Evaluation of the effect of palatoplasty on the quality of life and speech outcomes in patients with velocardiofacial syndrome.

BACKGROUND: Children diagnosed with velocardiofacial syndrome (VCFS) suffer from various disabilities. Palatal abnormalities, as well as speech and language impairment, adversely affect a child's quality of life (QoL) and are some of the most distressing aspects for the parents of these children. OBJECTIVES: The present study aimed to explore the effect of palatoplasty on the health-related quality of life (HRQoL) and speech outcomes in children with VCFS. MATERIAL AND METHODS: The study recruited 20 patients (N = 20) with VCFS and connected speech, aged 3 years or older, having either undiagnosed submucous cleft palate (SMCP) or velopharyngeal insufficiency (VPI), and requiring primary cleft palate surgery or revision surgery. Speech assessment was conducted prior to palatoplasty and 6 months after the surgery. Intelligibility and hypernasality were evaluated using the Cleft Audit Protocol for Speech - Augmented (CAPS-A). The parent proxy-report form of the Pediatric Quality of Life Inventory (PedsQL™) was used to evaluate and compare the HRQoL of the VCFS patients before and after palatoplasty. RESULTS: Significant improvement in the HRQoL scores was achieved after the surgery across all domains (physical, emotional, social, and school functioning), especially in the emotional and social dimensions (p < 0.000). The post-operative speech assessment based on CAPS-A demonstrated improvement in speech intelligibility and hypernasality in the majority of patients. CONCLUSIONS: Given that children with VCFS face various medical and social problems, suitable palatal interventions are beneficial, improving both the speech ability and QoL of these children.

Sustained antibacterial activity of orthodontic elastomeric ligature ties coated with a novel kombucha-derived bacterial nanocellulose: An in-vitro study.

Incipient carious lesions, the most common complication in orthodontic patients with fixed appliances, call for the development of novel preventive dental materials that do not rely on patient adherence. The present study aimed to assess the ability of elastomeric ligatures coated with bacterial nanocellulose (BNC) to deliver sustained antibacterial activity, during the standard 28-day interval between orthodontic appointments, without compromising their mechanical properties. Kombucha membrane was used to produce cellulose as a secondary product from the fermentation of tea broth with symbiotic bacteria and yeast culture. Characterization of BNC-coated elastomeric ligatures was performed using Fourier Transform Infrared Spectroscopy and Energy Dispersive Spectroscopy analysis. The samples were pre-treated by immersion first in isopropyl alcohol, then in 8 mL nanocellulose solution for 7 days. Tensile strain and strength of the BNC-coated and conventional ligatures were evaluated using a tensile testing machine. Direct contact and agar diffusion tests were performed to assess the antibacterial activity of nanocellulose. In addition, the release profile of BNC was evaluated. Data analysis was performed by one-way analysis of variance (ANOVA) followed by post-hoc Tukey's test and Wilcoxon signed-rank test. P values less than 0.05 was regarded as significant. There was no statistically significant difference in tensile strain and strength between the BNC-coated and conventional ligatures. The coated ligatures provided sustained antibacterial activity during the required 28 days. The use of BNC-coated elastomeric ligatures in patients with fixed orthodontic appliances might be a promising solution to plaque formation and subsequent enamel decalcification.

Prevalence and Features of Maxillary Sinus Septa in Patients with Cleft Lip and Palate: Cone Beam Computed Tomography Imaging Technique.

OBJECTIVE: The development of the maxillary sinus is different in patients with cleft lip and palate (CLP) compared to non-CLP individuals. To investigate the prevalence and features of maxillary sinus septa (MSS) in patients with CLP in comparison with the non-CLP population. DESIGN: Retrospective study. INTERVENTION: Cone beam computed tomography (CBCT) evaluation. SETTING: CLP center in Shiraz faculty of dentistry, Iran. PATIENTS: A total 306 sinuses (88 cleft and 218 noncleft) on 153 images (CLP group: n = 66; control group: n = 87) were examined to determine the prevalence of septa and characterize them. MAIN OUTCOME MEASURES: Sinus septa were characterized according to height, orientation, angle, origin, and location. The chi-square test, Mann-Whitney U test, and Fisher's exact test were used for statistical analysis. RESULTS: The prevalence of septa was 28.9% and 32.1% in the CLP and control groups, respectively. No significant difference was found between the study groups in terms of prevalence, location, and orientation of MSS. The average height and angle of septa were significantly higher in the control group compared to the CLP group. Inferior origin was significantly more prevalent in the control group than in the CLP group (P = .004). CONCLUSION: There was no difference in the prevalence of MSS between patients with CLP and non-CLP individuals. However, certain features of the septa were different in patients with CLP.

