Assessment of enamel surface roughness and hardness with metal and ceramic orthodontic brackets using different etching and adhesive systems: An in vitro study.

Background: This study aimed to evaluate enamel surface roughness and microhardness following the use of different bracket materials (metal or ceramic), etchants (total- and self-etchants), and adhesive systems (precoated or flash-free). Method: A total of 99 extracted human premolars were selected for the analysis. The surface roughness was first assessed (roughness control). One specimen from each subgroup was examined using a scanning electron microscope to illustrate the surface topography. Eighty-eight teeth were prepared using total- or self-etchants and bonded to precoated or flash-free adhesive metal or ceramic brackets. The remaining 11 specimens were not bonded to brackets (microhardness controls). The brackets were debonded after immersion in distilled water for 24 h. The specimens were again scanned for surface roughness and topography imaging. Finally, the microhardness was assessed using a micro-Vickers hardness test at a force of 200 g for 10 s. Result: An overall statistically significant increase in surface roughness and reduced surface microhardness were observed in all experimental groups when compared with those in the control groups. The etchant type was the only variable found to contribute to the measured surface properties, with increased roughness and reduced microhardness introduced by total-etching compared to those by self-etching. Conclusion: Orthodontic brackets introduced a significant increase in enamel surface roughness and reduce microhardness compared with untreated enamel, regardless of the bracket material, etchant type, and adhesive system. The etchant type was the only variable contributing to these changes, with total etching having a more pronounced effect.

Nonsyndromic Generalized Radiculomegaly of Permanent Dentition: A Rare Case Report.

Introduction: Radiculomegaly (marked elongation of dental roots) is a distinct dental abnormality with a major clinical significance that is closely related to oculofaciocardiodental syndrome (OFCD). Since OFCD syndrome was first identified in 1996, only a few cases of nonsyndromic/nonfamilial radiculomegaly have been reported. We report a new nonsyndromic/nonfamilial radiculomegaly case and the association of OFCD syndrome with the dental challenges. Case Presentation. 18-year-old medically free male presented to the screening dental clinics complaining of teeth malposition. Panoramic radiograph incidentally revealed extremely long and wide roots of almost all dentition. Apical radiographs and cone-beam computed tomography (CBCT) were taken to confirm this anomaly and to rule out any artifact. The images confirmed the excessive length of the roots. A cephalometric X-ray was performed on the patient to rule out any dentofacial deformity. History and physical examinations were negative for ocular or cardiac anomalies. Due to lack of evidence of physical signs and symptoms consistent with OFCD syndrome, genetic testing was not performed. Conclusion: Dentists need to be informed of the clinical and radiographic features of different dental anomalies, especially radiculomegaly, as it is considered one of the significant features of OFCD syndrome. Challenges related to radiculomegaly face dentists while the current literature has not yet provided a solid baseline for managing such patients. The challenges include repairing the root canals, extracting and/or moving the teeth orthodontically. Early diagnosis of the syndrome is crucial to prevent dental challenges and provide the best dental care services.

Effect of topical fluoride application and diode laser-irradiation on white spot lesions of human enamel.

OBJECTIVES: This study aims to evaluate the effectiveness of topical fluoride application and diode laser-irradiation on the hardness of demineralized enamel and to evaluate the esthetic improvement of the white spot lesions (WSLs) using a visual analog scale (VAS). MATERIALS AND METHODS: Artificial WSLs (3x3 mm) were created on the enamel surface of 45 human third molars. The teeth were randomly assigned into three groups (n = 15): group A, fluoride only; group B, combined therapy of fluoride and diode laser; and group C, control. Vicker's hardness number (VHN) was measured at baseline, after demineralization and after treatment. To evaluate the esthetic improvement after treatment, 14 raters evaluated each group's photographs using a 100-millimeter VAS. A one-way ANOVA or Brown-Forsythe and Games-Howell post hoc procedure were performed for statistical analysis. The level of significance was set at α = 0.05 for all tests. RESULTS: Group A mean VHN was significantly higher than groups B and C, and group B was significantly higher than group C (P < 0.05). However, the mean VAS rating for the combined therapy group (B) was significantly higher than that for groups A and C (P < 0.05). CONCLUSION: Combination therapy significantly improved the esthetic appearance of WSLs compared to the fluoride only group. However, there was less enamel hardness versus treatment with fluoride only.

