A scanning electron microscopy investigation of the precision of three orthodontic bracket slot systems.

OBJECTIVE: One of the most imprortant factors in achieving ideal teeth positions is the precision of the slot dimensions of orthodontic brackets into the archwires are inserted.This study aimed to assess the accuracy of the dimensions of orthodontic bracket slots and molar buccal tube apertures and to compare them with the specifications provided by the manufacturers. METHOD: A total of sixty brackets and ten molar buccal tubes with varying slot heights were examined using a scanning electron microscope from the mesial side. The dimensions and morphology of these bracket slots and buccal tubes apertures were assessed using the AutoCAD Software. A one-sample t-test was conducted to compare the measurements with the values provided by the manufacturer. RESULTS: The findings of the present study indicated that the height of the measured bracket slots and buccal tube apertures dimensions were significantly larger than the actual dimensions and exhibiting divergent walls. On the other hand, the depth of the brackets slots showed significantly smaller values than the actual one. CONCLUSION: A need for careful consideration when selecting a commercially accessible brand for everyday use is essential as certain materials may not meet acceptable standards.

Assessment of dental arch forms in a sample of children.

In this study, we investigated dental arch forms in a representative sample of children with mixed dentition. Twenty-four pairs of study models, belonging to twenty-four youngsters (twelve boys and twelve girls aged 8 to 9 years) with acceptable occlusion, were scanned and assessed by Ortho analyzer software. Three transversal and three vertical measurements were acquired to evaluate the lengths and widths of dental arches, and the ratios between these measurements were standardized. Next, the mean standardized parameters were used to define the dental arch form. Unpaired t-tests were used to analyze gender differences for all measures. Subsequently, frequencies and percentages were determined for each arch shape in both jaws and genders, and Pearson's Chi-squared test was used to evaluate differences between genders. Males exhibited higher mean values for all measurements, but without statistical significance. The most prevalent dental arch was the mid form (83.3%) for both jaws and genders.

Predicting the Mesiodistal Crown Dimensions of the Permanent First Molars from the Deciduous Second Molars.

BACKGROUND: This study aims to formulate regression equations that predict the mesiodistal crown widths of the permanent first molars utilizing the mesiodistal crown widths of the deciduous second molars. METHODS: Fifty pairs of study models belonging to 50 Iraqi children aged eight to nine years with sound mixed dentition were used to measure the mesiodistal crown widths of the permanent first molars and deciduous second molars using a pointed digital sliding caliper with 0.01 mm sensitivity. Side and gender differences were assessed, and the correlations between these teeth were obtained to develop the regression equations. RESULTS: The results revealed no significant side differences, so the samples were merged and analyzed for gender differences, which were found to be significant in all examined teeth except the mandibular permanent first molar. Direct, moderate, and highly significant correlations between the mesiodistal crown widths of the permanent first molars and deciduous second molars were found, which led to the development of regression equations. After applying these equations, the resultant predicted widths were compared to the actual widths, and the results revealed nonsignificant method differences. CONCLUSIONS: A new method was developed to predict the widths of permanent first molars from the adjacent primary second molars with high precision.

The Relation among Teeth and Maxillary Dental Arch Dimensions with Anterior Teeth Angulation and Inclination.

OBJECTIVES: This study aimed at finding out whether anterior teeth angulation and inclination have a relationship with the maxillary teeth and dental arch dimensions. METHODS: Fifty study models with normal occlusion were selected from the archive of the Department of Orthodontics at Baghdad Dental Faculty. Maxillary dental arch width and length at different points were determined in addition to measuring anterior teeth angulation, inclination, crown thickness, overjet, overbite, and Bolton's ratios. The unpaired t-test and Pearson's correlation coefficient test were used for data analysis. RESULTS: No statistical gender differences were reported in all measurements except the dental arch widths and length where males had significantly higher mean values. Only the maxillary incisor's inclination showed a direct weak significant correlation with the total arch length. CONCLUSIONS: The inclination of upper incisors had a minimal effect on increasing dental arch length.

Assessment of Ions released from Three Types of Orthodontic Brackets immersed in Different Mouthwashes: An in vitro Study.

