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Hussain U, Campobasso A, Noman M, Alam S, Mujeeb R, Shehzad S, Papageorgiou SN. Influence of elastomeric and steel ligatures on periodontal health during fixed appliance orthodontic treatment: a systematic review and meta-analysis. Prog Orthod 2024; 25:24. [PMID: 38880839 PMCID: PMC11180646 DOI: 10.1186/s40510-024-00520-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/20/2024] [Indexed: 06/18/2024] Open
Abstract
INTRODUCTION Metallic and elastomeric ligatures are widely used in orthodontics to secure the archwire within the bracket slots, but elastomeric ligatures have traditionally been associated with increased microbial colonization, which could adversely affect periodontal health. AIM This systematic review compares the periodontal effects of elastomeric and steel ligatures used for orthodontic fixed appliances. METHODS Unrestricted literature search of 7 databases (MEDLINE, Scopus, Web of Science, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and Virtual Health Library) up to July 2023 were performed for randomized / non-randomized clinical studies on humans comparing the two ligation methods during fixed-appliance therapy. After duplicate study selection, data extraction, and risk-of-bias assessment with the Risk of Bias (RoB) 2 or the Risk Of Bias In Non-randomized Studies - of Interventions (ROBINS-I) tool, random-effects meta-analyses of Mean Differences (MD) or Standardized Mean Differences (SMD) and their 95% confidence intervals (CIs) were carried out, followed by assessment of certainty of existing evidence with the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach. RESULTS A total of 11 studies (3 randomized / 8 non-randomized) with 354 patients (mean age 14.7 years and 42% male) were included. No statistically significant differences were seen for plaque index (5 studies; SMD = 0.48; 95% CI = -0.03 to 1.00; P = 0.07), gingival index (2 studies; MD = 0.01; 95% CI = -0.14 to 0.16; P = 0.89), probing pocket depth (2 studies; MD = 0; 95% CI = -0.17 to 0.16; P = 0.97), or Streptococcus mutans counts (4 studies; SMD = 0.40; 95% CI=-0.41 to 1.20; P = 0.21). Elastomeric ligatures were associated with moderately increased total bacterial load (3 studies; SMD = 0.43; 95% CI = 0.10 to 0.76; P = 0.03). Confidence in these estimates was low in all instances due to the inclusion of non-randomized studies with high risk of bias. CONCLUSIONS Existing low quality evidence indicates that ligature method does not seem to influence the periodontal health during fixed treatment, even if elastomeric ligatures are associated with a moderate increase of bacterial load. REGISTRATION PROSPERO (CRD42023444383).
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Affiliation(s)
| | - Alessandra Campobasso
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | | | - Shamsul Alam
- Health Department Khyber Pakhtunkhwa, Peshawar, Pakistan
| | | | - Sofia Shehzad
- Community Dentistry, Sardar Begum Dental College, Gandhara University, Peshawar, Pakistan
| | - Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center for Dental Medicine, University of Zurich, Plattenstrasse 11, Zurich, 8032, Switzerland.
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Marusamy KO, Alsibaie RB, Mostanteq NM, Alzahrani L, Aljuhani DH, Lashkar R. Awareness and Periodontal Health Practices of Fixed Orthodontic Appliance Patients: A Questionnaire-Based Survey. Cureus 2024; 16:e60335. [PMID: 38882991 PMCID: PMC11177247 DOI: 10.7759/cureus.60335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2024] [Indexed: 06/18/2024] Open
Abstract
A well-aligned dentition is more conducive to periodontal health, which is necessary for successful orthodontic therapy. Maintaining good dental hygiene is crucial for effective treatment, and patient cooperation, education, motivation, and attitude are all important components. Orthodontists must routinely check in with their patients to see whether they are maintaining their oral hygiene and if they are using any additional assistance. Negligence on the part of the patient may be the cause of poor treatment outcomes. This study aims to show how patient education can affect treatment outcomes and the development of a functional, aesthetically pleasing, and healthy dentition. Aim This study aims to investigate awareness, attitude, and periodontal health knowledge among orthodontic patients. Objectives The study explores the level of awareness and knowledge regarding periodontal health among orthodontic patients, examining its correlation with factors such as age, attitude, and duration of orthodontic treatment. Additionally, it aims to gauge the extent of education received by orthodontic patients regarding proper oral hygiene practices and the potential repercussions of neglecting them. Methods A questionnaire-based study with a cross-sectional design was performed in Jeddah, Saudi Arabia. A total of 428 participants were randomly selected from several private orthodontic clinics and hospitals. The participants in the study were individuals currently undergoing treatment with fixed orthodontic appliances. Information was gathered using a self-administered questionnaire. Results The patients undergoing orthodontic treatment have a moderate understanding of periodontal disease about dental plaque. The level of awareness of periodontal health was 41%, and the level of knowledge about periodontal health was 51%. When it came to periodontal health, adult orthodontic patients had a positive attitude toward fixed orthodontic treatment (mean score = 0.75). Subjects' attitudes regarding fixed orthodontic treatment were significantly impacted by the patient's consistency with his/her dental checkups (p value = 0.02). Conclusion The patients' periodontal health awareness was moderate, while their periodontal health knowledge was fair. Orthodontic patient's awareness levels, as well as knowledge levels, showed significant differences in age and duration but not sex. Results showed no significant difference among the attitude levels of orthodontic patients and age, sex, and duration.
