Root resorption during maxillary molar intrusion with clear aligners: a randomized controlled trial.

OBJECTIVES: To compare changes in maxillary molar root resorption, intrusion amount, dentoskeletal measures, and maximum bite force (MBF) between clear aligners (CA) and fixed appliances with miniscrew (FM) during molar intrusion. MATERIALS AND METHODS: Forty adults with anterior open bite were randomized into either CA or FM groups. Lateral cephalograms, cone-beam computed tomography (CBCT), and MBF were collected at pretreatment (T0) and 6 months of treatment (T1). Maxillary molar intrusion in FM were intruded by nickel-titanium (NiTi) closed-coil spring delivered force (150 grams/side) while clear aligners combined with squeezing exercise were performed in CA. Parametric tests were used for statistical analysis. RESULTS: After 6 months of treatment, significant root resorption of 0.21-0.24 mm in CA and 0.38-0.47 mm in FM were found while maxillary molars were intruded 0.68 and 1.49 mm in CA and FM, respectively. CA showed significant less root resorption and intrusion than FM. Overbite, bite closing, and MBF increased significantly. CA showed significantly less overbite and SN-MP changes but more MBF increase than FM. MBF in CA was correlated with the amount of maxillary molar intrusion (r = 0.736, P < .05). CONCLUSIONS: Maxillary molar intrusion and root resorption in CA were half the amount in FM in 6 months. The amount of maxillary molar root resorption was one-third of the intrusion distance. CA displayed less overbite increase and bite closing but more MBF increase than FM. MBF in CA was positively correlated with the molar intrusion amount.

Mandibular incisor root volume changes between anterior bite planes fabricated from acrylic resin and thermoplastic materials: a prospective randomized clinical trial.

OBJECTIVES: To compare mandibular incisor root volume change (RVC) after 6 months between an anterior bite plane fabricated from acrylic resin (ABP) and thermoplastic materials (TBP) in a group of growing patients. MATERIALS AND METHODS: Thirty-four deep bite patients (age: 11.57 ± 1.30 years) were randomized into the ABP or TBP group. The RVC from before treatment (T0) to 6 months after treatment (Tct) at the labio-coronal (La1), labio-middle (La2), labio-apical (La3), linguo-coronal (Li1), linguo-middle (Li2), and linguo-apical (Li3) segments were investigated from cone beam computed tomography (CBCT) images. Cephalometric changes between T0 and the visit that normal overbite was achieved (Tcep) were also assessed (α = 0.05). RESULTS: Thirty-four patients completed the trial. Treatment duration was 5.0 ± 2.9 months. Significant decrease in root volume (RV) was found at the La2, La3, and Li3 segments of the ABP group (P < .05). No significant RVC was found in any segment of the TBP group (P ≥ .05). Comparing between groups, the RVC at La3 and Li3 of the ABP group was significantly greater than that of the TBP group (P < .05). However, total RVC between groups was not significantly different (P ≥ .05). CONCLUSIONS: Growing patients undergoing deep bite correction for 6 months with ABP displayed more apical RVC of mandibular incisors than those who used TBP. However, total RVC between appliances was not significantly different.

Release of fluoride from orthodontic adhesives and penetration into enamel.

OBJECTIVE: The purpose of this work was to compare fluoride release from three orthodontic adhesives and fluoride penetration into the enamel surface. MATERIALS AND METHODS: A total of 156 extracted human premolar teeth were randomly assigned to three experimental groups and one control group (without bonding) with 39 teeth per group. Brackets were bonded to teeth using Fuji Ortho LC®, Illuminate®, or Light Bond®. The amount of fluoride released (ppm) into artificial saliva was measured by a fluoride ion-selective electrode connected to an ion analyzer on days 1, 3, 7, and 30. Fluoride penetration was investigated after 1, 2, and 3 months; 13 teeth of each group were randomly selected at every period of study and sectioned across the center of the bracket. The surface of the cross-section was studied under the scanning electron microscope, and the fluoride concentration (weight%) at 1, 2, and 3 µm below the outer enamel surface was determined by energy-dispersive X-ray microanalysis. RESULTS: On days 1, 3, 7, and 30, the mean cumulative fluoride release from the three orthodontic adhesives were significantly different (p < 0.05). Illuminate® released the greatest fluoride, followed by Fuji Ortho LC® and Light Bond®. After 1, 2, and 3 months, fluoride penetration into enamel was only found from Fuji Ortho LC®. The fluoride concentration decreased with depth but there were no significant differences (p > 0.05) over time at all depths. CONCLUSIONS: The in vitro study indicated that fluoride release is a common property of the three fluoride-releasing orthodontic adhesives: Illuminate®, Fuji Ortho LC®, and Light Bond®. However, detectable fluoride penetration is a specific property of Fuji Ortho LC®. Further clinical studies should be undertaken to investigate the benefit of the two adhesives Illuminate® and Fuji Ortho LC® on protection of enamel demineralization.

Factors influencing soft tissue profile changes following orthodontic treatment in patients with Class II Division 1 malocclusion.

BACKGROUND: Several studies have shown soft tissue profile changes after orthodontic treatment in Class II Division 1 patients. However, a few studies have described factors influencing the soft tissue changes. The purpose of this study was to investigate the factors influencing the soft tissue profile changes following orthodontic treatment in Class II Division 1 patients. METHODS: The subjects comprised 104 Thai patients age 8-16 years who presented Class II Division 1 malocclusions and were treated with different orthodontic modalities comprising cervical headgear, Class II traction and extraction of the four first premolars. The profile changes were evaluated from the lateral cephalograms before and after treatment by means of the X-Y coordinate system. Significant soft tissue profile changes were evaluated by paired t test at a 0.05 significance level. The correlations among significant soft tissue changes and independent variables comprising treatment modality, age, sex, pretreatment skeletal, dental and soft tissue morphology were evaluated by stepwise multiple regression analysis at a 0.05 significance level. RESULTS: The multiple regression analysis indicated that different treatment modalities, age, sex, pretreatment skeletal, dental and soft tissue morphology were related to the profile changes. The predictive power of these variables on the soft tissue profile changes ranged from 9.9 to 40.3%. CONCLUSIONS: Prediction of the soft tissue profile changes following treatment of Class II Division 1 malocclusion from initial patient morphology, age, sex and types of treatment was complicated and required several variables to explain their variations. Upper lip change in horizontal direction could be found only at the stomion superius and was less predictable than those of the lower lip. Variations in upper lip retraction at the stomion superius were explained by types of treatment (R(2) = 0.099), whereas protrusion of the lower lip at the labrale inferius was correlated with initial inclination of the lower incisor (L1 to NB), jaw relation (ANB angle), lower lip thickness and sex (R(2) = 0.403). Prediction of chin protrusion at the soft tissue pogonion was also low predictable (R(2) = 0.190) depending upon sex, age and initial mandibular plane angle (SN-GoGn). Additionally, age and sex also had mainly effect on change of the soft tissue profile in the vertical direction.