Evaluation of the diagnostic ability of the Fränkel manoeuvre to detect the contributing jaw in angle class II division 1 malocclusion.

BACKGROUND: A correct diagnosis of patients with an Angle Class II malocclusion is needed to guide treatment decisions toward the contributing jaw and to achieve better treatment outcomes. The aim of the study is to evaluate the diagnostic potential of the Fränkel manoeuvre (FM) for detecting the components determining sagittal discrepancy in Angle Class II division 1. MATERIALS AND METHODS: Anonymous questionnaires containing photographs were distributed totwo groups: general practitioner (GP) dentists and orthodontists. The level of the patient's profile aesthetics before (T0) and after (T1) the manoeuvre was determined using a 100 mm visual analog scale, and the 'profile improvement' score was defined as T1 minus T0. The diagnostic ability of the FM was calculated by comparison with lateral cephalometry as a reference standard using receiver operating characteristic (ROC) curve analysis. RESULTS: A total of 102 respondents participated in the survey; 40 were orthodontists, and 62 were GP dentists. According to the post-FM images, the "profile improvement" score (T1-T0) was significantly greater in patients with mandibular retrusion than in those with maxillary protrusion (p < 0.05). The predictive power of FM, coinciding with the area under the ROC curve, was 0.62 for GPs and 0.78 for orthodontists. CONCLUSIONS: The FM method is a useful and accurate tool for diagnosing skeletal Angle Class II malocclusion etiology (mandibular retrusion or maxillary protrusion), especially when used by orthodontists.

Well-Being of Orthodontic Patients Wearing Orthodontic Appliances.

Background and Objectives: Orthodontic appliances may cause discomfort for patients. This could influence the person's psychological well-being. The aim of this study was to examine the psychological health of patients wearing orthodontic appliances. It is important to analyze the well-being of patients during orthodontic treatment because it is started in a young age and it may affect one's psychological health. Therefore, for doctors and patients, it is important to understand and take every aspect of the treatment into consideration when deciding when to start the treatment and what appliance to choose. Materials and Methods: A total of 339 patients filled out an anonymous questionnaire. They were divided into four groups according to their age and type of appliance. The main reasons to seek treatment were crooked teeth and a bad bite. There was a statistically significant difference between women and men as women sought treatment because of crooked teeth; meanwhile, men indicated bad bite as their main reason for seeking treatment. Results: A total of 48.7% of subjects noted that they were feeling good during treatment; however, 4% of all patients noted that they were feeling bad. A total of 45% of subjects stated that they felt unhappy at least sometimes. A total of 43% of subjects felt stress. Conclusions: Even though patients indicated various negative aspects on their well-being during treatment, for the majority of the subjects, the end results significantly increased their psychological well-being.

Correlation Between Third Molar Mineralization and Midpalatal Suture Maturity: A Cone Beam Computed Tomography Study.

BACKGROUND Midpalatal suture ossification varies in patients of different ages, which can lead to making inaccurate presumptions when considering effective treatment timing based on chronological age. Chronological age provides only general information, whereas dental development correlates with skeletal growth, which suggests that tooth mineralization could be considered to be a precise criterion for determining the midpalatal suture's maturity. The present study was conducted to investigate the association between third-molar mineralization and midpalatal suture's maturation stages using cone-beam computed tomography (CBCT) images. MATERIAL AND METHODS The study involved 97 CBCT images of patients aged 8-37 years with normal growth and development. Subjects with cleft lip and palate, caries treatment, or present cavities in the third molars were not included in the study. The stages of midpalatal suture ossification were evaluated according to the protocol suggested by Angelieri et al, and the third-molar mineralization degree was measured by the Demirjian index. Statistical analysis was performed to evaluate correlations between the variables. RESULTS Patients with advanced third-molar mineralization stages were found to have greater midpalatal suture maturity. A statistically significant positive correlation was found between the stages of third-molar mineralization and midpalatal suture maturation (R=0.814, P<0.01). Third-molar development was also found to be associated with chronological age (R=0.883, P<0.01). CONCLUSIONS A measure of third-molar mineralization does not allow for accurate determination of the midpalatal suture maturation stage.

