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1.
BMC Oral Health ; 19(1): 250, 2019 11 20.
Artículo en Inglés | MEDLINE | ID: mdl-31747943

RESUMEN

BACKGROUND: Oral lichenoid reaction (OLR) is a type IV cell-mediated immune response in the oral cavity. There is an established relationship between various dental materials and OLR, but few cases reports reported the occurrence of a lichenoid reaction in association with the use of a Hawley retainer. CASE PRESENTATION: A female patient (twenty years of age) has been complaining of a reddish painful area on the tongue, which started one year ago and has been increasing in size over time. The patient completed orthodontic treatment two years ago and has been using a Hawley retainer for orthodontic retention since then. After performing histological analysis and patch test, the lesion was diagnosed as a lichenoid reaction to the Hawley retainer. Topical corticosteroids were prescribed, and the patient was asked to stop using the retainer and followed for six months. CONCLUSIONS: It is difficult to diagnose lichenoid lesions and even more challenging to differentiate between OLP and OLR, therefore it is essential to do a full intraoral and extraoral examination. OLL can occur in association with Hawley retainer, which we believe could be because it is made of an acrylic based material. Generally, OLL resolves after removal of the cause.


Asunto(s)
Erupciones Liquenoides/diagnóstico , Retenedores Ortodóncicos/efectos adversos , Lengua/patología , Femenino , Humanos , Liquen Plano Oral , Erupciones Liquenoides/inducido químicamente , Adulto Joven
2.
Am J Orthod Dentofacial Orthop ; 156(2): 186-192, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31375228

RESUMEN

INTRODUCTION: The purpose of this study was to compare and evaluate salivary microbial levels and periodontal status in patients using a fixed lingual retainer, a removable vacuum-formed retainer, or a Hawley retainer after orthodontic treatment with fixed appliances. METHODS: Forty-five patients who finished their orthodontic treatment with fixed appliances and were about to start the retention phase were randomly divided into the following 3 groups of 15 individuals each: the fixed lingual retainer group, the vacuum-formed retainer group, and the Hawley retainer group. Periodontal measurements, such as the plaque index, gingival index, probing depth, and bleeding on probing, were obtained at the following 4 time points: at debonding (T0) and 1 week (T1), 5 weeks (T2), and 13 weeks (T3) after debonding. Saliva samples were collected 3 times in total: at T0, T2, and T3. A quantitative analysis for Streptococcus mutans and Lactobacillus casei was performed with the use of real-time polymerase chain reaction. The Kruskal-Wallis test and 1-way analysis of variance were used for the statistical comparisons of the groups. RESULTS: No statistically significant difference in salivary S mutans and L casei levels was found among the 3 groups (P >0.05). They showed no statistically significant differences in plaque index, gingival index, bleeding on probing, and probing depth values (P >0.05). All periodontal parameters showed statistically significant decreases from T0 to T3 in all 3 groups (P <0.001). The S mutans and L casei levels were decreased significantly from T2 to T3 in the lingual retainer and Hawley retainer groups, whereas they decreased significantly from T0 to T3 in the vacuum-formed retainer group. CONCLUSIONS: Fixed and removable orthodontic retainers do not differ in salivary S mutans and L casei levels and periodontal status. With all retainers, regardless of whether they are fixed or removable, oral hygiene improved after orthodontic treatment with fixed appliances.


Asunto(s)
Aparatos Ortodóncicos Fijos/efectos adversos , Aparatos Ortodóncicos Removibles/efectos adversos , Retenedores Ortodóncicos/efectos adversos , Índice Periodontal , Saliva/microbiología , Adolescente , Adulto , Análisis de Varianza , Niño , ADN Bacteriano , Índice de Placa Dental , Femenino , Humanos , Lactobacillus casei , Masculino , Higiene Bucal , Diseño de Aparato Ortodóncico , Ortodoncia Correctiva/efectos adversos , Ortodoncia Correctiva/instrumentación , Streptococcus mutans , Vacio , Adulto Joven
3.
J Orofac Orthop ; 80(2): 88-96, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30778609

RESUMEN

PURPOSE: To evaluate the impact of a novel computer-fabricated lingual nitinol retainer compared to a conventional lingual flexible spiral wire twistflex retainer on oral health. METHODS: The study was based on a retrospective controlled clinical study with pilot character, an in vitro investigation of material-dependent biofilm formation and an analysis of biofilm formation after intraoral incubation. Sixty-one patients with completed fixed orthodontic treatment and retention phase for at least 6 months with twistflex retainers (group 1, n = 31) or computer-aided design/computer-aided manufacturing (CAD/CAM) nitinol retainers (group 2, n = 30) were included and examined regarding plaque index (PI), gingival index (GI), probing depths, bleeding on probing (BOP) and marginal recessions (MR). Material-dependent biofilm formation of twistflex, untreated nitinol and electropolished nitinol wire samples were assessed (1) in vitro: using optical density (OD) measurement of 10 samples of each and (2) in vivo: using histomorphometric analysis of 18 samples of each. RESULTS: Patients treated with nitinol retainers had significant better oral health indices (PI1 = 1.29 ± 0.06, PI2 = 0.94 ± 0.06; GI1 = 0.71 ± 0.05, GI2 = 0.56 ± 0.04; BOP1 = 0.11 ± 0.01, BOP2 = 0.08 ± 0.01; PD1 = 1.79 ± 0.03 mm, PD2 = 1.59 ± 0.04 mm) except for MR (0.08 ± 0.03 mm versus 0.08 ± 0.02 mm) compared to twistflex retainers. After 24 h intraoral incubation nitinol retainers demonstrated significant less biofilm formation compared to twistflex retainers. In the in vitro investigation the temporary significant differences between the groups were compensated in the end. CONCLUSIONS: Based on the results it can be assumed that nitinol-made CAD/CAM developed lingual retainers have a positive effect on oral health.


