Root symmetry between homologous upper incisors in non-orthodontic patients: A cross-sectional study.

The oral microbial flora may be significantly altered by orthodontic therapy and the use of fixed orthodontic brackets. Most orthodontic research has focused on cariogenic pathogens, while some evidence has demonstrated an increase in many known periodontal pathogens. However, little is known about the prevalence of the Gram-negative periodontal pathogen Selenomonas noxia (SN) among these patients. Using an existing saliva biorepository, n = 208 samples from adult and pediatric orthodontic and non-orthodontic patients were identified and screened for the presence of SN using qPCR and validated primers. In the pediatric study sample (n = 89), 36% tested positive for the presence of SN, with orthodontic patients comprising more SN-positive samples (87.5%) than SN-negative samples (78.9%), p = 0.0271. In the adult study sample (n = 119), SN was found in 28.6%, with orthodontic patients comprising 58.8% of positive samples and only 28.2% of negative samples (p < 0.0001). These data demonstrated that both pediatric and adult orthodontic patients exhibited higher prevalence of SN compared with age-matched non-orthodontic controls. As this microorganism is associated not only with periodontal disease but also long-term health issues such as obesity, more research is needed regarding the factors that increase the prevalence of this microbe.

The aim of the present work was to investigate the upper airway dimensions in adult non-orthodontic patients, equally divided according to their skeletal class. Methods: In this retrospective cross-sectional study, lateral cephalometric radiographs of adult patients referred for orthodontic consultation were collected. Cephalometric tracing was performed with dedicated software. For each measure, descriptive statistics were calculated. Cephalometric measurements between the different skeletal classes were compared. Linear regressions were performed between upper airway diameters and cephalometric measurements, sex and age. Significance was predetermined for p < 0.05. Results: Lateral cephalometric radiographs of 120 patients were reviewed. Nasopharynx length (NL) and depth (PD) measurements were significantly shorter in skeletal class III patients (p < 0.05). The superior pharyngeal airway space (SPAS) was found to be significantly shorter in class III patients as compared to class II patients (p < 0.05), and the mean airway space (MAS) of class I patients was found to be significantly shorter compared to class II patients (p < 0.05). Palate length (PL) values were found to be significantly longer in class I (p < 0.05). Linear regressions showed that the sella-nasion-A point angle (SNA) and Riedel’s angle between point A, the nasion and point B (ANB) significantly influenced NL and PD (p < 0.05). Conclusions: Class III patients show significantly shorter nasopharynx measurements; clinicians should consider that this sagittal discrepancy could be related to an altered anatomy of the upper respiratory tract.

Objective: The majority of oral lesions in the epithelial tissue are caused by local irritation so the purpose of this study is to compare between the patients have fixed orthodontic device and patients without orthodontic device and to perform cytomorphometric and cytological examinations of the oral mucosa epithelium close to metal brackets and band areas. Material and Methods: The study comprises 40 participants, divided into two distinct groups: a control group of 20 patient without fixed orthodontic appliance and the second group is 20 patients with fixed orthodontic appliance. Smears were collected from the oral mucosa adjacent to the orthodontic bracket and adjacent to the band area in the orthodontic patients while cell collection from non-orthodontic patients taken from buccal mucosa then the smears stained and analyzed using an alight microscope. Results: This study shows a significant difference in Nuclear area,cytoplasmic area and nuclear cytoplasmic area ratio between control, bracket and molar area, showing alteration change in the cell of the epithelial tissue adjacent to molar band then bracket area and appearance of type II inflammatory smears, according to Papanicolau classification especially in band area. Conclusion: Metal brackets and molar band cause cytomorphometric and cytomorphological changes adjacent oral mucosa cells. KEYWORDS Epithelial cell; Fixed appliances; Oral mucosa; Orthodontic appliance; Papanicolau Classification.

