Study on the role of nano antibacterial materials in orthodontics (a review) / Estudo sobre o papel dos materiais nanoantibacterianos na ortodontia

Nanoparticles (NPs) are insoluble particles with a diameter of fewer than 100 nanometers. Two main methods have been utilized in orthodontic therapy to avoid microbial adherence or enamel demineralization. Certain NPs are included in orthodontic adhesives or acrylic resins (fluorohydroxyapatite, fluorapatite, hydroxyapatite, SiO2, TiO2, silver, nanofillers), and NPs (i.e., a thin layer of nitrogen-doped TiO2 on the bracket surfaces) are coated on the surfaces of orthodontic equipment. Although using NPs in orthodontics may open up modern facilities, prior research looked at antibacterial or physical characteristics for a limited period of time, ranging from one day to several weeks, and the limits of in vitro studies must be understood. The long-term effectiveness of nanotechnology-based orthodontic materials has not yet been conclusively confirmed and needs further study, as well as potential safety concerns (toxic effects) associated with NP size.

Nanopartículas (NPs) são partículas insolúveis com diâmetro inferior a 100 nanômetros. Dois métodos principais têm sido utilizados na terapia ortodôntica para evitar a aderência microbiana ou a desmineralização do esmalte: NPs são incluídas em adesivos ortodônticos ou resinas acrílicas (fluoro-hidroxiapatita, fluorapatita, hidroxiapatita, SiO2, TiO2, prata, nanopreenchimentos) e NPs são revestidas nas superfícies de equipamentos ortodônticos, ou seja, uma camada fina de TiO2 dopado com nitrogênio nas superfícies do braquete. Embora o uso de NPs em ortodontia possa tornar acessível modernos recursos, pesquisas anteriores analisaram as características antibacterianas ou físicas por um período limitado de tempo, variando de 24 horas a várias semanas, por isso devem ser compreendidos os limites dos estudos in vitro. A eficácia de longo prazo de materiais ortodônticos com base em nanotecnologia ainda não foi confirmada de forma conclusiva, o que exige mais estudos, bem como potenciais preocupações de segurança (efeitos tóxicos) associadas ao tamanho da NP.

Awareness of malocclusion and attitude towards orthodontic treatment among trainee dental surgery technicians in Nigeria

Objective: Malocclusion affects aesthetics, the physical, psychological and social life of a person. The aim of this study was to evaluate the awareness of malocclusion and attitude towards orthodontic treatment among trainee dental surgery technicians in Nigeria. Materials and Methods: This was a descriptive cross-sectional study carried out among 68 final year (sixty-eight) trainee dental surgery technicians in Nigeria. The research instrument was a self-administered close ended questionnaire. Data was analyzed using SPSS version 20. P value (P<0.05) was regarded as significant. Results: Sixty-one (89.7%) of the respondents were females, while 7 (10.3%) were males. Fifty-seven (83.8%) have heard of the term malalignment of teeth, 53 (77.9%) of the students think malalignment is due to external habits. 61 (89.7%) are aware that few teeth may have to be removed for proper positioning of irregular teeth and 51 (75.0%) were aware that the irregular teeth can be corrected even after 40 years of age. More females were aware of malocclusion and had positive attitude towards orthodontic procedures when compared to the males, but the difference was not statistically significant (P>0.05).Conclusion. Majority of the respondents in this study were aware of the term malalignment and had positive attitude towards orthodontic treatment. More females constituted the study population.

Methodological Quality of Systematic Reviews Addressing Orthodontic Interventions: Methodological Study

ABSTRACT Objective: To assess the methodological quality and characteristics of systematic reviews (SRs) of interventional studies in orthodontics and assess how the certainty of the evidence is reported using the GRADE approach. Material and Methods: Six electronic databases were searched, followed by a hand search of the reference lists of eligible studies (PROSPERO #CRD42020180852). The required study design was randomized and nonrandomized studies of interventions published between January 2019 and May 2020. The Assessing the Methodological Quality of Systematic Reviews (AMSTAR 2) tool was used for the quality appraisal of the included SRs. Paired reviewers independently screened the studies, extracted data, and appraised the methodological quality. Results: The study included 46 SRs; 19.5% had moderate to high methodological quality, and the remaining had low to critically low methodological quality. Fifty-four percent of the reviews assessed the certainty of evidence using the GRADE approach, and 34.8% followed all GRADE criteria. Conclusion: Most reviews had a good judgment of the AMSTAR2 items, although some critical items contributed to decreased overall quality. Half of the reviews used the GRADE approach to assess the certainty of the evidence, and this approach should be included in future systematic reviews of interventions.

Gingival recession in canines orthodontically aligned: a narrative review / Recessão gengival em caninos ortodonticamente alinhados: uma revisão narrativa

Background: The orthodontic traction of impacted canines represents a great challenge for Orthodontics. Surgical exposure of the impacted canine and the complex orthodontic mechanics applied to align the tooth back to the arch can lead to complications involving supporting tissues inducing gingival recession when the teeth are moved out of the alveolar bone. Aim: The aim of this study is to present an updated bibliographic review of the main periodontal results found in the literature after the clinical management of impacted canines and the prevalence of gingival recession. Materials and methods: Research in electronic databases PubMed, PMC, and MedLine until June 2020 and reference lists of relevant publications were used to identify studies that assessed the periodontal status of impacted and orthodontically tractioned canines. Controlled and randomized clinical trials, literature reviews, systematic reviews, studies in humans, meta- analyzes and text that had at least one occurrence relating to gingival recession, periodontal outcomes and impacted canines tractioned orthodontically, whether by buccal or palatal, superior and / or lower as the eligibility criteria. Results: 691 articles were found in a free search. After applying the eligibility criteria, 7 relevant articles were subtracted, and these results were more frequent for upper canines. Conclusion: Currently, there is no clear evidence to determine which surgical technique procedure is better to discover canines in terms of periodontal outcomes. The results found stated that clinically the evidence were insignificant when compared to teeth normally erupted.

