Evaluation of Mandibular Projection in Class II Division 2 Subjects Following Orthodontic Treatment Using Clear Aligners.

AIM: The purpose of this study was to evaluate the mandibular growth and/or projection following maxillary incisor proclination, overbite correction, and maxillary dentoalveolar expansion without the use of any class II mechanics, in growing class II division 2 patients treated with clear aligners. MATERIALS AND METHODS: Before and after treatment cone-beam computed tomographic (CBCT) generated lateral and posteroanterior cephalograms of thirty-two patients with skeletal class II division 2, 16 in the treatment group and 16 in the untreated group, were reviewed to evaluate treatment-related changes. Upper incisors were proclined and protruded, as well as upper arch expansion and overbite correction were performed as part of their regular treatment. Cephalometric analysis was performed to evaluate skeletal and dental changes. Unpaired statistical t-tests were performed to determine if significant skeletal class II correction was achieved in the treatment group. RESULTS: In the treatment group, after treatment, the upper incisors became more proclined and protruded, and the inter-molar width increased while the overbite was reduced compared to the control group. An increase in skeletal mandibular growth and forward projection was also observed, thus contributing to an improvement of the sagittal skeletal relationship as evidenced by ANB and Wits values compared to the control group. CONCLUSION: A combination of upper incisor proclination, correction of deep overbite, and maxillary dentoalveolar expansion using clear aligners appears to contribute to an improvement of the skeletal class II relationship in growing patients with class II division 2. CLINICAL SIGNIFICANCE: This study shows that unlocking the mandible by correcting a deep overbite, proclining upper incisors, and expanding the upper arch in growing class II division 2 patients can improve skeletal class II using clear aligners. How to cite this article: Mirzasoleiman P, El-Bialy T, Wiltshire WA, et al. Evaluation of Mandibular Projection in Class II Division 2 Subjects Following Orthodontic Treatment Using Clear Aligners. J Contemp Dent Pract 2024;25(4):295-302.

American Board of Orthodontics (ABO) Discrepancy Index and peer assessment rating (PAR) index with models versus photographs.

BACKGROUND: The objectives of this study were to determine whether rating systems, such as the Peer Assessment Rating (PAR) and the American Board of Orthodontics Objective Grading System (ABO-OGS) can be applied to intraoral photographs. METHODS: Models and photographs of 50 cases were graded by 4 raters, and a 20% repeat of randomized cases was completed 2 weeks later. Intraclass correlation coefficients (ICCs) were used to assess inter- and intra-rater agreements, as well as the level of agreement between the ratings on models and photographs. RESULTS: The intra- and inter-rater agreements were considered good to excellent. The paired mean difference (model minus photo) for the PAR index and the ABO Discrepancy Index as a total was 2.405 and 1.156, respectively. Overjet was the subdomain that produced the highest differences between photos and models. The ABO- Discrepancy Index method on photographs was more reliable than the PAR index when grading pre-treatment and more-severe malocclusions. CONCLUSIONS: Both methods can be used, but the choice depends on the purpose of the evaluation, and on consideration of the weaknesses and strengths of each relating to its use on photographs.

A Cleft-Customized Occlusal Rating System to Assess Orthodontic Occlusal Improvement in Patients With Unilateral Cleft Lip and Palate.

OBJECTIVE: This study aimed to develop a new method to quantify occlusal improvement in patients with unilateral cleft lip and palate (UCLP) who had undergone orthodontic treatment and to evaluate its reproducibility. DESIGN: A panel of orthodontists decided on the relevance of different occlusal features to score initial and final 3-dimensional study models and panoramic radiographs. A subsequent subjective analysis was later performed by a local orthodontic panel. SETTING: The sample was obtained from the orthodontic clinical archives of a hospital known for the treatment of patients with craniofacial differences. PATIENTS: Thirty-one nonsyndromic patients, 17 males and 14 females, were randomly selected according to preestablished inclusion/exclusion criteria. INTERVENTIONS: The records corresponded to the period during which the patients were treated with conventional multibracket mechanics and adjunctive restorative procedures. MAIN OUTCOME/MEASURES: The intraclass correlation coefficient measured intraexaminer and interexaminer agreements. The Spearman correlation test assessed the relationship between the local orthodontic panel perception and the improvement scores. RESULTS: Inter- and intra-rater ICCs varied between fair/good to excellent. There was a strong correlation between the Cleft-Customized Occlusal Rating system classification of occlusal improvement and the local orthodontic panel's perception, thereby enabling the utilization of the interpretation scale by the panel. CONCLUSIONS: The method showed to be a useful tool in quantifying and classifying occlusal improvement in this specific population. As any other method, some limitations apply and need to be accounted for.

