Completion Of Orthodontic Treatment Research Articles

Frequency of posterior teeth that presented with pulpal calcifications after orthodontic treatment; a retrospective radiographic assessment.

Objective: To assess the pulpal calcification that was presented on radiographs after the completion of orthodontic treatment. Study Design: Retrospective Observational study. Setting: Department of Orthodontic, Ayub Medical College Abbottabad. Period: October 2023 to November 2023. Methods: Following the inclusion and exclusion criteria, the current study was carried out on patients who had reported and registered for orthodontic intervention within the previous five years and had case records from the orthodontics department available. A total of 670 case records were assessed for selecting 191 cases as per sample size. Results: Among 191 patients, 30.4% were male and 69.6% were female. The highest percentage belonged to the 14-16 age group (32%), followed by 20-22 (28.3%), 17-19 (26.2%), and 23-25 (12.6%) age groups. Pre-treatment calcification was 17.8% (n=34), rising to 28.3% (n=54) post-treatment. Pulp calcification significantly increased after orthodontic treatment (p<0.05). No significant differences were found between gender and age groups regarding pulp calcification (p>0.05). However, a significant association existed between pulp calcification and treatment duration (p<0.05). The 25-30 months treatment duration had the highest occurrence (n=27), followed by 31-36 months (n=19). Mandibular teeth had a higher prevalence of pulp calcification (53.7%) than maxillary teeth (46.3%), with tooth number 36 having the highest prevalence (25.9%). A significant relationship was observed between the left and right sides of the dental arches, with the left side exhibiting greater tooth calcification (68.5%) than the right side (31.5%). Conclusions: The present study concluded that there was an increase in the frequency of pulpal calcifications in the observed posterior teeth after orthodontic treatment. Pulpal calcifications were significantly more prevalent in the posterior teeth of the mandibular arch compared to the maxillary arch. Moreover, the likelihood of pulpal calcification increased over the duration of orthodontic treatment.

Skeletal stability of inter-molar mandibular distraction osteogenesis in growing patients

IntroductionThe aim of this retrospective study was to firstly assess the stability of surgical advancement using inter-molar mandibular distraction osteogenesis (IMDO) and secondly to assess the impact of the surgical intervention on subsequent mandibular growth in patients with residual growth.MethodsThe sample consisted of 17 (13F and 4M) consecutively treated patients who underwent IMDO and orthodontic treatment. Cephalometric analysis was performed at three time points: T0 prior to distraction; T1 post-distraction immediately prior to surgical removal of the distractors; and T2 following completion of orthodontic treatment when the final lateral cephalogram was taken (0.86–4.37 years after T1). Statistical comparison of lower facial height, mandibular length, growth, condylar position and anterior mandibular rotation was performed.ResultsNo association was found between changes in any of the cephalometric measurements and the length of the follow-up interval. The anterior mandibular segment underwent clockwise rotation during distraction and recovered to near its pre-distraction angulation during remodelling. An increase in the lower facial height of 1.88 ± 2.81mm also occurred during distraction (T0–T1) and was maintained during the follow-up period (T1–T2). Post-distraction (T1–T2) growth of lower facial height (p value 0.872) and mandibular length (p value 0.251) showed no association when compared to an untreated control group and an overall reduction in growth was reported.ConclusionsIMDO was highly stable within a follow-up period of 2.3 ± 0.9 years; however, growth appears to have been inhibited.

