Orthodontic Care Research Articles

Reduction by air purifier of particulate concentration during orthodontic procedures: a pilot study

BackgroundThe SARS-CoV-2 pandemic has raised awareness of the importance of air quality. This pilot study arose from the need to reduce the concentration of particulate matter in the dental office during orthodontic procedures. To evaluate the efficacy of using an air purifier during orthodontic care in the dental office to reduce the concentration of ambient particulate matter.ResultsSignificant reductions in particle numbers were obtained for all particle sizes except the largest particles counted (10 μm) through use of the air filter. A marked association between higher humidity levels and higher particle counts was also observed.ConclusionsUsing an air purifier during dental care achieves a significant reduction in the concentration of ambient particles in the dental office. There is a correlation between higher relative humidity and higher particle concentration. The probability of obtaining a maximum particulate concentration level of 0.3 and 0.5 μm is 1000 times lower when using an air purifier.

Socio-economic and gender dynamics influence on the parental decision-making process for children's orthodontic care - A study in Madinah, Saudi Arabia.

To investigate the socio-economic and personal factors that impact parental decisions regarding orthodontic treatment for their children in Madinah, Saudi Arabia. A digital self-administered questionnaire was employed to collect data from 414 parents, focusing on their motivations and barriers that influence their decision-making process regarding orthodontic treatment. Income level was the most significant factor in orthodontic decisions. Parents with higher incomes were twice as likely to choose orthodontic treatment for esthetic reasons compared to parents with middle incomes. The main incentive for seeking treatment was getting advice from dental professionals, with 60% of participants rating it as the most important factor. 34.5% of respondents identified cost as the main barrier, with middle-income parents being 151% more inclined to perceive it as a significant barrier compared to high-income parents. Gender dynamics revealed that mothers exhibited 48.9% greater concern regarding treatment costs compared to fathers, whereas fathers placed 2.105 times more importance on the orthodontist's reputation than mothers. Income levels, along with other socio-economic factors and gender dynamics, have a significant influence on parental decisions regarding orthodontic care. Personalized consultations that address these variations are crucial for improving communication between patients and practitioners and increasing the accessibility of treatment.

Survey of National Health Service (NHS) orthodontic practitioners in Wales, UK. Part 1: working patterns 2021-2022.

To ascertain the working patterns of the NHS orthodontic workforce in Wales and any possible future changes. Descriptive cross-sectional survey. NHS orthodontic practitioners in Wales. An anonymised email distributed an electronic two-part survey of the Welsh NHS orthodontic workforce. The survey consisted of three sections: (1) demographic information; (2) respondents' working pattern (part 1); and (3) perceptions of professional satisfaction (part 2). Part 1 of the survey yielded a 70.5% response rate (n = 79); 65.8% of the respondents were women. Of the respondents, 45.6% (n = 36) worked full time (F/T), 39.2% (n = 31) worked less than F/T and 15.2% (n = 12) worked more than F/T. Of the male respondents, 81.5% (n = 22) worked 10 sessions or more compared to 50% (n = 26) of women. The respondents undertook 508.5 orthodontic clinical sessions per week within Wales; of these sessions, 87.6% (n = 445.5) delivered NHS orthodontic care. Of the respondents, 8.4% (n = 7) were planning to increase their orthodontic clinical time within the next 2 years, 24.1% (n = 19) were planning to decrease it and 20.3% (n = 16) were unsure. One-quarter of respondents indicated that they were planning to stop clinical orthodontic activity within the next 5 years, including 53.3% (n = 8) of DwSIs, 37% (n = 10) of primary care specialists and 13.3% (n = 2) of consultants. The pandemic was an influencing factor for 80% of these clinicians. Part 1 of the survey suggested that the majority of the orthodontic workforce was female, were working full time or more, and spent most sessions delivering NHS care. One-quarter of respondents were planning to cease undertaking orthodontic activity within the next 5 years.

Bite Force Mapping Based on Distributed Fiber Sensing Network Approach.

