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1.
Eur J Paediatr Dent ; : 1, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38436607

RESUMO

BACKGROUND: It is quite common for white spots to develop on a tooth, due sometimes to a defective formation of the enamel layer, and sometimes to patches of demineralisation as a result of poor oral hygiene during orthodontic treatment with fixed braces. ICON DMG is currently the only noninvasive treatment for white spots. After a preliminary etching, it infiltrates the enamel, filling the spaces between the prisms with a resinous material that has a refraction coefficient very similar to that of healthy tooth enamel. The aim of this study was to test the efficacy of professional whitening procedures on teeth previously treated with ICON. The study hypothesis was that infiltration with ICON resin creates a barrier capable of preventing the bleaching action of the whitening agent. MATERIALS: White spots were artificially created on one half of the vestibular surface of 12 human teeth, while the other half was protected with a composite adhesive. The white spots were infiltrated with ICON and the protective adhesive was subsequently removed. A professional teeth whitening procedure was then completed on both halves of the teeth. A statistical analysis was performed to compare spectrophotometric recordings obtained before and after the ICON infiltration and teeth whitening procedures. CONCLUSION: The whitening procedure modified the colour of the teeth on the half not infiltrated with ICON (p<0.05), but there was no statistically significant change in colour on the half infiltrated with ICON. The presence of the ICON resin seems to act as a partial barrier to the action of the whitening agent.

2.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 59(3): 290-294, 2024 Mar 09.
Artigo em Chinês | MEDLINE | ID: mdl-38432664

RESUMO

Appropriate torque control of anterior teeth is of great significance to obtain ideal orthodontic treatment outcome. Clear aligners are less effective in torque control of anterior teeth due to their special application mode and material properties. Therefore, it is important to investigate how to improve the torque control of anterior teeth by using clear aligners, with the expectation of providing guidance for clinicians. This article discussed the methods to control the torque of anterior teeth by using traditional fixed appliances, the efficiency of clear aligner in controlling the torque of anterior teeth, the difficult points of clear aligner in controlling the torque of anterior teeth and the therapeutic methods to better control the torque of anterior teeth by using clear aligners.


Assuntos
Aparelhos Ortodônticos Removíveis , Técnicas de Movimentação Dentária , Humanos , Torque , Incisivo , Resultado do Tratamento
3.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 59(3): 295-300, 2024 Mar 09.
Artigo em Chinês | MEDLINE | ID: mdl-38432665

RESUMO

The success of clear aligner treatment relies on rational treatment planning, favorable patients' compliance and high-quality clinical dental monitoring. High-quality clinical dental monitoring involves not only evaluation of real-time tooth position and treatment-designed tooth position, but also the assessment of the root-alveolar bone relationship. However, fluent imaging tests with ionizing radiation are not realistic in clinical practice. Regarding the rapid advances in digital techniques, biomechanism based method, image processing algorithm-based method and multimodal data fusion-based method all exhibit great potential in monitoring tooth movement. This paper introduced the progress and clinical application in those methods for clinicians' reference.


Assuntos
Aparelhos Ortodônticos Removíveis , Técnicas de Movimentação Dentária , Humanos
4.
Front Pain Res (Lausanne) ; 5: 1365194, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38455874

RESUMO

Orthodontic forces are strongly associated with pain, the primary complaint among patients wearing orthodontic braces. Compared to other side effects of orthodontic treatment, orthodontic pain is often overlooked, with limited clinical management. Orthodontic forces lead to inflammatory responses in the periodontium, which triggers bone remodeling and eventually induces tooth movement. Mechanical forces and subsequent inflammation in the periodontium activate and sensitize periodontal nociceptors and produce orthodontic pain. Nociceptive afferents expressing transient receptor potential vanilloid subtype 1 (TRPV1) play central roles in transducing nociceptive signals, leading to transcriptional changes in the trigeminal ganglia. Nociceptive molecules, such as TRPV1, transient receptor potential ankyrin subtype 1, acid-sensing ion channel 3, and the P2X3 receptor, are believed to mediate orthodontic pain. Neuropeptides such as calcitonin gene-related peptides and substance P can also regulate orthodontic pain. While periodontal nociceptors transmit nociceptive signals to the brain, they are also known to modulate alveolar bone remodeling in periodontitis. Therefore, periodontal nociceptors and nociceptive molecules may contribute to the modulation of orthodontic tooth movement, which currently remains undetermined. Future studies are needed to better understand the fundamental mechanisms underlying neuroskeletal interactions in orthodontics to improve orthodontic treatment by developing novel methods to reduce pain and accelerate orthodontic tooth movement-thereby achieving "big gains with no pain" in clinical orthodontics.

