Orthodontic Patients Research Articles

Comparison of two treatment modalities in the management of gingival enlargement during orthodontic treatment: a randomized clinical trial.

This clinical trial aimed to evaluate and compare the effectiveness of diode laser gingivectomy, conventional gingivectomy, and nonsurgical periodontal treatment (NSPT) in the management of gingival enlargement (GE) during orthodontic treatment. forty-five healthy, orthodontic patients with labial gingival enlargement on the 6 anterior teeth were selected and randomly assigned to one of the groups (Conventional, Laser, and NSPT). Clinical parameters including clinical crown length (CCL) , periodontal pocket depth (PPD), and vertical gingival overgrowth index (vGOi) were recorded at baseline, 1 month, 3 months, and 6 months. Postoperative pain was evaluated at 1,3, and 7 days. Esthetic satisfaction and acceptance of the procedure were recorded on day 10 and repeated after 6 months. Statistically significant results were obtained for mean reduction in PPD for conventional, laser, and NSPT groups (-1.43, -.1.75, and -0.9 mm, respectively; P < 0.001), CCL gain (1.45, 1.7, and 0.38 mm, respectively; P<0.001) and mean vGOi score (-1.14, -1.29 and -0.76, respectively; P<0.001) over 6 months. Both test groups showed greater statistically significant changes in clinical parameters over 6 months compared to NSPT (P<0.001). There was a gradual decrease in postoperative pain for all three groups over 7 days, with conventional group showing statistical difference in mean pain score on days 1 and 3 compared to other groups. Both conventional and laser gingivectomies were more effective in controlling enlargement over non-surgical periodontal treatment alone at 1, 3, and 6 months. laser and conventional gingivectomies as adjunctive treatments achieved superior results when compared to NSPT alone in the treatment of GE and gingival inflammation during orthodontic treatment, with no significant clinical differences between the two treatments.

Orthodontist dressing: Its impact on patient perception and cooperation

Background and Aim: Communication skills, including non-verbal cues such as attire, play a significant role in patient perceptions of healthcare professionals. An orthodontist’s attire may influence patient cooperation during treatment. This study aims to investigate Nigerian orthodontic patients' perception regarding their orthodontists' dressing and its impact on patient cooperation. Materials and Methods: A cross-sectional descriptive study was conducted among orthodontic patients at the University of Port Harcourt Teaching Hospital in Nigeria. A structured, interviewer-administered questionnaire with 34 items was used to gather data from 131 participants. The questionnaire covered socio-demographic characteristics, understanding of the orthodontist's role, and preferences for the orthodontist's attire. Data were analyzed using IBM SPSS version 26, with significance set at p ≤ 0.05. Results: The study included 131 patients (82 females and 49 males), with a mean age of 19.2 ± 9.43 years. Most participants (88.6%) liked how their orthodontists dressed, with 50.4% stating that their orthodontists wore traditional white coats and 42.7% indicating that their orthodontists wore scrubs. When asked about the significance of the orthodontist's dressing, 46.6% indicated that it mattered to them, while the majority stated that it did not affect their cooperation or review appointments. Conclusion: The study reveals that while orthodontic patients have preferences for their orthodontists’ appearance, it does not significantly affect their cooperation or review attendance. These findings suggest that while maintaining a professional appearance is important, it may not be a determining factor in patient compliance.

Prevalence of microdontia among orthodontic patients of Kathmandu, Nepal

Background: Microdontia is a condition where the teeth are smaller than the normal size, which may involve all teeth or be limited to a single tooth or a group of teeth. The objective of this study was to find out the prevalence of microdontia among orthodontic patients of Kathmandu, Nepal. Methods: In this cross-sectional study, 190 orthodontic casts of patients (166 males and 224 females) who came for orthodontic treatment between the age of 14 to 28 years (mean age of 17.43±4.28 years) were randomly selected. The mesiodistal dimension of each tooth was recorded with the help of digital vernier caliper. A tooth was diagnosed as microdontia when it is smaller than the normal size. Data analysis was performed using SPSS version 21.0 with a confidence level set at 95% (P&lt;0.05). Chi-square test was used to determine the difference in prevalence of microdontia among the genders. Whereas, mesio-distal dimensions of teeth were compared on both sides of the jaws using student’s t-test. Results: The prevalence of overall microdontia was 6.66% (26) whereas prevalence of single tooth microdontia, multiple teeth and generalized microdontia was 2.3% (9), 2.83% (11) and 1.53% (6) respectively. There was no statistical difference in the prevalence of microdontia among genders (p=0.987). In addition, there was no statistical difference in the mesio-distal dimensions of teeth on both sides of the jaws (p&gt;0.05). Conclusion: The most common tooth affected by microdontia was maxillary lateral incisor. There was no statistically significant difference in prevalence of microdontia among genders. Keywords: Microdontia, Nepal, Orthodontic patients, Prevalence