Effect of drops containing Lactobacillus reuteri (DSM 17938 and ATCC PTA 5289) on plaque acidogenicity and other caries-related variables in orthodontic patients.

BACKGROUND: The purpose of the study was to investigate the effect of probiotics on biofilm acidogenicity and on the number of salivary Streptococcus mutans and lactobacilli in orthodontic patients. METHODS: This RCT was conducted on 28 young adults who were undergoing orthodontic treatment. The short-term prospective clinical trial lasted for three weeks. The test group rinsed daily with drops containing two Lactobacillus reuteri strains diluted in water, while the placebo group used drops without probiotics. The subjects were enrolled eight months since the beginning of orthodontic treatment. Plaque-pH, saliva and dental biofilm samples were obtained at baseline, one week and three weeks post intervention. RESULTS: Twenty-seven subjects successfully completed the trial period, only one drop out in the test group. No side effects were reported. A statistically significant increase in plaque pH at three weeks post-intervention was found for the test group (p < 0.05), while insignificant changes in the pH value were found for the placebo group in comparison to baseline (p > 0.05). In addition, the AUC7.0 showed a significant difference at three weeks between the test and placebo (p = 0.00002). The three-week samples of stimulated whole saliva showed a statistically insignificant difference in the number of S. mutans and lactobacilli between the two groups (p > 0.05). The qPCR analysis showed the ability of the two strains to get colonized in the dental biofilm without a significant effect on the microbial counts. CONCLUSION/CLINICAL IMPLICATIONS: A mixture of Lactobacillus reuteri has the ability to reduce the pH fall at the three-week follow-up. However, the short-term use of probiotics does not appear to have an effect on the number of salivary Streptococcus mutans and lactobacilli in saliva and on the dental biofilm. TRIAL REGISTRATION: Clinicaltrial.gov (Identifier: NCT04593017 / (19/10/2020)).

Oral Colonisation after the Administration of Drops Containing Lactobacillus reuteri.

PURPOSE: To investigate the oral colonisation potential after four weeks' administration of Lactobacillus reuteri and to examine the short-term effect of probiotics on salivary Streptococcus mutans and lactobacilli. MATERIALS AND METHODS: The study group comprised 13 young adults who volunteered after receiving verbal and written information. The short-term prospective clinical trial lasted 9 weeks, consisting of a 4-week intervention period with administration twice daily and a 5-week post-administration follow-up period with no probiotic consumption. Saliva and dental biofilm samples were obtained immediately before probiotic administration, after 2 weeks and after 4 weeks of L. reuteri administration. Follow-up samples were collected once every week on a regular basis after administration was terminated. The numbers of salivary S. mutans and lactobacilli were assessed by regular plating, while the presence of the two L. reuteri strains in saliva and dental biofilm was evaluated using quantitative polymerase chain reaction (qPCR). RESULTS: The occurrence of L. reuteri in the oral cavity increased gradually during the intervention period and reached the maximum level after four weeks of probiotic administration (p < 0.0001). The 4-week samples of stimulated whole saliva showed a statistically significant decrease in the number of S. mutans and a statistically significant increase in the salivary lactobacilli level in comparison to baseline. qPCR showed that the DSM 17938 strain has better colonisation for both saliva and dental biofilm than the ATCC PTA 5289 strain at the nine-week follow-up. CONCLUSION: Probiotics have the ability to colonise the oral cavity during usage, but it gradually disappears after the completion of intake. It also has ability to decrease the number of salivary S. mutans.

Evaluation of the airway space changes after extraction of four second premolars and orthodontic space closure in adult female patients with bimaxillary protrusion - A retrospective study.

