The effect of salbutamol sulphate inhalation (an anti-asthmatic medication) on the surfaces of orthodontic Archwires.

OBJECTIVES: This study aimed to compare the surface roughness and friction of different orthodontic archwires after exposure to salbutamol sulphate inhalation, an anti-asthmatic medication. METHODS: Orthodontic archwires (stainless-steel [StSt], nickel-titanium [NiTi], beta-titanium [ß-Ti], and copper-NiTi [Cu-NiTi]) were equally divided into two groups. The exposed groups were subjected to 20 mg salbutamol sulphate for 21 days and kept in artificial saliva. The control groups were only kept in artificial saliva. Surface changes were visualized using scanning electron microscopy (SEM). The average surface roughness (Ra) was evaluated using atomic force microscopy (AFM), and friction resistance forces were assessed using a universal testing machine. Statistical analyses were performed using t-tests and ANOVA followed by post hoc tests. RESULTS: Salbutamol sulphate did not change the surface roughness of StSt and NiTi archwires (p > .05). However, the change in the surfaces of ß-Ti and Cu-NiTi archwires was significant (p < .001). The frictional forces of exposed StSt, NiTi, and Cu-NiTi archwires did not change (p > .05). However, the frictional forces of ß-Ti archwires increased significantly after exposure to salbutamol sulphate (p = .021). Brushing with fluoride after exposure to salbutamol sulphate increased the frictional forces of ß-Ti only (p = .002). CONCLUSIONS: Salbutamol sulphate inhalation significantly affected the surface texture of ß-Ti and Cu-NiTi orthodontic archwires and increased the friction of ß-Ti archwires. These deteriorating effects were not detected on the surface of StSt and NiTi archwires. Therefore, we suggest that ß-Ti and copper titanium archwires should be used cautiously in individuals under salbutamol sulphate inhalation treatment.

Anthropometric and Cephalometric Facial Characteristics of Adult Saudi Patients with Skeletal Class III Malocclusions.

Objectives: We aimed to assess adult Saudi patients' facial anthropometry and cephalometric characteristics with skeletal Class III malocclusions compared to Class I malocclusion patients. Materials and Methods: Our cross-sectional study included a review of the orthodontic records of 108 patients: 54 patients with skeletal Class III malocclusions and 54 patients with skeletal Class I malocclusions, equally distributed between males and females. Using anthropometric landmarks, seven angular and eight linear measurements were recorded and compared between Class III and Class I patients. In addition, we compared three horizontal facial proportions and three horizontal neoclassical canons between the two groups. Finally, we used Student's t-tests to compare continuous variables and Chi-square tests for categorical variables. Results: Class III patients had significantly larger mandibular length, mandibular plane angle, mid- and lower-anterior face height, and posterior face height (P < 0.05) compared to Class I patients. Class III patients had significantly proclined upper incisors, retroclined lower incisors, and an obtuse interincisal angle (P < 0.05). The mouth: nose ratio differed significantly between skeletal Class III and I patients (P = 0.008). The orbital canon was valid in 14.8% of Class I and 9.3% of Class III patients, respectively. The orbitonasal proportion applied only to 31.5% and 20.4% of Class I and III patients, respectively. The naso-oral canon occurred in 18.5% and 1.9% of Class I and III patients, respectively. Conclusion: Saudis with Class III skeletal profiles have some distinctive Class III characteristics not observed in most other ethnic groups. The established horizontal facial proportions, neoclassical facial canons, and Class III skeletal profile did not apply to Saudis with skeletal Class I malocclusions, indicating that these proportions and characteristics may not be suitable as references when planning the surgical treatment for these patients.

Maxillary sinus volume in patients with canted occlusal plane: A cone-beam computed tomography study.

OBJECTIVES: To compare the maxillary sinus volume between both sides in adult patients with upper occlusal canting (>2 mm cant) and a control group (≤2 mm cant) using cone-beam computed tomography scans. MATERIALS AND METHODS: This retrospective study included a total of 84 scans (42 scans per group) according to predetermined selection criteria. OnDemand 3-D™ software was used for volumetric and linear measurements of the maxillary sinus. Maxillary occlusal canting was determined at the level of the maxillary first molars. It was defined as the vertical difference between right and left sides relative to the Frankfort horizontal plane. Non-parametric tests were applied. RESULTS: The median difference in the maxillary sinus volume between the sides was statistically significant between the control and cant groups (P < 0.001). Also, the median difference in the maxillary sinus craniocaudal height and apex sinus distance between the sides was statistically significant between the control and cant groups (P < 0.05 and P < 0.001, respectively). CONCLUSION: In adult patients, maxillary occlusal canting of more than 2 mm was associated with asymmetric maxillary sinus volumes. In the cant group, maxillary first molars on the canted-down side were in close proximity to the sinus floor, which suggests a limited leeway for molar intrusion.

