LOW CERTAINTY OF EVIDENCE SUPPORTS THE APPLICATION OF (AI) FOR THE AUTOMATIC DETECTION OF CEPHALOMETRIC LANDMARKS WITH PROSPECTS FOR IMPROVEMENTS.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Artificial Intelligence for Detecting Cephalometric Landmarks: A Systematic Review and Meta-analysis. J Digit Imaging. 2023 Jun;36(3):1158-1179. doi:10.1007/s10278-022-00766-w. SOURCE OF FUNDING: The study was financed in part by the Coordenacao de Aperfeicoamentode Pessoal de Nivel Superior-Brazil (CAPES)-Finance Code 001. TYPE OF STUDY/DESIGN: Systematic review and meta-analysis.

Fluoride-amorphous calcium phosphate and biomimetic nano-hydroxyapatite for enamel remineralization: An in-vitro study of surface microhardness and composition.

AIM: Fluoride-Amorphous Calcium Phosphate and Biomimetic Nano-Hydroxyapatite for Enamel Remineralization; An In-Vitro Study of Surface Microhardness and Composition. MATERIAL AND METHODS: Ninety-six extracted human premolars with sound buccal surface were divided using a randomization computer-generating software into four groups; Group I (control) sound untreated enamel, Group II (demineralized) demineralized to create white spot lesions, Group III (biom-n-HA) demineralized and then treated with biomimetic nanohydroxyapatite cream, and Group IV (F-ACP) demineralized and then treated using Fluoride-Amorphous Calcium Phosphate varnish. Each group was divided into two subgroups; subgroup "A" evaluated for mineral content using energy dispersive x-ray spectroscopy (EDX) and for surface microhardness using the Vickers microhardness test and Subgroup "B" evaluated for white spot lesion depth using a polarized light microscope (PLM). RESULTS: The highest microhardness (VHN) was found in the (F-ACP) group (mean=428.61±54.43) and then in the (Biom-n-HA) group (mean=408.11±70.16) followed by the (Control) group (mean=402.13±53.40) with no significant difference between them and finally in the significantly different (Demineralized) group (mean=256.99±45.83). The weight percentage of Ca (30.29±1.04 and 33.44±1.07) and Ca/P ratio (1.87±0.06 and 2.03±0.05) were significantly different between Group III and Group IV respectively. PLM measurements in Group II (198.83µm), Group III (60.17µm), and Group IV (26.33µm) were significantly different. CONCLUSIONS: Both the (Biom-n-HA) cream and the (F-ACP) varnish showed promising results for enamel remineralization. The increased enamel surface microhardness was consistent with the mineral content and the changes in the birefringence.

Acupressure versus NSAID for relief of orthodontic pain : A randomized controlled clinical trial.

AIM: To compare ibuprofen and acupressure for pain relief after insertion of elastomeric orthodontic separators. MATERIALS AND METHODS: A randomized control clinical trial was conducted in an orthodontic clinic. A total of 75 orthodontic patients aged 12-16 years participating in the study were randomly allocated to receive either 400 mg of oral ibuprofen, applying acupressure therapy, or no pain-relief approach. Pain scores were recorded on visual analog scales (10 cm) over a week at different times (4, 10, 18, 24 h, and 1 week). The margin of equivalence was defined as 10 mm. RESULTS: For all timepoints, the control group recorded the highest pain. For the ibuprofen and acupressure group, after 4 h, 18 h, and 1 week, no significant difference was noted. However, after 10 h, no significant difference in pain between the control and acupressure groups was noted and the ibuprofen group showed significantly lower pain. In the acupressure group, the highest pain was noted at 10 h. After this timepoint, pain progressively decreased with time and the lowest pain was noted after 1 week. In the control and ibuprofen groups, the highest pain was after 4 h, and then progressively decreased with time and the lowest pain was noted after 1 week. CONCLUSIONS: There was no significant difference in pain perception between participants using ibuprofen or acupressure and both groups recorded significantly lower pain than the control group at most of the observed timepoints. Results support the analgesic effect of the acupressure approach.

