Conventional Orthodontic Treatment Research Articles

An Umbrella Review for Assessment of Treatment Effectiveness of Clear Aligners Compared to Conventional Fixed Appliances in Orthodontic Patients

Introduction Orthodontic improvements, mainly through the previous decade, have led to a substantial rise in patients’ esthetic needs. Traditional orthodontic procedures have been linked with a compromise in facial appearance, which increases concern among patients pursuing orthodontic treatment. Methods PubMed, MEDLINE, Google Scholar, and Cochrane Library of Systematic Reviews databases were searched using appropriate entry terms and Boolean operators. Search strategy was conducted till June 2022 for systematic reviews and meta-analyses. Publications were systematically assessed for eligibility, and two observers independently graded the methodologic quality using AMSTAR-2 tool. For each meta-analysis, we estimated the summary effect size by the use of random-effects and fixed-effects models and the 95% confidence interval. We estimated the between-study heterogeneity expressed by I 2 (defined as large for I 2 ≥50%), evidence of small-study effects (i.e., large studies had significantly more conservative results than smaller studies), and evidence of excess significance bias (i.e., more studies than expected with significant results). Results Overall, 16 unique systematic reviews and meta-analyses following the eligibility criteria were selected for umbrella review. The results of qualitative analysis of studies revealed that 4 studies had a critically low risk of bias, 11 showed low risk, and 1 study had moderate risk. The results of the meta-analysis favored clear aligners with respect to oral hygiene and root resorption parameters. When tooth movements were considered, the results favored conventional orthodontic treatment. Conclusion Clear aligner therapy (CAT) has significant advantages with regard to efficiency (treatment time, chair time) in mild-moderate malocclusion cases. The overall accuracy of CAT when compared to fixed orthodontic treatment was found to be 55-82%.

The effect of single versus multiple piezocisions on the rate of canine retraction: a randomized controlled trial

BackgroundPiezocision is a minimally invasive surgical method aiming to accelerate tooth movement. However, its effect was found to be transient, appertaining to the regional acceleratory phenomenon (RAP). Hence, the aim of the study was to evaluate the effect of single and multiple piezocisions on the rate of orthodontic tooth movement (OTM). Moreover, the impact of both protocols on canine tipping and orthodontically induced inflammatory root resorption (OIIRR) has been assessed.MethodsThirty indicated patients for the therapeutic extraction of maxillary first premolars were enlisted in this split-mouth study, and they were randomly split into two equal groups, each including 15 subjects. In the Single Application Group (SAG), one side of the maxillary arch arbitrarily received a single piezocision before the onset of canine retraction, whereas in the Multiple Application Group (MAG), piezocisions were randomly performed on one side, three times on a monthly basis, over the 12-week study period. The contralateral sides of both groups served as the controls. Canine retraction was carried out bilaterally using nickel-titanium closed-coil springs, delivering 150 g of force, and the rate of tooth movement, as well as canine tipping were evaluated on a monthly basis, over a 3-month period. Cone-bean computed tomography scans were also conducted pre- and post- canine retraction, and OIIRR was assessed using Malmgren Index.ResultsThe reported outcomes revealed a significant increase in the amount of canine retraction, canine tipping, as well as root resorption scores on the experimental sides in both groups SAG and MAG post-retraction (p < 0.001). However, upon comparing the experimental sides in both groups, non-significant differences have been observed between them regarding all the assessed outcomes (p > 0.05).ConclusionsSingle and multiple piezocisions effectively accelerate OTM in comparison to conventional orthodontic treatment, with relative outcomes reported by both intervention frequencies. Accordingly, single piezocision is recommended as an adjunct to OTM. Furthermore, significant tooth tipping as well as a significantly higher root resorption risk accompanies both single and multiple piezocision applications in conjunction with OTM.Name of the RegistryClinicaltrials.govTrial Registration NumberNCT05782088Date of Registration23/03/2023 “Retrospectively registered”.URLhttps://clinicaltrials.gov/ct2/show/NCT05782088

Pain and root resorption due to surgical interventions to accelerate tooth movement in orthodontics: A systematic review and meta-analysis.