BACKGROUND & OBJECTIVES: Previous studies have found that first premolar extractions during orthodontic treatment may alter the upper airway dimensions. The objective of this study is to investigate the effects of second premolar extraction during orthodontic treatment on the dimensions of the upper airway in a sample of female adults. METHODS: Twenty-nine female adult patients with ages between 18 and 30 years old and incisor bimaxillary protrusion were included in this study. They were treated with comprehensive orthodontic treatment which included the extraction of four second premolars. Pre and post cephalometric radiographs were analyzed using Dolphin imaging software for changes in tongue length and height, soft palate thickness and length, the superior, middle, and inferior airway space, and vertical airway length. Descriptive statistics were used to characterize measurements. Student's paired t-test was preformed to compare the pre- and post-test mean values of the dimensions. RESULTS: A significant increase in the vertical airway length was observed after the extraction of the second premolars (p = 0.02). The soft palate length showed a tendency towards an increase that did not reach statistical significance (p = 0.053). No other significant changes in the airway soft tissue measurements were observed. The proclination and protrusion of the upper and lower incisors were significantly decreased compared to pre-treatment measurements.Interpretation & conclusions.Orthodontic treatment involving the extraction of all four second premolars in females with bimaxillary protrusion increases the vertical airway length, which is the amount of distance between base of the tongue and posterior nasal spine. No other significant alterations in the upper airway measurements were observed.

Prevalence of Work-related Musculoskeletal Disorders among Dental Students of King Saud University, Riyadh, Kingdom of Saudi Arabia.

AIM: To evaluate the presence of work-related musculoskeletal disorders (WRMSDs) among undergraduate dental students of the College of Dentistry, King Saud University (KSU), Riyadh, Saudi Arabia. MATERIALS AND METHODS: A questionnaire-based cross-sectional survey was conducted in 2017 and distributed to150 undergraduate female, and male dental students of KSU who had started to work with patients in the clinic or with manikins. Data were collected related to WRMSDs. RESULTS: Nearly, 142 (95%) students returned the completed questionnaire, 88 (62%) were females and 54 (38%) were males. The results of this study indicate that musculoskeletal symptoms among dental students of KSU are high. Females generally reported more WRMSDs. Seventy-two percent of females and 41% of males reported frequent headaches. Fourteen percent of females and 6% of males had some musculoskeletal pain disorders before joining the dental profession, whereas 68% of females and 43% of males reported pain attributed to their clinical dental work. In the majority of females (67%) and males (61%), the onset of pain was gradual. Commonly reported pain sites in both females and males were the neck, shoulder, upper and lower back. The most common pain sites, among females were shoulder and neck, and upper- and lower-back among males. CONCLUSION: The WRMSDs can affect the dental professionals from the early stages of their clinical carrier, even as dental students. Concrete steps are required to prevent the occurrence of WRMSDs among dental students by providing them the detailed knowledge about theoretical and practical aspects of dental ergonomics. Higher prevalence of WRMSDs among female dental students indicate that female dental professionals need to be extra vigilant to adhere to the principles of dental ergonomics from the very beginning of their clinical career. CLINICAL SIGNIFICANCE: The awareness to implement the principles of dental ergonomics among dental students can help to prevent early development of WRMSDs among them. The inclusion of dental ergonomics as a detailed stand-alone subject in the dental curriculum before the start of clinical training can contribute minimize the risk of WRMSDs throughout the professional life of the dentists.

Assessment of Knowledge about Dental Ergonomics among Dental Students of King Saud University, Riyadh, Kingdom of Saudi Arabia.

AIM: To assess the knowledge about dental ergonomics and work-related musculoskeletal disorders (WRMSDs) among dental students of King Saud University (KSU), Riyadh, Kingdom of Saudi Arabia, undergoing practical clinical training. MATERIALS AND METHODS: A self-designed questionnaire after pre-testing was distributed to 150 dental students of KSU undergoing clinical training, to collect data related to (a) basic knowledge about dental ergonomics; (b) any course/workshop about dental ergonomics attended; (c) basic knowledge about WRMSDs; (d) familiarity about preventive measures to decrease the risk of WRMSDs; and (e) knowledge about treatment options for WRMSDs. RESULTS: One hundred forty-two students (95%) returned the completed questionnaires, of them 54 (38%) were males and 88 (62%) were females. The main findings of the study are that only 30% of the students knew about dental ergonomics; 93% of students have not attended any course/workshop about dental ergonomics; about half the students knew about WRMSDs; 62% of the students did not know about preventive measures to decrease the risk of WRMSDs, and 80% of students did not have knowledge about treatment options for WRMSDs. In general, female students had a better understanding of dental ergonomics and WRMSDs than male students. CONCLUSION: The basic knowledge of the dental ergonomics among dental students at King Saud University, Riyadh, Kingdom of Saudi Arabia is not adequate. CLINICAL SIGNIFICANCE: There is a need for introducing dedicated theoretical and practical courses covering all aspects of dental ergonomics in the undergraduate curriculum of dental education.

