Effects of Low-Level Laser Therapy and Bracket Systems on Root Resorption during Orthodontic Treatment: A Randomized Clinical Trial.

This study aimed to assess the outcomes of low-level laser therapy (LLLT) with the conventional bracket (CB) and self-ligating (SL) bracket systems on root resorption (RR) during orthodontic treatment. A total of 32 patients were included in this randomized clinical trial. All the patients were randomly divided into four individual groups (SLL: self-ligating laser, CBL: conventional bracket laser, SLNL: self-ligating non-laser, CBNL: conventional bracket non-laser). RR was measured from the cone-beam computed tomography (CBCT) radiographs which were taken at two stages of the orthodontic treatment: pre-treatment (T1) and after leveling and alignment stage (T2). Wilcoxon rank test for the comparison was conducted to compare the RR at T1 and T2 stages within each group and showed a significant difference (p < 0.05) for various variables. Mann Whitney test compared the RR in laser and non-laser groups irrespective of the bracket systems and exhibited no significant differences except the left lateral incisor. Moreover, CB and SL groups showed no significant difference in RR among any tooth. Kruskal Wallis test was performed to compare the RR among all groups which presented no significant differences. LLLT and bracket systems have no consequences on RR until the leveling and alignment stage of orthodontic treatment.

External Apical Root Resorption and IL-1A, IL-1RN Gene Polymorphisms: A Systematic Review and Meta-Analysis of Prospective Studies

ABSTRACT Objective: To reconnoiter the IL-1A (-889) and IL-1RN (+2018) gene polymorphisms and their association with EARR. Material and Methods: The Science Direct, PubMed and Scopus databases were comprehensively searched by two independent reviewers. In addition, the bibliographies of all relevant publications and textbooks were searched manually. A meta-analysis was performed using data available up to May 9, 2020. Results: A total of 13 and 9 publications were selected for the systematic review and meta-analysis, respectively for both IL-1A and IL-1RN genes. Odds ratio (OR) was used to evaluate the association of the gene polymorphism and the risk of EARR. The risk of EARR was estimated using the overall OR from the published studies. No association was found for IL-1A gene for the risk of EARR. However, the dominant and co-dominant models of IL-1RN gene polymorphism were associated with the risk of EARR. Conclusion: More studies are warranted to determine the relationship between IL-1A and IL-1RN gene polymorphisms and EARR for a clearer understanding of their interactions.

Pain Perception and Rate of Canine Retraction Through Self-Ligating Brackets and Conventional Elastomeric Ligation System: A Split Mouth Study

Abstract Objective: To evaluate the rate of tooth movement and the pain perception via self-ligating (SL) and conventional elastomeric ligation brackets (CB) system. Material and Methods: This study has been conducted at the Orthodontic Department of Baqai Dental College, Baqai Medical University. The sample size of this study comprised 40 patients, falling between the age of 12-30 years without any sex discrimination. Shapiro-Wilk was used to check the distribution of data. Non-parametric Mann Whitney U test was applied to evaluate the pain associated with SL and CB brackets system. To analysis the canine retraction Wilcoxon test was applied for the comparison of CB and SL brackets system. For all statistical analyses, the p-value of <0.05 was considered significant. Results: Pain level associated with retraction via CB and SL shows significant differences. However, the rate of canine retraction via CB and SL shows no significant differences at stages T0-T1 and T1-T2. However, stage T2-T3 shows a significant difference. Conclusion: As pain during orthodontic treatment is mostly associated with the level of compression of the periodontal ligament, it may be hypothesized that lower frictional forces generate less compression of the periodontal ligament and blood vessels, and so alter the type of pain experienced.

Efficacy of Three Types of Plaque Control Methods During Fixed Orthodontic Treatment: A Randomized Controlled Trial.

AIM: The aim of this study was to evaluate and compare the efficacy of three types of plaque control methods among 13- to 35-year-old subjects receiving fixed orthodontic treatment in Coorg Institute of Dental Sciences, Virajpet, Coorg district, Karnataka, India. MATERIALS AND METHODS: A total of 111 subjects who fulfilled the inclusion and exclusion criteria were randomly included in the study. The subjects were recalled after 1 month of the commencement of fixed orthodontic treatment for the recording of baseline data including plaque index (PI), gingival index (GI), and modified papillary bleeding index (MPBI). After recording of the baseline data, the subjects were randomly allocated into each of the intervention groups, i.e., group A (manual tooth brush), group B (powered tooth brush), and group C (manual tooth brush combined with mouthwash) by lottery method. Further, all the subjects were recalled after 1 and 2 months for recording the data. RESULTS: Regarding plaque levels, it was seen that there was a highly statistically significant difference between the three groups (P = 0.001), with the manual tooth brush combined with chlorhexidine mouthwash group recording the lowest mean PI score of 0.5 ± 0.39. A comparison of the mean GI scores among the groups at the end of 2 months shows a highly statistically significant difference (P = 0.001). The mean MPBI scores at the end of 2 months were highly statistically significant among the three groups (P = 0.001), with the group C recording the lowest mean MPBI score of 0.3 ± 0.3. CONCLUSION: The powered tooth brush group subjects exhibited significantly lesser PI, GI, and MPBI scores than the manual tooth brush group at the end of 2 months, whereas the manual tooth brush combined with chlorhexidine mouth wash group subjects showed maximum improvement, having significantly lesser PI and GI scores than the powered tooth brush group.