5.
BMC Oral Health ; 24(1): 338, 2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38491450

RESUMO

BACKGROUND: Refinements are very common in clear aligner treatments. The aim of this study is to assess whether the predictability of deep overbite correction is similar over several refinements using clear aligners (Invisalign, Align Technology, San Jose, Calif) and examine the accuracy of vertical movement and inclination change of individual teeth. METHODS: This retrospective study included 20 deep bite patients (7M and 13F; 32.63 ± 11.88 years old; an initial overbite of 5.09 ± 0.98 mm), consecutively treated from September 2016 and March 2023, who completed at least two sets of aligners, including refinements. The initial, predicted, and achieved models were exported from ClinCheck or OrthoCAD (Cadent Inc, Carlstadt, NJ) and superimposed via best-fit surface-based registration using SlicerCMF (version 4.9.0; cmf.slicer.org). We also examined 15 out of 20 patients who completed treatments. The overbite correction and changes in vertical movement and inclination for individual teeth were measured. Descriptive statistics and a paired t-test or Wilcoxon signed-rank test were performed. P < 0.05 was considered statistically significant. RESULTS: The mean accuracy of overbite correction was 37.63% after 1st set, followed by 11.19%, 6.32%, and 13.80% (2nd-4th sets), respectively. There were statistically significant differences between the predicted and achieved vertical movements and inclination changes for all teeth for the 1st and 2nd sets. For the completed cases, the mean overbite correction was 38.54% compared to the initially planned overbite correction, which is similar to one of the 1st set. Still, the vertical movements and inclination changes of all teeth present statistically significant differences between the initially planned and finally achieved movements except for maxillary lateral incisor torque. CONCLUSIONS: The most overbite correction occurs during the 1st set of aligners, and refinement treatment does not significantly improve the deep bite correction.


Assuntos
Má Oclusão Classe II de Angle , Aparelhos Ortodônticos Removíveis , Sobremordida , Humanos , Adulto Jovem , Adulto , Sobremordida/terapia , Estudos Retrospectivos , Técnicas de Movimentação Dentária
6.
Br Dent J ; 236(5): 360, 2024 03.
Artigo em Inglês | MEDLINE | ID: mdl-38459292
7.
Br Dent J ; 236(6): 494, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38519695
8.
J Contemp Dent Pract ; 25(1): 41-51, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38514430

RESUMO

AIM: The study aims to correlate the frictional forces (FF) of four different types of commercially available ceramic brackets to their surface topography. MATERIALS AND METHODS: Two monocrystalline (MC) brackets (CLEAR™, Adanta, Germany; Inspire ICE™, Ormco, USA), one polycrystalline (PC) bracket (Symetri Clear™, Ormco, USA), one clear hybrid esthetic bracket (DISCREET™, Adanta, Germany), and a stainless-steel (SS) bracket (Victory™, 3M Unitek, USA) served as control. Both static friction (SF) and kinetic friction (KF) were recorded during sliding using an Instron universal machine in dry settings. The bracket slot surface topography was evaluated. A scanning electron microscope (SEM) and a profilometer machine were used for assessment before and after sliding. RESULTS: Frictional forces values during sliding were as follows in descending order; Inspire ICE™, CLEAR™, DISCREET™, Symetri Clear™, and, lastly, Victory™. Also, DISCREET™ scored the highest in surface roughness (Sa) values followed by Symetri Clear™. None of the correlations were statistically significant. CONCLUSION: Frictional forces produced during sliding were not always directly related to surface roughness. Monocrystalline ceramic brackets appeared to have the greatest FF and a low surface roughness. Furthermore, DISCREET™ scored a very low frictional value comparable to metal brackets yet showed the highest surface roughness. Metal brackets exhibited the greatest surface smoothness before sliding and the least SF. CLINICAL SIGNIFICANCE: Predicting the FFs produced during sliding mechanics would help the practitioner while choosing the bracket system to be used, and while planning the treatment mechanics, how much force to deliver, and how much tooth movement to expect. How to cite this article: AlBadr AH, Talic NF. Correlating Frictional Forces Generated by Different Bracket Types during Sliding and Surface Topography Using Scanning Electron Microscopy and Optical Profilometer. J Contemp Dent Pract 2024;25(1):41-51.


