Orthodontic

To investigate the short-term optical, chemical and morphological changes in Invisalign appliances. One 'as-received' Invisalign aligner, one 'as-received' Invisalign aligner immersed in artificial saliva for 14 days and 10 Invisalign aligners worn by 10 randomly selected patients for 14 days were used. Fourier'transform infra-red microspectroscopy was used to characterise any molecular changes on the surfaces of the appliances, spectrophotometry was used to evaluate any changes in colour and transparency, scanning electron microscopy and energy dispersive X-ray microanalysis were used to examine the surface morphology and elemental composition of deposits on the surfaces of the aligners and gas chromatography-mass spectrometry was used to identify substances released from the aligners into the artificial saliva. Aligners worn for 14 days had microcracks, abraded and delaminated areas, localised calcified biofilm deposits and loss of transparency. Monomers and/or...

Papageorgiou SN, G€ olz L, Jäger A, Eliades T, Bourauel C. Lingual vs. labial fixed orthodontic appliances: systematic review and meta-analysis of treatment effects. Eur J Oral Sci 2016; 00: 000–000. © 2016 Eur J Oral Sci The aim of this systematic review was to compare the therapeutic and adverse effects of lingual and labial orthodontic fixed appliances from clinical trials on human patients in an evidence-based manner. Randomized and prospective non-randomized clinical trials comparing lingual and labial appliances were included. Risk of bias within and across studies was assessed using the Cochrane tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Random-effects meta-analyses were conducted, followed by subgroup and sensitivity analyses. Six electronic databases were searched from inception to July 2015, without limitations. A total of 13 papers pertaining to 11 clinical trials were included with a total of 407 (34% male/66% female) patients. Compared with labial appliances, lingual appliances were associated with increased overall oral discomfort , increased speech impediment (measured using auditory analysis), worse speech performance assessed by laypersons, increased eating difficulty, and decreased intermolar width. On the other hand, lingual appliances were associated with increased intercanine width and significantly decreased anchorage loss of the maxillary first molar during space closure. Based on existing trials, there is insufficient evidence to make robust recommendations for lingual fixed orthodontic appliances regarding their therapeutic or adverse effects, as the quality of evidence was low.

Background: Although the headgear appliance has been used extensively to correct anteroposterior discrepancies, its treatment effects have not yet been adequately assessed in an evidence-based manner. Objective: Aim of this systematic review was to assess the therapeutic and adverse effects of early headgear treatment from controlled clinical trials on human patients in an evidence-based manner. Search methods: An unrestricted electronic search of six databases from inception to December 2015. Selection criteria: Randomized and prospective non-randomized controlled trials assessing the effects of headgear treatment on human patients. Data collection and analysis: After duplicate study selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, random-effects meta-analyses of mean differences (MDs) and relative risks (RRs), including their 95% confidence intervals (CIs) were performed, followed by subgroup and sensitivity analyses. Results: A total of 18 unique studies with a total of 930 (56% male/44% female) patients were included. Headgear treatment was associated with a posterior translation of the anterior maxilla border in the short term, as seen by the mean annualized change in the SNA angle (MD = −1.63°/ year; 95% CI = −2.20 to −1.06°/year; high quality evidence) compared to untreated patients. This effect was independent of the rotation of the palatal plane and the inclination of the upper incisors, while a proportional relationship with the initial discrepancy in SNA was seen. The clinical significance of this improvement diminished in the long term, although only limited evidence existed. Additionally, early headgear treatment might decrease the risk of dental trauma during the following years (RR = 0.34; 95% CI = 0.14 to 0.80; moderate quality evidence). Low quality evidence on the effect of headgear on the rotation of the palatal plane, the nasolabial angle, the occlusal outcome, and signs of temporomandibular disorders precluded robust assessments, due to risk of bias, inconsistency, imprecision, and small-study effects. Conclusions: Based on existing trials, headgear is a viable treatment option to modify sagittal growth of the maxilla in the short term in Class II patients with maxillary prognathism. Registration: PROSPERO (CRD42015029837). Funding: None.

Alumina has received considerable attention and has been historically well-accepted as biomaterials for dental and medical applications. This article reviews the applications of this material in dentistry. It presents a brief history, dental applications and methods for improving the mechanical properties of alumina-based materials. It also offers perspectives on recent research aimed at the further development of alumina for clinical uses, at their evaluation and selection, and very importantly, their clinical performance. This article also stated about the Functionally Graded Materials (FGMs) which has been conceived as a new material design approach to improve performance compared to traditional homogeneous and uniform materials. This technique allows the production of a material with very different characteristics within the same material at various interfaces. The importance of the FGM concept in biological applications and functions was highlighted. Fundamentally, the combination of mechanical properties and biocompatibility are very important factors in application of any biomaterial to medical or dental fields. The characteristics of the surface govern the biocompatibility of the material, and the mechanical strength is determined by the average mechanical strength of the materials. However, the fabrication of FGMs is most often hindered by the variation of elastic, plastic, thermal, chemical, and kinetic properties within the composite. Across a material interface, these discontinuities in material properties lead to the formation of residual stresses. Despite these challenges, compositional gradient structures offer significant benefits. Notable research literature is highlighted regarding (1) applications of alumina in various fields in dentistry; (2) improvement of the mechanical properties of alumina by microstructural manipulation, FGM as well as composite formulations involving metallic, intermetallic elements and bioceramics.