Evaluation of bracket failure in relation to different factors in patients experiencing comprehensive orthodontic treatment: a retrospective cohort study / Evaluación de la falla del bracket en relación con diferentes factores en pacientes que reciben tratamiento ortodóntico integral: un estudio de cohorte retrospectivo

Objective: The aim of this study was to investigate loose brackets in relation to various related factors in orthodontic patients who had completed orthodontic treatment. Material and Methods: In this retrospective study, 738 medical records of patients who had undergone comprehensive orthodontic treatment and matched specific inclusion criteria were selected. Paired t-tests and ANOVA, along with the Mann-Whitney test and Kruskal­Wallis analyses were performed to compare the means of variables between selected subgroups. Results: Loose brackets were found most frequently on premolars, followed by incisors and then canines (p<0.01). Male and young patients were found to have a higher incidence of loose brackets compared to female and adult patients (p=0.044 and p<0.01, respectively). The highest correlation coefficient value was found between treatment duration and total number of loose brackets (0.393), which was statistically significant. Conclusions: The frequency of total number of loose brackets increased with younger age group. Premolar teeth were found to be the most commonly affected teeth, followed by incisors and canines. Mandibular teeth presented more loose brackets than maxillary.

Objetivo: Fue investigar brackets sueltos en relación con varios factores relacionados en pacientes ortodónticos que habían completado el tratamiento de ortodoncia. Material y Métodos: En este estudio retrospectivo, se seleccionaron 738 registros médicos de pacientes que se habían sometido a un tratamiento ortodóntico integral y criterios de inclusión específicos coincidentes. Se realizaron pruebas t pareadas y ANOVA, junto con la prueba de Mann-Whitney y los análisis de Kruskal-Wallis para comparar las medias de las variables entre los subgrupos seleccionados. Resultados: Se encontraron corchetes sueltos con mayor frecuencia en los premolares, seguidos de incisivos y luego caninos (p<0.01). Se encontró que los pacientes masculinos y jóvenes tenían una mayor incidencia de corchetes sueltos en comparación con los pacientes femeninos y adultos (p=0.044 y p<0.01, respectivamente). El valor del coeficiente de correlación más alto se encontró entre la duración del tratamiento y el número total de corchetes sueltos (0.393), que fue estadísticamente significativo. Conclusiones: La frecuencia del número total de corchetes sueltos aumentó con el grupo de edad más joven. Los dientes premolares fueron los dientes más afectados, seguidos de los incisivos y los caninos. Los dientes mandibulares presentan más brackets sueltos que los maxilares.

Enamel demineralization around metal and ceramic brackets: an in vitro study.

AIM: To evaluate the degree of enamel demineralization of teeth bonded with ceramic and metal brackets. MATERIALS AND METHODS: In this cross-sectional experimental in vitro study, 60 extracted human premolar teeth were selected according to the experimental criteria. They were divided into three groups; 20 premolar teeth in each group. Teeth in group 1 were bonded with "ceramic brackets", and teeth in group 2 were bonded with "metal brackets", while teeth in group 3 served as the "control group" without any brackets. Teeth in all groups were then immersed in demineralization media, de-bonded, sectioned into three parts (proximal 1, middle, and proximal 2), and evaluated to determine the level of enamel demineralization under a Scanning Electron Microscope. RESULTS: On tooth level, the results show that the control group has significantly less enamel demineralization compared to the other two experimental groups, with mean values of 145.3 µm and 192.7 µm, respectively (P=0.000). The mean value of enamel demineralization in the metal group is 55.93 µm, compared to 72.55 µm in the ceramic group, which is significantly less (P≤0.05), while there is no difference between the control and metal group with regard to enamel demineralization. On section level, the control group has significantly less enamel demineralization in all three sections compared to the ceramic group, while a significant difference is found in one of the proximal sections when compared with the metal group. Moreover, the ceramic group has significantly higher enamel demineralization in the middle section compared to the metal group (73.54 µm, 46.5 µm, respectively) (P=0.000), while there is no statistical significant difference between the two experimental groups in proximal sections. CONCLUSION: In vitro, non-bonded teeth show least demineralization compared to the bonded teeth. Teeth bonded with ceramic brackets show significantly higher enamel demineralization compared to teeth bonded with metal brackets.

