Long-term Orthodontic Treatment Research Articles

CLINICAL STATE OF DIRECT RESTORATION OF SIDE TEETH IN ORTHODONTIC PATIENTS

Relevance. During long-term orthodontic treatment, there are favorable conditions for the development of dental caries and periodontal diseases.
 Aim of the study. Retrospective clinical evaluation of direct restorations of teeth in patients during treatment of orthodontic pathology with fixed appliances.
 Materials and methods. The condition of 227 direct photocomposite restorations of lateral teeth with localization on the occlusal and one of the contact surfaces and duration of functioning from 1 to 5 years was studied in 57 people who were treated with the use of fixed orthodontic equipment. Marginal fit, secondary caries and contact points were evaluated.
 Research results. In restorations with terms of 1-2 years, a violation of the marginal fit on the occlusal surface was found in 5 restorations (6.4% of their number with the given terms), on the vestibular and oral surfaces – in 7 (9%), in the area near the gums – in 10 restorations (12.8%). Secondary caries was detected on the vestibular surface in 2 restored teeth (2.6%), in the area near the gums – in 8 teeth (10.3%). There were violations of the contact point in 4 cases (5.1%). With terms of 4-5 years, in 3 restorations (10.3% of the number with these terms), violations of marginal fit were established on the occlusal surface, in 9 (31%) on the vestibular and oral surfaces, in 17 restorations (58.6%) – in the area near the gums. Secondary caries on the occlusal surface was found in 2 teeth (6.9%), on the vestibular and oral surfaces in 4 (13.8%), in the area near the gums – in 16 teeth (55.2%). Defects of the contact point were established in 19 cases (65.5%). Conclusions. In the conditions of orthodontic treatment with fixed equipment, the risk of developing disorders in photocomposite restorations in the area near the gums of the contact surfaces of the lateral teeth increases significantly.

Optimization of the condition of organs and tissue of the oral during the retention period of orthodontic treatment

Relevance. The retention period is the most important stage during which the structural and functional state of the organs and tissues of the mouth must be fully restored after long-term orthodontic treatment. An increase in the time spent by orthodontic equipment in the oral cavity associated with the use of retention devices also increases the risk of developing complications from the hard tissues of teeth and periodontal tissue, while the problem of preventing these complications is not fully addressed.Purpose. Based on a multi-level study of the condition of the organs and tissues of the mouth, to evaluate the effectiveness of the use of modern domestic means of intraoral hygiene in the retention period of orthodontic treatment.Materials and methods. 84 patients aged 18 to 45 years during the retention period of orthodontic treatment were examined. The control group consisted of 32 people using usual hygiene products. Patients of the second group (28 people) were prescribed anti-inflammatory hygiene products for the first 7 days after removal of the equipment; then using a combination of anti-inflammatory and remineralizing intraoral agents based on hydroxyapatite. In the third group (24 people), a rinse aid based on benzydamine (0.15%) and chlorhexidine (0.05%) was prescribed for the first 7 days after removal of the equipment; then use your usual hygiene products and any means to remineralize the enamel at night. The condition of periodontal tissues was assessed using the PMA index and the CPITN index. Enamel caries resistance was determined using the TER test. The desensitivity effect was studied using the dental sensitivity index of L.Yu. Orekhova - S.B. Ulitovsky. Examinations of patients were carried out on the day of removal of fixed orthodontic equipment, after 7 days, after a month and after 3 months from the start of the study.Results. The dynamics of changes in the CPITN index in the second group were 9.1% after 7 days of use, 35.6% after a month of study and 46.2% after 3 months from the start of observation. The dynamics of changes in the PMA index were 13.6% after 7 days of use, 39.7% after a month of study and 47.7% after 3 months from the start of observation. Remineralizing efficiency in the second group improved by 13.1% after 7 days, after a month of use to 36.1%, and after 3 months it increased to 57.4%. In patients of the second group, the desensitizing effectiveness was 27%, after 1 month -47%, after three months -56%.Conclusions. The data obtained allow us to recommend proven oral care products during the retention period of orthodontic treatment for the purpose of primary and secondary prevention of diseases of the hard tissues of teeth and periodontal tissue after removal of fixed orthodontic equipment (brackets).