Parents' Awareness of Malocclusion and Orthodontic Consultation for Their Children: A Cross-Sectional Study.

Parents' awareness of malocclusion and the appropriate timing to seek orthodontic consultation for their children has a substantial impact on children's orthodontic treatment. This cross-sectional study aims to investigate parents' awareness of malocclusion and orthodontic consultation of their children and the influence of parents' demographics on their awareness level. An electronic survey collected information about participants' demographics and awareness about malocclusion and orthodontic consultation of children. A total of 473 parents living in Jeddah, Saudi Arabia, participated in the study. The average awareness level among parents was moderate (3.09 ± 1.4). Male gender and unemployment were associated with low orthodontic awareness levels relative to moderate awareness (OR = 3.3, 95% CI = 1.8-5.8 and OR = 2.1, 95% CI = 1.1-3.8, respectively). Former or current orthodontic treatment was associated with high awareness levels (OR = 3.9, 95% CI = 2.4-6.5). There is still a need to raise the awareness of Saudi parents about malocclusion and orthodontic consultations for their children. Orthodontic awareness-raising campaigns should be designed to include fathers and parents with low socioeconomic status. The findings of this study also suggest that orthodontists can enhance their patient's awareness of malocclusion and orthodontic consultation for their children.

Factors influencing the orthodontic treatment plan in Class II malocclusion.

INTRODUCTION: This study aimed to investigate the influence of orthodontists' demographics and patient characteristics on the orthodontic treatment plan decision for borderline Class II Division 1 malocclusion in growing patients. METHODS: An electronic survey was distributed to orthodontists through the American Association of Orthodontists. Participating orthodontists were asked to select their preferred orthodontic treatment plan for 3 patients with borderline Class II Division 1 malocclusion. The survey also included questions about the patient-related factors contributing to the treatment decision for each patient. RESULTS: A total of 113 orthodontists completed the survey. United States-trained orthodontists were more likely to select growth modification and nonextraction relative to extraction (odds ratio, 3.50; 95% confidence interval, 1.01-12.12; odds ratio, 3.59; 95% confidence interval, 1.18-10.91, respectively). Clinicians with >15 years of experience were 72% less likely to prefer nonextraction relative to extraction in 1 patient and were 67% less likely to prefer growth modification relative to extraction in another patient. Working solely in private practice was associated with higher, but not statistically significant, odds of growth modification and nonextraction. The practice location was also associated with treatment plan decisions; however, findings were inconsistent between the patients. CONCLUSIONS: The orthodontist's experience, place of education, location, and type of practice appear to influence the preferred treatment plan for Class II malocclusion. Overall, the patient's profile and age were the most considered patient-related factors for growth modification, whereas the patient's profile, amount of crowding, and smile esthetics were the most considered factors for preferring extraction and nonextraction treatment modalities.

Adherence to Dietary Advice and Oral Hygiene Practices Among Orthodontic Patients.

INTRODUCTION: Adherence to dietary advice and proper oral hygiene practices during orthodontic treatment are critical to maintaining good oral health and achieving successful treatment results. Thus, understanding patients' habits and practices before, during, and after orthodontic treatment is needed to ensure better oral health-related behavior among these patients. PURPOSE: To investigate sugar-related dietary habits, visits to dental hygienists and dentists, and oral hygiene practices among patients during orthodontic treatment and after treatment compared to patients before treatment. METHODS: A cross-sectional self-administered survey collected data from 375 patients (aged 10 years and older) from the Orthodontic Department at King Abdulaziz University Dental Hospital, Jeddah, Saudi Arabia. Patients were grouped according to their history of receiving orthodontic treatment into: patients before orthodontic treatment, patients during treatment, and patients after treatment. The survey assessed sugar-related dietary habits, frequency of visits to hygienists and dentists, and oral hygiene practices. RESULTS: Patients during orthodontic treatment and those after treatment were less likely to eat sticky food compared to patients before treatment (OR=0.4, 95% CI=0.2-0.9 and OR=0.5, 95% CI=0.3-0.9, respectively). No significant differences were found in the odds of dental visits among the groups. Compared to patients before orthodontic treatment, patients during treatment and patients after treatment had higher odds of tooth brushing twice or more per day (OR=4.8, 95% CI=1.7-14.3, and OR=4.0, 95% CI=1.2-13.6, respectively) and were more likely to brush for an adequate time (OR=2.6, 95% CI=1.6-4.4 and OR=1.9, 95% CI=1.0-3.5, respectively). Moreover, the likelihood of flossing once daily was higher in patients during treatment and in patients after treatment relative to those before treatment. However, only patients during orthodontic treatment used interdental brushes more than patients before treatment. CONCLUSION: Patients' oral health-related behavior seems to improve during and after orthodontic treatment. The findings of this study suggest that orthodontists can play a role in improving oral hygiene practices among their patients. More reinforcement of dietary instructions and periodic dental and hygiene visits is needed during orthodontic follow-up appointments.

