Duration Of Orthodontic Treatment Research Articles

Effect of various biological ways on the orthodontic tooth movement

The duration of orthodontic treatment is the primary concern of utmost patients. Unfortunately, long orthodontic treatment time poses several disadvantages like an advanced predilection to dental caries, gingival recession, and root resorption. Thus, there is an increase in the demand to find the best method of faster tooth movement. Orthodontic treatment is formed on the premise that when force is delivered to a tooth and thereby transmitted to the adjacent investing tissues, certain mechanical, chemical, and cellular events take place within these tissues, which allow for the structural difference that contributes to the tooth movement. Conventionally, this process is slow, and orthodontic treatment time can range anywhere from 36-48 months. The body's responses to these forces are the crucial controllers of inflammation and tissue turnover. So, in this article, various pharmacological means are discussed that can enhance the rate of tooth movement.

Accelerated Orthodontics – A Review

Orthodontic treatment duration is one of the most challenging factors faced by all orthodontists till date but thanks to the surge in science and technology there are many ways to step up the treatment thereby reducing the overall treatment time. This review article will provide an insight on the various methods of accelerating the orthodontic treatment time duration.

The Effectiveness of Conventional and Accelerated Methods of Orthodontic Traction and Alignment of Palatally Impacted Canines in Terms of Treatment Time, Velocity of Tooth Movement, Periodontal, and Patient-Reported Outcomes: A Systematic Review.

The objective of the current review was to evaluate the effectiveness of traditional and accelerated methods of palatally impacted canine's (PIC) traction in terms of treatment duration, velocity, periodontal, and patient-reported variables.An electronic search for randomized controlled trials (RCTs) and controlled clinical trials (CCTs) published between January 1990 and October 2021 was conducted in nine databases. Five major orthodontic journals were hand searched for additional studies. The participants were patients with unilateral or bilateral PICs who received conventional or accelerated orthodontic treatment with fixed appliances. Cochrane’s risk of bias tool (RoB 2 tool) for RCTs and ROBINS-I tool for CCTs were used to assess the risk of bias. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) guidelines were used to assess the overall quality of the evidence.Nine articles (eight RCTs and one CCT) were included in this review (371 patients). There was no clarity in most studies about the possible effect of the mechanical traction method on treatment outcomes. The treatment duration decreased (about three to six months) when the open surgical method was used with traditional techniques and the traction velocity increased significantly (about 1-1.5 mm/month) when acceleration methods were used. No significant differences were found between the conventional intervention groups, as well as between the traditional and accelerated groups, in terms of most periodontal variables (p > 0.005).No significant differences were found in the pain levels associated with traditional PICs' traction when comparing different exposure methods in the short-term follow-up (1-10 days), while contradictory results were found in the pain incidence between these methods. The relationship between the pain/discomfort levels and the type of mechanical traction method was not evaluated. According to the GRADE, the quality of evidence supporting these findings ranged from low to very low.The combination of the open surgical technique with various designs of either superelastic wires or elastic traction means can lead to a reduction in the orthodontic treatment duration of PICs. The use of direct anchorage by miniscrews to move the PICs away from the adjacent teeth roots can lead to a reduction in root resorption and shorten the treatment duration. The evidence supporting these findings ranged from low to very low. The use of different types of mechanical means for conventional PICs' traction, with the use of open or closed traction techniques, does not lead to significant differences in periodontal outcomes between intervention groups. Contradictory results exist regarding the severity of the perceived pain in relation to the surgical exposure type, and the relationship between this variable and the mechanical traction method is still unclear. The use of accelerated methods for PICs' traction can lead to an increase in the velocity of traction movement with no significant differences in periodontal outcomes between accelerated and conventional methods. The evidence supporting these findings ranged from low to very low. More high-quality randomized CCTs are needed to establish good evidence in this field.The protocol of this systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42021274476) during the first stages of this review.

Redefining our protocol of the orthognathic surgery-first approach after 10 years of experience

The objective of this study was to update and redefine some concepts of the surgery-first (SF) approach, regarding its indications and contraindications, virtual planning work-up, surgical tips, and postoperative orthodontic benefits, after 10 years of experience. A retrospective analysis was made of orthognathic surgical procedures following the SF protocol between January 2010 and December 2019 to review inclusion and exclusion criteria, diagnostic workflow, surgical tips, and postoperative outcomes. A total of 148 SF procedures were performed during this period, which corresponded to only 9.2% of the total orthognathic surgeries performed, which means that we have broadened the exclusion criteria instead of reducing them. Surgical tips include interdental corticotomies solely in cases of anterior crowding and leaving the intermaxillary fixation miniscrews in place postoperatively for orthodontic skeletal anchorage. The mean duration of postoperative orthodontic treatment was reduced in comparison to conventional surgery (36.8 vs 87.5 weeks). The overall degree of satisfaction was high not only for the patients, but also for the orthodontists and surgeon. SF is especially indicated for patients who desire an immediate aesthetic result, with short-term orthodontics, or for treatment of sleep-related breathing disorders, if they meet the established criteria.

