Months Of Orthodontic Treatment Research Articles

Assessment of gingival recession in patients with fixed orthodontic appliances.

Objective: To assess the gingival recession in patients with fixed orthodontic appliances. Study Design: Descriptive Cross Sectional study. Setting: Department of Orthodontic, Liaquat University of Medical and Health Science Jamshoro and Department of Orthodontic, Civil Hospital Hyderabad. Period: 05-01-2021 to 04-06-2021. Material & Methods: A total of 183 patients aged 18–35 have been included in this descriptive cross-sectional research study. After the history was taken, the study participants went through a clinical examination, but for those patients with ongoing fixed orthodontic treatment, at least three to six months of orthodontic treatment have been completed. Gingival recession was assessed using Millers’ classification and oral hygiene index. Results: The average age of 183 individuals was 22.75+2.29 years. Women outnumbered men 65.5% to 35.5%. According to the oral hygiene index, 28.4% of patients scored exceptional (0-0), 39.3% acceptable (0-0.6), 25.7% fair (0.7-1.8), and 6.6% bad (1.9-3.0). Marginal gingival tissue recession categorization showed that 66.6% of patients had no recession, 21.8% had class I, 10.9% had class II, 0.5% had class III, and 0% had class IV. According to oral hygienic index, marginal tissue recession categorization was significant (p=0.001). At 0.035 significance level, marginal tissue recession and oral hygiene score were positively linked (r=183). Conclusion: Most of the cases with fixed orthodontic appliances had no gingival tissue recession, only few cases seen class I and class II. However, this mild gingival tissue recession was significantly associated to oral hygienic index.

Evaluation of the Prevalence of White Spot Lesions During Fixed Orthodontic Treatment Among Patients Reporting for Correction of Malocclusion: A Prevalence Study.

Despite recent breakthroughs in caries preventive measures, one of the biggest issues clinicians confront is preventing demineralization while undergoing orthodontic therapy. The buildup of plaques around orthodontic brackets over time causes white spot lesions (WSLs). The goal of the present research was to assess the prevalence of WSLs in patients undergoing orthodontic treatment before starting therapy and at six and 12 months into therapy, adopting the visual examination approach. We looked for WSLs on tooth surfaces gingival to an archwire because this is the area most likely to experience enamel demineralization during orthodontic treatment. The visual assessment was conducted using the following scale at baseline, six months, and 12 months for orthodontic patients: score 0: no demineralization or noticeable white patches on the surface; score 1: mild demineralization with a visible white spot but no surface disruption; score 2: moderate demineralization with a noticeable WSLthat has a roughened surface but does not need repair; and score 3: severe demineralization with a noticeable WSLthat needs repair.Fisher's exact test was used after a chi-square analysis to determine whether there were any differences between all three categories (six months, 12 months, and control). The frequency of WSL in patients at 12 months of orthodontic treatment was 46.57%, while it was 11.86% in patients who just started orthodontic treatment. The difference was statistically significant (p = 0.01), showing that the frequency was greater in patients at 12 months of orthodontic treatment as compared to patients who had just started undergoing orthodontic treatment. The frequency of WSL in patients at six months of orthodontic treatment was 37.34%, while it was 11.86% in patients who just started orthodontic treatment. The difference was statistically significant (p = 0.03), showing that the frequency was greater in patients at six months of orthodontic treatment as compared to patients who had just started undergoing orthodontic treatment. The frequency of WSL in patients at six months of orthodontic treatment was 37.34%, while it was 46.57% in patients at 12 months of orthodontic treatment. The frequency was greater in patients at 12 months of orthodontic treatment as compared to patients at six months of orthodontic treatment; however, the difference was non-significant statistically (p = 0.76). This clinical investigation revealed that the number of WSLs increased significantly during the first six months of treatment and then increased gradually until the final 12 months. During the first few months of treatment, doctors should assess the patients' dental hygiene habits and, if necessary, take further precautions to prevent demineralization.

Orthodontic treatment need, the types of brackets and the oral health-related quality of life.