Background: Permanent canines are amongst the teeth most affected by impaction and ectopic eruption. Although impacted canines are often subjected to surgical exposure and alignment with either the open or the closed technique for many decades, their treatment effects have not yet been systematically asssessed. Objectives: The aim of this systematic review was to critically assess whether significant differences exist in the outcomes of the open or closed surgical exposure of impacted canines. Search methods: An unrestricted electronic search of nine databases from inception to December 2016 was performed. Selection criteria methods: Included were randomized or prospective non-randomized studies comparing open versus closed exposure of impacted canines in human patients. Data collection and analysis: After duplicate study selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, random-effects meta-analyses of mean differences (MDs) and odds ratios (ORs), including their 95 per cent confidence intervals (CIs) were performed, followed by subgroup and sensitivity analyses. Results: A total of eight unique studies and a total of 433 (30.1% male/59.9% female) patients were included, with an average age of 15.2 years and a total of 453 impacted canines (48.6% and 51.4% in the open and closed exposure, respectively). Open exposure of impacted canines was associated with reduced duration of canine alignment (two studies; MD = –2.14 months; 95% CI = –4.23 to –0.05 months; P < 0.05; moderate heterogeneity and moderate quality) and lower odds of tooth ankylosis (one study; OR = 0.15; 95% CI = 0.03–0.83; P < 0.05; low quality) compared to closed exposure; both findings being independent of canine localization. However, initial alignment of palatally impacted canines took overall significantly longer than labially impacted canines (8.87 versus 4.17 months). Conclusions: Based on existing evidence, open surgical exposure seems to be superior in treatment duration and ankylosis risk over the closed technique. Due to the limited number of small included trials, further research is needed for robust clinical recommendations. Registration: PROSPERO (CRD42016051916).

Abstract
Purpose Although several prescriptions and techniques exist for comprehensive fixed appliance treatment, their treatment effects have not yet been adequately assessed in an evidence-based manner. The aim of this systematic review was to assess the therapeutic and adverse effects of various prescriptions or techniques for orthodontic appliances from randomized clinical trials on human patients.
Methods Eight databases were searched up to July 2016 for randomized trials assessing any orthodontic prescriptions or techniques in human patients. After elimination of duplicate studies, data extraction, and risk of bias assessment according to the Cochrane guidelines, random effects meta-analyses with mean differences (MD) and their 95% confidence intervals (CIs) were performed.
Results Compared to Roth preadjusted appliances, both Begg and modified Begg appliances were associated with statistically significantly worse occlusal outcome assessed with Peer Assessment Review (PAR) scores (1 trial, MD 3.1 points, 95% CI 1.9–4.3 points and 1 trial, MD 2.4 points, 95% CI 1.2–3.6 points, respectively) with low quality of evidence, due to bias and imprecision. Compared to a partially programmed fixed orthodontic appliance, a fully programmed appliance was associated with a statistically significant, but clinically irrelevant increase in treatment duration (1 trial, MD 2.4 months, 95% CI 0.6–4.2 months), supported by high quality of evidence. However, caution is needed in the interpretation of these results as only a limited number of small trials with methodological issues were available.
Conclusions Based on existing trials, there is limited evidence to support any robust clinical recommendation
regarding the prescriptions or techniques for fixed orthodontic appliances.
Registration: PROSPERO (CRD42016042727).
Funding: None.

Review Soft tissue changes following extraction vs. nonextraction orthodontic fixed appliance treatment: a systematic review and meta-analysis Konstantonis D, Vasileiou D, Papageorgiou SN, Eliades T. Soft tissue changes following extraction vs. nonextraction orthodontic fixed appliance treatment: a systematic review and meta-analysis. Eur J Oral Sci 2018; 00: 1–13. © 2018 Eur J Oral Sci The aim of this systematic review was to assess the effect of systematic extraction protocols during orthodontic fixed appliance treatment on the soft tissue profile of human patients. Nine databases were searched until December 2016 for controlled clinical studies including premolar extraction or nonextraction treatment. After elimination of duplicate studies, data extraction, and risk-of-bias assessment according to the Cochrane guidelines, random-effects meta-analyses of mean differences (MD) or standardized mean differences (SMD) and their 95% CIs were performed, followed by subgroup, meta-regression, and sensitivity analyses. Extraction treatment was associated with increased lower lip retraction (24 studies; 1,456 patients; MD = 1.96 mm), upper lip retraction (21 studies; 1,149 patients; MD = 1.26 mm), nasolabial angle (21 studies; 1,089 patients; MD = 4.21°), soft-tissue profile convex-ity (six studies; 408 patients; MD = 1.24°), and profile pleasantness (three studies; 249 patients; SMD = 0.41). Patient age, extraction protocol, and amount of upper incisor retraction during treatment were significantly associated with the observed extraction effects, while the quality of evidence was very low in all cases due to risk of bias, baseline confounding, inconsistency, and imprecision. Although tooth extractions seem to affect patient profile, existing studies are heterogenous and no consistent predictions of profile response can be made.