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.

Comparison of salivary leptin levels between underweight and overweight individuals and its role in orthodontic tooth movement

Introduction: The Aim of this study is to compare the concentration of salivary leptin levels between underweight and overweight individuals and its significance in orthodontic tooth movement. Methods: Fourty five underweight and overweight female subjects were taken in this study and they are divided into two groups, group I (underweight) and group II (overweight) depending on their mean body mass index. Angles class I malocclusion with bimaxillary protrusion were taken into this study. All subjects underwent upper first premolar extraction, and distal force is applied with lacebacks to maxillary canine. Salivary leptin samples were collected before force application (To), one hour after appliance placement T2, and one month after appliance placement (T3). Results: Overweight individuals show increased salivary leptin concentration three times greater than underweight individuals. Orthodontic tooth movement is decreased in overweight individuals when compared with underweight individuals. Conclusions: Increased salivary leptin levels showed a decreased tooth movement in overweight individuals than underweight individuals who showed decreased salivary leptin levels. Obese individuals require more orthodontic treatment duration time when compared with lean individuals.

Prognostic indicators of arthroscopic discopexy for management of temporomandibular joint closed lock

In order to optimize patient selection for temporomandibular joint (TMJ) arthroscopic discopexy to achieve favorable outcomes, prognostic indicators impacting the results are important to analyze. This longitudinal retrospective study aimed to analyze various prognostic factors impacting surgical outcomes following arthroscopic discopexy for management of TMJ closed lock using success criteria based on pain, maximal interincisal opening, diet, and quality of life. Furthermore, a quantitative MRI assessment was performed pre- and post-operatively. Multivariate analysis was used to evaluate various prognostic variables including gender, age, side, duration of illness, Wilkes staging, parafunctional habits, splint therapy and orthodontic treatment. A total of 147 patients (201 joints) were included. The outcome was categorized as excellent (n = 154/76.61%), good (n = 34/16.91%), or poor (n = 13/6.46%) with a success rate of 93.54%. Patients aged > 30 years old (p = 0.048), longer duration of illness (12–24 months: p = 0.034) and (> 24 months: p = 0.022), and patients with Wilkes stage IV (p = 0.002) were all significantly more likely to be in the poor outcome group. Finally, orthodontic treatment showed a significant association with excellent outcomes (p = 0.015). Age, duration of illness, Wilkes staging, and orthodontic treatment are considered significant prognostic factors that can predict the outcomes following the arthroscopic discopexy for management of TMJ closed lock.

Comparative effect of micro-osteoperforation and Photo-biomodulation on the rate of maxillary canine retraction: A split mouth randomized clinical trial.

The lengthy duration of comprehensive orthodontic treatment has always been a major concern. Various modalities have been proposed to accelerate the orthodontic tooth movement (OTM) with varying degree of success. However, there is limited literature, comparing the efficiency of two commonly used modalities which are relatively simple, safe and comfortable chair-side procedures to accelerate orthodontic tooth movement viz. Photo-biomodulation (PBM) being non-invasive and micro-osteoperforations (MOPs) being minimally invasive. The aim was to evaluate the comparative effect of PBM and MOPs on the rate of orthodontic tooth movement (OTM). In this split mouth study, thirty patients requiring ma-xillary first premolar extraction were randomly allocated for Photo-biomodulation (PBM) on one side and for micro-osteoperforations (MOPs) on other side of maxilla. Separate canine retraction was performed and movement was measured over a three month period. Micro-osteoperforations (MOPs) significantly increased the rate of maxillary canine retraction by 1.1 fold when compared to the Photo-biomodulation (PBM).The MOPs can successfully reduce the comprehensive fixed orthodontic treatment time by around 9% as compared to PBM. Micro-osteoperforation is a more efficient modality of accelerating tooth movement as compared to Photo-biomodulation which can be used in routine orthodontic practice.

