Orthodontic Braces Research Articles

Evaluation of Caries Risk Using Cariogram Among Orthodontic Patients Before and During Treatment: A Comparative Study.

Objective The primary objective was to examine the Cariogram parameters among orthodontic patients with fixed appliances and evaluate the impact of preventive measures on mitigating the risk of dental caries during orthodontic therapy. Materials and methods Patients visiting the representative orthodontic clinics across 14 districts of Kerala participated in the comparative cross-sectional study from January 2023 to January 2024. The sampling method employed in this study was convenience quota sampling, where study subjects were allocated from each of the low, moderate, and high caries risk profiles until the sample size reached the minimal requirement within each group. The baseline Cariogram scores were used to divide the consented participants into two distinct groups. The intervention group was provided with preventive initiatives, including toothpaste comprising 1,450 ppm fluoride, 0.2% NaF mouthwash, pre-cut strands of SuperFloss, an orthodontic toothbrush designed for orthodontic braces, and an interdental flexible brush, as well as videos, pamphlets, and brochures that promoted oral health habits. In contrast, the control group received normal oral health education solely through the use of pamphlets and brochures. After six months, the Cariogram elements were re-evaluated for individuals in both groups. The independent sample t-test and paired t-test were applied to evaluate statistically significant differences between and within the two groups, respectively, using IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, NY, US). The distribution of patients based on their caries risk profiles was compared between groups at the commencement of the study and six months later using the Chi-square test. Results While the intervention group had 20 males and 22 females, the control group consisted of 21 males and 21 females. The average age in the intervention and control groups was 20.7±3.56 years and 21.2±3.12 years, respectively. Between the two groups, age (t=-0.68; p=0.50) and gender differences (λ2=0.05; p=0.83) were statistically insignificant. The percentage mean of the "Chance to avoid caries" associated with the intervention group increased significantly from 46.15±0.96 to 57.88±1.91, (p<0.001). On the other hand, the chance to avoid caries in the control group at the commencement of the treatment and six months later was found to be statistically insignificant. A statistically highly significant differences for all the Cariogram parameters were found when contrasted between the groups after six months of orthodontic treatment. The distribution of caries risk categorization between the control and intervention groups after six months of orthodontic treatment was found to be statistically significant (λ2=20.16;p<0.0001). Further, a statistically significant difference was observed during the pre-treatment phase and six months later in the intervention group (λ2=13.02; p=0.001). Conclusion The study findings reveal that it would be prudent to utilize 0.2% sodium fluoride mouth rinse, SuperFloss, an orthodontic toothbrush designed for orthodontic braces, and an interdental flexible brush, along with toothpaste containing 1450 ppm fluoride daily, to mitigate the risk of dental cavities during orthodontic treatment, in comparison to the control group.

ETMR-04. OPTIC NERVE SHEATH MENINGIOMAS IN CHILDREN-DIAGNOSTIC AND THERAPEUTIC CHALLENGES BASED ON A CASE SERIES

Abstract BACKGROUND Optic nerve sheath meningiomas (ONSM) are rare, comprising 1-2% of paediatric CNS meningiomas. Despite slow growth, ONSM often lead to vision loss in the affected eye. Diagnosis is challenging due to the tumour’s proximity to the optic nerve, complicating biopsy or complete removal. METHODS We searched our Neuro-Oncology MDT database for patients treated for ONSM between Jan 2018 and Dec 2023. We retrospectively reviewed clinical presentation and diagnostic workup that led to the diagnosis of ONSM. RESULTS 6 children aged 3-15years (mean 9 years) were identified over 5 years. 3 children were treated at GOSH, 2 at UCLH and 1 at BCH. 3/6 patients were male. 2/6 underwent a biopsy. Presenting symptoms included headache, acute visual loss and eye pain. 2/6 patients presented with bilateral vision deterioration. The average time between onset of symptoms and presentation was 8 months (range 3–15 months). Identified causes of delayed diagnosis included delayed presentation related to COVID-19 pandemic (2 patients) and impaired quality of imaging due to dental braces (1 patient). Whilst awaiting diagnosis, 2 patients lost vision completely in their affected eye. Diagnostic workup included: optic disc examination (6 patients), lumbar puncture (2 patients), angiotensin-converting enzyme (sACE) (2 patients), MRI brain and spine (6 patients), CT scan (6 patients), PET-DOTATE scan (3 patients), NF2 genetic testing (4 patients). Two patients completed PBT therapy while 1 is undergoing radiotherapy. One patient underwent an enucleation, while the rest are under surveillance. CONCLUSIONS Paediatric ONSM diagnosis remains challenging despite advanced imaging. Our review highlights the added value of CT and PET-DOTATATE when a biopsy is high-risk. CT reveals calcification in 20-50% ONSM while the role of PET-DOTATATE is related to the expression of somatostatin receptor 2 in meningiomas. Despite optimal treatment, vision loss maybe unavoidable. Early multidisciplinary consultations are advised for enhanced outcomes.

