Orthodontic Appliances Research Articles

The Accuracy of Algorithms Used by Artificial Intelligence in Cephalometric Points Detection: A Systematic Review

The use of artificial intelligence in orthodontics is emerging as a tool for localizing cephalometric points in two-dimensional X-rays. AI systems are being evaluated for their accuracy and efficiency compared to conventional methods performed by professionals. The main objective of this study is to identify the artificial intelligence algorithms that yield the best results for cephalometric landmark localization, along with their learning system. A literature search was conducted across PubMed-MEDLINE, Cochrane, Scopus, IEEE Xplore, and Web of Science. Observational and experimental studies from 2013 to 2023 assessing the detection of at least 13 cephalometric landmarks in two-dimensional radiographs were included. Studies requiring advanced computer engineering knowledge or involving patients with anomalies, syndromes, or orthodontic appliances, were excluded. Risk of bias was assessed using Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) and Newcastle–Ottawa Scale (NOS) tools. Of 385 references, 13 studies met the inclusion criteria (1 diagnostic accuracy study and 12 retrospective cohorts). Six were high-risk, and seven were low-risk. Convolutional neural networks (CNN)-based AI algorithms showed point localization accuracy ranging from 64.3 to 97.3%, with a mean error of 1.04 mm ± 0.89 to 3.40 mm ± 1.57, within the clinical range of 2 mm. YOLOv3 demonstrated improvements over its earlier version. CNN have proven to be the most effective AI system for detecting cephalometric points in radiographic images. Although CNN-based algorithms generate results very quickly and reproducibly, they still do not achieve the accuracy of orthodontists.

Quality of life and career success: how Invisalign transforms your smile and future

The Invisalign clear aligner system has been widely studied and debated regarding its effectiveness and advantages when compared to traditional fixed orthodontic appliances. The main attraction of Invisalign is its discreet aesthetics and the convenience it provides to patients, making it a popular choice among those seeking a more comfortable and less visible treatment. Invisalign treatment was extremely effective in the orthodontic treatment in this case. The patient was very happy with the ease of treatment in terms of aesthetics and oral hygiene, and she did not want to undergo any type of orthodontic treatment that was visible or involved brackets. She also reports that her more aligned teeth have impacted her quality of life and her professional career, enabling her to speak more assertively and overcoming her fear of interacting in the corporate world, being hired by a large multinational company to be CFO, Chief Financial Officer, because she overcame her fear of expressing herself. Therefore, Invisalign was able to treat a case of class 1 malocclusion in a patient who supposedly would not undergo any type of treatment, opening up the possibility of treating this type of patient who needs orthodontics, has purchasing power, but does not want conventional treatment. This can disrupt their personal and professional life. And in a much shorter time, in the case of 7 months of treatment with 14 aligners, whereas if we were to perform conventional orthodontic treatment, it would certainly take more than 2 years of treatment, due to the very crowded and misaligned lower teeth and the fact that there is no space to place lower brackets, prolonging the treatment and we would have to place resin in the occlusal region to be able to place the conventional orthodontic appliance, causing a series of chewing discomforts and possible breakage of the appliance, prolonging the treatment time. It is a treatment that changed the life of the patient, who was previously shy and afraid of speaking in public, to a more confident and certain person who can indeed change her life, as happened in this case and in so many others. The objective of this article is to demonstrate how a beautiful and aligned smile positively impacts the patient's quality of life and professional success.

Encapsulated Chlorhexidine Gel Use in Adolescents Undergoing Orthodontic Treatment: A Randomised Trial

