Comparative Assessment of the Shear Bond Strength of Ceramic Brackets Bonded to the Enamel Surface with a Self-adhesive System.

Objectives: This study aimed to evaluate the shear bond strength of ceramic brackets bonded to the enamel surface using Vertise Flow, with or without the application of phosphoric acid. Materials and Methods: Forty-five extracted human premolar teeth were randomly assigned to three groups (N=15) based on the adhesive used for bonding: 1) Transbond XT, etch, and bond; 2) Vertise Flow; 3) Etch and Vertise Flow. After a 500-round thermocycling procedure, the shear bond strength was measured using a universal testing machine. The samples were then evaluated under a stereomicroscope to determine failure modes, and the Adhesive Remnant Index (ARI) was measured for each group. The data were analyzed with one-way ANOVA and post-hoc Tamhane at a significance level of P<0.05. Results: The highest shear bond strength values were observed in the Transbond XT (13.5±5.38MPa), acid etch and Vertise Flow (11.2±2.89MPa), and Vertise Flow (6.2±3.16MPa) groups, respectively, in descending order. The Vertise Flow group exhibited a significantly lower shear bond strength value compared to the other two groups, with no significant difference between the latter two. Conclusion: While all three study groups demonstrated clinically acceptable shear bond strength values, Vertise Flow showed lower values compared to the other two adhesives. The Vertise Flow composite resin system, whether used alone or with acid etching, remains a suitable choice for bonding ceramic brackets, offering the advantage of a simplified bonding procedure.

Accuracy of maxillary repositioning surgery in teaching hospitals using conventional model surgery.

PURPOSE: The aim of this study was to assess the accuracy of maxillary repositioning surgery in teaching hospitals using conventional model surgery. MATERIALS AND METHODS: A total of 73 patients undergoing single-piece LeFort I osteotomies in the maxilla and bilateral sagittal split osteotomies in the mandible were included in the study. Preoperative and immediate postoperative cone-beam CT were compared in computer software (Dolphin3D©). Maxillary landmarks relative to the vertical and horizontal reference lines were evaluated. The difference between the planned and achieved maxillary positions was measured. Distance error in millimeters and achievement ratio (achieved displacement/planned displacement*100) were calculated for different maxillary movements. RESULTS: Midline correction and advancement were the most accurate movements with an overall mean distance error of 0.53 mm and 0.63 mm respectively while posterior impaction and setback were the least accurate movements with 1.38 mm and 1.76 mm mean discrepancies, respectively. A significant difference was observed only in setback movement regarding the discrepancy value (P < .05). Although setback and down-graft movements tended to under-correction, all other movements were overcorrected. As the magnitude of maxillary movements increases, the accuracy decreases. In severe displacements (≥ 8 mm), the accuracy declines significantly (P < .05). CONCLUSION: Classic cast surgery and manually fabricated intermediate splints in teaching hospitals yield accurate and acceptable results in the majority of cases (84.6%). The accuracy of maxillary repositioning decreases as the magnitude of displacement increases.

Evaluation of the cell viability and antimicrobial effects of orthodontic bands coated with silver or zinc oxide nanoparticles: An in vitro study.

Objective: We aimed to evaluate the cell viability and antimicrobial effects of orthodontic bands coated with silver or zinc oxide nanoparticles (nano-Ag and nano-ZnO, respectively). Methods: In this experimental study, 30 orthodontic bands were divided into three groups (n = 10 each): control (uncoated band), Ag (silver-coated band), and ZnO (zinc oxide-coated band). The electrostatic spray-assisted vapor deposition method was used to coat orthodontic bands with nano-Ag or nano-ZnO. The biofilm inhibition test was used to assess the antimicrobial effectiveness of nano-Ag and nano-ZnO against Streptococcus mutans, Lactobacillus acidophilus, and Candida albicans. Biocompatibility tests were conducted using the 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide assay. The groups were compared using oneway analysis of variance with a post-hoc test. Results: The Ag group showed a significantly higher reduction in the number of L. acidophilus, C. albicans, and S. mutans colonies than the ZnO group (p = 0.015, 0.003, and 0.005, respectively). Compared with the control group, the Ag group showed a 2-log10 reduction in all the microorganisms' replication ability, but only S. mutants showed a 2-log10 reduction in replication ability in the ZnO group. The lowest mean cell viability was observed in the Ag group, but the difference between the groups was insignificant (p > 0.05). Conclusions: Coating orthodontic bands with nano-ZnO or nano-Ag induced antimicrobial effects against oral pathogens. Among the nanoparticles, nano-Ag showed the best antimicrobial activity and nano-ZnO showed the highest biocompatibility.

