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1.
Am J Orthod Dentofacial Orthop ; 156(2): 186-192, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31375228

RESUMO

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.


Assuntos
Aparelhos Ortodônticos Fixos/efeitos adversos , Aparelhos Ortodônticos Removíveis/efeitos adversos , Contenções Ortodônticas/efeitos adversos , Índice Periodontal , Saliva/microbiologia , Adolescente , Adulto , Análise de Variância , Criança , DNA Bacteriano , Índice de Placa Dentária , Feminino , Humanos , Lactobacillus casei , Masculino , Higiene Bucal , Desenho de Aparelho Ortodôntico , Ortodontia Corretiva/efeitos adversos , Ortodontia Corretiva/instrumentação , Streptococcus mutans , Vácuo , Adulto Jovem
2.
BMC Oral Health ; 19(1): 72, 2019 05 02.
Artigo em Inglês | MEDLINE | ID: mdl-31046726

RESUMO

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.


Assuntos
Halitose , Aparelhos Ortodônticos Fixos/efeitos adversos , Braquetes Ortodônticos/efeitos adversos , Humanos , Aparelhos Ortodônticos , Ensaios Clínicos Controlados Aleatórios como Assunto
3.
J Orofac Orthop ; 80(2): 88-96, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30778609

RESUMO

PURPOSE: To evaluate the impact of a novel computer-fabricated lingual nitinol retainer compared to a conventional lingual flexible spiral wire twistflex retainer on oral health. METHODS: The study was based on a retrospective controlled clinical study with pilot character, an in vitro investigation of material-dependent biofilm formation and an analysis of biofilm formation after intraoral incubation. Sixty-one patients with completed fixed orthodontic treatment and retention phase for at least 6 months with twistflex retainers (group 1, n = 31) or computer-aided design/computer-aided manufacturing (CAD/CAM) nitinol retainers (group 2, n = 30) were included and examined regarding plaque index (PI), gingival index (GI), probing depths, bleeding on probing (BOP) and marginal recessions (MR). Material-dependent biofilm formation of twistflex, untreated nitinol and electropolished nitinol wire samples were assessed (1) in vitro: using optical density (OD) measurement of 10 samples of each and (2) in vivo: using histomorphometric analysis of 18 samples of each. RESULTS: Patients treated with nitinol retainers had significant better oral health indices (PI1 = 1.29 ± 0.06, PI2 = 0.94 ± 0.06; GI1 = 0.71 ± 0.05, GI2 = 0.56 ± 0.04; BOP1 = 0.11 ± 0.01, BOP2 = 0.08 ± 0.01; PD1 = 1.79 ± 0.03 mm, PD2 = 1.59 ± 0.04 mm) except for MR (0.08 ± 0.03 mm versus 0.08 ± 0.02 mm) compared to twistflex retainers. After 24 h intraoral incubation nitinol retainers demonstrated significant less biofilm formation compared to twistflex retainers. In the in vitro investigation the temporary significant differences between the groups were compensated in the end. CONCLUSIONS: Based on the results it can be assumed that nitinol-made CAD/CAM developed lingual retainers have a positive effect on oral health.


Assuntos
Ligas , Desenho Assistido por Computador , Materiais Dentários , Aparelhos Ortodônticos Fixos , Contenções Ortodônticas , Adulto , Biofilmes/crescimento & desenvolvimento , Índice de Placa Dentária , Humanos , Pessoa de Meia-Idade , Saúde Bucal , Aparelhos Ortodônticos Fixos/efeitos adversos , Contenções Ortodônticas/efeitos adversos , Índice Periodontal , Estudos Retrospectivos , Adulto Jovem
4.
Photodiagnosis Photodyn Ther ; 25: 456-459, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30753923

RESUMO

BACKGROUND: The aim of the present study was to comprehensively review indexed literature regarding the potential role of antimicrobial photodynamic therapy (aPDT) in Orthodontics. METHODS: Indexed databases were searched up to and including January 2019 using the following key words: (a) antimicrobial photodynamic therapy; (b) antimicrobial photodynamic chemotherapy; (c) orthodontic; and (d) orthodontics. Original (clinical and experimental) studies, case-reports, and case-series were included. Letters to the Editor, commentaries and review articles were excluded. RESULTS: Out of the 29 studies identified in the initial search, 4 studies were processed for data extraction. Three studies were randomized clinical trials performed in humans and 1 study was experimental. Results from 2 studies showed that aPDT is effective in the treatment of gingival inflammation in patients undergoing orthodontic therapy (OT). One study showed that oral decontamination can be successfully performed using aPDT among patients undergoing OT. Results of the experimental study showed that aPDT helps in surface decontamination of orthodontic instruments. CONCLUSION: There is insufficient evidence in indexed literature to justify the potential role of aPDT in OT. Hence, further studies are required in this regard.