Effects of Orthodontic Treatment on Pulp Stone Formation: A Retrospective Study.

Objective: This retrospective study was aimed at determining the incidence of dental pulp stone formation during fixed orthodontic treatment. Materials and Methods: A total of 100 patients who received fixed orthodontic treatment were included in this study. Pre- and posttreatment panoramic radiographs of the patients were examined to identify pulp stones. The data were analyzed using McNemar's and Pearson's chi-square tests to investigate the correlations between having a dental pulp stone and gender, age, treatment type, and duration. Results: Dental pulp stones were detected in 17% of patients on pretreatment panoramic radiographs and 35% of patients on posttreatment panoramic radiographs. The incidence of pulp stones sharply increased in the pre- and posttreatment radiographs (38%) (P < 0.001). In addition, there were associations between age, treatment duration, and the incidence of pulp stones (P < 0.05). Nevertheless, no associations were found between treatment type, gender, and the presence of pulp stones. Dental pulp stones were most frequently observed in first molars (62%), followed by second molars (36%). Conclusion: Fixed orthodontic treatment may trigger pulp irritation and calcification, resulting in the formation of pulp stones. Although pulp stones have no serious consequences, an orthodontist must consider the probability of pulp stone formation because it can cause difficulties in endodontic treatment.

Comparison of the mechanical properties and surface topography of as-received and as-retrieved Copper-Nickel-Titanium arch wires: An ex-vivo study.

AIM: The mechanical and surface characteristics of Copper NiTi wires following intraoral aging in an important topic. This ex-vivo study is designed to assess the three most important mechanical properties; torsional stiffness, 3-point bending and surface hardness of the as-received Copper NiTi orthodontic archwires and compare them to the retrieved ones. MATERIAL AND METHODS: In this study, 50 round CuNiTi (0.016 inch) and 50 rectangular (0.018×0.025 inch) CuNiTi orthodontic wires (American Orthodontics, Tanzo Copper Nickel Titanium, Sheboygan, WI) were tested. The groups were as follow: 25 as-received 0.016 inch round CuNiTi archwires (group 1), 25 as-retrieved 0.016 inch round CuNiTi archwires (group 2), 25 as-received 0.018×0.025 inch rectangular CuNiTi archwires (group 3), and 25 as-retrieved 0.018×0.025 inch rectangular CuNiTi archwires (group 4). The physical properties of all of the samples were examined using Vickers hardness, bending and torsional tests. The Kolmogorov-Smirnov test was applied to assess the normal distribution of data. An independent t-test was used to compare the variables between the groups. RESULTS: The results showed that the hardness does not significantly differ between the as-received and as-retrieved archwires in both 0.016 and 0.018×0.025 inch archwires (P< 0.05). The bending test of the round wires showed that the values of the activation forces in the as-received ones were significantly higher than those of the as-retrieved (P=0.00). The torsional and bending test results of rectangular wires showed that the amounts of forces exerted from the as-retrieved archwires were significantly higher than the new archwires (P=0.00). CONCLUSIONS: Round CuNiTi archwires could be retied in the succeeding visits. However, the bending activation that declines significantly should be took into consideration. On the other hand, since bending and torsion activation of CuNiTi rectangular archwires increased after intraoral use, these wires should be retied cautiously.

Effect of 8% arginine toothpaste on Streptococcus mutans in patients undergoing fixed orthodontic treatment: randomized controlled trial.

