Reflection on patients' experience with orthodontic appliances wear and its impact on oral health related quality of life: observational comparative study.

BACKGROUND: The objective of this study was to explore and compare patient's experience with the use of a removable functional appliance or fixed orthodontic appliance and its influence on oral health-related quality of life. MATERIAL AND METHODS: This clinical trial included 81 participants having Class II Division 1 and age ranging between 10 and 16 years. The participants were included in any of a three equal groups according to the set inclusion and exclusion criteria; Group 1: patients treated with a Twin-Block functional appliance; Group 2: patients treated with a fixed orthodontic appliance only; and Group 3 (control group): patients not in orthodontic treatment yet. The COHIP SF-19 was used. Patients were given the questionnaire as follows: Group 1: (1) after at least 8 months from starting treatment; (2) after completing phase 1 by 2-3 months without wearing the appliance; Group 2: (1) just before debonding; (2) after finishing the treatment by 2-3 months without any appliances; and Group 3: (1) at the patient's first visit to the orthodontic clinic; (2) after 2-3 months from the first visit to the orthodontic clinic and before starting any treatment. RESULTS: The 81 participants were 31 males and 50 females with median age of 13 years. The total COHIP SF-19 scores at baseline were 57 (49-64), 67 (63-72), and 47 (42-53) for the Twin-Block, the fixed appliance, and the malocclusion groups, respectively. Two-month mean scores adjusted to the baseline scores were 64.82 ± 1.15, 65.65 ± 1.47, and 54.45 ± 1.44 for the Twin-Block, the fixed appliance, and the malocclusion groups, respectively. CONCLUSIONS: Both at baseline and two-months (adjusted to the baseline scores), participants in the malocclusion group showed compromised socio-emotional quality of life and reported the poorest total OHRQoL. At the baseline, better socio-emotional and total OHRQoL was reported by the fixed appliance group compared to the Twin-Block group but, after two months both groups gave similar sores. Therefore; patients' perceptions about their experience with the orthodontic appliance might change.

Three dimensional quantitative study of soft tissue changes in nasolabial folds after orthodontic treatment in female adults.

BACKGROUND: With the popularity of medical aesthetic programs, some female adults who will or are undergoing orthodontic treatment often wonder whether orthodontic treatment has adverse effects on the nasolabial folds (NLFs). The aims of the study were to investigate any potential changes in the NLFs and associated peripheral soft tissues after orthodontic treatment of female adults. METHODS: This study compared changes in the NLFs and peripheral soft tissues in female adults undergoing orthodontic treatment using the 3dMD Face system (3dMD, Atlanta, Ga). A total of 52 adult female patient cases (24 teeth extraction, 28 non-teeth extraction) were included to evaluate the effects of different orthodontic treatment regimens on the NLFs and peripheral soft tissues. RESULTS: In the NLFs area, the landmarks of the extraction group were all significantly negatively changed (P < 0.001; the NLF2s average value was - 0.72 mm), and the upper and middle parts of the landmarks were negatively changed in the non-extraction group (P < 0.05; the NLF2s average value was - 0.22 mm). Compared to the non-extraction group, the negative changes in the extraction group were more pronounced (P < 0.005). In the lip region, all landmarks in the extraction group were negative changes (P < 0.05; upper lip (ULP) = - 0.93 mm, lower lip (LLP) = - 1.46 mm), and most landmarks in the non-extraction group were positive changes (P < 0.01; ULP = 0.55 mm). In the cheek area, the left and right buccal of the extraction and non-extraction groups were all negatively changed (P < 0.05), and there was no significant difference between the two groups. CONCLUSION: After orthodontic treatment, the NLFs showed negative changes, which were more obvious in the extraction group. The lip soft tissue had a negative change in the extraction group and a positive change in the non-extraction group, indicating that orthodontic treatment affected the soft tissue around the nasolabial sulcus, and that tooth extraction would lead to more negative changes.

THE INFLUENCE OF THE ORTHODONTIC TREATMENT ON THE DEVELOPMENT OF THE TEMPOROMANDIBULAR JOINT DISORDER - LITERATURE REVIEW.

