Removable Appliances Research Articles

An overview of analgesic methodologies in orthodontics

Orthodontic treatments aim to enhance teeth functionality and aesthetics through various methods like permanent, removable, and functional appliances. These interventions may involve teeth removal, surgical procedures for alignment, and even jaw position adjustments. The treatment typically starts with the placement of an orthodontic device, followed by periodic adjustments. One major concern for patients is the associated pain, directly linked to the applied force. Various devices influence pain intensity, with fixed devices being more painful. Pain peaks after certain adjustments, like placing separators, and is attributed to decreased blood flow due to brace-induced force. Pain is the primary reason some patients consider discontinuing treatment. Pain management involves both pharmacological and non-pharmacological approaches, including the promising but still under-researched low-level laser therapy (LLLT) and light emitting diodes (LEDs). Dietary changes also play a role during treatment due to pain. Proper nutrition and oral hygiene guidance are essential from orthodontists and general dentists.

In Vitro Comparative Evaluation of the Efficacy of Antimicrobial Photodynamic Therapy, Chlorhexidine, Sodium Fluoride, and Hydrogen Peroxide for Acrylic Resin Disinfection.

Introduction: Plaque accumulation on the surface of removable orthodontic appliances could lead to dental caries, periodontitis, and fungal infections. This study evaluated the effectiveness of antimicrobial photodynamic therapy (aPDT), chlorhexidine (CHX), sodium fluoride (NaF), and hydrogen peroxide (H2O2) for the disinfection of acrylic resin. Methods: In this in vitro experimental study, 100 acrylic resin specimens were randomly divided into five groups (n=20 each): Enterococcus faecalis, Streptococcus mutans, Streptococcus salivarius, Streptococcus sanguinis, and Lactobacillus acidophilus. Each group was immersed separately in 5 mL of microbial suspension. They were then incubated until biofilm formation on their surface. Of each microorganism, one biofilm sample in phosphate-buffered saline was considered as negative control, and other biofilm samples (n=80) were subjected to aPDT with curcumin, 0.12% CHX (positive control), 1% H2O2, and 0.2% NaF. Finally, the number of colonies was counted. Data were analyzed by the Kruskal-Wallis and Mann-Whitney tests, two-way ANOVA, and Bonferroni adjustment at a significance level of 0.05. Results: The interaction effect of the treatment modality and type of microorganism was significant on the microbial count (effect size: 0.91, P<0.05). Maximum bacterial proliferation was noted in the following combinations: NaF/E. faecalis, H2O2/E. faecalis, and H2O2/S. salivarius. Microorganisms had no or insignificant growth and proliferation in the aPDT and CHX groups. Conclusion: The results supported the optimal antimicrobial efficacy of PDT which was comparable to that of CHX. aPDT showed superior antimicrobial efficacy to NaF and H2O2 for the disinfection of acrylic resin.

Increasing functional enamel resistance in children and adolescents during orthodontic treatment with removable appliances

Relevance. The average time of orthodontic treatment in children is often several years. However, the final mineralization of erupted permanent teeth occurs during this period. The skills developed at this age rarely guarantee a high level of individual oral hygiene. Thus, modern removable appliances (aligners) in children with mixed dentition have several advantages. Remineralization therapy performed simultaneously with orthodontic treatment is one of the essential advantages of using aligners.Purpose. The study aimed to conduct a comparative clinical assessment of changes in the enamel acid resistance and remineralization effectiveness in patients undergoing orthodontic treatment with removable appliances (aligners). Material and methods. Orthodontic follow-up observation involved 59 patients aged 8 to 14 years for six months. They made up three observation groups. The first (control) group included 17 people who visited the orthodontist for a check-up. The second (21 people) and third (21 people) groups comprised patients undergoing orthodontic treatment with aligners. Patients of the second group added ASEPTA TEENS paste to their daily oral care complex. Patients of the third group used ASEPTA remineralizing gel for children besides ASEPTA TEENS paste. The TER test assessed enamel acid resistance, and remineralization effectiveness was determined throughout the study.Results. The comparative analysis revealed that the enamel acid resistance increased in patients of the third group who had followed our recommended scheme of oral care product use with a complex of ASEPTA TEENS paste and ASEPTA remineralizing gel for children. The group showed a remineralization effectiveness of 39.5% after six months. Patients of the second group who used ASEPTA TEENS paste without gel applications for six months also showed an increase in remineralization effectiveness of 19.5% compared to the baseline.Conclusion. The results obtained during the study allow us to recommend ASEPTA remineralizing gel for children for oral care during orthodontic treatment with removable appliances (aligners) in patients with mixed dentition. Removable aligners allow you to combine orthodontic treatment and the preventive use of mineralizing agents for forming strong enamel and protecting it from demineralization.