There are several publications that show the efficacy of surgical interventions in accelerating the rate of tooth movement in orthodontics. Consequently, possible adverse effects must also be evaluated. The aim of the present study was to compare the perception of pain and root resorption between orthodontic treatment with a surgical acceleration intervention vs. conventional orthodontic treatment. An electronic search was conducted in the MEDLINE, Scopus, Web of Science (WoS), ScienceDirect, Cochrane Library, and Virtual Health Library (VHL) databases up to September 12, 2022. Randomized or non-randomized, controlled, parallel-arm or split-mouth clinical trials were included. Fixed-and random-effects meta-analyses were performed with regard to heterogeneity. The risk of bias (RoB) was assessed using the RoB 2.0 and ROBINS-I tools. A total of 1,395 articles were initially retrieved, 40 studies were finally included in the review and 15 studies were eligible for quantitative analysis. The meta-analysis showed a significant difference in pain perception between acceleration surgery vs. conventional orthodontics at 24 h (p = 0.040); however, this difference was not significant at 7 days (p = 0.080). Overall, the patients who underwent any acceleration procedure presented significantly less resorption as compared to those who were applied conventional treatment (p < 0.001). A similar significant difference was found in retraction movements (p < 0.001) and alignment movements (p = 0.030). In the first 24 h, surgical interventions for the acceleration of tooth movement produce a greater perception of pain as compared to conventional orthodontic treatment, but the perception is similar after 7 days. Acceleration surgery results in less root resorption - in alignment movements, and especially in retraction movements.

Does Socioeconomic Class and Educational Level of Orthodontic Patients have any Impact on their Satisfaction with Treatment duration, Perception and Attitude Towards Accelerated Orthodontics?

Background: There is growing attention globally on the satisfaction of orthodontic patients about the duration of orthodontic treatment, and the importance of accelerated orthodontics but more information is needed concerning factors that could influence the patients. Aim: To investigate possible influence of socioeconomic factors on their satisfaction with duration of orthodontic treatment, as well as their perception and attitude towards accelerated orthodontics. Materials and Methods: A 15-month clinic-based survey of all orthodontic patients at a Nigerian Teaching Hospital was carried out using a self-administered questionnaire that sought information on their satisfaction with the duration of conventional orthodontic treatment and their perception and attitude towards accelerated orthodontics. Using SPSS IBM Version 25, the data was analyzed and both descriptive, student’s t-test and ANOVA statistics were used to test the hypotheses. The significance level was set at P &lt; .05. Results: Social class did not show any significant associations with satisfaction with duration of orthodontic treatment and most of the variables for perception and attitudes to accelerated orthodontics (P &gt;.05), except for only two. Generally, patients’ educational level did not give any significant associations with either satisfaction with duration of orthodontic treatment or their perception and attitudes towards accelerated orthodontics (P&gt;.05). Conclusion and Recommendation: Socioeconomic status of the patients neither significantly influenced their satisfaction with the duration of orthodontic treatment nor their perception and attitudes towards accelerated orthodontics. Further similar research would be worthwhile.

Microbiological Analysis of Plaque and Its Composition in Three Patient Groups under Different Orthodontic Treatments.

This article analyzes differences in microbiological parameters and periodontal health conditions among three patient groups: those undergoing conventional orthodontic treatment with fixed appliances, patients undergoing orthodontic treatment with clear aligners, and a control group receiving no treatment. In this study, 60 patients were enrolled. The microbiological analysis employed a qualitative and semi-quantitative methodology of bacterial morphotype analysis. The analyses revealed a significant difference in favor of clear oral and periodontal health aligners. This could be attributed to better bacterial biofilm removal and reduced mechanical stress on the periodontal ligament, factors facilitated by the ease of clear aligner removal. Significant differences (p-value < 0.05) were observed for the Full-Mouth Plaque Score, Full-Mouth Bleeding Score, Plaque Index, and periodontal health assessment measurements. Although overall hygiene appears to be improved in patients in the aligners group compared to those treated with conventional orthodontic appliances, there are no statistically significant results regarding plaque composition. Microbiological aspects will be further addressed using more specific techniques in the follow-up of this research.

