Effect of 125-150 Hz Vibrational Frequency Electric Toothbrush on Teeth and Supporting Structures: A Finite Element Method Study.

AIM AND OBJECTIVE: The aim of this finite element method (FEM) study was to assess the safety of 125-150 Hz vibrational frequency electric toothbrush on teeth and associated structures. MATERIALS AND METHODS: A three-dimensional (3D) geometric model of entire skull having maxilla, mandible, and their dentitions was created using a computed tomography (CT) image of a healthy male patient. Linear static analysis was carried out by applying 15 g of force on anterior part of maxilla and mandible from labial and lingual sides each to calculate the primary displacement (sagittal, vertical, and transversal) and principal stress levels generated on the maxillary and mandibular dentition, on the maxilla and mandible and on the whole skull. RESULTS: A force of 15 g applied to maxillary anterior teeth from labial side caused a mean deflection of 0.003 mm and stress of 0.004 MPa on the teeth and supporting structures. A force of 15 g applied to maxillary anterior teeth from palatal side caused a mean deflection of 0.017 mm and stress of 0.017 MPa on the teeth and supporting structures. A force of 15 g applied to mandibular anterior teeth from labial side caused a mean deflection of 0.078 mm and stress of 0.051 MPa on the teeth and supporting structures. A force of 15 g applied to mandibular anterior teeth from lingual side caused a mean deflection of 0.077 mm and stress of 0.051 MPa on the teeth and supporting structures. CONCLUSION: For the applied loads and boundary conditions, very small or negligible amount of stresses were observed in maxilla, mandible, and their dentitions. The vibrational frequency of 150 Hz producing 15 g of force did not produce any harmful effects on maxilla, mandible, and their dentitions. Hence, 125-150 Hz of vibrational frequency can be considered optimum. CLINICAL SIGNIFICANCE: An electric toothbrush using the vibration of 125-150 Hz produces negligible stress on teeth and associated structures.

Microbial profile in different orthodontic appliances by checkerboard DNA-DNA hybridization: An in-vivo study.

INTRODUCTION: The design of the orthodontic bracket or appliance is 1 of the most important factors for creating retentive areas for biofilm formation. In orthodontics, this would be the first study to compare the microbial level changes in 3 different types of orthodontic appliances using checkerboard DNA-DNA hybridization technique. The purpose of this study was to evaluate and compare the extent of appearance of orange and red microbial complexes in patients undergoing orthodontic treatment using aligners, conventional metallic fixed labial appliances, and lingual fixed appliances. METHODS: A total of 60 patients, of which 20 patients were undergoing treatment with aligners, 20 patients with labial fixed appliances, and 20 patients with lingual fixed appliances, were included in our study. After 30 days, debonded brackets and rinsed aligners were stored and processed for analysis with checkerboard DNA-DNA hybridization. RESULTS: Most bacterial species showed moderate counts, with the exception of Treponema denticola, which showed a higher count in all 3 types of appliances. Fusobacterium nucleatum, Porphyromonas gingivalis, and T denticola were present in a higher percentage in the lingual appliance. Fusobacterium periodontium and Prevotella intermedia were present in a higher percentage in the labial fixed appliance. Campylobacter rectus, Tannerella forsythia, and Prevotella melaninogenica counts were moderate in all 3 appliances, with the first 2 microbes showing slightly higher counts in aligners. The association between all the microorganisms were statistically insignificant, with the exception of F nucleatum, which showed a strong statistically significant association in all 3 types of appliances. CONCLUSIONS: The microbial contamination in metallic brackets was higher than that of aligners, when used for a month. Lingual fixed appliances showed more microbial contamination than labial fixed appliances followed by aligners.

Comparison of Effectiveness of Corticotomy-assisted Accelerated Orthodontic Treatment and Conventional Orthodontic Treatment: A Systematic Review.