Comparative assessment of the orthodontic wire's friction coated with zinc oxide nanoparticles by two methods of chemical precipitation and hydrothermal process.

INTRODUCTION: In orthodontic treatment with sliding technique, reduction of frictional forces could result in a more effective treatment. Recently, wire coating with nanoparticles were proposed to reduce frictional forces.

In vitro evaluation of shear bond strength of orthodontic metal brackets to aged composite using a self-adhesive composite: Effect of surface conditioning and different bonding agents.

OBJECTIVES: Bracket bonding to composite surfaces is increasing. This study sought to assess the effect of different adhesives (acid etchant+Transbond XT™, acid etchant+Vertise Flow™, Vertise Flow™) with different surface treatments (no preparation, bur, sandblasting, Er:YAG laser) on shear bond strength (SBS) of metal brackets to aged composite. MATERIALS AND METHODS: In this in vitro, experimental study, Filtek™ Z250 composite discs were fabricated (10×4mm). After thermocycling (10,000 cycles between 5-55°C), the samples were randomly divided into three groups (n=48) based on the type of adhesive namely acid etchant+Transbond XT™, Vertise Flow™, and acid etchant+Vertise Flow™. Samples in each group were randomly divided into four subgroups (n=12) based on the surface treatment including no-treatment, diamond bur, sandblasting and Er:YAG laser. Samples in each group were randomly divided into three subgroups (n=12) based on the type of adhesive namely acid etchant+Transbond XT™, Vertise Flow™, and acid etchant+Vertise Flow™. After bracket bonding to composite discs, the samples underwent thermocycling (5000 cycles between 5-55°C), and their SBS was measured in a universal testing machine. The samples were then inspected under a stereomicroscope at x10 magnification to determine their mode of failure and adhesive remnant index (ARI). RESULTS: No significant difference was noted in SBS between adhesives in no-preparation and laser groups (P>0.05). In all adhesive groups, sandblast had highest SBS, but it was not significantly different in Vertise Flow™ groups, with and without etching. The SBS provided by acid etchant+Transbond XT™ was significantly higher than that of the other two adhesives (P<0.05). The SBS of sandblasted samples was significantly higher compared with other surface treatments in all adhesive subgroups (P<0.05). CONCLUSION: Bracket bonding to aged composite using Vertise Flow™ with or without surface treatment can serve as an alternative to the conventional orthodontic adhesives.

The Effect of Photobiomodulation on Distraction Osteogenesis.

Distraction osteogenesis (DO) is a surgical procedure to increase bone height in different body parts. DO includes a surgical incision, wherein the bone is cut and a device is installed for further separation of the two ends by gradual unscrewing of the device screw. New bone gradually forms and fills the gap, and the bone height increases as such. Photobiomodulation (PBM) or low-level laser therapy (LLLT) enhances the formation of soft and hard tissue such as bone and can, therefore, accelerate the process of DO and shorten the duration of different surgical phases of DO such as latency, activation, and consolidation. Different laser types with variable exposure settings and protocols have been used for this purpose. The gallium-aluminum-arsenide (GaAlAs) diode laser is the most commonly used laser type for LLLT. This study reviews 18 published articles on the effects of LLLT on DO and summarizes their findings to further elucidate this topic.

Shear Bond Strength of Molar Tubes to Enamel Using an Orthodontic Resin-Modified Glass Ionomer Cement Modified with Amorphous Calcium Phosphate.

OBJECTIVES: This study aimed to assess the shear bond strength (SBS) of molar tubes to the enamel surface of molar teeth using a resin-modified glass ionomer (RMGI) cement modified with amorphous calcium phosphate (ACP). MATERIALS AND METHODS: In this in-vitro study, 60 extracted human third molars were randomly divided into four groups for bonding of molar tubes to the enamel surface. Fuji Ortho LC and Fuji Ortho LC modified with ACP (1.55 wt%) were used in groups 1 and 2, respectively. In group 3, the enamel surface was sandblasted, and bonding was then performed using Fuji Ortho LC glass ionomer modified with ACP. In group 4, molar tubes were conventionally bonded using Transbond XT composite. The SBS was measured using a universal testing machine. RESULTS: The mean SBS of groups 1 to 4 was 10.22, 6.88, 9.4, and 13.68 MPa, respectively. Only the SBS of group 1 was not significantly different from that of groups 3 and 4 (P>0.05). Comparison of adhesive remnant index (ARI) scores of the groups revealed significant differences only between groups 1 and 4 (P<0.001) and between groups 1 and 2 (P=0.002). CONCLUSION: The results revealed that the addition of ACP to Fuji Ortho LC significantly decreased the SBS of molar tubes bonded to enamel compared to the conventional resin bonding system. Sandblasting of the enamel surface significantly increased the bond strength. Fuji Ortho LC modified with ACP is recommended for bonding of molar tubes to posterior teeth considering its cariostatic property.

