Maxillary labial frenectomy: a randomized, controlled comparative study of two blue (445 nm) and infrared (980 nm) diode lasers versus surgical scalpel.

BACKGROUND: This study aimed to compare the intra and postoperative complications of frenectomy procedure with a surgical scalpel versus 445 nm and 980 nm diode lasers. METHODS: This randomized controlled clinical trial was conducted on 174 patients requiring maxillary labial frenectomy. After completion of fixed orthodontic treatment and primary closure of maxillary diastema, the patients were randomly assigned into three groups (n = 58): group 1 (frenectomy via 445 nm diode laser, continuous-wave, 1.5 W), group 2 (frenectomy via 980 nm laser, continuous-wave, 1.7 W), and control group (V-Y plasty technique via scalpel). Intra-operative bleeding, discomfort in chewing and speaking, pain, and tissue healing were compared among the groups immediately, at 7 and 30 days postoperatively using the Kruskal-Wallis, Mann-Whitney, and Chi-square tests. RESULTS: Pain scores were significantly lower in group 1 compared to group 2 (immediately and day 7, P < 0.05). Significant faster tissue healing at days 7 and 30 were observed in group 1 compared to group 2 (P < 0.05). Group 1 was superior to the control group regarding lower intraoperative bleeding, discomfort in chewing and speaking (immediately and day 7), lower pain (immediately and day 7), and tissue healing (day 7) (P < 0.05 for all). Group 2 was significantly superior to the control group in lower intraoperative bleeding, discomfort in chewing and speaking (immediately and day 7), and better tissue healing (day 7) (P < 0.05 for all). CONCLUSIONS: In conclusion, diode laser frenectomy resulted in significantly lower intra and postoperative complications compared to the scalpel. Moreover, 445 nm diode laser showed significantly superior effects compared to 980 nm diode laser. TRIAL REGISTRATION: The study protocol was registered on 29.10.2022 at the Iranian Registry of Clinical Trials ( www.irct.ir ) (registration number: IRCT20220630055326N1).

Morphological evaluation of maxillary arch in unilateral buccally and palatally impacted canines: a cone-beam computed tomography (CBCT)-based study in Northern Iran.

Purpose: This study investigated the association between the maxillary impacted canines' position and the maxilla's morphological features in an Iranian population based on cone-beam computed tomography (CBCT) images. Material and methods: In this cross-sectional descriptive-analytical study, 47 CBCT images of unilateral buccally impacted maxillary canines and 47 CBCT images of unilateral palatally impacted maxillary canines were examined. Several morphological variables were compared between the impacted and non-impacted sides, and between the buccal and palatal impaction types. Results: Gender and age were not significantly associated with the canine impaction type. The alveolar bone height at the impacted side was significantly greater in the buccally impacted group than in the palatally impacted group (p = 0.016). In a comparison of the impacted and non-impacted sides, all variables of alveolar bone thickness at depth of 2 mm, maxillary arch width, and palatal volume had significantly smaller values in the impacted side in both buccally and palatally impacted groups (p < 0.05). The alveolar bone was significantly thicker at the depth of 10 mm in the impacted side of the buccal group (p = 0.024). The maxillary arch perimeter was significantly smaller in the impacted side of the buccal group (p = 0.008). The palatal depth did not significantly differ between the groups. Conclusion: Among the studied variables, the alveolar bone thickness showed contrary results at different depths. The palatal volume and maxillary arch width were significantly smaller on the impacted side in both buccal and palatal groups, and the arch perimeter showed the same results only in the buccal group.

Associations across 22 dental and craniovertebral anomalies or variations, sagittal skeletal relationships, and vertical growth patterns: a comprehensive epidemiological study of 43 dentoskeletal traits.

