Comparison of pain intensity and impacts on oral health-related quality of life between orthodontic patients treated with clear aligners and fixed appliances: a systematic review and meta-analysis.

OBJECTIVE: This study aimed to compare the pain intensity and impacts on oral health-related quality of life (OHRQoL) between orthodontic patients treated with clear aligners (CAs) and fixed appliances (FAs). METHODS: A systematic search was conducted up to December 2022 using PubMed, Web of Science, Cochrane Central Register of Controlled Trials, and Embase. Randomized controlled trials (RCTs) and prospective non-randomized controlled trials (non-RCTs) comparing pain intensity or OHRQoL between patients treated with CAs and FAs were included. The risk of bias (RoB) of individual studies was evaluated using the Cochrane RoB tool 2.0 and ROBINS-I tool for RCTs and non-RCTs, respectively. Further, meta-analyses were separately conducted for each included study using the total oral health impact profile (OHIP)-14 and visual analog scale (VAS) scores to evaluate OHRQoL and pain intensity, respectively. RESULTS: Overall, 12 studies (5 RCTs and 7 non-RCTs) were included in the study. Subgroup analyses conducted according to the total OHIP-14 scores revealed that patients treated with CAs had higher OHRQoL at 1 week, 1 month, and 6 months of the treatment. Meanwhile, subgroup analyses conducted according to the VAS scores revealed that pain levels were lower in the CA group only at 3 and 4 days of the treatment. CONCLUSIONS: Patients treated with clear aligners had higher OHRQoL than those treated with fixed appliances during orthodontic treatment. However, OHRQoL appeared to be similar between the two groups at the end of the treatment. Moreover, patients treated with clear aligners experienced lesser pain than those treated with fixed appliances on the third and fourth day after the initial treatment. The difference in pain intensity between the two treatment modalities was not noted at other time points.

Inflammatory parameters and color alterations of dental bleaching in patients wearing fixed orthodontic appliance: a randomized clinical trial.

BACKGROUND: Many orthodontic patients request dental bleaching during orthodontic treatment to achieve a faster aesthetic resolution, however, no attention has been paid to the inflammatory processes that can occur when both therapies are indicated together. So, this clinical trial evaluated the inflammatory parameters and color alterations associated with dental bleaching in patients wearing a fixed orthodontic appliance. METHODS: Thirty individuals aged between 18 and 40 years were equally and randomly allocated into three groups: FOA (fixed orthodontic appliance), BLE (dental bleaching), and FOA + BLE (fixed orthodontic appliance + dental bleaching). The orthodontic appliances and the bleaching procedures were performed in the maxillary premolars and molars. For dental bleaching a 35% hydrogen peroxide was used. The gingival crevicular fluid (GCF) and nitric oxide (NO-) levels were evaluated at different time-points. Color evaluation was performed using an Easyshade spectrophotometer at baseline (FOA, FOA + BLE, BLE), one month after (FOA + BLE) and 21 days after appliance removing (FOA + BLE and FOA groups), in each tooth bleached. The ANOVA and Tukey's tests, with a significance level of 5%, were used for statistical analysis. RESULTS: The GCF volume in the FOA + BLE and FOA groups significantly increased at the time points evaluated (p < 0.001); however, this did not occur in the BLE group (p > 0.05). On the other hand, NO- levels significantly decreased during dental bleaching with or without fixed orthodontic appliances (FOA + BLE and BLE groups; p < 0.05), while no significant changes were observed in the FOA group (p > 0.05). Significant changes in color were observed in the FOA + BLE and BLE groups compared to in the FOA group (p < 0.01). However, the presence of fixed orthodontic appliance (FOA + BLE) negatively affected the bleaching efficacy compared to BLE group (p < 0.01). CONCLUSIONS: Dental bleaching did not increase the inflammatory parameters in patients wearing fixed orthodontic appliance. However, in the presence of orthodontic appliances, the bleaching efficacy was lower than that of bleaching teeth without orthodontic appliances. TRIAL REGISTRATION: RBR-3sqsh8 (first trial registration: 09/07/2018).

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.

Oxidative stress and genotoxicity in oral epithelial cells from subjects undergoing orthodontic treatment with fixed appliances.

