Part Of Orthodontic Treatment Research Articles

Fracture resistance of CAD/CAM endocrowns made from different materials in maxillary premolar interproximal defects.

This in vitro study aims to compare the fracture resistance of three CAD/CAM materials used in endocrown restoration of interproximal defects in maxillary premolars. 45 maxillary premolars extracted as part of orthodontic treatment were included. Following standardized root canal treatment, all teeth were prepared into Mesial-Occlusal (MO) cavity types. The samples were then randomly divided into three groups: LD [repaired with lithium disilicate glass ceramics (IPS e.max CAD)], VE [treated with polymer-infiltrated ceramics (Vita Enamic)], and LU [repaired with resin-based nanoceramics (Lava Ultimate)]. Axial static loading was applied using a universal testing machine at 1mm/min until fracture, and fracture resistance and failure modes were recorded. Regarding Fracture Resistance Values (FRVs), the LD group exhibited significantly higher values than the other two groups, VE (P = 0.028) and LU (P = 0.005), which showed no significant difference (P = 0.778). On the other hand, regarding failure modes, the LD group had a higher prevalence of irreparable fractures compared to the other two groups, VE (P < 0.001) and LU (P < 0.001), which showed no significant difference. Although lithium disilicate glass ceramics exhibited higher FRVs, they had a lower repair probability. In contrast, polymer-infiltrated ceramics and resin-based nanoceramics contributed to tooth structure preservation. For maxillary premolars with interproximal defects following root canal treatment, resin ceramic composites are recommended for restoration to enhance abutment teeth protection.

Patients’ knowledge and perceptions of interproximal reduction as part of orthodontic treatment in a publicly-funded orthodontic service in the Republic of Ireland

Introduction Extractions for orthodontic reasons are on the decline and interproximal reduction (IPR) has become a popular alternative. No survey has been undertaken to identify patients’ perceptions regarding IPR. Objectives To determine patients’ knowledge and perceptions of having IPR as part of orthodontic treatment. Method A questionnaire was administered to patients receiving orthodontic treatment with IPR in a publicly funded orthodontic service. Information was collected on demographics, knowledge and perceptions of IPR. Results Thirty patients completed the questionnaire. Only 17% were aware of IPR before treatment, but all clearly understood its rationale after explanation. Most (93%) “did not mind” IPR being undertaken, 37% considered it “uncomfortable” and 13% “painful”. All perceived IPR as preferable to extraction. Compared to extraction, IPR was most commonly perceived as less painful, faster, and allowing retention of natural teeth. When asked what patients would tell a friend or family member about IPR, a small number would mention advantages over extraction, speed of the procedure and benefits for treatment. Most would provide reassurance as to the lack of pain and discomfort. Conclusions Although initially unfamiliar with IPR, patients found it easy to understand on explanation and considered it uncomfortable rather than painful. Minimal negative feedback was received and IPR was perceived as preferable to extraction.

Management of children with poor prognosis first permanent molars: an interdisciplinary approach is the key

Although there have been continuous improvements in child oral health over recent decades, first permanent molars (FPMs) remain susceptible to early caries and can often be affected by hypomineralisation. We highlight current thinking in caries management and the restoration of hypomineralised FPMs, while also discussing enforced loss of these teeth within the context of interceptive extractions or extractions as part of orthodontic treatment. Compromised FPMs can negatively impact on quality of life for a child and present significant management challenges for the dental team. Although a high-quality evidence base is lacking for the different treatment options, early diagnosis and multidisciplinary treatment planning are key to achieving the best outcomes.

A Modified C-Palatal Plate as a Skeletal Anchorage Appliance for Efficient Molar Distalization

Many patients and guardians prefer not to have teeth extracted as part of orthodontic treatment. Modified C-Palatal Plates (MCPPs) have been developed as an effective oral appliance. The design and procedure for placing these appliances involve a sequence of steps and specialized instruments such as a miniscrew driver. By understanding the biomechanics associated with MCPP placement, molar positioning can be optimized with less distal tipping and greater distalization. In addition to recognizing the various advantages of MCPPs, the implications of MCPPs should be considered, including the following: how far back the molars need to be moved, the effects of second and third molars in adolescents, the effects in maxillary pneumatization cases, potential impact on the airway, long-term stability, and a comparison of MCPPs to headgear. The purpose of this report is to introduce MCPP as an oral appliance that uses both miniscrews and miniplates to efficiently distalize molars minimizing the need for extraction.

