Comparison of alignment efficiency of different sizes of superelastic nickel-titanium archwires in the initial phase of fixed orthodontic treatment: A single-center, double-blind randomized clinical trial.

INTRODUCTION: This 3-arm parallel, double-blind study aimed to evaluate the alignment efficiency of 3 different diameters of superelastic nickel-titanium (NiTi) archwires during the initial phase of orthodontic treatment. METHODS: Ninety-three patients with nonextraction treatment in the mandibular arch (using 0.022-in Roth prescription brackets) were randomly allocated into 3 groups: 0.012-in NiTi (group 1), 0.014-in NiTi (group 2), and 0.016-in NiTi (group 3). The alignment change was measured using the modified Little's irregularity index before archwire placement and every 4 weeks. The alignment efficiency of the 3 groups was analyzed. RESULTS: Ninety patients were analyzed (group 1: n = 29, group 2: n = 31, and group 3: n = 30; overall mean age, 16.6 years). The overall Wald test analysis revealed that wire type was not statistically significant (P = 0.91), whereas time exhibited significance as expected (P <0.001). Furthermore, the interaction between wire type and time was not significant (P = 0.93). The time-adjusted estimated difference between 0.014-in and 0.012-in was -0.49 (95% confidence interval, -2.83 to 1.85; P = 0.68). The time-adjusted estimated difference between 0.016-in and 0.012-in was -0.45 (95% confidence interval, -2.95 to 2.05; P = 0.72). No harm was observed. CONCLUSIONS: The clinical performance of 3 different sizes of NiTi archwires was similar. In addition, 0.014-in and 0.016-in NiTi archwires demonstrated better performances in aligning any irregularities because of a greater number of wire deformations in the 0.012-in group. REGISTRATION: IR.TBZMED.REC.1395.1039. PROTOCOL: The protocol was not published before trial commencement. FUNDING: None.

Effect of smile on facial attractiveness before and after orthodontic treatment in females with more attractive and less attractive facial background.

INTRODUCTION: One of the goals of orthodontic treatment is to improve facial esthetics. This study aimed to determine the effect of smile on facial attractiveness before and after orthodontic treatment in females with "more attractive" and "less attractive" facial backgrounds. In addition, changes in facial attractiveness after orthodontic treatment were examined. METHODS: Frontal rest and smile photographs of 60 female patients (mean age, 26.32 years) before and after orthodontic treatment were included in 4 separate online questionnaires. The link for each questionnaire was sent to 40 layperson raters (20 females, 20 males). They were asked to give a score from 0 to 100 on the basis of the visual analog scale for the attractiveness of each image. Then the data were collected and analyzed. RESULTS: The mean score of the pretreatment smile was significantly smaller than the frontal rest view, and the difference was significantly greater in the "more attractive" group (P = 0.012). After treatment, the smiling view was significantly more attractive than the frontal rest view, and the difference was significantly greater in the "less attractive" group (P = 0.014). In addition, the attractiveness of both smiling and rest views increased significantly after orthodontic treatment, and these changes were significantly greater in the "more attractive" group (P <0.001 and P = 0.011). CONCLUSIONS: An unesthetic pretreatment smile negatively impacted facial attractiveness, and orthodontic treatment significantly improved facial attractiveness. These negative and positive effects were greater in more attractive facial backgrounds.

Effectiveness of Photobiomodulation on Orthodontic Mini Screw Stability: A Systematic Review.

Objective: Photobiomodulation therapy (PBMT) enhances bone regeneration and bone healing and has been suggested to improve the stability of orthodontic mini screws. This study aimed to systematically review the clinical influence of PBMT on orthodontic mini screw stability. Methods: A comprehensive search was run in the following electronic databases: PubMed, EMBASE, Web of Science, Scopus, and Cochrane. The clinical trials reporting the effects of PBMT on mini screw stability in human subjects were included. Two reviewers independently screened and extracted data. The Cochrane Risk of Bias Assessment Tool was used to investigate the quality of the included studies. The overall quality of evidence was evaluated through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. The primary outcome was the stability of mini screws, and the secondary outcomes were pain, inflammation [the interleukin (IL)-1ß, IL6, and IL8], and overall success rate. Quantitative synthesis could not be performed due to heterogeneities among studies. Results: Seven articles were finally included in the present review. Moderate-quality evidence suggests that if the PBMT continues until the third or fourth week, the stability of min screws would be promoted from the third to the eighth week after insertion. Although the evidence for secondary outcomes was limited, PBMT could positively affect the inflammation. Conclusions: PBMT exerted varying effects on the stability of mini screws at different time intervals. However, despite the limitations of studies, it seems to enhance the secondary stability of orthodontic mini screws primarily. Registration: The study protocol was registered on PROSPERO (https://www.crd.york.ac.uk/PROSPERO/) with the ID#CRD42020194058.