Impact of COVID-19 Pandemic on Treatment with Conventional Fixed Orthodontic Appliances Versus Clear Aligners in Saudi Arabia: A Multi-Center Cross-sectional Study

Background: This study aimed to compare the treatment progress and complications between patients receiving conventional orthodontic treatment and clear aligners during the coronavirus disease-2019 (COVID-19) pandemic. Methods: An electronic survey was distributed randomly among orthodontic patients in Saudi Arabia to understand how the global health crisis caused by COVID-19 affected orthodontic patients. The survey questions were structured into four sections, including demographic data, continuation of orthodontic follow-up appointments during the COVID-19, reasons for missed appointments, and problems of orthodontic patients. Data analysis consisted of simple descriptive statistics presented in frequency tables and percentages. Statistical significance was set at P≤0.05. Results: A total of 512 electronic responses were received. Sixty-two (12.11%) participants missed no orthodontic follow-up appointment during the COVID-19 lockdown. Hence, the study included 450 (87.89%) participants to evaluate the impact of COVID-19 pandemic on sustained orthodontic treatment. The proportion of patients in the fixed appliance group (35.2%, 86 patients) who responded that “they had not even once tried to communicate with their orthodontists” was significantly higher than that in the clear aligner group (9.2%, 19 patients) (P&lt;0.001). The proportion of participants who received fixed appliances (62.3%, 152 patients) and disagreed with the lockdown of orthodontic clinics during the COVID-19 was significantly higher than that in clear aligner users (19.4%, 40 patients) (P&lt;0.001). Conclusion: The results indicated that most issues were reported by patients who had fixed appliances. Thus, tele-orthodontics could provide a solution to continue dental practice during the COVID-19, and clear aligners are preferable to traditional orthodontic treatment methods.

Clear Aligners in Pediatric Dentistry: A Scoping Review.

Today not just adults but also children are affected by their looks and appearance. Their facial and dentalappearance primarily influence how they present themselves in the outside world. Poor esthetic appearance at any age, especially when it comes to children, affects their psychological status. In earlier times, correction of dentition used to be done withcrude methods, after which came the concept of braces, which were fixed on the labial surfaces. Even with these,the patients are equally concerned with their looks throughout the treatment, and thus neither adults nor children are eager to use the standard metallic-looking orthodontic gear. To tackle this problem, researchers have developed several solutions, andclear aligners are the modern and aesthetic answer. For effective tooth movement into the desired position, thin, transparent, plastic aligners known as invisible aligners are used, which are created using the computer-aided design/computer-aided manufacturing (CAD-CAM) technology. These aligners are analogous to the splints that cover the clinical crowns as well as the marginal gingiva. The treatment requires proper patient motivation as there can be poor compliance by patients. However, it can offer greater dental hygiene, comfort, and an excellent aesthetic experience during treatment. This review highlights the history of fabrication of clear aligners, examining the efficacy, advantages, and disadvantages of transparent aligners for pediatric patients and also dentists. It weighs aspects like aesthetic appeal, comfort, oral hygiene, treatment predictability, and practice efficiency when comparing transparent aligners, like Invisalign, to conventional orthodontic treatments. It also ascertains the applicability and worth of clear aligners in contemporary orthodontic practice, while examining patient happiness, compliance, and overall treatment results.

A digitalized analysis of incisal changes among orthodontically treated patients: A retrospective comparative study.

To compare incisor angulation and/or position changes among orthodontically treated patients with metal brackets and clear aligners. A total of sixty-two participants of both sexes, aged-16-40 years old, with CL I skeletal pattern and mild crowding following strict eligibility criteria were included. The patients were divided into two groups based on their treatment approach. Pre and post lateral cephalograms were collected from Riyadh Elm University (REU) and then digitally analyzed using WEBCEPH (Medical Image Analysis) software. Eight angular and two linear measurements were used for the assessment. The upper incisor angulation and position showed statistically significant differences when orthodontic clear aligners were used. In contrast, no significant difference was observed with the conventional orthodontic treatment. However, the upper incisal palatal root torque decreased after clear aligner therapy compared to conventional treatment. The inter-incisal angle demonstrated a significant increase with clear aligners compared to conventional treatment. The current study revealed the importance of definitive guidelines upon and after treatment, in addition to determining incisor changes. Orthodontic clear aligners are distinct from conventional treatments in controlling the incisors' angulation and position. The expansion treatment modality precedes Interproximal reduction in increasing the arch perimeter.

Accelarated Orthodontic Treatment Using Microosteoperforations: A Comparative Study.

