The results from this trial will serve as evidence for orthodontists and manufacturers and clarify whether the difference in orthodontic thermoplastics significantly impacts the efficiency of OTM. TRIAL REGISTRATION NUMBER ChiCTR2300070980. Registered on 27 April 2023. https://www.chictr.org.cn/showproj.html?proj=186253.
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Affiliation(s)
- Chuangchuang Mu
- Department of Orthodontics, Shanghai Stomatological Hospital, Fudan University, No.356 Beijing East Road, Shanghai, China
| | - Bingjing Sun
- Department of Orthodontics, Shanghai Stomatological Hospital, Fudan University, No.356 Beijing East Road, Shanghai, China
| | - Zhicheng Gong
- Department of Dental Technology, Shanghai Stomatological Hospital, Fudan University, Shanghai, China
| | - Yuanyuan Wei
- Department of Orthodontics, Shanghai Stomatological Hospital, Fudan University, No.356 Beijing East Road, Shanghai, China
| | - Li Chen
- Department of Orthodontics, Shanghai Stomatological Hospital, Fudan University, No.356 Beijing East Road, Shanghai, China
| | - Wei Zhang
- Department of Orthodontics, Shanghai Stomatological Hospital, Fudan University, No.356 Beijing East Road, Shanghai, China
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
| | - Haimiao Wu
- Department of Orthodontics, Shanghai Stomatological Hospital, Fudan University, No.356 Beijing East Road, Shanghai, China
| | - Bingjiao Zhao
- Department of Orthodontics, Shanghai Stomatological Hospital, Fudan University, No.356 Beijing East Road, Shanghai, China.
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Kamala C, Ujwala P, Sasidhar YN, Sudheer B. A comparative evaluation of mechanical wear of adhesives used for bonded retainers that underwent brushing for 1 hour under 36 mm of linear action, using computer-aided 3D scan-an in vitro study. Clin Oral Investig 2023; 27:5805-5812. [PMID: 37587351 DOI: 10.1007/s00784-023-05192-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 07/28/2023] [Indexed: 08/18/2023]
Abstract
OBJECTIVES The aim of the present study was to comparatively evaluate the mechanical wear of adhesives used in bonded retainers. MATERIALS AND METHODS Eighty mandibular acrylic teeth were included in the study that were divided into 4 different groups based upon the composite used. Each acrylic tooth was bonded with a retainer wire and composite of their respective group (Heliosit, Restofill, Tetric-N-flow, and Filtek Z350 XT). These bonded acrylic teeth were subjected to 3D scan in order to evaluate the volume and surface area of the composite. The 3D scans were recorded using MEDIT 3D scanner. After evaluating, the samples were subjected to brushing with the aid of a custom-made brushing simulator using a toothbrush with soft bristles and toothpaste slurry. The samples were subjected to 1 hr of brushing. These samples were again subjected to 3D scans to evaluate (post-test volume and surface area) and underwent statistical analysis. RESULTS The results showed the Heliosit group exhibited the highest mean volume (1.76 mm3) and surface area (4.81 mm2) difference between the pre-test and post-test values whereas the least mean volume difference (1.10 mm3) and surface area difference (3.21 mm2) were seen in the Tetric-N-flow group. CONCLUSION All the four composites underwent change in the mean surface area and volume after being subjected to brushing, suggesting that the composites routinely used for bonding fixed bonded lingual retainers are subjected to changes due to abrasion. The Heliosit group, which showed least filler loading among the 4 composites, exhibited least resistance to wear, whereas the Tetric-N-flow group which had highest filler loading among the composites exhibited highest resistance to wear. CLINICAL RELEVANCE The most crucial phase during orthodontic treatment is the retention phase. This phase is responsible for the long-term results of the treatment. The retainers that are placed in the oral cavity are subjected to changes due to oral environment, chemical changes, and mechanical changes. These changes have a direct effect on the retainers, which tend to alter their properties. Thus, the effects of these changes are to be studied thoroughly.
