Start Of Orthodontic Treatment Research Articles

Prognostic risk factors for apical root resorption in orthodontic patients – Are the Kjær’s morphologic characteristics of clinical relevance?

BackgroundPatients undergoing orthodontic treatment (OT) face an increased risk of developing external apical root resorption (EARR). A prognostic risk assessment prior to OT can potentially be conducted through anatomical features in panoramic radiography. This retrospective study aimed to assess the significance of Kjær's morphological characteristics in analyzing the risk of EARR. MethodsPanoramic radiographs of 1,156 patients (624 females, 532 males) were retrospectively analyzed. Anamnestic and treatment-related data were extracted from patient records. The mean age at the start of OT was 12.8 ± 2.2 years (min. 6.4 years, max. 22.3 years) and at the end of OT 15.9 years (min. 8.5 years, max. 24.1 years). The mean treatment duration was 3.1 ± 1.6 years. Panoramic radiographs with a minimum of two per patient were examined for the presence of Kjær’s characteristics. The degree of EARR was registered defining resorption in four degrees of severity. Bivariate analysis and multivariate Poisson regression were performed to assess the association between Kjær’s characteristics and EARR patient- and tooth- related (α = 0.05). ResultsIn total, 72.8% of the patients showed EARR at the end of OT with lateral maxillary incisors most frequently affected. Short roots (p < 0.001) were significantly associated with EARR in patients. Tooth-related microdontia (#12, #22, lower second premolars), narrow crowns (#11, #21, lower incisors), short roots (upper incisors, lower first molars) and ectopia (#11, #21, #13), such as shorter distal roots of the mandibular first molar showed a significant association with EARR depending on severity degree. The type of orthodontic appliance (fixed: p < 0.001, fixed and removeable: p = 0.008), as well as treatment duration (p < 0.001) were also identified as risk factors for EARR. ConclusionsAlthough the risk assessment for EARR development through panoramic radiography analysis is limited, predisposition appears to be present in specific dental characteristics and treatment-related factors.

Influence of malocclusion on OHRQoL in adolescents in initial orthodontic treatment phase.

Besides correcting malocclusions, another main objective of orthodontic treatment is to improve patients' oral health-related quality of life (OHRQoL). This study aimed to assess changes in OHRQoL of children within the first six months of orthodontic therapy with fixed orthodontic appliances. 85 patients aged 11 to 14 years requiring fixed orthodontic appliance therapy were included. The children completed the German version of the Child Perceptions Questionnaire (CPQ-G-11-14) before (T0), 1 month (T1) and 6 months (T2) after the start of orthodontic treatment. The type of malocclusion was categorized according to the Index of Orthodontic Treatment Need (IOTN). The initial type of malocclusion affected the children's OHRQoL, whereas gender and age did not. The IOTN dental health component (DHC) had a significant impact on the CPQ score (median CPQ of 15.00 for the group DHC 4 vs. 22.50 for DHC 5, p = 0.032). The onset of orthodontic treatment initially affected the CPQ domains "Oral symptoms" and "Functional limitations, with a change versus baseline of 2.00 (p = 0.001), but improved again after 6 months. Regression analysis demonstrated that children with an IOTN DHC 5 malocclusion experienced a greater impact on their ORHQoL, as indicated by a CPQ score 7.35 points higher than that of children with an IOTN DHC 4 malocclusion (p = 0.015). At the beginning of orthodontic treatment, the OHRQoL slightly worsens, probably due to the discomfort and appearance of the appliances. However, 6 months after the start of orthodontic treatment, OHRQoL improved again in patients with severe malocclusion (IOTN 4 and 5), and approached baseline values. The results help the clinician to better understand specific aspects of oral health that may be affected by different malocclusions, thereby improving the child's satisfaction and overall quality of life.