Evaluation of the Effect of Antibacterial Toothpastes Containing Chlorhexidine and Amine Fluoride on Oral Flora in Patients Undergoing Orthodontic Treatment-A Randomised Controlled Trial.

To compare the efficacy of chlorhexidine (CHX) and amine fluoride (AF) toothpastes on oral flora in fixed orthodontic treatment patients. Thirteen patients were given toothpaste containing AF, and 12 patients were given toothpaste containing CHX. Microbial and periodontal records were taken before, 1 week, and 5 weeks after the bonding procedure. Gingival index (GI), plaque index (PI), and bleeding on probing (BOP) values were recorded by the same expert calibrated before the study. Biofilm samples were taken, and then colony counts of the samples were evaluated. Whether the variable values obtained in the groups at the time of measurement were different was examined by Nonparametric Analysis of Longitudinal Data in Factorial Experiments-Nonparametric Tests for the F1_LD_F1 design for longitudinal data. Gender distribution was similar in the study groups (χ2 = 1.944; p = 0.163). The mean age of the patients did not differ in the groups (t = 0.502; p = 0.620). In general, the variable values analysed within the scope of the study did not show significant differences between groups and time (p > 0.05). When the pairwise interactions were analysed, it was found that there was a significant difference only for PI values (F = 3.411; p = 0.035). While there were no significant differences observed in BOP, GI, and S. mutans levels and changes in IgA and IgE values between toothpastes containing CHX and AF, the PI index of CHX-containing toothpastes exhibited a notably lower level. Both AF- and CHX-containing toothpastes can be used for managing biofilm, controlling bacteria, and minimising gingivitis in subjects undergoing fixed orthodontic treatment.

Addressing mucosal ulcers during orthodontic treatment: An urgent call for preventive strategies.

Mucosal ulcers are a common yet often overlooked complication during orthodontic treatment, significantly impacting patient comfort and compliance. This letter aims to highlight the prevalence, potential causes, and management strategies for mucosal ulcers in orthodontic patients. By reviewing recent literature and clinical observations, we underscore the necessity for proactive measures and tailored interventions to mitigate the incidence and severity of these lesions. Emphasizing the role of patient education and the use of protective devices, we call for a multidisciplinary approach to enhance patient care and treatment outcomes. This discussion is particularly relevant in the context of evolving orthodontic techniques and materials, which necessitate continuous adaptation of clinical practices to ensure patient safety and well-being.

Effectiveness of different types of toothbrushes on periodontal health in orthodontic patients with gingivitis: A randomized controlled study