INTRODUCTION: Despite researchers' recent interest in identifying links between some dental and craniovertebral abnormalities, there are many important, unassessed gaps in our knowledge of this matter. In addition, previous samples were small. This large study aimed to examine, for the first time, the occurrence/severity of numerous dental and skeletal anomalies or variations and their correlations with each other and with growth patterns. METHODS: This epidemiological study was conducted on pretreatment radiographs of 1194 patients from 3 cities (815 females). Skeletal sagittal skeletal relationships and vertical growth patterns were determined. The occurrence/severity were assessed for: cervical vertebral fusion (CVF), atlas posterior arch deficiency (APAD), ponticulus posticus (PP), sella turcica bridging (STB), hypodontia, oligodontia, hyperdontia, missing of maxillary laterals, microdontia, macrodontia, root dilaceration, odontoma, taurodontism, dental fusion, dental gemination, enamel pearl, permanent molar ankylosis, primary molar ankylosis, dens in dente, dens invaginatus, dental impaction, ectopic eruption, and dental transposition. Incidental findings were recorded as well. Concurrent anomalies, sex dimorphism, and correlations across variables were examined statistically, adjusting for the false discovery rate (α = 0.05). RESULTS: Prevalence was calculated for 43 dentoskeletal traits/anomalies (22 abnormalities/variations [plus their severities/types] as well as 21 incidentally found traits/anomalies). Dental impaction may be more common in hyperdivergent and severer cases of sella bridging; also, primary molar ankylosis was associated with missing teeth. Dental impaction was associated only with STB and not with PP, APAD, or vertebral fusion. The only association observed among the four skeletal anomalies was seen between APAD and CVF. Merely the variables 'sagittal skeletal relationships, vertical growth patterns, PP, and APAD' showed sexual dimorphism; of these, only vertical growth pattern and APAD remained sexually dimorphic after adjusting for the FDR; still, the other two remained marginally significant and worth further evaluations. Sex dimorphism did not exist in concurrent abnormalities. The skeletal Class III was associated with the concurrent occurrence of craniovertebral, dental, and dentoskeletal abnormalities. Skeletal Class I was associated with fewer occurrences of concurrent dental anomalies. Vertical growth patterns were not associated with concurrent dental or dentoskeletal anomalies. However, the hyperdivergent pattern was associated with fewer cases of concurrent craniovertebral abnormalities. CONCLUSIONS: STB and hyperdivergent pattern were associated with dental impaction. However, APAD, CVF, or PP were not associated with dental impaction. APAD was associated with CVF. Sexual dimorphism existed conclusively in the case of vertical growth patterns and APAD. Concurrent abnormalities (dental, skeletal, and dentoskeletal) were associated with skeletal Class III.

Efficacy of compound topical anesthesia combined with photobiomodulation therapy in pain control for placement of orthodontic miniscrew: a double-blind, randomized clinical trial.

This study aims to investigate the effect of compound topical anesthetic (CTA) application combined with photobiomodulation therapy (PBMT) on the level of pain perceived during placement of miniscrews and 24 h post the procedure in the buccal side of the maxillary bone. This randomized, prospective, single-center, split-mouth, double-blinded study included 25 subjects (12 males and 13 females, aged 16 to 35). Two anesthetic techniques before implantation were performed including Profound gel +PBM with 980 nm diode laser and local anesthesia with 2% lidocaine hydrochloride. Then, the miniscrews with the size of 1.6 mm in diameter and 8 mm in length were placed with a hand driver in the buccal side of the maxillary bone. The pain immediately after miniscrew placement (T1), also 12 h (T2), and 24 h (T3) post the procedure were collected by visual analog scale (VAS). Data were analyzed by SPSS version 22. There were no statistically significant differences in mean VAS scores within or between CTA combined with PBMT or injection applications, immediately after miniscrew placement (P = 0.75), 12 h after miniscrew placement (P = 0.4), and 24 h after miniscrew placement (P = 1.0). Compound topical anesthetic combined with PBMT provided adequate local anesthesia for the placement of miniscrews in the buccal side of the maxillary bone.

