Can a Self-etching Primer be Effective in Bonding Aligner Attachments to Different Types of Ceramics?

Objective: This in vitro study aimed to evaluate the effectiveness of pretreatment with a self-etching primer for bonding aligner attachments to lithium disilicate (LD) and monolithic zirconia (MZ) ceramics. Methods: Forty ceramics, including LD (n=20) and MZ (n=20), were divided into four study groups according to the surface pretreatments: LD specimens pretreated with universal primer (Monobond Plus, MP) after hydrofluoric acid etching (Group 1); MZ ceramics pretreated with MP after sandblasting (Group 2); LD ceramics pretreated with self-etching ceramic primer (Monobond etch & prime, MEP) (Group 3); and MZ ceramics pretreated with MEP after sandblasting (Group 4). The aligner composite (GC Aligner Connect) and universal adhesive (GPremio Bond) were used to prepare the resin attachments. The bond strength was evaluated by micro-shear bond strength (SBS) testing (0.1 mm/min) after thermocycling, and the remnant adhesive was scored according to the resin attachment remnant index (RARI). The SBS data were analyzed using ANOVA and Tukey tests, and the RARI scores were analyzed using the chi-square test. Results: Group 1 had the lowest SBS, and group 2 had the highest SBS. There were significant differences between the groups in terms of bond strength (p<0.05). The RARI scores showed no significant differences, regardless of the pretreatment and ceramic type. Conclusion: The use of a self-etching primer increased the bond strength of resin attachments on LD ceramics. For zirconia ceramics, both ceramic primers are recommended for aligner attachment bonding.

Stability and failure rate during 3 years of fixed retention: A follow-up of an randomized clinical trial on adolescents with four different lingual retainers.

OBJECTIVE: To evaluate stability outcomes and failure rates associated with four types of lingual retainers: (1) dead-soft wire, (2) multistrand stainless steel (SS) wire, (3) CAD/CAM nitinol, and (4) connected bonding pads (CBPs) after 3 years of retention. METHODS: This study enrolled 96 patients (66 females, 30 males) with a median age of 19 years with four types of lingual retainers: (1) 0.016 × 0.022-inch dead-soft wire, (2) 0.0215-inch five-strand SS wire, (3) 0.014 × 0.014-inch CAD/CAM nitinol wire, and (4) CBPs. The irregularity index, intercanine distances, and arch lengths were obtained and used to evaluate mandibular stability. Failure rates were also assessed during this study. Data were statistically analysed. RESULTS: Irregularity increased, whereas intercanine width and arch length decreased after 3 years of retention. The greatest irregularity was associated with the CBPs and the least with the CAD/CAM retainers. Changes in stability measurements were significantly higher in the dead-soft wire and CBPs than those in the CAD/CAM nitinol and multistrand SS wires. Parallel to these changes, the frequency of failure yielded similar results with the same significance between the groups. The failure rate of CBPs, in contrast to the CAD/CAM nitinol and multistrand SS wires, was significantly higher in the right quadrant (P < .05). CONCLUSION: After taking the 3-year results into consideration, CAD/CAM nitinol and multistrand SS wires were found to be more successful than the others in maintaining mandibular stability. The most failures were observed with CBPs after 3 years of retention.

Youtube videos as a source of information on digital indirect bonding: A content analysis.