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Affiliation(s)
- C Kamala
- GITAM Dental College and Hospital, Visakhapatnam, India.
| | - P Ujwala
- GITAM Dental College and Hospital, Visakhapatnam, India
| | - Y N Sasidhar
- GITAM Dental College and Hospital, Visakhapatnam, India
| | - B Sudheer
- GITAM Dental College and Hospital, Visakhapatnam, India
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Sim M, Park S. Orthodontic treatment using directly 3D-printed clear aligners. J Clin Orthod 2023; 57:606-613. [PMID: 38019793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Affiliation(s)
- Miyoung Sim
- Department of Orthodontics and Dentofacial Orthopedics, Tsurumi University School of Dental Medicine, Yokohama Japan.
| | - Sungwon Park
- Department of Dentistry, Jungang University Kwangmyeong Hospital, Kyeonggido, South Korea
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Curado MDM, Minervino BL, Leite CDO, Salles LP, Oliveira-Salles GHD, Gandini LG, Macedo SB. Preclinical in vitro study of streptococcus mutans accumulation in three fixed retainer designs: Microbiological assay. Dent Mater J 2023; 42:646-653. [PMID: 37423720 DOI: 10.4012/dmj.2023-003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
The use of fixed retainers in the lower arch is frequent; however, its presence increases the accumulation of biofilm and dental calculus. The objective of this research was to evaluate, in vitro, the accumulation of Streptococcus mutans (S. mutans) in 3 designs of fixed retainers. Nine models were reproduced in heat-cured acrylic resin and divided into groups: straight retainer (SR), retainer with vertical strap (RVS), retainer with horizontal strap (RHS). The accumulation of S. mutans was assessed using the MTT assay (3-4,5-dimethyl-thiazol-2-yl-2,5-diphenyltetrazolium bromide) and then measured using an automated reader. The RHS group showed less biofilm accumulation compared to the other groups (p<0.05). The distance between the tooth surface and the retainer showed a strong negative correlation with biofilm accumulation (rs=-0.79, p=0.00037). The RHS showed significantly less accumulation of S. mutans due to the distance between the retainer and the tooth surface. This research provides relevant data for a future randomized clinical trial.
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Affiliation(s)
- Marcelo de Morais Curado
- Department of Orthodontics, University of Planalto Central Apparecido dos Santos, Faculty of Dentistry
- Dentistry, University of Brasilia, Campus Universitário Darcy Ribeiro
| | - Bruno Lima Minervino
- Department of Orthodontics, University of Planalto Central Apparecido dos Santos, Faculty of Dentistry
| | | | - Loise Pedrosa Salles
- Endodontics, Post-Graduation in Dentistry, Faculty of Health Sciences, University of Brasilia, Campus Universitário Darcy Ribeiro
| | | | - Luiz Gonzaga Gandini
- Department of Orthodontics and Pediatric Dentistry São Paulo State University, School of Dentistry
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Bardideh E, Ghorbani M, Shafaee H, Saeedi P, Younessian F. A comparison of CAD/CAM-based fixed retainers versus conventional fixed retainers in orthodontic patients: a systematic review and network meta-analysis. Eur J Orthod 2023; 45:545-557. [PMID: 37471113 DOI: 10.1093/ejo/cjad033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
OBJECTIVE Comparing computer-aided design and computer-aided manufacturing (CAD/CAM) fixed retainers and conventional fixed retainers for their effectiveness in orthodontic patients using systematic review and meta-analysis of literature. SEARCH METHODS A comprehensive search was conducted in MEDLINE, Web of Science, EMBASE, Scopus, Cochrane's CENTRAL, Google Scholar, Ovid, and LILACS up to May 2023, with no language or date restrictions. SELECTION CRITERIA Only randomized clinical trials (RCTs) that complied with PICO questions were included, and the Cochrane Risk of Bias 2.0 (RoB 2) tool was used to assess the risk of bias in the included studies. DATA COLLECTION AND ANALYSIS Using custom-piloted forms, relevant data were retrieved from the included studies. Then a random-effects inverse variance meta-analysis was used to pool the results. Primary outcomes were stability of treatment results measured through dental cast measurements and periodontal status, while secondary outcomes were failure rates and patient-reported outcomes. RESULTS Seven RCTs with 601 participants were included in the review. In the short term (≤6 months), the meta-analysis showed no significant differences in inter-canine distance or arch length between