Comparison of efficacy of thermoplastic retainer with round and rectangular bonded lingual wire retainer in the mandible two years after orthodontic treatment: a randomised controlled trial.

OBJECTIVE: To analyse three protocols in maintaining the stability of orthodontic therapy results and their effect on gingival health. MATERIALS AND METHODS: Sixty-six subjects (pre-therapeutic age 11-18 years; 68% female) randomly allocated into three retention groups of equal size were analysed. The first group had a 0.673 × 0.268 mm (0.027 × 0.011 inches) rectangular braided steel retention wire bonded to the lingual surfaces of all mandibular teeth from canine to canine, and the second group had a 0.406 mm (0.016 inches) round twisted steel wire. The third group was the control, without wires, and only with vacuum-formed retainers. All three groups had vacuum-formed removable retainers in the maxilla. The frequency of wire detachment/breakage/loss of retainer, the occurrence of crowding of mandibular incisors, and changes in intercanine width and gingival health were monitored. RESULTS: Incidence and severity of relapse differed between groups (p = 0.001 and 0.049) being most common in the removable retainer group (incidence 68.2%; severity 0.7 ± 1.0 mm), followed by the round wire group (36.4%; 0.5 ± 1.2 mm) and rectangular wire group (13.6%; 0.1 ± 0.1 mm). The intercanine width decreased more without a bonded retainer (incidence 68.2%; severity 0.5 ± 0.7 mm) and with the round wire more (45.5%; 0.5 ± 0.7 mm) than with the rectangular (27.3%; 0.1 ± 0.3 mm). The difference was significant for incidence (p = 0.025), but not severity. Detaching of the wires/breakage/loss of retainer was similar. There were no significant differences in the accumulation of biofilm, calculus and gingivitis between appliances. CONCLUSION: A rectangular wire is the most effective in retention, and the impact of retention appliances on gingival health is similar. TRIAL REGISTRATION: ClinicalTrials.gov, NCT05121220. Registered 02 October 2021 - Retrospectively registered. CLINICAL RELEVANCE: Studying guidelines for reducing relapse, proper use of materials and appliances, the behavior of retention wires according to their profile in the retention phase, and possibilities of maintaining oral health will contribute to improving the stability of orthodontic therapy results.

Periodontal Health Status in Adults Exposed to Tobacco Heating System Aerosol and Cigarette Smoke vs. Non-Smokers: A Cross-Sectional Study.

Tobacco heating systems (THS) are new products on the market, advertised as a less harmful alternative for smokers, in which tobacco is heated and not burned like in conventional cigarettes. This research explored the effect on periodontal tissues in contact with heating and burning tobacco residual products (smoke and tobacco). METHODS: The sample included 66 subjects, patients of the Clinic of Dentistry in Rijeka, Croatia, aged 26-56 (median 38), 64% females. Three age- and gender-matched groups were formed (each N = 22): non-smokers, classic cigarettes smokers and THS smokers. Probing depth (PD) and clinical attachment loss (CAL) were primary research parameters. RESULTS: Three groups differed in average PD and CAL (p ≤ 0.002), with cigarette smokers having the highest and non-smokers the lowest values (p ≤ 0.002). THS consumers generally had lower values of periodontal indices than smokers, but only CAL differed significantly (p = 0.011). Periodontal indices CAL and PD were worse in THS consumers than non-smokers, but they did not reach a level of statistical significance. Cigarette smoking was the only predictor of periodontitis (average CAL ≥ 4 mm) in logistic regression models, with an odds ratio of 4.7 (95% confidence interval 1.2-18.3; p = 0.027). CONCLUSIONS: Exposure to nicotine-containing aerosol of THS in adults has a less harmful effect on periodontal tissues, measurable through periodontal indices (PD and CAL), compared to burning tobacco of conventional cigarettes. THS, presented as an alternative product to classic cigarettes, also has a detrimental effect on the periodontium.

Perfectionism, Self-Esteem, and Body Image Related to Self-Perception of Orofacial Appearance-Development and Validation of Psychometric Instrument.