MALDI-TOF/MS Profiling of Whole Saliva and Gingival Crevicular Fluid in Patients with the Invisalign System and Fixed Orthodontic Appliances.

The movement of teeth by orthodontic treatment with the Invisalign (IN) system and fixed orthodontic appliances (FOA) is characterized by the reconstruction of periodontal ligaments, alveolar bone, and gingiva. A reflection of these phenomena can be found in the composition of gingival crevicular fluid (GCF). A total of 90 samples from 45 participants (45 whole saliva and 45 GCF), including 15 patients with FOA, 15 patients with IN, and 15 patients with oral health, were subjected to matrix-assisted laser desorption/ionization mass spectrometry (MALDI-TOF/MS) analysis. Mass fingerprints were generated for each sample. Three models were tested: a quick classifier (QC), a genetic algorithm (GA), and a supervised neural network (SNN). For both groups of samples (saliva and GCF), the GA model showed the highest recognition abilities of 88.89% (saliva) and 95.56% (GCF). Differences between the treated (FOA and IN) groups and the control group in saliva and GCF samples were determined using cluster analysis. In addition, we monitored the effect of long-term orthodontic treatment (after 6 months) in the lag phase of orthodontic tooth movement. The results show increased levels of inflammatory markers (α-defensins), which may indicate an ongoing inflammatory process even after 21 days from force application.

Стоматологическое просвещение пациентов, находящихся на ортодонтическом лечении

The most effective method in acquiring a beautiful smile and even dentition is the use of a non-removable orthodontic technique – a bracket system. The number of adult patients using a bracket system as an orthodontic treatment is steadily increasing every year. In the process of long-term orthodontic treatment, various complications may arise, such as decrease in oral hygiene level due to new atypical areas of plaque accumulation and further formation of dental tartar – one of the leading factors of inflammatory diseases of periodontal tissues. We study the hygienic state of the oral cavity and the level of dental education in dynamics among patients undergoing orthodontic treatment. We assess the hygienic condition of the oral cavity in patients undergoing orthodontic treatment and their motivation for proper and successful treatment. We examined 110 patients aged 18 to 35 years. The results showed that the level of hygiene during the year of treatment was unstable and decreased, and therefore it is necessary to pay special attention to the motivation of the patient and the duration of the treatment.

Mechanical Properties of Orthodontic Cements and Their Behavior in Acidic Environments.

The present research is focused on three different classes of orthodontic cements: resin composites (e.g., BracePaste); resin-modified glass ionomer RMGIC (e.g., Fuji Ortho) and resin cement (e.g., Transbond). Their mechanical properties such as compressive strength, diametral tensile strength and flexural strength were correlated with the samples' microstructures, liquid absorption, and solubility in liquid. The results show that the best compressive (100 MPa) and flexural strength (75 Mpa) was obtained by BracePaste and the best diametral tensile strength was obtained by Transbond (230 MPa). The lowestvalues were obtained by Fuji Ortho RMGIC. The elastic modulus is relatively high around 14 GPa for BracePaste, and Fuji Ortho and Transbond have only 7 GPa. The samples were also subjected to artificial saliva and tested in different acidic environments such as Coca-Cola and Red Bull. Their absorption and solubility were investigated at different times ranging from 1 day to 21 days. Fuji Ortho presents the highest liquid absorption followed by Transbond, the artificial saliva has the best absorption and Red Bull has the lowest absorption. The best resistance to the liquids was obtained by BracePaste in all environments. Coca-Cola presents values four times greater than the ones observed for artificial saliva. Solubility tests show that BracePaste is more soluble in artificial saliva, and Fuji Ortho and Transbond are more soluble in Red Bull and Coca-Cola. Scanning electron microscopy (SEM) images evidenced a compact structure for BracePaste in all environments sustaining the lower liquid absorption values. Fuji Ortho and Transbond present a fissure network allowing the liquid to carry out in-depth penetration of materials. SEM observations are in good agreement with the atomic force microscopy (AFM) results. The surface roughness decreases with the acidity increasing for BracePaste meanwhile it increases with the acidity for Fuji Ortho and Transbond. In conclusion: BracePaste is recommended for long-term orthodontic treatment for patients who regularly consume acidic beverages, Fuji Ortho is recommended for short-term orthodontic treatment for patients who regularly consume acidic beverages and Transbond is recommended for orthodontic treatment over an average time period for patients who do not regularly consume acidic beverages.