Asunto(s)
Aleaciones , Diseño Asistido por Computadora , Materiales Dentales , Aparatos Ortodóncicos Fijos , Retenedores Ortodóncicos , Adulto , Biopelículas/crecimiento & desarrollo , Índice de Placa Dental , Humanos , Persona de Mediana Edad , Salud Bucal , Aparatos Ortodóncicos Fijos/efectos adversos , Retenedores Ortodóncicos/efectos adversos , Índice Periodontal , Estudios Retrospectivos , Adulto Joven
4.
J Contemp Dent Pract ; 19(10): 1163-1168, 2018 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-30498169

RESUMEN

AIM: To investigate the cytotoxicity and estrogenicity of Vivera® retainers by assessing their biological behavioral effects as-received from the manufacturer and after retrieved from patients. MATERIALS AND METHODS: In this, in vitro investigation six sets (maxillary and mandibular) of Vivera® retainers, three as received and three retrieved after four weeks of use by patients of an orthodontic postgraduate clinic, were immersed in the normal saline solution for 14 days following different modes of sterilization. The estrogenicity assays involved two cell lines, namely the estrogen-sensitive MCF-7 and the estrogen-insensitive MDA-MB-231. Following a 6 day incubation with the solutions to be tested, at concentrations varying from 5% to 20% v/v in medium supplemented with 2% fetal calf serum devoid of endogenous estrogens, estrogenicity was assessed by cell counting; p-Estradiol was used as positive control. The statistical analysis of data was performed with two-way analysis of variance (ANOVA) with appliance and concentration as predictors. Differences were further investigated with the Tukey multiple comparison tests at the 0.05 level of significance. RESULTS: No significant MCF-7 proliferation was induced by the three samples compared either to the eluents from as-received retainers or to the negative control. As expected, p-estradiol induced a potent stimulation of MCF-7 cell proliferation, while no effect was observed on MDA-MB-231 cells. CONCLUSION: Under the conditions of this experiment eluents of as-received and retrieved Vivera® retainers did not seem to exhibit xenoestrogenic activity. CLINICAL SIGNIFICANCE: Vivera® retainers can be used as part-time removable oral appliances following the manufacturer's instructions.


Asunto(s)
Proliferación Celular/efectos de los fármacos , Estrógenos , Aparatos Ortodóncicos Removibles/efectos adversos , Retenedores Ortodóncicos/efectos adversos , Estradiol/efectos adversos , Humanos , Inmersión , Técnicas In Vitro , Células MCF-7 , Solución Salina , Factores de Tiempo
5.
Prog Orthod ; 19(1): 24, 2018 Jul 23.
Artículo en Inglés | MEDLINE | ID: mdl-30033479

RESUMEN

BACKGROUND: This study aims to evaluate if invisible orthodontic retainers can affect sleep-time masticatory muscle activity (sMMA) over a short-term period in healthy individuals. METHODS: Nineteen (N = 19) healthy subjects underwent an in-home evaluation with a portable device for electromyographic (EMG) assessment. The study protocol provided two baseline recording nights, a night off, and then two additional nights with passive customized orthodontic retainers in situ. For each recording night, the sleep bruxism (SB) index (i.e., average number of SB events/hour) and the overall number of masseter muscle contractions were assessed. Comparison between values gathered over the four recording nights was made with a parametric test, based on the null hypothesis that there was no difference between wearing or not wearing the retainers as far as the sMMA variables are concerned. RESULTS: Average SB index of the first two nights without the retainers was 3.0 ± 1.5, whilst the average values with the retainers in situ was 3.6 ± 1.9. ANOVA test showed the absence of significant differences between the four nights. Similarly, no differences were shown between the four nights as for the total number of sMMA events. Based on that, the null hypothesis was not rejected. CONCLUSIONS: Findings suggest the absence of relevant effects of invisible orthodontic retainers on sMMA in healthy individuals during the short-term period.


Asunto(s)
Músculos Masticadores/fisiopatología , Retenedores Ortodóncicos/efectos adversos , Sueño , Adulto , Bruxismo/etiología , Bruxismo/fisiopatología , Electromiografía , Femenino , Humanos , Masculino , Músculo Masetero/fisiopatología , Sueño/fisiología
6.
Am J Orthod Dentofacial Orthop ; 153(6): 852-860, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29853243

RESUMEN

INTRODUCTION: Many studies on removable retainers have focused on retention efficacy and characteristics. However, studies on plaque accumulation, periodontal health, breakages, and patient compliance are still lacking. Thus, in this study, we aimed at evaluating these parameters in 2 groups of young patients wearing Essix or Hawley retainers for a 6-month period. METHODS: Seventy subjects were included. Periodontal health was investigated by measuring the plaque, gingival, calculus, and bleeding on probing indexes. Evaluations were performed at 1, 3, and 6 months of wearing. Accumulation of plaque on the retainers was also evaluated. Furthermore, compliance on wearing retainers and breakage data were collected by specific questionnaires. RESULTS: Subjects wearing Essix retainers had significantly higher levels of plaque, gingival, and calculus indexes and increased percentages of bleeding sites, compared with subjects wearing Hawley retainers. The Essix group also had increased accumulations of plaque and calculus on the retainers. Nonetheless, subjects of the Essix group had better overall experiences, self-perceptions, and comfort compared with those of the Hawley group. Essix retainers had higher incidences of little and serious breakages compared with Hawley retainers. CONCLUSIONS: Our results suggest that Essix retainers are well accepted by patients for their esthetic and oral comfort characteristics. However, Essix retainers may cause greater accumulations of plaque on both teeth and retainers, presumably because of inhibition of the cleaning effect of saliva caused by the thermoplastic material or the reduced opportunity for good hygiene on the retainer.


