Use of Antimicrobial Silver Coatings on Fixed Orthodontic Appliances, Including Archwires, Brackets, and Microimplants: A Systematic Review.

Orthodontic treatments, while essential for achieving optimal oral health, present challenges in infection control due to the propensity for bacterial adhesion and biofilm formation on orthodontic appliances. Silver-coated orthodontic materials have emerged as a promising solution, leveraging the potent antimicrobial properties of silver nanoparticles (AgNPs). Antibacterial coatings are used in orthodontics to prevent the formation of bacterial biofilms. This systematic review evaluated the literature on antimicrobial silver coatings on fixed orthodontic appliances, including archwires, brackets, and microimplants. Two evaluators, working independently, rigorously conducted a comprehensive search of various databases, including PubMed, PubMed Central, Embase, Scopus and Web of Science. This systematic review comprehensively examined in vitro studies investigating the antimicrobial efficacy of silver-coated orthodontic archwires, brackets, and microimplants. The review registered in PROSPERO CRD42024509189 synthesized findings from 18 diverse studies, revealing consistent and significant reductions in bacterial adhesion, biofilm formation, and colony counts with the incorporation of AgNPs. Key studies demonstrated the effectiveness of silver-coated archwires and brackets against common oral bacteria, such as Streptococcus mutans and Staphylococcus aureus. Microimplants coated with AgNPs also exhibited notable antimicrobial activity against a range of microorganisms. The systematic review revealed potential mechanisms underlying these antimicrobial effects, highlighted implications for infection prevention in orthodontic practice, and suggested future research avenues. Despite some study heterogeneity and limitations, the collective evidence supports the potential of silver-coated orthodontic materials in mitigating bacterial complications, emphasizing their relevance in advancing infection control measures in orthodontics.

Skeletal and dental age estimation via postmortem computed tomography in Polish subadults group.

This article is a retrospective analysis of postmortem computed tomography scans of ossification stages of the anterior and posterior intra-occipital sutures, the anterior arch of the atlas, and the neurocentral junction of the axis. We also analyzed the development of secondary ossification centers in the proximal humeral, femoral, and tibial epiphyses, and the distal femoral and tibial epiphyses. Additionally, the development of primary ossification centers in the wrist and metacarpals, and maxillary and mandibular deciduous tooth maturation. A total of 58 cadavers (35 males, 23 females), whose age ranged from 3rd month of pregnancy to 14 years, were analyzed. The results of this study show that analysis of synchondrosis closure, primary, and secondary ossification center development and deciduous tooth changes are a good tool for age estimation in subadults group (fetuses, newborns, infants, and children). The results of the study in a Polish population are consistent with those reported by other authors.

Postmortem computed tomography assessment of skeletal and dental age in Polish children, adolescents, and young adults.

This paper presents a retrospective analysis of postmortem computed tomography (PMCT) scans of secondary ossification centers in the medial clavicular epiphysis, iliac crest apophysis, proximal humeral epiphysis, distal femoral epiphysis, proximal tibial epiphysis, and distal tibial epiphysis. At the same time, we analyzed PMCT scans of the maxillary and mandibular incisors, canines, premolars, and molars. We assessed 203 corpses, whose age ranged from 2 to 30 years, including 156 males and 47 females. The purpose of our study was to compare the processes of secondary ossification center fusion and permanent tooth maturation. Our research hypothesis was that certain stages of skeletal and dental maturation occur along consistent timelines that can be related to the chronological age. Secondary ossification center fusion was evaluated based on Kreitner and also McKern and Steward's classifications. The process of permanent tooth maturation was evaluated with Demirjian's method. Spearman's correlation coefficients (Rho) were positive in all analyses, which indicates that epiphyseal fusion progresses with age. The strongest relationship between the age and the stages of ossification was observed in the proximal tibial epiphysis (p < 0.001; Rho = 0.93) in females and in the medial clavicular epiphysis (p < 0.001; Rho = 0.77) in males. Studies show the importance of concomitant analysis of skeletal and dental maturation with a subsequent comparison of the results to achieve a greater precision in age estimation. A comparison of the results obtained in the study population of Polish children, adolescents, and young adults with the results of other studies in populations of similar ages showed a number of similarities in the time windows of dental and skeletal maturation. These similarities may help in age estimation.