RETRACTED ARTICLE: The powerful effects of social media platforms on orthodontic patient knowledge’s improving, attitude management and it is influence on financial income of the orthodontic clinic

The aim of this study was increasingly influencing the health care landscape, so orthodontic patients can easily obtain information about orthodontic. The aim of this study was to investigate the benefits of using social media sites as a source of information to orthodontic patients for improving their knowledge about orthodontic care and treatment and the extend of its on reduce the duration of orthodontic treatment (DOT) and investigate the potential benefits of using social media platforms in marketing in orthodontic practices to increase the financial income of orthodontic clinics. 150 orthodontic patients were recruited as participants from the orthodontic clinic at the Near East University (in North Cyprus). The patients were 13 years and over from both sexes. Patients were excluded if they were not users of social media sites, had a history of previous orthodontic treatment, craniofacial syndrome, or low mental abilities. About 74% of the participants (mostly females) confirmed that social networking sites were the major driver for them to take the decision to come to the orthodontist and start orthodontic treatment. 73% of the respondents reported using social media sites as a source of information related to orthodontic treatment, where the Instagram was the most used program.

Efficacy of pulsed electromagnetic field in reducing treatment time: A clinical investigation

The long duration of orthodontic treatment is a major concern for the patient. This study aimed to evaluate the efficacy of pulsed electromagnetic field therapy (PEMF) in accelerating the orthodontic tooth movement, thus reducing treatment duration. Nineteen patients requiring extraction of first premolars were selected for this study. The study design was randomly assigned (sealed envelope randomization) split-mouth design. The rate of individual canine retraction by a nickel-titanium closed-coil spring was done. The experimental side received a PEMF generated by a circuit powered by a watch battery. The circuit was embedded in a removable appliance. Foil was used to obstruct the control side from PEMF exposure. Patients were instructed to wear the appliance for 8-10 hours. Appliance with the device was given from the commencement of canine retraction until the canine retraction of one side was complete. Tooth movement was measured on progress models. An average increase of 31% in the rate of tooth movement was observed with the PEMF. PEMF is a good option to reduce orthodontic treatment duration.

The Perception of Adults and Adolescents of Undergoing and Paying for Tooth Movement Acceleration Procedures in Turkey.

The aim of this study is to evaluate the opinions of adolescents and adults regarding nonconventional methods and their associated payment options in Turkey. A total of 183 subjects were asked to complete a questionnaire to evaluate their perception of various nonconventional acceleration methods: corticotomy, piezocision, micro-osteoperforation, vibration, drug injection, and customized appliances. The questionnaire also investigated how willing the patients would be to pay more and how much more they would accept to reduce the treatment time. About 38.7% of the adolescents and 44.4% of the adults were willing to undergo an additional procedure, and 59.6% of both groups chose customized appliances as their first preference as a way of accelerating the treatment process. About 45.4% of the total participants were neutral about paying more to reduce treatment time. Those patients who were willing to pay more accepted a maximum increase of only 10% even if that meant a 50% decrease in treatment time. Adults were slightly less tolerant of the duration of orthodontic treatment than adolescents and were more likely to undergo additional procedures and pay more for a shorter treatment time. In addition, the invasiveness of each procedure was the primary factor given when choosing an acceleration method, rather than its reduction rate.

Evaluation of the Influence of Fixed Orthodontic Treatment Duration on the Severity of Inflammatory Gingival Enlargement (Fixed Orthodontic Induced Gingival Enlargements) and Some Properties of Saliva

Background: Inflammatory gingival enlargement is a more common clinical feature with orthodontic therapy than other features. Therefore, this study was designed to the evaluation of the influence of fixed orthodontic treatment duration on the severity of inflammatory gingival enlargement (fixed orthodontic induced gingival enlargements) and some properties of saliva. Material and Methods: The sample size comprised 145 patients undergoing fixed orthodontic treatment for at least 6 months aged 13 - 32 years. They were divided according to orthodontic treatment duration into three groups. Group I (n = 47) included the patients who were treated for less than 6 months, group II (n = 51) included the patients who were treated for a period of 6 - 12 months, and group III (n = 47) included the patients who were managed for more than 12 months. Data were obtained from the outpatient clinics, college of dentistry, King Khalid University, Abha, Saudi Arabia, and some dental centers in Sana’a city, the Republic of Yemen. This study was conducted from October 2021 G to January 2022 G. Clinical examination was done for plaque index (PLI), gingival index (GI), and gingival enlargement indexes (GEI). Saliva was collected in sterile test tubes then salivary flow and pH were measured. Statistical analysis was done with SPSS (version 23) and ANOVA test to evaluate the impact of orthodontic treatment duration on the severity of inflammatory gingival enlargement and some properties of saliva. Results: The statistical analysis demonstrated the highest mean plaque index (PLI) was among groups III and I participants whereas, the highest mean gingival index and mean gingival enlargement were among groups II and III participants. The present study revealed an increase in salivary flow with decreased salivary pH values with an increase in orthodontic therapy duration. There were statistically significant differences in clinical findings and salivary flow and pH values were observed in the comparison between groups I, II and III except PLI (p < 0.05). Conclusion: There was a higher inflammatory gingival enlargement associated with a higher plaque index in patients under orthodontic treatment for more than 12 months more than the patients for less than 6 months and the patients for a period of 6 - 12 months. There were correlations between an increase of salivary flow and pH values and an increase of other variables in this study, such as plaque index, gingival index, and gingival enlargement index with an increased orthodontic therapy duration.