Assuntos
Braquetes Ortodônticos , Microscopia Eletrônica de Varredura , Fricção , Fios Ortodônticos , Desenho de Aparelho Ortodôntico , Análise do Estresse Dentário , Estética Dentária , Metais , Aço Inoxidável/química , Teste de Materiais , Propriedades de Superfície
9.
Cureus ; 16(2): e54696, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38523948

RESUMO

Tibial tubercle avulsion fractures, though rare, pose a significant challenge in pediatric orthopedics, particularly in athletic adolescents. For nondisplaced fractures, conservative treatment involves the use of braces or casts, while displaced fractures necessitate operative intervention, often through screw fixation. Concomitant soft tissue injuries should also be identified and addressed operatively to ensure complete repair of the extensor mechanism. This paper introduces a method for open reduction and internal fixation (ORIF) of tibial tubercle fractures with suture anchor repair of the distal patellar tendon avulsion. Two case examples of 14-year-old males with displaced fractures undergoing this procedure are presented. After standard screw fixation of the displaced fragment was performed, a single suture anchor was placed into the tibia and an onlay tension slide technique was utilized to secure the distal patellar tendon avulsion. Both patients underwent immobilization and protected weightbearing for four weeks with physical therapy initiated at six weeks. At four months postoperatively, both patients had returned to competitive sports without issue. The described technique may represent a reliable and reproducible method for addressing the distal patellar tendon avulsion component of tibial tubercle fractures. Its biomechanical advantages contribute to the complete repair of the extensor mechanism, enabling a successful return to competitive athletics without hardware complications.

10.
World J Clin Cases ; 12(7): 1320-1325, 2024 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-38524521

RESUMO

BACKGROUND: Developmental dysplasia of the hip (DDH) is a common osteoarticular deformity in pediatric orthopedics. A patient with bilateral DDH was diagnosed and treated using our improved technique "(powerful overturning acetabuloplasty)" combined with femoral rotational shortening osteotomy. CASE SUMMARY: A 4-year-old girl who was diagnosed with bilateral DDH could not stand normally, and sought surgical treatment to solve the problem of double hip extension and standing. As this child had high dislocation of the hip joint and the acetabular index was high, we changed the traditional acetabuloplasty to "powerful turnover acetabuloplasty" combined with femoral rotation shortening osteotomy. During the short-term postoperative follow-up (1, 3, 6, 9, 12, and 15 months), the child had no discomfort in her lower limbs. After the braces and internal fixation plates were removed, formal rehabilitation training was actively carried out. CONCLUSION: Our "powerful overturning acetabuloplasty" combined with femoral rotational shortening osteotomy is feasible in the treatment of DDH in children. This technology may be widely used in the clinic.

11.
BMC Oral Health ; 24(1): 350, 2024 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-38504207

RESUMO

BACKGROUND: Clear aligner therapy has gained popularity as a minimally invasive orthodontic treatment option. However, its impact on the masticatory musculature and the stomatognathic system is an area of growing interest, as it involves the adjustment of occlusion and tooth movement. This systematic review aims to comprehensively assess and synthesise existing evidence regarding the influence of clear aligner therapy on the masticatory musculature and the stomatognathic system. METHODS: An exhaustive search was performed on electronic databases that adhered to PRISMA guidelines. Clinical studies that evaluated the impact of patients receiving aligner orthodontic treatment on the muscles of the mastication and stomatognathic systems were included. A standardised data extraction form was devised for relevant variables. Two reviewers extracted the data variables. ROB-2 was used for bias evaluation in the selected studies. RESULTS: A total of six studies met the inclusion criteria. The wearing of clear aligners significantly impacted the muscles of mastication. Muscle activity and discomfort showed a significant alteration in the initial days of appliance placement. but this observation was temporary, with no significant changes thereafter in subsequent follow-up. Bite force reduction was also noted. All the studies evaluated showed good methodological quality. CONCLUSION: The review found that aligned orthodontic treatment may have a variable impact on muscles of mastication, with a potential for initial exacerbation of symptoms followed by possible improvement. However, due to the limited number of studies and their heterogeneous nature, further robust research is recommended to fully understand the relationship between aligned orthodontic treatment and masticatory muscles.