The influence of two forms of chlorhexidine on the accuracy of contemporary electronic apex locators.

BACKGROUND: Accurate determination of working length (WL) is crucial for the success of endodontic therapy. The aim of this study was to determine the influence of 2% chlorhexidine digluconate solution, 2% chlorhexidine digluconate gel and 2% hypochlorite solution on the accuracy of two devices: the Raypex 5 and the ApexDal. METHODS: Twenty-nine single-rooted human teeth were used in this study. The crowns were cut horizontally and embedded in an alginate mass. In each tooth, six endodontic measurements were made using two electronic apex locators (EALs): a Raypex 5 and an ApexDal. For each EAL, measurements were taken with the following products: 2% chlorhexidine solution (CHX-S group), 2% chlorhexidine gel (CHX-G group) and 2% NaOCl (NaOCl group). After performing an endodontic measurement, the endodontic instruments were stabilized with flow resin composite. Afterwards, the roots were removed from the alginate mass, and the apical one-third of each root was cut lengthways to recover the canal system. Last, the distance between the file tip and the apical foramen was measured under a microscope at 60 x magnification. RESULTS: Statistically significant differences were found between CHX-S and NaOCl and CHX-G and NaOCl, but no significant differences were detected between CHX-S and CHX-G during the testing of both devices. No statistically significant differences were observed between the Raypex 5 and ApexDal for all intracanal media tested. CONCLUSION: The EALs Raypex 5 and ApexDal had higher accuracy in the anatomical foramen of the root containing chlorhexidine in the gel or in the solution form than in the canal containing sodium hypochlorite.

Factors affecting the outcomes of direct pulp capping using Biodentine.

INTRODUCTION: This study aimed to evaluate the prognostic value of factors with regard to the treatment outcome of direct pulp capping using Biodentine (Septodont, Saint-Maur-des-Fossés, France), in permanent teeth in which the pulps were exposed during caries removal. METHODS: Between 2010 and 2014, 112 teeth with deep carious lesions underwent direct pulp capping. The patients were followed up at 2-3 months and 1-1.5 years with a routine examination on both recall visits. Periapical radiographs were taken at 1-1.5 years. Lack of patient complaints, positive reactions to cold and electric testing, no sensitivity to percussion, and no widening of the periapical ligament indicated success. The Fisher exact test was used for statistical analysis. The significance level was P = .05. RESULTS: Eighty-six teeth were available for 1-1.5 years follow-up. The overall success rate was 82.6%. Only age had a significant effect on the pulpal survival rate: the success rate was 90.9% in patients younger than 40 years and 73.8% in patients 40 years or older (P = .0480). Sex, initial or secondary caries treatment, occlusal or cervical/proximal caries, delayed placement of permanent filling, tooth position, and arch type did not influence the outcome. CONCLUSIONS: A patient's age influenced the outcome of direct pulp capping using this new calcium silicate cement. CLINICAL RELEVANCE: Asymptomatic vital permanent teeth with cariously exposed pulp can be treated successfully by direct pulp capping using Biodentine.

The electrical activity of the masticatory muscles in children with cleft lip and palate.

BACKGROUND: Information regarding masticatory muscle function in children with cleft lip and palate (CLP) is limited. As a consequence, research on masticatory muscle activity in cleft subjects is needed. AIM: To assess masticatory muscle activity in children surgically treated for CLP as well as identify the possible factors associated with this activity. DESIGN: The sample comprised 82 children with mixed dentition and Class I occlusions (25 children with unilateral CLP and 57 subjects with no cleft abnormalities). A DAB-Bluetooth Instrument (Zebris Medical GmbH, Germany) was used to take electromyographical (EMG) recordings of the temporal and masseter muscles both in the mandibular rest position and during maximum voluntary contraction (MVC). RESULTS: Patients with clefts showed a significant increase in temporal muscle activity at rest compared with the controls. The presence of clefts and unilateral posterior crossbites are factors strongly associated with increased temporal muscle EMG potentials during rest position. CONCLUSIONS: Children with clefts have altered temporal muscle function. The presence of posterior crossbites affects the temporal muscle activity in cleft subjects. Early diagnosis and orthodontic treatment of malocclusions are necessary to achieve functional improvement in these patients.

