Evaluation of the aesthetics and clinical findings in patients with missing maxillary lateral incisors treated with a 10-year interval.

INTRODUCTION: The most common treatment approaches for patients missing maxillary lateral incisors are implant replacement (IT) and orthodontic space closure (SC). Treatment techniques change and improve over time, and it is of interest to know if improvements differ between the methods. AIM: To compare the aesthetic outcome and other clinical findings in patients with one or two missing maxillary lateral incisors who were treated with a 10-year difference in time, with either orthodontic space closure or implant replacement. MATERIAL AND METHODS: A total of 88 patients were included in the study. Forty-four patients treated between 2011 and 2018 were included as the latter cohort (LC). The LC was compared to the early cohort (EC; n = 44), treated between 2001 and 2008. A total of 132 teeth was analysed: 62 teeth in the EC (28 teeth in IT cases and 34 teeth in SC cases) and 70 teeth in the LC (34 teeth in IT cases and 36 teeth in SC cases). Long-term clinical and aesthetic outcomes were evaluated. RESULTS: An improvement over time was found in crown length, BoP, papilla, the inclination of incisors, and overall appearance in IT cases and in crown colour and overbite in SC cases. A deterioration over time was found in crown length and BoP among the SC cases. CONCLUSION: Among the IT cases, an improvement in outcomes was noted over time. When comparing SC cases the colour of the crown and overbite had improved, while crown length and BoP had deteriorated over time.

Orthodontists' use of remote monitoring platforms pre-, amid, and post-COVID-19: a survey study.

BACKGROUND: Did the COVID-19 pandemic affect orthodontists' use of remote monitoring platforms? The goal of this research was to examine orthodontists' experiences implementing remote monitoring platforms before, during, and after the initial COVID-19 lockdown. METHODS: In this descriptive cross-sectional survey study, an electronic, anonymous questionnaire consisting of a series of 31 short-answer and multiple-choice questions was administered to an international sampling of practicing orthodontists. The target population in the study included currently practicing orthodontists who were graduates of an accredited orthodontic residency program. Participants were recruited in 2021 through collaboration with the American Association of Orthodontists (AAO) Partners in Research Program and the Harvard School of Dental Medicine Orthodontic Alumni Association. Descriptive analysis was conducted, reporting frequency (N and %) distributions for each question. The questionnaire aimed to describe whether orthodontists incorporated remote monitoring platforms into their practices, their experiences doing so, and if the COVID-19 pandemic influenced their use of these resources. RESULTS: Orthodontists' use of remote monitoring platforms was negligible prior to the pandemic; however, a quarter of surveyed orthodontists began using a remote monitoring platform during COVID-19 and nearly all respondents plan to continue using remote monitoring for the foreseeable future. Approximately half of orthodontists believe most patients' treatment progress can be monitored to the standard of care between in-person orthodontic appointments using remote monitoring platforms. Half of the orthodontists who do not currently use a remote monitoring platform in their practice are interested in learning more about how to implement one. CONCLUSIONS: The COVID-19 pandemic led to an increase in the interest and adoption of remote monitoring platforms in orthodontic practices. Most orthodontists had not incorporated remote monitoring platforms into their practices prior to the COVID-19 pandemic. However, this study revealed that a subset of orthodontists utilized the pandemic as motivation to incorporate remote monitoring into their practices and an additional group of orthodontists were interested in incorporating one in the future. Remote monitoring platforms garnered interest and importance with the arrival of the COVID-19 pandemic and may only have an increasing role in the field in years to come.

Orthodontics and Endodontics Clinical Practice Correlation: A Narrative Review.