Reflection on patients' experience with orthodontic appliances wear and its impact on oral health related quality of life: observational comparative study.

BACKGROUND: The objective of this study was to explore and compare patient's experience with the use of a removable functional appliance or fixed orthodontic appliance and its influence on oral health-related quality of life. MATERIAL AND METHODS: This clinical trial included 81 participants having Class II Division 1 and age ranging between 10 and 16 years. The participants were included in any of a three equal groups according to the set inclusion and exclusion criteria; Group 1: patients treated with a Twin-Block functional appliance; Group 2: patients treated with a fixed orthodontic appliance only; and Group 3 (control group): patients not in orthodontic treatment yet. The COHIP SF-19 was used. Patients were given the questionnaire as follows: Group 1: (1) after at least 8 months from starting treatment; (2) after completing phase 1 by 2-3 months without wearing the appliance; Group 2: (1) just before debonding; (2) after finishing the treatment by 2-3 months without any appliances; and Group 3: (1) at the patient's first visit to the orthodontic clinic; (2) after 2-3 months from the first visit to the orthodontic clinic and before starting any treatment. RESULTS: The 81 participants were 31 males and 50 females with median age of 13 years. The total COHIP SF-19 scores at baseline were 57 (49-64), 67 (63-72), and 47 (42-53) for the Twin-Block, the fixed appliance, and the malocclusion groups, respectively. Two-month mean scores adjusted to the baseline scores were 64.82 ± 1.15, 65.65 ± 1.47, and 54.45 ± 1.44 for the Twin-Block, the fixed appliance, and the malocclusion groups, respectively. CONCLUSIONS: Both at baseline and two-months (adjusted to the baseline scores), participants in the malocclusion group showed compromised socio-emotional quality of life and reported the poorest total OHRQoL. At the baseline, better socio-emotional and total OHRQoL was reported by the fixed appliance group compared to the Twin-Block group but, after two months both groups gave similar sores. Therefore; patients' perceptions about their experience with the orthodontic appliance might change.

Effects of fluorosed enamel on orthodontic bracket bonding : An in vitro study.

OBJECTIVE: To investigate the effect of enamel deproteinization and air abrasion on shear bond strength (SBS), adhesive remnant index (ARI) scores, and surface topography when bonding orthodontic brackets to fluorosed enamel. MATERIALS AND METHODS: The sample included 90 fluorosed and 30 normal premolars divided into four groups: group I (fluorosed premolars subjected to air abrasion before acid etching), group II (fluorosed premolars subjected to deproteinization before acid etching), group III (fluorosed premolars; control for groups I and II), and group IV (normal premolars; control for group III). Bonding procedures included etching with 37% phosphoric acid, priming with TransbondTM XT primer (3M Unitek, Monrovia, CA, USA), and application of TransbondTM XT adhesive paste (composite; 3M Unitek, Monrovia, CA, USA). Air abrasion was done using 50 µm aluminum oxide particles under 0.28 MPa pressure for 5 s with the micro-etcher held at a distance of 10 mm. Deproteinization was done for 60 s with 5% sodium hypochlorite (NaOCl). RESULTS: Fluorosed premolars subjected to deproteinization showed the lowest (median = 6.57 MPa) SBS among the four groups, followed by 8.14, 8.90, 8.14 MPa for groups I, III, and IV respectively. ARI scores were significantly different between the four groups (p = 0.006). Fluorosed enamel etched after air abrasion or deproteinization with NaOCl showed a predominance of type 4 etching pattern with some areas appearing unetched. CONCLUSIONS: Shear bond strength of all groups was within the 6-8 MPa acceptable range for orthodontic purposes. Fluorosed premolars subjected to deproteinization showed the lowest values. Further studies are recommended to scrutinize the deproteinization technique.

