Microbial contamination profile on esthetic elastomeric ligatures through the checkerboard DNA-DNA hybridization technique : A randomized split-mouth study.

OBJECTIVE: The aim of this study is to assess the microbial contamination of three different brands of esthetic elastomeric ligatures. MATERIALS AND METHODS: Different brands of esthetic ligatures (Unistick Pearl [American Orthodontics, Sheboygan, WI, USA], Power Sticks Pearl [Ortho Technology, Tampa, FL, USA], and Ease [Obscure, 3M Unitek, Monrovia, CA, USA]) were randomly assigned to permanent canines of 25 patients (aged 11-18 years) undergoing corrective orthodontic treatment. After 30 days, the ligatures were removed, processed, and the biofilm composition was analyzed by checkerboard DNA-DNA hybridization for 40 bacterial species. The microbiological data were analyzed using a nonparametric mixed model. RESULTS: The ligatures presented intense microbial contamination after 30 days, but no statistically significant differences were observed among the three groups (p > 0.05). The levels of the evaluated individual species and proportions of the microbial complexes showed no statistically significant differences among the ligature groups (p > 0.05). CONCLUSIONS: Esthetic elastomeric ligatures became multicolonized by several bacterial species after 30 days of exposure to the oral cavity. However, no relevant differences were observed among the biofilm composition formed on the different ligature brands.

Assessment of enamel surface roughness and hardness with metal and ceramic orthodontic brackets using different etching and adhesive systems: An in vitro study.

Background: This study aimed to evaluate enamel surface roughness and microhardness following the use of different bracket materials (metal or ceramic), etchants (total- and self-etchants), and adhesive systems (precoated or flash-free). Method: A total of 99 extracted human premolars were selected for the analysis. The surface roughness was first assessed (roughness control). One specimen from each subgroup was examined using a scanning electron microscope to illustrate the surface topography. Eighty-eight teeth were prepared using total- or self-etchants and bonded to precoated or flash-free adhesive metal or ceramic brackets. The remaining 11 specimens were not bonded to brackets (microhardness controls). The brackets were debonded after immersion in distilled water for 24 h. The specimens were again scanned for surface roughness and topography imaging. Finally, the microhardness was assessed using a micro-Vickers hardness test at a force of 200 g for 10 s. Result: An overall statistically significant increase in surface roughness and reduced surface microhardness were observed in all experimental groups when compared with those in the control groups. The etchant type was the only variable found to contribute to the measured surface properties, with increased roughness and reduced microhardness introduced by total-etching compared to those by self-etching. Conclusion: Orthodontic brackets introduced a significant increase in enamel surface roughness and reduce microhardness compared with untreated enamel, regardless of the bracket material, etchant type, and adhesive system. The etchant type was the only variable contributing to these changes, with total etching having a more pronounced effect.

Survival rates of mandibular fixed retainers: comparison of a tube-type retainer and conventional multistrand retainers : A prospective randomized clinical trial.

OBJECTIVE: The purposes of this study were to evaluate the survival rate of a tube-type mandibular fixed retainer and compare it to conventional multistrand retainers. MATERIALS AND METHODS: In all, 66 patients who had completed their orthodontic treatment were enrolled in this study. They were allocated randomly to a tube-type retainer group or a 0.020 multistrand fixed retainer group. In case of the tube-type retainer, a thermoactive 0.012 NiTi was placed into 6 mini-tubes passively bonded to the anterior teeth. The patients were recalled at 1, 3, 6, 12, and 24 months after retainer placement. During the 2­year follow-up period, any first-time failure of retainers was recorded. Kaplan-Meier survival analysis and log-rank tests were used to compare the failure rates between the two types of retainers. RESULTS: Of the 34 patients, 14 (41.2%) showed failure in the multistrand retainer group, whereas only 2 of 32 (6.3%) reported failure in the tube-type retainer group. There was a statistically significant difference in failure between the multistrand retainer and the tube-type retainer (log-rank test, P = 0.001). The hazard ratio was 11.937 (95% confidence interval 2.708-52.620; P = 0.005). CONCLUSION: The tube-type retainer can be used with fewer concerns about recurrent retainer detachments during orthodontic retention.

Effectiveness of surface treatment on bond strength of ceramic brackets to two types of CAD/CAM-prepared nanohybrid composites.