Bite force measurements are crucial in the realm of biomedical research, particularly in the areas of dentistry and orthodontic care. Various intraoral devices have been used to assess biting force, but each has limitations and drawbacks. Fiber optic sensors (FOSs) offer advantages such as electrical inertness, immunity to electromagnetic interference, and high sensitivity. Distributed fiber optic sensing allows an increase in the number of sensing points and can interrogate numerous reflections from scattering events within an optical fiber. We present four dental bites with heights of 6 mm, which enabled bilateral measurements. U-shaped sensors were prepared by embedding fibers into silicone by folding a single-mode fiber into four lines and multiplexing eight parallel nanoparticle-doped fibers. Dental bite models were created using two silicone materials (Sorta Clear 18 and Sorta Clear 40). The developed sensors were calibrated by applying weights up to 900 g, resulting in a linear response. Experiments were conducted to compare the efficacy of the dental bites. The collection of massive data was enabled by constructing a 2D map of the dental bites during multi-point sensing.

Factors Influencing the Decision Process within Seeking Orthodontic Care among the Saudi Population: A Cross-sectional Survey

Aims & Background Orthodontic treatment is the first choice for the treatment of many different types of malocclusions, and patients’ decision processes while seeking orthodontic treatment are multifactorial. The aim of the present study is to assess these factors influencing the decision process regarding the public and orthodontic treatment for themselves or for their children, as well as the factors influencing the selection of an orthodontist versus a general dentist in Saudi Arabia. Materials and Methods A survey-based questionnaire was distributed through social media accounts that included questions about demographic data, reasons for seeking orthodontic care, barriers to care, and sources of information that may influence the decisions regarding the choice of orthodontic treatment for the participants and their children. Results The final sample included 320 responses from eligible participants (181 men & 139 women with a mean age of 39.98). ‘Family dentist recommendation’ was the most important reason for participants to seek out orthodontic treatment for themselves or a child while finding a caregiver who can handle complications and the availability of appointments were the most important barriers in seeking orthodontic treatment. Participants also assumed an orthodontist would be more reliable in finishing the treatment in the expected duration, yet they expected that treatment with a general dentist would be less costly and more convenient. Conclusion A referral from the family dentist has the most impactful influence on seeking orthodontic care. People are keen to have their treatment done by an orthodontist, but the major barrier in seeking orthodontic care is finding a suitable candidate. Parents prioritize orthodontic treatment for their children more than for themselves.

Conceptual review of Clear Aligner Therapy (CAT)

Patients seeking orthodontic treatment often prioritize aesthetics, and aesthetics play a significant role in orthodontic care. Researchers have developed a range of options, such as ceramic or composite braces, lingual orthodontics, and transparent aligners, to meet the growing demand for alternatives to traditional braces. Clear aligner therapy, which consists of a series of transparent dental appliances designed to fit the shape of a patient's teeth, is one such alternative. Clear aligners, like traditional braces, use a progressive force to control tooth movement, but they do so without metal brackets or wires. This review will highlight the increasing popularity of clear aligners by summarizing a few commonly used systems today. It will also discuss the therapeutic outcomes of this approach, including its scope, limitations, effectiveness, and stability. Additionally, the review will evaluate the potential negative effects of clear aligner therapy.

TikTok talks teeth: a quantitative and qualitative analysis of fixed appliance related TikTok videos

Abstract Aim To quantitatively and qualitatively analyse the content, reliability and quality of TikTok videos related to orthodontic fixed appliances. Methods A new TikTok account was created, and three searches were conducted (#braces, #braceface and #bracetips). A total of 150 videos (n = 50 featured in the ‘Top’ tab were extracted for each of the three searches) were assessed for the analyses of quality, content and reliability using the modified DISCERN tool, a content score, and the Global Quality Scale (GQS). Results A total of 136 videos satisfied the inclusion criteria, involving 46.3% identified by dental professionals and 53.7% identified by laypersons. Of these, the videos uploaded by dental professionals rated higher in the three scoring tools compared to laypersons. The GQS score of videos was 2.36/5 and the content score was 1.31/5. Over 60% of the videos were of poor quality according to the GQS scale. A strong correlation between GQS and DISCERN scores was found. Conclusion The overall content, reliability, and quality of TikTok videos regarding orthodontic fixed appliances was poor. The videos allowed patients to supplement their knowledge about fixed appliances and become more involved in their orthodontic care; however, guidelines should be explored to ensure the dissemination of accurate orthodontic information on TikTok.