Anatomical consideration for optimal position of orthodontic miniscrews in the maxilla: a CBCT appraisal.

BACKGROUND: Orthodontic miniscrews are commonly used as temporary anchorage devices. Bone thickness and bone depth are important factors when placing miniscrews. There are no studies to assess the maxillary bone thickness for optimum miniscrew placement in a Saudi population. OBJECTIVE: Assess the proximity of the maxillary sinus and nasal cavity in areas where miniscrews are usually inserted using cone beam computed tomography (CBCT). DESIGN: Retrospective, cross-sectional. SETTING: Department of maxillofacial radiology in a Saudi dental school. PATIENTS AND METHODS: Using CBCT images, we measured the distance between the maxillary sinus and nasal cavity to the palatal bone, buccal intra-radicular and infrazygomatic crest areas. Mean values (SD) were compared at various locations, including by gender, and correlation with age was calculated. MAIN OUTCOME MEASURE: Mean bone thickness at commonly used sites for orthodontic miniscrew placements in the maxilla. Secondary outcome was the insertion angle in the infrazygomatic crest area. SAMPLE SIZE: CBCT images of 100 patients (50 males and 50 females). RESULTS: The mean (standard deviation) age for the sample was 25.4 (6.5) years with no significant difference between males and females. In the palate, the distance to the nasal cavity and maxillary sinus was greater anteriorly and decreased significantly posteriorly (P<.001). Buccally, the interdental bone depth was significantly greater between the second premolar and first molar (11.96 mm) compared to between the central and lateral incisors (7.53 mm, P<.001). The mean bone thickness of the infrazygomatic crest area at a 45° insertion angle was 4.94 mm compared to 3.90 at a 70° insertion angle (P<.001). No correlation was found between age and bone thickness. CONCLUSION: The distance to the nasal cavity and maxillary sinus was greater in the anterior than posterior areas. There is minimal risk of injuring the maxillary sinus or nasal cavity using the buccal approach. Caution is needed when placing miniscrews in the infrazygomatic crest area. LIMITATIONS: Cross-sectional study from one center; hence, findings cannot be generalized to other populations. CONFLICT OF INTEREST: None.

Adult Perceptions of Different Orthodontic Appliances.

Introduction: Pursuing an esthetically-pleasing orthodontic outcome, orthodontic patients must consider and choose from the different available options of orthodontic appliance. Practitioners need to be better informed of their customers' preferences to make better practice management decisions and satisfy their patients' needs. PURPOSE: To explore adult laypeople's perceptions of the attractiveness, acceptability, preference and economic value of different orthodontic appliances when they consider these appliances for themselves and for their children. PATIENTS AND METHODS: This cross-sectional survey included 199 adults (110 females). The average age of participants was 27.7 years. Participants answered a questionnaire evaluating and comparing multiple smiling images of an adult wearing different orthodontic appliances. Participants rated each appliance for: (1) attractiveness on a Likert scale; (2) acceptability of having the appliance placed for themselves and their children (with a yes/no response); (3) preference (by ranking all appliances in order); and (4) economic value (by providing the additional amount they are willing to pay for each appliance for themselves and their children). RESULTS: We found a statistically significant difference in the attractiveness scores between the different orthodontic appliances (p< 0.0001). The most attractive appliances were clear aligners and lingual brackets. The least attractive appliances were colored o-tied-brackets followed by shaped-brackets. Clear aligners were the most acceptable appliances among our participants to have placed on themselves (86.9%) and their children (84.9%). Shaped brackets were the least acceptable appliances among our participants to have placed on themselves (24.1%) and their children (36.2%). The most preferred appliances were lingual brackets (39.2%), followed by clear aligners (34.17%). The least preferred appliances were colored o-tied-brackets (4%). Participants varied with regards to how much more they were willing to pay for each of the different orthodontic appliances. The majority were willing to pay more for clear aligners and lingual brackets to have them placed on themselves but not to have them placed on their children. CONCLUSION: Adults preferred more innovative esthetic appliances over traditional ones and were willing to pay more to have them placed on themselves but not on their children.