IntroductionThe majority of orthodontic patients present with plaquebiofilm and related manifestations in the early stages of active fixed orthodontic appliance use. AimsTo evaluate the effects of a slow-delivery chlorhexidine:beta-cyclodextrin (Cx:β-Cd) gel compared with those of free Cx free formulations on clinical parameters in patients undergoing treatment with fixed orthodontic appliances. MethodsPatients aged 12-18 years received prophylaxis and scaling and were randomised to treatment groups in a double-blinded manner. They were treated with Cx:β-Cd, Cx, or placebo gel for 15 or 30 days. Bleeding on probing and the visible plaque index were recorded, and gingival crevicular fluid samples were collected for the assessment of cytokine expression. ResultsAt 15 days, the Cx:β-Cd group exhibited significantly less BOP than did the Cx and control groups (P < 0.001; n = 116). At 15 days, notable decreases in tumour necrosis factor-α and interferon-γ expression, as well as a substantial increase in interleukin-10 expression, were observed in the Cx:β-Cd and Cx groups relative to the control group (P < 0.05). The molecular encapsulation gel resulted in greater saliva Cx concentrations than did the free Cx gel released concentrations of 800 ng g−1. ConclusionCx:β-Cd gel is effective for the slow delivery of Cx, improving the gingival health of adolescents undergoing orthodontic treatment. Clinical relevanceA single application of encapsulated Cx gel, was a more effective antiseptic than a free Cx application in fixed orthodontice appliance wearers.

Three-dimensional digital imaging analysis of the palatal bone thickness for orthodontic mini-implant insertion – determination of the safe zone and angulation

BackgroundIn order to successfully perform orthodontic mini-implant procedures successfully for the subsequent anchoring of orthodontic appliances, it is crucial to know the palatal bone thickness. This is usually assessed using two-dimensional radiographs. The purpose of this study was to use a three-dimensional digital imaging measurement method to provide information on palatal bone volume and bone thickness and to make recommendations on the optimal and safe insertion site and angle for palatal mini-implants.MethodsFor this observational, cross-section study, pre-existing cone beam computed tomography scans of 184 patients were converted into 3D Standard Tessellation Language (STL) models of the maxilla. The area between the canine and the first molar was divided into 6 regions of interest (ROIs), three on the left side of the palate and three on the right side. The bone thickness of the palate was analyzed volumetrically and linearly while simulating different mini-implant insertion angles of 0°, 10°, 20° and 30° degrees relative to the palatal surface.ResultsAmong the ROIs, the greatest mean bone thickness was observed in the region of the first premolars with a mean distance (MD) of 10.44 ± 2.53 mm and decreased from anterior to posterior (MD: 3.44 ± 1.16 mm). The highest volume (Vol) values were also measured in the anterior palatal region (Vol: 1127.26 ± 483.91 mm3), while there was also a decrease in the posterior region (Vol: 394.36 ± 180.22 mm3). Regarding the simulated palatal mini-implant insertion sites, the greatest bone thickness was found in the anterior region, at the level of the canines with an angle of 0° (MD: 12.25 ± 3.75 mm). In the more posterior region, at the level between the first and second premolars, the greatest bone thickness was observed at an angle of 30° (MD: 7.93 ± 3.81 mm). Gender differences were found.ConclusionThis clinical study showed that the paramedian region at the level of the first premolar is the safest site for orthodontic mini-implant placement as evaluated by three-dimensional measurements. The results showed that implant insertion angle, gender and age are important aspects to consider when planning and inserting orthodontic palatal mini-implants.Trial registrationN.a.

Assessment of Oral Histology Knowledge and Its Application in Clinical Orthodontics, Operative Dentistry, Oral Medicine, and Oral Surgery

Objective: This study aims to assess the knowledge of oral histology among fifth-year dental students in Iraq and evaluate its relevance to various clinical dental disciplines, including orthodontics, operative dentistry, oral medicine, and oral surgery. Methods: A cross-sectional survey was conducted from February to May 2024 among dental students from both public and private institutions in Iraq. Participants were recruited through targeted online advertisements on platforms such as Telegram, WhatsApp, and Facebook. Results: The results compare clinical and basic knowledge between younger and older dental students. Younger students scored higher in understanding basic concepts like structural changes in the periodontal ligament, bone remodeling, tooth eruption enamel structure, cavity design and surgical interventions. However, older students excelled in clinical areas such as maxillofacial development, orthodontic appliances, and developmental anomalies. Conclusion: This study provides insights into the perceived value of oral histology education among dental students and its application in clinical practice. The findings may be encouraging early clinical involvement while reinforcing basic science concepts can lead to a more well-rounded and confident dental workforce.

