Course Of Orthodontic Treatment Research Articles

Perception of Dental Caries Risk and Prevention among Orthodontic Patients – A Cross-Sectional Survey

Aim: To investigate the perception of dental caries risk and prevention among patients undergoing orthodontic treatment and to assess the influence of the oral hygiene information attained during orthodontic visits on patients’ perception of dental caries prevention. Methods: A cross-sectional questionnaire gathered information from 207 orthodontic patients (aged 18 and older). The questionnaire included questions about patients’ demographics, perception of dental caries risk and prevention during orthodontic treatment, and oral hygiene information received in orthodontic visits. Frequency distributions of responses were evaluated. Chi-square test was used to assess the differences in patients’ perception of dental caries prevention by demographics, and the oral hygiene information received during orthodontic appointments. Results: 74.9% of orthodontic patients perceived to be responsible for dental caries during orthodontic treatment, and 30.4% of patients perceived that it is abnormal to develop dental caries during treatment. Patients receiving information about tooth brushing methods and oral hygiene accessories during orthodontic appointments had a better perception of appropriate oral hygiene in preventing dental caries (P= 0.01 and P= 0.04, respectively). Moreover, patients receiving dietary information during orthodontic appointments had a better perception of supporting a good diet and avoiding sweets in preventing dental caries (P< 0.001 and P= 0.02, respectively). Conclusion: There is a need to improve orthodontic patients’ perception of their risk of dental caries during orthodontic treatment and the manners that would help to avoid new decay lesions. Orthodontists should not underestimate the value of providing and reinforcing oral hygiene instructions throughout the course of orthodontic treatment.

Оцінка якості гігієнічного догляду за порожниною рота у дітей з вродженими незрощеннями губи та піднебіння у процесі ортодонтичного лікування

Introduction. Systematic monitoring of the of oral hygiene and professional hygiene with the use of modern, individually selected basic and additional hygiene products and items during orthodontic treatment is a mandatory component of the comprehensive rehabilitation of children with congenital cleft lip and palate (CLP). The aim: to evaluate the quality of individual oral hygiene care of children with congenital unilateral cleft lip and palate in the course of orthodontic treatment in the period of transitional dentition. Materials and methods. The determination of the hygienic condition of the oral cavity in the course of orthodontic treatment was done using the «Differentiated index for determining the indicator of individual oral hygiene, adjusted to take into account the different quality of hygiene on the upper and lower dental rows (DIOH). Results and their discussion. Prevention of diseases of hard tissues of teeth and periodontal tissues in children is important from birth and is especially necessary in the course of orthodontic treatment using removable and fixed orthodontic designs. Children with CLP have an increased risk of developing dental caries for a variety of reasons. Differential examination of the state of dental hygiene on the upper and lower jaws allows giving more targeted recommendations regarding oral hygiene, i.e. personify them. Conclusions. The use of hygiene indices, in particular those that reflect the difference between the level of hygiene on the jaw where the orthodontic appliance is placed and where it is absent, is appropriate for assessing the state of oral hygiene in children with dentognathic anomalies and providing recommendations for its improvement. Key words: congenital unilateral cleft lip and palate, hygiene index, prevention, diseases of hard tissues of teeth and periodontal tissues.

Challenges of a two-phase orthodontic treatment of a mandibular lateral incisor-canine transposition and a maxillary palatally displaced canine: A case report.

The management of eruption disturbances in orthodontics may be challenging and requires a careful diagnosis and treatment planning. This case report discusses the challenges of a two-phase orthodontic treatment of a patient presenting with a dental eruption pattern anomaly. A 10-year-old boy was presented with no complaints for a routine orthodontic evaluation during mixed dentition. The patient was diagnosed with a skeletal Class I malocclusion with unilateral posterior crossbite, incomplete mandibular lateral incisor-canine transposition and a unilateral maxillary ectopic canine. Phase 1 started with rapid maxillary expansion to correct maxillary constriction and the ectopic eruption of the right maxillary canine. In the mandibular arch, phase 1 included the extraction of the left primary lateral incisor and canine, alignment of the left permanent lateral incisor and orthodontic traction of the left permanent canine. The duration of phase 1 was 14 months. Phase 2 involved a comprehensive course of orthodontic treatment and started when the patient was aged 13 years. This phase lasted 18 months. An adequate dental occlusion was obtained, and the treatment results were stable after an 18-month follow-up. In this case, the early diagnosis of the dental anomalies was valuable as it allowed an early intervention to be undertaken, which resulted in overall treatment simplification and potentially minimised the adverse effects. This case report reinforces the importance of a careful follow-up during mixed dentition.