AIM: Herbs are used widely in medicine. The purpose of the present study was to assess the ion release from gold-plated orthodontic bracket compared with other stainless steel brackets, and based on the findings of the study, the orthodontists can choose the most biocompatible brackets and mouthwashes useful in the clinical practice. MATERIALS AND METHODS: A total of 150 orthodontic brackets from Orthotechnology™ Company, USA (50 stainless steel one-piece brackets, 50 stainless steel two-piece brackets, and 50 gold brackets) were immersed in four mouthwashes in addition to distilled water. Ten of each type of brackets in every media were immersed under 37°C for 45 days. Ions released in these mouthwashes were measured, and comparisons among different bracket types and among various mouthwashes were done by one-way analysis of variance (ANOVA) and then with Games-Howell tests. RESULTS: Increased amounts of ions released in herbal mouth-washes were recorded in gold and two-piece brackets in comparison with one-piece stainless steel brackets. CONCLUSION: Herbal mouthwashes must be used with caution as they showed an increased amount of ions released in comparison with chlorhexidine. One-piece stainless steel bracket system is the most compatible bracket type, as they released the least amount of ions. CLINICAL SIGNIFICANCE: One-piece stainless steel brackets are better than two-piece brackets in terms of ions released.

Pedodontists' awareness of orthodontics: An online survey.

OBJECTIVES: This study aimed to document knowledge, awareness, and ability to provide different aspects of orthodontic treatment currently provided by pedodontists. MATERIALS AND METHODS: A 14-item online questionnaire was sent to 120 pedodontists in different countries. Responses received within 2 months were analyzed as frequency and percentage. RESULTS: The response rate was 68.3%. Most respondents demonstrated adequate information about the etiology and diagnosis of different malocclusions and paid attention to patients' facial characteristics. The desire to learn from continuing education programs was higher for preventive and interceptive orthodontics. Space maintainers, habit breakers, management of anterior crossbite, and serial extraction were the orthodontic services most provided by pedodontists. CONCLUSIONS: Pedodontists should attend to continuing education about the etiology, diagnosis, and treatment planning for various malocclusions.

Awareness of orthodontic patients towards smartphone orthodontic apps.

BACKGROUND: Mobile phone applications (apps) can potentially enhance patient care as they are easy to use and offer multifunctions. In 2019, 305 orthodontic apps were documented, many of which were patient-focused; however, there was little information on how popular these applications are with orthodontic patients. The main aim of this study was to evaluate how well patients were now aware of orthodontic applications. METHODS: A survey asking 700 orthodontic patients about their knowledge of, access to, and use of orthodontic apps to facilitate their treatment resulted in 615 responses. RESULTS: The results showed that a smartphone was owned by 96% of patients. Apple (Apple Inc., Cupertino, CA, USA) was the most used platform, followed by Android (Google LLC, Mountain View, CA, USA). Seventy-five percent of patients have previously used social media to research information, with YouTube (YouTube, San Mateo, CA, USA) being the most popular site. Only 3% of patients knew that applications were available to aid with orthodontic therapy and 12 patients had utilized an app linked to orthodontics. Nevertheless, 88% of patients said they would be open to using an app to supplement their treatment. CONCLUSIONS: Although 88% of patients said they would be prepared to use an app to help with orthodontic treatment, there is currently a low level of knowledge of the existence of apps. Given the availability of applications geared toward those patients, it is necessary to evaluate these apps' quality and, when critical, direct patients toward high-quality, efficient apps.

Methods of measuring distal canine movement and rotation- A review.

This article provides an overview of the various methods for measuring distal canine movement and rotation during retraction. Various databases, including PubMed Central, Science Direct, Wiley Online Library, the Cochrane Library, Textbooks, Google Scholar, and Research Gate, and a manual search up until September 2022, were used to search for various methods of measuring distal canine movement and rotation during retraction. After excluding the duplicate articles, the papers explaining these techniques were included. Four significant techniques were identified. The digital method with 3D superimposition is the safest, most accurate, and most accessible of the methods reviewed.

Evaluating orthodontic bracket slot dimensions and morphology: A narrative review.

The current article aims to review the previous studies that measure the orthodontic bracket slot dimensions and geometry. Searches in different databases, including PubMed Central, Science Direct, Wiley Online Library, the Cochrane Library, Textbooks, Google Scholar, and Research Gate, in addition to a manual search, were performed about the methods of assessing orthodontic bracket slot dimension up to March 2023. The irrelevant and duplicate studies were eliminated, leaving 35 studies for this narrative review. The findings indicate that the slots are oversized with diverging walls in most studies. Manufacturers must respect the standards during manufacturing brackets and adhere to the actual dimensions and tolerance values.

The Role of Social Media in Communication and Learning at the Time of COVID-19 Lockdown-An Online Survey.