CAD/CAM and conventional fixed retainers in mandibular retainers. However, for Little's irregularity index, single-stranded stainless-steel retainers were notably worse than Ni-Ti CAD/CAM retainers at 3 and 6 months, while multi-stranded stainless-steel retainers only diverged from CAD/CAM at the 6-month milestone, despite the overall clinical inconsequence of these changes. CAD/CAM retainers were associated with a lower plaque index than traditional retainers but no significant difference in gingival index. Failure rates did not differ significantly between CAD/CAM and other types of retainers in mandibular retainers. Nonetheless, one study had a high amount of CAD/CAM retainer failures leading to the study being stopped. CONCLUSIONS In the short term, CAD/CAM fixed retainers show promise as an alternative to traditional retainers. They may enhance periodontal health, as indicated by lower plaque index scores than conventional retainers. However, extensive research is needed to determine the long-term durability and effectiveness of CAD/CAM retainers in orthodontic treatment, particularly regarding their failure rate. Until comprehensive evidence is available, the use of CAD/CAM retainers should be tailored for each case. REGISTRATION The protocol for this systematic review was registered at PROSPERO with the ID CRD42023412741.
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Affiliation(s)
- Erfan Bardideh
- Dental Research Center, Orthodontics Department, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahsa Ghorbani
- Undergraduate Student of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hooman Shafaee
- Dental Research Center, Orthodontics Department, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Pooya Saeedi
- Undergraduate Student of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farnaz Younessian
- Orthodontics and Pediatric Dentistry Department, School of Dentistry, University of Maryland, Baltimore, MD, United States
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Chen W, Ren J, Li J, Peng S, Zhang C, Lin Y. Effects of probiotics on the oral health of patients undergoing orthodontic treatment: a systematic review and meta-analysis. Eur J Orthod 2023; 45:599-611. [PMID: 37552088 PMCID: PMC10505686 DOI: 10.1093/ejo/cjad046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
BACKGROUND AND OBJECTIVE The effect of probiotics on oral health maintenance in orthodontic patients remains controversial. The aim of the study is to systematically review and assess the effects of probiotics on the oral health and microbiome of patients undergoing orthodontic treatment. SEARCH METHODS AND SELECTION CRITERIA Databases including PubMed, Web of Science, Cochrane Library, ClinicalTrials.gov, and ProQuest Dissertations & Theses Global databases were searched from their inception until June 2022. Randomised controlled trials that assessed the effects of probiotics on clinical and microbial outcomes in patients undergoing orthodontic treatment were included. DATA COLLECTION AND ANALYSIS Data screening and collection were performed, and the risk of bias (RoB) was assessed using the Cochrane RoB 2 tool. The meta-analysis evaluated the effects of probiotics on Streptococcus mutans (S. mutans) and Lactobacillus counts. The quality of the evidence from the meta-analyses was assessed with Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS A total of 405 records were identified, of which 15 studies were included in the qualitative synthesis and 4 in the meta-analysis. The patients in all the included studies were treated with fixed orthodontic appliances. Results regarding clinical outcomes were controversial; four out of five studies reported no significant changes in plaque in the probiotic group (P > .05), and two out of three studies reported no significant changes in the gingival index (P > .05). Regarding microbial outcomes, the meta-analysis results revealed that probiotics significantly increased the likelihood of reducing the abundance of S. mutans to below 105 CFU/ml (risk ratio: 2.05 [1.54, 2.72], P < .001) and reduced the likelihood of increasing the abundance of S. mutans to beyond 106 CFU/ml (risk ratio: 0.48 [0.28, 0.83], P = .009). However, the quality of evidence according to the GRADE was moderate. CONCLUSIONS AND IMPLICATIONS There is insufficient evidence to determine the clinical benefits of probiotics as a supplement for the oral health of patients undergoing orthodontic treatment. However, probiotics may have benefits in reducing the salivary S. mutans counts in orthodontic patients. REGISTRATION PROSPERO (CRD42022366650).
