Leveling the curve of Spee using different sized archwires: a randomized clinical trial of blood flow changes.

OBJECTIVES: To compare blood flow (BF) changes of teeth subjected to orthodontic forces during curve of Spee (COS) leveling using different archwires (AW). MATERIAL AND METHODS: Thirty subjects with COS > 5 mm were randomly assigned (1:1:1) into three groups based on the AW used: group 1: 0.017 × 0.025-inch stainless-steel (SS)AW, group 2: 0.019 × 0.025-inch SSAW, and group 3: 0.021 × 0.025-inch ß-titanium (TMA)AW. In the 3 groups, a 5 mm-depth reverse COS was placed in the AWs. A laser Doppler flowmeter was used to measure BF at different time intervals (T0-T4). RESULTS: In the 3 AWs group, BF of all measured teeth was reduced 20 min after force application. Afterwards, the BF values started to increase until the baseline values were almost restored within 1 week. Differences in BF changes between the extrusion and intrusion subgroups were observed within groups 1 and 3 during the first 20 min of force application (P < 0.05). Similar BF changes were recorded using the 3 different AWs. BF changes were associated with tooth type and the amount of COS depth change. CONCLUSIONS: During CoS leveling, similar BF changes were recorded using the 3 different AWs. Tooth type and the amount of COS depth change were associated with BF changes within the first 20 min of force application. Greater BF reduction was found in premolars compared to incisors during the first 20 min of AW placement. CLINICAL RELEVANCE: It is important to select a type of applied forces that minimally affect the BF. Intrusive forces appeared to have lower negative effects on the BF of teeth during COS leveling. TRIAL REGISTRATION: ClinicalTrial.gov (# NCT04549948).

White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared to fixed orthodontic treatment. A systematic review and meta- analysis.

OBJECTIVE: To analyse the available evidence regarding the incidence and severity of white spot lesions (WSLs), plaque accumulation and salivary caries-associated bacteria(SCB) in clear aligners (CA) verses conventional fixed (CF) orthodontic appliances. METHODS: Electronic searches of MEDLINE, Scopus, Embase, Google Scholar, Clinical trial registry, OpenGrey and ProQuest were done for all relevant studies. Eligibility criteria were; Randomized Controlled Trials and Non-Randomized Studies that compared the incidence and severity of WSLs, plaque accumulation and SCB between CA and CF appliances in patients undergoing orthodontic treatment. The risk of bias(ROB) and certainty of evidence was assessed independently by two reviewers using Cochrane's ROB and GRADEpro, respectively. Standardized mean difference (SMD) was used to estimate the effect size using STATA 17 software. RESULTS: A total of 14 studies met the eligibility criteria, and eight were suitable for meta-analysis. The qualitative results showed lower incidence and severity of WSLs, plaque accumulation, and SCB in CA group compared to CF appliances. The pooled results showed significantly lower plaque accumulation(SMD - 1.58;95%CI:-2.57,0.58;p = 0.002) in CA compared to CF appliances. CONCLUSIONS: A moderate-quality evidence reveals less plaque accumulation and less SCB in CA, which might be related to the reduced incidence and severity of WSLs associated with CA when compared with CF appliances. However, the results of the present study should be interpreted with caution given the high ROB among some of the included studies as well as the marked heterogeneity across the studies. CLINICAL RELEVANCE: For patients who can be treated with either CA or CF appliances, CA may be a better choice concerning oral health. REGISTRATION: Open Science Framework (DOI: https://doi.org/10.17605/osf.io/kcpvb ).

Evaluation of maxillary canine root and maxillary bone thickness and density in patients with displaced maxillary canines: A cone-beam tomography study.