The Effects and Mechanisms of PBM Therapy in Accelerating Orthodontic Tooth Movement.

Malocclusion is one of the three major diseases, the incidence of which could reach 56% of the imperiled oral and systemic health in the world today. Orthodontics is still the primary method to solve the problem. However, it is clear that many orthodontic complications are associated with courses of long-term therapy. Photobiomodulation (PBM) therapy could be used as a popular way to shorten the course of orthodontic treatment by nearly 26% to 40%. In this review, the efficacy in cells and animals, mechanisms, relevant cytokines and signaling, clinical trials and applications, and the future developments of PBM therapy in orthodontics were evaluated to demonstrate its validity. Simultaneously, based on orthodontic mechanisms and present findings, the mechanisms of acceleration of orthodontic tooth movement (OTM) caused by PBM therapy were explored in relation to four aspects, including blood vessels, inflammatory response, collagen and fibers, and mineralized tissues. Also, the cooperative effects and clinical translation of PBM therapy in orthodontics have been explored in a growing numbers of studies. Up to now, PBM therapy has been gaining popularity for its non-invasive nature, easy operation, and painless procedures. However, the validity and exact mechanism of PBM therapy as an adjuvant treatment in orthodontics have not been fully elucidated. Therefore, this review summarizes the efficacy of PBM therapy on the acceleration of OTM comprehensively from various aspects and was designed to provide an evidence-based platform for the research and development of light-related orthodontic tooth movement acceleration devices.

Comparison of Three-Dimensional Cephalometric Measurements of Different Populations

Objective: The purpose of this study is to compare three-dimensional cephalometric measurements of the skeleton and dentoalveolar region between Turkish individuals and individuals from other populations. Methods: This is a single-center, retrospective study using cone beam computed tomography images (CBCT). Individuals have no missing teeth, are between the ages of 18 and 30, have a balanced profile, and have an Angle Class I relationship. The CBCT images were obtained in DICOM format and analyzed in DOLPHIN 11.8 software. 61 parameters were measured on the CBCT images, and 14 parameters were contrasted with individuals from other populations. Results: Mandibular values were more protrusive in Korean and Chinese populations than in Turkish and Cypriot individuals. Similarly, upper facial height (N- ANS distance) was found to be much higher. It was found that the length of the mandibular corpus was shorter and the angle of convexity was higher in Turks and Cypriots than in Koreans and Chinese populations. Conclusion: Ethnic facial and skeletal characteristics play a fundamental role in the outcome and course of orthodontic treatment. Gender differences also play an important role when facial sizes and proportions are compared in different societies.

Factors that may increase the risk of external apical root resorption during orthodontic treatment : Retrospective clinical investigation.

To determine the correlation between external apical root resorption and malocclusion-related variables in patients treated with fixed orthodontic appliances. In all, 103patients aged 12-15years and treated with edge-wise appliances either without extractions or with four premolar extractions were included in this retrospective cohort study. External apical root resorption was assessed in the pre- and posttreatment panoramic radiographs of these patients for incisors, canines, premolars, and first molars. Atotal of 2332 teeth were evaluated in 206 panoramic radiographs obtained from 103patients. The gender of the patients, duration of orthodontic treatments, presence of premolar extractions, Angle classification, overbite, overjet and amount of crowding were assessed. Wilcoxon signed-rank test, Mann-WhitneyUtest, and Kruskal-Wallis test were used for statistical analysis of the data. Statistically significant (p < 0.001) root resorption occurred in all examined teeth during orthodontic treatment. The degree of root resorption observed in the premolars was significantly greater in premolar extraction cases than in nonextraction cases. Statistically significant negative correlations were found between the degree of root resorption of the maxillary lateral teeth and between the maxillary first premolar teeth and the amount of maxillary crowding. The orthodontic treatment protocols and the amount of tooth movements achieved were shown to be dependent on the severity of dental malocclusions and they have an influence on the amount of external apical root resorption that occurs during the course of orthodontic treatment.