OBJECTIVES: The aim of this study was to assess the influence of surface treatment on the shear bond strength of two different adhesive-coated orthodontic ceramic brackets to computer-aided design/computer-aided manufacturing (CAD/CAM) nanohybrid composite. METHODS: A total of 120 specimens (10 mmâ€¯× 10 mmâ€¯× 3 mm) were prepared from each type of CAD/CAM block (Grandio [GR], VOCO Cuxhaven, Germany; Lava Ultimate [LU], 3M ESPE, St. Paul, MN, USA). For each type of CAD/CAM block, the plates were divided into four groups based on the applied surface treatment: hydrofluoric acid (HF), grinding bur (GB), silica coating with CoJet system (CS), and titanium tetrafluoride (TiF4) 2 wt/v%. Maxillary central incisors of adhesive-coated ceramic orthodontic brackets (APC Flash-free Clarity Advanced Ceramic, 3M Unitek, Monrovia, CA, USA) were bonded using Transbond XT Primer (3M Unitek, Monrovia, CA, USA). Shear bond strength was conducted, and the modes of failure were assessed utilizing the adhesive remnant index. Surface roughness and topography of treated CAD/CAM were evaluated. Data were statistically analyzed using two-way analysis of variance (ANOVA) and Tukey's test. The Weibull analysis was conducted on shear bond strength data. RESULTS: Surface treatment with 2% TiF4 wt/v revealed significantly higher bond strength (GR, 14.51 ± 2.57 MPa; LU, 11.19 ± 2.17 MPa) than other groups for both types of CAD/CAM restorative materials (p < 0.05). Adhesive failures were the predominant mode of failure. Surface treatment with CS revealed higher surface roughness than other groups (p < 0.05). CONCLUSIONS: Surface treatment with 2% TiF4 wt/v enhanced the adhesion between orthodontic ceramic brackets to GR and LU CAD/CAM composite restorative materials. GR CAD/CAM nanohybrid composite had higher bond strength than LU to ceramic orthodontic brackets.

Evaluation of external apical root resorption caused by fixed functional treatment of class II malocclusion : Cast splint Herbst appliance vs. Forsus fatigue resistant device.

INTRODUCTION: The aim of this study was to evaluate and compare the effects of class II fixed functional treatment with a cast splint Herbst appliance (HA; Herbst Set I, Dentaurum, Ispringen, Germany) and Forsus fatigue resistant device (FRD; 3M Unitek Corp., Monrovia, CA, USA) on external apical root resorption (EARR) in posterior teeth. METHODS: In all, 40 patients (15 male and 25 female) with class II division 1 malocclusion were treated with two fixed functional appliances: HA (20 patients, mean age 14.60 ± 1.14 years) and FRD (20 patients, mean age 14.15 ± 1.28 years). The vestibular lengths of the first molars and premolars were measured on panoramic radiographs and converted to actual tooth length using the magnification coefficient (MC), which was calculated using dental models. Intragroup comparisons of pre- and posttreatment tooth lengths were performed with the paired t­test and Wilcoxon signed-rank test, while intergroup comparisons were performed with the Mann-Whitney U test. RESULTS: Pretreatment tooth length values decreased significantly with HA and FRD therapies for all posterior teeth. The maximum resorption was observed in the mandibular first premolar with a mean of 0.81 mm following HA and 1.55 mm following FRD treatment. While no significant difference existed between the EARR values of the HA and FRD groups for maxillary teeth, the amount of EARR of mandibular posterior teeth in the FRD group was significantly higher than in the HA group. CONCLUSIONS: In patients treated with HA or FRD, the tooth length of posterior teeth decreased to a clinically minor but statistically significant degree. The root resorption effect of FRD therapy in mandibular posterior teeth was significantly higher than that of HA therapy.

Effects of class II intermaxillary elastics on masticatory muscle activity balance, occlusal contact area and masticatory performance: A multicenter randomised controlled trial.

BACKGROUND: Bilateral Class II intermaxillary elastics (CII elastics) are commonly used in orthodontics; however, the effects of CII elastics on masticatory muscle activity and the occlusal contact area have not been studied. OBJECTIVES: To evaluate the short-term effects of CII elastics on masticatory muscle activity balance, occlusal contact area and masticatory performance in a group of adult orthodontic patients after 3 months. MATERIALS AND METHODS: Forty-three patients with a <3 mm Class II molar relationship receiving ongoing treatment with fixed appliances were recruited. The experimental group (n = 21) wore CII elastics (100-150 g/side) full time; the control group (n = 22) did not wear CII elastics. Surface electromyography, the areas of occlusal contact and near contact (ACNC) and the median particle size of a test food were assessed prior to (T0) and after one (T1) and 3 months (T2). Within- and between-group differences were analysed and the relationships between changes in dependent variables were examined (α = 0.05). RESULTS: At T2, the experimental group showed better masticatory muscle activity balance (p < .001) and masticatory performance (p < .05) than controls. Both masticatory muscle activity balance (p < .001) and masticatory performance (p < .001) significantly improved in the experimental group between T0 and T2. The changes in masticatory muscle activity balance and masticatory performance were significantly related (p < .05). No significant changes in cumulative ACNC or ACNC balance were observed (p > .05). CONCLUSION: After 3 months, CII elastics improved masticatory muscle activity balance, which led to better masticatory performance.

Effect of light-emitting photobiomodulation therapy on the rate of orthodontic tooth movement : A randomized controlled clinical trial.

