Orthodontic Therapy Research Articles

Ion Release from Stainless Steel Brackets Subjected to Tooth Bleaching Treatment.

Tooth discoloration in the form of staining is a common finding during conventional orthodontic treatment. Due to elevated esthetic standards, clinicians in the field of orthodontics are faced with increasing demands by patients to perform bleaching treatments while the appliances are still in place. Though the success of such treatments has been reported in literature, the effect of whitening agents on orthodontic appliances has not been evaluated. Increased ion release following corrosion of orthodontic brackets is considered a health hazard. In this study, we measured the amount of ion release from steel brackets under home and office bleaching treatment in order to evaluate the safety of such treatments during orthodontic therapy. In this experimental study, a total of 120 brackets were randomly divided into 3 groups. The first group was subjected to an office bleaching regimen (hydrogen peroxide 40%). The second group was subjected to a home bleaching treatment (carbamide peroxide 20%). The third group did not receive any bleaching treatment. The specimens of all groups were immersed in artificial saliva and after 30 days, the amount of released chromium, copper, iron, magnesium, and nickel ions was measured and compared using one way ANOVA. The results showed that ion release was significantly different between the three groups (pValue >0.05). For the chromium, iron, magnesium, and Nickel ion release the order was as follows: no bleaching < home bleaching < office bleaching. However, the copper ion release was greater in the group that received home bleaching. Ion release was enhanced when bleaching treatments were performed, with office bleaching having a more significant effect. Although the amounts of released ions were less than those permitted by WHO, we suggest that the clinicians recommend home bleaching for orthodontic patients that are seeking tooth whitening treatment.

Effect of Intraoral Appliance on Oral Health Status and Streptococcus mutans Count: A Longitudinal Study

Abstract Objective Appliances used in preventive and interceptive orthodontics, which are often provided to correct or intercept a specific malocclusion or habit, may be detrimental. to a child's oral health. The objective of this study was to evaluate the effect of intra oral appliance wear on the plaque index, gingival index, bleeding on probing, and on levels of salivary Streptococcus mutans. Materials and Methods A total of 60 children requiring any preventive or interceptive orthodontic treatment (appliance therapy) were randomly divided into two groups, as fixed orthodontic appliance group (n = 30) and removable appliance group (n = 30). Preoperative and post operative assessments of patients were done before and after wearing appliances. Assessment was done by determining oral hygiene status and microbiological evaluation of saliva for S. mutans count. S. mutans colonies were counted from saliva cultured on mitis-salivarius-bacitracin (MSB) agar. Statistical Analysis Data that are continuous in nature were summarized as standard deviation and mean. For “within group” comparisons, paired t-tests were used to analyze the continuous data. For “between group” comparisons, unpaired t-tests and Fisher's exact test were used to analyze the continuous data. Results Appliance treatment increases plaque and gingival indices. Plaque and gingival index changes 1 month after deployment of both fixed and removable appliances were essentially the same and statistically non-significant with p-values of 0.412 and 0.965. Bleeding on probing after insertion of both appliances was not statistically significant (p=0.423). S. mutans numbers increased following removable and fixed orthodontics. Fixed appliances had more S. mutans than removable appliances (p=0.014). Conclusion The inherent levels of these microorganisms are related with plaque accumulation due to fixed or removable appliances. Increase in the level of plaque and microorganisms after fixed and removable appliance therapy can hamper optimum oral health and thus is a concern for pedodontists. During orthodontic therapy, cariogenic pathogens should be reviewed, and to prevent cariogenic pathogens from increasing and to maintain oral hygiene during orthodontic treatment, proper recall visits, patient and parent education, and regular fluoride application are essential.

