Fixed Appliance Treatment Research Articles

Effect of calcium fluoride nanoparticles in prevention of demineralization during orthodontic fixed appliance treatment: a randomized clinical trial.

White spot lesions (WSLs) are the most common complications of fixed appliance orthodontic treatment. To evaluate the effectiveness of calcium fluoride nanoparticles-containing orthodontic primer (nCaF2-primer) in preventing the incidence of WSLs during orthodontic treatment. Single-centre, double-blinded, split-mouth, randomized clinical trial. The sample involved 31 orthodontic patients (≥12 years). Participants were recruited using a simple nonstratified randomization. Data collection, measurements, and analysis were performed blindly. Outcome measures included comparing the effect of nCaF2-primer with control primer (Transbond) regarding the degree of demineralization (DIAGNOdent pen), Streptococcus mutans (S. mutans) bacterial counting [real-time polymerase chain reaction device (PCR)], and WSLs incidence (pre- and post-operative photographs). The measurements were performed before bonding, 1, 3, and 6 months after bonding and after appliance removal. A two-way repeated measure analysis of variance test (for DIAGNOdent pen scores), and Wilcoxon signed-rank test (for the difference between bacterial counting and WSLs incidence) were used (P < 0.05). Thirty-one patients were recruited and randomized (mean age 17.9 ± 2.45 years). For the primary outcome (DIAGNOdent pen scores) and secondary outcome of S. mutans counting: 31 patients (310 teeth for each group) were included in scoring at T1 and T3, and 30 patients (300 teeth) were included at T6. While for the photographic scores, 26 patients were included after bracket bonding. The demineralization scores showed significant differences at all-time intervals within the 6 months after bracket bonding which was more noticeable after the first month. There was a significant difference in bacterial count between the two primer groups at the T1 only. Regarding photographic scores, there were no significant differences in the WSLs incidence between the two primers groups after brackets removal. No harm was detected during treatment, except the usual pain/gingival irritation. nCaF2-primer effectively decreased demineralization scores within the 6 months after bracket bonding. Moreover, it significantly reduced S. mutans colonization after the first month. However, the tested primer did not have an extra advantage in preventing WSLs development at the clinical level after appliance removal. The trial was registered with ClinicalTrials.gov on 8 May 2021 (registration number: NCT04994314).

Effects of chlorhexidine use on periodontal health during fixed appliance orthodontic treatment: a systematic review and meta-analysis.

Proper oral hygiene and absence of periodontal inflammation is pre-requisite for orthodontic treatment. Chlorhexidine (CHX) is an established oral antiseptic used in the treatment of periodontal disease, but its role in orthodontic therapy is unclear. To assess the efficacy of adjunct use of CHX-containing products in maintaining gingival health among orthodontic patients with fixed appliances. Five databases were searched without limitations up to August 2021. Randomized clinical trials (RCTs) assessing Gingival Index (GI) (primary outcome), Plaque Index (PI), Bleeding Index (BI), or Pocket Probing Depth (PPD). Study selection, data extraction, and risk of bias assessment were done independently in duplicate. Random-effects meta-analyses of mean differences (MDs) or standardized mean differences (SMDs) with their 95% confidence intervals (CIs) were conducted, followed by sensitivity and Grades of Recommendations, Assessment, Development and Evaluation analysis. Twenty RCTs (1001 patients) were included assessing CHX-containing mouthwashes (n = 11), toothpastes (n = 2), gels (n = 3), or varnishes (n = 4) compared to placebo/control (n = 19) or sodium fluoride-products (n = 4). In the short-term, CHX-containing mouthwash was associated with lower GI (n = 9; MD = -0.68; 95% CI = -0.97 to -0.38; P < 0.001; high quality), lower PI (n = 9; MD = -0.65; 95% CI = -0.86 to -0.43; P < 0.001; high quality), lower BI (n = 2; SMD = -1.61; 95% CI = -2.99 to -0.22; P = 0.02; low quality), and lower PPD (n = 2; MD = -0.60 mm; 95% CI = -1.06 to -0.14 mm; P = 0.01; low quality). No considerable benefits were found from the use of CHX-gel or CHX-varnish in terms of GI, PI, or PPD (P > 0.05/low quality in all instances). Use of a CHX-containing toothpaste was more effective in lowering PI (Heintze-index) than adjunct use of fluoride-containing mouthwash (n = 2; MD = -5.24; 95% CI = -10.46 to -0.02; P = 0.04), but not GI (P = 0.68) or BI (P = 0.27), while sensitivity analyses indicated robustness. Adjunct use of CHX mouthwash during fixed-appliance treatment is associated with improved gingival inflammation, plaque control, and pocket depths, but caution is warranted and recommendations about CHX use during orthodontic treatment of children/adults should consider the heterogeneous patient response, cost-effectiveness, and potential adverse effects. PROSPERO registration (CRD42021228759).