Assuntos
Músculos da Mastigação , Aparelhos Ortodônticos Removíveis , Humanos , Sistema Estomatognático , Oclusão Dentária , Força de Mordida
12.
BMC Oral Health ; 24(1): 358, 2024 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-38509532

RESUMO

OBJECTIVE: This study aimed to evaluate enamel surface integrity and time consumed during residual cement removal after bracket debonding using different adhesive removal burs with and without a dental loupe. MATERIAL AND METHODS: Sixty human-extracted premolars were collected, cleaned, mounted, and prepared for orthodontic bracket bonding. Teeth were randomly divided into three main groups (n = 20) based on the adhesive removal method: tungsten carbide system (TC), sof-lex discs system (SD), and diamond system (DB) groups. Then, each group was subdivided into two subgroups (naked eye and magnifying loupe subgroups). The brackets were bonded and then debonded after 24 h, and the Adhesive Remnant Index (ARI) was assessed. The adhesive remnants were removed by different systems, and the final polishing was performed by Silicone OneGloss. The enamel surface roughness was evaluated before bracketing (T0), after residual cement removal (T1), and finally after polishing (T2) using surface Mitutoyo SJ-210 profilometry and Scanning Electron Microscopy (SEM) to determine the Enamel Damage Index (EDI) score. The time consumed for adhesive removal was recorded in seconds. RESULTS: The Kruskal Wallis test showed a statistically significant difference in roughness values at T1 compared to T2 between subgroups (p < 0.001). When comparing EDI at T1 and T2, the Kruskal-Wallis H-test showed statistically significant differences in all subgroups. The pairwise comparisons revealed that EDI scores showed a statistically significant difference at T1 and T2 between DB vs. TC and SD (p = 0.015) but not between TC vs. SD (p = 1.000), indicating the highest roughness value observed in the DB group. The time for cement removal was significantly shorter in the magnifying loupe group than in the naked eye group and was shortest with the TC group, whereas the time was the longest with the DB group (p < 0.05). CONCLUSION: All three systems were clinically satisfactory for residual orthodontic adhesive removal. However, TC system produced the lowest enamel roughness, while the DB system created the greatest. The polishing step created smoother surfaces regardless of the systems used for resin removal.


Assuntos
Cimentos Dentários , Braquetes Ortodônticos , Compostos de Tungstênio , Humanos , Dente Pré-Molar , Descolagem Dentária , Esmalte Dentário , Cimentos de Ionômeros de Vidro , Braquetes Ortodônticos/efeitos adversos , Propriedades de Superfície
13.
BMC Oral Health ; 24(1): 292, 2024 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-38431544

RESUMO

BACKGROUND: Patients experiencing any malocclusion, may desire for treatment. However, there is no scientific information orthodontic treatment demand and the knowledge of young adults about orthodontic treatment. The aim of the study was to assess orthodontic treatment demand in young adults from Poland and Chile, their previous orthodontic experience and their knowledge on fixed and aligner orthodontic treatment. METHODS: The target group comprised people aged 18-30. The sample size was estimated as above 400 for each country. The survey was carried out in Polish and Spanish within 3 months and consisted of 25 questions delivered via social media. Comparisons were made between countries, age subgroups and gender. RESULTS: The response rate was 1,99%, what stands for 1092 responses, 670 from Chile and 422 from Poland, respectively. The percentage of young adults who were already treated was 42,9% in Poland and 25,0% in Chile. The ones planning to have orthodontic treatment within a year counted for 11,8% in Poland and 5,3% in Chile. Most young adults who want to be treated (20,6%) rely on doctor's recommendation on type of appliance while 14,7% of all respondents are interested solely in aligners. Most respondents have heard about aligners (58%). Direct provider-to-customer service without a doctor is not acceptable, neither in Poland (85,1%) nor in Chile (64,8%). Most young adults provided incorrect answers referring various aspects of aligner treatment. CONCLUSIONS: In both countries, patients demand to be treated and monitored by the orthodontist. A high percentage of patients want to be treated exclusively with aligners. Direct-to-consumer orthodontics does not seem attractive to patients. Young adults do not have adequate knowledge referring to aligner treatment. Many people want to be treated despite a previous orthodontic treatment.


