Orthodontic care in orthodontic patients during the COVID-2019 pandemic: emergency, emergency response and orthodontic treatment preference.

BACKGROUND: The objective of this study was to investigate the characteristics of emergencies and the requirement for emergency treatment after the suspension of orthodontic appointments. The attitude towards orthodontic treatment preference was evaluated as well, including receiving orthodontic treatment and the preference for orthodontic appliances. SUBJECTS AND METHODS: An electronic questionnaire was distributed to the patients, including 4 sections: Section 1 - demographic and basic information; Section 2 - the characteristics of emergencies and emergency treatment requirements; Section 3 - the NRS-11 for pain and Manchester Orofacial Pain Disability Scale used to evaluate the intensity of orofacial pain and disability; and Section 4 - attitudes towards receiving orthodontic treatment and appliance preference. Descriptive statistics, Pearson's chi-square test, Wilcoxon's rank-sum test and stepwise generalized linear model (GLM) were performed with significance set at P < 0.05. RESULT: Most participants' (91.61%) follow-up appointments were suspended. The emergency rate and emergency treatment requirements were not different between the fixed appliance (FA) and clear aligner (CA) groups. Patients who reported emergencies (P < 0.01) in the FA group (P < 0.05) and some emergencies in the FA (P < 0.05) suffered worse pain and disability. More FA participants preferred alternative appliances (P < 0.05) due to pain and disability (P < 0.05). CONCLUSION: FA patients' emergencies caused worse pain and disability when orthodontic appointments were suspended. Pain and disability were not the causes of emergency treatment requirements. The CA group seemed to show a tendency towards orthodontic appliance preference, which was an ideal modality to weather the epidemic, combined with telemedicine.

Clear aligner vs fixed self-ligating appliances: Orthodontic emergency during the 2020 coronavirus disease 2019 pandemic.

INTRODUCTION: The aim was to investigate the type, incidence, and degree of orthodontic-related emergencies in orthodontic patients during the 2020 coronavirus disease 2019 pandemic and compare the different effects of clear aligner (CA) and fixed self-ligating appliances on the orthodontic emergency. METHODS: The questionnaire was based on emergencies in orthodontics. The responses of 428 patients between the ages of 12 and 38 years (20.4 ± 7.03) in orthodontic treatment during 2020 were examined. RESULTS: The gender, age, and the type of orthodontic appliance affect the incidence of orthodontic-related emergencies. Female or adolescent patients treated by self-ligating appliances showed a higher incidence of emergencies. The patients treated by CA exhibited a much lower incidence of emergency. Appliance detachment and mucosa injury were very common in respondents, whereas accidental ingestion and other rare emergencies were less common. The most common reason leading to appliance detachment was chewing hard food. Interestingly, the fixed self-ligating appliances group was also affected by the accidental detachment of appliances to a large extent. The CA and self-ligating groups showed an almost equal incidence of accidental ingestion. The most common foreign body was elastics in both groups. However, the self-ligating group could accidentally ingest dangerous foreign bodies, such as archwires, miniscrews, and welded attachments. CONCLUSIONS: Orthodontic-related emergencies were very common in patients. The CA could effectively reduce orthodontic-related emergencies. Dentists should raise patients' awareness of proper appliance care. A proper and standard protocol should be developed.

In vitro comparison of the tensile strength of elastomeric ligatures exposed to Povidone Iodine 1%, Chlorhexidine 0.02%, and hydrogen peroxide 5.

OBJECTIVE: In orthodontic patients using any chemical substances in oral environment could change the elastomeric properties of their appliances. Since the beginning of the SARS-CoV-2 pandemic, efforts have been devoted to explore methods of prevention including the use of antiviral mouthwashes. This study aimed to investigate the effects of Povidone Iodine (PVP-I) and two other disinfecting solutions on the mechanical properties of orthodontic elastomeric ligatures. MATERIALS AND METHODS: In this study, 130 elastomeric ligatures in five groups (three test groups and two control groups) were examined in laboratory conditions for a period of 28 days. In the control group, specimens were kept dry in a dark environment while all other ligatures were stored in artificial saliva. Elastomeric ligatures were immersed into PVP-I solution (1%) Chlorhexidine (0.02%), and hydrogen peroxide (5%) for one minute each day in three time intervals of one day, 7 days and 28 days. Next, the maximum tensile strength of elastomeric ligatures was tested by a universal testing machine (CN 1174, Germany). RESULTS: The results showed that the tensile strength of elastomeric ligatures was significantly decreased in all three test groups after 28 days (p-value<0.05). However, the difference between groups was not statistically significant. Between-subject ANOVA test showed that there were significant correlations between the time of exposure and type of disinfecting solutions. CONCLUSIONS: PVP-I has comparable effects on elastomeric ligatures as artificial saliva, chlorhexidine, and hydrogen peroxide.

Incidence of orthodontic appliance failures during the COVID-19 lockdown period.

INTRODUCTION: As a result of the rapid spread of the disease caused by severe acute respiratory syndrome coronavirus 2, the World Health Organization declared a global pandemic on March 11, 2020. Governments worldwide adopted various measures to stop or slow the spread of coronavirus disease 2019 (COVID-19). One widely used measure was lockdown; workers who could work from home were instructed to do so, and nonessential businesses-including dental clinics-were closed for weeks or months. The purpose of this investigation was to document the incidence of fixed orthodontic appliance failures and the periodontal health status of patients undergoing fixed orthodontic treatment during and after the lockdown period. METHODS: The sample comprised 350 orthodontic patients (mean age, 16.85 ± 2.59 years; 249 female, 101 male) who underwent orthodontic and periodontal examinations in Adiyaman, Turkey, after a mean lockdown period of 103.7 ± 21.3 days. Frequencies of an orthodontic bracket, elastic ligature, molar band, and miniscrew failures of oral ulcers were recorded, and periodontal parameters were assessed. The effects of sex, age, and the bracket systems used in the patients on the frequencies of these failures were analyzed. RESULTS: It was revealed that 15.42% (n = 54) of all patients had ≥1 bracket bonding failure, and 8.16% (n = 4) of the patients with miniscrew implantation had ≥1 miniscrew failure. The incidence of bracket bonding failure was significantly higher in men than in women. No significant relationship was found between periodontal parameters and bracket bonding failure. Plaque and gingival scores were higher than those reported for a similar population before a lockdown. CONCLUSIONS: The results indicated that orthodontic appliances might have higher frequencies of failure during a lockdown than normal times, and lockdown periods may worsen the periodontal health status of the patients.