Malocclusion can affect the oral health-related quality of life (OHRQoL). The influence of the orthodontic treatment need (OTN) and the type of brackets on OHRQOL is not clear. The aim of the present study was to determine the relationships between OTN and the bracket type and OHRQoL during the first 6 months of orthodontic treatment (OT) in adult patients. This cohort study was conducted at the Department of Orthodontics of a private university. A total of 216 patients aged ≥18 years participated in the study (106 patients with conventional brackets and 110 with self-ligating brackets). The OHRQoL was evaluated using the 14-item Oral Health Impact Profile (OHIP-14) at 5 time points - before OT (T0), and at 24/48 h (T1), 1 month (T2), 3 months (T3), and 6 months (T4) after the installation of the orthodontic appliance. The OTN was evaluated with the dental aesthetic index (DAI) by 2 previously calibrated operators. For the statistical analysis, the χ2 test and the Mann-Whitney U test were used. Additionally, Poisson regression models were performed. The evidence of an association between OHRQoL and OTN was found only at T3 (p = 0.0095). No association was found between OHRQoL and the bracket type. However, in the regression models, OHRQoL was statistically significantly worse at T3 in the group with a greater OTN (IRR (incidence rate ratio) = 1.34; 95% CI (confidence interval): 1.21;1.48) and at T4 in the self-ligation group (IRR = 1.23; 95% CI: 1.12;1.36). The OHRQoL was affected in the same way at the beginning of OT, regardless of OTN and the bracket type used. However, a worse OHRQoL was observed at 3 months in subjects with greater OTN and at 6 months in patients with self-ligating brackets.

The effect of orthodontic fixed appliance treatment on periodontal health of among patients reporting to Khyber College of Dentistry, Peshawar.

Objective: To determine effect of orthodontic fixed appliance treatment on periodontal health. Study Design: Quasi Experimental. Setting: Khyber College of Dentistry, Peshawar. Period: 1st January 2021 to 30th July 2022. Material & Methods: This study was conducted 385 patients by non probability consecutive sampling technique. The inclusion criteria was both males and females, age 15-25 years, and having full complement of permanent dentition including first and second molars. Patients who were under medications affecting periodontal health, systemic conditions, para-functional habits and previous orthodontic treatment were excluded. Age and gender of patients were recorded. Community periodontal index (CPI) was recorded before the placement of orthodontic fixed appliances and after six months using CPI probe. Paired samples t-test was run to compare the CPI score before and after 6 months of orthodontic treatment. Results: The mean age was 22±4.95 year. The females were 200(62%) and males were 185(48%). The mean CPI score was statistically (p<0.001) highest after six months (2.88±1.19) than pre treatment (0.90±0.65). Among all age groups the CPI score increase statistically (p<0.001). The mean change (95% CI) in CPI score was 2.67(2.44, 2.90) in age group 15-20 years while 2.51(2.31, 2.70) in age group 21-25 years. In both males and females the results were statistically significant. Conclusion: Orthodontic fixed appliance treatment can adversely affect the periodontal health of the patients.

MINI DENTAL IMPLANT AS TREATMENT OF CHOICE IN A LATE TOOTH AVULSION WITH BONE RESORBTION: CASE REPORT

Tooth avulsion is a severe condition of traumatic dental injury. The long-time effect of untreated tooth avulsion is alveolar bone loss. The mini dental implant can be a treatment for single tooth replacement in a late tooth avulsion with bone resorption. The purpose of this study is to present a case report of the mini dental implant in a late avulsion of an anterior maxillary tooth without bone augmentation. Thirty years old male patients came to clinic with the left upper central incisor avulsed due to a traffic accident three years before. There has been mild vertical and horizontal bone resorption and diastemas. He wanted to replace the missing tooth with a fixed denture, and the patient refused any bone augmentation. The mini dental implant was an alternative treatment for this case. Orthodontic treatment was performed to regain space before mini dental implant placement because some teeth had been migrated, causing some diastemas. After seven months of orthodontic treatment, we inserted a 3.0 x 13.0 mm nobel active implant bone level and installed the healing abutment. The prosthetic crown was screwed carefully using a manual torque wrench with a maximum torque force not exceeding 15 Ncm. The mini dental implant could be a treatment for a late avulsion case without bone augmentation.