TMJ is highly prevalent stomatognathic disease affecting all age groups. Frequently, malocclusion can be the reason of the development of TMJ disorders. However, in addition to this, in the course of orthodontic treatment there may be some complaints about the pain and discomfort in temporomandibular joint, which is caused by orthodontic appliances that aimed to change the condition of malocclusion and mandibles. TMJ disorders are characterized with more complexity in case disorders are chronic or persistent. Orthodontic treatment has a potential role for the possible recovery as a consequence of correction of malocclusion. Pre-orthodontic preparation frequently is a necessary stage of orthodontic treatment. Orthodontists and general dentists must be aware of the multifactorial etiology of TMD and should accept recommendations about controlling the process before or after any dental or orthodontic interventions. The aim of this literature review is to show the effect of the orthodontic treatment in the development of temporomandibular joint disorders. The research may be an important factor for orthodontic patients for better assessment in order to avoid the post treatment complications. In the electronic database of PubMed, Google Scholar, Web of Science and Scopus using the key words the studies held before 2022 were searched and analyzed in addition to the data from the books related to temporomandibular joint and complications of orthodontic treatment. Orthodontic treatment in combined treatment of TMJ disorders has a potential role for the possible recovery. For the successful recovery it is essential clinicists to be informed about TMJ clinical signs and symptoms, have appropriate knowledge about all possible treatment means and detailed assessment of TMJ myofunctional condition before and after the orthodontic treatment. As a result of the correct control of the treatment process amongst the patients with the signs of TMJ dysfunction, the structure of temporomandibular joint is adapted to a new functional positioned that improves clinical condition in the surroundings. On the basis of this research and experience, it must be emphasized one more time that TMJ diagnosis must be a crucial criterion at a pre-orthodontic preparation stage in order to assess the treatment quality and avoid the post treatment complications.

Effects of high-frequency near infrared laser irradiation on experimental tooth movement-induced pain in rats.

Discomfort and dull pain are known side effects of orthodontic treatment. Pain is expected to be reduced by near-infrared (NIR) lasers; however, the mechanism underlying effects of short-pulse NIR lasers in the oral and maxillofacial area remains unclear. This study aimed to examine the effects of high-frequency NIR diode laser irradiation on pain during experimental tooth movement (ETM) on 120 J. NIR laser with 910 nm wavelength, 45 W maximum output power, 300 mW average output power, and 200 ns pulse width (Lumix 2; (Lumix 2; Fisioline, Verduno CN, Italy) was used for the experiment. A nickel-titanium-closed coil was used to apply a 50-gf force between the maxillary left-side first molar and incisor in 7-week-old Sprague-Dawley rats (280-300 g) to induce ETM. We measured facial-grooming frequency and vacuous chewing movement (VCM) period between laser-irradiation and ETM groups. We performed immunofluorescent histochemistry analysis to quantify levels of Iba-1, astrocytes, and c-fos protein-like immunoreactivity (Fos-IR) in the trigeminal spinal nucleus caudalis (Vc). Compared with the ETM group, the laser irradiation group had significantly decreased facial-grooming frequency (P = 0.0036), VCM period (P = 0.043), Fos-IR (P = 0.0028), Iba-1 levels (P = 0.0069), and glial fibrillary acidic protein (GFAP) levels (P = 0.0071). High-frequency NIR diode laser irradiation appears to have significant analgesic effects on ETM-induced pain, which involve inhibiting neuronal activity, microglia, and astrocytes, and it inhibits c-fos, Iba-1, and GFAP expression, reducing ETM-induced pain in rats. High-frequency NIR diode laser application could be applied to reduce pain during orthodontic tooth movement.

A Multidisciplinary Approach for the Management of Iatrogenic Severe Periodontitis Following Orthodontic Treatment with a 12-Year Follow-up.

