Orthodontic Elastics: A Multivariable Analysis of YouTubeTM Videos.

Background/Purpose: Whether YouTube videos contain precise and adequate information on certain orthodontic procedures remains unclear. This study aimed to investigate the content and quality of YouTube videos on orthodontic elastics and identify the predictors of high-level content YouTube videos. Materials and Methods: Two hundred YouTube videos were screened for eligibility, and after applying the inclusion criteria, 133 videos were excluded. Student's t-test was used to compare the characteristics, quality parameters, and total content of the low-level and high-level content videos. Chi-square or Fisher's exact tests were implemented to identify the source and content element differences across low-level and high-level content videos. Pearson's correlation coefficients were used to determine the relationship between the total content score, video information and quality index (VIQI), and YouTube characteristics. Stepwise linear multiple regressions with forward selection were used to test the association of the YouTube characteristics and VIQI with the total content score. Results: Among 67 included videos, only 19.4% of videos were classified as high-level content videos. High-level content videos had significantly higher mean number of likes (MD = 4041.7; SD = 4680.7; P-value=0.0068), VIQI score (MD = 4.17; SD = 4.87; P-value=0.0073), and total content score (MD = 4.04; SD = 1.23; P-value=<0.0001). The adjusted linear regression model demonstrated a significant association between the total content score and VIQI, where 1 unit increase in the VIQI was significantly associated with a 0.16 increase in the total content score (B = 0.16; standard error [SE]=0.04; P = 0.0003). Further, a significant association was observed between the total content score and video duration, where 1 minute increase in the video duration was significantly associated with a 0.15 increase in the total content score (B = 0.15; SE = 0.05; P = 0.008). Conclusion: This study demonstrated that YouTube content quality concerning orthodontic elastics is poor. Thus, future implementation of online visual content provided by certified orthodontists will ensure accurate and thorough information delivery.

Effect of Occlusal Splint Therapy on Condylar Movements Recorded Using an Electronic Pantograph: A Prospective Clinical Study.

Aims and Objective: The effect of occlusal splint therapy on the muscle activity has been addressed in the literature. However, its effect on condylar movements in subjects with normal and abnormal occlusions has not yet been investigated. This prospective clinical study addressed the effect of occlusal splint therapy on condylar movements in subjects with normal and abnormal occlusions using an electronic pantograph. Materials and Methods: Two groups of subjects were included in this study. The first group included subjects with normal occlusion, whereas the subjects in the other group were diagnosed with abnormal occlusion. The occlusal splint was fabricated, adjusted clinically, and delivered for each subject. Condylar movements were recorded using a Cadiax Compact II electronic pantograph at baseline, 2-, 4-, and 6-month follow-up periods to assess sagittal condylar inclination (SCI), immediate mandibular lateral translation (IMLT), and progressive mandibular lateral translation (PMLT). The t-test, one-way analysis of variance (ANOVA), and two-way ANOVA were used to compare the parameters between the groups and to assess the time effect on these parameters (α = 0.05). Results: Twenty subjects were recruited for this study (n = 10). Among them, 12 were women and eight were men, with a mean age of 34 years. In each group, insignificant differences were reported for each tested parameter at baseline and during the follow-up periods (P > 0.05). However, when comparing the two groups, the only significant difference was found in the SCI during the 6-month follow-up period (P = 0.014). Conclusions: Occlusal splints had an insignificant effect on the parameters SCI, IMLT, and PMLT up to 6 months of follow-up for subjects with normal or abnormal occlusion. SCI increased substantially in normal occlusion subjects compared with abnormal occlusion subjects during the 6-month follow-up period.

Treatment of bisphosphonate induced osteonecrosis of jaw in rats using an angiogenesis factor (A-Heal) and ABMDO (Autologous Bone Marrow Derived Osteoblasts).