Використання КПКТ черепа в ортодонтії

Actuality. Diagnostics in orthodontics is one of the most important stages, because the establishment of the final diagnosis and the choice of treatment methods directly depend on it. According to the diagnostic protocols of orthodontic patients, CBCT is currently not the gold standard, and is the method of choice. The goal is to analyze the available publications on the study of indications for CBCT and the impact of the information obtained on the choice of treatment method and/or control of the treatment. Materials and methods. Retrospective analysis of available publications on the resources https://pubmed.ncbi.nlm.nih. gov/ and https://www.sciencedirect.com/ and https://scholar.google.com/ and the formation of categories of indications for conducting CBCT in orthodontic practice and possible development trends in diagnostics based on CBCT The results. More than 200 publications were analyzed and 82 published in scientific publications in the period from 1998 to 2023 were selected, and the obtained data were systematized into the main groups of indications for conducting CBCT, namely: (1) assessment of the volume of the alveolar process for planning the possibility of tooth movement; (2) accurate determination of the localization of retained and overcomplete teeth; (3) assessment of the degree of ossification of the palatine suture for choosing a method of maxillary expansion; (4) study of angulation, morphology or root resorption; (5) quantification of nonunion defects of the lip and palate; (6) evaluation of the selection of TADs sizes and optimal areas for their installation; (7) help in determining the possible etiological factors of the occurrence of a pathological bite, for example, anomalies of the TMJ. Conclusions. The development of technologies and diagnostics of patients does not stand still, including 3D technologies in orthodontics as well, and the information that the doctor receives from CBCT influences the choice of treatment method and the evaluation of the conducted, which helps to improve the provision of orthodontic care and treatment, and we hope that in soon CBCT as a diagnostic method will take its place in diagnostic protocols and replace the gold standard, which is currently OPTG and TRG (cephalometry). Key words: cone-beam computed tomography, CBCT, orthodontics, diagnosis, canine retention, repid palatal expiation (RME), temporo-mandibular joint (TMJ), occlusion, articulator, treatment planning, treatment outcames.

Initial development of an 'Orthodontic Care Index' involving treatment need,-complexity and-priority.

The aim of this study was to develop an evidence-based scoring system for prioritizing limited orthodontic resources based on orthodontic treatment need (OTN), orthodontic treatment complexity (OTC), and orthodontic treatment priority (OTP), which is not merely a scoring system for malocclusion but also a comprehensive classification of orthodontic issues incorporating patient- and treatment-related factors, called Orthodontic Care Index (OCI). The development of the OCI involved eight phases, starting with a systematic literature review to identify all possible parameters involved in determining OTN, OTC, and OTP. An eight-member orthodontic specialist panel then evaluated and scored the significance of each parameter, resulting in a parameter-score list. Subsequently, a retrospective convenience sample of 61 patients was scored with the parameter-score list, and using the same convenience sample a gold standard was established through the expert opinion of a third orthodontic panel. Linear regression analysis was used to estimate weights of importance and construct a formula to calculate index scores. Lastly, the expert opinion was compared to the index scores, to determine the index performance. The preliminary index separately calculates OTN, OTC, and OTP for a patient as the weighted sum of his/her domain scores. The sensitivity of the index for predicting OTN, OTC, and OTP was high (98.1%, 82.9%, and 92.7% respectively), while the variability of each was relatively low (52.1%, 31.2%, and 52.6% respectively). The OCI shows promise as a guideline for prioritizing orthodontic care. It will be further refined and validated to enhance its performance and usefulness.