The study aimed to determine the muscle pattern of medial pterygoid, lateral pterygoid, and masseter (length, cross-section, and angulation) in adult non-orthodontic patients and its effect on craniofacial structures. The study was conducted from January 14, 2019 to January 14, 2020. Ethical clearance of this study was obtained from the ethical committee Ethical Clearance was obtained from Faculty of Dental Sciences, IMS, BHU, Institutional Ethical Committee with Ref no. Dean/2019/EC/1824 dated 23.04.2019 of the university. The sample size was estimated using the G-power statistical program. Power analysis indicated a minimum sample size of 27. Inclusion and exclusion criteria were set. Consent was taken from participants. Seventy-seven subjects who were willing to participate and have given written consent were enrolled for the study. Participants were sent for lateral cephalometry (Dolphin Cephalometric software) Dolphin Imaging and management solution, for 6 angular and 11 linear measurements. Nineteen subjects did not turn up for the scan. Twenty-eight participants underwent MRI (magnetic resonance imaging) to evaluate muscle patterns (masseter, medial, and lateral pterygoid). The intra-class correlation coefficient (ICC), Kolmogorov-Smirnov (KS) test, descriptive statistics, and multiple regression analysis were computed. The P value was set as ≤0.001(highly statistically significant) and ≤0.05 (significant relation). There was a highly statistically significant (p ≤ 0.001) association between masseter length to upper facial height (N-Ans) and ramal length (Cd-Go). Length of medial pterygoid was significantly related (p ≤ 0.05) with SNB and length of body of mandible (Pog-Go). The cross-section of this muscle showed significant relation with upper facial height (N-Ans) and ramal length (Cd-Go). The correlation of the length of lateral pterygoid with upper facial height (N-Ans) and maxillary length (A-Ptm) was highly significant. The muscle pattern has a significant correlation with maxillofacial morphology. The masseter muscle is the longest and thickest (cross-section) and is angulated vertically than the other two muscles (medial pterygoid and lateral pterygoid). Of the three muscles, the medial pterygoid influences more common craniofacial parameters suggestive of its symbiotic activity. Lateral pterygoid affects the maxillary length and facial height.

Slackia exigua (SE) is a recently identified intestinal microbe, which recent oral surveys suggest may be associated with oral diseases including caries and periodontal disease. Based upon the lack of information regarding this organism, the primary objective of this study was to determine the oral prevalence of this microbe and any potential associations with patient characteristics such as age, sex, or the presence of orthodontic appliances. This retrospective study involved the screening of an existing saliva repository composed of previously collected unstimulated clinical saliva samples. More specifically, N = 266 were identified and screened using a spectrophotometer at absorbances of A260 and A280 nm to determine their DNA purity and concentration. qPCR screening of these samples revealed a higher prevalence of Slackia exigua positive samples among pediatric patients (63.1%) compared with adults (36.9%) in this clinic population, p = 0.0007. In addition, higher percentages of Slackia exigua were observed among orthodontic patients (71.2%) compared with non-orthodontic patients (28.8%), p = 0.0001. These results did not vary by sex with nearly equal percentages of Slackia exigua positive males and females among adult and pediatric patients, as well as orthodontic and non-orthodontic samples. These results suggest a strong potential for association between the prevalence of this organism with age as well as orthodontic status, given that younger patients and those with orthodontic brackets (regardless of age) were most likely to harbor this pathogen in sufficient levels to be detected in saliva. More research will be needed to determine any associations with specific outcomes, such as caries or periodontal disease, among Slackia exigua positive patients within these specific populations.

Although many randomized controlled trials (RCT) have evaluated the efficacy of powered or electric toothbrushes compared with manual or traditional toothbrushes to remove biofilm and plaque, only one systematic review has been published for pediatric patients. The primary objective of this study was to perform a systematic review and meta analysis for this population. Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol, N = 321 studies were initially identified. Three independent, blinded abstract reviews were completed resulting in a total of n = 38/322 or 11.8% for the final analysis (n = 27 non-orthodontic, n = 11 orthodontic studies). Meta analysis of these outcome data have revealed a strong reduction in plaque index scores among pediatric patients using electric toothbrushes of approximately 17.2% for non-orthodontic patients and 13.9% for orthodontic patients. These results provide strong clinical evidence for recommending electric toothbrushing to pediatric patients, as well as those patients undergoing orthodontic therapy and treatment.