BackgroundThe aim of the study is to evaluate the effectiveness of different toothbrushes in reducing gingival inflammation and dental biofilm removal in gingivitis patients with fixed orthodontic appliances.MethodsFollowing baseline clinical assessments, including the Turesky modification of the Quigley-Hein plaque index (TQHI), gingival index (GI), bleeding on probing (BOP), and probing pocket depth (PPD), all patients received nonsurgical periodontal therapy. Patients were then randomly assigned to one of three groups: conventional toothbrush (C-TB), orthodontic toothbrush (O-TB), or single-tufted toothbrush (ST-TB). Each group received tailored oral hygiene instructions based on their assigned toothbrush type. Clinical assessments were repeated and recorded in the first week, sixth week, and third month.ResultsThirty-six patients with a mean age of 23.14 ± 3.86 (18–32 years) participated in the study. All groups with twelve patients each demonstrated significant improvements in clinical parameters compared to baseline. In the sixth week, the O-TB and ST-TB groups showed significantly greater improvements in TQHI and BOP scores compared to the C-TB group (p < 0.05). By the third month, the ST-TB group maintained significantly lower TQHI and BOP scores, while the O-TB group’s scores became similar to those of the C-TB group. ST-TB and C-TB groups had significantly lower GI scores than the O-TB group in all time points. Although the effectiveness of ST-TB was significantly higher than that of other toothbrushes, all toothbrushes demonstrated lower efficacy in the posterior region.ConclusionsThe ST-TB was shown to be more effective in reducing gingival inflammation over three months, while it demonstrated similar efficacy to the O-TB in dental biofilm removal. Further research is necessary to substantiate these findings and to demonstrate the efficacy of this approach in promoting periodontal tissue health in patients with fixed orthodontic appliances.Trial registrationThis study was registered with the National Library of Medicine Clinical Trials Registry Platform on 19/07/2024 as NCT06510179.

Perception about Clear Aligner Therapy among Patients Seeking Orthodontic Treatment in Public Tertiary Care Dental Hospital-Cross-Sectional Survey

Aim: Aim of the study is to assess perception about clear aligner therapy among patients seeking orthodontic treatment in public tertiary care dental hospital.  Material and Methods: This cross-sectional survey was conducted using a questionnaire that had been framed and tested for reliability and validity. It was used to collect information on the socio-demographic profile and the perspectives of orthodontic patients regarding Clear Aligner Therapy. Participants had been informed about the study, and only those who had consented were administered the questionnaire. The structured questionnaire consisted of 23 closed-ended questions, and the data was collected using Google Forms.  Results: Data from 294 patients were assessed, comprising 159 females (54.1%) and 134 males (45.6%), all between the ages of 15 and 45. Of these, 92% were aware of Clear Aligner Therapy (CAT). 31.3% patients perceived CAT to be less effective than fixed appliance (FA) therapy, with only 19.3% being aware of the cost of CAT. Additionally, 30.4% believed that CAT would result in a longer treatment duration compared to fixed appliances. However, 59.6% preferred CAT over fixed appliances for aesthetic reasons, and 78.6% favored CAT for better oral hygiene maintenance.  Conclusion: As Clear Aligner Therapy (CAT) represents one of the latest advancements in orthodontics, there is a pressing need to increase education and awareness among the general population to improve their understanding of this treatment option.

Effect of time between archwire changes on intended dentoalveolar expansion in orthodontic patients treated with fixed appliances : Aprospective controlled clinical trial.

To analyze the effects of the time span between archwire changes on the amount of transverse dental arch expansion. The design was aprospective, controlled clinical trial. Randomization was performed by computer-generated allocation tables. In all, 35patients were evaluated in three groups treated with fixed appliances and the same four sequential leveling archwires, however, with different replacement periods: 28days (4-week [4W] group), 56days (8-week [8W] group), and 84days (12-week [12W] group). Digital models were measured before the treatment (T0) and at the end of the evaluation period (T1) by ablinded operator with OrthoAnalyzer® software (3-Shape, Copenhagen, Denmark) and compared using MANOVA. Amultiple linear regression was also used to evaluate the influences of age, initial dental crowding, incisor inclination, and facial pattern on the amount of expansion. Mean expansion was 2.77 ± 0.84 mm (upper arch) and 3.12 ± 0.88 mm (lower arch) in the 12Wgroup; 1.96 ± 0.82 mm and 2.27 ± 0.96 mm in the 8Wgroup, and 1.11 ± 0.93 mm and 1.32 ± 0.91 mm in the 4Wgroup, respectively for the upper and lower arches. The amount of expansion varied significantly between the groups in the area of the canines, first premolars, and second premolars for both arches. Expansion was less in older patients. Initial dental crowding, incisor inclination and facial pattern had no influence on dental expansion. Longer time spans between archwire changes provided greater amounts of expansion, while age is inversely related, with younger patients expressing greater amounts of expansion. The results also suggest that the expansion provided by the fixed appliances is expressed mainly in the canine and premolar areas.