OBJECTIVES: The objective of this work was to evaluate the impact of fixed orthodontic appliances on oxidative stress (OS) and genotoxicity from oral epithelial cells. MATERIALS AND METHODS: Samples of oral epithelial cells were obtained from fifty-one healthy voluntary subjects who had an indication for orthodontic treatment. The samples were obtained before treatment and after 6 and 9 months of treatment. OS was evaluated by quantitating 8-hydroxy-2'deoxyguanosine (8-OHdG) and by performing relative gene expression with antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT). DNA degradation and instability were evaluated by multiplex polymerase chain reaction (PCR) and fragment analysis for human identification. RESULTS: The quantitation results showed that 8-OHdG increased during treatment, although this increase was not statistically significant. SOD increased by 2.5- and 2.6-fold after 6 and 9 months of treatment, respectively. CAT increased by threefold after 6 months of treatment, while after 9 months of treatment, the expression level decreased to a level similar to that before treatment. DNA degradation was found in 8% and 12% of DNA samples after 6 and 9 months of treatment, respectively, while DNA instability was detected in only 2% and 8% of DNA samples after 6 and 9 months of treatment, respectively. CONCLUSIONS: The results showed that OS and genotoxicity slightly changed after treatment with a fixed orthodontic appliance; in addition, a biological adaptation response to the treatment may occur after 6 months. CLINICAL RELEVANCE: OS and genotoxicity in the buccal cavity are risk factors for oral and systemic diseases. This risk may be reduced through antioxidant supplementation, by using thermoplastic materials, or by reducing the orthodontic treatment time.

Orthognathic surgery and aligners. A comparative assessment of periodontal health and quality of life in postsurgical orthodontic treatment with aligners versus traditional fixed appliances: a randomized controlled trial

Background: Removable clear aligners have become very popular in the last few decades, but they are still little used in the field of orthognathic surgery (OS). The objective of this study was to compare periodontal health and quality of life (QoL) associated to postsurgical orthodontic treatment. Material and methods: Patients with dentofacial deformities undergoing OS were randomly allocated to receive postsurgical orthodontic treatment with either fixed orthodontic appliances or Invisalign. The main outcomes were periodontal health and QoL. Plaque index, probing depth and bleeding on probing were assessed as periodontal health indicators. QoL was assessed through the Orthognathic Quality of Life Questionnaire (OQLQ-22) and the Oral Health Impact Profile (OHIP-14). Data were analyzed before surgery and end of treatment. Total duration of treatment was also recorded. Results: Twenty-eight patients were randomized, (16 women, 12 men). Periodontal assessment showed better outcomes for the Invisalign group: bleeding on probing (p=0.013), plaque index (p=0.001) and probing depth (p<0.001). The QoL questionnaires showed significant differences in favor of the Invisalign group: OHIP-14 (p=0.004) and OQLQ-22 (p=0.002). Total duration of treatment was similar in both groups (p=0.575). Conclusions: Compared to traditional orthodontics with fixed appliances, patients managed with clear aligners after OS (surgery-first approach) had better periodontal health and QoL outcomes. (AU)

Orthognathic surgery and aligners. A comparative assessment of periodontal health and quality of life in postsurgical orthodontic treatment with aligners versus traditional fixed appliances: a randomized controlled trial.

BACKGROUND: Removable clear aligners have become very popular in the last few decades, but they are still little used in the field of orthognathic surgery (OS). The objective of this study was to compare periodontal health and quality of life (QoL) associated to postsurgical orthodontic treatment. MATERIAL AND METHODS: Patients with dentofacial deformities undergoing OS were randomly allocated to receive postsurgical orthodontic treatment with either fixed orthodontic appliances or Invisalign. The main outcomes were periodontal health and QoL. Plaque index, probing depth and bleeding on probing were assessed as periodontal health indicators. QoL was assessed through the Orthognathic Quality of Life Questionnaire (OQLQ-22) and the Oral Health Impact Profile (OHIP-14). Data were analyzed before surgery and end of treatment. Total duration of treatment was also recorded. RESULTS: Twenty-eight patients were randomized, (16 women, 12 men). Periodontal assessment showed better outcomes for the Invisalign group: bleeding on probing (p=0.013), plaque index (p=0.001) and probing depth (p<0.001). The QoL questionnaires showed significant differences in favor of the Invisalign group: OHIP-14 (p=0.004) and OQLQ-22 (p=0.002). Total duration of treatment was similar in both groups (p=0.575). CONCLUSIONS: Compared to traditional orthodontics with fixed appliances, patients managed with clear aligners after OS (surgery-first approach) had better periodontal health and QoL outcomes.