Assuntos
Má Oclusão , Aparelhos Ortodônticos Removíveis , Ortodontia , Humanos , Adulto Jovem , Má Oclusão/terapia , Europa (Continente) , Chile , Inquéritos e Questionários
14.
Spine Deform ; 2024 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-38457029

RESUMO

BACKGROUND: This study determined brace wear adherence for patients treated with nighttime braces and evaluated the effect of brace adherence on curve progression. METHODS: One hundred twenty-two patients with AIS ages 10-16 years, Risser stages 0-2, major curves 20°-40° treated with Providence nighttime braces prescribed to be worn at least 8 h per night were prospectively enrolled and followed until skeletal maturity or surgery. Brace adherence was measured using iButton temperature sensors after 3 months of brace initiation and at brace discharge. RESULTS: Curve types were single thoracolumbar/lumbar (62%, n = 76), double (36%, n = 44), and single thoracic (2%, n = 2). Brace adherence averaged 7.8 ± 2.3 h after 3 months (98% adherence) and 6.7 ± 2.6 h at brace discharge (84% adherence). Curves that progressed ≥ 6° had decreased brace adherence than non-progressive curves after 3 months (7.0 h vs. 8.1 h, p = 0.010) and at brace discharge (5.9 h vs. 7.1 h, p = 0.017). Multivariate logistic regression analysis showed that increased hours of brace wear [odds ratio (OR) 1.23, 95% confidence interval (CI) 1.06-1.46], single curves (OR 3.11, 95% CI 1.35-7.53), and curves < 25° (OR 2.61, 95% CI 1.12-6.44) were associated with non-progression at brace discharge. CONCLUSIONS: Patients treated with nighttime bracing have a high rate of brace adherence. Lack of curve progression is associated with increased brace wear. Nighttime bracing is effective at limiting curve progression in AIS single thoracolumbar/lumbar and double curves. LEVEL OF EVIDENCE: Prognostic Level 2.

15.
Sci Rep ; 14(1): 5921, 2024 03 11.
Artigo em Inglês | MEDLINE | ID: mdl-38467693

RESUMO

Throughout treatment with fixed orthodontic appliances, effective plaque control is crucial to maintaining dental health. This in-vitro study evaluated the cleaning performance of eleven different brush heads of seven electric toothbrushes (oscillating-rotating and sonic motions) and varying brushing forces around orthodontic brackets. Six Mini Diamond® Twin brackets were placed on black-stained front teeth. Teeth were coated with white titanium oxide and brushed in a machine six times for one minute with two different brushing forces (1 N and 1.5 N). Eleven different brush heads were evaluated (either oscillating-rotating or sonic movements). The teeth were scanned and planimetrically evaluated after brushing. Three detailed plaque areas (DPAs) were created: proximal (< 1 mm to bracket), mid-tier (1-2 mm to bracket), and distant (> 2 mm to bracket). The proportion of contaminated proximal, mid-tier, and distant surfaces (white regions) in relation to the respective DPA was calculated. Independent of brushing forces, places with a higher distance (> 2 mm) to the orthodontic bracket had the least amount of residual contamination, followed by areas with a minor (1-2 mm) and proximal distance (< 1 mm). In all of the brushes tested and for both estimated brushing forces, the region with the highest residual contamination was the proximal area. The brush heads of the Paro® Sonic toothbrush left the least amount of residual contamination. The cleaning performance of electric toothbrushes around brackets on upper incisors varied across the brushes examined. The proximal area has the most residual contamination. Furthermore, 9 out of 11 toothbrushes cleaned more successfully with 1.5 N than with 1 N brushing force.