Introdução: O tracionamento ortodôntico de caninos inclusos representa um grande desafio para a Ortodontia. A exposição cirúrgica do canino impactado e a complexa mecânica ortodôntica aplicada para alinhar o dente de volta ao arco podem levar a complicações envolvendo os tecidos de suporte, induzindo recessão gengival quando os dentes são movimentados para fora do osso alveolar. Objetivo: O objetivo deste estudo foi apresentar uma revisão bibliográfica atualizada dos principais resultados periodontais encontrados na literatura após o manejo clínico de caninos impactados e a prevalência de recessão gengival. Materiais e métodos: Foram feitas pesquisas eletrônicas no PubMed, PMC e MedLine até junho de 2020 e uma listas de referência de publicações relevantes foram usadas para identificar estudos que avaliaram o estado periodontal de caninos impactados e tracionados ortodonticamente. Ensaios clínicos controlados e randomizados, revisões de literatura, revisões sistemáticas, estudos em humanos, metanálises e textos que tiveram pelo menos uma ocorrência relacionada a recessão gengival, desfechos periodontais e caninos impactados tracionados ortodonticamente, seja por vestibular ou palatino, foram os critérios de elegibilidade. Resultados: Foram encontrados 691 artigos em busca livre. Após a aplicação dos critérios de elegibilidade, 7 artigos relevantes foram subtraídos, sendo esses resultados mais frequentes para caninos superiores. Conclusão: Atualmente, não há evidências claras para determinar qual técnica cirúrgica é melhor para descobrir caninos em termos de resultados periodontais. Os resultados encontrados afirmaram que clinicamente as evidências foram insignificantes quando comparadas a dentes normalmente

Concordance of the vestibular bone thickness at the level of point a between teleradiography and cone beam computed tomography / Concordancia del espesor óseo vestibular a nivel del punto a entre telerradiografía y tomografía computarizada de haz cónico

Objective: The aim of this study was to determine the concordance of the vestibular bone thickness measured at the level of point A between Teleradiography and Cone Beam Computed Tomography (CBCT). Materials and Methods: This study consisted of a cross-sectional analytical design of concordance that evaluated the teleradiographies and CBCTs of 32 patients. The measurements were performed by three evaluators, specialists in orthodontics. Two of them measured the CBCTs and one evaluated the teleradiographs. The concordance of both tests was determined using the Concordance Correlation Coefficient. Results: When evaluating the value of the vestibular bone thickness at the level of point A between the CBCT and the teleradiography, it was observed that the mean value of the absolute difference between the two was 0.95±0.74, 95%CI [0.68­1.22], being statistically significant (p=0.0027). When the concordance between both tests was analyzed, it was observed that it was poor (CCC=0.204 95%CI [0.014­0.394]), although statistically significant (p<0.00001). Conclusions: It was possible to conclude that there is no concordance in the measurement of the vestibular bone thickness at the level of Point A between the Teleradiography and the CBCT.

Objetivo: El objetivo de este estudio fue determinar la concordancia del espesor óseo vestibular medido a nivel del punto A entre la Telerradiografía y la Tomografía computarizada de haz cónico (CBCT). Materiales y Métodos: Esta investigación presentó un diseño analítico transversal de concordancia en el que se evaluaron las telerradiografías y CBCT de 32 pacientes. Las mediciones fueron realizadas por tres evaluadores especialistas en ortodoncia, dos de ellos midieron los CBCT y uno las telerradiografías. La concordancia de ambos exámenes fue medida mediante Coeficiente de Correlación de Concordancia. Resultados: Al evaluar el valor del grosor óseo vestibular a nivel del punto A entre el CBCT y la telerradiografía, se observó que el valor promedio de diferencia absoluta entre ambos fue de 0,95±0,74 IC95% [0,68­1,22], siendo estadísticamente significativas (p=0,0027). Cuando se analizó la concordancia entre ambos exámenes se observó que esta fue pobre (CCC=0,204 IC95 % [0,014­0,394]), aunque estadísticamente significativa (p<0,00001). Conclusión: Se pudo concluir que no existe concordancia en la medición del espesor óseo vestibular medido a nivel del Punto A entre la Telerradiografía y el CBCT.

Tracción de tercer molar asociado a quiste dentígero y a nervio alveolar inferior: Reporte de caso / Traction of the third molar associated with a dentigerous cyst and inferior alveolar nerve: A case report

El objetivo de este estudio es presentar un reporte de caso de un paciente que presenta un tercer molar inferior asociado a un quiste dentígero, cuya lesión desplazó el diente hasta quedar inmerso dentro del canal alveolar inferior. Caso: Paciente acude por tratamiento de un quiste dentígero asociado a un tercer molar desplazado hacia nervio alveolar inferior y borde basilar. Se realiza una descompresión del quiste, además de una tracción de la pieza con ortodoncia para posteriormente ser extraída de forma segura. Conclusión: La tracción ortodóntica de tercer molar ofrece una buena alternativa frente a estos casos. Si bien la evolución del paciente frente a este tratamiento es favorable, falta evidencia que demuestre significativamente su eficacia.

The aim of this study is to present a case report of a patient with a lower third molar associated with a dentigerous cyst, whose lesion displaced the tooth into the inferior alveolar canal. Case: Patient asks for treatment of a dentigerous cyst associated with a displaced third molar towards the inferior alveolar nerve and basilar border. A cyst decompression was performed, in addition to a traction of the tooth with orthodontics to be later extracted in a safe way. Conclusion: Traction of the third molar offers a good choice in cases such as the one presented in this article. Although the evolution of the patient is favorable, there is a lack of evidence demonstrating its efficacy.

