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Mehyar L, Sandler J, Thiruvenkatachari B. Does observational study on the effectiveness of the Twin Blocks overestimate or underestimate the results? A comparative analysis of retrospective samples versus randomized controlled trial. J World Fed Orthod 2021; 10:43-48. [PMID: 33893064 DOI: 10.1016/j.ejwf.2021.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 03/17/2021] [Accepted: 03/17/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Class II malocclusion is one of the most common orthodontic problems. The Twin Block appliance has proven to be the most popular appliance for the correction of these malocclusions. Although randomized controlled trials (RCTs) on the Twin Block appliance have reported the changes to be mainly dentoalveolar, several nonrandomized studies have reported a significant skeletal improvement in these patients. Hence, the aim of this study was to compare the effectiveness of Twin Block appliance evaluated using an RCT or retrospectively selected cases (RSC) for the treatment of Class II Division 1 malocclusion in an adolescent population. METHODS This was a retrospective study. The results for an RCT were selected from a UK Class II multicenter study. Sixty-three patients from the trial were included. This group was matched with retrospectively selected Class II cases treated with a Twin Block functional appliance and their results submitted for Membership in Orthodontics examination in the United Kingdom, from four centers. The primary outcome was skeletal measurement ANB (A point, nasion, B point). Secondary outcomes included final peer assessment rating (PAR) scores and final overjet. Intrarater reliability of measurements was assessed. Independent samples t-test was carried out to look at the difference between the groups. RESULTS The reliability assessment showed excellent agreement for all measurements. The data were normally distributed. There was a statistically significant difference favoring the RSC group for final overjet (mean difference [MD] = 1.068, 95% confidence interval [CI] -0.67 to 1.47, P = 0.000) and final PAR (MD = 4.0, 95% CI -0.79 to 5.5, P = 0.000). There was no significant difference in the scores for final ANB (MD = 0.34, 95% CI -0.39 to 1.07, P = 0.33). CONCLUSION The RSCs show significantly improved overjet and PAR scores at the end of treatment and no statistically significant difference for skeletal change. The study raises the question of a potential role of observational studies in evaluating the effect of an intervention in orthodontics.
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Affiliation(s)
- Layan Mehyar
- Former Specialist Trainee in Orthodontics, School of Dentistry, The University of Manchester, Manchester, United Kingdom
| | - Jonathan Sandler
- Professor in Orthodontics, Consultant Orthodontist, Chesterfield Royal Hospital NHS Trust, Calow, Chesterfield, United Kingdom
| | - Badri Thiruvenkatachari
- Hon. Senior Lecturer/Consultant in Orthodontics, School of Dentistry, University of Manchester, Manchester, United Kingdom.
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Comparison of shear bond strength and ARI of four different adhesive systems used to bond molar tubes: An in vitro study. Int Orthod 2020; 19:117-122. [PMID: 33246877 DOI: 10.1016/j.ortho.2020.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 10/25/2020] [Accepted: 11/03/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The purpose of this in vitro study was to determine and compare the shear bond strength and ARI score of one traditional etch-and-rinse adhesive system serving as control, with those of two other all-in-one adhesives but with enamel acid etching preceding their application, and of one new 8th generation all-in-one bonding agent combined with a traditional adhesive used to bond stainless steel buccal tubes to molar teeth. MATERIAL AND METHODS Four groups of teeth were formulated according to the adhesive system used to bond the tubes on the molars. Shear bond strength was measured using a universal testing machine (Hounsfield, UK). After debonding, each enamel surface was imaged using Inspex HD l080p Vesa camera (Ash Technologies Ltd., Ireland) to determine the ARI score. RESULTS The mean SBSs in MPa for the four groups were respectively: A: 9.640 (±3.69), B: 10.261 (±3.03), C: 9.689 (±2.48), D: 8.412 (±3.02). No statistically significant differences were neither found through one-way ANOVA to exist between the group means (P: 0.715), nor for the ARI score frequence through Chi2 (P: 0.534). Maxcem Elite showed four and G-Premio Bond zero instances of enamel fracture. CONCLUSIONS 1. SBSs of all adhesives and ARI score distributions did not present any significant differences when used to bond stainless steel molar tubes. 2. All adhesives presented with acceptable shear bond strengths for clinical use. 3. Maxcem Elite under the tested conditions presented the greatest and G-Premio the least number of enamel fractures.