MOBILE APP AND SOCIAL MEDIA-BASED INTERVENTIONS MAY HAVE A POSITIVE INFLUENCE ON THE BEHAVIOR OF ORTHODONTIC PATIENTS.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: The influence of mobile applications and social media-based interventions in producing behavior change among orthodontic patients: A systematic review and meta-analysis. Al-Moghrabi D, Alkadhimi A, Tsichlaki A, Pandis N, Fleming PS. Am J Orthod Dentofacial Orthop. 2022;161(3):338-354. SOURCE OF FUNDING: Deanship of Scientific Research at Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia. TYPE OF STUDY/DESIGN: Systematic review with meta-analysis.

Home Oral Care with Biomimetic Hydroxyapatite vs. Conventional Fluoridated Toothpaste for the Remineralization and Desensitizing of White Spot Lesions: Randomized Clinical Trial.

Introduction: Biomimetic hydroxyapatite-based toothpastes have been investigated in recent years for their remineralizing activity on dental surfaces. The aim of the present study was to evaluate the efficacy of toothpaste containing biomimetic hydroxyapatite versus a 1450 pppm fluoride one in promoting the remineralization and desensitization of white spot lesions. Methods: 40 patients were randomly assigned to two different domiciliary oral hygiene treatments: toothpaste containing 1450 ppm of fluoride (control group) and toothpaste containing biomimetic hydroxyapatite (experimental group). Dental sensitivity/pain and dental erosion were assessed at baseline and after 15, 30, and 90 days using the following indexes: Schiff Air Index (SAI), Visual Analogue Scale (VAS), and Basic Erosive Wear Examination (BEWE). Results: Data were submitted for statistical analysis. SAI significantly decreased after 3 months (T3) of treatment only in the Trial group (p < 0.05). VAS values significantly decreased at T2 in the trial group (p < 0.05) with a further significant reduction at T3 (p < 0.05). BEWE scores did not significantly vary during the follow up neither in the trial nor in the control group. Conclusions: The hydroxyapatite-based toothpaste tested caused a reduction of hypersensitivity/pain values higher than conventional fluoride toothpaste.

Change in crown inclination accompanying initial tooth alignment with round archwires.

OBJECTIVE: To evaluate, in-vitro, the change in crown inclination that occurs during orthodontic leveling and alignment using different archwire-bracket-ligation combinations. MATERIALS AND METHODS: Four archwire types were tested: (1) 0.012-in stainless steel and (2) 0.0155-in stainless steel multi-stranded, (3) 0.012-in nitinol Orthonol® and (4) 0.012-in nitinol Thermalloy®. Combinations with five types of 0.022-in slot orthodontic brackets were tested: SmartClipTM and Time3® self-ligating brackets, Mini-Taurus® and Victory SeriesTM conventional brackets, and Synergy® conventional-low friction bracket. Conventional brackets were ligated with both stainless steel and elastomeric ligatures. The simulated malocclusion comprised 2.0mm gingival and 2.0mm labial displacements of a maxillary right central incisor. Rotation around the Y-axis (representing labio-palatal inclination) was measured for the different archwire-bracket-ligation combinations. RESULTS: The largest rotation was measured whith Orthonol® and Thermalloy® wires when combined with SmartClipTM brackets (8.07±0.24º and 8.06±0.26º, respectively) and with Synergy® brackets ligated with stainless steel ligatures (8.03±0.49º and 8.0±0.37º, respectively). The lower rotation was recorded when Thermalloy®, multi-stranded, and Orthonol® wires were ligated with elastomeric rings to Mini-Taurus® brackets (1.53±0.18º, 1.65± 0.23º and 1.70±0.28º, respectively) and to Victory SeriesTM brackets (1.68± 0.78º, 2.92± 1.40º and 1.74±0.46º, respectively). CONCLUSIONS: All archwire-bracket-ligation combinations produced lingual crown inclination; however, lower changes were observed when the conventional brackets were ligated with elastomeric rings. The multi-stranded archwire produced less rotation with nearly every bracket-ligation combination, compared to the other archwires. The effect of the archwire-bracket-ligation combination on tooth inclination during leveling and alignment should be considered during planning treatment mechanics.