PURPOSE: To develop an instrument for the assessment of perception of orofacial appearance and psychologic issues that can affect people's judgment. MATERIALS AND METHODS: A panel composed of five members (one psychologist, two prosthodontists, one orthodontist, and one final-year dental student) generated 31 items that could draw specific hypothetical dimensions. The questionnaire was self-administered by individuals attending local high schools and a university (n = 261; 26.4% men and 73.6% women) in the 14- to 28-year age range. Internal consistency, construct validity, responsiveness, and temporal stability were assessed. RESULTS: Factorial analysis and Cronbach alpha identified four dimensions (self-esteem, perfectionism, body image, and smile appearance concern) that could be best addressed using 17 items. Internal consistency was good (α in the .70 to .80 range). The dimensions were correlated with existing instruments that measure similar constructs. In responsiveness testing, tooth whitening did not induce changes in perfectionism or body image; however, it did increase self-esteem and decrease esthetic concern (P < .05). CONCLUSIONS: The newly created instrument, Orofacial Appearance Perception Questionnaire, is a consistent and reliable short instrument that measures psychologic issues related to the perception of orofacial appearance.

Effect of use of antiseptics and fluorides during orthodontic treatment on working properties of NiTi archwires in levelling dental arches : A randomized controlled trial.

PURPOSE: The goal was to investigate whether the application of antiseptics and fluorides during orthodontic treatment affects the biomechanics of the levelling of dental arches by changing the working properties of nickel-titanium (NiTi) archwires. METHODS: The sample consisted of 60 individuals aged 12-22 years (53% females). There were 20 individuals in each experimental group: (I) individuals conducted regular oral hygiene, (II) individuals used a high concentration of fluorides for intensive prophylaxis for the first month; and (III) individuals used chlorhexidine in the same manner. NiTi alloy archwires (dimensions 0.508â€¯× 0.508 mm) were analyzed 3 months after intraoral exposure and compared to as-received NiTi wires. Elastic modulus, yield strength, springback ratio, and modulus of resilience were calculated. Dimensions of the dental arches were analyzed when NiTi alloy (T1) was placed intraorally and after 3 months (T2). Change was quantified as the difference in dimensions (T2-T1). Anterior width-to-length ratio was used as a measure for dental arch shape. RESULTS: Intraoral exposure reduced elastic modulus, yield strength, springback ratio, modulus of resilience, loading, and unloading forces of NiTi wires (p ≤ 0.021). Chlorhexidine mouthwash and gel with high concentration of fluorides did not change these properties more than saliva with regular hygiene. The amount of change of dental arch shape in the maxilla and mandible did not differ significantly between the experimental groups. CONCLUSION: Using antiseptics or a high concentration of fluorides during orthodontic treatment does not significantly affect the mechanical properties of NiTi wires and would not have clinical implications in changing orthodontic biomechanics.

Temporal dynamics of adhesion of oral bacteria to orthodontic appliances.

Adhesion of the most common dental biofilm bacteria to alloys used in orthodontics in relation to surface characteristics was analyzed. Streptococcus mutans (S. mutans), Streptococcus oralis (S. oralis), Veillonella parvula (V. parvula), and Aggregatibacter actinomycetemcomitans (A. actynomicetemcomitans) were incubated for 4 h with nickel-titanium (NiTi) and stainless-steel (SS) wires. The surface roughness and free energy of the alloys, as well as the hydrophobicity of the alloys and bacteria, were assessed. NiTi had higher surface free energy and rougher (p<0.001) and more hydrophilic surfaces than SS (p<0.001). The hydrophobic properties of the bacteria decreased in the following order: V. parvula>S. oralis>S. mutans>A. actynomicetemcomitans. Bacterial adhesion generally increased over time, though this pattern was influenced by the type of alloy and the bacteria present (p<0.001). In a multiple linear regression, the principal predictor of adhesion was bacterial hydrophobicity (p<0.001), followed by time (p<0.001); alloy surface characteristics had a low influence.

The Central Role of the NAD+ Molecule in the Development of Aging and the Prevention of Chronic Age-Related Diseases: Strategies for NAD+ Modulation.