Orthodontic treatment aims to realign teeth in a functional and esthetic manner. When applied on an unhealthy periodontium, this may lead to advanced periodontal tissue breakdown. The present 12-year follow-up report describes the multidisciplinary management of a severe, iatrogenic, generalized periodontitis case that was caused/aggravated by orthodontic therapy on unhealthy periodontal tissues. Prompt therapy was applied through nonsurgical and surgical approaches, including soft and hard tissue grafting procedures combined with corrective orthodontic treatment on healthy tissues. This report is a clear demonstration that early disease detection and proper diagnosis combined with appropriate therapeutic approaches concomitant with strict supportive periodontal therapy could lead to long-term successful and maintainable outcomes, even in hopeless cases.

Efectos del tratamiento de ortodoncia sobre el tejido periodontal: revisión bibliográfi ca / Effects of the orthodontic treatment in the periodontal tissue: bibliographic review

Introducción: La ortodoncia mejora la estética, la oclusión, la posición dentoalveolar, favoreciendo la higiene y la salud periodontal. Sin embargo, también puede generar alteraciones como gingivitis, periodontitis, recesión o pérdida ósea. Lascomplicaciones están infl uenciadas por el tipo de técnica o aparatología y por factores asociados al paciente. El objetivo de esta revisión fue estudiar los efectos del tratamiento de ortodoncia sobre el periodonto.Material y métodos: Se realizó una búsqueda bibliográfi ca en Pubmed, Web of Science y Scielo de acuerdo con criterios de inclusión y exclusión previamente establecidos.Resultados: Tras aplicar los criterios de inclusión y excusión fueron seleccionadas un total de 37 referencias bibliográfi - cas entre 2011 y 2020.Conclusión: El adecuado tratamiento ortodóncico puede mejorar positivamente la salud periodontal al reducir el trauma oclusal y favorecer la higiene oral. El tratamiento ortodóncico puede tener efectosiatrogénicos periodontales (p.ej. gingivitis, recesiones, etc.). La combinación de ortodoncia y periodoncia es básica para el éxito y estabilidad del tratamiento (AU)

Manejo de defectos tipo recesiones múltiples luego de la terapia de ortodoncia: un caso reportado basado en la evidencia científica / The management of multiple recession like defects after orthodontic therapy: report of a case based on scientific evidence

Por qué en este caso hay nueva in- formación? - Este caso demostró métodos basado en la evidencia para el manejo de severas recesiones gingivales luego de la terapia or- todóntica. - La modificación del grosor gin- gival lleva a resultados estables a largo plazo estéticos y funcio- nales. - Este caso demostró beneficios clínicos usando injertos tomados desde el mismo sitio donador en diferentes momentos de tiempo. Cuales son las claves de éxito para manejar este caso? - Sólidos conocimientos de la anatomía periodontal - Identificación de las caracterís- ticas de RC relacionadas con las causas de la terapia ortodóntica. - ITCSE su toma del paladar. - Uso de colgajos sin tensión. - Incremento del grosor gingival para promover resultados a largo plazo. Cuales son las limitaciones prima- rias del éxito en este caso? - Necesidad de tomas de paladar en ambos lados - Anatomía de las RG y la fina en- cía que puede limitar la extensión del colgajo - Experiencia clínica (AU)

Comprehensive evaluation of factors that induce gingival enlargement during orthodontic treatment: A cross-sectional comparative study.

BACKGROUND: Gingival enlargement (GE) is one of the most common soft tissue problems encountered during fixed orthodontic treatment. Aims: This study aimed to evaluate the factors affecting GE in adolescents and young adults, compared with their normal peers. SUBJECTS AND METHODS: This is a cross-sectional comparative study. The sample consisted of 329 subjects (ages 10-30 years) of both genders, which was divided into four main groups: The control group (G0) with no orthodontic treatment; subjects who underwent orthodontic treatment were divided according to treatment duration into G1 (4-12 months), G2 (13-24 months), and G3 (>24 months). The clinical examinations included the level of debris, calculus (simplified oral hygiene), and GE indices. Regression analyses were used to assess the GE association in all the studied groups. RESULTS: The mean GE score increased significantly with increased treatment duration (0.42 ± 0.29 for G0 and 1.03 ± 0.52 for G3). GE scores of the lower arch were significantly higher in the anterior segment than in the posterior segment among all treatment groups. Regression analysis revealed that gender, age, oral hygiene, and treatment duration had a significant effect on GE (P < 0.05), while angle classification, overjet, overbite, treatment stage, bracket type, and therapeutic extraction did not show significant associations (P > 0.05). CONCLUSION: Gender, age, oral hygiene, and treatment duration were the most important risk factors for GE during fixed orthodontic treatment.