Objectives Aim of this systematic review was to assess the effect of orthodontic treatment with fixed appliances on the tooth color of patients. Methods Nine databases were searched up to May 2017 for clinical cohort studies on the effect of fixed appliance treatment on tooth color. After elimination of duplicate studies, data extraction, and risk of bias assessment according to the Cochrane guidelines, random effects meta-analyses of mean differences (MD) or means and their 95% confidence intervals (CIs) were performed, followed by GRADE (Grading of Recommendations Assessment, Development and Evaluation) assessment of the quality of evidence. Results Three nonrandomized and one randomized study with a total of 138 patients (46% male, 54% female) with average age of 15.7 years were included. Tooth color of treated patients was significantly altered during or after orthodontic treatment (4 studies; average of 3.2 E units; 95% CI = 2.0–4.4 E units), which was more than the variation among controls (1 study; MD = 1.9 E units; 95% CI = 1.7–2.2 E units). However, the quality of evidence was very low, due to the inclusion of nonrandomized studies, bias, and imprecision. Re-analysis of raw study data indicated that significant differences in clinically discernable treatment-induced color changes were seen between chemically and light-cured adhesives and among the various tooth categories. Conclusion Existing evidence of very low quality indicates that orthodontic treatment might be associated with alterations of tooth color, which are however not consistently clinically discernible. Treatment-induced color alterations might be dependent on bonding material and tooth type, but evidence supporting this is weak.

Introduction: Aim of this study was to assess the registration of orthodontic systematic reviews in PROSPERO. Method: Seven databases were searched for orthodontic systematic reviews published in 2012-2016. After duplicate study selection and data extraction, descriptive statistics, followed by chi-square/Fisher exact tests were calculated. Finally, bivariable/multivariable regression with relative risks (RR) and 95% confidence intervals (CIs) was used. Results: A total of 182 orthodontic systematic reviews were identified, 37 (20.3%) of which were registered in PROSPERO, with registration rates ranging from 4.3% in 2012 to 37.0% in 2016. Differences in review registration were found according to publication year, geographic origin, multicentre status, funding, and journal category. After controlling for confounders, each additional year was associated with increased registration probability (RR = 1.51; 95% CI = 1.19– 1.93). Reviews from South America were more likely to be registered than reviews from Europe (RR = 1.49; 95% CI = 1.06–2.11). Finally, reviews published in orthodontic specialty journals were more likely to be registered than reviews in general dentistry journals (RR = 1.87; 95% CI = 1.02– 3.49). Conclusions: A small percentage of orthodontic systematic reviews was registered a priori, although improvement signs have been seen since the initiation of PROSPERO.

Background: Although Rapid Maxillary Expansion (RME) has been used for over a century, its effect on upper airways has not yet adequately been assessed in an evidence-based manner. Objective: To investigate the volumetric changes in the upper airway spaces following RME in growing subjects by means of acoustic rhinometry, three-dimensional radiography and digital photogrammetry. Search methods: Literature search of electronic databases and additional manual searches up to February 2016. Selection criteria: Randomized clinical trials, prospective or retrospective controlled clinical trials and cohort clinical studies of at least eight patients, where the RME appliance was left in place for retention, and a maximum follow-up of 8 months post-expansion. Data collection and analysis: After duplicate data extraction and assessment of the risk of bias, the mean differences and 95 per cent confidence intervals (CIs) of upper airway volume changes were calculated with random-effects meta-analyses, followed by subgroup analyses, meta-regressions, and sensitivity analyses. Results: Twenty studies were eligible for qualitative synthesis, of which 17 (3 controlled clinical studies and 14 cohort studies) were used in quantitative analysis. As far as total airway volume is concerned patients treated with RME showed a significant increase post-expansion (5 studies; increase from baseline: 1218.3 mm 3 ; 95 per cent CI: 702.0 to 1734.6 mm 3), which did not seem to considerably diminish after the retention period (11 studies; increase from baseline: 1143.9 mm 3 ; 95 per cent CI: 696.9 to 1590.9 mm 3). Limitations: However, the overall quality of evidence was judged as very low, due to methodological limitations of the included studies, absence of untreated control groups, and inconsistency among studies. Conclusions: RME seems to be associated with an increase in the nasal cavity volume in the short and in the long term. However, additional well-conducted prospective controlled clinical studies are needed to confirm the present findings.

To compare palatal height index, arch width, and arch length characteristics in Iranian patients presenting with palatal and buccal canine impaction with a matched control group. The casecontrol study examined 53 patients with canine impaction. The subjects were divided into two groups determined by buccal or palatal impaction which were compared with 53 control subjects presenting without impaction. Subjects in the experimental groups were matched with individuals in the control group according to age, gender, crowding and type of malocclusion. Palatal height and arch length were measured with a Korkhaus three-dimensional divider. Arch width was determined in the anterior and posterior portions of the maxillary arch with a digital caliper. Data were compared with paired t-tests. The buccal canine impaction group exhibited mean differences in arch length between the case and control groups of 0.8 mm (SD 1.63, p = 0.041). The differences between the case and control groups in intermo...