Comparison of early and conventional autogenous secondary alveolar bone graft in children with cleft lip and palate: A systematic review.

PURPOSE: The literature is scarce on studies comparing secondary alveolar bone graft (SABG) performed early at approximately 5-6 years and at the conventional time at 9-11 years. This systematic literature review(SLR) aimed to compare clinical outcomes after two different timings of SABG in children with unilateral and bilateral cleft lip and palate. METHODS: The inclusion criteria were autogenous iliac grafts and the following study designs: case control, cohort, clinical controlled trial (CCT), randomized CCT (RCCT), and previous SLRs. Ovid MEDLINE, Ovid EMBASE, Web of Science, Scopus, Cochrane, ProQuest and Google Scholar were the primary databases. Two calibrated examiners worked independently to select the articles. The MINORS evaluation method for surgical non-RCTs was used to assess for quality. RESULTS: 1,111 articles were retrieved and 19 qualified. Different clinical and radiographic outcomes such as bone level, periodontal status, canine eruption and cleft-side tooth survival were evaluated by different assessment methods such as CBCT volume, computed tomography, periodontal evaluation, panoramic, intraoral radiographs, and Bergland scale. No RCCT or meta-analysis was found. None of the studies received the ideal score, which is 16 for non-comparison studies and 24 for comparison studies. CONCLUSION: Methodological variation, lack of standardization for initial cleft dimension and low-quality level rendered a fair comparison unfeasible. Although further studies are necessary, it can be assumed that early SABG also can be an acceptable option, but this was based on a single study with a reasonable level of evidence.

Comparison of two methods of visual magnification for removal of adhesive flash during bracket placement using two types of orthodontic bonding agents

ABSTRACT Objective: This study aimed to evaluate the effectiveness of two methods of visual magnification (operating microscope and light head magnifying glass) for removal of composite flash around orthodontic metal brackets. Material and Methods: Brackets were bonded in the center of the clinical crown of sixty well-preserved human premolars. Half of the sample was bonded with conventional Transbond XT (3M Unitek TM, USA), whereas the other half was bonded with Transbond TM Plus Color Change (3M Unitek TM, USA). For each type of composite, the choice of method to remove the flash was determined by randomly distributing the teeth into the following subgroups: A (removal by naked eye, n = 10), B (removal with the aid of light head magnifying glass, under 4x magnification, n = 10), and C (removal with the aid of an operating microscope, under 40x magnification, n = 10). Brackets were debonded and teeth taken to a scanning electron microscope (SS-x-550, Shimadzu, Japan) for visualization of their buccal surface. Quantification of composite flash was performed with Image Pro Plus software, and values were compared by Kruskal-Wallis test and Dunn’s post-hoc test at 5% significance level. Results: Removal of pigmented orthodontic adhesive with the aid of light head magnifying glass proved, in general, to be advantageous in comparison to all other methods. Conclusion: There was no advantage in using Transbond TM Plus Color Change alone. Further studies are necessary to draw a more definitive conclusion in regards to the benefits of using an operating microscope.

RESUMO Objetivo: este estudo teve o objetivo de avaliar a eficácia de dois métodos de magnificação visual (microscópio cirúrgico e lupa de pala) para remoção da resina residual em torno de braquetes ortodônticos metálicos. Material e Métodos: os braquetes foram colados no centro da coroa clínica de 60 pré-molares humanos bem preservados. Metade da amostra foi colada com Transbond XT convencional (3M UnitekTM, EUA), enquanto a outra metade foi colada com TransbondTM Plus Color Change (3M-UnitekTM, EUA). Para cada tipo de resina, a escolha do método para remover o resíduo foi determinada por meio da distribuição aleatória dos dentes nos seguintes subgrupos: A (remoção a olho nu, n = 10), B (remoção com a ajuda de lupa de pala, sob uma ampliação de 4x, n = 10) e C (remoção com auxílio de um microscópio cirúrgico, sob uma ampliação de 40x, n = 10). Os braquetes foram descolados e os dentes, levados a um microscópio eletrônico de varredura (SS-X-550, Shimadzu, Japão) para visualização de sua superfície vestibular. A quantificação da resina residual foi realizada por meio do software Image Pro Plus, onde os valores foram comparados utilizando-se o teste de Kruskal-Wallis e o teste post-hoc de Dunn, ao nível de significância de 5%. Resultados: a remoção da resina ortodôntica pigmentada com o auxílio da lente de aumento de pala provou, em geral, ser mais vantajosa, em comparação aos outros métodos testados. Conclusão: não houve vantagem em se usar a TransbondTM Plus Color Change sozinha. Estudos adicionais são necessários para se chegar a uma conclusão definitiva sobre os benefícios da utilização de microscópio cirúrgico.