Asunto(s)
Placa Dental/etiología , Placa Dental/prevención & control , Salud Bucal , Retenedores Ortodóncicos/efectos adversos , Cooperación del Paciente , Periodoncio , Adolescente , Femenino , Humanos , Masculino , Diseño de Aparato Ortodóncico , Estudios Prospectivos
7.
J Contemp Dent Pract ; 19(4): 443-449, 2018 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-29728551

RESUMEN

Aim: Retention is one of the stages of orthodontic treatment, which is an attempt to retain teeth in their corrected positions after active treatment with the use of fixed orthodontic appliances. The aim of the present study was to compare the stability of the results of orthodontic treatment and the gingival health between Hawley retainer (HR) and vacuum-formed retainer (VFR) with two different thicknesses. Materials and methods: In this randomized clinical trial, 66 patients undergoing comprehensive orthodontic treatment in a private office were evaluated after completion of treatment. The subjects were randomly assigned to three groups. At the end of orthodontic treatment, the subjects in all the groups received a fixed bonded retainer in the mandible; in the maxilla, group I received an HR, group II received a VFR with a thickness of 1.5 mm, and group III received a VFR with a thickness of 1 mm. The American Board of Orthodontics objective grading system (ABO-OGS) index was used at the end of treatment (before the delivery of the retainers) and 6 months after the use of retainers to evaluate the stability of the results of orthodontic treatment. Gingival index (GI) was used at the two above-mentioned intervals to evaluate gingival health. The ABO-OGS measurements were carried out on dental casts by a clinician who was blinded to the types of retainers the patients wore. Data were analyzed with Statistical Package for the Social Sciences (SPSS) version 20, using proper statistical analyses. Results: Six months after the delivery of retainers, ABO-OGS and GI scores with the 1.5 mm VFR were higher than those in the two other groups, with no significant differences between the three groups. There were no significant differences between the ABO-OGS scores before the delivery of retainers and 6 months after the use of retainers in any of the study groups. In the HR and 1.5 mm VFR groups, there were significant differences in GI scores between the period before the delivery of the retainers and 6 months after their delivery; however, in the 1 mm VFR group, no significant differences were observed in GI scores between the two time intervals. Conclusion: Hawley retainer and 1 mm thick and 1.5 mm thick VFRs were equally effective in preserving and stabilizing the results of orthodontic treatment during the 6-month interval after the completion of orthodontic treatment. In addition, there were no significant differences between the three retainers in relation to gingival health. Clinical significance: The VFR might be a good alternative for HR due to its better esthetic appearance and greater popularity with orthodontic patients. Keywords: American Board of Orthodontics model grading system, American Board of Orthodontics objective frading system, Gingival index, Hawley retainers, Vacuum-formed retainers.


Asunto(s)
Retenedores Ortodóncicos , Ortodoncia Correctiva/instrumentación , Índice Periodontal , Adolescente , Adulto , Niño , Diseño de Equipo/métodos , Femenino , Enfermedades de las Encías/etiología , Humanos , Masculino , Maloclusión/terapia , Retenedores Ortodóncicos/efectos adversos , Ortodoncia Correctiva/métodos , Resultado del Tratamiento , Vacio , Adulto Joven
8.
Cochrane Database Syst Rev ; 3: CD003452, 2018 03 13.
Artículo en Inglés | MEDLINE | ID: mdl-29534303