Effect of four premolar extractions on the vertical dimension of the face : Aretrospective cephalometric study.

Adequate control of the vertical dimension is of great importance in orthodontic treatment. Although existing evidence is very limited, extraction of four premolars is thought to contribute towards improved control of anterior facial height compared with non-extraction treatment protocols. Thus, the aim of this retrospective cohort study was to compare the effect of fixed-appliance treatment with extraction of four premolars to non-extraction treatment on the skeletal vertical dimension. Aconsecutive sample of 76children with skeletal hyperdivergence (49% male; mean age 11.9years) was divided into two groups for treatment with either non-extraction (n = 31) or extraction of four premolars (n = 45). Baseline characteristics were comparable: overjet 5.1 ± 2.5 mm, overbite 2.4 ± 1.9 mm, ANB angle 4.6 ± 2.3°, and SN-ML angle 40.2 ± 3.5°. Patients were treated with standard edgewise fixed appliances with closing loops/sliding mechanics. Vertical skeletal and dental outcomes were measured on lateral cephalograms before and after treatment. Data were analyzed with linear regression at 5%. Compared to non-extraction treatment, treatment with premolar extractions had no significant effect on the SN-ML angle (difference (Δ) = 0.07°; 95% confidence interval -0.90 to 1.01°; P = 0.88). Statistically significant changes between the extraction and non-extraction groups were only found for the parameters SNA (Δ -1.47°; P = 0.003), ANB (Δ -1.17°; P = 0.004), SN-OP (Δ -1.48°; P = 0.04), and L1-ML (Δ -6.39°; P < 0.001). Orthodontic treatment of children with skeletal hyperdivergence using systematic extraction of four premolars had minimal effects on the vertical facial dimension compared to non-extraction treatment.

A comparison of three different modalities in improving oral hygiene in adult orthodontic patients – An open label randomized controlled trial

The objective of the study was to compare outcomes in terms of Bleeding index (BI), Gingival Index (GI) and Orthodontic Plaque Index (OPI) with videographic and plaque disclosing tablets (PDT) versus verbal instructions in adult orthodontic patients undergoing fixed appliance treatment (FAT). Adult orthodontic patients were recruited form outpatient orthodontic clinic who fulfilled the inclusion criteria and were randomly allocated to three groups i.e., video, PDT AND VERBAL GROUPS: Subjects who had gingivitis as assessed by the Bleeding Index (BI), Gingival Index (GI) and Orthodontic Plaque Index (OPI) were recruited. Pre- and post-interventional measurements were taken at two intervals only for BI, GI and OPI. The primary outcome was to evaluate mean change in the BI, GI and OPI in the three study groups after six weeks. A computer-generated randomization list was used to allocate subjects to one of the three study groups using a random permuted block sampling of 6 and 9 to randomize the samples. A total of 99 subjects were assessed for eligibility out of which 96 participants were randomized as three of the participants declined to be part of this trial. The mean change in the oral hygiene indices score were assessed and we found no statistically significant difference among the three interventional groups. Pre- and postinterventional results showed statistically significant improvement in the oral hygiene indices for video and PDT group. No statistically significant difference for age, gender and education level on oral hygiene indices. Simple linear regression showed that video group produced significantly higher mean OPI change as compared to other groups. Visual aids performed better than verbal instructions. Gender, age, and education level did not have a statistically significant impact on oral hygiene indices.

