Presence Of Orthodontic Appliances Research Articles

Inflammatory parameters and color alterations of dental bleaching in patients wearing fixed orthodontic appliance: a randomized clinical trial

BackgroundMany orthodontic patients request dental bleaching during orthodontic treatment to achieve a faster aesthetic resolution, however, no attention has been paid to the inflammatory processes that can occur when both therapies are indicated together. So, this clinical trial evaluated the inflammatory parameters and color alterations associated with dental bleaching in patients wearing a fixed orthodontic appliance.MethodsThirty individuals aged between 18 and 40 years were equally and randomly allocated into three groups: FOA (fixed orthodontic appliance), BLE (dental bleaching), and FOA + BLE (fixed orthodontic appliance + dental bleaching). The orthodontic appliances and the bleaching procedures were performed in the maxillary premolars and molars. For dental bleaching a 35% hydrogen peroxide was used. The gingival crevicular fluid (GCF) and nitric oxide (NO-) levels were evaluated at different time-points. Color evaluation was performed using an Easyshade spectrophotometer at baseline (FOA, FOA + BLE, BLE), one month after (FOA + BLE) and 21 days after appliance removing (FOA + BLE and FOA groups), in each tooth bleached. The ANOVA and Tukey’s tests, with a significance level of 5%, were used for statistical analysis.ResultsThe GCF volume in the FOA + BLE and FOA groups significantly increased at the time points evaluated (p < 0.001); however, this did not occur in the BLE group (p > 0.05). On the other hand, NO- levels significantly decreased during dental bleaching with or without fixed orthodontic appliances (FOA + BLE and BLE groups; p < 0.05), while no significant changes were observed in the FOA group (p > 0.05). Significant changes in color were observed in the FOA + BLE and BLE groups compared to in the FOA group (p < 0.01). However, the presence of fixed orthodontic appliance (FOA + BLE) negatively affected the bleaching efficacy compared to BLE group (p < 0.01).ConclusionsDental bleaching did not increase the inflammatory parameters in patients wearing fixed orthodontic appliance. However, in the presence of orthodontic appliances, the bleaching efficacy was lower than that of bleaching teeth without orthodontic appliances.Trial registrationRBR-3sqsh8 (first trial registration: 09/07/2018).

Can Velopharyngeal MRI be Used in Individuals with Orthodontic Devices?

To evaluate the influence of common pediatric orthodontic appliances on velopharyngeal (VP) MRI and to compare MR image sequences to determine if sequence parameters impact the visibility of key VP structures commonly assessed in clinical VP MRI. Participants undergoing orthodontic treatment completed a VP MRI study. Level of distortion caused by orthodontic devices on 8 anatomical sites of interest and using variable MRI sequences was evaluated. Single institution. Nineteen participants undergoing orthodontic treatment. Level of distortion caused by metal artifacts and MR sequence used. The results of this study demonstrate that appliances such as hyrax palatal expanders and braces with stainless steel brackets are acceptable for a VP MRI, while class II corrector springs are not recommended. The HASTE MRI sequence with 2D imaging techniques should be utilized if the child has orthodontic devices, while FSE and 3D imaging techniques are not recommended. The presence of wire spring coils and molar bands are likely to not to interfere with the MRI evaluation. Findings from this study suggest that the presence of orthodontic appliances does not hinder visualization of all velopharyngeal structures during an MRI. Therefore, careful consideration must be made prior to disqualifying or recommending patients for VP MRI.

Prevalence of Oral Pathogen Slackia exigua among Clinical Orthodontic and Non-Orthodontic Saliva Samples.