Comparison of the Effects of Ketorolac and Acetaminophen on RANK-L Levels in the Gingival Crevicular Fluid during Orthodontic Tooth Movement: A Pilot Study

Background: Patients usually present pain due to the release of different inflammatory mediators such as prostaglandin E2 and RANK-L. Analgesics such as acetaminophen and ketorolac can inhibit RANK-L expression and this can affect orthodontic treatment by decreasing bone remodeling and slowing orthodontic dental movement. Several studies have reported a decrease in dental movement after administering some non-steroidal anti-inflammatory drugs. Proposal: The objective was to evaluate the RANK-L levels and a possible modulation by administering acetaminophen and ketorolac in patients starting orthodontic treatment. Methodology: A double-blind, randomized clinical trial was carried out with 24 subjects divided into three study groups: calcined magnesia as a placebo, acetaminophen, and ketorolac. Gingival crevicular fluid was obtained at four time points: before pharmacological intervention, at 24 h, at 48 h, and on the 5th day. RANK-L concentrations were evaluated through ELISA analysis. Also, interproximal space generated by the elastic separator at the end of the study was recorded in the different study groups using the visual analog scale. Results: An increase in RANK-L at 24 h was observed in the placebo group compared to the ketorolac and acetaminophen groups. However, no significant differences were observed in the interproximal space at day 5 in the three study groups. Conclusion: Patients who do not take analgesics at the start of orthodontic treatment have higher levels of RANK-L. Therefore, the use of ketorolac or acetaminophen could decrease bone remodeling and interfere with orthodontic dental movement.

Occlusal Changes with Clear Aligners and the Case Complexity Influence: A Longitudinal Cohort Clinical Study.

Clear aligners (CA) are used 22 h daily, creating a bite-block effect. This work aims to (i) analyze occlusal changes before the beginning of treatment, after the first set of CA and after the use of additional aligners; (ii) compare planned occlusal contacts with the ones obtained after the first set of CA; (iii) analyze the occlusal changes occurred after reaching the orthodontic goals after 3 months of using CA only at night; (iv) evaluate and characterize which tooth movements did not allow the treatment to be completed at the end of the first set of aligners, and finally (v) verify the possible relation between the changes in occlusal contact and areas and parameters such as case complexity and facial biotype. A quantitative, comparative, and observational longitudinal cohort study design was implemented to evaluate the clinical data and the complexity levels of cases receiving CA. A non-probabilistic and convenience sample of 82 individuals was recruited. The orthodontic malocclusion traits were classified as simple, moderate, or complex corrections based on the basis of the Align® recommendations with the Invisalign® evaluation tool. According to the Invisalign® criteria, patients need only one complex problem for their case to be classified as complex. Meshlab® v. 2022.02, ClinCheck® version Pro 6.0, My-Itero® version 2.7.9.601 5d plus, and IBM® SPSS Statistics software (Statistical Program for Social Sciences), version 27.0 for Windows were the software® used. A statistically significant decrease in area and occlusal contacts number were observed from before the start of orthodontic treatment (T0) to the end of treatment (T1). The changes in the occlusal area (from T0 to T1) were statistically different between hyperdivergent (28.24 [15.51-40.91]) and hypodivergent (16.23 [8.11-24.97]) biotypes (p = 0.031). A significant difference between the hyperdivergent (4.0 [2.0-5.0]) and normodivergent (5.5 [4.0-8.0]) group was found in T1 for the anterior contacts (p = 0.044). Anterior contacts obtained were significantly higher than the planned (p = 0.037) Between T1 and T2 statistically significant increases of occlusal areas, posterior and total contacts were observed. Occlusal contact and area were decreased, either at the end of the first set or after the use of additional aligners. Anterior occlusal contacts obtained were higher than planned as opposed to posterior occlusal contacts obtained. The hardest tooth movements to achieve to complete the treatment were distalization, rotation, and posterior extrusion. After completing orthodontic treatment (T1) to 3 months after (T2) using additional aligners only at night, posterior occlusal contacts were significantly increased, which could be due to the natural settling of the teeth in this period.

