Placement Of Orthodontic Appliances Research Articles

PAOO Technique for The Bimaxillary Protrusion: A Case Report

Background: Bimaxillary protrusion is a common malocclusion that can lead to functional and aesthetic issues. Conventional orthodontic treatment may not always be effective, and surgical approaches can be invasive. The Periodontally Accelerated Osteogenic Orthodontics (PAOO) technique is a minimally invasive alternative that involves corticotomy and orthodontic treatment. Objective: This case report aimed to evaluate the effectiveness of the PAOO technique for the correction of bimaxillary protrusion in a 16-year-old female patient. Methods: The PAOO technique involved corticotomy and piezocision on a 16-year-old female patient undergoing orthodontic treatment with a fixed appliance. The patient was being followed up for 18 months after orthodontic appliance placement with premolars extractions but did not get any favorable result and was referred by the Department of Orthodontics to undergo corticotomy procedure. The effectiveness of the treatment was evaluated using cephalometric and occlusal analyses. Results: The PAOO technique significantly improved the patient’s skeletal and dental parameters. The maxillary and mandibular incisors were retracted, resulting in a significant improvement in the patient’s profile. The occlusal analysis showed good intercuspation and a stable occlusion. Conclusion: The PAOO technique is a viable option for the correction of bimaxillary protrusion, as it can achieve significant improvements in skeletal and dental parameters with minimal invasiveness. Further studies are needed to validate these findings and compare the PAOO technique with conventional surgical and orthodontic approaches.

Nanocurcumin Release from Self-Cured Acrylic Resins; Effects on Antimicrobial Action and Flexural Strength.

The placement of orthodontic appliances into the oral area can lead to infection, inflammatory and gingival collapse. Using an antimicrobial and anti-inflammatory material in the matrix of orthodontic appliance may help to reduce these issues. This study aimed to assess the release pattern, the antimicrobial action and the flexural strength of self-cured acrylic resins after adding different weight percentages of curcumin nanoparticles (nanocurcumin). In this in-vitro study, 60 acrylic resin samples were divided into five groups (n = 12) based on the weight percentage of curcumin nanoparticles added to the acrylic powder (0 for control, 0.5, 1, 2.5, and 5%). Then, the dissolution apparatus was used for the release assessment of nanocurcumin form the resins. For antimicrobial action assessment, the disk diffusion method was used and a three-point bending test was performed with a speed of 5 mm/min to determine the flexural strength. Data were analyzed using one-way analysis of variance (ANOVA) and Post-Hoc Tukey tests (with p < 0.05 as significant level). The microscopic images showed the homogeny distribution of nanocuricumin in self-cured acrylic resins in varied concentrations. The release pattern showed a two-step release pattern for all concentrations of nanocurcumin. The one-way ANOVA outcomes indicated that adding curcumin nanoparticles to self-cured resin increased the diameter of the inhibition zones for the groups against Streptococcus mutans (S. mutans) significantly (p < 0.0001). Additionally, as the weight percentage of curcumin nanoparticles increased, the flexural strength decreased (p < 0.0001). However, all strength values were higher than the standard value (50 MPa). No significant difference was detected between the control group and the group with 0.5 percent (p = 0.57). Considering the proper release pattern and the potent antimicrobial activity of curcumin nanoparticles, then the preparing self-cured resins containing curcumin nanoparticles can be beneficial for antimicrobial aims without damaging the flexural strength to use in orthodontic removable applications.