The molecule NAD+ is a coenzyme for enzymes catalyzing cellular redox reactions in several metabolic pathways, encompassing glycolysis, TCA cycle, and oxidative phosphorylation, and is a substrate for NAD+-dependent enzymes. In addition to a hydride and electron transfer in redox reactions, NAD+ is a substrate for sirtuins and poly(adenosine diphosphate-ribose) polymerases and even moderate decreases in its cellular concentrations modify signaling of NAD+-consuming enzymes. Age-related reduction in cellular NAD+ concentrations results in metabolic and aging-associated disorders, while the consequences of increased NAD+ production or decreased degradation seem beneficial. This article reviews the NAD+ molecule in the development of aging and the prevention of chronic age-related diseases and discusses the strategies of NAD+ modulation for healthy aging and longevity.

Effect of personality traits on the association between clinically assessed malocclusion and the psychosocial impact of dental aesthetics.

OBJECTIVE: We aimed to assess whether personality traits affect the relationship between malocclusion and the psychosocial impact of dental aesthetics and whether they act as its mediators or moderators. SETTINGS AND SAMPLE POPULATION: The cross-sectional study included 252 participants with permanent dentition (62% female) aged 12-39 years. MATERIALS AND METHODS: The Big Five Inventory, the Psychosocial Impact of Dental Aesthetics Questionnaire and the Index of Complexity, Outcome and Need were used. Moderation and mediation were tested by hierarchical stepwise multiple linear regression. RESULTS: Malocclusion was the most significant predictor of dental self-confidence (DSC), aesthetic concern (AC), social impact (SI) and psychological impact (PI), accounting for 12%-28% of respective variability (P < .05). Adult age, male sex and higher neuroticism and agreeableness were additional predictors of higher DSC (P < .05). Adolescent age was a predictor of higher AC, SI and PI, and female sex of higher AC and PI (P < .05). Mediation by personality traits was not proven, however, openness, agreeableness and neuroticism were moderators. A tendency of decrease in AC was associated with an increase in malocclusion complexity in adolescents lower in openness and decrease in SI in adolescents with lower agreeableness. There was also a tendency of higher increase of AC associated with an increase of malocclusion degree in adults higher in neuroticism. CONCLUSION: In adolescents, openness and agreeableness moderate the relationship between malocclusion and AC and SI, respectively. Neuroticism is a moderator of the association between malocclusion and AC in adults.

To what extent are the characteristics of painful temporomandibular disorders predictors of self-reported limitations in jaw function?

OBJECTIVE: The study evaluated the extent to which the source, intensity, and duration of temporomandibular disorder (TMD) pain are predictors of limitations in jaw function. METHODS: The sample included 166 subjects (12-69 years) who self-administered the Jaw Function Limitation Scale (JFLS) and underwent clinical examinations. RESULTS: In univariate correlations, global limitation (long-form JFLS) as well as mastication, mobility, and communication had the highest correlation with headache attributed to TMD (r = 0.362-0.415; p < 0.001). Correlation was higher for pain intensity than chronicity. In multiple regression analysis, significant predictors of jaw limitations (long-form JFLS) were only headache and increasing age (p < 0.001), when controlling for demographic variables, the characteristics of pain, source of pain, and presence of intraarticular disorders. DISCUSSION: Limitation in jaw function is influenced more by pain than by the intracapsular condition and even more so by pain intensity than chronicity.

Satisfaction with smile appearance mediates oral health-related quality of life in adolescents regardless of orthodontic treatment need - a cross-sectional study.

OBJECTIVES: To explore the relationship between adolescents' oral health-related quality of life (OHRQoL), satisfaction with smile appearance, treatment need and treatment demand through direct and serial mediation models. MATERIALS AND METHODS: This cross-sectional study included 215 11-14-year-olds and their parents. The instruments included the Child Perceptions Questionnaire and the Index of Orthodontic Treatment Need. Satisfaction with smile appearance, orthodontic treatment demand and parental perception of their child's orthodontic treatment need was recorded on a Likert scale (0 = not at all to 4 = very much). Serial mediation models were used to assess the effects of malocclusion on the OHRQoL. RESULTS: Objective treatment need explained less than 5% of the adolescents' OHRQoL. Serial mediation models through satisfaction with smile appearance, parental perception of their child's orthodontic treatment need, and patients' orthodontic treatment demand explained 23-25% of the variance. CONCLUSIONS: Satisfaction with smile appearance mediates the OHRQoL in adolescents. Parents have no direct influence, but their perception of the need to correct their child's teeth might amplify adolescents' orthodontic treatment demand, leading to lower OHRQoL.

