Retention: taking a more active role.

Retention may be particularly challenging after the correction of specific malocclusion features, such as tooth rotations, open bite and expansion, which are all inherently unstable. In this article, some indications for active retention are reviewed by highlighting a variety of clinical techniques and appliances. Active retention is discussed in relation to preservation of tooth alignment and in the three planes of space: sagittal, vertical and transverse. In some situations, an active retention regimen may be helpful to minimise or counteract relapse after orthodontic treatment and to improve patient satisfaction during the typically lengthy post-treatment period.

Effect of different surface treatment methods on the shear bond strength of orthodontic brackets to temporary crowns.

INTRODUCTION: The number of adult patients seeking orthodontic treatment has been consistently increasing. Since the placing of the final restoration must be postponed until the completion of the orthodontic treatment, provisional restoration is recommended for the duration of the orthodontic treatment. These surfaces have special chemical properties, which necessitate the orthodontists to prepare the bonding area with special measures. METHODS: Polycarbonate and polymethylmethacrylate (PMMA) crowns (n=80) were randomly subdivided into 4 groups. Conditioning methods were grinding, sandblasting, CO2 laser and methyl methacrylate application. Samples underwent SBS testing. A scanning electron microscope (SEM) analysis was carried out. The data was analysed with ANOVA, Student t-test and Post-hoc test. Adhesive remnant index (ARI) was analysed with Chi2 test. RESULTS: In all surface treatments, the mean Shear Bond Strength (SBS) of PMMA was significantly higher than that of polycarbonate (P<0.001). In the polycarbonate groups, there was a significant difference between the mean SBS of the four treatment methods (P<0.001). However, there were no significant differences in PMMA group (P=0.076). In both crown materials, the mode of the failure was adhesive type, regardless of the conditioning method (P>0.05). CONCLUSIONS: PMMAs rendered higher bond strength than polycarbonates. In PMMA, all the surface treatment methods resulted in acceptable bond strength. However, if bonding the brackets to polycarbonate crown is needed, other conditioning methods are preferred over CO2 laser.

Effect of different surface treatment on the shear bond strength of metal brackets to bleached and desensitized enamel.

INTRODUCTION: The aim of this study was to determine the effect of bleaching and desensitizing on shear bond strength (SBS) of metal brackets to enamel. METHODS: One hundred extracted human premolar were randomly assigned to 5 groups of 20. In the first group (control), no bleaching or desensitizing agent was used. Groups 2 to 5 were bleached with 37.5% hydrogen peroxide and desensitized with 6.0% potassium nitrate. Surface treatment comprised of etching for 15seconds in groups 1, 2 and 3, Er:yag laser irradiation and etching in group 4 and sandblasting and etching in group 5. Premolar brackets were bonded with Transbond XT and cured for 20seconds and the SBS was tested using a universal testing machine. Adhesive remnant index (ARI) score was used to record the mode of bond failure. RESULTS: No significant difference was found between the mean SBS (MPa) in groups 1(15.22), 4(14.02), and 5(12.62). SBS in group 4 was significantly higher than group 2 (8.15) (P<0.001). Also, SBS in groups 2 (P<0.001) and 3(11.74) (P=0.012) were significantly lower than group 1. An increased frequency of ARI score of 2 and 3 was observed in groups 1, 4 and 5. CONCLUSIONS: Bleaching plus desensitizing significantly decreased the SBS of orthodontic brackets. Delaying the bonding procedure for at least 2 weeks or alternative surface treatment methods such as combined laser and acid etching or combined sand blasting and acid etching can improve the SBS.

Evaluation of the effect of different surface conditioning methods on shear bond strength of metal brackets bonded to aged composite restorations.

INTRODUCTION: There are controversies regarding the most reliable conditioning method of the aged composite surface to ensure optimum bond strength. The purpose of this study was to evaluate the shear bond strength of metal brackets to microhybrid composite restorations after different surface preparation techniques. MATERIALS AND METHODS: A total of sixty microhybrid composite samples were prepared using upper right central incisor celluloid crown as a mold. Samples were treated with 4 different surface conditioning methods: (1) etching, (2) sandblasting, (3) grinding, and (4) CO2 laser irradiation. Samples were then bonded with metal brackets and underwent shear bond strength testing. A scanning electron microscope was carried out and the data was analysed by one-way ANOVA and post-hoc Tukey test. Bond failure was examined by stereomicroscope and scored based on adhesive remnant index (ARI). Kruskal-Wallis test was used to compare ARI values (α=0.05). RESULTS: Shear bond strength values in the sandblasting group (17.18±1.53MPa) were significantly higher than the other groups. There was no significant difference between the grinding (12.87±3.38MPa) and laser (11.08±1.37MPa) groups (P=0.09). The lowest values were recorded in the etching group (6.78±1.69MPa). There was a significant difference in ARI scores among the four groups (P<0.001). ARI scores were mostly 2 and 3 in the sandblasting and grinding group, while in the etching and laser groups ARI was mostly 0 and 1. CONCLUSIONS: Surface preparation by sandblasting and CO2 laser provides clinically acceptable results with regards to bond strength and ARI score, however grinding and acid etching failed to produce the same results.