INTRODUCTION: This study investigated lateral incisor and canine morphology and dimensions, maxillary bone density, and volume in subjects with displaced maxillary canines. METHODS: Cone-beam computed tomography images for 134 palatally displaced canines (PDCs), 57 buccally displaced canines (BDCs), and 87 nondisplaced canines (NDCs) were analyzed. Canine and lateral incisor dimensions, alveolar bone dimensions, and maxillary bone volume and density were measured. RESULTS: The root length of BDCs was short compared with NDC and PDC groups. The lateral incisor was short in the PDC group compared with NDC and BDC groups. In the BDC group, maxillary bone volume was reduced compared with NDCs and PDCs. Significant differences were detected between BDC and PDC groups in bone density buccal to canines and between BDC and NDC groups in bone density distal to canines. The density of maxillary bone was the highest in the PDC group and the lowest in the BDC group compared with the NDC group. Eight variables were associated with the site of maxillary canine displacement: lateral incisor tip, alveolar bone density, alveolar bone width, bone density buccal to canine, canine width labiopalatally, maxillary bone volume, and canine midsagittal width. CONCLUSIONS: In PDCs, the maxillary lateral incisor was short, the canine root had a larger crown/root ratio, and maxillary bone volume was increased compared with NDCs. In BDCs, the canine root was shorter than NDCs and PDCs, maxillary bone volume was reduced compared with NDCs, and bone density at the buccal side was reduced compared with the PDC group.

The COVID-19 experience of orthodontists in the UK.

OBJECTIVE: To understand and compare the perceived impact and ongoing effects of the COVID-19 pandemic on orthodontic clinical services in the UK. DESIGN: Descriptive cross-sectional survey. SETTING: Online electronic questionnaire. PARTICIPANTS: Members of the British Orthodontic Society (BOS). METHODS: Electronic questionnaires were circulated between March and June 2021. The UK survey was distributed via emails from the BOS, Orthodontic Managed Clinical Networks and WhatsApp groups. RESULTS: A total of 560 unique responses were received. There were more respondents who were aged over 50 years (52%) then respondents who were aged below 50 years (48%) with the median age range being 50-54 years (20%). The main causes of disruption to clinical practice were felt to be national restrictions (85%), increased cross-infection measures (84%), social distancing (80%) and professional guidance (80%). Respondents felt more negatively in their opinions regarding dentistry's preparedness for the pandemic (5%) and how dentistry coped in the crisis (35%), when compared to orthodontic services specifically (8% and 58%, respectively). The respondents were not confident about the potential beneficial effects of a vaccination programme on orthodontic clinical service provision (21%). Telephone consultations (84%) and video consultations (61%) were the main adaptations used by the respondents during the pandemic. CONCLUSIONS: Respondents felt that COVID-19 will have long-term societal, clinical and professional implications. The majority of our respondents supported the vaccination and weekly testing of the orthodontic team. Respondents felt that during the pandemic there had been a deterioration in care provision and were not optimistic about a vaccination programme restoring services to pre-pandemic levels of activity. During the pandemic, patients in active orthodontic treatment have been prioritised but at the expense of new and review patients, and as services recover respondents were concerned about the difficulty of arranging dental extractions.

A comparative study of initial changes in pulpal blood flow between conventional and self-ligating fixed orthodontic brackets during leveling and alignment stage.

OBJECTIVES: To evaluate and compare the initial changes in pulpal blood flow (PBF) between conventional and self-ligating fixed orthodontic brackets during leveling and alignment stage using 0.016 × 0.022 NiTi as alignment archwire. MATERIALS AND METHODS: Twenty-two patients (16 females and 6 males) aged 19.00 ± 2.53 years who presented with mild lower arch crowding were selected to participate in the study. A split mouth study design was applied for each patient. The intervention (self-ligating brackets) was randomly allocated to the right or left side of the patient using the permuted random block size of 2 with 1:1 allocation ratio. Two different fixed appliance brackets were used in the lower arch (self-ligating brackets on one side and conventional brackets on the other side of the same patients. Two alignment archwires; 0.016″ NiTi and 0.016 × 0.022″ NiTi were used in this study. PBF was measured for the lower right and left sides using laser Doppler flowmetry at different time intervals (20 min, 24 h, 72 h, 1 week, and 1 month) RESULTS: PBF started to decrease 20 min after insertion of both archwires using both types of brackets. Maximum decrease was reached after 72 h of archwire insertion. After 1 week of force application, PBF started to increase to restore its original values after 1 month. Differences between the 2 groups were not significant (P > 0.05). CONCLUSIONS: In both treatment groups, PBF reduced within 48 h. PBF started to increase after 1 week until it reached its original values after 1 month. Changes in PBF at the measured time intervals in the two groups were similar. CLINICAL RELEVANCE: The use of 0.016 × 0.022″ NiTi immediately after 0.016″ NiTi for alignment does not produce any damaging effect on the teeth.