Does Mint have Antifungal and Antibacterial effect

Introduction: Patients undergoing fixed appliance treatment have many attachments on their teeth that act as an active site as plague retention sites for the attachment of food particles and subsequently microorganisms which later cause caries and periodontal diseases Orthodontic patients have an increase in the microorganisms because of the active sites for the plaque accumulation. Almost all conventional mouth freshners contain alcohol and fluoride, which are toxic (even lethal) if used in large amounts. This is often not the case with natural herbal mouth rinses. Mouth rinse comes into direct contact together with your mucosa and may be absorbed directly into your bloodstream. Mint which is a perennial plant has antimicrobial property and can be used as a mouth wash for these patients. Aim: To evaluate the efficacy of aqueous extracts of Mint on Candida albicans and Streptococcus mutans by evaluating their zone of inhibition. Methodology: Cell suspension with 108 cells were prepared using candida albicans and Streptococcus mutans. Using sterile micro tip, wells were made which was about 8mm in diameter. Lawn culture was made on appropriate media.

Coronal Resorption in Unerupted Anterior Permanent Teeth: Cases with Different Aetiologies? A Review

Two case reports are described along with differential diagnoses and management strategies from the literature for teeth discovered with intra-coronal resorption prior to their eruption. Our cases feature impacted maxillary anterior teeth. In both instances, significant coronal resorption presented itself mid-way through fixed appliance treatment, prior to full eruption of the involved teeth. This was detected radiographically and not through patient-reported symptoms. Once sufficiently erupted, root canal therapy was carried out in both cases and orthodontic treatment was successfully completed. CPD/Clinical Relevance: Orthodontists are often first to identify pathological lesions in unerupted teeth and should be equipped with differential diagnoses in order to manage and refer patients appropriately.

A Spot of Bother: Orthodontic-associated White Spot Lesions

White spot lesions (WSL) are a commonly reported risk of fixed appliance orthodontic treatment. This article reviews the incidence, aetiology and effectiveness of prevention and management of WSLs with a relevant case report. An adolescent male had fixed-appliance treatment and developed WSLs, despite prevention advice and careful monitoring, the WSLs progressed and ultimately led to the need for early removal of his orthodontic appliances. Removal of appliances prevented further damage and allowed partial resolution of the WSLs. CPD/Clinical Relevance: Careful monitoring of a patient's dental health during orthodontic treatment is essential; however, if oral health deteriorates, and demineralization occurs, rapid decisive action is necessary to limit irreversible damage.

Bite Force, Occlusal Contact and Pain in Orthodontic Patients during Fixed-Appliance Treatment.

Previously, bite force, occlusal contact and pain were investigated in orthodontic patients with moderate-to-severe malocclusion, but not in patients with minor malocclusion. The purpose of this study was to investigate changes in bite force, teeth in occlusal contact and pain in orthodontic patients with minor crowding before orthodontic treatment (T0), after bonding (T1), during treatment (T2), post-treatment (T3) and during retention (T4). In total, 27 patients (21 females, 6 males, median age 15.3 years) with neutral occlusion and normal craniofacial morphology were treated with non-extractions and fixed appliances. Differences in the registered data were analysed by a mixed linear model with repeated measures. Bite force and teeth in occlusal contact significantly decreased between T0 and T1 (p < 0.0001, respectively) and between T0 and T2 (p < 0.01, respectively). Bite force and teeth in occlusal contact significantly increased between T1 and T4 (p < 0.05, p < 0.0001, p < 0.001, respectively) and between T2 and T4 (p < 0.05, p < 0.0001, p < 0.01, respectively). No significant difference in pain was found. The results indicate that bite force and teeth in occlusal contact significantly decreased during treatment and reached baseline level at retention. The findings may prove valuable for informing orthodontic patients with minor malocclusion.

Clinical effectiveness of clear aligner treatment compared to fixed appliance treatment: an overview of systematic reviews.