Endodoncia y ortodoncia. Parte 2: casos clínicos / Endodontics and orthodontics. Part 2: clinical cases

Objetivo: Describir el tratamiento endodóncico de cuatro casos clínicos de reabsorción radicular desarrollada durante o tras un tratamiento ortodóncico. Casos clínicos: Después de la preparación y la desinfección de los conductos radiculares, estos fueron obturados por un tiempo prudencial con una medicación intraconducto de hidróxido de calcio, que luego fue reemplazada por MTA. Luego de un período de entre uno y cuatro años, según el caso, los tratamientos fueron evaluados clínica y radiográficamente. Los dientes que debieron ser extraídos fueron analizados histológicamente. Según la evolución clínica y radiográfica de los casos presentados, el uso inicial de hidróxido de calcio y su posterior reemplazo por MTA parecería ser un protocolo adecuado para completar el proceso de reparación de los tejidos apicales y perirradiculares en casos de reabsorciones radiculares provocadas por fuerzas ortodóncicas excesivas. Las enfermedades sistémicas deben ser tenidas en cuenta para la elección de la terapéutica (AU)

Aim: To describe the endodontic treatment of four clinical cases of permanent teeth suffering root resorption during or after orthodontic treatment. Clinical cases: Four clinical cases of permanent teeth with root resorption were endodontically treated. After the root canals were prepared and disinfected, they were medicated with calcium hydroxide. After an appropriate observation period, the canals were finally filled with MTA. The treatment outcomes were clinically and radiographically assessed at an interval between one to four years according to the clinical case. The histological findings of teeth that required extraction was also described. Our clinical and radiographic observations suggest that a temporary filling with calcium hydroxide and further obturation with MTA can provide a favorable intracanal environment for apical and periradicular tissue reparation. The clinician needs a full medical history to be aware of the systemic diseases in patients with root resorption that will be of importance for the proper selection of treatment (AU)

Periodontal evaluation of palatally impacted maxillary canines treated by closed approach with ultrasonic surgery and orthodontic treatment: a retrospective pilot study.

Aim of this study is the evaluation of the periodontal status of impacted canines treated by closed approach with ultrasonic surgery and orthodontic treatment compared with contralateral spontaneously erupted teeth. The periodontal conditions of the teeth adjacent to the canines (lateral incisors and first premolar) were also considered. 17 patients (9 females and 8 males; mean age: 15.2 years) with unilateral palatal impaction of maxillary canine were selected. All patients were treated by closed-flap surgery with ultrasonic instruments. Periodontal status was evaluated by assessing probing depth (PD), gingival recession and width of keratinized tissue (KT) 4.6 months after the end of the orthodontic treatment, on average. Test group was composed by impacted elements and adjacent teeth and control group by contralateral spontaneously erupted canines and adjacent teeth. Student's t-test was used to compare test and control group values of PD and width of KT. Significance threshold for Student's t-test was set at p < 0.05. The average probing depth values show no significant clinical differences between the test and control groups. Probing depths recorded at the mesiovestibular and distopalatal sides of the impacted canine were statistically significant compared to the control elements (p < 0.05). No gingival recession was detected on the treated canines. The measurement of KT did not differ significantly between the test and the control groups. In conclusion, the ultrasonic surgery for disinclusion associated with a closed approach and orthodontic traction allows the alignment of an impacted palatal canine without damaging the periodontium.

Efficacy and safety of micro-implant anchorage in Angle class II malocclusion orthodontic treatment: A protocol for systematic review and meta-analysis.

