A scanning electron microscopy investigation of the precision of three orthodontic bracket slot systems.

OBJECTIVE: One of the most imprortant factors in achieving ideal teeth positions is the precision of the slot dimensions of orthodontic brackets into the archwires are inserted.This study aimed to assess the accuracy of the dimensions of orthodontic bracket slots and molar buccal tube apertures and to compare them with the specifications provided by the manufacturers. METHOD: A total of sixty brackets and ten molar buccal tubes with varying slot heights were examined using a scanning electron microscope from the mesial side. The dimensions and morphology of these bracket slots and buccal tubes apertures were assessed using the AutoCAD Software. A one-sample t-test was conducted to compare the measurements with the values provided by the manufacturer. RESULTS: The findings of the present study indicated that the height of the measured bracket slots and buccal tube apertures dimensions were significantly larger than the actual dimensions and exhibiting divergent walls. On the other hand, the depth of the brackets slots showed significantly smaller values than the actual one. CONCLUSION: A need for careful consideration when selecting a commercially accessible brand for everyday use is essential as certain materials may not meet acceptable standards.

Thirteen-year-old female patient with Class II division 1 malocclusion and hypodivergent facial pattern treated with buccal fixed appliance. Case report no 230052. European College of Orthodontics. Commission of affiliation and titularisation.

DATE OF BIRTH: 24/09/1998; sex: female. PRE-TREATMENT DOCUMENTS: 13 years 5 months old; 07/03/2012. DIAGNOSIS: Skeletal Class I with biretrusion, hypodivergent facial pattern; angle's Class II division 1 with overbite; moderate dento-maxillary discrepancy; maxillary incisor malposition. TREATMENT PLANNING: Bimaxillary buccal fixed appliance with Class II elastics. Active treatment duration: 25 months. POST-TREATMENT DOCUMENTS: 15 years 7 months old; 09/05/2014. POST-RETENTION DOCUMENTS: (minimum 1 year) 16 years 9 months old; 08/07/2015. Retention period: unlimited.

Effect of Mobile Phone with and without Earphones Usage on Nickel Ion Release from Fixed Orthodontic Appliance.

INTRODUCTION: This study is an attempt to assess whether the usage of headphones could minimize the nickel ion release from fixed orthodontic appliance compared with hand-held mobile phones. The aim of the study is to validate the hypothesis whether there is a significant variation in nickel ion release from fixed orthodontic appliance among the patients using hand-held mobile phones and patients using mobile earphones. MATERIALS AND METHODS: This is a cross-sectional study where a total of 60 healthy individuals who were undergoing fixed orthodontic treatment in the Department of Orthodontics and Dentofacial Orthopedics, Adhiparasakthi Dental College and Hospital, Melmaruvathur, Chennai, India, and all these individuals were bonded and banded. All of them are class I malocclusion with bimaxillary protrusion. Salivary samples were collected in their regular checkup after two months and 7th, 14th, and 21st days salivary nickel level was evaluated based on their usage of mobile phones with earphones and without earphones. RESULTS: In this study, paired and independent t-tests were used. On basis of statistics results, the mean of nickel release in both male and female participants using mobile phones without earphones were significantly higher than the participants using mobile phone with earphones. CONCLUSION: By our study, we concluded that usage of mobile phones with earphones has a significant reduced effect on metal ion release from fixed orthodontic appliance when compared to usage of mobile phones without earphones.

Effects of blue-light LED toothbrush on reducing dental plaque and gingival inflammation in orthodontic patients with fixed appliances: a crossover randomized controlled trial.