AIM: To systematically review the comparative differences in the performance and timeliness of conventional orthodontic treatment with that of corticotomy-assisted accelerated orthodontic treatment. DATA SOURCES: The electronic databases PubMed and Google Scholar were searched from January 2007 to January 2018 in English, with manual searches of reference lists and gray literature. Thirty-six articles were included in the study with inclusion criteria as prospective clinical studies of patients treated with fixed conventional appliance and the intervention was the corticotomy-assisted accelerated orthodontic treatment method. STUDY SELECTION: Two reviewers assessed independently the eligibility of the included articles. One investigator abstracted study design information, intervention details, and harms data from all included studies into a standardized evidence table. The accuracy of these data was checked by the second investigator. We resolved any disagreements through discussion with other authors. RESULTS: Different aspects of the corticotomy-assisted accelerated orthodontics treatment method were investigated including risk factors, advantages, and disadvantages as compared to that of conventional orthodontic treatment. CONCLUSION: There is limited available evidence about effectiveness of corticotomy-assisted accelerated orthodontics. Although the current review indicates that the corticotomy-assisted accelerated orthodontic treatment method can fasten the treatment duration by 2.2-3 folds compared to conventional orthodontic treatment, furthermore, the level of evidence needs well-conducted prospective research with big sample size to draw valid conclusions. CLINICAL SIGNIFICANCE: Orthodontic treatment is a time-consuming process and due to noncompliance of patients, research has found different methods to accelerate the treatment, thus reducing the total treatment duration. Use of accelerated orthodontic techniques is expected to help clinicians in better treatment decisions for noncompliant patients.

Cytokine levels in gingival crevicular fluid during orthodontic treatment with aligners compared to conventional labial fixed appliances: a 3-week clinical study.

Objective: To test the hypothesis that the levels of IL-1ß and TNF-α increased more and IL-1α, IL-2, IL-6, IL-8 increased less, after 3 weeks of treatment with conventional labial fixed appliance and with aligners. Material and methods: Forty patients who were treated either with labial brackets (n = 20) or aligners (n = 20). Gingival crevicular fluid (GCF) samples were collected at baseline and after 21 days. Cytokine levels were evaluated by enzyme-linked immune sorbent assay (ELISA). Plaque index (PI), gingival index (GI), and bleeding on probing (POB) were also examined. Results: The levels of IL-1α, IL-1ß, IL-2, IL-6, IL-8 and TNF-α in the GCF were significantly increased in both groups. The levels of IL-2, IL-6, IL-8 increased more in patients treated with aligners compared to those treated by labial fixed appliances. There was a statistically significant difference in change of the mean cytokine levels of IL-1α, IL-2, IL-6, IL-8 and TNF-α compared to labial fixed appliances and aligners. Conclusions: The levels of the six studied cytokines in GCF (IL-1α, IL-1ß, IL-2, IL-6, IL-8 and TNF-α) increased after 3 weeks both after treatment with conventional labial fixed appliance and with aligners. IL-1ß and TNF-α showed a prominent increase compared to the other cytokines in the GCF of teeth by both the labial fixed appliance and aligners. However, there were only minor differences in the changes of the cytokine levels from baseline to 3 weeks between the two groups. There were no differences between the groups regarding PI, GI or POB.

Effect of 125 Hz and 150 Hz vibrational frequency electric toothbrushes on the rate of orthodontic tooth movement and prostaglandin E2 levels.

Objective: To evaluate the effects of an electric toothbrush with vibrational frequencies of 125 Hz and 150 Hz on the orthodontic tooth movement (OTM) rate and the production of prostaglandin E2 (PGE2). Methods: Out of thirty patients (aged 18-25 years; 16 females and 14 males), ten patients each formed Group A and B, who used electric toothbrushes with 125 Hz and 150 Hz vibrations, respectively. The remaining ten patients (Group C) served as the control group and did not use electric toothbrushes. The rate of OTM and levels of PGE2 using microcapillary pipettes were calculated before the start of retraction (T0), on the 30th day (T1), on the 60th day (T2), and on the 90th day (T3) from the start of retraction in all the groups. Results: There was a statistically significant difference in the mean OTM values and PGE2 levels in all three groups at different time intervals, with the maximum difference seen in Group B compared to Group A and least in Group C at T1, T2 and T3. Conclusions: The rate of OTM and levels of PGE2 were highest in patients who used an electric toothbrush with 150 Hz mechanical vibration compared to those who used an electric toothbrush with 125 Hz mechanical vibration and least in patients who did not use an electric toothbrush. Mechanical vibration led to an increase in the PGE2 levels and accelerated the OTM.