Association between genetic polymorphisms and external apical root resorption: A systematic review and meta-analysis.

OBJECTIVE: To date, only a few studies have investigated the relationships between genetic polymorphisms and external apical root resorption (EARR). Hence, the aim of this systematic review was to explore the relationship between different gene polymorphisms and their association with EARR. METHODS: A complete literature search was conducted by two independent reviewers. The PubMed, Science Direct, and Scopus databases were searched. In addition, the bibliographies of all textbooks and relevant articles were searched manually. A meta-analysis was performed using data entered into the electronic databases until February 28, 2017. RESULTS: On the basis of the search, we identified 17 and 7 publications for the systematic review and meta-analysis, respectively. Odds ratio (OR) was used to evaluate the association of the interleukin 1B (+3954) polymorphism and the risk of EARR. The overall OR from the studies was used to estimate the risk of EARR. However, no association was found and no publication bias was apparent for the risk of EARR in patients receiving orthodontic treatment. CONCLUSIONS: More research on the relationship between gene polymorphism and EARR is necessary to determine better specificity of possible interactions.

Comparison of popular sagittal cephalometric analyses for validity and reliability.

BACKGROUND: The analysis of skeletal relationships of jaws in the sagittal plane is of utmost importance in orthodontic diagnosis for which numerous lateral cephalometric analyses have emerged. None of the analyses is without flaws. Current study compares ANB, Wits appraisal, Beta angle, Yen angle and W angle for their validity and reliability in diagnosis of skeletal classes. METHODS: Pretreatment cephalograph of 209 orthodontic patients comprised of 92 males and 117 females were selected from orthodontic archives. Radiographs were traced for ANB, Wits appraisal, Beta angle, W angle and Yen angle measurements. Patients were divided into three skeletal classes i.e. class I, II and III based on measurements and incisor classification and profile recorded from their files. ANOVA was applied to check the validity of performed analyses and Cramer's correlation was performed to find out the correlation between analyses and skeletal classes. RESULTS: All performed analyses showed statistically significant difference in the values for all three skeletal classes p < .05. All measured analyses were found equally reliable in diagnosis of skeletal discrepancies. CONCLUSION: All five-skeletal cephalometric sagittal analyses are reliable and can be used in orthodontic diagnosis as alternative to each other.

New prediction equations for the estimation of maxillary mandibular canine and premolar widths from mandibular incisors and mandibular first permanent molar widths: A digital model study.

OBJECTIVE: The primary aim of the study was to generate new prediction equations for the estimation of maxillary and mandibular canine and premolar widths based on mandibular incisors and first permanent molar widths. METHODS: A total of 2,340 calculations (768 based on the sum of mandibular incisor and first permanent molar widths, and 1,572 based on the maxillary and mandibular canine and premolar widths) were performed, and a digital stereomicroscope was used to derive the the digital models and measurements. Mesiodistal widths of maxillary and mandibular teeth were measured via scanned digital models. RESULTS: There was a strong positive correlation between the estimation of maxillary (r = 0.85994, r(2) = 0.7395) and mandibular (r = 0.8708, r(2) = 0.7582) canine and premolar widths. The intraclass correlation coefficients were statistically significant, and the coefficients were in the strong correlation range, with an average of 0.9. Linear regression analysis was used to establish prediction equations. Prediction equations were developed to estimate maxillary arches based on Y = 15.746 + 0.602 × sum of mandibular incisors and mandibular first permanent molar widths (sum of mandibular incisors [SMI] + molars), Y = 18.224 + 0.540 × (SMI + molars), and Y = 16.186 + 0.586 × (SMI + molars) for both genders, and to estimate mandibular arches the parameters used were Y = 16.391 + 0.564 × (SMI + molars), Y = 14.444 + 0.609 × (SMI + molars), and Y = 19.915 + 0.481 × (SMI + molars). CONCLUSIONS: These formulas will be helpful for orthodontic diagnosis and clinical treatment planning during the mixed dentition stage.