To evaluate the available evidence regarding clinical effectiveness of clear aligner treatment (CAT). A comprehensive literature search was conducted for systematic reviews investigating effectiveness of CAT published up to July 15, 2021. This was accomplished using different electronic databases. No language restriction was applied. Screening, quality assessment, and data extraction were performed by two authors independently. Information was categorized and narratively synthesized for the key findings from moderate and high-quality reviews. A total of 361 potentially eligible reviews were identified. After excluding the non-relevant/low-quality reviews, 18 systematic reviews were included. CAT was found to be effective for mild to moderate malocclusions, and was associated with inferior outcomes when treating severe cases or with achieving specific tooth movements. There were conflicting results regarding treatment duration; however, CAT may be associated with shorter treatment in mild to moderate cases. Relapse was greater with CAT, while periodontal health was better. The risk of root resorption tended to be lower with CAT. Regarding pain, the results were unclear, although CAT was found to be more comfortable and associated with a reduced impact on eating and chewing. The level of evidence regarding CAT is moderate; hence, further high-quality randomized clinical trials are required. Evidence supports use of aligners as an alternate to fixed appliances in patients with mild-to-moderate malocclusion but not in severe cases. Advancement in technology could enhance the accuracy of CAT in delivering planned outcomes. CAT can be used effectively for selected cases with mild to moderate malocclusion. PROSPERO registration number: CRD42021246855.

Post-Expansion and end of treatment outcomes of semi-rapid maxillary expansion with a modified removable appliance.

Maxillary expansion is the mainstay therapy for maxillary transverse deficiency. There has been a constant search for the most effective yet biologically friendly method of maxillary expansion, alternatives being, slow, rapid and semi rapid. The purpose of this study was to explore the outcome of palatal expansion achieved using a removable plate and low continuous forces brought about by a semi rapid screw activation protocol. Retrospective study. Plaster models of 56 consecutive patients treated for maxillary expansion were obtained pre-treatment (T0), post-expansion (T1), and post fixed appliance treatment (T2). The radiographic images of the models were traced using Image J software. Linear and angular measurements were evaluated to measure transverse change. Interclass Correlation Coefficient [ICC] and Dahlberg's formula were used for reliability test. The differences in the mean values between the three duration groups [T0, T1 and T2] were analysed using Analysis of Variance (ANOVA). For multiple comparisons, a post hoc Tukey honestly significant difference (HSD) test was performed. Significant increase in inter-molar, alveolar and palatal linear widths were observed from T0 to T1 with significant relapses from T1 to T2, with an overall net gain remaining at T2. Similarly, significant increases in all angular measurements were observed from T0 to T1 with significant relapses from T1 to T2 and an overall insignificant change at T2 as compared to T0. The appliance and protocol were effective in producing transverse expansion with minimal molar and alveolar tipping.

Does Clear Aligner Treatment Result in Different Patient Perceptions of Treatment Process and Outcomes Compared to Conventional/Traditional Fixed Appliance Treatment: A Literature Review

This study sought to systematically review the literature to determine whether clear aligner treatment results in different patient perceptions of treatment process and outcomes compared with conventional fixed appliance treatment. A systematic review was conducted to identify studies that examined differences in patient perceptions between clear aligners and conventional fixed appliance treatment. Studies were identified through searching relevant terms using PubMed and Embase. Following review of identified articles, key information about the studies including study design, setting, comparison groups, sample size/response rate, study location, primary outcomes, and statistical tests used were extracted. A total of 13 articles were identified that met the inclusion criteria for this study. These studies described a variety of outcomes which were divided into two broad categories: treatment process (pain, chewing, speech, daily routine, etc.) and treatment outcomes (satisfaction level, smile outcome perceptions, etc.). There was the strongest evidence that clear aligners had a positive impact with respect to treatment process compared with fixed orthodontic appliances. This study highlights that clear aligners may be effective for improving treatment-process-related outcomes among orthodontic patients. More studies need to be conducted to determine whether clear aligners have a beneficial impact with respect to treatment outcomes.

Masseter muscle thickness and treatment outcomes in children with Class II division 1 malocclusion.

To investigate if treatment outcome in patients with Class II division 1 malocclusion treated by a variety of approaches is affected by masticatory muscle capacity. Seventy-four children with Class II division 1 malocclusion were included in the present study. These were divided into 54 children (10.4 ± 1.6 years of age) treated with fixed appliances including headgear and/or Class II intermaxillary elastics, 12 children (9.9 ± 1.9 years of age) treated with functional appliances and 8 children treated with fixed appliances and other means of treatment. Ultrasonographic masseter muscle thickness measurements were taken before treatment, while lateral cephalograms were taken before and after treatment. Multivariate linear regression analysis was used to assess the association between masseter muscle thickness and treatment outcomes, as well as the gonial angle and treatment outcomes. In children with Class II division 1 malocclusion treated by means other than functional appliances, treatment outcome is not associated with masseter thickness. This may be the case since the application of intermaxillary forces and torque application may offset the functional component in tooth movement. Outcomes following functional appliance treatment may be partly determined by the masticatory muscles. During functional treatment, children with a weaker masticatory system show greater dentoalveolar compensation. This is however not maintained during the second phase of fixed appliance treatment.