Assessment of patient satisfaction level with orthodontic treatment in private orthodontic practice: A questionnaire survey

Abstract Context: Patient satisfaction gives important insight into the patient’s expectations and perceptions of the quality of service. There have not been many studies done in Nepal on the evaluation of orthodontic treatment satisfaction after it has been completed. Aims: The goal of this study was to analyze patient satisfaction after orthodontic treatment was completed. Settings and Design: In Private Dental Clinics in Kathmandu, Nepal, 115 patients who had finished their orthodontic treatment within a year of the research’s inception were the subjects of this descriptive cross-sectional study. Materials and Methods: The patient was called over the phone for a follow-up examination. At the time of follow-up, the data was collected from them by a self-administered questionnaire. Statistical Analysis Used: The degree of satisfaction was measured using descriptive statistics, such as frequencies, percentages, and the Likert 5-point scale. The Mann–Whitney U-test was used to compare the levels of satisfaction between males and females, as well as across age groups (15–25 years) and those beyond 25 years after orthodontic treatment had finished. Results: The degree of satisfaction of patients was excellent regarding the behavior of the orthodontist. In terms of patient satisfaction, there was no discernible difference between patients of either gender. The degree of satisfaction with the orthodontist’s behavior varied significantly across patients in the age groups of 15–25 years and those above 25 years. Conclusion: The level of patient satisfaction following the completion of orthodontic treatment will aid in service improvement, planning, and organization, leading to high-quality care.

The orthodontic treatment and the periodontal status of patients.

Aim: To review and analyze modern professional literature on the impact of orthodontic treatment of maxillofacial anomalies on the periodontal status of patients, in particular, the subsiqent pathogenetic mechanisms of the development of periodontal diseases in this category of patients. Materials and Methods: Bibliometric and analytical methods were used data from international scientific sources in the field of studying the impact of orthodontic treatment on the state of periodontal tissues were used. Conclusions: Patients undergoing orthodontic treatment need the increased attention to the state of periodontal tissues and regular high-quality both professional and individual oral hygiene. A comprehensive approach to treatment and preventive measures for periodontal diseases, taking into account all pathogenetic links of their development in this category of patients, aims not only to keep the periodontium healthy, but also to ensure successful completion of orthodontic treatment. Taking into account consideration the periodontal status of patients allows individual correction of the treatment plan to increase its clinical effectiveness both in the early and in the long term.

A Systematic Review and Meta-Analysis of the Impact of Cancer and Its Treatment Protocol on the Success of Orthodontic Treatment.

There are several significant gaps in current studies of the relationship between anti-cancer medications and orthodontic care that call for more investigation. As a result, the main goals of this systematic review and meta-analysis were to summarise and assess the information that was available regarding the effect of radiotherapy and anti-cancer medications on the overall successful completion of an orthodontic treatment plan. A standardised data extraction form was devised in accordance with the PRISMA guidelines to conduct a systematic review and meta-analysis, with specific criteria implemented for selecting studies with low to moderate risk of bias. Five studies involving different methodologies were selected at the conclusion of the search strategy. The statistical analysis revealed an estimated odds ratio (OR) of 0.31 and relative risk (RR) of 0.48, indicating a statistically significant association between the use of radiotherapy and anti-neoplastic drugs and a noticeable reduction in the successful completion of orthodontic treatment. The heterogeneity analysis showed significant heterogeneity among the studies. This review emphasises that, although orthodontic therapies can still be beneficial for children receiving chemotherapy, the effectiveness of the therapy may be diminished in older populations. The findings further highlight how crucial it is to take cancer therapies into account when planning and managing orthodontic treatment in order to optimise results and reduce problems.

A Modified Retainer to Prevent Supra-Eruption of Maxillary Molars

The adult patients requiring orthodontic treatment usually need adjunctive dental care for complete rehabilitation. There are so many orthodontic appliances that are used as retainer after comprehensive treatment to retain the orthodontic tooth movement achieved. The purpose of this clinical pearl is to showcase a modified acrylic retainer to prevent the supra-eruption of terminal molar whose antagonist tooth was to be replaced using dental implant after the completion of orthodontic treatment.