RESUMEN

BACKGROUND: Prominent upper front teeth are a common problem affecting about a quarter of 12-year-old children in the UK. The condition develops when permanent teeth erupt. These teeth are more likely to be injured and their appearance can cause significant distress. Children are often referred to an orthodontist for treatment with dental braces to reduce the prominence of their teeth. If a child is referred at a young age, the orthodontist is faced with the dilemma of whether to treat the patient early or to wait and provide treatment in adolescence. OBJECTIVES: To assess the effects of orthodontic treatment for prominent upper front teeth initiated when children are seven to 11 years old ('early treatment' in two phases) compared to in adolescence at around 12 to 16 years old ('late treatment' in one phase); to assess the effects of late treatment compared to no treatment; and to assess the effects of different types of orthodontic braces. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 27 September 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2017, Issue 8), MEDLINE Ovid (1946 to 27 September 2017), and Embase Ovid (1980 to 27 September 2017). The US National Institutes of Health Ongoing Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA: Randomised controlled trials of orthodontic treatments to correct prominent upper front teeth (Class II malocclusion) in children and adolescents. We included trials that compared early treatment in children (two-phase) with any type of orthodontic braces (removable, fixed, functional) or head-braces versus late treatment in adolescents (one-phase) with any type of orthodontic braces or head-braces, and trials that compared any type of orthodontic braces or head-braces versus no treatment or another type of orthodontic brace or appliance (where treatment started at a similar age in the intervention groups).We excluded trials involving participants with a cleft lip or palate, or other craniofacial deformity/syndrome, and trials that recruited patients who had previously received surgical treatment for their Class II malocclusion. DATA COLLECTION AND ANALYSIS: Review authors screened the search results, extracted data and assessed risk of bias independently. We used odds ratios (ORs) and 95% confidence intervals (CIs) for dichotomous outcomes, and mean differences (MDs) and 95% CIs for continuous outcomes. We used the fixed-effect model for meta-analyses including two or three studies and the random-effects model for more than three studies. MAIN RESULTS: We included 27 RCTs based on data from 1251 participants.Three trials compared early treatment with a functional appliance versus late treatment for overjet, ANB and incisal trauma. After phase one of early treatment (i.e. before the other group had received any intervention), there was a reduction in overjet and ANB reduction favouring treatment with a functional appliance; however, when both groups had completed treatment, there was no difference between groups in final overjet (MD 0.21, 95% CI -0.10 to 0.51, P = 0.18; 343 participants) (low-quality evidence) or ANB (MD -0.02, 95% CI -0.47 to 0.43; 347 participants) (moderate-quality evidence). Early treatment with functional appliances reduced the incidence of incisal trauma compared to late treatment (OR 0.56, 95% CI 0.33 to 0.95; 332 participants) (moderate-quality evidence). The difference in the incidence of incisal trauma was clinically important with 30% (51/171) of participants reporting new trauma in the late treatment group compared to only 19% (31/161) of participants who had received early treatment.Two trials compared early treatment using headgear versus late treatment. After phase one of early treatment, headgear had reduced overjet and ANB; however, when both groups had completed treatment, there was no evidence of a difference between groups in overjet (MD -0.22, 95% CI -0.56 to 0.12; 238 participants) (low-quality evidence) or ANB (MD -0.27, 95% CI -0.80 to 0.26; 231 participants) (low-quality evidence). Early (two-phase) treatment with headgear reduced the incidence of incisal trauma (OR 0.45, 95% CI 0.25 to 0.80; 237 participants) (low-quality evidence), with almost half the incidence of new incisal trauma (24/117) compared to the late treatment group (44/120).Seven trials compared late treatment with functional appliances versus no treatment. There was a reduction in final overjet with both fixed functional appliances (MD -5.46 mm, 95% CI -6.63 to -4.28; 2 trials, 61 participants) and removable functional appliances (MD -4.62, 95% CI -5.33 to -3.92; 3 trials, 122 participants) (low-quality evidence). There was no evidence of a difference in final ANB between fixed functional appliances and no treatment (MD -0.53°, 95% CI -1.27 to -0.22; 3 trials, 89 participants) (low-quality evidence), but removable functional appliances seemed to reduce ANB compared to no treatment (MD -2.37°, 95% CI -3.01 to -1.74; 2 trials, 99 participants) (low-quality evidence).Six trials compared orthodontic treatment for adolescents with Twin Block versus other appliances and found no difference in overjet (0.08 mm, 95% CI -0.60 to 0.76; 4 trials, 259 participants) (low-quality evidence). The reduction in ANB favoured treatment with a Twin Block (-0.56°, 95% CI -0.96 to -0.16; 6 trials, 320 participants) (low-quality evidence).Three trials compared orthodontic treatment for adolescents with removable functional appliances versus fixed functional appliances and found a reduction in overjet in favour of fixed appliances (0.74, 95% CI 0.15 to 1.33; two trials, 154 participants) (low-quality evidence), and a reduction in ANB in favour of removable appliances (-1.04°, 95% CI -1.60 to -0.49; 3 trials, 185 participants) (low-quality evidence). AUTHORS' CONCLUSIONS: Evidence of low to moderate quality suggests that providing early orthodontic treatment for children with prominent upper front teeth is more effective for reducing the incidence of incisal trauma than providing one course of orthodontic treatment in adolescence. There appear to be no other advantages of providing early treatment when compared to late treatment. Low-quality evidence suggests that, compared to no treatment, late treatment in adolescence with functional appliances, is effective for reducing the prominence of upper front teeth.


Asunto(s)
Maloclusión de Angle Clase II/terapia , Aparatos Ortodóncicos Funcionales , Retenedores Ortodóncicos , Ortodoncia Correctiva/métodos , Adolescente , Factores de Edad , Niño , Aparatos de Tracción Extraoral , Humanos , Aparatos Ortodóncicos Funcionales/efectos adversos , Retenedores Ortodóncicos/efectos adversos , Ortodoncia Correctiva/efectos adversos , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento
9.
Am J Orthod Dentofacial Orthop ; 153(2): 175-183, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29407494

RESUMEN

INTRODUCTION: Clear aligners and to a lesser extent self-ligated brackets are considered to facilitate better oral hygiene than traditional fixed orthodontic appliances. This 3-arm parallel-group prospective randomized clinical trial compared the long-term and short-term effects of clear aligners, self-ligated brackets, and conventional (elastomeric-ligated) brackets on patients' oral hygiene during active orthodontic treatment. METHODS: Seventy-one participants (41 boys, 30 girls; mean age, 15.6 years) undergoing orthodontic treatment were randomly allocated through a computer-generated randomization schedule to one of the groups based on the choice of intervention: Clear Aligners (CLA) (Align Technology, San Jose, Calif) (n = 27), preadjusted edgewise fixed appliance with self-ligated brackets (SLB) (Carriere, Carlsbad, Calif (n = 22), or preadjusted edgewise fixed appliance with elastomeric ligated brackets (ELB) (Ortho Organizers Inc., Carlsbad, CA) (n = 22). For each participant, the primary outcome, plaque index (PI), and secondary outcomes, gingival Index (GI) and periodontal bleeding index (PBI), were measured at baseline (T0), after 9 months of treatment (T1), and after 18 months of treatment (T2). Blinding of the clinicians and the patients to the intervention was impossible. It was only done for outcome assessment and for the statistician. Ten participants did not receive the allocated intervention for various reasons. RESULTS: The means and standard deviations of PI at T0 (CLA, 0.50 ± 0.51; SLB, 0.65 ± 0.49; ELB, 0.70 ± 0.73), T1 (CLA, 0.83 ± 0.48; SLB, 1.38 ± 0.72; ELB, 1.32 ± 0.67), and T2 (CLA, 0.92 ± 0.58; SLB, 1.07 ± 0.59; ELB, 1.32 ± 0.67) were similar. The odds ratio (OR) for plaque index (0 or ≥1) comparing SLB or CLA to ELB was not significant. OR for SLB vs ELB = 1.54 at T0 (95% CI, 0.39-6.27), 0.88 at T1 (95% CI, 0.03-24.69), and 0.83 at T2 (95% CI, 0.02-27.70); OR for CLA vs ELB = 1.07 at T0 (95% CI, 0.30-3.88), 0.24 at T1 (95% CI, 0.01-1.98), and 0.17 at T2 (95% CI, 0.01-1.71). However, the odds ratios comparing CLA with ELB for GI (OR = 0.14; P = 0.015) and PBI (OR = 0.10; P = 0.012) were statistically significant at T1. CONCLUSIONS: In this prospective randomized clinical trial, we found no evidence of differences in oral hygiene levels among clear aligners, self-ligated brackets, and conventional elastomeric ligated brackets after 18 months of active orthodontic treatment. REGISTRATION: The trial is registered at ClinicalTrials.gov (NCT02745626). PROTOCOL: The protocol was not published before trial commencement.