Особенности оказания ортодонтической помощи детям с различным уровнем соматического здоровья

INTRODUCTION: Today, not all groups of the child population can receive full orthodontic care. This is typical for children with disabilities who have mental and neuromotor development disorders. To ensure optimal quality of orthodontic care in these cases, it is necessary to involve related specialists, the availability of modern equipment, and the psychological readiness of the doctor to work with children. The combination of these conditions will make it possible to fully provide orthodontic care to children with disabilities. AIM: To study features of rendering orthodontic care to children with different somatic health level MATERIALS AND METHODS: Orthodontic treatment of 50 children aged 7 to 16 years was carried out. The patients were divided into 3 groups based on the general somatic health status: children with anomalies of the position of teeth and bite, without burdening pathology; children with anomalies of the position of teeth and bite, with concomitant disorders of the respiratory, musculoskeletal and other systems; children with disabilities. Besides, the patients were classified by types of dental anomalies. Orthodontic treatment of patients from group 2 started after consultation with specialists. Patients from group 3 had a conclusion about the underlying disease and were referred to related specialists for consultation if necessary. RESULTS: The treatment of group 1 patients was without peculiarities. Removable and non-removable devices were used to correct dental anomalies. In all cases, a satisfactory result of treatment was obtained. In the treatment of group 2 patients, it was necessary to eliminate the concomitant pathology. Therapeutic measures aimed at restoring natural respiration and normalizing the function of the musculoskeletal system were recommended. As a result, anomalies of the dental system were corrected in 17 cases. In 3 cases, it was impossible to achieve correction of the distal bite due to the late start of treatment. In 1 patient, it was impossible to restore the function of the respiratory system. In 3 cases, the disorders in functioning of the musculoskeletal system were not completely corrected, which required further observation. The impossibility to restore the function of the respiratory system affected the result of treatment in 1 patient. Treatment of children from group 3 caused the greatest difficulty. A good clinical result was achieved in 3 cases, and in the rest ones the result was an improvement of the existing condition, but due to the peculiarities of the mental state of children, the treatment could not be fully completed. CONCLUSIONS: An effective algorithm for providing orthodontic care to children with disabilities has been developed. Before treatment, it is necessary to correct the concomitant pathology with participation of related specialists. It is recommended simple devices be used with good fixation in the oral cavity. The positive changes in the dental status obtained permit to further improve the overall health condition.

The Concept of Pain in Orthodontic Care

Pain is a subjective sensation that plays a crucial role in physiological illnesses. Orthodontic tooth movement frequently results in pain, serving as a major obstacle for individuals contemplating orthodontic treatment. Moreover, it is a key determinant leading to the cessation of treatment. This review aims to elucidate the notion of pain associated with orthodontic therapy. Nociception, a complex neurophysiological process, involves four component processes: transduction, transmission, modulation, and perception. During nociception, the central nervous system (cortex cerebri) senses the sensation of pain as powerful peripheral stimuli occur.

A Systematic Review and Meta-Analysis of the Impact of Cancer and Its Treatment Protocol on the Success of Orthodontic Treatment.

There are several significant gaps in current studies of the relationship between anti-cancer medications and orthodontic care that call for more investigation. As a result, the main goals of this systematic review and meta-analysis were to summarise and assess the information that was available regarding the effect of radiotherapy and anti-cancer medications on the overall successful completion of an orthodontic treatment plan. A standardised data extraction form was devised in accordance with the PRISMA guidelines to conduct a systematic review and meta-analysis, with specific criteria implemented for selecting studies with low to moderate risk of bias. Five studies involving different methodologies were selected at the conclusion of the search strategy. The statistical analysis revealed an estimated odds ratio (OR) of 0.31 and relative risk (RR) of 0.48, indicating a statistically significant association between the use of radiotherapy and anti-neoplastic drugs and a noticeable reduction in the successful completion of orthodontic treatment. The heterogeneity analysis showed significant heterogeneity among the studies. This review emphasises that, although orthodontic therapies can still be beneficial for children receiving chemotherapy, the effectiveness of the therapy may be diminished in older populations. The findings further highlight how crucial it is to take cancer therapies into account when planning and managing orthodontic treatment in order to optimise results and reduce problems.