American board of orthodontics- discrepancy index (ABO-DI) as prognostic factor for the duration of orthodontic treatment: A cross-sectional retrospective study

To evaluate American Board of Orthodontics-Discrepancy Index (ABO-DI) as a prognostic factor in predicting the duration of orthodontic treatment.This cross-sectional retrospective study was conducted on the pre-treatment and post-treatment records of 151 consecutively de-bonded cases, who were treated between January 2016 and September 2013 with comprehensive orthodontic therapy. The ABO-DI was used to assess the pretreatment severity of malocclusion. The sample was divided into three groups based upon the discrepancy score calculated from pretreatment study model and lateral cephalogram; Group-1 (DI score &amp;#60;16; n= 65), Group-2 (DI score 16-25; n= 49) and Group-3 (DI score&amp;#62; 25; n=37). The duration of orthodontic treatment was calculated as total treatment time (in months) from the date of placement of initial brackets and archwires to the date when orthodontic appliances were removed. Spearman’s correlation test and One way ANOVA analysis followed by Post-Hoc tests for multiple comparisons were used to assess the association between the ABO-DI scores and duration of orthodontic treatment.The mean duration of treatment for Group-1, Group-2 and Group-3 was found to be 25.83±8.42, 28.16±10.55 and 28.84±9.61 months respectively, but there was no statistically significant relationship between the severity of malocclusion on the duration of comprehensive orthodontic treatment (P&amp;#62;0.05). An insignificant correlation (P=0.102, r= -0.134) between different groups of severity of DI scores and treatment duration was revealed with Spearman test.The duration of orthodontic treatment increased with increase in severity of malocclusion, however, it is not a reliable tool for predicting the treatment duration.

Dental Implant Artifacts in MRI: Compatibility and Considerations

This review investigated dental implant artifacts in magnetic resonance imaging (MRI) and their safety in clinical practice. Dental prostheses, including implants, crowns, and orthodontic appliances, cause artifacts due to their high magnetic susceptibility, particularly in materials like iron, stainless steel, and cobalt-chromium. Titanium implants are considered safe under MRI environments according to the American Society for Testing and Material (ASTM) standards, with no reported thermal injury or dislodgement during examinations. Despite limited artifacts from titanium's paramagnetic nature, minute ferromagnetic components can still affect visualization. Thus, reducing artifacts in oral and maxillofacial MRI scans is crucial. Two main categories of artifact reduction techniques are identified: improved porous titanium or alternative materials like zirconia and adjusting MR parameters with advanced sequences. Recommendations include increasing the readout bandwidth, reducing slice thickness, using spin-echo sequences instead of gradient-echo, and employing short tau inversion recovery or DIXON techniques for fat suppression. Additional methods like VAT, VAT-SEMAC combination, and MAVRIC show promise, although applicability may be restricted in specific MRI scanners. Continuous advancements in dental implant materials and MRI sequences are needed to improve imaging quality and reduce artifacts. Collaboration among dental practitioners, radiologists, and MRI technologists is essential for refining techniques and ensuring patient safety. Although overall dental implant artifacts pose challenges, safety in MRI is well-established. Ongoing developments hold significant potential to enhance MRI imaging quality in patients with dental devices

Characterisation, comparison of surface topography and frictional resistance of zinc oxide- tin oxide nanocoated ceramic orthodontic brackets by radio frequency magnetron sputter coating method: An in vitro study