Long-Term Clinical and Radiographic Observation of Previously Regenerated Treated Incisors Subjected to Orthodontic Movement. A Case Series

IntroductionWith an increasing number of anterior traumatized teeth treated with regenerative endodontic procedures (REPs) nowadays, orthodontic movement of such teeth is expected to become a common scenario in everyday clinical practice. However, little is known about the clinical implications and the response capacity of regenerated tissues to orthodontic forces. MethodsThe aim of this clinical article was to report on 4 cases of REP-treated immature anterior permanent teeth subjected to orthodontic forces, and to describe the long-term response of the regenerated apical and intracanal tissues. ResultsSigns of orthodontic-induced external root resorption were observed in 2 of the 4 presented cases without, however, the presence of any associated adverse events. No other complications were observed, either clinically or radiographically, throughout the observation period. In the long-term, all 4 cases responded favorably to orthodontic forces, maintaining healthy apical tissues and structural integrity of both intracanal as well as apically regenerated tissues. ConclusionsThe orthodontic movement of REP-treated teeth seems feasible, nevertheless, special care should be implemented. Lightly acting orthodontic forces, short duration of active movement, and close monitoring of the patient seem to be prerequisites to limit complications to a minimum and achieve a favorable healing of REP-treated teeth in the long-term following orthodontic treatment completion.

Oral-health-related quality of life in adolescents: umbrella review

BackgroundTo evaluate oral conditions, demographic and socioeconomic characteristics of oral health-related quality of life (OHRQoL) in adolescents.MethodsUmbrella review, conducted according to the Preferred Reporting Items for Systematic Reviews and Meta Analyzes (PRISMA) checklist. The search strategy used a combination of words, applied in the electronic databases PubMed, WebScience, Embase, Lilacs, Scopus and Cochrane. Included publications until January 2022, without restrictions. Data collection took place with systematized practices and the eligibility criteria were studies focusing on OHRQoL; teenagers; adolescentes; present the term “systematic review” and/or “meta-analysis” in the title or abstract. The quality assessment followed the Assessment of Multiple Systematic Reviews (AMSTAR 2) and the adherence of the article to the PRISMA was verified.ResultsThree hundred sixty-two articles were identified, and 22 were included, published between 2009 and 2022. 21 Systematic reviews focused on the English language. Most studies showed heterogeneity in the methodological structuring process: 10 articles were considered of low and 10 critically low quality. Clinical conditions associated with worsening in quality of life were dental caries, malocclusion, dental trauma, toothache, edentulism, need for orthodontic treatment, irregular brushing, and periodontal disease. Socioeconomic factors related to housing, parental education, access to health care, absence of siblings and nuclear family influence OHRQoL. Completion of orthodontic treatment, health promotion programs, dental care and safe housing all have a positive impact.ConclusionWorse oral health status, older age, female sex and worse socioeconomic status were significantly associated with worse OHRQoL.Trial registrationPROSPERO CRD4202129352.

ASSESSING THE STATE OF THE ALVEILAR MORPHOTYPE IN PLANNING AND CARRYING OUT ORTHODONTIC TREATMENT OF PATIENT WITH INFLAMMATORY PERIODONTAL DISEAS ES

Aim: to assess the state of periodontal tissues when planning and performing controlled orthodontic movement of crowns and roots of teeth using the overlay of computed tomography on 3-D visualization of the process of movement of dentition in patients with inflammatory periodontal diseases.
 Methods: Based on the inclusion and non-inclusion criteria, the study involved 80 patients aged 25-35 years, who were divided into 2 groups - control (with clinically healthy periodontium) and main (with chronic generalized periodontitis) for orthodontic treatment of dentoalveolar anomalies. Orthodontic equipment for the comparison groups was identical (aligners, vestibular and lingual braces with passive self-ligation). Prior to the start of the orthodontic program, the alveolar morphotype was determined by CT of patients superimposed on the program for digital modeling of the future result; the optical density of the alveolar bone was estimated in Hounsfield units (HU). Clinical indicators for assessing the condition of periodontal tissues and after completion of the orthodontic program in the comparison groups.
 Results: After the completion of orthodontic treatment, patients of group 1 had a lower number of periodontal complications - 42% versus 54% in group 2, with initially normal periodontium with a thin alveolar morphotype; 18% and 23% - with a thick alveolar morphotype. The best results were noted in the aligners subgroup - 16% and 18% for groups 1 and 2, respectively; the worst - in the subgroup with lingually fixed braces - 50% and 55%, respectively. The most common periodontal complication was tissue recession. Thanks to the predictive planning of the assessment of patients' computed tomograms superimposed on the program of digital modeling of the final result after the displacement of teeth, a positive result of orthodontic treatment was obtained and the risk of negative impact of the orthodontic program on both intact periodontal tissues and damaged periodontium was minimized.
 Conclusions: The new ability to control the state of the alveolar ridge bone using 3-D visualization of tooth movement with CT overlay increases the efficiency of orthodontic treatment planning by 40%, ensuring a minimum of side effects and complications.