OBJECTIVE: To assess the effect of toothpaste containing 8% arginine on Streptococcus mutans (S. mutans) in dental plaque around orthodontic brackets, and to draw a comparison with a regular fluoride toothpaste. TRIAL DESIGN: A single-center, parallel-arm, triple-blind, randomized controlled trial was conducted. METHODS: The clinical trial was conducted at the Orthodontic Clinic, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran. Seventy-two patients (age range: 15-30 years) who required fixed orthodontic treatment were recruited and randomly assigned to arginine and fluoride groups. Randomization was performed using RANDOM.ORG online software, and the participants were divided into two parallel groups, with a 1:1 allocation ratio. Patients were requested to brush their teeth twice daily for 30 days with an experimental toothpaste. Plaque sampling was performed at two intervals, namely at the beginning of the study (T0) and 30 days later (T1). Real-time PCR was used to assess plaque samples in terms of the number of S. mutans surrounding stainless steel brackets in orthodontic patients. A triple-blind design was employed. RESULTS: The baseline characteristics (age, sex, and the relative number of S. mutans) between the groups were similar (p>0.05). Only the arginine group showed a significant decrease in the relative number of bacteria between T0 and T1 (p=0.02). CONCLUSION: Arginine is an important prebiotic agent in maintaining healthy oral biofilms, and prevent dental caries during fixed orthodontic treatments. TRIAL REGISTRATION: The trial was registered at the Iranian Registry of Clinical Trials (IRCT20181121041713N2), https://en.irct.ir/user/trial/42409/view.

Influence of a bleaching agent on surface and mechanical properties of orthodontic thermoplastic retainer materials : An in vitro study.

OBJECTIVE: To investigate the effect of a tooth whitening agent on surface roughness, surface hardness, and force delivery properties of polyethylene terephthalate glycol (PETG) thermoplastic retainer materials of two different thicknesses. METHODS: PETG sheets (1 mm and 1.5 mm) were thermoformed over a 30â€¯× 60â€¯× 10 mm3 rectangular stone model. Surface hardness, surface roughness, and results of a three-point bending test were evaluated before and after treatment (5 h daily for 14 days) with a 15% carbamide peroxide home bleaching agent. Data were analyzed using an independent sample t­test. RESULTS: Exposure of PETG specimens to the bleaching agent for 14 days significantly reduced surface hardness and increased surface roughness of samples of both thicknesses. The magnitude of force at different deflection points decreased significantly in the 1.5 mm thickness specimens treated with the bleaching agent, but no significant change was observed in the specimens with 1 mm thickness. CONCLUSION: Use of a home bleaching agent could have adverse effects on surface roughness and hardness of PETG materials leading to reduced survival time of thermoplastic orthodontic retainers.

Effect of 8% arginine toothpaste on Streptococcus mutans in patients undergoing fixed orthodontic treatment: randomized controlled trial

ABSTRACT Objective: To assess the effect of toothpaste containing 8% arginine on Streptococcus mutans (S. mutans) in dental plaque around orthodontic brackets, and to draw a comparison with a regular fluoride toothpaste. Trial design: A single-center, parallel-arm, triple-blind, randomized controlled trial was conducted. Methods: The clinical trial was conducted at the Orthodontic Clinic, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran. Seventy-two patients (age range: 15-30 years) who required fixed orthodontic treatment were recruited and randomly assigned to arginine and fluoride groups. Randomization was performed using RANDOM.ORG online software, and the participants were divided into two parallel groups, with a 1:1 allocation ratio. Patients were requested to brush their teeth twice daily for 30 days with an experimental toothpaste. Plaque sampling was performed at two intervals, namely at the beginning of the study (T0) and 30 days later (T1). Real-time PCR was used to assess plaque samples in terms of the number of S. mutans surrounding stainless steel brackets in orthodontic patients. A triple-blind design was employed. Results: The baseline characteristics (age, sex, and the relative number of S. mutans) between the groups were similar (p>0.05). Only the arginine group showed a significant decrease in the relative number of bacteria between T0 and T1 (p=0.02). Conclusion: Arginine is an important prebiotic agent in maintaining healthy oral biofilms, and prevent dental caries during fixed orthodontic treatments. Trial registration: The trial was registered at the Iranian Registry of Clinical Trials (IRCT20181121041713N2), https://en.irct.ir/user/trial/42409/view.