Asunto(s)
Higiene Bucal , Aparatos Ortodóncicos , Ortodoncia Correctiva/instrumentación , Adolescente , Índice de Placa Dental , Femenino , Humanos , Masculino , Aparatos Ortodóncicos/efectos adversos , Soportes Ortodóncicos/efectos adversos , Retenedores Ortodóncicos/efectos adversos , Ortodoncia Correctiva/efectos adversos , Índice Periodontal , Factores de Tiempo
10.
Am J Orthod Dentofacial Orthop ; 153(2): 248-254, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29407502

RESUMEN

INTRODUCTION: The adhesives used to bond orthodontic retentions are low-loaded composite resins with a resinous matrix containing bisphenol A diglycidyl ether dimethacrylate synthesized from bisphenol A (BPA), fluidizers such as triethylene glycol dimethacrylate (TEGDMA) and hydrophilic polymers such as hydroxyethylmethacrylate. BPA disrupts the endocrine balance, and TEGDMA has high risks for human health: eg, allergies and cytotoxicity. The aim of this study was to evaluate in vitro the release of monomers from orthodontic bonded retentions. METHODS: A reproducible model of bonded retentions was carried out using calibrated molds. We analyzed the release of monomers by gas phase chromatography coupled with mass spectrometry. RESULTS: This model allowed us to qualitatively and quantitatively evaluate the in-vitro release of monomers from orthodontic adhesives. The quantitative and qualitative analyses showed no BPA release above the 0.02 ppm detection limit. A greater release of TEGDMA was observed with Transbond LR (31.7 µg/mL) than with Transbond XT (13.12 µg/mL) (both, 3M Unitek, Monrovia, Calif). Other toxic components (iodobenzene, iodobiphenyl, triphenyl stibine, and so on) were also identified. CONCLUSIONS: Toxic and carcinogenic molecules not mentioned in the material safety data sheets were identified.


Asunto(s)
Retenedores Ortodóncicos , Péptidos/análisis , Péptidos Catiónicos Antimicrobianos , Cementos Dentales/efectos adversos , Cementos Dentales/química , Cromatografía de Gases y Espectrometría de Masas , Humanos , Técnicas In Vitro , Retenedores Ortodóncicos/efectos adversos , Péptidos/efectos adversos
12.
Eur J Orthod ; 40(4): 399-408, 2018 07 27.
Artículo en Inglés | MEDLINE | ID: mdl-29059293

RESUMEN

Background: Retainer have the potential to compromise periodontal health. Objectives: Evaluate the periodontal health implications of upper and lower bonded retainers (BRs) versus upper and lower vacuum-formed retainers (VFRs) over 12 months. Trial design: Two-arm parallel group multicentre randomized controlled clinical trial. Methods: Sixty consecutive patients completing upper and lower fixed appliance therapy and requiring retainers were recruited from three hospital orthodontic departments. They were randomly allocated to either upper and lower labial segment BRs (n = 30) or upper and lower full-arch VFRs (n = 30). Periodontal health was assessed using the plaque and gingival indices of Silness and Loe, and the calculus index of Greene and Vermillion. Data were collected at debond and placement of the retainers (T0), 3 months (T1), 6 months (T2), and 12 months (T3). A random sequence of treatment allocation was computer-generated and implemented by sealing in sequentially numbered opaque sealed envelopes independently prepared in advance. Patients, operators, and outcome could not be blinded due to the nature of the intervention. Results: Thirty patients received BRs (median age 16 years, interquartile range [IQR] = 2, 50% female, 50% male) and 30 received VFRs (median age 17 years, IQR = 4, 60% female, 40% male). Gingival inflammation decreased from baseline for both types of retainer. There was significantly less plaque and calculus accumulation and better gingival health with VFRs than BRs over the evaluated 12 months. No serious harm was observed. Limitations: It is not known how much the patients chose to wear their removable retainers. The results reported are after 1 year only. Conclusions: After 1 year, BRs were associated with greater accumulation of plaque and calculus than VFRs and minimally worse gingival inflammation than VFRs, but this did not appear to produce any clinically significant, adverse periodontal health problems. Trial registration: This trial was not registered. Funding: There was no funding.