EFFECT OF ORTHODONTIC TREATMENT OF GENERALIZED PERIODONTITIS ON ORAL HYGIENIC STATUS

Orthodontic treatment of patients with generalised periodontitis can have a negative impact on the periodontium. Removable orthodontic appliances have a lesser impact on the periodontium. Considering such details of orthodontic treatment for patients with generalized periodontitis, it is critical to start orthodontic treatment as early as possible, when significant manifestations of traumatic occlusion and pronounced displacements of teeth have not developed yet.
 The study aimed to determine the effectiveness of early orthodontic treatment using removable orthodontic appliances in patients with generalized periodontitis and its effect on the hygienic status of the periodontium. The study involved 40 adolescents (18-35 years) with generalized periodontitis who had displaced upper front teeth. Removable orthodontic appliances and individual retainers were used for orthodontic correction, and the patients underwent a comprehensive examination of the periodontium to assess their hygienic indices during the course of treatment.
 The assessment of the periodontal tissues shows that almost all patients had an inflammatory process in their periodontal tissues. Previously, the patients had undergone Phase 1 integrated treatment for generalized periodontitis. One month after the beginning of the orthodontic correction, there was certain deterioration in the periodontal condition. However, following the completion of orthodontic treatment, the hygienic condition of the periodontium improved.
 The study concluded that the combination of periodontal disease and tooth displacement requires comprehensive treatment using orthodontic methods. While the use of orthodontic treatment led to some deterioration in the periodontal condition, appropriate correction of drug treatment and rational oral hygiene practices can compensate for this.

Third molar position after completion of orthodontic treatment: a prospective follow-up.

To prospectively follow up a previously reported sample, analyzing (1) changes in third molar (M3) position after completion of 2 different types of orthodontic treatment: (2) non-extraction treatment with (HG) vs without cervical headgear (non-HG) and (3) first or second premolar extractions (PM1-2) compared to a non-extraction group (NE). A total of 474 patients were prospectively followed up. Panoramic radiographs were taken pre- (T1), post-treatment (T2) and at follow-up (T3). T3 records (a mean of three years after treatment) were available for 135 (HG vs non-HG) and 134 patients (PM1-2 vs NE), respectively. Angulation, vertical position, relation with the mandibular canal and mineralization status of M3 at T2 and T3 were statistically compared. The HG group presented more M3 with ideal vertical orientation at T3. In NE-cases, further improvement in angulation and orientation can be expected after debonding, as well as a deterioration in the relationship with the mandibular canal. Extractions accelerated upper M3 vertical eruption and PM2 extractions led to long-term larger lower retromolar spaces. The use of cervical headgear increased upper M3 uprighting three years after debonding, while little changes in M3 position were found after orthodontic treatment with extractions. However, PM2 extractions led to larger retromolar spaces and better M3 angulation in the long term.

Patient perceptions and attitudes regarding post-orthodontic treatment changes.