BACKGROUND: Angle class II malocclusion is clinically complex and common malocclusion type, which affects beauty. Conventional treatment has the disadvantages of long course of treatment, high cost, easy recurrence and limited curative effect. Clinical practice shows that micro-implant anchorage has certain advantages in the treatment of Angle II malocclusion, but lacks the evidence of evidence-based medicine. This study systematically evaluates the efficacy and safety of micro-implant anchorage in the treatment of Angle class II malocclusion. METHODS: A systematic search was performed by retrieving on English databases (PubMed, Embase, Web of Science, and the Cochrane Library) and Chinese databases (CNKI, Wanfang, Weipu [VIP], CBM). Besides, manually search for Google and Baidu academic of micro-implant anchorage in the treatment of Angle class II malocclusion in randomized controlled clinical research. The retrieval time limit was from the establishment of the database to September 2020. Two researchers independently extracted and evaluated the quality of the data in the included study. A meta-analysis was performed using RevMan5.3 software. RESULTS: In this study, the efficacy and safety of micro-implant anchorage against Angle class II malocclusion were evaluated by SNA, BNA, ANB, NLA°, Adverse reaction. CONCLUSIONS: This study will provide reliable evidence-based evidence for the clinical application of micro-implant anchorage in the treatment of Angle class II malocclusion. ETHICS AND DISSEMINATION: Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval was not required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences.OSF Registration number: DOI 10.17605/OSF.IO/UPBR8.

Root changes in buccal versus palatal maxillary impacted canines of adults: A longitudinal and retrospective 3-dimensional study before and after orthodontic traction.

OBJECTIVE: Maxillary impacted canines (MIC) could suffer root changes after canine traction. The aim of this study was to evaluate the 3-dimensional root changes in buccal versus palatal MIC after orthodontic traction. MATERIALS AND METHODS: This longitudinal and retrospective study included pre-treatment and after traction cone beam computed tomography scans (CBCTs) of 30 subjects with unilateral/bilateral MIC. A total of 43 MIC were divided into 2 groups: buccal (n=17) or palatal (n=26). Root changes in length and area after orthodontic traction were measured at sagittal, coronal and axial sections. Intergroup comparison was carried out by t or U Mann-Whitney tests, depending on normality. Multiple linear regression analysis was used to evaluate the influence of all predictor variables on root changes (P<0.05). RESULTS: Significant difference between groups was found for root area changes in the upper limit of the cervical third at axial section that showed greater appositional values for the palatal impacted canine group (-1.18mm2) and resorptive values for the buccal impacted canine group (0.62mm2) (P=0.024). Position of impaction palatal influenced the increase of root area in the coronal section and in the upper limit of the cervical third at axial section. Age directly influenced the decrease of total length and root area in sagittal and coronal sections, respectively. CONCLUSION: Orthodontic traction of MIC produced an important appositional root change in the palatal impaction group in the axial root area of the upper limit of the cervical third. Impaction position and age influenced the increase and decrease of root area and length of some specific radicular regions.

Do orthodontic patients develop more gingival recession in anterior teeth compared to untreated individuals? A systematic review of controlled studies.

OBJECTIVE: To investigate, in an evidence-based manner, the contemporary available information regarding the development of gingival recession in the anterior teeth of orthodontically treated and age-matched untreated individuals. MATERIAL AND METHODS: Eight databases were searched without restrictions from the date of coverage initiation to June 30th, 2019 (registration in PROSPERO: CRD42018080948). Studies evaluating gingival recession development following comprehensive orthodontic treatment were reviewed. Following study selection, data extraction and risk of bias assessment, the random effects model was employed for exploratory data synthesis. The confidence in the retrieved estimates was appraised using current guidelines. RESULTS: Finally, three studies, with a follow-up of 6 years maximum, were identified. Overall, the amount of gingival recession did not increase significantly immediately after treatment with normal occlusion. However, for some of the comparisons considered, the risk for orthodontic patients to present with labial gingival recession seemed to increase, especially during retention [mandibular incisors 6 years post-treatment: Odds Ratio: 8.81, 95% Confidence Interval: 1.93-40.07, p=0.005]. CONCLUSION: Although the amount of recession does not differ, some increase in the risk for gingival recession development in the anterior teeth may be encountered in orthodontically-treated individuals compared to untreated subjects with normal occlusion. However, these findings should be viewed cautiously until more studies of high quality become available. Good practice would suggest that it is important to identify patients at potential risk and consider the possible implications for orthodontic treatment.