Enamel demineralization during clear aligner orthodontic treatment compared with fixed appliance therapy, evaluated with quantitative light-induced fluorescence: A randomized clinical trial.

INTRODUCTION: The objective of this prospective randomized clinical trial was to investigate the relationship between clear aligner (CA) therapy and the development of white spot lesions and compare it with orthodontic fixed appliance (FA) therapy. METHODS: This was a prospective randomized clinical trial. The setting was the postgraduate orthodontic clinic at Jordan University of Science and Technology. A total of 49 patients (39 female, 10 male; mean age ± standard deviation, 21.25 ± 3 years) who required orthodontic treatment with either FAs or CAs were randomly allocated into 1 of 2 study groups. Eligibility criteria included healthy patients of both sexes (age range 17-24 years), Class I malocclusion with mild-to-moderate crowding (≤5 mm), nonextraction treatment plan, and optimum oral hygiene before treatment as determined by clinical examination. The participants were randomly assigned to a study group according to a simple randomization method using a coin toss by the patient; the text or tail side of the coin indicated treatment with CA (group 1), and the head side of the coin indicated orthodontic treatment with FA (group 2). Blinding was applicable for outcome assessment only. CA therapy was performed for group 1 and FA for group 2. Quantitative light-induced fluorescence (QLF) images were taken before treatment (T0) and 3 months later (T1). The QLF images were then analyzed to assess the research outcomes. The main outcome was the mean amount of fluorescence loss (ΔF). Number of newly developed lesions, deepest point in the lesion (ΔFMax), lesion area (pixels), and plaque surface area (ΔR30) were measured as secondary outcomes. Descriptive statistics and comparison within and between groups were calculated. RESULTS: In total, 42 of the 49 participants recruited completed the study (19 in the CA group and 23 in the FA group). The mean amount of fluorescence loss was 0.4% for the CA group (P = 0.283) and 1.2% for the FA group (P = 0.013). The difference between the 2 groups was significant (confidence interval [CI], -1.8 to -0.4; P = 0.002). The mean increase in lesion area was 82.2 pixels for the CA group (P <0.001) and 9.3 pixels for the FA group (P = 0.225). The difference between the 2 groups was significant (CI, -117 to -75.0; P <0.001). ΔR30 was 1.2% for the CA group and 10.9% for the FA group (CI, 6.847-12.479; P <0.001). The number of newly developed lesions in the CA group was 6 lesions/patient and 8.25 in the FA group (P = 0.039). No serious harm on the oral health of the participants in the 2 study groups was observed other than mild gingivitis associated with plaque accumulation. No serious harm was reported by any of the participants. CONCLUSIONS: Orthodontic treatment with CAs and FAs caused enamel demineralization. The CA group developed larger but shallower white spot lesions, whereas the FA group developed more new lesions with greater severity, but they were smaller in area. More plaque accumulation was found in the FA group compared with the CA group. REGISTRATION: NCT04107012. PROTOCOL: The protocol was published after trial commencement.

Incisor root resorption associated with palatally displaced maxillary canines: Analysis and prediction using discriminant function analysis.

