An evaluation of cephalometric predictors of anterior open bite; An assessment of dental and skeletal parameters in an orthodontic population.

BACKGROUND: Anterior open bite (AOB) malocclusion is one of the highly challenging malocclusions. Cephalometric radiographs have been used for the diagnosis of occlusal anomalies in the vertical and anteroposterior directions. This study aims to compare skeletal and dental features in open and non-open bite subjects to identify factors that help predict and categorize open bites in a Nigerian population. MATERIALS AND METHODS: Pretreatment cephalometric radiographs of 82 patients were recruited into this study. This study comprised 41 AOB patients and 41 (Class 1 malocclusion) patients (control group). The radiographs were obtained from the orthodontic unit, Department of Child Dental Health of the Lagos University Teaching Hospital, Idi-Araba Lagos. Cephalometric tracing and analysis of the obtained radiographs were used to identify and compare the skeletal and dental differences between the two groups. RESULTS: The mean age of the participants was 20.47 ± 8.05 years. The patients consisted of 26 (31.7%) males and 56 (68.3%) females. There was a significant difference in the open bite depth indicator (ODI) of the open bite (P value < 0.001). There was a statistically significant increase in the vertical skeletal parameters - lower facial height (LFH), total facial height (TFH), posterior facial height (PFH), Frankfort-mandibular plane angle (FMA), mandibular-maxillary angle (MMA), and gonial angle in the AOB group compared to the control group. The vertical height of the dentoalveolar segments measured was all significantly increased in the open bite group compared to the control group. CONCLUSION: The results suggest that the skeletal and dental vertical parameters, including ODI of the open bite subjects, varied compared with the non-open bite subjects in the Nigerian population studied and could be used to predict AOB tendency.

Survival analysis of temporary anchorage devices: A retrospective analysis in a Nigerian orthodontic patient population.

OBJECTIVES: Temporary anchorage devices (TADs) are skeletal anchorage devices. They are minimally invasive and placed by the orthodontist to prevent unwanted tooth movement. This study evaluated the survival rate of orthodontic TADs at 6 months. This study also assessed the effect of age, gender, side, site, dental arch of placement, and length of the TADs on its survival rate. MATERIALS AND METHODS: Ethical approval was obtained from the Health Research Ethics Committee of the hospital. The study sample comprised orthodontic patients who required the placement of TADs during treatment at a private dental facility in Lagos. Data for the study were obtained from the case files of the study subjects and included the subjects' age, gender, date of placement of the TADs, the site, side and arch of placement, the length of the TADs, and the survival rate of 6 months after placement. RESULTS: We reviewed 90 placed TADs and observed a survival rate of 88.9%. Most TAD failures occurred in the first month of placement (p = 001). There was no observable statistically significant effect of all other variables assessed (age, gender, arch, site, side, or implant length) on the survival rate of the TADs. CONCLUSIONS: The survival rate of TADs was high. Most TAD failures significantly occurred within one month of placement. There was no significant association between all other clinical variables and orthodontic mini-implant survival.

Iatrogenic fibrotic encapsulation of NANCE palatal arch appliance in the hard palate and its surgical management: a case report.

Fibrosis is the overgrowth of connective tissue resulting from chronic inflammatory reactions induced by persistent tissue injury such as iatrogenic injury from prolonged use of orthodontic appliances. We report a case of a 19-year-old female who presented with a complaint of dental malocclusion. Her first presentation was 5 years prior when she received a Nance palatal arch appliance. However, she did not keep to her follow-up appointments and could not complete her treatment. Intraoral examination revealed the Nance palatal arch appliance completely buried in fibrotic tissue of the hard palate. The appliance was resistant to removal by conventional means and surgical exposure and removal were performed. A new Nance palatal arch appliance was fabricated and fitted and the patient continued to receive further orthodontic treatment. This report elucidates the importance of regular dental appointments for patients on orthodontic therapy to prevent complications and minimize the need for surgical interventions.