Skeletal and Dentoalveolar Changes With Mandibular Expansion in Growing Children.

Introduction The primary objective of this study was to quantitatively analyze the skeletal and dentoalveolar parameters following the mandibular expansion with a banded appliance. It was also part of the study to evaluate the amount of dental expansion and assess the change in the intermolar and individual first molar angulation. The basal bone parameters were compared to assess the skeletal effect of removable mandibular expansion appliance therapy. Methods In this retrospective cone beam computed tomography (CBCT) study, a total of 80 subjects with mandibular expansion therapy were screened. After imposing inclusion/exclusion criteria, 70 patients (40 females and 30 males) with a mean age of 8.8±1.24 years and 4.79±3.59 months were included. The mean expansion period was 3.04±1.61 months. Skeletal parameters such as buccal cortical thickness, buccal bone width, and cortical density were measured at 2mm from the alveolar crest, mid-root, and apex region in the coronal slice at the level of the mesiobuccal root of the first molar. Expansion parameters such as intermolar width, intermolar angulation, and individual molar angulation were also measured in the same slice. Finally, basal bone parameters such as inter-mental foramina distance and anterior arch perimeter were recorded. Results No significant difference (p>0.05) was found for most skeletal parameters following the expansion, except for the mid-root buccal bone width (p<0.05). On average, 4.54±2.53 mm of dental expansion (p<0.05) was achieved at the first molar region. Individual molar angulation showed a statistically significant difference (right = 7.46±7.91°, left = 7.53±7.18°, p=<0.05). The basal bone parameters showed no significant difference (p>0.05). Conclusions The mandibular expansion device leads to an increase in intermolar distance. The amount of expansion achieved with such devices is due to the buccal tipping of the molars. Skeletal effects such as cortical thickness, buccal bone width, or changes in the basal bone dimensions should not be expected with mandibular expansion therapy.

Vertical effects of cervical headgear in growing patients with Class II malocclusion: a systematic review and meta-analysis.

Cervical headgear (cHG) has been shown to be effective in Class II correction both with dental and orthopaedic effects but has traditionally been associated with vertical adverse effects in terms of posterior mandibular rotation. To assess the treatment effects of cHG treatment in the vertical dimension. Unrestricted literature search of five databases up to May 2023. Randomized/non-randomized clinical studies comparing cHG to untreated controls, high-pull headgear (hp-HG), cHG adjuncts, or other Class II treatment alternatives (functional appliances or distalisers). After duplicate study selection, data extraction, and risk-of-bias assessment according to Cochrane, random-effects meta-analyses of mean differences (MD)/standardized mean diffences (SMD) and their 95% confidence intervals (CIs) were performed, followed by meta-regressions, sensitivity analyses, and assessment of certainty on existed evidence. Two randomized/16 non-randomized studies (12 retrospective/4 prospective) involving 1094 patients (mean age 10.9 years and 46% male) were included. Compared to natural growth, cHG treatment was not associated on average with increases in mandibular (eight studies; SMD 0.22; 95% CI -0.06, 0.49; P = 0.11) or maxillary plane angle (seven studies; SMD 0.81; 95% CI -0.34, 1.95; P=0.14). Observed changes translate to MDs of 0.48° (95% CI -0.13, 1.07°) and 1.22° (95% CI -0.51, 2.94°) in the SN-ML and SN-NL angles, respectively. No significant differences were seen in y-axis, facial axis angle, or posterior face height (P > 0.05). Similarly, no significant differences were found between cHG treatment and (i) addition of a lower utility arch, (ii) hp-HG treatment, and (iii) removable functional appliance treatment (P > 0.05 for all). Meta-regressions of patient age, sex, or duration and sensitivity analyses showed relative robustness, while our confidence in these estimates was low to very low due to the risk of bias, inconsistency, and imprecision. cHG on average is not consistently associated with posterior rotation of the jaws or a consistent increase in vertical facial dimensions among Class II patients. PROSPERO registration (CRD42022374603).