Assuntos
Braquetes Ortodônticos , Escovação Dentária , Projetos de Pesquisa , Incisivo , Movimento (Física) , Desenho de Equipamento , Método Simples-Cego
16.
NeuroRehabilitation ; 2024 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-38457159

RESUMO

BACKGROUND: Despite advances in stroke rehabilitation, challenges in upper limb motor recovery and postural stability persist, negatively affecting overall well-being. Arm slings and shoulder braces have been proposed to address these issues, but their efficacy in promoting postural stability remains unclear. OBJECTIVE: This pilot randomized controlled study aimed to evaluate the impact of a new shoulder brace (N1-Neurosling) on trunk postural stability during walking, pain, and upper limb muscle strength in chronic stroke survivors. METHODS: Twenty-four adult chronic stroke patients were involved and randomly assigned to the shoulder brace group (SBg) or control group (CTRLg). Were assessed at baseline (T0) and after 4 weeks (T1) through the Trunk Control Test, the Numerical Rating Scale, the Motricity Index, Manual Muscle Test, and instrumental wearable-based assessment. RESULTS: After 4 weeks, the SBg showed significant improvement in Trunk Control Test scores (p = 0.020) and smoothness of gait measured by log dimensionless jerk along the Antero-Posterior axis (- 5.31±0.25 vs. - 5.18±0.27, p = 0.018) compared to the CTRLg. The SBg also demonstrated a reduction in pain in the shoulder girdle and enhanced upper limb muscle strength. CONCLUSION: The use of the N1-Neurosling shoulder brace led to improvements in postural stability and smoothness of gait in stroke patients.