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Affiliation(s)
- Kavitha O Marusamy
- Orthodontics and Dentofacial Orthopedics, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Rima B Alsibaie
- Dentistry, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Njoud M Mostanteq
- Dentistry, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Lamia Alzahrani
- Dentistry, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Dania H Aljuhani
- Dentistry, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Renad Lashkar
- Dentistry, Ibn Sina National College for Medical Studies, Jeddah, SAU
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AlMoharib HS, Alqasem A, Almusfer G, Aldosari MA, Almadhoon HW. The effectiveness of water jet flossing and interdental flossing for oral hygiene in orthodontic patients with fixed appliances: a randomized clinical trial. BMC Oral Health 2024; 24:498. [PMID: 38678246 PMCID: PMC11055227 DOI: 10.1186/s12903-024-04166-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 03/19/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Orthodontic treatment presents challenges with plaque accumulation around brackets, archwires, and elastics, leading to retained plaque and gingival inflammation. Conventional toothbrushing may not be enough, requiring additional oral hygiene aids like interproximal brushes, dental flosses, and water flossers. Limited research exists on comparing water flossing and interdental flossing in orthodontic patients. Therefore, this study aims to assess their effectiveness in maintaining oral hygiene during active orthodontic treatment. METHODS A single-blind, randomized, parallel clinical study recruited orthodontic patients with full-mouth brackets and archwires. Thirty participants were randomly assigned to either water jet flossing or interdental flossing groups. All participants were instructed to brush twice daily with a provided toothbrush and toothpaste and use the assigned intervention once daily at night. Clinical measures, including the Gingival Bleeding Index (BI), Plaque Index (PI), and Gingival Index (GI), were recorded at baseline and day 14. Descriptive statistics and statistical tests were performed using SPSS software. RESULTS The water jet flossing group demonstrated a slightly higher, albeit non-significant, benefit in plaque removal (median difference of 6.79%%, P = 0.279) and bleeding reduction (median difference of 5.21%%, P = 0.172) compared to the interdental flossing group after two weeks. Both groups showed significant reductions in gingival bleeding index and plaque index from baseline to the 2-week follow-up. The interdental flossing group had median mean percentage differences of 16.13%% (plaque index) and 23.57% (gingival bleeding index), while the water jet flossing group had median percentage differences of 21.87% (plaque index) and 32.29% (gingival bleeding index). No significant changes in gingival index grades were observed in either group. CONCLUSION Both water jet flossing and interdental flossing were effective in reducing plaque accumulation and gingival bleeding among orthodontic patients. While no significant differences were found between the two methods, water jet flossing showed a potential advantage. Further research is needed to validate its effectiveness, assess long-term impact, and understand its benefits for orthodontic patients.
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Affiliation(s)
- Hani S AlMoharib
- Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Afyaa Alqasem
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
| | - Ghaida Almusfer
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad A Aldosari
- Orthodontics and Pediatric Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Luchian I, Surlari Z, Goriuc A, Ioanid N, Zetu I, Butnaru O, Scutariu MM, Tatarciuc M, Budala DG. The Influence of Orthodontic Treatment on Periodontal Health between Challenge and Synergy: A Narrative Review. Dent J (Basel) 2024; 12:112. [PMID: 38668024 PMCID: PMC11049074 DOI: 10.3390/dj12040112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/27/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
By correctly repositioning teeth, orthodontic therapy improves both the function and appearance of an occlusion. The relationship between teeth and the tissues that surround and support them significantly influences these alterations. With ever more adults seeking orthodontic care, orthodontists are increasingly seeing patients with periodontal issues. Concerns about the patient's appearance, such as uneven gingival margins or functional issues caused by inflammatory periodontal diseases, should be accounted for when designing orthodontic treatment plans. Furthermore, orthodontics may increase the chances of saving and recovering a degraded dentition in cases of severe periodontitis. Today, general dentists, dontists, and orthodontists play integrative roles that enable them to achieve the best possible results for their patients. This review will improve the results of interdisciplinary treatments and increase cooperation between dental specialists by drawing attention to the essential connection between orthodontics and periodontics in regular clinical practice.
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Affiliation(s)
- Ionut Luchian
- Department of Periodontology, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universității Street, 700115 Iasi, Romania;
| | - Zenovia Surlari
- Department of Prosthodontics, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universității Street, 700115 Iasi, Romania; (Z.S.); (D.-G.B.)
| | - Ancuta Goriuc
- Department of Biochemistry, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universității Street, 700115 Iasi, Romania
| | - Nicoleta Ioanid
- Department of Prosthodontics, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universității Street, 700115 Iasi, Romania; (Z.S.); (D.-G.B.)
| | - Irina Zetu
- Department of Orthodontics, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universității Street, 700115 Iasi, Romania; (I.Z.); (O.B.)
| | - Oana Butnaru
- Department of Orthodontics, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universității Street, 700115 Iasi, Romania; (I.Z.); (O.B.)
| | - Monica-Mihaela Scutariu
- Department of Oro-Dental Diagnosis, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universității Street, 700115 Iasi, Romania;
| | - Monica Tatarciuc
- Department of Dental Technology, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universității Street, 700115 Iasi, Romania;
| | - Dana-Gabriela Budala
- Department of Prosthodontics, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universității Street, 700115 Iasi, Romania; (Z.S.); (D.-G.B.)