Taxonomic Analysis of Oral Microbiome during Orthodontic Treatment.

Background Orthodontic appliances induce significant changes in the oral microbiome, but this shift in microbial composition has not been well established by the available evidence yet. Objectives To perform a systematic review of existing literature in order to assess the taxonomic microbial changes in orthodontic patients during Fixed Appliance Treatment (FAT) and Clear Aligner Treatment (CAT), using next-generation sequencing (NGS) technique of the bacterial 16S rRNA gene. Search Methods and Selection Criteria. The search for articles was carried out in PubMed, including articles published in English until May 2021. They included every human study report potentially relevant to the review. Data Collection and Analysis. After duplicate study selection and data extraction procedures according to the PICOS scheme, the methodological quality of the included papers was assessed by the Swedish Council on Technology Assessment in Health Care Criteria for Grading Assessed Studies (SBU) method. Results The initial search identified 393 articles, 74 of which were selected by title and abstract. After full-text reading, six articles were selected according to inclusion criteria. The evidence quality for all the studies was moderate. Conclusions Orthodontic treatment seems to transiently affect the composition of subgingival microbiome, although not salivary, maintaining a stable microbial diversity. Different results were found in the shift of microbiome between plaque and saliva, depending on the type of orthodontic treatment. This review should be interpreted with some caution because of the number, quality, and heterogeneity of the included studies.

Comparison of clinical outcomes between Invisalign and conventional fixed appliance therapies in adult patients with severe deep overbite treated with nonextraction

The use of aligner therapy for orthodontic treatment has increased substantially in the past decade. However, no study has compared treatment outcomes between the conventional fixed appliance and Invisalign therapies in patients with a severe deep overbite. This study included 50 consecutive adult patients who underwent treatment with either Invisalign (n=25; mean age, 23.3±8.5years) or a conventional fixed appliance (n=25; mean age, 23.1±6.5years) to correct overbite>5mm and>60% deep overbite. Cephalometric analysis and peer assessment rating was used to compare the clinical outcome between groups. Cephalometric analysis showed significant differences in N-Me (P=0.0005) and Mp-L6 (P=0.0001) between Invisalign and fixed appliance treatment groups. No significant differences were observed in the peer assessment rating analysis or total treatment duration between the 2 groups. Both Invisalign and conventional fixed appliances were effective in treating patients with a severe deep overbite. Invisalign therapy may be preferable over conventional fixed appliance therapy in patients with high angle and deep overbite. However, because this study had a retrospective design, the results should be viewed with caution.

Effect of various orthodontic adhesives on enamel colour changes after fixed treatment.

The aim of this study was to compare enamel colour changes of incisors and canines produced by various orthodontic adhesives following treatment with fixed appliances. The study included 300 maxillary and mandibular central and lateral incisors, and canines of 25subjects who finished fixed appliance treatment. The following adhesives were used according to the manufacturer's instructions: Transbond XT (3M Unitek, Monrovia, CA, USA), KurasperF (Kuraray Europe GmbH, Frankfurt, Germany), Grengloo (Ormco Corporation, Glendora, CA, USA) and Light Bond (Reliance Orthodontic Products, Itasca, IL, USA). Different adhesives were placed in each quadrant of the subjects. Pretreatment and posttreatment enamel colours were evaluated at the middle third of the buccal surfaces of teeth using the SpectroShade Micro Dental Colour Complete Tooth Analysis SystemTM (MHT International, Verona, Italy). Tooth colour was determined using the Commission Internationale de l'Eclairage L* a* b* system, and ∆E values were calculated. Pretreatment and posttreatment intragroup comparison results showed significant decreases in L* and b*, as well as insignificant changes in a* for all teeth. Significantly less enamel colour changes occurred in the KurasperF group compared with the Grengloo and Light Bond groups. Evaluating incisors and canines separately, overall intergroup comparisons were not significant. Enamel colour changes were significantly less only for the canines compared to the incisors in the Transbond XT and KurasperF groups. The ∆E values were 1.83-2.18 and 1.41-1.95 for incisors and canines, respectively. Although statistically less enamel colour changes occurred in the KurasperF group compared with the Grengloo and Light Bond groups, the observed changes were not clinically relevant.