Obesity is a widespread chronic inflammatory disorder characterized by an increased overall disease burden and significant association with periodontitis. The aim of this prospective clinical cohort study was to investigate the effect of obesity on orthodontic tooth movement. Fifty-five adolescent patients (27 males, 28 females) with a mean (SD) age of 15.1 (1.7) years and mean (SD) body mass index (BMI) of 30.2 (3.5) kg/m2 in obese and 19.4 (2.2) kg/m2 in normal-weight groups were followed from start of treatment to completion of tooth alignment with fixed orthodontic appliances. Primary outcome was time taken to complete tooth alignment, while secondary outcomes included rate of tooth movement and change in clinical parameters (plaque/gingival indices, unstimulated whole-mouth salivary flow rate, gingival crevicular fluid biomarkers). Data collection took place at baseline (start of treatment: appliance placement), 1 h and 1 wk following appliance placement, and completion of alignment. Results were analyzed by descriptive statistics followed by generalized estimating equation regression modeling. There were no significant differences between groups in time taken to achieve tooth alignment (mean [SD] 158.7 [75.3] d; P = 0.486). However, at 1 wk, initial tooth displacement was significantly increased in the obese group ( P < 0.001), and after adjusting for confounders, obese patients had a significantly higher rate of tooth movement compared with normal-weight patients (+0.017 mm/d; 95% confidence interval, 0.008-0.025; P < 0.001) over the period of alignment. Explorative analyses indicated that levels of the adipokines leptin and resistin, the inflammatory marker myeloperoxidase (MPO), and the cytokine receptor for nuclear factor kappa-B ligand (RANKL) were significantly different between obese- and normal-weight patients and associated with observed rates of tooth movement. This represents the first prospective data demonstrating a different response in obese patients compared with normal-weight patients during early orthodontic treatment. These differences in the response of periodontal tissues to orthodontic force in the presence of obesity have potential short- and long-term clinical implications.

Objective: The aim of this systematic review was to assess the occlusal outcome and duration of fixed orthodontic therapy from clinical trials in humans with the Objective Grading System (OGS) proposed by the American Board of Orthodontics. Methods: Nine databases were searched up to October 2016 for prospective/ retrospective clinical trials assessing the outcomes of orthodontic therapy with fixed appliances. After duplicate study selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, random-effects meta-analyses of the mean OGS score and treatment duration were performed and 95% confidence intervals (CIs) were calculated. Results: A total of 34 relevant clinical trials including 6,207 patients (40% male, 60% female; average age, 18.4 years) were identified. The average OGS score after treatment was 27.9 points (95% CI, 25.3–30.6 points), while the average treatment duration was 24.9 months (95% CI, 24.6–25.1 months). There was no significant association between occlusal outcome and treatment duration, while considerable heterogeneity was identified. In addition, orthodontic treatment involving extraction of four premolars appeared to have an important effect on both outcomes and duration of treatment. Finally, only 10 (39%) of the identified studies matched compared groups by initial malocclusion severity, although meta-epidemiological evidence suggested that matching may have significantly influenced their results. Conclusions: The findings from this systematic review suggest that the occlusal outcomes of fixed appliance treatment vary considerably, with no significant association between treatment outcomes and duration. Prospective matched clinical studies that use the OGS tool are needed to compare the effectiveness of orthodontic appliances. [Korean J Orthod 2017;47(6):401-413]

Background: Torque of the maxillary incisors is crucial to occlusal relationship and esthetics and can be influenced by many factors. The aim of this study was to assess the relative influence of the material of the orthodontic appliance (adhesive, bracket, ligature, and wire) on tooth displacements and developed stresses/strains after torque application. Methods: A three-dimensional upper right central incisor with its periodontal ligament (PDL) and alveolus was modeled. A 0.018-in. slot discovery® (Dentaurum, Ispringen, Germany) bracket with a rectangular 0.018 x 0.025-in. wire was generated. The orthodontic appliance varied in the material of its components: adhesive (composite resin or resin-modified glass ionomer cement), bracket (titanium, steel, or ceramic), wire (beta-titanium or steel), and ligature (elastomeric or steel). A total of 24 models were generated, and a palatal root torque of 5° was applied. Afterwards, crown and apex displacement, strains in the PDL, and stresses in the bracket were calculated and analyzed.

Effect of long-term orthodontic treatment on salivary nickel and chromium has not been quite assessed except in few retrospective studies with controversial results. The aim of this prospective study was to measure salivary levels of these ions during 1 year of orthodontic treatment. Saliva samples were collected from 20 orthodontic patients, before treatment (control) and 6 and 12 months later. Nickel and chromium concentrations were determined using atomic absorption spectrophotometry. Data were analyzed using one- and two-way repeated-measures ANOVA, Bonferroni, Friedman (α = 0.05), and Wilcoxon signed-ranks tests (α = 0.016). Average nickel level changed from 9.75 ± 5.02 to 10.37 ± 6.94 and then to 8.32 ± 4.36 μg/L in 1 year. Average chromium concentration changed from 3.86 ± 1.34 to 4.6 ± 6.11 and then to 2.04 ± 1.66 μg/L. Alterations in nickel values were not statistically significant [P = 0.468 (ANOVA)], but fluctuations in chromium levels were [P = 0.021 (Friedman)]. The dec...