Alignment efficiency of heat activated and superelastic nickel-titanium archwires in orthodontic patients over three months: A Single-center, randomized clinical trial.

The aim of this 2-arm parallel study was to evaluate the alignment efficiency of heat-activated nickel-titanium (NiTi-TE) and superelastic nickel titanium (NiTi-PSE) archwires over the first 3 months of orthodontic treatment and compare these groups. Randomized, double-blind, controlled, single-center trial in 52 patients with fixed orthodontic appliances from an orthodontic graduate program in the permanent dentition and moderate crowding in the lower arch. Patients were randomly allocated to one of two interventions: NiTi-TE and NiTi-PSE archwires, 0.014-inch (3M Unitek™, CA, USA) with a follow-up period of 3 months. The primary outcome was the alignment efficiency determined by the reduction in Little's irregularity index (mm), measured in three points, T0: before the start of orthodontic treatment, T1: 1 month later, T2: 2 months later, T3: 3 months later. Data were analyzed using independent sample t tests and repeated measures ANOVA. 52 patients (NiTi-TE n = 26; NiTi-PSE n = 26) were randomized and analyzed (average age: 21.73; standard deviation (SD): 6.07; average lower anterior irregularity: 5.20; SD: 0.76) for intention-to-treat (ITT) analysis. No statistically significant differences between the groups were found (mean of the differences: T1: 0.20; 95% CI: -0.558; 0.958; T2: 0.49: 95% CI: -0.339; 1.319; T3: 0.33; 95% CI: -0.308; 0.968). The resolution of crowding with each of the wires was significant (P < 0.0001) at all times. Twelve participants (2 treated with NiTi-TE and 10 treated with NiTi-PSE) lost follow-up due to face-to-face dental-procedures restrictions during the COVID-19 pandemic, the missing data was imputed. NiTi-TE and NiTi-PSE wires of 0.014-inch were similar in their clinical efficiency for the resolution of crowding during the first 3 months of orthodontic treatment. Clinical Trials NCT03256279.

Pain Perception during Orthodontic Treatment with Fixed Appliances

The present study aimed to determine the intensity of pain perception in patients undergoing fixed orthodontic treatment. We analyzed the severity of pain concerning four routine procedures: the placement of separating elastics, ring cementations, arch activations, and elastic tractions. Our study consisted of a sample of 100 patients between 12 and 35 years old during the initial months of orthodontic treatment with fixed appliances. The patients completed a questionnaire meant to assess their pain sensation perception. The study sample was divided according to age and sex. By determining the intensity of pain felt during the four orthodontic procedures, we found that the most painful one was the ring cementation in all four age groups. The therapeutic-arch-activation procedure ranked second, with a higher mean value (2.66) in the 18–24 age group; the least painful was considered the elastic traction procedure, with a higher value (1.33) in the group over 30 years old. The most painful period was during the first 3–4 days after procedures. Most patients showed moderate pain after following the studied orthodontic interventions and required analgesic medication, the most frequently used being Nurofen, ketonal or paracetamol. The level of pain felt was significantly higher in men than in women. Patients suffer differently from the intensity of perceived pain as they grow older.

Comparison of interleukin expression in gingival crevicular fluid between patients with invisible orthodontics treat-ment and fixed orthodontics treatment.

To compare the expression levels of interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-16, and IL-18 in gingival crevicular fluid between patients with invisible orthodontics treatment and fixed orthodontics treatment. A total of 67 patients with invisible orthodontic treatment were selected as the observation group, and 40 patients with fixed orthodontic treatment were selected as the control group. The expression levels of IL-1β, IL-6, IL-8, IL-10, IL-16, and IL-18 in gingival crevicular fluid before, 24 h, and 12 months after orthodontic treatment were detected. No significant difference in basic characteristics and interleukin expression levels in gingival crevicular fluid was observed between the two groups before orthodontic treatment (P>0.05). After 24 h of orthodontic treatment, the expression levels of IL-1β, IL-6, IL-8, IL-10, and IL-18 in gingival crevicular fluid increased in both groups; however, no significant difference was observed between the two groups (P>0.05). After 12 months of orthodontic treatment, the expression levels of IL-1β, IL-6, IL-8, IL-10, and IL-18 in gingival crevicular fluid in the observation group were significantly lower than those in the control group (P<0.05), and no significant difference in the expression level of IL-16 was observed between the two groups (P>0.05). Compared with patients with fixed orthodontics treatment, those with invisible orthodontics treatment had weaker oral inflammatory response, which was conducive to the recovery of the oral microenvironment.