BACKGROUND: Patients with fixed orthodontic appliances have higher plaque accumulation and gingival inflammation. Our aim was to compare the effectiveness of a light emitting diode (LED) toothbrush with a manual toothbrush in reducing dental plaque and gingival inflammation in orthodontic patients with fixed appliances, and to investigate the effect of the LED toothbrush on Streptococcus mutans (S. mutans) biofilm in vitro. METHODS: Twenty-four orthodontic patients were recruited and randomly assigned into 2 groups: (1) started with manual and (2) started with LED toothbrushes. After a 28-day usage and 28-day wash-out period, the patients switched to the other intervention. The plaque and gingival indices were determined at baseline and 28 days after each intervention. The patients' compliance and satisfaction scores were collected using questionnaires. For the in vitro experiments, S. mutans biofilm was divided into 5 groups (n = 6) with 15-, 30-, 60-, or 120-sec LED exposure, and without LED exposure as a control group. RESULTS: There was no significant difference in the gingival index between the manual and LED toothbrush groups. The manual toothbrush was significantly more effective in reducing the plaque index in the proximal area on the bracket side (P = 0.031). However, no significant difference was found between the two groups in other areas around the brackets or on the non-bracket side. After LED exposure in vitro, the percentages of bacterial viability after LED exposure for 15-120 s were significantly lower compared with the control (P = 0.006). CONCLUSION: Clinically, the LED toothbrush was not more effective in reducing dental plaque or gingival inflammation than the manual toothbrush in orthodontic patients with fixed appliances. However, the blue light from the LED toothbrush significantly reduced the number of S. mutans in biofilm when it was exposed to the light for at least 15 s in vitro. CLINICAL TRIAL REGISTRATION: Thai Clinical Trials Registry (TCTR20210510004). Registered 10/05/2021.

Comparative assessment of facemask therapy with and without skeletal anchorage in growing Class III patients with unilateral cleft lip and palate (UCLP): A single-center, prospective randomized clinical trial.

OBJECTIVE: The purpose of this study was to evaluate the maxillary protraction effect of facemask therapy with and without skeletal anchorage in growing Class III patients with unilateral cleft lip and palate (UCLP). MATERIALS AND METHODS: Thirty patients (aged 9-13 years) with UCLP having a GOSLON score 3 were selected for this prospective clinical study. The patients were allocated into two groups using computer generated random number table. Group I (facemask therapy along with two I shaped miniplates, FM + MP) and Group II (facemask mask along with tooth-anchored appliance, FM). Skeletal and dental parameters were evaluated on pre- and post-treatment lateral cephalograms and pharyngeal airway on cone-beam computed tomography systems (CBCT) for assessment of the treatment changes. RESULTS: Both methods proved to be effective with statistically significant improvements in skeletal and dental parameters (p < .05). Skeletal parameters (e.g., SNA, convexity-point A, ANB) with the FM + MP group showed greater change compared to those with FM group (SNA, 2.56°; convexity-point A, 1.22°; ANB, 0.35°). Significant proclination of maxillary incisors was observed in the FM group as compared to FM + MP group (U1 to NA, 5.4°; 3.37 mm). A statistically significant increase in pharyngeal airway volume was noted in both groups (p < .05). CONCLUSION: While both therapies are effective in protracting the maxilla in growing patients with UCLP, the FM + MP allows for a greater skeletal correction, minimizing the dental side effects seen with FM therapy alone. Thus, FM + MP appears to be a promising adjunct in reducing the severity of Class III skeletal correction needed in patients with cleft lip and palate (CLP).

The transfer accuracy of digital and conventional full-arch impressions influenced by fixed orthodontic appliances: a reference aid-based in vitro study.

OBJECTIVES: The aim of this in vitro study was to investigate the influence of fixed orthodontic appliances (FOAs) on the transfer accuracy of full-arch impressions by five intraoral scanners (IOSs): CS3600, Primescan, Trios 4, Medit i500, Emerald S, and one conventional alginate impression (CAI). MATERIALS AND METHODS: To compare the data with the actual model situation, an established reference aid-based method was applied. A test model with human teeth was used and modified for each testing group, resulting in five different settings: natural teeth (group A), metal brackets without/with wire (groups B/C), ceramic brackets without/with wire (groups D/E). A total of 300 (n = 12 × 5 × 5) scan datasets of IOSs were analyzed using a 3D software (GOM Inspect) and 60 (n = 12 × 5) plaster casts of CAI were measured with a coordinate measurement machine. The deviations between the reference aid and the impressions were determined. RESULTS: For all groups with brackets (B to E), IOSs showed a higher transfer accuracy compared to CAI, even for long-span distances. However, some significant differences between the IOSs were observed (p < 0.05). CONCLUSIONS: Within the limitations of this in vitro study, IOSs can be recommended for impressions with and without FOAs, even if CAI showed the smallest average deviations in settings without FOAs. CLINICAL RELEVANCE: IOSs are widely used in orthodontics and the current study demonstrated that their use enables fast impression taking even in settings with fixed orthodontic appliances. In addition, for these settings, the transfer accuracy is higher than with conventional alginate impressions. Nevertheless, a re-investigation in a clinical setting should be performed to verify the current in vitro findings.