PURPOSE: The aim of this study was to evaluate the effect of light-emitting photobiomodulation therapy (LPT) on the rate of canine distalization. METHODS: This study was performed on 60 extraction spaces formed by extraction of the upper first premolars of 30 patients (15 in the LPT group and 15 in the control group). Paul Gjessing (PG)-segmented canine retraction springs were used for canine distalization. In the LPT group, the Biolux OrthoPulse™ (Biolux Research Ltd, Vancouver, Canada) intraoral device (wavelength 850 nm LED light and an energy density of 63 mW/cm2 [±13 mW/cm2]) was used for 5 min per day over a period of 84 days. For each patient, the diagnosis was based on standard orthodontic documentation with photographs, digital model casts, and cephalometric and panoramic radiographs. The anchorage loss, canine rotations, canine inclinations, and molar inclinations were also evaluated on plaster models obtained on days 0, 21, 42, 63, and 84. The models were measured by using 3Shape OrthoAnalyzer software (3Shape, Copenhagen, Denmark). Measurements were made by a researcher and a blinded clinician. For statistical comparison, a paired-samples t­test and one-way analysis of variance (ANOVA) were used at the p < 0.05 level. RESULTS: The mean canine distalization rates were 1.36 mm/21 days and 1.02 mm/21 days in the LPT and control groups, respectively, and were statistically greater in the LPT group (p < 0.001). The amount of anchorage loss, canine rotations, canine inclinations and molar inclinations were not significantly different between the LPT and control groups at any of the timepoints. CONCLUSION: LPT has the potential to accelerate orthodontic tooth movement by 33%.

Effects of orthodontic treatment on body mass index, food habits and self-esteem of patients: A prospective single-arm cohort study.

Objectives: During orthodontic treatment, patients are often apprehensive about reduced food intake and loss of body weight. Body mass index (BMI) assessment is an inexpensive, easy method for screening and studying changes in weight categories. This research aimed to determine whether long-term changes in BMI, self-esteem, and food habits occur in patients during the first year of orthodontic treatment. Methods: BMI was calculated for 120 patients undergoing orthodontic treatment. Data were collected at baseline, and after the end of the first, second, third, sixth, and twelfth months. Rosenberg's self-esteem scale was used for scoring self-esteem. The Food Habit Assessment Scale was used to study changes in eating habits. Statistical analysis was performed with repeated measures ANOVA followed by Tukey HSD post-hoc test for BMI scores and Kruskal-Wallis test followed by Dunn's multiple comparison post-hoc tests for the Rosenberg scale and food habits questionnaire. Results: At the end of 12 months, 43.4% of patients had a decrease in BMI, 45.8% had a mild to moderate increase in BMI, and 10.8% of patients maintained their BMI levels. The changes were not statistically significant. Self-esteem changes were statistically significant for both genders. Changes in food habits were also significant. Conclusion: BMI decreased for the first 3 months and gradually recovered by the end of the first year of treatment. Self-esteem scores showed a significant improvement in both genders. Patients reverted to pre-treatment food habits by the end of the year.

Effectiveness of chlorhexidine oral rinse in preventing plaque accumulation and gingivitis in patients undergoing orthodontic treatment- a systematic review and meta analysis / Eficacia del enjuague oral de clorhexidina en la prevención de la acumulación de placa y la gingivitis en pacientes en tratamiento de ortodoncia: una revisión sistemática y metaanálisis

Aim: The aim of this review was to systematically assess and report the effectiveness of chlorhexidine (CHX) mouthwash in preventing plaque accumulation and gingivitis in patients undergoing orthodontic treatment. Material and Methods: The review was prepared according to the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines and registered under PROSPERO database (CRD42020170776). Four electronic databases were systematically searched along with a complimentary manual search of orthodontic journals until June 2022. Only Randomized Control Trials (RCTs) reporting on antiplaque and antigingivitis efficacy of Chlorhexidine mouthwash compared with placebo or control in orthodontic patients were included. Risk of bias assessment was done using Cochrane ROB-2. Quantitative analysis (Random-Effects Model and Standard Mean Difference (SMD)) with 95 % confidence interval was used. Results: Six RCTs were included for qualitative analysis and four were included for quantitative analysis with a total of 211 participants. Out of six studies, 3 were judged to have a low risk of bias, two had some concerns and one of them had high risk of bias. Random effects meta-analysis performed for anti-plaque effect reported a significant reduction of -1.2 SMD for CHX at 4 to 6 weeks with low heterogeneity (I2-35%). The anti-gingivitis effect at 4 to 6 weeks was significant for CHX with a SMD of -1.03 and a moderate heterogeneity (I2-65%). Conclusion: On analyzing the available evidence a moderate level of certainty supports a short-term reduction in plaque accumulation and gingivitis in orthodontic patients subjected to rinsing with chlorhexidine oral rinse.