Aesthetic Anxiety in a Child with Cleidocranial Dysplasia

Cleidocranial dysplasia (CCD) is a rare syndrome that affects the skeleton and teeth. It is characterized by absent or hypoplastic clavicles, mobile shoulder girdles, patent fontanelles, supernumerary teeth, retained deciduous and delayed permanent teeth. A 10 year old boy with CCD is reported with chief complaints of aesthetics and dental pain. The bullying and social agony at a tender age were alarming as the patient was highly distressed regarding his missing teeth. Juvenile aesthetic concerns and the psychosocial impact were emphasized in this case. He was treated with manual scaling, pulp therapy, restoration, and a prosthesis to speedily replace his missing teeth. Long-term orthodontic treatment was suggested. Due to the early diagnosis, a better prognosis exists for multidisciplinary treatment. Counselling was pivotal for dealing with his aesthetic anxiety and oral health. Special attention should be given to the aesthetics and psychosocial state of patients with syndromes in underdeveloped societies.

A comparative assessment of information recall and comprehension between conventional leaflets and an animated video in adolescent patients undergoing fixed orthodontic treatment: A single-center, randomized controlled trial

The objective of this 2-arm parallel trial was to investigate the recall and comprehension of the information of orthodontic patients undergoing fixed orthodontic treatment using either the verbal explanation supported with the British Orthodontic Society (BOS) leaflet or 3-dimensional (3D) animated content. Patients aged 12-18years, with no relevant medical history or learning and reading difficulties, who were to undergo orthodontic treatment, were randomized to receive information about fixed orthodontic treatment, using either verbal explanation supported with the BOS leaflet or 3D animated content on the basis of the BOS leaflet. Randomization was performed by block randomization; block size of 4 was used, from which 6 blocks with 6 different sequences (AABB, ABBA, ABAB, BBAA, BAAB, BABA). The blinded author asked patients a series of open-ended questions. The primary outcome measure was the total score of the questions. An independent 2 sample t test was conducted to determine if there was a statistical difference in total questions score between the conventional method (verbal and leaflet) and the 3D animation at the time of consent taking (T0) and again 1year later (T1). The secondary outcome measure was the time spent by the clinician delivering the information to the patient. Thirty-two patients were randomized into each group. After 1year, 1 patient was lost in each group. At the time of consent, the conventional group scored 79.1±18.4 compared with 76.4±12.8 for the 3D animation group with no statistically significant difference (95% confidence interval, -11.0 to 5.3), (P=0.492). One year later, again, there was no statistically significant difference (P=0.639) between the conventional group (75.6±12.3) and the 3D animation group (74.4±9.0) (95% confidence interval, -7.0 to 4.4). The average exposure time to the educational intervention in the conventional group was 8.5minutes more than the 3D animation group. The use of 3D animation or verbal and leaflet information is relatively equivalent in transferring knowledge to the orthodontic patient. The use of a 3D animated video reduces the clinician time needed in the clinic to deliver information to the patients and also allows multiple views and better suits the younger generation. Patients undergoing short- or long-term orthodontic treatment do not recall root damage as a risk of orthodontic treatment, which requires special attention from the orthodontist to reinforce this information. This trial was not registered. The protocol was not published before trial commencement.