Effectiveness of antimicrobial gels on gingivitis during fixed orthodontic treatment: A systematic review and meta-analysis.

OBJECTIVE: The present study was aimed to assess the effectiveness of antimicrobial gels along with conventional tooth brushing to improve gingival health in patients undergoing fixed orthodontic treatment. MATERIALS AND METHODS: All randomized and non-randomized clinical trials done on human subjects were explored in major health science databases (PubMed, CINAHL Plus, EBSCO Dent & Oral Sciences and Cochrane). An additional manual search was done on Google Scholar and on www.clinicaltrials.gov to identify any grey literature and unpublished data. Date of publication was not restricted during the data search. The assessment of risk of bias was done using the Cochrane Collaboration's Risk of Bias assessment tool. The meta-analysis was done using Review Manager Version 5.3.5 to analyse probing depth to be in two and four-week follow-up. This systematic review is reported according to the PRISMA statement and registered at PROSPERO (CRD42018084530). RESULTS: The electronic database search yielded 3733 records; hand search identified 14 articles meeting the selection criteria which were included in the qualitative data synthesis. Significant improvement in gingivitis has been reported using antioxidant-essential oil gel, cervitec gel (0.2% chlorhexidine), 2% chlorhexidine gel, amine fluoride gel, and 0.4% stannous fluoride gel with>98% availability of Sn+2 ions. Three articles with probing depth as comparable parameter were used for quantitative analysis. At the two and four-week follow-up, overall insignificant differences were observed in the antimicrobial gel group compared to the control group with regard to probing depth. CONCLUSIONS: The use of antioxidant-essential oil gel, amine fluoride gel, 0.4% stannous fluoride gel (98% availability of Sn+2) and 2% chlorhexidine gel resulted in significant improvement in gingivitis. However, probing depth in follow-up visits showed no significant difference between antimicrobial gel and control group.

Pharyngeal dimensional changes in class II malocclusion treatment when using Forsus® or intermaxillary elastics - An exploratory study.

OBJECTIVE: Pharyngeal airway obstruction can facilitate some forms of sleep disorder breathing (SDB) in susceptible children, especially in those having class II malocclusion. Changes in the anatomic areas surrounding the pharyngeal region during orthodontic treatment could hypothetically impact the pharyngeal airway dimensions. Management of a class II malocclusion on a growing individual with either intermaxillary elastics or different removable or fixed class II appliance designs have been proposed over the last century. The objective of this retrospective exploratory cohort study is to investigate to what extent the class II malocclusion treatment with either intermaxillary elastics (IME) or Forsus® fatigue resistance device (FFRD) leads to changes in oropharyngeal airway dimensions. MATERIALS AND METHODS: Twenty-nine patients diagnosed as class II with an average age of 12.7years were included in this study, (11 males, 18 females). The sample was divided into group 1: IME and group 2: FFRD. CBCT's scans before (T1) and after treatment (T2) were obtained and analysed using Dolphin software. Reliability was obtained using Intraclass Correlation Coefficient (ICC). Descriptive statistics, ANOVA and paired t-test were used for analysis. RESULTS: Intra-rater reliability test was excellent in all measurements for both groups. There were no statistically significant differences in pharyngeal airway dimensions between both groups (P=0.919). A statistically significant correlation was found for sex, where male patients had the highest increase in oro-space area (ORS), and in oropharyngeal volume. Children under 14-year-old in IME group showed statistically negative correlation for sub-mandibular (SM) and for ORS, meaning the younger the greatest increase. Additionally, individuals younger than 14years had a statistically significant increase in the vertical dimension. CONCLUSIONS: Both orthodontic treatment approaches appear to be associated with a similar increase in oropharyngeal airway dimensions. Male patients under 14-year-old had a greater significant increase compared to female patients and older children. Normal pharyngeal dimensions changes were not accounted for.

Variation of upper lip pressure on upper teeth during non-extraction orthodontic treatment: A prospective clinical study.