Cross-Cultural Adaptation of the Condition-Specific Malocclusion Impact Questionnaire for the Malayalam-speaking Population—A Psychometric Scale Validation Study

ObjectivesThe study aimed to develop a regional version of the Malocclusion Impact Questionnaire (MIQ-Malayalam) for the Malayalam-speaking Indian population.MethodsThe English version of MIQ was translated into Malayalam through a rigorous translation process, followed by cross-cultural adaptation. Young people aged below 18 years who were just about to start orthodontic treatment were invited to complete the Malayalam version of MIQ along with the available native version of the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). The MIQ-Malayalam was readministered after 14 days to assess test-retest reliability. Treatment need was assessed normatively using the Dental Health Component of the Index of Orthodontic Treatment Need (IOTN-DHC) and subjectively using Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN-AC).ResultsA total of 210 subjects completed the questionnaires (males = 47.2%; females = 52.8%; age = 12-17 years, mean = 15 years and 3 months; standard deviation = 1.9) and 50 completed repeat questionnaires. Internal consistency and test-retest reliability were high (Cronbach’s alpha = 0.952; Intra-class Correlation Coefficient = 0.93). Exploratory factor analysis derived 4 factors with exclusion of 1 item. There were significant differences ( P &lt; .05) in MIQ scores between IOTN-DHC subgroups, ensuring discriminant validity. There was a high correlation between total MIQ and total PIDAQ scores (rho = 0.884), while low between total MIQ and IOTN-AC scores (rho = 0.203).ConclusionThe Malayalam version of MIQ was found to be valid and reliable and can serve as a useful condition-specific measure of oral health-related quality of life.

Alignment efficiency of heat activated and superelastic nickel-titanium archwires in orthodontic patients over three months: A Single-center, randomized clinical trial.

The aim of this 2-arm parallel study was to evaluate the alignment efficiency of heat-activated nickel-titanium (NiTi-TE) and superelastic nickel titanium (NiTi-PSE) archwires over the first 3 months of orthodontic treatment and compare these groups. Randomized, double-blind, controlled, single-center trial in 52 patients with fixed orthodontic appliances from an orthodontic graduate program in the permanent dentition and moderate crowding in the lower arch. Patients were randomly allocated to one of two interventions: NiTi-TE and NiTi-PSE archwires, 0.014-inch (3M Unitek™, CA, USA) with a follow-up period of 3 months. The primary outcome was the alignment efficiency determined by the reduction in Little's irregularity index (mm), measured in three points, T0: before the start of orthodontic treatment, T1: 1 month later, T2: 2 months later, T3: 3 months later. Data were analyzed using independent sample t tests and repeated measures ANOVA. 52 patients (NiTi-TE n = 26; NiTi-PSE n = 26) were randomized and analyzed (average age: 21.73; standard deviation (SD): 6.07; average lower anterior irregularity: 5.20; SD: 0.76) for intention-to-treat (ITT) analysis. No statistically significant differences between the groups were found (mean of the differences: T1: 0.20; 95% CI: -0.558; 0.958; T2: 0.49: 95% CI: -0.339; 1.319; T3: 0.33; 95% CI: -0.308; 0.968). The resolution of crowding with each of the wires was significant (P < 0.0001) at all times. Twelve participants (2 treated with NiTi-TE and 10 treated with NiTi-PSE) lost follow-up due to face-to-face dental-procedures restrictions during the COVID-19 pandemic, the missing data was imputed. NiTi-TE and NiTi-PSE wires of 0.014-inch were similar in their clinical efficiency for the resolution of crowding during the first 3 months of orthodontic treatment. Clinical Trials NCT03256279.

