Tempo de tratamento ortodôntico com aparelhos autoligados: revisão de literatura

Introdução: Atualmente, braquetes autoligados têm sido sugeridos para reduzir o tempo de tratamento na Ortodontia. Objetivo: Dessa maneira, o presente estudo objetivou revisar a literatura acerca do tempo de tratamento com esses braquetes, em comparação com outros braquetes e tratamentos sugeridos. Revisão de literatura: Foi realizada pesquisa bibliográfica de caráter descritivo, que compreendeu o levantamento de referencial teórico na base de dados eletrônica Medline ­ PubMed. A seleção de artigos foi feita a partir dos títulos e resumos e a revisão compreendeu 4 artigos publicados na língua inglesa no período de 2019 a 2023. Conclusão: Há uma escassez de estudos clínicos envolvendo essa temática e o tratamento ortodôntico com aparelhos autoligados parece apresentar menor tempo de tratamento em comparação com aparelhos fixos tradicionais. No entanto, os estudos não mostraram diferenças estatisticamente significativas na redução desse tempo. Pode-se sugerir que mais estudos clínicos sejam conduzidos no intuito de elucidar essa questão.

Introduction: Currently, self-ligating brackets have been suggested to reduce treatment time in Orthodontics. Objective: Therefore, the present study aimed to review the literature about the treatment time with these brackets, in comparison with other brackets and suggested treatments. Literature review: Descriptive bibliographical research was carried out, which included the survey of theoretical references in the electronic database Medline ­ PubMed. The selection of articles was made based on titles and abstracts and the review comprised 4 articles published in the English language from 2019 to 2023. Conclusion: there is a shortage of clinical studies involving this topic and orthodontic treatment with self-ligating appliances seems to present shorter treatment time compared to traditional fixed appliances. However, the studies did not show statistically significant differences in reducing this time. It can be suggested that more clinical studies be conducted to elucidate this issue.

Alignment efficiency and three-dimensional assessment of root resorption after alignment with conventional and copper-nickel-titanium archwires: A randomized controlled trial

ABSTRACT Objective: To compare alignment efficiency and root resorption between nickel-titanium (NiTi) and copper-nickel-titanium (CuNiTi) archwires after complete alignment in mandibular anterior region. Methods: In this two-arm parallel single-blind randomized controlled trial, forty-four patients with Class I malocclusion with mandibular anterior crowding were recruited form orthodontic clinic of All India Institute of Medical Sciences (Jodhpur, India). Patients were randomly allocated into NiTi and CuNiTi groups, with a 1:1 allocation. Alignment was performed using 0.014-in, 0.016-in, 0.018-in, 0.019x0.025-in archwire sequence in the respective groups, which terminated in 0.019 x 0.025-in stainless-steel working archwire. The primary outcome was alignment efficiency, measured on study models from baseline (T0) to the first, second, third, fourth and fifth-month (T5). Secondary outcome was root resorption, measured from CBCT scans taken at T0 and T5. Mixed-factorial ANOVA was used to compare Little's Irregularity Index (LII). For assessing the proportion of patients with complete alignment at the end of each month, Kaplan-Meier survival curve was built and time to treatment completion was compared between groups using log rank test. Paired t-test was used to assess external apical root resorption (EARR) within groups, whereas independent t-test was used to evaluate LII and EARR between the groups. Results: Twenty-two patients were recruited in each group. One patient was lost to follow-up in the CuNiTi group. No statistically significant differences were observed in alignment efficiency between the groups (p>0.05). Intergroup comparison revealed that the changes in root measurement in three-dimensions were not statistically significant (p>0.05), except for mandibular right central incisor, which showed increased resorption at root apex in NiTi group (p<0.01). Conclusion: The two alignment archwires showed similar rate of alignment at all time points. Root resorption measurement did not differ between the NiTi and CuNiTi groups, except for the mandibular right central incisor, which showed more resorption in NiTi group.