Treatment and posttreatment effects of Herbst appliance therapy on trabecular structure of the mandible using fractal dimension analysis.

This controlled study aimed to evaluate the effects of Herbst therapy on the trabecular structure of the condyle and angulus mandible using fractal dimension analysis (FD-A) accompanied by skeletal cephalometric changes. The panoramic and cephalometric radiographs of 30 patients with skeletal Class II malocclusion treated with the Herbst appliance (C II-H group, mean age: 15.23 ± 1.08), 30 patients with skeletal Class II malocclusion that received fixed orthodontic treatment (C II-C group, mean age: 15.73 ± 1.38), and 30 patients with skeletal Class I malocclusion (C I-C group, mean age: 15.90 ± 1.30) were selected. FD-A was performed on the superoposterior region (C-SP) and centre of the condyles (C-C) and the mandibular angulus (Ang) on the panoramic radiographs taken at the pretreatment (T0), intermediate stage of treatment (T1), and posttreatment (T2) timepoints just like cephalometric analysis. Herbst therapy provided a statistically significant increase in SNB, ANS-Me, Na-Me, S-Go, Co-Gn and a decrease in ANB and overjet (P < 0.05). All skeletal changes remained stable during the fixed appliance treatment after Herbst. The FD values in C-C increased (P < 0.05), and C-SP values decreased (P < 0.05) during Herbst therapy, while after removal of the Herbst appliance, no significant change was observed despite an increase in C-SP. The Ang value did not change during Herbst treatment, but then increased significantly (P < 0.05). There was no significant change in the FD values of the C I-C and C II-C groups at any stage of treatment. The C-C and C-SP changes at T1-T0 period, C-SP and Ang changes at T2-T1 period, and C-C, C-SP, and Ang values at T2-T0 period were found higher in C II-H group compared with the C II-C group significantly (P < 0.05). Herbst therapy changed the trabecular structure of the condyles in different directions at the superoposterior and central regions of the condyles, while the structural complexity of the angulus mandible, which did not change during the Herbst treatment, increased during the fixed orthodontic treatment after Herbst.

Evaluation of apical root resorption in Class III patients who received one- or two-phase orthodontic treatment

Objectives: The aim of this study was to compare the incidence root resorption and dilaceration between the patients with and without previous orthopedic treatment after the fixed orthodontic treatment. Materials and Methods: The pre- and post-treatment digitized panoramic films of 40 Class III adult patients meeting the inclusion criteria were selected from patient population of the orthodontic department. Half of the patients were treated with two-phase treatment (orthopedic therapy followed by fixed appliance treatment; Group 1), while the others wore only fixed appliances (Group 2). Root resorption was evaluated from the first molar to the first molar for each arch using the ImageJ software (Bethesda, Maryland, USA). The presence of root dilacerations was also recorded on the pre-treatment panoramic radiographs. Paired samples t-test and Mann– Whitney U-test were used to compare root length. Results: Intragroup comparisons for each tooth indicated that the upper and lower incisors, first molars and upper left second premolars presented a significant decrease in Group 1 (P &lt; 0.05). In contrast, in Group 2, a significant decrease in tooth length was found only in the upper incisors (P &lt; 0.05). Intergroup comparisons for root length change indicated statistically significant differences for the lower incisors, upper second premolars, and all first molars except for the upper left molars (P &lt; 0.05). Nevertheless, the prevalence of root dilaceration in Group 1 was higher than that in Group 2. Conclusion: Class III patients who received two-phase treatments experienced more root resorption and dilaceration compared with patients who received one-phase treatments. It should be remembered that early orthopedic forces may have potential adverse effects on a dental root in the long-term.

Effect of micro-osteoperforations on external apical root resorption: A randomized controlled trial.