Associations among palatal impaction of canine, sella turcica bridging, and ponticulus posticus (atlas arcuate foramen).

INTRODUCTION: The palatal impaction of canine (PIC) can be predicted by some head and neck skeletal anomalies or variants. Since studies on this regard (especially vertebral anomalies) are scarce, this study was conducted. METHODS: This case-control study was done on 46 PIC orthodontic patients (34 females, 12 males) and 46 control orthodontic patients (36 females, 10 males). The diagnosis of PIC was done on lateral cephalographs and panoramic radiographs. On cephalographs, sella turcica bridging (occurrence and severity) and ponticulus posticus (occurrence and severity) were assessed. Associations between PIC, sella bridging, and ponticulus posticus were examined statistically (α = 0.05, ß ≤ 0.2). RESULTS: Cases' and controls' mean ages were 17.7 ± 4.0 and 17.4 ± 3.5, respectively. Of the case subjects, 22, 22, and 2 had respectively types I (normal), II, and III of sella bridging, while these numbers were 34, 12, and 0 in controls (chi-square P = 0.023 for severity, 0.010 for occurrence). Ponticulus posticus was observed in 28 cases (7 completed) and 17 controls (6 completed, P = 0.022 for occurrence, 0.056 for severity). Sella bridging was not associated with ponticulus posticus (Spearman P = 0.150). According to binary logistic regression, sella bridging can increase the odds of palatal canine impaction for OR = 2.8 times, while ponticulus posticus for OR = 2.6. Age and sex did not affect sella bridging or ponticulus posticus. CONCLUSIONS: Both sella bridging and ponticulus posticus can predict an increased rate of PIC for more than 2.5 times.

Correlations among chronological age, cervical vertebral maturation index, and Demirjian developmental stage of the maxillary and mandibular canines and second molars.

PURPOSE: Estimation of growth spurt from chronological age or dental development is of clinical interest to orthodontists. Since results in this regard are highly controversial and limited, this study was conducted to investigate associations among chronological age, skeletal development (cervical vertebral maturity [CVM]), and dental calcification (Demirjian) in girls and boys, independently. METHODS: Panoramic radiographs and lateral cephalographs of 112 boys and 112 girls were evaluated. Demirjian stages of dental development of the bimaxillary canines and second molars were determined. CVM stages of skeletal growth were as well estimated. Correlations among these were assessed. Differences between sexes and between maxilla/mandible arches were assessed. Cutoff points in Demirjian and chronological age reflecting skeletal growth spurt were found using receiver operator characteristic curve (α = 0.05, ß = 0.9 separately for girls and boys). RESULTS AND CONCLUSIONS: Sex dimorphism existed both in CVM index and in Demirjian indexes. Compared to dental development and calcification, chronological age was the best predictor of skeletal growth and maturation. In estimating chronological age by radiography means, in girls, Demirjian method was better than CVM. In boys, Demirjian was better than CVM in the case of the molars but not canines. The cutoff points estimated for chronological age and dental calcification that can reflect skeletal growth spurt (between CS-3-and-CS-4) were as follows: in boys, age of 12 years; in girls, age between 11 and 12 years; the upper and lower canines: between G and H; the maxillary and mandibular second molars: between F and G; in the case of all teeth: between F and G.

Evaluating the effect of photobiomodulation with a 940-nm diode laser on post-operative pain in periodontal flap surgery.