Effect of flapless piezopuncture on maxillary canine distalization. A preliminary randomized controlled trial

Several methods have been described to shorten orthodontic treatments, but the main disadvantage is their invasiveness. Animal studies have shown that piezopuncture can accelerate the rate of tooth movement without causing collateral damage. Objective: To evaluate the clinical outcome, in terms of safety and efficacy, of a flapless piezopuncture on maxillary canine distalization. Methods: A split-mouth randomized clinical trial was carried out on five patients. Piezopuncture was performed on a random side of the maxillary arch to assess the rate of canine movement on the stimulated side, compared to the non-stimulated control side after 15 (T1), 30 (T2), and 60 (T3) days. Also, immediate side effects and changes in buccal bone thickness after one year were assessed. Results: Distalization on the intervention versus control side at T1 was 1.24±0.21mm versus 0.64±0.33mm (p=0.005); at T2 it was 2.00±0.28mm versus 1.36±0.49mm (p=0.046); and at T3 it was 4.28±0.66mm versus 3.65±0.88mm (p=0.102). No adverse effects related to the surgical procedure were observed or reported by patients. The thickness of the buccal bone plate showed no significant changes. Conclusions: Flapless piezopuncture accelerates the rate of tooth movement in orthodontic patients over the first 15 days and its effect declines over the next 45 days.

Caracterización epidemiológica, clínica y cefalométrica del brote anormal de los terceros molares / Epidemiological, clinical and cephalometric characterization of the abnormal eruption of third molars

Introducción: El brote de los terceros molares es un proceso que no está del todo explicado, pero durante su erupción puede provocar diferentes accidentes o complicaciones. Objetivo: Caracterizar el brote anormal de los terceros molares según variables epidemiológicas, clínicas y cefalométricas. Método: Se realizó un estudio observacional, descriptivo y transversal en la Clínica Estomatológica Provincial Docente «Mártires del Moncada», de Santiago de Cuba, desde noviembre de 2019 a febrero de 2020. La población estuvo conformada por jóvenes de 18 a 25 años de edad; la muestra fue seleccionada por muestreo aleatorio simple. Se tuvieron en cuenta las siguientes variables: sexo, color de la piel, brote anormal y otras variables cefalométricas. Resultados: De los 84 dientes incluidos en el estudio, se detectaron 66 terceros molares con brote anormal (78,6 %). El promedio asociado al brote de estos molares de espacio óseo superior insuficiente fue igual para los superiores con medias de 25,9 mm; el de angulación inadecuada resultó obtuso en el superior izquierdo con 128,3º y agudo en los inferiores derechos con 58,8º; asimismo el mayor diámetro mesiodistal inadecuado fue el de los inferiores derechos con 15,7 mm. Conclusiones: El brote anormal de los terceros molares se caracteriza por afectar, de forma importante, a féminas y a individuos mestizos. Su observación se singulariza, fundamentalmente, en molares inferiores con espacios óseos posteriores reducidos, mesioangulaciones y diámetros mesiodistales considerables.

Introduction: eruption of the third molars is a process that is not fully explained in the literature; however it is known that their eruption can cause different complications. Objective: to characterize the abnormal eruption of third molars according to epidemiological, clinical and cephalometric variables. Methods: an observational, descriptive and cross-sectional study was carried out at "Mártires del Moncada" Provincial Teaching Dental Clinic, in Santiago de Cuba, from November 2019 to February 2020. The population consisted of young people aged 18-25 years; the sample was selected by simple random sampling. Gender, skin color, abnormal eruption and other cephalometric variables were taken into account. Results: sixty-six third molars with abnormal eruption were detected from the 84 teeth included in the study (78.6%). The average associated with the eruption of these molars with insufficient upper bone space was the same for the upper ones with means of 25.9 mm; the average with inadequate angulation was obtuse in the upper left third molar with 128.3º and the acute one in the lower right third molars with 58.8º; the lower right third molars likewise had the largest inadequate mesiodistal diameter with 15.7 mm. Conclusions: the abnormal eruption of third molars is characterized by significantly affecting females and mixed-race individuals. Its observation is singled out, fundamentally, in lower molars with reduced posterior bone spaces, mesioangulations and considerable mesiodistal diameters.

O uso de bisfosfonatos causa implicações na movimentação dentária ortodôntica? / Does the use of biophosphonates cause implications on the orthodontic tooth movement?

Bisfosfonatos são medicamentos que reduzem a reabsorção óssea, inibindo a atividade enzimática dos osteoclastos. Por essa razão, são amplamente utilizados no tratamento de várias doenças, como a osteoporose. Durante o tratamento ortodôntico, a aplicação de forças compressivas no dente promove a reabsorção e remodelação óssea, permitindo sua movimentação. Vários estudos in vivo observaram a diminuição da movimentação ortodôntica por bisfosfonatos, tornando o tema relevante devido à crescente demanda de tratamento ortodôntico em idosos ­ principais usuários dessa droga. Assim sendo, o objetivo deste trabalho é avaliar evidências do uso de bisfosfonatos no decorrer do tratamento ortodôntico e, mais especificamente, examinar seus efeitos na movimentação ortodôntica através de mensurações clínico-laboratoriais. Para isso, foi realizada uma revisão sistematizada na base de dados Pubmed através dos descritores Ortodontia e Bisfosfonatos. Buscou-se estudos em inglês entre 2015 e 2020. De 39 artigos compatíveis à proposta, 8 artigos passaram pelos critérios de inclusão e exclusão. Desses, a maioria dos autores é categórica em se referir ao uso de bisfosfonatos como um fator relevante para índices inferiores de movimentação. Porém, tais dados devem ser vistos com cautela, pois os métodos utilizados são variados, havendo uma grande heterogeneidade. Ademais, pequenas amostras e tempo curto dos experimentos não permitem uma generalização para pacientes de rotina. Como conclusão temos que a administração de bisfosfonatos associada à movimentação ortodôntica aparenta provocar uma duração prolongada no tratamento devido, fundamentalmente, aos índices inferiores de movimentação dentária planejada. Entretanto, os fatores específicos para tal não estão plenamente explicados.