Characteristics of Temporomandibular Disorders and Orofacial Pain in Individuals with Rheumatoid Arthritis.

PURPOSE: To compare characteristics of temporomandibular disorders (TMDs) in patients with rheumatoid arthritis (RA) to patients without RA. MATERIALS AND METHODS: The sample included 80 patients (aged 33 to 73 years; 88% women and 22% men) with 40 in each group. An international diagnostic protocol for TMDs was followed. RESULTS: Arthralgia was the most prevalent TMD in the RA group. Orofacial pain was more common in the RA group than in the controls (42.5% vs 15%, P = .031), with higher chronic pain grade and pain intensity (P ≤ .005). Somatization and depression were also increased (P < .001). In multiple logistic regression analysis, arthralgia (OR: 6.4; 95% CI: 1.1 to 37.1; P = .038) and age ≥ 55 years were predictors of RA (OR: 3.9; 95% CI: 1.4 to 10.8; P = .009) when controlling for the effects of biological sex and pain intensity. TMDs were related to 7.4 times higher odds for presence of orofacial pain, while RA was related to 3.4 times higher odds for pain. CONCLUSIONS: RA patients experienced more orofacial pain and higher pain intensity, somatization, and depression compared to healthy individuals. Pain is more influenced by TMDs than by RA. Int J Prosthodont 2023;36:630-636.

Clinical predictors of metal allergic sensitization in orthodontic patients.

OBJECTIVES: This study aimed to assess the predictors of allergic sensitisation to titanium and nickel in patients undergoing orthodontic treatment. METHODS: A total of 250 patients undergoing orthodontic treatment were invited to participate, and 235 were analysed (67% females). A patch test was performed using nickel sulphate, titanium, titanium dioxide, titanium oxalate, titanium nitride, and petrolatum as control. In addition, clinical signs of the oral mucosa, gingiva, tongue, lips, and allergological history were assessed. RESULTS: The predictors of metal allergic sensitisation in patients undergoing orthodontic treatment were adult age (OR = 2.6; 95% CI: 1.2-5.5; p = 0.016), female sex (OR = 3.0; 95% CI: 1.1-7.9; p = 0.025), exfoliative cheilitis (OR = 4.8; 95% CI: 1.9-12.4; p = 0.001), history of contact hypersensitivity (OR = 7.0; 95% CI: 1.3-35.4; p = 0.025), history of contact hypersensitivity to metals (OR = 8.3; 95% CI: 1.4-50.2; p = 0.021), and piercings (OR = 5.4; 95% CI: 2.1-13.9; p = 0.001). When predictors were analysed separately for these two metals, titanium sensitisation predictors were contact hypersensitivity to metals and piercing, whereas nickel sensitisation predictors were age and piercing. CONCLUSION: A positive patch test alone cannot draw definite conclusions regarding allergy. However, metal allergies in patients with orthodontic appliances could be considered in cases of previous contact hypersensitivity, previous reactions to metals, exfoliative cheilitis, and piercing.

Impacts of childhood malocclusion on the family.

