Comparison between round multi-strand wire and rectangular wire bonded retainers: a randomized clinical trial.

OBJECTIVE: The primary objective was to compare round multi-strand wire and Ortho-Flex-Tech™ rectangular wire retainers in terms of gingival health. The secondary objectives were to assess plaque/calculus accumulation, and to determine the effectiveness of these retainers in maintaining tooth alignment and their failure rate. MATERIAL AND METHODS: This single-center study was a two-arm parallel randomized clinical trial and was conducted at the Orthodontic clinics in Dental Teaching Center/Jordan University of Science and Technology. Sixty patients, with bonded retention for the mandibular anterior segment after fixed orthodontic treatment, were randomly selected. The sample comprised Caucasian patients with mild to moderate pretreatment crowding in the mandibular anterior region, Class I relationship, treated without extraction of mandibular anterior tooth. In addition, only patients presenting normal overjet and overbite after treatment were included. INTERVENTION: One group received round multi-strand wire retainer (30 patients, average age: 19.7 ± 3.8 years), while the other group received Ortho-Flex-Tech™ retainer (30 patients; average age: 19.3 ± 3.2 years). In both groups, the retainers were bonded to all mandibular anterior teeth from canine to canine. All patients were recalled one year after bracket debonding. Randomization sequence was created using Excel 2010, with a 1:1 allocation, using random block size 4. The allocation sequence was concealed in sequentially numbered, opaque and sealed envelopes. Only participants were blinded to the type of bonded retainer used. The primary outcome was to compare the gingival condition between the two groups. The secondary outcomes were to assess plaque/calculus indices, irregularity index of the mandibular anterior teeth and retainers' failure rate. Comparisons were conducted using Mann-Whitney U test or chi-square test. Statistical significance was predetermined at the p≤ 0.05 level for all tests. RESULTS: Complete data were collected for 46 patients (round multi-strand wire retainer group, n=24 patients; rectangular Ortho-Flex-Tech™ retainer group, n=22 patients). No significant differences were found in the gingival health parameters between the two groups (p>0.05). Ortho-Flex-Tech™ retainers maintained the alignment of mandibular anterior teeth more than multi-strand retainer (p<0.05). No significant difference was found in the failure rate between the two groups (p>0.05). CONCLUSIONS: Gingival health parameters and failure rate were not different in both groups. However, Ortho-Flex-Tech™ retainers were more efficient to retain the mandibular incisors than the multi-strand retainers; nevertheless, the difference was not clinically significant.

Effect of piezocision-assisted lower second molar protraction on periodontal tissues, alveolar bone height, and lower second molar root resorption.

OBJECTIVES: To assess the effect of piezocision on periodontal tissues and alveolar bone height and to detect lower second molar root resorption in piezocision-assisted mandibular second molar protraction compared to no-piezocision molar protraction. MATERIALS AND METHODS: Twenty-one subjects (four males, 17 females, aged 22.43 ± 2.83 years) who presented with bilateral extraction of lower first molars were included. The patients were divided into two groups; Group 1: Piezocision-assisted molar protraction (right or left side of subjects) in which piezocision was performed immediately before lower second molar protraction and, Group 2: No-piezocision molar protraction in which lower second molar protraction was not surgically assisted. Plaque index (PI), gingival index (GI), periodontal pocket depth (PPD), width of keratinized gingiva (WKG), gingival recession (GR), lower second molar mesial root resorption, alveolar bone height, and mandibular bone height were recorded at T1 (immediately before molar protraction) and at T2 (after second molar space closure). RESULTS: In the piezocision-assisted molar protraction group, significant changes were detected in the WKG (P < .001), GR (P < .05), and the mandibular bone height (P < .001). Compared to the no-piezocision group, piezocision-assisted molar protraction resulted in an increased WKG (P < .001) and less second molar mesial root resorption (P < .01). CONCLUSIONS: Piezocision does not have any detrimental effect on the periodontium and produces less root resorption.