Comparison of two methods of visual magnification for removal of adhesive flash during bracket placement using two types of orthodontic bonding agents.

OBJECTIVE:: This study aimed to evaluate the effectiveness of two methods of visual magnification (operating microscope and light head magnifying glass) for removal of composite flash around orthodontic metal brackets. MATERIAL AND METHODS:: Brackets were bonded in the center of the clinical crown of sixty well-preserved human premolars. Half of the sample was bonded with conventional Transbond XT (3M Unitek TM, USA), whereas the other half was bonded with Transbond TM Plus Color Change (3M Unitek TM, USA). For each type of composite, the choice of method to remove the flash was determined by randomly distributing the teeth into the following subgroups: A (removal by naked eye, n = 10), B (removal with the aid of light head magnifying glass, under 4x magnification, n = 10), and C (removal with the aid of an operating microscope, under 40x magnification, n = 10). Brackets were debonded and teeth taken to a scanning electron microscope (SS-x-550, Shimadzu, Japan) for visualization of their buccal surface. Quantification of composite flash was performed with Image Pro Plus software, and values were compared by Kruskal-Wallis test and Dunn's post-hoc test at 5% significance level. RESULTS:: Removal of pigmented orthodontic adhesive with the aid of light head magnifying glass proved, in general, to be advantageous in comparison to all other methods. CONCLUSION:: There was no advantage in using Transbond TM Plus Color Change alone. Further studies are necessary to draw a more definitive conclusion in regards to the benefits of using an operating microscope.

Can shielded brackets reduce mucosa alteration and increase comfort perception in orthodontic patients in the first 3 days of treatment? A single-blind randomized controlled trial.

INTRODUCTION: Orthodontic patients can experience pain and discomfort on the oral mucosa from trauma caused by friction with the brackets and the wires. In this split-mouth design, single-blind randomized controlled trial, we aimed to investigate whether brackets with a self-snapping customized plastic shield would induce less mucosa alteration and discomfort than those without the shield. METHODS: The overall sample comprised 42 patients (22 female, 20 male) from a government-funded orthodontic practice, with a mean age of 16.7 years. Eligibility criteria included, among others, no history of mouth ulcers or systemic diseases. Customized shields for the maxillary and mandibular brackets were fabricated and inserted on one side of the mouth. The null hypothesis was that bracket shielding would have no advantage. The primary outcomes were mucosal and discomfort assessments. As the secondary outcome, the numbers of spontaneous detachments of the shields were reported. Treatment allocation was mainly implemented using a random number table for selection of the intervention side. Only the raters in charge of assessing the oral mucosa were blinded to the side of the mouth where the shields had been placed. The mucosa was assessed by 3 calibrated raters at the following time points: immediately before bracket placement (baseline assessment, T0), 3 days after delivering the shields (direct assessment of intervention, T1), and 4 days after removal of the shields (indirect assessment of intervention, T2). The raters used a newly devised yardstick in which the higher the score, the more severe the alteration. Discomfort was assessed at T1 and T2 using a visual analog scale. The Mann-Whitney U test was performed at the 5% level of significance. RESULTS: Of 60 patients, 42 were eligible, and 35 were randomly selected to have one side of the mouth receive the intervention. Two patients discontinued the intervention at T1, and 5 stopped at T2. Seven additional patients were recruited and completed all time points. Thus, 42 patients participated at T0, 40 at T1, and 35 at T2. Thirty-five patients participated at all time points. At T1, no statistically significant difference in terms of mucosa alteration was observed between the 2 sides (median of all differences [MD], 0.0; 95% CI, 0.0-1.0; P = 0.11). The same occurred at T2 (MD, 0.0; 95% CI, 0.0-0.0; P = 1.00). The comfort level was statistically higher at T1 on the shielded side (MD, 14.0; 95% CI, 1.0-36.0; P = 0.04), whereas no difference was observed at T2 (MD, 0.0; 95% CI, 0.0-1.0, P = 0.81). No serious harm was observed. CONCLUSIONS: The customized bracket shields were effective in reducing discomfort during the first 3 days of orthodontic treatment despite no significant difference in terms of visible mucosa alteration. REGISTRATION: This trial was not registered. PROTOCOL: The protocol was not published before trial commencement. FUNDING: Expenses for the fabrication of the shields were covered by the main author (L.P.B.P.). Orthodontic materials were from the Center for Dental Specialties in Cajazeiras, Brazil.