Root Injury During Interradicular Insertion is the most Common Complication Associated with Orthodontic Miniscrews.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Complications reported with the use of orthodontic miniscrews: A systematic review. Giudice AL, Rustico L, Longo M, Oteri G, Papadopoulos MA, Nucera R. Korean J Orthod 2021 May 25;51(3):199-216. doi: 10.4041/kjod.2021.51.3.199. PMID: 33984227. SOURCE OF FUNDING: There is no information about funding. TYPE OF STUDY/DESIGN: Systematic review.

Comparative Evaluation of Twin Block Appliance and Fixed Orthodontic Appliance in Early Class II Malocclusion Treatment: A Randomized Controlled Trial.

AIMS: To compare skeletal, dentoalveolar, and soft tissue changes between Twin block and early fixed orthodontic appliance for class II division 1 malocclusion treatment through a randomized controlled trial. MATERIALS AND METHODS: Sample and randomization: This study was a randomized controlled trial with a 1:1 allocation ratio in which 40 patients were divided equally into two groups: control and experimental; each group had an equal number of boys and girls. Randomization was achieved using random blocks of 20 patients with allocation concealed in sequentially numbered, opaque, and sealed envelopes. Blinding was only applicable for data analysis of radiographic measurements. Intervention: Twin block appliance was used in the experimental group for 1 year. However, control group was treated with fixed appliance. Inclusion criteria: Skeletal class II division 1 malocclusion with mandibular retrognathism; cephalometric angular measurements: SNA ≥ 82, SNB ≤ 78, ANB ≥ 4; overjet ≥6 mm; and patient in circumpubertal stage cervical vertebral maturation (CVM2 and CVM3). Parameters for evaluation: Cephalometric skeletal, dental, and soft tissue angular and linear measurements were used for evaluation. RESULTS: SNB increased remarkably by 4° in the Twin block group, but only by 0.68 in the control group. There was a significant decrease in vertical dimensions (SN-GoGn) in the Twin block group compared to control group (p = 0.002). Significant enhancement in the facial profile of the patients was observed. CONCLUSIONS: The Twin block appliance induced significant skeletal and dental changes. These changes were more obvious relative to the slight changes induced by natural growth. CLINICAL SIGNIFICANCE: Early treatment of Class II due to mandibular retrusion with Twin block functional appliance is recommended due to its favourable skeletal effect. Early treatment with fixed appliance affects mainly the dentoalveolar component. Long term follow-up is needed for further insights.

Effects on root axes and resorption of simultaneous intrusion and retraction of maxillary central and lateral incisors using mini-implant supported three-piece burstone base arch: A prospective observational study.

OBJECTIVE: Prospective morphometric evaluation of the positional changes and root resorption of maxillary central and lateral incisors undergoing simultaneous intrusion and retraction (SIR) using mini-implant supported 3-piece Burstone base arch. MATERIALS AND METHODS: Bracket head type mini-implants were inserted between the maxillary second premolar and first permanent molar. After maxillary canine retraction, SIR of maxillary incisors was begun using mini-implant supported 3-piece Burstone arch. A segmental CBCT was taken before and after SIR of the maxillary four incisors. Data collected were analysed using Paired t test, ANOVA test, independent sample t test and Pearson's correlation test. RESULTS: Sixteen patients of 17.9±1.94 years mean age with class II division 1 malocclusion, deep bite≥4mm and overjet 5-8mm were selected. All mini-implants showed good stability during treatment with no looseness. Increasing the vertical end of the anterior segment up to 10mm led to controlled tipping and partial bodily retraction of the maxillary central and lateral incisors. The centre of resistance (CRe) of the four maxillary incisors was retracted 2.38±0.77mm and intruded 2.76±1.0mm with a mean change in axial inclination of 9.76±3.45°. The mean amount of root resorption of the four incisors was 1.29±0.59mm over a mean period of 6.2 months. CONCLUSIONS: The mini-implant supported 3-piece Burstone base arch had a pronounced effect on SIR of flared maxillary incisors with clinically insignificant amount of root resorption.