INTRODUCTION: Incisor root resorption associated with palatally displaced canine (PDC-IRR) is an important phenomenon that might alter the orthodontic treatment plan. The aims of this study were to investigate the prevalence and characteristics of PDC-IRRs, to compare PDC-IRR and PDC-No-IRR groups, to identify predictors for PDC-IRR, and to produce a valid PDC-IRR prediction model using discriminant function analysis. METHODS: Cone-beam computed tomography images for 107 palatally displaced canines (PDCs) and 51 fully erupted nondisplaced canines (NDC) were analyzed for the presence of incisor root resorption (IRR). The PDCs were divided into 2 groups: PDC-IRR (52 canines) and PDC-No-IRR (55 canines). The 3 groups were compared, and the following variables were measured: canine follicle size, contact with adjacent incisors, associated dental abnormalities, sector analysis, canine vertical relation to adjacent root, lateral incisor angulation and inclination, canine angulation and distance to reference planes (dental midline, midpalatal suture, occlusal plane, pterygoid vertical plane, and lateral incisor), and space available for canine in the dental arch. Discriminant functional analysis was used to produce a discriminant function equation to predict PDC-IRR. RESULTS: Root resorption affected 74% of lateral incisors adjacent to PDCs and 25.5% of lateral incisors adjacent to NDCs. IRR was located lingually in 41% of PDCs and in the mid and apical thirds in 89%. In the PDC-IRR group, 94.2% of canines were in contact with adjacent roots compared with 23.6% in the PDC-No-IRR group (P <0.001). Canine follicle size was >2 mm in 42% of PDC subjects. Overall mean value of follicle width in PDC canines was 1.79 ± 1.06 mm. Peg-shaped lateral incisors were recorded in 19% of PDC subjects compared with 4% in NDCs (P = 0.012). The stepwise analysis using cone-beam computed tomography records produced a discriminant function based on 3 variables. The analysis correctly predicted the outcome in 83% of subjects. The variables contributing to the prediction equation were canine contact with adjacent incisors, size of canine dental follicle, and the presence of peg-shaped lateral incisor. CONCLUSIONS: Canines in contact with adjacent incisor roots was the only risk factor detected for PDC-IRR. Very good predictive discrimination (83%) emerged for PDC-IRR subjects. Predictors of PDC-IRR were canine contact with adjacent incisor, size of canine dental follicle, and presence of peg-shaped lateral incisor.

A comparative study of initial changes in pulpal blood flow between clear aligners and fixed orthodontic appliances.

INTRODUCTION: The objective of this study is to evaluate and compare the initial changes of pulpal blood flow (PBF) using clear aligner and fixed orthodontic treatment. METHODS: A total of 45 subjects were subdivided into 2 groups: group 1; 25 subjects treated with preadjusted edgewise fixed appliance with 0.014″ nickel titanium as the alignment archwire and group 2; 20 subjects treated using clear aligner. In both groups, PBF was measured for the maxillary right and mandibular left teeth using Laser Doppler flowmetry at different time intervals (20 minutes, 48 hours, 72 hours, and 1 month) after the fitting of the nickel titanium archwire in group 1 and after the delivery of the second aligner in group 2. A repeated-measures analysis of variance and a Bonferroni post-hoc comparison test were applied to determine differences at the various time intervals. RESULTS: The PBF decreased in both types of appliances after force application. The maximum reduction in PBF was reached after 72 hours. It returned to its normal values within 1 month. The differences in PBF between the 2 groups did not reach any statistical significance. CONCLUSIONS: PBF in orthodontically treated teeth decreased 20 minutes after orthodontic force application in both fixed and clear aligner appliances. In both treatment groups, most changes occurred within 48 hours of force application. PBF returned to its normal values within 1 month. Changes in PBF in both treatment groups were comparable.

Three-dimensional assessment of the effect of micro-osteoperforations on the rate of tooth movement during canine retraction in adults with Class II malocclusion: A randomized controlled clinical trial.

INTRODUCTION: The purpose of this split-mouth trial was to investigate the effect of micro-osteoperforations (MOPs) on the rate of tooth movement. METHODS: Thirty-two patients (24 female, 8 male; mean age, 19.26 ± 2.48 years) who required fixed orthodontic treatment and maxillary first premolar extractions participated in this trial with MOPs randomly allocated to either the right or left sides distal to the maxillary canines. Eligibility criteria included Class II Division 1 malocclusion, healthy periodontal condition, no smoking, and no systemic disease. Miniscrews were used to support anchorage and retract the canines with the aid of closed-coil nickel-titanium springs with 150 g of force. Randomization was accomplished with block randomization with a permuted block size of 2 with a 1:1 allocation ratio to either right or left with allocations concealed in opaque, sealed envelopes. Blinding was used at the data collection and analysis stages. Three MOPs were performed using miniscrews (5 mm depth, 1.5 mm width) on the buccal bone distal to the canines on the randomly selected side. The primary outcome was the rate of canine retraction measured from 3-dimensional digital models superimposed at the rugae area from the baseline to the first, second, and third months. The following secondary outcomes were examined: anchorage loss, canine tipping, canine rotation, root resorption, plaque index, and gingival index. Pain level, pain interference with the patients' daily life, patients' satisfaction with the procedure and degree of ease, willingness to repeat the procedure, and recommendation to others were also evaluated. RESULTS: There was no statistically significant difference in the rates of tooth movement between the MOP and the control sides at all time points (first month: P = 0.77; mean difference, 0.2 mm; 95% CI, -0.13, 0.18 mm; second month: P = 0.50; mean difference, -0.08 mm; 95% CI, -0.33, 0.16 mm; third month: P = 0.76; mean difference, -0.05 mm; 95% CI, -0.40, 0.29 mm). There were also no differences in anchorage loss, rotation, tipping, root resorption, plaque index, periodontal index, and pain perception between the MOP and control sides at any time point (P >0.05). MOPs had no effect on the patients' daily life except for a feeling of swelling on the first day (P = 0.05). Level of satisfaction and degree of easiness of the procedure were high. A significant percentage of patients were willing to repeat the procedure and recommend it to others. No serious harm was observed. CONCLUSIONS: Three MOPs were not effective in accelerating tooth movement at any time point. Other secondary parameters evaluated were not different between the MOP and control sides except for the feeling of swelling on day 1 on the MOP side. Patients were highly satisfied with the MOP procedure, and many considered MOPs an easy procedure and were willing to repeat and recommend it to friends. REGISTRATION: This trial was registered at Clinicaltrials.gov with identifier number NCT02473471. PROTOCOL: The protocol was not published before trial commencement. FUNDING: This work was supported by Jordanian University of Science and Technology (grant number 20150263). No conflict of interest is declared.

