Orthodontic Therapy Research Articles

Reliability and self-perception of semi-automatically assessed orthodontic treatment need in elderly patients undergoing supportive periodontal therapy – a cross-sectional study

ABSTRACT Purpose Patients with periodontitis, who currently make up a large proportion of the adult population, show high interest in orthodontic therapy. It is therefore important to recognize and assess orthodontic treatment need in these patients. The index of orthodontic treatment (IOTN) is an established tool to determine malocclusions clinically and digitally. Materials and methods A semi-automatic IOTN-assessment using OnyxCeph3TM was performed on patients undergoing supportive periodontal therapy (SPT). Intra- and inter-rater reliability were investigated using intra-class-coefficient (ICC). Self-perceived aesthetic by patients and perception by the investigator according to the aesthetic component (AC) were compared to both each other and normative need, measured by the dental health component (DHC). Periodontitis stage and grade and the possibility of an orthodontic treatment were determined. Results The mean age of the 64 included patients in this study was 62.1 years (SD ± 8.6; min-max 45–81) at the time of the examination. Self-related AC was different to the investigator’s assessment (ICC: = 0.474; 95%-CI: [0.262, 0.643]). Normative treatment need compared to self-perceived treatment need resulted in poor reliability (ICC: = 0.098; 95%-CI: [−0.071, 0.298]). Comparison of IOTN between investigators showed moderate reliability for AC (ICC: = 0.618; 95%-CI: [0.331, 0.799]) and an excellent reliability for DHC (ICC: = 0.932; 95%-CI: [0.863, 0.967]). AC Intra-rater reliability was considered good (ICC: = 0.796; 95%-CI: [0.613, 0.898]). Orthodontic treatment was possible in 48 of the 64 patients. Conclusion Semi-automated IOTN-assessment showed satisfying inter- and intra-rater reliability, but patients’ self-perceived dental aesthetics differed from the dentist’s assessment as well as from the normative treatment need.

In vitro Evaluation of Various Retention Protocols in Sustaining Treatment Outcomes Following Orthodontic Therapy.

Orthodontic therapy aims at achieving stable treatment outcomes by ensuring retention of corrected tooth positions. Various retention protocols have been proposed, but their efficacy in sustaining treatment outcomes remains unclear. This in vitro study evaluated the effectiveness of different retention protocols in maintaining treatment outcomes following orthodontic therapy. Thirty extracted human premolars were subjected to simulated orthodontic movement and then divided into three groups: group A-Essix retainer, group B-Hawley retainer, and group C-bonded retainer. Retention efficacy was assessed through measurements of tooth movement over a period of 6 months using a digital caliper. The mean amount of mesial movement observed in group A was 0.5 mm (SD ± 0.1), in group B was 0.7 mm (SD ± 0.2), and in group C was 0.3 mm (SD ± 0.1). Statistical analysis revealed significant differences in retention efficacy among the three groups (P < 0.05). The bonded retainer demonstrated superior efficacy in sustaining treatment outcomes by minimizing post-orthodontic tooth movement compared to Essix and Hawley retainers. Thus, the bonded retainer may be considered a preferable option for retention following orthodontic therapy.

Management of Gummy Smile Using Esthetic Crown Lengthening Technique

Abstract Excessive gingival display is a major concern for a large number of patients visiting the dentist. It is a multifactorial condition that needs to be managed in a sequential manner in order to reach proper treatment technique that targets and resolves the underlying etiologies. There are different etiologies of a gummy smile, such as vertical maxillary excess, short and hyperactive upper lip, altered passive eruption, anterior dentoalveolar extrusion, or a combination of these causes. Many techniques have been used to restore the dentogingival relation for the management of gummy smile. The various treatment modalities for Excessive Gingival Display includes gingivectomy, modified lip repositioning, orthognathic surgery, orthodontic therapy, hyaluronic acid infiltration, botulin toxin injections. This case report deals with the correction of Excessive Gingival Display using conventional gingivectomy.