Pre-treatment oral microbiome analysis and salivary Stephan curve kinetics in white spot lesion development in orthodontic patients wearing fixed appliances. A pilot study.

BACKGROUND: White spot lesions (WSLs) are a formidable challenge during orthodontic treatment, affecting patients regardless of oral hygiene. Multifactorial in nature, amongst potential contributors to their development are the microbiome and salivary pH. The aim of our pilot study is to determine if pre-treatment differences in salivary Stephan curve kinetics and salivary microbiome features correlate with WSL development in orthodontic patients with fixed appliances. We hypothesize that non-oral hygiene determined differences in saliva could be predictive of WSL formation in this patient population through analysis of salivary Stephan curve kinetics, and that these differences would further manifest as changes in the oral microbiome. METHODS: In this prospective cohort study, twenty patients with initial simplified oral hygiene index scores of "good" that were planning to undergo orthodontic treatment with self-ligating fixed appliances for at least 12 months were enrolled. At pre-treatment stage, saliva was collected for microbiome analysis, and at 15-minute intervals after a sucrose rinse over 45 min for Stephan curve kinetics. RESULTS: 50% of patients developed a mean 5.7 (SEM: 1.2) WSLs. There were no differences in saliva microbiome species richness, Shannon alpha diversity or beta diversity between the groups. Capnocytophaga sputigena exclusively and Prevotella melaninogenica predominantly were found in WSL patients, while Streptococcus australis was negatively correlated with WSL development. Streptococcus mitis and Streptococcus anginosus were primarily present in healthy patients. There was no evidence to support the primary hypothesis. CONCLUSIONS: While there were no differences in salivary pH or restitution kinetics following a sucrose challenge and no global microbial differences in WSL developers, our data showed change in salivary pH at 5 min associated with an abundance of acid-producing bacteria in saliva. The results suggest salivary pH modulation as a management strategy to inhibit the abundance of caries initiators. Our study may have uncovered the earliest predecessors to WSL/caries development.

Self-ligating brackets do not reduce discomfort or pain when compared to conventional orthodontic appliances in Class I patients: a clinical study.

OBJECTIVES: To compare the intensity, location, and short-term impact of the periodontal discomfort/pain, as well as the related functional parameters of bite force and masticatory efficiency, between self-ligating and conventional orthodontic appliances. MATERIALS AND METHODS: In 20 patients referred for orthodontic treatment, samples were collected from the gingival sulcus to evaluate the level of substance P using enzyme-linked immunosorbent assay. Orthodontic devices were randomly bonded, with self-ligating appliances on one side and conventional brackets on the contralateral side. Pain threshold (PT), maximal bite force (MBF), and masticatory efficiency (ME) were assessed using standard validated techniques at the beginning of the treatment and 24 hours post-orthodontic activation with an 0.016-inch nickel-titanium wire. RESULTS: There were no significant differences (P > .05) in the substance P levels, PT, MBF, and ME between the self-ligating and conventional orthodontic appliances. CONCLUSIONS: There was no difference between conventional and self-ligating appliances in the parameters of pain: substance P and pressure. Functional aspects, such as pain, discomfort, and masticatory efficiency, should not be considered when making a therapeutic decision regarding the use of self-ligating vs conventional orthodontic appliances.

Assessment of the periodontal health status and gingival recession during orthodontic treatment with clear aligners and fixed appliances: A systematic review and meta-analysis.

BACKGROUND: The aim was to assess periodontal health maintenance and gingival recessions development in patients undergoing an orthodontic treatment with clear aligners (CA) and fixed appliances (FA). MATERIAL AND METHODS: An electronic search in MEDLINE, Scopus, The Cochrane Library, and Web of Science was performed up to September 2022 to identify all potential articles. Two investigators independently selected the studies according to the inclusion criteria. Prospective and retrospective studies assessing the periodontal health status and gingival recession development during the orthodontic treatment with buccal FA and CA were included. Case series, cross-sectional studies, and studies with less than two months of follow-up were excluded. Two investigators independently extracted the data from included articles and assessed risk of bias across studies using the Cochrane Collaboration tool. Qualitative and quantitative analyses of the data were performed. Pairwise meta-analysis using a random-effects model were used to compare periodontal indices between FA and CA treatment in different follow-up periods. RESULTS: From the 129 potential studies, finally 12 studies were included. Only 8 could be included in the quantitative analysis. CA seems to slightly maintain better periodontal health indices. Only plaque index in a mid-term follow-up (mean difference (MD): -0.99; 95%; Confidence interval (CI) [-1.94 to -0.03]; P=.04; I2=99%), and pocket probing depth at a long-term follow-up (MD: -0.93mm; 95% CI [-1.16 to 0.7]; P<0.0001) reported statistically significant results favoring CA. CONCLUSIONS: Up to the date there is not enough evidence to conclude that CA maintains better periodontal health during an orthodontic treatment than FA.