Interdisciplinary orthodontic camouflage treatment with extraction of fractured maxillary central incisor and tooth substitution to treat skeletal bimaxillary protrusion- A case report

Malformed or fractured central incisors with poor prognosis could be the choice of teeth for extraction when space is required for orthodontic treatment. This case report refers to a 14-year-old girl who had a fractured upper left central incisor associated with bimaxillary protrusion. She expressed her concern to correct her dental appearance and enhance her smile aesthetics. The patient had class I malocclusion with bimaxillary proclination and severe crowding in the lower arch. Due to the increased space requirement, extraction of teeth was required as part of orthodontic treatment. Patient had a class 2 skeletal profile with prominent upper front teeth and therefore increased space requirement in the upper arch in order to retract the prominent teeth to achieve favourable aesthetics. The choice of teeth for extraction were 14,34,44 and 21. In the second quadrant the central incisor was extracted due to its poor prognosis, and the lateral incisor, canine and first premolar were substituted for the central incisor, lateral incisor and canine respectively. In the lower dental arch the first premolars were extracted. The end of treatment objectives- class 1 molars, canines, incisors were achieved with greatly improved smile aesthetics. KEYWORDS Interdisciplinary orthodontics, Teeth substitution, Poor prognosis, Incisor extraction.

Canine retraction and anchorage loss using self-ligating and conventional brackets with sliding mechanics: A split-mouth clinical study.

Appliance biocompatibility, orthodontic treatment efficiency and patient convenience are the major issues confronting contemporary orthodontic practice. Very few studies have been published till date regarding the efficiency of self-ligating brackets as against conventional brackets. Hence, the present study was planned to compare the rate of canine retraction between self-ligating and conventional brackets and to determine the amount of anchorage loss during canine retraction. The present clinical study was designed as a prospective, observational study comprising of 25 patients requiring first premolar extraction as a part of orthodontic treatment. Self-ligating and conventional brackets were bonded using a split-mouth study design randomly. Retraction of canines was done with 150 grams of force using Dontrix gauge with E-chains. The study was conducted in relation to upper arch only, while the rate of retraction was evaluated every 4 weeks for 3 months. Average rates of retraction in 3 months were calculated. For anchorage loss, an acrylic guide plug was used in mid-treatment cast (T0) and after 3 months of retraction (T3). The statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 17.0 (SPSS Inc., Chicago, IL, USA). Independent t-test was used to compare the means of the two variables studied, while Pearson's correlation coefficient was used to evaluate the correlation between the variables studied in the groups included. P < .05 was considered statistically significant. The correlation coefficient between the average rate of canine retraction with self-ligating brackets vs. conventional brackets over a period of 3 months came out to be 0.6434, while on comparing the data in terms of anchorage loss over a period of 3 months, the respective correlation coefficient value was found to be 0.6659 with the results being statistically highly significant in either case (P < .001). Self-ligating brackets showed double the amount of displacement compared to conventional brackets in some of the cases. Also, chair side time was significantly reduced with self-ligating brackets as against conventional brackets.

The Effect of Lavender Inhalation on the Pain Perception of Orthodontic Separator Placement: An Open-Label Randomized Controlled Trial

Lavandula angustifolia Mill. (lavender) is known for its antibacterial, muscle relaxant, antispasmodic, sedative, and anesthetic effects, and is also proposed to be used as an analgesic agent. Despite several studies on the analgesic activity of lavender, this is the first experiment in patients with orthodontic pain. This "2-arm parallel" study aims to evaluate the effect of lavender oil inhalation on reducing pain after elastomeric separator placement as a part of orthodontic treatment. Patients who needed elastic separator placement in mesial and distal of first permanent molars of all quadrants prior to their first-ever fixed orthodontic treatment, with the age range of 20 to 24, were randomly assigned to one of the two study groups: lavender oil and sesame oil. Participants had to breathe in their medication for 2 minutes just before separator insertion, as well as 4, 8, 12, 24, 36, and 48 h afterward. A visual analog scale (VAS) was used to measure the level of pain during three oral situations, including rest, fitting posterior teeth, and chewing at the following periods: just before separator placement (T0), immediately after insertion (T1), 3 h post-insertion (T2), 12 h post-(T3), 24 insertion h post-insertion (T4), and 48 h after separator placement (T5). The current study indicated the effectiveness of lavender oil inhalation in reducing pain perception while chewing 48 h after elastic separator placement. The pain level in lavender inhalation was lower from 12 h to 48 h after separator insertion, although not considerable, indicating the probability of its effectiveness on delayed responses to orthodontic pain.