RESUMO Objetivo: Comparar os fios de níquel-titânio (NiTi) e de cobre-níquel-titânio (CuNiTi) quanto à eficiência do alinhamento e quantidade de reabsorção radicular, após alinhamento completo dos dentes da região anterior inferior. Métodos: Neste estudo clínico randomizado, cego, paralelo, de dois braços, quarenta e quatro pacientes com má oclusão Classe I e apinhamento anterior inferior foram recrutados na clínica ortodôntica do All India Institute of Medical Sciences (Jodhpur, India). Os pacientes foram alocados aleatoriamente nos grupos NiTi e CuNiTi, na proporção de 1:1. O alinhamento foi realizado usando a sequência de fios 0,014", 0,016", 0,018" e 0,019" x 0,025" nos respectivos grupos, finalizando com o arco de trabalho 0,019" x 0,025" de aço inoxidável. O desfecho primário foi a eficiência do alinhamento, medida nos modelos de estudo nos tempos inicial (T0) e após um, dois, três, quatro e cinco meses (T5). O desfecho secundário foi a reabsorção radicular, medida a partir de tomografias computadorizadas realizadas em T0 e T5. ANOVA fatorial mista foi utilizada para comparar o Índice de Irregularidade de Little (IIL). Para avaliar a proporção de pacientes com alinhamento completo ao fim de cada mês, foi construída uma curva de sobrevida pelo método de Kaplan-Meier, e o tempo até o fim do tratamento foi comparado entre os grupos por meio do teste log-rank. Um teste t pareado foi utilizado para avaliar a reabsorção radicular apical externa (RRAE) dentro dos grupos, enquanto um teste t independente foi utilizado para avaliar o IIL e a RRAE entre os grupos. Resultados: Vinte e dois pacientes foram recrutados em cada grupo. Um paciente perdeu o acompanhamento no grupo CuNiTi. Não foram observadas diferenças estatisticamente significativas entre os grupos quanto à eficiência do alinhamento (p>0,05). A comparação intergrupos revelou que as alterações na RRAE medida em três dimensões não foram estatisticamente significativas (p>0,05), exceto para o incisivo central inferior direito, que apresentou aumento da RRAE no grupo NiTi (p<0,01). Conclusão: Os dois tipos de fios de alinhamento apresentaram taxa de alinhamento semelhante em todos os momentos. A medida da reabsorção radicular não diferiu entre o grupo NiTi e CuNiTi, exceto para o incisivo central inferior direito, que apresentou maior reabsorção no grupo NiTi.

Stress distribution in lower second molar mesialization using mini-implants: a pilot study using 3D finite element analysis / Distribuição de tensões na mesialização do segundo molar inferior usando mini-implantes: um estudo piloto usando análise de elementos finitos 3D

Objective: to analyze the stress distribution in a 3D model that simulates second molar mesialization using two different types of mini-implants. Material and Methods: a mandible bone model was obtained by recomposing a computed tomography performed by a software program. The cortical and trabecular bone, a lower second molar, periodontal ligament, orthodontic tube, resin cement and the mini-implants were designed and modeled using the Rhinoceros 4.0 software program. The characteristics of self-drilling orthodontic mini-implants were: one with 7 mm length, 1 mm transmucosal neck section and 1.6 mm diameter and another with 5 mm length and 1.5 mm diameter. A total of 235.161 and 224.505 elements were used for the mesh. These models were inserted into the bone block and then subjected to loads of 200 cN (centinewton). The results were calculated and analyzed by the Ansys 17.0 software program for qualitative verification through displacement and maximum principal stress maps. Results: it was possible to observe that the periodontal ligament presented low displacement and stress values. However, the physiological values presented are among those capable to provide orthodontic movement, with compression and tensile area visualization staggered between 0.1 and -0.1 MPa (megapascal). Conclusion: within the limitations of the study, the mini-implants tested showed similar results where the load on the tooth allowed dental displacement (molar mesialization), with a tendency to rotate it, theoretically allowing the second molar to take the location of the first molar. (AU)

Objetivo: analisar a distribuição de tensões em um modelo 3D que simula a mesialização do segundo molar usando dois tipos diferentes de mini-implantes. Material e Métodos: um modelo de osso mandibular foi obtido por recomposição de uma tomografia computadorizada realizada por um software. O osso cortical e trabecular, um segundo molar inferior, ligamento periodontal, tubo ortodôntico, cimento resinoso e os mini-implantes foram projetados e modelados no software Rhinoceros 4.0. As características dos mini-implantes ortodônticos auto perfurantes foram: um com 7 mm de comprimento, 1 mm de secção transmucosa e 1,6 mm de diâmetro e outro com 5 mm de comprimento e 1,5 mm de diâmetro. Para a malha, foram utilizados 235.161 e 224.505 elementos. Esses modelos foram inseridos no bloco ósseo e então submetidos a cargas de 200 cN (centinewton). Os resultados foram calculados e analisados pelo software Ansys 17.0 para verificação qualitativa por meio de mapas de deslocamento e tensões máximas principais. Resultados: foi possível observar que o ligamento periodontal apresentou baixos valores de deslocamento e tensões. Porém, os valores fisiológicos apresentados são capazes de proporcionar movimentação ortodôntica, com visualização da área de compressão e tração escalonada entre 0,1 e -0,1 MPa (megapascal). Conclusão: dentro das limitações do estudo, os mini-implantes testados apresentaram resultados semelhantes onde a carga sobre o dente permitiu o deslocamento dentário (mesialização do molar), com tendência a girá-lo, permitindo teoricamente que o segundo molar ocupe do lugar do primeiro molar (AU)

Cambios en el pH salival de pacientes con ortodoncia fija, tras la aplicación de dos tipos de enjuagues bucales / Changes in salivary pH in patients with fixed orthodontics following the use of two types of mouthwashes