Assuntos
Infecções Bacterianas/tratamento farmacológico , Gengivite/tratamento farmacológico , Aparelhos Ortodônticos Fixos/efeitos adversos , Fotoquimioterapia/métodos , Infecções Bacterianas/etiologia , Gengivite/etiologia , Humanos , Fármacos Fotossensibilizantes/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto
5.
Clin Oral Investig ; 23(7): 2913-2919, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30612244

RESUMO

OBJECTIVE: This study aimed to evaluate the genotoxic effects in the oral epithelial cells of patients undergoing fixed orthodontic treatment and to compare these to a control group without treatment. The null hypothesis to be tested is that corrective orthodontic treatment at different periods does not cause genotoxic effects in patients. MATERIAL AND METHODS: An observational cross-sectional study including 74 patients enrolled in corrective orthodontic treatment and 21 control patients, between 11 and 35 years of age, of both genders, participated in the research. Patients undergoing treatment were divided into four treatment groups differentiated by treatment periods: G1, n = 21 (1 month to 12 months); G2, n = 21 (13 to 24 months); G3, n = 23 (25 to 48 months); and G4, n = 9 (over 48 months). Cells were collected by scraping the internal side of the cheek and subsequently placed in tubes containing 0.9% sodium chloride solution. The sample underwent evaluation for genotoxic effects by means of the micronucleus test (MNT). Bivariate analyses were performed using parametric tests (t test or ANOVA) and nonparametric tests (Chi-square test, Kruskal-Wallis test, Dunn post-test). The adopted level of significance was 5%. RESULTS: Statistically significant differences for any of the genotoxic abnormalities (binucleated, trinucleated, karyolysis, piknosis, nuclear buds) were not found except for karyolysis, which was higher in the control group than in G4 (p < 0.05). CONCLUSIONS: This study did not demonstrate evidence of genotoxic effects even after long periods of corrective orthodontic treatment. CLINICAL RELEVANCE: This study explores genotoxic effects in fixed orthodontic patients.


Assuntos
Dano ao DNA , Aparelhos Ortodônticos Fixos , Ortodontia Corretiva , Adolescente , Adulto , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Testes de Mutagenicidade , Aparelhos Ortodônticos Fixos/efeitos adversos , Adulto Jovem
6.
J Orofac Orthop ; 80(1): 9-16, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30413832

RESUMO

OBJECTIVES: Aim of this study is to evaluate success rates and complications related with symphyseal miniplate anchorage systems used for treatment of Class 2 and Class 3 deformities. METHODS: A total of 58 miniplates applied to 29 growing patients were evaluated. The first group comprised 24 symphyseal miniplates applied to 12 patients and Forsus Fatigue Resistant Devices were attached to the head of the miniplates for mandibular advancement. The second group consisted of 34 symphyseal miniplates applied to 17 patients and intermaxillary elastics were applied between acrylic appliances placed on the maxillary dental arch and the symphyseal miniplates for maxillary protraction. Success rate and complications of the symphyseal plate-screw anchorage system were evaluated. RESULTS: The overall success rate of symphseal miniplates was 87.9%. Six miniplates showed severe mobility and 2 miniplates broke during orthodontic treatment. Infection, miniplate mobility and mucosal hypertrophy were statistically different between the two groups. CONCLUSIONS: Symphyseal miniplates were generally used as successful anchorage units in most patients. Infection, mobility, and mucosal hypertrophy occurred more frequently in Class 2 deformity correction. However, the success rates regarding the two treatment modalities were comparable.


