Orthodontic Treatment In Patients Research Articles

Temporary skeletal anchorage – possibilities and mechanism of application. Literature review

To date, the use of a temporary skeletal anchorage in orthodontic treatment in almost every clinical case. Despite this, there are only two variants of this surgical instrument: mini-screws and mini-plates. Both variants of the skeletal anchorage have their positive and negative qualities, which, to one degree or another, affect the result and timing of treatment. The purpose of this literature review is to describe the main methods of using temporary skeletal anchorage, in which clinical cases their use is possible and contraindicated, as well as what positive and negative aspects can be observed during and after the treatment of orthodontic patients. The search for scientific data was carried out in the PubMed database using such keywords as: orthodontic skeletal anchorage, temporary anchorage, orthodontic mini-screw, orthodontic mini-plate. A literature search revealed that temporary skeletal anchorage allows the surgeon and orthodontist to predictably make changes to the jaw bones that were previously only possible with orthognathic surgery. Before installing a mini-screw or mini-plate, careful planning in the form of an examination and x-ray examination should be carried out. Ultimately, informed consent should be obtained explaining to the patient that orthognathia may still be necessary if the skeletal anchorage method fails. Although this is still a relatively new technique, some issues need to be considered and further clinical research is needed.

Особенности оказания ортодонтической помощи детям с различным уровнем соматического здоровья

INTRODUCTION: Today, not all groups of the child population can receive full orthodontic care. This is typical for children with disabilities who have mental and neuromotor development disorders. To ensure optimal quality of orthodontic care in these cases, it is necessary to involve related specialists, the availability of modern equipment, and the psychological readiness of the doctor to work with children. The combination of these conditions will make it possible to fully provide orthodontic care to children with disabilities. AIM: To study features of rendering orthodontic care to children with different somatic health level MATERIALS AND METHODS: Orthodontic treatment of 50 children aged 7 to 16 years was carried out. The patients were divided into 3 groups based on the general somatic health status: children with anomalies of the position of teeth and bite, without burdening pathology; children with anomalies of the position of teeth and bite, with concomitant disorders of the respiratory, musculoskeletal and other systems; children with disabilities. Besides, the patients were classified by types of dental anomalies. Orthodontic treatment of patients from group 2 started after consultation with specialists. Patients from group 3 had a conclusion about the underlying disease and were referred to related specialists for consultation if necessary. RESULTS: The treatment of group 1 patients was without peculiarities. Removable and non-removable devices were used to correct dental anomalies. In all cases, a satisfactory result of treatment was obtained. In the treatment of group 2 patients, it was necessary to eliminate the concomitant pathology. Therapeutic measures aimed at restoring natural respiration and normalizing the function of the musculoskeletal system were recommended. As a result, anomalies of the dental system were corrected in 17 cases. In 3 cases, it was impossible to achieve correction of the distal bite due to the late start of treatment. In 1 patient, it was impossible to restore the function of the respiratory system. In 3 cases, the disorders in functioning of the musculoskeletal system were not completely corrected, which required further observation. The impossibility to restore the function of the respiratory system affected the result of treatment in 1 patient. Treatment of children from group 3 caused the greatest difficulty. A good clinical result was achieved in 3 cases, and in the rest ones the result was an improvement of the existing condition, but due to the peculiarities of the mental state of children, the treatment could not be fully completed. CONCLUSIONS: An effective algorithm for providing orthodontic care to children with disabilities has been developed. Before treatment, it is necessary to correct the concomitant pathology with participation of related specialists. It is recommended simple devices be used with good fixation in the oral cavity. The positive changes in the dental status obtained permit to further improve the overall health condition.

Orthodontic treatment of an open bite after splint therapy for a patient with idiopathic condylar resorption

In the treatment of orthodontic patients with idiopathic condylar resorption, symptoms of temporomandibular joint disorders and constantly changing occlusions caused by an instability of mandibular position make it difficult for orthodontists to confirm definitive orthodontic diagnosis and treatment plans. Therefore, these patients' temporomandibular joint (TMJ) structures need to be stabilized with splint therapy before active tooth movement to identify and maintain the true mandibular position. For some idiopathic condylar resorption patients, orthognathic surgery can cause further resorption on the vulnerable condyles of the mandible; thus, effective orthodontic camouflage treatment after joint stabilization should be considered. During the orthodontic camouflage treatment, adverse loads on the TMJ structures, which could change the position of condyles, should be avoided, and TMJ-friendly mechanics must be applied.