Bisphosphonates are drugs that provide bone resorption by inhibiting the enzyme activity of osteoclasts. For this reason, they are widely used in the treatment of various diseases, such as osteoporosis. During orthodontic treatment, the application of compressive forces on the tooth promotes bone resorption and remodeling, allowing its movement. Several in vivo studies observed a decrease in orthodontic movement caused by bisphosphonates, making the topic relevant due to the growing demand for orthodontic treatment in the elderly - the main users of this drug. Therefore, the aim of this study is to evaluate evidence of the use of bisphosphonates during orthodontic treatment and, more specifically, to examine their effects on orthodontic movement through clinical and laboratory measurements. For this, a systematized review was performed in the Pubmed database using the descriptors Orthodontics and Bisphosphonates. Studies in English between 2015 and 2020 were sought. Of 39 articles compatible with the proposal, 8 articles passed the inclusion and exclusion criteria. Most authors are categorical in referring to the use of bisphosphonates as a relevant factor for lower movement rates. However, such data must be viewed with caution, as the methods used are sundry, with great heterogeneity. Furthermore, small administrations and short experimental times do not allow generalization to routine patients. In conclusion, the administration of bisphosphonates associated with orthodontic movement seems to cause a prolonged duration of treatment, fundamentally due to the lower rates of planned tooth movement. However, the specific factors for this are not fully explained.

Producción científica sobre Ortodoncia publicada en revistas biomédicas pertenecientes a universidades médicas cubanas / Scientific production on Orthodontics published in biomedical journals belonging to Cuban medical universities

La necesidad de impulsar la investigación en Ortodoncia y realizar un análisis de los artículos publicados en la web cubana, con la finalidad de conocer sus características bibliométricas, es cada vez mayor. El presente estudio tuvo como objetivo caracterizar la producción científica sobre Ortodoncia, publicada en revistas biomédicas profesionales patrocinadas por las universidades médicas cubanas entre enero del 2015 y agosto del 2021. Se realizó un estudio bibliométrico, observacional, descriptivo, longitudinal de la productividad científica acerca de Ortodoncia publicada en dichas revistas. Se empleó el gestor de referencias Zotero para procesar los metadatos y VOSviewer para analizar las redes de coautoría. Se constataron 158 artículos; el 15,19 por ciento se publicó en Medisan y el año más productivo fue el 2015. Predominaron los artículos originales (67,72 por ciento), con autoría múltiple (cinco autores), el sexo femenino (76,41 por ciento), los autores de nacionalidad cubana (98,38 por ciento) y procedentes de Santiago de Cuba/Cuba (15,19 por ciento). Se emplearon 2665 referencias con un índice de Price de 0,53. El área temática más abordada fue la Ortodoncia interceptiva (33,54 por ciento). Los artículos recibieron un total de 1041 citas en el Google Académico. El análisis de la red de coautoría permitió establecer 13 clústeres, donde fueron visualizados 106 autores, con 282 links y una fuerza de atracción total entre ellos de 97. Se concluye que la producción científica sobre Ortodoncia, por lo general, es baja. Es necesario lograr la indexación de estas revistas en las grandes bases de datos para así aumentar la visibilidad e impacto de los artículos(AU)

The need to promote research in orthodontics and to carry out an analysis of the articles published in the Cuban web, with the purpose of knowing their bibliometric characteristics, is increasing. The present study aimed at characterizing the scientific production on orthodontics, published in professional biomedical journals sponsored by Cuban medical universities between January 2015 and August 2021. A bibliometric, observational, descriptive, longitudinal, descriptive study of the scientific productivity about Orthodontics published in these journals was carried out. The reference manager Zotero was used to process the metadata and VOSviewer to analyze the co-authorship networks. A total of 158 articles were ascertained; 15.19percent ere published in Medisan and the most productive year was 2015. Original articles predominated (67.72percent), with multiple authorship (five authors), female gender (76.41percent), authors of Cuban nationality (98.38percent) and from Santiago de Cuba/Cuba (15.19percent). A total of 2665 references were used with a Price index of 0.53. Interceptive orthodontics (33.54percent) was the most common subject area. The articles received a total of 1041 citations in Google Scholar. The analysis of the co-authorship network made it possible to establish 13 clusters, where 106 authors were visualized, with 282 links and a total strength of attraction among them of 97. It is necessary to achieve the indexing of these journals in large databases in order to increase the visibility and impact of the articles(AU)

Soft tissue and incisor position changes in class I bimaxillary subjects after retraction using friction and frictionless mechanics

Aim: Bimaxillary protrusion is a common condition observed irrespective of race and ethnicity and is a chief concern for patients who seek orthodontic treatment. The aim of this study was to compare and evaluate changes in soft tissue structures and incisor positions in class I bimaxillary protrusion subjects undergoing orthodontic therapy when friction and frictionless mechanics were used. Methods: Two groups with a total of 40 patients aged 18­30 years diagnosed with class I bimaxillary protrusion treated by extracting first premolars were considered for this study. Patients treated with friction mechanics were included in Group 1 and those treated with frictionless mechanics in Group 2. The digital lateral cephalograms were calibrated and analyzed using Nemoceph software. Selected landmarks were marked on pre- and post-treatment cephalograms and assessed for intra- and inter-group soft tissue and incisor position changes. Student's t-test was used to analyze the collected data using SPSS 20 software. Result: Intragroup comparison revealed significant changes in both groups. Inter-group comparison of the selected parameters between groups 1 and 2 showed differences but without any statistical significance, except for the inter-incisal angle. Conclusion: Pre- and post-treatment comparison analysis revealed significant soft tissue changes in both groups. However, the comparison between friction and frictionless mechanics showed no statistically significant changes

Calidad de vida en pacientes atendidos durante la primera fase del tratamiento de ortodoncia / Quality of life in patients treated during the frst phase of orthodontic treatment

Objetivo: evaluar la calidad de vida en pacientes que se encuentran en la primera fase de tratamiento de ortodoncia, ofrecido por un programa de docencia-servicio de educación superior en la ciudad de Medellín. Métodos: se realizó un estudio transversal analítico en los pacientes atendidos en el servicio de ortodoncia. La muestra estuvo compuesta por un total de 104 pacientes. Se empleó un cuestionario estructurado de 12 ítems para evaluar información sociodemográfca. Para estudiar la calidad de vida relacionada con la salud bucal (CVRSB), la cual fue medida con el OHIP-14 (Oral Health Impact Profle 14) validado en el idioma español y datos clínicos tomados en el momento de la consulta odontológica. Resultados: el promedio de edad de los participantes fue de 25,7 ± 12,1 años, edad mínima de 12 y máxima de 60. Se encontraron diferencias estadísticamente signifcativas en los mayores de 30 años y con estudios superiores, principalmente en la extensión y la severidad del impacto en la calidad de vida. Respecto al OHIP-14, el mayor impacto lo presentaron aquellos con apiñamiento severo (8,1 RIC=13), mordida borde a borde (8,0 RIC=6) y relación molar clase III (9,0 RIC=10), con diferencias estadísticamente signifcativas. Conclusiones: este estudio permitió evidenciar que, en general, el impacto en la calidad de vida del OHIP-14 en los pacientes fue bueno durante la primera fase del tratamiento y que las diferencias están relacionadas con la edad, nivel de escolaridad y características oclusales, tales como apiñamiento, overbite y relación molar.

