The effects of low-level laser therapy and photodynamic therapy on oral health of fixed orthodontics patients. A systematic review and meta-analysis.

Objective To investigate the effect of low-level laser and photodynamic therapy on the oral health, and periodontal tissue of fixed orthodontic patients and the effect of using photobiomodulation methods compared to routine plaque removal methods and the amount of plaque in fixed orthodontic patients. Method and materials First, the title and summary of related articles were collected by using the search strategy electronic databases PUBMED, EMBASE, Cochrane's CENTRAL, Scopus, ISI and all the articles that were published from the beginning to February 2023 were evaluated. The title, abstracts and full texts of all the relevant studies were reviewed respectively, and those meeting the criteria were entered into our study. Finally, the quality of the studies was examined and the results of the studies were pooled by means of random effects inverse variance meta-analysis. Results Eighteen randomized studies, conducted between 2015 and December 2022, were selected for meta-analysis. Five studies were conducted as split-mouth, twelve as parallel-group, and one as a cross-over design. Among the studies, five examined the effects of low-level laser therapy and twelve assessed the effects of photodynamic therapy. The meta-analysis revealed that photodynamic therapy significantly reduced probing depth compared to scaling (MD=-0.2 mm, P<0.001), though the difference does not seem to be clinically significant. But no significant differences between photodynamic therapy and scaling or low-level laser therapy and control groups in terms of plaque index, or bleeding on probing, gingival crevicular fluid volume, gingival recession, clinical attachment loss, bacterial load and concentrations of inflammatory substances across multiple follow-up periods. Conclusion Moderate evidence indicates that photodynamic therapy (PDT) is comparable to conventional methods in improving oral health, as measured by periodontal indices, inflammatory proteins, bacterial colonies, and white spot lesions, making it a suitable alternative. Limited evidence suggests low-level laser therapy (LLLT) may improve oral health, particularly addressing caries, but further research is needed.

The Effects of Intrusion of Anterior Teeth by Skeletal Anchorage in Deep Bite Patients; A Systematic Review and Meta-Analysis.

BACKGROUND: Deep bite is known as one of the most common malocclusions, and its treatment and retention are often challenging. The use of mini-screws has been suggested as an ideal method for the intrusion of incisors in deep-bite patients. Still, there are conflicting reports regarding the superiority of this method compared to other common treatments. AIM: The aim of this systematic review and meta-analysis was to evaluate the effects of the intrusion of anterior teeth by skeletal anchorage in deep bite patients. METHODS: From the beginning to 15 September 2022, articles on the topic of interest were searched in electronic databases including PubMed, Web of Science, Scopus, EMBASE, and Cochrane's CENTRAL. Additionally, a hand search for pertinent studies and a search of the grey literature were carried out. After the selection of eligible studies, data extraction was performed using piloted forms. Inverse-variance random-effects meta-analyses were used to combine the outcome measures of dental indices, skeletal cephalometric indices, and dental cephalometric indices. RESULTS: A total of 15 studies (6 RCT; 9 CCT) were included in the systematic review and 14 were used in the meta-analyses. The differences in overbite changes (MD = -0.45, p = 0.04), true incisor intrusion [u1-pp] (MD = -0.62, p = 0.003) and molar extrusion [u6-pp] (MD = -0.40, p = 0.01) were statistically significant and TADs showed better treatment results than other intrusion methods (segmented intrusion arch, utility arch, J hook headgear). No significant differences regarding overjet, molar and incisor tipping, and skeletal indices between mini-screw and other intrusion methods could be found. CONCLUSION: The use of mini-screws leads to lower overbite and higher true intrusion (about 0.45 and 0.62 mm, respectively) compared to the use of other methods for intruding upper incisors. Furthermore, the effect of TAD on extrusion of molar teeth is less (by 0.4 mm) than other methods.

Comparison of self-etch primers with conventional acid-etch technique for bonding brackets in orthodontics: a systematic review and meta-analysis.