Effects of the COVID-19 pandemic on orthodontic care in Finland

Objectives To investigate the measures that were taken to limit the risk of COVID-19 contagion, how the risk of adverse effects on patient treatment outcomes was mitigated in orthodontic practices in Finland during the COVID-19 pandemic, and how these measures affected the course of orthodontic treatment. Materials and methods In January 2021, an online questionnaire was sent by email to the members of the Orthodontic Division of the Finnish Dental Association Apollonia (n = 361). An additional inquiry was sent to the chief dental officers of 15 health centers. Results A total of 99 clinically active members (39.8%) responded to the questionnaire. Of them, 97.0% had made changes in their practices, e.g. using additional protective gear such as visors (82.8%), incorporating preoperative mouthwashes (70.7%), and limiting the use of turbines (68.7%) and ultrasonics (47.5%). Two in three respondents reported temporary lockdowns (mean 1.9 months, range 0.3–5.0 months), during which some occlusions slightly regressed (30.2%) and some relapsed to a previous stage of treatment (9.5%). During this study, 59.6% of respondents reported that some treatments were still behind schedule. One in three respondents had used teleorthodontics because of the pandemic. Conclusions Preventive measures and changes in treatment procedures were implemented according to the local COVID-19 situation. Some treatments were prolonged, e.g. because of lockdowns or patient’s fear of contracting COVID-19 whilst receiving treatment. New methods like teleorthodontics were introduced for coping with the increased workload.

Root resorption: why we all need to get informed consent

Severe root resorption is a rare, but serious, complication of orthodontic treatment, which can affect the long-term prognosis of the teeth affected. This case presents a young, healthy patient with severe root resorption affecting nearly all of her dentition. It was an incidental finding by her GDP 8 months after completion of her orthodontic treatment. The article aims to raise awareness about the importance of obtaining a valid consent at the start of each orthodontic treatment, and highlight the possible risk factors associated with severe root resorption, diagnostic methods, and interventions to prevent or manage it when it occurs. CPD/Clinical Relevance: Although developing severe root resorption as a result of orthodontic treatment is relatively uncommon, the consequences are serious. This article highlights the importance of identifying high-risk orthodontic patients, where possible, and obtaining valid, informed consent prior to every course of orthodontic treatment.

Diode Laser Irradiation Effects on Miniscrew Stability and IL-1β and TGF-β1 Levels: A Split-Mouth Randomized Controlled Clinical Trial

Introduction: This study aimed to assess the effect of low-level laser therapy (LLLT) on miniscrew stability and concentrations of interleukin-1β (IL-1β) and transforming growth factor-beta (TGF-β1) in peri-miniscrew crevicular fluid in the course of orthodontic treatment. Methods: This randomized split-mouth double-blind clinical trial evaluated 18 patients requiring anterior retraction along with maximum anchorage. Miniscrews were placed between the maxillary second premolar and first molar. A diode laser was irradiated with a 980-nm wavelength and 100-mW output power in continuous-wave mode at four time points: T0 (1 hour after miniscrew placement), T1 (1 week later), T2 (at 1 month) and T3 (at 3 months) in one quadrant of the maxilla (laser group). The other quadrant of the maxilla underwent the pseudo-application of the laser (control group). The primary stability of miniscrews was measured by Periotest M and reported as Periotest value (PTV). Also, at each time point, samples were collected from the peri-miniscrew crevicular fluid one hour after laser irradiation to assess the concentration of IL-1β and TGF-β1. Results: The mean PTV (inverse of the stability) was smaller in the laser group compared with the control group at all time points; this difference was significant at T2 and T3. The mean concentration of IL-1β in the laser group was lower than that in the control group at all time points, and this difference was significantly remarkable at T0 and T3. The mean concentration of TGF-β1 in the laser group was lower than that in the control group at T0, T1 and T3; however, the difference was not statistically significant. Conclusion: The current results supported the efficacy of LLLT in increasing the miniscrew stability and decreasing the level of IL-1β pro-inflammatory cytokine.

Porphyromonas gingivalis, an Orthodontic point of view

Introduction: Porphyromonas gingivalis (Pg) levels progressively increase in quantity and quality in the course of orthodontic treatment posing a risk to periodontal health.Objective: To analyze the existing literature on the prevalence, clinical manifestations, diagnostic methods, treatment and prevention of Porphyromonas gingivalis from a systemic, oral and orthodontic point of view.Methodology: A literature review was carried out by searching databases using the keywords:

Assessment of the Efficacy of Different Desensitizing Agents on Dentinal Tubules Occlusion- An In vitro Study.