Comparison between round multi-strand wire and rectangular wire bonded retainers: a randomized clinical trial

ABSTRACT Objective: The primary objective was to compare round multi-strand wire and Ortho-Flex-Tech™ rectangular wire retainers in terms of gingival health. The secondary objectives were to assess plaque/calculus accumulation, and to determine the effectiveness of these retainers in maintaining tooth alignment and their failure rate. Material and Methods: This single-center study was a two-arm parallel randomized clinical trial and was conducted at the Orthodontic clinics in Dental Teaching Center/Jordan University of Science and Technology. Sixty patients, with bonded retention for the mandibular anterior segment after fixed orthodontic treatment, were randomly selected. The sample comprised Caucasian patients with mild to moderate pretreatment crowding in the mandibular anterior region, Class I relationship, treated without extraction of mandibular anterior tooth. In addition, only patients presenting normal overjet and overbite after treatment were included. Intervention: One group received round multi-strand wire retainer (30 patients, average age: 19.7 ± 3.8 years), while the other group received Ortho-Flex-Tech™ retainer (30 patients; average age: 19.3 ± 3.2 years). In both groups, the retainers were bonded to all mandibular anterior teeth from canine to canine. All patients were recalled one year after bracket debonding. Randomization sequence was created using Excel 2010, with a 1:1 allocation, using random block size 4. The allocation sequence was concealed in sequentially numbered, opaque and sealed envelopes. Only participants were blinded to the type of bonded retainer used. The primary outcome was to compare the gingival condition between the two groups. The secondary outcomes were to assess plaque/calculus indices, irregularity index of the mandibular anterior teeth and retainers' failure rate. Comparisons were conducted using Mann-Whitney U test or chi-square test. Statistical significance was predetermined at the p≤ 0.05 level for all tests. Results: Complete data were collected for 46 patients (round multi-strand wire retainer group, n=24 patients; rectangular Ortho-Flex-Tech™ retainer group, n=22 patients). No significant differences were found in the gingival health parameters between the two groups (p>0.05). Ortho-Flex-Tech™ retainers maintained the alignment of mandibular anterior teeth more than multi-strand retainer (p<0.05). No significant difference was found in the failure rate between the two groups (p>0.05). Conclusions: Gingival health parameters and failure rate were not different in both groups. However, Ortho-Flex-Tech™ retainers were more efficient to retain the mandibular incisors than the multi-strand retainers; nevertheless, the difference was not clinically significant.

RESUMO Objetivo: O objetivo principal desse estudo foi comparar a saúde gengival após o uso de dois tipos de contenção: uma feita com fio redondo multifilamentado e outra feita com fio retangular Ortho-Flex-Tech™. Os objetivos secundários foram avaliar o acúmulo de placa/cálculo, determinar a eficácia dessas contenções em manter o alinhamento dos dentes, bem como sua taxa de falha. Material e Métodos: Esse foi um estudo unicêntrico do tipo ensaio clínico randomizado paralelo de dois braços, conduzido nas clínicas ortodônticas do Centro de Ensino Odontológico da Jordan University of Science and Technology (Jordânia). Foram selecionados aleatoriamente sessenta pacientes com contenção colada no segmento anterior inferior após tratamento ortodôntico fixo. A amostra foi composta por pacientes caucasianos com apinhamento pré-tratamento leve a moderado na região anterior inferior, relação de Classe I, tratados sem extração de dentes anteriores inferiores. Além disso, foram incluídos apenas os pacientes que apresentavam sobressaliência e sobremordida normais após o tratamento. Intervenção: Um grupo recebeu contenção com fio redondo multifilamentado (30 pacientes, idade média: 19,7 ± 3,8 anos), enquanto o outro grupo recebeu contenção com fio retangular Ortho-Flex-Tech™ (30 pacientes; idade média: 19,3 ± 3,2 anos). Em ambos os grupos, as contenções foram coladas em todos os dentes anteriores inferiores de canino a canino. Todos os pacientes retornaram um ano após a descolagem dos braquetes. A sequência de randomização foi criada no Excel 2010, com uma alocação de 1:1, usando tamanho de bloco aleatório 4. A sequência de alocação foi ocultada em envelopes numerados sequencialmente, opacos e lacrados. Apenas os participantes desconheciam o tipo de contenção usada. O resultado primário foi a comparação dos dois grupos quanto à condição gengival. Os resultados secundários foram a avaliação dos índices de placa/cálculo, índice de irregularidade dos dentes anteriores inferiores e taxa de falha das contenções. As comparações foram realizadas usando o teste U de Mann-Whitney ou o teste qui-quadrado. A significância estatística foi predeterminada ao nível de p≤ 0,05 para todos os testes. Resultados: Dados completos foram coletados para 46 pacientes (grupo de contenção com fio multifilamentado redondo, n=24 pacientes; grupo de contenção com fio retangular Ortho-Flex-Tech™, n=22 pacientes). Nenhuma diferença significativa foi encontrada entre os dois grupos para os parâmetros de saúde gengival (p>0,05). As contenções Ortho-Flex-Tech™ mantiveram mais o alinhamento dos dentes anteriores inferiores do que as contenções com fio multifilamentado (p<0,05). Nenhuma diferença significativa foi encontrada entre os dois grupos quanto à taxa de falha (p>0,05). Conclusões: Os parâmetros de saúde gengival e a taxa de falhas não foram diferentes entre os dois grupos. No entanto, as contenções Ortho-Flex-Tech™ foram mais eficientes em conter os incisivos inferiores do que as contenções com fio multifilamentado; no entanto, essa diferença não foi clinicamente significativa.