This study aimed to assess orthodontic postgraduate students' use of social media during the COVID-19 lockdown. Ninety-four postgraduate students (67 master's students and 27 doctoral students) were enrolled in the study and asked to fill in an online questionnaire by answering questions regarding their use of social media during the COVID-19 lockdown. The frequency distributions and percentages were calculated using SPSS software. The results showed that 99% of the students used social media. The most frequently used type of social media was Facebook, 94%, followed by YouTube, 78%, and Instagram, 65%, while Twitter and Linkedin were used less, and no one used Blogger. About 63% of the students used elements of social media to learn more about orthodontics staging, biomechanics, and various approaches in managing orthodontic cases. About 56% of students tried uploading and downloading scientific papers, lectures, movies, presentations, and e-books from social media, while communication with professionals and searches about orthodontic products were reported in 47% of students' responses. On the other hand, 43% of the responses favored sharing orthodontic information and posts for teaching and discussion purposes. Generally, social media plays leading roles in the communication with, learning of, sharing of information with, and supervision of patients from a far during the COVID-19 lockdown.

Clinical management and infection control protocols during the COVID-19 pandemic: An online survey.

BACKGROUND: SARS-CoV-2 (COVID-19) is considered a highly infectious and life threatening disease. OBJECTIVE: The present paper aims to evaluate various aspects of preventive measures and clinical management of the scheduled visits for orthodontic patients to the dental clinics during the outbreak of COVID-19, and to assess how orthodontists dealt with this challenge. METHODS: Orthodontists in private and public clinics were invited to fill a questionnaire that addressed infection control protocols and concerns about clinical management of patients in the clinics during the pandemic. Frequncies and percentages of the responses were obtained and compared using Chi-square tests. RESULTS: About 77% of those working in private clinics, and 63% of those working in private and governmental clinics performed room disinfection following each patient. In case of patients needing urgent management and have active infection, 56% of the participants provided care under high infection control measures; on the contrary, 64% provided symptomatic intervention including orthodontic wax, analgesics and sometimes mouthwash. CONCLUSION: The COVID-19 pandemic has had a negative impact on the orthodontic treatments. All pre-cautionary measures have to be made available in the clinic in order to minimize the spread of viral infection with continuous dental health care training.

Rapid Apical Healing with Simple Obturation Technique in Response to a Calcium Silicate-Based Filling Material.

Background: Root canal sealers with high alkaline (pH more than 11) and bioactive properties (release ions) are more effective for healing the apical area and preventing reinfection in root canals. Pure calcium silicate-based bioceramic premixed injectable sealers lead to change the obturation technique because it depends on maximizing amount of sealer and single cone gutta-percha as a carrier. This retrospective clinical study aimed at demonstrating the effect of single cone gutta-percha with a calcium silicate-based filling, used to fill the root canal in a single visit, on the apical healing with different lesion size. Materials and Methods: 195 patients needing root canal treatment were treated at the Al-Jazaer private clinic in southern Iraq. Cases were obtained during the 2017-2021 period (retrospective study). All patients were treated with a simple hydraulic condensation technique that used calcium silicate-based filling materials as the sealer with single cone gutta-percha as the carrier, with a minimum follow-up period of approximately one year. Both treatment- and patient-related factors were evaluated. The clinical outcomes depended on classification with respect to complete (success) or incomplete (failure) healing. Statistical analysis was performed using a chi-square test to compare different related factors. Results: Radiographs for 195 patients were examined, and the average follow-up time was 20.44 months. The complete healing success rate was 164 (84.1%), and 31(15.9%) patients were not healed. The highly significant success rate was 88.7% for the initial treatment compared with 63.9% for retreatment. Small and medium lesions (<5 mm diameter) had a significant success rate compared to large lesions (>5 mm diameter). Sealer extrusion was found in 68.7% of cases, but it did not have any significant effect on the treatment result. Conclusions: The bioceramic calcium silicate-based filling sealer used with single-cone gutta-percha led to increased success of apical healing with a simple hydraulic condensation technique without multiple visit treatments and premedication material.

The Importance of the Maxillary and Mandibular Incisors in Predicting the Canines and Premolars Crown Widths.