Features of orthodontic treatment in patients with generalized periodontitis

The need for orthodontic treatment in patients with generalized periodontitis is unquestionable today. However, in the case of orthodontic treatment of patients with generalized periodontitis, it should be remembered that the orthodontic treatment itself can damage the periodontal tissues. Periodontologists should take this into account when choosing a method of orthodontic treatment. Considering these circumstances, the preparation "Calcinovа" was used to strengthen the bone mineralization of the alveolar process.Aim. To determine the effectiveness of orthodontic treatment of patients with generalized periodontitis using a drug to stimulate alveolar bone mineralization.Material and methods. This study was conducted on a group of 36 patients with generalized periodontitis of a young age (18-35 years) with the absence of autonomic dysfunction - a state of eutonia. Patients underwent orthodontic treatment. To strengthen the processes of bone mineralization of the alveolar bone, the patients of the main subgroup were prescribed the drug "Calcinova". All patients underwent a comprehensive examination of the periodontium with the determination of the necessary hygienic indices to assess the state of the periodontium during treatment.Results. The examination of patients with generalized periodontitis after carrying out appropriate measures of therapeutic treatment showed a significant improvement in the condition of periodontal tissues. The beneficial effect of orthodontic treatment and stimulation of alveolar bone mineralization on the periodontal condition of patients is shown. Particular dynamics of the pathological process under the influence of complex treatment have been established. Analysis of the obtained results confirms the need for orthodontic treatment of patients with generalized periodontitis using methods of bone mineralization stimulation. It is shown that their use increases the effectiveness of treatment of generalized periodontitis.Conclusions. The combination of orthodontic treatment and a drug that increases bone mineralization of the alveolar process significantly improves the periodontal condition of patients with generalized periodontitis. The effectiveness of the use of the drug "Calcinova" for stimulating bone mineralization of the alveolar process of patients and maintaining the level of attachment is shown.

Clinical and radiographic effect of simultaneously labial and lingual augmented corticotomy: a prospective case series study

Objective: To investigate soft-and hard-tissue changes after simultaneously labial and lingual augmented corticotomy in patients with insufficient alveolar bone thickness of lower anterior teeth both in labial and lingual side during orthodontic treatment. Methods: From January 2021 to June 2022, 10 patients [2 males and 8 females, (26.2±3.1) years old] who received orthodontic and orthognathic combined treatment from the Fourth Clinical Division, Peking University School and Hospital of Stomatology were selected. The alveolar bone thickness of lower anterior teeth both in labial and lingual side in these patients was less than 0.5 mm according to cone-beam CT examination before or during treatment, and 60 lower anterior teeth were included. The 10 patients were treated with simultaneously labial and lingual augmented corticotomy. The differences in gingival recession, papilla index and the differences in labial and lingual alveolar bone thickness of lower anterior teeth were compared. Results: Six months after surgery, the alveolar bone thicknesses at the 4 mm under cemento-enamel junction (CEJ), 8 mm under CEJ and at the apical level [labial side: (1.02±0.39), (2.22±0.89) and (4.87±1.35) mm; lingual side: (1.07±0.46), (2.31±1.04) and (3.91±1.29) mm] were significantly higher than that before surgery [labial side: (0.02±0.09), (0.06±0.21) and (2.71±1.33) mm]; lingual side: (0.14±0.29), (0.40±0.52) and (2.13±1.02) mm] (P<0.001), respectively. The increases in alveolar bone thickness of central incisors [apical level on labial side: (2.53±1.20) mm, 8 mm under CEJ on lingual side: (2.27±1.24) mm, apical level on lingual side: (2.66±1.49) mm] and lateral incisors [apical level on labial side: (2.42±1.30) mm, 8 mm under CEJ on lingual side: (2.28±0.92) mm, apical level on lingual side: (1.94±1.15) mm] were significantly higher than that of canines [apical level on labial side: (1.52±1.47) mm, 8 mm under CEJ on lingual side: (1.17±1.09) mm,apical level on lingual side: (0.74±1.37) mm] (P<0.01). There were no significant differences in the degree of gingival recession [labial side before surgery: (0.72±0.88) mm, lingual side before surgery: (0.80±1.09) mm; labial side 6 months after surgery: (0.72±0.81) mm,lingual side 6 months after surgery: (0.89±0.21) mm] and gingival papilla index [before surgery: 1.00(0.75, 2.00); 6 months after surgery: 1.00(1.00, 2.00) ] between pre-operation and 6 months after surgery (P>0.05). No serious complications occurred. Conclusions: The method used in this article for simultaneously labial and lingual augmented corticotomy was safe and feasible. This surgery has positive clinical significance for the stability of the periodontal tissue in orthodontic treatment for patients with alveolar bone thickness less than 0.5 mm of lower anterior teeth both in labial and lingual side.