Force degradation of orthodontic latex elastics: An in-vivo study.

INTRODUCTION: Our objectives were to assess the force degradation of orthodontic latex elastics over 48 hours in vivo and to study the relationship between the amount of mouth opening and the degree of force decay. METHODS: Fifty-two orthodontic patients wearing fixed appliances using Class II elastics were asked to wear premeasured-force 3/16-in heavy and medium intermaxillary elastics. The force amounts were measured and compared at different time intervals. RESULTS: Fifty percent of the force was lost after 3.9 hours for the medium elastics and after 4.9 hours for the heavy elastics. A continuous significant force drop in all elastics was seen at all time intervals (P <0.05, P <0.001). There was greater force loss in the heavy elastics compared with the medium elastics in vivo at all time intervals (P <0.001); the rates of force loss, however, were similar. CONCLUSIONS: Fifty percent of force degradation occurred in the first 4 to 5 hours. Because of breakage and for oral hygiene purposes, orthodontic elastics should be changed daily; otherwise, elastics can be used for 48 hours. Force decay of the elastics was correlated to the lateral distance between the maxillary canine and the mandibular first molar in occlusion.

Occlusal bite force change after orthodontic treatment with Andresen functional appliance.

OBJECTIVES: The aim of this study was to determine the occlusal bite force (OBF) changes, at the incisal and molar regions, after orthodontic treatment with functional appliance therapy in preadolescent subjects. MATERIALS AND METHODS: OBF was measured for patients (17 females and 16 males) before and after the treatment with Andresen functional appliance for an average period of 9 months (mean age was 11.8±1.1 years). Three variables were registered; maximum OBF at molar region and the average of three readings at the molar (AOBF) and incisal regions (IOBF). The same variables were measured in two occasions for a matching non-treated control group with a period of 9 months between the two measurements. RESULTS: No significant changes were seen in the OBF measured parameters in the control group. There was a reduction in all measured parameters. The mean reduction in maximum OBF was 76.1±12.4 N (P < 0.001), 58.5±13.0 N in AOBF (P < 0.001), and 69.3±11.6 N IOBF (P < 0.001). CONCLUSIONS: Treatment with functional appliance caused a significant reduction in OBF immediately after treatment.

Un "boxing" the reality: Knowledge, attitude, and perception of orthodontists, dental practitioners, and orthodontic patients toward mouthguards' wear during contact sports-A cross-sectional study.