Fast track orthodontics: A review on methods of accelerating orthodontic treatment

Orthodontic treatment is, possibly, in terms of duration extent, the lengthiest dental procedure performed. There will be an increased favorable attitude for orthodontic treatment if the duration of the orthodontic treatment is reduced. Unfortunately, long-term orthodontic treatment also poses several disadvantages like a higher predisposition to dental caries, gingival recession, and root resorption. Quickening orthodontic tooth movement (OTM), i.e., accelerating, can remarkably decrease treatment time and side effects. Orthodontic treatment comprises the response of the tissues surrounding the tooth on which the force is being applied that happens on a cellular, mechanical level, and chemical. So, to improve the body's response to these orthodontic forces, various ways were found to accelerate the treatment, such as surgical methods (corticotomy, piezosurgery, etc.), mechanical/physical stimulation methods (vibration, lasers), drugs, etc., Hence, this review captures the current knowledge on accelerated OTM.

Influence of different type of toothbrushes on gingival fluid proteolytic potential during orthodontic treatment

To study the effect of toothbrushes of various types on the accumulation of plaque and the proteolytic potential of gingival fluid as a pathogenic factors in long-term orthodontic treatment of patients with a distal permanent bite. We examined 63 patients of both sexes aged 11-18 years. Orthodontic treatment was carried out for the close position of the teeth with a distal permanent bite (K07.2) and cleft palate and lips (Q37.1). Patients were divided into three groups depending on the type of toothbrush used for individual oral hygiene: group 1 (n=21) - an orthodontic manual toothbrush (Professor Persin, «Spazzolificio Piave», Italy); Group 2 (n=22) - an ultrasonic toothbrush (Emmi-dent, EMAG AG, Germany) and group 3 (n=20) - an electric toothbrush ("Oral-B Pro-Expert, «Procter & Gamble», USA). The amount of soft plaque was assessed by the Silness-Loe hygiene index in the subgingival region. The activity of proteolytic enzymes - elastase, collagenase, and a α-inhibitor of proteinases was determined by the enzymatic method using a XL 200 biochemical analyzer («Erba Lachema», Czech Republic). The accumulation of plaque in the gingival region on both jaws during the entire period of orthodontic treatment is most pronounced when using a manual brush compared to ultrasonic and electric brushes. An increase in proteolytic activity in the gingival fluid with a simultaneous decrease in antiprotease potential with long-term orthodontic treatment of patients was observed when using a manual orthodontic brush, which can be regarded as an increase in the activity of the pathogenic factors for the development of local inflammatory and destructive changes. To prevent inflammatory and destructive changes during prolonged orthodontic treatment of patients, the use of ultrasonic and electric toothbrushes in daily oral hygiene is justified.

Influence of different type of toothbrushes on the incidence of enamel demineralization and gingivitis in the course of orthodontic treatment

The aim of the study was to determine the likelihood and frequency of complications, the impact of the use of various types of toothbrushes in the dynamics of orthodontic treatment with fixed appliances in patients with a distal permanent bite. The clinical study was conducted on 63 patients of both sexes, aged 11-18 years. Patients received long-term orthodontic treatment for a close tooth position with a distal permanent bite (K07.2) and cleft palate and lip (Q37.1). Three groups were conditionally distinguished depending on the type of toothbrush used for individual oral hygiene: group 1 (n=21) - an orthodontic manual toothbrush (Professor Persin, Spazzolificio Piave S.p.A, Italy); Group 2 (n=22) - an ultrasonic toothbrush (Emmi-dent, EMAG AG, Germany) and group 3 (n=20) - an electric toothbrush (Oral-B Pro-Expert, Procter & Gamble, USA). According to the Kaplan-Meier method, the probability of developing complications of orthodontic treatment was calculated as patients wear braces, and the impact on the effectiveness of orthodontic treatment of using toothbrushes of various types was evaluated. A frequency analysis of the complications of orthodontic treatment for the entire period of wearing fixed orthodontic structures revealed a difference only in respect to enamel demineralization. In group 1, enamel demineralization was more common (42.9%) compared with 2 (9.1%) and 3 (25%) groups (p=0.039). The likelihood of developing gingivitis was higher in group 1, the timing of the development of inflammatory processes in periodontium was also shortened in group 1 compared with groups 2 and 3. The frequency and timing of the development of gingivitis and enamel demineralization depended on the type of toothbrush used in daily oral hygiene. A marked deterioration in the oral hygiene during orthodontic treatment using a manual brush was accompanied by a more frequent development of gingivitis and enamel demineralization.

