Multidisciplinary approach to traumatized teeth: a case report.

Treatment of crown fractures often requires a multidisciplinary approach. In the anterior teeth, reestablishment of proper esthetics and function is quite important for the patient. However, crown-root fractures with fracture line below the gingival attachment or alveolar bone crest presents restorative difficulties. This case report presents a cervical tooth fracture that had been treated with minimal invasive approach with different disciplines. The tooth had endodontic treatment and a glass-fiber post, and a composite core was accomplished. Then, the tooth was extruded to the desired level with orthodontic forced eruption before definitive restoration.

A comparison of white spot lesion formation between a self-ligating bracket and a conventional preadjusted straight wire bracket.

AIM: Demineralization following removal of orthodontic appliances is a common problem. Presence of archwires, especially those with loops and different types of ligatures, complicate cleaning around bands and brackets during orthodontic treatment. These factors led clinicians to develop self-ligating brackets. The purpose of this study was to compare the incidence of white spot lesion formation with the use of a self-ligating bracket with conventional preadjusted straight wire brackets. METHODS: Twenty patients were randomly divided into 2 groups. In the first group (aged 13.4 ± 2.5 years), the teeth were bonded with In-ovation brackets; the second group's (aged 14 ± 3.34 years) teeth were bonded with conventional preadjusted straight wire brackets. The patients were followed throughout treatment, and the number of white spot lesions was noted at debonding. RESULTS: The results revealed no statistically significant differences in white spot lesion development between conventional straight wire and self-ligating brackets. CONCLUSION: No differences in terms of white spot lesion formation were found between conventional straight wire and self-ligating brackets, and white spot lesion formation does depend largely on patients' oral hygiene status, not the type of bracket or ligation used.

Effects of preoperative ibuprofen and naproxen sodium on orthodontic pain.

Three experimental groups of 20 patients each, all of whom were to undergo fixed orthodontic treatment, were enrolled in this prospective study. Group 1 was given a placebo, group 2 was given 400 mg ibuprofen, and group 3 was given 550 mg naproxen sodium. All the patients received only one dose that was given one hour before archwire placement. All patients were asked to complete a questionnaire concerning the pain perceived after archwire placement. The questionnaire was in the form of a seven-page booklet that contained 100-mm horizontal Visual Analogue Scale on which the patient marked the degree of discomfort at the indicated time periods. The patients were instructed to make a check on the scale at each time interval to represent the perceived severity of pain during each of four activities, ie, chewing, biting, fitting back teeth together, and fitting front teeth together. Incidence and severity of pain were recorded by the patient at two hours, six hours, nighttime on the day of appointment, 24 hours after the appointment, and two days, three days, and seven days after bonding. The results revealed that patients taking 550 mg naproxen sodium one hour before archwire placement had significantly lower levels of pain at two hours, six hours, and nighttime after adjustment than patients taking placebo or ibuprofen. However, the use of additional postoperative doses was recommended to control orthodontic pain completely.

Pain control during fixed orthodontic appliance therapy.

The control of pain during orthodontic treatment is of great interest to both clinicians and patients. However, there has been limited research into the control of this pain, and there is no standard of care for controlling this discomfort. This prospective study determines the pain sequelae in fixed orthodontic treatment and evaluates comparatively the analgesic effects of nonsteroidal anti-inflammatory drugs for the control of this pain. One hundred and fifty orthodontic patients who were to have teeth bonded in at least one arch were randomly assigned to one of six groups: (1) placebo/placebo, (2) ibuprofen/ibuprofen, (3) flurbiprofen/flurbiprofen, (4) acetaminophen/acetaminophen, (5) naproxen sodium/naproxen sodium, and (6) aspirin/aspirin. The pain evaluations were made during chewing, biting, fitting the front teeth, and fitting the back teeth using a 100-mm visual analogue scale (VAS) for seven days. All the analgesics succeeded in decreasing the pain levels compared with the placebo group. However, naproxen sodium and aspirin groups showed the lowest pain values, and the acetaminophen group showed VAS results similar to those of the two analgesics.

Effects of a chlorhexidine varnish on shear bond strength in indirect bonding.

The purpose of this study was to evaluate the effects of an antimicrobial varnish on the shear bond strength (SBS) of metallic orthodontic brackets bonded with an indirect bonding resin. For this purpose, 60 noncarious human premolars were divided into three equal groups. Group 1 was an indirect bonding control group and, after acid etching of the enamel, the brackets were indirectly bonded to the teeth with an indirect bonding resin. In group 2, before bonding, an antimicrobial varnish was painted on the etched enamel and indirect bonding was carried out as in group 1. In group 3, Transbond MIP primer and the antimicrobial varnish were thoroughly mixed in a 1:2 proportion, applied to the enamel surface, light cured for 20 seconds, and the brackets were direct bonded. A universal testing machine was used to determine the maximum load necessary to debond the brackets, the SBS values recorded, and the adhesive remnant index scores determined. Data were analyzed using analysis of variance (ANOVA), Tukey HSD, and chi-square tests. Results of ANOVA revealed statistically significant differences in the SBS among the various groups tested (P < .05). Indirect bonding of brackets with Sondhi Rapid Set after the application of the antimicrobial varnish showed significantly lower SBS when compared with both the group 2, indirect bonding control group, and the group 3, direct bonded-antimicrobial varnish group.

In vitro evaluation of shear bond strengths and in vivo analysis of bond survival of indirect-bonding resins.

In this study we evaluate the shear bond strengths (SBS) of indirect-bonding systems available on the market. For the in vitro study, 60 extracted premolars were divided into three groups. In indirect group I, the brackets were bonded to models using Therma Cure laboratory resin and transferred to the teeth using Custom IQ resin for indirect bonding. For indirect group II, the teeth were attached to models using Transbond XT and transferred using Sondhi Rapid Set. In the direct-bonding group, the brackets were bonded to teeth directly using Transbond XT The SBS were evaluated, and the comparisons were made. In the in vivo study, left half of the upper arch and right half of the lower arch were bonded using Sondhi's indirect-bonding resin and right half of the upper arch and left half of the lower arch were bonded using Therma Cure as a laboratory resin and Custom IQ as a clinical bonding resin. The failure rates of the brackets were followed for nine months. Analysis of variance and Tukey tests were performed. Mean SBS values (MPa) were 10.3 +/- 4.2, 6.1 +/- 1.6, and 12.8 +/- 5.4 for the indirect groups I and II and for the direct-bonding group, respectively. There were no significant differences between indirect group I and direct group (P > .05), whereas both yielded significantly higher SBS values compared with indirect group II. In vivo bond survival evaluation showed no differences between the two indirect-bonding systems available.

A practical method of fabricating a lingual retainer.

Retention is a major part of orthodontic treatment, not an optional secondary protocol. In recent years, studies investigating dentofacial changes during and after the growth period have led most clinicians to use fixed retention appliances after treatment. Fixed retainers can be attached to the teeth directly or indirectly. We present a practical, indirect method for bonding fixed retainers, using Sondhi Rapid-set Indirect Bonding Adhesive (3M Unitek, Monrovia, Calif).