Introducción: Los enjuagues bucales contribuyen a la inhibición de la formación de la placa bacteriana y, por tanto, pueden ayudar a mantener el pH salival cercano a neutro. Objetivo: Identificar cambios en el pH salival de pacientes portadores de aparatología ortodóncica fija, después del enjuague con una solución de Stevia rebaudiana Bertoni y un enjuague comercial de aceites esenciales. Métodos: Se realizó un experimento clínico con un diseño factorial mixto en pacientes portadores de aparatología ortodóncica fija. Una vez firmado el consentimiento informado, treinta y dos pacientes fueron asignados aleatoriamente a uno de 2 grupos: la solución de S. rebaudiana B. al 2 por ciento o un enjuague comercial de aceites esenciales. Se utilizaron 15 ml de enjuague durante 60 s en todos los pacientes. El pH salival fue medido por dos observadores independientes calibrados, utilizando papel medidor de pH antes del enjuague (medición basal) y después del enjuague, a los 5 y 20 min. Los datos fueron analizados mediante el ANOVA mixto. Resultados: Se encontró una interacción estadísticamente significativa entre el tipo de tratamiento y el momento de medición del pH. Los pH medio de los grupos S. rebaudiana y aceites esenciales fueron respectivamente en la medición basal: 6,61 y 6,52 (p = 0,72); a los 5 min: 7,61 y 7,77 (p = 0,40); y a los 20 min: 7,72 y 6,82 (p < 0,001). Conclusiones: Ambos enjuagues tenían el efecto de aumentar el pH salival a niveles alcalinos a los 5 min, pero solo el enjuague de S. rebaudiana B. al 2 por ciento mantuvo el pH básico a los 20 min(AU)

Introduction: Mouthwashes contribute to the inhibition of bacterial plaque formation and, therefore, may help to maintain salivary pH close to neutral. Objective: To identify changes in salivary pH in patients with fixed orthodontics after using a Stevia rebaudiana Bertoni solution and a commercial essential oil mouthwash. Methods: A clinical experiment with a mixed factorial design was carried out in patients with fixed orthodontic appliances. Once informed consent was signed, thirty-two patients were randomly assigned to one of 2 groups: 2 % S. rebaudiana B. solution or a commercial essential oil mouthwash. Fifteen ml of mouthwash was used for 60 s in all patients. Salivary pH was measured by two independent calibrated observers using pH-measuring paper before rinsing (basal measurement) and after rinsing, after 5 and 20 min. The data were analyzed by mixed ANOVA. Results: A statistically significant interaction was found between the type of treatment and the time of pH measurement. The medium pH of the S. rebaudiana and essential oil groups were respectively as per basal measurement: 6.61 and 6.52 (p = 0.72); after 5 min: 7.61 and 7.77 (p = 0.40); and after 20 min: 7.72 and 6.82 (p < 0.001). Conclusions: Both mouthwashes had the effect of increasing salivary pH to alkaline levels after 5 min, but only the 2 percent S. rebaudiana B. mouthwash maintained the basic pH after 20 min(AU)

Research progress on the relationship between orthodontic treatment and the oral microbiome / 口腔疾病防治

@#With the deepening of research in oral microbiomics, an important relationship between changes in the oral microbiome and orthodontic treatment has been found. Orthodontic treatment will have an impact on the oral and systemic microbiome. The presence of oral appliances can change the quantity and quality of the oral microbiometo and increase the risk of oral and even systemic diseases in patients undergoing orthodontic treatment. Compared with fixed orthodontic treatment, clear aligners will not have a harmful impact on the structure of the oral microbiome, which is more conducive to maintain oral health during the orthodontic treatment process. In addition, different bracket types and materials can lead to different changes in the oral microbiome, and the occurrence and development of orthodontic-related diseases, such as white spot lesions, dental caries, gingivitis and periodontitis, are also related to changes in the oral microbiome. At present, the role of the oral microbiome in the process of orthodontic treatment needs to be further studied. Whether a change in the oral microbiome caused by orthodontic treatment can be restored after orthodontic treatment is still uncertain and needs more research. This paper reviews the research progress on the application of microbiomics in orthodontics, including the impact of fixed appliances and clear aligners on the microbiome and the relationship between orthodontic-related diseases and the oral microbiome.

A double-blinded randomized clinical trial of pain perception during orthodontic treatment / Ensaio clínico randomizado duplo cego de percepção da dor durante tratamento ortodôntico

Introduction: Orthodontic movement can cause painful symptoms, especially in the early stages of treatment. Objective: This study aimed to compare the performance of chewing gum and ibuprofen in pain control during the initial period of orthodontic treatment. Material and method: A randomized blind clinical trial, with an allocation ratio of 1:1, was developed with patients aged ≥18 years old. The sample size was established considering a significance level of 5% and test power of 80%, resulting in a minimum of 30 volunteers per group (n=90). Participants were paired regarding sex, age, the severity of malocclusion, defined by the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN), and crowding, determined by Little's irregularity index. The sample was randomly allocated to three groups: Group I (control) placebo; Group II chewing gum; and Group III Ibuprofen. Pain perception was evaluated by the Visual Analog Scale (VAS) in the first 24, 36, and 48 hours after activation of the orthodontic appliance. The data were analyzed by generalized linear models for repeated measures in time. Result: No statistically significant difference (p>0.05) was observed among the groups for the methods of pain therapy evaluated in 24, 36, and 48 hours post-activation. Conclusion: There was no difference among the method used for pain control during the orthodontic treatment.