PURPOSE: To analyze the effects of children's malocclusions and associated quality of life on family relationships by evaluating psychometric characteristics of the Family Impact Scale (FIS) in adolescents seeking orthodontic treatment. MATERIALS AND METHODS: Included were 334 participants (children aged 11-14 years; 53% female and 47% male) and their parents (84% mothers, 16% fathers) who were recruited at two dental clinics in Croatia. The Child Perception Questionnaire, Parental-Caregiver Perception Questionnaire, and FIS were administered. Malocclusion severity was estimated using the Index of Orthodontic Treatment Need Dental Health Component. The presence of caries was also recorded. Factor analysis, t­test, Pearson correlation, and multiple linear regression analysis were used for statistical analysis. RESULTS: Unidimensional FIS measuring global family impacts had higher internal consistency (α = 0.73-0.81) compared to the specific dimensions of family impacts (α = 0.60-0.69). Global family impacts were higher in children with more severe malocclusions and existing dental caries, primarily influencing parental activity, and parental emotions dimensions (p < 0.05). In multiple regression, parental perception of child's emotional well-being, oral symptoms, and social well-being (p < 0.001) were significant predictors of global family impacts, whereas child's quality of life perception, malocclusion severity, or child sex were not. Reduction of an increased overjet by orthodontic treatment affected changes in the global family impacts, mainly by reducing the emotional issues of parents (p < 0.05). CONCLUSIONS: The child's malocclusion influenced the family, primarily parental emotions. Family influences were mostly determined by parental perception of the child's altered psychosocial well-being. The FIS had adequate psychometric properties.

The effect of nickel ions on the susceptibility of bacteria to ciprofloxacin and ampicillin.

To explore the interaction effects of ciprofloxacin and ampicillin with nickel on the growth of bacteria, Staphylococcus aureus strain ATCC 29213, Enterococcus faecalis ATCC 29212 and Escherichia coli ATCC 25922 were used. Minimum inhibitory concentrations (MICs) were determined for nickel, ciprofloxacin and ampicillin, and the checkerboard method was used to assess their cumulative effects on bacterial growth. The interactions between the metal and antibiotics were assessed by the fractional inhibitory concentration (FIC). The MICs for ciprofloxacin and ampicillin were 0.31 and 1 mg/L for E. faecalis, 0.62 and 1 mg/L for S. aureus and 0.005 and 2.5 for E. coli, respectively. The MIC for nickel was 1000 mg/L for all bacteria. The FIC results for ciprofloxacin and nickel demonstrated an antagonistic effect of the two agents on the growth of E. coli and E. faecalis and an additive effect on S. aureus. The FICs for ampicillin and nickel demonstrated a synergistic effect on the growth of E. faecalis and E. coli. Different interactions of metals and antibiotics were observed depending on the bacteria and the type of antibiotic.

Influence of personality traits on a patient's decision to accept orthognathic surgery for correction of dentofacial deformity.

OBJECTIVES: To investigate the influence of personality traits in addition to quality of life (QoL) on the decision to accept orthognathic surgery. MATERIALS AND METHODS: A total of 108 patients (68% female) aged 14-53 years (median, 18 years; interquartile range, 17-25.75 years), with skeletal malocclusions of Index of Orthognathic Functional Treatment Need grades 3-5 (moderate to very great need for surgery) were included in this cross-sectional study. Personality traits of extraversion, neuroticism, agreeableness, openness, consciousness, perfectionism, and self-esteem and dimensions of Orthognathic Quality of Life Questionnaire were compared between patients who accepted orthodontic preparation for orthognathic surgery and those who refused (n = 55 vs 53). RESULTS: Patients who accepted the suggested surgical procedure had higher age, perfectionism, facial esthetic (FE) concern, social aspect, and impairment of oral function (OF) as well as lower self-esteem with small to medium effect sizes (P ≤ .040; r = 0.198-0.399). Other personality traits and awareness of dentofacial deformity did not differ between the groups. In multiple logistic regression analysis, while controlling for sex, perfectionism, and self-esteem, the following predictors of acceptance of orthognathic surgery were higher: FE concern (odds ratio [OR], 3.4; 95% confidence interval [CI], 1.3-9.1), OF (OR, 3.0; 95% CI, 1.0-8.6), and age ≥18 years (OR, 2.7; 95% CI, 1.0-7.1; P < .001). CONCLUSIONS: Extraversion, neuroticism, agreeableness, conscientiousness, and openness do not significantly affect a patient's decision to accept orthognathic surgery. The influence of self-esteem and perfectionism is primarily on perception of alteration of QoL induced by dentofacial deformity.

Pandemic Financial Stress in Dental Medicine in Croatia.