Assessment of Gender Dimorphism on Sagittal Cephalometry in Pakistani Population.

OBJECTIVE: To determine and compare the cephalometric values among Pakistani males and females using commonly used sagittal skeletal measurements (ANB, Wits appraisal, Beta-angle) and newly developed cephalometric analyses (Yen-angle and W-angle). STUDY DESIGN: Observational, cross-sectional study. PLACE AND DURATION OF STUDY: Orthodontic Department of Baqai Medical University, Karachi, Pakistan, from August to October 2013. METHODOLOGY: Atotal of 209 pre-treatment lateral cephalometric radiographs of orthodontic patients were selected from departmental records, comprised of 92 males and 117 females. Radiographs were traced for measurements of ANB, Wits appraisal, Beta-angle, W-angle and Yen-angle. Patients were categorized into skeletal classes I, II, and III on the basis of performed measurements, incisor classification, and profile recorded from their records. Descriptive analysis was used to obtain median interquartile range in both the genders and Mann-Whitney U-test was used to observe gender dimorphism. RESULTS: Skeletal class II was the most prevalent type of malocclusion. There were no difference in the obtained measurements between males and females except the Wits appraisal and Beta-angle in class II patients, which showed significant difference in values (p < 0.05). CONCLUSION: Pakistani population has no significant different difference in the craniofacial morphology of males and females, with the exception of Wits-appraisal and Beta-angle in class II cases.

Intermaxillary tooth size discrepancy in a Pakistani population: A stereomicroscope versus digital caliper.

OBJECTIVE: Comprehensive diagnosis and treatment planning are essential in a successful orthodontic practice. The purpose of this study is to determine and compare intermaxillary tooth size discrepancy (IMTSD) using traditional digital caliper (DC) measurement on plaster dental models and stereomicroscopic digital dental models (SM). MATERIALS AND METHODS: The samples were randomly selected from different states of Pakistan. Total 7168 variables were measured on plaster dental casts (128) and SM digital dental models (128) according to the selection criteria. For IMTSD, the 6 variable measured as for anterior tooth size (maxilla, mandibular), overall tooth size (maxilla, mandibular), Bolton's anterior ratios (BAR), and Bolton's overall ratios (BOR). The independent t-test and ANOVA were used for statistical analyses. RESULTS: Significant sexual disparities in the sum of anterior tooth size and overall tooth size via DC and SM methods. No significant sexual disparities for BAR and BOR. No statistically significant differences were found in BAR and BOR between DC and SM. No significant differences were found on IMTSD ratio among different arch length and arch perimeters groups. CONCLUSIONS: Norms were developed based on DC and SM for IMTSD. Sexual disparities were observed in the sum of teeth size. However, no significant differences in BAR and BOR for IMTSD between the two methods.

Cone-beam computed tomography evaluation of Pont's index predictability for Malay population in orthodontics.

INTRODUCTION: In orthodontic treatment, three-dimensional (3D) dental casts has a significant role in diagnosis and treatment planning. The aim of this study was to evaluate Pont's index predictability in orthodontics. MATERIALS AND METHODS: Premolar arch width, molar arch width and mesiodistal width of the maxillary incisors were measured three-dimensionally to assess shape of dental arches. The data source was cone beam computed tomography (CBCT) high volumetric data acquisitions from Malay ethnic background. Arch widths were measured and recorded from 53 subjects (32 male and 21 female with the mean age, 25.81), both the maxillary and mandibular arches, to obtain CBCT high volumetric data. All measurements were obtained through CBCT Planmeca Romexis TM Software 2.3.1.R (Helsinki, Finland). RESULTS: Pont's formula overestimated the upper and lower interpremolar distance, with mean differences of 8.35 ± 3 mm and 12.02 ± 3.20 mm, respectively. Furthermore, the formula overestimated the upper and lower intermolar distance, with mean differences of 7.87 ± 3 mm and 16.14 ± 5.86 mm, respectively. CONCLUSIONS: The results indicate that Pont's index is not practical for use with the Malaysian population since the index overestimated interpremolar and intermolar widths. This raises questions whether the index is a true predictor of arch width measurements.

Human Mesiodistal Tooth Width Measurements and Comparison with Dental Cast in a Bangladeshi Population.