Expanding the clinical application of OPM-MEG using an effective automatic suppression method for the dental brace metal artifact

Optically pumped magnetometer magnetoencephalography (OPM-MEG) holds significant promise for clinical functional brain imaging due to its superior spatiotemporal resolution. However, effectively suppressing metallic artifacts, particularly from devices such as orthodontic braces and vagal nerve stimulators remains a major challenge, hindering the wider clinical application of wearable OPM-MEG devices.A comprehensive analysis of metal artifact characteristics from time, frequency, and time–frequency perspectives was conducted for the first time using an OPM-MEG device in clinical medicine. This study focused on patients with metal orthodontics, examining the modulation of metal artifacts by breath and head movement, the incomplete regular sub-Gaussian distribution, and the high absolute power ratio in the 0.5–8 Hz band. The existing metal artifact suppression algorithms applied to SQUID-MEG, such as fast independent component analysis (FastICA), information maximization (Infomax), and algorithms for multiple unknown signal extraction (AMUSE), exhibit limited efficacy. Consequently, this study introduced the second-order blind identification (SOBI) algorithm, which utilized multiple time delays for the component separation of OPM-MEG measurement signals. We modified the time delays of the SOBI method to improve its efficacy in separating artifact components, particularly those in the ultralow frequency range. This approach employs the frequency-domain absolute power ratio, root mean square (RMS) value, and mutual information methods to automate the artifact component screening process.The effectiveness of this method was validated through simulation experiments involving four subjects in both resting and evoked experiments. In addition, the proposed method was also validated by the actual OPM-MEG evoked experiments of three subjects. Comparative analyses were conducted against the FastICA, Infomax, and AMUSE algorithms. Evaluation metrics included normalized mean square error, normalized delta band power error, RMS error, and signal-to-noise ratio, demonstrating that the proposed method provides optimal suppression of metal artifacts. This advancement holds promise for enhancing data quality and expanding the clinical applications of OPM-MEG.

Clear aligner's adverse effects: A systematic review protocol.

With the growing popularity of clear aligners, more patients have chosen to use them instead of traditional orthodontic braces to correct their malocclusions. Clear aligners offer distinct advantages over conventional fixed braces, such as limited aesthetic impact, the convenience of easily removing them for meals, improved accessibility for brushing and flossing, and a treatment approach that avoids the use of metal, minimizing potential irritation to the cheeks and gums. Manufacturers point out a disadvantage that can be administered in this type of treatment. Still, to our knowledge, a comprehensive review of the published literature assessing the adverse/negative effects of clear aligners has not yet been conducted. A systematic review, with or without meta-analysis, will be performed. The inclusion criteria will be studies involving individuals using clear aligners and reporting potential adverse/negative effects during or after treatment. No restrictions about time or language will be applied. The studies screening will be conducted in two stages. Two independent reviewers will initially evaluate the title and abstract under the eligibility criteria. Subsequently, the same two reviewers will examine the articles' full text in-depth. The results will be synthesized in the form of a narrative description and incorporate a meta-analysis if justified. Furthermore, we will present details regarding the sample characteristics, intervention, study objectives, methodologies employed, and primary findings. This study aims to investigate the potential adverse effects and their frequency among orthodontic patients wearing clear aligners. Moreover, the outcomes of this review have the potential to illuminate specific inherent limitations of aligner therapy as a comprehensive orthodontic approach.