The aim of this study was to evaluate the efficacy of low-power of 940-nm diode laser on post-operative pain after undisplaced flap surgery. This randomized clinical trial study was conducted using a split-mouth design. The study participants comprised 30 patients who needed periodontal flap surgery for periodontal pockets on the same tooth on both sides of the mandible. One side of the mandible was subjected to undisplaced flap surgery plus treatment with a 940-nm diode laser, and on the contralateral side, the surgery was conducted without applying the laser. Patients received anti-inflammatory medication and analgesics after surgery. The patients were asked to report the number of analgesics they took and the pain they experienced each night for 1 week using a visual analogue scale. An independent-sample t test was used to compare the results between the two groups. Patients reported less pain on days 2, 3, 4, 5, 6, and 7 after surgery in the laser-treated group (p < 0.05). Furthermore, fewer analgesics were used in this group on days 3, 4, 5, 6, and 7 following the surgery (p < 0.05). The 940-nm diode laser with the settings used in this study could significantly reduce pain and the number of analgesics taken by patients after undisplaced flap surgery.

Effects of fixed orthodontic treatment on nickel and chromium levels in gingival crevicular fluid as a novel systemic biomarker of trace elements: A longitudinal study.

INTRODUCTION: Nickel and chromium might induce hypersensitivity. Therefore, they are of interest to orthodontists. Gingival crevicular fluid (GCF) is highly relevant to orthodontic treatments and might reflect systemic changes associated with the inflammatory response induced by orthodontic forces. Therefore, it might also be used to show metal ion changes. Nevertheless, baseline metal levels of GCF are unknown, and the effect of orthodontic treatment on GCF metal levels has not been investigated. The aim of this study was to assess the levels of nickel and chromium in GCF. METHODS: Based on a pilot study, the sample size was predetermined as 24 × 3 measurements to obtain test powers above 90%. Nickel and chromium concentrations were measured before treatment and 1 month and 6 months later in 12 female and 12 male patients who had fixed orthodontic appliances using atomic absorption spectrophotometry. The gingival index was also evaluated in each session. The effects of treatment on GCF ions were analyzed using repeated-measures analysis of variance and Friedman tests (α = 0.05, ß ≤0.01). RESULTS: The gingival index worsened over time (chi-square test, P <0.001). The mean nickel levels were 3.894 ± 1.442, 5.913 ± 2.735, and 19.810 ± 8.452 µg per gram, respectively, at baseline, month 1, and month 6. Chromium concentrations were 1.978 ± 0.721, 4.135 ± 1.591, and 13.760 ± 3.555 µg per gram, respectively. Compared with the baseline, nickel increased by 150% and 510%, respectively, in the first and sixth months (Friedman, P <0.0001), and chromium increased by 200% and 700%, respectively (analysis of variance, P <0.0001). CONCLUSIONS: Six months of fixed orthodontic treatment might intensify the levels of nickel and chromium in the GCF as well as gingival inflammation.

Shear bond strength of metal brackets to feldspathic porcelain treated by Nd:YAG laser and hydrofluoric acid.

Adult orthodontic treatment requires bonding orthodontic attachment to dental restorations. Ceramics are commonly used as esthetic restorative materials for the crowns and bridges. The present study evaluated the shear bond strength of metal orthodontic brackets to the feldspathic porcelain surfaces following conditioning by different powers of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser and hydrofluoric acid as a conventional method. Seventy-two glazed porcelain samples were prepared and randomly attributed to six equal groups of 12. In the conventional hydrofluoric (HF) group, the specimens were etched by 9.6% hydrofluoric acid for 4 min. In laser groups, samples were conditioned by 0.75-, 1-, 1.25-, 1.5-, and 2-W Nd:YAG laser for 10 s. Metal brackets were bonded to porcelain samples and after being stored in distilled water for 24 h, they were subjected to thermocycling for 500 cycles. The debonding was carried out by a Zwick testing machine. The data were statistically analyzed by ANOVA and Tamhane multiple comparisons tests. The mean ± SD of the shear bond strength in the laser group 0.75, 1, 1.25, 1.5, and 2 W and HF group was 2.2 ± 0.9, 4.2 ± 1.1, 4.9 ± 2.4, 7 ± 1.7, 9.6 ± 2.7, and 9.4 ± 2.5, respectively. Together with the increased power of laser, the mean shear bond strength was increased continuously and no significant differences were found between the HF group and the laser groups with power of 1.5 or 2 W. Also, there was no significant difference between all test groups in ARI scores. There was no significant difference between bond strength of laser groups with power of 1.5 and 2 W and HF-etched group. So, Nd:YAG laser with appropriate parameters can be used as an alternative method for porcelain etching.