BACKGROUND AND OBJECTIVE: The aims of this study were to create Bisphonates Related Osteonecrosis of the Jaw (BRONJ) in rats and treat them with an angiogenesis factor (A-Heal) and ABMDO (Autologous Bone Marrow Derived Osteoblasts). MATERIALS AND METHODS: Thirty female Wistar rats were procured. Rats were labeled as Group I to III. Group I = Osteoblast group, Group II = A-Heal and Group III Control group. In Groups I-III, BRONJ was created and treated in Group I with ABMDO, Group II with A-Heal and Group III was the control group. At the end of the four weeks post treatment, all the animals were humanely killed. The intact maxillae were removed in total. Histopathological and radiological examinations were carried out with physicians blinded to the groups. RESULTS: Computerized tomography revealed that Groups I and II demonstrated the presence of dense osteosclerosis, intralesional calcifications, and adequate healing of the overlying soft tissues compared to Group III, which showed the presence of bone erosions at the alveolar ridge with a lack of intralesional calcifications and ulceration of the overlying soft tissues. Histologically, H&E staining Group 1 and Group 2 both showed marked reactive bone formation. Group 2 additionally revealed the most prominent vascular proliferation (also highlighted by Factor VIII, an endothelial cell marker) among all groups. Group 3 showed cartilaginous proliferation with less reactive bone formation, implicating decreased endochondral ossification compared to Groups 1 and 2. CONCLUSION: This study shows that angiogenesis factor (A-Heal) and ABMDO were successful in the treatment of experimentally created BRONJ in an animal model.

Exome array identifies functional exonic biomarkers for pediatric dental caries.

BACKGROUND: Pediatric dental caries is common among Arab children, however we are still searching for possible genes and molecular mechanisms that influence caries development. AIM: To identity genetic predispositions of dental caries among Saudi children with high DMFT (Decayed, Missing, and Filled Teeth). DESIGN: This case-control study analysed putative functional exonic-variants (n = 243,345) to study the molecular genetics of pediatric caries with high dmft index, 8.75 ± 4.16 on Arab-ancestry subjects with primary dentition (n = 111; 76 cases, dmft>5 and 35 controls, dmft = 0). RESULTS: Pediatric caries is significantly associated with single nucleotide polymorphisms (SNP) in the GRIN2B-rs4764039C (p-value = 2.03 × 10-08) and CFH-rs1065489G (p-value = 8.26 × 10-08) genes, even after Bonferroni correction. Irregular tooth brushing habits (p = 0.0404) and irregular dental visits (p = 0.0050) are significantly associated with caries. Functional enrichment analysis of significant genes is associated with calcium-activated chloride channel, Staphylococcus aureus infection, and N-linked glycosylation. CONCLUSION: Genetic predispositions are found to be significantly associated with the high prevalence of pediatric caries, which is a disorder of multigene-environment interaction. The significant functional exonic variants identified can be biomarkers for the early diagnosis of pediatric dental caries in Arabs.

An Evaluation of Microbial Flora, Alkaline Phosphatase and IL-8 Levels in GCF of Orthodontic Patients with Self-Ligating and Conventional Brackets.

PURPOSE: To compare the microbial flora, alkaline phosphatase (ALP) and interleukin-8 (IL-8) levels during orthodontic treatment with self-ligating brackets versus conventional brackets. PATIENTS AND METHODS: Forty patients were included in this study and distributed equally between two groups. One group received conventional edgewise brackets while the other group received DAMON self-ligating brackets. Periodontal parameters were recorded and biochemical and microbial analyses were conducted before bonding (baseline), and 14, 30, and 45 days after bonding. Paired t-test was performed to estimate the intergroup differences from the baseline at the various time points; unpaired t-test was used for intragroup comparisons. RESULTS: A significantly higher prevalence of gram-negative as well as gram-positive microorganisms was found in the group with conventional brackets than that with self-ligating brackets. Alkaline phosphatase (ALP) activity and interleukin-8 (IL-8) levels were significantly higher in the gingival crevicular fluid of the group with conventional brackets than that with self-ligating brackets. CONCLUSION: The conventional bracket-ligature technique exhibited an increase in IL-8 levels, ALP activity, and microbial colonization compared with that of the self-ligature technique. Accordingly, self-ligating brackets are recommended in orthodontic patients to improve periodontal health and minimize damage outcomes of periodontal tissue interventions.