Evaluation of Antimicrobial Efficiency, Shear Bond Strength, and Adhesive Remnant Index of TiO2 Infiltrated Orthodontic Adhesive - An In Vitro Study.

Enamel demineralization is an unavoidable adverse effect encountered with bonding brackets in orthodontic therapy. Introducing nanoparticles into the composite adhesive paste can prevent enamel demineralization. Titanium dioxide (TiO2) is known to exhibit direct antimicrobial efficiency. This study aimed to assess the antibacterial efficiency and shear bond strength (SBS) of an orthodontic bonding composite infiltrated with TiO2 nanoparticles. This in vitro study evaluated the efficiency of TiO2 nanoparticle-incorporated light-curing orthodontic composite paste (ENLIGHT, ORMCO). Twenty extracted premolars were randomly and equally allocated to the two study groups, N = 10. While a conventional composite was utilized for the bonding brackets in Group I, a TiO2-incorporated composite was used in Group 2. The adhesive remnant index (ARI) scores given by Artun and Bergland et al. and SBS were determined. Furthermore, the antimicrobial efficiency was estimated using the minimum inhibitory concentration (MIC)/minimum bactericidal concentration (MBC) and agar well diffusion assay for six composite disc specimens. The results were statistically analyzed using the chi-square test and Student's t test, at P < 0.05. After 24 h of curing, no statistical mean difference was observed between the two groups in terms of ARI or SBS scores (P > 0.05). However, there was a significant increase in the antimicrobial efficiency of Group II when compared with Group I (P < 0.05). TiO2 nanoparticle-incorporated orthodontic composites improve the antimicrobial efficiency with no significant change in the SBS. The ARI scores indicate the presence of 50% remnant orthodontic composite on the tooth enamel surface post debonding.

Evaluation of Orthodontic Retention Protocols and Their Impact on Treatment Stability: Insights from a Tertiary Care Study

ABSTRACT Context: The goals of orthodontic therapy are to provide stable treatment results and the best possible tooth alignment. Orthodontic retention regimens are essential for avoiding relapses after treatment; however, there is ongoing discussion on the best regimen. Methods: Orthodontic patients treated at a tertiary care center were the subject of a retrospective analysis. Information was gathered about follow-up evaluations, treatment techniques, patient demographics, and retention procedures. Relapse rates and occlusal characteristics were among the objective variables used to evaluate treatment stability. A statistical analysis evaluated the effectiveness of various retention strategies. Findings: When it came to preserving treatment stability, fixed retainers outperformed detachable appliances, Hawley retainers, and Essix retainers. The mean changes in occlusal parameters and relapse rates were greater for removable appliances, but the performance of Hawley and Essix retainers was moderate. Significant variations in retention techniques were verified by statistical analysis, with fixed retainers outperforming alternative detachable retainers and removable appliances. In conclusion, compared to alternative detachable retainers and removable equipment, fixed retainers are more successful in preserving treatment stability. Retention protocols, however, must to be established with each patient’s needs and treatment preferences in mind. The length of patient compliance and retention has a crucial role in determining the stability of therapy, underscoring the significance of patient education and continued monitoring. To improve long-term treatment results and optimize orthodontic retention techniques, further research and technical developments are required.

White Spot Lesions in Fixed Orthodontics: A Literature Review on Etiology, Prevention, and Treatment.