In recent years, orthodontic research has witnessed significant progress as it ventures into the exploration of nanoparticle coating to augment the surface properties of orthodontic appliances. The present study aimed to evaluate the surface characteristics, surface topography and frictional resistance (FR) of ceramic brackets (CB) nanocoated with zinc oxide- tin oxide (ZnO-SnO) by radio frequency magnetron sputter coating method.26 polycrystalline maxillary canine CB, split into two groups, were used in the current in vitro investigation. Group A of the RF magnetron sputter coating method was used to coat ZnO-SnO nanoparticles (Nps) on brackets, while group B of the process used uncoated brackets. Following coating, brackets underwent EDAX and SEM imaging. Atomic force microscopy (AFM) was used to assess the surface topography, and frictional resistance (FR) was also examined. An analysis of the data was conducted using SPSS (Version 23.0). An independent parametric t-test was used to compare the results between the groups.Brackets coated by RF sputter coating method had a porous and aggregated morphology when viewed under SEM. EDAX spectroscopy images showed uncoated brackets presented aluminium, oxygen, silica and calcium signal peaks at 60.83 wt %, 13.43 wt %, 24.57 wt % and 1.17 wt % respectively while the coated brackets showed signal peaks of zinc, oxygen, silica and tin at signal peaks of 20.98 wt %, 54.85 wt %, 10.52 wt % and 13.65 wt %. Groups A and B showed a surface roughness (SR) of 180.62 ± 9.49 nm and 316.77 ± 14.10. A statistically significant difference was observed in the SR between the 2 groups (p=0.00). The mean FR were higher for uncoated brackets (8.18 ± 0.76) p=0.00.Zn-SnO2 Nps were effectively coated onto ceramic brackets through the RF magnetron sputter coating technique. In comparison to uncoated brackets, the coated brackets exhibited a lower FR and SR.

Metal ions released during canine retraction using fixed orthodontic appliance: Prospective clinical study

Background: Metal ions released from dental alloys pose a significant concern due to their potential local and systemic effects. One of these effects is hypersensitivity, particularly associated with nickel-containing dental alloys. Aims: to measure metal ion concen-tration in saliva during orthodontic space closure on a 0.019X0.025 working archwire. Material and Methods: Trial design: Con-trolled clinical trial. Setting: Orthodontic treatment was provided at the Postgraduate Orthodontic Teaching Clinics and saliva testing was performed at the Faculty of Chemical Engineering/ Jordan University of Science and Technology (JUST). Methods Participants and interventions: Twenty-eight participants with bimaxillary proclination requiring extraction of all first premolar teeth participated in this study. Teeth alignment started with 0.014-inch nickel titanium (NiTi) archwire, then with a sequence of 0.018-inch, 0.016X0.022-inch, and 0.019X0.025-inch NiTi archwires, before 0.019X0.025-inch Stainless Steel (SS) rectangular archwire was reached. Patients were monitored monthly for a period of three months. Three unstimulated saliva samples were collected from each patient; before the commencement of treatment (T0), when 0.019X0.25-inch SS archwire was reached before space closure (T1), and one month after space closure (T2). Ion concentration in saliva samples was measured using an inductively coupled plasma mass spectrometer (ICP-MS). Results: Before treatment, iron concentration (53 Fe and 54 Fe) averaged 197.05 (64.35) mg/L and 425.48 (164.43) mg/L, respectively. Iron concentration increased during the alignment stage of orthodontic treatment (P&lt;0.05) with no sig-nificant increase during space closure (P&gt;0.05). Other investigated ions (Cr, Co, Ni, and Ti) did not show significant changes during orthodontic treatment (P&gt;0.05). Conclusions: There was no increase in the metal ions concentration (Fe, Cr, Ti, and Ni) during space closure using a 0.019X0.025 working archwire and the Fe ion concentration increased in the initial stages of orthodontic treatment

Impact of Different Orthodontic Appliances on Mandibular Condyle, Anterior Region of Mandibular, and Maxillary Sinus Using Panoramic Radiography.