Effect of Steam Heat Sterilization on the Accuracy of 3D Printed Surgical Guides.

INTRODUCTION: Steam heat sterilization could be one of the factors that affects the dimensional accuracy of surgical guides, leading to an error during guided implant surgery. OBJECTIVE: The purpose of this study was to investigate the effect of steam heat sterilization on the dimensional changes of surgical guides. MATERIALS AND METHODS: A total of 27 surgical guides, which were made by either Formlabs printer (Formlabs Inc., Somerville, MA) or Simplant (DENTSPLY Implants NV, Hasselt, Belgium), were scanned using an intraoral scanner before and after sterilization. The dimensional changes at the center of the implant sleeves were analyzed using the computer-aided design interactive software for 65 implant sites before and after steam heat sterilization at 121°C for 20 minutes. RESULTS: There was no significant difference between the mean x, y, and z axes of the center of the sleeves when measured before and after sterilization (P values were 0.37, 0.24, and 0.29, respectively). Nonparametric analysis showed no significant difference between the mean deviations of either surgical guide (P = 0.908). CONCLUSION: Steam heat sterilization has a nonsignificant effect on the dimensional changes of the tested surgical guides.

Pain perception among patients treated with passive self-ligating fixed appliances and Invisalign® aligners during the first week of orthodontic treatment.

OBJECTIVE: This study was performed to compare the perception of pain between patients treated with passive self-ligating fixed appliances and those treated with Invisalign aligners. METHODS: This prospective study conducted in Saudi Arabia used an estimated sample of 64 patients from a private dental clinic. After obtaining written informed consent, the patients were divided into two groups; one group (n = 32) was treated using passive self-ligating fixed appliances and the other group (n = 32) using Invisalign® aligners. Immediately after fitting the appliances, the patients' perception of pain was evaluated through a close-ended and coded self-administrated questionnaire by using a visual analog scale (VAS). Their responses were recorded at 4 hours, 24 hours, day 3, and day 7. Mann-Whitney U-test, Kruskal-Wallis test, and Pearson's chi-square test were performed for statistical analysis. RESULTS: A lower percentage of patients treated with Invisalign aligners reported pain than did patients treated with passive self-ligating fixed appliances, and these differences were statistically significant (p = 0.001). Similarly, the mean VAS score for the Invisalign group was significantly lower than that for the passive self-ligating fixed appliance group at different intervals during the first week of treatment. The intensity of pain with both appliances peaked at 24 hours (mean VAS score, 3.87) and was lowest (mean VAS score, 1.62) on day 7. CONCLUSIONS: During the first week of orthodontic treatment, patients treated with Invisalign aligners reported lower pain than did those treated with passive self-ligating fixed appliances.

Patient Satisfaction with Orthodontic Treatment Received in Public and Private Hospitals in Dammam, Saudi Arabia.

BACKGROUND: The demand for orthodontic treatment is on the rise, and there are high patient expectations for improved dentofacial appearance. Patient satisfaction with orthodontic treatment is associated with improving treatment outcomes. OBJECTIVE: To evaluate patient satisfaction with orthodontic treatment received in public and private hospitals. MATERIAL AND METHODS: This cross-sectional study was conducted on a calculated sample of patients who received orthodontic treatment in public and private hospitals in Dammam, Saudi Arabia. A validated questionnaire (five-point Likert scale) was used to assess patient satisfaction with orthodontic treatment. RESULTS: A total of 229 out of 243 patients completed the survey (response rate = 94.2%). The mean age of the participants was 22.69 ± 6.34 years. More females (65.5%) than males (34.5%) participated in the study. The participants gave the highest satisfaction score to the doctor-patient relationship (mean score 4.33). This was followed by dentofacial improvement (mean score 4.23), dental functions (mean score 4.20), and psychosocial improvement (mean score 3.94). The participants provided significantly more positive perspective about doctor-patient relationship in public than private hospitals (P = 0.014). The patients treated in private hospitals were more satisfied with dental functions domain than those who received treatment in public hospitals (P = 0.023). The patients treated by public orthodontists were significantly more satisfied with other domains (situational aspect and residual category) than by the private orthodontists. CONCLUSION: The doctor-patient relationship was the most important factor in satisfaction with orthodontic treatment. Overall, patients treated in public hospitals were more satisfied with orthodontic treatment than those in private hospitals.