Functional properties of superelastic orthodontic nickel-titanium archwires with protective titanium nitride coatings

Today there are many manufacturers of orthodontic archwires composed of a nickel-titanium (TiNi) alloy with different elastic-force characteristics. A limited number of orthodontic archwires is available for initial tooth alignment, since reactive stresses do not always satisfy the condition 160 ≤ σc ≤ 200 MPa. The use of orthodontic archwires with polymer coatings having better aesthetics is increasing. However, they show excessive wear and color change during a long-term orthodontic treatment. The aim of this paper is to study and optimize the functional characteristics of superelastic archwires composed of Ti-50.8 аР % Ni alloy with TiN coatings deposited at varying deposition times. A three-point bending test was carried out to evaluate the functional properties. The distance between the supporters was 10 mm. The archwires were subjected to bending at a temperature of 23 ± 3 °C. Each test was continued until deformation of 1.5; 3; 4.5 and 6 % was reached. It has been found that titanium nitride coatings deposited on the Ti-50.8 at. % Ni surface alloy by the vacuum-plasma method act as the barrier layer to prevent the release of nickel ions into biological environment. Heat treatment (~400 °C) during deposition allows the required elastic-force characteristics and functional properties of the material to form. The optimal reactive stress (160-200 MPa) and the reverse martensitic transformation temperature occurred near room temperature can be obtained due to an appropriate selection of the deposition parameters. In the martensitic phase at room temperature, the archwire can be deformed. When the archwire sample is placed in oral cavity and heated to temperatures above 30 °C the material is in the superelastic state. Further research is needed in terms of coating stability during deformation when the material in superelastic state, as well as conducting corrosion testing, studying biocompatibility of archwire samples with titanium nitride coatings in order to successfully implement the proposed technology in dental practice. The prototypes of orthodontic TiNi archwires with protective and decorative TiN coatings will be obtained for medical application.

Apical root resorption after orthodontic treatment in patients with unilateral cleft lip and palate.

The aims of this retrospective longitudinal study were to present the incidence of external apical root resorption (EARR) in the maxillary anterior teeth of patients with complete unilateral cleft lip and palate (CUCLP) and to evaluate the influence of orthodontic treatment variables on the development of EARR. Forty-one patients with CUCLP participated in the study. Orthopantomograms (OPGs), taken before (T2) treatment with multiband orthodontic appliances (MBA), and periapical radiographs (PAs) of the maxillary anterior teeth taken at the end (T3) of orthodontic treatment (OT) were assessed for EARR. The incidence of EARR at T3 (97.6%) was considerably higher than at T2 (51.2%). Central incisors and canines on the cleft side showed a significantly higher score (p < 0.01, p < 0.05 respectively) of EARR in comparison to the same group of teeth on the non-cleft side. Preexisting EARR and abnormal root morphology were identified as predisposing factors for EARR. Patients with CUCLP treated with MBA have higher incidence of EARR on the maxillary anterior teeth of the cleft side. Severe EARR is rather rare but more often seen on central incisors of the cleft side. As most of the patients with cleft lip and palate undergo a challenging and long-term OT with MBA, it is of importance to identify the predisposing factors related to the special anatomical features of the bone and teeth located in the cleft area, as well as the special OT needs of these patients.

Effect of fixed orthodontic treatment on oral microbiota and salivary proteins.