Pendampingan Fase Pencarian Jati Diri Remaja Muhammadiyah Jakarta, Fokus Pada Penguatan Pemahaman Berbagai Bentuk Narkoba dan Kesehatan Gigi

Background: The adolescent phase is a phase of physical, psychological, and social change, expressed through imitation and exploration behavior such as trying new culinary delights. Many teenagers forget about their dental health. Apart from that, in their psychological condition, which is still unstable, adolescence is a period that is vulnerable to the influence of drug dealers. It is hoped that this activity can increase understanding and awareness regarding the dangers of drugs and improve hygiene in physical care, especially teeth. Method: 89 SMA 4 Muhammadiyah East Jakarta students participated in this activity. The stages of this activity are carried out by collecting knowledge level data, providing education, evaluating educational results, and mentoring. Results: 100% of SMA Muhammadiyah 4 East Jakarta students did not consume drugs, and 92% did not use dental braces. 18% of students smoke, 29% regularly have dental health checks at the dentist, and 38% have had toothache. Conclusion: High School Muhammadiyah 4 East Jakarta students do not use drugs. It is necessary to provide guidance and assistance to the 18% of students who smoke and 71% who do not visit the dentist regularly to improve their lifestyle and avoid things that are not good for themselves.

Management of enamel demineralization- An iatrogenic effect of orthodontic treatment: A case report

Areas of demineralised enamel, usually referred to as white spot lesions (WSLs), constitute to a clinical problem in Orthodontics following treatment with fixed appliances. They result due to an imbalance between de- and remineralisation of enamel, caused by the inter-relationship of several factors. This manuscript is intended to elucidate the presentation of a clinical case treated with orthodontic braces with 10-year follow up, and management of demineralization with veneers that occurred due to long term fixed orthodontic treatment. The goal of treatment has been achieved according to patient’s desire and satisfactory digital veneer placement. No further relapse has been seen in the follow up. The treatment resulted in an aesthetic, functional, and stable occlusion, along with improved facial profile.

Nociceptor mechanisms underlying pain and bone remodeling via orthodontic forces: toward no pain, big gain.

Orthodontic forces are strongly associated with pain, the primary complaint among patients wearing orthodontic braces. Compared to other side effects of orthodontic treatment, orthodontic pain is often overlooked, with limited clinical management. Orthodontic forces lead to inflammatory responses in the periodontium, which triggers bone remodeling and eventually induces tooth movement. Mechanical forces and subsequent inflammation in the periodontium activate and sensitize periodontal nociceptors and produce orthodontic pain. Nociceptive afferents expressing transient receptor potential vanilloid subtype 1 (TRPV1) play central roles in transducing nociceptive signals, leading to transcriptional changes in the trigeminal ganglia. Nociceptive molecules, such as TRPV1, transient receptor potential ankyrin subtype 1, acid-sensing ion channel 3, and the P2X3 receptor, are believed to mediate orthodontic pain. Neuropeptides such as calcitonin gene-related peptides and substance P can also regulate orthodontic pain. While periodontal nociceptors transmit nociceptive signals to the brain, they are also known to modulate alveolar bone remodeling in periodontitis. Therefore, periodontal nociceptors and nociceptive molecules may contribute to the modulation of orthodontic tooth movement, which currently remains undetermined. Future studies are needed to better understand the fundamental mechanisms underlying neuroskeletal interactions in orthodontics to improve orthodontic treatment by developing novel methods to reduce pain and accelerate orthodontic tooth movement-thereby achieving "big gains with no pain" in clinical orthodontics.

CBCT and modern intraoral scanners as tools for developing comprehensive, interdisciplinary treatment plans.