Malocclusion and Craniofacial Characteristics in Saudi Adolescents with Sickle Cell Disease.

BACKGROUND: Sickle cell disease can result in dentofacial abnormalities. However, in Saudi Arabia, there are limited data with respect to orthodontic manifestations in patients with sickle cell disease. OBJECTIVE: To determine the malocclusion and craniofacial characteristics in sickle cell disease adolescents and compare them with that of controls from the Eastern Province of Saudi Arabia. METHODS: This comparative cross-sectional study included 112 Saudi patients with sickle cell disease, aged 12-18 years, and 124 age-matched Saudi controls from three major hospitals in Al Khobar and Dammam, Saudi Arabia. The Dental Aesthetic Index was used to assess malocclusion and orthodontic treatment needs. Digital lateral cephalometric radiographs were recorded for each patient and control, and its analysis included linear and angular measurements. RESULTS: The prevalence of malocclusion was 87.5% in sickle cell disease patients and 54% in controls (P = 0.0001). The percentage of sickle cell disease patients with severe malocclusion that required orthodontic treatment was higher than that of controls (37.5% vs. 26.6%). In the sickle cell disease cohort, incisal segment crowding (72.4%), overjet (67.3%) and maxillary misalignment in the anterior segment (56%) were the most prevalent types of malocclusions and were significantly higher than that of controls (P < 0.05). About 38% and 67% of the sickle cell disease patients had openbite and posterior crossbite, respectively, compared with 19.3% (P = 0.001) and 37.1% (P = 0.0001) of controls, respectively. Cephalometric analysis showed that SNA (86.7°) and ANB (9.9°) angles were significantly higher in sickle cell disease patients than in controls (81.5° and 2°, respectively). In addition, lower central incisor-to-Frankfort horizontal plane (55°) and interincisal angles (121.5°) were significantly lower in sickle cell disease patients than in controls. CONCLUSION: Adolescents with sickle cell disease had a higher prevalence of malocclusion and greater orthodontic treatment needs than controls. Similarly, they had greater incisal crowding, overjet, openbite and posterior crossbite and demonstrated higher SNA, ANB and lower interincisal angles than controls. The findings of this study suggest that adolescents with sickle cell disease should be provided frequent dental examinations and early orthodontic treatment to improve their oral health, and thus quality of life.

Extraction of primary canines for interceptive orthodontic treatment of palatally displaced permanent canines: A systematic review.

OBJECTIVE: To determine whether the successful management of palatally displaced permanent canines (PDCs) can be achieved by the interceptive extraction of primary maxillary canines. MATERIALS AND METHODS: Digital databases (Medline, Scopus, Web of Science, and Cochrane) were searched to retrieve articles published from 1952 to April 2016. The university librarian developed search strategies for each database. Two calibrated reviewers independently reviewed potentially related titles and abstracts. Papers meeting the inclusion and exclusion criteria were read in full. The selected articles were evaluated and scored according to methodological quality criteria. RESULTS: Four randomized clinical trials (RCTs) were included in the systematic review. Compared with two older studies, two more recent RCTs were found to have better study designs, were better conducted, and involved better reporting of the results. The included studies compared intervention groups (children with PDCs undergoing extraction of primary canines) with controls (subjects with PDCs but no primary canine extractions). In three of the four studies, the interceptive extraction of primary canines facilitated eruption of PDCs in more than 65% of cases. Overall, the intervention groups had a markedly higher incidence of successful eruption of PDCs (50%-69%) compared with the control groups (36%-42%). CONCLUSIONS: Based on the available evidence, it is reasonable to conclude that eruption of PDCs can be facilitated by extraction of primary canines. However, further high-quality, randomized clinical trials are warranted in other population groups. It is hoped that this study will help orthodontists make evidence-based decisions about clinically managing PDCs.