Radiographic assessment and management of two deeply and horizontally impacted maxillary central incisors: A clinical case report.

This case report describes the treatment of a 9-year-old boy with impacted maxillary central incisors due to 2 supernumerary teeth. A sequential approach comprising of surgical removal of the supernumerary teeth and 2 stages of surgical exposure and orthodontic traction of the impacted teeth resulted in correct repositioning of incisors. Close monitoring and multidisciplinary cooperation during various stages of treatment led to a successful esthetic outcome, with optimal periodontal health and functional occlusion.

An Adult Case of Crouzon Syndrome: Diagnostic Features and Treatment Modalities.

Craniosynostosis syndromes are birth defects characterized by the premature fusion of one or more cranial sutures before the completion of brain growth and development. Crouzon syndrome (CS) is the most common craniosynostosis condition. The CS manifestations result from the early fusion of superior and posterior sutures of the maxilla along the orbital wall and affect the cranial vault, base, orbital, and maxillary regions. This report presents a rare case of a 25-year-old male CS patient referred for orthodontic treatment with the chief complaint of severe irregularities in the arrangement of teeth and abnormal facial appearance. In this report, the clinical, cephalometric features, and initial orthodontic management of this patient are discussed as part of multidisciplinary management.

Radiological Evaluation of the Accuracy of Demirjian, Nolla, and Willems Methods for Dental Age Estimation in 3-17-Year-Old Iranian Children.

Background: The stage of tooth formation is one of the most reliable indicators for predicting a patient's developmental age by radiographs. This study compared the accuracy of three distinct dental age estimation methods (Demirjian, Nolla, and Willems) in children aged 3-17 in the northern Iranian population. Methods: This cross-sectional study examined panoramic radiographs of 434 children aged 3-17 from Mazandaran Province, Iran, who had teeth 31-37 present on the left mandible. This study employed the Demirjian, Nolla, and Willems methods to estimate the dental age of the sample and compare it with the chronological age. The data were analyzed using SPSS v16. A paired t-test was used to compare chronological and dental ages. The Pearson correlation was used to correlate the chronological and dental ages. The errors of different methods were compared using the Wilcoxon test. P values < 0.05 were considered significant for all tests except Wilcoxon. For Wilcoxon, a P value < 0.017 was considered significant. Results: The three methods presented differing mean estimated ages. The Demirjian method delivered the highest mean, and all three methods differed significantly when compared in pairs. The results showed that the Demirjian method overestimated chronological age by 0.25 years (P < 0.001) in girls and 0.09 years (P = 0.28) in boys. The Willems method underestimated chronological age by 0.05 years (P = 0.47) in girls and 0.12 years (P = 0.13) in boys. The Nolla method underestimated chronological age by 0.41 years (P < 0.001) in girls and 0.40 years (P < 0.001) in boys. The accuracy of each method varied with the patient's age. Conclusion: According to the findings, the Willems method outperformed the Demirjian method, and the Demirjian method exceeded the Nolla method for estimating dental age in Iranian children aged 3-17. Overall, the Demirjian method overestimated the age of the study population, whereas the other two underestimated it.

In Vitro Comparative Evaluation of the Efficacy of Antimicrobial Photodynamic Therapy, Chlorhexidine, Sodium Fluoride, and Hydrogen Peroxide for Acrylic Resin Disinfection.