The effects of statins on dental and oral health: a review of preclinical and clinical studies.

The statin family of drugs are safe and effective therapeutic agents for the treatment of arteriosclerotic cardiovascular disease (CVD). Due to a wide range of health benefits in addition to their cholesterol lowering properties, statins have recently attracted significant attention as a new treatment strategy for several conditions, which are not directly related to normalizing a lipid profile and preventing CVD. Statins exert a variety of beneficial effects on different aspects of oral health, which includes their positive effects on bone metabolism, their anti-inflammatory and antioxidant properties, and their potential effects on epithelization and wound healing. Additionally, they possess antimicrobial, antiviral, and fungicidal properties, which makes this class of drugs attractive to the field of periodontal diseases and oral and dental health. However, to the best of our knowledge, there has been no comprehensive study to date, which has investigated the effects of statin drugs on different aspects of dental and oral health. Therefore, the primary objective of this paper was to review the effect of statins on dental and oral health. Results of our extensive review have indicated that statins possess remarkable and promising effects on several aspects of dental and oral health including chronic periodontitis, alveolar bone loss due to either extraction or chronic periodontitis, osseointegration of implants, dental pulp cells, orthodontic tooth movement, and orthodontic relapse, tissue healing (wound/bone healing), salivary gland function, and finally, anti-cancer effects. Hence, statins can be considered as novel, safe, inexpensive, and widely-accessible therapeutic agents to improve different aspects of dental and oral health.

Patient-centered evaluation of alignment changes during the first stage of orthodontic treatment: A longitudinal observational study.

Background . The aim of this longitudinal observational study was to evaluate patients' perceptions of alignment changes during the first stage of fixed orthodontic treatment. Methods . Ninety-three non-extraction patients (mean age: 17.6 years) who were scheduled to undergo fixed-appliance treatment in the first author's private office were included. Patients assessed the alignment of their teeth subjectively using visual analogue scale at the bonding session and four, eight and 12 weeks later. The amount of Little's irregularity index at each session was calculated on stone casts. Freidman test was used to compare the "alignment changes" between different intervals. Correlation coefficients were calculated using Spearman test between Little's irregularity indices and alignment scores reported by the patients in each session. Results . No patients reported regression in alignment changes during three-month course of treatment. The final changes (from bonding session to the 12th-week visit) were smaller than the sum of the three intervals, which indicated that patients became more perceptive as the treatment progressed. Comparison of two scores reported for each session (in the same session and in the next session) revealed that patients could not recall their previous situation well. Patients do not perceive alignment changes in the same way as clinicians. Furthermore, patients who were 16 or older perceived smaller alignment changes during the first four-week period and smaller final alignment changes. Conclusion . To obtain better patient compliance and improve their motivation throughout orthodontic treatment, patientspecific measures should be undertaken, including reminding them about their initial conditions and highlighting the changes as the treatment progresses.

Evaluation of mast cell counts and microvessel density in reactive lesions of the oral cavity.

Background. Reliable immunohistochemical assays to assess the definitive role of mast cells (MCs) and angiogenesis in the pathogenesis of oral reactive lesions are generally not available. The aim of the present study was to evaluate mast cell counts (MCC) and microvessel density (MVD) in oral reactive lesions and determine the correlation between MCC and MVD. Methods. Seventy-five cases of reactive lesions of the oral cavity, including pyogenic granuloma, fibroma, peripheral giant cell granuloma, inflammatory fibrous hyperplasia, peripheral ossifying fibroma (15 for each category) were immunohisto-chemically stained with MC tryptase and CD31. Fifteen cases of normal gingival tissue were considered as the control group. The mean MCC and MVD in superficial and deep connective tissues were assessed and total MCC and MVD was computed for each lesion. Results . Statistically significant differences were observed in MCC and MVD between the study groups (P < 0.001). MC tryptase and CD31 expression increased in the superficial connective tissue of each lesion in comparison to the deep con-nective tissue. A significant negative correlation was not found between MCC and MVD in oral reactive lesions (P < 0.001, r = -0.458). Conclusion. Although MCs were present in the reactive lesions of the oral cavity, a direct correlation between MCC and MVD was not found in these lesions. Therefore, a significant interaction between MCs and endothelial cells and an active role for MCs in the growth of oral reactive lesions was not found in this study.