Short- term effect of probiotic Lactobacillus reuteri consumption on the salivary microbiome profile of subjects undergoing orthodontic treatment with fixed appliances.

Objective: This prospective clinical study aim was to analyze the effect of the probiotic Lactobacillus reuteri Prodentis lozenges on salivary microbiome of subjects wearing fixed orthodontic appliances. Methods: Saliva samples were collected prior to consumption and 14th-day post probiotic lozenges consumption (n=40, age 18-23). Oral hygiene index-score (OHI-S) and papilla bleeding index (PBI) were recorded. The salivary microbiome was profiled by next-generation sequencing using the V3-V4 region of 16S-rRNA. Microbial composition, diversity and taxonomic biomarkers were analysed in comparison to probiotic intervention and the clinical characteristics of the cohort using standard bioinformatics tools. Results: The diversity and bacterial community structures did not change significantly in salivary microbiome of periodontally healthy subjects during short-term probiotic intervention. Probiotic consumption correlated with reduction of OHI and PBI scores (50% reduction of scores, P<0.001). The reduction of clinical indices was evident in conjunction with significantly reduced abundance of oral pathogens, such as Porphyromonas pasteri, Treponema sp., Fretibacterium fastidiosum, Kingella oralis and Propionibacterium acnes. Conclusion: Short-term probiotic intervention helped maintaining good oral health in patients undergoing fixed orthodontic therapy. Although overall oral microbiome structure remained largely unchanged, a significant alteration in the abundance of health and disease-associated species highlighted the beneficial effect of probiotic.

Microbial colonisation associated with conventional and self-ligating brackets: a systematic review.

BACKGROUND: Decalcification and gingivitis caused by plaque accumulation around brackets are common iatrogenic effects of fixed appliances. The influence of conventional versus self-ligating bracket design on microbial colonisation is unknown. OBJECTIVE: To assess the levels of microbial colonisation associated with conventional and self-ligating brackets. SEARCH SOURCES: Three databases were searched for publications from 2009 to 2021. DATA SELECTION: Randomised controlled trials comparing levels of microbial colonisation before and during treatment with conventional and self-ligating brackets were assessed independently and in duplicate. DATA EXTRACTION: Data were extracted independently by two authors from the studies that fulfilled the inclusion criteria. Risk of bias assessments were made using the revised Cochrane risk of bias tool for randomized trials. The quality of the included studies was assessed using the Critical Appraisal Skills Programme Checklist. RESULTS: A total of 11 randomised controlled trials were included in this systematic review. Six of the studies were found to be at low risk of bias and five presented with some concerns. The studies were considered moderate to high quality. Five trials reported no statistically significant difference in microbial colonisation between bracket types. The remaining studies showed mixed results, with some reporting increased colonisation of conventional brackets and others increased colonisation of self-ligating brackets. The heterogeneity of study methods and outcomes precluded meta-analysis. CONCLUSION: Of the 11 studies included in this systematic review, five found no differences in colonisation between conventional and self-ligating brackets. The remaining studies showed mixed results. The evidence is inconclusive regarding the association between bracket design and levels of microbial colonisation.

Evaluation of Change in Surface Enamel Microhardness in Patients Undergoing Fixed Orthodontic Appliance Therapy - A Randomized Control Trial.

AIM: This study aims at determining the amount of enamel decalcification in terms of microhardness. MATERIALS AND METHODS: Twenty patients requiring treatment by extraction method for Class I malocclusion with bimaxillary protrusion were selected for the study. Twenty patients were randomly divided into control group and experimental group. In the control group (n = 40), extraction of permanent first premolars was done on day 1 of bonding to assess the Vickers hardness number (VHN) of enamel surface, and in the experimental group (n = 40), extraction of the contralateral premolars was done on the 28th day after bonding to assess the VHN of enamel surface. The values are tabulated and analyzed by SPSS software. RESULTS: There is significant surface enamel dissolution of enamel crystals in the experimental group compared to the control group, and a statistically significant difference in VHN is evident between the control and experimental groups. The surface enamel dissolution (VHN) is not significant difference noted between mandibular and maxillary premolars of the control and experimental groups. CONCLUSION: The present study has demonstrated a higher level of surface enamel dissolution in the experimental group. There is a marked difference in the VHN between the control and experimental groups, which is statistically significant. The scanning electron microscopy study also confirms the presence of surface enamel demineralization following orthodontic bonding.