Accelerated orthodontic treatment has gained popularity in recent years as patients seek shorter treatment durations. Microosteoperforations (MOPs) have emerged as a minimally invasive technique to expedite tooth movement. This study aims to compare the effectiveness of MOPs in accelerating orthodontic treatment with conventional methods. A randomized controlled trial was conducted on 60 orthodontic patients requiring dental alignment. The participants were divided into two groups: Group A (MOPs) and Group B (conventional orthodontic treatment). In Group A, MOPs were performed at the beginning of the treatment. Both groups received monthly orthodontic adjustments. Treatment duration, rate of tooth movement, and patient discomfort were measured and compared between the two groups. The study found that in Group A, the treatment duration was reduced by 30% compared to Group B (P < 0.05). The rate of tooth movement in the MOPs group was 1.5 times higher than the conventional group (P < 0.01). Additionally, patient-reported discomfort levels were similar between the two groups. No adverse events related to MOPs were observed during the study. MOPs significantly accelerate orthodontic treatment, reducing treatment duration by 30% and increasing the rate of tooth movement by 1.5 times compared to conventional methods. Importantly, MOPs are well-tolerated by patients, making them a valuable option for expediting orthodontic treatment with minimal discomfort. This study highlights the potential benefits of integrating MOPs into orthodontic practice to improve treatment efficiency and patient satisfaction.

Accelerated Orthodontic Treatment using Biomodulation: A Randomized Clinical Trial

ABSTRACT Background: Orthodontic treatment often spans several months or even years, which can be burdensome for patients. Biomodulation techniques have emerged as potential strategies to expedite orthodontic tooth movement. Materials and Methods: A randomized clinical trial was conducted with a sample of 60 orthodontic patients, aged 12–30 years, requiring fixed appliance therapy. Patients were randomly assigned to either the biomodulation group (n = 30) or the control group (n = 30). The biomodulation group received low-level laser therapy (LLLT) along with traditional orthodontic treatment, while the control group received conventional orthodontic treatment without LLLT. Treatment duration, pain perception, and orthodontic tooth movement were assessed during the study period. Results: The results demonstrated a significant reduction in treatment duration in the biomodulation group compared to the control group. The biomodulation group exhibited a 30% reduction in overall treatment time, with an average treatment duration of 8.4 months, while the control group required an average of 12 months (P &lt; 0.001). Pain perception during orthodontic adjustments was lower in the biomodulation group. Additionally, biomodulation was associated with a statistically significant increase in the rate of tooth movement, as evidenced by a 20% reduction in the time required to achieve desired tooth alignment (P &lt; 0.01). Conclusion: Biomodulation through low-level laser therapy represents a promising adjunct to traditional orthodontic treatment, significantly accelerating tooth movement and reducing treatment duration.

Dental and Periodontal Changes After Accelerated Correction of Lower Anterior Teeth Crowding With Periodontally Accelerated Osteogenic Orthodontics (PAOO) Procedure: A Randomized Controlled Trial.

Objective To evaluate the relative efficacy of periodontally accelerated osteogenic orthodontics (PAOO) compared to conventional fixed appliances in correcting lower anterior teeth crowding using a non-extraction treatment approach. Material and methods A single-center, two-arm, parallel-group randomized controlled trial was conducted on 38 patients (9 males, 29 females) with moderate crowding. These patients did not require premolar extraction and were randomly allocated into two treatment groups: the PAOO group and the conventional orthodontic treatment group. The Little Irregularity Index (LII) measured crowding intensity on pre-treatment study models. Changes in this index were recorded monthly in both treatment groups. The inter-canine width, inter-second-premolar width, plaque index (PI), gingival index (GI), and papillary bleeding index (PBI) were also measured before and after the leveling and alignment stage. Statistical analysis between the two groups was performed using Mann-Whitney U tests. Results For the LII, the average time for irregularity resolution was three months in the PAOO group, compared to five months in the conventional orthodontic treatment group. Regarding changes in inter-second-premolar width, the PAOO procedure led to a significant decrease in the increase of inter-second-premolar width, with an average increase of +1.52 mm compared to +2.71 mm in the control group. For the GI and PBI, it was found that their values significantly increased with PAOO application, averaging 0.18 and 0.17, respectively, compared to 0.05 and 0.07 in the control group. Conclusions The use of PAOO in orthodontic treatment accelerated the leveling and alignment process by 40%. Changes in the inter-canine width, the inter-second-premolar width, and the status of periodontal tissues were minimal and clinically negligible.