Research on the connection between endodontic therapy and orthodontics is lacking. This overview of the literature synthesizes the findings from the fields of orthodontics and endodontics and explains how they are related. Beginning with the diagnosis, treating the patient at the appropriate time, moving endodontically treated teeth and traumatized teeth, resorbing roots by orthodontic mechanics, and managing traumatized teeth with orthodontic therapy. Multiple electronic databases were utilized including (PubMed, Scopus, Science Direct, and Web of Science) to perform manual literature searches. A total of 31 articles were reviewed and summarized in this paper in keywords like "Endodontically Treated Teeth and Orthodontic Treatment," "Endodontically Treated Tooth and Orthodontic Movement," "Orthodontic Treatment in RCT Teeth," "Root Canal Treatment with Orthodontic Movement," "Trauma with Orthodontic Movement," "Orthodontic and Endodontic." Orthodontic treatment of endodontically treated and traumatized teeth is a subject of controversy. The lack of research on the topic makes it a hard decision to make when to treat these teeth. Especially given that both orthodontic and endodontic treatments have multiple consequences on each other's outcomes. Thus, it is crucial for clinicians to understand how they integrate and have a guideline to refer to during decision-making. Successful orthodontic tooth movement could be carried out immediately after endodontic treatment. However, traumatized teeth need a follow-up period before initiating orthodontic movement, which ranges from three months to 12 months depending on the type of trauma and severity. Careful radiographic and clinical follow-up should be done during the healing period. Collaborative teamwork is important between orthodontists and endodontists for the success of treatment, and to achieve satisfactory outcomes.

Enhancing Orthodontic Renewal and Retention Techniques: A Systematic Review.

Orthodontists have a variety of options available for retainers. Research in Orthodontics focuses on assessing outcomes important to clinicians; however, there is inconsistency in how these outcomes are selected and evaluated. This review sought to assess the effects of different orthodontic retainers on patients' quality of life (QoL). Various approaches were employed in this systematic review, and a thorough search was conducted across six databases. The review involved a comprehensive evaluation of six included studies, highlighting changes in dental structure post-treatment, emphasizing the role of extraction procedures and the quality of debonding in improving retention. The study identified key outcomes for orthodontic clinical trials, highlighting orthodontists' preferences for specific retainer types. Moreover, it discussed the impact of sociocultural influences on retention care. Involving patients actively in discussions about whether to end or extend the retention phase was deemed essential. Noteworthy improvements in occlusal outcomes were linked to extraction treatments. Gender and malocclusion severity influenced QoL before and after orthodontic treatment. The degree of improvement observed in the Class III malocclusion group was comparatively lower than that in the Class I and Class II groups. Orthodontic treatment was found to yield favorable psychological outcomes, as evidenced by notable enhancements in self-esteem and social engagement among individuals. Fixed appliances were shown to negatively affect oral health-related quality of life (OHRQoL), particularly for those with aesthetic and functional concerns. A consensus has been reached on the essential themes and outcomes that should be incorporated in clinical trials related to orthodontic retention for non-cleft and non-surgical cases.

Evaluation of the use of a clinical practice guideline for external apical root resorption among orthodontists.

BACKGROUND: External apical root resorption (EARR) is a frequently observed adverse event in patients undergoing fixed appliance therapy. Assessing the patients' risk during treatment is important, as certain factors are assumed to be associated with an increased likelihood of occurrence. However, their predictive value remains limited, making evidence-based clinical decision-making challenging for orthodontists. To address this issue, the Dutch Association of Orthodontists (NvVO) developed a clinical practice guideline (CPG) for EARR in accordance with the AGREE II instrument (Appraisal of Guidelines for Research and Evaluation II) in 2018. The aim of this study is to get insight into the actual utilization and the practical implementation of the guideline among orthodontists. The hypothesis to be tested was that after its introduction, clinical practice for EARR has changed towards the recommendations in the CPG. OBJECTIVE: To investigate the use of the 2018 clinical practice guidelines for EARR among orthodontists 3 years after its introduction. METHODS: A questionnaire using a 7-point Likert scale was developed concerning four domains of EARR described in the guideline. The questionnaire was piloted, finalised, and then distributed digitally among Dutch orthodontists. REDCap was used for data collection, starting with an invitation email in June 2021, followed by two reminders. Effect was tested by the Mann-Whitney U test, and the influence of demographic variables was analysed. RESULTS: Questionnaires were sent out to all 275 and completed by 133 (response rate 48%); N = 59 females and N = 73 males were included; 81% had their training in the Netherlands, 89% had ≥ 6 years of work experience, and 89% worked in private orthodontic practice. One hundred thirty orthodontists (98.5%) reported changes in clinical practice. The biggest positive change in clinical behaviour regarding EARR occurred if EARR was diagnosed during treatment. Sex, clinical experience, country of specialist training, and working environment of the respondents did not affect clinical practices regarding EARR. CONCLUSIONS: This questionnaire demonstrated that, 3 years after introduction of the guideline, orthodontists improved their self-reported clinical practices to a more standardised management of root resorption. None of the demographic predictors had a significant effect on the results.