Change in crown inclination accompanying initial tooth alignment with round archwires

ABSTRACT Objective: To evaluate, in-vitro, the change in crown inclination that occurs during orthodontic leveling and alignment using different archwire-bracket-ligation combinations. Materials and Methods: Four archwire types were tested: (1) 0.012-in stainless steel and (2) 0.0155-in stainless steel multi-stranded, (3) 0.012-in nitinol Orthonol® and (4) 0.012-in nitinol Thermalloy®. Combinations with five types of 0.022-in slot orthodontic brackets were tested: SmartClipTM and Time3® self-ligating brackets, Mini-Taurus® and Victory SeriesTM conventional brackets, and Synergy® conventional-low friction bracket. Conventional brackets were ligated with both stainless steel and elastomeric ligatures. The simulated malocclusion comprised 2.0mm gingival and 2.0mm labial displacements of a maxillary right central incisor. Rotation around the Y-axis (representing labio-palatal inclination) was measured for the different archwire-bracket-ligation combinations. Results: The largest rotation was measured whith Orthonol® and Thermalloy® wires when combined with SmartClipTM brackets (8.07±0.24º and 8.06±0.26º, respectively) and with Synergy® brackets ligated with stainless steel ligatures (8.03±0.49º and 8.0±0.37º, respectively). The lower rotation was recorded when Thermalloy®, multi-stranded, and Orthonol® wires were ligated with elastomeric rings to Mini-Taurus® brackets (1.53±0.18º, 1.65± 0.23º and 1.70±0.28º, respectively) and to Victory SeriesTM brackets (1.68± 0.78º, 2.92± 1.40º and 1.74±0.46º, respectively). Conclusions: All archwire-bracket-ligation combinations produced lingual crown inclination; however, lower changes were observed when the conventional brackets were ligated with elastomeric rings. The multi-stranded archwire produced less rotation with nearly every bracket-ligation combination, compared to the other archwires. The effect of the archwire-bracket-ligation combination on tooth inclination during leveling and alignment should be considered during planning treatment mechanics.

RESUMO Objetivo: Avaliar, in vitro, as mudanças na inclinação das coroas dentárias que acontecem durante o alinhamento e nivelamento usando diferentes combinações de arcos/braquetes/ligaduras. Material e Métodos: Foram usados quatro tipos de arcos ortodônticos: (1) 0,012" de aço inoxidável, (2) 0,0155" de aço multifilamentado, (3) Orthonol® 0,012" de nitinol e (4) Thermalloy® 0,012" de nitinol. Esses arcos foram combinados com cinco tipos de braquetes ortodônticos com slot 0,022": braquetes autoligáveis SmartClipTM e Time3®, braquetes convencionais Mini-Taurus® e Victory SeriesTM, e braquetes convencionais de baixo atrito Synergy®. Os braquetes convencionais receberam ligaduras de aço ou elastoméricas. A má oclusão simulada foi composta por um deslocamento do incisivo central superior direito em 2 mm para a cervical e 2 mm para a vestibular. A rotação ao redor do eixo Y (representando a inclinação vestibulolingual) foi medida para as diferentes combinações de arco/braquete/ligadura. Resultados: A maior rotação foi medida quando os arcos Orthonol® e Thermalloy® foram usados com os braquetes SmartClipTM (8,07±0,24º e 8,06±0,26º, respectivamente) e com os braquetes Synergy® com ligaduras metálicas (8,03±0,49º e 8,0±0,37º, respectivamente). A menor rotação foi vista quando os arcos Thermalloy®, multifilamentado e Orthonol® foram presos por ligaduras elastoméricas aos braquetes Mini-Taurus® (1,53±0,18º, 1,65±0,23º e 1,70±0,28º, respectivamente) e aos braquetes Victory SeriesTM (1,68±0,78º, 2,92±1,40º e 1,74±0,46º, respectivamente). Conclusões: todas as combinações arco-braquete-ligadura produziram inclinação palatina da coroa. Entretanto, as menores mudanças foram observadas quando os braquetes convencionais receberam ligaduras elastoméricas. O arco multifilamentado produziu menor rotação com quase todas as combinações braquete-ligadura, em comparação aos outros arcos. O efeito da combinação arco-braquete-ligadura na inclinação dentária durante o alinhamento e nivelamento deve ser considerado durante o planejamento da mecânica dos tratamentos.