Asunto(s)
Gingivitis/etiología , Retenedores Ortodóncicos/efectos adversos , Ortodoncia Correctiva/efectos adversos , Adolescente , Cálculos Dentales/etiología , Placa Dental/etiología , Femenino , Humanos , Masculino , Maloclusión/terapia , Diseño de Aparato Ortodóncico , Aparatos Ortodóncicos Fijos/efectos adversos , Ortodoncia Correctiva/instrumentación , Índice Periodontal , Vacio , Adulto Joven
13.
Eur J Orthod ; 40(1): 29-36, 2018 01 23.
Artículo en Inglés | MEDLINE | ID: mdl-28472259

RESUMEN

Background: Various types of orthodontic appliances can lead to speech difficulties. However, speech difficulties caused by orthodontic appliances have not been sufficiently investigated by an evidence-based method. Objectives: The aim of this study is to outline the scientific evidence and mechanism of the speech difficulties caused by orthodontic appliances. Search methods and selection criteria: Randomized-controlled clinical trials (RCT), controlled clinical trials, and cohort studies focusing on the effect of orthodontic appliances on speech were included. A systematic search was conducted by an electronic search in PubMed, EMBASE, and the Cochrane Library databases, complemented by a manual search. Data collection and analysis: The types of orthodontic appliances, the affected sounds, and duration period of the speech disturbances were extracted. The ROBINS-I tool was applied to evaluate the quality of non-randomized studies, and the bias of RCT was assessed based on the Cochrane Handbook for Systematic Reviews of Interventions. No meta-analyses could be performed due to the heterogeneity in the study designs and treatment modalities. Results: Among 448 screened articles, 13 studies were included (n = 297 patients). Different types of orthodontic appliances such as fixed appliances, orthodontic retainers and palatal expanders could influence the clarity of speech. The /i/, /a/, and /e/ vowels as well as /s/, /z/, /l/, /t/, /d/, /r/, and /ʃ/ consonants could be distorted by appliances. Although most speech impairments could return to normal within weeks, speech distortion of the /s/ sound might last for more than 3 months. The low evidence level grading and heterogeneity were the two main limitations in this systematic review. Conclusions: Lingual fixed appliances, palatal expanders, and Hawley retainers have an evident influence on speech production. The /i/, /s/, /t/, and /d/ sounds are the primarily affected ones. The results of this systematic review should be interpreted with caution and more high-quality RCTs with larger sample sizes and longer follow-up periods are needed. Registration: The protocol for this systematic review (CRD42017056573) was registered in the International Prospective Register of Systematic Reviews (PROSPERO).


Asunto(s)
Aparatos Ortodóncicos/efectos adversos , Trastornos del Habla/etiología , Odontología Basada en la Evidencia/métodos , Humanos , Aparatos Ortodóncicos Fijos/efectos adversos , Retenedores Ortodóncicos/efectos adversos , Estudios Prospectivos
14.
Eur J Orthod ; 40(2): 115-125, 2018 04 06.
Artículo en Inglés | MEDLINE | ID: mdl-28549122

RESUMEN

Background: Although post-treatment changes are almost inevitable, and retention has long been recognized as one of the most critical and routine problems faced by orthodontists, there remains a lack of certainty regarding the parameters of any definitive retention protocol following orthodontic treatment. Objective: To investigate the performance of the Hawley-type retainers. Search methods: Search without restrictions in 15 databases and hand searching until December 2016. Selection criteria: Randomized clinical trials comparing the performance of Hawley-type retainers to other removable appliances or comparing different Hawley-type retainers' wearing schedules. Data collection and analysis: Following study retrieval and selection, data extraction and individual study risk of bias assessment using the Cochrane Risk of Bias Tool took place. The overall quality of the available evidence was assessed with the Grades of Recommendation, Assessment, Development, and Evaluation approach. Results: Finally, 10 studies were identified involving 854 individuals, followed for up to 1 year after debonding. Eight studies compared subjects using Hawley and clear thermoplastic retainers; another compared Hawley to positioner and, finally, one trial involved individuals allocated to different Hawley appliance wearing schedules. Three studies were considered as being of low, four of unclear, and three of high risk of bias. In general, few differences were observed between the Hawley and other removable retainers regarding outcomes relevant to maxillary and mandibular dental arch measurements, dental arch relationships and occlusal contacts, speech evaluation, patient reported outcomes, adverse effects, and problems related to the appliances, as well as economic evaluation related outcomes. Moreover, no differences were observed between the compared Hawley wearing schedules. Overall, the quality of the available evidence was considered low. Conclusions: Given the overall quality of the available evidence and the multitude of parameters, which may have affected the results of the included trials, good practice would suggest further research in the respective field in order to increase both the quantity and quality of information available. Registration: PROSPERO (CRD42015029279). Funding: No funding was received for the present systematic review.


Asunto(s)
Retenedores Ortodóncicos , Ortodoncia Correctiva/instrumentación , Arco Dental/patología , Humanos , Mandíbula/patología , Maxilar/patología , Diseño de Aparato Ortodóncico , Retenedores Ortodóncicos/efectos adversos , Evaluación de Resultado en la Atención de Salud , Ensayos Clínicos Controlados Aleatorios como Asunto/normas , Habla
15.
Angle Orthod ; 87(5): 658-664, 2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-28686089

RESUMEN

OBJECTIVE: To investigate the long-term influence of fixed lingual retainers on the development of mandibular gingival recession and to compare the prevalence with untreated individuals. MATERIALS AND METHODS: The material consisted of 144 subjects: 96 orthodontically treated patients followed for 5 years after therapy and 48 untreated age-matched subjects. The treated patients were divided in two groups: one receiving a fixed mandibular retainer (n = 48) and one receiving no form of retention in the mandible (n = 48). The presence or absence of gingival recession and calculus accumulation were scored before treatment (T0), after debonding (T1), and 5 years after debonding (T5) for each tooth in the mandibular intercanine region using plaster models and intraoral photographs. The chi-square test, one-way ANOVA, and Cochran's Q test were used to evaluate inter- and intragroup differences. RESULTS: The prevalence of patients with recession increased gradually and significantly throughout the observation periods in all groups, but the intergroup differences at T5 were not significant. Significantly more calculus accumulation was observed at T5 in the retainer group compared with the group without retainers. CONCLUSIONS: Long-term presence of fixed lingual retainers does not seem to increase the development of mandibular gingival recession, but does increase calculus accumulation.