Introdução: A movimentação ortodôntica pode causar sintomatologia dolorosa, principalmente nas fases iniciais do tratamento. Objetivo: Este estudo teve como objetivo comparar o desempenho da goma de mascar e do ibuprofeno no controle da dor durante o período inicial do tratamento ortodôntico. Material e método: Foi desenvolvido um ensaio clínico randomizado cego, com razão de alocação de 1:1, com pacientes com idade ≥ 18 anos. O tamanho da amostra foi estabelecido considerando um nível de significância de 5% e poder do teste de 80%, resultando em um mínimo de 30 voluntários por grupo (n=90). Os participantes foram pareados quanto ao sexo, idade, gravidade da má oclusão, definida pelo Componente de Saúde Bucal (DHC) do Índice de Necessidade de Tratamento Ortodôntico (IOTN), e apinhamento, determinado pelo índice de irregularidade de Little. A amostra foi distribuída aleatoriamente em três grupos: Grupo I (controle) placebo; Goma de mascar Grupo II; e Grupo III Ibuprofeno. A percepção da dor foi avaliada pela Escala Visual Analógica (EVA) nas primeiras 24, 36 e 48 horas após a ativação do aparelho ortodôntico. Os dados foram analisados por modelos lineares generalizados para medidas repetidas no tempo. Resultado Não foi observada diferença estatisticamente significativa (p>0.05) entre os grupos para os métodos de terapia da dor avaliados em 24, 36 e 48 horas pós-ativação. Conclusão: Não houve diferença entre o método utilizado para controle da dor durante o tratamento ortodôntico.

Information and Communications Technology in Dentistry: an informative and educational approach for patients with fixed orthodontic appliances

ABSTRACT Objective: To develop and make available, at no cost to the user, Information and Communications Technology (ICT) tools for Dentistry, providing dental information and advice geared toward patients undergoing orthodontic treatment with fixed appliances. Material and Methods: A Dentistry-based content that contemplated information and advice concerning orthodontic treatment with fixed appliances was elaborated. The materials, which included instructions on oral hygiene and treatment strategies when faced with possible complications, were evaluated and validated by specialists, whose assessments reached a 85% approval. From the validated content, products using four distinct ICT tools were formulated. Results: The following technological products were developed: a program for community radios, three blog posts, four educational and informative videos, and a smartphone application - using texts, as well as images and videos. These ICT tools, geared toward patients wearing fixed orthodontic appliances, were made available by internet at no cost to the user, and the number of accesses is already expressive. Conclusion: These technological-scientific tools, developed and provided freely to the population, can aid patients during their treatment with fixed orthodontic appliances, contributing to the dissemination of reliable information, and clarifying doubts that may arise during orthodontic therapy. These free ICT tools serve to facilitate access to scientific knowledge, thereby favoring social inclusion, bearing in mind that this educational and informative material was offered in a simple and accessible manner to the general population.

RESUMO Objetivos: Desenvolver e disponibilizar, gratuitamente, ferramentas de tecnologia da informação e comunicação (TIC) para a Odontologia, abordando informações e orientações direcionadas a pacientes em tratamento ortodôntico com aparelho fixo. Material e Métodos: Foi elaborado um conteúdo que contemplou informações e orientações concernentes ao tratamento ortodôntico com aparelho fixo. O material, que abrangeu instruções sobre higiene bucal e sobre abordagens diante de possíveis intercorrências, foi avaliado e validado por especialistas. A partir do conteúdo validado, foram elaborados produtos utilizando quatro ferramentas distintas de TIC. Resultados: Foram desenvolvidos os seguintes produtos tecnológicos: um programa para rádios comunitárias, três postagens para blog, quatro vídeos educacionais e informativos, e um aplicativo para smartphones, utilizando não apenas textos, mas também imagens e vídeos. Essas ferramentas de TIC direcionadas a pacientes fazendo uso de aparelho ortodôntico fixo foram disponibilizadas gratuitamente via internet, e já contam com expressivo número de acessos. Conclusões: As ferramentas técnico-científicas, desenvolvidas e fornecidas livremente à população, podem auxiliar pacientes durante o tratamento com aparelho ortodôntico fixo, contribuir para disseminar informações confiáveis e esclarecer dúvidas que surgem durante a terapia ortodôntica. Essas ferramentas gratuitas de TIC facilitam o acesso ao conhecimento científico e, consequentemente, favorecem a inserção social, tendo em vista que esse material educacional e informativo foi ofertado de maneira simples e acessível à população.