Impact of functional appliances on muscle activity: a surface electromyography study in children.

BACKGROUND: Electromyography (EMG) is the most objective tool for assessing changes in the electrical activity of the masticatory muscles. The purpose of the study was to evaluate the tone of the masseter and anterior temporalis muscles in growing children before and after 6 months of treatment with functional removable orthodontic appliances. MATERIAL/METHODS: The sample conisted of 51 patients with a mean age 10.7 years with Class II malocclusion. EMG recordings were performed by using a DAB-Bluetooth instrument (Zebris Medical GmbH, Germany). Recordings were performed in mandibular rest position, during maximum voluntary contraction (MVC), and during maximum effort. RESULTS: The results of the study indicated that the electrical activity of the muscles in each of the clinical situations was the same in the group of girls and boys. The factor that determined the activity of the muscles was their type. In mandibular rest position and in MVC, the activity of the temporalis muscles was significantly higher that that of the masseter muscels. The maximum effort test indicated a higher fatigue in masseter than in temporalis muscles. CONCLUSIONS: Surface electromyography is a useful tool for monitoring muscle activity. A 6-month period of functional therapy resulted in changes in the activity of the masticatory muscles.

Automatic method of analysis of OCT images in the assessment of the tooth enamel surface after orthodontic treatment with fixed braces.

INTRODUCTION: Fixed orthodontic appliances, despite years of research and development, still raise a lot of controversy because of its potentially destructive influence on enamel. Therefore, it is necessary to quantitatively assess the condition and therein the thickness of tooth enamel in order to select the appropriate orthodontic bonding and debonding methodology as well as to assess the quality of enamel after treatment and clean-up procedure in order to choose the most advantageous course of treatment. One of the assessment methods is computed tomography where the measurement of enamel thickness and the 3D reconstruction of image sequences can be performed fully automatically. MATERIAL AND METHOD: OCT images of 180 teeth were obtained from the Topcon 3D OCT-2000 camera. The images were obtained in vitro by performing sequentially 7 stages of treatment on all the teeth: before any interference into enamel, polishing with orthodontic paste, etching and application of a bonding system, orthodontic bracket bonding, orthodontic bracket removal, cleaning off adhesive residue. A dedicated method for the analysis and processing of images involving median filtering, mathematical morphology, binarization, polynomial approximation and the active contour method has been proposed. RESULTS: The obtained results enable automatic measurement of tooth enamel thickness in 5 seconds using the Core i5 CPU M460 @ 2.5GHz 4GB RAM. For one patient, the proposed method of analysis confirms enamel thickness loss of 80 µm (from 730 ± 165 µm to 650 ± 129 µm) after polishing with paste, enamel thickness loss of 435 µm (from 730 ± 165 µm to 295 ± 55 µm) after etching and bonding resin application, growth of a layer having a thickness of 265 µm (from 295 ± 55 µm to 560 ± 98 µm after etching) which is the adhesive system. After removing an orthodontic bracket, the adhesive residue was 105 µm and after cleaning it off, the enamel thickness was 605 µm. The enamel thickness before and after the whole treatment decreased by about 125 µm. CONCLUSIONS: This paper presents an automatic quantitative method for the assessment of tooth enamel thickness. This method has proven to be an effective diagnostic tool that allows evaluation of the surface and cross section of tooth enamel after orthodontic treatment with fixed thin-arched braces and proper selection of the methodology and course of treatment.

Electromyographic Assessment of Muscle Activity in Children Undergoing Orthodontic Treatment-A Systematic Review.