Mobile app for comprehensive management of orthodontic patients with fixed appliances : Design and use.

OBJECTIVES: This study aimed to design and implement a mobile phone application (app) aiming to enhance the cooperation and oral hygiene of orthodontic patients. METHODS: An orthodontic app named "Labkhand" was designed by a team of orthodontists and programmers according to the needs and scheduled interventions for patients. The aim of this app was to obviate the orthodontic needs of patients by providing educational content in the form of texts and videos, oral hygiene reminders, appointment reminders, and nutrition reminders. It also enabled instant messaging and chatting between patients and dental personnel. In this study, 61 patients were monitored during their orthodontic treatment procedure. All patients were evaluated using a questionnaire with 7 questions before and after a 6-month treatment period. A total of 31 patients were instructed to use the app, while the other 30 patients received treatment without the app. The collected data were analyzed using paired t­test and analysis of covariance (ANCOVA) test. RESULTS: While the control group's questionnaire score remained almost the same (P > 0.05), the mean questionnaire score of patients in the intervention group significantly increased after using the app compared to the baseline scores acquired before using the app (P < 0.001). The greatest improvement was noted in topics related to "reminding of appointments", "general information about orthodontic treatment", and "oral hygiene maintenance and instructions". "Quality of services" and "patient-orthodontist communication" showed the least improvement in patient satisfaction. CONCLUSIONS: The Labkhand orthodontic app has multiple functions and can obviate the needs of orthodontic patients easily and at a low cost.

Comparison of cytokine level changes in gingival crevicular fluid between the aligner and pendulum appliance during early molar distalization : A single-center, prospective, observational study.

PURPOSE: There is currently a lack of evidence pertaining to gingival crevicular fluid cytokine levels in patients treated with the pendulum appliance. This study aimed to compare changes in cytokine secretion levels in gingival crevicular fluid (GFC) between the aligner and pendulum appliance in patients undergoing molar distalization. METHODS: GFC samples were collected from 28 participants with asymmetrical dental class II malocclusion who were undergoing molar distalization using aligners or pendulum appliances. An enzyme-linked immunosorbent assay was used to detect cytokine secretion levels during asymmetrical molar distalization for up to 14 days. Periodontal health indices and tooth movements were also assessed. RESULTS: No significant difference was found for the distalization distance between the two appliances. The Silness and Loe Plaque Index and Lobene Modified Gingival Index increased in the pendulum group but not in the aligner group at 14 days. Interleukin-1ß and tumor necrosis factor­α were upregulated in both groups. In the pendulum group, receptor activator of nuclear factor kappa­Β ligand and osteoprotegerin secretion levels were significantly upregulated and downregulated, respectively; smaller changes in these two cytokines were observed in the aligner group. CONCLUSIONS: Pendulum appliances exert stronger forces than aligners, which cause more changes in the secretion of inflammatory mediators in young patients.

Magnetic resonance imaging artefacts caused by orthodontic appliances and/or implant-supported prosthesis: a systematic review.

OBJECTIVES: Dental materials, including orthodontic appliances and implants, are commonly mentioned as a possible source of artefacts in magnetic resonance imaging (MRI). The aim of the present study was to undertake a systematic review of the relevant literature on MR image artefacts due to dental materials, limited to orthodontic appliances and implant-supported dental prosthesis, on both technical and diagnostic levels. METHODS: The MEDLINE (PubMed) bibliographic database was searched up to September 2020. The search was limited to studies published in English, using the search string: (MRI or magnetic resonance) and (artefact or artifact) and (dental or ortho or implant or restoration or restorative). The studies were assessed independently by three reviewers, focusing on the following parameters: MRI sequences, tested materials, assessed parameters, efficacy level and outcome. RESULTS: The search strategy yielded 31 studies, which were included in this systematic review. These studies showed that metallic dental materials, commonly present in orthodontic appliances and implant-supported dental prosthesis led to diverse types/severities of artefacts in MR images. Fifteen studies were in vivo, based on human subjects. The studies differed substantially in terms of tested materials, assessed parameters, and outcome measurements. CONCLUSIONS: Metallic dental materials cause artefacts of diverse types and severities in MR images of the head and neck region. However, the diagnostic relevance of the investigated artefacts for the diverse MRI applications is yet to be studied.