Tongue Adaptation and Airway Changes in Two Different Bracket Systems: A Randomised Clinical Trial

Introduction: Orthodontics apart from correcting the malocclusions provide an invariably indirect effects on surrounding musculature and airway by means of creating room for proper tongue posture which helps in improvement of oropharyngeal airway dimensions along with dentoalveolar corrections which in this study was experimented with two different bracket systemsMBT and Damon self-ligating systems. Aim: To assess the adaptation of tongue and oropharyngeal airway changes following treatment with two different bracket systems. Materials and Methods: This randomised clinical trial was conducted in the Department of Orthodontics, Saveetha Dental College and Hospital, Chennai, Tamil Nadu, India, and included 20 participants and categorised into two groups: Group 1 and group 2 included participants who underwent orthodontic treatment with Damon appliance therapy with Damon Copper NiTi (CuNiTi) wires and MBT prescription with Damon CuNiTi wires. Lateral cephalogram and intraoral scanning was done at the start of orthodontic treatment (T0) and after one year (T1). Cephalometric and occlusal model assessment to determine the adaptation of tongue and Oropharyngeal Dimensions (OD) were determined (T0-T1) using the Facad® and 3-shape software. Independent t-tests and paired t-tests were done to compare T0 and T1 for both the groups were done using Statistical Package for the Social Sciences (SPSS) software. Results: Results of paired t-tests showed a statistically significant difference at the Interpremolar distance (IPM1) region of both groups 1 and 2 between T0 and T1 (p=0.034, p=0.011), Intercanine distance (IC) of group 2 upper (p=0.043) and IPM2 of both the groups in the upper arch (p=0.042, p=0.022). Cephalometric results showed a significant increase in all the assessed parameters within the groups between T0 and T1 (p&lt;0.05). Oropharyngeal space did not show any difference in both the systems however comparatively increased in group 1 than in group 2. Conclusion: Treatment with Damon and MBT prescriptions with Damon Cuniti wires showed significant alterations in adaptation of tongue and oropharyngeal space and also in bringing about arch expansion in maxilla and mandible with the greatest expansion noted for first premolar of both the groups and IC and Interpremolar (2nd premolar) width of the upper arch of both the groups.

Ramanujan’s Equation as an Aid to Predict Arch Perimeter Changes with Precision: A Retrospective Study

Introduction The aim of this study was to evaluate the validity of Ramanujan’s equation in measuring arch perimeter on untreated natural dentition models and their orthodontically corrected posttreatment models. The secondary objective was to apply the equation to predict the arch perimeter gained by the expansion of the molar teeth or proclination of the incisor teeth and compare it with the actual posttreatment arch perimeter changes. Methods 32 maxillary and mandibular (16 pretreatment and 16 posttreatment each) fairly aligned diagnostic casts of orthodontically treated nonextraction patients with class I molar relationships were used. The arch perimeter was measured using 0.012 mm stainless steel wire and was compared with the calculated arch perimeter obtained using Ramanujan’s equation. Pearson correlations were used to determine the correlation between the measured and predicted values. Paired t-tests were used to assess changes in different variables in the pre- and posttreatment study casts of maxilla and mandible. Results Positive correlation of 0.06 (90% CI) between predicted and measured values was found. In maxillary ( P = .04) study models, predicted arch perimeter by use of Ramanujan’s equation was more reliable than mandibular ( P = .74) study models. Conclusion Ramanujan’s equation can be an important aid to calculate the arch perimeter change by the expansion of molar teeth and proclination of incisor teeth 0.06 (90% CI). It is helpful for more accurate nonextraction treatment planning before the start of orthodontic treatment. In maxillary ( P = .04) study models, calculated arch perimeter using Ramanujan’s equation is even more reliable than mandibular study models ( P = .74).