Acceleration Techniques for Teeth Movements in Extractive Orthodontic Therapy

For a world that is constantly trying to speed up every procedure while obtaining the maximum result, traditional orthodontics have the biological limitation of using light and constant forces that allow tooth movement in a time frame that is only sometimes short. The treatment time could be lengthened if surgical procedures are programmed in the plan. Methods to accelerate tooth movement and reduce the duration of treatment while minimising complications are investigated and reported in the dental literature (e.g., low-level laser therapy, corticotomy, and micro-osteoperforations). This systematic review aims to analyse and summarise the strategies for quickening orthodontic movement during extraction orthodontic treatment, including any potential drawbacks or adverse consequences. The review will evaluate each approach’s effectiveness, safety, and evidence quality, compare their benefits and disadvantages, and analyse the implications for clinical practice and future research. Pubmed, Science Direct, Scopus, and Web of Science were searched using the keywords “acceleration” AND “dental movement” AND “orthodontic” between 1 April 2003 and 1 April 2023. After carefully scanning the study findings, forty-four publications were chosen for the systematic review. Most therapies discussed and provided in the literature seem promising and successful in enhancing orthodontic treatments. The success of operations like corticotomies, piezo-incisions, micro-osteoperforations, osteogenic distraction, low-level laser therapy, the administration of pharmacological treatments, and infiltrations with PRF and PRP were statistically significant and appear to be promising and effective in optimising orthodontic treatments. These strategies expedite treatment and enhance the patient experience, potentially broadening orthodontic appeal and minimising issues like cavities and enamel demineralisation. Further studies, with larger samples and standardised treatment protocols, are needed to investigate the efficacy of these tooth movement acceleration modalities.

Soft tissue and incisor position changes in class I bimaxillary subjects after retraction using friction and frictionless mechanics

Aim: Bimaxillary protrusion is a common condition observed irrespective of race and ethnicity and is a chief concern for patients who seek orthodontic treatment. The aim of this study was to compare and evaluate changes in soft tissue structures and incisor positions in class I bimaxillary protrusion subjects undergoing orthodontic therapy when friction and frictionless mechanics were used. Methods: Two groups with a total of 40 patients aged 18–30 years diagnosed with class I bimaxillary protrusion treated by extracting first premolars were considered for this study. Patients treated with friction mechanics were included in Group 1 and those treated with frictionless mechanics in Group 2. The digital lateral cephalograms were calibrated and analyzed using Nemoceph software. Selected landmarks were marked on pre- and post-treatment cephalograms and assessed for intra- and inter-group soft tissue and incisor position changes. Student’s t-test was used to analyze the collected data using SPSS 20 software. Result: Intragroup comparison revealed significant changes in both groups. Inter-group comparison of the selected parameters between groups 1 and 2 showed differences but without any statistical significance, except for the inter-incisal angle. Conclusion: Pre- and post-treatment comparison analysis revealed significant soft tissue changes in both groups. However, the comparison between friction and frictionless mechanics showed no statistically significant changes.

Photobiomodulation and Orthodontic Treatment with Clear Aligners: A Case Report of Severe Crowding and Agenesis

This paper aims to demonstrate the effectiveness of photobiomodulation in accelerating orthodontic treatment with clear aligners in correcting an orthodontic malocclusion characterized by severe crowding and agenesis in an adult subject. An adult male patient with Class I malocclusion, a mild Class III skeletal base and severe crowding was treated with 88 Invisalign® (Align Technology, Santa Clara, CA, USA) pairs of aligners replaced every 5 days in combination with an Orthopulse™ (Biolux Research, Vancouver, BC, Canada) photobiomodulation device for home use by the patient. The total orthodontic treatment time was 440 days. Orthopulse™ is a photobiomodulation device that generates continuous beams of near-infrared light (NIR—near-infrared) with a wavelength of 850 nm and a power of 42 mW/cm2 to produce an average energy density on the surface of the silicone impression of 9.3 J/cm2. The combined use of clear aligners and the Orthopulse™ device allowed the patient to replace the aligners according to an experimental 5-day protocol to speed up the orthodontic therapy and, thus, resolve the malocclusion in less time than the manufacturer’s standard.