Smart eye-tracking technology (SEET) that determines visual attention using smartphones can be used to determine the aesthetic perception of different types of clear aligners. Its value as a communication and comprehension tool, in addition to the ethical and legal concerns which it entails, can be assessed. One hundred subjects (50 F, 50 M; age range 15–70) were equally distributed in non-orthodontic (A) and orthodontic (B) groups. A smartphone-based SEET app assessed their knowledge of and opinions on aligners. Subjects evaluated images of smiles not wearing aligners, with/without attachments and with straight/scalloped gingival margins, as a guided calibration step which formed the image control group. Subsequently, the subjects rated the same smiles, this time wearing aligners (experimental images group). Questionnaire data and average values for each group of patients, and images relating to fixation times and overall star scores, were analyzed using these tests: chi-square, t-test, Mann–Whitney U, Spearman’s rho, and Wilcoxon (p < 0.05). One-way ANOVA and related post-hoc tests were also applied. Orthodontic patients were found to be better informed than non-orthodontic patients. Aesthetic perception could be swayed by several factors. Attachments scored lower in aesthetic evaluation. Lips distracted attention from attachments and improved evaluations. Attachment-free aligners were better rated overall. A more thorough understanding as to the opinions, expectations and aesthetic perception of aligners can improve communication with patients. Mobile SEET is remarkably promising, although it does require a careful medicolegal risk–benefit assessments for responsible and professional use.

Akkermansia muciniphila (AM) is one of many highly abundant intestinal microbes that influences homeostasis and metabolic disorders and may also play a role in oral disorders. However, there is little evidence regarding the oral prevalence of this organism. Based upon this lack of evidence, the primary goal of this project is to survey an existing saliva repository to determine the overall prevalence of this organism and any associations with demographic or patient characteristics (age, sex, body mass index, race/ethnicity, orthodontic therapy). Using an approved protocol,, a total n = 141 pediatric samples from an existing saliva repository were screened using qPCR revealing 29.8% harbored AM with nearly equal distribution among males and females, p = 0.8347. Significantly higher percentages of pediatric, non-orthodontic patients were positive for AM (42.3%) compared with age-matched orthodontic patients (14.3%)—which were equally distributed among non-orthodontic males (42.1%) and non-orthodontic females (42.5%). In addition, analysis of the adult samples revealed that nearly equal percentages of males (18.2%) and females (16.7%) harbored detectable levels of salivary AM, p = 0.2035. However, a higher proportion of non-orthodontic adult samples harbored AM (21.3%) compared to orthodontic samples (12.8%, p = 0.0001), which was equally distributed among males and females. These results suggest that both age and the presence of orthodontic brackets may influence microbial composition and, more specifically, are associated with reduction in AM among both pediatric and adult populations from their baseline levels.

BackgroundPrevious studies of pulpal blood flow (PBF) changes in anterior teeth have been limited in the early phase of orthodontic treatment; less is known about the blood supply of anterior teeth in bimaxillary protrusion patients after orthodontic retraction.MethodsFifty bimaxillary protrusion patients (25 orthodontic patients ready for debonding and 25 non-orthodontic patients) were selected as study participants. The PBF of maxillary and mandibular anterior teeth were measured using laser Doppler flowmetry. For orthodontic patients, the PBF was measured at 1 day (T1), 1 month (T2), and 3 months (T3) after fixed appliance removal. Non-orthodontic patient PBF was measured as a control. Cone-beam computed tomography (CBCT) examinations before and after orthodontic treatment were performed for orthodontic patients to measure the root resorption. The anterior teeth in orthodontic group were further divided into subgroups according to root resorption and patient age.ResultsAt T1 and T3, PBF changes did not differ significantly between the orthodontic and non-orthodontic groups. Maxillary lateral incisor, maxillary central incisor, and mandibular lateral incisor PBFs at T2 were significantly higher in the orthodontic group (P = 0.048, P = 0.04, and P = 0.021). No significant difference in PBF was found between the root resorption and non-resorption subgroups at any time point. Adolescent patients showed a higher PBF in the maxillary lateral incisor at T2 (12.23 ± 3.48) relative to that at T1 (9.10 ± 3.76) and T3 (9.81 ± 2.80) with statistically significant difference (P = 0.020).ConclusionFor bimaxillary protrusion patients with four premolars extraction, PBF in the maxillary anterior teeth increased transiently after orthodontic appliance removal and then returned to non-orthodontic levels 3 months later. This effect was more pronounced in adolescents. The PBF of anterior teeth after orthodontic retraction may not be influenced by root resorption.

