Orthodontists on Social Media: Instagram's Influence.

Objective: The aim of this study was to determine how orthodontists utilize the social media application Instagram for health communication. Methods: Four Turkish keywords were manually searched on the Instagram platform on February 12, 2022: "orthodontist" (ortodontist), "orthodontics" (ortodonti), "orthodontic specialist" (ortodonti uzmani), and "doctor of orthodontist" (ortodonti doktoru). A total of 195 orthodontist accounts matching the inclusion criteria were divided into two groups: public and private. Profile information analyses were performed, and the results for public and private accounts were compared. Public accounts were further divided by gender and whether they shared a company name in their profiles. Groups were compared according to post content and type of patient photo. Statistical analysis involved the Shapiro-Wilk test, an Independent Samples t-test, the Mann-Whitney U test, and chi-square and Kappa tests. Results: The number of posts (96.06±149.30 vs. 195.36±248.51) and followers (1,250.56±2,347.47 vs. 4,071.43±6,557.63) were higher for public accounts. The number of followers (3,171.62±4,645.08 vs. 5,472.57±8,595.99) and daily posts (0.17±0.37 vs. 0.23±0.43) were higher for accounts with a company name. In the content analysis, posts on clear aligners (1.51±4.74 vs. 6.60±18.60, p<0.05) and patient and company advertisements were more common (0.49±1.85 vs. 3.70±10.70, p<0.05) for accounts with a company name. Conclusion: While public orthodontist accounts commonly promote fixed mechanics as a treatment option, accounts with a company name adopt a different approach, emphasizing the sharing of information about clear aligners.

Retrospective comparison of two different miniscrew-supported molar distalization methods applied in the buccal and palatal regions.

BACKGROUND: To compare dentofacial effects of distalization with miniscrew-supported pendulum and infrazygomatic crest miniscrews. METHODS: The study included 36 patients whose lateral cephalometric radiographs were obtained before (T0) and after (T1) distalization. Patients were divided into two groups according to the treatment methods: 1) distalization with miniscrew-supported pendulum (MSP) (n = 19; 14 girls and 5 boys; mean age 16.9 ± 1.46 years) and 2) distalization with infrazygomatic crest (IZC) miniscrews (n = 17; 8 girls and 9 boys; mean age 17.0 ± 1.68 years). Dental, skeletal and soft tissue measurements were performed on lateral cephalograms taken from individuals. RESULTS: A significant molar distalization was achieved both in the MSP group (3.52 ± 0.76 mm at 8.71 ± 2.02 months) and the IZC group (3.5 ± 0.74 mm at 9.7 ± 2.5 months) (P < 0.001 for both). Premolar distalization was significantly lower in the MSP group (1.73 ± 1.09 mm) than in the IZC group (2.81 ± 0.79 mm) (P < 0.01). Significant molar tipping was observed in both groups (P < 0.001), while no significant difference was found between the groups (P > 0.05). Retrusion of maxillary incisors were significantly higher in the IZC group (2.75 mm) than in the MSP group (0.98 mm) (P < 0.01). A significant difference was found between the two groups with regard to the changes in overjet and overbite (P < 0.05). CONCLUSIONS: Both distalization methods were found to be effective in achieving a Class I molar relationship in patients with Class II malocclusion.

Conventional Twin-Block Versus Cervical Headgear and Twin-Block Combination: Therapeutic Effects on the Craniofacial Structures in Growing Subjects.