Alveolar bone density and its clinical implication in the placement of dental implants and orthodontic mini-implants.

OBJECTIVES: To assess the bone density in maxilla and mandible in dentate and edentulous patients in Saudi population. METHODS: This study involved a retrospective analysis of cone beam CT images of 100 patients (50 male and 50 female) who have come to College of Dentistry, University of Dammam, Dammam, Kingdom of Saudi Arabia between January 2014 and 2015. Using the bone density option in the Simplant software, the Hounsfield unit (HU) was calculated at the edentulous sites. While for dentate sites, a region of interest was selected coronally at 3-5 mm to the root apex using I-CAT vision software. The densities of the buccal bone and cancellous bone were measured at interradicular areas of a specific teeth.  RESULTS: The highest bone density at the edentulous sites was at the mandibular anterior region (776.5 ± 65.7 HU), followed by the mandibular posterior region (502.2 ± 224.2 HU). Regarding the dentate sites, the highest bone density was at the buccal cortical plate of the lower incisor teeth (937.56 ± 176.92 HU) and the lowest bone density was at the cancellous bone around the posterior maxillary teeth (247.12 ± 46.75 HU).  CONCLUSION: The alveolar bone density at dentate and edentulous sites in our population is generally lower than the norm reference density of other populations, which dictates the need for quantitative assessment of bone density before implants and mini-implants placement.

Parametric Simulations of Slanted 1D Photonic Crystal Sensors.

Photonic crystals and band gap materials act as manipulators of light and have a plethora of applications. They are made up of stacks of alternating dielectric constants. This article shows the simulations of an inclined, one dimensional and tuneble photonic crystal, using numerical finite element methods. The photonic crystal was made up of silver nanoparticles embedded in a hydrogel matrix and it has the ability to change and recover its periodicity. A series of factors concerning the geometry of the lattice were tested in order to analyze the efficiency, performance and optimize the properties of the optical sensor. These factors range from the size of the nanoparticles and their density within the stacks, to observing the effect of diffraction angle in readouts.

Little's irregularity index: photographic assessment vs study model assessment.

INTRODUCTION: The aim of this study was to investigate whether photographic images are accurate and reliable to assess Little's irregularity index (LII) compared with study model measurements. METHODS: Ten plastic models with different levels of incisor irregularity were photographed occlusally at 9 angulations ranging from 70° to 110° on 3 occasions. Clinical occlusal photographs and study models of 72 dental arches were selected from 16 patients participating in a study of incisor alignment. LII was measured from the models by using digital calipers and from the digital images with ImageJ software (Rasband WS, National Institutes of Health, Bethesda, Md; http://rsb.info.nih.gov/ij/, 1997-2006). RESULTS: Photographs of the plastic models and the direct measurements of the models showed high levels of reliability and repeatability (intraclass correlation coefficients [ICC], 0.999 and 0.983). Validity was shown by the limits of agreement between the plastic models and the photographs at 90°, 70°, and 110°, which were -0.2621 to 0.9547, -0.1961 to 1.3205, and -0.7399 to 2.0405, respectively, and the ICC were 0.993, 0.983, and 0.969, respectively. The intraexaminer and interexaminer ICC for the clinical photographs were 0.997 and 0.987, and intraexaminer agreement for the study models was 0.995. The limits of agreement and the ICC between the photographic method and study model method were -1.9656 to 1.2861 and 0.986. CONCLUSIONS: LII can be measured from photographs with good reliability and repeatability. The limits of agreement indicate that, for the mean value of a group of subjects, the photographic method is valid, but care is needed in interpreting an individual measurement.