The aim of this cross-sectional research was to investigate how the COVID-19 pandemic affected the activity of dental medicine in the Republic of Croatia in 2020. It included 136 doctors of dental medicine who completed an online survey regarding their personal and professional information; work in dental offices; and level of fear for their own health, the health of others, and financial existence; and their attitude about vaccination. There was a significantly higher decrease in patient visits in dental offices that do not have a contract with public health insurance (70% vs. 37%; p < 0.001) and in dental offices that have a higher percentage of profit from dental tourism (32% vs. 14%; p < 0.001). Fear of financial existence was significantly higher in the group of dentists who do not have a contract with public health insurance (p = 0.0) and is positively correlated with the percentage of profit from dental tourism (r = 0.299; p < 0.001). Dentists with a higher level of fear that they or their loved ones would get infected due to the nature of their job are more likely to get vaccinated (p ≤ 0.007). The decision to get vaccinated and wearing a disposable coat/apron was related to fear when all other parameters were controlled for (R = 0.44; p = 0.037). In conclusion, the COVID-19 pandemic had a minimal impact on the profession of dental medicine in Croatia but represented a larger financial stress for dentists working in dental offices that do not have a contract with public health insurance and have a higher percentage of income from dental tourism.

Immunohistochemical and Histopathological Features of Persistent Gingival Enlargement in Relation to Metal Allergic Sensitisation during Orthodontic Treatment.

This study aimed to analyse the immunohistochemical profile of inflammatory infiltrates in the gingival tissue of patients undergoing orthodontic treatment in relation to patients' titanium and/or nickel allergy status. Patients with gingival enlargement received initial periodontal therapy, followed by external gingivectomy in the case of persistent gingival enlargement. The sample included 44 patients (22 had metal allergic sensitisation). Histopathological changes were assessed, and an immunohistochemical analysis was performed on formalin-fixed and paraffin-embedded gingival samples using antibodies against CD1a, CD3, CD4, CD8, CD20, CD68, and CD138. Computer-assisted image analysis was performed to evaluate the positive cell count in the gingival tissue. The gingiva of the sensitised patients was characterised by the absence of multifocal inflammatory infiltrates (p < 0.05), while pronounced exocytosis and band-like inflammatory infiltrates were more frequently observed in sensitised patients. In addition, there was an increase in Langerhans cells and T-helper lymphocytes and a decrease in naïve T-lymphocytes, cytotoxic T-lymphocytes, macrophages, and plasma cells in the sensitised subjects compared to non-sensitised. However, the differences were only statistically significant for macrophages, with a moderate effect size (82.8 vs. 133.9; p = 0.041; r = 0.308). The absence of multifocal inflammation appears to be the most characteristic histopathological feature of the gingiva of sensitised patients. Although their gingiva presented certain characteristics of late hypersensitivity immune reactions the observed changes imply dominant irritative effect e.

Orthodontic treatment demand in young adolescents - Are parents familiar with their children's desires and reasons?

AIM: To assess the levels of agreement between parents and adolescents about young adolescents' orthodontic treatment demand and to what extent is treatment demand conditioned by family and psychosocial impacts and oral function. DESIGN: This cross-sectional study included 221 adolescents (11-14 years, 54% female) and their parents. A 5-point scale was used to assess orthodontic treatment demand. Adolescents self-administered the Child Perceptions Questionnaire, and parents self-administered the Parental-Caregivers Perceptions Questionnaire and Family Impact Scale. The Index of Orthodontic Treatment Need Dental Health Component (IOTN DHC) was used for determining malocclusion severity. Intraclass correlation coefficient and Cohen's kappa coefficient were used for the assessment of agreement between two informants. RESULTS: The parent-child agreement on children's orthodontic treatment demand was weak, concording in 67.4% of cases. The most common reasons for seeking orthodontic treatment derive from the emotional (EW) and social well-being domains for both informants. In linear regression, the adolescent's reporting of impaired EW and IOTN DHC was the only significant linear predictor of orthodontic treatment demand. CONCLUSION: Parents cannot correctly assess the orthodontic treatment demand of their children. Impaired EW is the most significant self-reported determinant of adolescents' demand for orthodontic treatment. Family relationships and parental perspective have a low influence.