Psychological appraisal of orthodontic patient during COVID-19 pandemic

Objective: The Aim of this study was to check Psychological appraisal of orthodontic patient during COVID 19 outbreak, and whether the pandemic have affected the attendance of the orthodontic patients. Method: Total 500 patients participated in the survey. A questionnaire consisting of 11 multiple-choice questions was distributed. Upon receiving of the completed questionnaires, the data were statistically analyzed. Results: A total of 500 Orthodontic patients (232 M, 268 F) completed the survey. Participants between 20 and 29 years old were the most common (n=232) age group. Most participants were student (n=363). A total of 331 patients (66.2%) believed that there was a greater risk of COVID-19 at orthodontic practice, but 328 patients (65.6%) felt comfortable going back to the orthodontist. 290 (58%) people willing to start orthodontic treatment if COVID-19 persists. Out of 500 orthodontic patients 450 (90%) were undergoing fixed treatment and 1(3.3%) patients were having removable appliances. Among the 484(96.8%) patients with orthodontic treatment, 466 (96.3%) return to the orthodontic practice, while 18(3.6%) patients were not able come back.

Risk assessment of external apical root resorption associated with orthodontic treatment using computed tomography texture analysis.

This study aimed to quantitatively assess maxillary central incisor roots using pre-orthodontics computed tomography (CT) texture analysis as part of a radiomics quantitative analysis. This retrospective case-control study included 16 patients with external apical root resorption (EARR) and 16 age- and sex-matched patients without EARR, after orthodontic treatment who underwent pre-orthodontics CT for jaw deformities. All patients were treated with a fixed orthodontic appliance before and after surgical orthodontic treatment. EARR was defined as root resorption ≥ 2mm of the left and right maxillary central incisors on CT images more than 2years after the start of orthodontic treatment. Texture features of the maxillary central incisor with and without EARR after orthodontic treatment were analyzed using the open-access software, MaZda Ver. 3.3. Ten texture features were selected using the Fisher method in MaZda from 279 original parameters, which were calculated for each of the maxillary central incisors with and without EARR. The results were tested using the Student's t test, Welch's t test, or Mann-Whitney U test. Four gray-level run length matrix features and six gray-level co-occurrence matrix features displayed significant differences between both the groups (p < 0.01). CT texture analysis was able to quantitatively assess maxillary central incisor roots and distinguish between maxillary central incisor roots with and without EARR. CT texture analysis may be a useful method for predicting EARR after orthodontic treatment.

Retainer in different malocclusion: A review

The purpose of this review article is to discuss the different type of retainers used to stabilize the treatment outcome in different malocclusions. Strategic and through search of the literature from different databases was undertaken using free text and MESH terms.Extensive study of the literature suggests that the duration and type of retention varies for different malocclusion and should be planned at the start of orthodontic treatment, as it plays important role in stabilizing the treatment outcome.Irrespective of the type of appliance used for retention, the patient should be informed and prepared for the long term or indefinite use of retainers and its role in maintaining the treatment results.

Motivation, Perception, and Behavior of the Adult Orthodontic Patient: A Survey Analysis.

Purpose The article is aimed at improving the understanding of the sociocultural profile of adult orthodontic patients and their expectations. In particular, it addresses three main aspects: the motivation and needs that underpin the decision to start orthodontic treatment, how it influences the patients' daily life, and the different oral hygiene demands. Materials and Methods An online survey was completed by 276 patients undergoing orthodontic treatment with different techniques. The questions asked concerned gender, age, type of appliance, any previous orthodontic treatments, type of any previous retainers, reasons for therapy, satisfaction, pain, problems in eating, daily number of teeth brushings and flossings before and during the treatment, perception of cost, sensation of visibility of the appliance, and if they would recommend orthodontic treatment. Results A significant role within our sample is played by gender; 87.94% consisted of female patients out of which 72.57% wanted to improve their aesthetics, while only 54.84% of male patients cited the same reason. Invisible aligners were preferred by 67.70% of the patients due to them being considered the least painful, causing the fewest problems with eating, and the least visible. Metal braces were perceived as the less expensive treatment. Over a third of the patients (33.85%) had previously undergone orthodontic treatment, among them 54.05% wore a mobile retainer, 31.08% a fixed one, and 14.86% both. Daily tooth brushing and flossing increased during therapy with clear aligners by 48.94% and 126.39%, respectively. Conclusions The greatest demand for orthodontic treatments comes from women, as they pay more attention to aesthetics, which makes the clear aligners the most common choice. The relapse after orthodontic treatment seems to cause a higher demand for retreatment, and oral hygiene habits significantly improve during orthodontic treatment, especially with the clear aligners.