Efficacy of lower arch leveling, lower incisors' root resorption, and pain associated with the correction of curve of Spee using different orthodontic archwires: a randomized clinical trial.

OBJECTIVES: To compare between 3 archwires (AWs) for leveling curve of Spee (COS) in terms of efficacy of reduction, external apical root resorption (EARR), pain experienced, and the lower arch dimensional changes during COS leveling. TRIAL DESIGN: Randomized clinical trial. SETTING: Jordan University of Science and Technology Postgraduate dental clinics. MATERIAL AND METHODS: Fifty-three subjects with COS > 5 mm were included in this study. The subjects were randomly divided into three groups based on the AW used: group 1, 0.017 × 0.025-inch stainless-steel (SS) AW; group 2, 0.019 × 0.025-inch SS AW; and group 3, 0.021 × 0.025-inch ß-titanium (TMA) AW. The intervention was randomly allocated using the permuted random block size of 3 with a 1:1:1 allocation ratio. In the three groups, a 5-mm depth reverse COS was placed in the AWs. The following time points were defined for COS assessment: T1, before interventional leveling AW placement; and T2-T7, 1-6 months after interventional leveling AW placement. Records consisted of dental study models and periapical (PA) radiographs. Pain scores were recorded using visual analogue scale. Patients were followed up on a monthly basis until COS < 1.5 mm. MAIN OUTCOME MEASURES: COS depth reduction, lower incisors' EARR, pain scores, and arch dimensional changes. RESULTS: An overall reduction of 3.82 mm, 4.47 mm, and 3.85 mm of the depth of COS was achieved in groups 1, 2, and 3, respectively. The mean differences of 0.65 mm between groups 1 and 2 and 0.62 mm between groups 2 and 3 were significant at P < 0.05. Lower incisors' EARR during leveling COS ranged from 0.68 to 0.72 mm, from 0.63 to 0.82 mm, and from 0.53 to 0.88 mm in groups 1, 2, and 3, respectively (P > 0.05). Higher pain scores were reported by group 2 subjects during the first 24 h. Arch length and width increased significantly in groups 2 and 3 (P < 0.05). In all groups, COS leveling was achieved by lower incisor intrusion and proclination and lower molar extrusion. CONCLUSIONS: All investigated AWs were effective in leveling COS with minimal lower incisors' EARR (< 1 mm). COS was leveled by lower incisors' intrusion and proclination and lower molar extrusion. Pain scores were the highest in group 2 during the first 24 h. CLINICAL RELEVANCE: The 3 investigated leveling AWs were effective for the leveling COS and at the same time safe on the roots of the lower anterior teeth.