To determine patient perceptions and attitudes regarding posttreatment changes at least 2 years after completion of orthodontic treatment. A total of 125 patients (75 females, 50 males, aged 22.93 ± 2.98 years) were enrolled at least 2 years after debonding. Participants had either vacuum-formed retainers (VFRs) or bonded retainers (BRs). Posttreatment changes were evaluated digitally by comparing tooth positions at debonding and at least 2 years after debonding. A questionnaire was used to assess patient attitudes. Retainer usage, awareness of relapse, satisfaction with their current occlusion, and whether posttreatment changes were severe enough for them to consider retreatment were investigated. All patients showed some posttreatment changes in irregularity. Only 74% of patients wearing VFRs and 47.1% of patients wearing BRs were aware of posttreatment changes. Patients were more likely to notice posttreatment changes if there was an increase in mandibular irregularity of 1-3 mm. Awareness of posttreatment changes in the upper arch was higher in both groups. The majority of participants were satisfied with the results even if they noticed some minor posttreatment changes (VFR, 69.4%; BR, 76.5%). Dissatisfaction with posttreatment changes did not necessarily mean that a patient wanted retreatment. A total of 26% of patients wearing VFRs and 52.9% of patients wearing BRs were unaware of posttreatment changes. Approximately half of the patients who noticed posttreatment changes were still satisfied with the result 2 years after debonding. Even patients dissatisfied with the effect of posttreatment changes do not necessarily want retreatment.

Apical Root Resorption of Endodontically Treated Teeth after Orthodontic Treatment: A Split-mouth Study

The influence of pulp status on orthodontically induced root resorption has attracted attention. The purpose of this study was to compare orthodontically induced root resorption in endodontically treated teeth and their contralateral vital teeth in a split-mouth design. The sample included 173 patients who had at least one endodontically treated tooth, and their vital contralateral teeth served as the control group before the completion of orthodontic treatment. Apical root resorption measurements were performed by the comparison of digital panoramic X-ray images obtained at the beginning and at the end of the orthodontic treatment. Kruskal-Wallis, Mann-Whitney U, and Wilcoxon tests were used for statistical analysis. There was no statistically significant difference in apical root resorption between the endodontically treated teeth and the contralateral teeth (p>0.05). Sex and tooth type had no effect on apical root resorption both in the endodontically treated teeth and the contralateral vital teeth (p>0.05). Orthodontic treatment with extraction caused more apical root resorption in the vital teeth than in the endodontically treated teeth (p<0.05). The quality of the endodontic treatment had no significant influence on apical root resorption (p>0.05). Endodontic treatment does not produce greater apical root resorption compared with the vital teeth.

Orthodontic treatment with Orthoworld Fastbraces®: a retrospective analysis of treatment duration, outcomes, and patient satisfaction