Asunto(s)
Recesión Gingival/epidemiología , Recesión Gingival/etiología , Retenedores Ortodóncicos/efectos adversos , Adolescente , Niño , Cálculos Dentales/epidemiología , Cálculos Dentales/etiología , Placa Dental/etiología , Índice de Placa Dental , Femenino , Humanos , Estudios Longitudinales , Masculino , Mandíbula/patología , Índice de Higiene Oral , Diseño de Aparato Ortodóncico , Ortodoncia Correctiva/efectos adversos , Ortodoncia Correctiva/instrumentación , Índice Periodontal , Prevalencia , Estudios Retrospectivos , Factores de Tiempo , Adulto Joven
16.
Eur J Orthod ; 39(4): 453-461, 2017 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-28430890

RESUMEN

Background: Hawley retainers (HRs) and vacuum formed retainers (VFRs) are the most commonly used removable retainers in the orthodontic practice. Patients' cooperation in wearing these appliances is affected by the levels of discomfort and oral impairment. The evidence regarding their acceptably among orthodontic patients is limited. Aims: To compare the acceptability of HRs and VFRs over a 6-month period in a group of fixed orthodontic patients. Trial Design: Two-arm parallel-group randomized controlled trial. Methods: Patients being treated at the Orthodontic Department of Saudi Swiss Consultant Dental Centre, Al-Khobar, Saudi Arabia, who met the inclusion criteria were invited to participate. Inclusion criteria were treatment only with fixed appliances, no lateral expansion treatment, no hypodontia, no cleft lip and palate, no surgical corrections, no extraction-based plans, 18 years old or greater, and willingness to wear maxillary and mandibular removable retainers. Participants were distributed randomly using concealed envelopes into two groups: HR group and VFR group. A pilot-tested questionnaire was filled at three times: 1 week after fitting of the retainer (T1), 3 months and 6 months following appliance fitting (T2 and T3, respectively). Ten questions were given on biting, fitting of the appliance, speech, appearance, oral hygiene, durability, gingival irritation, swallowing, self-confidence, and comfort. Responses were given on a visual analogue scale. Blinding was employed during data analysis. Results: Ninety-four patients were included primarily. Six patients in the Hawley group and two patients in the VFR group failed to complete the study. Therefore, 86 patients were included the analysis (HR group: 41; VFR group: 45). No significant differences were found between the two groups in biting, fitting of the appliance, and hygiene perception, whereas significant differences were detected in speech (P < 0.05), appearance (P < 0.001), gingival irritation (P < 0.001), durability (P < 0.001), swallowing (P < 0.001), self-confidence, and comfort (P < 0.001). No harm to any patient was noticed during the trial. Conclusions: Over a 6-month period of retention, VFR was significantly more acceptable than HR in speech, appearance, gingival irritation, swallowing, self-confidence, and comfort. Subjects in the HR group believed that their retainers were significantly more durable than those in the VFR group at the final assessment. Both retainers were equal regarding fitting of the appliance, biting, and hygiene perception. Registration: Not registered. Protocol: The protocol was not published before trial commencement. Funding: This trial was funded by the Saudi Swiss Consultant Dental Centre.


Asunto(s)
Maloclusión/terapia , Retenedores Ortodóncicos , Ortodoncia Correctiva/instrumentación , Adulto , Estética Dental , Femenino , Humanos , Masculino , Mandíbula , Maxilar , Higiene Bucal , Diseño de Aparato Ortodóncico , Retenedores Ortodóncicos/efectos adversos , Ortodoncia Correctiva/efectos adversos , Ortodoncia Correctiva/psicología , Cooperación del Paciente , Satisfacción del Paciente , Habla , Vacio , Adulto Joven
17.
Br Dent J ; 222(1): 19-20, 2017 Jan 13.
Artículo en Inglés | MEDLINE | ID: mdl-28084389

RESUMEN

Lingual arches are fixed space maintainers utilised for the preservation of leeway space in cases of mild mandibular crowding. They are normally bonded using glass-ionomer cement applied to the internal surface of molar bands. As with any fixed appliance/retainer, if molar bands are not sufficiently monitored they have the potential to pose a significant threat to an individual's dental health. Unconventionally, in our example a lingual arch was used as a long-term fixed retainer with harmful consequence to one of the banded first permanent molars. A general understanding of molar bands and fixed retainers is important for patients' general dental health by the prevention of discrete caries progression.


Asunto(s)
Maloclusión de Angle Clase II/terapia , Retenedores Ortodóncicos , Adolescente , Humanos , Enfermedad Iatrogénica/prevención & control , Masculino , Diseño de Aparato Ortodóncico , Retenedores Ortodóncicos/efectos adversos
18.
Eur J Orthod ; 39(1): 69-75, 2017 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-26969423

RESUMEN

AIM: To explore 1. how Swiss general dentists deal with complications associated with fixed orthodontic retainers, 2. collaboration between general dentists and orthodontists with regards to the organization and responsibility for long-term follow-up of orthodontic retainers, and 3. the need for standardized clinical guidelines regarding orthodontic retention. METHODS: A structured questionnaire was sent to 201 randomly selected dentists. They were asked about their experience with retainers, opinions regarding the advantages and disadvantages of different types of retainers, responsibility for patients wearing bonded retention and the communication between orthodontists and general dentists. Statistical analysis was carried out using SPSS software. RESULTS: The response rate was 61 per cent. About 55 per cent of the respondents had had experience with bonding fixed retainers and even more were familiar with their follow-up and repair. In case of complications, dentists usually contacted orthodontists according to the following rule: the more severe the complication, the more intense the communication. Most dentists hesitated to remove retainers when requested to do so by the patient and attempted to convince them to continue wearing them. Retainers bonded to all six anterior teeth were considered more efficient than those bonded to canines only; however, possible side effects (e.g. unwanted changes of the torque) were not well known. 66.4 per cent respondents were willing to take responsibility for patients in retention as early as 6 months after retainer placement. 93.2 per cent respondents would welcome the establishment of standardized guidelines. CONCLUSIONS: Swiss general dentists have good knowledge of orthodontic retention and follow-up procedures. Nevertheless, introduction of clinical guidelines including information on the possible side-effects of bonded retention is justified.