Tooth size discrepancy in orthodontic patients with skeletal anterior open bite.

OBJECTIVE: To find out if there is any relationship between tooth size discrepancy (TSD) and skeletal anterior open bite (AOB) and to assess the correlation between the amount of AOB and TSD. METHOD: A total of 100 Class I subjects were included in this study (average age 15.21 ± 2.84 years). Fifty patients had skeletal AOB (>3 mm) and 50 subjects acted as controls and had a normal overbite. Teeth mesio-distal widths were measured using a digital caliper. Anterior, overall, and posterior TSD ratios were calculated. An independent t-test was employed to assess differences between groups and between genders. Pearson correlation coefficient was used to assess the correlation between the amount of AOB and TSD. RESULTS: Significant differences in anterior (p = .038) and posterior (p = .015) TSD ratios were detected. In the skeletal AOB group, no significant gender differences were detected (p > .05), whereas in the normal bite and total sample group, males had smaller posterior teeth compared to females (p < .05). All the differences were smaller than 1 SD of Bolton's ratios. No significant correlation was found between the amount of AOB and TSD ratios (p > .05). CONCLUSIONS: Skeletal AOB had larger anterior and smaller posterior mandibular teeth, but the differences were less than 1 SD of Bolton's ratios. Males have smaller mandibular posterior teeth than females. The amount of AOB is not correlated with the TSD ratios.

Cranial base measurements in different anteroposterior skeletal relationships using Bjork-Jarabak analysis.

OBJECTIVES: To assess the linear and angular cranial base measurements (Bjork polygon) in different anteroposterior (AP) skeletal relationships using Bjork-Jarabak analysis. MATERIALS AND METHODS: Pretreatment lateral cephalograms of 288 (146 women, 142 men, mean ages 21.24 ± 2.72 years and 22.94 ± 3.28 years, respectively) adult patients were divided into Class I, II, and III skeletal relationships according to their ANB angle. Linear and angular measurements of Bjork polygon were measured and compared among different skeletal relationships. Analysis of variance was performed to detect the differences among groups. Independent-sample t-test was used to detect differences between men and women. RESULTS: The Class II skeletal relationship has a significantly larger saddle angle than Class III does (P < .05), whereas Class III has a significantly larger gonial angle than Class II does (P < .05). The articular angle and sum of Bjork polygon angles were not significantly different among groups (P > .05). Anterior (N-S) and posterior (S-Ar) cranial base lengths were similar in the different AP skeletal relationships (P > .05). The ramal height and body of the mandible length were significantly larger in Class III compared with Class I and II (P < .05). Women had a significantly larger articular angle than men did (P < .05), although men had significantly larger linear measurements of Bjork polygon than women did (P < .05). CONCLUSIONS: The Class III skeletal relationship has a smaller saddle angle and larger mandibular length and gonial angle. Men have a larger cranial base and mandibular linear measurements and a smaller articular angle compared with women.

Effect of piezocision on mandibular second molar protraction.

OBJECTIVES: To assess the effects of piezocision on the rate of mandibular second molar protraction. MATERIALS AND METHODS: Thirty-one subjects (average age: 22.26 ± 5.63 years) who presented with at least one extracted mandibular first molar were selected to participate in the study. The subjects were subdivided into one of two groups, 22 molars each: group 1, where piezocision was performed immediately before molar protraction and group 2, where molar protraction was performed with no piezocision. Piezocision was performed by making two vertical incisions mesial and distal to the extraction space, and bone cuts were done with a length up to the mucogingival line at a depth of 3 mm. The rate of second molar protraction, duration of space closure, and level of interleukin-1-ß (IL-1ß) in gingival crevicular fluid (GCF) during the first month of space closure were recorded. RESULTS: During the first 2 months after surgery, the rates of second molar protraction were 1.26 ± 0.12 mm/month and 0.68 ± 0.19 mm/month in the piezocision and no piezocision groups, respectively (P < .001). Duration of lower first molar space closure was 9.61 ± 0.98 months in the piezocision group and 10.87 ± 1.52 months in the no piezocision group (P < .01). The level of IL-1ß in GCF was higher in the piezocision group compared to the no piezocision group, up to 1 week after surgery (P = .02). CONCLUSIONS: Although piezocision doubled the rate of second molar protraction during the first 2 months after surgery, overall second molar protraction was increased by only 1 month.