Incline Correct: A Novel Device for Accurate Inclination of Twin Block Appliances

Retrognathic mandible is the most common feature in growing children with skeletal Class II malocclusion. This does not self-correct with growth. Functional appliances are known to exert beneficial effects to improve this skeletal pattern. Among several removable functional appliances, Twin Block is the most preferred. Twin Blocks are designed for full-time wear such that maximum benefit from functional forces can be obtained. The maxillary and mandibular bite blocks occlude at a 70° angle on complete closure. It is important to angulate the inclines at exactly 70°, as an increase in this angulation will require a conscious effort from the patient. Incline Correct is designed to accurately measure and construct inclines at 70° to the occlusal plane.

Early Treatment of Class II Division 1 Malocclusions with Prefabricated Myofunctional Appliances: A Case Report

Removable functional appliances (RFA) have long been employed to address Class II malocclusion, particularly in cases involving a significant overjet, a deep bite, and molar class 2 issues. Notably divergent from RFA, myofunctional appliances (PMA) offer several distinct advantages, including applicability in noncompliant patients, adaptability in cases of dental element scarcity, suitability for allergic patients, impression-free utilization, and reduced costs. Within the array of clinical cases treated with PMA, we chose to present an intricate case involving an 8-year-old girl. Our aim was to showcase the immediate effects of PMA and to track the progress over a two-year span. Following one year of PMA treatment, substantial improvements were observed in a large overjet, a deep bite, and lip incompetence—factors often associated with elevated risks of dental trauma. These improvements not only positively impacted dental aesthetics but also engendered normalized nasal respiration and diminished palatal impingement, thereby enhancing the overall quality of life. Upon reaching the two-year mark, the clinical status pertaining to Class II malocclusion remained stable. Further treatment was advised in a subsequent phase to refine imperfections in the dental arch form. Nonetheless, comprehensive data from the prolonged follow-up of patients treated with these appliances are essential to establish robust scientific evidence concerning their long-term efficacy.

Orthodontists' instructions for oral hygiene in patients with removable and fixed orthodontic appliances.

The aim of this questionnaire-based survey was to evaluate information on frequencies, instructions and products relating to oral hygiene (OH) in orthodontic practices. Using a computer-generated randomization list, 1000 orthodontists were selected and sent a questionnaire. The size and number of inhabitants of the federal states of Germany were considered. The federal states with the highest return rate (Baden-Wuerttemberg [BW], Bavaria [B], Hesse [H], Lower Saxony [LS], Nordrhein-Westphalia [NRW]) were considered and differences between the 16 federal states were divided into North, South, East and Central Germany. The response rate of the questionnaires was 52.4%. The majority (53.8%) worked in one practice alone. Most (59.1%) have been orthodontists for 5-25 years. For vestibular multibracket appliances (MBA) in BW, B, H and LS over 90% recommended interdental brushes (IDB). In NRW 91.4% recommend fluoride gel. In B and H more than 80% chose electric toothbrush (ETB), in BW, LS and NRW more than 80% manual toothbrush (MTB). For lingual MBA (LMBA) in BW, H, LS and NRW with approximately 50% each fluoride gel, IDB and MTB were chosen. In B fluoride gel, IDB and ETB. For removable apparatus (RA), five federal states recommended MTB (>80%) and ETB (BW, B, H > 80%; NRW > 70%; LS > 60%). Electric toothbrushes are recommended for the use with all appliances, only with removable appliances manual toothbrushes are favoured. For vestibular MBA it is strongly advised to use IDB additionally.

Effect of Different Cleaning Regimes on Biofilm Formation of Acrylic-Based Removable Orthodontic Appliance: A Randomized Clinical Trial.