Purpose: The aim of this study was to evaluate YouTube videos as a source of information for digital indirect bonding techniques. Materials and methods: The keyword "digital indirect bonding" was first searched on YouTube, resulting in 57 recorded videos. Descriptive parameters, including source, target audience, purpose, duration, upload date, number of likes, dislikes, views, and comments, were then evaluated. After this initial assessment, the interaction index and viewing rate were calculated. Video content quality was determined using a 5-point scale that categorized videos as having poor, moderate, or good content quality. This rating was based on the presence and discussion of various topics related to digital indirect bonding, including digital scan, digital bracket placement, transfer tray production from a 3D-printed model or direct production as a 3D-printed tray, clinical application, and advantages and/or disadvantages. The videos were assessed for quality using the global quality scale (GQS) and video information and quality index (VIQI). Statistical evaluation was conducted using Kruskal-Wallis, Chi-square, and Pearson correlation analysis, and intraclass correlation coefficients were calculated to determine the rating reliability. Results: The majority of the videos were classified as having poor content quality (41.9%), followed by moderate (38.7%) and good (19.4%) content quality. No significant differences were found between the videos in terms of descriptive parameters. However, videos with good content quality had significantly higher GQS and VIQI scores than moderate and poor content videos. The total content showed significant correlations with GQS and VIQI (r=0.780 and r=0.446, respectively; plt;0.05). Conclusion: In conclusion, while the majority of YouTube videos regarding digital indirect bonding were of poor content quality, those that were of good content quality could be considered a useful source of professional information.

Comparison of enamel demineralization and periodontal status between direct and digital indirect bonding techniques : A split-mouth clinical trial of direct vs. digital indirect bonding.

OBJECTIVES: This randomized clinical trial aimed to evaluate the effects of digital indirect bonding (DIB) compared to the direct bonding (DB) technique in terms of enamel demineralization and periodontal status. MATERIALS AND METHODS: A total of 24 patients (17 females, 7 males) with a mean age of 13.83 ± 1.55 years were bonded using DB and DIB techniques using a split-mouth study design. Bonding techniques were randomly allocated to quadrants. Demineralization measurements were performed with the DIAGNOdent pen (Kavo, Biberach, Germany) from four sides (distal, gingival, mesial, and incisal/occlusal) of all brackets immediately after bonding, 1 month (T1), and 6 months (T2) after bonding. Periodontal measurements were taken before bonding and at the same time points (T1 and T2). Data were statistically analyzed with the Mann-Whitney U test to determine possible differences between groups. RESULTS: Incisal/occlusal sides exhibited the lowest demineralization values at T2. The gingival side of upper centrals, mesial side of upper laterals, and distal sides of upper first premolar and lower laterals brackets bonded with the DIB technique exhibited significantly increased demineralization compared with the DB technique from T0 to T2 (p < 0.05). Periodontal parameters increased 1 month after bonding and decreased during the follow-up. Bonding technique showed no statistically significant difference in plaque index, gingival index, and bleeding on probing values at any time interval. CONCLUSION: There were many locations around the brackets with significantly higher demineralization after 6 months in patients who received digital indirect bonding compared to the DB group. Although periodontal health was generally adequate, complete removal of adhesive flash should be carefully carried out to decrease the risk of demineralization during indirect bonding technique with digital workflows.

Comparison of periodontal status and failure rates with different retainer bonding methods and adhesives: a randomized clinical trial.

OBJECTIVES: This single-center, randomized clinical trial evaluated and compared retainer bonding among different methods and adhesives in terms of periodontal status and failure rates. MATERIALS AND METHODS: A total of 100 patients from the orthodontic department of Pamukkale University were randomly assigned to the following 4 groups: group 1, direct bonding (DB) with two-step adhesive; group 2, DB with one-step adhesive; group 3, indirect bonding (IDB) with two-step adhesive; and group 4, IDB with one-step adhesive. Eligibility criteria included good finishing results and oral hygiene, no periodontal or systemic problems, and no missing anterior teeth or restorations. Randomization was carried out using computer-generated random numbers with allocation concealment by opaque, sealed envelopes. The main outcomes were plaque index (PI), gingival index (GI), and calculus index (CI) recorded at bonding, 6 months (T1), and 12 months (T2) after bonding. A secondary outcome was failure rate. The periodontal outcome assessor was blinded. Data were analyzed using the Mann-Whitney U-test, Kruskal-Wallis test, and chi-square test. RESULTS: PI and GI increased with time in all study groups, but there were no significant differences among groups at any time point. A small amount of calculus was observed in all study groups, with the increase in CI for group 3 significantly greater at the T2-T1 time interval (P < .05). There were no significant differences between groups for 12-month failure rates. CONCLUSIONS: The one-step retainer adhesive was similar in terms of periodontal status and failure rate. Therefore, a one-step adhesive can be used during bonding, regardless of technique.

