Contributions and Concerns about the Use of Teledentistry in Clinical Orthodontics.

PURPOSE: Teledentistry uses computer-based technology to render remote healthcare-related therapy and/or consultation. The purpose of this study was to review the contributions and concerns about the use of teledentistry in clinical orthodontics. MATERIALS AND METHODS: The focused question was "What are the benefits and limitations of the use of teledentistry in clinical orthodontics?" PubMed/Medline, Scopus, Embase, Google-Scholar and ISI Web of knowledge databases were searched up to and including February 2021 using the following key words: 1. teledentistry; 2. teleorthodontics; 3. ethics; 4. orthodontics; 5. SCOPE: The inclusion criteria were: (a) clinical studies; (b) case reports; and (c) case series. Studies on animal models, in vitro and/or ex vivo studies, letters, commentaries, and narrative and systematic reviews were not included in the search. The design of the study was tailored to recapitulate the relevant information. RESULTS: Four clinical studies fulfilled the eligibility criteria and were processed for data extraction. All studies had been performed after obtaining informed consent from the participants. Three studies reported that teledentistry was useful in clinical orthodontics. In one study, a clear conclusion could not be drawn regarding the benefits of teledentistry in clinical orthodontics. Two out of the four studies did not obtain prior approval from an institutional review board or ethics committee. Three studies did not report any measures that were undertaken to safeguard the electronic transfer of patient-related health information. CONCLUSIONS: Teledentistry is a useful tool for initial patient assessments; however, it is not a reliable alternative for in-office clinical orthodontic practice.

Influence of Fixed Orthodontic Therapy on Pharyngeal Airway Dimensions after Correction of Class-I, -II and -III Skeletal Profiles in Adolescents.

The aim was to compare the influence of fixed orthodontic therapy (OT) on the pharyngeal airway space dimensions after correction of class-I, -II and -III skeletal profiles and among untreated adolescent patients. A control group comprising of untreated patients was also included. Demographics and OT-related information was retrieved from patients' records. Measurements of airway spaces in the nasopharynx, oropharynx and hypopharynx were performed on lateral cephalograms. p-values under 0.05 were considered statistically significant. The results showed no statistically significant differences in the naso-, oro- and hypo-pharyngeal airway spaces among patients with class-I, -II and -III skeletal profiles and individuals in the control group. There were no statistically significant differences when naso-, oro- and hypo-pharyngeal airway spaces were compared among patients with class-I, -II and -III skeletal profiles. In conclusion, in non-extraction cases without maxillary expansion, fixed OT does not affect the naso-, oro- and hypo-pharyngeal airway spaces in patients with skeletal Class-I, -II and -III skeletal profiles. Further studies involving patients undergoing ME and premolar extraction are needed to elucidate the influence of fixed OT on the naso-, oro- and hypo-pharyngeal airway spaces.

Awareness of Dental Esthetic Standards Among Dental Students and Professionals.

PURPOSE: This study investigated the level of esthetic awareness of dental students and professionals. MATERIAL AND METHODS: Photographs depicting facial and smile features that deviate from universally accepted esthetic standards were presented in a questionnaire. Participants were asked to rate the images and to identify the main discrepant criteria. Eight hundred questionnaires were distributed to dental students, and clinicians. The data were analyzed using chi-square tests, Student's t-test and one-way ANOVA with Tukey's post hoc tests for multiple comparisons. RESULTS: Students had 45.2% correct answers compared to 51.6% for clinicians. Among students, the highest awareness was found among 5th year students, followed by interns, 4th year and 3rd year students. The difference in the percentage of correct answers between clinicians and students overall was significantly higher for some criteria than for others, such as gingival esthetics, lip features, smile zone (incisal plane), facial features, and buccal corridor. Among clinicians, specialists responded correctly more often than did general practitioners in most of the investigated aspects. CONCLUSION: The ability of different group samples to diagnose discrepancies of smile esthetics was refined and enhanced with increased clinical experience and knowledge.

Influence of low-level laser therapy on orthodontically-induced inflammatory root resorption. A systematic review.

OBJECTIVE: The aim was to assess the influence of low-level laser therapy (LLLT) on orthodontically-induced inflammatory root resorption (OIIRR). METHODS: A systematic search was conducted in indexed databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The eligibility criteria were as follows: (a) original clinical and animal/experimental studies; (b) prospective studies; (c) intervention: effect of LLLT on OIIRR; (d) control group (OIIRR without LLLT); (e) statistical analysis; and (f) tomographic or histologic assessment of OIIRR. Quality assessment of the experimental and clinical studies was performed following the Animal Research Reporting In-vivo Experiments (ARRIVE) and Consolidated Standards of Reporting Trials (CONSORT) guidelines, respectively. The risk of bias of the included studies was also determined. RESULTS: Nine (7 experimental and 2 clinical) of the initially identified 39 studies were included. One clinical and 2 experimental studies showed that LLLT during orthodontic tooth movement (OTM) significantly reduces OIIRR. One experimental study reported that LLLT during OTM in sockets treated with alloplastic materials significantly reduces OIIRR. One experimental study found that LLLT after OTM significantly repairs OIIRR, whereas one clinical study did not report a significant reparative affect. Three experimental studies showed that LLLT increases OIIRR during OTM, corticotomized-OTM, and OTM into grafted defects, respectively. The minimum, median and highest ARRIVE scores (out of 20) of the included experimental studies were 15, 17 and 19, respectively. The mean CONSORT score of the included clinical studies was 23 (out of 25). CONCLUSIONS: In conclusion, the influence of LLLT on OIIRR remains debatable.