Assuntos
Má Oclusão de Angle Classe III/terapia , Má Oclusão de Angle Classe II/terapia , Procedimentos de Ancoragem Ortodôntica , Aparelhos Ortodônticos Fixos , Placas Ósseas , Criança , Feminino , Humanos , Masculino , Procedimentos de Ancoragem Ortodôntica/efeitos adversos , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Aparelhos Ortodônticos Fixos/efeitos adversos , Estudos Retrospectivos , Resultado do Tratamento
7.
J Oral Rehabil ; 46(3): 257-267, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30378703

RESUMO

BACKGROUND: Although inflammation can alter cytokines release and nerve function, it is not yet fully established if orthodontic-induced inflammation can cause significant extraoral trigeminal somatosensory alterations and release of inflammatory chemical mediators. OBJECTIVE: The primary aim of this study was to investigate the impact of orthodontic separator and short-term fixed orthodontic appliance on the extraoral trigeminal somatosensory function and concentrations of cytokines in the gingival crevicular fluid (GCF). METHODS: Twenty-two female patients were evaluated as follow: baseline, 24 hour-after elastomeric separator (-aES), 24 hour- and 1 month-after bonding brackets (-aBB) at both arches. The outcome variables were as follows: self-reported pain (Visual Analog Scale), QSTs (current perception threshold-CPT, cold detection threshold-CDT, warm detection threshold-WDT, mechanical detection threshold-MDT, mechanical suprathreshold-MST and wind-up ratio-WUR. All QSTs were performed at infra-orbital and mental nerve entry zone at patient`s dominant side. In addition, GCF samples in order to assess cytokines profile (IL-1ß,IL-8,IL-6 and TNF-α) were collected. ANOVA and Tukey's post hoc analyses were performed (a = 5%). RESULTS: Patients reported higher pain intensity 24 hour-aBB compared to baseline and 24 hour-aES (P < 0.050). Patients were less sensitive to pin-prick pain (MST) at 24 hour-aBB and 1 month-aBB compared to baseline (P < 0.006). Significant increases in IL-6 levels were observed 24 hour-aBB (P < 0.001). Multiple comparison analysis showed significant increase in IL-1ß levels (P < 0.001) and TNF-α (P < 0.001) 1 month-aBB compared to baseline. CONCLUSION: Elastomeric separators only induced mild pain and were not able to significantly increase proinflammatory cytokines level in the GCF. In addition, orthodontic fixed appliance may induce only minor somatosensory changes at extraoral trigeminal locations.


Assuntos
Citocinas/metabolismo , Dor Facial/fisiopatologia , Líquido do Sulco Gengival/metabolismo , Mediadores da Inflamação/metabolismo , Aparelhos Ortodônticos Fixos/efeitos adversos , Técnicas de Movimentação Dentária/efeitos adversos , Adolescente , Criança , Dor Facial/metabolismo , Feminino , Humanos , Medição da Dor , Limiar Sensorial/fisiologia , Adulto Jovem
8.
Eur J Orthod ; 41(1): 59-66, 2019 01 23.
Artigo em Inglês | MEDLINE | ID: mdl-29722800

RESUMO

Background: Caries is an undesirable side-effect of treatment with fixed orthodontic appliances. Therefore, it is crucial to understand how orthodontic treatment and different fluoride regimens affect caries risk and individual risk factors. Objective: To evaluate the effects of orthodontic treatment and different fluoride regimens on caries risk and caries risk factors, including cariogenic bacteria. Trial design: Three-armed, parallel group, randomized, controlled trial. Methods: Patients referred to the Specialist Clinic of Orthodontics, Mölndal Hospital, Sweden, were distributed randomly into the following groups: group I (Control group), 1450 ppm fluoride (F) toothpaste; group II, 1450 ppm F toothpaste plus 0.2 per cent sodium fluoride (NaF) mouth rinse; and group III, 5000 ppm F toothpaste. The inclusion criteria were: age 12-20 years; and bimaxillary treatment with fixed appliances. The primary outcome variables were: caries risk; and the numbers of cariogenic bacteria. Radiographs were taken before treatment to determine the caries status. Data were collected before treatment and after 1 year with a fixed appliance. The variables were compiled into a Cariogram to assess the caries risk. Comparisons were made over time within and between the groups. The generation of randomization sequence was performed in blocks of 30. Blinding was employed during the data analysis and the caries registration. Recruitment: The clinical study duration was from October 2010 to December 2012. Results: Overall, 270 patients were randomized, of which 15 were excluded from the study. Therefore, 255 patients were included in the analyses. The caries risk increased significantly during orthodontic treatment in group I (P < 0.0001), whereas groups II and III had unchanged caries risks. All the groups showed statistically significant increases in the numbers of cariogenic bacteria. Harms: No harms were reported during the trial. Conclusions: To avoid an increased risk of caries during orthodontic treatment, everyday use of high-fluoride toothpaste (5000 ppm F) or mouth rinse (0.2% NaF) in combination with ordinary toothpaste is recommended. Registration: The trial was not registered.