Does YouTube provide adequate information about orthodontic pain?

OBJECTIVES: To evaluate the content and quality of information about orthodontic pain on YouTube. MATERIALS AND METHODS: YouTube was searched using the keywords "orthodontic pain" and "brace pain." A total of 65 videos were chosen for the final analysis. Videos were classified into high- and low-content groups using an eight-point scoring system and reviewed according to selected orthodontic pain-related topics. Video quality was rated by the Video Information and Quality Index (VIQI) and Global Quality Scale (GQS). Statistical data analysis was performed using SPSS 28.0 software, Mann-Whitney U-tests, χ2 tests, and Spearman correlation coefficients. RESULTS: Most YouTube videos related to orthodontic pain were low content (86.2%), and a few were high content (13.8%). Pharmacological pain relief was the most prevalent topic (50.8%), followed by duration of pain (32.3%) and influence of pain on patient quality of life (29.2%). The least-mentioned topic was possible location of pain (7.7%). Most of the videos were uploaded by laypeople (64.6%). Videos uploaded by dental professionals had significantly higher means of GQS scores (P = .035), flow of information (P < .001), information quality (P = .008), and total VIQI (P < .001). Compared with low-content, high-content videos had a higher mean of flow of information (P = .037). There was a weak correlation between total content and GQS scores and a strong correlation between GQS and VIQI scores (r = 0.740; P < .01). CONCLUSIONS: Overall, YouTube was found to be an inadequate source of information on orthodontic pain.

White spot lesions risk management prior and during the orthodontic treatment.

OBJECTIVE: To evaluate the efficiency of various interventions performed before and during orthodontic treatment which aim to reduce the incidence of WSL. MATERIALS AND METHODS: Using PRISMA guidelines in search of clinical trials published between 2017 and 2022, a literature analysis was performed. This search was conducted using following Medical Subject Heading (MeSH) terms in 2 databases: "prevention and control" AND "Orthodontics" AND "Tooth Demineralization". Supplementary, a manual search was conducted in Google Scholar. RESULTS: The literature search resulted in a total of 3626 study articles, of which 8 publications were used in the present review, according to a selection based on the pre-established eligibility criteria. The review showed that F varnish, 10% Xylitol varnish had positive outcomes in comparison with placebo. 0.44% APF formulated daily oral rinse and nanosilver mouthwash were better than 0.2% NaF weekly rinse and CHX, F mouthwashes respectively. NovaMin toothpaste (TP), MIPP and MIV, examined in different studies, proved no significant difference over regular F TP. MIV compared to ProSeal provided no statistically significant between-group differences as well. Clinpro 5000 provided superior protection against enamel decalcification when compared to Clinpro Tooth Creme and MI Paste. CONCLUSION: The white spot lesions have improved, regressed, or eliminated using topical agents including fluoride, xylitol, or casein phosphopeptide-amorphous calcium phosphate during the fixed orthodontic treatment. More research is needed in order to determine the most effective therapeutic approach for the treatment of surface and subsurface demineralization of the enamel.

The relationship between congenital cleft lip and palate malformation, skeletal and dental occlusal anomalies, and the influence of its treatment on affected patients' oral health-related quality of life (OHRQoL).