This study aimed to evaluate the effects of different cleaning regimes of acrylic-based removable orthodontic appliances on bacterial biofilm formation and whether the surface modification, i.e., polished acrylic fitting surface, reduces biofilm formation. This double-blind, parallel, randomized clinical trial involved thirty-nine orthodontic patients indicated for removable orthodontic appliances. The patients were allocated into three groups according to the cleaning method: brushing with a denture brush and chlorhexidine (CHX) toothpaste, Lacalut cleaning tablet, and a combination of both cleaning methods. Each patient wore an upper removable appliance containing eight wells fitted with eight detachable acrylic tiles (four polished and four unpolished) for seven days. Five types of oral microbiota were evaluated using selective growth media and biochemical tests. The biofilm cleaning efficacy was assessed using the colony-forming unit (CFU) and scanning electron microscopy (SEM). Statistical Analysis. Data from the CFU using different cleansing regimes were compared, following log transformation, using one-way analysis of variance (ANOVA). The polished and unpolished tiles were compared for biofilm formation on each cleansing method using an independent t-test. There was no significant difference among the three cleaning methods on the polished or unpolished tiles. However, in polished tiles, streptococci were significantly reduced in all cleaning methods, whereas staphylococci and Staphylococcus aureus were markedly decreased in brushing and combination cleaning methods. However, the total number of anaerobic bacteria was significantly reduced in polished tiles using the combination method only. Polishing the fitting surface of an acrylic-based orthodontic appliance reduced the tested bacterial biofilm formation and may enhance cleaning efficiency. Brushing and combination methods showed superior cleaning effects compared to cleaning tablets. This trial is registered with NCT05707221.

Vertical, Sagittal and Transverse Effects of Semi Rapid Maxillary Expansion Protocol Using a Removable Expansion Appliance: A Cephalometric and Model Based Study

Vertical, Sagittal and Transverse Effects of Semi Rapid Maxillary Expansion Protocol Using a Removable Expansion Appliance: A Cephalometric and Model Based Study

A Cephalometric Study of Pharyngeal Dimensions Following Twin Block Treatment

Objective: To assess and compare changes in pharyngeal airway widths (PAW) using lateral cephalograms before and after treatment with a removable twin block appliance. Methodology: Lateral cephalogram records were taken before (T0) and after (T1) the treatment of 50 Class II subjects (ANB&gt;40; 28 males, 22 females; mean age 12.6 years) using the removable twin block appliance. The study period spanned 12 months. Airway volumes, including upper airway width (UAW), middle airway width (MAW), and lower airway width (LAW), were compared between T0 and T1. The data were analyzed using SPSS statistical software via paired t-test. A p-value of ?0.05 was considered statistically significant. Results: A total of 50 patients were included in the study, and airway changes were analyzed at two different times prospectively (T0 and T1). The male-to-female ratio was 1:0.8 (44% females, 56% males). The mean upper airway width (UAW) at T0 and T1 was 14.04 mm and 15.3 mm, respectively. The mean middle airway width (MAW) at T0 and T1 was 8.8 mm and 11.8 mm, respectively, while the mean lower airway width (LAW) at T0 and T1 was 7.5 mm and 10.2 mm, respectively. The mean age was 12.6 years, and the mean BMI was 21. The mean SN-Md angle was 31.8 degrees. At T1, a significant increase in airway volume was observed in upper airway width (UAW), middle airway width (MAW), and lower airway width (LAW) (P=0.000). Conclusion: Treatment with the Twin Block Appliance in growing subjects resulted in an increase in the overall posterior pharyngeal airway volumes.

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.

Correction of Central Diastema and Individual Dental Malposition with Removable Orthodontic Appliance

Background: Central diastema refers to an anterior spacing between maxillary central incisors and malposition of the individual teeth refers to the teeth being crowded in the upper and lower jaws. There are many causative factors that contribute to the occurrence of these two cases, such as heredity, frenulum deformity, gender, and bad habit. Removable orthodontic appliances are devices that can be used in cases of mild malocclusion. Objective: The purpose of writing this case report is to show that removable orthodontic appliances are the first choice for dentists. Case: A 23-year-old male patient came to UMY Dental and Oral Hospital (RSGM UMY) complaining that his front teeth had spacing and some irregularly arranged teeth. The patient felt uncomfortable with the condition of the teeth. Patient complaints are felt as early as 3 years ago. One year ago, had already used a removable orthodontic appliance and after the treatment is finished then used a retainer but only for 1 month because the retainer is missing. The case of this patient is class I Angle with central diastema and malposition of individual teeth. Case Management: Treatment is carried out using removable orthodontic appliances. The appliances component uses a simple spring on tooth 31 and 41, retentive component uses Adam’s clasp on teeth 16, 26, 36 and 46. Labial arch with a U loop in between canine and first premolar. Conclusion: The removable orthodontic appliance should be used to correct cases of mild malocclusion such as a central diastema with mild malposition of the individual teeth.