BACKGROUND This retrospective study of 44 patients requiring removable functional dental appliances aimed to compare the use of a maxillary expansion device, twinblock/monoblock, face mask, and chincup on maxillary sinus dimensions, mandibular anterior region bone density (MABD), and mandibular condyle head bone formation (MCBF) using panoramic radiography. MATERIAL AND METHODS The patients were divided into 4 groups based on the treatment modalities used: group A, maxillary expansion device (n=11); group B, twinblock/monoblock (n=11); group C, face mask (n=11); and group D, chincup (n=11). MABD and MCBF were assessed using the fractal analysis method, while maxillary sinus dimensions were compared using the ImageJ program. Different groups of patients were tested by the Mann-Whitney U test, with Bonferroni correction. RESULTS Group A showed an increase in MABD, MCBF, and average maxillary sinus indentation base length (MSIL) and a decrease in average planar base length (MSPL) and maxillary sinus area (MSA) (P<0.05). Group B showed an increase in MABD, MSIL, MSPL, MSA, and MCBF (P<0.05). Group C showed an increase in MABD, MSIL, MSPL, and MCBF, with a decrease in MSA (P>0.05). Group D showed an increase in MCBF, MABD, MSIL, and MSA, with a decrease in MSPL at the end of treatment, compared with pretreatment (P<0.05). CONCLUSIONS Orthodontic treatment with different removable functional dental appliances has varying effects on the mandible and maxilla. Possible changes in the maxilla and mandible should be considered before treatments with removable functional dental appliances.

Effect of maxillary molars distalization using clear aligners and fixed orthodontic appliances on the positional and dimensional temporomandibular joint parameters: a three-dimensional comparative study

ObjectiveThe use of clear aligners (CAs) for orthodontic treatment has substantially increased in recent decades. However, limited empirical evidence exists regarding their potential effects on the temporomandibular joint (TMJ). The aim of this study was to assess the effect of maxillary molar distalization on the positional and dimensional TMJ parameters between CAs and conventional fixed orthodontic appliances (FAs) in skeletal class II malocclusion.MethodsThis is a retrospective cohort study examined 70 adult patients with skeletal class II malocclusion with similar baseline characteristics based on American Board of Orthodontics (ABO) discrepancy index scores. The patients were treated by maxillary distalization movement by CAs or FAs, of which there were two equal groups of 35 patients were included in each group. CBCTs on TMJs were performed before and after treatment through Anatomage Invivo Dental 6.0. The measured parameters included inclination, position, condyle and articular fossa dimensions, and the volumetric joint spaces.ResultsIn both groups, linear measurements of the maxillary molar position revealed significant improvement after treatment (P < 0.001). Regarding TMJ parameters, intra-group comparisons revealed significant changes in FA group in the anterioposterior condylar inclination and condylar position across the three planes. Additionally, the pretreatment-centric condylar position in the glenoid fossa was 45.7% and 40% in the CA and FA groups, respectively. After treatment, these percentages changed to 51.4% and 31.4%, respectively. In inter-group comparisons, significant changes were noted in the mediolateral condylar position, which was more inward in the FA group than the CA group.ConclusionThe FA group had more significant dimensional and positional changes in the mandibular condyle than the CA group; nevertheless, the changes are considered clinically negligible.

Effects of orthodontic wax and ora-aid on pain and discomfort at the beginning of orthodontic treatment.

Wounds may occur in the mouth during orthodontic treatment. Orthodontists use a variety of substances to eliminate the irritation. This randomized clinical trial aimed to examine the effect of orthodontic wax and ora-aid material on wound healing, the duration of staying in the mouth, and the effect on pain and to evaluate the effect on the patient's quality of life. The study included two hundred forty patients aged 11-14 years. At the end of 1 week, patients with no wound were determined as the control group G1(n:65), patients using Ormco orthodontic wax as G2(n:86), and patients using Ora-aid as G3(n:89). The patients were asked to fill out the questionnaire given to them five times in total, as T0 when the wound occurred, T1 after 24h, T2 after 48h, T3 after 96h, and T4 after 168h. The study's results demonstrated no significant differences in the level of pain between males and females. For all post-baseline time points, the Ora aid group had a lower VAS for pain when compared with the Ormco orthodontic wax group (P < 0.01). This study demonstrated that ora-aid effectively reduces the mucosal discomfort associated with orthodontic appliances, and this product may be a suitable alternative to traditional orthodontic wax material for dealing with oral mucosal injuries during orthodontic treatment. This product may be a suitable alternative to traditional orthodontic wax material for dealing with oral mucosal injuries during orthodontic treatment.