OBJECTIVE: Non-syndromic (N/S) cleft lip and/or palate is the most common congenital anomaly to undergo long multidisciplinary treatment. This study investigates patients living with orofacial anomaly and having prolonged treatment by evaluating OHRQoL. It is essential to understand its influence on affected patients' daily life to prepare the most appropriate care for the complete physical, mental, and social well-being of an individual. MATERIALS AND METHODS: In order to evaluate the influence of undergoing treatment and living with an orofacial anomaly on patients' OHRQoL, randomly selected patients with N/S cleft lip and (or) palate treated in the Clinic of Orthodontics of Lithuanian University of Health Sciences filled a modified CPQ questionnaire. The questionnaire of 60 closed questions was about undergoing treatment and its effect on patients' self-confidence level, mastication, fluent pronunciation, discomfort, ability to socialize, emotions, etc. Statistical data was expressed as a frequency and percentage. RESULTS: Of the 20 patients 13-24 year-old (mean age 16.2±3.25) 50% were males, 50% were females, 80% wore orthodontic braces, other 20% wore Quadhelix appliance. All 20 patients experienced pain during treatment, 60% of all patients avoided being among people, were bullied. 65% of respondents felt more confident and happy after orthodontic treatment began. 70% of all patients experienced difficulty in speaking, biting hard food. CONCLUSION: The questionnaire showed no difference between different orthodontic appliance types and patients' OHRQoL, although overall prolonged treatment and orofacial anomaly does affect a patient's regular daily functions, oral hygiene habits, self-confidence level, social life, and mental well-being.

Genetic and environmental influences on third molar root mineralization.

OBJECTIVE: To assess the genetic and environmental influences on the variability of human third molar (M3) root mineralization stages via a twin study. DESIGN: The study sample consisted of 162 same-sex twins (66 dizygotic and 96 monozygotic, mean age: 17.9 years) with normal growth and development. Panoramic radiographs were evaluated to assess root mineralization stages of the upper and lower third molars, using the method of Demirijian et al. (1973). Zygosity was established using 15 specific DNA markers. RESULTS: Females developed their third molar roots earlier in life than males. Monozygotic twins (MZ) demonstrated higher intra-pair correlations for M3 root development stages than did DZ twins. An ACE model with additive genes, as well as common and specific environmental factors, provided the best explanation of variation in M3 root development. The mineralization of M3 roots showed highly additive genetic determination, varying from 60 to 63%, whereas a common environment contributed from 25 to 27%, and a specific environment only accounted 14% of the total variation, at most. CONCLUSIONS: A considerable proportion of the total variability of the third molar root mineralization rate can be attributed to additive genetic effects, while common and specific environmental effects have a smaller, yet significant, impact.

Smile aesthetics as perceived by dental students: a cross-sectional study.

BACKGROUND: An aesthetic smile has a number of components, and people generally equate a good dental appearance with success in many areas of life. The features that determine smile aesthetics could provide significant insights into post-treatment satisfaction and may predict a patient's objectives when undergoing treatment. The purpose of this study was to evaluate how smile characteristics are perceived by dental students. METHODS: The study was performed in 431 local and international dental students at the Lithuanian University of Health Sciences. The study data were collected using a three-part questionnaire. The first part of the questionnaire included sociodemographic items, i.e., student gender, age, nationality, and years of study; the second consisted of questions about facial aesthetic features; and the third elicited responses to photographs of 17 different smiles retrieved from the Lithuanian University of Health Sciences Clinic of Orthodontics database. The smile aesthetics were evaluated according to their dentolabial, dentogingival, dental, and dental arch characteristics using a 5-point numeric rating scale (1, best; 5, worst). The data were analysed using the Pearson's chi-square and Mann-Whitney U tests. RESULTS: The study included 336 local and 95 international dental students (132 men [30.6%], 299 women [69.4%]). Significantly more women than men focused on a person's teeth when communicating (41.5% vs.32.6%, p < 0.005). Women were more critical than men when evaluating gingival smile, the 'golden proportion', occlusal cant, and dental crowding. The most unfavourable smile characteristics were identified in the dental analysis category, with hypodontia ranked as the worst smile feature (mean numeric rating scale score 4.71). CONCLUSION: Among dental students, the most distracting characteristics of a smile when determining its attractiveness were hypodontia, gingival smile, a reversed curvature of the occlusal plane, and dental crowding.