Effect of an enzyme-containing mouthwash on the dental biofilm and salivary microbiome in patients with fixed orthodontic appliances: a randomized placebo-controlled pilot trial.

BACKGROUND: Mouthwashes containing oral antiseptics or enzymes are suggested suitable for controlling biofilm accumulation in patients with fixed appliances and thereby limiting unwanted side effects during the orthodontic treatment. OBJECTIVES: To evaluate the effect of an enzyme-based mouthwash on the amount of dental biofilm and the composition of the salivary microbiome in patients undergoing treatment with fixed orthodontic appliances. TRIAL DESIGN: Randomized double-blind placebo-controlled trial. MATERIAL AND METHODS: In total, 35 young adolescents (14-18 years) under treatment with fixed appliances were consecutively enrolled and randomly allocated to an experimental or a placebo group by opening a computer-generated numbered envelope. The subjects were instructed to rinse twice daily during an intervention period of 8 days with experimental mouthwash or placebo without active enzymes. Unstimulated whole saliva samples were collected at baseline and after 8 days. The participants and examiner were blinded for the allocation. The primary outcome was the Orthodontic Plaque Index (OPI) and the secondary was the composition of the salivary microbiome. RESULTS: In total, 28 adolescents (21 females and 7 males) completed the trial and there were no differences in age, clinical, or microbial findings between the test (n = 14) and the placebo group (n = 14) at baseline. We found a decreased OPI in the test group after 8 days and the difference was statistically significant compared with the placebo group (P < 0.05). There were no significant treatment effects on the richness and global composition of the salivary microbiome. HARMS: In total, one participant in the test group claimed nausea and abandoned the project. In total, two participants did not like the taste of the mouthwash but used it as instructed. No other adverse events or side effects were reported. LIMITATIONS: Short-term pilot trials may by nature be sensitive for selection and performance biases and are not designed to unveil persisting effects. CONCLUSION: Daily use of enzyme-containing mouthwash reduced the amount of dental biofilm in adolescents under treatment with the fixed orthodontic appliances, without affecting the composition of the salivary microbiota. ETHICAL APPROVAL: Approved by the Regional Ethical Board, Lund, Sweden (Dnr 2020-05221). CLINICAL TRIAL REGISTRATION: NCT05033015.

Immediate effect of clear aligners and fixed appliances on perioral soft tissues and speech.

OBJECTIVES: To compare the immediate three-dimensional (3D) perioral soft-tissue changes and impact on speech induced by clear aligners and fixed appliances. MATERIALS AND METHODS: In this repeated-measure experimental study, stereophotogrammetric 3D photographs of 40 participants were recorded before and immediately after the introduction of clear aligners and fixed appliances. The 3D surface meshes were registered to quantify changes in the direction and magnitude of nine soft tissue landmarks located on the upper and lower lips. Self-reported speech disturbance was evaluated using a questionnaire. Data were analysed using repeated-measures analysis of variance. RESULTS: In the vertical plane, the clear aligners induced inferior displacement (range 0.4-1.5 mm) for all nine landmarks (P < .01), whereas fixed appliances induced inferior displacement only of A-point (0.4 ± 0.9 mm), right crista philtri (0.5 ± 1.1 mm) and left crista philtri (0.7 ± 1.1 mm). The clear aligners induced greater vertical changes than fixed appliances for all landmarks (P < .05). In the sagittal plane, both clear aligners and fixed appliances slightly advanced all perioral landmarks, except subnasale. Fixed appliances caused greater changes than clear aligners for right cheilion (+0.8 mm), left cheilion (+0.8 mm) and labrale inferius (+0.9 mm) (P < .01). Both orthodontic appliances had a significant self-perceived effect on speech, with clear aligners affecting speech to a greater degree. CONCLUSION: Clear aligners and fixed appliances produced immediate effects on perioral soft tissues, which are most evident in the vertical plane for clear aligners, and in the sagittal plane for fixed appliances. Speech was affected by both appliances.