A qualitative evaluation of attitudes toward extractions among primary care orthodontists in Great Britain

The need to extract permanent teeth as part of orthodontic treatment has been keenly debated over many decades. Changes in the frequency of extraction have been well documented; however, we continue to lack an understanding of what influences clinicians' decisions regarding extracting permanent teeth. Purposive sampling was undertaken to obtain representative views from primary care practitioners across Great Britain with a range of experience representing genders and wide geographic distribution. Twenty participants (9 female, 11 male) took part in in-depth, qualitative, 1-to-1 interviews based on a piloted topic guide. Interviews were conducted via video conferencing software with audio recording and verbatim transcription. Thematic analysis was performed with discussion and agreement to identify the main themes. Five main themes were identified: (1) patient-related factors, such as age and features of the malocclusion, (2) operator factors, including the level of experience, (3) setting, with regard to geographic location and method of remuneration, (4) mechanical approaches, including variations in appliance systems; and (5) self-directed ongoing education, including both formal continuing professional development and informal learning from peers. These factors acted as barriers, enablers, or both in relation to nonextraction treatment. Five key influences on extraction decisions among orthodontists in Great Britain were identified. Extraction choices appear to be influenced by various interrelated factors, evolving over time and with increased experience.

Labial frenectomy: current clinical practice of orthodontists in the United Kingdom

To obtain views of orthodontists in the United Kingdom on frenectomy in terms of its indications and timing and a recommended retention regimen after correction of median diastema. A 14-item online questionnaire was sent to orthodontic specialists for completion. The questionnaire covered demographics and orthodontists' experience and views on frenectomy. Three hundred and fifty-three orthodontists with various background and experience responded to the survey. Three-quarters of respondents routinely performed a blanche test to aid diagnosis of the abnormal frenum; however, only 15% carried out radiographic investigation. Three-quarters of the orthodontists would consider frenectomy as a part of orthodontic treatment, and variation existed among the clinicians in terms of its timing. Frenectomy without orthodontic treatment was not preferred. There was much variation in the retention regimen after diastema closure regardless of frenectomy. Complete consensus among the orthodontists was not obtained; however, some agreement was found regarding the development of a logical diagnosis and treatment approach. High-quality studies are required to produce national protocols or UK guidelines.

Physical properties of root cementum: Part 28. Effects of high and low water fluoridation on orthodontic root resorption: A microcomputed tomography study

Transient inflammatory surface resorption, referred to as orthodontic induced inflammatory root resorption (OIIRR), is an iatrogenic consequence of orthodontic tooth movement. Systemic fluoride has been associated with a reduction of OIIRR. This study aimed to investigate the effects of water fluoridation levels on OIIRR in a clinically applicable human orthodontic model. Twenty-eight patients who required bilateral maxillary first premolar extraction as part of orthodontic treatment were selected from 2 cities with high and low water fluoridation of ≥2 ppm and≤0.05 ppm, respectively. Patients were separated into high fluoride (HF) and low fluoride (LF) groups on the basis of water fluoridation levels. Bilateral maxillary first premolar teeth were subjected to 150 g of buccal tipping forces for 12 weeks with reactivation every 4 weeks. Teeth were extracted at the end of 12 weeks. Root resorption crater volume was determined using microcomputed tomography and 3-dimensional reconstruction. HF group showed significantly less mean root resorption volume on the palatal root surface when compared with the LF group (P= 0.025). This difference was specifically displayed at palatal apical regions (P= 0.041). When root resorption volumes from the zones of orthodontic pressure (buccal cervical, palatal apical) were combined, the mean difference between HF and LF groups was statistically significant (P= 0.045). Findings of the present study indicated a positive correlation between water fluoridation and the reduction of OIIRR, especially at the zones of orthodontic pressure, using a clinically relevant human orthodontic model.