Lactobacillus brevis CD2 attenuates traumatic oral lesions induced by fixed orthodontic appliance: A randomized phase 2 trial.

OBJECTIVE: To evaluate the effect of the probiotic Lactobacillus brevis CD2 on the prevention of early traumatic oral lesions induced by a fixed orthodontic appliance. SETTINGS AND SAMPLE POPULATION: Twenty orthodontic patients (14-57 yo) were recruited from a private clinic. SUBJECTS AND METHODS: In a phase 2, double-blind clinical trial, all patients were randomly allocated (1:1 ratio) to a 21-day course of soluble tablets containing L brevis CD2 (4 billion colony-forming units after breakfast, lunch and dinner) or placebo, starting at the day of orthodontic appliance placement. The primary outcomes were days with oral lesions and lesion-related pain [ranging between 0 (no pain) and 10 (maximum pain)]. Oral health-related quality of life was measured using OHIP-14 before and after treatments. RESULTS: All patients completed the study. Ten were treated with L brevis (28.1 ± 13.3 yo, 70% women), and 10 received placebo (27.5 ± 9.1 yo, 60% women). The oral lesions lasted significantly less time (P = .018) in patients treated with L brevis (2.5 ± 1.0 days) than with placebo (4.9 ± 3.0 days). Pain score was significantly lower (P = .039) when L brevis was used [median (min-max): 0 (0-4) vs. 3 (0-5)]. OHIP-14 scores were not significantly different between treatments. CONCLUSIONS: Lactobacillus brevis CD2 reduced almost 50% the persistence of traumatic oral lesions in patients with fixed orthodontics. Yet, there was no improvement in quality of life compared to placebo, suggesting that such differences in persistency and pain related to oral lesions may be considered clinically irrelevant.

Adjunctive orthodontic management of a missing upper right central incisor in a 12-year-old male using a fixed orthodontic appliance

This article presents a successful orthodontic management of a 12-year-old male using a fixed orthodontic appliance (straight wire technique). His orthodontic treatment was hinged on creating enough space to accept an artificial tooth, correcting the horizontal and vertical relationships of the upper incisors to the lower and the midline shift. Ultimately, an esthetic smile was achieved; function and self-esteem were improved when the artificial tooth was finally fixed.

The efficacy of analgesics in controlling orthodontic pain: a systematic review and meta-analysis.

BACKGROUND: Patients who had gone through orthodontic treatment experienced pain and discomfort which could be the highest-ranking reason for treatment disturbance or early termination. Thus, this review aimed to assess the efficacy of analgesics on the relief of pain in orthodontic treatment. METHODS: A computerized literature search was conducted in the databases of EMBASE (via OVID, 1974 to 2019 Week 50), MEDLINE (via OVID, 1946 to Dec 2019), the Cochrane Central Register of Controlled Trials (CENTRAL) (December 2019). The Cochrane Collaboration's Review Manager 5.3 software was applied in the present study. And methodological quality was evaluated by the Cochrane Risk of Bias Tool. RESULTS: We identified twelve publications including 587 patients in 19 randomized controlled trials. The results showed that the mean difference of naproxen in visual analogue scale (VAS) were - 1.45 (95% CI -2.72, - 0.19; P = .02), - 2.11 (95% CI -3.96, - 0.26; P = .03) and - 1.90 (95% CI -3.33, - 0.47; P = .009) in 2 h, 6 h and 24 h respectively. As for ibuprofen, the standard mean differences were - 1.10 (95% CI -1.49, - 0.71), - 1.63(95% CI -2.32, - 0.95) and - 1.34 (95% CI -2.12, - 0.55) at 2 h, 6 h, and 24 h, with the overall P values all < 0.001. The mean difference of acetaminophen is - 0.68, - 1.34, - 1.91 at three time points and the overall P values all < 0.01. CONCLUSIONS: This meta-analysis suggests that the use of analgesics is effective for patients in controlling orthodontic pain. Ibuprofen and naproxen are both of stable analgesic effects which could peak at 6 h, while the analgesic effect of acetaminophen increases steadily from 2 h through 24 h. Compared with ibuprofen and acetaminophen, naproxen shows a stronger analgesic effect either at 2 h or 6 h, and its effect lasts to 24 h.