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Tietmann C, Jepsen S, Heibrok H, Wenzel S, Jepsen K. Long-term stability of regenerative periodontal surgery and orthodontic tooth movement in stage IV periodontitis: 10-year data of a retrospective study. J Periodontol 2023; 94:1176-1186. [PMID: 37010261 DOI: 10.1002/jper.23-0081] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/28/2023] [Accepted: 03/29/2023] [Indexed: 04/04/2023]
Abstract
BACKGROUND This study aimed to evaluate the long-term effectiveness of regenerative treatment of intra-bony defects in combination with consecutive orthodontic therapy (OT) in stage IV periodontitis. METHODS Twenty-two patients with a total of 256 intra-bony defects were analyzed after regenerative surgery followed by OT initiated 3 months later. Changes in radiographic bone level (rBL) and probing pocket depths (PPD) were evaluated after 1 year (T1), final splinting (T2), and 10 years (T10). RESULTS Mean rBL gain was significant with 4.63 mm (±2.43 mm) after 1 year (T1), 4.19 mm (±2.61 mm) at final splinting (T2), and 4.48 mm (±2.62 mm) after 10 years (T10). Mean PPD was significantly reduced from 5.84 mm (±2.05 mm) at baseline to 3.19 mm (±1.23 mm) at T1, to 3.07 mm (±1.23 mm) at T2, and to 2.93 mm (±1.24 mm) at T10. Pocket closure (PPD ≤ 4 mm) was achieved in 90% of all defects. Tooth loss amounted to 4.5%. CONCLUSIONS Within the limitations of this retrospective study design, these 10-year findings suggest that in motivated and compliant patients with stage IV periodontitis and in need of OT an inter-disciplinary treatment can lead to favorable and stable long-term results.
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Affiliation(s)
- Christina Tietmann
- Private Practice for Periodontology, Aachen, Germany
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | | | - Sven Wenzel
- Private Practice for Periodontology, Aachen, Germany
| | - Karin Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
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Cadenas de Llano-Pérula M, Castro AB, Danneels M, Schelfhout A, Teughels W, Willems G. Risk factors for gingival recessions after orthodontic treatment: a systematic review. Eur J Orthod 2023; 45:528-544. [PMID: 37432131 DOI: 10.1093/ejo/cjad026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
BACKGROUND/OBJECTIVES To systematically review the available evidence concerning the risk factors for gingival recessions (GR) after orthodontic treatment (OT). DATA COLLECTION AND ANALYSIS Data was obtained and collected by systematically searching 3 data bases: Pubmed, EMBASE, and Web of Science until 20 April 2023. Controlled trials, cohort, case-control or cross-sectional studies describing GR or clinical crown height (CCH) after OT were included. The risk of bias in the selected studies was evaluated with the methodological index for non-randomized studies. RESULTS Forty-eight articles were included, investigating the following six risk factors for GR: 1. OT (n = 21), 2. Type of orthodontic intervention (n = 32), 3. Patient's baseline occlusal and skeletal characteristics (n = 14), 4. Mucogingival characteristics (n = 10), 5. Oral hygiene (n = 9), and 6. Others (n = 12). Significantly higher prevalence, severity and extent of GR were found in orthodontic patients by 10/15, 4/10, and 2/2 articles respectively. 10/16 articles reported significantly more GR and increased CCH in patients where orthodontic incisor proclination was performed. The evidence surrounding maxillary expansion and orthodontic retention was too heterogeneous to allow for? definitive conclusions. Pre-treatment angle classification, ANB, overjet, overbite, arch width and mandibular divergence were found not to be associated with GR (9/14), while pre-treatment crossbite, symphysis height and width were (5/7 studies). A thin gingival biotype, presence of previous GR, baseline width of keratinized gingiva and facial gingival margin thickness were correlated with increased risk of GR after OT by nine articles, while pocket depth was not. Oral hygiene, sex, treatment duration, and oral piercings were found not to be linked with GR in orthodontic patients, while GR was reported to increase with age in orthodontic patients by 50 per cent of the articles investigating this factor. The mean risk of bias for comparative and not comparative studies was 14.17/24 and 9.12/16. LIMITATIONS The selected studies were quite heterogeneous regarding study settings, variables reported and included very limited sample sizes. CONCLUSION Although studies regarding the risk factors for GR are relatively abundant, they are very heterogeneous concerning design, studied factors, methodology and reporting, which often leads to contradictory results. Uniform reporting guidelines are urgently needed for future research. PROSPERO REGISTRATION CRD42020181661. FUNDING This research received no funding.
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Affiliation(s)
- Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven, Belgium
- Research group Orthodontics, KU Leuven, Belgium
| | - Ana Belén Castro
- Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven, Belgium
- Research group Periodontology and Oral Microbiology, KU Leuven, Belgium
| | - Margaux Danneels
- Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven, Belgium
- Research group Orthodontics, KU Leuven, Belgium
| | - Alix Schelfhout
- Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven, Belgium
- Research group Periodontology and Oral Microbiology, KU Leuven, Belgium
| | - Guy Willems
- Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven, Belgium
- Research group Orthodontics, KU Leuven, Belgium
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Jepsen K, Sculean A, Jepsen S. Complications and treatment errors involving periodontal tissues related to orthodontic therapy. Periodontol 2000 2023; 92:135-158. [PMID: 36920050 DOI: 10.1111/prd.12484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 10/25/2022] [Accepted: 01/04/2023] [Indexed: 03/16/2023]
Abstract
In this review, typical clinical complications involving periodontal tissues are illustrated that can be encountered in conjunction with orthodontic therapy (OT). Special considerations are given for various clinical scenarios, such as the patient presenting in periodontal health, with periodontitis, or with mucogingival conditions. While some of the complications are seen as common side effects of OT, other, more severe, problems that could have been avoided may be viewed as treatment errors. Recommendations are made on how to prevent these complications, based on the currently available evidence, on clinical practice guidelines, and on expert opinion. In conclusion, while there are several areas in which OT can have unwanted adverse effects on periodontal/mucogingival conditions, there is also great potential for synergies, offering opportunities for close cooperation between the two specialties (periodontics and orthodontics) for the benefit of patients affected by tooth malpositioning and/or periodontal or mucogingival problems.
