Comparison of Pain Levels on Patients Undergoing Fixed Orthodontic Treatment with 2 Different Self-Ligating Bracket Systems.

Objective: Comparison of pain levels of patients treated with 2 different passive self-ligating bracket systems right after initial archwire placement. Methods: A total of 34 patients with mild crowding were allocated randomly to 2 groups to be treated using 2 different self-ligating brackets. 0.014 inch copper nitinol and 0.014 inch superelastic nitinol archwires were selected as the initial archwire for Damon Q and SmartClip SL3 systems respectively. Seven page questionnaires that consisted of 3 visual analogue scales were handled to patients to mark their pain levels while chewing, biting with anterior teeth, and biting with posterior teeth at 2nd hour, 6th hour, 2nd day, 3rd day, and 7th day time intervals. Pain scores were measured manually using a ruler and noted. Results: The SmartClip group reported less pain at the 2nd and the 6th hours while chewing. Pain levels were the highest at the 6th h and the 2nd day for the Damon Q and SmartClip SL3 groups respectively. The SmartClip group reported more pain for the first two days, and after the 2nd day, pain scores were very similar to the Damon group. No statistically significant differences were reported between the groups. Conclusion: The highest pain sensation was reported for the 2nd day and decreased toward the 7th day. The SmartClip SL3 group reported lower pain scores in the first two days, but the levels were equaled on the 2nd day and after.

A comparison of treatment results of adult deep-bite cases treated with lingual and labial fixed appliances.

OBJECTIVES: To compare the cephalometric treatment results of adult deep-bite cases after labial and lingual fixed orthodontic treatment. MATERIALS AND METHODS: A total of 102 patients underwent lingual orthodontic treatment and complete records were evaluated. The following inclusion criteria were used: patients who had Angle Class I or mild Class II malocclusion; comprehensive orthodontic treatment that did not include intrusion mechanics or any extractions; patients with an initial overbite of more than 3.7 mm. Thirteen patients met the inclusion criteria. These cases were matched with the same number of patients according to age with a labial orthodontic treatment group. Pre- and post-treatment cephalometric radiographs were evaluated. Independent t test or Fisher exact tests were performed to assess the differences between the groups. RESULTS: Proclination of the upper incisors was higher in the labial group. Incisor mandibular plane angle (IMPA) showed an increase of 1.2° in the lingual group and 9.7° in the labial group. Lower incisor edge was approximately in a stable sagittal position in the lingual group but significant lower incisor proclination was seen in the labial group. The lower incisors were intruded (-1 mm) in the lingual group but lower incisors were minimally extruded (0.3 mm) in the labial group. No significant difference was found in the movements of upper and lower molars for both groups. CONCLUSIONS: The nature of lower incisor movement involved less protrusion in lingual orthodontics than the labial treatment. Lingual orthodontic treatment is a better option in adult cases where intrusion of lower incisors without labial tipping is desired.

Quantitative analysis of biofilm formation on labial and lingual bracket surfaces.

OBJECTIVES: To evaluate and compare the biofilm formation between labial and lingual orthodontic brackets. MATERIALS AND METHODS: Twenty patients with a mean age of 24 ± 8.8 who had received labial or lingual orthodontic treatment were enrolled in the study. Biofilm formation on 80 brackets was analyzed quantitatively with the Rutherford backscattering detection method. Five micrographs were obtained per bracket with views from the vestibule/lingual, mesial, distal, gingival, and occlusal aspects. Quantitative analysis was carried out with surface analysis software (ImageJ 1.48). Data were analyzed by Mann-Whitney U and Kruskal-Wallis tests (α = 0.05). RESULTS: Total biofilm formation was 41.56% (min 29.43% to max 48.76%) on lingual brackets and 26.52% (min 21.61% to max 32.71%) on labial brackets. Differences between the two groups were found to be significant. No difference was observed in intraoral location. The biofilm accumulation was mostly located on gingival, mesial, and distal surfaces for both groups. CONCLUSIONS: The biofilm accumulation on lingual orthodontic therapy was found to be more than labial orthodontic therapy.

Lingual Treatment of an Adult Patient with a Simplified Extraction Protocol.

Successful orthodontic treatment of adult cases depends on the biological, mechanical, and esthetic requirements of patients. While customized lingual appliance systems meet the esthetic expectations of the patients, they provide improved patient comfort, have three-dimensional mechanical control, and can be used for the treatment of all types of malocclusions. This report demonstrated the use of fully customized lingual orthodontic brackets for treating an adult case with extraction.

Extraction Orthodontic Treatment in an Autistic Patient.

Autism is a condition that restricts brain development. Early diagnostic criteria are as follows: less responsive to social stimuli, inability to develop natural speaking skills, lack of communication skills, and limited and repetitive behaviors. Orthodontic treatment is a challenging process for doctors in autistic patients. The clinical and cephalometric examination of a 17-year and 7-month-old autistic patient revealed class I malocclusion, increased vertical dimensions, proclined upper and lower incisors, and inconsistent lip closure. The treatment plan involved four premolar extractions from each quadrant. Upper and lower 1. premolar extraction with fixed treatment caused reduction in vertical dimensions and significant improvement in lip closure and incisor inclination. Due to the increased metabolic activity in these patients, treatment was completed in 13 months. As a result, autistic patients can be successfully treated. In this process, it is important to include communication as a major part of treatment.

Indirect Bonding Revisited.

In recent years, the popularity of indirect bonding increased due to advantages such as reduction of chair time and enhancement of patient comfort. Although the indirect bonding technique has improved over the years, the literature has shown different techniques of bracket placement; furthermore, new materials were specially developed for this technique. The aim of this article is to provide a review of the literature, advantages, disadvantages, and laboratory and clinical stages of the indirect bonding technique.

Effects of mandibular incisor intrusion obtained using a conventional utility arch vs bone anchorage.

OBJECTIVE: To compare the dentofacial effects of mandibular incisor intrusion using mini-implants with those of a conventional incisor intrusion mechanic, the utility arch. MATERIALS AND METHODS: Twenty-six deep-bite patients were enrolled to one of the two groups. In group 1 the mandibular incisors were intruded using a 0.16 × 0.22-inch stainless-steel segmental wire connected to two mini-implants. In group 2 the mandibular incisor intrusion was performed using a conventional utility arch. Conventional lateral cephalometric radiographs were taken at pretreatment and at the end of intrusion. Thirty landmarks were identified to measure 23 linear and 20 angular measurements. Intragroup comparisons were made using a paired t-test or a Wilcoxon test. Intergroup comparisons were made using a Student's t-test or a Mann-Whitney U-test. RESULTS: The duration of intrusion was 5 months for group 1 and 4 months for group 2. In the implant group, the mean amount of change was 0.4 mm/mo for the incisor tip and 0.3 mm/mo for the center of resistance, and in the utility arch group, the mean amount of change was 0.25 mm/mo for the incisor tip and 0.2 mm/mo for the center of resistance. The mandibular incisors showed an average protrusion of 7° in the implant group and 8° in the utility arch group. CONCLUSIONS: Incisor intrusion that was achieved using an implant-supported segmented archwire was no different than the movement achieved with a conventional intrusion utility arch. The only difference between the two methods was in the molar movement.