O efeito da alteração da inclinação da posição natural da cabeça em 7º sobre medidas cefalométricas / The effect of altering the natural head position in 7º on cephalometric measurements

O objetivo do presente estudo foi avaliar as alterações das medidas angulares e lineares mais comumente utilizadas em cefalometria, quando a posição natural da cabeça (PNC) é modificada durante a tomada da telerradiografia em norma lateral (acréscimo e decréscimo de 7° em relação à PNC). Para tanto, foram analisadas 90 telerradiografias de 30 pacientes do sexo feminino (média de idade de 22,7 anos). Em cada paciente, foram obtidas três telerradiografias em um único momento: PNC, PNC acrescida de 7° e PNC com decréscimo de 7°. Os resultados apontaram alterações significativas para as medidas SN.VER, HF.VER e ângulo Z, porém, não foram observadas diferenças estatisticamente significantes para as demais grandezas: SNA, SNB, ANB, PP.GoGn, 1.PP, IMPA, 1.1, SN.GoGn, FMA, SN.PP, S-N, ENA-ENP, Co-Gn, Co-Go e Go-Gn. Sendo assim, concluiu-se que a inclinação da cabeça do paciente, dada pelo acréscimo ou decréscimo de 7° em relação à PNC, não apresenta interferência para as medidas cefalométricas aqui estudadas, salvo aquelas que levam em consideração a linha vertical verdadeira para sua construção...

The aim of the present study was to assess the alterations in angular and linear cephalometric measurements when modifying the natural head position (NHP) inclination to +7 or -7 degrees. Ninety cephalometric radiographs of 30 female patients (average of 22.7 years old) were obtained as follows: NHP, with +7 degrees and with -7 degrees. Statistically significant differences were observed for measurements SN.VER, HF.VER and Z angle. No influence was observed on all other measurements: SNA, SNB, ANB, PP.GoGn, 1. PP, IMPA, 1.1, SN.GoGn, FMA, SN.PP, S-N, ENA-ENP, Co-Gn, Co-Go and Go-Gn. It was concluded that tipping the head towards +7 or -7 degrees in relation to NHP has no interference to cephalometric measurements studied here, except those which use the true vertical line for its construction...

Impact of toothbrushing with a dentifrice containing calcium peroxide on enamel color and roughness.

This in vitro study sought to evaluate both the bleaching potential and changes to average surface roughness (Ra) of enamel after brushing with a dentifrice. Fifty-four enamel specimens (4 x 4 x 2 mm) were divided into 3 groups (n = 18) and treated with 1 of 3 dentifrices: 1 with calcium peroxide, and 2 without. The samples were submitted to 20,000 brushing cycles. Color and Ra were measured before and after brushing. Although the Ra increased in all groups after brushing, only the dentifrice containing calcium peroxide resulted in an increase in reflectance.

Longitudinal stability of rapid and slow maxillary expansion

OBJECTIVE: The aim of this retrospective study was to compare the longitudinal stability of two types of posterior crossbite correction: rapid maxillary expansion (RME) and slow maxillary expansion (SME). METHODS: Study casts of 90 adolescent patients were assessed for interdental width changes at three different periods: pretreatment (T1), post-treatment (T2) and at least, five years post-retention (T3). Three groups of 30 patients were established according to the treatment received to correct posterior crossbite: Group A (RME), group B (SME) and group C (control- Edgewise therapy only). After crossbite correction, all patients received fixed edgewise orthodontic appliances. Paired t-tests and one-way ANOVA were used to identify significant intra and intergroup changes, respectively (P < 0.05). RESULTS: Except for intercanine distance, all widths increased in groups A and B from T1 to T2. In the long-term, the amount of relapse was not different for groups A and B, except for 3-3 widths which showed greater decrease in group A. However, the percentage of clinically relapsed cases of posterior crossbite was similar for rapid and slow maxillary expansion. CONCLUSION: Rapid and slow maxillary expansion showed similar stability in the long-term. .