Shared decision making for patients needing dentofacial orthopedics, orthognathic surgery, and conventional non-surgical fixed appliance therapy: a comparison between Pakistani patients' and clinicians' perspective.

Shared decision making (SDM) involves presenting patients with relevant information about a health issue and reaching a clinical decision based on their preferences. However, its application in orthodontics lacks documentation. This study aimed to assess and compare the perspectives of patients and clinicians on SDM in different cases. A cross-sectional study was conducted at a tertiary care hospital in Pakistan, involving 90 patients categorized into three groups (dentofacial orthopedics, orthognathic surgery, and conventional non-surgical fixed appliance treatment). Following clinical assessment and treatment plan discussions, patients and clinicians completed a 12-item dyadic observing patient involvement in decision making (OPTION) questionnaire, to gauge their perspectives on SDM. Mean OPTION scale scores were compared using paired sample t-tests between clinicians and patients, and intergroup comparisons utilized paired sample t-tests and Pearson correlation coefficients. OPTION scores were similar between patients/parents and clinicians. However, statistically significant differences were found regarding the questions about "different sources of information", "different options (including the possibility of doing nothing)" and "concerns regarding management", with the patients giving overall lower OPTION scores. Patients gave lower SDM OPTION scores for conventional orthodontic treatment, but higher scores for orthopedic and orthognathic surgery, as compared to the clinicians. The current study revealed an overall consensus in the mean total scores of OPTION scales between patients and clinicians. However, when stratified, patients showed higher SDM scores for orthopedic and orthognathic cases, and lower scores for conventional orthodontic treatment.

Impact of orthodontic treatment on OHRQoL of adolescents: a longitudinal study.

The aim of this study was to evaluate the extent to which orthodontic treatment need is perceived by the patients and by the orthodontist, as well as the possible impacts on the OHRQoL (Oral Health-Related Quality of Life) over the course of conventional orthodontic treatment in adolescent patients. The sample consisted of 55 adolescents. The perception of patients and orthodontists relative to the malocclusion was evaluated by the IOTN (Index of Orthodontic Treatment Need). The OHRQoL was evaluated by the Child-OIDP (Child-Oral Impacts on Daily Performances) questionnaire before the conventional orthodontic appliance was bonded (T0); and at the following time intervals: after one week (T1), one month (T2), three months (T3), six months (T4), and after the end of orthodontic treatment (T5). Adolescents who had large orthodontic treatment needs had a poor OHRQoL, according to their self-perception (p=0.003) and according to the orthodontist's perception (p<0.001), when compared with patients with small and moderate needs. There was statistically significant difference in the OHRQoL between the time intervals T0 and T1 (p=0.021), T2 and T3 (p<0.001), T3 and T4 (p=0.033), and T0 and T5 (p<0.002). At the end of treatment, all evaluated participants reported an improvement in OHRQoL. It was concluded that adolescents and orthodontists agreed with regard to the perception of orthodontic treatment need. In the first week and in the first month of orthodontic treatment, there was a negative impact on the OHRQoL. After three months, an improvement of OHRQoL was detected, which has progressed over time.

Treatment outcome comparison of Invisalign vs fixed appliance treatment in first premolar extraction patients

In this study, we compared the dentitional changes after Invisalign and conventional orthodontic treatment with 4 first premolar extractions. 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. 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). 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.

Ion Release from Stainless Steel Brackets Subjected to Tooth Bleaching Treatment.

Tooth discoloration in the form of staining is a common finding during conventional orthodontic treatment. Due to elevated esthetic standards, clinicians in the field of orthodontics are faced with increasing demands by patients to perform bleaching treatments while the appliances are still in place. Though the success of such treatments has been reported in literature, the effect of whitening agents on orthodontic appliances has not been evaluated. Increased ion release following corrosion of orthodontic brackets is considered a health hazard. In this study, we measured the amount of ion release from steel brackets under home and office bleaching treatment in order to evaluate the safety of such treatments during orthodontic therapy. In this experimental study, a total of 120 brackets were randomly divided into 3 groups. The first group was subjected to an office bleaching regimen (hydrogen peroxide 40%). The second group was subjected to a home bleaching treatment (carbamide peroxide 20%). The third group did not receive any bleaching treatment. The specimens of all groups were immersed in artificial saliva and after 30 days, the amount of released chromium, copper, iron, magnesium, and nickel ions was measured and compared using one way ANOVA. The results showed that ion release was significantly different between the three groups (pValue >0.05). For the chromium, iron, magnesium, and Nickel ion release the order was as follows: no bleaching < home bleaching < office bleaching. However, the copper ion release was greater in the group that received home bleaching. Ion release was enhanced when bleaching treatments were performed, with office bleaching having a more significant effect. Although the amounts of released ions were less than those permitted by WHO, we suggest that the clinicians recommend home bleaching for orthodontic patients that are seeking tooth whitening treatment.