Evaluation of relapse with thermoplastic retainers equipped with microsensors.

OBJECTIVES: To examine relapse with thermoplastic retainers equipped with microsensors 1 year after treatment. MATERIALS AND METHODS: A total of 42 patients (29 females, 13 males) treated with four premolar extractions were included in this study. Thermoplastic appliances equipped with TheraMon microsensors (Handelsagentur Gschladt, Hargelsberg, Austria) were used to assess daily wear time (DWT), and the patients were monitored at 2-month intervals for a period of 12 months. At the end of the follow-up, the following two groups were formed based on the mean DWT: short wear time (SWT; <9 h/d) and long wear time (LWT; ≥9 h/d). Digital models were constructed before treatment (T0), at debonding (T1), and 6 months (T2) and 12 months (T3) after debonding. Little's Irregularity Index (LII) and the intercanine and intermolar widths, arch lengths, overjet, and overbite were calculated based on the digital models. Data were analyzed statistically. RESULTS: Irregularity and overjet increased, whereas transverse measurements and arch lengths decreased with time in both groups. During the retention period, overbite decreased in the SWT group but increased in the LWT group. There were significant differences between groups only in mandibular irregularity. The LII values of the SWT group were significantly higher than those of the LWT group for the T1-T2 and T1-T3 time intervals (P < .05). CONCLUSIONS: A mean DWT less than 9 hours/day was inadequate for controlling irregularity within clinically acceptable limits. A wear time of at least 9 h/d is recommended for the maintenance of mandibular anterior alignment.

Effectiveness of different orthodontic adhesives and a universal bonding resin on the bond strength of brackets to different ceramics / Eficácia de diferentes adesivos ortodônticos e uma resina de ligação universal na resistência adesiva de bráquetes à diferentes cerâmicas

Objective: The aim of this study was to evaluate the effectiveness of different adhesives on the shear bond strength (SBS) of brackets bonded to different ceramic materials. Material and Methods: Fifty disk-shaped specimens were produced from lithium disilicate (IPS e.max CAD) and monolithic zirconia (Cercon) materials. Each specimen was polished with a three-step diamond polishing system. The polished ceramic surfaces were conditioned with universal bonding resin (Assure Plus) without pre-treatment, except for two specimens. Central brackets were bonded onto different ceramic specimens with different adhesives as follows: group 1: conventional adhesive onto the lithium disilicate; group 2: one-step adhesive onto the lithium disilicate; group 3: conventional adhesive onto the monolithic zirconia; group 4: one-step adhesive onto the monolithic zirconia. After thermal cycling, the specimens were subjected to the SBS test. The adhesive remnant index (ARI) scores were also recorded to evaluate bond failure type. Kruskal­Wallis and Mann-Whitney U tests were used for statistical analysis. Results: There were statistically significant differences among the SBS values (p˂0.05). The monolithic zirconia group with universal bonding resin and conventional orthodontic adhesive demonstrated the highest SBS value (6.34 MPa) and ARI scores. The lithium disilicate group showed the lowest SBS value (2.17 MPa) with the same protocol. No adhesive remained on the lithium disilicate specimens. Conclusion: One-step adhesive and universal bonding resin combination should not be considered as an alternative for lithium disilicate and monolithic zirconia restorations. Conventional adhesive and universal bonding resin application can be effective on non-pretreated ceramic surfaces during orthodontic bonding (AU)