Introduction: Plaque accumulation on the surface of removable orthodontic appliances could lead to dental caries, periodontitis, and fungal infections. This study evaluated the effectiveness of antimicrobial photodynamic therapy (aPDT), chlorhexidine (CHX), sodium fluoride (NaF), and hydrogen peroxide (H2O2) for the disinfection of acrylic resin. Methods: In this in vitro experimental study, 100 acrylic resin specimens were randomly divided into five groups (n=20 each): Enterococcus faecalis, Streptococcus mutans, Streptococcus salivarius, Streptococcus sanguinis, and Lactobacillus acidophilus. Each group was immersed separately in 5 mL of microbial suspension. They were then incubated until biofilm formation on their surface. Of each microorganism, one biofilm sample in phosphate-buffered saline was considered as negative control, and other biofilm samples (n=80) were subjected to aPDT with curcumin, 0.12% CHX (positive control), 1% H2O2, and 0.2% NaF. Finally, the number of colonies was counted. Data were analyzed by the Kruskal-Wallis and Mann-Whitney tests, two-way ANOVA, and Bonferroni adjustment at a significance level of 0.05. Results: The interaction effect of the treatment modality and type of microorganism was significant on the microbial count (effect size: 0.91, P<0.05). Maximum bacterial proliferation was noted in the following combinations: NaF/E. faecalis, H2O2/E. faecalis, and H2O2/S. salivarius. Microorganisms had no or insignificant growth and proliferation in the aPDT and CHX groups. Conclusion: The results supported the optimal antimicrobial efficacy of PDT which was comparable to that of CHX. aPDT showed superior antimicrobial efficacy to NaF and H2O2 for the disinfection of acrylic resin.

Associations between body dysmorphic disorder (BDD) with the dental health component of the index of orthodontic treatment need (IOTN-DHC) and other BDD risk factors in orthodontic patients: A preliminary study.

Objective: Body dysmorphic disorder (BDD) is a form of obsessive-compulsive disorder that may be negatively associated with the self-image. It might be associated with orthodontic treatment demand and outcome, and therefore is important. Thus, this study was conducted. Methods: The Yale-Brown Obsessive-Compulsive Scale modified for Body Dysmorphic Disorder (BDD-YBOCS) questionnaire was used in 699 orthodontic patients above 12 years of age (222 males, 477 females), at seven clinics in two cities (2020-2021). BDD diagnosis and severity were calculated based on the first 3 items and all 12 items of the questionnaire. The dental health component of the index of orthodontic treatment need (IOTN-DHC) was assessed by orthodontists. Multivariable and bivariable statistical analyses were performed on ordinal and dichotomized BDD diagnoses to assess potentially associated factors (IOTN-DHC, age, sex, marital status, education level, and previous orthodontic consultation) (α = 0.05). Results: IOTN-DHC scores 1-5 were seen in 13.0%, 39.9%, 29.8%, 12.4%, and 4.9% of patients. Age/sex/marital status/education were not associated with IOTN-DHC (p > 0.05). Based on 3-item questionnaire, 17.02% of patients had BDD (14.02% mild). Based on 12-item questionnaire, 2.86% had BDD. BDD was more prevalent or severer in females, married patients, patients with a previous history of orthodontic consultation, and patients with milder IOTN-DHCs (p < 0.05). Conclusions: IOTN-DHC was negatively/slightly associated with BDD in orthodontic patients. Being female and married may increase BDD risk.

Detection of vertical root fractures using digitally enhanced images: reverse-contrast and colorization.