Background: The aim of this study was to compare the torque efficacy of square and rectangular wires in
0.018- and 0.022-in. conventionally ligated brackets.
Methods: Brackets of the same prescription were evaluated in both slot dimensions. Identical acrylic resin
models of the maxilla were bonded with the brackets and mounted on the Orthodontic Measurement and
Simulation System. Ten 0.018 × 0.018 in., 0.018 × 0.022 in., and 0.018 × 0.025 in. stainless steel wires were
evaluated in the 0.018-in. brackets and ten 0.019 × 0.019 in., 0.019 × 0.025 in., and 0.019 × 0.026 in. stainless
steel wires were evaluated in the 0.022-in. brackets. A 15° buccal root torque was gradually applied to the
right central incisor bracket, and the moments were recorded at this position. One-way ANOVA was applied
for both bracket slot sizes along with post hoc analysis for the various archwire sizes.
Results: The mean measured moments varied between 10.78 and 30.60 Nmm among the assessed wire-and-bracket
combinations. Both square and rectangular archwires in the 0.018-in. bracket system exerted statistically significantly
higher moments in comparison with their counterparts in the 0.022-in. bracket system. Rectangular archwires exerted
statistically significantly higher moments than square archwires, both for the 0.018- and the 0.022-in. bracket system.
Conclusions: Rectangular archwires seem to be more efficient in torque exertion, especially in 0.018-in. brackets.

Objectives: To compare the failure pattern of four different bracket types and to assess its effect on treatment duration. Materials and Methods: A total of 78 white patients (28 male, 50 female) with a mean age of 12.6 years were included in this retrospective cohort study and treated for a mean period of 30.6 months. The patients were treated in a private practice with stainless steel conventionally ligated brackets, ceramic conventionally ligated brackets, stainless steel self-ligating brackets, or nickel-free self-ligating brackets. The loss of at least one bracket during the course of treatment was analyzed with Cox proportional hazards survival analyses and generalized linear regression. Results: The overall bracket failure rate at the tooth level was 14.1% (217 brackets), with significant differences according to tooth type (between 8.0%–23.4%) and bracket type (between 11.2%–20.0%). After taking confounders into account, patients treated with ceramic brackets lost more brackets (hazard ratio ¼ 1.62; 95% confidence interval ¼ 1.14–2.29; P ¼ .007) than patients with stainless steel brackets. On average, treatment time increased by 0.6 months (95% confidence interval ¼ 0.21–1.05; P ¼ .004) for each additional failed bracket. Conclusions: Bracket failure was more often observed with ceramic brackets and was associated with increased treatment duration. (Angle Orthod. 0000;00:000–000.)

+5 0 +5 0 +8 0 +8 0 +6 0 +6 0 Key 2-Crown Angulation Relation Key 2-Crown Angulation Relation • Crown angulation (tip) Normal occlusion is dependent upon proper distal crown tip, especially of the upper ant. teeth (longest crowns). Degree of tip of incisors, determines the amount of MD space they consume & has a considerable effect on post. occlusion as well as ant. esthetics.

A priori registration of randomized clinical trials is crucial to the transparency and credibility of their findings. Aim of this study was to assess the frequency with which registered and completed randomized trials in orthodontics are published. We searched ClinicalTrials.gov and ISRCTN for registered randomized clinical trials in orthodontics that had been completed up to January 2017 and judged the publication status and date of registered trials using a systematic protocol. Statistical analysis included descriptive statistics, chi-square or Fisher exact tests, and Kaplan-Meier survival estimates. From the 266 orthodontic trials registered up to January 2017, 80 trials had been completed and included in the present study. Among these 80 included trials, the majority (76%) were registered retrospectively, while only 33 (41%) were published at the time. The median time from completion to publication was 20.1 months (interquartile range: 9.1 to 31.6 months), while survival analysis indicated that less than 10% of the trials were published after 5 years from their completion. Finally, 22 (28%) of completed trials remain unpublished even after 5 years from their completion. Publication rates of registered randomized trials in orthodontics remained low, even 5 years after their completion date.

Patients of Dr. Hutta were generally impressed and gave good reviews for the “honest, skilled” dentist, the “no hidden or extra costs with services”, and the “friendly, helpful” front desk staff and assistants. Other patients gave praise for “how they’re always on time”, the “professional, always happy and helpful” staff and assistants, and the convenient office hours and location.