Effects of wearing fixed orthodontic appliance on dynamic balance, reaction time, and pain perception in adolescents and young adult elite athletes

ABTRACT Objective To investigate the effects of using fixed orthodontic appliance on dynamic balance, auditory/visual reaction times, as well as pain perception in adolescent and young adult elite athletes. Methods A total of 34 elite athletes (n = 19 males) aged 16–21 years from different sports (track and field sprint, long jump and discus throw) were randomly allocated to treatment (n = 17) or control (n = 17) groups. The treatment group received self-ligating brackets with 0.04 cm super-elastic nickel-titanium arch wire, placed in the brackets to correct the teeth position. Perceived pain (i.e., visual analogue scale), dynamic balance (i.e., Y balance test), and auditory reaction time and visual reaction time using Direct RT software were assessed before (day−1), and on five occasions after fixed orthodontic appliance placement (day+1, +3, +7, +14, and +30). The two groups’ quantitative data [expressed as mean (standard deviation)] for each occasion were compared using the Student’s t-test. Comparisons of the Y-balance test, auditory reaction time, visual reaction time, and pain visual analogue scale data were each made between the 6 occasions via a factorial A × B analysis of variance in order to check for the possible interaction between the two groups and the (6) consecutive days (occasions). Results Compared to the control group, the treatment group showed significantly (i) lower values of anterior reach for both the dominant ([78(4) vs. 75(3)%, respectively]) and the non-dominant [76(3) vs. 74(4)%, respectively] legs at day+3, and (ii) higher values of pain visual analogue scale at day+1, day+3, and day+7 [0.00(0.00) vs. 4.94(1.25); 0.00(0.00) vs. 4.12(1.17), and 0.00(0.00) vs. 0.41(0.51), respectively). Factorial analysis of variance revealed that only pain visual analogue scale values were different between the two groups at day+1 and day+3. Conclusion FOA induced a high pain level during the first week following its placement in elite athletes.

Impact of fixed orthodontic appliances on blood count and high-sensitivity C-reactive protein levels: A prospective cohort study

The aim was to elucidate the magnitude of alterations in systemic blood counts in healthy patients during the first 14 days after fixed orthodontic appliance placement. This prospective cohort study consecutively included 35 White Caucasian patients starting orthodontic treatment with fixed appliances. The mean age was 24.48 ± 6.68 years. All patients were physically and periodontally healthy. Blood samples were collected at 3 time points: (1) baseline (exactly before the placement of appliances), (2) 5 days after bonding, and (3) 14 days after baseline. Whole blood and erythrocyte sedimentation rates were analyzed in automated hematology and erythrocyte sedimentation rate analyzer. Serum high-sensitivity C-reactive protein levels were measured by the nephelometric method. Standardized sample handling and patient preparation procedures were adopted to reduce preanalytical variability. A total of 105 samples were analyzed. All clinical and orthodontic procedures were performed without complications or side effects during the study period. All laboratory procedures were performed per protocol. Significantly lower white blood cell counts were detected 5 days after bracket bonding, compared with baseline (P<0.05). Hemoglobin levels were lower at 14 days than baseline (P<0.05). No other significant shifts or alteration patterns were observed over time. Orthodontic fixed appliances led to a limited and transient change in white blood cell counts and hemoglobin levels during the first days after bracket placement. The fluctuation of high-sensitivity C-reactive protein levels was not significant, demonstrating a lack of association between systemic inflammation and orthodontic treatment.

Use of liquid-based cytology samples reveals genomic instability and cell death in patients undergoing orthodontic treatment.

To examine the use of liquid-based exfoliative cytology to determine the presence of genomic instability and cell death in the oral mucosa of patients with orthodontic appliances. Fifty-four oral mucosa samples were collected from 18 patients and divided into three stages: T0, before fixation of orthodontic appliances; T1, 25 days after appliance fixation; T2, 90 days after appliance fixation. All samples were Papanicolaou-stained and observed by microscopy (1,000 cells/sample) to ascertain the frequency of micronucleated cells (MN) and nuclear abnormalities (nuclear buds (NB), binucleated (BN), condensed chromatin (CC), karyorrhexis (KR), and karyolysis (KL)). Differences were analyzed statistically using the Mann-Whitney, Wilcoxon, Kruskal-Wallis and chi-squared tests. After placement of orthodontic appliances, significant differences were observed for genomic instability biomarkers (MN and NB) and cell death (CC, KR and KL) (P < 0.05). Female patients and older patients exhibited a higher frequency of MN. Liquid-based cytology has revealed that orthodontic appliances induce genomic instability and cell death in epithelial tissue of the oral mucosa, facilitating sample preservation and yielding more than one preparation per sample. Future studies should investigate whether such cell damage can be reversed through cell repair or whether cell alterations evolve and lead to disease.