Objetivo: El objetivo de esta revisión fue evaluar e informar sistemáticamente la efectividad del enjuague bucal con clorhexidina (CHX) para prevenir la acumulación de placa y la gingivitis en pacientes que reciben tratamiento de ortodoncia. Material y Métodos: La revisión se preparó de acuerdo con las pautas de Preferred Reporting Items for Systematic Reviews (PRISMA) y se registró en la base de datos PROSPERO (CRD42020170776). Se realizaron búsquedas sistemáticas en cuatro bases de datos electrónicas junto con una búsqueda manual gratuita de revistas de ortodoncia hasta junio de 2022. Solo se incluyeron ensayos controlados aleatorios (ECA) que informaron sobre la eficacia antiplaca y antigingivitis del enjuague bucal con clorhexidina en comparación con placebo o control en pacientes de ortodoncia. La evaluación del riesgo de sesgo se realizó mediante Cochrane ROB-2. Se utilizó un análisis cuantitativo (modelo de efectos aleatorios y diferencia de medias estándar (SMD)) con un intervalo de confianza del 95 %. Resultados: Se incluyeron seis ECA para el análisis cualitativo y cuatro para el análisis cuantitativo con un total de 211 participantes. De los seis estudios, se consideró que tres tenían un bajo riesgo de sesgo, dos tenían algunas preocupaciones y uno de ellos tenía un alto riesgo de sesgo. El metanálisis de efectos aleatorios realizado para el efecto antiplaca informó una reducción significativa de -1,2 SMD para CHX a las 4 a 6 semanas con baja heterogeneidad (I2-35%). El efecto antigingivitis a las 4 a 6 semanas fue significativo para CHX con una SMD de -1,03 y una heterogeneidad moderada (I2-65%). Conclusión: Al analizar la evidencia disponible, un nivel de certeza moderado apoya una reducción a corto plazo en la acumulación de placa y gingivitis en pacientes ortodóncicos sometidos a enjuague con enjuague bucal con clorhexidina.

Comparison of two treatment protocols for intrusion and retraction of maxillary anterior teeth using mini-implants : A prospective clinical trial.

OBJECTIVE: The primary objective of this study was to compare the magnitude of incisor intrusion and retraction between two different treatment protocols and the secondary objective was to evaluate overall treatment effects. MATERIALS AND METHODS: Thirty-four patients with proclined upper anterior teeth, increased overbite, and incisal show were randomly assigned to two treatment groups (G1 and G2). Upper first premolar extractions were performed in all cases. In G1, space closure was performed with conventional straight-wire friction mechanics with NiTi (nickel titanium) coil springs placed on 0.019â€³â€¯× 0.025″ stainless steel wires in a 0.022 slot system with an additional intrusive force via a midline mini-implant. In G2, NiTi coil springs were placed from buccal mini-implants placed onto 0.016â€³â€¯× 0.022″ SS wires in a 0.022 slot system bilaterally. Lateral cephalograms and study models taken at the beginning and at the end of 6 months of treatment were assessed. RESULTS: Both groups showed a statistically significant mild maxillary incisor intrusion, reduction in overjet, overbite, incisal show and a reduction in lower anterior facial height. There was a mild intrusion of the maxillary first permanent molar in G2 (not significant). Mesial movement of the maxillary first permanent molar was noted in G1 but distal movement occurred in G2. Constriction of the entire maxillary arch was noted in G1, whereas constriction was seen in the molar region only in G2. Root resorption was noticed in both groups. CONCLUSION: Both groups produced comparable results. Except for molar control, all the results obtained were comparable between the two mechanics. Application of an intrusive force in the midline may be beneficial in patients treated with conventional straight-wire mechanics to treat increased overbite when anchorage requirement is not high.

Effectiveness of miniscrew-assisted rapid maxillary expansion: a systematic review and meta-analysis.

OBJECTIVES: To compare the effectiveness and side effects of miniscrew-assisted rapid maxillary expansion (MARME) with conventional rapid maxillary expansion (RME) in the treatment of transverse maxillary deficiency. MATERIALS AND METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs). We searched in the MEDLINE, Embase, and Cochrane Central databases. The quality of included RCTs was evaluated using the Cochrane risk-of-bias tool. The primary outcome was the extent of dentoskeletal expansion achieved. Secondary outcomes were the dental and periodontal side effects. We calculated summary weighted mean differences (MD) with 95% confidence intervals (CI) using random-effects meta-analysis. RESULTS: Six RCTs involving 287 participants met the inclusion criteria. Compared to conventional RME, MARME was associated with a greater palatal suture opening (mm) measured at the anterior nasal spine (MD = 1.21, 95% CI 0.75 to 1.66), first premolars (MD = 1.13, 95% CI 0.72 to 1.55), first molars (MD = 1.18, 95% CI 0.28 to 2.09), and posterior nasal spine (MD = 1.14, 95% CI 0.30 to 1.98), increased palatal width (mm) at the first molars (MD = 0.75, 95% CI 0.30 to 1.20), and reduced buccal inclination (degrees) of the first premolars (MD = - 6.06, 95% CI - 10.36 to - 1.76) and first molars (MD = - 3.17, 95% CI - 5.35 to - 0.99). CONCLUSIONS: MARME is associated with the following advantages over traditional tooth-borne RME: increased palatal suture opening, increased palatal width, and reduced buccal tooth inclination. REGISTRATION: This study is registered with PROSPERO, CRD42021256750. CLINICAL RELEVANCE: MARME may be preferred over conventional RME in cases with fused mid-palatal sutures or where further buccal tooth inclination is undesirable.