Objective: To compare the short-term effects of the conventional twin-block (TB) appliance and the cervical headgear TB (CHG-TB) appliance on craniofacial structures. Methods: The retrospective controlled study examined lateral cephalograms taken from 46 growing subjects. Individuals were divided into two groups according to the treatment. Group I consisted of 15 individuals (9 girls, 6 boys, mean age: 12.34±1.23 years) treated with the TB appliance and Group II consisted of 16 individuals (9 girls, 7 boys) treated with the CHG-TB appliance (mean age: 12.50±1.30 years). To distinguish the treatment effects of these appliances on growth, a control group of 15 untreated individuals (9 girls, 6 boys, mean age: 11.82±1.16 years) was included from the archives. Results: Significant improvements were found in the interdental and maxillo-mandibular measurements in the treatment groups (p<0.001). Significant differences were observed in the SNA, SN/PP, and SN/GoGn values in the CHG-TB group compared to other groups (p<0.05). The mandible showed a significant downward movement in both treatment groups compared with the control group (p<0.001), while the change in SNB angle was statistically significant only in the TB group compared to the control group (p<0.05). Lower incisors showed significant proclination only in the TB group (p<0.05). Conclusion: The CHG-TB appliance was found to be more effective in limiting maxillary growth and preventing lower incisor proclination compared with the TB appliance, whereas the TB appliance was more effective in anterior mandibular movement.

Orthodontics in an online community: A computational analysis of r/Braces subreddit.

BACKROUND: This study aimed to analyze the semantic network and content analyses of the posts published in a subreddit related to orthodontic treatment on Reddit (Advance Publications, Inc., San Francisco, California). METHODS: The eight threads in the r/Braces subreddit were divided into two categories: 1) "treatment process" (Braces are off!!!, Braces progress, Before and after!, and Day 1!) and 2) "question/problem" (Question, Discussion!, Need advice! and Rant!). For both categories, a semantic network analysis was performed using the Leximancer software (Leximancer Pty Ltd., Brisbane, Australia). In addition, the quality of the posts published in the "question" thread and the usefulness of the replies provided to these questions (useful, misleading, or neutral) were analyzed. RESULTS: Seven themes (braces, teeth, months, day, worth, started, and result) that mostly emphasized orthodontic treatment and treatment duration were elicited from the "treatment process" category, and seven themes (teeth, orthodontist, braces, week, bands, brush, and extractions) that mostly emphasized orthodontic treatment, orthodontists, and time were elicited from the "question/problem" category. It was also revealed that users voted on the posts related to the "treatment process" category and moved the posts to the list of top posts on the platform. In the "question" thread, 47.79% of the posts asked for advice and 21.11% of them were related to failures. In addition, 69% of the replies were categorized as "useful." CONCLUSIONS: Reddit is a successful data mining platform, and the users provide highly useful replies to the questions posted on Reddit regarding orthodontic treatment.

Reverse Forsus vs. facemask/rapid palatal expansion appliances in growing subjects with mild class III malocclusions : A randomized controlled clinical study.

PURPOSE: To investigate the skeletal, dental, and soft tissue effects of reverse Forsus (RF; 3M Unitek, Monrovia, CA, USA) and facemask/rapid palatal expansion (FM/RPE) appliances in growing subjects with class III malocclusions. METHODS: The data of this prospective randomized controlled trial (RCT) were derived from pre- and posttreatment/observation lateral cephalograms of 45 subjects with mild class III malocclusions: group 1 (8 girls, 7 boys; mean age 10.54 years) received a FM/RPE appliance; group 2 (6 girls, 9 boys; mean age 10.49 years) received the RF appliance; and an untreated control group (7 girls, 8 boys; mean age 10.66 years) was matched to the treatment groups with regard to sagittal skeletal and dental classifications. Angular and linear measurements were evaluated using lateral cephalograms. Statistical analyses were performed by one-way analysis of variance, Kolmogorov-Smirnov test, Kruskal-Wallis, paired-samples t­test, and Wilcoxon test, whereby p < 0.05 was accepted to be statistically significant. RESULTS: The intermaxillary (ANB), interdental (overjet), and sagittal lip relations in the FM/RPE and RF groups showed significant improvements compared to the control group (p < 0.05). Although the anterior and inferior traction of the maxilla was greater in the FM/RPE group compared to the RF group (p < 0.05), both treatment groups showed similar clockwise rotation of the mandible compared to the control group. While significantly more proclination of maxillary incisors occurred in the RF group compared to the FM/RPE and control groups (p < 0.05), both treatments led to significantly retroclined mandibular incisors compared to the control group (p < 0.001). CONCLUSION: Both therapies led to intermaxillary and interdental improvements. The RF appliance had a limited effect on the maxilla and it mostly had dentoalveolar effects when compared to FM/RPE therapy.