White spot lesions (WSLs) are a common complication after treatment using fixed orthodontic appliances. Decalcification of enamel surrounding fixed orthodontic appliances, known as WSLs, poses a significant aesthetic difficulty during and after treatment, as the purpose of fixed orthodontic therapy is to improve facial and dental appearance. Modern dentistry utilizes remineralization therapiesto non-invasively treat WSLsto prevent the progression of disease and enhance the strength, appearance, and functionality of the affected tooth. This review aims to identify and assess the etiology, formation, and risk factors, as well as current treatment approaches used in achieving WSLs remineralization, induced by fixed orthodontic appliances.An electronic search on the PubMed and ScienceDirect databases was performed using a selected keyword.A total of 172 studies (from 2013 to 2023) were retrieved. Their references were also checked to find other relevant studies. Duplicate copies were excluded. After the abstract and full-text screening, only 39 studies were included. Even though numerous studies address the different treatment modalities for managing post-orthodontic WSLs, such as antiseptics; fluoridessuch as dentifrices, mouthwash, and varnish, and remineralizing agents such as casein phosphopeptides amorphous calcium phosphate, biomimetic self-assembling peptides, lasers, bleaching, microabrasion, and resin infiltration. There is a lack of evidence-based studies that examine the long-term effects of WSLtreatment. Further well-performed controlled clinical trials with long-term follow-up are needed to establish best clinical practice.

Effect of Orthodontic Treatment on Endodontically Treated Teeth

ABSTRACT Background: This research has been conducted to assess the effect of orthodontic treatment on endodontically treated tooth. Materials and Methods: Overall, fifty subjects had been recruited. The participants received root canal therapy within 3 months as well as had an appointment for fixed orthodontic therapy. All candidates underwent an intraoral investigation. Radiographic evaluation as well as therapy planning were completed. Fixed orthodontic therapy had been initiated. All of the participants had been recalled. Endodontically restored teeth had been evaluated. All outcomes were assessed via Statistical Package for the Social Sciences (SPSS) software. Results: In this study, there were 25 males and 25 females. Pulp stones were seen in 15 subjects. Apical periodontitis was seen in nine subjects. Apical root resorption was seen in seven subjects, and enamel decalcification was seen in four subjects. Overall, 35 out of 50 subjects showed negative effects of orthodontic treatment on endodontically treated teeth. Conclusion: Excessive orthodontic force may result in increased pulp and peri-apical inflammation.

Aligning Archwires in Orthodontics: Exploring the Past, Present, and Future - A Comprehensive Narrative Review

Orthodontic wires facilitate the required dental adjustments in the context of orthodontic therapy. The archwire has played a crucial role in orthodontic treatment, and the increasing emphasis on aesthetic preferences from patients, as well as the development of composite and ceramic brackets, have prompted investigations into aesthetic archwires that complement these brackets. Orthodontic wires are produced using a diverse range of materials. The utilisation of all available wire types can improve patient comfort, decrease chairside time, and shorten the overall duration of treatment. The individual clinician must possess comprehensive knowledge and comprehension of the various requirements and alternatives throughout the therapeutic process. This article provides an overview of the history of materials utilised in producing orthodontic aligning archwires, the latest advancements in these materials currently accessible in the market, and the future of archwire production.

Assessment of the Need for Surgical Debridement of Periapical Tissues Among Patients of Older Age Groups as a Manifestation of Ageism

Endodontic therapy is aimed at cleaning the root canal system and creating barriers to prevent re-infection of roots and peripical tissues. The presence of persistent bacteria or reinfection of a previously mechanically treated and disinfected root system causes the development of apical periodontitis and the need to implement surgical aids. Against the background of an increase in the number of patients of older age groups, characterized by obliteration of the root canal system, the relevance of surgical aids for apical periodontitis increases. At the same time, based on their own life experience, patients of older age groups may perceive the refusal to perform orthodontic therapy and the offer of surgical benefits as age-related egoism. Purpose of work: to study the severity of periapical changes and indications for surgical intervention among patients of older age groups. Materials and methods. The endodontic and periapical status of 300 patients was assessed in the 1st subgroup aged 60 to 70 years and the 2nd subgroup aged over 71 years. The results of the study. The greatest number of ageist conclusions in assessing the feasibility of providing surgical benefits was revealed in women with higher education.