Orthodontic treatment in patients with periodontitis - anarrative literature review.

Patients with periodontitis often require an inter-disciplinary approach, including orthodontic treatment, for effective rehabilitation of masticatory function, aesthetics and quality of life. The aim of this narrative review was to comprehensively discuss literature focusing on the biology, indications and inter-disciplinary connections related to the orthodontic approach in patients with periodontitis and to present clinical concepts in accordance with valid guidelines. The outcomes of the experimental studies indicate that orthodontic tooth movement (OTM) can be performed safely for teeth with reduced periodontium, provided infection and inflammation are controlled. Orthodontic treatment can correct pathological tooth migration, is not associated with deterioration of clinical periodontal parameters and improves aesthetics. Intrusion is safe when performed with light forces and under a strict oral hygiene regimen. Teeth can be moved either towards or away from the intrabony defect previously subjected to regenerative procedures, and research suggests that OTM has the potential to enhance bone formation after regenerative therapy. The data on orthodontic movement of teeth with furcation involvement are very scarce. The improvement in furcation involvement following either combined periodontal and orthodontic treatment was only documented in animal model studies. Due to bone and tooth loss, special consideration should be given to orthodontic treatment mechanics. © 2023 Australian Dental Association.

The use of lingual brackets and miniscrews as anchorage in orthodontic treatment in patients with a high-angle skeletal Class II relationship

The use of lingual brackets and miniscrews as anchorage in orthodontic treatment in patients with a high-angle skeletal Class II relationship

Facial profile changes following orthodontic treatment in patients

This literature review aims to find out how orthodontic treatment can provide changes to the facial profile. The article is based on a literature review. Changes in the dentoskeletal and soft tissue profile around the mouth are found in orthodontic treatment. Correct positioning of the teeth over the basal bone can alter the profile, including the position of the upper and lower lips, na-solabial angle and labiomental angle. Through cephalometric radiography, hard and soft tissue structures can be analyzed si-multaneously, and tracing, then measuring, and evaluating. It was concluded that there is a relationship between orthodontic treatment and changes in the dentoskeletal and soft tissue profiles around the mouth.

Correlation between orthodontic treatment and temporomandibular joint disorders

Orthodontic treatment aims to regulate the growth and development of the jaw and teeth. The temporomandibular joint (TMJ) is a hinge joint that connects the upper and lower jaw bones between the temporal bone and the head of the mandibular con-dyle. Orthodontic treatment of patients with a history of restriction of TMJ movement experienced statistically significant re-sults and reduction of TMJ pain. The results of the analysis of 6 journals stated that orthodontic treatment had a significant re-lationship with temporomandibular joint disorders. Orthodontic treatment can cause TMD such as structural disorders of the TMJ and functional disorders. Orthodontic treatment can also help overcome TMD such as reducing pain in the TMJ and pro-viding balance to the occlusion.