The aim of the present prospective comparative cohort study was to analyze changes in Streptococcus (S.) mutans and Lactobacillus in the saliva of patients with fixed orthodontics. Salivary parameters, including secretory immunoglobulin A (sIgA), myeloperoxidase (MPO) and lactate dehydrogenase (LDH), were investigated during orthodontic treatment, as well as immune response and inflammatory processes. A total of 15 patients were included and treated with fixed appliances. Whole saliva was obtained at four time-points: Prior to bonding (T1), 3 months after bonding (T2), 6 months after bonding (T3) and 18 months after bonding (T4). Quantitative polymerase chain reaction was performed to evaluate changes in total bacteria, S. mutans and Lactobacillus DNA in saliva. ELISA was applied to measure sIgA, MPO and LDH levels. The level of total bacteria remained stable during the 18-month treatment period, and the quantity of Lactobacillus exhibited a slight but non-significant increase. S. mutans remained stable over the first 6 months and significantly increased at T4 (P<0.05), and there was a significant difference in S. mutans levels between two types of braces. A higher level of S. mutans was found in patients with conventional braces, as compared to those with self-ligating braces (P<0.05) who exhibited an unchanged level of S. mutans during this period. The amount of sIgA, MPO and LDH remained constant during the orthodontic treatment period. No correlation was detected between sIgA and bacterial quantity. In conclusion, S. mutans in patients with conventional braces increased significantly in the late period of treatment, which indicated that white spot lesions may occur after long-term orthodontic treatment. As the type of braces may be considered a latent influencing factor, self-ligating braces should be preferred. However, the effect of fixed orthodontic treatment on Lactobacillus and sIgA, MPO and LDH in the oral microenvironment was insignificant (Chinese Clinical Trial Registry no. ChiCTR-RCH-13003295).

Prevention of complications in patients with cleft lip and palate combined with teeth crowding receiving long-term orthodontic treatment

This study aim was to improve the effectiveness of treatment of patients with cleft lip and palate in combination with crowding of teeth receiving long-term orthodontic treatment. The study involved 30 patients divided in 3 groups in which chlorhexidine-containing medication was included in the individual prevention and treatment program. The effectiveness of using 0.2% CG gel was assessed after 6 months to control the development of inflammatory phenomena in periodontal tissues during long-term orthodontic treatment. The obtained clinical and laboratory data indicate the normalization of the cytokine profile and oral hygiene indices as a result of using a CG-containing preparation for effective control of the biofilm etiological factor.

EVALUATION OF DENTAL EDUCATION AND ORAL HYGIENE OF PATIENTS UNDERGOING ORTHODONTIC TREATMENT

During long-term orthodontic treatment there are various complications associated with a reduction in the level of hygiene. The article is devoted to the study of the hygienic condition of the oral cavity and the level of dental education in dynamics in patients undergoing orthodontic treatment. The examination and questioning of 40 patients aged from 18 to 35 years with fixed orthodontic appliances. In patients after 12 months of use braces deteriorating hygienic condition of the oral cavity. Care should be taken to inform patients about the care products and hygiene items, and their rational use, depending on the timing of orthodontic treatment and dental status.

Orthodontic treatment stability predictors: A retrospective longitudinal study.

To examine medium- to long-term orthodontic treatment stability and its possible association with certain variables. In a retrospective longitudinal study of 70 postretention patients, the Peer Assessment Rating (PAR) index was measured at the start (T1) and end (T2) of treatment and between 4 and 10 years afterwards (T3). The stability was considered absolute when the T2 and T3 values were identical and relative when the difference was within the ±5 range. Among the 70 patients, 65.8% were female and 34.2% were male. Their mean age was 14.5 years. The mean treatment length was 2.4 years. The mean retention phase was 3.3 years. The mean pre- and posttreatment PAR scores were 29.8 (T1) and 6.3 (T2). The mean T1-T2 difference was 23.6. The mean T2-T3 difference was -0.39. Within the study, 7.1% presented absolute stability and 68.6% presented relative stability. Lower anterior segment alignment and overbite were the most unstable occlusal features and tended to worsen. Fixed retainer (odds ratio [OR] 0.31; 95% confidence interval [CI] 0.10-0.98) as a protective factor and years without retention (OR 1.32; 95% CI 1.03-1.68) as a risk factor are predictor variables of instability in the case of lower anterior segment alignment. The PAR value at the end of treatment (OR 1.29; 95% CI 1.08-1.54) and extractions (OR 4.76; 95% CI 1.05-21.6) before treatment are predictors for midline instability.

Another way of looking at treatment stability.