Alinhadores Ortodônticos Removíveis Versus Aparelhos Ortodônticos Fixos: uma Revisão da Literatura / Removable Orthodontic Aligners Versus Fixed Orthodontic Appliances: a Literarture Review

Com intuito de pontuar os paralelos entre as técnicas ortodônticas com aparelhagem fixa e alinhadores transparentes, este estudo propôs revisar a literatura científica sobre alinhadores ortodônticos removíveis versus aparelhos ortodônticos fixos. Foram selecionados artigos de 2005 a 2021, utilizando as bases de dados PubMed, Scopus, Web of Science, Cochrane Library, Clinical Trials e Opengrey. Os artigos abordavam temáticas como sensação dolorosa, saúde periodontal, higiene, microbiota, reabsorção radicular, qualidade de vida e efetividade do tratamento. Os alinhadores apresentaram maior aceitabilidade pelos pacientes e vantagens claras em relação à dor, higiene, qualidade de vida, reabsorção radicular e saúde periodontal, sendo inferior aos aparelhos ortodônticos fixos na efetividade do tratamento e na interferência na fala.

In order to point out the parallels between orthodontic techniques with fixed appliances and transparent aligners, this study proposed to review the scientific literature on removable orthodontic aligners versus fixed orthodontic appliances. Articles from 2005 to 2021 were selected, using the PubMed, Scopus, Web of Science, Cochrane Library, Clinical Trials and OpenGrey databases. The articles addressed issues such as pain, periodontal health, hygiene, microbiota, root resorption, quality of life and treatment effectiveness. Aligners showed greater acceptability by patients and clear advantages in relation to pain, hygiene, quality of life, root resorption and periodontal health, being inferior to fixed orthodontic appliances in terms of effectiveness and speech capacity.

Adjunctive orthodontic management of a missing upper right central incisor in a 12-year-old male using a fixed orthodontic appliance

This article presents a successful orthodontic management of a 12-year-old male using a fixed orthodontic appliance (straight wire technique). His orthodontic treatment was hinged on creating enough space to accept an artificial tooth, correcting the horizontal and vertical relationships of the upper incisors to the lower and the midline shift. Ultimately, an esthetic smile was achieved; function and self-esteem were improved when the artificial tooth was finally fixed.

Colagem Indireta por Meio de Sistemas CAD/CAM: Descrição da Técnica / Indirect Bonding Using CAD/CAM Systems: Description of the Technique

Com o intuito de obter resultados clínicos cada vez mais precisos nos tratamentos ortodônticos, as novas tecnologias de colagem in- direta têm assumido um papel relevante na Ortodontia. Com o desenvolvimento dos meios de obtenção e manipulação das imagens digitais, surgiu a possibilidade de realizar o planejamento ortodôntico no ambiente virtual, simulando o resultado desejado, bem como o melhor posicionamento dos acessórios ortodônticos nos dentes para atingir esse objetivo. A possibilidade de impressão tridimensional a partir da tecnologia CAD/CAM permitiu que a guia para a transferência dos bráquetes, na colagem indireta, fosse confeccionada diretamente no software após planejamento digital da posição dos mesmos. Atualmente, algumas empresas têm disponibilizado pro- gramas ou ofertado a possibilidade de executar planejamento digital, bráquetes customizados, arcos personalizados e guias para a colagem indireta. Este artigo tem o objetivo de realizar uma revisão de literatura reunindo informações recentes sobre colagem indireta utilizando o sistema CAD/CAM em relação à precisão de colagem e tempo do tratamento ortodôntico. Conclui-se que a colagem indireta por meio de sistemas CAD-CAM apresenta confiabilidade em relação à precisão do posicionamento dos bráquetes.Em relação ao tempo de tratamento, diversos estudos sugerem que este foi reduzido com o método, porém, a variedade de técnicas e softwares existentes, além da diversidade dos métodos científicos, indicam a necessidade de mais investigações. Apesar disso, a colagem indireta digital tem se mostrado uma opção interessante a ser incorporada ao tratamento ortodôntico.

New indirect bonding technologies have assumed an important role in Orthodontics to obtain increasingly accurate clinical results in orthodontic treatments. With the development of means of obtaining and manipulating digital images, the possibility to carry out orthodontic planning in the virtual environment arose, simulating the desired result, as well as the best positioning of orthodontic accessories on teeth to achieve this goal. The possibility of three-dimensional printing using CAD/CAM technology allowed the guide for the transfer of brackets, in indirect bonding, to be made directly in the software after digital planning of their position. Currently, some companies have made programs available or offered the possibility of executing digital planning, customized brackets, personalized arches and guides for indirect bonding. This article aims to perform a literature review, gathering recent information on indirect bonding using the CAD/CAM system in relation to bonding accuracy and time of orthodontic treatment. It is concluded that the indirect bonding using CAD/CAM systems presents reliability in relation to the precision of the positioning of brackets. Regarding the treatment time, several studies suggest that it was reduced with the method, however, the variety of existing techniques and software, in addition to the diversity of scientific methods, indicate the need for further investigations. Despite this, indirect digital bonding has proved to be an interesting option to be incorporated into orthodontic treatment.