ADOLESCENTS WITH REMOVABLE CLASS II CORRECTORS EXPRESS HIGHER DISSATISFACTION AND ARE MORE LIKELY TO DISCONTINUE TREATMENT.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Pacha MM, Fleming PS, Johal A. Complications, impacts, and success rates of different approaches to treatment of Class II malocclusion in adolescents: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop. 2020;158:477-494.e7. doi: 10.1016/j.ajodo.2020.03.021. Epub 2020 Sep 2. PMID: 32888735. SOURCE OF FUNDING: There is no information about funding. TYPE OF STUDY/DESIGN: Systematic review with meta-analysis.

ADDING TEMPORARY ANCHORAGE DEVICES (TADs) TO THE FORSUS™ CLASS II CORRECTION SYSTEM MAY NOT ENHANCE THE SAGITTAL SKELETAL EFFECTS BUT MAY CONTROL THE INCLINATION OF THE MANDIBULAR INCISORS.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: A comparison of the effects of Forsus appliances with and without temporary anchorage devices for skeletal Class II malocclusion. Liu L, Zhan Q, Zhou J, Kuang Q, Yan X, Zhang X, Shan Y, Lai W, Long H. Angle Orthod. 2020 Dec 30. doi:10.2319/051120-421.1. Epub ahead of print. PMID: 33378419. SOURCE OF FUNDING: National Natural Science Foundation of China (No. 82,071,147, 81,571,004, and 81,500,884). TYPE OF STUDY/DESIGN: Systematic review with meta-analysis.

Universal Adhesive for Fixed Retainer Bonding: In Vitro Evaluation and Randomized Clinical Trial.

This study aims to assess the efficacy of a universal adhesive (Scotchbond Universal, 3M ESPE) (SB) in total-etch mode, compared to a traditional orthodontic primer (Transbond XT Primer, 3M ESPE) (XT Primer), to perform bonding of orthodontic fixed retainers along with the Transbond XT Light Cure Adhesive Paste (3M ESPE). For the in vitro study, a round section wire (Ortosmail Krugg) was bonded using XT Primer for 20 bovine incisors (Group 1) and SB for other 20 (Group 2). Samples were debonded in a universal testing machine applying a tangential force to specimens (crosshead speed of 1 millimeter per minute). Shear bond strength (SBS) and adhesive remnant index (ARI) scores were calculated. For the in vivo study, 100 patients needing upper and lower canine-to-canine fixed retainers after orthodontic treatment were randomly assigned to two groups of 50 participants each, i.e., group 1 (retainer bonding with XT Primer) and group 2 (retainer bonding with SB). Over two years, examinations were carried out monthly, and detachments were registered by considering the teeth and arches affected. In vitro, no statistically significant differences in SBS and ARI scores were demonstrated between the two groups, both showing a mean bond strength of about 12 MPa and major frequency of ARI "2" (>50% remnant adhesive on the enamel). Conversely, a significantly lower failure rate over 2 years was assessed clinically for group 2 in both arches. Independently of the adhesive and arch, incisors reported a significantly higher failure rate than canines. Scotchbond Universal used in total-etch mode could be a valid alternative to the traditional orthodontic Transbond XT Primer.

Expression of biological markers in gingival crevicular fluid of teeth with orthodontically induced root resorption.