A retrospective three-dimensional study of the mandibular growth during preoperative orthodontics in late adolescent patients with skeletal Class III malocclusion

IntroductionThe mandible's ongoing development presents a contraindication for combined orthodontic–orthognathic treatment. The aim of this study was to evaluate the mandibular stability before and after preoperative orthodontic treatment in late adolescent patients with skeletal Class III malocclusion and to investigate the most appropriate time to start preoperative orthodontic treatment. Material and methodsThe study population consisted of 58 adolescents, aged between 15 and 21 years, with skeletal Class III malocclusion; the adolescents underwent CT scans at the beginning (T1) and the end (T2) of preoperative orthodontic treatment. The CT data were analyzed using ITK-SNAP and 3D Slicer software, and the effects of age and gender on mandibular development were investigated. ResultsIn these 58 patients, there were no significant local bone alterations in the condyle and anterior chin point between T1 and T2 and no significant changes in the mandibular branch height, mandibular body length, condylar distance, and mandibular angle distance (p>0.05). The mandibular growth at the angel of mandible was statistically significant (p<0.05), but it was not clinically significant because the mean value of the growth was small (right: 0.416±0.986 mm, left: 0.328±0.886 mm). No effect of age and gender on mandibular development was observed. ConclusionThe mandibular morphology was stable during preoperative orthodontic treatment in patients at the late adolescent stage. This study provides evidence for the possibility of early implementation of preoperative orthodontics.

Orthodontic management of traumatic dental injuries in Norway and orthodontists' perceptions of referral routines: A quality assurance survey.

Orthodontic treatment of patients with traumatic dental injuries is challenging, with limited evidence of routines and outcomes. The aims of this study were: (i) to describe how orthodontists perceive the information on traumatic dental injuries received by referral from the Public Dental Health Service before orthodontic treatment and (ii) to assess orthodontists' knowledge and working routines in managing traumatic dental injuries. Data were obtained through a survey of all practicing orthodontists registered as members of the Norwegian Association of Orthodontists (n = 203). Eighty-three orthodontists were enrolled, most of whom had received their dental degree (73.0%) and specialist orthodontic training (88.5%) in Norway. They reported examining patients with a history of traumatic dental injury at weekly (34.2%) or monthly (38.0%) basis. In 85.5% of cases, they obtained a history of traumatic dental injury from patients. Half of the respondents (51.3%) favoured two-phase early orthodontic treatment for patients with an overjet ≥6 mm. The observation time and treatment strategy showed considerable discrepancies across traumatic dental injury diagnoses. Most (59.1%) orthodontists considered the information on previous traumatic dental injuries provided by the Public Dental Health Services referral 'inadequate', more commonly in cases of mild (83.5%) than severe (57.5%) traumatic dental injuries. Orthodontic management of patients with traumatic dental injuries was characterised by lack of uniformity in both recommended observation time before orthodontic treatment and management strategy. The referral routines by the Public Dental Health Services for patients with traumatic dental injuries were perceived as 'inadequate' in terms of frequency and quality. The results indicate the requirement of standardisation of routines related to orthodontic management of traumatic dental injuries and referral routines by the Public Dental Health Services.

EFFECT OF ORTHODONTIC TREATMENT OF GENERALIZED PERIODONTITIS ON ORAL HYGIENIC STATUS

Orthodontic treatment of patients with generalised periodontitis can have a negative impact on the periodontium. Removable orthodontic appliances have a lesser impact on the periodontium. Considering such details of orthodontic treatment for patients with generalized periodontitis, it is critical to start orthodontic treatment as early as possible, when significant manifestations of traumatic occlusion and pronounced displacements of teeth have not developed yet.&#x0D; The study aimed to determine the effectiveness of early orthodontic treatment using removable orthodontic appliances in patients with generalized periodontitis and its effect on the hygienic status of the periodontium. The study involved 40 adolescents (18-35 years) with generalized periodontitis who had displaced upper front teeth. Removable orthodontic appliances and individual retainers were used for orthodontic correction, and the patients underwent a comprehensive examination of the periodontium to assess their hygienic indices during the course of treatment.&#x0D; The assessment of the periodontal tissues shows that almost all patients had an inflammatory process in their periodontal tissues. Previously, the patients had undergone Phase 1 integrated treatment for generalized periodontitis. One month after the beginning of the orthodontic correction, there was certain deterioration in the periodontal condition. However, following the completion of orthodontic treatment, the hygienic condition of the periodontium improved.&#x0D; The study concluded that the combination of periodontal disease and tooth displacement requires comprehensive treatment using orthodontic methods. While the use of orthodontic treatment led to some deterioration in the periodontal condition, appropriate correction of drug treatment and rational oral hygiene practices can compensate for this.