Quality of life of families of adolescents undergoing fixed orthodontic appliance therapy: Evaluation of a cohort of parents/guardians of treated and untreated individuals.

BACKGROUND: Quality of life (QoL) measurements have been employed in medicine and dentistry to assess the effect of diseases and treatment on individuals' lives. AIM: To assess the effect of the initial 12 months of fixed orthodontic appliance therapy on the families of Brazilian adolescents. DESIGN: A cohort of 11- to 12-year-old adolescents and their parents/guardians participated. Treatment group (TG) consisted of 101 parents/guardians of adolescents who began fixed orthodontic appliance therapy. They completed four sets of the Family Impact Scale (FIS) at baseline, 1 month, 6 months and 12 months after the bonding of fixed appliances. Control group (CG) was composed of 175 parents/guardians of adolescents, who did not begin treatment, answering four sets of the FIS at the same intervals. The subscales of FIS were parental/family activity (PA), parental emotions (PE), family conflict (FC) and financial burden (FB). Statistical analysis was performed. RESULTS: The interaction of group (treatment) with time allowed one to observe significant changes in the PA (P < .001), PE (P < .001), FC (P < .001) and overall FIS score (P < .001), demonstrating an improvement in the subscale and overall QoL of families of adolescents. CONCLUSIONS: The effect of fixed orthodontic appliance therapy on the families of adolescents was highly beneficial.

Salivary flow rate, pH and buffering capacity in patients undergoing fixed orthodontic treatment - A prospective study.

BACKGROUND: Human saliva has got many important functions like lubrication of the oral tissues, making oral functions like speech, mastication and deglutition possible and also protecting teeth and oral mucosal surfaces in different ways. Dental Caries is one of the common complications in patients undergoing orthodontic treatment. Subjects with impaired saliva flow rate often show high caries incidence. A low flow rate combined with a low or moderate buffer effect clearly indicates poor salivary resistance against microbial attack. AIM: To investigate the changes in stimulated and unstimulated salivary flow rate, pH and buffer capacity in patients undergoing therapy with fixed orthodontic appliances. MATERIALS AND METHODS: Salivary flow rate, pH and buffering capacity of 20 patients who underwent fixed orthodontic treatment at Department of Orthodontics, Ragas Dental College and Hospital, Chennai were examined using GC saliva check buffer kit. The procedure was carried out during the initiation of orthodontic treatment and subsequently, one month and six months after the placement of appliance. RESULTS: Results showed there was a significant increase in the salivary flow rate one month and six months after placement of fixed appliance while pH and buffering capacity showed no significant changes. CONCLUSION: Salivary flow rate increases significantly during fixed orthodontic treatment. Salivary pH and buffering capacity showed no significant changes suggesting that they are not sole factors for demineralization in orthodontic patients.

Do fixed orthodontic appliances cause halitosis? A systematic review.

OBJECTIVE: To examine: (I) the current evidence of the impact of fixed orthodontic appliances on the development of halitosis in patients undergoing orthodontic treatment, and (II) the influence of different orthodontic bracket systems on halitosis. MATERIAL AND METHODS: Three electronic databases (PubMed, Scopus, and Cochrane Library) were searched prior to March 15, 2018. The review was systematically conducted and reported according to the Cochrane Handbook and the PRISMA statement. Only Randomised Clinical Trials (RCTs) were considered. Selected full-text papers were independently assessed by four investigators and any disagreements were resolved by consensus. The Cochrane Handbook was used to grade the risk of bias and the quality of evidence was rated according to GRADE. RESULTS: Out of 363 identified studies, three RCTs on halitosis and fixed orthodontic appliances met the inclusion criteria. The risk of bias in the three studies was rated as high and the quality of evidence was rated as very low. CONCLUSIONS/CLINICAL IMPLICATIONS: There is a lack of scientific evidence that subjects with fixed orthodontic appliances develop halitosis during treatment. Additional well-conducted RCTs with extended periods of assessment are needed as well as consensus concerning cut-off values for the diagnosis of halitosis.

Effect of Dentifrice Containing Crab-Shell Chitosan on the Accumulation of Dental Plaque in Fixed Orthodontic Appliances Patients: A Randomized Controlled Trial.