ObjectiveThis study aimed to investigate the effect of micro-osteoperforations (MOPs) on external apical root resorption (EARR) during the initial orthodontic alignment phase of maxillary anterior crowding.MethodsThirty patients (25 females, 5 males; mean age, 22.66 ± 3.27 years) who presented with moderate crowding of the upper labial segment and underwent extraction-based fixed appliance treatment were recruited. They were randomly allocated to receive adjunctive therapy with MOPs (n = 15) or treatment with fixed appliances only (control group; n = 15). EARR was measured from long-cone periapical radiographs taken at the start and the sixth month of treatment. A correction factor for the enlargement difference was used to calculate EARR. Data were analyzed with descriptive statistics and repeated-measures analysis of variance.ResultsThe mean root lengths of 168 teeth were measured and showed no statistically significant difference (p > 0.05) after six months of fixed appliance treatment in the MOP (mean difference [MD] = 0.13 mm; 95% confidence interval [CI] = −0.10–0.35) and control group (MD = 0.14 mm; 95% CI = −0.10–0.37). Most of the roots in the MOP and control groups (42.86% and 52.38%, respectively) showed only mild resorption. Less than 8% of the roots in both groups (7.14% in the MOP group and 4.76% in the control group) showed moderate resorption.ConclusionsAcceleration of orthodontic tooth movement with adjunctive MOPs therapy during the alignment phase does not exacerbate EARR in patients with moderate crowding of the upper labial segment in comparison with controls.

Do orthodontists aim to decrease the duration of fixed appliance treatment?

OBJECTIVES:The aim of the present study was to investigate the trends in the use of fixed appliance and accelerated orthodontics to decrease the treatment duration. Further, this study aimed to assess the effect of demographic factors on the participant's choice of treatment modality.METHODS:This was a cross-sectional study in the form of questionnaire-based online survey especially designed and distributed to 265 orthodontists via email. The questions aimed to collect basic information about the participants and respondents’ choices for decreasing the treatment duration. The data were analyzed according to gender, level of academic education and years of clinical experience using Chi-square test.RESULTS:A response rate of 85.2% was reported. Most of the orthodontists aimed to reduce the treatment duration by the biomechanical (66.8%) and surgical approaches (27.4%). The use of sliding mechanics (69.4%) and one-step retraction was more common (66.3%). MBT bracket prescription was more prevalent (51.7%), followed by Roth (41.1%). Conventional brackets were used more than self-ligating brackets, and aesthetic brackets were avoided by one third of the respondents. NiTi wires were the most commonly used wires during the alignment stage (44.2%). However, the effect of gender, years of clinical experience and specialty level of education showed some effects on the use of certain techniques and clinical practice of the respondents.CONCLUSIONS:Most of the orthodontists aimed to decrease orthodontic treatment duration by using biomechanical and surgical approaches. Gender and clinical experience to a certain extent affected the participants’ choice during orthodontic treatment.

Comparison of the rate of orthodontic space closure, with and without probiotic supplements: A randomised control trial

To compare the rate of orthodontic space closure with and without systemic administration of probiotics. Cluster randomised controlled trial, an invivo RCT study. Forty-eight male patients undergoing orthodontic fixed appliance treatment were recruited based on purposive sampling technique and randomly allocated to group A (control) and group B (experimental). During retraction, the patients in the experimental group were given 90 probiotic capsules each and instructed to take one capsule per day along with breakfast for 90 days. The distance between the canine and 2nd premolar on the maxillary arch in both groups were measured using a digital vernier calliper. The measurements were taken before starting the retraction, after 30 days, after 60 days and after 90 days of retraction. The collected data was calculated and tabulated for statistical analysis. Independent t-test revealed that pre retraction, there was no statistically significant difference (p&gt;0.05) between the control and experimental. Post retraction, there was significant (p&lt;0.05) reduction in mean retraction value of the control group than the experimental group. Paired t-test showed a significant (p&lt;0.05) reduction in the control group than experimental after 30 days of probiotic therapy month and a highly significant (p&lt;0.01) difference between control and experimental groups after 60 days of probiotic therapy. There was no significant difference in the rate of orthodontic space closure between the groups after one month of probiotic therapy. There was a significant reduction in the rate of orthodontic space closure in the probiotic group when compared with the control group after two months of probiotic therapy.