A short-term evaluation of oral hygiene education methods in fixed orthodontics patients: a randomized clinical trial comparing assistant training, software, and social media

ObjectiveTo compare the effectiveness of different oral hygiene education strategies on periodontal health in fixed orthodontic patients in a one-month period: assistant-led instruction, social media-based education, and custom-made software.MethodsSixty orthodontic patients from Mashhad University of Medical Sciences’ Dentistry School were randomly assigned into three groups. Each group received oral health education differently: via assistant instruction, educational videos on social media, or a researcher-designed software for Android smartphones. After a month, participants’ oral health was evaluated using the plaque index (PI) and the gingival index (GI).ResultsAssistant-led education group demonstrated the highest PI (1.26 ± 0.70) and GI (0.92 ± 0.67), while the software group reported the lowest indices (PI = 0.68, GI = 0.46 ± 0.46). The social media group’s measurements fell between these extremes (PI = 0.89 ± 0.75, GI = 0.60 ± 0.52). Significant group differences were found for both PI and GI (P = 0.028 and P = 0.047, respectively). Pairwise comparison revealed significantly lower PI and GI in the software group compared to the assistant group. No significant differences were found between the social media and other groups.ConclusionOur results suggest that the use of specially designed software could be the most effective strategy for improving oral hygiene in orthodontic patients. Meanwhile, traditional assistant-led education showed the least effectiveness. The study supports the potential benefit of utilizing digital tools, such as bespoke software and social media, in oral health education for orthodontic patients.Trial registrationThe study was registered in the Iranian Registry of Clinical Trials (IRCT) database with the identification code IRCT20200609047705N2 in 13.07.2021.

Comparison of acceptability of orthodontic appliances in children in mixed dentition treated with removable acrylic appliances and Invisalign first: a cross-sectional study

PurposeThis study aimed to compare the acceptability of removable acrylic appliances (RA) and Invisalign First (IF) clear aligners (Aligntech, USA) among children undergoing orthodontic treatment during the mixed dentition period, considering the severity of malocclusions.MethodsA total of 40 patients, aged 6 to 13 years, were recruited for the study. Malocclusion severity was evaluated using the Index of Orthodontic Treatment Need-Dental Health Component (IOTN-DHC). Patients completed the "Acceptance of Orthodontic Appliance Scale (AOAS)" via a face-to-face Google survey. To assess the reliability of the AOAS, the survey was resent to five patients after three months for a second response, and reliability analysis was conducted. Additionally, inter-rater reliability was evaluated by having all patients independently assessed by a second researcher. Data were analyzed using SPSS Statistics version 26 (IBM Corp., Armonk, NY, USA), with statistical significance set at p < 0.05.ResultsAlthough no significant difference was found in IOTN-DHC scores, the IF group demonstrated significantly higher AOAS scores compared to the RA group (p = 0.014). Survey responses revealed noticeable distinctions between groups regarding speaking discomfort, preference for orthodontic appliances, and facial appearance comfort. A negative correlation (r = -0.477, p = 0.034) was observed between malocclusion severity and appliance acceptance.Clinical significanceThis study underscores the significant superiority and advantage of IF over RA among pediatric orthodontic patients during the mixed dentition period.

Incidence of unexpected condylar displacement following comprehensive orthodontic treatment in adults.

To evaluate the incidence and pattern of unexpected/excessive condylar displacement after comprehensive orthodontic treatment in adults. Adult patients (age ≥18 years) who underwent comprehensive orthodontic treatment with pre-(T1) and post-treatment (T2) cone beam computed tomography scans were consecutively collected within an orthodontic cohort (N = 291). T1 and T2 CBCTs were superimposed three-dimensionally (3D) and condylar displacement was estimated by the 3D changes of condylar neck point (CdN) between T1 and T2 (ΔCdN). Participants with excessive condylar displacement (ΔCdN >1 mm) were classified as condylar displacement (+) and otherwise as displacement (-). The incidence and pattern of condylar displacement, association with factors such as sex, age, skeletal relationship, extraction pattern, treatment duration, history of temporomandibular joint disorder, and presence of condylar resorption with the final occlusal outcome were investigated. The incidence of unexpected condylar displacement >1 mm in the adult orthodontic cohort was 6.2%. Females (vs males; OR: 9.07; [95% CI: 1.19-69.23]) and Skeletal Class II (vs Classes I and III; OR: 4.57 [95% CI: 1.58-13.20]) demonstrated significantly higher odds of unexpected condylar displacement (P < .05). Condylar resorption was not evident in participants with condylar displacement and did not interfere with the final orthodontic outcome. Unexpected 3D condylar displacement exceeding 1 mm was noted in approximately 6% of the adult orthodontic patient cohort. However, the condylar displacement per se was not associated with condylar resorption and did not cause clinical concerns.