BACKGROUND: Patients with fixed orthodontic encounter problems in cleaning their teeth and mouths. Dental plaque tends to accumulate on wires, brackets, and surfaces between bonding materials and brackets. Plaque accumulation increases the risks of decalcification, caries, and gingivitis. Chitosan extract is a potential antibacterial agent and inhibitor of dental plaque formation. This study aims to assess the effectiveness of chitosan-containing dentifrice in decreasing plaque accumulation in patients with fixed orthodontic appliances. MATERIALS AND METHODS: This was a prospective, randomized, double-blind study which involved 32 samples (randomly allocated to the control and chitosan groups, after the power of the study was considered) from patients with orthodontic appliances undergoing the last stage of fixed active orthodontic treatment. Plaque accumulation before and after dentifrice use was measured using a plaque index according to O'leary, before and after using toothpaste within 5 days. The patients were instructed to brushing with chitosan-containing dentifrice and chitosan-free dentifrice as a control. Washout period that needed between brushing with chitosan-containing dentifrice and chitosan-free dentifrice as a control was 7 days. Each mouthwash used routinely for 5 days with the same duration and intensity. The data obtained was then analyzed with one-way analysis of variance followed by post hoc least significant difference. The level of significance was set as 0.05. RESULTS: Plaque accumulation before and after dentifrice use significantly differed (P < 05) between the control and chitosan groups. The average reductions in plaque accumulation were greater in the chitosan group and control group brushing using chitosan-containing dentifrice. CONCLUSION: Dentifrice-containing chitosan more effectively reduces dental plaque accumulation in patients with fixed orthodontic appliances than dentifrice without chitosan.

O uso da tecnologia CAD/CAM na Ortodontia ­ setup ortodôntico e colagem indireta pelo sistema eXceed™ / The CAD/CAM technology in Orthodontics ­ Orthodontic setup and indirect bonding using the eXceedTM System

Os sistemas CAD/CAM, incluindo o sistema eXceed™, possibilitam aos ortodontistas a realização de diagnóstico, planejamento de casos clínicos e posicionamento virtual de bráquetes. A posição de cada acessório, determinada pelo software, é transferida para o modelo tridimensional do paciente sobre o qual um dispositivo de transferência para colagem indireta (CI) de bráquetes é produzido. A CI permite uma melhoria na precisão da colagem de acessórios ortodônticos, diminuindo o tempo e o custo do tratamento devido a uma menor necessidade de dobras de finalização e reposicionamento de bráquetes. O caso clínico apresentado tem o objetivo de apresentar um tratamento ortodôntico utilizando o método de CI com posicionamento virtual de bráquetes idealizado pelo sistema eXceed™. O posicionamento dos bráquetes programado pelo sistema eXceed™ permitiu um posicionamento "ideal" dos dentes dispensando a implementação de dobras de finalização e proporcionando uma oclusão equilibrada. Essa nova tecnologia demonstrou ser eficiente e eficaz, e o setup ortodôntico fornecido pelo sistema ficou acordante com o resultado final do tratamento ortodôntico (AU)

CAD/CAM systems, including the eXceed™ system, allow orthodontists to perform diagnosis, treatment plan, and brackets virtual positioning. The positioning of each bracket, determined by the software, is transferred to a tridimensional patient model enabling to build an indirect bonding (IB) tray. IB allows improvement in the ideal bracket positioning, decreasing treatment time and cost due to less detailed finishing bends and/or bracket repositioning. The clinical case report purpose is to present an orthodontic treatment using IB with virtual bracket positioning using eXceed™ system. The bracket virtual positioning from eXceed™ system allowed an ideal final teeth positioning eliminating detailed finishing bends and reaching the ideal occlusion as planned. This new technology has shown to be efficient and effective, and the virtual tridimensional orthodontic setup has been in agreement with the final treatment occlusion (AU)

The Effectiveness of Two Manual Slim Bristles Toothbrushes among Fixed Orthodontic Appliance Patients / Jurnal Sains Kesihatan Malaysia