Objective: To evaluate the quality of life in patients with orthodontic treatment in the frst phase of treatment who consult in a higher education teaching-service program in the city of Medellín. Methods: An analytical cross-sectional study was conducted in the patients treated in the orthodontic service. The sample consisted of a total of 104 patients. A 12-item structured questionnaire was used with sociodemographic information, regarding quality of life related to oral health (QOLHR), which was measured with the OHIP-14 (Oral Health Impact Profle 14) validated in the Spanish language and clinical data taken at the time of the dental consultation. Results: The average age of the participants was 25.7 ± 12.1 years, with a minimum age of 12 and a maximum of 60. Statistically signifcant diferences were found in those over 30 years of age and with higher education, mainly in the extension and severity of impact on quality of life. Regarding OHIP-14, the greatest impact was presented by those with severe crowding (8.1 IQR=13), edge-to-edge bite (8.0 IQR=6) and class III molar relationship (9.0 IQR=10), with Statistically signifcant diferences. Conclusions: This study made it possible to show that in general the impact of the quality of life of OHIP-14 in patients was good in the frst phase of treatment and that the diferences are related to age, level of education and its dimensions with occlusal characteristics such as such as crowding, overbite and molar relationship of the patients reported during orthodontic treatment.

Efetividade do uso de instruções digitais (apps e mensagens de telefone) comparadas às instruções convencionais (verbais e escritas) na melhora da higiene bucal em pacientes ortodônticos: uma revisão sistemática e meta-análise / Effectiveness of using digital instructions (apps and phone messages) compared to conventional instructions (verbal and written) in improving oral hygiene in orthodontic patients: a systematic review and meta-analysis

Objetivo: Comparar o efeito do uso de instruções convencionais (verbais ou escritas) e instruções digitais (apps e mensagens de telefone) na cooperação e melhora da higiene oral dos pacientes ortodônticos.Métodos: Foram conduzidas buscas em seis bases de dados. Seleção dos estudos, extração de dados e análise do risco de viés dos artigos com a ferramenta Cochrane foram realizadas. Resultados de meta-análises foram apresentados em diferença média (DM) e intervalo de confiança (IC). Resultados: Seis estudos foram incluídos. No geral, os estudos mostraram que indivíduos que recebem instruções convencionais e digitais de higiene bucal apresentam uma melhora do índice de placa e índice gengival ao longo do tratamento ortodôntico (p < 0,05). Os indivíduos que só recebem instruções convencionais não apresentam melhora dos índices (p > 0,05). Os resultados são confirmados por duas meta-análises, sendo o índice de placa (DM = -1,30, IC = -2,52 - -0,08) e o índice gengival (DM = -0,27, IC = -0,42 - -0,12) melhor entre indivíduos que receberam instruções convencionais e digitais em comparação a indivíduos que receberam somente instruções convencionais. Meta-análises mostraram que não há diferença para índice de placa (DM = 0,57, IC = -0,61 ­ 1,74) e índice gengival (DM = -0,46, IC = -1,52 - 0,59) durante o tratamento entre indivíduos que somente receberam instruções de higiene convencionais e aqueles que só receberam instruções digitais. Indivíduos que só receberam instruções convencionais apresentam um aumento de lesões de mancha branca ao longo do tratamento (p < 0,05). O risco de viés variou de baixo a alto. Conclusão: Instruções digitais junto às convencionais são eficientes na melhora da higiene bucal dos pacientes em tratamento ortodôntico.

Aim: To compare the effects of the use of conventional instructions (verbal or written) and digital instructions (apps and phone messages) for the cooperation and improvement of oral hygiene in orthodontic patients. Methods: Searches were conducted in six databases. Selection of studies, data extraction, and risk of bias analysis of articles were performed using the Cochrane tool. For meta-analysis results, mean difference (MD) and confidence interval (CI) were provided. Results: Six studies were included. Overall, studies demonstrated that individuals who received conventional and digital oral hygiene instructions show an improvement in both the plaque and gingival indices over the course of orthodontic treatment (p < 0.05). By contrast, individuals who only received conventional instructions showed no improvement in the indices (p > 0.05). The results were confirmed in two meta-analyses, with the plaque index (MD = -1.30, CI = -2.52 - -0.08) and the gingival index (MD = -0.27, CI = -0.42 - -0.12) presenting better outcomes among individuals who received conventional and digital instructions, as compared to individuals who received only conventional instructions. Meta-analyses showed that there is no difference between the plaque index (MD = 0.57, CI = -0.61 ­ 1.74) and the gingival index (MD = -0.46, CI = -1.52 ­ 0.59) concerning the course of treatment between individuals who only received conventional hygiene instructions and those who only received digital instructions. Individuals who only received conventional instructions showed an increase in white spot lesions throughout the treatment (p < 0.05). The risk of bias ranged from low to high. Conclusion: Both digital instructions and the conventional instructions are efficient in improving the oral hygiene of patients during orthodontic treatment.