Slackia exigua (SE) is a recently identified intestinal microbe, which recent oral surveys suggest may be associated with oral diseases including caries and periodontal disease. Based upon the lack of information regarding this organism, the primary objective of this study was to determine the oral prevalence of this microbe and any potential associations with patient characteristics such as age, sex, or the presence of orthodontic appliances. This retrospective study involved the screening of an existing saliva repository composed of previously collected unstimulated clinical saliva samples. More specifically, N = 266 were identified and screened using a spectrophotometer at absorbances of A260 and A280 nm to determine their DNA purity and concentration. qPCR screening of these samples revealed a higher prevalence of Slackia exigua positive samples among pediatric patients (63.1%) compared with adults (36.9%) in this clinic population, p = 0.0007. In addition, higher percentages of Slackia exigua were observed among orthodontic patients (71.2%) compared with non-orthodontic patients (28.8%), p = 0.0001. These results did not vary by sex with nearly equal percentages of Slackia exigua positive males and females among adult and pediatric patients, as well as orthodontic and non-orthodontic samples. These results suggest a strong potential for association between the prevalence of this organism with age as well as orthodontic status, given that younger patients and those with orthodontic brackets (regardless of age) were most likely to harbor this pathogen in sufficient levels to be detected in saliva. More research will be needed to determine any associations with specific outcomes, such as caries or periodontal disease, among Slackia exigua positive patients within these specific populations.

Automatic dental biofilm detection based on deep learning.

To estimate the automated biofilm detection capacity of the U-Net neural network on tooth images. Two datasets of intra-oral photographs taken in the frontal and lateral views of permanent and deciduous dentitions were employed. The first dataset consisted of 96 photographs taken before and after applying a disclosing agent and was used to validate the domain's expert biofilm annotation (intra-class correlation coefficient=.93). The second dataset comprised 480 photos, with or without orthodontic appliances, and without disclosing agents, and was used to train the neural network to segment the biofilm. Dental biofilm labelled by the dentist (without disclosing agents) was considered the ground truth. Segmentation performance was measured using accuracy, F1 score, sensitivity, and specificity. The U-Net model achieved an accuracy of 91.8%, F1 score of 60.6%, specificity of 94.4%, and sensitivity of 67.2%. The accuracy was higher in the presence of orthodontic appliances (92.6%). Visually segmenting dental biofilm employing a U-Net is feasible and can assist professionals and patients in identifying dental biofilm, thus improving oral hygiene and health.

La evaluación de la resistencia al cizallamiento del cemento de ionómero de vidrio modificado con resina con la adición de vidrio bioactivo 45S5 utilizando dos métodos convencionales.

Introduction: There is a high prevalence of enamel caries around brackets due to the young age of the majority of orthodontic patients, and to the difficulty of plaque removal in presence of orthodontic appliances. Recently, protective agents such as bioactive glasses (BGs) were introduced to enhance remineralization and prevent demineralization of tooth structures. This study aimed to assess the shear bond strength (SBS) of resin-modified glass ionomer cement (RMGIC) with addition of 45S5 BG to enhance its remineralizing potential using two conventional methods. Material and methods: This in-vitro experimental study evaluated three groups (n=20) of orthodontic brackets bonded to enamel using Transbond XT (group 1), light-cure RMGIC (group 2) and RMGIC with BG added (group 3). Samples underwent 7000 thermal cycles and their SBS was measured. The adhesive remnant index (ARI) score was also determined. Quantitative data were analyzed using one-way ANOVA while qualitative data were analyzed using a chi-square test. Discussion: The results showed no significant difference in SBS between study groups, however the ARI scores were significantly different among the groups. The RMGIC group showed the highest ARI while RMGIC doped with BG showed the lowest ARI score. Conclusion: Addition of 30% w/v 45S5 BG to RMGIC does not cause a significant change in SBS of orthodontic brackets bonded to enamel, while resulting in less amount of luting agent remnants on the enamel surface after debonding.

Effect of Propolis mouthwash on plaque and gingival indices over fixed orthodontic patients.