Objetivo: o objetivo deste estudo foi avaliar a eficácia de diferentes adesivos na resistência ao cisalhamento (SBS) de bráquetes colados a diferentes materiais cerâmicos. Material e métodos: Cinquenta espécimes em forma de disco foram produzidos a partir de materiais de dissilicato de lítio (IPS e.max CAD) e zircônia monolítica (Cercon). Cada amostra foi polida com um sistema de polimento de diamante de três passos. As superfícies cerâmicas polidas foram condicionadas com resina de ligação universal (Assure Plus) sem pré-tratamento, exceto para dois corpos-de-prova. Bráquetes centrais foram colados em diferentes corpos de prova cerâmicos com diferentes adesivos da seguinte forma: grupo 1: adesivo convencional sobre dissilicato de lítio; grupo 2: adesivo de uma etapa sobre o dissilicato de lítio; grupo 3: adesivo convencional sobre zircônia monolítica; grupo 4: adesivo de uma etapa sobre a zircônia monolítica. Após a ciclagem térmica, os corpos-de-prova foram submetidos ao teste SBS. Os escores do índice de remanescente adesivo (ARI) também foram registrados para avaliar o tipo de falha de adesão. Os testes U de Kruskal-Wallis e Mann-Whitney foram usados para análise estatística. Resultados: Houve diferenças estatisticamente significativas entre os valores de SBS (p˂0,05). O grupo de zircônia monolítica com resina de colagem universal e adesivo ortodôntico convencional demonstrou o maior valor de SBS (6,34 MPa) e escores de ARI. O grupo de dissilicato de lítio apresentou o menor valor de SBS (2,17 MPa) com o mesmo protocolo. Nenhum adesivo permaneceu nas amostras de dissilicato de lítio. Conclusão: A combinação de adesivo de uma etapa e resina de ligação universal não deve ser considerada como uma alternativa para restaurações de dissilicato de lítio e zircônia monolítica. A aplicação de adesivo convencional e resina de colagem universal podem ser eficazes em superfícies de cerâmica não pré-tratadas durante a colagem ortodôntica (AU)

Effects of different lingual retainers on periodontal health and stability.

OBJECTIVES: To evaluate the effects of different lingual retainers on periodontal health and stability of mandibular anterior teeth at the 1-year follow-up. MATERIALS AND METHODS: One hundred thirty-two patients were randomly allocated to four groups using different lingual retainers: group 1, 0.016 × 0.022-in dead-soft wire; group 2, 0.0215-in 5-strand stainless steel wire; group 3, 0.014 × 0.014-in computer-aided design/computer-aided manufacturing nitinol retainer (Memotain); group 4, connected bonding pads. Plaque, gingival, and calculus indexes were used to evaluate periodontal health, and Little's irregularity index, intercanine width, and arch length measurements were performed to evaluate stability. All measurements were performed at each time point (debonding and 3, 6, 9, and 12 months). RESULTS: The mean value of the gingival index obtained in group 3 was lower than the mean value for all other groups. The mean value of the calculus index was the lowest in group 3, and there was a significant difference between group 3 and groups 1 and 2. No differences were found among the groups in terms of plaque index, intercanine width, and arch length. The least irregularity was obtained in groups 2 and 3. There were no significant differences between these groups and groups 1 and 4. CONCLUSIONS: Gingival inflammation and calculus accumulation were the lowest in group 3 (Memotain). The irregularity for Memotain and stainless steel retainers was less than or the other groups. However, no clinically significant worsening of periodontal health or relapse were seen in any groups after 1 year.

The short-term effects of manual and interactive powered toothbrushes on the periodontal status of orthodontic patients: A randomized clinical trial.

OBJECTIVE: To compare the effects of manual and interactive powered toothbrushes on periodontal status of patients during fixed orthodontic treatment. MATERIALS AND METHODS: Thirty-six patients aged 12 to 18 years were included in this parallel design randomized clinical trial. Patients were randomly divided into two groups: manual toothbrushes (MT group) and interactive powered toothbrushes (PT group). The plaque index (PI), gingival index (GI), and bleeding on probing (BOP) scores were obtained before brushing (T0), 4 weeks (T1), 2 months (T2), and 4 months (T3) after brushing initiation. Periodontal measurements were performed by the same researcher that blinded to the groups' randomization. Data were analyzed with Mann-Whitney U and Friedman tests for the comparison of parameters between groups and times. RESULTS: Significant differences were found in PI values at all time intervals (P < 0.001), with one exception (T2-T3 in the MT group). The GI changes between timepoints were parallel to the BOP findings of the PT group. Both groups had significantly lower bleeding scores in both T0-T2 and T0-T3 time intervals (P < 0.001). There was a significant reduction in the bleeding score of PT group between T1-T3 time interval (P < 0.05); however, there were no significant differences between the groups at any timepoint. PI and GI scores were statistically decreased in the PT group compared with the MT group from baseline to 4 months (P < 0.05). CONCLUSION: All periodontal parameters decreased during the 4-month study period. The interactive powered toothbrushes may be an alternative to manual toothbrushes in terms of maintenance of periodontal health during fixed orthodontic treatment.