RESUMO Objetivo: Avaliar o efeito de um dentifrício contendo arginina a 8% no Streptococcus mutans (S. mutans) da placa bacteriana ao redor de braquetes ortodônticos, e compará-lo a um dentifrício fluoretado convencional. Desenho do estudo: Foi conduzido um estudo unicêntrico, com braços paralelos, triplo-cego, controlado e randomizado. Métodos: O ensaio clínico foi conduzido na Clínica de Ortodontia da Faculdade de Odontologia da Universidade de Ciências Médicas de Shiraz, no Irã. Setenta e dois pacientes (com idades variando de 15 a 30 anos) que necessitavam de tratamento ortodôntico com aparelho fixo foram recrutados e alocados aleatoriamente nos grupos arginina ou flúor. A randomização foi feita usando o programa on-line RANDOM.ORG, e os participantes foram divididos em dois grupos paralelos, com proporção de alocação de 1:1. Solicitou-se aos pacientes que escovassem os dentes duas vezes ao dia com a pasta experimental, durante 30 dias. Amostras da placa bacteriana foram coletadas em dois intervalos: ao começo do estudo (T0) e após 30 dias (T1). Um PCR em tempo real foi usado para avaliar as amostras de placa, em termos de números de S. mutans ao redor dos braquetes de aço inoxidável nos pacientes ortodônticos. Um desenho de estudo triplo-cego foi usado. Resultados: As características iniciais (idade, sexo e quantidade relativa de S. mutans) foram semelhantes entre os grupos (p>0,05). Apenas o grupo arginina mostrou uma redução significativa na quantidade de bactérias entre T0 e T1 (p=0,02). Conclusão: A arginina é um agente prebiótico importante na manutenção de biofilmes bucais saudáveis, e previne as cáries dentárias durante o tratamento ortodôntico com aparelho fixo. Registro do ensaio: O ensaio foi registrado no Iranian Registry of Clinical Trials (IRCT20181121041713N2), https://en.irct.ir/user/trial/42409/view.

Effect of high concentration nano-hydroxyapatite serum on shear bond strength of metal brackets following three different enamel surface preparation methods: An in vitro study.

OBJECTIVE: White spot lesion (WSL) is one of the most important complications of fixed orthodontic treatment. Many methods have been studied to prevent this problem. This study is aimed to investigate the effect of high concentration nano-hydroxyapatite (nHAP) on shear bond strength (SBS) of metal brackets and Adhesive Remnant Index (ARI) score in different preparation methods. MATERIAL AND METHODS: Sixty human premolars, which were extracted for orthodontic reasons were included in this in vitro study. The teeth were randomly divided into 4 groups of 15 each: one control group and three nHAP groups. After applying nHAP for 2 to 3 minutes daily for 10 days, the groups 2 to 4 underwent sandblasting using 50µm aluminium oxide and 30 seconds etching, 60 and 30 seconds etching, respectively, and the brackets were then bonded to the teeth. After debonding, SBS and ARI scores were recorded. Data were analysed using the ANOVA test and posthoc test for pairwise comparisons. RESULTS: No significant difference was observed in SBS between the control group and the nHAP groups. The sandblasted teeth showed significantly higher SBS than the 30 seconds etching after nHAP application (P=0.02). The teeth etched for 60 seconds showed a significantly higher ARI score than the 30 seconds etched teeth with (P=0.003) or without (P<0.001) nHAP application. CONCLUSIONS: The use of nHAP before bracket bonding can be considered as a caries preventive method since it did not compromise the SBS. Sixty seconds etching is recommended for less likely damage to the enamel after debonding.

Prevalence of Malocclusion and Occlusal Traits in Children with Autism Spectrum Disorders.