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Affiliation(s)
- Wener Chen
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong SAR, China
| | - Jianhan Ren
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong SAR, China
| | - Jiachen Li
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong SAR, China
| | - Simin Peng
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong SAR, China
| | - Chengfei Zhang
- Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong SAR, China
| | - Yifan Lin
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong SAR, China
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Sonesson M, Twetman S. Prevention of white spot lesions with fluoride varnish during orthodontic treatment with fixed appliances: a systematic review. Eur J Orthod 2023; 45:485-490. [PMID: 37032523 PMCID: PMC10505687 DOI: 10.1093/ejo/cjad013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
BACKGROUND Fluoride varnish (FV) is an established technology for primary and secondary caries prevention. OBJECTIVE The aim of this review was to evaluate the preventive effect of FV on development of white spot lesions (WSL) when regularly applied during orthodontic treatment with fixed appliances. SEARCH METHODS We searched PubMed, Scopus and Google Scholar up to October 2022 using predetermined keywords. SELECTION CRITERIA We included randomized controlled trials of a duration of minimum 12 months and at least quarterly FV applications. DATA COLLECTION AND ANALYSIS Based on abstracts, we retrieved full-text papers, extracted key outcome data, and assessed risk of bias. Primary outcome was prevalence of WSLs on subject level after debonding. We conducted a narrative synthesis and pooled comparable outcome data in a random effects model. RESULTS We included seven studies covering 666 patients and assessed four publications with low or moderate risk of bias and three with high. The prevalence of WSLs at debonding varied between 12 and 55%. All studies presented results in favour for the FV intervention, one reached statistical significance on subject level. Five studies provided data for a meta-analysis. The pooled risk ratio was 0.64 [95% CI: 0.42, 0.98], indicating a statistically significant preventive effect. Certainty of evidence was graded as very low after reducing for risk of bias, inconsistency and imprecision. LIMITATIONS We pooled data on subject level and did not consider lesion severity on tooth level. CONCLUSIONS AND IMPLICATIONS Even if the certainty of evidence was very low, it was shown that FV can prevent development of WSL when regularly applied during orthodontic treatment. Larger investigations reporting a core outcome set are required to increase the certainty of evidence. REGISTRATION PROSPERO database (CRD42022370062).
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Affiliation(s)
- Mikael Sonesson
- Department of Orthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Svante Twetman
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Tayebi A, Sheikh Davoodi N, Rahimipour K, Mousavi R, Mirzadeh M, Amin M, Vaseghi E. Mobile app for comprehensive management of orthodontic patients with fixed appliances : Design and use. J Orofac Orthop 2023; 84:311-320. [PMID: 34994803 DOI: 10.1007/s00056-021-00370-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 11/22/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES This study aimed to design and implement a mobile phone application (app) aiming to enhance the cooperation and oral hygiene of orthodontic patients. METHODS An orthodontic app named "Labkhand" was designed by a team of orthodontists and programmers according to the needs and scheduled interventions for patients. The aim of this app was to obviate the orthodontic needs of patients by providing educational content in the form of texts and videos, oral hygiene reminders, appointment reminders, and nutrition reminders. It also enabled instant messaging and chatting between patients and dental personnel. In this study, 61 patients were monitored during their orthodontic treatment procedure. All patients were evaluated using a questionnaire with 7 questions before and after a 6-month treatment period. A total of 31 patients were instructed to use the app, while the other 30 patients received treatment without the app. The collected data were analyzed using paired t‑test and analysis of covariance (ANCOVA) test. RESULTS While the control group's questionnaire score remained almost the same (P > 0.05), the mean questionnaire score of patients in the intervention group significantly increased after using the app compared to the baseline scores acquired before using the app (P < 0.001). The greatest improvement was noted in topics related to "reminding of appointments", "general information about orthodontic treatment", and "oral hygiene maintenance and instructions". "Quality of services" and "patient-orthodontist communication" showed the least improvement in patient satisfaction. CONCLUSIONS The Labkhand orthodontic app has multiple functions and can obviate the needs of orthodontic patients easily and at a low cost.