Sugar-free chewing gum versus conventional analgesic drugs for pain relief with fixed orthodontic appliances. A systematic review and meta-analysis.

To compare the effect of chewing sugar-free gum towards alleviating self-reported orthodontic treatment (OT) pain compared with conventional analgesic drugs (CADs). An unrestricted search of indexed databases and manual searching was performed up to September 2021. Randomised controlled trials (RCTs) comparing the impact of chewing gum and CADs on relieving self-reported orthodontic pain were included. Data screening, extraction and risk of bias (RoB) assessment were performed by two authors. Meta-analyses were performed using a random-effects model. The quality of available evidence was assessed using the Grades of Recommendation, Assessment, Development and Evaluation approach. Nine RCTs were included. Eight RCTs used the Visual Analogue Scale for self-reported pain assessment, while one RCT used the Numeric Rating Scale. Five RCTs had a high RoB and four RCTs had a moderate RoB. Power analysis for sample size estimation was performed in six RCTs. Separate meta-analyses were performed by pooling quantitative data from five RCTs that compared self-reported orthodontic pain between chewing gum and ibuprofen groups for the following timepoints: baseline; immediately; 2 hours; 6 hours; bedtime; 24 hours; 2 days; 3 days; 5 days; and 7 days after the placement of orthodontic appliances. None of the timepoints individually indicated a difference in self-reported pain scores between chewing sugar-free gum and ibuprofen groups. The overall level of evidence was very low. Chewing sugar-free gum is a potentially useful alternative to CADs towards pain alleviation during fixed OT.

Evaluation of Pain, Dietary Intake, Body Mass Index, and Periodontal Status in Patients Undergoing Fixed Orthodontic Treatment With Bite Raiser.

Background The aim of this study is to evaluate the effect of bite raisers on patients' body mass index (BMI), nutrient intake, periodontal status, and pain experienced during orthodontic treatment. Material and Methods This cohort study included 44 patients aged 18 to 35 years old; undergoing fixed orthodontic treatment. Patients of the intervention group received a composite resin bite raiser (3M Espe, St. Paul, USA)over their first mandibular molars along with fixed orthodontic appliances (slot 0.022 × 0.030", 3M Unitek, Monrovia, Calif), while the control group only received a fixed orthodontic appliance. Pain levels using the visual analog scale (VAS), dietary intake (calories, proteins, carbohydrate, and fat intake), body mass index (BMI), tooth mobility, bleeding on probing (BOP), and pocket depth (PD) were assessed for all patients in the first three months after fixed orthodontic appliance placement. The data were analyzed using SPSS software version 22.0 (IBM Corp, Armonk, NY, USA)at a significance level of 0.05. Results The pain had an increasing and then decreasing significant trend during the study for all patients (P<0.001). Calory intake also had an increasing and then decreasing significant trend for all participants (P=0.007). The consumption of carbohydrates and BMI significantly decreased during the study in both groups of patients (P<0.01) and tooth mobility, BOP, and PD significantly increased for all participants (P<0.001). No significant differences were observed between the intervention and control groups in terms of the above-mentioned variables. Conclusion The application of bite raiser does not influence patients' pain, dietary intake, BMI, and periodontal status. However, fixed orthodontic appliances affect patients' calorie and carbohydrate intake, patients' BMI, and periodontal indexes including tooth mobility, BOP, and PD.

Monitoring orthodontic tooth movement in rats after piezocision by bone scintigraphy.