Tooth color alteration after debonding in orthodontic patients with adhesive removal using composite bur or tungsten carbide bur: a single center, randomized controlled clinical trial / Alteração da cor do dente após descolagem de braquetes em pacientes ortodônticos pela remoção de adesivo usando broca de compósito ou broca carbide de tungstênio: ensaio clínico unicêntrico randomizado e controlado

Objective: The objective of this study was to determine whether recently developed fiber reinforced composite burs provided better results by comparing tooth discoloration after debonding of orthodontic brackets. Material and Methods: A split-mouth, randomized controlled trial was carried out in one orthodontic office; including 23 patients with intact, vital and caries-free four upper incisors aged 12 to 30 years who completed their fixed orthodontic treatment. For each patient, upper central and lateral incisors on each side of the mouth were randomly selected to remove the adhesive with either a tungsten carbide bur (TC) (n = 46) or a fiber-reinforced composite bur (FC) (n=46). Color evaluation of each tooth was conducted at two time points: immediately after finishing and polishing procedure and two months afterwards. The primary outcome would be the amount of color change in each group during the post treatment phase. The participants, the person assessing the color change and the statistician were blinded to TC group assignment. Color changes in each group were analyzed with the Paired T-test. The color change corresponding to the resin removal method was also statistically analyzed with the Independent T-test at α=0.05 as the level of significance. Results: 86 teeth, 43 in each group, were analyzed. The ΔE value was 3.713±1.161, for teeth finished TC and 2.114±0.514 for teeth finished with FC (p<0.01). Conclusion: Adhesive removal with FC bur results in a more color-resistant tooth surface in comparison with tungsten carbide bur. (AU)

Objetivo: O objetivo deste estudo foi determinar se as brocas de material compósito reforçadas com fibras, recentemente desenvolvidas, proporcionam melhores resultados, pela comparação da descoloração dentária após a remoção de braquetes ortodônticos. Material e Métodos: Um ensaio clínico controlado randomizado com boca dividida foi realizado em um consultório ortodôntico, incluindo 23 pacientes, com idade entre 12 e 30 anos, com incisivos superiores intactos, vitais e livres de cárie, que completaram o tratamento ortodôntico com aparelho fixo. Para cada paciente, incisivos centrais e laterais superiores de cada lado da boca foram selecionados aleatoriamente para remover o adesivo ortodôntico com uma broca carbide de tungstênio (TC) (n = 46) ou uma broca de compósito reforçada com fibra (FC) (n = 46). A avaliação da cor de cada dente foi realizada em dois momentos: imediatamente após o acabamento e polimento e dois meses após. O resultado primário foi a quantidade de mudança de cor em cada grupo durante a fase pós-tratamento. Os participantes, a pessoa que avaliou a mudança de cor e o estatístico não tinham conhecimento da atribuição ao grupo TC. As mudanças de cor em cada grupo foram analisadas com o teste-t pareado. A mudança de cor correspondente ao método de remoção da resina também foi analisada estatisticamente com o teste-t independente considerando um nível de significância α = 0,05. Resultados: foram analisados 86 dentes, 43 em cada grupo. O valor de ΔE foi 3,713 ± 1,161, para dentes finalizados com broca TC e 2,114 ± 0,514 para dentes finalizados com broca FC (p <0,01). Conclusão: A remoção do adesivo com broca FC resulta em uma superfície de dente mais resistente à cor em comparação com a broca carbide de tungstênio (AU)

Salivary flow rate, pH and buffering capacity in patients undergoing fixed orthodontic treatment – A prospective study

Background: Human saliva has got many important functions like lubrication of the oral tissues, making oral functions like speech, mastication and deglutition possible and also protecting teeth and oral mucosal surfaces in different ways. Dental Caries is one of the common complications in patients undergoing orthodontic treatment. Subjects with impaired saliva flow rate often show high caries incidence. A low flow rate combined with a low or moderate buffer effect clearly indicates poor salivary resistance against microbial attack. Aim: To investigate the changes in stimulated and unstimulated salivary flow rate, pH and buffer capacity in patients undergoing therapy with fixed orthodontic appliances. Materials and Methods: Salivary flow rate, pH and buffering capacity of 20 patients who underwent fixed orthodontic treatment at Department of Orthodontics, Ragas Dental College and Hospital, Chennai were examined using GC saliva check buffer kit. The procedure was carried out during the initiation of orthodontic treatment and subsequently, one month and six months after the placement of appliance. Results: Results showed there was a significant increase in the salivary flow rate one month and six months after placement of fixed appliance while pH and buffering capacity showed no significant changes. Conclusion: Salivary flow rate increases significantly during fixed orthodontic treatment. Salivary pH and buffering capacity showed no significant changes suggesting that they are not sole factors for demineralization in orthodontic patients.