The aim of this narrative literature review is to present the possibilities of using cone beam computed tomography (CBCT) and 3D dental scanners to prepare comprehensive, interdisciplinary treatment plans. Scanners are instruments whose usage seems to be a key element of modern digital dentistry. Their importance in orthodontic treatment with overlay appliances, planning modern prosthetic treatments (CAD/CAM) and implantology cannot be overestimated. These scanners allow for accurate imaging of the tooth structures and their positioning independently in the maxilla and mandible as well as in the occlusion. As a result, dentists can plan treatment, e.g., in the case of the need to implant dental implants, prosthetic crowns or orthodontic braces. Dentistry was revolutionized to a similar extent by the introduction of CBCT to everyday diagnostics, which is the most advanced imaging technology that provides even more detailed images in 3 dimensions. Its use has enabled a wider and more precise range of diagnostics, which in turn has improved the quality of multidisciplinary treatment planning. This paper explains how scanners and CBCT can be used in orthodontics and prosthetics based on the articles found in 3 databases: PubMed, Scopus and Embase. The review included 28 articles on the aforementioned topics and was presented with a brief description of the content of each article.

Initial arch wires used in orthodontic treatment with fixed appliances.

Initial arch wires used in orthodontic treatment with fixed appliances.

Pertanggungjawaban Hukum Perbuatan Praktek Tukang Gigi

Introduction: The practice of dental artisans which is now increasingly mushrooming in the community seems to have caused serious problems, namely victims of practices that are not in accordance with procedures. Several cases indicate that it turns out that the practice of dental artisans has become one of the people's choices given the low cost and practicality in providing services, even though medically the consequences are often not considered, and if a victim arises, the legal issue is whether dental artisans can be held legally responsible, if so, what form? liability under civil law and criminal law, even according to health law itself. &#x0D; Purposes of the Research: The purpose of this article is to examine and anylize forms of legal protection for the victim in the practice of dental artisan.&#x0D; Methods of the Research: Answering the legal issues of this research, the research method using normative legal research is supported through a statutory approach, a concept approach and a case study approach. The sources of legal materials are primary, secondary and tertiary sources of legal materials collected through literature study and several documents which are then analyzed using qualitative analysis.&#x0D; Results of the Research: The results of the study concluded that judging from the health law and the law on the practice of medicine and dentistry, it is clear that the dentist profession is one of the academic professions that must be pursued through formal academic education in higher education so as to obtain a dental professional degree, while dental artisans also get education although not through formal education. Likewise with their professional practice, both dentists and dental artisans have a clear practice basis, namely the law on medical practice and the Regulation of the Minister of Health, where in these regulations it is emphasized that apart from permits as well as reporting and supervision carried out by the Health Office where dental artisans perform practice. It turns out that not a few dental artisan practices do not get a permit, even in practice there are many cases such as the installation of dental braces, cleaning and installation of teeth that are not up to standard, resulting in victims who, when viewed from the law on the health of the victim, need legal protection. One form of protection is legal liability, both according to civil law and according to criminal law.

Edukasi Pertolongan Pertama Kasus Gawat Darurat Gigi pada Remaja Wilayah Kayu Mas Jakarta Timur`1

Emergency dental issues such as throbbing toothaches, dental trauma (fractures, dislodgment from the gums), teeth pierced by orthodontic wires, and wires from dental braces causing injuries by piercing the gums, are some of the health problems that can result in prolonged suffering for those experiencing them. Every case has a different level of emergency. Although for some people it is not considered a real emergency, it is still a condition that urgently requires proper action before going to the dentist. Therefore, there is a need for increased knowledge to provide first aid before visiting a dentist. Collaborative efforts between medical professionals, alumni, and professional students from the Faculty of Dentistry at Trisakti University conducted an activity involving education for the adolescent community at the Integrated Child-Friendly Public Space (RPTRA) in Kayu Mas, East Jakarta, on March 16, 2023. Before and after the distribution of education, pre and post-tests were conducted, showing significant improvements in knowledge regarding dental emergencies. The conclusion drawn from this activity underscores the importance of knowing the initial steps to handle dental emergencies in order to receive appropriate medical care.