Root fracture diagnosis is a clinical difficulty that in most cases can only be detected through radiography. The objective of this study was to compare the diagnostic accuracy of two types of digitally enhanced images (reverse-contrast and colorization) with original digital radiographies in detecting experimental root fractures. Two hundred extracted single-rooted human teeth were endodontically instrumented and then divided in two groups, one control group and one test group, including fractured teeth. Vertical root fractures were experimentally made in the fractured group. The digital image of each tooth was taken, using the paralleling technique. There were three groups of images: (i) original, (ii) reverse contrast, and (iii) colorized. Three experienced dental specialists examined the images with no prior knowledge of the distribution of the root fractures. Two-way analysis of variance was used to assess the differences in accuracy, sensitivity, and specificity of each technique in detecting root fractures. Cohen's kappa coefficients were calculated to investigate the degree of interobserver agreement. The accuracy, sensitivity, and specificity of original images were 67.4%, 66.7%, and 68%, respectively; these amounts were 61.5%, 61%, and 65.5% in reverse contrast images and 66.4%, 70.7%, and 62% in colorized digital radiography. The original images had the best inter observer kappa coefficients (between 0.45 and 0.55). The results showed that the accuracy of original images is better than reverse contrast and colorized images. Use of reverse-contrast and colorization digital images in root fracture detection should be regarded as an adjunct to other diagnostic methods not as a highly critical diagnostic aid.

Effects of Novel versus Conventional Porcelain Surface Treatments on Shear Bond Strength of Orthodontic Brackets: A Systematic Review and Meta-Analysis.

BACKGROUND: Despite the importance of identifying proper novel porcelain preparation techniques to improve bonding of orthodontic brackets to porcelain surfaces, and despite the highly controversial results on this subject, no systematic review or meta-analysis exists in this regard. OBJECTIVE: To comparatively summarize the effects of all the available porcelain surface treatments on the shear bond strength (SBS) and adhesive remnant index (ARI) of orthodontic brackets (metal, ceramic, polycarbonate) bonded to feldspathic porcelain restorations. Search Methods. A search was conducted for articles published between January 1990 and February 2021 in PubMed, MeSH, Scopus, Web of Science, Cochrane, Google Scholar, and reference lists. Eligibility Criteria. English-language articles comparing SBS of feldspathic porcelain's surface preparation methods for metal/ceramic/polycarbonate orthodontic brackets were included. Articles comparing silanes/bonding agents/primers without assessing roughening techniques were excluded. Data Analysis. Studies were summarized and risk of bias assessed. Each treatment's SBS was compared with the 6 and 10 MPa recommended thresholds. Studies including comparator (HF [hydrofluoric acid] + silane + bonding) were candidates for meta-analysis. ARI scores were dichotomized. Fixed- and random-effects models were used and forest plots drawn. Egger regressions and/or funnel plots were used to assess publication biases. RESULTS: Thirty-two studies were included (140 groups of SBS, 82 groups of ARI). Bond strengths of 21 studies were meta-analyzed (64 comparisons in 14 meta-analyses). ARIs of 12 articles were meta-analyzed (28 comparisons in 8 meta-analyses). Certain protocols provided bond strengths poorer than HF + silane + bonding: "abrasion + bonding, diamond bur + bonding, HF + bonding, Nd:YAG laser (1 W) + silane + bonding, CO2 laser (2 W/2 Hz) + silane + bonding, and phosphoric acid + silane + bonding." Abrasion + HF + silane + bonding might act almost better than HF + silane + bonding. Abrasion + silane + bonding yields controversial results, being slightly (marginally significantly) better than HF + silane + bonding. Some protocols had controversial results with their overall effects being close to HF + silane + bonding: "Cojet + silane + bonding, diamond bur + silane + bonding, Er:YAG laser (1.6 W/20 Hz) + silane + bonding." Few methods provided bond strengths similar to HF + silane + bonding without much controversy: "Nd:YAG laser (2 W) + silane + bonding" and "phosphoric acid + silane + bonding" (in ceramic brackets). ARIs were either similar to HF + silane + bonding or relatively skewed towards the "no resin on porcelain" end. The risk of bias was rather low. Limitations. All the found studies were in vitro and thus not easily translatable to clinical conditions. Many metasamples were small. CONCLUSIONS: The preparation methods HF + silane + bonding, abrasion + HF + silane + bonding, Nd:YAG (2 W) + silane + bonding, and phosphoric acid + silane + bonding (in ceramic brackets) might provide stronger bonds.

Relationship between Craniovertebral Abnormalities and Maxillary Lateral Incisors Agenesis: A Case-Control Study.