Finite element analysis of the mechanical behavior of 3D printed orthodontic attachments used in aligner treatment

The composite attachment loss during orthodontic clear aligner therapy is an adverse event that commonly happens in clinical practice and can affect the overall outcome and length of treatment. The aim of our research is to provide a basis for the further study of an innovative digital protocol and application method for orthodontic aligner attachments. Two 3D models were designed, one based on the proposed protocol and the other on the conventional method for aligner attachment application. Four attachment shapes were used to identify the maximum values for the von Mises equivalent stresses, the maximum displacements values and the areas in which these values were recorded through FEM analysis. The results of the mechanical simulation show lower values of von Mises stress recorded in the 3D printed attachments assemblies, independent of their shape, when simulated under the same boundary and load conditions. The trapezoidal prism shaped 3D printed model has a 3.7 times smaller displacement value (0.088 [mm]) compared to the adhesive resin model (0.326 [mm]). In conclusion, the proposed protocol for aligner attachments and the introduction of innovative materials is a promising method of solving conventional attachment problems in current orthodontic treatments.

Gummy Smile: A Narrative Review

Imaginary line that follows the lower superior lip is known as the grin level, and it appears to be convex. Gummy smile is caused by gingival band exposures that are 3 mm or greater throughout normal speech or smiles. Multifactorial etiology can be demonstrated by extrusion of the anterior teeth, excessive labial contraction, shorter upper lip, gingival excess, and excessive vertical maxillary growth up. In addition to being useful for orthognathic, plastic, and periodontal surgery, orthodontic therapy is also frequently interdisciplinary. Many techniques can be used to treat the issue of excessive gingival show. These operations involve both non-surgical and surgical techniques. The technique to be chosen may vary depending on the underlying reason of the gummy smile.

The Role of Orthodontics in the Management of Maxillofacial Fractures in Children: A Review on Contemporary Approaches.

Maxillofacial fractures present complex challenges requiring effective orthodontic management to restore function and aesthetics. This review explores various orthodontic techniques, including fixed braces, maxillomandibular fixation (MMF), functional orthodontic therapy (FOT), and acrylic splints, emphasizing their roles in stabilizing fractures and promoting healing. The management of condylar fractures is discussed, highlighting the benefits of early intervention with functional appliances to facilitate condylar remodeling in children and adolescents. Additionally, the review covers splinting methods for dental and dentoalveolar fractures and the use of open reduction internal fixation (ORIF) for maxillary fractures. It addresses the complications and challenges of fracture management, the need for a multidisciplinary approach, and the limitations of current studies. Future directions include the use of advanced technologies such as virtual surgical planning (VSP) and 3D printing to enhance treatment precision and outcomes. This review provides a comprehensive overview of orthodontic strategies for maxillofacial fractures, offering insights into clinical applications and future advancements.

Evaluation of Gingival Issues Encountered by Adults Receiving Fixed Orthodontic Treatment in Dakshina Kannada Population: A Questionnaire Study

Background: Fixed orthodontic components used in orthodontic treatment can serve as a focal point for plaque and biofilm accumulation, leading to plaque-associated gingivitis. This occurs due to the intricate interaction between the host (patient) and the microbial environment surrounding these components. Alterations in gingival color, shape, size, texture, and contour should serve as warning signs for both the patient and the orthodontist, prompting them to take preventive measures against further progression. It's crucial to educate both the orthodontist and the patient about the potential complications linked to the gingival response during treatment.  Methods: This Questionnaire study sample size of 150 was performed to evaluate the gingival problems faced by the patients undergoing fixed orthodontic therapy in Dakshina kannada population .  Results: Most individuals undergoing orthodontic treatment were typically in the age range of 19 to 24 years old. There was a higher proportion of female participants compared to males, and the majority of them maintained good oral hygiene. Young adults demonstrated greater awareness and understanding of the treatment, which contributed to improved gingival health outcomes.  Conclusion: The responsibility for maintaining oral health predominantly rests with the patient, who must ensure adherence to proper, effective, and thorough oral hygiene routines. It's imperative for every orthodontic patient to receive encouragement and education regarding the gingival changes associated with orthodontic treatment and the importance of maintaining good oral hygiene practices.