Enamel demineralization around two different orthodontic bracket adhesive systems: An in vivo study.

OBJECTIVE: To compare the enamel demineralization around the two precoated adhesive bracket systems, APC Flash-Free and APC PLUS (3M Unitek, Monrovia, CA, USA), in clinical settings. MATERIAL AND METHOD: This prospective experimental in-vivo study included 40 premolar teeth, which were planned for extraction due to orthodontic purposes. They were divided into two groups (Group A; n = 20 teeth were bonded with APC Flash Free ceramic brackets and group B; n = 20 teeth were bonded with APC Plus ceramic bracket). After four weeks, the teeth were extracted, sectioned, and examined under the Scanning Electron Microscope (SEM) to evaluate the amount of demineralization from the enamel surface to the deepest point. RESULTS: Findings revealed that the mean values of demineralization under SEM were significantly higher in APC Plus compared to APC Flash Free (149.95 µm vs. 112.96 µm, respectively) (P < 0.05). The difference between the two systems was mainly found in the middle part of the facial surfaces, while there were no differences between the two systems in the proximal parts. CONCLUSION: The enamel demineralization around APC Flash-Free adhesive bracket system was significantly less than that of APC plus Adhesive bracket system, which can be due to the absence of the caries promoting adhesive flash during tooth bonding using the flash free system.

The characteristics of dental occlusion in patients with moderate to severe obstructive sleep apnea in Saudi Arabia.

OBJECTIVES: To evaluate characteristics of dental occlusion among non-obese Saudi adult patients suffering from moderate to severe obstructive sleep apnea(OSA). METHODS: Following ethical approval, a cross-sectional study was conducted at Sleep Disorders Center, King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia, between January and March 2017. Non-obese adult Saudi patients with moderate/severe OSA (apnea-hypopnea index more than 15) and without history of malocclusion or edentulism were included with an estimated sample size of 50. Demographic details and severity of OSA as diagnosed by polysomnography were recorded. Characteristics of dental occlusion, namely molar, canine and incisor relationship, overjet, overbite, crossbite and arch form were obtained through calibrated examiners (kappa 0.81). Descriptive statistical analysis and Chi-square test, with 95% significance level (p less than 0.05), were used to identify relationships between the severity of OSA and characteristics of dental occlusion. RESULTS: A total of 51 patients (31 males, 20 females; mean age 49.45±10.35 years), were enrolled in the study. Severity of OSA was moderate in 17 patients and severe in 34 patients. Severe form of OSA was more among males (64.7%) and in patients with Class-II division-1 incisor relationship (94.1%). Neither the demographic characteristics, nor characteristics of dental occlusion showed statistically significant relationship with the severity of OSA. CONCLUSION: The results of the present cross-sectional study indicate that the characteristics of dental occlusion are not related to the severity of OSA among non-obese adult Saudi patients.

Shear bond strength of new and rebonded orthodontic brackets to the enamel surfaces.