Duration of presurgical orthodontic treatment in individuals with nonsyndromic oral clefts undergoing orthognathic surgery

Introduction: Evaluating the length of orthodontic-surgical treatment is a key factor to properly inform and guide the patient about the duration of treatment and consequently achieve agreement and adherence to treatment, as well as for health-care institutions that sponsor this type of treatment. Objective: The aim of the present study was to investigate the duration of orthodontic treatment before orthognathic surgery, in patients with nonsyndromic oral clefts, as well as the number of consultations required for that purpose. Materials and Methods: This was an observational, retrospective, descriptive study conducted on data obtained from the patients' medical records. The study analyzed 485 medical records and, after applying the inclusion criteria, the sample included 227 medical records. All data were tabulated in an Excel spreadsheet for calculation of means and standard deviations (SDs), for the time period analyzed. Results: The time for orthodontic preparation was 8.2 years with a range of attendance from 1 to 130 visits and a mean of 37 visits (SD ± 24). Conclusion: The results suggest that there is a longer time than reported in the literature for orthodontic preparation for orthognathic surgery, which could contribute to the increase in total time for orthodontic-surgical treatment.

Evaluation and comparison of periodontal and orthodontic parameters in patients managed with periodontally accelerated osteogenic orthodontics versus conventional orthodontic treatment

Introduction: Periodontally Accelerated Osteogenic Orthodontics (PAOO) is a clinical procedure which is gaining popularity due to its claims to increase in alveolar bone width, shorter treatment time, increased post treatment stability, and decreased amount of apical root resorption. However, there is paucity of literature available on changes in periodontal and orthodontic parameters following (PAOO).Aims and Objective: The aims of the current study were to evaluate the efficacy of orthodontic treatment with PAOO and compare the treatment duration between the PAOO based fixed orthodontic treatment and the conventional fixed orthodontics in patients with bi-maxillary dentoalveolar protrusion. Materials and Methods: Group A consisted of 12 bimaxillary dentoalveolar protrusion patients who underwent PAOO during orthodontic treatment and Group B consisted of 12 Bimaxillary dentoalveolar protrusion patients who underwent conventional orthodontic treatment without PAOO. Statistical analysis was performed using the Wilcoxon test for a paired group comparison. Pre- and posttreatment measurements of each parameter were averaged (mean – SD), and all tests were performed at the 5% significance level. P values ≥0.05 were regarded as statistically significant. Results: No significant changes were seen in values probing depth, clinical attachment loss, width of keratinized attached gingiva, plaque index and gingival index between the two groups. However, statistically significant difference was seen in the orthodontic treatment duration between the two groups. Conclusion: It can be concluded that PAOO is a safe and reliable procedure which decreases the total orthodontic treatment duration significantly with stable periodontal results as achieved with conventional orthodontic treatment.

Factors affecting orthodontic treatment time and how to predict it

Orthodontic treatment time has been associated with certain parameters that can affect the different aspects of treatment regards to the patient and orthodontist. Therefore, a large set of research has focused on studying these factors. Many factors have been proposed in the literature as significant predictors for prolonged orthodontic treatment duration. In general, these factors are related to the patient, orthodontist, procedure, and severity of the underlying condition. Acquiring more knowledge about these factors can help orthodontists speed up the treatment plan, which might enhance the treatment outcomes and enhance the levels of satisfaction. In the current study, we have provided updated evidence regarding the different factors affecting orthodontic treatment time according to evidence from studies in the literature. Many factors were reported, including factors related to the procedure and the underlying condition, and factors related to the patient and orthodontist. Increasing knowledge and experience of the orthodontist might increase the level of satisfaction as it has been reported to significantly reduce the treatment duration. However, this should be accompanied by adequate patient compliance, which was also reported to be a significant predictor for prolonged treatment duration. Investigating the application of recent modalities that can speed up the treatment plan is not adequately validated, indicating the need for future validating studies.

Effects of interproximal enamel reduction techniques used for orthodontics: A systematic review.