Comparison of skeletal anchorage distalizers effect in maxillary buccal segment: A systematic review.

OBJECTIVE: The aim of this systematic review was to evaluate and compare distalization effect in maxillary buccal segment between Palatal Skeletal Anchorage (PSA) and Zygoma Gear Appliance (ZGA) in evidence-based way. MATERIALS AND METHODS: Relevant studies published between January 2007 till December 2017 in PubMed, ScienceDirect, AJO-DO and Scopus electronic databases were identified. Inclusion criteria were: English language, study performed on humans, randomized or nonrandomized clinical trials, assessment of buccal segment distalization by Palatal or Zygomatic skeletal anchorage and patient's clinical preoperative and post-operative evaluation measured by cephalometric analysis. Quality assessment of included studies was performed. RESULTS: A total of 357 scientific publications, articles, clinical trials related to the used keywords were identified during the search. Thirteen articles fulfilled our inclusion criteria. PSA system showed maxillary molar distalization distance range between 1.8 mm to 6 mm. ZGA presented molar distalization range from 4.37 mm to 5.31 mm. Results of maxillary buccal segment distal movement distance, treatment duration, adverse treatment effects or failure of mini-implants and the appliance were evaluated. CONCLUSION: There was evidence that both of skeletal anchorage systems are effective nonextractive therapy for Angle Class II malocclusion and maxillary buccal segment distalization in greater than 3 mm space deficiency.

A survey of protocols and trends in orthodontic retention.

BACKGROUND: The objectives of this study were to evaluate retention procedures and protocols which are used by the orthodontists in Lithuania and to identify commonly used types of dental retainers. METHODS: One hundred seven questionnaires in total with 28 multiple-choice questions were sent to all members of the Lithuanian Orthodontic Society. The questionnaire was organized into eight sections representing specific information about socio-demographic status of the respondents, selection of a retention system, details of commonly used fixed and removable retainers, the duration of the retention period, supervision of the retainers, instructions for patients, and necessity of common retention guidelines. RESULTS: The overall response rate was 75.7%. All of the respondents prescribed retainers after the orthodontic therapy. More than 40% of the respondents combined fixed and removable retainers in different clinical situations, but the first-choice option after an expansion of the maxillary dental arch was the removable retainer (54.3%); meanwhile, a fixed retainer was used after a correction of any rotations of the mandibular anterior teeth (49.4%). The Hawley retainer was preferred by 90.1% of the respondents for a maxillary dental arch, and 74.1% of them preferred it for a mandibular dental arch. The most preferable fixed retainer was the retainer bonded to all six anterior teeth (in the upper dental arch-by 71.6%; in the lower one-by 80.2%). There was no consensus on the duration of a retention period. Most of the orthodontists checked up retainers three times during the first year (fixed ones-by 42.0%; removable ones-by 30.0%) and once per year after the 1-year retention period (fixed ones-by 44.4%; removable ones-by 40.7%). All orthodontists gave instructions for taking care of an orthodontic retainer. It was observed that the orthodontists with less than 10 years of experience used a protocol based on the skills learned during their postgraduate studies, while orthodontists with more than 10 years of experience used retention procedures based on their orthodontic work practice (p < 0.05). CONCLUSIONS: A combination of fixed and removable retainers was the most often used in an orthodontic retention. Evidence-based guidelines are desired for a common retention protocol.

Effect of Rebonding on the Bond Strength of Orthodontic Tubes: A Comparison of Light Cure Adhesive and Resin-Modified Glass Ionomer Cement In Vitro.