Objectives: This study aims to evaluate the outcomes of orthodontic treatment using Orthoworld FASTBRACES® and assess patient satisfaction with various treatment parameters. A total of 559 eligible patients out of 20,240 cases treated between 2010 and 2023 were included in this review. Patients were categorized into two groups based on the type of brackets used: 29 patients with ceramic brackets and 530 patients with metal brackets. Following completion of orthodontic treatment, patients were invited to complete a comprehensive questionnaire, which assessed treatment duration, number of visits, brackets and wires used, types of issues encountered, patient understanding of treatment, overall comfort level, compliance, and satisfaction with the speed of treatment. Methods: A retrospective analysis was conducted on 20,240 orthodontic cases treated with Orthoworld FASTBRACES® between 2010 and 2023. From this pool, 559 patients met the inclusion criteria for this study. The adult patient group was considered age 18 and older. The adult patient cohort was divided into two groups: 27 patients with ceramic brackets and 368 patients with metal brackets. All patients underwent comprehensive orthodontic treatment using the Orthoworld FASTBRACES® system. Results: Among the 559 patients included in this review, a detailed analysis of treatment outcomes and adult patient satisfaction was performed. The mean treatment duration was calculated for both the ceramic bracket group (n = 363.04 days) and the metal bracket group (n = 439.20 days). The average number of visits required for each group was recorded at 16.82 days for the ceramic bracket group and 14.67 days for the metal bracket group. During treatment, various issues were encountered and categorized as bracket-related, wire-related, tooth-related, patient- related, allergic reactions, soft tissue irritation, bracket placement issues, performance-related issues, and hard tissue complications. Metal group had the highest number of issues with patients complaining of tooth issues (n=32), bracket issues (n=18), and soft-tissue issues (n=8). Both groups reported low numbers ( n &lt; 8) for bracket performance issues (metal: n=4; ceramic n=0), placement issues (metal: n=2; ceramic n=1), wires issues (metal: n=5; ceramic n=0), hard tissue issues (metal: n=3; ceramic n=0), ingestion issues (metal: n=1; ceramic n=0), and allergic reactions (n=0 for both groups). Following the completion of orthodontic treatment, patients were asked to complete a questionnaire evaluating their understanding of the treatment, overall comfort level, compliance, and satisfaction with the speed of treatment. Patient responses were collected and analyzed to determine the rating of patient understanding, comfort, compliance, and happiness with the treatment duration. The average score for patient responses ranged between 3.14 to 3.42 (i.e., above average) for treatment evaluation survey (Avg: 3.25 ceramic group vs 3.37 metal group). Conclusion: This analysis of orthodontic treatment with Orthoworld FASTBRACES® provides valuable insights into treatment outcomes and patient satisfaction. The findings shed light on the treatment duration, number of visits, brackets and wires utilized, and types of issues encountered during the course of treatment. Patient feedback regarding their understanding of treatment, comfort level, compliance, and satisfaction with the speed of treatment further contributes to the assessment of FASTBRACES® as an orthodontic treatment modality. The metal bracket group had a larger number of cases and a slightly longer average duration of treatment compared to the ceramic bracket group. However, the differences in average scores for patient understanding, comfort, satisfaction, and compliance were minimal between the two groups.

Orthodontic treatment and patient satisfaction with Orthoworld Fastbraces® in pediatric population

Objectives: To evaluate the outcomes of orthodontic treatment using Orthoworld FASTBRACES® and assess patient satisfaction with various treatment parameters. A total of 164 eligible pediatric patients out of 20,240 cases treated between 2010 and 2023 were included in this review. Patients were categorized into two groups based on the type of brackets used: 2 patients with ceramic brackets and 162 patients with metal brackets. Following completion of orthodontic treatment, patients were invited to complete a comprehensive questionnaire, which assessed treatment duration, number of visits, brackets and wires used, types of issues encountered, patient understanding of treatment, overall comfort level, compliance, and satisfaction with the speed of treatment. Methods: A retrospective analysis was conducted on 20,240 orthodontic cases treated with Orthoworld FASTBRACES® between 2010 and 2023. From this pool, 559 patients met the inclusion criteria for this study. The pediatric patient group was considered ages 11-17. The pediatric patient cohort was divided into two groups: 2 patients with ceramic brackets and 162 patients with metal brackets. All pediatric patients underwent comprehensive orthodontic treatment using the Orthoworld FASTBRACES® system. Results: Among the pediatric patients included in this review, a detailed analysis of treatment outcomes and pediatric patient satisfaction was performed. The mean treatment duration was calculated for both the ceramic bracket group (n=420 days) and the metal bracket group (n=395 days). The average number of visits required for each group was recorded at 15.5 days for the ceramic bracket group and 14.4 days for the metal bracket group. During treatment, various issues were encountered and categorized as bracket-related, wire-related, tooth-related, patient-related, allergic reactions, soft tissue irritation, bracket placement issues, performance-related issues, and hard tissue complications. Metal group had the highest number of issues with patients complaining of tooth issues and bracket issues. Both groups reported low numbers (n&lt;5) for bracket performance issues, placement issues, soft-tissue issues wires issues, hard tissue issues, ingestion issues, and allergic reactions. Following the completion of orthodontic treatment, pediatric patients were asked to complete a questionnaire evaluating their understanding of the treatment, overall comfort level, compliance, and satisfaction with the speed of treatment. Patient responses were collected and analyzed to determine the rating of patient understanding, comfort, compliance, and happiness with the treatment duration. The average score for patient responses was greater than 3 (i.e., above average) for treatment evaluation survey for both treatment groups. Conclusion: The analysis of pediatric patients undergoing orthodontic treatment with FASTBRACES® reveals promising results in terms of reduced alignment duration and improved oral hygiene practices. The study emphasizes the importance of precise bracket and wire placement and highlights the expertise of orthodontic practitioners in achieving successful outcomes.