Effects of adhesive flash-free brackets on enamel demineralization and periodontal status.

OBJECTIVES: To evaluate the effects of adhesive precoated (APC) flash-free brackets on enamel demineralization and periodontal status in patients during fixed orthodontic treatment. MATERIALS AND METHODS: Thirty patients, age 12 to 18 years, who had Angle Class I or Class II malocclusion with mild to moderate crowding in the permanent dentition were selected for this study. APC flash-free and conventional ceramic brackets were bonded for a split-mouth study design. The quadrant allocation was randomized. Demineralization records were obtained immediately after bonding (T0), 1 month after bonding (T1), and 6 months after bonding (T2). Clinical periodontal measurements, including gingival index, plaque index, and bleeding upon probing, were obtained before bonding (T0) and at the same time points (T1 and T2). Data were analyzed using Mann-Whitney U and Friedman tests to compare parameters between groups and times. RESULTS: Demineralization values decreased on most sides of the brackets for both groups between T0 and T1. In the conventional group, there was significantly higher demineralization on more sides compared with flash-free brackets between T1 and T2. With one exception, the decreased values were found in the incisal/occlusal sides of all brackets at T2. All periodontal parameters showed significant increases after 6 months of treatment in both groups. Intergroup comparison showed no significant differences in demineralization or periodontal measurements at any of the time points. CONCLUSIONS: The effects of APC flash-free and conventional brackets on enamel demineralization and periodontal health did not differ from each other.

Effects of adhesive flash-free brackets on debonding pain and time: A randomized split-mouth clinical trial.

OBJECTIVES: To evaluate the effects of adhesive precoated (APC) flash-free brackets on the level of pain, amount of remnant adhesive, and removal time during the debonding procedure. MATERIALS AND METHODS: Thirty patients (20 female, 10 male) aged 12 to 18 years undergoing nonextraction fixed orthodontic treatment were included in this study. APC flash-free and conventional ceramic brackets were bonded with a split-mouth study design. Bracket types were randomly allocated to quadrants. During the removal of the brackets, the visual analogue scale (VAS) was used to assess the level of pain for each tooth. The adhesive remnant index (ARI) was used to determine the amount of adhesive remaining on the tooth surface. Adhesive removal times were calculated per quadrant. The data were analyzed using the Wilcoxon test for comparisons between groups. RESULTS: Pain scores were generally higher for the conventional group than for the flash-free group. There were no differences in VAS scores across most tooth types during debonding. Overall, ARI results showed more adhesive remnants in the conventional bracket group (P < .001). Except for the right maxillary quadrant, the times required to remove the adhesive were significantly longer for the flash-free brackets than the conventional brackets (P ≤ .005). CONCLUSIONS: Although removal time was slightly longer for the flash-free adhesive than for the conventional adhesive, lower pain scores were generally observed for the flash-free adhesive brackets during the debonding procedure. Both time and pain differences could be considered clinically insignificant.

Effects of xylitol impregnated toothbrushes on periodontal status and microbial flora in orthodontic patients.