BACKGROUND: The purpose of this cross-sectional study was to evaluate the prevalence of malocclusion in children with autism spectrum disorders (ASDs) and to determine the most common occlusal traits. MATERIALS AND METHODS: The present cross-sectional study was conducted among 7-15 years old children with ASDs and randomly selected healthy children with the same demographic characteristics. Molar relationship, lip incompetence, overbite, overjet, midline deviation, crossbite, and crowding/spacing were recorded. A descriptive analysis was performed for all variables. A comparison of the presence or absence of malocclusion traits between children with and without ASDs was assessed using the chi-square test. Univariate and multivariate logistic regressions were used to calculate odds ratio (OR) and 95% confidence intervals (95% CI) to assay various parameters between autism and non-autism group. RESULTS: A total of 96 patients were assessed, 47 patients in the ASD group, and 49 in the control (non-ASD) group. The results showed no significant difference between the ASD and control groups in terms of the overall prevalence of malocclusion (P>0.05). However, the prevalence of increased overjet and Class II molar relationship was significantly higher in the ASD group compared to the control group (P=0.03). Patients in the control group showed a higher prevalence of midline deviation (P=0.001). CONCLUSION: Despite a higher prevalence of overjet and Class II molar relationship in children with ASDs, the prevalence of malocclusion was not higher in this group of patients.

Effect of mini-screw-facilitated micro-osteoperforation on the rate of orthodontic tooth movement: a single-center, split-mouth, randomized, controlled trial.

OBJECTIVE: The present study aimed to evaluate the effect of MOP over a 3-month period and to determine the influence of the number of perforations on the rate of canine retraction. In addition, the amount of pain and discomfort caused by the MOP method was evaluated. TRIAL DESIGN: A single-center, split-mouth, triple-blind, randomized, controlled trial was conducted. METHODS: The clinical trial was conducted from December 2018 to July 2019 in the Orthodontic Clinic, Shiraz Dental School. Twenty-eight patients (range from16.3 to 35.2 years) who need fixed orthodontic treatment were recruited and randomly assigned to MOP1 and MOP2 groups. In each patient one side of the mouth worked as a control side which received no MOPs. Four months after first premolars extraction, patients in MOP1 group received 3 MOPs on the buccal surface of alveolar bone in the experimental side to accelerate canine retraction whereas patients in MOP2 group received 3 buccal MOPs and 3 palatal MOPs in the experimental side. The amount of canine retraction was measured every 28 days at three intervals on both sides of the mouth. Pain perception was also measured on the day of MOP procedure and subsequently at 24 h. Randomization was performed using online software RANDOM.ORG; the recruited patients were divided into two parallel groups with a 1:1 allocation ratio then the side of MOPs intervention in each subject was randomly determined with coin tossing. Triple blinding design was employed. RESULTS: The result of the intra-examiner reliability using ICC was 0.97 (P <  0.001), indicating excellent repeatability and reliability of the measurements. The baseline characteristics between the groups were similar (P > 0.05). There was a significant difference in the rate of canine retraction between the MOP groups and the contralateral control sides, as well as between the MOP1 and MOP2 groups (P <  0.05). CONCLUSION: The MOP procedure was effective in accelerating orthodontic tooth movement, although the amount of acceleration was not clinically significant in the case of canine retraction. An increase in the number of MOPs resulted in a significant acceleration of the canine retraction. TRIAL REGISTRATION: The trial was registered 30 November 2018 at the Iranian Registry of Clinical Trials (IRCT20181121041713N1).

Photogrammetric Evaluation of Soft Tissue Profile and Frontal Photographs in Repaired Bilateral Cleft Lip and Palate.

OBJECTIVE: To evaluate the soft tissue profile and frontal photographs of 8- to 12-year-old patients with repaired complete bilateral cleft lip and palate (BCLP). METHODS: The profile and frontal photographs obtained from 31 nonsyndromic BCLP children (aged 8-12 years: 14 boys and 17 girls) were analyzed and compared with an age- and sex-matched normal population (18 boys and 32 girls). In each patient, 12 soft tissue angular and proportional parameters on the frontal photograph and 12 angular parameters for the profile photographs were developed and measured. Student t test was used to compare the mean value of the parameters between both sexes. RESULTS: In the frontal view, there was a significant difference between the 2 study groups in the facial symmetry angle (P < .001), lower facial height proportion (P < .001), upper lip proportion (P < .001), and interalar width/distance between the inner canthus of the eyes (P < .001). In the profile view, there was a significant difference between the control group and the patients with cleft lip and palate in terms of nasofrontal angle (P < .001), nasal angle (P < .001), angle of the inferior facial third (P = .032), head position angle (P < .001), facial convexity angle (P < .001), total facial convexity angle (P < .001), and vertical nasal angle (P < .001). CONCLUSION: In comparison with the normal population, the face of patients with repaired BCLP showed several soft tissue deformities, especially in the nasofrontal region, even after a surgical repair.