The Role of Interproximal Reduction (IPR) in Clear Aligner Therapy: A Critical Analysis of Indications, Techniques, and Outcomes.

Interproximal reduction (IPR) has become a standard practice in orthodontic treatment, particularly in the clear aligner therapy. It became an integral part of the digital plan when using clear aligners. Given the irreversible nature of IPR, precise planning and performance is essential. This article aims to analyze and summarize the existing literature on IPR in the context of clear aligners. The goal is to help clinicians to gain essential knowledge for safely and effectively navigating IPR. The review critically examines different perspectives found in the literature, covering indications, methods, and outcomes. Topics exploring the impact of IPR on treatment outcomes include space gaining, addressing tooth size discrepancies, tooth shape adjustments, resolving malocclusion, and enhancing aesthetics. Emphasizing precision of the procedure by the clinician and awareness of contraindications, the article also discusses the impact of IPR on patients. This includes considerations like increased pulp temperature, susceptibility to cavities due to changes in enamel roughness, effects on soft tissues, and post-IPR tooth sensitivity.

Effects of Froggy Mouth Appliance in Pediatric Patients with Atypical Swallowing: A Prospective Study.

Atypical swallowing has a high incidence in growing subjects. Orthopedic treatment with orthodontic appliances and speech therapy are the main approaches to this problem. The aim of this prospective study was to evaluate the changes in the dental arches induced by one year of treatment with the Froggy Mouth myofunctional appliance designed to correct atypical swallowing. In total, 16 patients with atypical swallowing were instructed to use the Froggy Mouth appliance. A digital intraoral impression was taken at baseline (T0). The Froggy Mouth appliance had to be used for 15 min/day throughout the treatment period. At the end of the first year of treatment (T1), another impression was taken with the same intraoral scanner. Digital casts of the T0 and T1 impressions were obtained using software and the two casts were superimposed to record the following measurements: upper intercanine distance, upper arch diameter, upper arch width, overbite and overjet. The data were statistically analyzed (significance threshold: p < 0.05). Student's t-test was used to compare pre- and post-treatment measurements. Linear regressions were performed to assess the influence of arch width on anterior and posterior diameters. A significant increase was found for the upper arch diameters (p < 0.05), whereas no statistically significant difference was found for the incisor relationship (overjet/overbite) (p > 0.05). To date, the efficacy of this appliance has not been extensively studied. According to the present prospective study, the Froggy Mouth protocol could be a valuable method as a myofunctional therapy for atypical swallowing, but further studies are needed to confirm these preliminary results.

Assessment of the quality and accuracy of information contained within the websites of marketed orthodontic products: a cross-sectional investigation.

OBJECTIVES: To assess the quality and accuracy of information contained within the websites of providers of marketed orthodontic products. MATERIALS AND METHODS: Twenty-one websites of orthodontic appliance and adjunct (product) providers were identified. The website content was assessed via two validated quality-of-information instruments (DISCERN and the Journal of the American Medical Association [JAMA] benchmarks) and an accuracy-of-information instrument. Website content was qualitatively analyzed for themes and subthemes. RESULTS: More than half (n = 11; 52.3%) of the assessed websites contained clinician testimonials. The mean (SD) DISCERN score was 33.14 (5.44). No website recorded the minimum of three JAMA benchmarks required to indicate reliability. The most common content themes related to quality-of-life impact and treatment duration. Just 8% of the statements within the websites were objectively true. The Pearson correlation coefficient indicated that the DISCERN scores were correlated with the accuracy-of-information scores (r = .83; P < .001). CONCLUSIONS: The quality and accuracy of information contained within the websites of the providers of marketed orthodontic products was poor. The combined use of DISCERN and the accuracy-of-information instrument may help overcome the shortcomings of each. Clinicians should check the accuracy of information on orthodontic product provider websites before adding links to those websites on their own sites.

A Hypothesis Testing of Archwire Rounding for the Efficacy of Torque Springs in Orthodontics: A Finite Element Study.