OBJETIVO: o objetivo desse estudo retrospectivo foi comparar a estabilidade em longo prazo em dois tipos de correção da mordida cruzada posterior, sendo a expansão rápida (ERM) e a expansão lenta da maxila (ELM). MÉTODOS: modelos de estudos de 90 pacientes adolescentes foram avaliados quanto às alterações na largura interdentária em três diferentes tempos: pré-tratamento (T1), pós-tratamento (T2) e pelo menos cinco anos pós-contenção (T3). Três grupos de 30 pacientes foram definidos de acordo com o tratamento realizado para a correção da mordida cruzada posterior: Grupo A (ERM), grupo B (ELM) e grupo C (controle - apenas tratamento com técnica Edgewise). Após correção da mordida cruzada, todos pacientes receberam aparelhos ortodônticos fixos corretivos Edgewise. Teste t pareado e análise de variância a um critério (ANOVA) foram realizados para identificar alterações significantes intra- e intergrupos, respectivamente (p < 0,05). RESULTADOS: exceto para a distância intercaninos, todas as larguras aumentaram nos grupos A e B de T1 para T2. Em longo prazo, a quantidade de recidiva não foi diferente para os grupos A e B, exceto para a largura 3-3, que apresentou uma maior diminuição no grupo A. Clinicamente, entretanto, a porcentagem de casos com recidivas da mordida cruzada posterior foi semelhante para expansões rápida e lenta da maxila. CONCLUSÃO: Expansões rápida e lenta da maxila apresentaram estabilidades semelhantes em longo prazo. .

Comparison of friction produced by two types of orthodontic bracket protectors

INTRODUCTION: Fixed orthodontic appliances have been regarded as a common causative factor of oral lesions. To manage soft tissue discomfort, most orthodontists recommend using a small amount of utility wax over the brackets in order to alleviate trauma. This in vitro study aimed at evaluating friction generated by two types of bracket protectors (customized acetate protector [CAP] and temporary resin protector [TRP]) during the initial stages of orthodontic treatment. METHODS: An experimental model (test unit) was used to assess friction. In order to measure the friction produced in each test, the model was attached to a mechanical testing machine which simulated maxillary canines alignment. Intergroup comparison was carried out by one-way ANOVA with level of significance set at 5%. RESULTS: The friction presented by the TRP group was statistically higher than that of the control group at 6 mm. It was also higher than in the control and CAP groups in terms of maximum friction. CONCLUSION: The customized acetate protector (CAP) demonstrated not to interfere in friction between the wire and the orthodontic bracket slot. .

INTRODUÇÃO: o aparelho ortodôntico fixo é considerado um fator causador de traumas na mucosa bucal. Com o intuito de controlar o desconforto no tecido mole, diversos ortodontistas recomendam a utilização de uma pequena quantidade de cera utilidade sobre os braquetes como forma de proteção. Esse estudo teve como objetivo avaliar, in vitro, o atrito gerado por dois tipos de protetores de braquetes (protetor de acetato e de resina - PPA e PRT) durante os estágios iniciais do tratamento ortodôntico. MÉTODOS: o atrito gerado pelos protetores no fio ortodôntico foi avaliado em unidades de teste de modelos experimentais. Esses modelos foram ligados a uma máquina de ensaios mecânicos que simulava o alinhamento do canino superior. A comparação intergrupos foi realizada pela ANOVA, com nível de significância de 5%. RESULTADOS: a fricção apresentada pelo grupo PRT foi estatisticamente maior do que a do grupo controle ao nível de 6mm. Para o atrito máximo, a média do grupo PRT foi estatisticamente maior do que a dos grupos controle e PPA. CONCLUSÃO: o protetor de acetato demonstrou não interferir no atrito entre o fio e a ranhura do braquete ortodôntico. .

Longitudinal stability of rapid and slow maxillary expansion.