BackgroundIn patients with fixed orthodontics, the presence of orthodontic appliances causes dental plaque accumulation and hygiene problems. The purpose of this study was to evaluate the effect of Propolis and chlorhexidine mouthwashes on plaque and gingival indices in patients who are undergoing orthodontic treatment.Material and MethodsIn this triple blind study, in total, 37 patients aged from 15 to 35 years those who have been undergoing fixed orthodontic treatment were studied. After that, one of the mouthwashes that containing either Propolis or Chlorhexidine was randomly prescribed to patients. The patients were asked to use mouthwashes twice a day after brushing their teeth for three weeks consecutively. Indicators of plaque, gingival and periodontal status (PI, GI, CPI) were determined on Ramford teeth at the beginning and at the end of three weeks for each patient. Then the results were analyzed statistically.ResultsThe difference between the values of plaque index (P<0.001), gingival index (P=0.006) and periodontal index (P= 0.005) before and after administration of Propolis were statistically significant. The difference was also statistically significant for all three indexes of plaque (P<0.001), gingival (P=0.001) and periodontal (P=0.003) before and after chlorhexidine mouthwash usage. The indices after using mouthwashes were not statistically significant different between two mouthwash groups.ConclusionsIt seems that Propolis mouthwash can be used as a suitable alternative in patients with fixed orthodontic treatment without the side effects of chlorhexidine mouthwash. Key words:Mouthwash, antimicrobial, Oral hygiene, Propolis, Dental plaque.

Gingival hyperplasia in orthodontic patients: Case study

IntroductionGingival hyperplasia is a multi-factorial overgrowth of gingival tissues. ObjectivesTo evaluate orthodontic appliance association on gingival hyperplasia and examine a maintenance protocol to manage it. Materials and methodsA case of a healthy 26-yr-old male presenting with maxillary and mandibular chronic inflammatory gingival enlargement associated with prolonged orthodontic therapy was examined. The patient has no prior history of gingival enlargement before orthodontic treatment. A strict maintenance protocol was followed along with patient’s oral hygiene instruction and motivation. ResultsA significant improvement of gingival tissue health observed in terms of color, consistency and texture. ConclusionLocal irritation in combination with bacterial plaque is mainly causing gingival hyperplasia in presence of orthodontic appliance. Proper home oral hygiene and in office care can reduce the possibility of gingival hyperplasia in orthodontic patients.

Factors correlated with developing caries during orthodontic treatment: Changes in saliva and behavioral risks

Background/purposeThe aim of this study was to identify salivary changes during orthodontic treatment with follow-up for 30 months. Materials and methodsIn 25 patients salivary markers (unstimulated and stimulated saliva, buffer capacity, and pH) were evaluated. The decayed, missing, and filled surfaces (DMFS) index, plaque index (O’Leary), and a questionnaire were employed to evaluate patient’s hygiene and dietary habits. Data were analyzed by a paired t test, a MANOVA model with repeated-measures analysis, a multiple-regression analysis, and a Spearman correlation test. ResultsDuring treatment, the DMFS index increased significantly (P=0.007), the plaque index decreased by 28.4%, and the unstimulated salivary flow showed differences (P=0.009). Stimulated saliva flow increased in females after placement of the appliance; the buffer capacity diminished in males during therapy, and salivary pH remained at basal values. Statistically significant associations were revealed by the multiple-regression analysis and Spearman test; the salivary factors of the unstimulated salivary flow rate, buffer capacity, and pH were associated with the final DMFS index (P<0.0001); the frequency of eating food between meals was associated with the DMFS index (r=0.4918; P=0.0125), and the frequency of changing the toothbrush was associated with the DMFS index (r=−0.4299; P=0.0320). ConclusionThe multiple caries-related factors examined in this study changed during orthodontic treatment, but many of these stayed within normal values. Saliva is an important protector of oral mucosal tissues and teeth, and its constant role is supported even in adverse conditions, such as the presence of orthodontic appliances in the mouth.