Agreement of treatment recommendations based on digital vs plaster dental models.

INTRODUCTION: The purpose of this study was to investigate differences in orthodontists' treatment plans based on digital models compared with plaster models. Additionally, we assessed whether digital or plaster models influence the reliability of orthodontists' treatment plans, as well as the amount of time required to arrive at the plan. METHODS: Sixteen orthodontists planned treatment for 20 patients at 2 time points using either the same or different model formats (digital or plaster). The treatment plan decisions and time spent making the plans were recorded. The permutation test and a random effects model were used to analyze the data. RESULTS: The treatment plans arrived at with digital and plaster models were similar. With respect to extractions, the mean difference between digital and plaster formats was 11.9% (95% CI, 7.5%-16.3%). For surgery, the mean difference was 9.4% (95% CI, 5.0%-13.8%). There was no significant difference in the agreement rate between those who viewed models in different formats compared with those who viewed models twice in the same format (P >0.05). The time spent to plan treatment with plaster models was not significantly different from the time spent with digital models (P = 0.87). CONCLUSIONS: Based on this study, digital models can be substituted for plaster models with no significant differences in the final plans, the reliability of the plans, and the time required to create the plan.

Recommendations for clear aligner therapy using digital or plaster study casts.

BACKGROUND: Clear aligner therapy has evolved considerably since its introduction 20 years ago. Clinicians have become more experienced with aligner therapy, but little is known about the types of malocclusions that clinicians currently treat with aligners. Similarly, it is not known if viewing digital vs plaster models has any impact on the treatment planning process for aligners. The aim of this study was to assess which types of malocclusions are recommended for treatment with clear aligners, and also to determine if recommendations for aligner treatment differed when using digital versus plaster models. METHODS: Sixteen orthodontists treatment planned 20 cases at two time points with either the same or different model formats (digital versus plaster). As part of the treatment planning process, they were asked whether each patient was a good candidate for Invisalign® treatment, and if not, why. Generalized estimating equations regression (GEE), the permutation test, and a logistic regression model with GEE were used to analyze the data. RESULTS: No significant difference was found between the Invisalign® choices in the digital model group and those in the plaster model group at T1 (p = 0.59). There was no significant difference between the agreement rate of the different formats group and that of the same format group (p = 0.97). Cases with extractions had less Invisalign® recommendations (15%) compared to cases with no extractions (55%) (p = 0.0015). Cases with surgery had less Invisalign® recommendations (29%) compared to cases with no surgery (57%) (p = 0.035). CONCLUSIONS: In this study, viewing orthodontic records with digital versus plaster models did not influence decisions about Invisalign® recommendations. Additionally, the orthodontists in this study tended to not recommend Invisalign® for extraction cases, surgical cases, or difficult cases.

Esthetic evaluation of lip position in silhouette with respect to profile divergence.

INTRODUCTION: The aim of this study was to determine the preferred lip position in silhouette profiles with different amounts of divergence. METHODS: A normal profile was constructed based on normal values and was altered using software (Photoshop CS, version 8.0; Adobe Systems, San Jose, Calif) to produce a series of 15 profiles in 3 sets (straight, anterior, and posterior divergent). Each set consisted of 5 photographs with different lip positions from -4 mm to +4 mm in 2-mm increments. We asked 240 people in 5 panels (79 senior dental students, 26 orthodontists, 27 maxillofacial surgeons, 27 prosthodontists, and 81 laypeople) to rate the profiles. Mann-Whitney and Kruskal-Wallis tests, and intraclass correlation coefficients were used to analyze the data. RESULTS: In the anterior and posterior divergent profiles, most groups tended to prefer the original lip positions for both the male and female profiles. In the straight divergent profile, the results were scattered and inconsistent in the different groups. In the posterior divergent profile, the orthodontists and the surgeons selected the 4-mm lip retrusion as the least attractive, and other groups selected the 4-mm lip protrusion as the least attractive. In the anterior and straight divergent profiles, all groups were unanimous in the selection of the 4-mm lip protrusion as the least attractive images. Significant differences were found between the raters in the rankings of some images. No significant difference was found between the male and female raters in the rankings of the profile images. CONCLUSIONS: It is important to establish a normal lip position, especially for a patient with an anterior or a posterior divergent profile. Posterior divergent patients should be treated cautiously so that excessive lip retrusion does not result.