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Affiliation(s)
- Karin Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
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ElNaghy R, Al-Qawasmi R, Hasanin M. Does orthodontic treatment using clear aligners and fixed appliances affect periodontal status differently? Evid Based Dent 2023; 24:73-74. [PMID: 37188919 DOI: 10.1038/s41432-023-00890-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 03/30/2023] [Indexed: 05/17/2023]
Abstract
DESIGN Systematic review and meta-analysis of clinical trials, and prospective or retrospective cohort. The protocol of the study was registered in advance on PROSPERO. DATA SOURCES An electronic search in MEDLINE (PubMed), Web of Science, Scopus, and The Cochrane Library was conducted by two independent authors up to September 2022. Additionally, OpenGrey and www.greylit.org were searched for gray literature, whereas ClinicalTrials.gov was searched for detecting any relevant unpublished data. STUDY SELECTION The review question was defined in PICOS format as follows: population (P), patients undergoing orthodontic therapy; intervention (I), orthodontic therapy with clear aligner (CA); comparison (C), orthodontic therapy with fixed appliances (FA); outcome (O), periodontal health status and development of gingival recession; studies (S), randomized clinical trials (RCTs), controlled clinical trials, and retrospective or prospective cohort studies. Cross-sectional studies, case series, case reports, studies without a control group, and studies with less than 2 months follow-up were excluded. DATA ANALYSIS Periodontal health status was assessed as a primary outcome and it was measured in terms of pocket probing depth (PPD), gingival index (GI), plaque index (PI) and bleeding on probing (BoP). Gingival recession (GR) was assessed as secondary outcome, and was measured as the development or progression of GR, shown by the apical migration of the gingival margin occurring between pre- and post-orthodontic treatment. Each periodontal index was assessed in three-time points; short-term (2-3 months from baseline), mid-term (6-9 months from baseline), and long-term (12 months or more from baseline). A descriptive analysis of included articles was performed. Pairwise meta-analyses were conducted to compare outcomes assessed in FA and CA groups and were only performed when studies reported similar periodontal indices at similar follow-ups. RESULTS 12 studies (3 RCTs, 8 prospective cohort studies, 1 retrospective cohort study) were included in the qualitative synthesis, of which, 8 studies were included in the quantitative synthesis (meta-analysis). A total of 612 patients (321 treated with buccal FA and 291 with CA) were assessed. Results from meta-analyses favored CA in regards to PI, demonstrating a significant difference in the mid-term follow-up (number of studies = 4, standardized mean difference [SMD] = -0.99, 95% confidence interval [CI] = -1.94 to -0.03, I2 = 99%, P = 0.04). There was a tendency to report better GI values with CA, specifically in long-term (number of studies = 2, SMD = -0.46 [95% CI, -1.03 to 0.11], I2 = 96%, P = 0.11). However, no statistical significance between the two treatment modalities was shown for any follow-up intervals (P > 0.05). As for PPD, the long-term follow-up showed statistical significance favoring CA (SMD = -0.93 [95% CI, -1.06 to 0.7], P < 0.0001), whereas short- and mid-term follow-ups did not show significant differences between FA and CA. Overall, patients treated with CA showed better values of BoP and less GR when compared to patients treated with FA. CONCLUSIONS Available evidence is still not enough to conclude the superiority of clear aligner therapy in terms of periodontal status during orthodontic treatment compared to fixed appliances.
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Affiliation(s)
- Rahma ElNaghy
- Division of Graduate Orthoodntics, University of Detroit Mercy School of Dentistry, Detroit, Michigan, USA.
| | - Riyad Al-Qawasmi
- Division of Graduate Orthoodntics, University of Detroit Mercy School of Dentistry, Detroit, Michigan, USA
| | - Majd Hasanin
- Division of Graduate Orthoodntics, University of Detroit Mercy School of Dentistry, Detroit, Michigan, USA
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Soleymanijadidi P, Moradi M, Hamedirad F, Ghanavati Z, Maleki Dizaj S, Salatin S. Nanocurcumin Release from Self-Cured Acrylic Resins; Effects on Antimicrobial Action and Flexural Strength. Bioengineering (Basel) 2023; 10:bioengineering10050559. [PMID: 37237629 DOI: 10.3390/bioengineering10050559] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/29/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023] Open
Abstract
The placement of orthodontic appliances into the oral area can lead to infection, inflammatory and gingival collapse. Using an antimicrobial and anti-inflammatory material in the matrix of orthodontic appliance may help to reduce these issues. This study aimed to assess the release pattern, the antimicrobial action and the flexural strength of self-cured acrylic resins after adding different weight percentages of curcumin nanoparticles (nanocurcumin). In this in-vitro study, 60 acrylic resin samples were divided into five groups (n = 12) based on the weight percentage of curcumin nanoparticles added to the acrylic powder (0 for control, 0.5, 1, 2.5, and 5%). Then, the dissolution apparatus was used for the release assessment of nanocurcumin form the resins. For antimicrobial action assessment, the disk diffusion method was used and a three-point bending test was performed with a speed of 5 mm/min to determine the flexural strength. Data were analyzed using one-way analysis of variance (ANOVA) and Post-Hoc Tukey tests (with p < 0.05 as significant level). The microscopic images showed the homogeny distribution of nanocuricumin in self-cured acrylic resins in varied concentrations. The release pattern showed a two-step release pattern for all concentrations of nanocurcumin. The one-way ANOVA outcomes indicated that adding curcumin nanoparticles to self-cured resin increased the diameter of the inhibition zones for the groups against Streptococcus mutans (S. mutans) significantly (p < 0.0001). Additionally, as the weight percentage of curcumin nanoparticles increased, the flexural strength decreased (p < 0.0001). However, all strength values were higher than the standard value (50 MPa). No significant difference was detected between the control group and the group with 0.5 percent (p = 0.57). Considering the proper release pattern and the potent antimicrobial activity of curcumin nanoparticles, then the preparing self-cured resins containing curcumin nanoparticles can be beneficial for antimicrobial aims without damaging the flexural strength to use in orthodontic removable applications.