OBJECTIVES: To investigate whether the use of xylitol-impregnated toothbrushes affects periodontal condition and microbial flora in orthodontic patients with poor oral hygiene. MATERIALS AND METHODS: Forty-four patients with baseline mean Turesky plaque index scores ≥1.5 were randomly divided into two groups. Half received xylitol-containing toothbrushes and the other half, xylitol-free toothbrushes. The periodontal measurements and saliva samples were taken at baseline (T0), 1 month later (T1), and 3 months after brushing (T2) to evaluate periodontal health and microflora changes. Periodontal status was assessed with plaque index (PI), gingival index (GI), and bleeding on probing (BOP) scores. Data were statistically analyzed with Mann-Whitney U and Friedman tests. RESULTS: All periodontal parameters significantly decreased from T0 to T1 and from T0 to T2 in both groups. The PI and GI scores reduced significantly in the control group, while BOP scores reduced in both groups between T1 and T2. Intergroup comparisons showed significant differences for BOP, PI, and GI at T0, T1, and T2 times, respectively. For microbial parameters, there were no statistically significant differences within groups from T0 to T1. Total bacterial counts significantly decreased in the xylitol group between T1 and T2. Decreases in Streptococcus mutans and total bacteria were significant in both groups from T0 to T2. No significant differences were found between the groups in microbial flora at any time. CONCLUSIONS: A 3-month use of xylitol-containing toothbrushes showed almost the same changes and provided no positive effects on periodontal and microbial parameters compared to the control group.

Effects of one-step orthodontic adhesive on microleakage and bracket bond strength: An in vitro comparative study.

OBJECTIVE: To evaluate the effects of one-step orthodontic composite combined with primer on microleakage and shear bond strength (SBS) of metal and ceramic brackets. MATERIALS AND METHODS: This in vitro study included 144 extracted premolar teeth. Teeth were divided into two main groups according to the bracket type (metal and ceramic). In each group, brackets were bonded with three different bonding systems: two-step total-etch (37% phosphoric acid+Transbond XT primer+Transbond XT light cure adhesive), one-step self-etch (Transbond Plus self-etch primer+Transbond XT light cure adhesive), and one-step orthodontic adhesive (37% phosphoric acid+GC Ortho Connect light cure adhesive). A total of 6 groups (n=12) were performed for each evaluation. All samples were subjected to thermal cycling. After dye penetration, sections were prepared and assessed under stereomicroscope. After SBS test, adhesive remnant index (ARI) scores were determined. Data were analyzed statistically. RESULTS: There were no significant differences between total-etch and one-step orthodontic adhesive for microleakage. Self-etch adhesive showed more microleakage at occlusal interfaces (P<0.05). The highest and lowest mean SBS values were found in ceramic brackets bonded with total- and self-etch adhesives, respectively. No significant differences were found among the SBS values of the groups. However, the differences between ARI scores were found statistically significant (P<0.05). CONCLUSIONS: Orthodontic composite integrated with primer can be used safely instead of two-step total-etch adhesives during the bonding of metal and ceramic brackets due to less microleakage and adequate SBS values.

Effects of Different Combinations of Er:YAG Laser-Adhesives on Enamel Demineralization and Bracket Bond Strength.

OBJECTIVE: The purpose of this study was to investigate the demineralization around brackets and shear bond strength (SBS) of brackets bonded to Er:YAG laser-irradiated enamel at different power settings with various adhesive systems combinations. METHODS: A total of 108 premolar teeth were used in this study. Teeth were assigned into three groups according to the etching procedure, then each group divided into three subgroups based on the application of different adhesive systems. There were a total of nine groups as follows. Group 1: Acid + Transbond XT Primer; group 2: Er:YAG (100 mJ, 10 Hz) etching + Transbond XT Primer; group 3: Er:YAG (200 mJ, 10 Hz) etching + Transbond XT Primer; group 4: Transbond Plus self-etching primer (SEP); group 5: Er:YAG (100 mJ, 10 Hz) etching + Transbond Plus SEP; group 6: Er:YAG (200 mJ, 10 Hz) etching + Transbond Plus SEP; group 7: Clearfil Protect Bond; group 8: Er:YAG (100 mJ, 10 Hz) etching + Clearfil Protect Bond; group 9: Er:YAG (200 mJ, 10 Hz) etching + Clearfil Protect Bond. Brackets were bonded with Transbond XT Adhesive Paste in all groups. Teeth to be evaluated for demineralization and SBS were exposed to pH and thermal cyclings, respectively. Then, demineralization samples were scanned with micro-CT to determine lesion depth values. For SBS test, a universal testing machine was used and adhesive remnant was index scored after debonding. Data were analyzed statistically. RESULTS: No significant differences were found among the lesion depth values of the various groups, except for G7 and G8, in which the lowest values were recorded. The lowest SBS values were in G7, whereas the highest were in G9. The differences between the other groups were not significant. CONCLUSIONS: Er:YAG laser did not have a positive effect on prevention of enamel demineralization. When two step self-etch adhesive is preferred for bonding brackets, laser etching at 1 W (100 mJ, 10 Hz) is suggested to improve SBS of brackets.