Incorporation of metal and color alteration of enamel in the presence of orthodontic appliances

To test the null hypothesis that it is not possible to incorporate metal ions arising from orthodontic appliance corrosion into tooth enamel with resulting tooth color change. This in vitro study used atomic absorption spectrophotometry to evaluate the presence of nickel, chromium, and iron ions in tooth enamel in three groups: a group submitted to cyclic demineralization and remineralization processes with solutions in which orthodontic appliances were previously immersed and corroded, releasing metallic ions; a control group; and another group, submitted to cycling only, without the presence of orthodontic appliances. The influence of the incorporation of these metals on a possible alteration in color was measured with a portable digital spectrophotometer using the CIE LAB system. At the end of the experiment, a significantly higher concentration of chromium and nickel (P < .05) was found in the group in which corrosion was present, and in this group, there was significantly greater color alteration (P ≤ .001). There was chromium and nickel incorporation into enamel and tooth color change when corrosion of orthodontic appliances was associated with cycling process. The null hypothesis is rejected.

Biological evaluation of alveolar bone remodeling in methylprednisolone treated –rats during orthodontic tooth movement

Background: Bone remodeling and metabolism associated with orthodontic tooth movement are regulated by a large number of local and systemic factors. The widespread useof therapeutic corticosteroids (GCs) today raise concerns with regard to their effects on mineralized tissue metabolism. This study aimed to investigate the effect of Methylprednisolone treatment on alveolar bone remodeling during orthodontic tooth movement. Materials and Methods: A twenty-six 12-weeks old male Wistar albino rats were divided into 2 groups; control group (n = 13) without any drug administration during the study and steroidal group (n = 13) which received 5 mg/kg/day of methylprednisolone for 3 weeks. A split- mouth design was used performing orthodontic tooth movement on the upper right 1st molar by applying 20 g of mesial force using superelastic closed-coil spring attached to the incisors for 21 days while the upper left side served as the non-appliance side. Orthodontic tooth movement was evaluated on weekly basis using digital caliber. The rats were sacrificed after 3 weeks and alveolar bone remodeling process was evaluated by counting the number of osteoblast and osteoclast cells at the compression and tension sites at the coronal and apical levels of the mesiobuccal root of upper 1st molar in both appliance and non-appliance sides using digital microscope at 400× magnification. At day of sacrifice serum measurements for alkaline phosphatase (ALP) and acid phosphatase (ACP) activity were carried out. Results: Showed that in the steroid group there was significantly greater amount of orthodontic tooth movement, greater reduction of bone formation and an increase in bone resorption with the presence of orthodontic appliance, increase in serum ACP activity and reduction of serum ALP activity as compared with the control group,(P ≤ 0.05). Conclusion: The Methylprednisolone therapy in low-medium doses elicits a noticeable change in the bone turnover rate during orthodontic tooth movement.

The role of the mouthguard in the prevention of sports-related dental injuries: a review.

This paper examines the literature dealing with oral-facial injuries received during participation in sport and the possibilities open to athletes for their prevention. In particular, the paper examines five different aspects of this topic: the risk of dental injury while playing sports, the role of the mouthguard in preventing injury, types of athletic mouthguard, implications for patients undergoing orthodontic treatment and behavioural aspects of mouthguard wear. It is clear from this review that participation in a number of sports does carry a considerable risk of sustaining dental injury, not only in the so-called contact sports such as rugby and hockey, but also in less obviously dangerous sports such as basketball. Although some evidence exists to the contrary, the majority of studies have found the mouthguard to be the most effective way of preventing such injuries. It is also clear that the custom-fabricated mouthguard, in particular the pressure-laminated variety, is seen to afford most protection. Athletes undergoing orthodontic treatment present a particular problem as they are potentially at greater risk of injury because of increased tooth mobility and the presence of orthodontic appliances. The fabrication of mouthguards for these patients is also problematic and the literature covering this is reviewed. As with other preventive measures, mouthguard usage is often less than the dental profession would like; the reasons for this are explored in a small number of studies. While much progress has been made in this area, the profession could do much more to promote the greater use of mouthguards.