Multidisciplinary Management in a Patient with Hemifacial Microsomia and Microglossia

Hemifacial Microsomia (HFM) is second most common congenital craniofacial anomaly following cleft lip and palate. On contrary, microglossia is a very rare congenital anomaly. To the best of our knowledge, HFM associated with microglossia has not been reported in the literature. This is a case report of a 13-year-old girl who presented with features of hemifacial microsomia, blindness, microglossia, hypodontia, bilateral transposition between upper first premolar and canine, anterior crowding and deep bite. Her treatment was started with fixed orthodontic appliance and arches were aligned by maintaining the transposed position of the teeth. After completion of orthodontic treatment, maxillary right and left first premolars were contoured into lateral incisor and canine, respectively, to have satisfactory functional and aesthetic outcome.

Comparative evaluation of salivary microbial levels of red complex bacteria in patients wearing three different types of fixed lingual retainers: a clinical study

Introduction: One of the major challenges for orthodontists is the long-term stability of orthodontic treatment. This has urged orthodontists to seek methods to ensure stable results following the completion of orthodontic treatment. Incisor crowding is reported to occur in follow-up stages of orthodontically treated patients. Maintenance of incisor alignment following orthodontic treatment has led to the development of retainers (removable and fixed). Fixed lingual retainers have been criticized for their potential to compromise the periodontal status, due to accumulation of plaque and calculus along the retainer wire. Objectives: The aim of this study was to evaluate and compare salivary microbial levels of the “Red Complex Bacteria” after orthodontic treatment with fixed appliances, during the retention period using three different types of fixed lingual retainer wires. Materials and methods: 30 patients who have completed orthodontic treatment and met the inclusion criteria were randomly divided into 3 groups with 10 patients each. Fixed lingual retainers (Retainium or Penta-One or Bond-a-Braid wire) were bonded to the lingual surfaces of the six anterior teeth. Saliva samples were collected at debonding (T0), 4 weeks after debonding (T1) and 8 weeks after debonding (T2). Saliva samples were stored at -80o Celsius followed by PCR testing, One- way ANOVA test followed by Tukey's post hoc Test was used to compare the mean PCR values of P. gingivalis, T. denticola and T. forsythia (Red Complex Bacteria) between 3 groups at different time intervals. Repeated measures of ANOVA test followed by Bonferroni's post hoc Test was used to compare the mean PCR values of various microorganisms between different time intervals in each group. Results: The PCR test results demonstrated that the highest Red Complex Bacterial growth was observed in Group 3 (Bond-a-Braid wire) followed by Group 2 (Penta-One wire). Whereas the least Red Complex Bacterial growth was observed in Group 1 (Retainium wire) at different time intervals (T0, T1, T2). The maximum growth of P. gingivalis was observed at debonding (T0). The least growth of P. gingivalis was seen at 8 weeks after debonding (T2). Similarly, T. denticola and T. forsythia showed highest values at debonding (T0), while lowest values were observed at 8 weeks after debonding (T2). Conclusion: The present study concluded that there is statistically significant difference (p&lt;0.001) in the salivary microbial levels (Red Complex Bacteria) with different types of fixed lingual retainer wires at three time intervals (T0, T1 and T2).

Periodontal and Orthodontic Synergy in the Management of Stage IV Periodontitis: Challenges, Indications and Limits.