Pain experience during initial alignment with three types of nickel-titanium archwires: a prospective clinical trial.

OBJECTIVE: To clinically evaluate the pain intensity during the week following initial placement of three different orthodontic aligning archwires. MATERIALS AND METHODS: A consecutive sample of 75 patients requiring upper and lower fixed orthodontic appliances were alternately allocated into three different archwires (0.014-inch superelastic NiTi, 0.014-inch thermoelastic NiTi or 0.014-inch conventional NiTi). Assessments of pain/discomfort were made on a daily basis over the first 7-day period after bonding by means of visual analog scale and consumption of analgesics. The maximum pain score was recorded. The possible associations between age, gender, degree of crowding, and teeth irregularity and the pain intensity were also examined. Demographic and clinical differences between the three groups were compared with chi-square test or analysis of variance (ANOVA) test. RESULTS: No statistically significant differences were found in the pain intensity when the three aligning NiTi archwires were compared (P  =  .63). No significant differences in pain perception were found in terms of gender, age, lower arch crowding, and incisor irregularity. The intake of analgesics was the least in the superelastic NiTi group. CONCLUSION: The three forms of NiTi wires were similar in terms of pain intensity during the initial aligning stage of orthodontic fixed appliance therapy. Gender, age, and the degree of crowding have no effect on the perceived discomfort experienced by patients undergoing fixed orthodontic treatment.

A clinical comparison of three aligning archwires in terms of alignment efficiency: A prospective clinical trial.

OBJECTIVES: To clinically evaluate the effectiveness of three orthodontic aligning archwires in relation to tooth alignment speed during the initial alignment stage of treatment. MATERIALS AND METHODS: A consecutive sample of 74 patients requiring lower only or upper and lower fixed orthodontic appliances were randomly allocated into three different archwires (0.014-inch superelastic nickel-titanium [NiTi], 0.014-inch thermoelastic NiTi, or 0.014-inch conventional NiTi). Good quality impressions were taken of the lower arch before archwire placement (T0) and at designated serial stages of alignment (every 2 weeks: T2, T4, T6, …, T16). The change in tooth alignment was measured in millimeters from the resultant casts using Little's irregularity index. Demographic and clinical differences among the three groups were compared with the chi-square or analysis of variance (ANOVA) test. The difference in the change of lower anterior tooth alignment over time among the three groups was explored with a Split Plot ANOVA (SPANOVA, or within- and between-groups ANOVA). The Kruskal-Wallis nonparametric test was used when data were not normally distributed. RESULTS: The SPANOVA and Wilks Lambda Multivariate test confirmed that the wire type had no influence on the rate of change in alignment (P  =  .98). CONCLUSION: The three forms of NiTi wires were similar in terms of their alignment efficiency during the initial aligning stage of orthodontic fixed appliance therapy.

Comparison of personality traits, attitude toward orthodontic treatment, and pain perception and experience before and after orthodontic treatment.