Use of liquid-based cytology samples reveals genomic instability and cell death in patients undergoing orthodontic treatment.

PURPOSE: To examine the use of liquid-based exfoliative cytology to determine the presence of genomic instability and cell death in the oral mucosa of patients with orthodontic appliances. METHODS: Fifty-four oral mucosa samples were collected from 18 patients and divided into three stages: T0, before fixation of orthodontic appliances; T1, 25 days after appliance fixation; T2, 90 days after appliance fixation. All samples were Papanicolaou-stained and observed by microscopy (1,000 cells/sample) to ascertain the frequency of micronucleated cells (MN) and nuclear abnormalities (nuclear buds (NB), binucleated (BN), condensed chromatin (CC), karyorrhexis (KR), and karyolysis (KL)). Differences were analyzed statistically using the Mann-Whitney, Wilcoxon, Kruskal-Wallis and chi-squared tests. RESULTS: After placement of orthodontic appliances, significant differences were observed for genomic instability biomarkers (MN and NB) and cell death (CC, KR and KL) (P < 0.05). Female patients and older patients exhibited a higher frequency of MN. CONCLUSION: Liquid-based cytology has revealed that orthodontic appliances induce genomic instability and cell death in epithelial tissue of the oral mucosa, facilitating sample preservation and yielding more than one preparation per sample. Future studies should investigate whether such cell damage can be reversed through cell repair or whether cell alterations evolve and lead to disease.

Assessment of oral hygiene maintenance in 12-18-year-old children and teenagers with fixed orthodontic appliances.

BACKGROUND: Good oral hygiene is very important to ensure successful orthodontic treatment. Orthodontic treatments may cause plaque accumulation and in this way the development of caries and periodontal diseases which are basically caused by dental plaque. The aim of this study was to compare the features of oral hygiene among different age groups and genders in patients with fixed orthodontic appliances. MATERIAL AND METHODS: The study involves 118 patients aged 12 to 18 (64 males (54.2%) and 54 females (45.8%)) with fixed orthodontic appliances from the Department of Orthodontics at Danylo Halytskiy Lviv National Medical University. The patients completed the questionnaires which included 19 questions about their oral hygiene. RESULTS: It was revealed that 59 females (92.19±3.35%) believe that oral hygiene is important, but among the males number of such persons have been significantly lower - 41 (75.93±5.82%), p<0.05. Statistically significant result was obtained showing that females (46 patients (71.88±5.62%) use interdental brushes more regular (every day) than males (26 (48.15±6.80%), p<0.05. Comparing the differences between the regularity of teeth brushing in different age groups showed that 53 patients (82.81±4.72%) aged 12 to 15 and 46 (85.19±4.83%) aged 16 to 18 claimed that they brush their teeth regularly, twice a day, 8 (12.50±4.13%) and 6 (11.11±4.28%), respectively - once a day. CONCLUSION: In patients with fixed orthodontic appliances oral hygiene of 16-18-year-old respondents is better than the oral hygiene of 12-15-year-old ones.

Clinical, histopathological and immunohistochemical changes of the superficial marginal periodontium caused by orthodontic treatment with fixed metallic orthodontic appliances.

Malocclusions negatively influence dental function, physical well-being, and quality of life. According to data provided by the World Health Organization (WHO), malocclusions represent the third most widespread oral health problem, after dental caries and periodontal diseases. In recent years, more and more people call for orthodontic treatment with fixed braces that aim at establishing a dental, aesthetic, and functional balance, compatible with a normal life. Our study assessed the histopathological and immunohistochemical changes that occurred in superficial marginal periodontal components, in a number of 23 patients diagnosed with malocclusions, as a result of orthodontic treatment with fixed metal braces. The purpose of the study was to evaluate the remodeling of the tissues in the superficial periodontium during orthodontic migration, microscopic aspects that are essential to evaluate the effectiveness of the orthodontic treatment.

Effect of fixed orthodontic appliances on gingival status and oral microbiota: a pilot study.