This retrospective study described the clinical and radiographic long-term outcomes of combined periodontal and orthodontic treatment (OT) with fixed appliances in patients with Stage IV periodontitis and pathologic tooth migration (PTM) in the anterior sextants. OT was performed in either one or both arches, using tooth-supported or skeletal anchorage, following completion of active periodontal treatment and accurate planning of tooth movement biomechanics. Twenty-nine patients were identified and retrospectively examined when presenting for a supportive periodontal care (SPC) appointment. The mean SPC duration was 8.9 years (range 5 to 12 years). All anterior-migrated teeth showed statistically significant periodontal improvement compared to baseline values and stable radiographic bone levels at the final follow-up. Residual probing depths were 2.9 ± 0.5 mm at the end of active periodontal treatment, and they remained stable at the completion of OT (2.9 ± 0.6 mm) and at the last follow-up visit (2.8 ± 0.5 mm). These findings suggest that OT is a safe and effective treatment in improving the long-term prognosis of teeth with PTM in Stage IV periodontitis provided that periodontal health has been re-established and maintained with individualized SPC sessions.

Is there a difference among different bonded retainers in regard to survival rate?

Design A retrospective study.Cohort selection Inclusion criteria included: participants of any age who had completed their fixed orthodontic treatment on both arches and were treated by the same orthodontist in their private practice; had bonded retainers for five years, which were placed immediately after the orthodontic treatment in both arches; had one of three types of bonded retainers (0.026 × 0.010 inch Bond-A-Braid, 0.038 × 0.016 inch Ortho-FlexTech and Reliance Retainium Superior Brand Lingual Retainer Wire); had a final overbite of 2-4 mm after the completion of orthodontic treatment. Subjects who got their retainers changed, repaired or removed before five years, and syndromic patients, were excluded from the study.Data analysis The participants who agreed to contribute to the study and came for the final clinical examination were assessed for the retention status and the periodontal/gingival indies. Retention and retainer status: unwanted tooth movements and time and type of retainer failure. Periodontal/gingival indies: maximum pocket depth (PD) from the lingual side for the retained teeth and bleeding on probing (BOP). The authors performed a series of analyses to compare the orthodontic retainers regarding several outcomes and demographic variables. Briefly, the authors compared the orthodontic retainers concerning: i) age and treatment duration using analysis of variance (since the data were found to be normally distributed based on the Kolmogorov-Smirnov test); ii) demographic variables and BOP using several Chi-square tests; iii) PD via the Kruskal-Wallis test; and iv) survival rate through a Cox regression model alongside log-rank test.Results In total, 118 patients were included in this study, of which, 90 were women and 28 were men, with an average age of 22.34 ± 6.44 years. There was no statistically significant difference in the survival rate between the three types of retainers or between men and women. Likewise, there was no statistically significant difference in survival rate between the different age groups for the maxilla and mandible. Different maximum and minimum failure rates were observed between teeth in the maxilla and the mandible in the three retainers' group.Conclusions No difference was found between the three types of bonded retainers in regard to the survival rate and periodontal indices.

Knowledge, attitude, and awareness on the protocols and trends in orthodontic retention among dental students.

This survey aimed at evaluating the knowledge and awareness regarding the various retention protocols used in orthodontic practice. A survey has been conducted among the dental students by circulating 15 close-ended questions online to analyze the data collected on the protocols and trends in orthodontic retention. The male and female distribution among the study population was evaluated, and the retention protocols used were computed; statistical analysis was performed using SPSS software. Ninety-four percent accepted that Hawley retainers are predominantly used compared to fixed retainers. Eighty-seven percent agreed that they aim at a more stable dentition by the completion of orthodontic treatment. The Chi-square test on the knowledge of respondents on the permanent retention to be followed after orthodontic treatment to close generalized spacing is statistically not significant, P = 0.056. Within the considered limitations, it is clear that there is awareness among the dentists regarding the use of a retention appliance to ensure stability at the finish of orthodontic treatment. But the protocol for the same remains variable. Further studies can be performed to identify the effectiveness of each of the different retention protocols and their indications in various cases.