Piezocision, corticocision of mineralized tissue by ultrasound showed promising results in accelerating tooth movement induced by orthodontic appliances although the biologic effects of this procedure are not well-understood so far. The aim of this study was to investigate the impact of piezocision on bone remodeling in rats by bone SPECT imaging. Ten male Wistar rats underwent surgical placement of orthodontic appliances on each side of the maxilla followed by piezocision on one side only. Each rat underwent 99mTc-MDP bone SPECT/CT imaging before surgery (T0), and 2 (T1) and 4 weeks (T2) after surgery. Bone uptake is expressed as median [IQR] min-max in percentage of the injected activity per ml computed from the 10 voxels with the highest uptake (%IAmax10/ml). Pooled data regardless of the piezocision showed a significant increase in bone uptake from T0 (3.2 [2.8-3.9] 2.6-4.9) to T1 (4.4 [3.8-4.6] 3.4-4.8; p = 0.001). Thereafter, the uptake decreased to T2 (3.8 [3.1-4.4] 2.8-4.8; p = 0.116). No significant differences in bone uptake were found between the maxilla sides without and with piezocision: T1: without (4.3 [3.8-4.5] 3.4-4.8) vs. with (4.5 [3.7-4.6] 3.5-4.7; p=0.285), T2: without (4.0 [3.1-4.5] 2.8-4.8) vs. with (3.7 [3.0-4.4] 2.8-4.8; p=0.062). 99mTc-MDP bone SPECT imaging in rats was able to reproduce changes in bone uptake in the maxilla after placement of orthodontic appliances inducing measurable tooth movement. An additional effect of piezocision on bone remodeling in terms of bone uptake was not detectable which is probably due to the pronounced and significant effects induced by the orthodontic appliances per se, which may mask the potential effects of additional piezocision.

Changes in clinical periodontal parameters after removal of fixed orthodontic appliances

The placement of orthodontic appliances influences plaque growth and maturation. Significant differences in biofilm formation and periodontal reaction between different bracket types and between bonded teeth compared with control teeth have been reported, however, have reported significant attachment loss during orthodontic treatment.In patients with a history of periodontitis resulting in displaced teeth, possible orthodontic tooth movements include changes in alignment, space redistribution, and intrusion.To see the changes in clinical periodontal parameters after removal of fixed orthodontic appliancesAfter debonding of braket at dental clinic and before final polishing, probing depth (PD), plaque index (PI), gingival index (GI) and bleeding on probing (BOP) were assessed on the first molars and central incisors of both arches.Probing depth decreased in the right maxillary first molar. Plaque index and gingival index also got deceased. Bleeding on Probing reduced significantly.Buccal probing depth returned to &amp;#60; 3 mm in the first month and interproximal depth in the second month. The mean gingival index was 0.5 after 2 months. Bleeding on probing in half of the teeth was negative after the first month and in other half in the second month.

Surgical exposure and fix orthondontic combination for maxilla canine impacted treatment

Objective: Teeth that are buried in the jawbone or obstructed by gum tissue and fail to emerge from the typical occlusive surface, causing malocclusion, are known as impacted teeth. Canine teeth are kept for masticatory function strength, aesthetics, and malocclusion repair. Impacted canines can be retrieved using a combination of surgery and fixed orthodontic equipment to restore a normal arch and position Methods: An impacted maxillary left canine caused edema in the palatal area in a 22-year-old female patient at RSKGM-P UNAIR who was referred by orthodontics. The impacted tooth's position was determined using radiography, occlusal projection, and CBCT. The procedures included flap surgery with a full thickness incision, flap opening, orthodontic button insertion on the crown of the buried canine, ligature wire implantation, and flap repositioning and suturing. Results: Combined surgical technique and orthodontic appliance placement on impacted canines can place canines in normal arches and in the space available and in the occlusive position of the teeth, Surgical exposure combined with fixed orthodontic treatment of the affected maxillary surgery on the left maxillary canine was performed. Conclusion: In terms of the ultimate position of the canines in the normal arch and aesthetic appearance, a combination of surgical exposure and fixed orthodontic treatment of the impacted maxillary left canine produced good results.