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Affiliation(s)
- Parsa Soleymanijadidi
- Dental Materials Research Center, Health Research Institute, Babol University of Medical Sciences, Babol 47176-4774, Iran
| | - Meysam Moradi
- Dental Materials Research Center, Health Research Institute, Babol University of Medical Sciences, Babol 47176-4774, Iran
| | - Fahimeh Hamedirad
- Dental Materials Research Center, Health Research Institute, Babol University of Medical Sciences, Babol 47176-4774, Iran
| | - Zahra Ghanavati
- Dental Materials Research Center, Health Research Institute, Babol University of Medical Sciences, Babol 47176-4774, Iran
| | - Solmaz Maleki Dizaj
- Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz 51548-53431, Iran
- Department of Dental Biomaterials, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz 51548-53431, Iran
| | - Sara Salatin
- Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz 51548-53431, Iran
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Di Spirito F, D'Ambrosio F, Cannatà D, D'Antò V, Giordano F, Martina S. Impact of Clear Aligners versus Fixed Appliances on Periodontal Status of Patients Undergoing Orthodontic Treatment: A Systematic Review of Systematic Reviews. Healthcare (Basel) 2023; 11:healthcare11091340. [PMID: 37174882 PMCID: PMC10178428 DOI: 10.3390/healthcare11091340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/28/2023] [Accepted: 04/29/2023] [Indexed: 05/15/2023] Open
Abstract
The present umbrella review of four systematic reviews with meta-analysis aimed to assess whether clear aligners are associated with better periodontal conditions compared with fixed appliances in patients undergoing orthodontic treatment. The present study protocol was developed in accordance with the PRISMA statement before the literature search, data extraction, and analysis and was registered on PROSPERO (CRD42023401808). The question formulation, search, and study selection strategies were developed according to the PICO model. Systematic reviews with a meta-analysis published in English without date restriction were electronically searched across the Cochrane Library, Web of Science (Core Collection), Scopus, EMBASE, and MEDLINE/PubMed databases until 10 February 2023. An assessment of study quality was performed using the AMSTAR 2 tool. Differences in the PI, GI, and BOP in the short- and medium-term follow-ups, in the PPD in long-term follow-up, and the gingival recessions in the short-term follow-up were found between subjects with clear aligners and fixed appliances, revealing a slight tendency for clear aligners to be associated with healthier periodontal conditions. However, even if statistically significant, such differences would be negligible in a clinical environment. Therefore, the impact of orthodontic treatment with clear aligners and fixed appliances on periodontal health status should be considered comparable.
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Affiliation(s)
- Federica Di Spirito
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
| | - Francesco D'Ambrosio
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
| | - Davide Cannatà
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
| | - Vincenzo D'Antò
- School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Francesco Giordano
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
| | - Stefano Martina
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
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Periodontal Phenotype Modification Using Subepithelial Connective Tissue Graft and Bone Graft in the Mandibular Anterior Teeth with Mucogingival Problems Following Orthodontic Treatment. Medicina (B Aires) 2023; 59:medicina59030584. [PMID: 36984585 PMCID: PMC10057352 DOI: 10.3390/medicina59030584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 03/10/2023] [Accepted: 03/14/2023] [Indexed: 03/18/2023] Open
Abstract
Among the complications of orthodontic treatment, mucogingival problems with gingival recession in the mandibular anterior teeth are challenging for clinicians. Mucogingival problems can lead to esthetic deficits, thermal hypersensitivity, tooth brushing pain, and complicated plaque control. Herein, we present a case of a 16-year-old female with gingival recession in the left mandibular central incisor after orthodontic treatment. The preoperative clinical findings showed a thin soft tissue biotype with root prominence in the mandibular anterior area. The interdental area was relatively depressed. After reflection of the full-thickness flap, root coverage using a bone graft substitute and subepithelial connective tissue graft obtained from the palatal mucosa was performed. The 6-month and 5-year postoperative clinical findings showed improved soft tissue phenotype. The cross-sectional CBCT scans 5 years after surgery showed a well-maintained labial bone plate in the mandibular incisors. Within the limitations of this case report, for patients with gingival recession in the mandibular incisors after orthodontic treatment, a successful biotype modification can be achieved with a combined procedure using subepithelial connective tissue graft with bone graft substitutes.