Influence of probiotics on the periodontium, the oral microbiota and the immune response during orthodontic treatment in adolescent and adult patients (ProMB Trial): study protocol for a prospective, double-blind, controlled, randomized clinical trial

BackgroundOrthodontic treatment with fixed appliances is often necessary to correct malocclusions in adolescence or adulthood. However, oral hygiene is complicated by appliances, and prior studies indicate that they may trigger oral inflammation and dysbiosis of the oral microbiota, especially during the first 3 months after insertion, and, thus, may present a risk for inflammatory oral diseases. In recent periodontal therapeutic studies, probiotics have been applied to improve clinical parameters and reduce local inflammation. However, limited knowledge exists concerning the effects of probiotics in orthodontics. Therefore, the aim of our study is to evaluate the impact of probiotics during orthodontic treatment.MethodsThis study is a monocentric, randomized, double blind, controlled clinical study to investigate the effectiveness of daily adjuvant use of Limosilactobacillus reuteri (Prodentis®-lozenges, DSM 17938, ATCC PTA 5289) versus control lozenges during the first three months of orthodontic treatment with fixed appliances. Following power analysis, a total of 34 adolescent patients (age 12–17) and 34 adult patients (18 years and older) undergoing orthodontic treatment at the University Hospital Erlangen will be assigned into 2 parallel groups using a randomization plan for each age group. The primary outcome measure is the change of the gingival index after 4 weeks. Secondary outcomes include the probing pocket depth, the modified plaque index, the composition of the oral microbiota, the local cytokine expression and—only for adults—serum cytokine levels and the frequencies of cells of the innate and adaptive immune system in peripheral blood.DiscussionPreventive strategies in everyday orthodontic practice include oral hygiene instructions and regular dental cleaning. Innovative methods, like adjuvant use of oral probiotics, are missing. The aim of this study is to analyse, whether probiotics can improve clinical parameters, reduce inflammation and prevent dysbiosis of the oral microbiota during orthodontic treatment. If successful, this study will provide the basis for a new strategy of prophylaxis of oral dysbiosis-related diseases during treatment with fixed appliances.Trial registrationThis trial is registered at ClinicalTrials.gov in two parts under the number NCT04598633 (Adolescents, registration date 10/22/2020), and NCT04606186 (Adults, registration date 10/28/2020).

Angle Class II Division 1 Malocclusion in an Adolescent Patient Treated with Four First Premolars Extraction and Temporary Anchorage Devices

This case report describes a successful orthodontic treatment in an Angle Class II division 1 malocclusion with severe space deficiency by temporary anchorage device (TAD) in a 15-year-old male patient. The skeletal analysis showed mandibular retrognathism and slightly hyperdivergent growth pattern. The treatment plan included four first premolars extractions combined with TAD application which used for anteroposterior and vertical anchorage control. The orthodontic treatment was to achieve the effect of counter-clockwise rotation of mandible for the patient who still has remaining growth. After 23 months of orthodontic treatment, Angle Class I molar relationship was achieved. The patient was satisfied with his facial appearance.

Evaluating changes in the color and luminosity of dental enamel after orthodontic treatment: A clinical study.