Are asthma and allergy associated with increased root resorption following orthodontic treatment? A meta-analysis.

The aim of this study is to systematically investigate the available evidence from human studies regarding the association of asthma and/or allergy with EARR. Unrestricted searches in 6 databases and manual searching were performed up to May 2022. We looked for data on EARR after orthodontic treatment in patients with/without asthma or allergy. Relevant data were extracted, and the risk of bias was assessed. An exploratory synthesis was carried out using the random effects model, and the overall quality of the evidence was assessed with the Grades of Recommendation, Assessment, Development, and Evaluation. From the initially retrieved records, nine studies met the inclusion criteria (three cohort and six case-control). Overall, increased EARR was observed in the individuals with allergies in their medical history (Standardised Mean Difference [SMD]: 0.42, 95% Confidence Interval [CI]: 0.19 to 0.64). No difference in EARR development was observed among individuals with or without a medical history of asthma (SMD: 0.20, 95% CI: -0.06 to 0.46). The quality of available evidence, excluding studies at high risk, was rated as moderate for the exposure to allergy, and low for the exposure to asthma. Increased EARR was noted in individuals with allergies compared to the control group, while no difference was observed for individuals with asthma. Until more data become available, good practice would suggest that it is important to identify patients with asthma or allergy and consider the possible implications.

Biometric parameters of the upper dental arch in patients with a stable result of orthodontic treatment of abnormal position of the crowns of the maxillary canines

Aim to evaluate the metric parameters of the upper dentition in patients with a stable result of orthodontic treatment of anomalies in the position of the crowns of the upper canines in the long-term follow-up period.&#x0D; Material and methods. We conducted an open study on a sample of patients after orthodontic treatment using clinical and instrumental methods. We analyzed 126 clinical cases of patients aged from 18 to 44 years with completed orthodontic treatment of abnormal position of the crowns of the maxillary canines with satisfactory aesthetic and functional results. The duration of the retention period ranged from 5 to 10 years. 75 patients met the inclusion criteria for the study.&#x0D; Results. The study showed that the biometric parameters of the dental arches after the end of orthodontic treatment did not always correspond to the individual norm of a patient. An increase in the transversal size of the upper dentition in the region of the premolars was determined in 44 patients (58.6%), a slight narrowing in the region of the first molars in 34 patients (45.4%), lengthening or shortening of the anterior part of the dental arch in 32 (42.7%) and 23 (30.6%) patients, respectively. With the proportionality of the mesio-distal dimensions of the incisors of the upper and lower jaws (Tonn's Index 1.340.03) and the relative macrodontia of the canines of the lower jaw (anterior Bolton's ratio 81.03.2%), the symmetrical position of the crowns of canines of the upper jaw and the value of the rotational angle of 28.02.1corresponded to the functionally optimal results of orthodontic treatment.&#x0D; Conclusion. Aesthetically satisfactory and functionally stable results of orthodontic treatment of patients with anomalies in the position of the crowns of the maxillary canines during the retention period correspond to the following biometric parameters of the upper dental arch and / or their combination: lengthening of the anterior region, an increase in the transversal size in the region of the first premolars and a decrease in the region of the first molars in maintaining the individual norm of intercanine width. The stability of the results of orthodontic treatment in patients with anomalies in the position of the canines and the shape and / or size of the dental arches is ensured by the maximum possible leveling of violations of the anatomical and topographic norms of the teeth position.