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12
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Fleming PPS, Andrews DJ. Orthodontic Treatment: Getting the timing right. Semin Orthod 2023. [DOI: 10.1053/j.sodo.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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13
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Hussain U, Alam S, Rehman K, Antonoglou GN, Papageorgiou SN. Effects of chlorhexidine use on periodontal health during fixed appliance orthodontic treatment: a systematic review and meta-analysis. Eur J Orthod 2023; 45:103-114. [PMID: 36001494 DOI: 10.1093/ejo/cjac044] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Proper oral hygiene and absence of periodontal inflammation is pre-requisite for orthodontic treatment. Chlorhexidine (CHX) is an established oral antiseptic used in the treatment of periodontal disease, but its role in orthodontic therapy is unclear. OBJECTIVES To assess the efficacy of adjunct use of CHX-containing products in maintaining gingival health among orthodontic patients with fixed appliances. SEARCH METHODS Five databases were searched without limitations up to August 2021. SELECTION CRITERIA Randomized clinical trials (RCTs) assessing Gingival Index (GI) (primary outcome), Plaque Index (PI), Bleeding Index (BI), or Pocket Probing Depth (PPD). DATA COLLECTION AND ANALYSIS Study selection, data extraction, and risk of bias assessment were done independently in duplicate. Random-effects meta-analyses of mean differences (MDs) or standardized mean differences (SMDs) with their 95% confidence intervals (CIs) were conducted, followed by sensitivity and Grades of Recommendations, Assessment, Development and Evaluation analysis. RESULTS Twenty RCTs (1001 patients) were included assessing CHX-containing mouthwashes (n = 11), toothpastes (n = 2), gels (n = 3), or varnishes (n = 4) compared to placebo/control (n = 19) or sodium fluoride-products (n = 4). In the short-term, CHX-containing mouthwash was associated with lower GI (n = 9; MD = -0.68; 95% CI = -0.97 to -0.38; P < 0.001; high quality), lower PI (n = 9; MD = -0.65; 95% CI = -0.86 to -0.43; P < 0.001; high quality), lower BI (n = 2; SMD = -1.61; 95% CI = -2.99 to -0.22; P = 0.02; low quality), and lower PPD (n = 2; MD = -0.60 mm; 95% CI = -1.06 to -0.14 mm; P = 0.01; low quality). No considerable benefits were found from the use of CHX-gel or CHX-varnish in terms of GI, PI, or PPD (P > 0.05/low quality in all instances). Use of a CHX-containing toothpaste was more effective in lowering PI (Heintze-index) than adjunct use of fluoride-containing mouthwash (n = 2; MD = -5.24; 95% CI = -10.46 to -0.02; P = 0.04), but not GI (P = 0.68) or BI (P = 0.27), while sensitivity analyses indicated robustness. CONCLUSIONS Adjunct use of CHX mouthwash during fixed-appliance treatment is associated with improved gingival inflammation, plaque control, and pocket depths, but caution is warranted and recommendations about CHX use during orthodontic treatment of children/adults should consider the heterogeneous patient response, cost-effectiveness, and potential adverse effects. REGISTRATION PROSPERO registration (CRD42021228759).
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Affiliation(s)
- Umar Hussain
- Department of Orthodontics, Saidu College of Dentistry, Swat, Pakistan
| | - Shamsul Alam
- Health Department Khyber Pakhtunkhwa, Peshawar, Pakistan
| | - Khalid Rehman
- Department of Public Health, Khyber Medical University, Peshawar, Pakistan
| | - Georgios N Antonoglou
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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14
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Morikawa S, Watanabe K, Otsuka R, Asoda S, Nakagawa T. Periodontal therapy for localized severe periodontitis in a patient receiving fixed orthodontic treatment: a case report. J Med Case Rep 2023; 17:19. [PMID: 36658639 PMCID: PMC9854180 DOI: 10.1186/s13256-023-03751-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/01/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Orthodontic treatment involves movement of teeth by compression and resorption of the alveolar bone using orthodontic forces. These movements are closely linked to the interactions between the teeth and the periodontal tissues that support them. Owing to an increase in adults seeking orthodontic treatment, orthodontists increasingly encounter patients with periodontal diseases, in whom orthodontic treatment is contraindicated. In rare cases, periodontitis may develop after treatment initiation. However, no approach for treating periodontitis after the initiation of orthodontic treatment has been established. Here, we present an approach for managing localized severe periodontitis manifesting after initiating orthodontic treatment. CASE PRESENTATION A 32-year-old Japanese woman was referred to the Department of Dentistry and Oral Surgery by an orthodontist who observed symptoms of acute periodontitis in the maxillary molars that required periodontal examination and treatment. A detailed periodontal examination, including oral bacteriological examination, revealed localized severe periodontitis (stage III, grade B) in the maxillary left first and second molars and in the mandibular right second molar. After consultation with the orthodontist, the orthodontic treatment was suspended based on the results of the bacteriological examination to allow for periodontal treatment. Full-mouth disinfection was performed with adjunctive oral sitafloxacin. Periodontal and bacteriological examinations after treatment revealed regression of the localized periodontitis with bone regeneration. Thereafter, orthodontic treatment was resumed, and good progress was achieved. CONCLUSIONS Orthodontists should recognize the risk of acute severe periodontitis in young adults. Asymptomatic patients with localized severe periodontitis may clear a screening test before orthodontic treatment but develop acute symptoms with bone resorption during orthodontic treatment. Therefore, patients requiring orthodontic treatment should be examined by their family dentist or a periodontist to rule out periodontal issues that may impede orthodontic treatment. The patients should also be informed of age-related risks. Further, periodontists, family dentists, and orthodontists who treat adults should be informed about periodontitis and the need for interdisciplinary collaboration. In patients who develop periodontitis after orthodontic treatment initiation, temporary interruption of orthodontic treatment and aggressive periodontal intervention may facilitate recovery.
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Affiliation(s)
- Satoru Morikawa
- grid.26091.3c0000 0004 1936 9959Department of Dentistry and Oral Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan
| | - Kazuya Watanabe
- grid.26091.3c0000 0004 1936 9959Department of Dentistry and Oral Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan ,Watanabe Orthodontic Office, 1-11-26-2F Kichijoji-honcho, Musashino, Tokyo 180-0004 Japan
| | - Ryo Otsuka
- Familia Orthodontics, 1-7-5-12F Sakuragi-cho, Omiya-ku, Saitama, Saitama 330-0854 Japan
| | - Seiji Asoda
- grid.26091.3c0000 0004 1936 9959Department of Dentistry and Oral Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan
| | - Taneaki Nakagawa
- grid.26091.3c0000 0004 1936 9959Department of Dentistry and Oral Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan
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15
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Kee YJ, Moon HE, Lee KC. Evaluation of alveolar bone changes around mandibular incisors during surgical orthodontic treatment of patients with mandibular prognathism: Surgery-first approach vs conventional orthognathic surgery. Am J Orthod Dentofacial Orthop 2023; 163:87-94. [PMID: 36127191 DOI: 10.1016/j.ajodo.2021.08.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 08/01/2021] [Accepted: 08/01/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION This retrospective study aimed to investigate the alveolar bone changes around mandibular incisors in patients with skeletal Class III malocclusion treated with surgery-first orthognathic approach (SFA) and conventional orthognathic surgery (COS) using cone-beam computed tomography scans. METHODS Sixty-four patients were divided into 2 groups according to the inclusion of presurgical orthodontic treatment; the SFA group included 32 patients treated without presurgical orthodontic treatment, and the COS group included 32 patients treated with presurgical orthodontic treatment. Cone-beam computed tomography scans were obtained before treatment, after presurgical orthodontic treatment, and after treatment for the COS group and were obtained before and after treatment for the SFA group. The measurements of vertical alveolar bone height and horizontal bone thickness at 4 levels and the alveolar bone area surrounding the mandibular incisors were compared according to the treatment progress and groups. RESULTS The vertical bone levels and horizontal bone thickness of the labial and lingual sides and the area of the alveolar bone around the mandibular incisors were reduced after treatment in both SFA and COS groups. Vertical bone loss was more prominent than horizontal bone loss after treatment in both groups, and alveolar bone loss was greater on the lingual side than on the labial side. There were no significant differences in alveolar bone changes around the mandibular incisor between the SFA and COS groups. However, the alveolar bone was reduced more in the COS group than in the SFA group. CONCLUSIONS The results indicate that SFA and COS may trigger degeneration of the alveolar bone around the mandibular incisors after treatment in patients with mandibular prognathism. Careful consideration is needed to avoid iatrogenic degeneration of the periodontal support around the incisors, particularly during presurgical orthodontic treatment.