The Effectiveness of Two Manual Slim Bristles Toothbrushes among Fixed Orthodontic Appliance Patients / Jurnal Sains Kesihatan Malaysia

@#This research aimed to evaluate the oral hygiene status in fixed orthodontic appliance patients when using two different slim bristles toothbrushes and to assess patients’ toothbrush perception. Twenty six fixed orthodontic appliance patients participated in the six weeks prospective, crossover clinical trial. All patients used two different slim bristles toothbrushes (Toothbrush A and Toothbrush B) for two weeks each with a washout period in between. Gingival health and plaque value were assessed based on Lӧe & Silness Gingival Index and Silness & Lӧe Plaque Index at baseline, week 2, week 4 (washout) and week 6. At the end of the trial, patients’ toothbrush perception was assessed through questionnaire. All data were analysed using SPSS version 22. The mean age of the patients was 21.5 ± 4.3 years, with female predominant (n= 17, 65.4%). More than half were Malay (n= 15, 57.7%) and had tertiary education (n=14, 53.8%). Patients could achieve good oral hygiene when using Toothbrush A (65.4%) and Toothbrush B (69.2%). However, the occurrence of gingivitis was significantly higher when using Toothbrush A (OR=1.889, 95% CI=1.207-2.957, p value < 0.05). Toothbrush B was felt to clean better (n= 14, 53.8%) while Toothbrush A was perceived to be easier to use (n=14, 53.8%). Both toothbrushes maintained patients’ oral hygiene status. However, when using Toothbrush B, oral health status was better as it significantly reduced gingivitis occurrence compared to Toothbrush A. As for the toothbrush perception, most patients preferred Toothbrush A to be taken home.

Influence of the SmartClip self-ligating bracket on plaque control in orthodontic patients / 口腔疾病防治

Objective@#To explore the influence of the SmartClip self-ligating bracket and traditional metal bi-wing brackets on plaque control and to provide a reference for the oral healthcare of orthodontic patients.@*Methods@#The patients were divided into the SmartClip self-ligating bracket group, the metal bi-wing bracket group, and the control group, consisting of untreated volunteers, and the patients were examined before treatment, 1 month after the treatment started, 3 months after the treatment started, and when the treatment ended. The oral hygiene status was recorded at four time points, and the plaque index of the following six teeth was compared among the time points: the upper-right central incisor (UR1), the lower-left central incisor (LL1), the upper-right first molar (UR6), the lower-left first molar (LL6), and the upper left canine (UL3) and the lower-right canine (LR3).@*Results@#Compared with before treatment, after first month, third month and end of treatment the plaque index of LL1, LR3, LL6 and UR6 in both the SmartClip self-ligating bracket group and the traditional metal bi-wing bracket group was increased, and the difference was statistically significant (P < 0.05). There was no significant difference in PLI index between the end of treatment and 3 months after orthodontic treatment (P > 0.05). There was no statistically significant difference in PLI index in the control group at each time period (P > 0.05). After three months of orthodontic treatment, the plaque index of LL1 and LR3 in the SmartClip self-ligating bracket group was higher than that in the traditional metal bi-wing bracket group, and the difference was statistically significant (P < 0.05).@*Conclusion@#Lower anterior and posterior areas are susceptible to plaque accumulation in treatment with fixed orthodontic appliances. The SmartClip self-ligating bracket system has no advantage over the traditional metal bi-wing bracket in terms of oral hygiene.

Influences on periodontal health and conditions of patients with periodontitis by clear aligner treatment / 中华口腔医学杂志

No matter what kind of therapies you choose, clear aligner treatment (CAT) or fixed orthodontic treatment (FOT), the therapy must be performed on the basis of periodontal health and follow the rule that the treatment cannot be harmful to the periodontal tissues. Doctors and patients prefer the clear aligner treatment because of its features, such as aesthetic, removable and comfortable. There are many studies which consider the influences of CAT on the periodontal health, and the conclusions are relatively consistent. The CAT is more beneficial for the plaque-control and maintaining the periodontal health. However, there are a few articles which are talking about applying the CAT to the patients with severe periodontitis. This article mainly reviews the effect of CAT towards the patients with periodontitis, and provides some reference when the patients with severe periodontitis need to choose a proper treatment.

Treatment of a patient with considerably thin alveolar bone and severe open bite / 华西口腔医学杂志

This case report describes the treatment of a 25-year-old woman with a severe open bite. This patient presented a grade Ⅲ open bite, considerably thin alveolar bone, and evident labial buccal and lingual root form. The open bite was corrected by fixed orthodontic treatment and masticatory exercises. However, the increased pressure in the labial muscle caused by lip muscle exercise suppressed the canines, which resulted in the protrusion of the apices of canine roots out of the alveolar bone. Afterward, HX brackets, instead of self-locking, were used and bonded reversely in the occlusal-gingival direction on the upper canines. The lip muscle exercises were decreased. After adjustment, the roots penetrated back into the cancellous bone, the severe open bite was corrected, and a normal overbite and overjet were achieved. ClassⅠcanine and molar relationships were established. The masticatory function and profile were both considerably improved. This case report showed that a severe nonskeletal open bite can be corrected using orthodontic treatments combined with masticatory exercises.