Has the COVID-19 Pandemic Affected Orthodontists' Interest in Various Orthodontic Appliances?

Objective: To determine the changes in orthodontists' interest in various orthodontic appliances during the coronavirus disease-2019 (COVID-19) pandemic. Methods: A questionnaire probing respondents' interest in orthodontic appliances and techniques, including standard buccal metal brackets, self-ligating brackets, standard ceramic brackets, lingual brackets, clear aligners, orthodontic facemasks, removable functional appliances, fixed functional appliances, orthognathic surgery, orthodontic miniscrews, and lingual retainers, was prepared using Google Forms and then sent to the Turkish Orthodontic Society to invite all members of the society to participate in the survey. Of the 1903 members invited, 230 (response rate, 12.08%) orthodontists completed the questionnaire. Results: The respondents' interest in brackets did not change among 70% of the respondents (standard buccal metal bracket 80%, self-ligating bracket 72.2%, standard ceramic bracket 77%, and lingual bracket 76.5%). A significant difference was observed between the genders only about the interest in standard metal brackets and fixed functional appliances (p<0.05 for both). Interest in standard metal brackets decreased as respondents' work experience increased (p<0.05). The interest in self-ligating brackets was higher among respondents with 1-5 years of experience than among other respondents (p<0.05). Interest in self-ligating brackets increased more among lecturers and residents than among clinicians (p<0.05). Conclusion: The interest of orthodontists in clear aligners showed the highest increase during the COVID-19 pandemic among all orthodontic appliances, whereas their interest in other appliances, particularly standard buccal metal brackets, did not change.

Evaluation of Orthodontic Patients' Anxiety Levels During the COVID-19 Pandemic: A 1-Year Follow-Up.

OBJECTIVE: The aim of this study was to evaluate the anxiety levels of orthodontic patients during the 1-year period in the ongoing pandemic. METHODS: The study included patients between the ages of 12 and 30 years and who were continuing their fixed orthodontic treatment at Adiyaman University, Faculty of Dentistry, Department of Orthodontics and filled out the State-Trait Anxiety Inventory. A total of 266 patients filled out the questionnaire at their first clinical visit between June 8 and July 8, 2020 (T0) and 176 of 190 patients (response rate: 92.63%) that were still under treatment filled out the questionnaire for a second time between June 15 and July 16, 2021 (T1). RESULTS: In the total population, there was a significant decrease in the State-Trait Anxiety Inventory-S score (P < .05), while there was no significant change in the State-Trait Anxiety Inventory-T score (P > .05). Anxiety scores were significantly higher in women and individuals aged over 18 years at T0 (P < .05), whereas only the anxiety scores of individuals aged over 18 years were significantly higher in T1 than in individuals aged below 18 years (P < .05). The State-Trait Anxiety Inventory-S score showed a significant decrease at T1 compared to T0 for female patients (36.02 ± 11.32 vs. 38.82 ± 9.84) and patients aged under 18 years (34.26 ± 9.54 vs. 36.85 ± 9.26) (P < .05). CONCLUSION: The state anxiety levels of orthodontic patients decreased during the 1-year period of the pandemic, while there was no significant change in their trait anxiety levels.

Comparison of the short-term effects of tooth-bone-borne and tooth-borne rapid maxillary expansion in older adolescents.