OBJECTIVE: To compare personality traits, attitude toward orthodontic treatment, and pain perception and experience before and after orthodontic treatment. MATERIALS AND METHODS: One hundred subjects (50 male and 50 female) were included in this study. The mean (SD) age was 17.5 (2.05) years at T1 and 19.15 (2.32) years at T2. The instruments for data collection were questionnaires that included assessment of patients' personality traits, attitudes toward orthodontic treatment, and pain perception/experience. Subjects completed the questionnaires at two different times: before orthodontic treatment (T1) and after fixed orthodontic treatment (T2). Subjects were treated by fixed orthodontic appliances for an average (SD) period of 18.64 (0.35) months. Paired sample t-test and chi-square test were used to detect any differences. RESULTS: Significant changes in personality traits were detected after orthodontic treatment irrespective of gender. Neuroticism, openness, agreeableness, and conscientiousness scores were improved (P < .001). A positive attitude toward orthodontic treatment was reported at T1 (4.31 [±1.26]) and improved at T2 (3.98 [±1.16]) irrespective of gender (P < .05). The average (SD) expected pain score (T1) was 4.73 (1.88) and the average (SD) experienced pain score (T2) was 4.63 (1.58). Significant difference in the expected and experienced pain scores was not detected (P  =  .11). CONCLUSIONS: Personality traits and attitude toward orthodontic treatment improved after orthodontic treatment. Reported actual pain experience during orthodontic treatment was similar to that expected before treatment.

Mandibular symphysis morphology and dimensions in different anteroposterior jaw relationships.

OBJECTIVE: To assess the morphology and dimensions of mandibular symphysis (MS) in different anteroposterior jaw relationships and to investigate whether craniofacial parameters have any correlation with its shape and/or dimensions. MATERIALS AND METHODS: Lateral cephalograms of subjects with Class I, Class II, and Class III skeletal relationships were traced. Several craniofacial and MS parameters were measured. MS parameters were compared between the three groups using analysis of variance and were correlated with the craniofacial parameters using the Pearson correlation coefficient. RESULTS: Larger angle of concavity of the chin, more inclination of the alveolar bone toward the mandibular plane, and larger MS dimensions and area (P < .001) were found with a Class III skeletal relationship compared to Class I and Class II relationships. The Pearson correlation coefficient between Id-Me and AFH was r  =  0.83 and between Id-Me and LAFH it was r  =  0.81. CONCLUSIONS: The dimensions and configuration of MS in the Class III relationship were different than those in Class I and Class II relationships; the alveolar part of MS compensated for the skeletal relationship in the Class III pattern. MS dimensions were strongly correlated to anterior facial dimensions.

Effect of fixed orthodontic appliances bonded with different etching techniques on tooth color: a prospective clinical study.

INTRODUCTION: For most orthodontic patients, esthetic concerns are as important as functional demands. The purpose of this study was to assess the effect of self-etching primer and conventional acid etching on tooth color after orthodontic treatment. METHODS: A total of 34 patients were enrolled in a clinical trial and divided into 2 groups based on age: adolescents (≤17 years) and adults (>17 years). Tooth color of all maxillary and mandibular anterior teeth was measured before bonding and after debonding using a spectrophotometer (Vita Easyshade Compact; Vita Zahnfabrik, Bad Säckingen, Germany). Two types of etching techniques were used for orthodontic bonding, self-etching primer and conventional acid etching, in a randomized split-mouth design. Tooth color measurements were done according to the system of the Commission Internationale de l'Eclairage (lightness, red/green, and yellow/blue). The corresponding tooth color differences between pretreatment and posttreatment, etching groups, sexes, and age groups were calculated. RESULTS: Tooth color was significantly changed in all (L, a, b) color parameters (P <0.05). The lightness value decreased by 2.16 units, and the red/green and yellow/blue values increased by 0.32 and 1.78, respectively. The average tooth color difference after orthodontic treatment was 2.85 units. No significant difference was found between self-etching primer and conventional acid etching in their effects on tooth color (P >0.05). Men and adolescents had more color change than did girls and adults (P <0.05). CONCLUSIONS: Fixed orthodontic appliances caused tooth color changes; self-etching primer and conventional acid etching had similar effects on tooth color; men and adolescents had greater color changes than did girls and adults.

The effect of different bracket base cleaning method on shear bond strength of rebonded brackets.