Evaluating Stress Distribution Pattern in Periodontal Ligament of Maxillary Incisors during Intrusion Assessed by the Finite Element Method.

STATEMENT OF THE PROBLEM: The use of miniscrews has expedited the true maxillary incisor intrusion and has minimized untoward side effects such as labial tipping. PURPOSE: The aim of this study was to assess the stress distribution in the periodontal ligament of maxillary incisors when addressed to different models of intrusion mechanics using miniscrews by employing finite element methods. The degree of relative and absolute intrusion of maxillary incisors in different conditions was also evaluated. MATERIALS AND METHOD: Finite element model of maxillary central incisor to first premolar was generated by assembling images obtained from a three-dimensional model of maxillary dentition. Four different conditions of intrusion mechanics were simulated with different placement sites of miniscrews as well as different points of force application. In each model, 25-g force was applied to maxillary incisors via miniscrews. RESULTS: In all four models, increased stress values were identified in the apical region of lateral incisor. Proclination of maxillary incisors was also reported in all the four models. The minimum absolute intrusion was observed when the miniscrew was placed between the lateral incisor and canine and the force was applied at right angles to the archwire, which is very common in clinical practice. CONCLUSION: From the results yield by this study, it seems that the apical region of lateral incisor is the most susceptible region to root resorption during anterior intrusion. When the minimum flaring of maxillary incisors is required in clinical situations, it is suggested to place the miniscrew halfway between the roots of lateral incisor and canine with the force applied to the archwire between central and lateral incisor. In order to achieve maximum absolute intrusion, it is advised to place miniscrew between the roots of central and lateral incisors with the force applied at a right angle to the archwire between these two teeth.

Comparison of the effects of preemptive acetaminophen, ibuprofen, and meloxicam on pain after separator placement: a randomized clinical trial.

BACKGROUND: This study aims to evaluate and compare the effect of pre-procedural administration of acetaminophen, ibuprofen, and meloxicam in reducing pain after separator placement. METHODS: Three hundred twenty-one patients who needed orthodontic treatment and aged above 15 were randomly assigned to one of the three study groups: group A: 650 mg acetaminophen, group B: 400 mg ibuprofen, and group C: 7.5 mg meloxicam. All subjects received a single dose of medication 1 h prior to separator placement. Using visual analog scale, patients recorded their pain perception during rest, fitting posterior teeth together, and chewing at time intervals of immediately, 2, 6, 24, and 48 h after separator placement. RESULTS: There was no significant difference between acetaminophen, ibuprofen, and meloxicam in post-separator placement pain control when administered 1 h before the procedure. In all the groups, at rest, pain level elevated after separator placement and reached its peak at 24 h and then subsided until 48 h. But during chewing and fitting of the posterior teeth, some of the groups reached a peak in pain at 48 h. No significant difference was found in pain experience between males and females. CONCLUSIONS: Meloxicam can be used as an effective analgesic in orthodontic pain control considering it has less gastric side effects compared to the conventional nonsteroidal anti-inflammatory drugs. TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT2015041821828N1.

Esthetic evaluation of incisor inclination in smiling profiles with respect to mandibular position.

INTRODUCTION: The smile is a key facial expression, and a careful assessment of the facial profile in smiling is an essential part of a complete orthodontic diagnosis. The aim of this study was to determine the preferred maxillary incisor inclination in the smile profile with regard to different mandibular positions. METHODS: A smiling profile photograph of a man with normal facial profile features was altered digitally to obtain 3 different mandibular sagittal positions in 4-mm decrements or increments from -4 to +4 mm. In each mandibular position, the inclination of the maxillary incisors was changed from -10° to +10° in 5° increments. A total of 234 raters (72 senior dental students, 24 orthodontists, 21 maxillofacial surgeons, 25 prosthodontists, and 92 laypeople) were asked to score each photograph using a Likert-type rating scale. Mann-Whitney, Kruskal-Wallis, and intraclass correlation coefficient tests were used to analyze the data. RESULTS: In retruded and protruded mandibles, normal incisor inclination and the most retroclined incisors were selected as the most and the least attractive images, respectively, by almost all groups. With an orthognathic mandible, the image with the most retroclined incisors was selected as the least attractive, but the raters were not unanimous regarding the most attractive image. The intraclass correlation coefficient was 0.82 (high level of agreement). Also, the sex of the raters had no effect on the rating of the photographs. CONCLUSIONS: It is crucial to establish a normal incisor inclination, especially in patients with a mandibular deficiency or excess. An excessive maxillary incisor lingual inclination should be avoided regardless of the mandibular position.