INTRODUCTION: Mouthguards (MGs) have the potential to prevent contact sport-related dental injuries. However, varying perceptions of their effectiveness persist, influencing recommendations by dental professionals. AIM: To assess the attitudes, knowledge, and perceptions of orthodontists, other dental practitioners (general dentists and other dental specialists), and orthodontic patients involved in contact sports regarding the use of MGs. METHODOLOGY: A cross-sectional survey was designed to collect information from dental clinicians (orthodontists and other dental practitioners) and their orthodontic patients about using MGs during sports participation. A convenience sampling technique was used to recruit the participants for an online survey. A total of 107 (32 males/75 females) dental clinicians and 147 (75 males/72 females) orthodontic patients (mean age 17.5 ± 5.84 years) participated in the study. Pre-validated questionnaires, specifically designed for dental clinicians and orthodontic patients, were used. Data were analyzed using SPSS software (version 28.0; SPSS). RESULTS: Nearly 50% of dental clinicians have recently recommended MGs to their patients in their clinical practice out of which 59% preferred the stock type; 33% of dental clinicians enquired their patients about involvement in contact sports during initial visits. The majority of orthodontic patients acquired knowledge about MGs through the Internet. More than half of orthodontic patients expressed unwillingness to pay for MGs, and 89% of orthodontic patients found using MGs during contact sports uncomfortable. CONCLUSION: The findings provide valuable insights into the practices and attitudes of dental clinicians and orthodontic patients regarding MGs, their recommendations, and the comfort levels associated with using them during contact sports.

Taxonomic discordance of immersive realities in dentistry: A systematic scoping review.

OBJECTIVES: This review aimed to map taxonomy frameworks, descriptions, and applications of immersive technologies in the dental literature. DATA: The Preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) guidelines was followed, and the protocol was registered at open science framework platform (https://doi.org/10.17605/OSF.IO/H6N8M). SOURCES: Systematic search was conducted in MEDLINE (via PubMed), Scopus, and Cochrane Library databases, and complemented by manual search. STUDY SELECTION: A total of 84 articles were included, with 81 % between 2019 and 2023. Most studies were experimental (62 %), including education (25 %), protocol feasibility (20 %), in vitro (11 %), and cadaver (6 %). Other study types included clinical report/technique article (24 %), clinical study (9 %), technical note/tip to reader (4 %), and randomized controlled trial (1 %). Three-quarters of the included studies were published in oral and maxillofacial surgery (38 %), dental education (26 %), and implant (12 %) disciplines. Methods of display included head mounted display device (HMD) (55 %), see through screen (32 %), 2D screen display (11 %), and projector display (2 %). Descriptions of immersive realities were fragmented and inconsistent with lack of clear taxonomy framework for the umbrella and the subset terms including virtual reality (VR), augmented reality (AR), mixed reality (MR), augmented virtuality (AV), extended reality, and X reality. CONCLUSIONS: Immersive reality applications in dentistry are gaining popularity with a notable surge in the number of publications in the last 5 years. Ambiguities are apparent in the descriptions of immersive realities. A taxonomy framework based on method of display (full or partial) and reality class (VR, AR, or MR) is proposed. CLINICAL SIGNIFICANCE: Understanding different reality classes can be perplexing due to their blurred boundaries and conceptual overlapping. Immersive technologies offer novel educational and clinical applications. This domain is fast developing. With the current fragmented and inconsistent terminologies, a comprehensive taxonomy framework is necessary.

Maximum occusal bite force for children in different dentition stages.

This study was carried out to record maximum occlusal bite force (MOBF) among different dentition stages in children and to study the relation of occlusal bite force to weight, height, and gender. A total of 1011 children (500 females and 511 males) aged from 3 to 18 years were examined. The subjects were divided into 5 groups according to their dentition stage as the following:- early primary dentition stage (100 males and 100 females, average age was 3.37 ± 0.23 years), late primary dentition stage (104 males and 100 females, average age was 5.86 ± 1.15 years), early mixed dentition stage (100 males and 100 females, average age was 8.15 ± 0.67 years), late mixed dentition stage (100 males and 100 females, average age was 9.97 ± 0.86 years ), and permanent dentition stage (107 males and 100 females, average age was 14.03 ± 2.14 years). Occlusal bite force was measured using a hydraulic occlusal force gauge. The means of MOBF for the different dentition stages were:- 176 N in early primary stage, 240 N in late primary stage, 289 N in early mixed stage, 433 N in late mixed stage, and 527 N in the permanent dentition stage, respectively. Gender differences were detected in groups 2, 3 and 4. Height and age significantly correlated with the MOBF in all dentition stage groups except group 1. In conclusion, the MOBF increased with age. Age, gender, and height were significant predictors of the MOBF.