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Affiliation(s)
- Youn-Ju Kee
- Department of Orthodontics, School of Dentistry, Chonnam National University, Gwangju, South Korea
| | - Ha-Eun Moon
- Department of Orthodontics, School of Dentistry, Chonnam National University, Gwangju, South Korea
| | - Kyungmin Clara Lee
- Department of Orthodontics, School of Dentistry, Chonnam National University, Gwangju, South Korea.
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16
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Kim BR, Cho HA, Shin H. The effects of orthodontic treatment on personal dental expenditures in South Korea: a follow-up study using Korean health panel survey. BMC Health Serv Res 2022; 22:1598. [PMID: 36585698 PMCID: PMC9805093 DOI: 10.1186/s12913-022-09009-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 12/26/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND This study aimed to investigate the effects of orthodontic treatment on cumulative out-of-pocket (OOP) expenditures for up to 8 years and the factors contributing to changes in individual OOP dental expenses. METHODS The data of adults aged ≥19 years, 218 with experience of orthodontic treatment (OT group) and 654 without experience of orthodontic treatment (non-OT group) were extracted from the Korea Health Panel Survey between 2009 and 2017 using the propensity score matching method. The total personal OOP expenditure for dental care incurred after orthodontic treatment in the OT group and that incurred in the matched non-OT group were calculated. Since dependent variables, cumulative dental expenditures, were continuous with excess zeros, Tweedie compound Poisson linear models were used to explore the influence of orthodontic treatment experience and demographic and socioeconomic factors, including private insurance, on per capita OOP dental expenditures. RESULTS The OT group had socioeconomic characteristics distinct from those of general dental patients. The Box-Cox transformed per capita OOP expenditures for dental care in the OT group were lower than those in the non-OT group (P < 0.05). When all covariates were held constant, the non-OT group spent 1.4-times more on OOP dental expenditures, but this was not statistically significant (P > 0.1). The data from those with higher incomes revealed the opposite trend (P < 0.05), while the other covariates were not statistically significant. CONCLUSIONS Orthodontic treatment had no positive or negative effect on future oral care use. This finding is similar to the inconsistent results of previous clinical studies on oral health and orthodontic treatment.
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Affiliation(s)
- Bo-Ra Kim
- grid.443736.10000 0004 0647 1428Department of Dental Hygiene, Namseoul University, Cheonan-si, South Korea
| | - Han-A Cho
- grid.496515.a0000 0004 0371 6987Department of Dental Hygiene, Shinhan University, Uijeongbu-si, South Korea
| | - Hosung Shin
- grid.410899.d0000 0004 0533 4755Department of Social and Humanity in Dentistry, Wonkwang University School of Dentistry, 460 Iksan-daero, Iksan-si, 54538 South Korea
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17
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Samita, Verma SK, Sharma VK, Moinuddin, Ahad A. Effect of 1% curcumin gel on myeloperoxidase activity in GCF and periodontal status in the initial phase of orthodontic tooth movement. J Orthod Sci 2022; 11:55. [PMID: 36411813 PMCID: PMC9674938 DOI: 10.4103/jos.jos_143_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 05/30/2021] [Accepted: 03/10/2022] [Indexed: 11/27/2022] Open
Abstract
AIM To explore the potential effect of locally applied 1% Curcumin on myeloperoxidase (MPO) enzymatic activity in gingival crevicular fluid (GCF) and on the periodontal status during the initial phase of orthodontic tooth movement. SETTINGS AND DESIGN Forty patients (26 females and 14 males) aged 12-25 years who required fixed orthodontic treatment were randomly divided into two equal groups. The control and test groups were similar in the various baseline parameters, including standard oral hygiene protocol. Moreover, 1% Curcumin gel was applied around mandibular anterior teeth in the test group twice daily, from three days before to 14 days after the placement of archwires. MPO activity and periodontal status were recorded at five different time points; before placement of archwire (baseline), immediately after placement of archwire, 2 hours, 7 days, and 14 days later. STATISTICAL ANALYSIS USED The data were analyzed using the paired t-test for intra-group differences and the unpaired t-test for intergroup differences at five different time points. Statistical significance in the intragroup and intergroup difference of Plaque and Gingival index was calculated using the unpaired t-test. RESULTS Maximum MPO enzymatic activity in GCF was observed two hours after the placement of the archwire. MPO activity decreased slightly on the seventh day, but values were still elevated as compared to baseline. However, MPO activity came back to the values similar to baseline on day 14 in the control group and significantly lower than the baseline in the test group. The inter-group differences in clinical periodontal parameters were non-significant. CONCLUSIONS The locally applied 1% Curcumin gel appears to decrease the MPO activity in GCF on the 14th day after placement of the archwires. However, clinical periodontal status in the initial phase of tooth movement is unaffected by curcumin if patients adhere to good plaque control.