Two-Dimensional Analysis of the Size of Nasopharynx and Adenoids in Non-Syndromic Unilateral Cleft Lip and Palate Patients Using Lateral Cephalograms.

OBJECTIVES: Cleft lip and palate (CLP) is the most common congenital anomaly of the head and neck region. The upper airway in CLP patients is affected by retarded maxillary growth. Small size of the nasopharynx can also lead to mouth breathing. This study aimed to compare the size of nasopharynx and adenoids in non-syndromic unilateral CLP (NSUCLP) patients and healthy controls two-dimensionally on lateral cephalograms. MATERIALS AND METHODS: This retrospective study was performed on 30 children with NSUCLP (mean age of 11.3 years) and 30 sex- and age-matched healthy controls with class I skeletal relationship. The bony boundaries of the nasopharynx, nasopharyngeal airway and adenoids were outlined on lateral cephalograms and their surface area was calculated and compared between the two groups. The percentage of nasopharynx occupied by the adenoids was calculated for each individual and compared between the two groups using independent t-test. RESULTS: Size of nasopharynx in NSUCLP children was significantly smaller than that in healthy controls (P=0.0001). Size of adenoids was significantly larger in NSUCLP children (P=0.0001). Size of nasopharyngeal airway was smaller in NSUCLP patients than controls (P=0.0001). Percentage of nasopharynx occupied by the adenoids was significantly greater in NSUCLP patients (P=0.0001). CONCLUSIONS: The size of nasopharynx is smaller while the size of adenoids is larger in NSUCLP children compared to healthy controls; this can lead to mouth breathing and velopharyngeal incompetence.

Effectiveness of MI Paste Plus and Remin Pro on remineralization and color improvement of postorthodontic white spot lesions.

BACKGROUND: This clinical trial investigated the effectiveness of two remineralizing creams on regression of white spot lesions (WSLs) after orthodontic therapy. MATERIALS AND METHODS: The study included patients with WSLs on their upper anterior teeth who recently completed orthodontic treatment at the Department of Orthodontics of Mashhad Dental School and two private offices. The participants were randomly assigned into three groups by treatment: (1) a 12-week regimen of a cream containing casein phosphopeptide-amorphous calcium phosphate and fluoride (MI Paste Plus); (2) a 12-week regimen of a cream containing hydroxyapatite and fluoride (Remin Pro); and (3) usual home care (control). Thirty-nine patients participated and three withdrew. The main outcomes including area, mineral content, and color of WSLs were measured at enrolment and 4, 8, and 12 weeks later, respectively. Blinding was applied for outcome assessment only. The data were analyzed by analysis of variance and repeated measures analysis at the statistical significance of P < 0.05. RESULTS: Over a 3-month period, the application of both MI Paste Plus and Remin Pro caused significantly greater reduction in area and significantly higher increase in mineral content of WSLs compared to the control group (P < 0.05). The appearance of WSLs improved significantly in both experimental groups (P < 0.05), but not in the control group. No side effect was observed throughout the experiment. CONCLUSION: The application of either MI Paste Plus or Remin Pro was effective in reducing the area, increasing the mineral content and improving the appearance of demineralized enamel, indicating that these products could be recommended for managing postorthodontic WSLs.

Influence of Root Canal Tapering on Smear Layer Removal.

The purpose of the study presented here was to compare the influence of root canal taper on the efficacy of irrigants and chelating agents in smear layer removal. Eighty mesial roots of molar teeth were selected and prepared with rotary instruments. In group A, file 30/0.02 and in group B, file 30/0.4 were placed at working length and the smear layer was removed. In groups C and D, root canal preparation was the same as in groups A and B, respectively, except that the smear layer was not removed. The amount of the smear layer was quantified using a scanning electron microscope. Greater smear layer was detected in the apical portion of each group, whereas no significant difference was detected between groups in other portions. No statistical difference was found between canals with different tapers.

Combined chlorhexidine-sodiumfluoride mouthrinse for orthodontic patients: Clinical and microbiological study.