Dentoskeletal effects of class II malocclusion treatment with the modified Twin Block appliance.

BACKGROUND: The purpose of this study was to prospectively assess the dentoskeletal effect of a modified Twin Block appliance for treatment of class II malocclusions. MATERIAL AND METHODS: Lateral cephalograms of 25 Class II malocclusion patients were compared to evaluate skeletal, dentoalveolar and soft tissue changes pre- and post-treatment with a modified Twin Block appliance. A total of 33 angular and linear variables were used for analysis. The differences were calculated at the start and end of treatment. The paired T test was performed to compare the cephalometric measurements before and after treatment. RESULTS: Compared the pre- and post- treatment measurements, there was a significant increase in SNB (P<0.001), CO-Gn (P<0.001), ANS-Me (P=0.001), Mandibular base (P<0.001), Lower 1 to NB (°) (P=0.004), Lower 1 to NB (mm) (P<0.001), and Z-angle (P=0.001) following functional therapy with modified Twin Block appliance. On the other hand, a significant decrease was observed in ANB (P<0.001), NA-Pog (P<0.001), overjet (P<0.001), and overbite (P=0.007), Upper 1 to palatal plane (P=0.007), UL-E-line (P<0.001), LL-E-line (P=0.001), and H-angle (P=0.002) after treatment with modified Twin Block appliance. CONCLUSIONS: The modified Twin-Block improves facial esthetics in Class II malocclusion by a combination of changes in skeletal as well as dentoalveolar structures. The increase of mandibular unit length was observed to be due to a true mandibular growth not just a repositioning of the mandible. The modified appliance, however, did not show any superior effects in terms of less dental compensation compared to the conventional Twin-Block appliance. Key words:Dentoskeletal effect, Modified Twin Block, Class II malocclusion.

Long-term antimicrobial assessment of orthodontic brackets coated with nitrogen-doped titanium dioxide against Streptococcus mutans.

BACKGROUND: The antimicrobial properties of orthodontic wire and brackets with nitrogen-doped titanium dioxide (N-doped TiO2) coating have been studied in the past. However, the evaluation period had been short and limited to 30 days. The aim of the present study was to extend the evaluation period (up to 90 days) of assessing the long-term antimicrobial effects of stainless steel orthodontic brackets coated with nitrogen-doped titanium dioxide (N-doped TiO2). METHODS: A total of 40 stainless steel pre-adjusted premolar brackets were equally divided into two groups; namely the control group (n=20, uncoated brackets) and the experimental group (n=20, coated brackets). RF magnetron sputtering was used to apply a thin film of TiO2 on the bracket surface. The crystalline structure of the thin film was assessed using X-ray diffraction. The antimicrobial property of the brackets against Streptococcus mutans (S. mutans) was evaluated using the survival rate by colony-forming units (CFU) at four intervals: 24 hours (T0), 30 days (T1), 60 days (T2), and 90 days (T3). 2-way ANOVA Repeated Measures was used to compare the effects between the groups over the time. RESULTS: There was no significant interaction between group and time (p = 0.568). The orthodontic brackets coated with the N-doped TiO2 thin film showed a significant CFU reduction (37.71 ± 5.21, 37.81 ± 5.03, 37.98 ± 5.37, and 37.74 ± 5.21 at T0, T1, T2, and T3, respectively) compared to the uncoated brackets (400.91 ± 14.67, 401.58 ± 14.01, 400.31 ± 14.68, and 402.04 ± 13.98 at T0, T1, T2, and T3, respectively) through visible light (p < 0.001). CONCLUSION: N-doped TiO2 coated orthodontic brackets showed strong antimicrobial property against S. mutans over a period of 90 days, which is effective in preventing enamel decalcification during orthodontic therapy.