Knowledge and awareness regarding uses of extracted natural tooth in clinical practice.

Restoration of aesthetics is one the major patients' concern in dentistry which may be disrupted due to tooth-loss secondary to trauma, or as part of orthodontic treatment or periodontal problem. A number of treatment options are available for the replacement of teeth, but they may be expensive, and time-consuming, involving artificial teeth. For immediate tooth replacement, patient's own intentionally extracted or unintentionally avulsed tooth maybe used. The current narrative review was planned to discuss various techniques for the use of natural tooth pontic, which preserves the original contours, size and colour of the replaced tooth. Before using these teeth in a prosthesis, they need to be thoroughly disinfected and stored in appropriate medium according to the global guidelines. This reversible option would boost patient's confidence, preserve natural tooth anatomy and improve patient's acceptance.

Changes in head posture after rapid palatal expansion in mouth-breathing children.

Abstract Introduction. It is well known that previously has been demonstrated a correlation between respiratory function and the harmonious craniofacial development and head posture respectively. Aim of the study. The purpose of this study was to investigate the correlation between rapid maxillary expansion (RME) and the change in natural head position (NHP) resulting from the consequent change in airway resistance and to elucidate how RME influences NHP in terms of cephalometric angles in children with nasal obstruction. Material and methods. The study included 12 girls and 8 boys who had a history of mouth breathing, as confirmed by the parents and ORL specialist and due to this fact, they underwent RME as part of orthodontic treatment. Dental casts, clinical photographs and lateral skull radiographs exposed in natural head position were obtained at the first visit (T1) and 8-10 months (T2) later for all subjects. In order to evaluate the patient’s lateral skull radiographs, I used AudaxCeph software, within which I created a new type of analysis. Student T test and Pearson correlation test were used to statistically analyze the results. Results. Our findings demonstrate that no significant changes in any of the variables are observed in patients treated with rapid maxillary expansion, however a positive correlation was observed in the variables measured before and after the treatment, respectively between the anomaly and the measured values. Positivity can also be detected when examining the correlation between the patient’s gender and the measured values. Conclusions. Based on the obtained results, we cannot state that there is a correlation between rapid maxillary expansion and cervical posture.

The effect of 12\u2009weeks of mechanical vibration on root resorption: a micro-CT study

ObjectiveThe aim was to investigate the effect of mechanical vibration on root resorption with or without orthodontic force application.Material and methodsTwenty patients who required maxillary premolar extractions as part of orthodontic treatment were randomly divided into two groups of 10: no-force group and force group. Using a split-mouth procedure, each patient’s maxillary first premolar teeth were randomly assigned as either vibration or control side for both groups. A buccally directed vibration of 50 Hz, with an Oral-B HummingBird device, was applied to the maxillary first premolar for 10 min/day for 12 weeks. After the force application period, the maxillary first premolars were extracted and scanned with micro-computed tomography. Fiji (ImageJ), performing slice-by-slice quantitative volumetric measurements, was used for resorption crater calculation. Total crater volumes were compared with the Wilcoxon and Mann–Whitney U tests.ResultsThe total crater volumes in the force and no-force groups were 0.476 mm3 and 0.017 mm3 on the vibration side and 0.462 mm3 and 0.031 mm3 on the control side, respectively. There was no statistical difference between the vibration and control sides (P > 0.05). There was more resorption by volume in the force group when compared to the no-force group (P < 0.05).ConclusionMechanical vibration did not have a beneficial effect on reducing root resorption; however, force application caused significant root resorption.