Effect of low-level laser irradiation on the rate and short-term stability of rotational tooth movement in dogs.

INTRODUCTION: Low-level laser therapy (LLLT) has many biostimulative effects such as acceleration of mesiodistal orthodontic tooth movement. However, its effects on the extent and short-term stability of rotational tooth movement have not been researched. The purpose of this study was to investigate the effect of low-level laser irradiation during rotational tooth movement on the rate of movement and the amount of relapse in dogs. METHODS: In this interventional study, fixed orthodontic appliances were used to rotate both mandibular lateral incisors in 8 dogs. Sixteen teeth were divided into 2 groups: the experimental group with LLLT during orthodontic force application, and a control group with orthodontic couple force application only. In the first group, the gallium-aluminum-arsenide diode laser (810 nm, 200 mw, 10 seconds, 2 J/session, 32 J/cm(2)/point) was emitted on 2 points at the buccal side of the roots on days 0, 1, 2, 3, 4, 7, 14, 21, and 28 during 4 weeks of movement, and the amount of relapse was then observed for 3 months. The extent of rotational movement was measured on dental casts, and the statistical analysis was carried out with t tests. RESULTS: There was no significant difference between the LLLT group and the control group on the amount of rotational tooth movement (P = 0.66). The mean percentages of relapse after 1 week, 1 month, and 3 months were 33.02%, 53.44%, and 60.64% in the LLLT group and 54.22%, 68.74%, and 73.92% in the control group, respectively. This demonstrates significant differences between these groups at all studied times (P ≤0.05). This difference was greatest in the first week and then decreased until the end of the third month. The greatest percentage of relapse in both groups was registered in the first week after tooth movement. CONCLUSIONS: The total energy dose of the laser used in this study could not accelerate rotational tooth movement, but it did effectively reduce the relapse tendency in teeth rotated by orthodontic movements.

The effect of different environmental factors on force degradation of three common systems of orthodontic space closure.

BACKGROUND: Different environmental conditions, such as high temperature or exposure to some chemical agents, may affect the force decay of different methods of space closure during orthodontic treatment. The aim of this in vitro study was to evaluate the force decay pattern in the presence of tea as a popular drink in some parts of the world and two mouthwashes that are usually prescribed by the orthodontist once the treatment is in progress. MATERIALS AND METHODS: Elastic chain (EC), nickel-titanium (Ni-Ti) closed coil spring and tie-back (TB) method were used as the means of space closure. The specimens were placed in five different media: Hot tea, hot water (65°), chlorhexidine mouthwash, fluoride mouthwash and the control group (water at 37°). The specimens were stretched 25 mm and the elastic force of three systems was measured at the beginning of the study, after 24 h, after 1 week and after 3 weeks. One-way ANOVA was used to compare the results between the groups and Duncan test was carried out to compare the sets of means in different groups (P ≤ 0.05). RESULTS: Tea increases the force decay in the EC and TB groups. Oral mouthwashes also resulted in more rapid force decay than the control group. EC and Ni-Ti groups were not much affected in the presence of oral mouthwashes. CONCLUSION: Regarding the immersion media, TB method showed the biggest variation in different media and Ni-Ti coil spring was least affected by the type of media.

Evaluation of the effect of four surface conditioning methods on the shear bond strength of metal bracket to porcelain surface.