Orthodontic Treatment in Pediatric Patients with Autism Spectrum Disorder: Compliance and Satisfaction: Pilot Study

Background: Most children with ASD require orthodontic treatment to correct a malocclusion, to restore masticatory function, and for cosmetic reasons. The use of orthodontic devices, however, could lead to a distortion of the child’s routine, causing mood alterations, on the one hand, and a worsening of their oral hygiene status, on the other. The aim of this study is to evaluate the impact of orthodontic therapy on the daily management and level of collaboration of children with ASD determined using the Frankl scale. Materials and methods: An anonymous questionnaire was administered to 20 pairs of parents of children in which they were asked to evaluate any behavioral changes and/or difficulties encountered at the beginning of orthodontic treatment as well as their degree of satisfaction with the level of information received from medical personnel. Results: In about half of the sample, there were behavioral changes and difficulties in managing the treatment. Most of the responses received indicated parental satisfaction both with regard to the emotional impact on the children with respect to the introduction of the treatment and with regard to the attention received from the medical staff. Furthermore, there was a statistically significant increase (p = 0.001) in the Frankl scale score after treatment. Conclusions: Home management, which has always been the most difficult obstacle to overcome, with the support of a competent team can not only improve the quality of life of patients affected by ASD but also improve their collaboration and state of oral health without altering their emotionality.

Elastodontic Therapy with Oral Bioactivator Devices: A Review

Scientific studies have shown that dysfunctional problems associated with dysmorphisms are the base of malocclusion. The position of the mouth and the head is a component of the general postural arrangement, so any head misalignment creates disharmonies and tensions among the neck muscles. Elastodontics is a treatment based on the use of removable elastomeric devices. These functional appliances are made of elastomeric material, acting tridimensionally on a neuromuscular system with orthopaedic and dental effects. Bioactivators have a vestibular and lingual flange with a free central area that permits them to position teeth without constraints. The flanges are linked by an occlusal plane that maintains the two skeletal bases and teeth in first-class normocclusion with propulsive and retropulsive effects on the maxilla and mandible. Elastomeric devices are generally well tolerated by patients requiring simple collaboration and management. This review aim is to describe the indications and limits of orthodontic therapy with elastomeric devices to provide an overview of elastodontics.

Full mouth rehabilitation of young adults with oligodontia: Two case reports emphasizing implantology, prosthodontics, and restorative intervention

Oligodontia, a severe form of hypodontia characterized by the absence of multiple permanent teeth, presents considerable challenges in dental treatment. Successful management of this condition requires early detection and a comprehensive, multidisciplinary approach. While the complete restoration of missing teeth is typically postponed until all permanent teeth have erupted or after orthodontic therapy, it is crucial to consider additional factors such as the patient's oral hygiene status, socioeconomic circumstances, and long-term maintenance therapy for achieving optimal treatment outcomes. This case reports showcase the effective treatment of oligodontia in two young male patients: a 17-year-old Chinese individual and a 19-year-old Caucasian individual. These cases serve to emphasize the significance of early diagnosis, multidisciplinary collaboration, and personalized treatment planning in addressing the challenges posed by oligodontia. Although orthodontic intervention was not pursued in the presented cases, it is important to recognize its integral role in the overall treatment of oligodontia. The restoration of missing dentition has a profound positive impact on aesthetics, function, and the overall quality of life. The presented cases underscore the importance of early intervention and sustained motivation throughout the treatment process. By emphasizing the value of early detection, comprehensive teamwork, and individualized treatment approaches, clinicians can strive to achieve optimal outcomes for patients with oligodontia.