Aim:The aim of the current research was to evaluate the effectiveness of three desensitizing agents on the occlusion of dentinal tubules.Materials and Methods:Eighty human maxillary and mandibular permanent premolar teeth that were subjected to extraction in the course of orthodontic treatment were utilized in this study. The teeth were subjected to sectioning by employing a double-sided diamond disk. A block was procured from every even cervical dentinal surface with dimensions of 4 mm × 4 mm × 3 mm (L × B × H) by sectioning the tooth transversely. Further, 35% phosphoric acid was utilized for 30 s to cause dentinal etching, thereby exposing the dentinal tubules. The blocks of dentin were assigned at random to one of the following four groups (n = 20): group I: control, group II: bioactive glass containing desensitizing agent, group III: 1% nano-hydroxyapatite containing desensitizing agent, group IV: tri-calcium phosphate-containing desensitizing agent. The exterior of the specimens was scanned and evaluated using a scanning electron microscope.Results:1% nano-hydroxyapatite-containing desensitizing agent (2.04 ± 0.08) exhibited higher mean dentinal tubular blockage, followed by the bioactive class-containing desensitizing substance (2.26 ± 0.19), tri-calcium phosphate desensitizing agent (2.84 ± 0.10), and the control group (4.18 ± 0.12) in that order. Amid the experimental groups employing the various desensitizing substances, there were significant differences statistically with P < 0.001.Conclusion:The current research concluded that each of the three desensitizing agents was efficient in dentinal tubular occlusion regardless of their different chemical constitution. However, it was noted that 1% nano-hydroxyapatite-containing desensitizing agent was marginally superior to the bioactive glass- and tri-calcium phosphate-containing desensitizing agents.

Patient-Reported Outcome Measures on Oral Hygiene, Periodontal Health, and Treatment Satisfaction of Orthodontic Retention Patients up to Ten Years after Treatment-A Cross-Sectional Study.

Background: This cross-sectional study evaluated patient-reported outcome measures (PROMs) on (1) oral hygiene, (2) periodontal health, (3) retainer failure, (4) orthodontic treatment satisfaction, and (5) outcome satisfaction in orthodontic retention patients. The purpose of the study was to evaluate whether orthodontic retention treatment is associated with patient-reported outcome measures on oral hygiene, periodontal health, and treatment satisfaction. Methods: A ten-item questionnaire on the five PROMs was conducted among 211 consecutive retention patients up to ten years following orthodontic treatment. Linear regression models were computed to detect possible associations between the PROMs and retention treatment or patient characteristics. Results: The presence of a fixed lingual retainer was not associated with the reduced ability to perform oral hygiene, self-perceived periodontal health, or orthodontic outcome satisfaction. Older patients were more content with the orthodontic treatment result (p < 0.05). Patients with fixed lingual retainers in the mandible were less satisfied with the course of orthodontic treatment (p < 0.05). Smokers more often reported gingival bleeding (p < 0.05). Females reported increased gingival recessions (p < 0.05) and perceived their teeth as longer than before treatment (p < 0.05). Longer orthodontic treatment duration corresponded to retainer failure (p < 0.05). Conclusions: In general, long-term orthodontic retention patients were satisfied with orthodontic treatment. These patients reported the satisfactory ability to perform adequate oral hygiene and periodontal health, and they communicated a high degree of treatment and outcome contentment. However, patients with a retainer in the mandible were less satisfied with orthodontic treatment.

Chewing Patterns and Muscular Activation in Deep Bite Malocclusion.