OBJECTIVE: This study evaluated the effect of superpulse CO2 laser irradiation and deglazing of porcelain surfaces on the shear bond strength (SBS) of metal orthodontic brackets, and compared it with two conventional etching techniques. METHODS: Forty-eight Feldspathic porcelain fused to metal specimens embedded in cylindrical acrylic resin tubes were fabricated, and all the specimens were divided into four groups. In Group 1, the specimens were roughened with a diamond bur and etched with hydrofluoric acid (HFA) gel for 4 min. In Group 2, the specimens were roughened with a bur and irradiated by a CO2 laser with a 2 W power setting for 20 sec. In Group 3, the specimens were only irradiated by a CO2 laser. In Group 4, the porcelain surface was sandblasted with 50 µm aluminum oxide. Before bonding, the bracket silane was applied on the porcelain surfaces. SBS was evaluated by a Universal testing machine (Zwickroll, Germany). The remaining adhesive after the bond failure was evaluated using an adhesive remnant index (ARI). Statistical analysis was conducted by analysis of variance (ANOVA), Tukey, and Kruskal-Wallis tests. RESULTS: ANOVA revealed significant differences in SBS among the four groups (p<0.001). Group 1 demonstrated significantly higher bond strength (13.13±2.47) when compared with the other groups. Group 2 showed higher bond strength (9.60±1.91) when compared with group 4 (6.40±1.67) (p=0.016). Group 1 displayed the highest ARI scores among the groups. CONCLUSIONS: Deglazing combined with HFA etching produced the highest bond strength, but CO2 laser irradiation provided adequate bond strength and allowed for elimination of the HFA step. Deglazing is not recommended as a preliminary step before CO2 laser conditioning.

Clinical and radiographic comparison of the effects of two types of fixed retainers on periodontium - a randomized clinical trial.

BACKGROUND: Most orthodontists believe that fixed retainers are necessary to maintain ideal dental relationships. However, untoward side effects might result from their long-term placement. The aim of this study was to evaluate the clinical and radiographic effect of two commonly used fixed retainers on the health of the periodontium. METHODS: Thirty patients were randomly divided into two groups to receive either a fiber-reinforced composite retainer or a spiral wire retainer extended on the lingual surfaces of both maxillary and mandibular arches from canine to canine. Periapical radiographs were obtained from the patients at the time of placement of the retainers and after the 6-month period to assess the radiographic conditions of the periodontium. Clinical examination was carried out at the same two time intervals. RESULTS: Even though there were no significant differences between the two groups of study at the beginning of the trial, there were statistically significant differences after the 6-month follow-up regarding the main outcomes of the study. Nearly all indices showed to deteriorate after 6 months in the fiber-reinforced group, while in the spiral wire group, this was not the case. As for the secondary outcomes, radiographic examination did not reveal any statistically significant differences after 6 months or between the two groups. CONCLUSIONS: It can be concluded that spiral wire retainers elicit less detrimental periodontal response in the short-term follow-up compared to fiber-reinforced composite retainers as revealed by the primary outcomes of the study. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01314729.

Changes in cephalometric variables after orthognathic surgery and their relationship to patients' quality of life and satisfaction.

OBJECTIVES: This study was designed to assess the relationship between postsurgical cephalometric changes and quality of life and satisfaction after orthognathic surgery. MATERIAL AND METHODS: Sample size consisted of 30 patients with class III and 25 patients with class II malocclusion treated with bilateral sagittal split osteotomy and Le Fort I osteotomy. Profile convexity, lower facial height proportion, lip position and length, nose, and chin position were measured on pre and post-treatment cephalograms. To assess the patients' satisfaction and quality of life (QoL) after surgery, the questionnaire of the Rustemeyer's study and Oral Health Impact Profile (OHIP) questionnaire were used, respectively. The paired-sample t-test, Spearman correlation analysis and Pearson correlation analysis was used in SPSS statistical software. RESULTS: In class III malocclusion patients, decrease in facial angle, convexity angle, mentolabial angle, and increase in upper lip protrusion had the most positive impact on QoL. Decrease in facial angle and increase in upper lip protrusion were correlated positively with satisfaction questionnaires. In class II malocclusion patients, increase in convexity angle, facial angle and mentolabial angle had the most positive impact on satisfaction and QoL. CONCLUSIONS: Consideration both subjective and objective parameters affecting on the patients' satisfaction and their quality of life is essential.

Comparison of the shear bond strength of orthodontic brackets in bonding and rebonding: preparation with laser versus conventional acid etch technique.