BACKGROUND: Bonding with self-etch primers (SEPs) is one of the most popular systems for attaching orthodontic brackets to the enamel surface. There are conflicting reports about the efficacy and success of these systems compared with acid-etch (AE) bonding. OBJECTIVE: This systematic review and meta-analysis was performed to compare SEP with conventional AE technique for bonding brackets in fixed orthodontics. SEARCH METHODS: Articles related to the subject of interest were searched in electronic databases, including PubMed, ISI Web of Science, Scopus, EMBASE, and Cochrane's CENTRAL, from inception to 2 June 2021. Search for grey literature, and hand search for relevant studies were also performed. SELECTION CRITERIA: Based on the PICO model, randomized clinical trials using full-arch bonded fixed orthodontic appliances comparing SEP and conventional AE systems were included in the review process. DATA COLLECTION AND ANALYSIS: After assessing the risk of bias, data from the included studies were extracted using custom piloted forms. Inverse-variance random-effects meta-analyses were performed to combine the results of bracket failure, adhesive remnant index (ARI), and bonding time. RESULTS: Nineteen randomized clinical trials were included in the systematic review and 17 randomized clinical trials [5 parallel-group (PG) and 12 split-mouth (SM) studies] were included in the meta-analysis. No significant difference in bracket failure at 6 months [risk ratio (RR) = 1.50, P = 0.26, 12 SM] and (RR = 0.68, P = 0.34, 2 PG), 12 months (RR = 1.6, 8 SM) and (RR = 1.17, P = 0.54, 2 PG), and ≥18 months (RR = 0.84, P = 0.31, 3 SM) and (RR = 1.20, P = 0.3, 3 PG) between SEP and AE groups could be found. Also, ARI score was similar between different bonding systems [mean difference (MD) = -0.44, P = 0.06, 4 SM]. The bonding time per tooth was faster in the SEP group (MD = -26.55, P < 0.001, 2 SM) and (MD = -24.00, P < 0.001, 2 PG). LIMITATIONS: inclusion of three studies with a high risk of bias and high amount of inconsistency between the results of individual studies were the biggest limitations of our review. CONCLUSIONS: The bracket bonding failure and ARI score were not significantly different between self-etch and conventional AE bonding systems. The bonding time was lower for the SEP, but some other requirements for SEPs like pumice prophylaxis could diminish this advantage. REGISTRATION: The protocol for this systematic review was registered at PROSPERO with the ID CRD42021248540.

Orthodontic and surgical treatment of facial asymmetry in a patient with unicoronal craniosynostosis.

This case report presents the unique treatment of a patient with varying asymmetries at different levels within the face. The patient was a 17-year-old male with a diagnosis of right unilateral coronal synostosis. He had frontal and superior orbital retrusion on the fused side, and bossing of the contralateral side. The middle and lower portions of his face were rotated toward the nonfused side. This unique diagnosis presented particular challenges to surgical and orthodontic correction. The treatment approach, which included a combination of Le Fort I and II osteotomies, bilateral sagittal split osteotomy, and orthodontic treatment with 4 premolar extractions, enabled simultaneous correction of nasal, midfacial, lower facial, and dental asymmetries. The orthodontist and surgeon integrated their efforts to correct dentofacial asymmetry in all 3 planes of space. Facial esthetics and dental function were significantly improved with no appreciable relapse occurring over a 2-year retention period.

Covering of fiber-reinforced composite bars by adhesive materials, is it necessary to improve the bond strength of lingual retainers?

OBJECTIVES: The objectives were to evaluate the shear bond strength (SBS) of fiber-reinforced composite (FRC) retainers when bonding them to teeth with and without covering the FRC bars using two different adhesive systems. MATERIALS AND METHODS: Hundred and twenty extracted human maxillary premolars were randomly divided into eight groups (n = 15). FRC bars (4 mm length, Everstick Ortho(®), Stick Tech, Oy, Turku, Finland) were bonded to the proximal (distal) surfaces of the teeth using two different adhesives (Tetric Flow [TF, Ivoclar Vivadent, Switzerland] and resin-modified glass ionomer cement [RMGIC, ODP, Vista, CA, USA]) with and without covering with the same adhesive. Specimens were exposed to thermocycling (625 cycles per day [5-55°C, intervals: 30 s] for 8 days). The SBS test was then performed using the universal testing machine (Zwick, GMBH, Ulm, Germany). After debonding, the remaining adhesive on the teeth was recorded by the adhesive remnant index (0-3). RESULTS: The lowest mean SBS (standard deviation) was found in the TF group without covering with adhesive (12.6 [2.11] MPa), and the highest bond strength was in the TF group with covering with adhesive (16.01 [1.09] MPa). Overall, the uncovered RMGIC (15.65 [3.57] MPa) provided a higher SBS compared to the uncovered TF. Covering of FRC with TF led to a significant increase in SBS (P = 0.001), but this was not true for RMGIC (P = 0.807). Thermal cycling did not significantly change the SBS values (P = 0.537). Overall, eight groups were statistically different (ANOVA test, F = 3.32, P = 0.034), but no significant differences in bond failure locations were found between the groups (Fisher's exact tests, P = 0.92). CONCLUSIONS: The present findings showed no significant differences between SBS of FRC bars with and without covering by RMGIC. However, when using TF, there was a significant difference in SBS measurements between covering and noncovering groups. Therefore, the use of RMGIC without covering FRC bars can be suggested, which can be validated with in vivo studies.