Barriers to Obtaining Orthodontic Care for Patients with Orofacial Clefts: A Survey of Orthodontists and Families

Barriers to Obtaining Orthodontic Care for Patients with Orofacial Clefts: A Survey of Orthodontists and Families

Handling orthodontic complaints

This article explains some proven strategies for successful complaints handling across different areas of orthodontic practice, while stressing the need to recognise and understand the subtleties often encountered when managing complaints about orthodontic care and treatment, and the importance of taking them into account. It will also suggest some ‘upstream’ strategies for making complaints less likely. CPD/Clinical relevance: This paper aims to give orthodontic practitioners clinical insight into complaints handling procedures across private and NHS practice.

Impact of COVID-19 Lockdown on Patients Undergoing Orthodontic Treatment: A Survey Based Study

OBJECTIVE: To evaluate how the COVID-19 lockdown influenced patients receiving orthodontic therapy. METHODOLOGY: An Ambispective study was done by collecting the data from July to August 2022. An investigative questionnaire containing 17 questions wascirculated to 325 respondents/patients. The data wascollected using a convenience sampling technique. Patients undergoing orthodontic treatment with fixed appliances aged 18 to 40 years were included in the study. Both male and female respondents who participated in the survey varied in terms of their ages, i.e., between 18 to 40 years. Version 24 of a statistical package for social sciences (SPSS) has been used for data analysis. RESULTS: According to the study's findings, the lockdown's impact on patients undergoing orthodontic treatments was significant. For instance, anxiety & psychological distress were created during the lockdown because of concerns regarding the closure of hospitals and delayed visits to orthodontists or problems in getting appointments. Because of this, patients feared prolonged treatment durations and orthodontic emergencies,including discomfort, wires pinching them, ruptured skin, damaged brackets, ligature ties and bondable buccal tubes, etc. CONCLUSION: Due to covid-19 lockdown, patients found difficulty in their regular appointments or monthly checkups as the hospitals were closed. Patients also experienced mental distress, making it imperative to comprehend the psychology of individuals experiencing orthodontic care. KEYWORDS: COVID-19 lockdown, Orthodontic treatment, Psychological distress, Treatment needs, Pandemic, Emergencies

Area-level inequalities in the provision of NHS orthodontic care in England from 2016 to 2019.

Objective To investigate geographic inequalities in the provision of NHS orthodontic care in England at the area level.Methods NHS dental activity data were analysed for the three financial years April 2016 to March 2019. The measures used were units of dental activity (UDA), units of orthodontic activity (UOA) and commencement of orthodontic treatment. Two orthodontic activity indices were created to assess relative volumes of care. Deprivation was measured using the index of multiple deprivations. Slope and relative inequality indices were used to assess inequality.Results Nearly 12.4 million UOA and 572,987 courses of treatment in England were reported under NHS arrangements in the three years studied. There were significant variations in the rates of UOA (0-716) and UDA (148-918) provided per 100 children (0-17 years) at the local authority level. The variation was not associated with deprivation at the local authority level.Conclusions There were significant disparities in the provision of NHS orthodontic treatment at the local authority level, but this was not associated with area-level measures of deprivation. Inequality in the uptake of orthodontic care may not be due to area-level disparities in service provision.