Elution study of acrylic monomers from orthodontic materials using high performance liquid chromatography (HPLC).

PURPOSE: Main goal of the study was the identification and quantitative analysis of monomer elution from materials commonly used in fixed orthodontic therapy. Studies have shown severe health effects of monomers including cytotoxic, allergenic or mutagenic potential and endocrine changes. This in vitro study focusses primarily on five resins which are usually processed intraorally and remain in the oral cavity long-term. METHODS: We tested the elution of monomers from specimens (7.5 mmâ€¯× 1.5 mm) immersed in artificial saliva at body temperature (37 °C) for 30 min to 5 weeks. The used method is in accordance with DIN EN ISO 10993-13. The five tested materials were BrackFix® (Voco GmbH, Cuxhaven, Germany), Triad®Gel (DeguDent GmbH, Hanau, Germany), and Transbond™ XT, LR and Plus (3M Unitek, Monrovia, CA, USA). All aliquots were analyzed using high performance liquid chromatography (HPLC). Data were statistically analyzed. RESULTS: All five analyzed materials eluted substances over a period of 5 weeks. Identified substances included bisphenol A (BPA), triethylene glycol dimethacrylate (TEGDMA) and urethane dimethacrylate (UDMA). BPA eluted from Transbond™ Plus, XT, LR and BrackFix®. The cumulated mean values after 35 days ranged from 16.04 to 64.83 ppm, depending on the material. TEGDMA eluted with a mean of 688.61 ppm from Transbond™ LR. UDMA with a mean of 1682.00 ppm from Triad®Gel. For each material the highest concentrations of all these substances were found in the first elution period. Other substances that were not equivocally identified or of low concentration also eluted. CONCLUSION: Using the described method, it is possible to qualitatively and quantitatively determine the in vitro elution of monomers from orthodontic materials. The concentrations of the substances identified were below the current maximum recommended intake. However, a cumulative effect and low-dose effects should be considered for both patients and dental professionals, especially for young patients. Measures to reduce exposure patients and practitioners are suggested.

Comparison of multiforce nickel-titanium wires to multistrand wires without force zones in bending and torque measurements.

PURPOSE: The aim was to compare rectangular multiforce nickel-titanium (NiTi) wires to rectangular wires with only one force zone. Both types of wires are primarily intended for use during the levelling phase of orthodontic treatment. Thus, basic mechanical properties were examined by means of a three-point bending test. Torque expression, which is dependent on both wire parameters and interslot distances, was analyzed using the Orthodontic Measurement and Simulation System (OMSS). MATERIAL/METHODS: Four multizone products were tested: DuoForce™ (Forestadent, Pforzheim, Germany), TriTanium™ (American Orthodontics, Sheboygan, WI, USA), Triple Force™ (ODS, Kisdorf, Germany), Bio-Active™ (GC, Breckerfeld, Germany), and two multistrand products without force zones: a nine-strand NiTi, TurboWire™ (Ormco, Orange, CA, USA) and an eight-strand stainless steel (SS) wire, Multibraid™ (GAC, Dentsply Sirona, York, PA, USA). All the wires had the dimension 0.40 mmâ€¯× 0.56 mm (0.016 inchâ€¯× 0.022 inch) except the nine-strand NiTi wire TurboWire™, which had a dimension of 0.43 mmâ€¯× 0.65 mm (0.017 inchâ€¯× 0.025 inch). Six different bracket systems in the 0.018 inch slot system were chosen: the conventional brackets discovery® and discovery® smart (Dentaurum, Ispringen, Germany), the active self-ligating brackets InOvation™ and InOvation™ mini (GAC, Dentsply Sirona, York, PA, USA) and the passive self-ligating brackets Carrière™ (ODS, Kisdorf, Germany) and BioPassive® (Forestadent, Pforzheim, Germany). The first set-up was a three-point bending test according to DIN EN ISO 15841. For the second experiment, the bracket products glued on a maxilla model were combined with the wire products. The torque moments arising during torqueing of the wires between +20° and -20° were measured in three positions: first incisor, canine and second bicuspid. RESULTS: Bending tests confirmed variation of the force corresponding to the force zones. The nine-strand NiTi wire TurboWireTM and the eight-strand SS wire Multibraid™ did not show any variation dependent on the tested area. Torque-moments generated by the multizone wires were higher compared to the braided wires. The nine-strand NiTi wire showed the lowest moments in spite of the higher dimension. As expected, increasing the interbracket distance reduced the torque moments. CONCLUSION: The tests verified the existence of multiple force zones in the NiTi wires for forces and moments, respectively. As the torque-moments arising from the multizone wires were rather high, it is not recommended to use these wires as a first "leveling wire" in orthodontic treatment, especially in extremely crowded cases.