Aligners, can my child use them too?

This is a frequently asked question. The answer depends on various factors, with cooperation being among the most essential. As a parent, you must ask yourself if you can rely on your child to wear aligners correctly for most of the day. If the answer to this question is yes, then clear aligners may be a better choice than traditional braces. There are three major benefits of clear aligners in children: 1. Greater comfort, aligners are less voluminous than traditional braces and more likely to prevent irritation, mouth ulcers and other discomfort that derives from the movement of the orthodontic wire or braces. 2. Better hygiene, as their removal during meals and tooth cleaning manoeuvres makes home oral hygiene easier. 3. Better aesthetics, thanks to the transparency of the plastic replacing the metal. However, a certain degree of caution is advised to those who are considering this treatment option. Although aligners allow us to start resolving certain tooth malpositions (which can cause periodontal and aesthetic problems or increase the severity of damage in the event of trauma), and to improve alignment and minor crowding at an early age, it must not be forgotten that the intervening period for changing the definitive position of individual teeth is still the period of permanent teeth. It is important to consider whether a child has a dental or skeletal problem. In cases where a child's problem is exclusively dental, the aligner may be one of the tools used. In cases of skeletal problems, the literature advises against the aligner, as it is not the right instrument at this stage of development. The literature in some cases refers to aligners as the universal remedy, valid for every malocclusion, presenting them as a panacea for all orthodontic problems of very young patients. It is necessary to remain open to the innovations that the market offers us and that can improve our daily clinic, and aligners can be a valid support in this regard, but, as dentists, we should always keep a critical and open eye on treatments with an evidence-based rationale. As with all other orthodontic appliances, aligners must be evaluated on a case-by-case basis, keeping in mind that they are one of the tools in the hands of the clinician. When the clinical situation makes it possible and when both the child's requirements and the parent's expectations are fulfilled, it is certainly worth considering clear aligners as a viable route in the family-child's orthodontic treatment, making it as simple and convenient as possible. Lastly, we should remember the concept of efficiency regarding an orthodontic treatment, which depends on its cost/benefit ratio, with the former being understood in a biological sense and in terms of its impact on the life of the patient and their family with respect to duration, cooperation required, discomfort induced by the equipment used and frequency of check-ups. The latter should obviously be considered in terms of results obtained in relation to the pre-established treatment goals. A consideration that we should always keep in mind: let us never forget that is the orthodontist who treats the patient, not the appliance!

Therapeutic Awareness Trends of Dentistry among Public in Tamil Nadu: A web engine search based study

Brief Background - The awareness of the dental ailments and its treatment modalities was initially assessed by means of questionnaire based epidemiological surveys. However, the advancement in technology will not only be used by the public to know about the importance of various dental ailments but also their treatment. On the other hand, the technology also utilizes to find out the awareness of the same among public. Google trends is a web engine based tool, provided by google. It allows the public to identify the popularity of a particular search term. Using this particular tool, we could identify the search trend of various dental terms pertaining to disease and treatment digitally. To evaluate the awareness of dental ailments and its treatments in Tamilnadu in 2020 and to compare the same, with that of previous decade to analyze the change in awareness over time. Material and Methods - Google is the most commonly used by the general public worldwide. Hence we used Google search Engine to know the awareness of dental ailments and the treatment modalities among the general public. Five keywords were selected for each dental specialty. All the key words were run through google trends web engine. Results - On the whole significantly highest searched terminology in Tamilnadu for the year of 2020 was extraction with 67 searches. Following this dental braces were the next commonly searched term with the count of 44. The significantly searched term for the year of 2010 was removable denture with 64 searches. The next commonly searched term was impaction with 56 searches and dental floss with 55 searches. Conclusion - The current study is a novel attempt and paves a new platform to evaluate the awareness of disease, its trend and its treatment in dentistry and various other specialties. Key Words - Dental disease, Dental therapy, Google trends, Oral health awareness, Web awareness

Interactions between X-/gamma rays and alloys used in dental braces: A study on theory and simulations

