The effect of mastic mouthwash on halitosis and oral hygiene in orthodontic patients: a randomized clinical trial.

BACKGROUND/OBJECTIVES: The aim of this trial was to investigate the effect of mastic mouthwash on halitosis using as a proxy the levels of the Volatile Sulfur Compounds (VSCs), and the effect on plaque and gingival indices in adolescents undergoing orthodontic treatment with fixed conventional labial appliances. SUBJECTS/METHODS: The study was a double-blinded, placebo-controlled, parallel-group, randomized clinical trial. Thirty patients with fixed orthodontic appliances were randomly allocated at a 1:1 ratio, to either the mastic-mouthwash or the placebo-mouthwash group. Eligibility criteria included ages between 13 and 18, active orthodontic treatment with fixed appliances, good general health, and total initial VSCs levels above 150 ppb. The primary outcome was the objective hydrogen sulfide (H2S) level, measured with the Oral ChromaTM device. The secondary outcomes were (1.) the methyl-mercaptan (CH3SH) and (2.) dimethyl sulfide [(CH3)2S] levels, measured with the same device, (3.) the subjective perception of the own malodour via questionnaires, and (4.) the oral hygiene assessed with the use of the Modified Silness and Löe Plaque Index (PI-M) and the Silness and Löe Gingival Index (GI) at baseline (T0) and after 2 weeks (T1). Stratified randomization by gender was used, and allocation was concealed with opaque numbered sealed envelopes. RESULTS: H2S level dropped from 221.00 ppb (T0) to 125.00 ppb (T1), and the difference between treatment groups was statistically significant in favour of the mastic group (coef: 72.34, 95% CI: 8.48, 136.27, P = 0.03). The levels of the other VSCs, the subjective measurements of oral malodour, and the oral hygiene indices did not differ between treatment arms. LIMITATIONS: The objective organoleptic assessment by a calibrated examiner was not performed. CONCLUSIONS/IMPLICATIONS: Mastic mouthwashes could be an alternative treatment for adolescent patients suffering from halitosis during orthodontic treatment with fixed appliances. REGISTRATION: The trial was registered at ClinicalTrials.gov (identifier: NCT05647369).

Thermo-mechanical properties in bending of a multizone nickel-titanium archwire: A retrieval analysis.

Objective: This study aimed to compare the mechanical and thermal properties in the anterior and posterior segments of new and retrieved specimens of a commercially available multizone superelastic nickel-titanium (NiTi) archwire. Methods: The following groups of 0.016 × 0.022-inch Bioforce NiTi archwires were compared: a) anterior and b) posterior segments of new specimens and c) anterior and d) posterior segments of retrieved specimens. Six specimens were evaluated in each group, by three-point bending and bend and free recovery tests. Bending moduli (Eb) were calculated. Furthermore, the new specimens were evaluated with scanning electron microscopy/energy-dispersive X-ray spectrometry. A multiple linear regression model with a random intercept at the wire level was applied for data analysis. Results: The forces in the posterior segments or new specimens were higher than those recorded in the anterior segments or retrieved specimens, respectively. Accordingly, Eb also varied. Higher austenite start and austenite finish (Af) temperatures were recorded in the anterior segments. No statistically significant differences were found for these temperatures between retrieved and new wires. The mean elemental composition was (weight percentage): Ni, 52.6 ± 0.5; Ti, 47.4 ± 0.5. Conclusions: The existence of multiple force zones was confirmed in new and retrieved Bioforce archwires. The retrieved archwires demonstrated lower forces during the initial stages of deactivation in three-point bending tests, compared with new specimens. The Af temperature of these archwires may lie higher than the regular intraoral temperature. Even at 2 mm deflections, the forces recorded from these archwires may lie beyond biologically safe limits.

A randomized, 3-month, parallel-group clinical trial to compare the efficacy of electric 3-dimensional toothbrushes vs manual toothbrushes in maintaining oral health in patients with fixed orthodontic appliances.

INTRODUCTION: The aim of this single-blinded, parallel-group, randomized clinical trial was to compare the efficacy of electric 3-dimensional (3D) toothbrushes and manual toothbrushes in removing plaque and reducing gingival inflammation in orthodontic patients. METHODS: Eighty adolescents with fixed orthodontic appliances in both arches were randomized at a 1:1 ratio, with an equal number of both sexes, in this examiner blinded, parallel clinical trial. Eligibility criteria included subjects aged between 12 and 16 years, good general health, nonextraction orthodontic treatment, and plaque-induced gingivitis, excluding patients with active caries or periodontitis, tooth agenesis, syndromes, disabilities, and craniofacial deformities, ≥2 cervical and/or proximal fillings, dental prostheses or dental implants, and subjects smoking or using antibiotics or medication predisposing to gingival enlargement. Patients were assigned to use either an electric 3D orthodontic toothbrush (Oral-B Pro-1000 with Oral-B Ortho head; Procter & Gamble, Cincinnati, Ohio) or a manual toothbrush (Oral-B Orthodontic brush; Procter & Gamble) and instructed to brush twice daily for 2 minutes. The main outcomes were: (1) plaque removal, assessed with the Modified Silness and Löe plaque index and the Modified Full Mouth Plaque Score, and (2) gingival inflammation reduction, assessed with the Modified Silness and Löe Gingival Index and the Modified Simplified Gingival Index. Measurements were taken at baseline, 1, 2, and 3 months. Randomization was achieved with 2 random sequences, one for each brush, written and sealed in opaque numbered envelopes. Blinding was possible for outcome assessment only. RESULTS: Considerable variability was observed among patients in the values of all dependent variables. There was no difference between interventions over time for any of the outcomes, and the main effects for treatment and time were also not statistically significant. For Modified Silness and Löe plaque index, the interaction was 0.001 (95% confidence interval, -0.011 to 0.013; P = 0.89). CONCLUSIONS: No difference in plaque removal efficacy and gingival inflammation reduction was found between the electric 3D and manual toothbrushes in adolescents with fixed orthodontic appliances. Therefore, orthodontists should focus on enhancing their patients' dental awareness and oral hygiene, along with professional prophylaxis and other oral hygiene aids, independently of the brush used. REGISTRATION: This trial was registered at ClinicalTrials.gov (Identifier: NCT02699931). PROTOCOL: The protocol was not published before trial commencement. FUNDING: Electric and manual toothbrushes and toothpastes for all participants were provided by Procter & Gamble (Oral-B). Miscellaneous costs were covered by the participating departments.

Orthodontic Status and Orthodontic Treatment Need of 12- and 15-Year-Old Greek Adolescents: A National Pathfinder Survey.

The purpose of this research was to assess the orthodontic status and orthodontic treatment needs of 12- and 15-year-old schoolchildren in Greece, in relation to sociodemographic factors and parental education level. A total of 1102 12-year-old children and 1131 15-year-old adolescents across Greece were assessed using the Modified Dental Health component (DHC) of the Index of Orthodontic Treatment Need (IOTN). An amount of 38.7% of 12-year-olds and 33.7% of 15-year-olds were in definite need of orthodontic treatment. The most common etiologic factors were tooth eruption and position anomalies. A higher rate of orthodontic treatment need was recorded among subjects with lower parental education level. Class I malocclusion was found in 50.9%, Class II in 38.4% and Class III in 10.8% of the total sample. A higher incidence of dental trauma was found in the 12-year-olds presenting with a Class II molar relationship and >3 mm overjet. The need for orthodontic treatment in Greece was higher, in comparison to other European countries, with one out of two children presenting a severe overjet associated with a high incidence of dental trauma. One out of three adolescents were still judged as having a need for orthodontic treatment by the age of 15.