The effect of different bracket base cleaning method on shear bond strength of rebonded brackets.

AIM: To assess the effect of different bracket base conditioning method on shear bond strength (SBS) of rebonded brackets. MATERIALS AND METHODS: Eighty brackets were bonded to freshly extracted premolar teeth using light cured composite adhesive. SBS was measured for 20 random samples as control group (G1). After debonding, 60 debonded brackets were allocated randomly into three groups of bracket base conditioning methods to remove the remaining adhesives. G2: bracket base cleaned with slow speed round carbide bur (CB), G3: cleaned with ultrasonic scaler (US), G4: cleaned with sandblasting (SB). After that, brackets were rebonded in the same manner as frst bonding and SBS was measured. Modifed adhesive remnant index (ARI) was recorded for all groups. RESULTS: SBS for new brackets was 11.95 MPa followed by 11.65 MPa for G2, 11.56 MPa for G4 and 11.04 MPa for G3 group. There were no statistically signifcant differences between all groups (p = 0.946). In all groups, failure mode showed that the majority of adhesive composite remained on the bracket base with ARI of 4. There was no statistically signifcant difference between all groups in ARI (p = 0.584). CONCLUSION: In-offce methods; slow speed CB and US are effective, quick and cheap methods for bracket base cleaning for rebonding.

Acceptability and attractiveness of intra- and extra-oral orthodontic appliances.

OBJECTIVES: To evaluate the acceptability of different intra-oral and extra-oral orthodontic appliances, to rank orthodontic appliances from the most to the least attractive and to investigate the factors that may affect the acceptance of orthodontic treatment. SUBJECTS: A random sample of 800 students (schoolchildren and university students) were invited to participate in this study and a total of 688 students were included (86%). METHODS: A self-administrated structured questionnaire was constructed for the purpose of this study. RESULTS: More than one-half in each age group (53%) claimed that they would accept to have orthodontic treatment. Acceptance of the different orthodontic appliances was affected by gender, age and type of school. Removable appliance was reported as the most acceptable and facemask was reported as the least acceptable orthodontic appliances. Majority of subjects ranked ceramic and facemask appliances as the most and the least attractive orthodontic appliances, respectively. The predictor variables for the acceptance of orthodontic treatment were perceived demand for orthodontic treatment, perceived positive effect of orthodontic treatment and expected benefits from orthodontic treatment. CONCLUSIONS: Removable appliance was the most acceptable orthodontic appliance whereas ceramic appliance was ranked as the most attractive one. Facemask was the least acceptable and the least attractive option.

Orthodontic Curricula in Undergraduate Dental Education-A Scoping Review.

OBJECTIVE: To investigate commonalities and variations in the learning outcomes, curriculum content, assessment methods, and competencies in undergraduate orthodontic curricula globally. METHODS: This scoping review followed the updated methodological guidance proposed by the Joanna Briggs Institute and reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). A search on electronic databases PubMed, Scopus, and Embase was conducted for the last 25 years. Google Scholar was used to identify eligible unpublished and grey literature. RESULTS: The total number of reports identified was 231. After removal of 62 duplicates, 169 reports were included in the title and abstract screening. Finally, 17 studies were included in the review, which included 13 cross-sectional surveys, three expert panel proceedings, and one discussion paper. Marked variations were reported in undergraduate orthodontic curricula and competency assessments at the level of individual countries, regionally as well as globally. The challenges of imparting competency in orthodontic treatment during undergraduate dental education are also acknowledged. CONCLUSION: Lack of consistency in undergraduate orthodontic education was evidenced by several Delphi studies aiming to develop a consensus on orthodontic teaching in undergraduate programs. A common message emanating from the available studies on undergraduate orthodontic education seems to emphasize a focus on assessment and diagnosis of the orthodontic treatment needs of patients and a basic understanding of contemporary treatment options to facilitate patient referral.

Bite force changes after surgical correction of mandibular prognathism in subjects with increased vertical dimension : A prospective clinical trial.