Assuntos
Bactérias/isolamento & purificação , Cariostáticos/administração & dosagem , Cárie Dentária/prevenção & controle , Fluoretos/administração & dosagem , Aparelhos Ortodônticos Fixos/efeitos adversos , Cremes Dentais/química , Adolescente , Cariostáticos/uso terapêutico , Criança , Assistência Odontológica/métodos , Cárie Dentária/etiologia , Cárie Dentária/microbiologia , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Fluoretos/uso terapêutico , Humanos , Masculino , Antissépticos Bucais/química , Antissépticos Bucais/uso terapêutico , Método Simples-Cego , Fluoreto de Sódio/uso terapêutico , Suécia , Adulto Jovem
9.
Curr Microbiol ; 76(2): 213-221, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30542916

RESUMO

Although periodontal diseases during fixed appliance treatment are a common issue, few studies have focused on the clinical and microbial factors associated with orthodontic appliances. Hence, we investigated changes in the subgingival microbial community and their association with periodontal changes at the early stage of fixed appliance treatment. Subgingival plaques from ten female patients with fixed appliances were obtained at three time points: before, 1 month and 3 months after the placement of the brackets (T0, T1 and T2). The 16S rRNA gene sequencing was used to analyze the microbial community of the subgingival plaque. The Plaque Index (PI) and Gingival Bleeding Index (GBI) were also recorded. The GBI significantly increased at T2, and the PI showed a temporary increase without a significant difference. The alpha diversity indices were stable. However, the beta diversity was significantly higher at T2 compared to T0 and T1. The relative abundance of core microbiomes at the genus level was relatively stable. Four periodontal pathogens at the species level, including Prevotella intermedia (Pi), Campylobacer rectus (Cr), Fusobacterium nucleatum (Fn), and Treponema denticola (Td), increased without significant differences. The subgingival microbial community affected by fixed appliance treatment might cause transient mild gingival inflammation.


Assuntos
Bactérias/classificação , Carga Bacteriana , Gengiva/microbiologia , Microbiota , Aparelhos Ortodônticos Fixos/efeitos adversos , Adulto , Bactérias/isolamento & purificação , Bactérias/patogenicidade , Índice de Placa Dentária , Feminino , Hemorragia , Humanos , Inflamação/etiologia , Inflamação/microbiologia , Doenças Periodontais/etiologia , Doenças Periodontais/microbiologia , Porphyromonas gingivalis/isolamento & purificação , Porphyromonas gingivalis/patogenicidade , Prevotella intermedia/isolamento & purificação , Prevotella intermedia/patogenicidade , RNA Ribossômico 16S/genética , Fatores de Tempo , Adulto Jovem
10.
Mycoses ; 62(3): 247-251, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30561858

RESUMO

OBJECTIVES: We investigated the colonisation by Candida spp in patients using orthodontic fixed appliances by characterising the isolated Candida strains and by evaluating the host oral mucosa response through the measure of human ß-defensins 3 (HBD-3) expression and Interleukin-1ß/IL-10. METHODS: Ninety patients were enrolled after signing an informed consent. Prevalence, susceptibility to fluconazole, genotyping and oral fungal burden of Candida sp. isolated were determined. Host responses were evaluated by measuring HBD-3 expression as well as IL-1ß and IL-10 in saliva. RESULTS: The colonisation rate reached 6.7% (6/90), and 5 patients were colonised with C. albicans strains and one with one with C. tropicalis. The fluconazole MIC90/susceptibility of C. albicans strains ranged 1/0.25-1 µg/mL. However, isolated strains did not present different genotype (SAB>0.9), C. albicans colonisation seems to be influenced by the duration of treatment and by level expression of HBD3 that were higher in colonised patients (not statistically different). A negative correlation between the fungal burden and IL-1ß levels was found in colonised patients but not for IL-10. CONCLUSIONS: Our study revealed that patients with orthodontic fixed appliances were mainly colonised by C. albicans, which was related to a decrease in HBD-3 expression and IL-1ß levels.