Background: Deep bite, a frequent malocclusion with a high relapse rate, is associated with craniofacial features that need to be considered in the course of orthodontic treatment. Methods: This study included 81 patients with deep bite malocclusion (11.4 ± 1.1 [yr.mo]; M = 32 and F = 49), and 14 age- and gender-matched controls (9.11 ± 1 [yr.mo]; M = 5 and F = 9). The patients with deep bite malocclusion were treated with functional therapy. The chewing cycles and masticatory muscle EMG activity were recorded concomitantly before treatment in both groups (n = 95). Following correction of the malocclusion, a second recording took place (n = 25). Results: The kinematic variables showed the same dependency on bolus hardness in those with deep bite and in the controls. The masticatory muscle EMG activity was increased in those with deep bite, but decreased as a result of functional treatment. The chewing patterns showed a tendency towards a reduced lateral component, which significantly increased after treatment, indicating that functional therapy impacts the neuromuscular coordination of mastication, as well as dental positioning. Conclusions: Deep bite is a complex malocclusion, involving alterations in chewing and masticatory muscle activity. Orthognathodontic treatment should not only consider and correct the teeth position, but should also address muscular hyperactivity.

A qualitative meta-synthesis of research into patients' past experiences and perceptions of orthodontic treatment outcomes.

There is a growing body of evidence emphasizing the importance of research into patient-centred experience in orthodontics. Benefits following orthodontic treatment are mainly related to improved aesthetics and psychosocial outcomes. However, treatment experience from the perspective of orthodontic patients is yet to be fully understood. To understand the past experiences and current perceptions of treatment outcomes of orthodontic patients. A qualitative meta-ethnography. Qualitative studies and mixed-methods articles with a distinct qualitative component presenting patients' perception of outcomes and overall experiences after an active course of orthodontic treatment were included. Comprehensive electronic searches were conducted in MEDLINE, Scopus, Web of Science, PsycINFO, and EMBASE up to May 2021, supplemented by grey literature and manual searches. Two independent reviewers were involved in study selection, data extraction, and quality appraisal. The Critical Appraisal Skills Programme tool for qualitative research was used to assess the quality of included studies. Analysis of data was conducted using meta-ethnographic methods. Out of 801 retrieved search hits, six studies fulfilled the inclusion criteria and were included in the synthesis. The analysis revealed three main themes and associated sub-themes: (1) Reflection on the past treatment experience, (2) Patient satisfaction with treatment outcomes, and (3) Learning to live with retainers. Results express patients' opinions shortly after treatment, and the long-term impact of orthodontic treatment is yet to be understood. Orthodontic patients mainly viewed their experiences and treatment results positively. Desirable aesthetic outcomes, psychosocial outcomes, and satisfaction with smiles were often reported in the studies reviewed. However, some barriers to optimal experiences were noticed concerning orthodontic retention. PROSPERO (CRD42020180121).

Assessment of the effect of orthodontic treatment on the stability of pre-orthodontic recession coverage by connective tissue graft: a randomized controlled clinical trial.

To compare the changes in periodontal parameters after orthodontic treatment in patients having isolated gingival recession treated with and without pre-orthodontic gingival recession coverage. Thirty-six patients requiring orthodontic treatment with a facially positioned mandibular anterior tooth with labial recession were randomly allocated to either test group: root coverage by subepithelial connective tissue graft (SCTG) followed by orthodontic treatment, or control group (orthodontic treatment only). Primary clinical parameters included recession depth, keratinized tissue width, root coverage, root esthetic score, and gingival phenotype. The patients were followed up for at least 1 year. Level of gingival margin attained in test group teeth after SCTG were maintained at end of orthodontic treatment (P = .727). Root coverage achieved was 69.33 ± 30.74% versus 22.36 ± 27.70% in test and control group, respectively (P = .000), and gain in keratinized tissue width was 1.59 ± 0.73 mm in test versus 0.41 ± 0.49 mm in control group (P = .000). The number of teeth with improved gingival phenotype and decreased hypersensitivity was also observed to be statistically significant in the test group (P = .049, P = .002). Root coverage procedure may be performed before the planned orthodontic treatment as graft stability is preserved throughout the course of orthodontic treatment.

