Comparison of bracket bond failure with the aerosol-generating and novel non-aerosol-generating bonding techniques during the SARS-CoV-2 pandemic among orthodontic patients: A retrospective cohort study.

BACKGROUND: As per the Centers for Disease Control and Prevention (CDC) guidelines, dentists must avoid the aerosol-generating procedures during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. OBJECTIVES: This study aimed to compare the rate of bracket bond failure with the aerosol-generating and non-aerosol generating bonding techniques. MATERIAL AND METHODS: A retrospective cohort study was conducted during the SARS-CoV-2 pandemic on a sample of 44 patients (880 teeth), equally divided into 2 groups: the conventional aerosol-generating bonding technique (ABT); and the novel non-aerosol-generating bonding technique (NABT). The rate of bracket survival and total number of bracket breakages in the 2 groups were assessed by means of the survival regression analysis. The influence of pre-treatment factors, such as the sagittal jaw relationship (ANB), the Frankfort-mandibular plane angle (FMA), overjet, overbite, and upper and lower crowding, on the rate of bracket survival was also evaluated. RESULTS: There was a statistically significant difference between ABT and NABT in terms of bracket survival. The mean bracket survival with ABT was 176.21 ±77.89 days and with NABT it was 162.53 ±83.34 days. The novel technique showed a hazard ratio of bracket survival of 2.99 as compared to the conventional method. There was a statistically significant influence of overjet on the rate of bracket survival (p = 0.010). The posterior segment had a higher rate of bracket failure as compared to the anterior segment in NABT, which was statistically significant (p < 0.001). However, this difference was statistically non-significant in the case of ABT. CONCLUSIONS: There was an increased rate of bracket failure with NABT as compared to ABT. The rate of bracket breakages in the anterior quadrants was comparable for both bonding techniques.

Prevalence of white spot lesions and risk factors associated with the COVID-19 pandemic.

BACKGROUND: The objective of this study was to investigate the impact of the COVID-19 pandemic on the prevalence and persistence of white spot lesions (WSLs) among patients treated with traditional braces. METHODS: A group of 434 consecutively finished cases who had pretreatment and post-treatment digital photographs taken were included in this study. Each set of photographs was evaluated by two investigators to determine prepandemic and postlockdown WSLs, in addition to changes in oral hygiene (OH) and other risk factors. RESULTS: There was a statistically significant difference in the development of WSLs pre-COVID-19 lockdown (PRL) versus post-COVID-19 lockdown (POL) (P < 0.001). The overall prevalence for the development of WSLs increased to 52.8% POL. For patients with good pretreatment OH, the risk of developing WSLs POL (42.0%) was two times greater than the rate in PRL (20.1%). For patients whose OH worsened during treatment, 81.2% of POL patients developed WSL compared with 69.6% of PRL patients. The incidence of WSLs was statistically greater in the maxillary anterior region POL than PRL, whereas the incidence in the mandibular anterior region did not reach statistical significance. The distribution of WSLs was greater POL for each tooth irrespective of the arch. CONCLUSIONS: Because of the COVID-19 pandemic, the prevalence of visible WSLs increased from 29.5% to 52.8%. Patients whose hygiene worsened during orthodontic treatment are at an increased risk of developing WSLs.

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.

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.