The Effectiveness of Probiotics on Oral Health During Adult Orthodontic Treatment With Fixed Appliances: A Two-Arm Parallel-Group Randomized Controlled Clinical Trial.

Fixed orthodontic appliances interfere with daily oral care procedures, causing more plaque accumulation and thus increasing the risk of periodontal diseases. Probiotics have been suggested to maintain oral health using beneficial bacteria. However, the evidence to determine the clinical benefits of probiotics as a supplement to oral health in orthodontic patients is still insufficient. This trial aimed to investigate the protective effect of probiotics on oral health and prevent the development of inflammation of the gingiva and periodontal tissues during orthodontic treatment using fixed orthodontic appliances. This was a single-blinded, single-center, two-arm randomized controlled trial conducted between March 2023 and June 2024.A total of 50 patients (13 males (26%) and 37 females (74%) with a mean age of 21.33±2.04) who required a non-extraction-based treatment using fixed orthodontic appliances were enrolled and randomly divided into two groups: the probiotics group (PG) who underwent orthodontic treatment with probiotic tablets of Lactobacillus reuteri and the control group (CG) who underwent orthodontic treatment without probiotics. The following periodontal parameters were recorded: plaque index (PI), gingival index (GI), papillary bleeding index (PBI), and probing depth (PD). These indices were assessed three times: before the start of orthodontic treatment (T0) and after three months (T1) and after six months (T2) of applying fixed appliances. The mean values for PI, GI, PBI, and PD were statistically significantly lower in the PG compared to the CG at both time points T2 and T3 (p<0.05). In the PG, there was a significant difference in the PI between time points T0 and T1 (p<0.001), but there was no significant difference between T1 and T2 (p=0.074). The GI, PBI, and PD differences were also insignificant (p>0.05). Conversely, all studied periodontal parameters significantly increased during the assessment periods in the CG (p<0.001). Using probiotic lozenges that contain Lactobacillus reuteri, alongside regular teeth brushing, during the first six months of fixed orthodontic treatment in adults can help maintain good oral hygiene. This approach reduces plaque buildup and helps prevent the onset of clinical signs associated with periodontal disease.

Evaluation of Two Mini-implant Lengths in the Infrazygomatic Crest Region: A Randomized Clinical Trial.

Temporary anchorage devices (TADs) have revolutionized fixed orthodontic appliance treatment through anchorage controlling in the clinic and play an essential role in resolving many complex cases. Due to the limited space, there is a risk of injury to the roots while using interradicular microimplants. Therefore, the infrazygomatic crest (IZC) area can be an alternative mini-implant insertion site in the maxillary arch. The aim of the study was to evaluate the primary stability, pain perception, sinus penetration, late stability, and failure rate with two mini-implant lengths in the IZC area. Forty-eight mini-implants (Tusk Dental Co., Ltd., Canada) with two different lengths (length/diameter: 12/2 and 14/2 mm) were grouped by length (24 per group) and inserted bilaterally into the IZC area of 24 patients. The data were statistically analyzed, considering a significance level of p < 0.05. Sinus penetration prevalence did not differ significantly between 12-mm (54.2%) and 14-mm (62.5%) mini-implants (p > 0.05). Primary stability was significantly higher with the 14-mm mini-implants (p < 0.05). The failure rate did not differ significantly between the 12-mm (20.8%) and 14-mm (16.7%) mini-implants (p > 0.05). While the failure rate was similar between 12- and 14-mm mini-implants, the 14-mm mini-implants were more likely to damage adjacent structures. Therefore, shorter mini-implants should be preferred over longer mini-implants for most cases requiring IZC TADs. ClinicalTrials.gov identifier: NCT06293872.

Comprehensive evaluation of the antibacterial and antibiofilm activities of NiTi orthodontic wires coated with silver nanoparticles and nanocomposites: an in vitro study.