Photobiomodulation therapy assisted orthodontic tooth movement: potential implications, challenges, and new perspectives / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Over the past decade, dramatic progress has been made in dental research areas involving laser therapy. The photobiomodulatory effect of laser light regulates the behavior of periodontal tissues and promotes damaged tissues to heal faster. Additionally, photobiomodulation therapy (PBMT), a non-invasive treatment, when applied in orthodontics, contributes to alleviating pain and reducing inflammation induced by orthodontic forces, along with improving tissue healing processes. Moreover, PBMT is attracting more attention as a possible approach to prevent the incidence of orthodontically induced inflammatory root resorption (OIIRR) during orthodontic treatment (OT) due to its capacity to modulate inflammatory, apoptotic, and anti-antioxidant responses. However, a systematic review revealed that PBMT has only a moderate grade of evidence-based effectiveness during orthodontic tooth movement (OTM) in relation to OIIRR, casting doubt on its beneficial effects. In PBMT-assisted orthodontics, delivering sufficient energy to the tooth root to achieve optimal stimulation is challenging due to the exponential attenuation of light penetration in periodontal tissues. The penetration of light to the root surface is another crucial unknown factor. Both the penetration depth and distribution of light in periodontal tissues are unknown. Thus, advanced approaches specific to orthodontic application of PBMT need to be established to overcome these limitations. This review explores possibilities for improving the application and effectiveness of PBMT during OTM. The aim was to investigate the current evidence related to the underlying mechanisms of action of PBMT on various periodontal tissues and cells, with a special focus on immunomodulatory effects during OTM.

Ability and inability of artificial intelligence in orthodontics / 中华口腔医学杂志

With the development of artificial intelligence (AI) technology, it has a wide range of explorations in orthodontics. AI has greater application prospects in precise measurement, multidimensional diagnosis, treatment planning and efficacy prediction. At the same time, there are certain limitations in the application of AI, such as risks caused by individual variability, black box properties and unclear delineation of medical responsibilities. This paper summarized the history and current status of AI applications in orthodontics and discussed future development trends, to provide reference for clinical orthodontics.

Tanaka-Johnston's mixed dentition analysis among orthodontic patients in Tanzania

Background: Lower incisors are the first teeth to erupt, their sizes are reliable and little changes occur on the lower arch during mixed dentition. These teeth can be used to predict the size of remaining unerupted teeth. Tanaka Johnston's analysis is the most widely used method of mixed dentition analysis worldwide. The aim of the study was to assess the accuracy of Tanaka-Johnston's methods of mixed dentition analysis among orthodontic patients in Tanzania. Methods: A cross-sectional study design was carried out at MUHAS dental clinic involving models from orthodontic patients. Data collection involved actual teeth size measurement and prediction using Tanaka-Johnston's method. Comparison between the actual measurements and the predicted measurements was assessed using students' paired t-tests. Prediction equations for the present study were generated using a simple linear regression analysis. Results: Tanaka Johnston's method significantly overestimated the combined width of upper canines and premolars in the female group (p=0.000). However, the method underestimated the lower jaw measurements in both sexes (p<0.05). New prediction equations for the present study were generated for each sex and arch separately. For the upper jaw, it was Y=11.97+ 0.56X for males and Y = 10.97+0.49X for females. While for the lower jaw, it was Y= 10.8 +0.51X for males and Y=11.39+0.47X for females. Conclusion: Tanaka-Johnston's methods of mixed dentition analysis was found to be inaccurate in estimating the size of unerupted canines and premolars in the study sample. Therefore, new prediction formulas were generated.

Abordagem interdisciplinar no tratamento da macroglossia na síndrome de Beckwith-Wiedemann: relato de caso / Interdisciplinary approach in the treatment of macroglossia in Beckwith-Wiedemann syndrome: case report

RESUMO O objetivo deste estudo foi relatar a abordagem interdisciplinar no manejo da macroglossia em um caso de paciente com síndrome de Beckwith-Wiedemann, no período de dez anos. O acompanhamento iniciou pela equipe de Cirurgia Bucomaxilofacial, seguido da Fonoaudiologia, em função de dificuldades alimentares. Após avaliação clínica e instrumental, aos 8 meses de idade, iniciou-se a intervenção fonoaudiológica com foco na disfagia orofaríngea e na terapia miofuncional orofacial. Foi verificado, com 1 ano e 11 meses, ausência de sinais de alteração de deglutição em fase faríngea e melhora na postura de lábios e língua. Aos 3 anos, foram iniciados estímulos para retirada dos hábitos orais e o treino da função mastigatória. O tratamento ortodôntico para correção de mordida aberta anterior e mordida cruzada posterior unilateral iniciou-se aos 6 anos. Aos 7 anos e 5 meses de idade, constatou-se estabilidade do modo respiratório nasal e adequação da postura de repouso de lábios e língua. Aos 9 anos, em função de recidiva das alterações oclusais, optou-se pela redução cirúrgica da língua seguida de terapia miofuncional orofacial, retomada aos 9 anos e 3 meses. O resultado foi a correção da postura da língua na deglutição e a adequação da fala. A associação dos tratamentos, envolvendo Fonoaudiologia, Ortodontia e Cirurgia Bucomaxilofacial foi considerada efetiva no manejo da macroglossia, resultando na adequação e equilíbrio das funções orofaciais.

ABSTRACT This study aims to report the interdisciplinary management of macroglossia in a Beckwith-Wiedemann syndrome patient during ten years. Clinical follow-up started by the Oral and Maxillofacial Surgery team, followed by Speech Therapy due to feeding difficulties. After clinical and instrumental evaluation, at 8 months old, the speech therapy intervention was indicated, focusing on oropharyngeal dysphagia and orofacial myofunctional therapy. At 1 year and 11 months, no signs of swallowing alteration in the pharyngeal phase and improvement in the posture of the lips and tongue were found. At the age of 3, stimulation to remove oral habits and train masticatory function were initiated. Orthodontic treatment to correct anterior open bite and unilateral posterior crossbite started at age 6. At 7 years and 5 months, there was stability in the nasal breathing mode and adequacy of resting posture of lips and tongue. At the age of 9, due to relapse of the occlusal alterations, surgical reduction of the tongue was indicated, followed by orofacial myofunctional therapy, restarted at the age of 9 years and 3 months. The result was the correction of the posture of the tongue during swallowing and speech adequacy. The association of treatments involving Speech Therapy, Orthodontics and Oral and Maxillofacial Surgery was considered effective in the management of the macroglossia. It resulted in the adequacy and equilibrium of orofacial functions.