This systematic review aimed to determine the effects of the interproximal enamel reduction (IPR) techniques used in orthodontics. Six databases were searched: PubMed, Scopus, Web of Science, Dentistry & Oral Sciences Source, ScienceDirect and Clinical Trials. Grey literature was sourced from Google Scholar. The risk of bias was assessed by Risk of Bias 2, Newcastle-Ottawa Scale and Robins-I depending on the design of the evaluated study. Additionally, the quality of the included studies was determined using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. This systematic review included randomized clinical trials, non-randomized clinical trials and observational studies with a control group that reported the effects of IPR for orthodontic purposes on the teeth and periodontium. Case reports, and in vitro and in vivo studies were excluded. Eight clinical studies match the eligibility criteria. As a result, no demineralization of the enamel, no increase in caries incidence, no periodontal changes or dental sensitivity was found after IPR. Also, considering the duration of orthodontic treatment, IPR resulted in a quicker technique than dental extractions. At the risk-of-bias assessment, all observational studies showed low risk, the non-randomized clinical trial had a critical bias, and all randomized clinical trials exhibited some concerns. The overall quality of the studies was found to be between low and very low. After the analysis of the data from included studies, it was concluded that the IPR procedures could be useful to treat dental crowding in orthodontic clinical practice without negative effects. However, more randomized controlled clinical trials with a longer follow-up time and high-quality studies are required to generate robust statements.

The nature and accuracy of Instagram posts concerning marketed orthodontic products.

To scrutinize claims contained within Instagram posts related to six popular marketed orthodontic products. Three hundred publicly available Instagram posts were identified using the following Instagram hashtags: #carrieremotion, #damonbraces, #invisalign, #acceledent, #propelorthodontics, and #myobrace. Pilot coding was undertaken on a subset of claims (n = 50) and a coding guide was developed. The associated claims were categorized under 24 recognized themes and their accuracy assessed on a five-point scale. Of 1730 posts screened, 300 were included for analysis. The majority of posts were based on photographs (n = 244, 81.3%) with the remainder (n = 56, 18.7%) including videos. Half of the posts involved a picture of the product in isolation (n = 150, 50%), with clinical cases presented in a minority (n = 99, 33%). Overall, 472 claims were included with treatment duration being the most frequent theme (n = 125, 26.5%). In terms of accuracy, most of the claims were judged to be "false" (n = 283, 60%) with less than 2% considered "objectively true." Most of the claims relating to six popular marketed orthodontic products concerned treatment duration. The vast majority of these claims were not supported by evidence and were judged to be false. Efforts should be made to promote the provision of accurate orthodontic information and to verify marketing claims on social media platforms.

Frontier in Orthodontics – Dental Tooth Movement Acceleration

There is an increased tendency for researchers to focus on the methods accelerating tooth movement due to the high demand by adult patients for short orthodontic treatment duration. Unfortunately, longer orthodontic treatment duration poses certain risks such as increase likelihood for caries, gingival recession, and root resorption. This also leads to a higher demand to identify the methods to increase tooth movement with minimum possible side-effects. The purpose of this review is to describe the success approaches in acceleration of tooth movement and to highlight their pros and cons. Biological methods of tooth movement have shown that cytokines, RANKL show good results for accelerating tooth movement and raloxifene is best used for retention as it decreases relapse. Osteotomy and corticotomy are useful in increasing the rate of tooth movement but are invasive. Osteoperforations is less invasive and can give good results for acceleration of orthodontic tooth movement.

Perception of orthodontists & post graduates regarding techniques to reduce orthodontic treatment duration: A prospective questionnaire study

Prolonged orthodontic treatment timing might cause pathologic changes like root resorptions, periodontal problems & psychological impact on patients. By shortening of treatment duration it helps to prevent undesired sequelae & increased motivation towards treatment. Recently a number of techniques with the potential to reduce treatment time had been administered. The major categories were: - Biological through local or systemic administration of drugs, Mechanical or physical stimulation such as vibrators & low energy lasers, surgically facilitated accelerated orthodontic treatment like corticotomy and piezocision. Therefore the aim of this study is to help in evaluating the knowledge & utilization of techniques used by an orthodontists & Post-graduates in their practice. Keywords: Accelerated orthodontic treatment, Orthodontic treatment time, Prospective questionnaire study, Reduction in treatment time

Speeding Orthodontics: A Review Article

The request for orthodontic treatment has grown quickly in the last years. One of the most critical issues in orthodontic treatment is how to decrease the duration of orthodontic treatment since the most common complaint of orthodontic patients is prolong the time of treatment which is a huge burden on patients. Orthodontic tooth movement can be enhanced by different methods and techniques. The current study reviewed and summarized the evidence regarding the success of different methods on speeding orthodontic tooth movement.