Comparative Study of the Shear Bond Strengths and Bracket Failure Rates of Two Orthodontic Adhesive Systems

Abstract Objective: To evaluate and compare the shear bond strengths (SBS) and bracket failure rates (BFR) of orthodontic brackets bonded with Light Cure adhesive against those bonded with Self Cure adhesive. Material and Methods: The study had in vitro and in vivo parts. In the in vitro part to determine SBS of Light Bond(LB)(R) and Rely.a.Bond(RB)(R) adhesives used in bonding brackets to 88 extracted teeth, each adhesive type was used to bond 44 brackets. The clinical study was conducted to determine the BFR of the LB(R) and RB(R) adhesives by bonding 256 teeth using each adhesive type. A standardized bonding procedure was followed in both the in vitro and in vivo parts of the study. Data were analyzed using frequency, percentage, mean, independent t-test, chi-square, and Pearson Correlation statistics. A p-value of ≤ 0.05 was considered significant. SPSS version 21.0 was used to analyze the data generated. Results: There was a significantly higher mean SBS 10.6MPa for LB(R) adhesive than the 7.0MPa of the RB(R) adhesive. In the in vivo study, (LB)(R) had a greater but not significant BFR of 9.0% than RB(R) (8.0%). No significant relationship existed between the SBS of either adhesive type (as determined in vitro) and their BFR in vivo. Conclusion: Higher SBS of LB(R) did not translate to less BFR in the clinic, nor did a lower SBS of RB(R) translate to more BFR in the clinic (AU).

Impact of the coronavirus disease 2019 pandemic on orthodontic patients and their attitude to orthodontic treatment.

INTRODUCTION: This study aimed to assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on the orthodontic patient. It also assessed the knowledge and attitude of patients to the COVID-19 infection and the willingness to carry out specific precautionary measures in the orthodontic clinics to mitigate the spread of the virus. METHODS: It was a cross-sectional descriptive study. Questionnaires were distributed to orthodontic patients via Google forms. The questionnaire assessed participants' knowledge, attitude, the impact of the COVID-19 pandemic on orthodontic treatment, and willingness to carry out infection control precautionary measures in the orthodontic clinic. RESULTS: A total of 304 responses were obtained; 83 males (27.3%), 221 females (72.7%) with a mean age of 35.6 years. Subjects demonstrated good knowledge of COVID-19 infection (94.7%). Most respondents (95%) considered the infection as dangerous and believed the orthodontic patient was at risk of contracting the disease but were willing regardless to carry on with their orthodontic treatment during the pandemic. Fear of contracting the COVID-19 virus during orthodontic appointments and missed orthodontic appointments (74%), and increased treatment time (50%) were the immediate and long-term concerns, respectively. A high acceptance rate of compliance to precautionary measures to mitigate virus spread in the clinic was observed. CONCLUSIONS: The COVID-19 pandemic has had a negative impact on the orthodontic treatment and the financial and emotional wellbeing of orthodontic patients. Patients were willing to continue with orthodontic management during the pandemic while complying with precautionary measures to prevent disease spread in the orthodontic practice setting.

Perception of dental midline deviation amongst dental professionals and lay people

Objective: This study was conducted to evaluate the perception of midline coincidence as a determining factor in smile aesthetics. Methods: A single of a female smile was intentionally altered with a software program (Adobe Photoshop, CS5. 1990-2010, Adobe system incorporated). The alteration involved shifting the upper midline by 0.5mm to the left in four variations. These altered images were then rated by two groups, 30 in each group, the professionals and the lay persons using a visual analogue scale. Results: There was a statistically significant difference between the professionals and the laypeople in the perception of midline coincidence as a factor in assessing smile aesthetics, (p=0.038, T=2.1). Conclusion: The orthodontists, general dentists, other professionals and the laypersons detected specific dental aesthetic discrepancies at varying levels of deviation

Dental esthetics and oral health-related quality of life in young adults.

INTRODUCTION: Dental esthetics affects how people are perceived by society and how they perceive themselves, and this may also affect their oral health-related quality of life (OHRQoL). The aim of this study was to compare the impacts of self-perceived and normatively assessed dental esthetics on the OHRQoL of a young adult population. METHODS: This was a cross-sectional descriptive study involving 375 undergraduate university students, aged 18 to 30 years old. Data collection was carried out through oral examinations and self-administered questionnaires. Dental esthetics of the students was assessed using the esthetic component of the Index of Orthodontic Treatment Need. Two OHRQoL instruments were used: the shortened version of the Oral Health Impact Profile and the Psychosocial Impact of Dental Aesthetics Questionnaire. RESULTS: Statistically significant relationships (P <0.05) were recorded between both self-perceived and normatively assessed dental esthetics of the students, respectively, and 3 of the 4 Psychosocial Impact of Dental Aesthetics Questionnaire subscales: dental self-confidence (Kruskall-Wallis, P = 0.000; P = 0.000), psychological impact (P = 0.003, P = 0.047), and esthetic concern (P = 0.006, P = 0.003). The only exception was the social impact subscale, in which a significant relationship was recorded only with self-perceived dental esthetics (P = 0.040). For the shortened version of the Oral Health Impact Profile scale, marked differences were also observed between the impacts recorded for both self-assessments and normative assessments, respectively, particularly for the psychological disability domain (Fisher exact test, P = 0.021, P = 0.000; P = 0.064, P = 0.096). CONCLUSIONS: Differences exist between the impacts of self-perceived and normatively assessed dental esthetics on the OHRQoL of young adults, particularly in the psychosocial domains. These differences should be considered in orthodontic treatment planning for young adult populations.