A comparison of shear bond strength of immediate and delayed bonding of brackets to FRC bars using various orthodontic adhesives.

BACKGROUND: Fibre reinforced composite bars (FRC) have applications as bonded retainers, space maintainers and anchorage/movement units. However, the bond strength of attachments to FRC anchorage bars is unknown. AIMS: To compare the shear bond strengths of brackets bonded immediately to FRCs with different orthodontic adhesive systems and bonded with the same adhesives after a 48-hour delay, abraded with a diamond bur and etched with phosphoric acid. METHOD: One hundred and five recently extracted upper premolars were randomly assigned to seven groups (N = 15 teeth per group). FRCs were bonded to the buccal surfaces of the teeth and stainless steel orthodontic brackets were bonded to the FRCs with the following adhesive systems: Group 0 (Tetric Flow); Groups 1, 2 and 3 (Immediate bonding with chemically cured, no-mix and light cured composites, respectively, the bars covered with Tetric Flow); Groups 4, 5 and 6 (Bonding to FRCs delayed 48 hours, then bonded with chemically cured, no-mix and light cured composites, respectively, the bars covered with Tetric Flow). The FRC bars in Groups 4, 5 and 6 were abraded with a coarse-grit diamond bur before bonding the attachments to the bars. The shear bond strengths (SBS) were measured with a universal testing machine, and the adhesive remaining on the teeth after debonding was scored with the Adhesive Remnant Index (ARI). Data were analysed using analysis of variance (ANOVA), Duncan's post-hoc and Fisher's Exact test. RESULTS: There were no statistically significant SBS differences between Groups 0 (Mean SBS: 9.56 MPa), 1 (Mean SBS: 9.74 MPa), 2 (Mean SBS: 10.72 MPa) or 3 (Mean SBS: 9.54 MPa). Groups 4, 5 and 6 (Bonding delayed by 48 hours) had SBSs of 11.79 MPa, 11.63 MPa and 13.11 MPa, respectively, and were significantly higher than the SBSs in Groups 1, 2 and 3 (Immediate bonding). There were no significant differences in ARI scores among the groups. CONCLUSIONS: The mean SBSs in all groups fell within the clinically acceptable range (> 7 MPa). The combination of a 48-hour delay between placement of an FRC bar and bonding an attachment, abrading the FRC with a diamond bur and etching with phosphoric acid resulted in higher bond strengths.

Comparison of dietary intake between fixed orthodontic patients and control subjects.

BACKGROUND: Adolescence is a period of rapid physiological and psychological development which is associated with an increased demand in nutritional requirements. Orthodontic therapy is also commonly initiated during this phase of life and nutritional intake may also change during treatment. AIMS: To compare the nutrient intakes of adolescents wearing fixed orthodontic appliances and a control group matched for age and gender. METHOD: A total of 180 patients aged between 15 and 17 years participated in this study (90 in the study group and 90 controls). Demographic data were collected by questionnaire and dietary intake was assessed using a 24-hour memory recall and was analysed using Dietplan6 software (Forestfield Software Ltd, UK). Comparisons between groups were assessed by the Independent sample t-test dnd the SPSS was used for statistical analysis. RESULTS: Orthodontic patients consumed a similar number of total calories, protein and carbohydrate (p > 0.05); however, they had a greater intake of total fat, saturated fat, monosaturated fat, polysaturated fat, linolenic fat, linoleic fat and cholesterol and significantly lower intake of fibre, chromium and beta-carotene (p < 0.05) compared with the Control group. The intake of other macro- and micro-nutrients did not differ significantly between groups. CONCLUSIONS: Adolescents receiving orthodontic treatment have an altered dietary intake that can be harmful to their health. As adolescents are at a critical stage of development and dietary intake is of particular importance, it is recommended that targeted nutritional guidance is provided to patients during orthodontic treatment.