To determine the contribution of normal physiological changes to the overall manifestation of a relapse after orthodontic treatment. We analyzed long-term changes in the dentition of patients with Class I malocclusions after orthodontic treatment compared with a representative group with untreated Class I malocclusions. Study participants (n = 66; mean age, 12 years at treatment initiation) were treated for Class I malocclusions. Dental changes were evaluated at 2, 5, 10, and 15 years after treatment. Control participants (n = 79) had untreated Class I malocclusions (n = 53 evaluated at ages 12 and 22 years; n = 26 evaluated at ages 19 and 39 years). Dental changes were evaluated with the Peer Assessment Rating (PAR) index. In untreated and treated groups, PAR scores increased over time with gender-specific changes. In the untreated groups, the PAR score significantly increased in male participants between the ages of 12 and 22 years (P = .04) and in female participants between the ages of 19 and 39 years (P = .001). In the treated group, early posttreatment changes were primarily related to the initial treatment response. Later changes in the PAR score could be attributed to physiological changes, with the same gender-specific changes as those observed in the untreated group. The pattern of physiological changes in dentition for participants between the ages of 12 and 39 was different between sexes. Females showed more relapse than males between 10 and 15 years posttreatment. This distinction should be considered when evaluating long-term orthodontic treatment responses.

The psycho-social impact of malocclusions and treatment expectations of adolescent orthodontic patients.

To evaluate the short- and long-term orthodontic treatment (OT) expectations, malocclusion severity, and oral health-related quality of life (OHRQoL) status of adolescent patients using qualitative and quantitative methodology. Adolescents (n = 105; 42 males and 63 females) aged between 12 and 17 years participated in this interview and questionnaire-based study. The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) and the Oral Impacts on Daily Performances (OIDP) scale evaluated OHRQoL status. Study casts were analysed using the Dental Aesthetics Index (DAI) and the Index of Complexity, Outcome and Need (ICON). Mann-Whitney test and Spearman's correlations tested various univariate variables. With similar index-determined OT need (DAI, P = 0.371 and ICON, P = 0.932) females tended to have worse OHRQoL status (PIDAQ scores, P-values ranged from 0.006 to 0.0001 and scores for the OIDP question related to smiling, laughing, and showing teeth without embarrassment, P-value = 0.015). Occlusal index scores did not have statistically significant associations with the OHRQoL scales. Better dental appearance was expected by 85 per cent of the adolescents in the short-term and by 51 per cent in the long-term after OT. The associated psycho-social expectations were: 1. improved dental self-confidence, 2. positive psychological impact/improved self-worth, and 3. positive social impact. Female adolescent patients tended to experience worse psycho-social impacts related to their malocclusions compared with males with similar index-determined OT need. Index-determined OT need scores did not correlate with the OHRQoL scales. Adolescent patients expected OT to improve their dental appearance and QoL aspects.

Buried teeth–identification, causes and management

Impacted teeth have several causes and can lead to problems if left untreated. Their management includes extraction, long-term orthodontic treatment or monitoring for problems, and depends on both human and clinical factors

Effects of Long-Term Fixed Orthodontic Treatment on Salivary Nickel and Chromium Levels: a 1-Year Prospective Cohort Study

Effect of long-term orthodontic treatment on salivary nickel and chromium has not been quite assessed except in few retrospective studies with controversial results. The aim of this prospective study was to measure salivary levels of these ions during 1year of orthodontic treatment. Saliva samples were collected from 20 orthodontic patients, before treatment (control) and 6 and 12months later. Nickel and chromium concentrations were determined using atomic absorption spectrophotometry. Data were analyzed using one- and two-way repeated-measures ANOVA, Bonferroni, Friedman (α = 0.05), and Wilcoxon signed-ranks tests (α = 0.016). Average nickel level changed from 9.75 ± 5.02 to 10.37 ± 6.94 and then to 8.32 ± 4.36μg/L in 1year. Average chromium concentration changed from 3.86 ± 1.34 to 4.6 ± 6.11 and then to 2.04 ± 1.66μg/L. Alterations in nickel values were not statistically significant [P = 0.468 (ANOVA)], but fluctuations in chromium levels were [P = 0.021 (Friedman)]. The decrease in chromium concentration after 12months was significant compared to the control [P = 0.004 (Wilcoxon)]. Although slightly increased after 6months, the concentration of both ions dropped to levels slightly lower than the control groups after 12months.