AIM: The goal was to investigate interleukin­1 receptor antagonist (IL-1ra) and dentin sialophosphoprotein (DSPP) levels in gingival crevicular fluid (GCF) as potential biomarkers for orthodontically induced root resorption (OIRR) using enzyme-linked immunosorbent immunoassay (ELISA). MATERIALS AND METHODS: In all, 74 subjects were assigned to one of three groups: (1) orthodontic group included orthodontic patients who showed radiographic evidence of 1-3 mm root resorption of a maxillary central incisor, (2) pediatric group included pediatric patients who showed radiographic evidence of physiologic root resorption of a lower second primary molar, and (3) control group included subjects who had no orthodontic treatment and showed no radiographic evidence of root resorption. Samples from the GCF were collected with endodontic absorbent paper points inserted 1 mm below the gingival margin of the tooth. The IL-1ra and DSPP levels were evaluated using ELISA. RESULTS: The IL-1ra levels were 657.5 ± 51.5, 319.9 ± 181.3, and 129.4 ± 54.9 pg/ml for the control, orthodontic, and pediatric groups, respectively. The DSPP levels were 1.6 ± 1.0, 30.1 ± 9.6, and 39.2 ± 3.3 pg/ml for the control, orthodontic, and pediatric groups, respectively. Post hoc analyses revealed significant differences for IL-1ra and DSPP between any two groups. Sensitivity and specificity of IL-1ra for the diagnosis of OIRR showed 80% reliability and a cutoff value of ≤432.6 pg/ml, while the analysis of DSPP showed 100% reliability and a cutoff value of ≥7.33 pg/ml. CONCLUSIONS: The levels of IL-1ra and DSPP detected in the orthodontic and pediatric groups indicate a possible association with OIRR. Efforts to develop tests for screening, diagnosis, and monitoring OIRR based on biological markers should continue.

Powered vs manual tooth brushing in patients with fixed orthodontic appliances: A systematic review and meta-analysis.

OBJECTIVE: The objective of this systematic review and meta-analysis was to compare powered and manual toothbrushes for oral hygiene maintenance in orthodontic patients. METHODS: Electronic databases, including MEDLINE, Scopus, Google scholar, PubMed, Web of Science, the Cochrane Oral Health Group's Trials Register, and CENTRAL, were searched without language restrictions. Randomized clinical trials directly comparing manual and powered toothbrushing including patients with fixed orthodontic appliances reporting predefined outcomes with a follow-up period of at least 4 weeks were included. Using predefined data extraction forms, 2 authors independently undertook data extraction with conflict resolution by the third author. Quality assessment was based on the Cochrane Risk of Bias tool, and overall evidence base was assessed using the Grading of Recommendations Assessment, Development and Evaluation system. A random effects meta-analysis combined the treatment effects across studies. RESULTS: Five trials were considered appropriate for inclusion in the meta-analysis with 8 trials excluded. There are slight differences in plaque index reduction of 0.05 (-0.04, 0.13) and 0.11 (-0.10, 0.33) at 4 week and 8 week follow up, respectively, favoring manual toothbrushing, but this was not statistically significant. There are slight differences in gingival index reduction of -0.02 (-0.06, 0.02) and -0.01 (-0.05, 0.02) at 4 week and 8 week follow up, respectively, favoring powered brushing, but again, this was not statistically significant. The overall quality of evidence was very low to moderate for the primary outcomes. CONCLUSIONS: Using manual or powered tooth brushing with fixed orthodontic appliances does not reduce plaque or gingival indexes at 4 weeks and 8 weeks. This conclusion is, however, based on low quality of evidence from few studies. Greater standardization of the methodology used is desirable in future trials to increase our confidence in these findings.

Imaging Software Programs for Reliable Mathematical Measurements in Orthodontics.