Effectiveness of Various Remineralizing Agents on White Spot Lesions after Orthodontic Treatment: A Comparative Study

To evaluate and compare the ability of three commercially available remineralizing agents on the surface microhardness (SMH) of enamel after induction of white spot lesions (WSLs) by demineralization. About 80 sound mandibular human premolars that were later removed as a part of orthodontic treatment were employed in this research under the inclusion criteria. After cleaning and disinfecting the teeth, their crowns were mounted in acrylic resin and painted with nail varnish, not including a 3 mm × 3 mm window in the middle of the buccal surface. Each tooth was soaked in 15 mL of a demineralizing solution at a pH of 4.5 that was prepared for this study and left in a place for 10 subsequent days to permit the formation of WSLs after which the SMH was again assessed. The premolar teeth were then randomly allocated and equally divided into one of the four groups of 20 each depending on the treatment they received as Group 1: control group, Group 2: Colgate sensitive Pro-Relief toothpaste group, Group 3: Amflor group, and Group 4: Enafix group. After 15 days, the microhardness of all samples was estimated and alterations in the same were noted. Scanning electron microscopy (SEM) was used to evaluate the surface morphology. Enhanced and highest mean SMH was present in the Colgate sensitive Pro-Relief group (53.26 ± 0.10) followed by Enafix group (47.72 ± 0.21), Amflor group (44.84 ± 0.66), and control group (39.52 ± 0.32), respectively after application of remineralizing agents. Except for Group 3 vs Group 4, statistically significant differences (p < 0.05) were noted in all the groups. All the three agents employed in this study, that is, Colgate sensitive Pro-Relief toothpaste, Amflor, and Enafix improved the SMH of teeth after the therapy given over 15 days compared to the microhardness following demineralization. White spot lesions often occur on labial surfaces of teeth after orthodontic treatment. Hence, these lesions pose esthetic challenges thereby affecting treatment satisfaction perceived by the patient. As esthetics and appearance are of foremost significance after orthodontic treatment, elimination protocols for remineralization of WSLs are of utmost importance employing economic means. How to cite this article: Nalawade VA, Jeri SY, Dash BP, et al. Effectiveness of Various Remineralizing Agents on White Spot Lesions after Orthodontic Treatment: A Comparative Study. J Contemp Dent Pract 2021;22(5):545-548.

Heat shock protein 70 and the extent of nuclear damage in periodontal ligament compression side cells with orthodontic force application – An ex-vivo evaluation

Increased levels of heat shock proteins after several types of stress play a central role in cellular homeostasis allowing for continued cell survival. This study was aimed at quantitatively analysing the expression pattern of major damage associated molecular patterns (DAMPs)-HSP70, and the amount of nuclear damage incident in periodontal ligament compression side cells. Sixteen subjects with bimaxillary dentoalveolar protrusion requiring extraction of all first premolars as part of orthodontic treatment were selected. Extractions were carried out pretreatment from control group. In the experimental group, a buccally directed spring, with force range of 70-120gms promoting bodily movement of maxillary first premolars was placed. Periodontal ligament was scraped from the middle third of the root from the compression side, the cells were isolated and cultured followed by HSP70 protein estimation with western blot analysis and the extend of nuclear damage was assessed with COMET assay. Western Blot analysis of HSP70 revealed a statistically significant increased expression of HSP70 (P<0.05; CI=95%) in the force applied group compared with the control group. COMET assay could demonstrate significant amount of nuclear fragmentation in the compression side periodontal ligament cells in comparison to control group (P<0.05; CI=95%). All these findings demonstrated, for the first time, that orthodontic force application augments release of HSP70 from periodontal ligament cells as a measure to restore tissue homeostasis. Further the study demonstrated that orthodontic forces induce DNA fragmentation, which is quantified more than double the amount observed in the control group.

Orthodontic bonding to atypical tooth surfaces

Orthodontic bonding techniques continue to evolve with the ever-changing population. With the demand for orthodontic treatment increasing, the specialty is regularly presented with restored dentitions, anterior crowns, bleached teeth, as well as those presenting with developmental conditions, such as fluorosis and amelogenesis imperfecta. Reduced orthodontic bond strength can lead to failure of the appliance and in turn lead to prolonged treatment times and patient dissatisfaction. This article aims to summarize the recommended methods for bonding and give an updated review of optimizing techniques. CPD/Clinical Relevance: Adequate bracket bond strength is an essential part of orthodontic treatment, to prevent breakages and reduce treatment time and risk factors.