Background: Surface electromyography (sEMG) can provide an objective and quantitative image of the functional state of neuromuscular balance in the stomatognathic system. The objective of this systematic review is to examine current scientific evidence regarding the effects of orthodontic treatment on muscle electromyographic (EMG) activity in children. Methods: The search strategy included the PubMed, PubMed Central, Web of Science, Scopus, and Embase databases. The inclusion criteria were studies assessing EMG muscle activity in children undergoing orthodontic treatment compared with untreated children. The Cochrane risk-of-bias tool (RoB2) and the Newcastle-Ottawa Scale (NOS) were used to evaluate the quality of the studies. The quality of evidence assessment was performed using GRADE analysis. The PRISMA diagram visually represented the search strategy, as well as screening and inclusion process. Results: The search strategy identified 540 potential articles. Fourteen papers met the inclusion criteria. Six studies were judged at a low risk of bias. The certainty of evidence was rated as moderate to low, according to the GRADE criteria. Studies showed alterations in EMG muscle activity in children undergoing orthodontic treatment. Conclusions: Orthodontic treatment appears to affect muscle activity in children undergoing orthodontic treatment. However, the quality of evidence is low and, therefore, it is not possible to definitively state this effect. Further long-term studies are needed to confirm the findings of this review. Study protocol number in PROSPERO database: CRD42023491005.

Laryngeal cartilage calcifications on lateral cephalometric radiographs.

The aim of this study was to determine the influence of age and gender on the incidence of calcification in laryngeal cartilage diagnosed on lateral cephalometric radiographs routinely taken for orthodontic diagnosis. The lateral cephalometric radiographs of 957 patients who met the study criteria were analyzed from among the 1000 lateral radiographs originally collected. The images were evaluated independently by two investigators. Given the dichotomous dependent variable (calcification or no calcification), a mixed logistic regression model was used to test how age and gender affected calcification. The effect of age and gender reliably determined the likelihood of laryngeal cartilage calcification. The greatest differences in the degree of calcification by gender were found at ages 20-25 years. The degree of calcification increased with age, reaching 100% in women at age 30 and in men at age 50. In women, the degree of calcification was higher than in men from the age of 13 years and levelled off at the age of 50 years. The interrater agreement was strong k = 0.97, z = 30.0, p < .001. Calcification can be detected by orthodontists trained in lateral cephalogram analysis and can be used as a screening or diagnostic tool to detect calcified areas in the larynx.

Surface electromyography in orthodontics - a literature review.

Electromyography is the most objective and reliable technique for evaluating muscle function and efficiency by detecting their electrical potentials. It makes it possible to assess the extent and duration of muscle activity. The main aim of surface electromyography is to detect signals from many muscle fibers in the area of the detecting surface electrodes. These signals consist of a weighted summation of the spatial and temporal activity of many motor units. Hence, the analysis of the recordings is restricted to an assessment of general muscle activity, the cooperation of different muscles, and the variability of their activity over time.                         This study presents the main assumptions in the assessment of electrical muscle activity through the use of surface electromyography, along with its limitations and possibilities for further use in many areas of orthodontics. The main clinical uses of sEMG include the diagnostics and therapy of temporomandibular joint disorders, an assessment of the extent of stomatognathic system dysfunctions in subjects with malocclusion, and the monitoring of orthodontic therapies.

Surface electromyography in the assessment of masticatory muscle activity in patients with pain-related temporomandibular disorders: a systematic review.

Background: Temporomandibular disorders (TMD) are a set of painful conditions affecting the orofacial region that are prevalent and constitute the most frequent type of non-dental pain complaint in the maxillofacial area. Pain-related TMD (TMD-P) is characterized by ongoing pain in the masticatory muscles, the temporomandibular joint, or surrounding structures. Due to the multiple factors that contribute to the development of this condition, it can be challenging to accurately diagnose. One of the useful method for assessing patients with TMD-P is surface electromyography (sEMG). The aim of this systematic review was to provide a comprehensive overview of the current scientific literature on the evaluation of masticatory muscle activity (MMA) in individuals diagnosed with TMD-P, through the utilization of sEMG. Methods: To gather relevant information, electronic databases such as PubMed, Web of Science, Scopus, and Embase were searched using specific keywords including: "pain" AND ("temporomandibular disorder*" OR "temporomandibular dysfunction*") AND "surface electromyography" AND "masticatory muscle activity." The inclusion criteria were studies assessing MMA in patients with TMD-P using sEMG. The Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies was utilized to evaluate the quality of the studies that were included in the review. Results: The search strategy identified 450 potential articles. Fourteen papers met the inclusion criteria. Global quality rating for significant part of the articles was weak. Most studies showed greater sEMG activity of the masseter (MM) and temporal anterior (TA) muscles at rest in TMD-P subjects than in the asymptomatic controls, while the MM and TA muscles were less active in the pain-related TMD group compared to the non-TMD group during maximal voluntary clenching (MVC). Conclusion: There were differences in MMA in the TMD-pain population compared to a healthy control group during various tasks. The diagnostic efficacy of surface electromyography in assessing individuals with TMD-P remains unclear.