PURPOSE: To compare the short-term effects of tooth-bone-borne and tooth-borne rapid maxillary expansion (RME) devices on dentofacial structures in older adolescents. METHODS: The retrospective study reviewed pre- and posttreatment lateral and posteroanterior cephalometric images and orthodontic model records of patients who underwent maxillary expansion. Two groups were formed, in which the same upper jaw expansion protocol was applied with two different maxillary expansion devices: the first group consisted of 15 individuals treated with tooth-bone-borne (hybrid) RME (HRME; 9 girls and 6 boys; mean age, 16.9 ± 0.42 years) and the second group consisted of 15 individuals treated with tooth-borne (conventional) RME (CRME; 8 girls and 7 boys; mean age, 16.74 ± 0.54 years). Cephalometric and orthodontic model measurements were conducted on the records taken before and after treatment. RESULTS: Significant skeletal and dental expansions were observed in both groups (p < 0.05). However, the increase in nasal width measurements in the HRME group (2.24 ± 0.61 mm) was significantly higher than the increase in the CRME group (1.12 ± 0.25 mm; p < 0.01). Buccal tipping of the premolars was significantly less in the HRME group (0.46 ± 0.35°) than in the CRME group (2.46 ± 0.63°; p < 0.01). The amount of tipping of the molars was higher in the HRME group (4.76 ± 0.88°) compared to the CRME group (2.9 ± 1.03°; p < 0.01). CONCLUSION: Although the HRME device increase the nasal width in older adolescents to a greater extent, more dental side effects were seen at the maxillary first molars.

YouTube as a source of information on adult orthodontics: a video analysis study.

BACKGROUND: The purpose of this study was to evaluate the content and quality of YouTube videos on the topic of adult orthodontics. METHODS: Four Turkish keywords were searched on YouTube: ``orthodontic treatment in older ages'' (ileri yaslarda ortodonti tedavisi); ``orthodontic treatment in adults'' (yetiskinlerde ortodonti tedavisi); ``braces treatment in older ages'' (ileri yaslarda video information and quality index dis teli tedavisi); and ``braces treatment in adults'' (yetiskinlerde dis teli tedavisi). A total of 184 videos, ranked according to their relevance, were examined; out of these, 52 videos on the topic of adult orthodontics were included in the study. The information content score (with a scoring system consisting of 6 questions), reliability score, (VIQI), interaction index, and viewing rate of the videos were evaluated. The Mann-Whitney U test, Student's t test, and Spearman correlation coefficients were used for statistical analysis. RESULTS: Explanations provided on all videos included in the study were given by orthodontists, to inform patients. The average content score of the videos was 2.55 ± 0.99 out of 6, and the reliability score was 3.07 ± 0.92 out of 5. The VIQI score was found to be 16.05 ± 2.76 out of 20. A total of 34 (65%) of the videos were scored as as having poor content, and 18 (35%) had rich content. Rich-content videos were observed to be significantly longer (P < 0.05) and have higher VIQI scores (P < 0.001). CONCLUSIONS: Although the information provided by YouTube videos about adult orthodontics was only moderately sufficient, this study found that YouTube is a reliable source of information.

Incidence of orthodontic appliance failures during the COVID-19 lockdown period.

INTRODUCTION: As a result of the rapid spread of the disease caused by severe acute respiratory syndrome coronavirus 2, the World Health Organization declared a global pandemic on March 11, 2020. Governments worldwide adopted various measures to stop or slow the spread of coronavirus disease 2019 (COVID-19). One widely used measure was lockdown; workers who could work from home were instructed to do so, and nonessential businesses-including dental clinics-were closed for weeks or months. The purpose of this investigation was to document the incidence of fixed orthodontic appliance failures and the periodontal health status of patients undergoing fixed orthodontic treatment during and after the lockdown period. METHODS: The sample comprised 350 orthodontic patients (mean age, 16.85 ± 2.59 years; 249 female, 101 male) who underwent orthodontic and periodontal examinations in Adiyaman, Turkey, after a mean lockdown period of 103.7 ± 21.3 days. Frequencies of an orthodontic bracket, elastic ligature, molar band, and miniscrew failures of oral ulcers were recorded, and periodontal parameters were assessed. The effects of sex, age, and the bracket systems used in the patients on the frequencies of these failures were analyzed. RESULTS: It was revealed that 15.42% (n = 54) of all patients had ≥1 bracket bonding failure, and 8.16% (n = 4) of the patients with miniscrew implantation had ≥1 miniscrew failure. The incidence of bracket bonding failure was significantly higher in men than in women. No significant relationship was found between periodontal parameters and bracket bonding failure. Plaque and gingival scores were higher than those reported for a similar population before a lockdown. CONCLUSIONS: The results indicated that orthodontic appliances might have higher frequencies of failure during a lockdown than normal times, and lockdown periods may worsen the periodontal health status of the patients.