In the field of dentistry, the utilization of dental X-rays plays a pivotal role in ensuring accurate diagnoses for various dental conditions. A crucial aspect of this practice involves understanding how these X-ray emissions interact with dental braces. In the presented study, the details of how X-rays and gamma rays interact with different materials used in dental braces, namely stainless steel, nitinol, elgiloy, and beta-titanium alloys, were examined. This investigation was carried out through a combination of advanced simulation codes such as FLUKA and GEANT4, alongside theoretical calculations using the WinXCOM approach. A comprehensive analysis was conducted at fourteen distinct energy levels, ranging from 20 to 150 keV with 10 keV increments. The primary focus of this study revolves around quantifying the shielding characteristics of gamma and X rays as they traverse through these dental brace materials. To achieve this, some gamma/X-ray shielding parameters, buildup-factors, and kerma relative to air were meticulously simulated and calculated. Additionally, the energy deposits within these materials and the subsequent generation of secondary radiations are thoroughly explored. Significantly, these results highlight that elgiloy alloy demonstrates the highest attenuation of X-ray and gamma ray intensities compared to the other considered materials. This comprehensive study thus offers valuable insights into the behavior of dental braces when subjected to ionizing radiation, with potential implications for patient safety and diagnostic accuracy in dental radiology.

Conventional gingivectomy for chronic gingival enlargement in orthodontic treatment: a case report

Background: Gingival enlargement, also known as gingival overgrowth, is an enlargement of the gum tissue. There are many possible causes for enlarged gums. Gingival enlargement is general feature of gingival diseases. It is common note to chronic inflammatory gingival enlargement was caused by poor of oral hygiene. Orthodontic braces can interfere with good oral hygiene, contributing to the development of the inflammatory process. One of the most common soft tissue problems related to fixed orthodontic appliances is gingival hypertrophy or hyperplasia. Maintaining oral hygiene is hindered in cases of gingival hypertrophy due to orthodontic appliances. The most widely used surgical method to treat gingival hypertrophy is gingivectomy.&#x0D; Case Report : A 27-year-old patient was referred to the periodontal clinic of Airlangga University Dental Hospital because of primary gingival swelling with gingival bleeding during brushing in the anterior mandibular region. On intra oral examination showed excessive gingival with probing depth was range 4 mm on teeth 42-32, revealing the presence of pseudopockets. Clinical examination revealed generalized gingival enlargement as well as generalized bleeding on examination. After explaining the condition and treatment to the patient, he was registered for phase I treatment. After evaluating phase I therapies, phase II treatment with gingivectomy and gingivoplasty were required using a scalpel.&#x0D; Conclusion: Conventional gingivectomy gives satisfactory result in treating the inflammatory gingival enlargement.

Adhesion of Orthodontic Braces to Different Restorative Materials: Influence of Surface Conditioning Methods

Adhesion of Orthodontic Braces to Different Restorative Materials: Influence of Surface Conditioning Methods

What’s new for the clinician – summaries of recently published papers

Interdental cleaning devices in the form of dental floss and interdental brushes have traditionally being used as adjuncts to plaque removal in the interproximal areas of teeth. However, their routine use among younger adolescents has been reported in many studies to be less than optimal. In orthodontic patients, fixed braces promote supra- and subgingival accumulation of biofilm by impeding oral hygiene resulting in an altered oral microbiome, enamel decalcification and gingivitis1. It was recently shown that patients with upper and lower multibracket appliances are affected significantly more frequently by gingivitis (65%) and white spot lesions (30%).1 Additionally, in the predominantly young orthodontic patients, interdental spaces are often too narrow to use interdental brushes and flossing is challenging and time-consuming. Oral irrigators are easy to use even in the presence of orthodontic braces and are therefore favoured by many patients. Most oral irrigators use a stream of water only to mechanically remove plaque from interproximal areas but there are also oral irrigators which use a mixture of air and water, called microburst technology.