Assuntos
Candida/isolamento & purificação , Portador Sadio/epidemiologia , Fatores Imunológicos/análise , Mucosa Bucal/imunologia , Micoses/epidemiologia , Aparelhos Ortodônticos Fixos/efeitos adversos , Saliva/microbiologia , Adolescente , Adulto , Candida/classificação , Candida/efeitos dos fármacos , Candida/imunologia , Candida albicans , Portador Sadio/microbiologia , Contagem de Colônia Microbiana , Feminino , Genótipo , Humanos , Interleucina-10/análise , Interleucina-1beta/análise , Masculino , Testes de Sensibilidade Microbiana , Micoses/microbiologia , Prevalência , Adulto Jovem , beta-Defensinas/análise
11.
J Dent ; 82: 1-10, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30579859

RESUMO

OBJECTIVES: To systematically review the effectiveness of professionally applied topical fluorides in the prevention and reversal of Enamel White Spot Lesions (EWSLs) occurring during multi-bracketed fixed orthodontic treatment. DATA: Randomized/quasi-randomized controlled clinical trials. SOURCES: Four electronic databases and grey literature (up to February, 2018). STUDY SELECTION: Two reviewers independently selected studies, extracted data and assessed risk of bias using the Cochrane Risk of bias tool 2.0. Only 11 studies fulfilled the inclusion criteria, seven assessing reversal and four assessing prevention of EWSLs. Six of the eleven studies were included for quantitative synthesis, three assessing prevention and three assessing reversal of EWSLs. CONCLUSIONS: Using the Mantel-Haenszel fixed-effect method, the risk ratio was found to be 0.39 (95% C.I.: 0.26-0.59) in studies evaluating the prevention of EWSLs. On employing an inverse-variance fixed-effect method for mean DIAGNOdent scores, the standardized mean difference was found to be 0.57 less in the professional topical fluoride group than the control group (95% C.I.: 0.23 to -0.91) in studies evaluating reversal of EWSLs. Professional topical fluoride application brought 25-30% reduction in the incidence of EWSLs after debonding; however, the effect of professional topical fluoride application in a reversal of EWSLs was unclear due to the concerns in interpreting DIAGNOdent values to estimate EWSLs. CLINICAL SIGNIFICANCE: Due to a limited number of clinical trials, further research is warranted to identify the type of professional fluoride agent, the concentration of fluoride and the frequency of applications in prevention or reversal of EWSLs in patients undergoing multi-bracketed fixed orthodontic treatment.


Assuntos
Esmalte Dentário , Fluoretos Tópicos , Cariostáticos/farmacologia , Esmalte Dentário/efeitos dos fármacos , Esmalte Dentário/patologia , Fluoretos Tópicos/farmacologia , Humanos , Aparelhos Ortodônticos Fixos/efeitos adversos , Resultado do Tratamento
13.
Prog Orthod ; 19(1): 25, 2018 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-30066184

RESUMO

BACKGROUND: Fixed orthodontic appliances might be associated with intraoral adverse effects on enamel, due to plaque accumulation and their colonization by oral microbes. At the same time, the demand for esthetic alternatives to orthodontic treatment, like thermoplastic aligners, is growing. However, thermoplastic aligners may behave differently intraorally than fixed appliances in terms of bacterial colonization and biofilm formation. Therefore, the aim of this prospective cohort study was to assess the salivary prevalence of the cariogenic bacteria Streptococcus mutans, Lactobacillus acidophilus, and Streptococcus sanguinis among adolescents treated orthodontically with thermoplastic aligners or fixed appliances. METHODS: Thirty adolescent patients (17 girls/13 boys; mean age 13.8 years old) were assigned to treatment with either (i) self-ligating fixed appliances with nickel-titanium archwires or (ii) aligners constructed from clear transparent polyethylenterephthalat-glycol copolyester (PET-G) thermoplastic sheets. Whole stimulated saliva was collected from each patient at three time points: at baseline (before bonding and initiation of orthodontic therapy or before insertion of the thermoplastic aligners), after 2 weeks, and after 1 month. A simplified plaque index, a simplified gingival index, and the decayed, missing, and filled teeth (DMFT) index were assessed from the clinical examination of the patients. Microbiological analysis of salivary bacteria was performed by quantitative polymerase chain reaction, followed by descriptive and inferential statistics at the 5% level. RESULTS: Although patients treated with aligners had significantly lower plaque and gingivitis scores throughout treatment compared to patients treated with fixed appliances, no significant difference could be found between the S. mutans counts of the two groups at any time through treatment (P > 0.05). On the other hand, patients treated with aligners had significantly lower salivary S. sanguinis counts at all time points than patients treated with fixed appliances (P < 0.05). Finally, almost no L. acidophilus were identified in the collected saliva samples in either of the treated samples. CONCLUSIONS: Within the limitations of this study, there were no differences in the salivary counts of S. mutans or L. acidophilus among adolescent patients treated for 1 month with thermoplastic aligners or self-ligating appliances. On the other hand, patients treated with aligners had lower salivary levels of S. sanguinis compared to those treated with self-ligating appliances.


