Factors influencing orthodontic treatment time for non-surgical Class III malocclusion

ABSTRACT To improve orthodontic treatment efficiency, orthodontists must know which variables could interfere with orthodontic treatment time. Objective: To identify variables and their effect size on orthodontic treatment time of Class III malocclusion. Material and Methods: Forty-five Class III malocclusion cases were selected from 2008 patients’ records. Clinical charts, cephalometric radiographs, and pre and posttreatment dental casts were evaluated. Age, sex, PAR index at T1 and T2, overjet, missing teeth, extractions, number of treatment phases, missed appointments, appliance breakages, and cephalometric variables SNA, SNB, ANB, Wits, SnGoGn, CoA, CoGn, IMPA, 1.PP were investigated by multiple linear regression analysis and stepwise method at p<0.05. The sample was also divided into two groups: Group 0-2 (patients who had missed two clinical appointments or less) and Group >2 (patients who missed more than 2 appointments), to detect the influence of this data on treatment time and the quality of the treatment (PAR T2). Results: Average treatment time was 30.27 months. Multiple regression analysis showed that missed appointment (R2=0.4345) and appliance breakages (R2=0.0596) are the only variables able to significantly predict treatment duration. Treatment time for patients who missed more than 2 appointments was nearly one year longer. However, no significant influence on PAR T2 was observed for those patients. Conclusion: Orthodontic treatment duration in Class III patients is mainly influenced by factors related to patient compliance. Patients who missed more appointments did not show worse orthodontic finishing, but longer treatment. No occlusal, cephalometric, or demographic variable obtained before treatment was able to give some significant prediction about treatment time in Class III patients.

Cleansing orthodontic brackets with air-powder polishing: effects on frictional force and degree of debris

ABSTRACT Introduction: Debris buildup on the bracket-wire interface can influence friction. Cleansing brackets with air-powder polishing can affect this process. Objective: The aim of this study was to evaluate the frictional force and amount of debris remaining on orthodontic brackets subjected to prophylaxis with air-powder polishing. Methods: Frictional force and debris buildup on the surface of 28 premolar brackets were evaluated after orthodontic treatment. In one hemiarch, each bracket was subjected to air-powder polishing (n = 14) for five seconds, while the contralateral hemiarch (n = 14) served as control. Mechanical friction tests were performed and images of the polished bracket surfaces and control surfaces were examined. Wilcoxon test was applied for comparative analysis between hemiarches at p < 0.05. Results: Brackets that had been cleaned with air-powder polishing showed lower friction (median = 1.27 N) when compared to the control surfaces (median = 4.52 N) (p < 0.01). Image analysis showed that the control group exhibited greater debris buildup (median = 2.0) compared with the group that received prophylaxis with air-powder polishing (median = 0.5) (p < 0.05). Conclusion: Cleansing orthodontic brackets with air-powder polishing significantly reduces debris buildup on the bracket surface while decreasing friction levels observed during sliding mechanics.

RESUMO Introdução: o acúmulo de detritos na interface braquete-arco pode influenciar no atrito, mas a limpeza dos braquetes usando jatos de bicarbonato de sódio pode interferir nesse processo. Objetivo: o objetivo desse estudo foi avaliar a força de atrito e a quantidade de detritos remanescentes em braquetes ortodônticos submetidos à profilaxia com jatos de bicarbonato de sódio. Material e Métodos: avaliou-se, ao final do tratamento ortodôntico, a força de atrito e o acúmulo de detritos na superfície de 28 braquetes de pré-molares. Em uma hemiarcada, os braquetes foram jateados com bicarbonato de sódio (n = 14) por 5 segundos, enquanto a hemiarcada contralateral serviu de controle (n = 14). Foram realizados ensaios mecânicos de atrito e análise imagiológica dos braquetes de ambas as hemiarcadas, a jateada e a controle. O teste de Wilcoxon foi utilizado para a análise comparativa entre as hemiarcadas, com p < 0,05. Resultados: os braquetes submetidos à limpeza com jatos de bicarbonato de sódio apresentaram menor atrito (mediana = 1,27N), quando comparados aos do lado controle (mediana = 4,52N) (p < 0,01). A análise imagiológica demonstrou que o grupo controle apresentou maior acúmulo de detritos (mediana = 2,0), em comparação ao grupo que recebeu profilaxia com jatos de bicarbonato (mediana = 0,5) (p < 0,05). Conclusão: a limpeza dos braquetes ortodônticos por meio do jateamento com bicarbonato de sódio reduz significativamente o acúmulo de detritos na superfície deles, bem como os níveis de atrito observados durante a mecânica de deslizamento.