The Influence of the COVID-19 Pandemic on Orthodontic Treatments: A Survey Analysis.

: BackgroundCoronavirus disease 2019 represents the pandemic of the 21st century that has negatively affected the lives of the whole of humanity. For many months, the only weapons to fight against this infection were protective masks and social isolation. During recent months, fear of the virus has led people to avoid crowded environments and events, and to reduce medical checks, limiting them only to emergencies. Outpatient clinics, doctors’ offices, and all closed-in environments were required to limit the patients’ access. Nowadays, the presence of specific protocols around the world, and the extended vaccination campaign, have allowed a reduction of many restrictions. Unfortunately, the virus is still widespread, and dental practice and dental treatments suffer the consequences. Dental therapies in general, and in particular orthodontics, are not considered lifesaving. Due to this, orthodontists, in this historical time, must find solutions for motivating patients to start or continue therapies, while providing a safe way for them to do so. There are orthodontists who have developed, during this period, different ways to help them in treating and communicating with patients. Aim: The aim of this study is to assess the influence of the pandemic on the choice to start orthodontic treatment, oral health care, and the importance placed on the appearance of dental occlusions. Materials and Methods: This study is a survey analysis of 159 people, which was posted in Facebook groups of adult orthodontic patients. The timestamps and answers of responses were analyzed to avoid duplicated or interrupted questionnaires. Conclusions: This study found that the current health emergency has not reduced the demand for orthodontic care, while some patients’ behaviors are changing in relation to oral hygiene and the importance that they attribute to dental health. It seems that dentists’ availability plays a key role in this period of sanitary emergency.

RETRACTED ARTICLE: The powerful effects of social media platforms on orthodontic patient knowledge’s improving, attitude management and it is influence on financial income of the orthodontic clinic

The aim of this study was increasingly influencing the health care landscape, so orthodontic patients can easily obtain information about orthodontic. The aim of this study was to investigate the benefits of using social media sites as a source of information to orthodontic patients for improving their knowledge about orthodontic care and treatment and the extend of its on reduce the duration of orthodontic treatment (DOT) and investigate the potential benefits of using social media platforms in marketing in orthodontic practices to increase the financial income of orthodontic clinics. 150 orthodontic patients were recruited as participants from the orthodontic clinic at the Near East University (in North Cyprus). The patients were 13 years and over from both sexes. Patients were excluded if they were not users of social media sites, had a history of previous orthodontic treatment, craniofacial syndrome, or low mental abilities. About 74% of the participants (mostly females) confirmed that social networking sites were the major driver for them to take the decision to come to the orthodontist and start orthodontic treatment. 73% of the respondents reported using social media sites as a source of information related to orthodontic treatment, where the Instagram was the most used program.

Effect of orthodontic treatment on periodontal health of periodontally compromised patients.