Assuntos
Aparelhos Ortodônticos Fixos/microbiologia , Aparelhos Ortodônticos Removíveis/microbiologia , Saliva/microbiologia , Adolescente , Carga Bacteriana , Índice CPO , Placa Dentária/microbiologia , Feminino , Gengivite/etiologia , Gengivite/microbiologia , Humanos , Lactobacillus acidophilus , Masculino , Aparelhos Ortodônticos Fixos/efeitos adversos , Aparelhos Ortodônticos Removíveis/efeitos adversos , Índice Periodontal , Estudos Prospectivos , Streptococcus mutans , Streptococcus sanguis
14.
Orthod Craniofac Res ; 21(4): 175-185, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30028077

RESUMO

The aim of this systematic review was to assess qualitative changes induced by fixed appliance orthodontic treatment on the subgingival microbiota. Seven databases were searched up to August 2017 for randomized and nonrandomized clinical studies assessing the effect of orthodontic appliances on the subgingival bacteria in human patients. After elimination of duplicate studies, data extraction and risk of bias assessment according to the Cochrane guidelines, random-effects meta-analyses of relative risks (RR) and their 95% confidence intervals (CIs) were performed. According to controlled studies, the presence of Aggregatibacter actinomycetemcomitans in the subgingival crevicular fluid of orthodontic patients was increased 3-6 months after fixed appliance insertion compared to untreated patients (2 studies; RR = 15.54; 95% CI = 3.19-75.85). There was still increased subgingival prevalence of Aggregatibacter actinomycetemcomitans (3 studies; RR = 3.98; 95% CI = 1.23-12.89) and Tannerella forsythia in orthodontic patients up to 6 months after appliance removal compared to untreated patients. However, caution is warranted due to high risk of bias and imprecision. Insertion of orthodontic fixed appliances seems to be associated with a qualitative change of subgingival microbiota, which reverts to some extent back to normal in the first months after appliance removal. However, there is limited evidence on the timing and extent of these changes.


Assuntos
Gengiva/microbiologia , Microbiota , Aparelhos Ortodônticos Fixos/efeitos adversos , Aparelhos Ortodônticos/efeitos adversos , Aggregatibacter actinomycetemcomitans/isolamento & purificação , Carga Bacteriana , Bases de Dados Factuais , Placa Dentária/microbiologia , Líquido do Sulco Gengival/microbiologia , Humanos , Ortodontia Corretiva , Tannerella forsythia/isolamento & purificação
15.
Angle Orthod ; 88(6): 806-811, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29911908

RESUMO

OBJECTIVES:: To examine possible changes in the levels of salivary antioxidants, C-reactive protein (CRP), cortisol, pH, proteins, and blood in patients treated with fixed orthodontic appliances. MATERIALS AND METHODS:: Salivary samples from 21 orthodontic patients who met specific inclusion criteria were collected before the beginning of orthodontic treatment (T0; baseline), 1 hour after bonding (T1), and 4-6 weeks after bonding (T2). Oxidant-scavenging ability (OSA) was quantified using a luminol-dependent chemiluminescence assay. Cortisol and CRP levels were measured using immunoassay kits. pH levels and presence of proteins and blood in the samples were quantified using strip-based tests. RESULTS:: A significant decrease in salivary pH was observed after bonding ( P = .013). An increase in oxidant-scavenging abilities during orthodontic treatment was detected, but the change was not statistically significant. Cortisol and CRP levels slightly increased after bonding, but the difference was small without statistical significance. Changes in the presence of proteins and blood were also insignificant. CONCLUSIONS:: Exposure to fixed orthodontic appliances did not show a significant effect on salivary parameters related to inflammation or stress, with the exception of a significant but transient pH decrease after bonding.


