Effect of aligners on patients' oral health-related quality of life and anxiety: a prospective pilot study.

BACKGROUND: This prospective study explored the impact of aligners on the oral health-related quality of life and anxiety of patients during the first month of orthodontic treatment and the first month of the retention phase. METHODS: A total of 23 male and female patients (median age 25 y) treated with clear aligners were included. The OHRQoL questionnaire was used at certain time points during treatment (T1: placement of the first aligner; T2: after one day of use; T3: after seven days; T4: after one month; and T5: after one month in the retention phase). The State-Trait Anxiety Inventory (STAI) was also self-administered to assess state and trait anxiety (Y1 and Y2 subscales, respectively) at the T1, T4 and T5 time points. A population average generalized estimating equations logistic regression model was fit to assess the effect of time on the responses, and the Wald test was used to examine the overall effect of time. RESULTS: Overall time was a significant predictor for most of the questions. However, time was marginally significant for the OHRQoL questions evaluating oral symptoms such as bad taste/smell, sores, and food accumulation. Tooth discolouration did not differ between time points. The general activity disturbance was significantly lower in the retention phase. Higher depression and anxiety scores were reported at the initial appointment and decreased thereafter. CONCLUSIONS: CAT has a negative impact on quality of life and psychological status during the initial days of treatment. These impairments ameliorate at later treatment stages.

The Effect of Third Molars on the Mandibular Anterior Crowding Relapse-A Systematic Review.

The present systematic review updates the evidence on wisdom teeth contributing to lower incisor crowding following orthodontic treatment. Relevant literature was searched on online databases, namely Pubmed, Scopus, and Web of Science, up to December 2022. Eligibility criteria were formulated using the PICOS approach and PRISMA guidelines. Eligible research included original clinical studies involving patients previously being treated orthodontically with permanent dentition at the end of treatment, regardless of sex or age. The initial search yielded 605 citations. After considering eligibility criteria and removing duplicates, only 10 articles met the criteria for inclusion. The risk of bias of eligible studies was evaluated using the Cochrane Handbook for Systematic Reviews and Interventions tool. The majority were highly biased, mainly regarding allocation concealment, group similarity, and assessment blinding. The vast majority did not report statistically significant associations between the presence of third molars and crowding relapse. However, a minor effect has been suggested. Seemingly, there is no clear connection between mandibular third molars and incisor crowding after orthodontic treatment. The present review did not find adequate evidence to advocate preventative removal of the third molars for reasons of occlusal stability.

Orthodontic Treatment of Palatally Impacted Maxillary Canines with the Use of a Digitally Designed and 3D-Printed Metal Device.

The purpose of this article is to present a computer designed and 3D-printed metal device, which was used for the surgical exposure and orthodontic treatment of maxillary palatally impacted canines. In two cases which presented a palatally impacted canine, a Cone-Beam Computed Tomography (CBCT) was acquired and an intraoral scanning was performed, to determine the exact location of the canine. Based on a digital model, a device leaning on the teeth and mucosa was designed to serve as a guiding tool for the oral surgeon to expose the crown of the canine and help the orthodontist to provide proper traction. The device was then 3D-printed in biocompatible dental alloy and placed in the patients' mouth. After the surgical exposure of the canine's crown in both cases, a gold chain apparatus was bonded on and it was mounted on the metal projection of the device through an elastic chain. Within 3 months of traction, the crown of the canines appeared in the patients' palate to the exact location that was predicted and guided. A 3D-designed and manufactured metal device, with information acquired by CBCT and intraoral scanning, can be used for the exposure and traction of palatally impacted canines.

Bimaxillary Dentoalveolar Protrusion Case Treated with Anchorage by Buccally Implemented Mini-Implants Using a 3D-Printed Surgical Guide.

The article presents a case of bimaxillary dentoalveolar protrusion treated by distalizing the upper and lower teeth, using anchorage from mini implants. A 16-year-old male patient presented with severe upper and lower incisor proclination with protruding lips and a convex profile, with a background of bimaxillary dentoalveolar protrusion. Instead of having four premolars extracted, retraction of the dentition was decided with absolute anchorage, provided by mini implants. In order to carry out the procedure in one stage, four mini-implants were inserted as close to the root of the 1st molars as possible. Implementation was facilitated by a surgical template which was created on a digital model and then 3D printed. Accurate placement was achieved and the case was successfully treated by significant uprighting of the incisors and retraction of the anterior dentition, closing the spaces in the upper and lower arch. Facial aesthetics were also improved. A digitally designed surgical guide was utilized in this case of bimaxillary dentoalveolar protrusion in order to facilitate the accurate placement of the mini implants which were used for a one-stage retraction of the dentition.

Accuracy of Mini-Implant Placement Using a Computer-Aided Designed Surgical Guide, with Information of Intraoral Scan and the Use of a Cone-Beam CT.

BACKGROUND: The purpose of the study was to investigate the accuracy of mini-implant placement with the use of a computer designed surgical guide derived by intraoral scanning alongside Cone-Beam Computed Tomography (CBCT) or the use of a 2D radiograph. METHODS: Thirty-five mini-implants (Aarhus® System: n = 20, Ø: 1.5 mm and AbsoAnchor®: n = 15, Ø: 1.3-1.4 mm) were placed in the maxilla and mandible of 15 orthodontic patients for anchorage purposes in cases where a CBCT was needed due to impacted teeth or for safety reasons. All were placed with the help of a computer designed surgical guide. One implant became loose and was excluded from the study. For 18 mini-implants (study group), CBCT and intraoral scanning were used for guide design, while for 16 (control group) only intraoral scanning and panoramic imaging information were used. Mini-implant position was recorded by angular and linear measurements on digital models created by combining Digital Imaging and Communications in Medicine (DICOM) and stereolithography (.stl) files. Accuracy in positioning was determined by comparing corresponding measurements for virtual and real positioned mini-implants on digital models before and after operation. The results were statistically analyzed with t-tests and the Mann-Whitney test. RESULTS: No significant statistical differences were found for pre- and post-operational angular measurements in the study group, while significant statistical differences occurred on the same measurements for the control group (coronal angle 13.6° pre-op and 22.7° post-op, p-value = 0.002, axial angle 13.4° pre-op and 15.9° post-op, p-value = 0.034). Linear measurements pre- and post-operational for either group presented no significant statistical differences. CONCLUSIONS: A 3D designed and manufactured surgical guide with information concerning CBCT and intraoral scanning ensures accuracy on mini-implant placement while design of the guide without the use of a CBCT is less accurate, especially on inclination of the implant.

Treatment of an Avulsed and Ankylosed Incisor through Single Tooth Alveolar Osteotomy and Conventional Orthodontic Mechanisms.

We present the treatment of an injured and avulsed incisor (which was afterwards ankylosed), by subapical osteotomy and conventional orthodontic mechanisms. A 9-year-old boy presented for orthodontic treatment with an injured and avulsed central incisor, which, after initial repositioning, ended up with ankylosis and severe root resorption. The case was treated by single tooth alveolar osteotomy and distraction osteogenesis through conventional orthodontics, advocating for the floating bone concept due to the short vertical distance by which the tooth alveolus part had to be relocated. Orthodontic treatment of the avulsed central incisor was completed after osteotomy and distraction osteogenesis, and the tooth was restored to its proper position, aiming to address issues of aesthetics and function for the time being. The patient was finally referred to a prosthodontist for future and final implant rehabilitation due to severe root resorption. Distraction osteogenesis after surgical procedures is a reliable solution for dealing with an ankylosed and submerged tooth.