OBJECTIVES: The objective of this study was to compare the shear bond strength (SBS) of new and rebounded orthodontic brackets bonded to the buccal sound and cleaned enamel surfaces using two orthodontic adhesives: resin-modified glass-ionomer (RMGI) and resin-composite. MATERIALS AND METHODS: Forty premolars were randomly allocated into four groups, 10 teeth/group. New and rebonded brackets were bonded to sound and cleaned enamel surface, and then were subjected to thermocycling. The bond strength was determined using a universal testing machine at a crosshead speed of 1 mm/min. Remaining adhesives on enamel after bracket debonding was scored independently by two investigators who were not aware of the four different groups, using adhesive remnant index (ARI). RESULTS: There was a statistical significant difference in SBS of the four groups (P = 0.005). SBS values were significantly higher with cleaned enamel surfaces after adhesive removal compared to sound enamel. SBS was significantly higher for rebonded brackets, when compared with the new brackets. No significant difference was found between the two adhesives types. The level of agreement between the two raters was higher toward the classification of higher categories of ARI (scores 5 and 6) with agreement percentage 91.7% and 100%, respectively. There was more adhesive remained among resin-composite groups. CONCLUSIONS: The bond strength of debonded sandblasted stainless-steel brackets was higher than new brackets. Resin-composite and RMGI orthodontic adhesives used in this study exhibited sufficient SBS values for bonding brackets to sound and cleaned enamel and comparable to each other.

Incidence of orthodontic brackets detachment during orthodontic treatment: A systematic review.

OBJECTIVES: To evaluate the incidence of orthodontic brackets detachment during orthodontic treatment. METHODS: Using electronic databases; eligible studies up to January 2018 were retrieved, independently reviewed, and screened. The Coleman Methodology Scoring System (CMS) and Cochrane Collaboration's tool were used to assess quality and risk of bias in the included studies. RESULTS: Of the seventeen studies included in the final synthesis, thirteen were categorized as randomized clinical trials (RCTs), one prospective cohort and retrospective survey each, whereas two studies could not be categorized. The number of patients in the selected studies ranged between 19 and 153; the mean age was between 10.5 to 38.7 years, and male to female ratio was 353:495. Almost all studies had a high risk of bias, and more than half of the studies had CMS score of 70 or above. The numbers of brackets examined in the studies ranged between 361 and 3336. The incidence of brackets detachment ranged from 0.6 to 28.3%. CONCLUSIONS: The incidence of brackets detachment during orthodontic treatment is high.

Caries risk profiles in orthodontic patients: A 4-year follow-up study using the Cariogram model in governmental vs. private clinics.

OBJECTIVES: To (1) analyze caries-related factors and (2) evaluate caries risk using the Cariogram model for governmental and private orthodontic patients at de-bonding and 4 years after de-bonding. MATERIALS AND METHODS: Forty orthodontic patients with mean age of 26.4 years were recruited from a governmental (G) group (n = 20) and private (P) group (n = 20) and were examined at de-bonding (T1) and 4 years after de-bonding (T2). The examination included a questionnaire, plaque scoring, caries examination, bitewing radiographs, and assessment of salivary secretion rate, buffering capacity and cariogenic microorganisms. The data were entered into the Cariogram program to illustrate the caries risk profiles. RESULTS: The chance to avoid new cavities was higher in P-group compared to G-group at T1 (58% and 31%, respectively) (P < 0.01) and T2 (77% and 52%, respectively) (P < 0.001). Plaque index was significantly higher in G-group, and fluoride was used significantly more in P-group at T1 and T2 (P < 0.05). The chance to avoid new cavities was higher at T2 compared to T1 (64% and 44%, respectively) (P < 0.001). Saliva secretion rate and buffer capacity were significantly increased, and the plaque index was significantly decreased at T2 compared to T1 (P < 0.01). CONCLUSION: According to the Cariogram, orthodontic patients were less likely to avoid new cavities at de-bonding and 4 years after de-bonding in government clinics compared to private clinics, and the caries risk significantly decreased 4 years after orthodontic treatment for all patients, regardless of the location of treatment.

Diagnosing the severity of buccal caries lesions in orthodontic patients at de-bonding using digital photographs.