Does orthognathic treatment improve patients’ psychosocial well-being?

Objective To analyse changes in patients’ psychosocial well-being from before treatment until post-surgical orthodontic treatment (including retention) is completed. Materials and methods Data was collected six times: before treatment (T0), 6–8 weeks after the placement of orthodontic appliances (T2), 3–4 weeks before surgery (T3), six weeks after surgery (T4), one year after surgery (T5) and after completing orthodontic treatment (T6; 20–57 months after surgery). At T0, 60 patients participated while at T6, data was available for 15 patients. All patients completed the Orthognathic Quality of Life Questionnaire (OQLQ), Rosenberg Self-Esteem Questionnaire (RSES), Acceptance and Action Questionnaire II (AAQ-II) and the Symptom Checklist 90 (SCL-90). All pairwise comparisons between variables were conducted with the Wilcoxon signed-rank test. Results OQLQ function, RSES, AAQ-II and SCL GSI worsened from T0 to T2. At T5, improvements compared to T0 were found in all aspects of OQLQ and SCL GSI. When comparing results at T6 to T0, improvements where only found in OQLQ sum, OQLQ facial aesthetics and OQLQ function. Conclusions Although well-being of orthognathic patients seems to improve during treatment, many improvements cannot be verified anymore at the completion of the retention period. Most stable changes are found in the oral function component and in the facial aesthetics component of the OQLQ.

The Effects of Static Magnetic Field on Orthodontic Tooth Movement in Mice.

The application of static magnetic field (SMF) has been considered an effective and noninvasive method to accelerate orthodontic tooth movement. The objective of this study was to explore the effects of SMF on orthodontic tooth movement in mice. A total of 105 Balb/c mice (body mass: 25-30 g) were divided into experimental group (SMF + force, 48), control group (force only, 48), and blank group (neither SMF nor force, 9). After the placement of orthodontic appliances, the experimental group was exposed to the SMF environment generated by Neodymium-iron-boron (NdFeB) magnets with anintensity of 20-204 mT. At 1, 3, 7, 14, 21, and 28 days after appliance insertion, eight animals in both experimental and control groups were sacrificed and the left maxillae were dissected to measure the distance of tooth movement, respectively. Meanwhile, the width of periodontal ligament (PDL), length of hyalinized zone, and the number of osteoclasts were evaluated by hematoxylin-eosin and tartrate-resistant acid phosphatase staining. We finally found that the experimental group demonstrated an enhanced rate and greater cumulative amount of tooth movement than the control group (0.2887 ± 0.0041 mm vs. 0.2114 ± 0.0089 mm, P < 0.05). On Days 7, 14, and 28, the experimental group also displayed a significantly greater width of PDL. Earlier formation and removal of the hyalinized zone, and significantly more osteoclasts were observed in the experimental group as well. The results suggested that SMF may be a promising nonsurgical intervention to accelerate orthodontic tooth movement. © 2021 Bioelectromagnetics Society.

Salivary Metalloproteinase-8 and Metalloproteinase-9 Evaluation in Patients Undergoing Fixed Orthodontic Treatment before and after Periodontal Therapy.