For patients with fixed orthodontic appliances, adequate daily dental plaque removal is more difficult. As a result, dental plaque accumulates more quickly and gingivitis and white spots develop more often. In non-orthodontic patients, electric toothbrushing is more effective in dental plaque removal than a manual toothbrush. This structured literature review shows that there is limited evidence that electric toothbrushes are more effective in plaque removal than a manual toothbrush in patients with fixed orthodontic appliances.

Background: Dental cavities or caries have been identified as among the most prevalent of preventable oral conditions. However, studies are discovering new information regarding the incidence and prevalence of several cariogenic organisms, including Streptococcus mutans (SM), the recently discovered Scardovia wiggsiae (SW), as well as Streptococcus sobrinus (SS). These studies have revealed varying prevalence among different populations, such as those undergoing orthodontic treatment. Based upon this information, the main goal of the current study was to assess the prevalence of specific cariogenic organisms (SS and SW) within saliva samples originally obtained from a dental school-based clinic. Methods: The protocol for this retrospective study of DNA isolated from previously collected saliva samples was reviewed and approved by the Institutional Review Board (IRB) as exempt research. In brief, clinical DNA samples were screened for SS and SW using quantitative polymerase chain reaction (qPCR). Demographic and subgroup (Orthodontic, non-Orthodontic) analysis was also performed. Results: This study found that pediatric (12-17 year old patient) samples were much more likely to harbor either SW or SS compared with adult (&gt;18 year old patient) samples. In addition, this study found many more SW-positive samples among pediatric orthodontic patients compared with either adult or pediatric non-Orthodontic patients, which may suggest this population may be at higher risk for SW-related caries or other negative oral health outcomes. Finally, this study found these microbial populations to be strongly linked within the same patient samples. Conclusions: This study has demonstrated that prevalence of SW and SS may be more highly associated with specific population subgroups, including SS observed in non-orthodontic patients and SW found among pediatric orthodontic patients. These results also differ from previous evidence, which found only minor and partially overlapping prevalence of these and other oral microbes. The results of this current study may suggest that SS and SW may be more strongly correlated within similar oral microbial communities and their presence may be directly or indirectly linked through one or more behavioral, microbial or other factors – although more research will be needed to determine these mechanisms.

Objective: To compare the periodontal health status among orthodontic and non-orthodontic groups aged between 14-30 years of both genders. Study design And Setting: This comparative cross sectional study was conducted at Department of Orthodontics and Periodontics from January 2019-till June 2019 at dental Hospital of Bahria Dental College Karachi. Methodology: Those patients aged 14-30 under orthodontics treatment for about 3 months and were able to give consent were included in the study. Periodontal status among both groups (65 orthodontics and 65 non orthodontic) patients was evaluated with the help of CPITN probe on index teeth. To assess the oral hygiene status; the questionnaire was formulated regarding the use and frequency of toothbrush; use of interdental cleaners such as interdental brush, use of mouthwash, use of tongue cleaners and dental appointments. A single observer from periodontics department was appointed for observation and record data of patients coming to orthodontic department and to carry out a clinical examination. The data was scrutinized using SPSS 23, and using the chi-square test various other comparisons were performed. Results: Statistically significant association was observed in CPITN scores between the orthodontic and non-orthodontic patients (p &lt; 0.05). Patients who underwent orthodontic treatment had increased plaque accumulation and probing depth which resulted in periodontal tissue destruction. Conclusion: It was concluded that the periodontal condition of ortho patients was deteriorating as compare to non ortho patient. There was no noticeable attachment loss found that could lead to mobility of the tooth and its loss