Evaluation of Smile Characteristics in Three Different Sagittal Malocclusions Before and After Nonextraction Orthodontic Treatment.

INTRODUCTION: To investigate the smile esthetics variables in three malocclusion classifications of angle to find out if the final smile esthetics was correlated with the initial types of malocclusion. MATERIALS AND METHODS: This cross-sectional study was performed on 90 adult patients (18-28 years old) with three classes of malocclusion (n = 30 for each class), who were just treated by an orthodontist based on standard edgewise (0.018 inch). A standardized smile mesh analysis was used to evaluate seven smile characteristics. RESULTS: Orthodontic treatment improved all the smile characteristics in the three groups. All groups showed an increase in smile width, smile index, and vertical indices; while, the transverse indices decreased. Significant increase was observed in four smile measurements in patients with Class II malocclusion. Comparing the smile characteristic changes among the three groups revealed that the changes induced by orthodontic treatment were significantly higher in patients with Class II malocclusion. CONCLUSION: The smile esthetics in all the three types of malocclusion benefited from the orthodontic treatment; however, the changes were more significant in Class II malocclusions. None of the three malocclusion types showed significant difference between the pre- and post-treatment smile characteristics.

Impact of nanohydroxyapatite on enamel surface roughness and color change after orthodontic debonding.

BACKGROUND: The aim of this prospective in vitro study was to evaluate the effect of nanohydroxyapatite (nanoHAP) serum on the enamel surface roughness and tooth color stability after orthodontic debonding procedure. METHODS: The crowns of 30 premolars were embedded in acrylic blocks with a 4 mm × 5-mm-sized window on the middle third of buccal surfaces. Primary roughness values were evaluated by an atomic force microscope (AFM). After bracket debonding, and polishing procedures, the second roughness parameters were recorded. Specimens were then randomly assigned to two equal groups. NanoHAP serum and HAP toothpaste were applied for 10 days in the first and second groups, respectively. Then, after the third AFM, initial color parameters were measured. Following 1-week immersion in the coffee solution, second color assessment was performed. The fourth AFM was registered after 2 months of aging process. RESULTS: All roughness parameters were elevated following debonding procedure. There was no statistically significant reduction in roughness parameters after 10 days of nanoHAP serum or HAP toothpaste application. Both groups showed significant color change after immersion in the coffee solution. CONCLUSIONS: NanoHAP serum with the protocols used in this study could not restore enamel surfaces to their original condition.

Comparison of the effects of preemptive acetaminophen, ibuprofen, and meloxicam on pain after separator placement: a randomized clinical trial.

BACKGROUND: This study aims to evaluate and compare the effect of pre-procedural administration of acetaminophen, ibuprofen, and meloxicam in reducing pain after separator placement. METHODS: Three hundred twenty-one patients who needed orthodontic treatment and aged above 15 were randomly assigned to one of the three study groups: group A: 650 mg acetaminophen, group B: 400 mg ibuprofen, and group C: 7.5 mg meloxicam. All subjects received a single dose of medication 1 h prior to separator placement. Using visual analog scale, patients recorded their pain perception during rest, fitting posterior teeth together, and chewing at time intervals of immediately, 2, 6, 24, and 48 h after separator placement. RESULTS: There was no significant difference between acetaminophen, ibuprofen, and meloxicam in post-separator placement pain control when administered 1 h before the procedure. In all the groups, at rest, pain level elevated after separator placement and reached its peak at 24 h and then subsided until 48 h. But during chewing and fitting of the posterior teeth, some of the groups reached a peak in pain at 48 h. No significant difference was found in pain experience between males and females. CONCLUSIONS: Meloxicam can be used as an effective analgesic in orthodontic pain control considering it has less gastric side effects compared to the conventional nonsteroidal anti-inflammatory drugs. TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT2015041821828N1.