Fixed orthodontic appliances act as a niche for microbial growth and colonization. Coating orthodontic wires with antimicrobial silver nanoparticles (AgNPs) and nanocomposite was adopted in this study to augment the biological activity of these wires by increasing their antibacterial and antibiofilm properties and inhibiting bacterial infections that cause white spot lesions and lead to periodontal disease. Three concentrations of biologically synthesized AgNPs were used for coating NiTi wires. The shape, size, and charge of the AgNPs were determined. Six groups of 0.016 × 0.022-inch NiTi orthodontic wires, each with six wires, were used; and coated with AgNPs and nanocomposites. The antimicrobial and antibiofilm activities of these coated wires were tested against normal flora and multidrug-resistant bacteria (Gram-positive and Gram-negative bacterial isolates). The surface topography, roughness, elemental percentile, and ion release were characterized. AgNPs and nanocomposite coated NiTi wires showed significant antimicrobial and antibiofilm activities. The chitosan-silver nanocomposite (CS-Ag) coated wires had the greatest bacterial growth inhibition against both Gram-positive and Gram-negative bacteria. The surface roughness of the coated wires was significantly reduced, impacting the surface topography and with recorded low Ni and Ag ion release rates. NiTi orthodontic wires coated with AgNPs, and nanocomposites have shown increased antimicrobial and antibiofilm activities, with decreased surface roughness, friction resistance and limited- metal ion release.

Impact of Demographic, Clinical, and Preventive Factors on Caries Susceptibility and Cavitation in a Six-to-15-Year Cohort.

Dental caries continues to represent one of the most widespread oral health challenges on a global scale, particularly in adolescents. This cross-sectional investigation examines the impact of demographic, clinical, and preventive factors on caries susceptibility and cavitation in children aged six to 15 years, thereby offering a thorough analysis of risk patterns and preventive strategies. This prospective, cross-sectional study was conducted on 2,000 schoolchildren, aged six to 15 years. Demographic and clinical data anddata on preventive factors were gathered using the American Academy of Pediatric Dentistry (AAPD) Caries-Risk Assessment Tool (CAT). Based on clinical assessments and self-reported behaviors, participants were classified into high-, medium-, and low-risk groups. Statistical methodologies, including chi-square analyses and odds ratios (OR), were employed to evaluate the significance of the relationships among the variables. The associations between gender, educational attainment, and caries risk were statistically significant (p = 0.001), demonstrating that females exhibited a greater vulnerability than their male counterparts. Individuals enrolled in higher education levels showed an increased prevalence of high-risk categorization. Notable variations among communities were also observed, with specific demographics presenting a heightened susceptibility to caries. The frequency of tooth brushing, sugar intake, and regular dental examinations exhibited strong correlations with caries risk, whereas cavitation was recorded in 65.50% of the subjects. Key predictors included visible plaque, diminished salivary flow, and use of orthodontic appliances (p = 0.001). Preventive strategies, such as the application of fluoridated products and daily tooth brushing, have been found to significantly mitigate the risk of cavitation. This investigation emphasizes the complex, multifaceted nature of caries susceptibility, accentuating the critical role of demographic, clinical, and preventivefactors.

Digital Models and 3D Biomechanics Analysis in Orthodontics. Part 1: Vector Calculations

Biomechanics is essential for optimizing orthodontic appliances and controlling dental movement. Charles J. Burstone pioneered a three-dimensional (3D) approach in orthodontics, advocating for a shift beyond appliance-focused methods. Initially, biomechanics studies were constrained to two-dimensional (2D) analysis due to the complexities of 3D evaluation. Despite progress in computational tools and digital modeling, orthodontic biomechanics has largely maintained a 2D orientation. This paper advances orthodontic biomechanics into 3D, re-evaluating concepts previously limited to 2D frameworks. A dedicated software, DDP-Ortho (Ortolab, Poland), is introduced to enable orthodontists to analyze and resolve biomechanical challenges in 3D, facilitating appliance designs with precise 3D force systems. The representation and calculation of force vectors and moments in 3D are detailed, emphasizing the inherent complexity absent computational support. Key processes such as vector subtraction and addition, fundamental for assessing and refining orthodontic force systems, are explained. Additionally, the vector split (couple replacement) method, previously described in 2D, is extended to 3D, addressing the unique constraints and challenges of this approach. These tools promise to refine the accuracy and effectiveness of orthodontic treatments, setting the stage to examine the interactions between 3D force systems and dental movement, which will be addressed in a subsequent paper, to broaden the potential of contemporary orthodontic therapy.