The purpose of this study was to determine the impact of different enamel preparation procedures and compare light cure composite (LCC) and resin-modified glass ionomer (RMGI) on the bond strength of orthodontic metal tubes rebonded to the enamel. Twenty human molars were divided into two groups (n = 10). Tubes were bonded using LCC (Transbond XT) in group 1 and RMGI (Fuji Ortho LC) in group 2. The tubes in each group were bonded following manufacturers' instructions (experiment I) and then debonded using testing machine. Then, the same brackets were sandblasted and rebonded twice. Before the first rebonding, the enamel was cleaned using carbide bur (experiment II) and before second rebonding, it was cleaned using carbide bur and soda blasted (experiment III). Mann-Whitney and Wilcoxon signed-rank tests showed no significant difference between RMGI and LCC bond strengths in case of normal bonding and rebonding, when enamel was cleaned using carbide bur before rebonding. Enamel soda blasting before rebonding significantly increased RMGI tensile bond strength value compared to LLC (p < 0.05). LCC and RMGI (especially RMGI) provide sufficient bond strengths for rebonding of molar tubes, when residual adhesive from previous bonding is removed and enamel soda blasted.

Relationship between malocclusion, soft tissue profile, and pharyngeal airways: A cephalometric study.

BACKGROUND AND OBJECTIVE: The recent years have been marked by a search for new interrelations between the respiratory function and the risk of the development of malocclusions, and algorithms of early diagnostics and treatment have been developed. The aim of the study was to evaluate the relationships between hard and soft tissues and upper airway morphology in patients with normal sagittal occlusion and Angle Class II malocclusion according to gender. MATERIALS AND METHODS: After the evaluation of clinical and radiological data, 114 pre-orthodontic patients with normal or increased ANB angle, were randomly selected for the study. The cephalometric analysis was done by using the Dolphin Imaging 11.8 computer software. RESULTS: Comparison of the cephalometric values of soft tissue and airway measurements performed statistically significant negative correlation between the width of the upper pharynx and the ANB angle was found: the ANB angle was decreasing with an increasing width of the upper pharynx. The airways showed a statistically significant negative correlation between the width of the lower pharynx and the distance from the upper and the lower lips to the E line. Logistic regression analysis was performed to evaluate significant factors that could predict airway constriction. The upper pharynx was influenced by the following risk factors: a decrease in the SNB angle, an increase in the nose tip angle, and younger age; while the lower pharynx was influenced by an increase in the distance between the upper lip and the E line and by an increase in the upper lip thickness. CONCLUSIONS: During critical period of growth and development of the maxillofacial system, the patients with oral functional disturbances should be monitored and treated by a multidisciplinary team consisting of a dentist, an orthodontist, a pediatrician, an ENT specialist, and an allergologist. Cephalometric analysis applied in our study showed that Angle Class II patients with significantly decreased facial convexity angle, increased nasomental, upper lip-chin, and lower lip-chin angles, and upper and lower lips located more proximally to the E line more frequently had constricted airways.

Heritability of mandibular cephalometric variables in twins with completed craniofacial growth.

OBJECTIVES: To determine genetic and environmental impact on mandibular morphology using lateral cephalometric analysis of twins with completed mandibular growth and deoxyribonucleic acid (DNA) based zygosity determination. MATERIALS AND METHODS: The 39 cephalometric variables of 141 same gender adult pair of twins were analysed. Zygosity was determined using 15 specific DNA markers and cervical vertebral maturation method was used to assess completion of the mandibular growth. A genetic analysis was performed using maximum likelihood genetic structural equation modelling (GSEM). RESULTS: The genetic heritability estimates of angular variables describing horizontal mandibular position in relationship to cranial base and maxilla were considerably higher than in those describing vertical position. The mandibular skeletal cephalometric variables also showed high heritability estimates with angular measurements being considerably higher than linear ones. Results of this study indicate that the angular measurements representing mandibular skeletal morphology (mandibular form) have greater genetic determination than the linear measurements (mandibular size). CONCLUSIONS: The shape and sagittal position of the mandible is under stronger genetic control, than is its size and vertical relationship to cranial base.