The aims of this clinical study were to evaluate the Color change - ΔE (based on spectrophotometry and visual analysis) and luminosity - L* (based on spectrophotometry) of dental enamel surface (after orthodontic treatment) around the area where orthodontic brackets were fixed, based on different cementing materials such as a resin (R group) and resin-modified glass ionomer cement (RMGIC group). The split-mouth study initially comprised 14 patients. Orthodontic brackets were fixed to the upper central incisors with resin or RMGIC. The color of the buccal surface of each tooth was measured through spectrophotometry and visual examination before the bracket-fixation process. Four individuals were excluded during the follow-up; thus 10 patients were evaluated (n=10). Brackets were removed after 12 months of orthodontic treatment, tooth color measurement and visual examination were performed again, and Adhesive Remaining Index (ARI) was also measured. ΔE and L* results were subjected to Student's t-test and by repeated-measures analysis of variance, respectively (α=0.05). ARI data were analyzed in percentages. There was statistically significant difference in ΔE between groups; the R group showed statistically higher values of L* after orthodontic treatment. ARI of 2 and 3 prevailed in the RMGIC group, whereas the R group presented 0 and 1. After orthodontic treatment, the RMGIC group presented smaller changes in ΔE, and the increase in the white scale was observed on the enamel surface around the area where brackets were fixed in the R group. The visual analysis did not show color change on the evaluated teeth.

Apolipoprotein E is an effective biomarker for orthodontic tooth movement in patients treated with transmission straight wire appliances

Orthodontic tooth movement (OTM) is the core component of orthodontic treatment and is increasingly popular for treating malocclusions. In this study, we aimed to investigate the role of apolipoprotein E (ApoE) in OTM.Thirty patients treated with transmission straight wire technology were selected and longitudinally tracked at 2 different stages of orthodontic treatment (initial 2 months and 12 months of orthodontic treatment). Total saliva was collected and analyzed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Western blotting was used to detect the difference in ApoE expression in the saliva samples of the 2 groups. The expression of ApoE was further verified by immunohistochemical staining in a mouse model of tooth movement.The results of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry showed significant differences in the components of the salivary peptides in the 2 groups and peptides with a molecular weight of 2010.7 Da were predicted to be ApoE by database analysis. Western blotting further verified a significant difference in the expression of salivary ApoE in the 2 groups. In addition, an OTM model was successfully constructed in mice. The immunohistochemical staining results showed that ApoE expression significantly increased after force loading in the OTM model.This study indicated that ApoE participated in and played a role during OTM in patients treated with transmission straight wire technology. This relationship might be related to alveolar bone reconstruction and root resorption. The results provide new ideas for research on the mechanism of tooth movement using precision medicine based on saliva detection.

Oral Impacts of Aligners versus Fixed Self-Ligating Lingual Orthodontic Appliances

The aim of this prospective study was to compare a fixed lingual orthodontic appliance with a commonly used aligner system, focusing on oral impacts and speech disturbances, during the first 3 months of orthodontic treatment. Two groups of adults were evaluated: 21 treated with Invisalign® and 26 with In-Ovation L® lingual brackets. Health-related quality of life questionnaires were used to assess the oral impacts, and speech samples were collected for speech evaluation by professionals. The levels of pain and painkiller intake were similar, increasing on the first day, and decreasing at 3 months. Subtle injuries on the lip and cheeks were initially reported in the aligner group. Lingual patients experienced more discomfort in swallowing and opening the mouth, tongue injuries and food residues, even at 3 months. The consonants “s” and “z” were mainly affected in both groups immediately after appliance insertion, but more often in the aligner group. These speech disturbances recovered in the following 3 months. In conclusion, both groups reported disturbances in quality-of-life measures; however, patients wearing lingual appliances experienced more disturbances, which persisted after three months. Speech disturbances were slightly more pronounced in the aligner group and recovered after three months.

Occlusal contacts evaluation along orthodontic treatment with clear aligners and fixed appliance

The present research aim was to assess how occlusal contacts change along the initial 6 months of orthodontic treatment with fixed appliance and clear aligners. A sample with 40 patients was divided into 2 groups: Clear Aligners (CA) and Fixed Appliance (FA). In order to register occlusal contacts, patients were posit and instructed about how bite in habitual maximum intercuspidation. Registrations were perfomed monthly along 6 starting treatment months and noted in an occlusogram. A parametric test was applied to evaluate data since it presented a normal distribution according to Shapiro-Wilk test. For inter- and intergroup data analysis the Anova test was performed with a 5% significance level. Statistical tests were executed on Jamovi software (Jamovi Stats, Version1.2, Sydeney, Australia). There was a reduction in the amount of occlusal contacts for indivduals from both groups, CA and FA. Such reduction was more significative in the 3 starting months for FA group and between 3rd and 4th months for CA group. Therefore, the sort orthodontic appliance had no significant influence over occlusal contacts.