Ectopic Permanent Molars: A Review.

Ectopic permanent molar is a condition in which the permanent tooth deviates from its normal path of eruption. The etiology of this eruption anomaly is multifactorial, with both general and local factors. The principal results suggest that a valid indicator of irreversible consequences is the degree of impaction of the first permanent molar. Self-correction is most common between the ages of 7 and 8, after which help may be required. Accordingly, early management can assist in preventing subsequent potential challenges that could interfere with maintaining a balanced occlusion. Several variables, including the degree of mesial tilting, the level of root resorption, and the condition of the second primary molar, may be crucial in choosing the most effective method of treatment. Interproximal wedging and distal tipping are the two basic therapeutic strategies for ectopic permanent molars. Additionally, the use of fixed or removable appliances might also be required. Delaying treatment until a later stage is not recommended because early diagnosis and treatment are essential for optimal management. This review aims to provide a comprehensive overview of ectopic permanent molars, including their prevalence, etiologic factors, self-correction rates, clinical implications for adjacent teeth, and various treatment techniques, that emphasizes the importance of early detection and intervention in the successful management of ectopic permanent molars. In addition, it highlights the importance of future research into the contributing variables of irreversible ectopic molar outcomes.

Corticotomy-Assisted Orthodontic Treatment: A Literature Review

The increased number of adults seeking orthodontic treatment has led to the need for faster results as social limitations arise with the use of fixed or even removable appliances. Corticotomy-assisted orthodontic treatment (CAOT) has been proposed as a technique that accelerates tooth movement and leads to a substantial reduction in treatment time. This review was conducted by searching four databases for original articles about CAOT, review articles and articles about alternative techniques and periodontal effects up to 31 December 2022. The aim of the review was to present the historical and biological background of CAOT, the description of the technique and some alternative and less invasive techniques that have been proposed. Indications, contraindications and periodontal side effects are also discussed.

Ectopic Eruption of the Maxillary Permanent First Molar: A Brief Review and Clinical Case Report

The Ectopic Eruption of the Maxillary Permanent First Molar (EEMPFM) is an eruption anomaly, characterized for the maxillary permanent first molar’s impaction in the distal surface of the deciduous second molar. The etiology is related with change of the axial axis of eruption of the permanent first molar associated with missing space in the maxilla. The diagnosis is the combination of clinical and complementary examination. There are two types of Ectopic Eruption: the reversible and the irreversible. The irreversible type requires orthodontics treatment, because it causes root resorption of the deciduous second molar, causing its premature loss. For the treatment, procedures can be used with the aim of promoting distal inclination of the ectopic first molar, using separator elastics, removable or fixed appliances. The aim of this work is to report a clinical case of a patient of 9 years and 6 months old, female gender, who attended the Clinic presenting EEMPFM of the maxillary right permanent first molar. The treatment was a removable appliance composed with an acrylic base plate with clasps and a finger spring activated against a resin button bonded on the mesiobuccal cusp of the maxillary right permanent first molar. The correction of this anomaly was obtained with 35 days of treatment. Therefore, the sequence of procedures from diagnosis to the indication of an adequate treatment method is fundamental to obtain satisfactory results.

Success of orthodontic treatment of linguoverted mandibular canine teeth using a direct inclined plane appliance.