Heritability estimates of dental arch parameters in Lithuanian twins.

BACKGROUND: The genetic influence on dental arch morphology may be country-specific, thus it is reasonable to check the estimates of genetics across different populations. The purpose of this study was to evaluate the heredity of dental arch morphology in the sample of Lithuanian twins with accurate zygosity determination. MATERIAL AND METHODS: The study sample consisted of digital dental models of 40 monozygotic (MZ) and 32 dizygotic (DZ) twin pairs. The estimates of heritability (h(2)) for dental arch breadth and length were calculated. RESULTS: All dental arch breadths and lengths were statistically significantly larger in men than in women. Arch length differences between genders were less expressed than largest breadth differences. In the upper jaw the largest genetic effect was found on the arch breadth between lateral incisors. The heritability of dental arch length demonstrated similar differences between upper and lower jaw with mandible dental arch length being more genetically determined. CONCLUSIONS: The largest genetic impact was found on the upper dental arch breadth between lateral incisors. Similar, but lower heritability is inherent for canines and first premolars of the upper jaw and first premolars of the lower jaw. It also can be noted, that arch breadths between posterior teeth show lower heritability estimates than between anterior teeth on both jaws. The dental arch in the upper jaw has more expressed genetic component than in the lower jaw.

The prevalence of malocclusion and oral habits among 5-7-year-old children.

BACKGROUND: Digit sucking, tongue thrust swallowing, and mouth breathing are potential risk factors for development of malocclusion. The purpose of this study was to verify the prevalence of different occlusal traits among 5-7-year-old children and assess their relationship with oral habits. MATERIAL AND METHODS: The study included 503 pre-school children (260 boys and 243 girls) with a mean age of 5.95 years. Different occlusal traits were verified by intraoral examination. Oral habits were diagnosed using data gathered from clinical examination of occlusion and extra-oral assessment of the face, combined with a questionnaire for parents. RESULTS: The study demonstrated that 71.4% of the children presented with 1 or more attributes of malocclusion and 16.9% had oral habits. The vertical and sagittal malrelation of incisors, as well as spacing, were the predominant features. This study showed that digit suckers have higher incidence of anterior open bite (P=0.013) and posterior crossbite (P=0.005). The infantile type of swallowing demonstrated strong association (P=0.001) with anterior open bite. CONCLUSIONS: Non-nutritive sucking habits and tongue thrust swallowing are significant risk factors for the development of anterior open bite and posterior crossbite in pre-school children.

Comparative cephalometric study of Class II division 1 malocclusion between Lithuanian and Jordanian females.

The Class II malocclusions have a strong hereditary component as etiologic factor, both in families and in ethnic and racial groups. The purpose of this study to compare skeletal and dentoalveolar morphology in Class II division I malocclusion of Lithuanian and Jordanian females. The sample consisted of 60 standardized lateral cephalograms (30 Jordanian - 30 Lithuanian). The mean age of the subjects was 14.8+/-1.11 years. Criteria for cephalometric comparison were 5 linear and 10 angular cephalometric variables. Repeating landmark identification tested reproducibility of the measurements. Unpaired t-test was performed to assess the difference of malocclusion between both groups. Results considered to be statistically significant when p

Implants for orthodontic anchorage. Meta-analysis.

The purpose of this article was to review and update current data of the use of implants for orthodontic anchorage. A meta-analysis of selected literature was carried out and a total of 415 articles were identified in this process. Having reviewed the articles or their abstracts/summaries the data were evaluated and the articles were categorized according to the journal and the year of publication, the type of the article and the type of the implant. The interest in the possibilities of the implant usage for orthodontic anchorage is noticeably increasing and today it has reached the peak. In order to facilitate the understanding of the wide range of implants, we suggested the classification of the implants for orthodontic anchorage according to the shape and size, the implant bone contact and the application of the implant. We systemized the information about types of implants and their advantages in respect of traditional orthodontic treatment.