Do Different Orthodontic Malocclusions Affect Patients' Self-Concept and Psychosocial Status?

OBJECTIVE: The aim of this study was to evaluate the self-concept and psychosocial status measured by the levels of social phobia and loneliness in a sample of adolescent patients with different malocclusions and to explain the relationships, if any, between malocclusions. METHODS: This study was performed on 90 (41 females and 49 males) orthodontic patients with a mean age of 13.52±1.81 years. The patients were divided into three groups (Class I, Class II, and Class III) according to the different types of malocclusions. Piers-Harris Children's Self-Concept Scale (PHCSCS) was used to determine the self-concepts of patients. In addition, the levels of social phobia and loneliness were measured by Capa Social Phobia Scale for Children and Adolescents (CSPSCA) and University of California Los Angeles (UCLA) Loneliness Inventory, respectively. Data were analyzed statistically. The self-concept, social phobia, and loneliness scores of each group were compared using two-way analysis of variance (ANOVA) and Tukey's post hoc test. RESULTS: Self-concept scores did not significantly differ between the groups, except for the popularity subscale. Patients with Class II malocclusion had the lowest popularity scores. No significant differences were found between the levels of social phobia and loneliness among groups (p>0.05). CONCLUSION: Our findings demonstrated that different malocclusions do not affect patients' self-concept and psychosocial well-being.

Effect of bracket type on halitosis, periodontal status, and microbial colonization.

OBJECTIVE: To determine the effect of bracket type on halitosis, periodontal status, and microbial colonization. MATERIALS AND METHODS: Forty-six patients scheduled for fixed orthodontic treatment (age 11-16 years) were selected from the orthodontic department of Suleyman Demirel University. Patients were divided into two groups with random distribution of brackets; 23 patients were treated with self-ligating brackets (group SLBs), the others with conventional brackets (group CBs). Halitosis measurements and periodontal and microbial records were obtained before the placement of brackets (T0), 1 week later (T1), and 5 weeks after bonding (T2). Periodontal parameters, including plaque index (PI), gingival index (GI), and bleeding on probing index (BOP), were obtained from all the bonded teeth. Halitosis measurements were performed at the same time. Microbial samples were obtained from the buccal surfaces of all the bonded teeth. Data were analyzed by using a repeated-measurement analysis of variance test for the comparison of parameters between groups and times. RESULTS: Periodontal parameters and halitosis results were higher in the CBs group than in the SLBs group (P<.05). In the SLBs group, halitosis and BOP values revealed no pronounced changes between T1 and T2 (P>.05). Intra- and intergroup comparisons showed that there were no statistically significant differences for microbial colonization between all the time intervals (P>.05). CONCLUSION: Bracket type has an effect on halitosis and periodontal status. Therefore, self-ligating brackets may be advised in order to prevent patients from developing halitosis and to increase the likelihood of good oral hygiene during orthodontic treatment.

Lasers in orthodontics.

Many types of dental lasers are currently available that can be efficiently used for soft and hard tissue applications in the field of orthodontics. For achieving the desired effects in the target tissue, knowledge of laser characteristics such as power, wavelength and timing, is necessary. Laser therapy is advantageous because it often avoids bleeding, can be pain free, is non-invasive and is relatively quick. The high cost is its primary disadvantage. It is very important to take the necessary precautions to prevent possible tissue damage when using laser dental systems. Here, we reviewed the main types and characteristics of laser systems used in dental practice and discuss the applications of lasers in orthodontics, harmful effects and laser system safety.