Influence of clinical experience on accuracy of virtual orthodontic attachment bonding in comparison with the direct procedure.

OBJECTIVES: To compare the accuracy of bonding orthodontic attachments in a digital environment with the direct bonding procedure depending on the level of the orthodontist's clinical experience. MATERIALS AND METHODS: A total of 1120 artificial teeth of 40 identical models (20 solid sets + 20 digital sets) were divided into four groups: (1) direct bonding (experienced clinicians). (2) direct bonding (postgraduate students), (3) virtual bonding (experienced clinicians), and (4) virtual bonding (postgraduate students). The differences in individual position of the placed attachments were measured after three-dimensional superimposition of the models using customized software. RESULTS: In the interoperator comparison, experienced clinicians were more exact than postgraduate students in virtual bonding in the angular dimension. Between the bonding techniques, virtual bonding was more accurate than the direct technique. The prevalence of errors was higher in the direct procedure than virtual bonding, and the errors were more significant in the premolar and molar teeth. CONCLUSIONS: Clinical experience had a positive influence in achieving a higher rate of correctness/accuracy in the angular dimension only during virtual bonding. Virtual bonding was more accurate than direct bonding in the vertical and horizontal dimensions. Early diagnosis of errors in the bonding positions of attachments could be of benefit to both clinicians and patients by predicting discrepancies that may lead to undesirable orthodontic movements.

Influence of psychological stress exposure on orthodontic therapy: A comprehensive review.

The aim of the present study was to comprehensively review the influence of psychological stress exposure (PSE) on orthodontic therapy (OT). Original clinical and experimental studies were assessed. Quality assessment of experimental studies was performed using the Animal Research Reporting In Vivo Experiment (ARRIVE) guidelines. Six studies (2 clinical and 4 experimental) were included. One clinical study showed that PSE during OT significantly increases nickel release from orthodontic appliances into the saliva. In another study, maternal support was found to be an important predictor of the outcome of OT. In one experimental study, chronic PSE increased orthodontic tooth movement (OTM), and in two experimental studies, PSE decreased OTM. One study on rats reported that PSE is not a risk factor for orthodontically-induced root resorption during OTM. One experimental study showed a significantly higher number of osteoclasts in the bone on the side of OTM in restrained rats compared with unrestrained rats. One study showed decreased osteoclast counts in the bone during OTM under PSE. The lowest, highest, and mean ARRIVE scores (out of 20) for the experimental studies were 16, 18, and 16.75 ± 0.96, respectively. The role of PSE in clinical orthodontics remains unclear, most likely due to a lack of studies in humans. Further power-adjusted, well-designed, and randomized studies are needed.

Evaluation of jawbone morphology and bone density indices in panoramic radiographs of selective serotonin reuptake inhibitor users: a preliminary study.

OBJECTIVES:: To assess the influence of selective serotonin reuptake inhibitor (SSRI) use on jawbone and bone mineral density by retrospective analysis of panoramic radiographs. METHODS:: Radiographic and clinical records were sourced from the Division of Orthodontics and TMJD, Eastman Institute for Oral Health, University of Rochester. Randomly selected adults (20-65 years) were categorized into: "Active" (with history of SSRI use of >6 months) and a "Control" group. Panoramic indices: Klemetti index (KI), panoramic mandibular index, antegonial notching index, condylar pathology, mandibular cortical width (MCW)⁠ and mean ramus height were recorded. Frequency-weighted Χ2 tests and multinomial regression controlling for age and gender were applied to categorical indices (KI, condylar pathology, antegonial notching index). Multivariate generalized linear modeling was applied to mean ramus height, MCW and panoramic mandibular index. Multiple regression analyses determined: (a) panoramic indices that best predicted SSRI use, and (b) independent predictors of KI category. RESULTS:: 64 SSRI users and 48 Controls were assessed. SSRI users had significantly higher odds of having worse KI status than normal [mildly to moderately eroded cortex: odds ratio (OR) = 2.926, 95% CI (1.07-8.04) and severely eroded cortex: OR = 19.86, 95% CI (3.91-100.69)], more frequent flat condylar anatomy (right side: p = 0.009, left side: p < 0.001) but greater ramus height (p = 0.001) and mandibular cortical width (p = 0.032). Age, gender, SSRI use each significantly impacted KI. Only SSRI use significantly impacted condylar pathology, ramus height and MCW. KI category (OR = 1.3) was the best panoramic predictor of SSRI use. Conversely, KI category C3 was significantly predicted by SSRI use (OR = 31.2, p = 0.002), female gender (17.5, p = 0.006), and severe antegonial notching (OR = 1289, p < 0.001). CONCLUSIONS:: SRRI use was significantly associated with worse panoramic morphometric indices: KI, condylar pathology, ramus height, and MCW, where KI was its strongest predictor. Worse KI was independently predicted by SSRI use.

Translational mini-screw implant research.

It is important to thoroughly test new materials as well as techniques when these innovations are to be utilized in the human clinical situation. Translational research fills this important niche. The purpose of translational research is to establish the continuity of evidence from the laboratory to the clinic and in so-doing, provide evidence that the material is functioning appropriately and that the process in the human will be successful. This concept applies to the mini-screw implant; which, has been very successfully introduced into the orthodontic armamentarium over the last decade for application as a temporary anchorage device. The examples of translational research that will be illustrated in this paper have paved the way to ensure that clinicians have evidence to confidently utilize mini-screw implants in orthodontic practice. Needless to say, more studies are needed to ensure a safe, effective and efficient manner to practice orthodontics.