Evaluation of Hard Tissue, Soft Tissue and Airway Changes Post Twin Block Therapy: An In-vitro Study

Introduction: Aesthetic improvement happens to be one of the main reasons for seeking orthodontic treatment in patients with Angle’s Class II malocclusion. Prognathic maxilla, retrognathic mandible or a combination of both are the main aetiological factors for this malocclusion. Growth modification treatment with different methods can be performed in order to correct skeletal class II malocclusion. Appliance therapy to correct similar malocclusions should immaculately be directed towards addressing the dentoskeletal discord, in order to gain a favourable facial aesthetic result. Aim: To assess the effects of twin block on mandibular length, soft tissue profile and Oropharyngeal Airway (OAW) dimensions in skeletal class II malocclusion patients. Materials and Methods: An in-vitro study was carried out in the Department of Paedodontics at Sardar Patel Postgraduate Institute of Dental and Medical Sciences, Lucknow from June 2018 to March 2021. Study was done on lateral cephalograms of 15 growing children with Angle’s Class II Division 1 malocclusion in the age group of 9-12 years, who had undergone functional appliance therapy with twin block appliance. Standardised lateral cephalograms were evaluated at pretreatment (0 month) and postactive phase of twin-block therapy (9-12 months). Selected hard tissue, soft tissue and airway landmarks were marked and traced to evaluate hard tissue, soft tissue and airway changes. The data was analysed using statistical package for social sciences (SPSS) version 21. Results: There was a statistically significant increase in effective mandibular length (Condyle-Gnathion) and mandibular base length Gonion-Pogonion (Go-Pog) values (p&lt;0.001). Significant decrease in the facial convexity Glabella- Soft tissue Nasion (G-Sn) Soft tissue Nasion- Soft tissue Pogonion (Sn-Pog) was observed and airway dimensions showed significant increase after twin block therapy. Conclusion: Correction of Class II malocclusion by twin block appliance resulted in significant cephalometric changes in the hard tissue profile (increase in mandibular length), together with clinically favourable soft tissue changes and OAW dimensions.

Assessment of orthodontic treatment needs in patients with β-thalassemia major and sickle cell disease.

Patients suffering from hemoglobinopathies may suffer from pathogic dental and orofacial features. This study aimed to assess the prevalence of malocclusion and the need for orthodontic treatment in patients with β-thalassemia major (BTM) and sickle cell disease (SCD). The study was conducted on 311 blood transfusion-dependent patients with BTM or SCD and 400 healthy individuals aged 10 to 16. The types of malocclusion were evaluated based on Angle's classification and Dewey's modification, and their oral habits were recorded using a questionnaire. The need for orthodontic treatment was assessed through the Dental Health Component of the Index of Orthodontic Treatment Need (IOTN), and the data were compared with normal participants. The Index of Orthodontic Treatment Need-Dental Health Component (IOTN-DHC) assessment showed that patients had a higher prevalence of objective need for treatment (IOTN grades 4 and 5) compared to healthy children. The prevalence of class II malocclusion was significantly higher in patients. Patients showed significantly less Angle's Class I malocclusion compared to normal participants. Oral habits were presented in 61%, 64.15% and 62.4% of normal participants, BTM and SCD patients, respectively. The higher prevalence of Angle's class II malocclusion and higher percentage of IOTN grade 4 and 5 among BTM and SCD patients reveal the importance of early orthodontic assessment and intervention in children with BMT and SDC.

Rehabilitation with orthognathic surgery and orthodontic treatment in patient with severe occlusal disharmony: A case report

Rehabilitation with orthognathic surgery and orthodontic treatment in patient with severe occlusal disharmony: A case report

Psychosocial Influence of Malocclusion Among Nepalese Patients Seeking Orthodontic Treatment: A Hospital Based Cross-Sectional Study

