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The biological aspect of orthodontic tooth movement is influenced by the magnitude and duration of the applied force. This initiates signaling cascades essential for bone remodeling, which involve activating various cell signaling pathways that enhance the metabolism of the periodontal ligament, leading to localized bone resorption and deposition. This process facilitates tooth movement on the pressure side and promotes healing on the tension side. The remodeling associated with orthodontic tooth movement is an inflammatory reaction involving mediators. Key components in this process include hormones, systemic influences, cyclic adenosine monophosphate, specific cytokines like interleukin 1, colony-stimulating factors, calcium, collagenase, and prostaglandins, all of which are essential for the biological adjustments necessary for tooth movement. Medications that influence molecular pathways critical for the homeostasis of periodontal tissues or that affect changes during orthodontic tooth movement and clastic cell regulation can potentially modulate tooth movement. With the recent increase in prescription medication use, it is essential for clinicians to be aware of medication consumption in prospective patients and understand its potential impact on orthodontic treatment. This review aimed to explore the effects of commonly prescribed medications on the rate of orthodontic tooth movement, thoroughly review the existing evidence on this topic, and identify potential areas for future research.
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The implementation of Clear Aligner Therapy (CAT) in adult orthodontics exemplifies the integration of advanced technology in the dental healthcare sector. Representing a significant shift in modern orthodontics, CAT offers a convenient and aesthetic alternative to traditional fixed appliance treatments for mal-aligned dentition. This narrative review aims to explore the applicability of CAT, delineating its biomechanics, indications, contraindications, scope, limitations, and factors influencing long-term stability and successful outcomes. A comprehensive literature search was conducted using databases like Google Scholar, PubMed, Cereus, and the Cochrane Library. Articles were selected based on their relevance to clear aligners, without brand specificity, and covered a wide range of cases to establish CAT's scope and limitations. This review includes individual case studies, systemic reviews, comparative analyses, case reports, finite element analyses, and prospective and retrospective analyses, all contributing to a nuanced understanding of CAT's applicability and long-term treatment stability. The conclusion underscores CAT's growing acceptance in orthodontics, including its application in challenging cases, and highlights key determinants that bolster its long-term efficacy.
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Background and Objective: Loosening of abutment screws in dental implants is a mechanical complication that affects prosthetic treatments and hence, patient satisfaction. Blood contamination of abutment screws may play a role in this phenomenon. However, only limited research attention has been given to this issue. In the present study, we determined the effect of blood contamination and decontamination protocol on the reverse torque value (RTV) of abutment screws. Materials and Methods: A questionnaire-based survey was sent to 210 implantologists requesting feedback on their attitude to the blood contamination issue and the decontamination protocols used. The survey responses were used in a selection of the decontamination solutions that were used in the subsequent in vitro study on the effects of blood decontamination protocol on the RTV of abutment screws. Thus, three study groups were used (n = 20 abutment screws in each group): Group 1 (control group; blood-contaminated screws); Group 2 (screws decontaminated with 5.25% sodium hypochlorite (NaOCl) solution); and Group 3 (screws decontaminated with normal saline solution (0.9%)). Then, each of the connections were subjected to thermocycling, and RTVs of the screw were measured using a digital torque meter. Intragroup and intergroup RTVs were analyzed for significance using analysis of variance (ANOVA) and Tukey's honestly significant difference (HSD) tests. Results: 48% of the implantologists responded to the survey; 80% of them were concerned with blood contamination in the implant connection, especially before abutment loading and 85% of them used either chlorhexidine solution or normal saline solution as the decontamination agent. The mean RTV for Group 2 screws (30.27 ± 2.8 N.cm) was significantly greater than that for Group 3 screws (26.02 ± 1.99 N.cm) which, in turn, was significantly greater than that for Group 1 screws (23.64 ± 1.84 N.cm). Conclusion: Decontamination of blood-covered connections using 5.25% NaOCl solution or normal saline solution restores the RTV of abutment screws. This finding may have clinical relevance in that the decontaminated screws may contribute to the low incidence of screw loosening and, ultimately, improved patient satisfaction.
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Background: Patients health education by healthcare workers has been affected by pandemic guidelines. This study aimed to evaluate the influence of an audio-mediated intervention for patient health education (PHE) on treatment compliance and treatment satisfaction among patients seeking prosthodontic treatment during the Covid pandemic. Methods: A total of 666 patients (aged 40-70 years) who fulfilled the study criteria were treated for denture-associated disease. PHE for 5 different categories was performed using an educational audio (MP3) in the experimental group (Group E), and traditional methods (oral/verbal) in the control group (Group C). Patient/clinician satisfaction with the PHE program was evaluated with a pre-validated questionnaire, whereas treatment compliance and satisfaction were evaluated using a denture hygiene index (DHI) and a visual analog scale (VAS). Differences between qualitative variables were determined using the chi-square test, whereas continuous variables were assessed using an unpaired t-test. Differences were considered to be statistically significant at p ≤ 0.05. Results: Patient satisfaction with PHE was significantly higher and differed in the Group E for two parameters: education method (80%), educational material (94%). For all parameters of procedural education, patient/clinician satisfaction was significantly higher for Group E [method (93%), material (85%), patient preparation (89%), personalized education (84%), program (93%)]. From three different ratings of disease education, 70% in Group E rated education as "effective" as compared to 41% in the Group C. Effectiveness of post treatment, education measured through DHI, revealed a lower hygiene score in Group E (m = 1.18) as compared to Group C (m = 2.92), with differences being significant. For treatment satisfaction, patients in Group E rated higher for speech (m = 8.21), ease of chewing (m = 7.36), and general satisfaction (m = 7.9). Conclusion: This study concluded that using audio as a means of imparting PHE positively influences the treatment compliance and satisfaction among outpatients and overcomes the drawback of wearing mask during the pandemic.