Comparison of rate of tooth movement and pain perception during accelerated tooth movement associated with conventional fixed appliances with micro-osteoperforations - a randomised controlled trial.

OBJECTIVES: To investigate the influence of micro-osteoperforation (MOP) on rate of orthodontic tooth movement and pain perception with fixed appliances. DESIGN: 2 arm parallel randomized controlled trial with an allocation ratio of 1:1. SETTING: The outpatient department of a dental college. PARTICIPANTS: 105 patients were screened, out of which 60 met the inclusion criteria and consented to participate; consisting of 33 females and 27 males requiring en-masse retraction following first premolar extractions. METHODS: The experimental group consisted of patients bonded with a fixed appliance (Gemini 3M) who received MOP distal to canines throughout the period of retraction every 28 days. These were compared with a control group treated with identical brackets without MOP and were assessed for rate of tooth movement (canine retraction) and pain perception using a Visual Analogue Scale (VAS) of 10 mm. RESULTS: Prior to commencement, all baseline parameters were matched between the two groups (p>0.05). A statistically significant increase in rate of tooth movement in the MOP group (p<0.05). CONCLUSION: MOP appears to enhance the rate of tooth movement with no differences in pain perception.

A prospective randomized controlled trial on the comparative clinical efficiency and hygiene of a ceramic inter locking retainer and a flexible spiral wire bonded retainer.

BACKGROUND: The lower canine to canine retainer is one of the most commonly used retention appliance. OBJECTIVE: Compare and assess the clinical efficiency and oral hygiene maintenance with 2 retainers: flexible spiral wire and ceramic interlocking bonded. SETTING AND SAMPLE POPULATION: Orthodontic department of a dental college. PARTICIPANTS, STUDY DESIGN AND METHODS: Prospective randomized controlled trial that involved 40 patients who had completed orthodontic treatment and were randomly allotted to either group: flexible spiral wire (FSW) or ceramic interlocking retainers. Allocation ratio was 1:1. ELIGIBILITY CRITERIA: Completed fixed orthodontic treatment with an acceptable treatment result. MAIN OUTCOMES: Oral hygiene was assessed at 3 (T1) and 6 (T2) months intervals after debonding using Gingival and Plaque index. The contact point displacement was assessed using 3D model superimposition and bonded retainer failure was noted. RANDOMIZATION AND BLINDING: Computer-generated random allocation, only data analyzer was blinded. STATISTICS: Data normality was tested using the Shapiro-Wilk and Q-Q plot. Mixed model analysis was used to assess differences between the two groups for the above-mentioned parameters. The failure rate of the retainer was calculated by the Chi-Square test. RESULTS: Only the plaque index score was significantly greater in the FSW group and showed a statistically significant difference (P < 0.05), rest of the parameters showed no statistically significant difference over the specified time points, although a mild increase in relapse was noted in both groups No serious harms were reported. CONCLUSION: Both retainers seem to be effective in maintaining the treatment results however the FSW seems to accumulate more plaque over a given period of time thereby mandating proper hygiene maintenance and follow-up.

Comparison of orthodontic space closure using micro-osteoperforation and passive self-ligating appliances or conventional fixed appliances.

OBJECTIVES: To examine the effect of micro-osteoperforation (MOP) on the space closure rate using passive self-ligating or conventional brackets. MATERIALS AND METHODS: This was a two-arm parallel randomized controlled trial undertaken at the outpatient department of a dental college. There were 60 participants (30 women and 30 men) who fulfilled the inclusion criteria. Both the study and control groups were subjected to MOPs throughout the period of space closure. MOPs were repeated every 28 days. The experimental group (mean age 19.5 ± 1.66 years) was bonded with passive self-ligating brackets while the control group (mean age 19.9 ± 1.13 years) was bonded with conventional brackets. Both groups were examined and compared for rate of space closure. An evaluation was conducted for both groups until the entire extraction space was closed and confirmed by evaluation of a tight contact between the canine and the second premolar using a piece of dental floss. RESULTS: Before the initiation of retraction, all initial criteria were similar between the two groups (P > .05). No difference was observed between the two groups in the rate of space closure (P > .05). CONCLUSIONS: MOP in conjunction with passive self-ligation does not increase the rate of orthodontic space closure when compared with MOP used with conventional brackets.

Comparison of transverse maxillary dental arch width changes with self-ligating and conventional brackets in patients requiring premolar extraction - A randomised clinical trial.

OBJECTIVE: The purpose of this study was to evaluate, the change in the transverse maxillary arch dimensions, in patients requiring all first premolar extractions when using Active and Passive Self-ligating brackets, and comparing them with Conventional brackets. MATERIALS AND METHODS: This study was a non-blinded randomised clinical trial, which consisted of 42 patients (21 males and 21 females) within the age group of 16-25 years, having bimaxillary protrusion. They were divided into three groups with 14 patients each. In Group 1 - Conventional brackets (3M Unitek), in Group 2 - Passive Self-ligation brackets: Smart Clip (3M Unitek), and in Group 3 - Active Self-ligation brackets: Empower AO (American Orthodontics) were bonded. All brackets had MBT prescription and 0.02" slot size. Dental study models were taken before the start of treatment and after six months of retraction. Inter-canine and intermolar widths were measured in all the three groups in the above mentioned stages. RESULTS: As compared to Conventional brackets, Self-ligating brackets (Passive and Active) showed greater increase in the transverse arch widths. Furthermore, between Passive and Active Self-ligating brackets, Passive Self-ligating brackets - Smart Clip (Group 2) showed a greater increment in the transverse arch dimensions, with an increase of 4.89mm in the inter-canine width and 3.4mm in intermolar width. CONCLUSION: Significant difference was found between Self-ligating brackets and the Conventional bracket system regarding maxillary arch width dimensional changes. Passive Self-ligating brackets - Smart Clip (Group 2) showed the highest and inter-molar width increase.

Periodontically accelerated orthodontic tooth movement: A narrative review.

Adult orthodontics has gained widespread acceptance recently with the introduction of more esthetic options for the patient. The major deterrent that remains is the prolonged treatment time associated with comprehensive orthodontic treatment. The objective of this paper is to present a review of techniques, which could be employed by the orthodontist in conjunction with a periodontist to enhance the rate of orthodontic tooth movement. The biological rationale and clinical manipulation have been discussed with a brief review of the current literature about these techniques. The interdisciplinary approach involving the orthodontist and the periodontist can benefit the patient by affording them with reduced treatment time.