Shear Bond Strength of Orthodontic Brackets Bonded with Thermo-Cured Glass-Based Materials-An In Vitro Study.

The results of orthodontic therapy largely depend, among other factors, on the preparation of the tooth enamel itself and the choice of material used to bond orthodontic brackets. The aim of this in vitro study was to determine the shear bond strength (SBS) and adhesive remnant index (ARI) score of thermo-cured glass-ionomers on different pretreated enamel, in comparison with the commonly used composite cement. Three commercially available nano-ionomer or highly viscous glass-ionomer cements (EQUIA Forte® Fil, EQUIA Fil, Ketac Universal) and two types of compo-sites (Heliosit Orthodontic, ConTec Go!) were investigated in this study. The research involved two hundred human premolars. The teeth were cleaned and polished, then randomly divided into five groups according to the enamel preparation method and the type of material. The enamel was treated in three different ways: polyacrylic acid, phosphoric acid, 5% NaOCl + etching with phosphoric acid, and a control group without treatment. Glass-ionomer cement was thermo-cured with heat from a polymerization unit during setting. Statistical analysis was performed using a Chi-square test and one-way ANOVA for independent samples. Spearman's Rho correlation coefficient was used to examine the relationship. Regardless of the material type, the results indicated that the weakest bond between the bracket and tooth enamel was found in samples without enamel pretreatment. The majority of the materials stayed on the brackets in samples without enamel preparation, according to ARI scores. The study's findings demonstrated that the strength of the adhesion between the bracket and enamel is greatly influenced by enamel etching and glass-ionomer thermo-curing. Clinical investigations would be required to validate the outcomes.

Oral Hygiene Practices and Oral Health Knowledge among Adult Orthodontic Patients: A Best Practice Implementation Project

Orthodontic therapy is associated with a more significant accumulation of dentobacterial plaque and impaired oral hygiene, which increase the risk of developing dental caries and periodontal disease. Therefore, it is crucial to educate orthodontic patients about proper oral hygiene maintenance and oral health before and during treatment. The aim of this pilot study was to implement evidence-based best practices related to oral hygiene in adult orthodontic patients and improve compliance. In addition to evaluating oral hygiene practices, another goal of the project was to assess the knowledge of orthodontic patients regarding oral health. Questionnaires with seven pre- (before) and post-test criteria (90 day after implementation) were developed based on the best evidence available. This project was conducted in a private dental clinic in Split, Croatia, and included 45 patients. The baseline audit showed a gap between clinical practice and the best evidence. Three criteria achieved a high compliance baseline, while after implementation, there were substantial improvements in compliance for all. The everyday use of mouthwash improved from 17.8% at baseline to 66.7% at follow-up, as did the use of interdental aids, which increased from 55.6% to 91.1%. Statistically significant differences were found in the total score for oral health knowledge between the baseline (6.67 ± 1.74) and the follow-up audit (7.78 ± 0.56, p ≤ 0.001). The strategies developed in this project were effective in providing essential information to adult orthodontic patients and improving compliance with evidence. Guidelines on this topic should be designed to assist orthodontists and patients in maintaining oral health and oral hygiene.