Effect of carbonated hydroxyapatite synthesis from cuttlefish shells on orthodontic relapse prevention: in silico study

Background: Relapse occurs frequently, 70–90% of the time, and typically compromises the outcome of orthodontic therapy. Calcium carbonate (CaCO3), which is found in cuttlefish shells, can be used to make a better biomaterial. One example is carbonated hydroxyapatite, which is very similar to human bone tissue and can stop osteoclast activity on the pressure side of the retention phase. This is a factor in orthodontic relapse, which is when the bone doesn't remodel properly. In this study, a test was done to see if carbonated hydroxyapatite (CHA) could be used as an alternative material to stop orthodontic relapse. The test was based on how the RANK-RANKL, OPG, and TGF-β proteins interacted with each other.&#x0D; Method: CHA extracted from cuttlefish shells after 6 hours of calcination at 1000°C. RANK-RANKL, OPG, and TGF-β interactions were investigated in silico using molecular docking. &#x0D; Result: A cuttlefish shell extract containing CHA has the potential to be used as an alternate material to prevent orthodontic recurrence. CHA chemicals can disrupt the link between RANK and RANKL and enhance OPG and TGF-β expression. This induces enhanced proliferation, which increases the number of osteoblasts and osteoblast differentiation while decreasing the rate of osteoclast activity.&#x0D; Conclusion: Cuttlefish shell with CHA extract has the potential to be used as an alternative material to prevent orthodontic relapse.

Impact of malocclusion of oral health related quality of life among 13-18 years visiting dental hospital

Malocclusion is one of the most significant factors affecting oral health, and it is significant not only for financial and physical comfort but also for quality of life (QoL) by impairing appearance, interpersonal connections, function, self-confidence, socializing, and psychological well-being. Objectives: This study was piloted to evaluate OHRQoL in children between the ages of 13 and 18 who were seeking orthodontic treatment at Abbottabad International Medical and Dental College, Abbottabad and to determine the relationship between the need for orthodontic management, gender, age and OHRQoL. Methodology: A descriptive cross-sectional study using a questionnaire was done among 900 young individuals, ages 13 to 18, who visited the department of orthodontics. The OASIS survey was completed by the participants. All patients aged 13 to 18 who reported for treatment at the orthodontic department between January 2023 till June 2023 were included while those having a history of jaw trauma, those who are undergoing orthodontic therapy, and those who have undergone orthodontic treatment were omitted from the study.

Morphometric evaluation of alveolar bone after orthodontic treatment of multiple impacted teeth in the unilateral maxillary anterior region

This study aimed to investigate the height and thickness of alveolar bone by cone-beam computed tomography imaging after orthodontic treatment in the unilateral maxillary anterior region and speculate on reasons for the difference in alveolar bone morphology. This study selected 11 patients (3 males and 8 females; mean age, 9.42 ± 1.45 years). Cone-beam computed tomography was performed for these 11 patients before and after treatment using Dolphin Imaging software (Dolphin Imaging and Management Solutions, Chatsworth, Calif). Labial and palatal alveolar bone thickness (BT) at root apices and different levels along the roots and loss of alveolar bone height was measured for each impacted tooth and its contralateral homonymous tooth. After orthodontic therapy, all 3 impacted anterior teeth had different degrees of loss of labial alveolar bone height compared with the normal side (central incisor: -1.5 mm, P<0.005; lateral incisor: -1.06 mm, P<0.01; canine: -0.59 mm, P< 0.01). The lateral incisors also showed palatal alveolar bone height loss compared with the unaffected side (-0.8 mm, P<0.005). Alveolar BT at root apices of impacted canines was 1.14 mm thicker than the normal side (P<0.005). Central and lateral incisors were similar to the normal side. The thickness of the alveolar bone at 8, 10, and 12 mm of the impacted canine position was still larger than that on the healthy side, whereas the difference in average thickness between the healthy and affected side had been significantly reduced compared with pretreatment measurements. There is satisfactory retention of alveolar bone height in canines after orthodontic treatment; however, alveolar bone loss is slightly worse at central and lateral incisors. Retention of alveolar BT was normal for impacted anterior teeth, whereas excess apical alveolar BT at the canines, although still present, was substantially less significant than had been observed before treatment.