BACKGROUND: Achieving the proper buccolingual inclination of teeth is a cornerstone in orthodontic treatment, directly impacting the attainment of ideal occlusal relationships and long-term stability. A practical torque expression that moves the tooth in its proper position across all three planes is imperative to finish orthodontic cases optimally. The primary focus of this research is to investigate Burstone's hypothesis about Warren torque springs when applied to the rectangular wire. Additionally, it examines the hypothesis of rounding these wires in between the bracket wings of the target tooth to be moved. This study aims to determine whether the rounding of wires, in conjunction with the use of torque springs, influences orthodontic outcomes, addressing a notable gap in current literature and resolving controversies in orthodontic practice. METHODS: A three-dimensional set of maxillary teeth was modeled. A 0.022" MiniSprint™ brackets and Stainless steel archwires of 0.019" × 0.025" and 0.017" × 0.025" (Forestadent, Pforzheim, Germany) were generated. Warren torque spring was modeled and used in the simulation on the upper right central incisor. Four case scenarios were simulated. In two scenarios, the archwires were untouched for both archwire sizes. In comparison, in the other two scenarios, each archwire size was rounded for the upper right maxillary incisor bracket area. Stresses in the Warren torque springs were calculated, the root tip displacement in the four scenarios was measured in millimeters, and both were analyzed. RESULTS: The root tip displacement was highly affected by rounding the archwire. The increase in root tip displacement was 1538% for the Warren torque spring on 0.019" × 0.025" and 783% for 0.017" × 0.025". The amount of root tip displacement was about 18.8 mm for 0.017" × 0.025" with rounding and 12.2 mm for 0.019" × 0.025". The concentration of the stresses in the Warren torque spring was in the neck of the spring next to the coils. CONCLUSION: Rounding the archwires while using the Warren torque spring on a rectangular archwire will increase the efficiency of the spring and, in turn, will exhibit more torque on the tooth. Smaller dimensions of rectangular archwires will give more torque in conjunction with Warren torque springs compared to larger sizes of archwires.

Dental and Periodontal Changes After Accelerated Correction of Lower Anterior Teeth Crowding With Periodontally Accelerated Osteogenic Orthodontics (PAOO) Procedure: A Randomized Controlled Trial.

Objective To evaluate the relative efficacy of periodontally accelerated osteogenic orthodontics (PAOO) compared to conventional fixed appliances in correcting lower anterior teeth crowding using a non-extraction treatment approach. Material and methods A single-center, two-arm, parallel-group randomized controlled trial was conducted on 38 patients (9 males, 29 females) with moderate crowding. These patients did not require premolar extraction and were randomly allocated into two treatment groups: the PAOO group and the conventional orthodontic treatment group. The Little Irregularity Index (LII) measured crowding intensity on pre-treatment study models. Changes in this index were recorded monthly in both treatment groups. The inter-canine width, inter-second-premolar width, plaque index (PI), gingival index (GI), and papillary bleeding index (PBI) were also measured before and after the leveling and alignment stage. Statistical analysis between the two groups was performed using Mann-Whitney U tests. Results For the LII, the average time for irregularity resolution was three months in the PAOO group, compared to five months in the conventional orthodontic treatment group. Regarding changes in inter-second-premolar width, the PAOO procedure led to a significant decrease in the increase of inter-second-premolar width, with an average increase of +1.52 mm compared to +2.71 mm in the control group. For the GI and PBI, it was found that their values significantly increased with PAOO application, averaging 0.18 and 0.17, respectively, compared to 0.05 and 0.07 in the control group. Conclusions The use of PAOO in orthodontic treatment accelerated the leveling and alignment process by 40%. Changes in the inter-canine width, the inter-second-premolar width, and the status of periodontal tissues were minimal and clinically negligible.

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.

Evaluation of the Quality and Reliability of YouTubeTM Videos Created by Orthodontists as an Information Source for Clear Aligners.