The effectiveness of scaling therapy on periodontal indexes in adolescents with fixed orthodontic appliances: a prospective cohort study

ABSTRACT Background Although fixed orthodontic therapy offers numerous advantages, inadequate adherence to specific guidelines can lead to negative consequences, primarily affecting the gums. To enhance periodontal health, several surgical and non-surgical approaches, including scaling, have been employed.The purpose of this clinical study was to evaluate the adjunctive role of scaling therapy on (the improvement of gum health parameters among patients undergoing fixed orthodontic treatment(FOT) during the period of 6 months. Methods In this interventional study,78 patients were randomly assigned to either case or control groups. Oral hygiene techniques were taught to both groups. Periodic scaling was done were performed at three times (1,3 and 6 months) after the starting of orthodontic treatment in the intervention group. Periodontal indices were measured and compared at baseline and all follow-up times between groups. The data were analysed with the repeated measure test at the significant level of 0.05 in the SPSS software (ver.22). Findings This study was conducted on 78 patients with a mean age of 21 ± 9 years old, including 37 women and 41 men that assigned to two equal groups of 39. The results of repeated measured analysis showed that the mean of GI and BOP indices increased significantly during the follow-up period of the study in the control group, but a non-significant decrease was obtained in the intervention group. But, the average of Pl.I index decreased significantly during the follow-up period in the intervention group, compared to the control group. Conclusions Scaling as an adjunct therapy helps to improve clinical periodontal parameters in patients undergoing FOT.

Awareness of orthodontic patients towards smartphone orthodontic apps.

Mobile phone applications (apps) can potentially enhance patient care as they are easy to use and offer multifunctions. In 2019, 305 orthodontic apps were documented, many of which were patient-focused; however, there was little information on how popular these applications are with orthodontic patients. The main aim of this study was to evaluate how well patients were now aware of orthodontic applications. A survey asking 700 orthodontic patients about their knowledge of, access to, and use of orthodontic apps to facilitate their treatment resulted in 615 responses. The results showed that a smartphone was owned by 96% of patients. Apple (Apple Inc., Cupertino, CA, USA) was the most used platform, followed by Android (Google LLC, Mountain View, CA, USA). Seventy-five percent of patients have previously used social media to research information, with YouTube (YouTube, San Mateo, CA, USA) being the most popular site. Only 3% of patients knew that applications were available to aid with orthodontic therapy and 12 patients had utilized an app linked to orthodontics. Nevertheless, 88% of patients said they would be open to using an app to supplement their treatment. Although 88% of patients said they would be prepared to use an app to help with orthodontic treatment, there is currently a low level of knowledge of the existence of apps. Given the availability of applications geared toward those patients, it is necessary to evaluate these apps' quality and, when critical, direct patients toward high-quality, efficient apps.

Periodontal changes induced by fixed orthodontic therapy.

Orthodontic therapy is a complex process involving a series of specialists in the dental field: the oral-maxillo-facial surgeon, the periodontologist, sometimes even the prosthetist, implantologist, or general practitioners. The injuries of the oral mucosa induced by orthodontic therapy include gingival overgrowths, traumatic lesions of the oral mucosa, different degrees of periodontal damage manifested by gingival retraction, alveolar bone resorption. From a total of 327 subjects who came to the Dental Clinic in Craiova 74 subjects were selected, who presented with gingival overgrowth associated with fixed orthodontic therapy. Subjects' age ranged from 14 to 56 years and experienced bleeding and gingival discomfort as well as alterations in physiognomic function. None of the patients included in the study have systemic diseases and are not under medical treatment. The clinical and statistical study took place between May 2022 and December 2023. Each patient was given a personal record containing personal data as well as oral and systemic health status. The examination of the periodontal status aimed at the evaluation of the following indices: assessment of oral hygiene using the OHI-S index and the O'Leary plaque index, assessment of superficial periodontal status using the Löe/Silness gingival inflammation index, periodontometry was performed in order to determine the depth of periodontal pockets, the level of gingival insertion, and the McGaw gingival overgrowth index. OHI-S index comprises two elements: the Debris Index and the Calculus Index. The purpose of our study is to present the incidence of cases of gingival overgrowth induced by fixed orthodontic therapy and to highlight how certain irritating factors can exacerbate the symptoms of gingival overgrowth of orthodontic etiology. The majority of patients were female, aged between 30 and 55 years. Most clinically examined patients have presented with Grade II gingival hyperplasia. Factors that have exacerbated the symptoms of orthodontically induced gingival overgrowth include: incorrectly adapted prosthetic restorations, unpolished massive coronal fillings, root remnants, bacterial plaque, and tartar. Clinical examination of the oral cavity revealed the presence of gingival inflammation (localized or generalized), simple or complicated, treated and untreated odontal lesions, and coronal fillings made of light-curing composite material of significant size, being unfinished and unpolished, sometimes with sharp edges directly injuring the adjacent gingival mucosa, marginally incorrectly adapted prosthetic works. In the case of child and adolescent patients, significant amounts of bacterial plaque and tartar buildup were observed. In most of the cases examined, it was observed that the gingival overgrowth had a firm consistency, pinkish-reddish colour and gingival bleeding was evident during probing. Gingival overgrowth caused by orthodontics induces a number of important periodontal changes. It is worth noting that gingival overgrowth induced by fixed orthodontic therapy, in most of the cases examined, co-exists with favouring factors that amplify its severity. In our study, the favouring factors were bacterial plaque and calculus accumulation, sharp-edged odontal lesions, marginally ill-fitting prosthetic restorations or massive unfinished crown fillings. Therefore, removing the contributing factors can help improve the symptoms but also to reverse the inflammatory phenomena.