Assessment of the efficacy of different desensitizing agents on dentinal tubules occlusion- An In vitro study

Aim: The aim of the current research was to evaluate the effectiveness of three desensitizing agents on the occlusion of dentinal tubules. Materials and Methods: Eighty human maxillary and mandibular permanent premolar teeth that were subjected to extraction in the course of orthodontic treatment were utilized in this study. The teeth were subjected to sectioning by employing a double-sided diamond disk. A block was procured from every even cervical dentinal surface with dimensions of 4 mm × 4 mm × 3 mm (L × B × H) by sectioning the tooth transversely. Further, 35% phosphoric acid was utilized for 30 s to cause dentinal etching, thereby exposing the dentinal tubules. The blocks of dentin were assigned at random to one of the following four groups (n = 20): group I: control, group II: bioactive glass containing desensitizing agent, group III: 1% nano-hydroxyapatite containing desensitizing agent, group IV: tri-calcium phosphate-containing desensitizing agent. The exterior of the specimens was scanned and evaluated using a scanning electron microscope. Results: 1% nano-hydroxyapatite-containing desensitizing agent (2.04 ± 0.08) exhibited higher mean dentinal tubular blockage, followed by the bioactive class-containing desensitizing substance (2.26 ± 0.19), tri-calcium phosphate desensitizing agent (2.84 ± 0.10), and the control group (4.18 ± 0.12) in that order. Amid the experimental groups employing the various desensitizing substances, there were significant differences statistically with P < 0.001. Conclusion: The current research concluded that each of the three desensitizing agents was efficient in dentinal tubular occlusion regardless of their different chemical constitution. However, it was noted that 1% nano-hydroxyapatite-containing desensitizing agent was marginally superior to the bioactive glass- and tri-calcium phosphate-containing desensitizing agents.

Removable retainers in Orthodontics

One of the most challenging phase for an orthodontist is to retain the corrections achieved during the course of orthodontic treatment. Retainers are passive orthodontic appliances that help in maintaining and stabilizing the position of teeth long enough to permit reorganization of supporting structures after the active phase of orthodontic therapy. This article provides a comprehensive review about the various types of orthodontic retainers available today.

Abstracts from the World Federation for Laser Dentistry—Asia Pacific Division Virtual Conference July 16–17, 2021

Abstracts from the World Federation for Laser Dentistry—Asia Pacific Division Virtual Conference July 16–17, 2021

Reducing the burden of orthodontic care for children with clefts: evaluating the effectiveness of pre-alveolar bone graft orthodontics in unilateral non-syndromic cleft patients (PABO study)\u2014\xa0A\xa0study protocol for a multicentric randomised controlled trial

BackgroundAn alveolar cleft commonly affects 75% of cleft lip and palate patients. While it is common practice to provide a course of orthodontic treatment before alveolar bone grafting, there are no previous high-quality studies reporting on the benefits of this type of treatment.AimThe aim of the study is to evaluate the effectiveness of pre-alveolar bone graft orthodontics for unilateral non-syndromic cleft palate patients.MethodThe PABO trial is a multicentric, parallel, two-arm, single-blinded randomised controlled trial. The inclusion criteria include unilateral cleft alveolus patients requiring bone graft and between the age group of 8 and 13 years with erupted upper central incisors. Participants will be recruited at three centres across India. Participants will be randomised to orthodontic treatment or no orthodontic treatment group. Both groups of participants will have alveolar bone graft surgery and will be followed up for 6 months after surgery. The primary outcome will be the success of the alveolar bone graft measured by anterior oblique radiograph and secondary outcomes include quality of life, cost analysis and quality of the dento-occlusal outcome. Data analysis will be carried out by an independent statistician at the end of the study.DiscussionThis study is the first to evaluate the effect of orthodontics on alveolar bone graft success. The increased burden of care for these patients with multiple treatments required from multiple specialists from birth to adult life highlights the need for reducing unnecessary treatment provision.Trial RegistrationClinical Trials Registry – India, CTRI/2020/10/028756. Trial prospectively registered on 29 October 2020..

Canine avulsion: An extreme complication of a fixed mandibular lingual retainer

The use of fixed retainers at the end of a course of orthodontic treatment has become standard practice. The main complication that can occur with fixed retainers is the detachment of the wire from one or more teeth. A less common complication is unwanted tooth movement. This article presents a patient with extreme tooth movement associated with a mandibular fixed retainer. Ten years after orthodontic treatment, a 26-year-old male sought treatment for post-orthodontic movement of the mandibular anterior 6 teeth. Despite the fixed retainer still being attached to all teeth, the apex of the right canine was completed avulsed labially. Severe labial recession was also present on the left lateral incisor. The canine was extracted, and the fixed retainer was removed. Significant root resorption identified on a panoramic radiograph contraindicated any further extensive orthodontic intervention. This case highlights that clinicians and patients should be aware of this rare but serious complication.