20-Year Change in the Perception of Orthodontic Treatment: A Cross-Sectional Study.

OBJECTIVE: To compare the changes in the perception towards orthodontics between the first and second decades over the 20-year period based on a collaborative hypertext dictionary site. METHODS: The orthodontics-related entries were searched on the EksiSozluk website (http://www.eksisozluk.com). The keyword was determined as "dis teli" ("brace") and a total of 1,028 entries that were contributed between 2001 and 2021 were analyzed. Entries were divided into five general categories based on their content: definition, asking for advice, humor, advertising, and transfer of experience. The transfer of experience category was further divided into four subcategories: procedure, motivation, advice, and complaint. For each entry, the attitude of the contributor was also noted. Entries were compared between the two decades with regard to content and attitude towards orthodontics. RESULTS: The average number of entries contributed per year was 13.40 ± 10.58 in the first decade and was 89.40 ± 44.67 in the second decade, the increase was statistically significant (P < .05). A significant difference was observed between the two decades in terms of content (P < .05). There was a proportional decrease in the definition and an increase in the transfer of experience. Moreover, the rate of entries containing a complaint decreased and motivation increased in the second decade (P < .05). On the other hand, there was also a significant change between the two decades with regard to the distribution of attitudes, whereby the rate of positive entries increased in the second decade (P < .05). CONCLUSION: The contributors' attitudes towards orthodontics shifted from negative in the first decade to positive in the second decade.

Effects of the COVID-19 pandemic on new patient visits for orthodontic treatment: A comparison of 2020 and the previous 3 years.

BACKGROUND: Coronavirus disease (COVID-19) has led to unprecedented challenges in the arts, sports, education, finance, and healthcare. The aim of this study was to compare demographic characteristics of new-patient visits for orthodontic treatment in the pandemic year (2020) versus previous years. METHODS: The retrospective study included patients who sought care at a tertiary orthodontic referral center between January 1, 2016 and December 31, 2020. Clinical and demographic characteristics, including age, age group (child, young adult, adult), gender, and numbers of monthly and annual new-patient visits were compared between the pre-pandemic (2017-2020) and post-pandemic (2020) periods. The daily average numbers of appointments were compared for 2019 versus 2020. RESULTS: The average number of monthly new-patient visits was 240.69 ± 81.48 in the pre-pandemic period, as opposed to 113.75 ± 88.89 in the year 2020 (P < 0.001). The average number of monthly new-patient visits decreased by 48.3% in 2020 compared to 2019, while the average number of daily new-patient visits in 2020 decreased significantly in all months (P < 0.05), except for January (P = 0.613) compared to the monthly numbers from the previous year. No significant difference was found between the pre-pandemic period and 2020 with regard to gender (P = 0.410). In all years, the numbers of new-patient visits were higher for women, compared with men, and for children, compared with adults. CONCLUSIONS: The results indicated a sharp decrease in the number of new-patient visits for orthodontic treatment in the pandemic year (2020) compared to previous years.

Evaluation of effects of a modified asymmetric rapid maxillary expansion appliance on the upper airway volume by cone beam computed tomography.

BACKGROUND/PURPOSE: The rapid maxillary expansion is accepted as the gold standard for the treatment of unilateral posterior crossbite in growing children. This study used cone beam computed tomography (CBCT) to evaluate the effects of a modified asymmetric rapid maxillary expansion (ARME) appliance on the upper airway volumes. MATERIALS AND METHODS: A modified ARME appliance was used on 12 adolescent male patients (mean age: 13.92 ±â€¯0.82 years) with a class I skeletal relationship and posterior unilateral crossbite. Lateral cephalometric measurements and upper airway volume were evaluated using CBCT images. The posterior airway volumes of the oropharyngeal and nasopharyngeal airways were measured. RESULTS: Cephalometric measurements showed significant (P < 0.05) posterior rotation of the mandible. There was no significant movement of the maxilla according to the cranial base on the sagittal plane. Nasopharyngeal and oropharyngeal airway volumes increased significantly (P < 0.05). CONCLUSION: The results of this study demonstrate that treatment with the modified ARME has no significant effect on the maxilla but may increase the upper airway volume.