Is Apical Root Resorption Greater When Using Clear Aligners as Compared to Conventional Fixed Appliances in Adult Patients Following Orthodontic Treatment? A literature Review

Background: Apical root resorption has been identified as a potential risk/adverse effect of conventional orthodontic treatment, however, with changing dental demand and increasing patient preference for clear aligners therapy, the availability of evidence-based information on its incidence/severity following treatment with either clear aligners or fixed appliance is of relevance to clinical practice in providing guidance on orthodontic treatment risk to patients and therefore contributing to the process of obtaining valid informed consent. Objectives: The aim of this study is to undertake a literature review to establish whether apical root resorption following orthodontic treatment is greater in adult patients treated with clear aligners as compared to conventional fixed appliances, to analyse and appraise the data, to make appropriate recommendations relevant to orthodontic practice and is widely referenced by orthodontists. Search Methods: A systematic literature search of three databases (Medline, Embase, Web of science), Google scholar and a hand search of relevant journals was done. Selection Criteria: Primary research studies high in the hierarchy of evidence that investigated/compared apical root resorption following extraction/non-extraction based orthodontic treatment with fixed appliance or clear aligners in adult patients equal to or greater than 18 years between January 2010 and December 2021 were selected for this systematic review. Data Collection and Analysis: Studies were accessed, duplicates eliminated, data extracted with the use of a customized data extraction form, and quality assessed using a critical appraisals skills programme tool. Results: A total of 67 studies were identified, and after the elimination of duplicates and quality assessment, six studies were selected for review. The Cochrane Rob 2 bias tool was used to assess the risk of bias of the selected studies. Apical root resorption prevalence/severity was measured using two different radiographic methods: 3-Dimesional (CBCT-scan) and 2-Dimensional (panoramic/periapical radiographs). Conclusions: The majority of the studies showed that the severity/prevalence of apical root resorption is less in clear aligners compared to fixed appliance treated patients, however, they are characterized by different baseline malocclusion/treatment duration/modalities, study design flaw, inconsistency in outcome measurement/calculation. Due to these limitations, it is difficult to arrive at a conclusion and make recommendations applicable to everyday clinical practice. The clinician should take into consideration factors that increase the risk of apical root resorption such as genetic predisposition, treatment duration, force application (types and location), types of tooth movement, initial malocclusion and extraction/ non-extraction-based treatment in deciding on the orthodontic treatment option and gaining patient consent.Limitations: The current evidence has a number of limitations including the lack of robust prospective studies on apical root resorption, different methods of outcome measurement and calculation, different baseline malocclusions, the evaluation of apical root resorption in only one treatment modality and short treatment duration which may influence the validity of the study conclusions. A meta-analysis could not be performed due to the heterogeneous outcome recording methods. Further research is recommended

PAOO Technique for The Bimaxillary Protrusion: A Case Report

Background: Bimaxillary protrusion is a common malocclusion that can lead to functional and aesthetic issues. Conventional orthodontic treatment may not always be effective, and surgical approaches can be invasive. The Periodontally Accelerated Osteogenic Orthodontics (PAOO) technique is a minimally invasive alternative that involves corticotomy and orthodontic treatment. Objective: This case report aimed to evaluate the effectiveness of the PAOO technique for the correction of bimaxillary protrusion in a 16-year-old female patient. Methods: The PAOO technique involved corticotomy and piezocision on a 16-year-old female patient undergoing orthodontic treatment with a fixed appliance. The patient was being followed up for 18 months after orthodontic appliance placement with premolars extractions but did not get any favorable result and was referred by the Department of Orthodontics to undergo corticotomy procedure. The effectiveness of the treatment was evaluated using cephalometric and occlusal analyses. Results: The PAOO technique significantly improved the patient’s skeletal and dental parameters. The maxillary and mandibular incisors were retracted, resulting in a significant improvement in the patient’s profile. The occlusal analysis showed good intercuspation and a stable occlusion. Conclusion: The PAOO technique is a viable option for the correction of bimaxillary protrusion, as it can achieve significant improvements in skeletal and dental parameters with minimal invasiveness. Further studies are needed to validate these findings and compare the PAOO technique with conventional surgical and orthodontic approaches.