AIM: To evaluate the reliability of linear and angular measurements taken using different software programs in orthodontics. MATERIALS AND METHODS: A sample of four software programs from different manufacturers, namely MicroDicom viewer, Photoshop® CS3, AutoCAD®, and Image-Pro®, were used for measuring the geometric features of four types of miniscrews from different manufacturers. Each miniscrew type presented a group: Group I, Tomas® (Dentaurum, Ispringen, Germany); Group II, HUBIT® (HUBIT, Gyeonggi-do, Korea); Group III, AbsoAnchor® (Dentos, Daegu, Korea); and Group IV, Creative (Creative, Zhejiang, China). Measurements of apical face angle, thread angle, lead angle, flank, pitch depth, and width were taken on 45 × magnification scanning electron microscope images of the shafts of the miniscrews. One assessor measured the seven geometric features for the four types of miniscrews using the four software programs twice in two sessions separated by a three week interval. RESULTS: Pairwise comparisons, for each of the four miniscrew groups, showed that the only common result observed was the significant difference (p < 0.001) between measurements of flank taken by the four software programs. When measurements of the four types of miniscrews were pooled into one group, a high degree of intra-rater reliability (ICC range from 0.9 to 1.0) for all the seven geometric features was found with all the four software programs. The paired t-test showed insignificant difference (at p ≤ 0.05) between the first and second measurements, except for a few measurements including pitch width measured by Image-Pro® (p = 0.012), MicroDicom (p = 0.023), and Photoshop® (p = 0.001). CONCLUSIONS: Results did not give absolute superiority to one software program over the others and suggested an assessor effect. Assessor estimates could have been affected, among other factors, by the design of the miniscrews and the technical features of the software programs.

Enamel around orthodontic brackets coated with flash-free and conventional adhesives.

OBJECTIVE: To evaluate enamel roughness and color after debonding flash-free adhesive precoated brackets and brackets coated with conventional orthodontic adhesives using nonbonded enamel as control. MATERIALS AND METHODS: A total of 80 extracted human premolars were divided into the following four groups: group I: APCTM Flash-Free adhesive precoated brackets; group II: APCTM PLUS adhesive precoated brackets; group III: noncoated brackets, which were coated manually at the time of bonding (all three brackets were ClarityTM Advanced ceramic brackets [3M Unitek, Monrovia, CA, USA]); group IV: nonbonded enamel (control). Bonded premolars were subjected to demineralization, and then brackets were debonded. Each group was then divided into two subgroups to assess enamel around the debonded brackets, and also enamel in the control group, using an atomic force microscope and spectrophotometer. In addition, 12 samples were used to assess the bracket/adhesive/enamel junction with a scanning electron microscope. RESULTS: Mean values of root mean square roughness (Rq) and maximum profile valley depth (Rv) for APCTM Flash-Free, APCTM PLUS, and ClarityTM Advanced groups were 140 nm and 482 nm, 210 nm and 727 nm, and 447 nm and 1243 nm, respectively. All three groups showed higher roughness and depth values than the control enamel. Spectrophotometer results yielded ∆E* of 3.7 ± 0.6, 5.1 ± 0.4, and 7.1 ± 0.6 for APC™ Flash-Free, APC™ PLUS, and ClarityTM Advanced groups respectively. Color coordinates showed progressively higher L* and b* values and progressively lower a* values from group I to group III. CONCLUSIONS: Under the same demineralization conditions, enamel around debonded APC™ Flash-Free adhesive precoated brackets showed less roughness and color changes compared to the other two groups.

Functional Appliances May Be Effective in Correcting Skeletal Class II Malocclusion in the Long Term; However, the Quality of the Evidence Was Very Low and the Clinical Significance Was Limited.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Long-term effects of functional appliances in treated versus untreated patients with class II malocclusion: A systematic review and meta-analysis. Cacciatore G, Ugolini A, Sforza C, Gbinigle O, Plüddemann A. PLoS One 14:e0221624. SOURCE OF FUNDING: Authors reported no specific funding for this research study. TYPE OF STUDY/DESIGN: Systematic review with meta-analysis of data.