Did the coronavirus disease 2019 pandemic affect orthodontic treatment outcomes? A clinical evaluation using the objective grading system and Peer Assessment Rating index.

INTRODUCTION: This study aimed to compare the treatment outcome of patients whose orthodontic treatment was completed before or during the coronavirus disease 2019 pandemic. METHODS: Pretreatment and posttreatment models of 100 patients treated with fixed orthodontic appliances were evaluated using the peer assessment rating (PAR) index. Posttreatment models and panoramic radiographs were measured and scored with the objective grading system (OGS). All patients had their treatment plans before the coronavirus disease 2019 pandemic, but the orthodontic treatment finishing date was before (prepandemic: group 1, n = 50) or during (pandemic: group 2, n = 50) the pandemic. Intergroup comparisons were tested with an independent samples t test or Mann-Whitney U test. Chi-square test statistics and Fisher exact test were used to compare categorical variables. RESULTS: Significant higher posttreatment weighted maxillary alignment score was found in group 2. However, no significant difference was found between the groups concerning the mean total weighted PAR reduction (29.8 ± 9.9 vs 25.6 ± 8.7) and posttreatment total weighted PAR scores (1 vs 2). The PAR index score improvement (%) was similar between the groups (93.7 ± 7.1 vs 89.9 ± 13.0). No statistically significant difference was found between the groups for the total OGS score (32 vs 33). A lower score for marginal ridge height (4 vs 3) and a higher score for buccolingual inclination (7 vs 11), and a lower score for occlusal relationship (3 vs 1) were found in group 2. Canceled appointments (1.1 ± 0.7 vs 4.8 ± 1.6) and the number of missed appointments (0.6 ± 0.5 vs 1.1 ± 0.8) were statistically higher in group 2, whereas the total number of appointments (27.3 ± 8.8 vs 21.8 ± 5.4) were statistically less. The treatment duration was comparable in both groups. CONCLUSIONS: Reduced and irregular appointments during the pandemic resulted in significantly higher posttreatment weighted maxillary alignment and worsening of the buccolingual inclination. However, the PAR score improvement, total OGS score, and treatment duration were not affected.

Essential Attributes of Clear Aligner Therapy in terms of Appliance Configuration, Hygiene, and Pain Levels during the Pandemic: A Brief Review.

Fixed orthodontic treatment has been compromised at many levels during the pandemic period, as clinics underwent a prolonged lockdown and patients could not be treated regularly. With the end of the pandemic nowhere in sight, may be it is time to put newer tools, such as clear aligner therapy, for better use. Fixed orthodontic appliances by nature are not always self-limiting, which, if left unmonitored over a long period may cause undesirable side effects, pain, and discomfort. The undesired tooth movements that may occur with arch wire-guided mechanics in addition to problems with cut wires or removed brackets may be minimized with the use of aligners. While the benefits of using aligners are for all to see, they do require extensive planning and careful evaluation of the progress. This article reviews the advantages of using aligners during the pandemic period and how it can be beneficial in helping orthodontists resume their practice.