Assuntos
Aparelhos Ortodônticos Fixos , Saliva/química , Adolescente , Proteína C-Reativa/análise , Estudos de Casos e Controles , Colagem Dentária/efeitos adversos , Feminino , Humanos , Hidrocortisona/análise , Concentração de Íons de Hidrogênio , Masculino , Aparelhos Ortodônticos Fixos/efeitos adversos , Estudos Prospectivos , Proteínas e Peptídeos Salivares/análise
16.
J Biol Regul Homeost Agents ; 32(2 Suppl. 2): 75-80, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29720333

RESUMO

Metal ions accumulate inside the epithelial cells of the oral mucosa and damage the DNA. The aim of this study was to analyze whether DNA damage and/or apoptosis also occurs after a short-term exposure to the metals of fixed orthodontic appliances. 23 subjects were enrolled in the test group and 8 patients in the control group. Analyses performed on samples of oral mucosa were cell count, cellular viability, quantification of intracellular metal concentration, comet and micronuclei tests and quantification of intracellular Glutathione (GSH). The obtained results indicated that orthodontic appliances release metal ions, especially chromium, that cause inflammatory processes leading to DNA damages. These phenomenon are visible only after 30 days from application of fixed orthodontic appliances.


Assuntos
Cromo/efeitos adversos , Dano ao DNA/efeitos dos fármacos , Aparelhos Ortodônticos Fixos/efeitos adversos , Cromo/química , Humanos , Inflamação/induzido quimicamente , Mucosa Bucal/efeitos dos fármacos , Mucosa Bucal/patologia
17.
Angle Orthod ; 88(5): 590-595, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29761706

RESUMO

OBJECTIVES: To evaluate the genotoxic and cytotoxic effects of Haas appliances through micronuclei test and cytogenetic damage analysis in buccal mucosa epithelial cells of patients undergoing orthodontic treatment. MATERIALS AND METHODS: Twenty-eight patients, 6-12 years of age and of both genders, who required a Haas appliance for the correction of a posterior crossbite were included. Epithelial cells from the mucosa were collected by gently scraping the inside of both the right and left cheeks. The cells were collected before the insertion of the appliance (T0), 1 month after the device was installed (T1), and again 3 months after the appliance was immobilized (T2). The cells were processed to obtain slides. Feulgen/Fast Green was used as the staining method, and the number of normal, karyolytic, pyknotic, nuclear buds, bi/trinucleated, and micronucleus cells were counted under light microscopy. Cellular abnormalities were evaluated with parametric and nonparametric tests for comparison of the means by analysis of variance testing, Tukey posttest, or the Kruskal-Wallis test and then by Dunn's posttest. The significance level was 5%. RESULTS: There were no statistically significant changes in the micronuclei in the evaluated periods ( P > .05). Nuclear buds increased at T1 ( P < .05), returning to baseline levels at T2. Other abnormalities (cariolytic, pyknotic, and bi/trinucleated cells) showed a significant increase at T1 and T2 ( P < .0001). CONCLUSIONS: The Haas appliance did not cause an increase in micronuclei in cells of the buccal mucosa. However, statistically significant increases in cariolytic, pyknotic, and bi/trinucleated cells were observed during treatment, suggesting possible DNA damage.


Assuntos
Mucosa Bucal/efeitos dos fármacos , Aparelhos Ortodônticos Fixos/efeitos adversos , Criança , Dano ao DNA/efeitos dos fármacos , Feminino , Humanos , Masculino , Má Oclusão/terapia , Testes para Micronúcleos , Mucosa Bucal/citologia , Técnica de Expansão Palatina/instrumentação
18.
Caries Res ; 52(6): 463-467, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29669345

RESUMO

This cross-sectional study assessed the relationship between fixed orthodontic treatment duration and caries activity. Two hundred and sixty 10- to 30-year-olds were divided into 4 groups (n = 65): no fixed orthodontic appliances (G0), orthodontic treatment for 1 year (G1), 2 years (G2), or 3 years (G3). Orthodontic treatment duration was significantly associated with active caries: prevalence was 1.5% for G0, 27.7% for G1, and 72.3% for G2 and G3; the median number of lesions was 0 for G0 and G1 and 2 for G2 and G3. No differences were observed between G2 and G3. The longer the duration of orthodontic treatment, the higher the prevalence/extent of active caries lesions.