Smart Phone Application Reminder for Patients with Fixed Orthodontic Appliance to Improve Oral Hygiene

INTRODUCTION: In light of the extensive use of mobile phones and their associated software applications (Apps), as well as the undisputed role of reminders and Apps in behavioral interventions, the goal of this study was to evaluate the usefulness of an application for smartphones (Brush DJ) to enhance oral hygiene compliance in individuals with fixed orthodontic therapy. MATERIALS AND METHODS: In this prospective study, 82 patients between the ages of 18 and 22 were divided into four groups, two of which (the experimental group and the control group) had just begun fixed orthodontic treatment (called New) and the other two (the experimental group and the control group) were have passed fifth months from the beginning of the treatment (called Old). Patients in the intervention group were asked to use the Brush DJ smartphone App after getting traditional oral hygiene training, compared to patients in the control group who got conventional oral hygiene instruction. At baseline (T0), 4 weeks, 8 weeks, and 12 weeks following the start of the study, the plaque index (PI) and marginal bleeding index (MBI) were measured. Only patients with the software completed a questionnaire to determine how frequently and how long they brushed their teeth each day. RESULTS: Both New and Old orthodontic cases in the intervention groups showed improvements in PI, whereas the parameter of bleeding showed no significant differences. During the follow-up period, application usage was associated with a higher brushing frequency and duration. CONCLUSION: Apps might significantly improve the oral hygiene compliance of orthodontic patients by acting as reminders and motivators.

The reliability of a modified three-stage cervical vertebrae maturation method for estimating skeletal growth in males and females.

Reliability of the six-stage cervical vertebrae maturation method to evaluate skeletal growth was evaluated on the combined male and female samples and revealed diverse results. The current study aimed to determine the reliability of the modified three-stage cervical vertebrae maturation method for estimating the skeletal growth of males and females. Pretreatment lateral cephalometric radiographs of 137 orthodontic patients were utilized to evaluate the intra- and inter-observer reliability of a modified cervical vertebrae maturation method. Four independent examiners categorized each radiograph into one of the three skeletal growth stages according to the cervical vertebrae morphology: (1) a pre-peak group (combining the CS1 and CS2 stages), (2) a peak group (combining the CS3 and CS4 stages), and (3) a post-peak group (combining the CS5 and CS6 stages). The Kappa index and the Fleiss multirater Kappa test were carried out to determine the reproducibility of this method. The studied sample included cephalometric radiographs of 68 males (49.6%) and 69 females (50.4%) aged between 7 and 58 years; no significant age difference was found between the sexes (p = 0.189). The overall inter-observer reliability was 0.689 (p < 0.001), and the inter-observer reliability for the post-peak stage showed only Kappa = 0.896 (p < 0.001). The Kappa values were significantly greater in males than in females during the peak stage (0.626 and 0.488, respectively). A modified three-stage cervical vertebrae maturation method showed substantial overall inter-examiner agreement; however, differential reliability for diverse skeletal maturation stages and sexes was found.

Association between molar incisor hypomineralisation and tooth agenesis: a cross-sectional study in Brazilian children and adolescents.

The aim of the present was to assess the association between MIH and tooth agenesis (TA) in orthodontic patients from the Federal University of Rio Grande do Norte, Natal, Brazil. A cross-sectional study was performed to evaluate the presence of MIH and TA in a sample of 371 pretreatment orthodontic records from patients aged 9-18years. Statistical analyses were performed using the Chi-square and Fisher's exact tests, and logistic regressions. There was a statistically significant association between the prevalence of tooth agenesis and MIH. A higher percentage of third molar agenesis, maxillary premolar agenesis, and mandibular second premolar agenesis was observed among children with MIH-affected teeth. Patients with MIH had a 2.43 times greater chance of third molar agenesis, and a 5.88 times higher likelihood of mandibular premolar agenesis. There is a weak association between MIH and TA. Furthermore, the presence of hypomineralised molars increases the risk of tooth agenesis.