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Affiliation(s)
- Ali Tayebi
- Department of Orthodontics, Qazvin University of Medical Sciences, Qazvin, Iran
| | | | - Kasra Rahimipour
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Daneshjou Boulevard, Evin, Tehran, Iran.
| | - Reza Mousavi
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Daneshjou Boulevard, Evin, Tehran, Iran
| | - Monirsadat Mirzadeh
- Metabolic Disease Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohammadreza Amin
- Faculty of Dentistry, Qazvin University of Medical Sciences, Qazvin, Iran
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Abu Arqub S, Al-Moghrabi D, Tsichlaki A, Sanders D, Uribe F. The dark side of fixed retainers: Case series. Am J Orthod Dentofacial Orthop 2023; 164:e72-e88. [PMID: 37452794 DOI: 10.1016/j.ajodo.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/01/2023] [Accepted: 06/01/2023] [Indexed: 07/18/2023]
Abstract
This article focuses on on the presentation and management 9 adult patients who experienced complications because of their maxillary or mandibular fixed retainers 5-33 years after orthodontic treatment. Such complications include the development of an anterior crossbite, open bite, incisal cant, and twist- and x-effects. The detrimental effects on periodontal health were highlighted, especially in the mandibular canines. A range of fixed retainer types was identified, including flexible spiral wire bonded to 4 maxillary or 6 mandibular anterior teeth, rigid wire bonded to mandibular canines only and fiber-reinforced composite fixed retainer. Orthodontic retreatment was necessary in all patients using fixed appliances or clear aligners. Radiographic findings from cone-beam computed tomography or orthopantomogram before and after retreatment are presented when available. Despite the improvement of teeth position clinically, the cone-beam computed tomography scans taken directly after the completion of orthodontic retreatment did not show notable improvement with regards to root proximity to the cortical plates. The prevention of further complications was highlighted, including the use of dual retention, remote monitoring, frequent follow-up appointments and the importance of developing clear guidelines for monitoring patients in retention for treating clinicians and general dentists to promote early detection of adverse changes.
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Affiliation(s)
- Sarah Abu Arqub
- Department of Orthodontics, College of Dentistry, University of Florida, Gainesville, Fla.
| | - Dalya Al-Moghrabi
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | | | | | - Flavio Uribe
- Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut Health, Farmington, Conn
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ElNaghy R, El-Aassar YM, Hasanin M. ACTIVATION OF FIXED LABIAL APPLIANCES, BRIEFLY AT INITIATION, MAY REDUCE MASTICATORY PERFORMANCE AND BITE FORCE. J Evid Based Dent Pract 2023; 23:101885. [PMID: 37689452 DOI: 10.1016/j.jebdp.2023.101885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/11/2023]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Duarte L, Bezerra AP, Flores-Mir C, De Luca Canto G, Pereira LJ, Vega Gonçalves TMS. Activation and installation of orthodontic appliances temporarily impairs mastication. Angle Orthod. 2022 Mar 1;92(2):275-286. doi: 10.2319/061,221-469.1. PMID: 34,878,525; PMCID: PMC8887415. SOURCE OF FUNDING Not reported. TYPE OF STUDY/DESIGN Systematic review with meta-analysis of data.
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