Utilización del botón de Nance modificado para la propulsión mandibular / Utilization of the modified Nance button for mandibular propulsion

RESUMEN Introducción: En sus inicios la mayoría de los aparatos funcionales fueron removibles, pero cada día más se incrementan los fijos. Su combinación puede incrementar la eficacia en el tratamiento del retrognatimo mandibular. Objetivo: Presentar los resultados del tratamiento con el botón de Nance modificado en una paciente con retrognatismo mandibular. Caso clínico: Paciente femenina de 13 años de edad, que presenta perfil convexo, disfunción neuromuscular, dentición permanente en ambos maxilares con presencia de ligero apiñamiento anterior, relación molar bilateral de distoclusión de ½ unidad, resalte y sobrepase incisivos de 6 mm, mala relación intermaxilar causada por retrognatismo de la mandíbula y escaso remanente de crecimiento mandibular activo. La primera etapa del tratamiento, incluyó psicoterapia, mioterapia y avance mandibular con un aparato funcional fijo (botón de Nance modificado para la propulsión mandibular). A los nueve meses de iniciar el tratamiento se comprobó el cambio en las relaciones intermaxilares en sentido antero-posterior, con disminución del ángulo ANB hasta 20 e incremento del SNB a 78, como reflejo de una buena relación de las bases ósea por crecimiento mandibular. Conclusiones: El tratamiento realizado a la paciente con el botón de Nance modificado para la propulsión mandibular, permitió la obtención de relaciones intermaxilares favorables.

ABSTRACT Introduction: In the beginning, most of the functional appliances were removable, but the fixed ones are increasing every day. Their combination can increase the effectiveness in the treatment of mandibular retrognathymus. Objective: To present the results of the treatment of a patient with mandibular retrognathism treated with the modified Nance button. Case report: A 13-year-old female patient with convex profile, neuromuscular dysfunction, permanent dentition in both jaws with the presence of slight anterior crowding, bilateral distoclusion molar ratio of ½ unit, incisor protrusion and overhang of 6 mm, poor intermaxillary relationship caused by retrognathism of the mandible and little remnant of active mandibular growth. The first stage of treatment included psychotherapy, myotherapy and mandibular advancement with a fixed functional appliance (modified Nance button for mandibular propulsion). Nine months after starting the treatment, the change in the intermaxillary relationships in the anteroposterior direction was verified, with a decrease in the ANB angle to 20 and an increase in the SNB to 78, as a reflection of a good relationship of the bone bases due to mandibular growth. Conclusions: One year after treatment with the modified Nance button for mandibular propulsion, a correct relationship of the patient's bone bases was achieved.

Nuevas opciones de aparatos funcionales para tratar pacientes con retrognatismo mandibular / New functional appliance options for treating patients with mandibular retrognathia

RESUMEN Fundamento: El estudio sobre los aparatos actuales de la ortopedia funcional de los maxilares puede aportar nuevos conocimientos para el perfeccionamiento del tratamiento de pacientes con retrognatismo mandibular. Objetivo: Profundizar en los nuevos aparatos de la ortopedia funcional de los maxilares para el tratamiento de pacientes con retrognatismo mandibular. Desarrollo: Se realizó una revisión bibliográfica en las bases de datos SciELO, PubMed, Ebsco, Cumed y Lilacs. En la búsqueda se revisaron 37 artículos, de ellos más del 80 % son de los últimos cinco años. Se identificaron bases teóricas de la ortopedia funcional de los maxilares en el tratamiento de pacientes con retrognatismo mandibular y los aparatos que se utilizan en la actualidad. Conclusiones: Existen nuevas opciones de aparatos funcionales, en su mayoría fijos y clasificados como dentosoportados pasivos, para el tratamiento de pacientes con retrognatismo mandibular.

ABSTRACT Background: The study of the current jaw functional orthopedic appliances can provide new knowledge for the improvement of the patients' treatment with mandibular retrognathia. Objective: To study deeply the current jaw functional orthopedic appliances for the patients' treatment with mandibular retrognathia. Development: A bibliographic review was conducted in the SciELO, PubMed, Ebsco, Cumed and Lilacs databases. A total of 37 articles were reviewed, more than 80 % from the last five years. Theoretical bases on the jaw functional orthopedics in the patients' treatment with mandibular retrognathia and current appliances in use were identified. Conclusions: New functional appliance options, mostly fixed and classified as passive dent supportive, are available for the patients' treatment with mandibular retrognathia.