(1) Background: Metalloproteinase-8 (MMP-8) and metalloproteinase-9 (MMP-9) are members of a family of proteases of major importance during orthodontic tooth movement. Their levels increase during orthodontic therapy and in periodontally affected tissues. Orthodontic fixed appliances retain dental plaque and can cause gingival inflammation. When gingival inflammation is present, the forces produced during orthodontic tooth movement can aggravate tissue reaction and cause the destruction of supportive periodontal tissue. This study aimed to identify biomarkers that facilitate the assessment of periodontal status during orthodontic treatment. (2) Methods: Our study was conducted on 111 patients who were about to receive fixed orthodontic treatment. We determined the salivary levels of MMP-8 and MMP-9 and bleeding on probing (BOP) before applying the orthodontic fixed appliance (T1), one week after appliance placement (T2), and during orthodontic treatment, one month after non-surgical periodontal treatment (T3). (3) Results: Patients undergoing orthodontic treatment show a significant increase in BOP, MMP-8, and MMP-9 levels one week after orthodontic appliance placement (T2) and a decrease in these parameters one month after periodontal treatment (T3). Statistically significant correlations were found between MMP-8 levels and BOP values at T1, T2, and T3. (4) Conclusion: In our study patients undergoing orthodontic treatment show a significant increase in BOP, MMP-8, and MMP-9 levels one week after orthodontic appliance placement and a decrease in these parameters one month after periodontal treatment. Strong positive statistically significant correlations were found between MMP-8 levels and BOP and medium positive statistically significant correlations between MMP-9 and BOP values before and after orthodontic treatment and periodontal treatment. MMP-8, MMP-9, and BOP could be used to assess the periodontal status of orthodontic patients.

Salivary microbial changes during the first 6 months of orthodontic treatment.

BackgroundOrthodontic treatment is widely used to treat malocclusion. However, the influence of treatment on the oral microbiome remains unclear. In this study, we investigated salivary microbial changes in patients undergoing orthodontic treatment.MethodsIn total, 19 orthodontic patients participated in this study. Saliva samples were collected at the following three timepoints: before (T0) and 3 months (T1) and 6 months (T2) after the placement of orthodontic appliances. High-throughput sequencing was performed based on the 16S rRNA gene V4 region.ResultsThe phyla of Proteobacteria, Bacteroidetes, Firmicutes, Actinobacteria and Fusobacteria were predominant. Observed Species, Chao1 and ACE, which represent α diversity, were significantly decreased at T1 and subsequently increased at T2. In addition, the β diversity at T1 based on the Bray-Curtis distances differed from T0 and T2. The relative abundances of Prevotella, Porphyromonas and Peptostreptococcus were decreased with treatment, whereas those of Capnocytophaga and Neisseria exhibited the opposite results. In total, 385 of 410 operational taxonomic units were shared at T0, T1 and T2. The co-occurrence networks with hub nodes at T1 were the most complex.ConclusionOrthodontic treatment temporarily affected the saliva microbial community. This dynamic alteration in species did not induce deterioration in oral health. Oral hygiene instructions were necessary and should be emphasized during each visit. Further studies with longer observation periods and more participants are required.

Short-term effects of fixed orthodontic appliance on concentrations of mutans streptococci and persister cells in adolescents

Orthodontic patients are at an increased risk for developing caries. Dental caries is a biofilm-mediated disease, with mutans streptococci (MS) as the primary etiologic bacterial group. It has been suggested that persister cells (PCs), a subset of cells within the biofilm, contribute to the chronic infectious nature of dental caries. PC formation can be induced by environmental stressors such as orthodontic treatment. The aim of this study was to quantify MS, aerobic and facultative anaerobe bacterial PC proportions from plaque samples during the initial stage of orthodontic treatment. This study is the first to analyze the role of PCs in a population of patients highly susceptible to caries, that is, patients undergoing orthodontic treatment. Plaque samples were collected from 17 participants (11 males and 6 females; age range: 11-18years) before and 1month after insertion of fixed orthodontic appliances. Percentages of MS and PCs were determined with selective media and a classical persister microbial assay, respectively. There was a statistically significant decrease in %MS (P=0.039) but no statistically significant difference in %PCs (P=0.939) after 1month of orthodontic appliance placement. Our study illustrated the technical feasibility of analysis of PCs in plaque samples of patients during orthodontic treatment and revealed that PC formation during orthodontic treatment is highly variable across individuals.