OBJECTIVE: The objectives of this prospective clinical study are to quantify the variation of pressure exerted by the upper lip on the upper teeth during the alignment phase and to evaluate its capacity to adapt to changes in dental position. MATERIALS AND METHODS: Thirty young subjects in skeletal Class I relationship requiring non-extraction orthodontic treatment were included in this study. The pressure exerted by the upper lip on the upper central incisors and right canine were measured during rest and swallowing positions using a pressure transducer before bracket placement (T0), after bracket placement (T1), three months (T2) and six months later (T3). Maxillary intercanine width (CC), upper arch length (U) and crowding (C) were measured on stone models at T1, T2 and T3 to determine the existence of a correlation between the variation of lip pressure and these variables. RESULTS: The lip pressure significantly increased after bracket placement and remained relatively stable during the six-month period. The labial pressure on the incisors was the only variable to significantly decrease at T3, though remaining significantly higher than the starting pressure. A positive correlation was found between the variation of the inter-canine distance and the labial pressure on the canine at rest whereas a negative correlation exists between the crowding and the labial pressure on the incisors at rest. CONCLUSION: This study showed that increasing inter-canine width disrupts the muscle equilibrium and therefore is prone to relapse, whereas the upper lip can better adapt to the protrusion of upper incisors.

Dental and skeletal changes associated with the Damon system philosophical approach.

OBJECTIVE: To compare the skeletal and dentoalveolar changes produced by the Damon system's treatment philosophy to traditional orthodontic treatment techniques. MATERIALS AND METHODS: An electronic search in four major databases was completed: Cochrane, PubMed, EMBASE, and Google Beta Scholar on October 5th, 2018. Randomized controlled trials, prospective and retrospective controlled clinical trials were included in this systematic review. The quality assessment of individual studies was done using two different tools: The Cochrane Risk of Bias Assessment Tool (RTCs) and The Methodological Index for Non-Randomized Studies (MINORS) (non-RCTs). RESULTS: Seven studies were included for this qualitative analysis. Six studies compared the Damon system to various types of conventional (non self-ligating bracket) system as a comparison group. One study used a quad helix as a comparison for a few months before a full bonding appointment with conventional brackets. The majority of studies found an increase in maxillary inter-canine, inter-premolar, and intermolar distance after the treatment in both the Damon and comparison groups. Yet, all studies concluded that there is no significant difference in the final transverse dimension between the two groups. One study also found that the transverse expansion was achieved mainly by tipping movement of posterior dentition, and a decrease in the posterior buccal bone area was evident in both groups after treatment. CONCLUSION: There is not enough evidence to support the claim that the Damon system allows additional arch expansion with better tipping control than with traditional techniques.

Comparative evaluation of salivary microbial levels and periodontal status of patients wearing fixed and removable orthodontic retainers.

INTRODUCTION: The purpose of this study was to compare and evaluate salivary microbial levels and periodontal status in patients using a fixed lingual retainer, a removable vacuum-formed retainer, or a Hawley retainer after orthodontic treatment with fixed appliances. METHODS: Forty-five patients who finished their orthodontic treatment with fixed appliances and were about to start the retention phase were randomly divided into the following 3 groups of 15 individuals each: the fixed lingual retainer group, the vacuum-formed retainer group, and the Hawley retainer group. Periodontal measurements, such as the plaque index, gingival index, probing depth, and bleeding on probing, were obtained at the following 4 time points: at debonding (T0) and 1 week (T1), 5 weeks (T2), and 13 weeks (T3) after debonding. Saliva samples were collected 3 times in total: at T0, T2, and T3. A quantitative analysis for Streptococcus mutans and Lactobacillus casei was performed with the use of real-time polymerase chain reaction. The Kruskal-Wallis test and 1-way analysis of variance were used for the statistical comparisons of the groups. RESULTS: No statistically significant difference in salivary S mutans and L casei levels was found among the 3 groups (P >0.05). They showed no statistically significant differences in plaque index, gingival index, bleeding on probing, and probing depth values (P >0.05). All periodontal parameters showed statistically significant decreases from T0 to T3 in all 3 groups (P <0.001). The S mutans and L casei levels were decreased significantly from T2 to T3 in the lingual retainer and Hawley retainer groups, whereas they decreased significantly from T0 to T3 in the vacuum-formed retainer group. CONCLUSIONS: Fixed and removable orthodontic retainers do not differ in salivary S mutans and L casei levels and periodontal status. With all retainers, regardless of whether they are fixed or removable, oral hygiene improved after orthodontic treatment with fixed appliances.