Pre-eruptive intracoronal resorption in orthodontic patients: A retrospective analysis of 3,143 patients

ObjectivesThe aim of this retrospective study was to analyze the occurrence and characteristics of pre-eruptive intracoronal resorptions in a clinical orthodontic patient population. Materials and methodsPatients treated in an orthodontic department (University of Pécs, Pécs, Hungary) were included. Unerupted teeth on panoramic radiographs were analyzed for intracoronal radiolucent lesions. For each patient, the demographic data, jaw localization, number of unerupted teeth with pre-eruptive intracoronal resorption lesions, number of lesions per tooth, size and localization of pre-eruptive intracoronal resorption defects, affected tooth's surface, pulp involvement and ectopic position of the tooth with defects were recorded. ResultsIn the 3,143 patients investigated, 55 teeth in 49 patients showed pre-eruptive intracoronal resorption lesions (subject incidence: 1.56%). The incidence on unerupted teeth was 0.25%. Pre-eruptive intracoronal resorption was significantly more common in mandibles (43 mandibular vs. 12 maxillary lesions) with an odds ratio of 12.84 (95% Confidence Interval: 5.19–31.74) and no gender differences were found (p = 0.746). The occurrence of pre-eruptive intracoronal resorption was highest in the youngest (7–10 years) mixed dentition status group (p < 0.001). Most of the lesions (44 of 55, or 80.0%) were localized in the dentin, occupying two-third or less of the dentin thickness. Only 12.73% (7/55) of the lesions were not localized on the occlusal surface. Of the lesions, 89.1% (49/55) showed no obvious size increase over an average follow-up of 36.4 ± 8.1 months. ConclusionsPre-eruptive intracoronal resorption may occur mainly in the mixed dentition stage in orthodontic patients. Careful and attentive radiographic evaluations may facilitate early detection and follow-up of the lesions’ possible dimensional changes, especially when resorption influences orthodontic extraction therapy.

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

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

Comparison of self-rated pain and salivary alpha-amylase and cortisol levels during early stages of fixed orthodontic and clear aligner therapy

Objectives To compare self-rated orthodontic pain (OP) and whole salivary alpha-amylase (αA) and cortisol levels (CL) during early stages of fixed orthodontic and clear aligner therapy (CAT). Methods In groups 1 and 2, malocclusions were treated using fixed orthodontic appliances and CAT, respectively. In Group-3, individuals had normal occlusion and had never undergone orthodontic therapy. Self-rated OP was assessed using the visual-analogue-scale at baseline (T0); after 24-hours (T1) of appliance activation; and after 30 days (T2). Unstimulated whole saliva was collected and αA and CL were measured using enzyme-linked immunosorbent assay. p < .01 was considered statistically significant. Results Twenty-four (Group-1), 24(Group-2) and 25 (Group-3) patients were included. In groups 1 and 2, participants had Class-I malocclusion with anterior-crowding in both arches. At baseline (T0) none of the participants reported pain on mastication. In groups 1 (p < .01) and 2 (p < .01), OP was higher at T1 than T2. In groups 1 and 2, αA and CL were higher at T1 (p < .01) than T0 and T2. At T1 and T2, salivary αA and CL were higher in groups 1 (p < .01) and 2 (p < .01) than Group-3. In groups 1 and 2, a significant correlation was recorded between OP and αA (p < .01) and CL (p < .01) at T1 interval. Conclusion Self-rated OP and salivary αA and CL during the early stages of fixed OT and CAT are similar. Whole salivary αA and CL and OP and are high during the first 24 hours of fixed OT and CAT activation.

The Validity and Reliability of Automatic Tooth Segmentation Generated Using Artificial Intelligence.