Longitudinal assessment of salivary vitamin D binding protein during orthodontic tooth movement

BackgroundVitamin D is critical for bone physiology. In this study, we quantified Vitamin D Binding Protein (VitDBP) levels in saliva as a measure of Vitamin D during orthodontic tooth movement.MethodsIn this longitudinal study, saliva samples were collected from 73 orthodontic patients for 4 timepoints for the first six months of orthodontic treatment, along with dental casts at the beginning and the end of the study period. The saliva was measured for VitDBP as a biological marker for bone apposition and clinical tooth movement. We used the absolute change in Little's Irregularity Index as a quantitative measure for alignment. In addition, we measured the levels of alkaline phosphatase (ALP) in saliva as a marker of bone turnover.ResultsBoth low (< 2.75 ng/ml) and high (> 6.48 ng/ml) VitDBP levels were associated with reduced tooth movement. Significant (p < 0.05) seasonal changes in VitDBP using a two-season year model were found with lower levels observed in the summer (Apr–Sept) than in the winter (Oct–Mar).ConclusionsClinically significant orthodontic tooth movement is associated with an optimal range of VitDBP in saliva. Normal levels of VitDBP correlated with more orthodontic tooth movement, suggesting a "normal" range of salivary content of VitDBP. Given the strong trend that is independent of the confounding factors (ex. age, race or gender), the predictive value or salivary VitDBP for tooth movement should be studied in larger cohorts in future studies.

Surface Electromyography (sEMG) Activity of Masticatory Muscle (Masseter and Temporalis) with Three Different Types of Orthodontic Bracket.

Objective This pre-post study is aimed at determining the effects of masticatory muscle activity (masseter and temporalis) measured via sEMG between conventional, self-ligating, and ceramic bracket after six months of orthodontic treatment. Methods A total of eighteen (18) malocclusion patients were identified. Malocclusion patients were subdivided into 3 groups based on the bracket selection (conventional, self-ligating, and ceramic bracket) with 6 patients for each group. sEMG of muscles were done using a two-channel electromyography device, where pregelled and self-adhesive electrodes (bilateral) were applied. Chewing and clenching of masseter and temporalis muscle activity were recorded for 20 s pre and 6 months of orthodontic treatment using sEMG (frequency 60 Hz). The data were analysed by using repeated measures ANOVA in IBM SPSS Statistics Version 24.0. Results Chewing and clenching for masseter muscle showed no significant difference (P > 0.05) in sEMG activity of three types of the brackets. However, for temporalis muscle, there was a significant difference found in sEMG activity during chewing (P < 0.05) and clenching (P < 0.05) between these three brackets. Conclusion The activity of temporalis muscle showed significant changes in chewing and clenching, where the conventional group demonstrated better muscle activity pre and at six months of fixed appliances.

Salivary microbiome and periodontal status of patients with periodontitis during the initial stage of orthodontic treatment

Patients with severe periodontitis typically present with pathologic tooth migration. To improve esthetics and masticatory function, orthodontic treatment is required. Research on periodontal orthodontic treatment has been sparse, particularly from the microbial perspective. Hence, we analyzed the microbial and clinical changes in patients with well-controlled periodontitis in the early stage of orthodontic treatment. Ten patients with well-controlled periodontitis were asked to collect saliva before and 1 and 3months after appliance placement (T0, T1, and T2, respectively) and underwent clinical examinations before and 1, 3, and 6months after appliance placement (T0, T1, T2, and T3, respectively). The microbial community of saliva was analyzed by 16S rRNA gene sequencing. Gingival index, the plaque index, and the probing pocket depth were clinically assessed. The plaque index significantly increased from T0 to T1 and decreased at T2 and T3. The probing pocket depth and gingival index increased slightly at T2, but not significantly, in both the high-risk site and low-risk site. The alpha and beta diversity increased at T1. The microbial community structure was similar at T0 and T2. The relative abundance of core genera and periodontal pathogens was stable during the initial 3months of orthodontic treatment. The orthodontic appliance promoted plaque accumulation and altered the microbial community of patients with well-controlled periodontitis during the first month of orthodontic treatment. The microbial community returned to the basal composition at 3months after appliance placement, and the periodontal inflammation during the 6-months orthodontic treatment was under control.