Scope of antimicrobial photodynamic therapy in Orthodontics and related research: A review.

BACKGROUND: The aim of the present study was to comprehensively review indexed literature regarding the potential role of antimicrobial photodynamic therapy (aPDT) in Orthodontics. METHODS: Indexed databases were searched up to and including January 2019 using the following key words: (a) antimicrobial photodynamic therapy; (b) antimicrobial photodynamic chemotherapy; (c) orthodontic; and (d) orthodontics. Original (clinical and experimental) studies, case-reports, and case-series were included. Letters to the Editor, commentaries and review articles were excluded. RESULTS: Out of the 29 studies identified in the initial search, 4 studies were processed for data extraction. Three studies were randomized clinical trials performed in humans and 1 study was experimental. Results from 2 studies showed that aPDT is effective in the treatment of gingival inflammation in patients undergoing orthodontic therapy (OT). One study showed that oral decontamination can be successfully performed using aPDT among patients undergoing OT. Results of the experimental study showed that aPDT helps in surface decontamination of orthodontic instruments. CONCLUSION: There is insufficient evidence in indexed literature to justify the potential role of aPDT in OT. Hence, further studies are required in this regard.

Influence of psychological stress exposure on orthodontic therapy: A comprehensive review.

The aim of the present study was to comprehensively review the influence of psychological stress exposure (PSE) on orthodontic therapy (OT). Original clinical and experimental studies were assessed. Quality assessment of experimental studies was performed using the Animal Research Reporting In Vivo Experiment (ARRIVE) guidelines. Six studies (2 clinical and 4 experimental) were included. One clinical study showed that PSE during OT significantly increases nickel release from orthodontic appliances into the saliva. In another study, maternal support was found to be an important predictor of the outcome of OT. In one experimental study, chronic PSE increased orthodontic tooth movement (OTM), and in two experimental studies, PSE decreased OTM. One study on rats reported that PSE is not a risk factor for orthodontically-induced root resorption during OTM. One experimental study showed a significantly higher number of osteoclasts in the bone on the side of OTM in restrained rats compared with unrestrained rats. One study showed decreased osteoclast counts in the bone during OTM under PSE. The lowest, highest, and mean ARRIVE scores (out of 20) for the experimental studies were 16, 18, and 16.75 ± 0.96, respectively. The role of PSE in clinical orthodontics remains unclear, most likely due to a lack of studies in humans. Further power-adjusted, well-designed, and randomized studies are needed.

Influence of corticosteroid therapy on orthodontic tooth movement: A narrative review of studies in animal-models.

The aim was to assess the influence of corticosteroid therapy (CST) on orthodontic tooth movement (OTM). A narrative review of studies performed in animal models. Indexed databases were searched up to and including May 2018 to address the following focused question: "Does CST affect OTM?" The following eligibility criteria were imposed: (a) original studies; (b) presence of a control group (OTM without CST); (c) intervention: effect of CST on OTM; and (d) statistical analysis. Quality assessment was performed using the Animal Research Reporting In Vivo Experiment (ARRIVE) guidelines. Case series, case reports, commentaries, historic reviews and letters to the Editor were excluded. Ten studies performed on animal models were included. The experimental duration ranged between 3 and 49 days. Two studies reported that CST decreases the magnitude of OTM, two studies showed no significant influence of CST on OTM, and two studies found that CST increases OTM. Two studies reported CST significantly decreases bone density and increases bone resorption during OTM. In one study, CST significantly decreased orthodontically induced root resorption. The minimum, median and highest scores (out of 20) based on ARRIVE guidelines were 7, 15.5 and 18, respectively. The influence of CST on OTM in animal models remains debatable.

Influence of nicotine on orthodontic tooth movement: A systematic review of experimental studies in rats.

OBJECTIVE: The objective of this systematic review was to assess the impact of nicotine administration on orthodontic tooth movement (OTM). METHODS: A systematic search was conducted in PubMed, Scopus, EMBASE, MEDLINE (OVID) and Web of Knowledge databases and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Studies evaluating the influence of nicotine on OTM, and with the presence of a control group (OTM without nicotine administration), were included. Quality assessment of the selected studies was performed following the Animal Research Reporting in Vivo Experiment (ARRIVE) guidelines. RESULTS: Six of the initially identified 108 articles fulfilled the inclusion criteria and were selected. All included studies were performed in male rats, which underwent OTM with or without nicotine administration. Since there was a variation among the included studies regarding nicotine dosage and the duration and magnitude of force application during OTM only a qualitative analysis could be performed. The studies reported that nicotine administration accelerated OTM by inducing alveolar bone resorption around the moving teeth. It was also found that nicotine increased root resorption during experimental OTM. More standardized animal research or clinical studies are warranted to further evaluate the impact of nicotine on OTM. CONCLUSIONS: On an experimental level, nicotine exposure in rats jeopardizes OTM by increasing alveolar bone loss and root resorption. From a clinical perspective, further studies are needed to assess the impact of habitual use of tobacco products on OTM.