Interdisciplinary treatment to replace missing upper lateral incisors, 4.5 years follow up / Tratamiento interdisciplinario para reposición de incisivos laterales superiores faltantes, seguimiento de 4,5 años

Introduction: Multidisciplinary diagnosis and planning are essential to define the treatment option that will provide the best individual results for patients with congenitally missing upper lateral incisors. Objective: To determine the function and aesthetics after the therapeutic use of osseintegrated implants to replace congenitally missing upper lateral incisors in a young female at 4.5 years follow-up. Case report: The patient was a 13 years old female (at beginning of treatment) with congenitally missing upper lateral incisors condition. Five months after the orthodontic active treatment, the space for placing the implants was achieved. After 2 years of Orthodontic treatment and the evaluation of the craniomandibular growth term by hand radiography, two implants were placed with an expanded bone technique in the position of the upper lateral incisors. After 4 months, osseointegration was clinically confirmed and two screw retained temporary crowns were performed using temporary plastic abutments and acrylic teeth and recalled at 4.5 years to control. Conclusions: Our results showed predictable esthetics and functional results in a patient with congenitally missing upper lateral incisors. This was possible due to a multidisciplinary approach between the diagnosis and treatment performed (Orthodontics, Implantology and Prosthodontics(AU)

Introducción: El diagnóstico y la planificación multidisciplinarios son esenciales para definir la opción de tratamiento que proporcionará los mejores resultados individuales para los pacientes con incisivos laterales superiores que faltan congénitamente. Objetivo: Fue determinar la función y la estética después del uso terapéutico de implantes osteointegrados para reemplazar los incisivos laterales superiores ausentes congénitamente en una mujer joven a los 4,5 años de seguimiento. Presentación del caso: La paciente, mujer de 13 años (al inicio del tratamiento) con una condición congénita de incisivos laterales superiores ausentes. Cinco meses después del tratamiento activo de ortodoncia, se logró el espacio para la colocación de los implantes. Después de 2 años de tratamiento de Ortodoncia y la evaluación del término de crecimiento cráneo-mandibular corroborado mediante radiografía de mano, se colocaron dos implantes con técnica de hueso expandido en la posición de los incisivos laterales superiores. Después de 4 meses, se confirmó clínicamente la osteointegración y se realizaron dos coronas provisionales atornilladas utilizando pilares de plástico provisionales y dientes acrílicos y se controlaron a los 4,5 años de seguimiento. Conclusiones: Nuestros resultados mostraron resultados estéticos y funcionales predecibles en un paciente con incisivos laterales superiores ausentes congénitamente. Esto fue posible gracias a un abordaje multidisciplinar entre el diagnóstico y el tratamiento realizado (Ortodoncia, Implantología y Prostodoncia(AU)

A radiation free alternative to CBCT volumetric rendering for soft tissue evaluation / Um método alternativo à TCFC sem radiação ionizante para a avaliação de tecidos moles da face

Objective: The aim of the present study is to evaluate whether a "radiation free" method using 3D facial scan can replace Cone Beam Computed Tomography (CBCT) volumetric rendering of soft tissue of the patient to assess maxillofacial surgery outcomes and compare the reference points and angular measurements of patient facial soft tissue. Material and Methods: Facial soft tissue scan of the patient's face, before and after orthognathic surgery and a CBCT of the skull for volumetric rendering of soft tissues were carried out. The 3D acquisitions were processed using Planmeca ProMax 3D ProFace® software (Planmeca USA, Inc.; Roselle, Illinois, USA). The participant were positioned in a natural position during the skull scannering. Three sagittal angular measurements were performed (Tr-NA, Tr-N-Pg, Ss-N-Pg) and two verticals (Go-N-Me, Tr-Or-Pg) on facial soft tissue scan and on the patient's 3D soft tissue CBCT volumetric rendering. Results: A certain correspondence has been demonstrated between the measurements obtained on the Proface and those on the CBCT. Conclusion: A radiation free method was to be considered an important diagnostic tool that works in conditions of not subjecting the patient to harmful ionizing radiation and it was therefore particularly suitable for growing subjects. The soft tissue analysis based on the realistic facial scan has shown sufficient reliability and reproducibility even if further studies are needed to confirm the research result.(AU)

Objetivo:Avaliar se um método "livre de radiação" usando escaneamento facial 3D pode substituir a renderização volumétrica da tomografia computadorizada de feixe cônico (TCFC) dos tecidos moles do paciente para analisar os resultados da cirurgia maxilofacial e comparar os pontos de referência e medições angulares afim de avaliar a correspondência entre as duas metodologias. Material e Métodos: Foi realizado o escaneamento dos tecidos moles faciais do paciente, antes e depois da cirurgia ortognática e uma tomografia computadorizada de feixe cônico do crânio para renderização volumétrica dos tecidos moles. As aquisições 3D foram processadas usando o software Planmeca ProMax 3D ProFace® (Planmeca USA, Inc.; Roselle, Illinois, USA). O participante foi posicionado em posição natural durante o escaneamento do crânio. Três medições angulares sagitais foram realizadas (Tr-NA, Tr-N-Pg, Ss-N-Pg) e duas verticais (Go-N-Me, Tr-Or-Pg) nas imagens de scaneamento e nas imagens do tecido mole facial da reconstrução tridimensional da TCFC. Resultados: Uma certa correspondência foi demonstrada entre as medidas obtidas no Proface® e aquelas na TCFC. Conclusão: Um método livre de radiação deve ser considerado uma importante ferramenta de diagnóstico que funciona em condições de não submeter o paciente a radiação ionizante nociva e, portanto, é particularmente adequado para indivíduos em crescimento. A análise de tecidos moles com base na varredura facial realista mostrou confiabilidade e reprodutibilidade, porém mais estudos são necessários para confirmar o resultado da pesquisa. (AU)