OBJECTIVE: The purpose of this study was to compare the bond strength of orthodontic brackets using laser versus acid etching. BACKGROUND DATA: Debonding of brackets is a common problem in orthodontic treatments. MATERIALS AND METHODS: Eighty extracted premolar teeth were divided into two groups. The enamel of the teeth in group A and B were etched using CO2 laser and phosphoric acid, respectively. The brackets were bonded to the teeth using Transbond XT and then debonded from the teeth by Instron machine. The remaining composite on the tooth surface was removed by a tungsten carbide polishing bur. Both groups were divided into two subgroups (A1, A2 and B1, B2). The teeth were prepared again with laser in A1, B1 subgroups and with acid in A2, B2 subgroups. At each stage, the shear bond strength and residual adhesive index were measured. One way ANOVA and χ(2) tests were used to analyze data. RESULTS: The mean shear bond strength was significantly lower in group A and higher in group B compared with all other groups (p < 0.05). Most of the bond failures were degree 0 and 1 in groups A, A1, and B1, and degree 2 and 3 in groups B, A2, and B2. CONCLUSIONS: Primary preparation with acid has a higher bond strength value than does CO2 laser. Less adhesive residue remained on enamel after tooth preparation with laser following debonding. Secondary preparation of the enamel using laser has higher bond strength value than does primary preparation with laser, which can rationalize use of laser in rebonding of brackets.

Laser applications in orthodontics.

A laser is a collimated single wavelength of light which delivers a concentrated source of energy. Soon after different types of lasers were invented, investigators began to examine the effects of different wavelengths of laser energy on oral tissues, routine dental procedures and experimental applications. Orthodontists, along with other specialist in different fields of dentistry, can now benefit from several different advantages that lasers provide during the treatment process, from the beginning of the treatment, when separators are placed, to the time of resin residues removal from the tooth surface at the end of orthodontic treatment. This article outlines some of the most common usages of laser beam in orthodontics and also provides a comparison between laser and other conventional method that were the standard of care prior to the advent of laser in this field.

Fracture Resistance of Composite Fixed Partial Dentures Reinforced with Pre-impregnated and Non-impregnated Fibers.

BACKGROUND AND AIMS: The mechanical properties of fiber-reinforced composite fixed partial dentures (FPDs) are af-fected by fiber impregnation. The aim of this in vitro study was to compare the fracture resistance of composite fixed partialdentures reinforced with pre-impregnated and non-impregnated fibers. MATERIALS AND METHODS: Groups (n=5) of three-unit fiber-reinforced composite FPDs (23 mm in length) from maxillary second premolar to maxillary second molar were fabricated on two abutments with pontic width of 12 mm. One group was fabricated as the control group with composite (Gradia) and the other two groups were fabricated with composite (Gradia) reinforced with pre-impregnated fiber (Fibrex ribbon) and non-impregnated fiber (Fiber braid), respectively. The specimens were stored in distilled water for one week at 37°C and then tested in a universal testing machine by means of a three-point bending test. Statistical analysis consisted of one-way ANOVA and a post hoc Scheffé's test for the test groups (α=0.05). RESULTS: Fracture resistance (N) differed significantly between the control group and the other two groups (P<0.001), but there were no statistically significant differences between the pre-impregnated and non-impregnated groups (P=0.565). The degree of deflection measured (mm) did not differ significantly between the three groups (P=0.397), yet the mean deflection measured in pre-impregnated group was twice as that in the other two groups. CONCLUSION: Reinforcement of composite with fiber might considerably increase the fracture resistance of FPDs; how-ever, the type of the fiber used resulted in no significant difference in fracture resistance of FPD specimens.

The association of oral health-related quality of life and self-perceived esthetic impairment with orthodontic treatment seeking.

AIM: To assess oral health-related quality of life (OHRQOL) and self-perceived esthetic impairment in patients seeking orthodontic treatment and to compare them with peers in the same age group who had never undergone orthodontic treatment. A correlation between OHRQOL and lower self-perceived esthetic impairment was also searched for. METHODS: The sample comprised 209 individuals (12 to 20 years of age), of whom 110 were about to receive or had already started orthodontic treatment at Shiraz Dental School, Shiraz, Iran, (orthodontic group) and 99 participants who had never received orthodontic treatment (control group). OHRQOL was recorded with the validated Persian version of the short form of the Oral Health Impact Profile. The aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN) instrument was used to record examiner and self-perceived esthetic impairment in both groups. RESULTS: The Mann-Whitney test revealed that the orthodontic group had significantly worse OHRQOL than the control group (P = .005). The former group also had significantly higher self-perceived IOTN AC scores (P < .00). The weighted Kappa test was used to report the agreement between the examiner and self-perceived esthetic impairment. No significant intersex differences were found in either group. The Spearman correlation coefficient showed a significant correlation between higher IOTN AC scores and worse OHRQOL (P = .007) in the control group. No such correlation was found in the treatment group. CONCLUSION: Individuals who sought orthodontic treatment had higher self-perceived IOTN AC scores and worse OHRQOL than the control group.