17.
Cochrane Database Syst Rev ; 2: CD007859, 2024 02 06.
Artigo em Inglês | MEDLINE | ID: mdl-38319008

RESUMO

BACKGROUND: Initial arch wires are the first arch wires inserted into fixed appliance at the beginning of orthodontic treatment. With a number of different types of orthodontic arch wires available for initial tooth alignment, it is important to understand which are most efficient and which cause the least amount of root resorption and pain during the initial aligning stage of treatment. This is the third update of a Cochrane review first published in 2010. OBJECTIVES: To assess the effects of initial arch wires for the alignment of teeth with fixed orthodontic braces, in terms of the rate of tooth alignment, amount of root resorption accompanying tooth movement, and intensity of pain experienced by patients during the initial alignment stage of treatment. SEARCH METHODS: We searched Cochrane Oral Health's Trials Register, CENTRAL, MEDLINE, Embase, and two ongoing trials registries on 4 July 2022. SELECTION CRITERIA: We included randomised controlled trials (RCTs) of different initial arch wires used to align teeth with fixed orthodontic braces. We included people with full-arch fixed orthodontic appliances on the upper arch, lower arch, or both arches. DATA COLLECTION AND ANALYSIS: Two independent review authors were responsible for study selection, data extraction, and assessment of risk of bias in included studies. We contacted corresponding authors of included studies to obtain missing information. We resolved disagreements by discussion between the review authors. Our main outcomes were alignment rate (movement of teeth in mm), root resorption, time to alignment, and intensity of pain measured on a 100-mm visual analogue scale (VAS). We pooled data from studies with similar interventions and outcomes using random-effects models. We reported mean differences (MDs) with 95% confidence intervals (CIs) for continuous data, risk ratios (RRs) with 95% CIs for dichotomous data, and alignment rate ratios with 95% CIs for time-to-event data. Two independent review authors assessed the certainty of evidence. We resolved disagreements by discussion between the review authors. MAIN RESULTS: We included 29 RCTs with 1915 participants (2581 arches) in this review. Studies were generally small (sample sizes ranged from 14 to 200 participants). Duration of follow-up varied between three days and six months. Eleven studies received funding, six received no funding, and 12 provided no information about funding sources. We judged eight studies at high risk of bias, nine at low risk, and 12 at unclear risk. We grouped the studies into six main comparisons. Multistrand stainless steel wires versus wires composed of other materials Six studies with 409 participants (545 arches) evaluated multistrand stainless steel (StSt) wires versus wires composed of other materials. We are very uncertain about the effect of multistrand StSt wires versus other wires on alignment rate (4 studies, 281 participants, 417 arches; very low-certainty evidence). There may be little to no difference between multistrand StSt wires and other wires in terms of intensity of pain (MD -2.68 mm, 95% CI -6.75 to 1.38; 2 studies, 127 participants, 127 arches; low-certainty evidence). Conventional nickel-titanium wires versus superelastic nickel-titanium wires Four studies with 266 participants (274 arches) evaluated conventional nickel-titanium (NiTi) wires versus superelastic NiTi wires. There may be little to no difference between the different wire types in terms of alignment rate (124 participants, 124 arches, 2 studies; low-certainty evidence) and intensity of pain (MD -0.29 mm, 95% CI -1.10 to 0.52; 2 studies, 142 participants, 150 arches; low-certainty evidence). Conventional nickel-titanium wires versus thermoelastic copper-nickel-titanium wires Three studies with 210 participants (210 arches) evaluated conventional Ni-Ti versus thermoelastic copper-nickel-titanium (CuNiTi) wires. We are very uncertain about the effects of the different arch wires on alignment rate (1 study, 66 participants, 66 arches; very low-certainty evidence). There may be little to no difference between conventional NiTi wires and thermoelastic CuNiTi wires in terms of time to alignment (alignment rate ratio 1.30, 95% CI 0.68 to 2.50; 1 study, 60 participants, 60 arches; low-certainty evidence). Superelastic nickel-titanium wires versus thermoelastic nickel-titanium wires Twelve studies with 703 participants (936 arches) evaluated superelastic NiTi versus thermoelastic NiTi wires. There may be little to no difference between superelastic NiTi wires and thermoelastic NiTi wires in alignment rate at four weeks (MD -0.28 mm, 95% CI 0.62 to 0.06; 5 studies, 183 participants, 183 arches; low-certainty evidence). We are very uncertain about the effects of the different wires on root resorption (2 studies, 52 participants, 312 teeth; very low-certainty evidence). Superelastic NiTi wires compared with thermoelastic NiTi wires may result in a slight increase in time to alignment (MD 0.5 months, 95% CI 0.21 to 0.79; 1 study, 32 participants, 32 arches; low-certainty evidence) but are probably associated with a slight increase in intensity of pain (MD 6.96 mm, 95% CI 1.82 to 12.10; 3 studies, 94 participants, 138 arches, moderate-certainty evidence). Single-strand superelastic nickel-titanium wires versus coaxial superelastic nickel-titanium wires Three studies with 104 participants (104 arches) evaluated single-strand superelastic NiTi versus coaxial superelastic NiTi wires. Use of single-strand superelastic NiTi wires compared with coaxial superelastic NiTi wires probably results in a slight reduction in alignment rate at four weeks (MD -2.64 mm, 95% CI -4.61 to -0.67; 2 studies, 64 participants, 64 arches, moderate-certainty evidence). Different sizes of nickel-titanium wires Two studies with 149 participants (232 arches) compared different types of NiTi wires. There may be little to no difference between different sizes of NiTi wires in terms of pain (low-certainty evidence). AUTHORS' CONCLUSIONS: Superelastic NiTi wires probably produce slightly more pain after one day than thermoelastic NiTi wires, and single-strand superelastic NiTi wires probably have a lower alignment rate over four weeks compared with coaxial superelastic NiTi wires. All other evidence on alignment rate, root resorption, time to alignment, and pain is of low or very low certainty in all comparisons. Therefore, there is insufficient evidence to determine whether any particular arch wire material or size is superior to any other. The findings of this review are imprecise and unreliable; well-designed larger studies are needed to give better estimates of the benefits and harms of different arch wires. Orthodontists should exercise caution when interpreting the findings of this review and be prepared to adapt their treatment plans based on individual patient needs.


Assuntos
Ligas , Braquetes Ortodônticos , Reabsorção da Raiz , Humanos , Níquel , Titânio , Reabsorção da Raiz/etiologia , Aço Inoxidável , Cobre , Braquetes Ortodônticos/efeitos adversos , Dor
18.
PLoS One ; 19(2): e0292069, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38324512