Candida Species in Children Undergoing Orthodontic Treatment with Removable Appliances: A Pilot Study.

The purpose of this study was to analyze the effect of orthodontic treatment with removable appliances on the growth of Candida spp. in children undergoing orthodontic treatment. The study included 60 patients of equal numbers as to gender from the orthodontics department of the Pomeranian Medical University in Szczecin, Poland. All patients were aged 6-12 years and were qualified for orthodontic treatment with removable appliances. The following examinations were performed on the day of treatment initiation (T1) and 6 months after the start of treatment (T2); a collection of oral swabs for culture on Sabouraud's medium and the identification of fungal colonies using the VITEK®2 YST. At T1, 42 (70%) subjects, were free of Candida, while after 6 months of treatment, the number decreased to 25 (41.67%). Two types of fungi, C. albicans and C. parapsilosis, predominated in the test performed at T1. The study at T2 showed that C. albicans most frequently colonized the oral cavity in 23 children (38.33%). Three new strains C. dubliniensis, C. kefyr, and C. krusei were identified at T2. Statistical analysis showed a significant correlation between the culture results and the age of the patient at T2. Patients older than 9 years had significantly more positive tests. Orthodontic treatment with removable appliances contributes to increased oral colonization by Candida spp.

Predicting Interest in Orthodontic Aligners: A Google Trends Data Analysis.

Aligners are an example of how advances in dentistry can develop from innovative combinations of 3D technologies in imaging, planning and printing to provide new treatment modalities. With increasing demand for esthetic orthodontic treatment, aligners have grown in popularity because they are esthetically more pleasing and less obstructive to oral hygiene and other oral functions compared to fixed orthodontic appliances. To observe and estimate aligner treatment interest among Google Search users, Google Trends data were obtained and analyzed for the search term, "Invisalign". A prediction of interest for the year 2022 for three European Union countries with the highest GDP was developed. "Invisalign" was chosen to represent all orthodontic aligners as the most searched term in Google Trends for aligners. This is the first study to predict interest in the query "Invisalign" in a Google search engine. The Prophet algorithm, which depends on advanced statistical analysis methods, positions itself as an automatic prediction procedure and was used to predict Google Trends data. Seasonality modeling was based on the standard Fourier series to provide a flexible model of periodic effects. The results predict an increase in "Invisalign" in Google Trends queries in the coming year, increasing by around 6%, 9% and 13% by the end of 2022 compared to 2021 for France, Italy and Germany, respectively. Forecasting allows practitioners to plan for growing demand for particular treatments, consider taking continuing education, specifically, aligner certification courses, or introduce modern scanning technology into offices. The oral health community can use similar prediction tools and methods to remain alert to future changes in patient demand to improve the responses of professional organizations as a whole, work more effectively with governments if needed, and provide better coordination of care for patients.

Oral Health and Teledentistry Interest during the COVID-19 Pandemic.