OBJECTIVE: The aims of this study were (1) to evaluate the severity of buccal caries lesions according to the International Caries Detection and Assessment System (ICDAS) criteria via scoring buccal caries lesions on digital photographs at the time of de-bonding and (2) to compare this method with clinical examination. MATERIALS AND METHODS: In total, 89 patients treated with upper and lower fixed appliances were clinically examined immediately after de-bonding by the first author and buccal caries were scored according to the ICDAS-II. Close-up digital photographs were taken of 245 teeth with different buccal caries lesion scores according to the ICDAS-II. Thirteen postgraduate orthodontics students independently scored the buccal caries lesions in the digital photographs using the modified clinical criteria (ICDAS-II). Intra- and inter-examiner reliabilities were evaluated by calculating the weighted kappa. To evaluate the validity of diagnosing the severity of buccal caries lesions using digital photographs compared to clinical examination, Spearman's correlation coefficient was calculated. RESULTS: Intra-examiner reliability and the reliability between each examiner and the clinical examination showed moderate-to-excellent agreement, with kappa values of 0.52-0.83. Scoring buccal caries lesions via clinical examinations and scoring via photographs were well correlated according to the modified ICDAS-II criteria (Spearman's correlation coefficient, 0.76). CONCLUSIONS: Thus, scoring buccal caries lesions on digital photographs according to ICDAS-II criteria is a reliable and valid method for assessing the severity of buccal caries lesions.

Diagnosing the severity of buccal caries lesions in governmental and private orthodontic patients at debonding, using the ICDAS-II and the DIAGNOdent Pen.

OBJECTIVES: To clinically evaluate the prevalence of buccal caries and white spot lesions (WSLs) at debonding in governmental and private orthodontic patients, using the International Caries Detection and Assessment System (ICDAS-II) and the DIAGNOdent Pen, and to study the correlation between the two methods. MATERIALS AND METHODS: A cross-sectional study was carried out on the nonextracted premolars and anterior teeth of 89 orthodontic patients. They were recruited into two groups based on the treatment center they attended: governmental group (G; n=45) and private group (P; n=44). Immediately after debonding, the examination of buccal caries and WSLs on premolars and anterior teeth was carried out using the ICDAS-II and the DIAGNOdent Pen. Cross-tabulation was applied to study the correlation between the ICDAS-II index and the DIAGNOdent Pen by calculating the Spearman correlation coefficient. RESULTS: The G group showed a significantly higher (P<.0001) prevalence of WSLs and/or buccal caries compared to that of the P group based on evaluation by the two methods. Based on ICDAS-II, 43% of the patients in the P group and 9% in the G group were free from any WSLs. In the G group, 22% of the patients had ≥16 LESIONS, whereas there were none for the P group. The Spearman correlation coefficient between the two methods was .71. CONCLUSIONS: The prevalence of caries and/or WSLs at debonding was significantly higher in the G group compared to the P group. The clinical index (ICDAS-II) showed a good correlation with the DIAGNOdent Pen.

Caries risk profile using the Cariogram in governmental and private orthodontic patients at de-bonding.

OBJECTIVES: To analyze various caries-related factors in orthodontic patients at de-bonding, and to test the null hypothesis that there is no difference in caries risk between governmental and private orthodontic patients immediately after orthodontic treatment. MATERIALS AND METHODS: A cross-sectional examination was carried out on 89 orthodontic patients aged 13-29 years, mean age 21.5 years. They were divided into two groups based on the center of treatment, governmental group (G) (n  =  45) and private group (P) (n  =  44). The investigation comprised a questionnaire, plaque scoring, caries examination, bitewing radiographs, salivary secretion rate, buffering capacity, and cariogenic microorganisms. Data were entered into the Cariogram PC program to illustrate caries risk profiles. RESULTS: Findings revealed that "the chance of avoiding new cavities," according to the Cariogram, was high in the P-group and low in the G-group (61% and 28%, respectively) (P < .001). Decayed, missing, and filled surfaces (DMFS), plaque index, mutans streptococcus and lactobacillus counts, and salivary buffer capacity were significantly higher in the G-group compared with the P-group (P < .05). The total number of caries lesions at de-bonding in the G-group was more than two times higher than that in the P-group (150 vs 68) (P < .001). CONCLUSIONS: The "chance to avoid new cavities" in orthodontic patients at de-bonding was less in the governmental group compared with the private group, as illustrated by the Cariogram. The governmental group also had significantly less favorable values than the private group for most of the caries-related factors.