Alinhadores Ortodônticos Removíveis Versus Aparelhos Ortodônticos Fixos: uma Revisão da Literatura / Removable Orthodontic Aligners Versus Fixed Orthodontic Appliances: a Literarture Review

Com intuito de pontuar os paralelos entre as técnicas ortodônticas com aparelhagem fixa e alinhadores transparentes, este estudo propôs revisar a literatura científica sobre alinhadores ortodônticos removíveis versus aparelhos ortodônticos fixos. Foram selecionados artigos de 2005 a 2021, utilizando as bases de dados PubMed, Scopus, Web of Science, Cochrane Library, Clinical Trials e Opengrey. Os artigos abordavam temáticas como sensação dolorosa, saúde periodontal, higiene, microbiota, reabsorção radicular, qualidade de vida e efetividade do tratamento. Os alinhadores apresentaram maior aceitabilidade pelos pacientes e vantagens claras em relação à dor, higiene, qualidade de vida, reabsorção radicular e saúde periodontal, sendo inferior aos aparelhos ortodônticos fixos na efetividade do tratamento e na interferência na fala.

In order to point out the parallels between orthodontic techniques with fixed appliances and transparent aligners, this study proposed to review the scientific literature on removable orthodontic aligners versus fixed orthodontic appliances. Articles from 2005 to 2021 were selected, using the PubMed, Scopus, Web of Science, Cochrane Library, Clinical Trials and OpenGrey databases. The articles addressed issues such as pain, periodontal health, hygiene, microbiota, root resorption, quality of life and treatment effectiveness. Aligners showed greater acceptability by patients and clear advantages in relation to pain, hygiene, quality of life, root resorption and periodontal health, being inferior to fixed orthodontic appliances in terms of effectiveness and speech capacity.

Morphometric evaluation of the slot of aesthetic orthodontic brackets / Evaluación morfométrica de la ranura de brackets estéticos ortodóncicos

Introduction: Dental malocclusion is a public health problem and orthodontics is the specialty in charge of diagnosing and treating it, aesthetic brackets are an alternative, the costs are varied, which makes its precision doubtful. Objective: Evaluate the measurement and geometry of the slot of three brands of aesthetic brackets and verify their precision. Material and Methods: Twenty-four aesthetic Roth prescription 0.022" slot polycrystalline ceramic brackets were evaluated in three brands: American Orthodontics (United States), Morelli (Brazil) and Class One (China). Eight samples were measured per group in a specialized laboratory certified in measurement and calibration, the measurements of internal and external height were verified, per mesial and distal; and the parallelism of the slot of each bracket. The results were processed with SPSS 22 and tests of variance (ANOVA), Tukey and Student's t were used. Results:The measurements of the brackets' grooves do not correspond to the measurements announced by the manufacturers, these are greater, however, American Orthodontics is within the tolerance range (p<0.01); the slots in the mesio-distal direction and the lingual vestibule are not parallel in Morelli and Class One. Conclusion: The results of this study indicate that the slots of the supports are oversized, their geometry is not precise and varies greatly between brands and prices. The three-dimensional control of the tooth could be compromised.

Introducción: La maloclusión dental es un problema de salud pública y la ortodoncia es la especialidad encargada de diagnosticarla y tratarla, los brackets estéticos son una alternativa, los costos son variados lo que hace dudar su precisión. Objetivo: Evaluar la medida y geometría de la ranura de tres marcas de brackets estéticos y corroborar su precisión. Material y Métodos: Se evaluaron 24 brackets estéticos cerámicos policristalinos de ranura 0,022" prescripción Roth en tres marcas: American Orthodontics (Estados Unidos), Morelli (Brasil) y Class One (China). Se midieron ocho muestras por grupo en un laboratorio especializado y certificado en medición y calibración, se verificaron las medidas de altura interna y externa, por mesial y distal; y el paralelismo de la ranura de cada brackets. Los resultados fueron procesados con SPSS 22 y se utilizaron pruebas de varianza (ANOVA), Tukey y t de Student. Resultados: Las medidas de las ranuras de los brackets no se corresponden con la medida anunciada por los fabricantes, estas son mayores, sin embargo, American Orthodontics y Morelli se encuentra dentro del rango de tolerancia (p<0,01); las ranuras en sentido mesio distal y vestíbulo lingual no son paralelas estadísticamente en Morelli y Class One. Conclusión: Los resultados de este estudio indican que las ranuras de los soportes se encuentran sobredimensionadas, su geometría no es precisa y varía mucho entre marcas y precios. El control tridimensional del diente se podría ver comprometido.