Factors Affecting Satisfaction With the Process of Orthodontic Treatment in Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife

Objectives: This study aims to determine the factors contributing to patient satisfaction with orthodontic treatment at Obafemi Awolowo University Teaching Hospital Complex. The specific objectives were to identify factors improving and negatively impacting patient satisfaction, and determine the level of patient satisfaction. Methods: A cross-sectional study design was employed, which involved patients attending the orthodontic clinic at Obafemi Awolowo University Teaching Hospital Complex. A self-administered questionnaire assessed patient demographics, satisfaction levels, and factors influencing satisfaction. Data analysis was performed using descriptive statistics, chi-square tests, and mean scores. Results: Of the 67 respondents, 91% reported satisfaction with their orthodontic treatment. The doctor-patient relationship received the highest mean satisfaction score, while psycho-social improvement received the lowest. Dissatisfied patients were predominantly females in the 21-30 age group. Factors such as dento-facial and dental function improvements significantly affected satisfaction levels. Conclusion: The majority of orthodontic patients at Obafemi Awolowo University Teaching Hospital Complex reported satisfaction with their treatment. Improving patient communication, managing expectations, and addressing dento-facial and dental function improvements can enhance satisfaction levels. Strengthening the doctor-patient relationship and optimizing clinic experiences can improve patient satisfaction.

Practical application of teledentistry in orthodontic patients during the Covid-19 pandemic

Aim: Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) or COVID-19 infection has been an unusual plummet in dentistry. Various measures were adopted to slow or halt the spread of COVID-19. Many countries suspended activities that are deemed “non-essential.” Several dental procedures fall into this category, and only emergencies that cannot be postponed are still allowed. Therefore, followup visits for active orthodontic treatment should be treated with special new standard precautions. This review aims to reduce orthodontic treatment appointments by providing an overview of the available methods and their purpose in patient monitoring, i.e., teleorthodontic. Methods: A total of 5 articles demonstrating the practical application of teledentistry including teleorthodontic were included. Result: Most emergencies can be handled via teleorthodontics, which can reassure and follow patients from afar. Teleorthodontics achieved its goal of reducing patient visits while keeping regular monitoring without sacrificing results. Conclusion: Teleorthodontics can handle most emergencies assist and follow up patients remotely while at their homes. It can reduce the number of patient visits while maintaining regular monitoring without compromising the results of orthodontics treatment. These findings still need further development in efficacy, cost-effectiveness, and long-term outcomes, but we believe teleorthodontics plays an essential role during the COVID-19 outbreaks.

Comparison of bond failure with resin-modified glass ionomer cement and visible light-cured composite bonding systems in orthodontic patients: A split-mouth randomized controlled trial.

Resin-modified glass ionomer cement (RMGIC) is considered a fluoride-releasing bonding agent. The aim of the study was to evaluate the rate of bracket bond failure with light-cured composite (LCC) and RMGIC, and to evaluate factors that contribute to the rate of bracket failure with both bonding agents. A randomized controlled trial was conducted on a sample size of 33 patients. The patients were randomly allocated for bonding with visible LCC (control group) or RMGIC (intervention group) using the lottery method. The study was double-blinded. The rate of bracket bond failure was assessed after a follow-up of minimum 3 months and evaluated using the survival regression analysis, taking into account the effects of bonding agents and other factors influencing bracket bond failure. A total of 33 participants were recruited for the study, and 66 quadrants for the intervention and control groups were randomly selected and analyzed. The data was normally distributed and the mean age of the subjects was comparable between both bonding systems. The results of the regression analysis indicated that there was no statistically significant difference between the rate of bracket bond failure with RMGIC and LCC (p = 0.081). However, after analyzing the mean days of survival, it was found that bracket survival was negligibly low with RMGIC, with a mean of 216.00 ±133.72 days as compared to LCC, with a mean survival of 224.11 ±124.59 days. No adverse effects were observed during the course of the trial. There was no difference in the rate of bracket bond failure between the intervention and control groups. The survival rate of brackets treated with RMGIC was found to be comparable to that of LCC, with a minimal difference.