OBJECTIVE: The aim of this retrospective study was to compare the longitudinal stability of two types of posterior crossbite correction: rapid maxillary expansion (RME) and slow maxillary expansion (SME). METHODS: Study casts of 90 adolescent patients were assessed for interdental width changes at three different periods: pretreatment (T1), post-treatment (T2) and at least, five years post-retention (T3). Three groups of 30 patients were established according to the treatment received to correct posterior crossbite: Group A (RME), group B (SME) and group C (control- Edgewise therapy only). After crossbite correction, all patients received fixed edgewise orthodontic appliances. Paired t-tests and one-way ANOVA were used to identify significant intra and intergroup changes, respectively (P < 0.05). RESULTS: Except for intercanine distance, all widths increased in groups A and B from T1 to T2. In the long-term, the amount of relapse was not different for groups A and B, except for 3-3 widths which showed greater decrease in group A. However, the percentage of clinically relapsed cases of posterior crossbite was similar for rapid and slow maxillary expansion. CONCLUSION: Rapid and slow maxillary expansion showed similar stability in the long-term.

A glimpse into the curricular format of comprehensive care clinics in Brazilian dental schools.

OBJECTIVE: This study aimed to describe some curricular aspects of comprehensive dental care clinics in Brazil. MATERIALS AND METHODS: An email survey was sent to all academic affairs deans of Brazilian undergraduate dental programmes. It contained questions regarding the (1) curricular format and (2) characteristics of comprehensive dental care clinics. RESULTS: Sixty-seven dental schools agreed to participate. It was observed that curricular changes have contributed to modify the structure of these clinics in 88.1% of the schools surveyed. The main alteration was related to an increase in credit hours and offer of this type of care at different levels of the dental curriculum. In 95.5% of the schools, clinical procedures were prioritized according to level of complexity. Inter-disciplinarity (37.3%) and teaching innovation (58.2%) were frequent challenges in the process of change. Progress in combining teaching and clinical services was reported by 50.8% of schools. In 32.8%, clinical procedures were still being performed intra-murally. CONCLUSIONS: Changes in the curriculum of Brazilian comprehensive dental care clinics were observed by this survey.

Improvement of the orthodontic bracket bond strength with pre-heated composite restoratives.

AIM: This study aimed to evaluate the effect of pre-heated composite restoratives on the shear bond strength (SBS) of orthodontic brackets. METHODS: The following materials were tested: a microhybrid composite restorative (Filtek Z250), two nanofilled composite restoratives (Filtek Z350 and NT Premium), a nanohybrid composite restorative (Brilliant) and a conventional orthodontic adhesive (Transbond XT). All materials were stored for 1 h in the incubator either at 25°C (room temperature simulation) or 60°C before bonding 100 orthodontic brackets on bovine lower incisors (n = 10). One Coat Bond SL and Transbond XT were used to bond the composite restoratives and the Transbond XT adhesive paste, respectively. After storage in distilled water for 24 h, the brackets were subjected to SBS test at a speed of 0.5 mm/min until bracket debonding. The Adhesive Remnant Index (ARI) was assigned to the fractured specimens. Data were analyzed using the one-way ANOVA and the Tukey post-hoc test (p < 0.05). The Kruskal-Wallis test was used to compare ARI scores between the groups (p < 0.05). RESULTS: There was no statistically significant difference between the materials at room temperature. Samples bonded with pre-heated materials showed a statistically higher SBS than those bonded with room temperature materials. Samples bonded with the pre-heated orthodontic adhesive showed the highest SBS among all the pre-heated materials. All preheated composite restoratives produced an SBS mean higher than that of Transbond XT stored at room temperature. CONCLUSION: The use of pre-heated composite restoratives and orthodontic adhesives might be an alternative approach to bond orthodontic brackets.

Randomized clinical controlled trial on the effectiveness of conventional and orthodontic manual toothbrushes

The objective of this study was to compare the effectiveness of two manual toothbrushes (conventional and orthodontic). The following clinical parameters were used: VPI (visible plaque index) and GBI (gingival bleeding index). Patients, 64 total (30 males and 34 females), in the permanent dentition, with a mean age of 17.8 years, were randomly selected from a practice specializing in orthodontics. Each participant received audio-visual instructions on oral hygiene as well as a kit of materials containing two manual toothbrushes (orthodontic and conventional). Each toothbrush was randomly allocated to one side of the mouth (split-mouth design) and used for a period of approximately 4 weeks. The VPI and GBI were measured by a single calibrated examiner before (T0) and after (T1) the implementation of interventions. The Mann-Whitney test was used to compare the VPI values between the groups, and the Student t-test for independent samples was used to compare GBI values. The level of significance was set at 5%. No statistically significant difference was observed between the groups at T0 for both VPI and GBI, and at T1 for the GBI. The manual orthodontic toothbrush produced a statistically lower VPI (P < 0.05) at T1, but this did not seem to be of clinical importance.