First Clinical Appointment after the COVID-19 Lockdown: Reflections from Orthodontic Patients and Their Anxiety Levels.

OBJECTIVE: To evaluate the views and anxiety levels of orthodontic patients during the first clinical appointment after the coronavirus disease 2019 (COVID-19) lockdown. METHODS: Data were collected using a questionnaire that was administered to patients aged over 14 years who resumed their scheduled orthodontic treatment at Adiyaman University, Faculty of Dentistry, Department of Orthodontics during the normalization period after the COVID-19 lockdown. Anxiety levels of the participants were assessed using the State-Trait Anxiety Inventory (STAI). RESULTS: The study included 241 participants, comprising 177 (73.4%) women and 64 (26.5%) men with a mean age of 17.73 ± 3.27 years. Anxiety levels were significantly higher in women (State-trait index-State anxiety [STAI-S]: 39.26 ± 9.81, State-trait index-Trait anxiety [STAI-T]: 43.53 ± 9.16) than in men (STAI-S: 34.32 ± 10.12, STAI-T: 38.5 ± 7.87) (P < .01). No significant relationship was found between the presence of chronic diseases and anxiety levels (P > .05), while a positive correlation was found between age and trait anxiety (P = .041). Of all patients, 79.7% were positive about rescheduling their clinical appointment. Participants with higher anxiety levels indicated that they considered dental clinics as risky environments for the spread of COVID-19 infection (P < .01) and thus wanted to resume their treatment once the pandemic had ended (P < .05). CONCLUSION: The results indicate that patients receiving fixed orthodontic treatment were anxious in the clinic.

Management of Medially Displaced Sub-Condylar Mandibular Fractures in Pediatric Population Using Novel Atraumatic Approach.

ABSTRACT: The appropriate treatment of pediatric mandibular condyle fractures is subject to much debate and concern among surgeons, with improper treatment potentially resulting in a number of adverse outcomes. Such outcomes include the disruption of mandible growth, decreased posterior facial height, facial asymmetry, and temporomandibular joint ankylosis. Several surgical and nonsurgical approaches to these fractures have been described in the literature; however, each one carries its own risk of various complications. In this study, the authors illustrate a new atraumatic approach for mild to moderately displaced subcondylar fractures, with least possible complications and unexpected outcomes. In this study, 6 patients (2 female and 4 male) with unilateral medially displaced condylar base and neck fractures, angulated between 30 and 45 degrees, were treated using a novel intraoral approach. The follow-up period varied from 12 to 18 months. All patients achieved normal occlusion and had painless functioning of the temporomandibular joint with proper mouth opening (>35 mm) without any recurrence at long term follow up. This minimally invasive approach could eliminate the possibility of major complications and be considered a safe and feasible surgical technique for certain cases of pediatric mandibular condyle fracture.

The Effects of Using Plaque-Disclosing Tablets on the Removal of Plaque and Gingival Status of Orthodontic Patients.

OBJECTIVE: The aim of this study was to investigate the effects of using plaque-disclosing tablets (PDTs) on the plaque and gingival index scores of patients wearing fixed orthodontic appliances. METHODS: In group A (n=16), the subjects were motivated by conventional oral hygiene instructions, including verbal information about tooth brushing. The patients in group B (n=17) were motivated using PDTs used in the dentists' office to show the locations of biofilms in addition to the instructions given to group A. Both the chairside demonstration performed in group B and the at-home use of disclosing tablets were undertaken by those in group C (n=15). The periodontal parameters were recorded before applying the fixed appliance (T0) and after the first (T1) and third (T2) months. RESULTS: The plaque index (PI) scores of group C were significantly lower (p<0.05), when compared to groups A and B, after the first (T1) and third months (T2); however, no significant differences (p>0.05) were found between groups A and B. The gingival status of group C did not change significantly (p>0.05) over the three months and was statistically lower when compared to groups A and B. CONCLUSION: The use of PDTs at home may enhance the plaque removal efficiency and gingival health stability, by facilitating self-examination.