PURPOSE: Occlusal bite force (OBF) is the most important parameter in assessing biting efficiency. The aim of this study was to record OBF changes after surgical correction of high angle maxillary/mandibular (Max/Mand) class III patients and to compare these with that recorded in class III patients with average Max/Mand angle. MATERIALS AND METHODS: Initially included were 42 patients with severe class III skeletal malocclusion who were scheduled for orthodontic surgery: group 1-22 patients with increased vertical relationship scheduled for bimaxillary surgery; group 2-20 patients with average vertical relationship scheduled for mandibular setback only. OBF measurements before surgery (T0), at debonding (T1) and at least 3 months after debonding (T2) were recorded using a portable occlusal force gauge. The following were also measured: maximum OBF (MOBF) achieved by the subject on each side, averaged OBF on each side (AOBF) and maximum OBF at the incisal region (MIOBF). At T2, only 33 patients (group 1: 17 and group 2: 16) were included in the analysis due to loss to follow-up. RESULTS: MOBF increased significantly in group 1, while no significant changes were detected in group 2. MIOBF increased after surgical correction in both groups. Significant increase in MIOBF was observed at T1 (P < 0.001) followed by an insignificant decrease during the observation period (3-6 months after treatment; P > 0.05). The two groups differed significantly in MOBF at T1 and T2, while no statistically significant differences were detected between the groups for MIOBF changes at the various time intervals (P > 0.05). The number of posterior teeth with occlusal contacts increased in both groups. Relapse was detected in group 1 where the number of posterior teeth in contact decreased during the observation period (T1-T2). CONCLUSION: OBF greatly improved after surgical correction of the vertical morphology. Correction of high angle mandibular prognathism improves oral function in addition to esthetics.

The COVID-19 experience of orthodontists in Jordan.

OBJECTIVES: To understand the impact of the COVID-19 pandemic on orthodontic clinical services in Jordan. MATERIALS AND METHODS: Google Forms electronic questionnaires were distributed between March and June 2021 using the WhatsApp platform of the Jordanian Orthodontic Society and via direct WhatsApp messages. The survey was identical and contemporaneous to that used in the United Kingdom. RESULTS: The survey yielded 127 unique responses, giving a response rate of 53.1%. The factors that had the greatest impact on service delivery were government guidance (78%), patients' fear of attending (70.1%), and increased cross-infection measures (65.4%). The survey revealed that there had been a perceived deterioration in oral hygiene (60.3%) and levels of compliance (61.9%) in patients in active treatment even though patients in treatment were prioritized during the pandemic. Also, 56.8% of respondents felt clinical staff should be vaccinated and undergo regular testing for COVID-19. Orthodontists within Jordan were optimistic regarding the speed at which clinical services would return to pre-pandemic levels of activity with 32.5% anticipating this would take less than 6 months. CONCLUSIONS: Patients in active orthodontic treatment, during COVID-19, have been prioritized but at the expense of new and review patients. Respondents in Jordan felt COVID-19 would have ongoing effects on clinical care, professional practice, and society. Most respondents supported the vaccination of orthodontic staff and were optimistic about the effect of a vaccination program on restoring clinical services.

Effect of piezocision-assisted lower second molar protraction on periodontal tissues, alveolar bone height, and lower second molar root resorption.

OBJECTIVES: To assess the effect of piezocision on periodontal tissues and alveolar bone height and to detect lower second molar root resorption in piezocision-assisted mandibular second molar protraction compared to no-piezocision molar protraction. MATERIALS AND METHODS: Twenty-one subjects (four males, 17 females, aged 22.43 ± 2.83 years) who presented with bilateral extraction of lower first molars were included. The patients were divided into two groups; Group 1: Piezocision-assisted molar protraction (right or left side of subjects) in which piezocision was performed immediately before lower second molar protraction and, Group 2: No-piezocision molar protraction in which lower second molar protraction was not surgically assisted. Plaque index (PI), gingival index (GI), periodontal pocket depth (PPD), width of keratinized gingiva (WKG), gingival recession (GR), lower second molar mesial root resorption, alveolar bone height, and mandibular bone height were recorded at T1 (immediately before molar protraction) and at T2 (after second molar space closure). RESULTS: In the piezocision-assisted molar protraction group, significant changes were detected in the WKG (P < .001), GR (P < .05), and the mandibular bone height (P < .001). Compared to the no-piezocision group, piezocision-assisted molar protraction resulted in an increased WKG (P < .001) and less second molar mesial root resorption (P < .01). CONCLUSIONS: Piezocision does not have any detrimental effect on the periodontium and produces less root resorption.