Objective: This study aimed to evaluate the quality, reliability, and content usefulness of videos created by orthodontists on clear orthodontic aligners. Methods: Videos were screened using YouTubeTM by conducting a search for "Invisalign". After a preliminary evaluation of the first 250 results, 61 videos that met the selection criteria were scored and their length, days since upload, and numbers of views, likes, dislikes, and comments were recorded. These data were used to calculate the interaction index and viewing rate. Video reliability was assessed using a five-item modified DISCERN index, and video quality was assessed using the Video Information and Quality Index. A 10-item content usefulness index was created to determine the usefulness of the video content. Descriptive statistics of the parameters were calculated, and correlation coefficients were calculated to evaluate the relationships between the parameters. Results: The mean reliability score was 2.75±1.02 (out of 5), and the total quality score was 11.80±3.38 (out of 20). The total content usefulness index was quite low, with a mean score of 2.52±2.14 (out of 10). Interaction index and viewing rate were positively correlated with reliability score (r=0.463, p<0.01; r=0.295, p<0.05) and total quality score (r=0.365, p<0.01; r=0.295, p<0.01, respectively). The reliability score was positively correlated with the total quality score (r=0.842, p<0.01) and total content usefulness index (r=0.346, p<0.01). Conclusion: Videos about orthodontic aligner treatment have average reliability and quality but largely insufficient content.

Integrated Care Strategies for Unilateral Cleft Lip and Palate: A Multidisciplinary Treatment Approach for Profile Correction.

Cleft lip and palate (CLP) is a prevalent congenital craniofacial deformity that can be unilateral or bilateral. This case report highlights the interdisciplinary approach to managing a 24-year-old male with unilateral CLP (UCLP), emphasizing the complexity of associated dental and skeletal challenges. The patient had undergone multiple surgeries, including lip closure at three months, palate repair at seven years, and alveolar bone grafting at 12 years. Clinical assessments revealed a retruded maxilla, an absence of lateral incisors, and scars from previous surgeries. Radiographic evaluations indicated a Class III skeletal pattern and confirmed the presence of a cleft on the left side. Orthodontic treatment commenced with maxillary arch alignment, followed by Le Fort I surgery to address maxillary retrusion, correct skeletal malocclusion, and close the alveolar cleft space. The post-surgical phase involved orthodontic adjustments, crossbite correction, and alignment of the mandibular arch. Despite the discontinuation of treatment due to the patient's relocation, the interdisciplinary collaboration achieved significant improvements, including a corrected facial profile, maxillary advancement, closure of the cleft space, and enhanced dental alignment. The patient's confidence and functionality were positively impacted. This case underscores the importance of a coordinated interdisciplinary approach to addressing the multifaceted challenges associated with UCLP, aiming to optimize both aesthetic and functional outcomes for improved patient well-being.

Contributions of Digital Simulation to Orthodontic Therapeutic Decision-Making: A Case Report.

Adult orthodontics aims to achieve optimal functional and aesthetic corrections. However, for several reasons, some patients will wish to benefit from a limited treatment where only certain aspects of a malocclusion will be corrected. In these clinical situations, the therapeutic objectives must be adjusted to the individual needs of the patient insofar as they can bring them real benefits. The use of digital technology makes it possible to study the therapeutic possibilities better and visualize the occlusal results before choosing the best therapeutic approach, especially in cases requiring customization. The aim of this clinical case report is to illustrate the orthodontic compromise made after the analysis of the digital setup in an adult patient who presented with a class III malocclusion but refused orthodontic-surgical therapy and requested an alternative treatment.

Study on decision-making for orthodontic treatment plans based on analytic hierarchy process.

BACKGROUND: Orthodontics is a common treatment for malocclusion and is essential for improving the oral health and aesthetics of patients. Currently, patients often rely on the clinical expertise and professional knowledge of doctors to select orthodontic programs. However, they lack their own objective and systematic evaluation methods to quantitatively compare different programs. Therefore, there is a need for a more comprehensive and quantitative approach to selecting orthodontic treatment plans, aiming to enhance their scientific validity and effectiveness. METHODS: In this study, a combination of the analytic hierarchy process (AHP) and semantic analysis was used to evaluate and compare different orthodontic treatment options. An AHP model and evaluation matrix were established through thorough research and semantic analysis of patient requirements. This model considered various treatment factors. Expert panels were invited to rate these factors using a 1-9 scale. The optimal solution was determined by ranking and comparing different orthodontic treatment plans using the geometric mean method to calculate the weights of each criterion. RESULTS: The research indicates a higher preference for invisible correction compared to other orthodontic solutions, with a weight score that is 0.3923 higher. Factors such as comfort and difficulty of cleaning have been given significant attention. CONCLUSION: The Analytic Hierarchy Process (AHP) method can be utilized to effectively develop orthodontic treatment plans, making the treatment process more objective, scientific, and personalized. The design of this study offers strong decision support for orthodontic treatment, potentially improving orthodontic treatment outcomes in clinical practice and ultimately enhancing oral health and patients' quality of life.

