Cleansing efficacy of an oral irrigator with microburst technology in adolescent orthodontic patients. A randomized-controlled crossover study.

OBJECTIVES: Simplifying interdental space cleaning is a constantly discussed topic. The present study aimed to compare the cleansing efficacy of an oral irrigator with that of dental flossing in adolescent patients with fixed braces after four weeks of home-use. MATERIALS AND METHODS: The study design is a randomized, single-blinded cross-over study. Following a twenty-eight-day period of product utilization in a home setting, a comparative analysis was conducted on hygiene indices, the Rustogi Modified Navy Plaque Index (RMNPI) and the Gingival Bleeding Index (GBI), between the test group (oral irrigator) and the control group (dental floss). RESULTS: Seventeen adolescent individuals completed the study. After 28 days of cleaning with the oral irrigator, RMNPI was 58.81% (55.31-66.47) compared to 59.46% (52.68-68.67) with dental floss (p = 0.070). Subgroup analyses did not indicate the superiority of either method. GBI after the test phase with the oral irrigator was 28.93% (23.21-33.97) and insignificantly higher compared to 26.40% (21.01-31.41) achieved with dental floss (p = 0.1585). CONCLUSIONS: Neither of the two products demonstrated statistically significant superiority in terms of cleaning efficacy. Therefore, no recommendation can be made in favor of one over the other. It was found that the high initial hygiene indices for fixed orthodontic appliances could be improved through increased awareness and precise instruction. CLINICAL RELEVANCE: For adolescent patients who struggle to use interdental brushes an oral irrigator may be suggested as a simple alternative in hard-to-reach areas, such as those around a fixed dental appliance.

Periodontitis: orthodontic implications and management.

Orthodontics is increasingly ingrained in the overall management of patients with periodontitis. Advanced periodontitis is often characterised by pathological tooth migration, loss of posterior support and incisal proclination. Orthodontics may therefore offer both aesthetic and therapeutic benefit. A tailored approach to treatment, however, is necessary given the myriad of presentations and associated risk. The nuances underpinning effective treatment planning, space creation, treatment mechanics, and retention in the periodontal patient are described.

The role of orthodontics in the prevention and management of gingival recession.

Careful management of orthodontic patients presenting with thin periodontal phenotype is paramount. Combined orthodontic-periodontal input is helpful both in terms of diagnosis and stabilisation but also to coordinate care. Well-executed orthodontics offers the potential to safeguard periodontal health but also to induce significant aesthetic improvement either in isolation or combined with increasingly predictable muco-gingival procedures.

Achieving excellence with interdisciplinary approaches in complex orthodontic adult patients.

Over the last decades the percentage of adult orthodontic patients has substantially increased. Undeniably, an important motif for seeking orthodontic care at an older age is smile improvement, but this is not all. Frequently, impaired dentofacial aesthetics are combined with several other issues: severe dentoskeletal malocclusions; multiple tooth loss due to caries or endodontic failure; dental agenesis or trauma; periodontal breakdown; or functional problems, such as temporomandibular disorders or obstructive sleep apnoea. Therefore, comprehensive adult treatment mostly requires close collaboration of a team of equally well-trained dental specialists to select and execute the most suitable treatment option for the individual patient from day one. With joint planning, intensive communication with the patient and the involved specialists, and continuous monitoring of the treatment process, true patient-centred care can be delivered. In order to serve the individual patient best, the treating orthodontist does not only need thorough speciality training and continuing education, but furthermore, should be well-equipped with sufficient knowledge of the other dental fields of expertise. In combination with digital technology as an important tool for enhancing communication and efficient exchange of information between all involved team members, excellent joint clinical skills will take comprehensive interdisciplinary treatment to the next level.

Digital Platform Facilitates Successful Facially Driven Orthodontic-Restorative Treatment.

This case report presents a novel digital technique for prosthetically driven orthodontic treatment. A 28-year-old patient who had undergone orthodontics as a teenager experienced a relapse and presented with esthetic concerns. The author utilized state-of-the-art software to create a virtual orthodontic-restorative treatment outcome with virtual restorations. This approach helped guide tooth movement, improve team communication, and optimize treatment outcomes while allowing for minimally invasive restorative treatment.

Digital planning in joint orthodontic-restorative care.

Combined orthodontic-restorative treatment represents an increasing proportion of our practice, mirroring increasing provision of adult orthodontics and refinements in appliance design. By harnessing simple digital technology, it may be possible to promote more predictable aesthetic, biological and functional interdisciplinary outcomes. In particular, digital approaches can be embedded in the diagnostic and treatment planning phase, enhancing our communication with patients and colleagues while also permitting more detailed analysis and more refined planning.

The role of orthodontics in the management of tooth wear.

Pathological tooth wear is a dental problem that affects all age groups and appears to be increasing in prevalence. A subset of these patients may benefit from a combination of orthodontic and restorative care which will be discussed in this article. Orthodontics can help to create the necessary vertical, anterior-posterior and mesio-distal space for restorative work, reducing the need for tooth reduction and lessening the biological costs of restorative care, helping to reposition the gingival margins where this impacts upon aesthetics, as well as correcting co-existing malocclusion.

Principles of interdisciplinary orthodontic and restorative treatment.

Dentistry has changed significantly in the last two decades. Interdisciplinary treatment planning strives to deliver the highest quality of care through innovative collaborations among providers and the patient. The complexity of the care and challenges in interdisciplinary team communications are primary hurdles. We discuss five principles of interdisciplinary orthodontic-restorative treatment and outline a four-step interdisciplinary treatment planning process, starting with a comprehensive clinical examination to collect subjective and objective data. Diagnostic records, including 3D models, videos, 2D photos, questionnaires, and reports, are then evaluated to develop a problem list and treatment objectives. Treatment simulation is used to envision the outcome and guide the formulation of an orthodontic-restorative treatment plan. The plan can be broken down into stages, depending on the condition of the teeth and the planned restorative treatment. The challenges and opportunities presented by digital dentistry and the potential for more efficient interdisciplinary treatment are presented. In sum, this article provides an overview of the principles and framework for interdisciplinary orthodontic-restorative treatment, emphasising the importance of collaboration, communication and comprehensive treatment planning.