Correlation of Palatal Index With Pharyngeal Airway in Various Skeletal Patterns.

Introduction This retrospective study aimed to correlate palatal index with pharyngeal airway in class I, class II and class III skeletal patterns. Materials and methods A total of 30 individuals with a mean age of 17.5 years were included in the study. The subjects were categorized on the basis of ANB (A point, nasion, B point) angle into skeletal class I, II, and III patterns (N=10). Using Korkhaus analysis, palatal height, palatal breadth, and palatal height index were calculated from the study models. From the lateral cephalogram, the dimensions of the upper and lower pharyngeal airways were measured using McNamara Airway Analysis. The results were calculated using the ANOVA test. Results A statistically significant difference was found in all three groups of class I, II, and III malocclusions for palatal index and airway dimensions. The skeletal class II malocclusion participants exhibited the highest mean values for the palatal index (P=0.03). Class I had the highest mean value for the upper airway (P=0.041), whereas class III had the highest mean value for the lower airway (P=0.026). Conclusion It was concluded that subjects with the class II skeletal pattern have a high palate and reduced upper and lower airways when compared with class I and class III skeletal patterns, which showed larger upper and lower airways, respectively.

Comparison of Alveolar Bone Thickness, Sagittal Root Positions, and Arch Forms in Class I, II, and III Malocclusions: A Cephalometric Study.

OBJECTIVE: This retrospective study aimed to evaluate the sagittal root position, arch shapes, and alveolar bone thickness in classes I, II, and III of skeletal patterns. MATERIAL AND METHODS: Alveolar bone thickness, sagittal root placements, and arch morphologies in classes I, II, and III malocclusions were measured using 30 study models and 30 lateral cephalograms, both with a mean age of 16.5 years. Based on their sagittal relations, 30 participants were classified into three groups each (classes I, II, and III). The ANOVA test was used to calculate the results. RESULTS: Between the three classes, there were statistically significant differences in the AP jaw relationship and root placements. Sagittal root location and dental arch shape showed no statistically significant correlation. CONCLUSION: There was no correlation between the dental arch form and sagittal root position, and classes II and III were found to have higher mandibular incisor inclination. On all levels, oval arch forms were prevalent.

Effectiveness of mobile phone applications in improving oral hygiene care and outcomes in orthodontic patients.

OBJECTIVES: To assess the effectiveness of mobile phone applications in improving oral hygiene care and oral health outcomes in patients undergoing fixed orthodontic treatment. MATERIALS AND METHODS: PUBMED/MEDLINE, CINAHL, EMBASE, COCHRANE, PROQUEST, Google Scholar, and Web of Science were systematically searched for original studies published between January 2000 and March 2020. The eligibility criteria being: (i) observational study [cross-sectional, case-control, cohort study, or RCTs] that reported mobile phone application as an intervention or exposure for oral hygiene care. Standard Protocol Items Recommendations for Interventional Trials (SPIRIT) statement was used for quality assessment of interventional studies. The comprehensive search strategy yielded 154 studies after the removal of duplicates. Based on eligibility criteria only 5 studies were included in the data extraction phase. RESULTS: This review finds that smartphone applications have a significant short term effect in the improvement of oral hygiene when measured using plaque index and gingival index scores. The mean plaque index and gingival index reduced significantly in three out of five studies. The intervention groups [62%] had a lower level of plaque at a 12-week interval as compared to the control group [72%]. Short term follow-ups showed greater improvement in oral hygiene following smartphone application administration. CONCLUSION: Within the available evidence, a recommendation can be made for the use of mobile applications in the orthodontic process [oral hygiene] care. CLINICAL RELEVANCE: Further research for the development of patient-centered applications for patient safety, clinical decision making, and increasing their effectiveness in the treatment of orthodontic patients are required.