BACKGROUND: Orthodontic appliances impede good dental plaque control by brushing. Antimicrobial mouth rinses were suggested to improve this performance. We therefore aimed to investigate the effects of combined mouthrinse containing chlorhexidine (CHX) and sodium fluoride (NaF) on clinical oral hygiene parameters,and plaque bacterial level. MATERIAL AND METHODS: In this double-blind clinical study, 60 fixed orthodontic patients aged 14-25 years were randomly assigned to one of four mouthrinses groups: 1- combined CHX /NaF 2- CHX 0.06% 3- NaF0.05% 4-placebo. Following baseline examination patients were instructed to use the assigned mouthrinse twice daily for 21 days. Bleeding index (BI), modified gingival index (MGI) and plaque index (PI) were determined at the baselineand after three weeks of rinsing. Samples from supragingival plaque were obtained for the assessment of total bacterial, Streptococcus mutans and Lactobacilli colony counts. Data were analyzed by Wilcoxon, Kruskal-Wallis, and Mann-Whitney tests. RESULTS: Clinical parameters; All three active mouth rinses induced significant improvements of BI, MGI, and PI (P<0.05). Results of CHX/NaF were slightly, but not significantly, better than CHX. CHX/NaF and CHX induced significantly more changes than NaF and placebo. Microbiological measurements; Except placebo, other mouthrinses reduced total bacterial, Streptococcus mutans, and Lactobacilli counts significantly (P<0.05). CHX/NaF acted against Lactobacilli significantly more than others. CONCLUSIONS: Adding CHX0.06%/NaF0.05% combined mouth rinse to daily oral hygiene regimen of orthodontic patients significantly improved oral hygiene status. Effect of this combined mouth rinse on dental plaque Lactobacilli was remarkable. However, large controlled trials could provide more definitive evidence. KEY WORDS: Mouthrinse, fluoride, chlorhexidine, plaque.

Effect of low-level laser therapy on dental pain induced by separator force in orthodontic treatment.

BACKGROUND: Patients undergoing orthodontic treatment experience varying degrees of pain with separator insertion. A survey of patients' attitude towards orthodontic treatment revealed that pain was the most discouraging factor related to their treatment. Moreover, it was the highest ranking reason for wanting to discontinue care. The purpose of this study was to determine the effect of low-level laser irradiation on dental pain induced by forces from separators in orthodontic treatment. MATERIALS AND METHODS: This study was an experimental clinical trial. Twenty-nine patients were recruited for this research. Low-level laser irradiation was applied on one half of the maxillary and mandibular arches for 5 days. The opposite half of the arches was considered the control group. Laser irradiation was applied for 30 seconds in the alveolar bone between the second premolars, first molars, and second molars. Pain perception was evaluated with a standardized questionnaire that was answered by patients before and after laser irradiation. Data was analyzed by Wilcoxon and Friedman test. P value ≤0.05 was considered significant. RESULTS: The highest pain level was reported at day 1 following separator placement and decreased gradually until day 5. At day 4 and 5, the pain intensity was lower in the laser group than in the control group; however, this finding was not statistically significant. At day 1 and 3, the pain intensity was higher in the laser group than in the control group; however, it was not statistically significant. At day 2, the pain intensity was lower in the laser group than in the control group and was statistically significant. CONCLUSION: Our findings suggest that there is no statistically significant difference in pain by using low-level laser irradiation.

Effects of crown-root angle on stress distribution in the maxillary central incisors' PDL during application of intrusive and retraction forces: a three-dimensional finite element analysis.

BACKGROUND: Different crown-root angulations of maxillary central incisors can be assumed as a potential reason for many underscored outcomes of orthodontic treatments. The aim of this study was to determine the effects of the different crown-root angles on stress distributions in the maxillary central incisor's periodontal ligament (PDL) during application of intrusive and retraction forces using a 3D finite element method. METHODS: Two models of a maxillary central incisor were constructed using ANSYS software: the first one with an angle of 166.7° (as a sample of the maxillary central incisor in a class II, division 2 patient) and the other one with an angle of 173.4° (normal angulation). Each of the samples was loaded twice by an intrusive force (0.25 N) and a retraction force (0.5 N) through the ideal position of brackets. RESULTS: FEM results showed little difference between stress distributions in the two models during intrusion (ten thousandth) compared to retraction (thousandth). In the application of retraction force, the stress concentration on the curved tooth was less than the other. CONCLUSION: To produce similar patterns of stress in the PDL, orthodontists can apply 1.18 times heavier retraction forces on the maxillary central incisors in class II, division 2 patients compared to class I patients.