Three-dimensional imaging control of osteogenesis induced by minimally invasive corticotomies: Perspectives from a case report.

Corticotomies are now an integral part of the orthodontist's therapeutic arsenal in adult orthodontics. In recent years, the number of publications about different surgical techniques has increased significantly. This shows that practitioners and patients have a common interest. It is now accepted that corticotomies cause a regional acceleratory phenomenon, which enables a faster dental movement, a reduction in treatment time, as well as a reduction in the risk of root resorption. The perspective of osteogenesis induced by corticotomies has already been mentioned in literature. It could provide a real advantage in maintaining the periodontium, reducing the risk of fenestration or dehiscence and the stability of long-term treatment by increasing the dental bone envelope. Through a clinical case, treated by mini- invasive surgical technique (as described in the previous article), we highlight the potential for osteogenesis induced by alveolar corticotomies and the utility of this procedure in adults.

Relación del tratamiento ortodóncico con el riesgo a la aparición o agravamiento de recesiones gingivales. Parte 1: bibliografía publicada / Relationship between orthodontic treatment and the risk of appearance or worsening of gingival recessions. Part 1: literature published

El objetivo del presente artículo es proveer un resumen ordenado de la bibliografía publicada en las últimas décadas, concerniente a la aparición o el agravamiento de las recesiones gingivales en relación a los tratamientos ortodóncicos. Diferentes estudios, en modelos animales, han demostrado que el movimiento ortodóncico hacia vestibular genera con bastante frecuencia dehiscencias óseas. En la mayoría de los casos, esto no se acompaña con la aparición de recesiones gingivales. Los estudios retrospectivos constituyen al momento la mejor evidencia disponible. Si bien se encuentran problemas metodológicos en los mismos, es posible establecer algunas conclusiones. El tratamiento ortodóncico puede contribuir a la aparición de recesiones gingivales o al agravamiento de las mismas. La prevalencia de las mismas es baja al terminar el tratamiento, pero se incrementa a medida que transcurren los años. Las piezas dentarias con mayor prevalencia son los incisivos inferiores, especialmente los centrales. El tratamiento con mayor asociación ha sido la vestibularización de los mismos, pero también se han encontrado asociaciones en pacientes de clase III cuando los incisivos son retrotraídos en un intento de camuflar su malposición. Son necesarios estudios prospectivos para evaluar esta asociación, en los cuales se midan variables como el biotipo gingival, o la presencia de crestas delgadas o dehiscencias óseas y se las relacione con diferentes movimientos y técnicas ortodóncicos a fin de establecer criterios de riesgo(AU)

The objective of this article is to provide an ordered summary of the literature published in recent decades, concerning the appearance or worsening of gingival recessions in relation to orthodontic treatments. Different studies, in animal models, have shown that the orthodontic movement toward the vestibular bone generates bone dehiscence quite frequently. In most cases, this is not accompanied by the appearance of gingival recessions. Retrospective studies are currently the best available evidence. Although methodological problems are found in them, it is possible to establish some conclusions. Orthodontic treatment can contribute to the appearance of gingival recessions or aggravation of them. The prevalence of them is low at the end of treatment, but increases as the years pass. The teeth with more prevalence are the lower incisors, especially the central ones. The treatment with greater association has been the proclination of them, but associations have also been found in class III Angle patients when the incisors are retruded in an attempt to camouflage their malposition. Prospective studies are needed to evaluate this association, in which variables such as the gingival biotype, or the presence of thin ridges or bone dehiscences are measured and related to different orthodontic movements and techniques in order to establish risk criteria (AU)