To evaluate the effect of fixed orthodontic treatment on periodontal parameters in periodontally compromised adult orthodontic patients. This was a prospective, randomized, controlled clinical trial. Thirty-six periodontally compromised adult patients (mean age: 29.67 ± 4.8 years) were randomly allocated to either test (perio-ortho) or control group (perio). After periodontal stabilization in both groups, orthodontic treatment was started in the test group, whereas the control group remained on periodontal maintenance only. Evaluation and comparison of clinical parameters (plaque index [PI]; gingival index [GI]; bleeding on probing [BOP]; probing depth [PD]; clinical attachment level [CAL]) of both groups was assessed at three time intervals: T0 (base line), T1 (at start of orthodontic treatment), and T2 (1 year after start of orthodontic treatment). Radiological parameters (alveolar bone levels [ABL]) were recorded using CBCT at T1 and T2. Intragroup analysis showed statistically significant improvement in all clinical and radiological periodontal parameters in both groups (P ≤ .05). Intergroup comparison revealed improvement in the periodontal parameters was not statistically significant between the groups (P ≥ .05). Subgroup analysis showed reduction in the number of moderate and severe periodontitis sites in both groups with significant more gains in ABL in the test group compared to the control group. Orthodontic treatment after periodontal stabilization does not have any detrimental effect on periodontal health in adult periodontally compromised orthodontic patients and may add to the benefits achieved by periodontal treatment alone.

Unilateral palatally impacted canines: Evaluation of pulpal condition after surgical exposure and orthodontic alignment

ObjectiveThe study aimed to assess changes in the pulpal condition of unilateral palatally impacted canines during and after orthodontic alignment. In particular, the effects of patient's age at treatment start, treatment duration and angle of canine displacement were analyzed. Materials and methodsClinical and radiographical examinations were conducted on a total of 66 patients with a unilateral palatally impacted canine, who previously underwent surgical exposure and were treated with multi-bracket appliances afterwards. After assessing the pulpal condition, the position of the canine was evaluated by analyzing the α-angle, d-distance and s-sector based on a modified version of the criteria proposed by Ericson and Kurol. A stepwise logistic regression was conducted to estimate the prognostic value of following parameters for the development of abnormal pulpal condition: alignment time, age at start of treatment, α-angle, d-distance and s-sector. ResultsOccurrence of abnormal pulpal condition of the impacted canine was significantly correlated with patient's age at the start of orthodontic treatment (p < 0.001), canine inclination (p = 0.005), distance between the canine and the occlusal plane (p = 0.002) and impaction location between the upper jaw midline and the axis of the central incisor (p = 0.012). ConclusionBeginning treatment of palatally impacted canines at an early age can avoid pulpal damage. Besides, inclination, distance to the occlusal plane and initial location require special orthodontic management to ensure pulpal protection.

Seven-year follow-up of a patient with hereditary gingival fibromatosis treated with a multidisciplinary approach: case report

BackgroundHereditary gingival fibromatosis (HGF) is rare in clinical practice, and the long-term results of the combined orthodontic-periodontal treatment of HGF are rarely reported.Case presentationThis study reports for the first time the results of seven years of follow-up in a seven-year-old girl with HGF. The diagnosis was confirmed by clinical signs, family history and histopathological examination. First, periodontal scaling and oral hygiene reinforcement were performed regularly in the mixed dentition stage. Next, gingivoplasty was performed on the permanent dentition. Two months after the surgery, treatment with fixed orthodontic appliances was conducted. The teeth were polished on a monthly basis, and oral hygiene was reinforced to control gingival enlargement. Gingival hypertrophy recurred slightly, and gingivectomies were performed in the months following the start of orthodontic treatment. Follow-up was performed for 24 months with orthodontic retention, and gingival enlargement remained stable after the combined treatment.ConclusionsThe risk of gingival hyperplasia recurrence during and after orthodontic treatment is high, but satisfying long-term outcomes can be achieved with gingivectomy, malocclusion correction, and regular follow-up maintenance.