Introduction: Biomechanical analysis of orthodontic tooth movement is complex, as many different
tissues and appliance components are involved. The aim of this finite element study was to assess
the relative effect of material alteration of the various components of the orthodontic appliance on
the biomechanical behaviour of tooth movement.
Methods: A three-dimensional finite element solid model was constructed. The model consisted
of a canine, a first, and a second premolar, including the surrounding tooth-supporting structures
and fixed appliances. The materials of the orthodontic appliances were alternated between: (1)
composite resin or resin-modified glass ionomer cement for the adhesive, (2) steel, titanium,
ceramic, or plastic for the bracket, and (3) β-titanium or steel for the wire. After vertical activation
of the first premolar by 0.5 mm in occlusal direction, stress and strain calculations were performed
at the periodontal ligament and the orthodontic appliance.
Results: The finite element analysis indicated that strains developed at the periodontal ligament
were mainly influenced by the orthodontic wire (up to +63 per cent), followed by the bracket (up to
+44 per cent) and the adhesive (up to +4 per cent). As far as developed stresses at the orthodontic
appliance are concerned, wire material had the greatest influence (up to +155 per cent), followed
by bracket material (up to +148 per cent) and adhesive material (up to +8 per cent).
Limitations: The results of this in silicostudy need to be validated by in vivostudies before they
can be extrapolated to clinical practice.
Conclusion: According to the results of this finite element study, all components of the orthodontic
fixed appliance, including wire, bracket, and adhesive, seem to influence, to some extent, the
biomechanics of tooth movement.

The variable prescription is widely described under the clinical aspect: the clinics is the result of the evolution of the state-of-the-art, aspect that is less considered in the daily literature. The state-of-the-art is the key to understand not only how we reach where we are but also to learn how to manage propely the torque, focusing on the technical and biomechanical purpos-es that led to the change of the torque values over time. The aim of this study is to update the clinicians on the aspects that affect the torque under the biomechanical sight, helping them to understand how to managing it, following the “timeline changes” in the different techniques so that the Variable Prescription Orthodontic (VPO) would be a suitable tool in every clinical case.

Introduction: The aim of this study was to examine the effect of Allium sativum (garlic) extract on the biofi lm formation by Streptococcus mutans on the surface of orthodontic mini-implants. Materials and Methods: Three brands (Dentos, Forestadent and Hubit) of titanium mini-implants were used as samples, which were divided into four groups each containing S. mutans along with four different concentrations of garlic extract-0 mg/ml, 16 mg/ml, 32 mg/ml, 64 mg/ml and 1 mini-implant from each of the three brands. The amount of viable S. mutans bacteria, as well as its biofi lm formation on the surface of mini-implants was determined quantitatively as well as qualitatively using microbial viability assay, electron dispersive X-ray spectroscopy and scanning electron microscopy analysis. ANOVA test was done. Results: 32 mg/ml and 64 mg/ml concentration of garlic extract showed a considerable antimicrobial effi cacy against S. mutans and effectively prevented the biofi lm formation by S. mutans on the surfaces of all the mini-implants with 32 mg/ml being the lowest effective concentration of garlic extract to prevent S. mutans biofi lm formation and 64 mg/ml being the most potent concentration. Conclusion: Garlic extract can be a promising alternative to other chemical agents used in mouthwashes to prevent bacterial biofi lm formation on the surface of orthodontic mini-implants and can thus help in the reduction of mini-implant failure due to biofi lm formation. It has a potential to serve as a herbal substitute to chlorhexidine, which has been shown to exhibit several side-effects during long-term use.

fine details like in Intraorals; reduced sharpness (due to increased object-film distance). •Proximal surfaces of premolar overlap. •Uneven magnification and geometric distortion. •Clinically important objects may be outside focal trough and therefore may be distorted or not imaged at all.

Objective: To determine if text messaging reminders regarding intra oral elastic wear have any influence on the level of compliance in an orthodontic population. Materials & Methods: Eighty orthodontic patients were considered out of which 40 patients (20 Males & 20 Females) were assigned to a text message group (Study Group) & 40 patients (20 Males & 20 Females) were assigned to a Non-text message group (Control group), who did not receive a reminder text message. Message was sent once daily for a period of one month. The participants were given a fixed number of elastics (60 per patient) at the start of the study and were asked to collect used elastics for the period of one month and counts of these were used to assess compliance. Results: Compliance with elastic wear had significant difference among patients. Female patients proved to be more compliant compared to males in both the groups. The study group returned more number of used elastics than the control group, suggesting increased compliance. Conclusion: A text message reminder system explaining the importance of wearing Intra-oral elastics sent to patients once daily is an effective way to improve compliance in orthodontic patients.

It has been claimed that the opus loop is capable of delivering a constant and optimum M/F ratio without the need for gable bends. To compare the forces, moments and moment/force (M/F) ratios of the opus loop, L-loop, T-loop and vertical helical closing loop (VHC loop) in a segmented arch with the finite element method (FEM). The FEM was used to compare 3D models of closing loops in rectangular (0.016 x 0.022 inch) stainless steel wire. The L-, T- and VHC loops were designed with and without preactivation bends. The opus loop had no preactivation bends. The T-Loops were 10 mm in height and 10 mm in length. The horizontal and vertical forces, the moments and the M/F ratios at the alpha and beta ends were recorded at 0, 0. 1, 0.4, 0.7 and 1 mm intervals. The highest horizontal and vertical forces were produced by the L-loop (with and without preactivation bends) and in most cases the lowest forces were produced by the VHC loop. Loops with preactivation bends produced marked changes in...