Background: The purpose of the present study was to use the combined mesiodistal crown widths of the mandibular and maxillary incisors as predictors for the combined mesiodistal crown widths of mandibular and maxillary canines and premolars. Materials and Methods: One hundred and twenty pairs of study models belong to 120 Iraqi adult subjects with normal dental and skeletal relations were included in the study. The crown widths of the mandibular and maxillary incisors, canines, and premolars were assessed at the maximum mesiodistal dimension on the dental casts using a digital electronic caliper with 0.01 mm sensitivity. The correlation between combined mesiodistal crown widths of the mandibular and the maxillary incisors and combined mesiodistal crown widths of mandibular and maxillary premolars and canines has been determined using Pearson's coefficient correlation test for each arch and gender. Using simple regression analysis, the equations predicting the widths of the mandibular and maxillary premolars and canines were established. The predicted and the actual mesiodistal crown width values have been compared with the use of a paired sample t-test. Results: According to the findings of the present study, males had significantly wider teeth compared to females. Correlations between the measured parameters ranged from moderate to strong. A nonsignificant difference between actual and predicted mesiodistal crown widths was discovered. Conclusions: With a high degree of accuracy, the combined mesiodistal widths of the maxillary and the mandibular incisors could be utilized for predicting the combined mesiodistal crown widths of the mandibular and maxillary canines and premolars.

Anthropometric measurements of peri-oral region in a sample of Iraqi thalassemic patients.

OBJECTIVES: Thalassemia, one of the most widespread autosomal recessive disorders, is characterized by anomalies in the synthesis of hemoglobin beta chains and is frequently coupled with variable craniofacial characteristics. Thalassemic patients suffer from severe anemia, which triggers several defense mechanisms in the body, such as bone marrow expansion, which forces the bones to expand, resulting in craniofacial bone deformities. This study aims to assess and compare the orofacial dimensions of ß-thalassemia patients with those of a control group across similar ages and gender. MATERIALS AND METHODS: Three hundred Iraqi individuals agreed to participate in this study (150 non-thalassemic and 150 thalassemic patients with an equal distribution of genders). A well-trained researcher carried out five anthropometric measurements by using an electronic digital caliper. Gender and group differences were tested using an independent sample t test. RESULTS: Mouth width showed clinical and statistically significant group differences among all measurements in the study group. CONCLUSIONS: All measurements except mouth width showed nonsignificant clinical group differences.

The Use and Preference of Functional Appliances among a Sample of Iraqi Orthodontists: A Web-Based Survey.

Objectives: This study evaluated the use and preference of different types of functional appliances among a sample of Iraqi orthodontists. Materials and Methods: About 200 orthodontists were invited to fill out an online Google form questionnaire with multiple-choice questions. The questions were modified from previous England and Malaysian studies. The data were tabulated as frequency tables. Results: The response rate was 61%. About 91.80% of the participants used functional appliances, with the removable type being the most used. The twin block was thought to be the best compliance one but not the most used functional appliance. About 62% depended on the clinical observations in determining the growth spurt and asked patients to wear the appliance full-time except at meal time. The majority preferred a period of retention of about 4-6 months and frequent visits for adjustments. Conclusions: Removable functional appliances are the most frequently used among the studied sample.

Carbonated Soft Drinks and Orthodontics: Review of Literature.

This study aims to review the effects of various types of carbonated soft drinks on the behavior of different orthodontic materials as well as on the enamel surface and tooth movement. Articles and books from 1990 to 2020 explaining the effects of carbonated soft drinks on general health and orthodontic materials and tooth movement were electronically searched. The major effects of carbonated soft drinks are explained and discussed in this review. Patients with orthodontic problems must be warned about the side effects of carbonated soft drinks on general and dental health and orthodontic appliances in particular.

Assessment of Maxillary Incisors' Angulation and Position in Different Types of Malocclusions Using Cone-Beam Computed Tomography.

BACKGROUND: This study is aimed to assess the maxillary incisors' root position, angulation, and buccal alveolar bone thickness in both genders and different classes of malocclusion using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Two hundred and six CBCT images were gathered and analyzed by three-dimensional On-Demand software to measure the variables of 803 maxillary central and lateral incisors. Genders and class difference was determined by unpaired t-test, one-way ANOVA, and Chi-square tests. RESULTS: Buccal root position of the maxillary incisors accounted for in the majority of the cases followed by the middle and palatal positions. The thickness of alveolar bone appears to have nearly the same pattern of decreasing in the mean values above the level of 2 mm from the crest of the bone up to the 6 mm level then increase in the apex of the root. The angle between the long axis of the maxillary incisors and the corresponding alveolar bone is higher significantly in class II followed by class I and III with no significant gender difference. CONCLUSIONS: most of the maxillary incisors examined were located in a very close position to the buccal cortical plate and covered by a thin buccal bone wall. The apparent association was noted between the incisors' root position and angulation in the alveolar bone with the buccal bone thickness.