Soft tissue facial changes among adult females during alignment stage of orthodontic treatment: a 3D geometric morphometric study

BackgroundTo investigate changes in facial morphology during the first six months of orthodontic treatment among adult females receiving orthodontic treatment.Methods43 adult females receiving orthodontic treatment were randomly recruited. 3D facial images were taken at baseline (T0), three months (T1), and six months (T2) after treatment initiation. Spatially dense facial landmarks were digitized to allow for sufficient details in characterization of facial features. 3D geometric morphometrics and multivariate statistics were used to investigate changes in mean and variance of facial shape and facial form associated with treatment.ResultsWe observed statistically significant changes in facial shape across the three treatment stages (p = 0.0022). Pairwise comparisons suggested significant changes from T0 to T1 (p = 0.0045) and from T0 to T2 (p = 0.0072). Heatmap visualization indicated that the buccal and temporal region were invaginated while the labial region became protruded with treatment. The magnitude of shape change was 0.009, 0.004, and 0.010 from T0 to T1, T1 to T2, and T0 to T2, respectively, in unit of Procrustes distance. The average magnitude of change per-landmark was 1.32 mm, 0.21 mm, and 1.34 mm, respectively. Changes in mean facial form were not statistically significant (p = 0.1143). No changes in variance of facial shape were observed across treatment stages (p > 0.05).ConclusionRate of facial changes was twice as fast during the first three months as that during fourth to sixth month. Buccal and temporal region became invaginated while labial region became protruded with treatment.

Influence of orthodontic treatment on the state of dental hard tissues, prevention of complications

SummaryOrthodontic treatment of dentoalveolar anomalies is car-ried out using fixed and removable appliances, which af-fects the homeostasis of the oral cavity and increases the risk of developing carious lesions of the enamel. Purpose of the study: comparative assessment of the level of oral hygiene and the prevalence of enamel carious lesions at the stage of orthodontic treatment using removable and non-removable appliances. Materials and methods:90 patients aged 18 to 35 years were examined: 45 patients of the 1st group, who were treated with aligners, and 45 patientsof the second group, who were treated with a bracket system. In all patients, the level of oral hygiene was determined by the OHI-S (Green-Vermillion) index, as well as the level of CPU before and after 12 months of orthodontic treatment. Results: before the start of orth-odontic treatment, the OHI-S index in patients of the first and second groups was 0.86±0.67 and 0.89±0.74 points, respectively. After 12 months, there was a deterioration in the parameters of oral hygiene to a greater extent in patients of the second group who were treated with a fixed technique: the OHI-S index was 1.98±0.79 points. The value of the CPU index before the start of orthodontic treatment in patients of the first and second groups was 7.1±1.32 and 6.9±1.46, respectively. After 12 months of orthodontic treatment, there was an increase in the CPU index in the studied persons of the second group, who were treated with a bracket system: the CPU index was 13.6±1.78. In patients of the first group, the CPU indica-tor practically did not change and amounted to 7.9±1.25. Conclusion: with high caries susceptibility and the pre-sence of non-carious enamel lesions, orthodontic treat-ment with removable appliances should be preferred in order to avoid the development of complications.

Correction of Bimaxillary Protrusion with Four First Premolar Extractions and T-Loop Mechanics – A Case Report

Bimaxillary protrusion is a condition characterized by proclined upper and lower incisors with an increased prominence of the lips. This is a case of a 18-year-old with bimaxillary protrusion, mild crowding on the maxilla and mandible, and mandibular dental midline shift to the left by 1 mm. The four first premolars were extracted using a pre-adjusted bracket. This bracket had in-built prescriptions of torque, tip, and in-out for orthodontic cases. There were three pre-adjusted orthodontic bracket systems: Andrews, Roth, and MBT. T-loop was also used to achieve controlled space closure. After 26 months of orthodontic treatment, the patient’s profile was straighter and a pleasant smile was achieved at the end of treatment.