RESUMO

INTRODUCTION: Adolescent Idiopathic Scoliosis (AIS) is a 3D deformity of the spine that affects 3% of the adolescent population. Conservative treatments like bracing aim to halt the progression of the curve to the surgical threshold. Computer-aided design and manufacturing (CAD/CAM) methods for brace design and manufacturing are becoming increasingly used. Linked to CAD/CAM and 3D radiographic reconstruction techniques, we developed a finite element model (FEM) enabling to simulate the brace effectiveness before its fabrication, as well as a semi-automatic design processes. The objective of this randomized controlled trial is to compare and validate such FEM semi-automatic algorithm used to design nighttime Providence-type braces. METHODS AND ANALYSIS: Fifty-eight patients with AIS aged between 10 to 16-years and skeletally immature will be recruited. At the delivery stage, all patients will receive both a Providence-type brace optimized by the semi-automatic algorithm leveraging a patient-specific FEM (Test) and a conventional Providence-type brace (Control), both designed using CAD/CAM methods. Biplanar radiographs will be taken for each patient with both braces in a randomized crossover approach to evaluate immediate correction. Patients will then be randomized to keep either the Test or Control brace as prescribed with a renewal if necessary, and will be followed over two years. The primary outcome will be the change in Cobb angle of the main curve after two years. Secondary outcomes will be brace failure rate, quality of life (QoL) and immediate in-brace correction. This is a single-centre study, double-blinded (participant and outcome assessor) randomized controlled trial (RCT). TRIAL REGISTRATION NUMBER: ClinicalTrials.gov: NCT05001568.


Assuntos
Cifose , Escoliose , Humanos , Adolescente , Criança , Escoliose/diagnóstico por imagem , Escoliose/terapia , Coluna Vertebral , Radiografia , Tratamento Conservador/métodos , Resultado do Tratamento , Ensaios Clínicos Controlados Aleatórios como Assunto
19.
Angle Orthod ; 94(2): 194-199, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38381802

RESUMO

OBJECTIVES: To assess effectiveness of an experimental sterilization method based on the exposure of an O3/O2 gas mixture directly inside the packaging for clear aligners. MATERIALS AND METHODS: Fifty samples consisting of pieces of polyethylene terephthalate glycol (PET-G) aligners were contaminated by manual handling and subsequently divided into different groups (n = 30 for exposure to O3/O2 gas at different times, n = 10 for positive control with 2% chlorhexidine digluconate, n = 10 for negative control). The measurement of optical densities (OD) of the initial and final microbial cultures was recorded for all groups. Kruskal-Wallis test was used for differences between groups while Wilcoxon test was used to compare initial and final OD values within groups. Statistical significance was set at P < .05. RESULTS: Comparison within the groups showed statistically significant differences for exposure to the gaseous mixture (72 hours), for positive and negative controls. Other significant differences were found in the multiple comparisons between the application of gaseous ozone (48 hours and 72 hours) and the negative control. CONCLUSIONS: The direct exposure of gaseous ozone on the aligners inside their packaging showed microbicidal capacity at 72 hours, which was equivalent to the positive control with immersion in chlorhexidine digluconate. This innovative sterilization procedure could be considered in the final manufacturing processes of clear aligners to eliminate the potentially pathogenic microorganisms that are deposited on surfaces of these orthodontic devices.


Assuntos
Clorexidina/análogos & derivados , Aparelhos Ortodônticos Removíveis , Ozônio , Clorexidina/farmacologia , Esterilização
20.
J Mech Behav Biomed Mater ; 152: 106451, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38310814

RESUMO

The objective of this work is to analyse the performance of clear aligners made of thermoplastic materials. Within this framework, the damage evolution stages and damage states of the aligners at different cycles of the compressive loading are evaluated using the Acoustic Emission (AE) technique. Three different clear aligner systems were prepared: thermoformed PET-g (polyethylene terephthalate glycol) and PU (polyurethane), and additively manufactured PU. Cyclic compression tests are performed to simulate 22500 swallows. The mechanical results show that the energy absorbed by the thermoformed PET-g aligner remains stable around 4 Nmm throughout the test. Although the PU-based aligners show a higher energy absorption of about 7 Nmm during the initial phase of the cyclic loading, this gradually decreases after 12500 cycles. The time-domain based, and frequency-based parameters of the stress wave acoustic signals generated by the aligners under compression loading are used to identify the damage evolution stages. The machine learning-based AE results reveal the initiation and termination of the different damage states in the aligners and the frequency-based results distinguish the different damage sources. Finally, the microscopy results validated the damage occurrences in the aligners identified by the AE results. The mechanical test results indicate that the thermoformed PET-g has the potential to match the performance and requirements of the dentistry of the popular Invisalign (additively manufactured PU). The AE results have the potential to identify at which cycles the aligners may start losing their functionality.


Assuntos
Acústica , Aparelhos Ortodônticos Removíveis , Fenômenos Físicos , Microscopia , Poliuretanos
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