An assessment of the pH changes and metal ions released into artificial saliva by fake orthodontic braces

BackgroundThis present study assesses changes in the pH as well as the metal ions that fake braces release into artificial saliva (AS) using a pH meter and inductively coupled plasma atomic emission spectroscopy (ICP-AES), respectively.MethodsThree sets of fake archwires (AWs) and brackets (Bs) as well as a set of controls were immersed in AS and placed in an incubator shaker at 50 rpm and 37°C. At Days 0, 1, 7, 14, 21, and 28, the pH of the AS medium was measured and 3.0 ml of AS was collected and stored at -20°C for elemental analysis.ResultsSignificant changes in pH were observed on Days 0, 1, 7, 14, 21, and 28 in the AS of the AW group. However, these changes were only observed in the B group on Days 0 and 7. The fake samples released a large quantity of sodium (Na), potassium (K), and calcium (Ca) ions, at concentrations exceeding 100 mg/L, post-28 days of immersion. The control and fake braces samples released other ions; such as lithium (Li), magnesium (Mg), barium (Ba), chromium (Cr), copper (Cu), lead (Pb), and aluminium (Al); at concentrations that did not exceed 10 mg/L.ConclusionsThe pH of the AS of all the samples increased post-incubation. Only 10 ions; namely, Na, Li, K, Mg, Ca, Ba, Cr, Cu, Pb, and Al; were detected in the AS.

Antimicrobial and mechanical assessment of cellulose-based thermoformable material for invisible dental braces with natural essential oils protecting from biofilm formation

Controlling biofilm formation in the oral cavity during orthodontic treatments is crucial. Therefore, antimicrobial surfaces for invisible dental appliances are of interest to both therapists and patients. Here we present a cellulose-based thermoformable material used for invisible braces that can be loaded with essential oils (EOs) having antibacterial and antifungal properties. We hypothesize that this material can absorb and release EOs, thus providing an antimicrobial effect without compromising the safety and mechanical properties necessary for dental invisible braces. Conventional microbiology and isothermal microcalorimetry analyses revealed that the thermoformable material loaded with essential oils significantly delayed the biofilm formation of oral streptococci (S. mutans and S. mitis) under static conditions (p < 0.05) and while simulating saliva flow (p < 0.05). In addition, cytotoxicity tests (ISO 10993-5), revealed that the loaded material is well tolerated by human gingival fibroblasts. Finally, the loading with antibacterial agents did not significantly alter the mechanical properties and stability of the material (initial force (p = 0.916); initial stress (p = 0.465)). Compared to gold-standard clear aligner materials, this material offers a reliable transmission of forces for orthodontic treatments. Moreover, this approach exhibits the potential for acting as an oral drug delivery platform for multiple compounds.

The efficacy of the dental Water Jet, orthodontic, and conventional toothbrushes in plaque removal around orthodontic braces in adolescents: A randomized controlled trial.

Orthodontic treatment improves both masticatory function and the aspects of facial esthetics through the correct alignment of the teeth. If oral hygiene is neglected during fixed orthodontic treatment, it may lead to plaque accumulation and gingivitis. The aim of this randomized controlled trial was to evaluate the effectiveness of the dental Water Jet (DWJ), and orthodontic toothbrush (O-TH) in removing dental plaque around the orthodontic braces compared to conventional toothbrush (C-TH) in adolescents. This was a three-arm, double-blind, and parallel-group randomized active-controlled trial. Forty-five patients were randomly allocated into three groups: DWJ, the O-TH, and the C-TH (control group). The primary outcome measure was dental plaque accumulation change from the baseline (t0 ) to post-cleaning (t1 ), and plaque scores were recorded using the Orthodontic Plaque Index (OPI). The current clinical trial was registered and approved by Australian New Zealand Clinical Trials Registry (ACTRN12623000524695). A statistically significant difference was noted in the OPI scores between different time points in the DWJ group, the O-TH group, and the C-TH group (p < .05). However, no significant difference was noted between the groups after the cleaning procedure (p > .05). The level of oral hygiene was not satisfactory in patients undergoing fixed orthodontic treatment. In addition, the efficacy of the DWJ was not superior to O-TH nor to C-TH in plaque removal.