THE ROLE OF NEW TECHNOLOGIES IN DEFINING SALIVARY PROTEIN COMPOSITION FOLLOWING PLACEMENT OF FIXED ORTHODONTIC APPLIANCES - BREAKTHROUGH IN THE DEVELOPMENT OF NOVEL DIAGNOSTIC AND THERAPEUTIC PROCEDURES.

SUMMARYHuman saliva is rich in proteins of variable functions (e.g., enzymes, immunoglobulins, cytokines) and origin (blood plasma, salivary glands, or oral microflora). Circadian dynamics, volume and composition (electrolytes, pH, protein, etc.) of secreted saliva vary with local and systemic physiological and pathophysiological conditions. Therefore, the composition of saliva, protein in particular, has been intensively investigated to identify the potential markers and/or mechanisms of systemic and local diseases. Proteomic techniques used for the analysis of biological fluids have enabled great advances in salivary protein stabilization (as the main precondition for their analysis) and detection of those found in saliva in very low concentrations, including small proteins and peptides. This review brings the main characteristics of current proteomic techniques such as liquid chromatography-mass spectrometry, two-dimensional electrophoresis-mass spectrometry, and surface-enhanced laser desorption ionization/time of flight/mass spectrometry. These techniques enable simultaneous identification of hundreds and thousands of protein molecules, as well as identifying those of a potential biological value in particular states. This literature review is focused on the state-of-the-art and possibilities offered by proteomic techniques in analyzing the effects of orthodontic appliances on salivary protein composition and searching for potential markers of therapeutic success/failure or for the molecules by which therapeutic effects are achieved.

Effect of ozone and diode laser (635 nm) in reducing orthodontic pain in the maxillary arch\u2014a randomized clinical controlled trial

The effect of ozone, diode laser irradiation, and presence of teeth crowding/spacing on pain perception in orthodontic patient was tested. Overall, 76 patients [55 women and 21 men; age 35.1(6.4) years] who met the inclusion criteria participated in the study. Immediately after fixed orthodontic appliance placement, the patients were exposed to a pain relief treatment (one single session) using either 635-nm diode laser (SmartM, Lasotronix, Warsaw, Poland) or ozone therapy (OzoneDTA, Apoza, New Taipei City, Taiwan) by placing the handpieces in the area of each teeth apex and interdental papillae, from the maxillary right first molar to the maxillary left first molar. Subjects were divided into three groups: control group (G1, n = 26), ozone (G2, n = 26, exposed to ozone therapy, generator probe type 3, working time per point 5 s, 23 points, application time 1 min and 55 s), and laser group (G3, n = 25, exposed to continuous mode diode laser, 400 mW, handpiece diameter 8 mm, spot area 0.5024 cm2, power density per second 1.59 W/cm2, dose 2 J per point, time: 5 s per point, 23 points, total energy per session 46 J, application time 1 min and 55 s). The level of teeth crowding was assessed using the Lundstrom indicator. The patients received a questionnaire for pain assessment (the Numeric Rating Scale, NRS-11, grade level 0–10) and recorded at 7 time points (1 h, 6 h, and 1, 2, 3, 4, and 5 days ) after the fixed orthodontic appliance placement. The mean pain values for the diode laser, ozone, and control group were 3.6 (1.31) (95% CI, 2.95–4.25), 5.25 (3.37) (95% CI, 3.52–6.98), and 5.75 (2.40) (95% CI, 4.69–6.81), respectively. We observed lower pain values in the diode laser group compared to the control group (p = 0.0237). The use of ozone in this study did not result in significant pain reduction in comparison to control (p = 0.8040) and laser groups (p = 0.1029). There were no differences in pain perception between patients with crowded teeth and non-crowded teeth in each group (G1, p = 0.66, G2, p = 0.86, G3, p = 0.24). The use of 635-nm diode laser led to decreased pain perception; however, ozone and presence of teeth crowding/spacing did not affect the pain perception in orthodontic patients during the first 5 days after the fixed orthodontic appliance placement.

Effectiveness of Enzyme Dentifrices on Oral Health in Orthodontic Patients: A Randomized Controlled Trial.