Comparation of periodontal health of patients treated by the invisalign system with those treated by fixed orthodontic appliance / 实用口腔医学杂志

60 cases(aged 18-40 years) underwent orthodontic treatment were divided into 2 groups.30 patients in group A were treated with invisible aligners,while 30 in group B with fixed orthodontic appliance.Periodontal indices (PI,GI,SBI,PD)were examined before treatment,6 weekes,6 months and 12 months after treatment.Before and 6 weeks after treatment the indices were not statistically different between groups,6 and 12 months after treatment the indices of group A were lower than those of group B (P ＜ 0.05).The invisalign appliance is more propitious to periodontal health than the fixed orthodontic appliance.

Effect of Kangfuxin Liquidon on gingiva groove liquid IL-1β, PGE2, sICAM-1in fixed orthodontic patients with gingivitis / 中国生化药物杂志

Objective To analyze the effect of Kangfuxin Liquidon on gingiva groove liquid interleukin 1β(IL-1β), prostaglandin E2 (PGE2), soluble adhesion molecule-1 (sICAM)in fixed orthodontic patients with gingivitis. Methods 96 cases of patients with fixed orthodontic gingivitis consult the draw method were divided into control group and experimental group, 48 cases in each group. The control group were treatedby gums clean, experimental group based on the control group were treattedby Kangfuxin Liquidon. The IL-1β, PGE2, sICAM-1 levels, periodontal status, the grade of swelling and pain, the clinical curative effect were compared between two groups. Results After treatment, the IL-1β, PGE2, sICAM levels of experimental group were lower than the control group (10.54±1.41) ng/L vs.(11.85±1.71)ng/L, (284.62±35.21) ng/L vs.(314.65±39.48)ng/L, (150.49±18.11) μg/L vs.(162.83±20.26) μg/L,the differences were statistically significant (P<0.05).The periodontal status, swelling and pain grading ofexperimental group were better than control group (P<0.05). Theeffective rate of experimental group was higher than the control group (95.83%vs.79.17%) (P<0.05). Conclusion Kangfuxin Liquidon can reduce fixed orthodontic patients with gingivitis gingiva groove IL-1β, PGE2, sICAM-1 levels, improve the periodontal status, relieve swelling and pain, improve the clinical curative effect.

Clinical application of cone beam CT in the diagnosis of traumatic anterior teeth before orthodontic treatment / 口腔疾病防治

Objective@# To explore the clinical application of cone beam CT in the diagnosis of traumatic anterior teeth before orthodontic treatment in order to reduce the risk of orthodontic treatment failure due to adhesion. @*Methods @# 48 fixed orthodontic treatment cases with the history of anterior teeth trama were selected. The anterior teeth were examined by CBCT to exclude root and alveolar bone adhesions. @*Results @#3 cases of root-alveolar bone adhesion were found, and the upper anterioa teeth of the remaining 45 cases were successfully moved by orthodontic treatment. @*Conclusion @#CBCT examination is recommended to check the periodontal ligament in patients of fixed orthodontic treatment with the history of anterior teeth trauma in order to exclude the root-alveolar bone adhesion cases.

Two-year survival analysis of twisted wire fixed retainer versus spiral wire and fiber-reinforced composite retainers: a preliminary explorative single-blind randomized clinical trial / 대한치과교정학회지

OBJECTIVE: Traditional retainers (both metal and fiber-reinforced composite [FRC]) have limitations, and a retainer made from more flexible ligature wires might be advantageous. We aimed to compare an experimental design with two traditional retainers. METHODS: In this prospective preliminary clinical trial, 150 post-treatment patients were enrolled and randomly divided into three groups of 50 patients each to receive mandibular canine-to-canine retainers made of FRC, flexible spiral wire (FSW), and twisted wire (TW). The patients were monitored monthly. The time at which the first signs of breakage/debonding were detected was recorded. The success rates of the retainers were compared using chi-squared, Kaplan-Meier, and Cox proportional-hazard regression analyses (α = 0.05). RESULTS: In total, 42 patients in the FRC group, 41 in the FSW group, and 45 in the TW group completed the study. The 2-year failure rates were 35.7% in the FRC group, 26.8% in the FSW group, and 17.8% in the TW group. These rates differed insignificantly (chi-squared p = 0.167). According to the Kaplan-Meier analysis, failure occurred at 19.95 months in the FRC group, 21.37 months in the FSW group, and 22.36 months in the TW group. The differences between the survival rates in the three groups were not significant (Cox regression p = 0.146). CONCLUSIONS: Although the failure rate of the experimental retainer was two times lower than that of the FRC retainer, the difference was not statistically significant. The experimental TW retainer was successful, and larger studies are warranted to verify these results.