The effects of pterygomaxillary disjunction in surgically assisted rapid maxillary expansion: A systematic review and meta-analysis.

OBJECTIVE: This study aims to assess the expansive effects of pterygomaxillary disjunction (PMD) in surgically assisted rapid maxillary expansion (SARME) surgery using a meta-analysis approach. MATERIALS AND METHODS: The study conducted a comprehensive literature search across five databases: PubMed, Scopus, Medline, Embase, and Cochrane, adhering to the PRISMA 2020 guidelines. Dental alterations were assessed using either cone-beam computed tomography (CBCT) or dental casts, while skeletal changes were exclusively measured from CBCT scans. We analysed the dentoskeletal changes between PMD +/- groups and conducted a within-group comparison. The primary focus of the results was on the mean differences observed in pre- and post-operative measurements. RESULTS: Dental expansion was larger in the PMD+ group but not statistically significant. Skeletal expansion showed a significantly larger expansion in the posterior region in the PMD+ group (P = .033). Without PMD, anterior palatal expansion was significantly larger (P = .03), and the buccal tipping of posterior teeth was also significantly larger (P = .011) to achieve acceptable dental expansion outcomes. CONCLUSIONS: Both PMD +/- groups of SARME surgery can achieve satisfactory dental expansion outcomes. However, bone expansion and tooth inclination are also important factors that influence orthodontic treatment and post-expansion stability. By reducing the bony resistance with PMD, larger posterior palatal expansion and more parallel bony expansion are observed. In contrast, without PMD, there is smaller palatal expansion and greater tooth inclination in the posterior region. This could potentially lead to compromised periodontal conditions following expansion.

Tongue pressure and maxillofacial muscle activities during swallowing in patients with mandibular prognathism.

BACKGROUND: Coordination among lip, cheek and tongue movements during swallowing in patients with mandibular prognathism remains unclear. OBJECTIVES: This study aimed to identify the temporal sequences of tongue pressure and maxillofacial muscle activities during swallowing in patients with mandibular prognathism and compared characteristics with those of healthy volunteers. METHODS: Seven patients with mandibular prognathism (mandibular prognathism group) and 25 healthy volunteers with individual normal occlusion (control group) were recruited. Tongue pressures and masseter, orbicularis oris, mentalis and supra- and infrahyoid muscle activities while swallowing gel were measured simultaneously using a sensor sheet system with five measurement points and surface electromyography, respectively. Onset time, offset time and durations of tongue pressure and muscle activities were analysed. RESULTS: In the mandibular prognathism group, tongue pressure was often produced first in more peripheral parts of the palate. Offset of tongue pressure in the posteromedian and peripheral parts of the palate and maxillofacial muscle activities except for orbicularis oris were delayed. Duration of tongue pressure in the anteromedian part of the palate was significantly shorter and durations of masseter, mentalis and suprahyoid muscle activities were significantly longer. Times to onset of orbicularis oris and suprahyoid muscle activities based on first onset of tongue pressure were significantly shorter. CONCLUSION: These results suggest that patients with mandibular prognathism may exhibit specific patterns of tongue pressure production and maxillofacial muscle activities during swallowing.

Evidence-based potential of generative artificial intelligence large language models in orthodontics: a comparative study of ChatGPT, Google Bard, and Microsoft Bing.