AIM: This analysis was aimed to determine the mesiodistal tooth width of human teeth and to compare with the measurements on plaster model in a Bangladeshi population. MATERIALS AND METHODS: The samples of 2,892 teeth of Bangladeshi subjects were collected for this purpose. This article presents mesiodistal tooth width measurements made on all types of teeth and compares with the mesiodistal tooth width measurements of dental cast collected from Bangladeshi subjects between the ages of 18 and 24 years. The mesiodistal dimension was recorded, involving the maximum mesiodistal dimension of each tooth when measurement was rendered parallel to the occlusal and labial surfaces. Descriptive and comparative statistics were applied. RESULTS: The mean, standard deviation and 95% confidence interval of mesiodistal tooth width measurements were determined and have been with the mesiodistal tooth width measurements of dent al cast. Significant differences have been observed between mesiodistal tooth size of direct measurement on tooth (DMT) and measurement on plaster model (MPM) for the maxillary first molar (p < 0.001) and mandibular incisors to first premolar (p < 0.001). CONCLUSION: These data should prove to be helpful to the practitioner for performing successful orthodontic treatment in Bangladeshi population. CLINICAL SIGNIFICANCE: Direct measurement of mesiodistal tooth width and individual variation of maxillary and mandibular permanent central incisor to first molar of the Bangladeshi individuals showed some distinguishable features, which will certainly help an orthodontist for diagnosis and treatment plan of an orthodontic case.

Maxillary and mandibular anterior crown width/height ratio and its relation to various arch perimeters, arch length, and arch width groups.

OBJECTIVE: To investigate the maxillary and mandibular anterior crown width/height ratio and its relation to various arch perimeters, arch length, and arch width (intercanine, interpremolar, and intermolar) groups. MATERIALS AND METHODS: The calculated sample size was 128 subjects. The crown width/height, arch length, arch perimeter, and arch width of the maxilla and mandible were obtained via digital calliper (Mitutoyo, Japan). A total of 4325 variables were measured. The sex differences in the crown width and height were evaluated. Analysis of variance was applied to evaluate the differences between arch length, arch perimeter, and arch width groups. RESULTS: Males had significantly larger mean values for crown width and height than females (P ≤ 0.05) for maxillary and mandibular arches, both. There were no significant differences observed for the crown width/height ratio in various arch length, arch perimeter, and arch width (intercanine, interpremolar, and intermolar) groups (P ≤ 0.05) in maxilla and mandible, both. CONCLUSIONS: Our results indicate sexual disparities in the crown width and height. Crown width and height has no significant relation to various arch length, arch perimeter, and arch width groups of maxilla and mandible. Thus, it may be helpful for orthodontic and prosthodontic case investigations and comprehensive management.

Camouflage of Severe Skeletal Class II Gummy Smile Patient Treated Nonsurgically with Mini Implants.

Skeletal class II has always been a challenge in orthodontics and often needs assistance of surgical orthodontics in nongrowing patients when it presents with severe discrepancy. Difficulty increases more when vertical dysplasia is also associated with sagittal discrepancy. The advent of mini implants in orthodontics has broadened the spectrum of camouflage treatment. This case report presents a 16-year-old nongrowing girl with severe class II because of retrognathic mandible, and anterior dentoalveolar protrusion sagittally and vertically resulted in severe overjet of 13 mm and excessive display of incisors and gums. Both maxillary central incisors were trimmed by general practitioner few years back to reduce visibility. Treatment involved use of micro implant for retraction and intrusion of anterior maxillary dentoalveolar segment while lower incisors were proclined to obtain normal overjet, and overbite and pleasing soft tissue profile. Smile esthetics was further improved with composite restoration of incisal edges of both central incisors.

Bolton tooth size ratio and its relation with arch widths, arch length and arch perimeter: a cone beam computed tomography (CBCT) study.

OBJECTIVE: The prime aim of the study was to measure and compare the 3D CBCT Bolton tooth size ratio in relation to the upper and lower arch widths, arch length and arch perimeter. MATERIALS AND METHODS: The data source was CBCT high volumetric data from the archives. Tooth size, arch widths, arch length and arch perimeter were measured in maxilla and mandibular arches. The independent t-test and ANOVA were used for statistical analyses. RESULTS: The female Bolton anterior ratio (BAR) (78.373) and Bolton overall ratio (BOR) (93.231) show a greater tooth size ratio in comparison to male BAR (77.162) and BOR (93.124), respectively. However, no significant difference was found in the sexual comparison of all the measurements. Tooth size ratio in arch width groups also showed no significant difference. Significant discrepancies in the arch length (p < 0.05) groups and overall ratio and in the arch perimeter groups (p < 0.05 and p < 0.01) and anterior ratio were revealed. CONCLUSIONS: Tooth size ratios during orthodontic treatment for different arch length and arch perimeter groups need to be evaluated carefully.