Plaque accumulation and white spot lesions are common adverse effects of fixed orthodontic appliance use. This study compared the effects between enzyme-containing and conventional dentifrices on orthodontic patients. This double-blind randomized controlled trial included 42 orthodontic patients (25 women and 17 men: 22.7 ± 4.2 years) from Taipei Medical University Hospital between 2017 and 2018. The patients were randomly divided into three groups and assigned to dentifrice use during the first 3 months of the orthodontic treatment: group 1 used dentifrices containing enzymes including amyloglucosidase and glucose oxidase, group 2 used dentifrices containing 1450 ppm fluoride, and group 3 used natural dentifrices containing no chemical agent. White spot lesion index (WSL), gingival bleeding index (GBI), and visible plaque index (VPI) were recorded and analyzed. WSL, GBI, and VPI values exhibited no significant difference among the three groups. WSL increased significantly in group 3, GBI decreased significantly in all groups, and VPI decreased significantly in groups 1 and 2. No significant difference was observed between the use of enzyme-containing and conventional dentifrices after fixed orthodontic appliance placement.

Evaluation of Changes in Cariogenic Bacteria in a Young Moroccan Population with Fixed Orthodontic Appliances.

Fixed orthodontic appliances hinder the maintenance of proper oral hygiene and result in dental plaque accumulation. Many studies report that qualitative changes in the dental flora occur after initiating the orthodontic treatment, but there is a paucity of literature on the same topic among Moroccan orthodontic patients. The aim of this study was to evaluate the changes of the oral microbial flora during the orthodontic treatment period of a young Moroccan population. Materials and Methods. Dental plaque samples of 18 patients, who were randomly selected before the placement of orthodontic appliances, were collected to isolate and identify the bacterial species involved using classical bacteriological methods for species' culture and identification. The reading was recorded at T0 before placement of the device. New samples were taken again one month later and then three months afterwards, where the readings were recorded as T1 and T2, respectively. The culture was made via Columbia Agar with 5% sheep blood, Todd Hewitt Broth, and Schaedler medium containing vitamin K3. Bacterial species were identified using API-20 Strep for Streptococci and API-20 A for anaerobic bacteria. The phoenix system was used for identification. Results. After three months of orthodontic treatment, the increase in the frequency of Streptococcus sobrinus and Streptococcus mitis were significant (0.01 and 0.02, respectively) as well as for Lactobacillus (0.03). No significant difference was recorded for other bacterial species. Conclusion. There is a significant qualitative change in oral microorganisms after three months of orthodontic treatment, especially for bacteria that are incriminated in caries formation.

Orthodontic appliances did not increase risk of dental caries and periodontal disease under preventive protocol.

To assess periodontal parameters and microbial species levels after orthodontic appliance placement in patients who received oral hygiene instructions and who were monitored and motivated throughout the study. The Periodontal Index was recorded and saliva collection was performed before (T0) and 30 (T1), 60 (T2), and 90 (T3) days after orthodontic appliance placement in 15 patients (mean age 17.53 ± 8.0 years). Analysis was carried out using checkerboard DNA-DNA hybridization. Nonparametric statistical analysis was performed. The Periodontal Index did not change. The total amount of the purple and red complexes and Candida species showed a significant decrease from T2. The green, yellow, and orange complex showed a significant decrease at T3. The specific species analysis showed that Prevotella nigrescens, Pseudomonas putida, Fusobacterium periodonticum, Pseudomonas aeruginosa, Peptostreptococcus anaerobius, and Tanerella forsythia showed high incidence before bonding, and their levels decreased at T2 and T3. Only Porphyromonas gingivalis showed increased levels at T2 and displayed the highest level at T3. The Streptococcus group decreased their levels from T2 onward. A dynamic change in microbial levels was identified. The decrease in the levels of complexes present was only possible due to the mechanical method of oral hygiene implemented in this sample.