BACKGROUND: This pilot study aimed to investigate how fixed orthodontic appliances simultaneously applied on the upper and lower arches affect the oral environment in the medium term. METHODS: The oral status of 30 orthodontic patients was evaluated using the number of decay-missing-filled teeth (DMFT), plaque (PI), and gingival indices (GI) before bonding of fixed orthodontic appliances (T0) and during the therapy (T1). Besides, the gingival crevicular fluid (GCF) and a dental plaque were collected. Samples were analyzed for selected Candida sp. and for 10 selected oral bacteria using mass spectroscopy and multiplex polymerase chain reaction, respectively. RESULTS: In 60% of patients, deterioration of the oral status (demonstrated by the increase in PI) was recorded (p < 0.05). Moreover, the changes in PI correlated with those of GI (p < 0.001). At the T1 time point, the mean representation of Actinomyces sp. in the total prokaryotic DNA in GCF and dental plaque of individual patients increased compared to T0 (p < 0.05). The probability of finding any of the 7 selected periodontal bacteria combined with Candida sp. was 10 times higher in patients in whom PI deteriorated between T0 and T1 (p < 0.01). CONCLUSIONS: Changes in the oral microbial diversity and an increase in PI were observed in the medium term after bonding of orthodontic appliance. Our study highlights the importance of a complex approach in this type of research as the association between clinical characteristics and combined microbial parameters is higher than when evaluated separately.

Oral Microbiota Changes during Orthodontic Treatment.

Orthodontic treatment has become increasingly popular due to its benefits in improving facial and smile aesthetics, self-esteem and the function of the stomatognathic apparatus. However, orthodontic appliances make it more difficult to brush teeth effectively, as they interfere with tooth brushing and facilitate the accumulation of dental plaque (biofilm), which induces a quantitative and qualitative change in the oral microbiota. It can cause several adverse effects, such as gingivitis, periodontitis, white spot lesions (WSL), caries and halitosis, induced by an increase in periodontopathogenic and cariogenic bacteria. Therefore, this article resumes the main findings on the changes in the oral microbiota induced by different orthodontic appliances (removable, fixed and clear aligners) and gives some practical strategies in order to reduce the impact and/or incidence of local dental/periodontal complications.

Reacciones Adversas durante el tratamiento de Ortodoncia: Incidencia e Impacto en España / Adverse reactions during orthodontic treatment: Incidence and impact in Spain

Introducción: Las reacciones alérgicas preocupan cada vez más a los profesionales sanitarios en todos los ámbitos debido al incremento de la susceptibilidad de la población a múltiples alérgenos. Se estima que entre 10 y 30% de los ortodoncistas en España han sido testigos de reacciones adversas asociadas a aparatos ortodónticos, adhesivos y otros materiales. Objetivo: Estimar el número de reacciones alérgicas que se producen en la práctica clínica ortodóncica en España y determinar la necesidad de utilizar dispositivos sin níquel en las consultas de ortodoncia en el momento actual. Métodos: Se encuestó a una muestra de 100 ortodoncistas (23 en formato papel y 77 online) para cuantificar retrospectivamente el número de pacientes que habían sufrido reacciones adversas en sus consultas y describir dichas reacciones frente a los aparatos y otros materiales utilizados. Resultados: El 21% de los encuestados refirió haber observado entre sus pacientes alguna reacción alérgica intraoral o extraoral en relación con aparatos ortodónticos y otros materiales. En la mita de los casos, la reacción se presentó como eritema u otros síntomas localizados en la mucosa oral y/o en los labios. Conclusiones: Una quinta parte de los ortodoncistas admiten haber tenido en su práctica clínica al menos un paciente con una reacción alérgica intraoral o extraoral causada por algún aparato de ortodoncia en los últimos 5 años (AU)

Introduction: Allergic reactions are of increasing concern to healthcare professionals in all settings due to the already increasing susceptibility of the population to multiple allergens. It is estimated that between 10 and 30% of orthodontists in Spain have witnessed adverse reactions associated with orthodontic appliances and adhesive materials. Objective: To estimate the number of allergic reactions that occur in orthodontic linical practice in Spain and to determine the need to use nickel-free devices in orthodontic practices at the present time. Methods: A sample of 100 orthodontists was interviewed (23 in paper format and 77 online) to retrospectively quantify the number of patients who had suffered adverse reactions in their practices and to describe these reactions to the appliances used. Results: 21% of the respondents reported having observed an intraoral or extraoral allergic reaction to orthodontic appliances among their patients. In half of the cases the reaction presented as erythema or other symptoms located on the oral mucosa and/or lips. Conclusions: One-fifth of orthodontists admit to having had at least one patient with an intraoral or extraoral allergic reaction caused by any orthodontic appliance in the last 5 years (AU)