Determining the impact of orthodontic patients' characteristics on their usage and preferences of social media

The prevalence of malocclusion and a need for orthodontic treatment is high. Orthodontic appliances increase biofilm accumulation by expanding plaque retention sites. The aim of this study was to investigate the self-reported changes in oral hygiene habits among adolescents receiving orthodontic treatment. A cross-sectional study of 291 patients aged 10–17 years (mean (M) = 12.98; standard deviation (SD) = 2.36) was conducted in the Department of Orthodontics, Lithuanian University of Medical Sciences (LSMU) Hospital (Kaunas, Lithuania) during the fall semester (October–January) of the 2017/2018 study year. An anonymous self-administered questionnaire covered background information, experience of orthodontic treatment, oral hygiene habits and the seeking of professional dental care. Statistical data analysis was performed using SPSS version 22. To establish relationships between categorical variables, Chi-squared tests (χ2) were used. A p-value ≤ 0.05 was set to indicate statistically significant difference. The univariate logistic regression analysis evaluated the probability of an event given a certain risk indicator, including odds ratio (OR) and its confidence interval (95% CI). Associations were found between the usage of auxiliary measures (OR = 1.797 (1.118–2.887), p = 0.015), tongue cleaning (OR = 1.712 (1.059–2.767), p = 0.028), mouth rinsing after meals (OR = 1.707 (1.048–2.781), p = 0.032) and experience of orthodontic treatment, respectively. More orthodontic patients underwent professional oral hygiene regularly than non-orthodontic patients (p = 0.024). More patients with fixed orthodontic appliances reported significantly changed oral hygiene habits, while more orthodontic patients with removable appliances did not change their oral hygiene habits.

Objectives: Many factors influence the presence and growth of oral microbial flora, including the use of orthodontic appliances. Although much research has focused on classical oral pathogens, much less information is available to determine the relationship between Aggregatibacter actinomycetemcomitans and Fusobacterium nucleatum among these patients. The primary objective of this study was to determine the relationship between oral prevalence of Aggregatibacter and Fusobacterium among orthodontic and non-orthodontic patient saliva samples. Experimental Methods: This study was a retrospective study of previously collected saliva samples from orthodontic (n=55) and non-orthodontic (n=55) patients using an approved protocol. DNA was extracted and screened for Aggregatibacter actinomycetemcomitans and Fusobacterium nucleatum. Males and females were equally represented, although a majority of patients participating in this study were Hispanics and ethnic minorities. Results: PCR analysis of the DNA revealed that 54.5% of orthodontic samples harbored significant levels of Aggregatibacter Actinomycetemcomitans, while 29.1% of non-orthodontic samples harbored significant levels of Aggregatibacter actinomycetemcomitans (p=0.0068). In addition, screening for Fusobacterium revealed 38% of orthodontic samples harbored this organism, compared with 33% of non-orthodontic samples (p=0.4599). Screening of these samples using the 16S universal primer revealed AA-positive orthodontic samples had the highest PCR band intensity, with similar band intensity of AA-Negative orthodontic samples AA-positive non-orthodontic samples, AA-negative non-orthodontic samples. While screening for Fusobacterium using the 16S universal primer revealed higher band intensity (microbial burden) among the FN-positive samples among both the orthodontic and non-orthodontic samples. In brief, although microbial burden was lower among the corresponding non-orthodontic samples in general, the FN-positive samples were found to harbor the highest band intensity and microbial burden. Conclusions: This study provides significant data that clearly suggest a correlation between overall microbial oral burden and Aggregatibacter presence in orthodontic patients. Both AA and FN were more prevalent among orthodontic patient samples than non-orthodontic samples, although the difference in the prevalence of FN was not statistically significant. In addition, it was demonstrated the AA was more prevalent than FN overall, and among each of the categories evaluated (orthodontic, non-orthodontic). AA appears to be more prevalent among patients with orthodontic brackets than FN, although both organisms appear to have similar characteristics. This may suggest that although both organisms facilitate heterotypic associations between varying species of oral bacteria, AA may be an earlier or more significant organism in this process in orthodontic patients.