A new model for managing tooth movement: Smart orthodontic brackets in the Internet of Dental Things (IoDT)

Orthodontic appliances apply forces that facilitate the movement of teeth within the alveolar bone. Conventional orthodontic brackets are passive and do not have any built-in mechanisms rely on the orthodontist's visual assessment and manual adjustments to monitor and guide the progress of the treatment. However, recent technological advancements have provided greater control over the direction, magnitude, and speed of tooth movement. In this hypothesis, we propose the concept of smart orthodontic brackets, which integrate nanoelectronics and the Internet of Dental Things (IoDT). Smart orthodontic brackets represent a revolutionary approach to monitoring and managing orthodontic treatments. It can provide orthodontists with real-time data on tooth movement, enabling more precise adjustments and personalized treatment plans. Additionally, it can facilitate remote monitoring of patients, reducing the need for frequent in-person visits and improving access to orthodontic care. Moreover, the integration of nanoelectronics, IoDT, and smart orthodontic brackets could open up new avenues for research and development. It could pave the way for the creation of smart orthodontic appliances that automatically adjust forces based on real-time feedback, optimizing treatment outcomes. Furthermore, it could contribute to the development of innovative preventive and diagnostic tools, improving early detection and intervention in orthodontic issues. Therefore, smart orthodontic brackets represent a new conceptual technology-based model that integrates nanoelectronics and the IoDT to enhance the regulation and supervision of tooth movement. Further research and exploration in this area can have significant implications for the field of orthodontics, offering improved treatment outcomes, increased accessibility, and novel opportunities for innovation.

Dental vibrator – Faster, better and painless tooth movement: A review

Today, many people receive orthodontic treatment for better occlusion, improved oral function and harmonized facial appearance. However, two perplexing challenges have not been solved in clinical orthodontics, i.e. long treatment time (on average 2-3 years) and iatrogenic root resorption. Figuring out these challenges will dramatically improve the quality of orthodontic care. The following article deals with the first challenge i.e Long treatment time and the most reliable and effective way to enhance the tooth movement.

In Vitro Investigation of the Mechanical Properties of Blended 3D-Printing Resins for Orthodontic Aligners: A Comparison between Commercial Resin and Nickel-Titanium Wire

This scientific article investigates the mechanical properties of a novel three-dimensional-printing resin specifically designed for orthodontic aligners and compares it to other commonly used resins. The resin was made by blending two commercially available and certified resins to produce aligners with improved mechanical properties compared to each separate resin. The study examined the effect of the addition of NextDent Ortho Rigid resin on the mechanical properties of the specimens, more specifically analyzing the relationship between the amount of the added rigid resin and the mechanical properties of the specimens. The mechanical properties of the specimens and the nickel-titanium wires were analyzed using a three-point bending test setup. The results showed no statistically significant differences within the different groups of specimens. The study provides valuable insights into the potential of the resin to meet the mechanical demands of orthodontic treatments. It will contribute to the advancement of personalized orthodontic care through three-dimensional-printing technology. Blending commercially available and certified resins enables orthodontic practitioners to select the most suitable resin for each case, providing better outcomes for patients and increasing the efficiency of the treatment process. Further research and evaluation would be required to determine the suitability of the blended resin for orthodontic treatments.

Comparing the Salzmann Index to automatic qualifying conditions when selecting medically necessary orthodontic patients

This study compared the Salzmann Index (SI) to the American Association of Orthodontists-proposed Automatic Qualifying Conditions (AQC) list in determining eligibility for medically necessary orthodontic care (MNOC). In Pennsylvania, The SI must reflect a score of ≥25, whereas the AQCs are considered binary indicators of a treatment need-the presence of any AQC qualifies a patient for treatment under Medicaid. This study was designed to determine whether the same patients are selected as eligible for MNOC regardless of which selection method is used. The orthodontic records of 139 participants aged 10-17 years were used to calculate SI scores and identify any AQCs present. McNemar's test of agreement was used to compare patients selected for treatment needs on the basis of SI to those selected on the basis of the presence of an AQC. The mean SI score was 14.7. Twelve patients (8.6%) were selected for treatment needs because of an SI of ≥25, whereas 44 patients (31.7%) were deemed to have at least 1 AQC present. Of the 44 patients with AQCs, only 11 had SI scores of ≥25. McNemar's test of agreement found that SI score and AQC presence did not select patients similarly (P<0.001). The SI and AQCs do not appear to select the same patients for MNOC, suggesting that replacing the SI with a list of AQCs would significantly impact which patients are selected for Medicaid-funded orthodontic care in Pennsylvania.