BACKGROUND: The increasing utilization of large language models (LLMs) in Generative Artificial Intelligence across various medical and dental fields, and specifically orthodontics, raises questions about their accuracy. OBJECTIVE: This study aimed to assess and compare the answers offered by four LLMs: Google's Bard, OpenAI's ChatGPT-3.5, and ChatGPT-4, and Microsoft's Bing, in response to clinically relevant questions within the field of orthodontics. MATERIALS AND METHODS: Ten open-type clinical orthodontics-related questions were posed to the LLMs. The responses provided by the LLMs were assessed on a scale ranging from 0 (minimum) to 10 (maximum) points, benchmarked against robust scientific evidence, including consensus statements and systematic reviews, using a predefined rubric. After a 4-week interval from the initial evaluation, the answers were reevaluated to gauge intra-evaluator reliability. Statistical comparisons were conducted on the scores using Friedman's and Wilcoxon's tests to identify the model providing the answers with the most comprehensiveness, scientific accuracy, clarity, and relevance. RESULTS: Overall, no statistically significant differences between the scores given by the two evaluators, on both scoring occasions, were detected, so an average score for every LLM was computed. The LLM answers scoring the highest, were those of Microsoft Bing Chat (average score = 7.1), followed by ChatGPT 4 (average score = 4.7), Google Bard (average score = 4.6), and finally ChatGPT 3.5 (average score 3.8). While Microsoft Bing Chat statistically outperformed ChatGPT-3.5 (P-value = 0.017) and Google Bard (P-value = 0.029), as well, and Chat GPT-4 outperformed Chat GPT-3.5 (P-value = 0.011), all models occasionally produced answers with a lack of comprehensiveness, scientific accuracy, clarity, and relevance. LIMITATIONS: The questions asked were indicative and did not cover the entire field of orthodontics. CONCLUSIONS: Language models (LLMs) show great potential in supporting evidence-based orthodontics. However, their current limitations pose a potential risk of making incorrect healthcare decisions if utilized without careful consideration. Consequently, these tools cannot serve as a substitute for the orthodontist's essential critical thinking and comprehensive subject knowledge. For effective integration into practice, further research, clinical validation, and enhancements to the models are essential. Clinicians must be mindful of the limitations of LLMs, as their imprudent utilization could have adverse effects on patient care.

Compressive strength and fluoride release profile of a glass ionomer cement reinforced with silver-hydroxyapatite-silica hybrid nanoparticles: An in vitro study.

OBJECTIVES: This study aimed to prepare a glass ionomer (GI) cement reinforced with silver-hydroxyapatite-silica (Ag/HA/Si) hybrid nanoparticles and assess its compressive strength and fluoride release profile. MATERIAL AND METHODS: In this in vitro, experimental study, 60 cylindrical specimens were fabricated with 4mm diameter and 6mm height in 6 groups (n=10) using BracePaste composite, GC Fuji II LC pure RMGI, and RMGI reinforced with 0.1wt%, 0.5wt%, 1wt%, and 2wt% Ag/HA/Si hybrid nanoparticles. The specimens were subjected to compressive force in a universal testing machine to measure their compressive strength (MPa). To assess their fluoride release profile, discs with 3mm diameter and 2mm thickness were fabricated from Fuji II LC pure resin-modified glass ionomer (RMGI), and RMGI with 0.1wt%, 0.5wt%, 1wt%, and 2wt% hybrid nanoparticles, and the concentration of released fluoride was measured by a digital ion-selective electrode. Data were analysed by ANOVA and Scheffe test (alpha=0.05). RESULTS: The compressive strength was 114.14MPa for BracePaste composite, and 97.14, 97.84, 100.65, 109.5, and 89.33MPa for GI groups with 0%, 0.1%, 0.5%, 1% and 2% hybrid nanoparticles, respectively, with no significant difference among them (P=0.665). Addition of 1% (0.21±0.07µg/mL, P=0.029) and 2% (0.45±0.22µg/mL, P=0.000) hybrid nanoparticles to RMGI significantly increased the amount of released fluoride, compared with the control group (0.09±0.03µg/mL). CONCLUSIONS: Addition of Ag/HA/Si hybrid nanoparticles to RMGI in the tested concentrations had no significant effect on its compressive strength but addition of 1wt% and 2wt% concentrations of Ag/HA/Si hybrid nanoparticles increased its fluoride release potential.

A 10-year-old boy with class II oligodontia treated with buccal fixed appliances and agenesis space closure of the four second premolars: Case report No. 230075 - Titularisation Collège Européen Orthodontie (CEO), European College of Orthodontics.

The patient presented in this case report is a 10-year-old boy with hyperdivergent skeletal Class II associated with familial genetic agenesis of the second premolars. The treatment plan chosen was to close the spaces of agenesis using a bimaxillary appliance fixed buccally. The advantages and disadvantages of this treatment option were discussed. The result was stable and made it possible to avoid an implant-prosthetic solution, which would undoubtedly have been more restrictive over time.