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Bergamo AZN, Nelson-Filho P, do Nascimento C, Casarin RCV, Casati MZ, Andrucioli MCD, Kuchler ÉC, Longo DL, da Silva LAB, Matsumoto MAN. Cytokine profile changes in gingival crevicular fluid after placement different brackets types. Arch Oral Biol 2017; 85:79-83. [PMID: 29032048 DOI: 10.1016/j.archoralbio.2017.09.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 08/02/2017] [Accepted: 09/24/2017] [Indexed: 01/28/2023]
Abstract
OBJECTIVE The aim of this study was to examine the relationship between bracket design and ratio of five proinflammatory cytokine, in gingival crevicular fluid (GCF), and bacterial adhesion without tooth movement influence. DESIGN The sample was comprised of 20 participants, aged 11 to 15 years old (mean age: 13.3 years±1.03). A conventional Gemini™ metallic bracket and two self-ligating brackets, In-Ovation®R and SmartClip™, were bonded to the maxillary incisors and canines. GCF was collected using a standard filter paper strip before and 60days after bonding. The cytokine levels (IL-12, IL-1α, IL-1β, IL-6 and TNF-α) were performed by the LUMINEX assay. The levels of the red and orange bacterial complexes were analyzed by the Checkerboard DNA-DNA hybridization. The data of cytokine and bacterial complexes were carried out using the non-parametric tests at 5% of significance level. RESULTS Increased cytokine levels were observed. However, only the SmartClip™ group showed a significantly increased level of TNF-α (p=0.046). The SmartClip™ brackets group presented higher levels of red complex bacteria. CONCLUSIONS The bracket design affected cytokine levels and bacterial adhesion since it was observed that the proinflammatory cytokines released in GCF to the SmartClip™ group showed an increase in the TNF-α levels associated with higher bacterial levels, which possibly represents greater inflammatory potential. Thereby, the bracket design should be considered in patients with risk of periodontal disease and root resorption.
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Affiliation(s)
- Ana Zilda Nazar Bergamo
- Department of Pediatric Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, Brazil.
| | - Paulo Nelson-Filho
- Department of Pediatric Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, Brazil
| | - Cássio do Nascimento
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, SP, Brazil
| | | | | | | | - Érika Calvano Kuchler
- Department of Pediatric Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, Brazil
| | - Daniele Lucca Longo
- Department of Pediatric Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, Brazil
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Bergamo AZN, Nelson-Filho P, Andrucioli MCD, do Nascimento C, Pedrazzi V, Matsumoto MAN. Microbial complexes levels in conventional and self-ligating brackets. Clin Oral Investig 2016; 21:1037-1046. [PMID: 27270902 DOI: 10.1007/s00784-016-1865-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 05/26/2016] [Indexed: 01/15/2023]
Abstract
OBJECTIVES The aims were to evaluate the levels of bacterial species in saliva and in situ and to assess whether the design of brackets influences the risk of developing periodontal disease. MATERIALS AND METHODS Twenty patients (13.3 mean age) were bonded with self-ligating brackets and a conventional bracket. Saliva was collected before bonding and 30 and 60 days after bonding. One sample of each bracket was removed 30 and 60 days after bonding. The analysis was determined by checkerboard DNA-DNA hybridization. The data was evaluated by the non-parametric test. RESULTS A significant increase in the levels of bacterial species in the saliva occurred in 15 of the 22 analyzed species. The self-ligating brackets presented the highest incidence percentages for the orange and red complexes 60 days after bonding. In situ analyses showed different patterns according to the bracket design. The levels of Campylobacter rectus showed significant differences (p = 0.011) 60 days after bonding among the three brackets; the highest values were observed in the In-Ovation®R bracket. CONCLUSIONS The bracket design seems to influence the levels of bacterial species involved in periodontal disease. Considering the wide variety of bacterial species, additional studies are needed to aid in the establishment of effective protocols to prevent the development of periodontal disease during orthodontic treatment. CLINICAL RELEVANCE A dynamic alteration in the oral microbiota may lead to inflammatory reactions in the supporting soft and hard tissues. The different types of brackets interfere with bacterial adherence. Bracket design should be considered in orthodontic treatment.
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Affiliation(s)
- Ana Zilda Nazar Bergamo
- Department of Pediatric Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, Avenida do Café, S/N, Monte Alegre, Ribeirão Preto, SP, CEP: 14040-904, Brazil.
| | - Paulo Nelson-Filho
- Department of Pediatric Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, Avenida do Café, S/N, Monte Alegre, Ribeirão Preto, SP, CEP: 14040-904, Brazil
| | - Marcela Cristina Damião Andrucioli
- Department of Pediatric Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, Avenida do Café, S/N, Monte Alegre, Ribeirão Preto, SP, CEP: 14040-904, Brazil
| | - Cássio do Nascimento
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, SP, Brazil
| | - Vinícius Pedrazzi
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, SP, Brazil
| | - Mírian Aiko Nakane Matsumoto
- Department of Pediatric Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, Avenida do Café, S/N, Monte Alegre, Ribeirão Preto, SP, CEP: 14040-904, Brazil
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Jayachandran B, Padmanabhan R, Vijayalakshmi D, Padmanabhan J. Comparative evaluation of efficacy of self-ligating interactive bracket with conventional preadjusted bracket: A clinical study. Contemp Clin Dent 2016; 7:158-62. [PMID: 27307660 PMCID: PMC4906856 DOI: 10.4103/0976-237x.183049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Aims and Objectives: This clinical study was conducted to compare the interactive self-ligating twin brackets and the standard double width brackets for their efficiency in Rate of Retraction. Materials and Methods: A total of 20 patients with Angle's class I or class II or class III dento-alveolar malocclusions between the age group of 18-25 years were selected. 10 patients in each group both males and females were randomly selected for the study. Ten patients were bonded using conventional brackets (Group I) the other ten patients were bonded using Interactive self-ligating brackets (Group II). The Rate of retraction was quantified using the scanned models. Pretreatment and post treatment models were taken and scanned to measure the amount of Incisor movement and Anchor loss. Results: (1) Interactive Self-ligating brackets showed significant Rate of retraction when compared with conventional brackets on right and left quadrant. (Group I 0.545 ± .205: Group II 0.827 ± .208 P = .013*) (Group I 0.598 ± .160: Group II 0.804 ± .268 P = .071) (2) Interactive self-ligating brackets when compared with conventional brackets had significant amount of incisor movement on right and left quadrant. (Group I 3.51 ± .548: Group II 4.38 ± .1.06 P = .047*) and (Group I 3.66 ± .899: Group II 4.67 ± 1.02 P = .047*) (3) Conventional brackets showed significant Amount of Anchor loss when compared with that of Interactive self-ligating brackets on right and left quadrant. (Group I .948 ± .392: Group II 0.501 ± .229 P = .013*). In the left side (Group I 0.861 ± .464: Group II 0.498 ± .227 P = .060). Conclusion: The interactive self-ligating brackets show more efficiency in Rate of Retraction, Amount of Incisor movement and Amount of Anchor loss when compared with the conventional brackets.