Comparative Evaluation of Pulpal Response to Tri-antibiotic Paste and Allium Sativum with Formacresol as Pulpotomy Medication in Primary Teeth:An in vivo Study

Background:-To evaluate and compare Pulpal Response to Tri-antibiotic Paste and Allium Sativum with Formacresol as Pulpotomy Medication in Primary Teeth. Materials and Methods:-30 children in age group 7-9 years have bilateral primary teeth indicated for orthodontic serial extraction .children divided into two groups, (group I) included(15) children had bilateral primary teeth, the right side tooth treated with tri-antibiotic past (3 mix) (group IA) and left side tooth treated by formacresol (group IB) and (group II) included (15) children had bilateral primary teeth, the right side tooth treated with allium sativum oil (A. sativum) (group IIA) and left side tooth treated by formacresol (group IIB) . Each tooth was treated with standard pulpotomy procedure. . Patients were recalled after 15 and 30 days’ time interval as a part of orthodontic treatment. Teeth in each group were extracted and were subjected to decalcification procedure for histopathological evaluation. Results:- In group(I A) Nearly normal pulpal architecture was observed. Another finding common to all experimental groups was the presence of inflammatory processes of different levels of severity. Moderate amount of inflammatory cell infiltration was noted about 50-60% in cases after 15 and 30 days. In addition the results of group (IB), (IIB) there was pulpal inflammation was prominently observed in all cases treated with formacresol. After 15 days about 33.3% of cases showed severe inflammation with lymphocytes and foamy macrophages while 66.6% showed moderate inflammatory infiltration. By the end of 14 days cases with severe pulpal inflammation were about 46.6%. Also, in group (IIA) there was pulpal inflammation was prominently observed in all cases treated with formacresol. After 15 days about 33.3% of cases showed severe inflammation with lymphocytes and foamy macrophages while 66.6% showed moderate inflammatory infiltration. By the end of 30 days cases with severe pulpal inflammation were about 46.6%.Conclusion:- 1-Odontoblast remained vital in most cases treated with Both Tri-antibiotic paste and A. sativum . 2-Interal root resorption found in most specimens treated with formacresol .Recommendations: Further clinical studies with long time evaluation periods should be done to investigate the effects of the three medicament on pulp tissues of primary teeth .

Interceptive extractions for first permanent molars: a clinical protocol.

Treatment planning for compromised first permanent molars (FPM) can be difficult. In this paper, we present a clinical protocol to support decision-making. Interceptive loss of an FPM should be considered: where the restoration required to repair the compromised FPM is likely to be large; if the FPM is compromised because of molar-incisor hypomineralisation (MIH); where orthodontics requiring loss of tooth units is planned; or if third permanent molars (TPM) are present. Planning requires careful assessment of the prognosis of the FPM and 8-10 years is the ideal age to do this. If the prognosis is uncertain, the decision of whether or not to extract can be influenced by the presence or absence of the TPM. If the decision to extract the FPM is made, timing is dependent on whether or not extractions will be required as part of orthodontic treatment.

How Many Teeth are Extracted as Part of Orthodontic Treatment? A Survey of 2038 UK Residents

How Many Teeth are Extracted as Part of Orthodontic Treatment? A Survey of 2038 UK Residents

Histopathological Evaluation of Dental Pulp of Primary Teeth Pulpotomized with Formocresol with/without a Capping Agent: A Randomized Clinical Trial.

Objectives:This study aimed to assess the reaction of dental pulp of pulpotomized teeth with/without applying a capping agent. This study was performed as randomized clinical trial.Materials and Methods:This split-mouth clinical trial was conducted on eight pairs of primary canine teeth scheduled for extraction as part of orthodontic treatment. The teeth were randomly assigned to the intervention and control groups. In the intervention group, canine teeth were restored with amalgam after pulpotomy with formocresol. In the control group, zinc oxide eugenol paste was applied as the capping agent after pulpotomy with formocresol, and the teeth were then restored with amalgam. After 1 month, the teeth were extracted in both groups and stained with hematoxylin and eosin for histological analysis. Pulp reaction was assessed in terms of pathological parameters. Data were analyzed using the Mann–Whitney U-test and Fisher's exact test. The statistical analysis software was SPSS 16.Results:No significant difference was found between the two groups in terms of inflammation, vitality, internal resorption, bleeding, presence of osteoclasts and dentinoclasts, and internal regeneration. Dentinal bridge did not form in any group.Conclusion:According to the results of this study, formocresol pulpotomy of primary teeth can be completed without the application of a capping agent.