Studying the variation of roots’ lengths of mandibular incisors during surgically-assisted orthodontic alignment using Cone Beam Computed Tomography

IntroductionOrthodontic root shortening is one of the complications which may cause movement of the teeth or even losing them. Many previous studies have found that accelerated orthodontic treatment using alveolar corticotomy could minimize the shortening and resorption of the roots. However, the X-ray imaging techniques used did not demonstrate the resorption on all root surfaces, and in some cases, they did not demonstrate root shortening unless it becomes aggressive. This study is to Evaluate variations in roots’ lengths of mandibular incisors during surgical-assisted orthodontic (SAO) alignment by alveolar corticotomy using cone beam computed tomography (CBCT). MethodsIn this study, we evaluated 96 mandibular incisors of 24 patients who suffered from moderate dental crowding in the anterior region of the mandible. The patients were divided into two groups: the control group which was submitted to conventional orthodontic treatment and the study group which was submitted to surgically-assisted orthodontic treatment using alveolar corticotomy. CBCT images were used to evaluate roots’ lengths at two times (T0, T1). ResultsThe result of this study showed statistically significant differences in root shortening of the two groups, and the mean of this shortening was lower in the study group in comparison with the control group. ConclusionsThe (SAO) technique using alveolar corticotomy minimizes root shortening of the mandibular incisors during the initial alignment stage of orthodontic treatment.

Role of six cytokines and bone metabolism biomarkers in gingival crevicular fluid in patients undergoing fixed orthodontic appliance treatment in comparison with aligners: a clinical study.

The objective of this study was to assess bone biomarkers and cytokines in patients with conventional labial appliances (CLAs) and aligners. Participants were recruited to undergo orthodontic treatment with CLAs and aligners according to predefined inclusion and exclusion criteria. Periodontal examination was accomplished at baseline and 4 weeks using the plaque index (PI), gingival index (GI), and bleeding on probing (BoP). Samples of gingival crevicular fluid (GCF) were collected at baseline (T0) before the start of treatment and at the 1-month follow-up (T1) to assess bone metabolic and inflammatory biomarkers. GCF from participants with CLAs and aligners was evaluated with enzyme-linked immunosorbent assay. Comparison between labial conventional orthodontic treatment and aligners were assessed using an unpaired t-test. The difference between T0 and T1 was measured using a paired t-test. BoP, PI, and GI demonstrated no significant difference between participants treated with aligners and subjects with CLAs at baseline and at 4 weeks (P > .05). Bone markers and other biomarkers (tumor necrosis factor α, interleukin [IL]-α, IL-2, IL-6, and IL-8) showed significant differences (P < .05). Also, a significant difference between CLAs and aligners was noted among all biomarkers (P < .05) except IL-β. Aligners and CLAs increase the level of inflammatory and bone metabolic biomarkers after 1 month.

The Use of Orthodontic Mini-Implants and Temporary Anchorage Devices (TADs) for the Management of Complex Orthodontic Cases

Orthodontic treatment often involves correcting improperly positioned teeth and jaws, as well as malocclusion or misaligned bite patterns. Anchorage is a critical component of all types of orthodontic tooth movement, and temporary anchorage devices (TADs) and orthodontic mini-implants (OMIs) have become popular adjuncts to conventional orthodontic treatment. TADs and OMIs provide stable anchorage, reduce the need for patient compliance, and can decrease treatment time. These devices can be used in various orthodontic cases, such as Class II and III malocclusions, deep bites, open bites, and impacted teeth. However, proper case selection, placement, and maintenance are crucial for achieving successful treatment outcomes with TADs and OMIs. The result of these devices is influenced by factors such as the insertion site, insertion angle, and amount of bone contact. The factors contributing to TAD and OMI failure are multifactorial and include conditions related to the device, the patient, and the clinician. The review provides a comprehensive analysis of the benefits and drawbacks of TADs and OMIs, their clinical applications, and the factors influencing their success.