Prevalence and intensity of bacteraemia following orthodontic procedures.

BACKGROUND: There is a possibility that bacteria may enter the blood stream during some non-surgical manipulation procedures, which include orthodontic treatment procedures (alginate impression taking, separator placement, band cementation, and archwire change). OBJECTIVES: The aim of this study was to determine the prevalence and intensity of bacteraemia associated with orthodontic procedures in patients seen at the Lagos University Teaching Hospital, Nigeria. METHODOLOGY: A total of 100 subjects who presented at the Orthodontic Clinic of the Lagos University Teaching Hospital and who met the inclusion criteria were recruited for the study. Four orthodontic procedures were investigated: alginate impression taking, separator placement, band cementation and archwire placement. Subjects were randomly placed in one of the four procedure groups. Peripheral blood was collected for microbiologic analysis before the orthodontic procedures and within 2 min of completion of the procedures. The BACTEC automated blood culture system and the lysis filtration method of blood culturing were used for microbiological analysis of the blood samples. The Wilcoxon signed rank test, the McNemar χ(2) test, the Mann-Whitney U-test, and Spearman and point bi-serial correlations were used for statistical evaluation at the P<0.05 level. RESULTS: A significant increase in the prevalence and intensity of bacteraemia was observed following separator placement. The predominant bacteria isolated from the blood cultures were Streptococcus viridans and Staphylococcus species. CONCLUSION: Separator placement induced the highest levels of bacteraemia. Use of a 0.2% chlorhexidine mouth rinse is recommended prior to separator placement in orthodontic patients.

Orthodontic treatment complexity and need in a Nigerian teaching hospital.

OBJECTIVE: The aim of this study was to assess the orthodontic treatment need and complexity in a major referral orthodontic centre in Lagos, Nigeria. METHOD: Pre-treatment dental casts of 150 consecutive patients were assessed using the Index of Complexity, Outcome and Need (ICON). RESULTS: Fifty-seven (38%) of the population needed orthodontic treatment. Twenty-five (16.7%) cases were classified as difficult or very difficult, 14.7% moderate and 68.6% belonged to the easy/mild categories. The overall mean ICON score was 43 ± 17.8 SD. There were no significant age or gender differences in the pre-treatment ICON score. There was a significant association (p<0.05) between treatment need and social class: more subjects from the lower social class needed orthodontic treatment than subjects from the higher social class. CONCLUSIONS: More than one third of the population had a need for orthodontic treatment, of which close to one fifth were in the difficult to very difficult category. Patients in the lower socio-economic class had greater need for orthodontic treatment than those from the higher class.

Emotional effects of malocclusion in Nigerian orthodontic patients.

AIM: To assess the emotional effects of malocclusion among Nigerian orthodontic patients. DESIGN: A questionnaire survey. SUBJECTS AND METHODS: A questionnaire was completed by 221 Nigerian orthodontic patients undergoing routine orthodontic care at the Orthodontic Unit, Department of Preventive Dentistry, University College Hospital, Ibadan and the Department of Child Dental Health, Lagos University Teaching Hospital, Lagos, both in South-West Nigeria. The participants were comprised of 97 (43%) males and 124 (56.1%) females with age range of 6-40 years (mean age, 13.82 +/- 8.01 SD). Data were analyzed using descriptive statistics and Chi-square test. RESULTS: About 44% of all participants had not yet accepted their malocclusions, while 56.6% of all subjects reported for orthodontic care due to aesthetic reasons. Twenty-seven percent of the subjects were depressed the first time they notice their malocclusions. Over 40% of the participants reported feeling less confident as a result of their malocclusions and about 55% of them felt their malocclusions negatively affected their general facial appearances. Normal activities restricted in some of the subjects due to malocclusion included laughing in public (48.9%), meeting people in public (32%), and forming close relationships (20.4%). The majority (64.7%) of the subjects discussed their malocclusions with their parents, followed by dentists (35.3%). CONCLUSION: The psychosocial effects of malocclusion in Nigerian orthodontic patients were considerable with no significant gender differences. Considering such factors, professional counseling of Nigerian orthodontic patients is encouraged.