BACKGROUND: The COVID-19 pandemic outbreak has significantly changed access to dental treatments. METHODS: The data related to oral health and teledentistry topics were collected from the open database Google Trends. The analyzed material was collected from 19 June 2016 to 6 June 2021 among anonymous search engine users. The following expressions were analyzed: "dental care", "emergency dental care", "oral health", "periodontitis", "teledentistry", "is it safe to go to the dentist", and "COVID-19" and "PPE dentist". RESULTS: During the first lockdown in 2020, a significant increase in "emergency dental care" phrase queries was detected, with a simultaneous decrease in regular "dental care" questions, as well as a peak in the queries for "periodontitis" preceded by lower interest in "oral health." The number of searches stated for "teledentistry" increased during the time of the pandemic 5 times and for and "PPE dentist" 30 times. The risk of visiting the dental studio was seen in almost 40 times increase in the query "is it safe to go to the dentist." CONCLUSIONS: The COVID-19 imprinted a stigma on oral health care. In this difficult epidemiological situation, teledentistry might become a helpful solution.

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The Implications of the COVID-19 Pandemic on the Interest in Orthodontic Treatment and Perspectives for the Future. Real-Time Surveillance Using Google Trends.

BACKGROUND: The COVID-19 pandemic outbreak may have a large impact on orthodontic treatment. Regular orthodontic visits were strongly and widely interrupted by the unprecedented epidemiological threat. METHODS: The data regarding orthodontic queries were investigated in a real-time surveillance using Google Trends. Search terms "braces", "invisalign", "get braces", "get braces off", "braces pain" and the phrase "social distancing" were analyzed regarding the year preceding the pandemic outbreak and the time of the pandemic. Moreover, the five-year trend for queries "braces" vs. "invisalign", as an example of different types of orthodontic appliances, was compared. RESULTS: There was a significant decrease in orthodontics phrase queries in the spring of 2020, connected with the worldwide restrictions and lockdowns announced all over the world. There was a lower interest in the "braces pain" query during the first lockdown in 2020. The number of searches for "invisalign" increased steadily over time, while the number of searches for "braces" was relatively stable across the investigated time period. CONCLUSIONS: The course of the COVID-19 pandemic has had a large impact on the orthodontic-related search queries. Orthodontists must be better-prepared for any sudden changes in the possible future in the epidemiological situation that may change accessibility to dental offices.

Electromyographic activity analysis of temporal and masseter muscles in psychoactive substance addicts. / Elektromiograficzna analiza czynnosci miesni zwaczy i skroniowych u osób uzaleznionych od substancji psychoaktywnych.

OBJECTIVES: As part of this study, a comparative analysis of the temporal and masseter muscle electrical activity at rest and during mandible excursion positions (protrusion, laterotrusion and maximal occlusion) was performed among patients aged 21 to 68 years. METHODS: Each of three groups: opioid addicts, alcohol addicts and the control group - consisted of 30 individuals (90 individuals in total, including 37 females and 53 males). Electrodes were placed on the masseter venters and mandibular movements were executed: right/left lateral, protrusion, intercuspation, rest and MVC. Then the same routine was applied to the anterior parts of temporal muscles. RESULTS: Based on EMG data in alcohol addicts, higher electrical activity of masseters and temporal muscles was observed during the mandible excursions, compared to the control group. In comparison of opiate addicts to healthy controls, no statistical significance was observed in electrical activity of masseter and temporal muscles. CONCLUSIONS: On the basis of the conducted research, a conclusion can be drawn that alcohol addiction significantly affects the function of the largest muscles of the stomatognathic system.

Surface Electromyography as a Method for Diagnosing Muscle Function in Patients with Congenital Maxillofacial Abnormalities.

Electromyography (EMG) is the most objective and reliable method available for imaging muscle function and efficiency, which is done by identifying their electrical potentials. In global surface electromyography (sEMG), surface electrodes are located on the surface of the skin, and it detects superimposed motor unit action potentials from many muscle fibers. sEMG is widely used in orthodontics and maxillofacial orthopaedics to diagnose and treat temporomandibular disorders (TMD) in patients, assess stomatognathic system dysfunctions in patients with malocclusions, and monitor orthodontic therapies. Information regarding muscle sEMG activity in subjects with congenital maxillofacial abnormalities is limited. For this reason, the aim of this review is to discuss the usefulness of surface electromyography as a method for diagnosing muscle function in patients with congenital malformations of the maxillofacial region. Original papers on this subject, published in English between 1995 until 2020, are located in the MEDLINE/PubMed database.