This study evaluated the success rate of orthodontic treatment of linguoverted mandibular canines in dogs using a directly applied inclined plane device. Medical records were retrospectively evaluated at 11 veterinary dental specialty hospitals from 1999 to 2021. Malocclusion classes included 41.7% in class 1, 47.2% in class 2, 6.9% in class 3, and 4.2% in class 4. The severity of linguoversion was mild in 7.6% of teeth, moderate in 33.9%, and severe in 58.5%. There was complete resolution of linguoversion in 71.2% of teeth, functional resolution in 25.4%, and failure in 3.4%. The median treatment time was 42 (11-174) days. Adjuvant orthodontic treatments were performed at the same time as the inclined plane in 45.7% of teeth, including active force orthodontics, extractions of non-strategic teeth, gingivectomy, and odontoplasty. While the inclined plane was in place, 31.4% of dogs required an anesthetized appliance adjustment, and at the time of appliance removal, complications occurred in 19.4% of dogs. Of the teeth that had initial resolution, 14.4% had rebound movement that required additional treatment. This study supports the idea that an acrylic inclined plane is a good treatment option for linguoverted mandibular canines, with a 96.6% success rate within a median of 6 weeks. Yet, orthodontic retention may be necessary in these cases to avoid the need for additional therapies.

Management of Anterior Single Tooth Crossbite Using Removable Posterior Teeth Bite Plane Along With Z-Spring: A Case Report

Anterior crossbite is defined as a malocclusion characterized by the anterior maxillary teeth lingual position compared to mandibular anterior teeth. The prevalence of anterior crossbite that has been reported in the mixed dentition stage varies between 1.6 percent and 7.9 percent. Anterior crossbite cases should be treated by emergency intervention in the early period to prevent the consequences of malaligned teeth and their effect on the normal overall growth and development of the child. Patient compliance in such type of treatment intervention is of utmost importance. This case report presents the correction of single tooth crossbite with the removable posterior bite plane along with Z-spring. Various other treatment modalities have been also proposed to correct an anterior dental crossbite, such as tongue blades, reversed stainless steel crowns, fixed acrylic planes, bonded resin-composite slopes, and removable acrylic appliances incorporating finger springs. This treatment modality is possible in the early stages of developing malocclusion. Children with untreated anterior crossbite could develop complications such as gingiva recession, TMJ dysfunction, and worsening of mandibular displacement. As self-correction is rare in these alterations, early interception is recommended to allow normal occlusion and facial development.

Effect of nanoparticle addition on antimicrobial properties for acrylic removable orthodontic appliance

Removable orthodontic appliances have acrylic resin-based plate components that often result in plaque retention and bacterial build-up, leading to dental and periodontal problems. Several studies have tried adding nanoparticles to acrylic resins to over-come these problems. This review discusses the effect of nanoparticle addition on the antimicrobial properties of orthodontic removable acrylic resin. A literature review was conducted on 10 articles obtained from PubMed, ScienceDirect, and Google Scholar by determining inclusion, exclusion and keyword criteria. Literature search using boolean search based on inclusion criteria obtained data that the addition of various nanoparticle materials such as zinc oxide, titanium dioxide, magnesium oxide produces good antimicrobial properties, especially in the process of inhibiting microbial adhesion. It is concluded that the addi-tion of nanoparticles to acrylic resin orthodontic appliances provides effective antimicrobial properties so that it can be applied clinically to prevent diseases in the oral cavity such as gingivitis and dental caries.

Impact of orthodontic treatment on speech and phonetics: a review

Orthodontic devices, including both fixed and removable devices, have the potential to impact dental anatomy, the space within the oral cavity, the displacement of the tongue, and the production of speech. The usage of fixed labial appliances may cause transient or persistent speech and phonetics changes, particularly affecting sibilant and stopped sounds. Lingual fixed appliances, while providing aesthetic advantages, can lead to difficulties in maintaining oral hygiene, pain in the tongue, and speech disturbances. Orthodontic retainers, used post-treatment, can also affect speech and phonetics by altering the oral cavity space and tongue position. Other appliances like removable appliances, palatal expanders, and prosthetic dental appliances may also disrupt speech production. Objective, semi-objective, and subjective assessments are utilized to evaluate speech disruptions induced by orthodontic devices. Patients considering orthodontic aligners should be informed about potential temporary limitations in speech production, which can be managed by removing the device when necessary. The adaptation to orthodontic treatment may vary based on individual characteristics. Orthodontists should consider these effects and communicate them to patients. This review article explores the effect of orthodontic treatment on speech and phonetics.