INTRODUCTION Traditionally, orthodontic treatment focuses on normative criteria, though psychosocial dimension has equal importance. The aim of the study was to evaluate the psychosocial impact of malocclusion among patient seeking orthodontic treatment using psychosocial impact of dental aesthetics questionnaire (PIDAQ). MATERIAL AND METHODS A cross-sectional study was conducted in Department of Orthodontics and Dentofacial Orthopedics, UCMS during the period of July 2021 to Dec 2021. The study was approved by Institutional Review Committee of UCMS (IRC/081/21). Sixty patients seeking orthodontic treatment of age group 18-30 years answered questions concerning self perceived psychosocial impacts of malocclusion using Nepali version of PIDAQ, desire of orthodontic treatment based on scale ranging from 0 to 4. Clinical examination was performed to assess the severity of malocclusion based on the basis of Dental Health Component of Index of Orthodontic treatment need (IOTN-DHC). RESULTS Results showed no significant differences in total PIDAQ scores and its subscale (p&gt;0.05) among genders. There was signifi- cant difference in total PIDAQ scores and its subscale (p&lt;0.05) among patients with different desire of orthodontic treatment. Patient with very strong desire have the highest scores of total PIDAQ (42.27±11.40).Significant difference in total PIDAQ score and its subscale (p&lt;0.05) was seen among patients with difference grades of IOTN-DHC. CONCLUSION Equal self-perceived impacts of malocclusion were seen in both male and female. There was greater desire of Orthodontic treatment in patients with increased self-perceived psychosocial impact of malocclusion. Significant increase in PIDAQ score was also seen with increasing severity of malocclusion.

Predictability of Invisalign® Clear Aligners Using OrthoPulse®: A Retrospective Study.

This preliminary retrospective study evaluates how effective the OrthoPulse® (Biolux Technology, Austria) is in increasing the predictability of orthodontic treatment in patients treated with Invisalign® clear aligners (Align Technology Inc., Tempe, AZ, USA). A group of 376 patients were treated with Invisalign® orthodontic clear aligners in association with an OrthoPulse®. The OrthoPulse® was prescribed for 10 min a day for the entire duration of the orthodontic treatment. The OrthoPulse® App remotely tracked the percentage compliance of each patient. The number of aligners planned with the ClinCheck software at the beginning of the treatment and the number of total aligners (including the adjunctive aligners) used to finish the treatment were then considered. After applying inclusion/exclusion criteria, a total of 40 patients remained in the study and were compared with a control group of 40 patients with the same characteristics as the study group. A statistical analysis was carried out to investigate whether using OrthoPulse® led to a statistical reduction in the number of adjunctive aligners, thus leading to a more accurate prediction of the treatment. The statistical analysis showed that patients who used OrthoPulse® needed fewer finishing aligners and a greater predictability of the treatment was obtained. In fact, in the treated group the average number of additional aligners represented 66.5% of the initial aligners, whereas in the control group 103.4% of the initially planned aligners were needed. In conclusion, in patients treated with clear aligners, OrthoPulse® would appear to increase the predictability of orthodontic treatment with clear aligners, thus reducing the number of finishing phase requirements.

Orthodontic Retainers and the Stability of the Maxillary Arch in Unilateral Cleft lip and Palate Patients: A Systematic Review.

The aim of this systematic review was to elucidate the role of orthodontic retainers on the stability of compensatory orthodontic treatment in patients with unilateral cleft lip and palate. Five electronic databases (PubMed, Scopus, Web of Science, LILACS, and LIVIVO) and the grey literature (OpenGrey and Google Scholar) were investigated, according to the population, exposure, comparator, outcomes and Study design eligibility criterion. The risk of bias assessment was determined based on the Risk of Bias In Nonrandomized Studies of Exposure (ROBINS-E) and the level of evidence with the GRADE tool. Three studies were included: two presented moderate risk of bias and one high. A moderate level of evidence revealed a mean value of 0.6 mm of intercanine relapse distance, and great variability between the data, regardless of the use or type of retention or rehabilitation. Relapse in the posterior region showed clinical significance, from -1 to -1.7 mm, especially in individuals who did not use retention, except in patients with symmetrical arches with Hawley retainer, where this value varies from -0.2 ± 0.63 mm. Orthodontic retainers do not seem essential to prevent relapse at anterior maxillary dimensions after compensatory orthodontic treatment in patients with unilateral cleft lip and palate. Relapse in the posterior region can achieve greater clinical significance, which highlights the need for prolonged use of Hawley retainers and periodic evaluation of the stability of treatment results. Prospective studies with a longer follow-up can improve the certainty of the evidence.