@#This research aimed to evaluate the oral hygiene status in fixed orthodontic appliance patients when using two different slim bristles toothbrushes and to assess patients’ toothbrush perception. Twenty six fixed orthodontic appliance patients participated in the six weeks prospective, crossover clinical trial. All patients used two different slim bristles toothbrushes (Toothbrush A and Toothbrush B) for two weeks each with a washout period in between. Gingival health and plaque value were assessed based on Lӧe & Silness Gingival Index and Silness & Lӧe Plaque Index at baseline, week 2, week 4 (washout) and week 6. At the end of the trial, patients’ toothbrush perception was assessed through questionnaire. All data were analysed using SPSS version 22. The mean age of the patients was 21.5 ± 4.3 years, with female predominant (n= 17, 65.4%). More than half were Malay (n= 15, 57.7%) and had tertiary education (n=14, 53.8%). Patients could achieve good oral hygiene when using Toothbrush A (65.4%) and Toothbrush B (69.2%). However, the occurrence of gingivitis was significantly higher when using Toothbrush A (OR=1.889, 95% CI=1.207-2.957, p value < 0.05). Toothbrush B was felt to clean better (n= 14, 53.8%) while Toothbrush A was perceived to be easier to use (n=14, 53.8%). Both toothbrushes maintained patients’ oral hygiene status. However, when using Toothbrush B, oral health status was better as it significantly reduced gingivitis occurrence compared to Toothbrush A. As for the toothbrush perception, most patients preferred Toothbrush A to be taken home.

Microbiological Changes and Caries-Preventive Effect of an Innovative Varnish Containing Chlorhexidine in Orthodontic Patients.

The aim of this study was to investigate the effects of Cervitec Plus® on the level of mutans streptococcus (SM) and lactobacillus (LB) colonies and the development of white spot lesions (WSLs) in patients with fixed orthodontic appliances. Informed consent was obtained from 32 volunteers (age 16.5 ± 2.75 years). At baseline, levels of the bacterial colonies were determined in saliva and plaque using a chairside test (CRT Bacteria, Ivoclar-Vivadent, Schaan, Liechtenstein), and the number of WSLs was registered. After placing the fixed appliance, Cervitec Plus® or placebo varnishes (Ivoclar-Vivadent, Schaan, Liechtenstein) were applied monthly around the brackets and tubes, randomly in the right or left (test and placebo) quadrants of the same dental arch. SM and LB colonies in saliva and the SM colonies in plaque were determined on 11-21, 13-23, 15-25, and 16-26 teeth monthly over a 6-month period. At the sixth month, the number of new WSLs was determined. By the end of the study, compared with baseline, the ratio of saliva samples belonging to the low-risk category was significantly higher (p ≤ 0.01) from the 2nd month regarding the SM (76 vs. 52%) and LB (69 vs. 52%); reduction of SM in plaque was significantly greater on the test than placebo sides (6.69 ± 1.71 and 4.45 ± 1.60, respectively; p ≤ 0.01). The mean number of new WSLs was significantly lower in the test (0.06 ± 1.60) than in the placebo quadrants (1.13 ± 1.50, p ≤ 0.01). CONCLUSION: Monthly use of Cervitec Plus® could result in a significant improvement in oral health of orthodontic patients.

In vivo determination of tooth mobility after fixed orthodontic appliance therapy with a novel intraoral measurement device.

OBJECTIVE: Valid measurement systems recording tooth mobility upon displacement within the subtle range of physiological strains are missing. Here, we introduce a novel in vivo measurement device and demonstrate a first clinical application by monitoring tooth mobility changes during retention after fixed multibracket appliance therapy. MATERIALS AND METHODS: Tooth mobility was measured in vivo on 21 patients (11 female, 10 male; mean age 16.1 ± 3.1 years) by displacing the upper first incisor 0.2 mm lingually for 0.2, 0.5, 1, 2, 5, and 10 s with the novel intraoral device. Measurements were recorded directly after, as much as 2, 7, and 14 days and up to 6 months after appliance debonding. RESULTS: Device performance was precise and valid in clinical use. Data revealed significant interindividual varying tooth mobility, which was very high during the first 2 days after appliance removal. After 1 week, mobility values decreased, but were generally higher upon short loadings compared to long ones. After 3 months, tooth mobility was significantly lower than directly after debonding. Interestingly, males exhibited significantly less mobility than females. CONCLUSIONS: Our work is the first using an in vivo measurement device capable of performing and recording tooth displacements within this delicate range and in such precision. Furthermore, our findings elucidate tooth mobility changes after multibracket treatment, giving important information for retention periods. CLINICAL RELEVANCE: Establishment of this novel measurement device in clinical use is an important improvement when approaching the complexity of tooth mobility in vivo regarding different issues like orthodontics, periodontal disease, or bruxism.