Influência da adição de partículas de vidro bioativas em adesivos resinosos, na cimentação de bráquetes ortodônticos / Influence of the addition of bioactive glass particles in resin adhesives in the cementation of orthodontic brackets

O objetivo deste estudo foi desenvolver e avaliar um adesivo resinoso modificado com a incorporação de partículas de vidro bioativas (SCHOTT Bioactive Glass) em diferentes concentrações. Foram avaliados a resistência ao cisalhamento (RU), o índice de remanescente dentário (IRA), o grau de conversão (GC) e a liberação de cálcio. Foram utilizados 50 incisivos bovinos que foram fixados, através de suas raízes, em um molde de PVC, com resina acrílica autopolimerizável. As amostras foram alocadas em 5 grupos (n=10): TXT - Adesivo Transbond XT (3M Unitek, Monrovia, CA, EUA) sem adição de partículas de vidro bioativas, TXT20, TXT30, TXT50 ­ Adesivo Transbond XT acrescido respectivamente de 20%, 30% e 50% de partículas de vidro bioativas e SH - Adesivo resinoso FL BOND ll (SHOFU Inc.) com biomaterial SPRG. As amostras receberam uma profilaxia com pedra pomes e condicionamento com ácido fosfórico à 37%. Em seguida foi aplicada uma fina camada do sistema adesivo indicado na face vestibular dos incisivos bovinos, em todos os grupos e fotopolimerizado por 20 segundos, utilizando-se um fotopolimerizador RADII-Cal (SDI, Victoria, Austrália). Depois foi aplicada uma pequena quantidade de pasta resinosa fotopolimerizável Transbond XT (3M Unitek, Monrovia, CA, EUA) sobre a superfície dos bráquetes autoligados (MORELLI, Sorocaba, São Paulo, Brasil) e estes foram devidamente colados na face vestibular, no centro da coroa clínica do incisivo bovino e fotopolimerizado por 20 segundos, em cada face. Posteriormente as amostras foram submetidas ao teste de resistência ao cisalhamento. O índice de remanescente adesivo foi avaliado em estereomicroscópio DISCOVERY V20 (ZEISS). Os adesivos resinosos foram submetidos ao teste de grau de conversão e liberação de cálcio. Os dados foram inicialmente submetidos ao teste de normalidade e depois submetidos ao teste de ANOVA um fator, seguido do teste de Tukey para análise de comparações múltiplas, com nível de significância de 0,05. De acordo com os resultados obtidos na resistência de união ao cisalhamento (MPa±Dp) a maior média foi observada no grupo TXT 19,50±1,40A, seguida do grupo TXT20 18,22±1,04AB, seguida do grupo SH 17,62±1,45B, seguida do grupo TXT30 14,48±1,46C e a menor média TXT50 14,13±1,02C. No grau de conversão a maior média foi observada no grupo TXT20 73,02±3,33A que foi estatisticamente semelhante ao grupo SH 68,50±1,09A, seguida do grupo TXT 60,28±1,06B e TXT30 58,84±4,06B e a menor média foi do grupo TXT50 40,67±1,21C.Para a liberação de cálcio a maior média foi TXT50 2,23±0,11D, seguida por TXT30 0,74±0,00C, TXT20 0,55±0,00B, SH 0,47±0,04B e TXT 0,14±0,00A. Concluiu-se que a incorporação de partículas de vidro bioativas influenciou na resistência de união ao cisalhamento, no grau de conversão e na liberação de cálcio (AU).

The objective of this study was to develop and evaluate a resin adhesive modified with the incorporation of bioactive glass particles (SCHOTT Bioactive Glass) in different concentrations. Shear bond strength (SBS), adhesive remnant index (ARI), degree of conversion (DC) and calcium release were evaluated. Fifty bovine incisors were used, which were fixed through their roots in a PVC mold with self-curing acrylic resin. The samples were allocated into 5 groups (n=10): TXT ­ Transbond XT Adhesive (3M Unitek, Monrovia, CA, USA) without addition of bioactive glass particles, TXT20, TXT30, TXT50 ­ Transbond XT Adhesive rescpectively increased by 20%, 30% and 50% bioactive glass particles and SH ­ FL BOND ll resin adhesive (SHOFU Inc.) with SPRG biomaterial. The samples received prophylaxis with pumice stoe and conditioning with 37% phosphoric acid. Then, a thin layer of the indicated adhesive system was applied to the buccal surface of the bovine incisors, in all groups, and light cured for 20 seconds, using a RADII-Call curing light (SDI, Victoria, Australia). Then, a small amount of Transbond XT light-curing resinous paste (3M Unitek, Monrovia, CA, USA) was applied on the surface of the self-ligating brackets (MORELLI, Sorocaba, São Paulo, Brazil) and these were duly bonded on the buccal surface, in the center of the clinical crown of the bovine incisor and light cured for 20 seconds, on each side. Subsequently, the samples were submitted to the shear bond test. The adhesive remnant index was evaluated using a DISCOVERY V20 stereomicroscope (ZEISS). The resin adhesives were submitted to the degree of conversion and calcium release test. The data were initially submitted to the normality test and then submitted to the one-way ANOVA test, followed by the Tukey test for analysis of multiple comparisons, with a significance level of 0.05. According to the results obtained in the shear bond strength (MPa±Dp), the highest average was observed in the TXT group 19.50±1.40A, followed by the TXT20 group 18.22±1.04AB, followed by the SH group 17.62±1.45B, followed by the TXT30 group 14.48±1.46C and the lowest mean TXT5014.13±1.02C. In the degree of conversion, the highest average was observed in the TXT20 73.02±3.33A group, wich was statiscally like the SH group 68.50±1.09A, followed by the TXT 60.28±1.06B and TXT30 group 58.84±4.06B and the lowest mean was for the TXT50 group 40.67±1.21C. For calcium release, the highest mean was TXT50 2.23±0.11D, followed by TXT30 0.74±0.00C, TXT20 0.55±0.00B, SH 0.47±0.04B and TXT 0.14±0.00A. It was concluded that the incorporation of bioactive glass particles influenced in the shear bond strength, in the degree of conversion and in the release of calcium (AU).