Introduction: Torque of the maxillary incisors is essential in esthetics and proper occlusion, while torque expression is influenced by many factors. The aim of this finite element study was to assess the relative effect of tooth morphology, bracket prescription, and bracket positioning on tooth displacement and developed stresses/strains after torque application. Methods: A three-dimensional upper right central incisor with its periodontal ligament (PDL) and alveolus was modelled. The tooth varied in the crown–root angle (CRA) between 156°, 170°, and 184°. An 0.018-inch slot discovery® (Dentaurum, Ispringen, Germany) bracket with a rectangular 0.018 × 0.025-inch β-titanium wire was modelled. Bracket torque prescription varied between 0°, 12°, and 22°, with bracket placement at the centre of the middle, gingival or incisal third of the crown. A total of 27 models were generated and a buccal root torque of 30° was applied. Afterwards, crown and apex displacement, strains in the PDL, and stresses in the bracket were calculated and analysed statistically. Results: The palatal crown displacement was significantly affected by bracket positioning (up to 94 per cent), while the buccal apex displacement was significantly affected by bracket prescription (up to 42 per cent) and bracket positioning (up to 23 per cent). Strains in the PDL were affected mainly by CRA (up to 54 per cent), followed by bracket positioning (up to 45 per cent). Finally, bracket prescription considerably affected the stresses in the bracket (up to 144 per cent). Limitations: These in silico results need to be validated in vivo before they can be clinically extrapolated. Conclusion: Tooth anatomy and the characteristics of the orthodontic appliance should be considered during torque application.

Background and objectives

As the most common complication of orthodontic treatment, pain can negatively impact quality of life and cause patients to discontinue treatment. However, few studies have evaluated pain during orthodontic treatment, with controversial findings. This study assessed the intensity and duration of pain and discomfort caused by active orthodontic treatment.
Methods

This descriptive cross-sectional study examined 67 patients (22 men, 45 females; age range: 18–32 years) undergoing fixed orthodontic treatment. Patients were interviewed after the active treatment stage to assess their perceived pain and discomfort at different sites during different activities by a visual analogue scale. Frequency and duration of pain in different areas were analyzed by the chi-squared and chi-squared goodness-of-fit tests (α = 0.05).
Results

Among the 67 patients, 65.7% experienced general dentogingival pain or discomfort and 34.3% had localized dentogingival pain or discomfort (p = 0.010, chi-squared goodness-of-fit test). Masticating soft foods reduced discomfort (p = 0.000, chi-squared) in the tongue, cheeks, and in or around the teeth and gingivae. Pain and discomfort were mostly moderate while masticating sticky, fibrous, and firm foods. Mild pains were mostly reported during tooth brushing and while consuming soft foods (p < 0.05, chi-squared). Pain and discomfort tended to last for more than 4 weeks, except in the tongue, where pain and discomfort lasted less than 4 weeks (p < 0.05, chi-squared goodness-of-fit test).
Conclusions

Pain and discomfort occur for more than 4 weeks after beginning fixed orthodontic treatment. Changing diets to incorporate softer foods is recommended to alleviate pain.
Keywords:
Orthodontic appliances, Tooth movement, Facial pain

Objective: The aim of the present study was to make an evaluation of inter-canine width before and after the stage of levelling and alignment in the mandible using three different orthodontic arch wires. Subjects and methods: Thirty orthodontic patients both males and females were selected and treated by the same researcher. The patients were randomly divided equally into three groups according to the type of wire that was used, so Group A, B and C will be used. Group A, this group included 10 patients treated with (CNA) wire. Group B, this group included 10 patients treated with (Cu NITI) wire. Group C, this group included 10 patients treated with (NITI) wire. Results: The results showed that inter-canine width showed no significance after the finishing of the leveling and alignment stage.

 ABSTRACT  Objective: The aim of this study was to evaluate the effect of Platelet Rich Plasma (PRP) in accelerating tooth movement in adult male subjects. Materials and methods: The sample in this clinical trial study consisted of 18 adult male patients with therapeutic need for extraction of maxillary first premolars and maximum canine retraction. By use of split mouth design on maxilla, after 2months of premolars extraction, the injection of prp was performed randomly on one side of maxilla, and no action was applied on the other side Results: Analysis of the rate of canine retraction between the prp application and control sides shows significant differences during the first and second months. Conclusion: The results of this study showed that PRP technique accelerate the rate of orthodontic tooth movement.

Ingin tampil lebih percaya diri dengan pasang behel gigi atau kawat gigi di Jogja? Disini tempatnya untuk pasang behel gigi di Yogyakarta. Kami melayani pemasangan behel gigi permanen, gigi lepasan, behel gigi metal, behel gigi damon, behel gigi estetik, behel gigi transparan, behel gigi fashion dan behel gigi lain yang aman dan nyaman untuk anak, ibu hamil, orang tua, dan orang dewasa. Siap melayani masyarakat Piyungan, Berbah, Prambanan, Kalasan, Patuk, Dlingo, Banguntapan, Bantul, Sleman, Wonosari, Wates, Jogja, dan sekitarnya. Kami siap melayani pemasangan behel sesuai kebutuhan Anda dengan ditangani oleh dokter gigi dan perawat gigi terbaik dan kompeten.