BackgroundThe biological responses involved during retention phase have been studied for many years but little is known about the effect of saliva proteome during retention phase of post-orthodontic treatment. This study aims to identify the protein profiles during retention phase in relation to biological processes involved by Liquid Chromatography Mass Spectrometry (LC-MS) approach.Material and MethodsA total of 5 ml of unstimulated saliva was collected from each subject (10 non-orthodontic patients and 15 post-orthodontic patients with 6-months retention phase). Samples were then subjected to LC-MS analysis. The expressed proteins were identified and compared between groups. Incisor irregularity for both maxilla and mandible were determined with Little’s Irregularity Index at 6-months retention phase.Results146 proteins and 135 proteins were expressed in control and 6-months retention phase group respectively. 15 proteins were identified to be co-expressed between groups. Immune system process was only detected in 6-months retention phase group. Detected protein in immune system process was identified as Tyrosine-protein kinase Tec. Statistical significant of incisor irregularity was only found in mandible at 6-months retention phase.ConclusionsOur study suggests that immune system process protein which is Tyrosine-protein kinase Tec could be used as biomarker for prediction of stability during retention phase of post-orthodontic treatment. Key words:Orthodontics, proteomics, retention, LC-MS, saliva.

Purpose: This cross-sectional study evaluates the impact of self-perceived malocclusion on oral health-related quality of life (OHRQoL) and also whether aesthetic self-assessment is similar to professional evaluation. Methods: this crosssectional study gathered 63 adults aged 18–36 years (28.68 ± 4.99), 42 women and 21 men, with no history of orthodontic treatment. OHRQoL was evaluated using the Brazilian short version of the Oral Health Impact Profile questionnaire (OHIP-14). Perception of malocclusion was evaluated using the aesthetic component of the Index of Complexity, Outcome and Need (ICON), socioeconomic status and theEconomic Classification Criteria of Brazil. Statistical analysis was conducted using the Mann–Whitney test, Spearman correlations and Wilcoxon test, with p < 0.05. Results: the overall average score and standard deviation for OHIP-14 was 5.17 (± 6.50). There was a weak correlation between the aesthetic component perceived by the participants and their evaluation of quality of life. Only the psychological domains (psychological discomfort and psychological disability) showed significant poor correlations. Gender and socioeconomic status did not affect aesthetic perception of malocclusion and OHRQoL. There was a significant difference between the professional assessments and those of participants. Conclusion: significant weak correlations between self-perceived malocclusion and OHRQoL were foundin participants who were not seeking orthodontic treatment; the greatest impacts were seen in the domains of psychological discomfort and psychological disability, and aesthetic self-perceived malocclusion was significantly less relevant than the professional evaluation in this studied group.

Dental caries remains one of the most prevalent oral health diseases in the United States, affecting nearly half of all children and a majority of adults. Most medically important cariogenic bacteria, including Streptococcus, Lactobacillus, Actinomyces and Veillonella species are well known, although recent evidence has identified the new cariogenic pathogen Scardovia wiggsiae (S. wiggsiae) among children and minorities with severe early childhood caries. Based upon these new findings, the goal of this project was to determine the prevalence of this new cariogenic pathogen S. wiggsiae from a repository of previously collected pediatric saliva samples from orthodontic patients. DNA was isolated from previously collected saliva samples (n=48) and was subsequently screened for the presence of S. wiggsiae using Polymerase Chain Reaction (PCR) and primers designed specifically to distinguish this organism. Fifteen (15) samples tested positive for S. wiggsiae, representing 31.25% of the samples screened. As previous studies from this laboratory using adult orthodontic patients and pediatric non-orthodontic patients revealed prevalence of and 14 and 21.5%, respectively - these findings suggest that the newly identified cariogenic pathogen S. wiggsiae may disproportionately affect pediatric orthodontic patients for reasons that are not well understood, which imply more detailed and focused research in this area is needed. As previous research has demonstrated that oral health status and caries risk may be related to education, income and socioeconomic status, these findings help to elucidate and contextualize the risks facing these populations.

Comparative study on factors affecting patient cooperation for dental treatments between orthodontic patients and non-orthodontic patients