This study aimed at evaluating the precision of the segmented tooth model (STM) that was produced by the artificial intelligence (AI) program (CephX®) with an intraoral scan (IOS) and insignia outcomes. Methods. 10 patients with Cl I malocclusion (mild-to-moderate crowding) who underwent nonextraction orthodontic therapy with the Insignia™ system had IOS and CBCT scans taken before treatment. AI was used to produce a total of 280 STMs; each tooth will be measured from three aspects (apexo-occlusal, mesiodistal, and labiolingual) for DICOM and STL formats. Also, root volume measurements for each tooth generated by using the CephX® software and Insignia™ system were compared. The software used for these measurements was the OnDemand3D program used for the multiplanar reconstruction for DICOM format and Geomagic® Control X™ used for STL format. Statistics. An intraclass correlation (ICC) analysis was used to check the agreement between the volume measurement of the segmented teeth generated by using the CephX® and Insignia™ system. Also, it was used to check the agreement between the STL (IOS), STL (CephX®), and DICOM tooth models. In addition, it was used to determine the intraexaminer repeatability by remeasuring five randomly selected individuals two weeks after the initial measurement. After confirmation of the data normality using the Shapiro-Wilk test, the right and left tooth models and the differences between the DICOM, CephX® (STL), and IOS (STL) tooth models were compared using a paired t-test. The STL (IOS), STL (CephX®), and DICOM tooth models were compared utilizing the ANOVA test. p < 0.05 was set as the statistical significance level. Result. Overall data showed good agreement with ICC. The measurements of the various tooth types on the right and left sides did not differ significantly. Also, there was no significant difference between the three groups. Conclusions. The automatic AI approach (CephX®) may be advised in the clinical practice for patients with mild crowding and no teeth restorations due to its speed and effectiveness.

The Effects and Mechanisms of PBM Therapy in Accelerating Orthodontic Tooth Movement.

Malocclusion is one of the three major diseases, the incidence of which could reach 56% of the imperiled oral and systemic health in the world today. Orthodontics is still the primary method to solve the problem. However, it is clear that many orthodontic complications are associated with courses of long-term therapy. Photobiomodulation (PBM) therapy could be used as a popular way to shorten the course of orthodontic treatment by nearly 26% to 40%. In this review, the efficacy in cells and animals, mechanisms, relevant cytokines and signaling, clinical trials and applications, and the future developments of PBM therapy in orthodontics were evaluated to demonstrate its validity. Simultaneously, based on orthodontic mechanisms and present findings, the mechanisms of acceleration of orthodontic tooth movement (OTM) caused by PBM therapy were explored in relation to four aspects, including blood vessels, inflammatory response, collagen and fibers, and mineralized tissues. Also, the cooperative effects and clinical translation of PBM therapy in orthodontics have been explored in a growing numbers of studies. Up to now, PBM therapy has been gaining popularity for its non-invasive nature, easy operation, and painless procedures. However, the validity and exact mechanism of PBM therapy as an adjuvant treatment in orthodontics have not been fully elucidated. Therefore, this review summarizes the efficacy of PBM therapy on the acceleration of OTM comprehensively from various aspects and was designed to provide an evidence-based platform for the research and development of light-related orthodontic tooth movement acceleration devices.

The Need for Orthodontic Therapy forChildren and Adolescents in the Health Center Mostar According to the IOTN Index

The Need for Orthodontic Therapy forChildren and Adolescents in the Health Center Mostar According to the IOTN Index

Assessment of Soft Tissue, Airway Dimension and Hyoid Bone Position in Class II Patients Treated by PowerScope Class 2 Corrector.