Pregnancy is a special period in a woman's life, during which the restructuring of all its organs and systems of the body happens. Every year increases the number of women aged 18-35 years, looking to cosmetic dentistry to improve the aesthetic aspects of their smile and, in particular, as the most gentle approach of orthodontic treatment. But due to the extended length of orthodontic treatment, this group is in the range with the greatest probability of occurrence of pregnancy and then treatment coincides with the period of pregnancy. How reasonable this decision is and what features should take into account the doctor, we discussed in detail in a previous article " Features of orthodontic treatment during pregnancy ". Today, we will answer the question-what method of orthodontic treatment is preferred during pregnancy. Eventually opinions about orthodontic treatment in pregnancy change. Previously, an obstetrician-gynecologist would advise not to start treatment until the completion of periods of pregnancy and early and late postpartum in order to avoid possible risks. But modern technology called offer an alternative that significantly reduces these risks. In the study of materials, dispensary books of pregnant, and based on their own experience of orthodontic treatment, came to the idea of a clear advantage of new technologies correction of bite in front of the old as modern methods of orthodontic treatment to help avoid the problems that arise in the treatment of classical methods. First of all, let's understand what are the ways to align teeth. In traditional orthodontic braces are used, as well as quite new district today clear aligners. Bracket system is a non-removable device, which is mounted on the inside or the outside of the teeth for the entire period of treatment to obtain a correct bite. One bracket is glued (exclusive lock) on each tooth defining the direction. Locks are interconnected orthodontic arch that serves as a source of strength for the movement of dentition. Whatever forms the arc has not accepted, and whatever obstacle is standing in front of her, it always strives to return to its original state and thus aligns the teeth. The most important disadvantage is that the braces are very visible, even worse, they give the person a sense of embarrassment and insecurity. Also do not forget about the shortcomings such as pain and constant discomfort. Besides the obvious aesthetic shortcomings, it is important to identify the most important clinical aspect-hindered oral hygiene is especially important during pregnancy. Studies show that pregnant women are more likely to suffer from gingivitis, caused by the accumulation of plaque on the tooth surfaces, which leads to inflammation of the gums. The symptoms of this disease are redness, inflammation and gum bleeding. Gingivitis occurs during pregnancy less frequently because of elevated levels of hormones in the body to provoke an increased reactivity of the gum in response to stimuli located in plaque. However, the main cause of gingivitis is still flush not hormones.

Autotransplantation of teeth, if carried out successfully, ensures that alveolar bone volume is maintained due to physiological stimulation of the periodontal ligament. Autotransplantation has been carried out for many years, but with varying success rates. As a result, it is seldom regarded as an appropriate treatment option for patients. Autotransplantations of teeth are widely used in cases of severe impactions, early loss of permanent teeth, or congenital aplasia. However, sometimes patients may not have a donor tooth available becaus e o f p r e v i o u s e x t r a c t i o n. To solve such problems, teeth cryopreservation systems have been developed. There are many clinical reports and animal experiments showing the efficacy of teeth cryopreservation. Hence, unnecessary wisdom teeth, supernumerary teeth and healthy premolars extracted by orthodontic treatment should be used as donor teeth for replacing a missing tooth in the future. In this review, the biological properties of cryopreserved teeth, clinical application of missing teeth are discussed.

Objective The aim of this report is to present an interdisciplinary treatment involving periodontics, orthodontics, dental implant placement, and prosthodontics with a fully digital dentistry approach. Clinical Considerations The patient presented with an edentulous ridge on the area of the lower left lateral incisor as well as gingival recession on the adjacent teeth. After performing a digital orthodontic setup and indirect bonding bracket placement, a dental implant placement was carried out before orthodontic treatment in combination with guided bone regeneration (GBR), connective tissue graft (CTG) and periodontal accelerated osteogenic orthodontics (PAOO). In a 6‐month period, orthodontic treatment was fully completed and the dental implant was restored at 8 months. Following one‐and‐a‐half years, significant gingival recession reduction was accomplished and soft tissue augmentation around the dental implant appeared stable with a good functional and esthetic result. Conclusio...

Background: Fluoride content in saliva and dental plaque plays a key role in the prevention and control of dental caries. Fluoride varnish adheres to the tooth surface for longer period and prevents its immediate loss, thus acting as slow-releasing reservoirs. Aim: to evaluate the effect of different fluoride varnishes forms on the level of fluoride ions in saliva and their antibacterial action on streptococcus mutans. Materials and methods: Seventy five school children of age 12-15 years were selected fulfilling inclusion and exclusion criteria and divided into three groups: Group I (Duraphat varnish); Group II (Bifluorid 10) ; Group III (MI varnish). Salivary samples were collected and fluoride ions were recorded at baseline, one, two, 24,48 hours after applications. Salivary streptococcus mutans (CFUs X 10 6) was assessed at baseline and after one, two, three, and four weeks of applications. Results: Statistical significant higher mean values of fluoride ions Group II (Bifluorid 10); Group III (MI varnish) after one, two, 24, 48 hours of applications. Statistical significant reduction was detected in the streptococcus mutans level with the three used varnishes with different levels. Conclusion: After 48hrs of fluoride varnishes application, (MI varnish) fluoride varnish with CPP-ACP was superior to other varnishes to maintain high level of salivary fluoride ions. Fluoride varnish with CPP-ACP and Bifluorid 10 varnishes keep the saliva with low level of cariogenic streptococcus mutans after four weeks of application.