Randomized clinical controlled trial on the effectiveness of conventional and orthodontic manual toothbrushes.

The objective of this study was to compare the effectiveness of two manual toothbrushes (conventional and orthodontic). The following clinical parameters were used: VPI (visible plaque index) and GBI (gingival bleeding index). Patients, 64 total (30 males and 34 females), in the permanent dentition, with a mean age of 17.8 years, were randomly selected from a practice specializing in orthodontics. Each participant received audio-visual instructions on oral hygiene as well as a kit of materials containing two manual toothbrushes (orthodontic and conventional). Each toothbrush was randomly allocated to one side of the mouth (split-mouth design) and used for a period of approximately 4 weeks. The VPI and GBI were measured by a single calibrated examiner before (T0) and after (T1) the implementation of interventions. The Mann-Whitney test was used to compare the VPI values between the groups, and the Student t-test for independent samples was used to compare GBI values. The level of significance was set at 5%. No statistically significant difference was observed between the groups at T0 for both VPI and GBI, and at T1 for the GBI. The manual orthodontic toothbrush produced a statistically lower VPI (P < 0.05) at T1, but this did not seem to be of clinical importance.

Influence of adhesion promoters and curing-light sources on the shear bond strength of orthodontic brackets.

CONTEXT: The effect of different curing units on bond strength of orthodontic brackets is still unclear when utilizing nanofilled composites in comparison with traditional Transbond-XT. AIM: To evaluate the influence of two adhesive promoters and two curing-light units on the shear bond strength (SBS) of orthodontic brackets. SETTINGS AND DESIGN: The factors under study were adhesive promoters (nanofilled composite - Filtek-Z350 flowable restorative and conventional orthodontic adhesive - Transbond XT) and curing-light units (halogen lamp - Ultralux and LED device - Radii-Call). MATERIAL AND METHODS: Forty lower bovine incisors were utilized. The teeth were distributed in four groups (n = 10) according to the combination between adhesive promoters and curing-light units. Scotchbond Multipurpose-Plus and Transbond-XT primer were used to bond Filtek-Z350 Flowable Restorative and Transbond-XT, respectively. After storage in distilled water for 24 h, the brackets were subjected to SBS test at a speed of 0.5 mm/min until bracket debonding. The Adhesive Remnant Index (ARI) was assigned at fractured specimens. STATISTICAL ANALYSIS USED: Analysis of variance and Tukey test were utilized. The Kruskal-Wallis test was used to compare ARI scores between the groups (p<0.05). RESULTS: There was statistically significant difference between the adhesive promoters tested. Transbond-XT showed higher SBS means than Filtek-Z350. There was no statistically significant difference between both curing-light units tested in this study, neither between ARI scores. CONCLUSIONS: The conventional orthodontic adhesive presented higher bond strength than the nanofilled composite, although both materials interacted similarly to the teeth. The curing-light devices tested did not influence on bond strength of orthodontic brackets.

Is lower incisor inclination a good parameter to estimate alveolar bone level? A cone-beam CT evaluation.

This study verified whether an IMPA above the normative value could be a sign of reduced lower incisor labial bone height. Such association, which could improve the quality of treatment planning, was not confirmed. A cone-beam CT is still recommended when a more precise diagnosis is needed.

Preliminary clinical reports of a novel night-guard tooth bleaching technique modified by casein phosphopeptide-amorphous calcium phosphate (CCP-ACP).

Although supervised night-guard bleaching has proved successful for whitening teeth, both mineral loss and tooth sensitivity are still common problems. The present study introduces a novel remineralizer as well as describes the utilization of a possibly low sensitivity supervised night-guard vital tooth bleaching technique. A 22% carbamide peroxide gel was mixed with the casein phosphopeptide-amorphous calcium phosphate-containing MI Paste. The peroxide/MI Paste mixture was prepared with 1 ml of each material until obtaining a homogeneous paste. Five patients were instructed to follow a home bleaching protocol for 3 weeks. The outcome was assessed visually with a Vitapan scale. All subjects presented reduction of at least two Vitapan scale units after bleaching and no sensitivity was reported. The concomitant use of MI Paste and peroxide might not affect the gel effectiveness and still reduce hypersensitivity levels.