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Affiliation(s)
- Balajee Jayachandran
- Department of Orthodontics, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Ratna Padmanabhan
- Department of Orthodontics, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Devaki Vijayalakshmi
- Department of Orthodontics, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Janardhanam Padmanabhan
- Department of Orthodontics, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
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Capistrano A, Cordeiro A, Siqueira DF, Capelozza Filho L, Cardoso MDA, Almeida-Pedrin RRD. From conventional to self-ligating bracket systems: is it possible to aggregate the experience with the former to the use of the latter? Dental Press J Orthod 2015; 19:139-57. [PMID: 25162578 PMCID: PMC4296614 DOI: 10.1590/2176-9451.19.3.139-157.sar] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction Orthodontics, just as any other science, has undergone advances in technology that
aim at improving treatment efficacy with a view to reducing treatment time,
providing patients with comfort, and achieving the expected, yet hardly attained
long-term stability. The current advances in orthodontic technology seem to
represent a period of transition between conventional brackets (with elastic
ligatures) and self-ligating brackets systems. Scientific evidence does not always
confirm the clear clinical advantages of the self-ligating system, particularly
with regard to reduced time required for alignment and leveling (a relatively
simple protocol), greater comfort for patients, and higher chances of performing
treatment without extractions - even though the number of extractions is more
closely related to patient's facial morphological pattern, regardless of the
technique of choice. Orthodontics has recently and brilliantly used bracket
individualization in compensatory treatment with a view to improving treatment
efficacy with lower biological costs and reduced treatment time. Objective This paper aims at presenting a well-defined protocol employed to produce a better
treatment performance during this period of technological transition. It explores
the advantages of each system, particularly with regards to reduced treatment time
and increased compensatory tooth movement in adult patients. It particularly
addresses compensable Class III malocclusions, comparing the system of
self-ligating brackets, with which greater expansive and protrusive tooth movement
(maxillary arch) is expected, with conventional brackets Capelozza Prescription
III, with which maintaining the original form of the arch (mandibular arch) with
as little changes as possible is key to yield the desired results.
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Muguruma T, Iijima M, Brantley WA, Ahluwalia KS, Kohda N, Mizoguchi I. Effects of third-order torque on frictional force of self-ligating brackets. Angle Orthod 2014; 84:1054-61. [PMID: 24738791 DOI: 10.2319/111913-845.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To investigate the effects of third-order torque on frictional properties of self-ligating brackets (SLBs). MATERIALS AND METHODS Three SLBs (two passive and one active) and three archwires (0.016 × 0.022-inch nickel-titanium, and 0.017 × 0.025-inch and 0.019 × 0.025-inch stainless steel) were used. Static friction was measured by drawing archwires though bracket slots with four torque levels (0°, 10°, 20°, 30°), using a mechanical testing machine (n = 10). A conventional stainless-steel bracket was used for comparison. RESULTS were subjected to Kruskal-Wallis and Mann-Whitney U-tests. Contact between the bracket and wire was studied using a scanning electron microscope. RESULTS In most bracket-wire combinations, increasing the torque produced a significant increase in static friction. Most SLB-wire combinations at all torques produced less friction than that from the conventional bracket. Active-type SLB-wire combinations showed higher friction than that from passive-type SLB-wire combinations in most conditions. When increasing the torque, more contact between the wall of a bracket slot and the edge of a wire was observed for all bracket types. CONCLUSIONS Increasing torque when using SLBs causes an increase in friction, since contact between the bracket slot wall and the wire edge becomes greater; the design of brackets influences static friction.
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Affiliation(s)
- Takeshi Muguruma
- a Instructor, Division of Orthodontics and Dentofacial Orthopedics, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
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Amat P. [Not Available]. Orthod Fr 2013; 84:3-8. [PMID: 23531285 DOI: 10.1051/orthodfr/2013043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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