This study aims to assess the changes in the soft tissue, pharyngeal airway dimensions, and hyoid bone position in patients treated with PowerScope Class 2 corrector to correct the skeletal Class II pattern. This study was conducted on a sample of 20 cases diagnosed with Class II malocclusion. The lateral cephalograms were taken before (T1) and after functional appliance therapy (T2) and were traced. The outcomes were compared for the mean changes in soft tissue, airway way dimension, and hyoid bone position. The paired t-test was used for the data comparisons wherein p < 0.05 was kept for statistical significance. The mean values before and after treatment for H angle, mentolabial angle, lower lip E-line, upper lip S-line, lower lip S-line, and lip strain were 19.88 ± 2.77 vs 17.13 ± 1.659, 94.09 ± 12.164 vs 101.75 ± 11.28, -2.47 ± 1.213 vs -1.38 ± 0.976, 3.99 ± 0.19 vs 2.64 ± 0.32, 9.01 ± 0.247 vs 9.43 ± 0.238, 10.24 ± 0.510 vs 10.64 ± 0.52, respectively, which were statistically significant (p < 0.05). All airway spaces (except for lower pharyngeal space) and hyoid bone parameters were significantly improved posttreatment. The facial convexity, upper E-line, Z-angle, nasolabial angle, and lower pharyngeal space did not show statistically significant changes. The rest of the soft tissue parameters, oropharyngeal air spaces, and hyoid positioning measured in the study showed significant improvement after treatment with the PowerScope appliance in Class II patients. Class II malocclusion is the most common dental anomaly with a high degree of prevalence in the population. This study will help the clinician in understanding the improvement of soft tissue, airway dimension, and hyoid bone position changes on treatment with a fixed functional appliance for the correction of Class II cases, thereby ensuring the greater success of orthodontic therapy in the future.

Retention using braided bonded wires: a 2-year follow-up of the dentition and oral hygiene with predictors of relapse

Abstract Objective To assess gingival health and predictors of relapse related to braided-wire bonded retainers after the active phase of comprehensive orthodontic treatment. Materials and methods Fifty-one subjects were recruited in a prospective study of whom 42 were available for analysis after 2 years of retention (pre-therapeutic ages 11–18 years; 66% female). A rectangular wire retainer (0.027 × 0.011″) was bonded to the mandibular incisors. Little’s index of incisor irregularity; intercanine width; the accumulation of biofilm, calculus and gingivitis; and the incidence of retainer detachment, were recorded. Subjects were examined before orthodontic therapy, upon therapy completion, and after 2 years of retention. Results The incidence of retainer detachment over the 2 years was 27%. The post-treatment incidence of irregularity was 17%, and intercanine width reduction was 24%. Calculus accumulation increased significantly during retention (p &lt; 0.001) but not the extent of gingivitis. A multiple logistic regression demonstrated that an increase of mandibular intercanine width by ≥3 mm correspondingly increased the odds of relapse 14.3 times (95% confidence interval [CI], 1.1–196.1; p = 0.046). Patients presenting with retainer failure were 10 times (95% CI 1.6–62.8; p = 0.014) more likely to experience relapse. Subjects who experienced relapse had retainer failure earlier than those without relapse (19 vs. 23 months; p = 0.003). The occurence of relapse was not related to a treatment change in incisor irregularity, the duration of treatment, the age of the patient, gender nor to a change of intercanine width during retention. Conclusion Post-treatment changes in the mandibular arch incorporating bonded retainers were not large, but were common. An increase in mandibular incisor irregularity during retention is mostly related to treatment-induced intercanine width expansion. The bonded retainer often detached and increased calculus accumulation.

Assessment of Skeletal Age using Hand-Wrist Radiographs Following BJORK System Sample Size - Prospective Study.

The planning of effective orthodontic therapy greatly benefits from an understanding of the skeletal maturation and stage of growth of the patients seeking orthodontic treatment. However, the patient's various craniofacial structures have varying levels of growth potential. The patient is exposed to additional radiation when hand-wrist radiographs are regularly used to forecast growth. As an alternative, cervical vertebrae in the lateral cephalograph have been suggested. When arranging orthodontic treatment for growing children, it is important to take into account the pubertal growth spurt, which is a crucial time in therapy. Finding out how much growth a patient with skeletal discrepancy would experience during adolescence is one of the key goals of conducting a hand and wrist radiograph.