Objectives: This study aimed to investigate whether the sella turcica bridging (STB) and ponticulus posticous (PP) are associated with the congenital missing maxillary lateral incisor (CMMLI), based on lateral cephalograms of patients who needed orthodontic treatment. Materials and Methods: This case-control study examined 160 panoramic images and lateral cephalograms of 2000 patients seeking orthodontic treatment. The case group included 80 patients with CMMLI (40 with unilateral and 40 with bilateral CMMLI) and the control group included 80 patients without CMMLI. Panoramic images were used to diagnose CMMLI and lateral cephalograms showed STB and PP extension. The researchers used statistical analyses to examine the relationship among STB, PP, and CMMLI (P < 0.05). Results: The prevalence of STB type I, II, and III was 47.5%, 35%, and 17.5% in the case group and 72.5%, 22.5%, and 5% in the control group, respectively, determining a positive relationship between CMMLI and STB and a significant relationship between bilateral CMMLI and STB (P < 0.05 for both). The prevalence of normal, incomplete, and complete PP extension was 80%, 5%, and 15% in the case group and 82.5%, 5%, and 12.5% in the control group, respectively. There was no significant relationship between CMMLI and PP extension (P > 0.05) and between the STB and the PP extension (P > 0.05). Conclusion: CMMLI was significantly related to STB but not to PP extension. Investigating the relationship between unilateral/bilateral CMMLI, STB, and PP has shown only a significant relationship between bilateral CMMLI and STB. There was no significant relationship between STB and PP extension.

Comparison of shear bond strength of rebonded brackets prepared with different methods of resin removal: an in vitro study.

AIM: Clinicians and researchers have always made every effort to achieve proper bonding between the surface of the tooth and the rebonded orthodontic brackets in order to prevent the re-fracture failure of orthodontic pressures throughout treatment. The aim of this study was to determine the bond strength of rebonded brackets by four adhesive removal methods.

Short-term and long-term alterations of condylar position after bilateral sagittal split ramus osteotomy for mandibular setback: A preliminary before-after clinical trial.

Background: Because of the importance of the condyle, it is crucial to document all changes in its position after orthognathic surgery. Since previous studies in this regard are mostly controversial and limited by two-dimensional radiography technique, this study was conducted. Materials and Methods: This prospective clinical trial was performed on 102 measurements (17 patients, 2 condyles each, and 3 time points). Cone-beam computerized tomography imaging was done for 17 skeletal Class-III patients (10 females and 7 males, mean age, 24.05 ± 4.78 years) undergoing fixed orthodontic treatment, at three time points T0 (before surgery), T1 (immediately after surgery), and T2 (8 months after surgery). Condylar positions were measured. Position changes were evaluated during the course of the study. They were also compared between right/left sides and between men and women. Tests in use were repeated-measures one- and two-way analysis of variance and paired t-tests (α =0.05, α =0.017). Results: Alterations in various anatomical condyle parameters over the 8-month course of the study did not reach the level of significance (P ≥ 0.078). At all intervals, mean anterior-posterior index (API) remained between -12 and +12 (indicative of central position of the condyle in the glenoid fossa). Between men and women, left superior joint space, left anterior joint space, and left API differed (P ≤ 0.05). Left condyle mean superior joint space and anterior joint space were greater in men compared to women in all the three intervals; left condyle mean API was greater in women compared to men (more posterior in men, P ≤ 0.05). Conclusion: Condyles might not change significantly after 8 months post-surgery. However, small changes might be observed, and these changes might differ between the left and right sides and between males and females.

Diode laser chairside frenectomy in orthodontics: A case series (DIODE LASER FRENECTOMY: CASE SERIES).

Offering the whole orthodontic and surgical treatment to the patient as a single package in a one office can save them considerable time and the trouble. Diode laser enables orthodontists to do so while enjoying its benefits over the scalpel.