Do customized orthodontic appliances and vibration devices provide more efficient treatment than conventional methods? / 대한치과교정학회지

The incorporation of technological advances in the field of clinical orthodontics to increase treatment efficiency has led to the development of customized appliances (Insignia®), archwires (Suresmile®), and the production of devices to enhance tooth movement (Acceledent®). This review presents a comprehensive study of the literature concerning these products, and analyzes the available evidence of their efficiency. To date, one pilot study has evaluated the efficiency of the Insignia® system, three retrospective studies have assessed the efficiency of the Suresmile® system, and a few Acceledent® reports have described its effect on treatment time. Critical appraisal of the reviewed papers revealed that the efficiency of the Insignia® system cannot be confirmed based on the available evidence, while the use of Suresmile® can reduce overall treatment time in simple cases. The acceleration of tooth movement by Acceledent® devices has not yet been confirmed.

Influence of bimaxillary protrusion on the perception of smile esthetics

To evaluate the impact of bimaxillary protrusion on smile esthetics as perceived by dental professionals and laypersons. One hundred and fifty evaluators, equally distributed into their respective panels [orthodontists, general dentists, and laypersons], participated in this cross-sectional study conducted in April to December 2012 in Riyadh, Saudi Arabia. The patient sample consisted of 14 female patients divided equally into 2 groups: bimaxillary protrusion patients, and patients who have had 4-premolar extraction treatment. Two standardized photographs [frontal and three-quarter close-up smile views], and a lateral cephalogram were taken for each patient. The evaluators were asked to rate the attractiveness of each photo according to a 100-mm visual analog scale. These esthetic ratings were correlated with the patients' cephalometric measurements. The bimaxillary protrusion group was rated significantly as less attractive than the treatment group by each evaluator panel. Panel comparison showed that laypeople were less receptive of bimaxillary protrusion than dental professionals. Frontal and three-quarter views of the same smiles were not similarly rated for esthetic perceptions. Correlational analysis revealed that the dentoalveolar measurement with the highest significant negative correlation to the smile esthetics was the upper incisors to palatal plane [U1-PP] angle. Patients with bimaxillary protrusion were found to be less attractive than patients who were treated for the condition. This was especially evident among the laypersons. An increase in the upper incisor inclination, as well as a decrease in the interincisal angle compounds the bimaxillary effect

Orthodontic treatment and referral patterns: a survey of pediatric dentists, general practitioners, and orthodontists

This study aims to assess the orthodontic diagnostic skills, referral patterns, and the perceptions of orthodontic benefits of pediatric and general dentists in comparison with orthodontists. Two online surveys were e-mailed to pediatric dentists, general dentistry practitioners, and orthodontists registered as members of the Saudi Dental Society and the Saudi Orthodontic Society. The surveys included questions about the type of orthodontic treatment provided, referral trends, and timing; presumed benefits associated with successful orthodontic treatment; and diagnosis and treatment plans of seven cases representing different malocclusions. In total, 25 orthodontists, 18 pediatric dentists, and 14 general practitioners completed the survey. Only 38.8% of pediatric dentists and 7.1% of general practitioners reported that they practiced orthodontics clinically. The perceptions of the three groups toward the benefits of orthodontic treatment were comparable in the psychosocial areas. However, the orthodontists perceived significantly lesser effects of orthodontic treatment on the amelioration of temporomandibular disorder [TMD] symptoms. Pediatric dentists tended to rate the need and urgency of treatment higher, while general practitioners tended to rate the need of treatment lower. The selected treatment plans for three early malocclusion cases showed the greatest discrepancies between the orthodontists and the other two groups. The orthodontists consistently and significantly downplayed the perceived benefit of orthodontic treatment to reduce TMD symptoms. Also, while there was a similarity in the diagnosis, there were notable differences in the proposed treatment approaches, perceived treatment need, and timing of intervention between the three groups of practitioners

Assessment of fluoride concentrations in commercially available mouthrinses in central Saudi Arabia

To assess the fluoride concentration of different commercially available mouthrinses in central Saudi Arabia, and compare the obtained measurements with label values. This cross-sectional study identified 25 brands of mouthrinses in the markets of Riyadh city between August and September 2013. Nineteen brands of mouthrinses whose labels indicate the percentage of sodium fluoride [NaF] and 6 brands not indicating the fluoride percentage were included in the study. Three bottles of 2 manufacturing batches of each brand were acquired, coded, and analyzed after dilution using specific electrodes for fluoride and an ion analyzer at the College of Science, King Saud University, Riyadh, Saudi Arabia. The average fluoride concentrations in the tested mouthrinses ranged from 8.4 ppm [Voza] to 448.7 ppm [Sensodyne "Pronamel"]. Analysis of variance showed a statistically significant difference [p<0.05] in the fluoride concentration between the studied 25 brands. Almost 60% of the brands' fluoride concentrations were significantly different [mainly lower] from the label value. However, only 5 brands contain fluoride at a concentration not significantly different from the recommended fluoride concentration in daily mouthrinses 0.05% [225 ppm]. Most of the studied commercially available mouthrinses contain topical fluoride at concentrations below the manufacturers' label value, but above the recommended 0.05%