AIM: To assess the effect of different bracket base conditioning method on shear bond strength (SBS) of rebonded brackets. MATERIALS AND METHODS: Eighty brackets were bonded to freshly extracted premolar teeth using light cured composite adhesive. SBS was measured for 20 random samples as control group (G1). After debonding, 60 debonded brackets were allocated randomly into three groups of bracket base conditioning methods to remove the remaining adhesives. G2: bracket base cleaned with slow speed round carbide bur (CB), G3: cleaned with ultrasonic scaler (US), G4: cleaned with sandblasting (SB). After that, brackets were rebonded in the same manner as frst bonding and SBS was measured. Modifed adhesive remnant index (ARI) was recorded for all groups. RESULTS: SBS for new brackets was 11.95 MPa followed by 11.65 MPa for G2, 11.56 MPa for G4 and 11.04 MPa for G3 group. There were no statistically signifcant differences between all groups (p = 0.946). In all groups, failure mode showed that the majority of adhesive composite remained on the bracket base with ARI of 4. There was no statistically signifcant difference between all groups in ARI (p = 0.584). CONCLUSION: In-offce methods; slow speed CB and US are effective, quick and cheap methods for bracket base cleaning for rebonding.

Alveolar bone density changes around miniscrews: a prospective clinical study.

INTRODUCTION: Our objective was to assess the effects of miniscrews on interproximal alveolar bone density and adjacent gingival tissue health. METHODS: Forty-four titanium miniscrews were inserted between maxillary second premolars and first molars on both sides of the dentition in 22 consecutive patients (15 female, 7 male; ages, 14-24 years). A control area (between the maxillary first and second premolars) was also assessed. Both miniscrew (study) and control areas were monitored clinically and radiographically at different time points: before insertion of the miniscrews and at 1 month, 3 months, and 6 months after insertion. Software associated with a digital intraoral radiography machine was used to assess changes in alveolar bone density. Clinical gingival parameters of the study and control areas were also recorded. A repeated-measures analysis of variance and the Bonferroni post-hoc pairwise comparison tests were used to assess the changes at the different time points. RESULTS: Thirty-nine miniscrews were successful for the study duration. Male subjects had significantly (P <0.001) higher alveolar bone density than did the females at baseline. Alveolar bone density around the miniscrews increased significantly (P <0.001) between 3 and 6 months after insertion upon loading. Alveolar bone density of the control area did not change significantly during the experiment (P >0.05). The width of keratinized gingiva increased significantly (P <0.001) in the study and control areas after insertion of miniscrews and remained with no significant change throughout the study. CONCLUSIONS: Miniscrews increased the alveolar bone density significantly after 3 months of insertion and were not associated with detrimental effects on the adjacent gingival tissues.

Factors affecting demineralization during orthodontic treatment: a post-hoc analysis of RCT recruits.

INTRODUCTION: Our aim was to determine predictors for the presence and degree of demineralization during orthodontic treatment. This study was a post-hoc analysis of recruits for a randomized controlled trial. Two hundred thirty patients were included in this study and assessed for demineralization at debond by using quantitative light-induced fluorescence to determine their eligibility for a randomized controlled trial assessing the effectiveness of various toothpastes at reducing demineralization during retention. METHODS: Data about patients' demographics, treatments, oral hygiene, and pretreatment status of the first permanent molars were extracted from case notes. Data on the presence and severity of white spot lesions (WSLs) were obtained from the trial's data base. Univariate analyses and multiple regression were undertaken to assess for associations between the factors and the presence and severity of WSLs. RESULTS: Sixty-five patients (28.3%) had no WSLs, and 165 (71.7%) had 1 to 12. The mean number of WSLs per patient with demineralization was 2.9 (95% CI, 2.5 and 3.3). Patients with WSLs were significantly (P = 0.002) younger and more likely to have diseased first molars (P = 0.04). Participants with inadequate pretreatment oral hygiene developed more WSLs (P = 0.03). Boys (P = 0.001) and participants with diseased first molars (P = 0.06) had significantly greater demineralization. CONCLUSIONS: Sex, pretreatment age, oral hygiene, and clinical status of the first molars can be used as predictors for the development and severity of WSLs during orthodontic treatment.