Facial aesthetic concern is a powerful predictor of patients' decision to accept orthognathic surgery.

OBJECTIVE: To investigate differences in quality of life in subjects with and without skeletal malocclusions and factors influencing patients' decision to accept orthognathic surgery. MATERIALS AND METHODS: DESIGN: Cross-sectional with stratified sampling. SETTINGS AND SAMPLE POPULATION: 190 Caucasian subjects (65% females), aged 17-46 years. 95 subjects were consecutive patients referred to University Dental Clinic for skeletal malocclusion treatment of which 58 subjects accepted suggested surgery, 37 refused. The other 95 were age-and sex-matched controls, without malocclusions, recruited from the pool of students and employees of local high schools and university. MAIN OUTCOME MEASURES: Psychosocial and functional issues were evaluated by Orthognathic Quality of Life Questionnaire. Complexity of malocclusion and treatment need was assessed by the Index of Orthognathic Functional Treatment Need. RESULTS: Discriminant analysis demonstrated that in quality of life, three groups differed mostly in facial aesthetic concern, followed by altered oral function, then by social interactions which were the highest in the group that accepted surgery. When controlling for age, sex, oral function impairment, awareness of facial deformity and inhibitions in social contacts in a multiple logistic regression analysis, only IOFTN and facial aesthetic concern were significant predictors of orthognathic surgery acceptance, increasing the odds for acceptance by 2.9x and 4.7x, respectively (P ≤ .045). CONCLUSION: Facial aesthetic concern is very important factor in patients' decision-making process for accepting orthognathic treatment for skeletal malocclusions, with greater importance than high normative need for functional orthognathic treatment.

Presence and Maturation Dynamics of Mandibular Third Molars and Their Influence on Late Mandibular Incisor Crowding: A Longitudinal Study.

The objective of this study was to investigate the relationship between the absence, presence and dynamics of mandibular third molar development and the occurrence and amount of late mandibular incisor crowding. Dental plaster casts and panoramic radiographs of 72 orthodontically untreated subjects from the Nittedal growth study, Norway were analyzed. The subjects were recalled for a checkup at 12, 15, 18 and 21 years of age. Mandibular incisor crowding was assessed using Little's irregularity index and dental maturation of the third molars by the Cameriere's index. The majority of the subjects (64%) had ≥1 mm increase in irregularity; 22% experienced an increase of 0.1-0.9 mm and 14% had unchanged or decreased irregularity. Incisor irregularity increased with age, regardless of absence or presence of third molars. The amount of change in incisor irregularity from 12 to 21 years did not differ significantly between subjects with hypodontia of third molars, extraction and those with third molars present. No differences were observed between erupted, unerupted or impacted third molars. No correlation was found between the amount of change in irregularity and maturation of the third molars. In conclusion, occurrence and amount of mandibular late incisor crowding is not significantly influenced by the presence of mandibular third molars or their development dynamics.

Risk Assessment of Oxidative Stress Induced by Metal Ions Released from Fixed Orthodontic Appliances during Treatment and Indications for Supportive Antioxidant Therapy: A Narrative Review.

The treatment with fixed orthodontic appliances could have an important role in the induction of oxidative stress and associated negative consequences. Because of the simultaneous effects of corrosion, deformation, friction, and mechanical stress on fixed orthodontic appliances during treatment, degradation of orthodontic brackets and archwires occurs, causing higher concentrations of metal ions in the oral cavity. Corroded appliances cause the release of metal ions, which may lead to the increased values of reactive oxygen species (ROS) due to metal-catalyzed free radical reactions. Chromium, iron, nickel, cobalt, titanium, and molybdenum all belong to the group of transition metals that can be subjected to redox reactions to form ROS. The estimation of health risk due to the amount of heavy metals released and the level of selected parameters of oxidative stress generated for the time of treatment with fixed orthodontic appliances is presented. Approaches to avoid oxidative stress and recommendations for the preventive use of topical or systemic antioxidants during orthodontic treatment are discussed.