A Female Hair Clip and Orthodontists' Neck-Back Pain Perception: A Survey.

This study aimed to clarify the effect of large hair clips on patient head posture on the dental chair headrest and its harmful impact on orthodontist body posture and neck-back pain. One hundred orthodontists voluntarily participated in a web-based questionnaire designed and distributed online by using the Google form posted in the Telegram group of Iraqi orthodontists to assess the opinions of orthodontists regarding the effect of a large hair clip on the patient's position on the dental chair and site of pain perception during different stages of orthodontic treatment. Ninety percent of the orthodontists get bothered by the large hair clip. About 92% of the responses preferred their patients to remove the large hair clip; 99% of them responded that the large hair clip does affect the position of the patient's head on the chair's headrest. Eighty-nine percent responded that a large hair clip could disturb the operator during taking intraoral photographs, and 64% disturbed while taking dental impressions. Orthodontists reported that 4% had "back pain," 28% had "neck pain," and 60% had both "back and neck pain" during bonding appointment, while only 8% reported "no pain." Regarding the activation appointments, 4% had "back pain," 26% had "neck pain," and 48% had both, while only 22% reported "no pain." During the debonding appointments, 7% of the respondents had "back pain," 29% had "neck pain," and 44% had both "back and neck pain," yet 20% stated absence of pain. Wearing a hair clip and changing patient position on dental chair and orthodontist posture during different stages of orthodontic work such as bonding, regular recall, and depending on the procedure may be directly related to the neck-back pain perception to an orthodontist.

Predicting Canine and Premolar Mesiodistal Crown Diameters Using Regression Equations.

OBJECTIVES: The current study aimed to predict the combined mesiodistal crown widths of maxillary and mandibular canines and premolars from the combined mesiodistal crown widths of maxillary and mandibular incisors and first molars. MATERIALS AND METHODS: This retrospective study utilized 120 dental models from Iraqi Arab young adult subjects with normal dental relationships. The mesiodistal crown widths of all teeth (except the second molars) were measured at the level of contact points using digital electronic calipers. The relation between the sum mesiodistal crown widths of the maxillary and mandibular incisors and first molars and the combined mesiodistal crown widths of the maxillary and mandibular canines and premolars was assessed using Pearson's correlation coefficient test. Based on this relation, regression equations were developed to predict the sum widths of maxillary and mandibular canines and premolars; then, the predicted mesiodistal crown sum widths were compared with the actual one using a paired sample t-test. RESULTS: Statistically, the predicted mesiodistal crown sum widths were nonsignificantly different from the actual ones. CONCLUSIONS: The combined mesiodistal widths of maxillary and mandibular canines and premolars can be predicted successfully from the combined mesiodistal widths of the maxillary and mandibular incisors and first molars with a high degree of accuracy reaching to more than 86%.

A New Method for Prediction of Dental Arch Perimeter.

PURPOSE: Dental arch length, width, and perimeter are considered to be important for the diagnosis and treatment of orthodontic cases. This study aimed to utilize dental arch width and length to create an equation for predicting dental arch perimeter. MATERIALS AND METHODS: Sixty-seven pairs of study models for patients with normal occlusion who received dental treatment were included in this study. Dental arch width at the level of the canines, first premolars, and first molars, in addition to dental arch length and perimeter, were measured using a digital vernier with 0.01mm accuracy. Data were subjected to step-wise regression analysis to determine the major predictors of arch perimeters and develop regression equations for both arches. The predicted arch perimeters were compared with the actual measured values using paired sample t-test. RESULTS: For both arches, the perimeter showed a direct, moderate to strong, highly significant correlation with the length and width measurements. Findings from step-wise regression analysis indicated that there was a strong correlation between arch perimeter and the inter-canine width and arch length, which explained 67.7% of the variation in arch perimeter in the maxillary arch. In the mandibular arch, inter-molar width, inter-canine width, and arch length explained 55.1% of the variation in the dental arch perimeter. The arch perimeter values predicted from the developed equations were not significantly different from the actual values that were measured. CONCLUSION: New regression equations based on dental arch width and length at the level of the premolars, molars, and canines were developed to predict dental arch perimeters for both the mandibular and maxillary arches.