Influence of orthodontic treatment on the state of dental hard tissues, prevention of complications

SummaryOrthodontic treatment of dentoalveolar anomalies is car-ried out using fixed and removable appliances, which af-fects the homeostasis of the oral cavity and increases the risk of developing carious lesions of the enamel. Purpose of the study: comparative assessment of the level of oral hygiene and the prevalence of enamel carious lesions at the stage of orthodontic treatment using removable and non-removable appliances. Materials and methods:90 patients aged 18 to 35 years were examined: 45 patients of the 1st group, who were treated with aligners, and 45 patientsof the second group, who were treated with a bracket system. In all patients, the level of oral hygiene was determined by the OHI-S (Green-Vermillion) index, as well as the level of CPU before and after 12 months of orthodontic treatment. Results: before the start of orth-odontic treatment, the OHI-S index in patients of the first and second groups was 0.86±0.67 and 0.89±0.74 points, respectively. After 12 months, there was a deterioration in the parameters of oral hygiene to a greater extent in patients of the second group who were treated with a fixed technique: the OHI-S index was 1.98±0.79 points. The value of the CPU index before the start of orthodontic treatment in patients of the first and second groups was 7.1±1.32 and 6.9±1.46, respectively. After 12 months of orthodontic treatment, there was an increase in the CPU index in the studied persons of the second group, who were treated with a bracket system: the CPU index was 13.6±1.78. In patients of the first group, the CPU indica-tor practically did not change and amounted to 7.9±1.25. Conclusion: with high caries susceptibility and the pre-sence of non-carious enamel lesions, orthodontic treat-ment with removable appliances should be preferred in order to avoid the development of complications.

Translation and validation of the Swedish version of the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) for adolescents

Objective The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) is an instrument developed for assessment of orthodontic aspects of oral health-related quality of life (OHRQoL). This study aimed to translate and validate the Swedish version of PIDAQ for use in Swedish adolescents 12–19 years of age. Material and methods The translation was made according to the process described in ‘Guidelines for Establishing Cultural Equivalency of Instruments’ by Ohrbach et al. Field testing was performed in a group of consecutive patients who were about to start orthodontic treatment (untreated group) and a group of consecutive patients who had recently finished orthodontic treatment (treated group). Results During the translation procedure, a Swedish version of PIDAQ was formed. In the field testing, a total of 144 questionnaires, 72 from untreated patients (mean age 14.6 years) and 72 from treated patients (mean age 17.3 years) were collected. The exploratory factor analysis detected two factors, which differs from the factor structure in the original questionnaire. The mean total PIDAQ score was significantly higher (p < .001) in the untreated group, 40.6 (20.3), than in the treated group, 9.4 (10.5), implying a high discriminant validity. Reliability was excellent, with internal consistency Cronbach’s alpha values varying from 0.94 to 0.97. Conclusion The Swedish version of PIDAQ demonstrates good validity and excellent reliability and is suitable for future research on the effect of malocclusion on OHRQoL in Swedish 12- to 19-year-olds.

Pain and Oral-Health-Related Quality of Life in Orthodontic Patients During Initial Therapy with Conventional, Low-Friction, and Lingual Brackets and Aligners (Invisalign): A Prospective Clinical Study.

The aim of this study was to compare pain and its relationship with the oral quality of life of patients with different types of orthodontic appliances: conventional and conventional low-friction brackets, lingual brackets, and aligners. A prospective clinical study was carried out with a sample size of 120 patients (54 men, 66 women) divided into 4 groups of 30 patients each. The modified McGill questionnaire was used to measure pain at 4, 8, and 24 h and 2, 3, 4, 5, 6, and 7 days after the start of treatment, and the Oral Health Impact Profile-14 (OHIP-14) questionnaire was used to measure the oral-health-related quality of life (OHRQoL) in the first month of treatment. The maximum peak of pain was obtained between 24 and 48 h of treatment. It was found that patients in the lingual orthodontic group described lower levels of pain at all times analyzed, and their scores in the total OHIP-14 indicated less impact on their oral quality of life (1.3 ± 1.2, p < 0.01) compared with the other groups analyzed. There was little difference with the aligners group (Invisalign) (1.7 ± 1.9, p < 0.01). The technique used influences the pain and quality of life of patients at the start of orthodontic treatment.