Asunto(s)
Recubrimiento Dental Adhesivo/métodos , Retenedores Ortodóncicos/efectos adversos , Ortodoncistas/normas , Humanos , Encuestas y Cuestionarios , Torque
19.
Am J Orthod Dentofacial Orthop ; 151(1): 15-27, 2017 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-28024770

RESUMEN

INTRODUCTION: The objectives of this 2-arm parallel trial were to compare the numbers of failures of mandibular fixed retainers bonded with indirect and direct methods and to investigate the posttreatment changes 2 years after placement. METHODS: Sixty-four consecutive patients from the postgraduate orthodontic clinic of the University of Geneva in Switzerland were randomly allocated to either an indirect or a traditional direct bonding procedure of a mandibular fixed retainer at the end of their orthodontic treatment (T0). Eligibility criteria were the presence of the 4 mandibular incisors and the 2 mandibular canines, and no active caries, restorations, fractures, or periodontal disease of these teeth. The patients were randomized in blocks of 4 (using an online randomization service) with allocation concealment secured by contacting the sequence generator for assignment. The patients were recalled 12 months and 24 months (T3) after retainer bonding. The main outcome was any first-time failure of retainers (ie, at least 1 composite pad debonded or fractured); unexpected posttreatment changes of the mandibular incisors and canines were a secondary outcome. Impressions and lateral cephalograms were taken at T0 and T3: changes in mandibular intercanine and interpremolar distances and mandibular incisor inclination were assessed. Blinding was applicable for outcome assessment only. The chi-square test and Cox regression were used to compare the survival rates of the retainers bonded with direct and indirect methods. Paired t tests were used to assess differences in intercanine and interpremolar distances and mandibular incisor inclination at T0 and T3. Significance was set at P <0.05. RESULTS: Sixty-four patients were randomized in a 1:1 ratio. One patient dropped out at baseline, and 3 patients did not reach the T3 recall. In 24 of 60 (40%) patients, the fixed retainer failed within 2 years: 13 of 30 (43%) in the indirect bonding group and 11 of 30 (37%) in the direct bonding group (log-rank test, P = 0.64). The hazard ratio was 1.26 (95% confidence interval, 0.56-2.81; P = 0.58). Bond failures occurred mainly during the first year. There were no clinically significant changes in mandibular intercanine distance, interpremolar distance, and incisor inclination between T0 and T3, or between groups. In 5 patients (17%), all in the direct bonding group, unexpected posttreatment changes, systematically consisting in a lingual inclination of the mandibular left canine, were observed. In 1 patient (3%), the change was considered clinically severe. No other serious harm was observed. CONCLUSIONS: There was no difference in the risks of failure between mandibular retainers bonded with direct and indirect methods. Bonded retainers are effective in maintaining intercanine and interpremolar distances. There seem to be fewer unexpected posttreatment changes with retainers bonded with the indirect compared with the direct method. REGISTRATION: The trial was not registered. PROTOCOL: The protocol was not published before trial commencement. FUNDING: No funding or conflict of interest to be declared.


Asunto(s)
Recubrimiento Dental Adhesivo/métodos , Retenedores Ortodóncicos , Técnica de Colado Dental , Fracaso de la Restauración Dental , Estudios de Seguimiento , Humanos , Estimación de Kaplan-Meier , Mandíbula , Retenedores Ortodóncicos/efectos adversos , Factores de Riesgo
20.
Am J Orthod Dentofacial Orthop ; 151(1): 74-81, 2017 01.
Artículo en Inglés | MEDLINE | ID: mdl-28024787

RESUMEN

INTRODUCTION: Fixed retainers are widely used after orthodontic treatment, sometimes for extended periods, despite insufficient knowledge of their possible long-term adverse effects on the periodontium. The aim of this study was to evaluate whether bonded orthodontic retainers have an adverse long-term effect on the marginal bone levels of the mandibular front teeth. METHODS: The study included 62 consecutive patients in 3 groups: (1) patients who underwent orthodontic treatment and wore a fixed retainer for 10 years, (2) patients who underwent orthodontic treatment but did not have a fixed retainer, and (3) untreated controls. The marginal bone levels were measured by cone-beam computed tomography 10 years after treatment. Additionally, multivariate data analysis was used to analyze possible correlations between the marginal bone levels at 10 years and the variables obtained from the study casts and profile radiographs. RESULTS: The results demonstrated a significantly lower marginal bone level on the buccal side of the mandibular front teeth in the orthodontically treated patients compared with the orthodontically untreated group. There was no difference in the marginal bone levels between the retainer group and the no-retainer group. Multivariate analysis indicated that a low marginal bone level was correlated with a basal open vertical relationship, posterior rotation of the mandible, pretreatment of the incisor protrusion, and extraction therapy. CONCLUSIONS: Within the limits of this research design, the long-term retention phase in general does not seem to cause any adverse effects on the marginal bone levels after 10 years.


Asunto(s)
Remodelación Ósea , Retenedores Ortodóncicos/efectos adversos , Diente/anatomía & histología , Adulto , Estudios de Casos y Controles , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Masculino , Mandíbula/diagnóstico por imagen , Ortodoncia Correctiva/efectos adversos , Ortodoncia Correctiva/métodos , Factores de Tiempo , Diente/diagnóstico por imagen
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