Investigation of genetic polymorphisms in genes encoding growth factors and dental pulp calcification in orthodontic patients

Background and objectivesPulp calcification is associated with many factors and triggers, including individual genetic predisposition and orthodontic forces. This study aimed to investigate whether genetic polymorphisms in epidermal growth factor (EGF), epidermal growth factor receptor (EGFR1), transforming growth factor-beta 1 (TGFβ1), and transforming growth factor-beta receptor 2 (TGFβR2) are associated with a risk of dental pulp calcifications in orthodontic patients. Materials and methodsDigital orthopantomography (OPG) and genomic DNA from 132 patients were analyzed in this cross-sectional study. Pulp calcification was observed in the maxillary and mandibular first molars. Genomic DNA extracted from saliva cells was used to genotype eight genetic polymorphisms using real-time polymerase chain reaction: EGF (rs2237051 and rs4444903), EGFR (rs2227983 and rs763317), TGFβ1 (rs1800469 and rs4803455), and TGFβR2 (rs3087465 and rs764522). The association between pulp calcification and genetic polymorphisms was analyzed using allelic and genotypic distributions, and haplotype frequencies (P < 0.05). ResultsThe prevalence of pulp calcification was 42.4 % in 490 molars. Genotypic analysis and allelic distribution showed no statistically significant association between the evaluated growth factors and molar calcification (P > 0.05). No haplotype combinations showed a statistically significant difference (P > 0.05). ConclusionThe genetic polymorphisms investigated were not associated with dental pulp calcification in orthodontic patients. Further studies should investigate other polymorphisms in genes encoding growth factors.

Clear aligners for patients with severe gingival recession: A case report

Fixed appliances are an excellent treatment approach for mild to severe malocclusions. Increasingly, aligner-based treatments are being provided as a treatment option. The latter may be preferable to fixed appliances in selected cases. A young adult with severe gingival recession is presented who was treated successfully with aligner-based treatment with minimal deterioration of the gingival tissue levels. However, limits should be applied to the buccal and labial movement of teeth to reduce the risk of worsening of the gingival recession. CPD/Clinical Relevance: Aligner-based treatment may be preferable for orthodontic patients with severe gingival recession.

Lip and incisor changes in patients with different ethnicities treated with extraction versus nonextraction: A cone-beam computed tomography study

This study used cone-beam computed tomography (CBCT) via voxel-based superimposition to evaluate lip and incisor changes after orthodontic treatment with four premolar extractions (Ext) versus nonextraction (Non-Ext) among African American (AA) and White (W) patients. A total of 240 CBCTs of 120 adolescent orthodontic patients with Class I skeletal/dental relationships were included. Patients were initially divided according to treatment, and then each group was subdivided according to patients' ethnicity (Ext/W = 30, Ext/AA = 30, Non-Ext/W = 30, and Non-Ext/AA = 30). CBCTs were imported into Invivo6 for voxel-based superimposition. Lip and incisor measurements were recorded. Independent t tests and two-way ANOVA were used for statistical assessment. The Non-Ext/W group had a greater increase in all outcome variables compared with the Non-Ext/AA group, with a significant change in volume and position of upper (UL) and lower lips (LL), inclination of upper (U1) and lower incisors (L1), and position of U1. The Ext/AA group had a greater decrease in all measured outcomes compared with the Ext/W group, with significant change in inclination of U1 and L1, and position and volume of LL. W patients had more crowding than AA patients in both treatment approaches. Retraction ratios of 6.5:1 and 2.1:1 were recorded between the U1 and UL positions, and L1 and LL positions, respectively. There were no direct interaction effects between ethnicity and treatment, nor were there any significant effects of ethnicity after controlling for the covariates. Ethnicity alone has no impact on incisor and lip position after treatment. However, ethnicity in the form of initial presentation of malocclusion can have a significant influence.