Effect of the caries-protective self-assembling peptide P11-4 on shear bond strength of metal brackets.

PURPOSE: During orthodontic treatment with fixed appliances, demineralization around brackets often occurs. The aim of this in vitro study was to investigate the effect of the caries-protective self-assembling peptide P11­4 (SAP P11-4) on the shear bond strength of metal brackets. METHODS: In all, 45 extracted human wisdom teeth were available for the study. The teeth were randomly divided into 3 groups (each n = 15) and pretreated as follows: test group 1: application of SAP P11­4 (Curodont Repair, Windisch, Switzerland) and storage for 24 h in artificial saliva; test group 2: application of SAP P11­4; control group: no pretreatment with SAP P11­4. A conventional metal maxillary incisor bracket (Discovery, Dentaurum, Ispringen) was adhesively bonded to each buccal surface. The shear bond strength was tested according to DIN 13990. After shearing, the Adhesive Remnant Index (ARI) was determined microscopically (10 נmagnification). Analysis of variance (ANOVA) was used to check the groups for significant differences (α = 0.05). The distribution of the ARI scores was determined with the χ 2 test. RESULTS: There was no significant difference in shear forces between the groups (p = 0.121): test group 1 = 17.0 ± 4.51 MPa, test group 2 = 14.01 ± 2.51 MPa, control group 15.54 ± 4.34 MPa. The distribution of the ARI scores between the groups did not vary (p-values = 0.052-0.819). CONCLUSION: The application of the caries protective SAP P11­4 before bonding of brackets did not affect the shear bond strength. Therefore, pretreatment of the enamel surface with SAP P11­4 shortly before bracket insertion can be considered.

Side effects of twistflex retainers-3D evaluation of tooth movement after retainer debonding.

PURPOSE: Evaluation of tooth movement after retainer debonding in retainer-associated misalignment cases. METHODS: This pilot study is based on a retrospective data analysis. Adult patients (age 25.5 ± 4.9 years) wearing fixed twistflex retainers and having visible retainer-associated misalignment were included and examined for tooth movement after retainer debonding. Orthodontic study models were taken at retainer debonding (t0) and 14 (±1) weeks later (t1). They were digitally superimposed using 2D/3D dental imaging software and tooth movement was analyzed in all three dimensions. RESULTS: A total of 23 teeth (12 upper teeth: 10 incisors, 2 canines; 11 lower teeth: 7 incisors, 4 canines) were analyzed. Mean overall tipping was 1.11 ± 0.82° in the mesial/distal direction (angulation, x­axis), 2.02 ± 1.9° in the buccal/lingual direction (inclination, y­axis) and 1.28 ± 0.99° around the tooth axis (z-axis). Mean overall bodily movement was 0.30 ± 0.31 mm in the mesial/distal direction (angulation, x­axis), 0.10 ± 0.13 mm in the buccal/lingual direction (inclination, y­axis), and mean in- or extrusion 0.22 ± 0.24 mm (z-axis). Mean tipping and bodily movement were more pronounced in the upper jaw. CONCLUSION: The present data shows that tooth movement after debonding of twistflex retainers can be expected in misalignment cases.

Effect of piezocision on molar intrusion in open-bite treatment using a modified MEAW technique.

PURPOSE: The aim of this retrospective study was to investigate whether a piezocision technique influences molar intrusion in open-bite cases. METHODS: In all, 30 patients with open-bite malocclusion were assigned to one of two groups: the piezocision group comprised 15 patients who were treated using curved arches and anterior elastics with the simultaneous combination of piezocision which was performed interdentally in the upper posterior region, while the control group comprised 15 patients who were treated with the same treatment mechanics without piezocision. In both groups, after leveling and aligning, upper 0.017â€¯× 0.025 accentuated curve and lower 0.017â€¯× 0.025 reversed curve of Spee NiTi archwires were placed. Anterior vertical elastics were applied between laterals and the canines on both sides. The effects of treatments were investigated on cone-beam computed tomography images acquired before use of elastics and after correction of open-bite. RESULTS: Open-bite closure was achieved in 2.85 ± 0.85 and 4.1 ± 1.58 months in the piezocision and control groups, respectively, while total treatment lasted 1.4 ± 0.42 and 1.7 ± 0.43 years, respectively. Extrusion of lower posterior teeth (p < 0.05) was observed together with extrusion of incisors and canines (p < 0.001) in the piezocision group, while only incisors and canines were extruded in the control group (p < 0.001). There were no significant differences between the groups (p > 0.05) except significant lower incisor extrusion (p < 0.05) and counter-clockwise rotation of the lower occlusal plane in the piezocision group (p < 0.001). CONCLUSION: The duration of open-bite correction was significantly shorter in the piezocision group. No molar intrusion was observed in either group. Open bite correction was achieved mainly by extrusion and retrusion of the incisors while maintaining upper molar positions.