Clinical effectiveness of regenerative periodontal surgery and orthodontic tooth movement with clear aligners in stage IV periodontitis: a case series.

To evaluate the clinical effectiveness of regenerative treatment of intrabony defects in combination with consecutive orthodontic therapy with clear aligners in stage IV (type 2) periodontitis. Ten patients with a total of 103 intrabony defects were analyzed after regenerative surgery using collagen-deproteinized bovine bone mineral with or without collagen membrane or enamel matrix derivative followed by orthodontic therapy with clear aligners. Changes in radiographic bone level and probing pocket depths were evaluated after 1 year (T1) and at final splinting (T2) after orthodontic tooth movement. Mean radiographic bone level gain was significant, with 2.13 ± 1.64 mm at T1 and 3.02 ± 2.00 mm at T2. Mean probing pocket depth was significantly reduced from 5.40 ± 1.80 mm at baseline to 3.78 ± 1.73 mm at T1, and remained stable with 3.73 ± 1.70 mm at T2. Pocket closure (≤ 4 mm probing pocket depth) was accomplished in 76% of all defects. Tooth loss amounted to 2.9%. Within the limitations of the retrospective study design, the findings suggest that the interdisciplinary treatment of periodontitis stage IV by regenerative periodontal surgery and consecutive orthodontic therapy with clear aligners can lead to favorable results.

Efficacy of F-ACP-Containing Dental Mousse in the Remineralization of White Spot Lesions after Fixed Orthodontic Therapy: A Randomized Clinical Trial.

Fixed appliance (FA) therapy predisposes patients to white spot lesions (WSLs). The F-ACP complex (amorphous calcium phosphate nanoparticles enriched with carbonate and fluorine and coated with citrate) has been effective for in vitro enamel remineralization. The aim of this study was to evaluate the efficacy of the F-ACP complex in remineralizing WSLs after FA therapy. One hundred and six adolescents (aged 12-20 years) were randomized into study and control groups after FA therapy. Patients in the study group were advised to use dental mousse containing F-ACP applied within Essix retainers for six months. The presence of WSLs was recorded at baseline (T0), 3 months (T1), and 6 months (T2) according to the International Caries Detection and Assessment System (ICDAS). Visual Plaque Index (VPI) and Gingival Bleeding Index (GBI) were recorded. Among 106 study participants, 91 (52 and 39 in study and control groups, respectively) completed the study. The results showed that the ICDAS score was significantly lower (p < 0.001) in the study group than in the control group between T0 and T2. The application of mousse containing the F-ACP complex inside Essix retainers for six months is effective in remineralizing white spot lesions in patients after FA therapy without side effects.