Evaluating Clear Aligners Versus Fixed Appliances for Periodontal Patients: A Comprehensive Narrative Review of Current Evidence

Periodontal patients may face orthodontic problems because of bone support loss, such as maxillary incisor proclination, spacing, rotation, extrusion, pathologic tooth migration (PTM) or traumatic occlusion. Orthodontic treatment is therefore an element within the comprehensive treatment of periodontitis after the periodontal condition has stabilized. The presence of fixed appliances (FAs) promotes the accumulation of bacterial biofilm and impedes hygiene procedures. The increasing popularity of clear aligner (CA) treatment is due to the convenience of use, less discomfort, better esthetics, easier hygiene, lower failure rate, and shorter, less frequent visits. Therefore, the question arises whether treatment with aligners is a good solution for periodontal patients. To answer this question, the PubMed/Medline, Cochrane Library and EMBASE databases were searched using the following keywords: periodontitis, orthodontic treatment, clear aligners, multibracket orthodontic appliances, fixed appliance, root resorption, gingival recession and pathologic tooth migration. The search strategy identified 18 relevant studies. A total of 1090 participants took part in the analyzed studies. The available literature was analyzed in terms of the occurrence of root apex resorption, the possibility of treating pathologic tooth migration, the occurrence of gingival recession, periodontal health status and occlusal stability in patients treated with CAs and FAs. Despite statistically significant differences in terms of Plaque Index (PI), probing depth (PD), apical root resorption and gingival recession favor the use of CAs. However, these values are mostly of no clinical significance. It is possible to treat PTM with CAs, but it is limited by the high degree of tooth mobility and incisor inclination. Obtaining perfect occlusion is comparably difficult in both CA and FA treatment. When planning orthodontic treatment in patients with reduced periodontium, the use of both CAs and FAs should be considered. The choice of method would ultimately depend on the patient’s dental condition.

Treatment of gingival enlargement caused by orthodontic treatment

The aim of this study was to assess the healing process of gingival enlargement in adolescents with and without fixed orthodontic appliances using conventional scalpel treatments over a 3-month follow-up period. 20 patients with gingival enlargement were divided into two groups. The control group, without fixed orthodontic appliances, received mechanical treatment through conventional scalpel. Test group, comprising patients with fixed orthodontic appliances, was treated using conventional scalpel. Follow-up visits were conducted on days 1 and 90. Clinical periodontal parameters, including plaque index, gingival index, bleeding on probing, probing pocket depth, and gingival overgrowth index, were compared across groups at different time intervals from baseline. All groups exhibited statistically significant reductions in clinical periodontal parameters during the study period (P &lt; 0.05). Test group, treated with conventional scalpel, showed the fastest and most consistent improvements in the healing process compared to baseline. Conventional scalpel therapy proved to be an effective method for treating gingival enlargement, with no reported discomfort or pain during or after the procedure. Given the challenges patients with fixed orthodontic appliances face in maintaining oral hygiene, they should be scheduled for more frequent follow-ups and given thorough home-care instructions.

Customized lingual orthodontics: clinical features and difficulties

Lingual orthodontic technology has been in existence for over 50 years, undergoing various stages of emergence, development, decline, and maturity. In recent years, with the advancement of digital technology, customized lingual orthodontics has gradually become widely used in clinical practice, representing a significant achievement of digital technology in orthodontic clinical diagnosis and treatment. The integration of digital technology has made customized lingual orthodontics more convenient, precise, and efficient, enhancing patient comfort while significantly reducing the operational difficulty and technical barriers for orthodontists. This article focuses on analyzing the technical characteristics, operational challenges, and coping strategies of customized lingual orthodontics based on digital technology, aiming to provide a reference for clinical practice.