Assuntos
Cárie Dentária/etiologia , Aparelhos Ortodônticos Fixos/efeitos adversos , Ortodontia Corretiva/efeitos adversos , Adolescente , Adulto , Criança , Estudos Transversais , Cárie Dentária/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Fatores de Tempo , Adulto Jovem
19.
Angle Orthod ; 88(3): 259-266, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29517274

RESUMO

OBJECTIVE: The objective of this study was to evaluate and compare the effects of PowerScope and Forsus in the treatment of Class II division 1 malocclusion. MATERIALS AND METHODS: This was a 2-arm parallel, double-blind, randomized, controlled trial. A total of 28 Class II division 1 malocclusion patients indicated for treatment with fixed functional appliances were randomized and equally divided (n = 14) among PowerScope (American Orthodontics, Sheboygan, Wis; mean age 14.11 ± 1.3 years) and Forsus (3M Unitek Corp, Monrovia, Calif; mean age 15.5 ± 1.1 years) groups. Skeletal and dentoalveolar effects of PowerScope and Forsus were compared. The secondary outcomes were evaluation of patient comfort and operator convenience. Randomization was accomplished with a 1:1 allocation ratio, and concealment was achieved by sealed opaque envelopes. The participants and data collectors were all blinded to study group allocation. Data were analyzed for 26 patients, 13 in each group, as one patient from each group discontinued treatment. Statistical comparisons were carried out using Student's t-tests and chi square tests ( P ≤ .05). RESULTS: A significantly greater mesial mandibular movement and improvement in sagittal skeletal relation were found in the Forsus patients ( P ≤ .05). The forward movement of the mandibular molar and incisors were greater in the PowerScope patients (2.3 mm and 2.80 mm) than in the Forsus patients (1.9 mm and 2.38 mm). CONCLUSIONS: Both PowerScope and Forsus are effective in correcting Class II malocclusion. The percentage of dentoalveolar effects in correcting Class II malocclusion is more for PowerScope when compared with Forsus. Patient comfort was the same with both appliances. This trial was registered.


Assuntos
Má Oclusão de Angle Classe II/terapia , Aparelhos Ortodônticos Fixos , Aparelhos Ortodônticos Funcionais , Adolescente , Método Duplo-Cego , Feminino , Humanos , Masculino , Desenho de Aparelho Ortodôntico , Aparelhos Ortodônticos Fixos/efeitos adversos , Aparelhos Ortodônticos Funcionais/efeitos adversos , Dor/etiologia , Técnicas de Movimentação Dentária/efeitos adversos , Adulto Jovem
20.
Angle Orthod ; 88(3): 292-298, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29509026

RESUMO

OBJECTIVES: To quantify the intensity and duration of pain experience in adults over the initial three visits of fixed appliance-based orthodontic treatment. A secondary objective was to assess the relationship between pain experience and analgesic use, dental irregularity, gender, and age. MATERIALS AND METHODS: A prospective longitudinal study design was adopted. Fifty-eight adults undergoing fixed appliance treatment in five orthodontic practices recorded pain experience at four time points (4 hours, 24 hours, 3 days, and 7 days) following the initial bond-up appointment (T0) and first (T1) and second (T2) routine follow-up adjustment appointments using a visual analogue scale. In addition, subjects recorded the dosage and frequency of analgesic use. RESULTS: A slightly greater proportion of women (57%) were recruited, with a mean sample age of 34.69 (SD 12.11) years. Peak pain was experienced between 24 hours and 3 days following appliance placement (T0) and subsequent adjustments (T1 and T2). The highest mean pain score arose at T0 followed by T2 and T1 adjustments, with the difference between pain levels at these appointment intervals being statistically significant ( P < .001). The use of analgesics following each appointment mirrored pain experience, with pain score, appointment, and time point all being significant predictors of analgesic consumption. The level of dental irregularity, gender, or age did not predict pain levels reported. CONCLUSIONS: Adults undergoing fixed orthodontic therapy should be advised that they are most likely to experience increased levels of pain for 1 to 3 days following placement of their appliance and subsequent adjustment visits.


Assuntos
Aparelhos Ortodônticos Fixos/efeitos adversos , Odontalgia/etiologia , Adulto , Analgésicos/uso terapêutico , Feminino , Humanos , Estudos Longitudinais , Masculino , Má Oclusão/terapia , Ortodontia Corretiva/efeitos adversos , Cooperação do Paciente , Estudos Prospectivos , Qualidade de Vida , Odontalgia/tratamento farmacológico , Escala Visual Analógica
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