Site-specific subgingival colonization by Actinobacillus actinomycetemcomitans in orthodontic patients

A high prevalence of Actinobacillus actinomycetemcomitans (Aa) in subgingival plaque in patients for orthodontia already has been observed. The present study had the following aims: 1) to ascertain a direct relationship between the orthodontic appliance placement and the subgingival colonization by Aa , and 2) to determine whether the Aa growth specifically occurred on teeth with braces attached or whether the presence of orthodontic appliances could also cause the isolation of Aa in teeth free from therapeutic appliances. Twenty-four young systemically and periodontally healthy subjects with malaligned and crowded teeth in the anterior sextants of both dental arches participated in this study. After 1 session of ultrasonic scaling with oral hygiene instructions during the first experimental session, the mesiobuccal sites of the first molars and the distobuccal sites of the lateral incisors in both dental arches in each participant were subjected to clinical and microbiologic examination for the recovery of Aa . Clinical examination consisted of recording the presence of plaque and the examination of gingival bleeding on probing and probing depth. Microbiologic sampling was obtained with the insertion of 3 sterile paper points at the deepest part of each gingival sulcus. Altogether, 192 periodontal sites were examined. After the examinations, the patients received fixed orthodontic appliances in only 1 dental arch (test sites) and the other one was left free from appliances (control sites). Clinical examination and microbiologic sampling were repeated in the same experimental test and control sites after 4, 8, and 12 weeks. At the 12-week session, the orthodontic appliance was removed from the test arch, and, 4 weeks later, a further clinical and microbiologic examination was performed. The results showed that, during the period with orthodontic appliances, the presence of plaque scores and the gingival bleeding on probing scores were increased significantly and that Aa , initially absent from all but 1 subject, was isolated in 19 and 20 subjects after 4 and 8 weeks, respectively. Furthermore, no gingival sites from the control teeth (free from Aa colonization at baseline) showed positive results for the sought-after bacterium throughout the entire length of the study. It was concluded that the placement of orthodontic appliances promotes the subgingival growth of Aa ; this specific microbial change is specifically restricted to subgingival plaque from orthodontic appliance–bearing teeth. The presence of orthodontic bands and brackets therefore cannot affect the microbiologic condition of the whole mouth. (Am J Orthod Dentofacial Orthop 1999;115:423-8)

Eighteen-month evaluation of the effects of a 0.4% stannous fluoride gel on gingivitis in orthodontic patients

The purpose of this study was to determine whether conventional toothbrushing and twice daily use of a brush-on 0.4% stannous fluoride (SnF2) gel containing more than 90% available Sn2+ would be more effective for controlling plaque accumulation and gingivitis in the presence of orthodontic appliances than conventional toothbrushing alone. Consecutively treated adolescents who were to receive full-mouth fixed orthodontic appliances were assigned to one of two groups according to age and sex criteria. The first group (control, n = 35) used toothbrushing with a standard fluoride toothpaste, whereas the second group (treatment, n = 30) used toothbrushing supplemented with a 0.4% SnF2 gel used twice daily for the entire 18-month study period. Clinical assessments (Plaque Index, Gingival Index, bleeding tendency, and coronal staining) were made single blind before appliances were placed and 1, 3, 6, 9, 12, and 18 months after appliances were placed. Complete data were obtained for 32 control and 23 SnF2 gel subjects. The results indicated that the SnF2 gel group had significantly lower scores for plaque index (p < 0.01), gingival index (p < 0.001), and bleeding tendency (p < 0.001) at all examinations than did the control group. In the SnF2 group, one subject developed mild coronal staining, and two subjects developed moderate staining. We conclude that the use of a 0.4% SnF2 gel containing more than 90% available Sn2+ is an effective adjunct to mechanical tooth cleaning in preventing gingivitis in adolescents undergoing orthodontic treatment with fixed appliances.