Pattern of skeletal and dental malocclusions in Saudi orthodontic patients

To determine the distribution of skeletal and dental malocclusions in a sample of Saudi orthodontic patients. Six hundred and two randomly selected pretreatment orthodontic records were evaluated in this descriptive, retrospective study conducted between June to September 2009 at the Orthodontic Clinic of the College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia. Cephalometric analysis using Dolphin software to measure the A point, Nasion, B point [ANB] angle and Wits appraisal was performed to determine the skeletal malocclusion. Angle's classification was evaluated to determine the molar relationship using study models. The most common dental malocclusion was Angle Class I followed by the asymmetric molar relationship. The most common skeletal malocclusion using ANB angle was Class I, while the most common skeletal malocclusion using Wits appraisal was Class II. No gender difference was seen in the distribution of the molar relationship and skeletal relationship using both ANB angle and Wits appraisal. The pattern of skeletal and dental malocclusions in Saudi orthodontic patients differs, based on the variability of the methods used to assess the anteroposterior jaw-base relationship

Evaluation of incisors inclination in five cephalometric analysis methods

Various cephalometric analyses may provide conflicting results for the skeletal sagittal relationship and incisors inclination. The aim of this study was to evaluate the various cephalometric analyses by relating the upper and lower incisors to different reference points and lines. One hundred and two pre-treatment lateral cephalometric radiographs were selected and stratified into three groups according to their skeletal sagittal relationship. Five methods for measuring the upper and lower incisors inclination were applied and then compared using Analysis of Variance [ANOVA] statistical test. The findings of the present study demonstrated that there is a statistically significant [p<0.05] difference between the angular and the linear evaluation methods in lower incisors. More than half [55%] of the cases showed a difference of > 3 standard deviations [SD] between the five methods in the mandibular incisors. L1-NA [mm] and L1-APog [mm] had a weak correlation with the other measurements, while the angular measurements were strongly correlated. Variations in the measurements of incisors inclination exist due to many factors. The clinicians should understand the weaknesses of each method and interpret the results cautiously

Orthodontic treatment of an anterior openbite with the aid of corticotomy procedure: case report

This case report illustrates the orthodontic treatment combined with the corticotomy technique in an adult patient to accelerate tooth movement and shorten the treatment time. The patient was a 22-year-old woman with an anterior open bite and flared and spaced upper and lower incisors. First, fixed orthodontic appliances [bidimensional edgewise brackets] were bonded, and a week later buccal and lingual corticotomy with alveolar augmentation procedure in the maxillary arch from the first molar to the contralateral first molar, and from canine to canine in the mandibular arch was performed. Orthodontic therapy proceeded with frequent activation of the appliances to retract the incisors every 2 weeks. The total treatment time was 5 months and no adverse effects were observed at the end of active treatment. The addition of the decortication procedure to the conventional orthodontic therapy decreased the duration of treatment significantly. Successful closure of the anterior open bite with adequate overbite and interdigitation of the teeth were achieved

Morphological features of bimaxillary protrusion in Saudis

To analyze the pre-treatment cephalometric features in Saudi adults with bimaxillary protrusion and to develop cephalometric standards to clarify the overall presentation of this malocclusion for clinicians. A descriptive retrospective study was designed in which lateral cephalometric radiographs of 60 individuals with Class I skeletal and dental relationship and decreased interincisal angle were collected between June 2007 and December 2008 at the Orthodontic Clinic, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia. Radiographs were studied and compared to those of 60 individuals with similar skeletal and dental relationships, but with normal interincisal angle. The measurements were calculated electronically using Dolphin[Registerd] software. The data were analyzed using the t-test. Saudi individuals with bimaxillary protrusion had a vertical skeletal pattern that is similar to that of the control group, however, they demonstrated increased procumbency of the upper and lower lips. Comparing females to males with bimaxillary protrusion revealed significant increase in male lip thickness. On the other hand, no significant difference was detected in the amount of lip protrusion between males and females. Saudi subjects with bimaxillary protrusion demonstrated distinctive soft tissue features when compared to the control group and to other ethnic groups with bimaxillary protrusion

Fluoride content of bottled drinking waters available in Riyadh, Saudi Arabia

This study aimed to examine the fluoride concentration of commercially available bottled water products in Riyadh, Saudi Arabia, and to assess the accuracy of the labeling of fluoride concentration on the tested brands. Fifteen randomly selected commercial brands of bottled water were obtained from supermarkets in Riyadh, Saudi Arabia. Three bottles of each brand were purchased, and fluoride content was measured using a combination fluoride-ion-selective electrode. The average reading for each brand was estimated and also compared with the fluoride content printed on the label. The mean [ +/- SD] fluoride content of the 12 local bottled water samples was 0.79 [ +/- 0.09] mg/L with a range from 0.5 to 0.83 mg/L. The mean fluoride concentration of the three imported brands was 0.67 [ +/- 0.02] mg/L with a narrow range of fluoride content [0.65-0.69]. All tested samples mention the fluoride content on the label except two imported brands. Five samples showed a significant difference between our evaluation and stated content of fluoride that ranged between +0.46 and _0.2 mg/L. Bottled drinking waters available in Riyadh, Saudi Arabia contain differing concentration of fluoride, but within a safe range for use as a source of systemic fluoride. In addition, the manufactures' labeling of fluoride content may be inaccurate