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Affiliation(s)
- Samita
- Department of Orthodontics, Dr. Ziauddin Ahmad Dental College, Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India,Address for correspondence: Dr. Samita, L-6, Vikram Colony, Ramghat Road, Aligarh, Uttar Pradesh - 202 001, India. E-mail:
| | - Sanjeev K. Verma
- Department of Orthodontics, Dr. Ziauddin Ahmad Dental College, Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Vivek K. Sharma
- Periodontics, Dr. Ziauddin Ahmad Dental College, Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Moinuddin
- Department of Biochemistry, Jawaharlal Nehru Medical College, Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Abdul Ahad
- Department of Dentistry, Medini Rai Medical College, Palamu, Jharkhand, India
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Effects of Multibracket Orthodontic Treatment versus Clear Aligners on Periodontal Health: An Integrative Review. Dent J (Basel) 2022; 10:dj10100177. [PMID: 36285987 PMCID: PMC9600623 DOI: 10.3390/dj10100177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 11/23/2022] Open
Abstract
Objective: This integrative review aimed to identify studies comparing the periodontal health in patients wearing multibracket orthodontic appliances and clear aligners. Materials and methods: An integrative literature search was performed through different databases, PubMed/Medline, PMC, and the Cochrane Library. This work was submitted to a search strategy following the PICO method and included the focus question: “Could the chosen orthodontic appliance change significantly the oral hygiene of the patient, impairing the periodontal health?” This work included analytical and controlled studies on humans published between 2005 and 2020, in the English language, establishing a comparison of the periodontal status in patients undergoing orthodontic multibracket and clear aligners therapies. The main periodontal indexes assessed were plaque index (PI), pocket depth (PD), gingival index (GI), and bleeding on probing (BoP). Results: The electronic research displayed 386 articles on PMC, 106 on PubMed, and 40 on the Cochrane Library. After removal, just 25 articles were selected for full-text screening, but just eight studies were eligible for this integrative review. It was enumerated that 204 patients were treated with aligners and 294 with multibracket orthodontic appliances, mainly elastomeric ligated brackets. Only the plaque index displayed a significant difference between the two groups and general data obtained showed a better control for periodontal health in the clear aligners. Limitations such as age, malocclusion severity, therapeutic choice, and different time measure was observed. In addition, the oral hygiene instruction and follow-up by a professional were different, and the role of malocclusion was not present in the studies. Conclusions: Within the limitations of this study, better results for periodontal health were found in the clear aligners. Therefore, more studies are necessary to affirm that aligners are synonymous with better gingival conditions in comparison with multibracket appliances. Other variables such as oral hygiene instructions, motivation, and supportive treatment tend to be more prevalent than the type of appliance itself in the periodontal evaluation.
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Yang CYM, Atsawasuwan P, Viana G, Tozum TF, Elshebiny T, Palomo JM, Sellke T, Elnagar MH. Cone‐Beam
Computed Tomography Assessment of Maxillary Anterior Alveolar Bone Remodeling in Extraction and
Non‐Extraction
Orthodontic Cases Using Stable
Extra‐Alveolar
Reference. Orthod Craniofac Res 2022; 26:265-276. [PMID: 36104955 DOI: 10.1111/ocr.12609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 09/08/2022] [Accepted: 09/11/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To explore alveolar cortical positional change in response to tooth movement in extraction and non-extraction orthodontic cases, using cone-beam computed tomography (CBCT) and stable extra-alveolar references. MATERIALS AND METHODS The pre-treatment (T1) and post-treatment (T2) CBCT scans of 25 extraction (EXT) and matched 25 non-extraction (Non-EXT) orthodontic cases were imported into Dolphin Imaging 3D, and oriented uniformly. Sagittal and axial CBCT cross-sections were traced using customized software-generated guides. The displacement of teeth and alveolar bone cortices were automatically measured using the palatal plane (PP) and the line perpendicular to PP and passing Sella as reference. Intra- and inter-group differences between T1 and T2 were analysed. Subjects were also superimposed three-dimensionally using Geomagic Control X for qualitative analysis of cortical remodelling. RESULTS The EXT group showed incisor retraction, while the Non-EXT group exhibited statistically significant incisor anterior tipping (P < .05). In EXT, both the labial and palatal cortices are resorbed. Non-EXT showed labial cortex anterior modelling, and statistically significant palatal cortex resorption (P < .05). In both groups, statistically significant decrease in total and palatal alveolar widths, increase in labial widths, and palatal dehiscence were observed. Comparatively, EXT showed significantly more incisal total and palatal width decrease and palatal vertical bone loss. CONCLUSION Labial cortical remodelling was shown to follow anterior tooth movement, but the palatal cortical response to incisor retraction and labial cortical remodelling in general remained inconclusive. Narrowing of the alveolar housing and palatal dehiscence were observed regardless of extraction following orthodontic treatment.
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Affiliation(s)
- Chih Yau Michael Yang
- Department of Orthodontics, College of Dentistry University of Illinois Chicago Chicago Illinois USA
| | - Phimon Atsawasuwan
- Department of Orthodontics, College of Dentistry University of Illinois Chicago Chicago Illinois USA
| | - Grace Viana
- Department of Orthodontics, College of Dentistry University of Illinois Chicago Chicago Illinois USA
| | - Tolga F. Tozum
- Department of Periodontics, College of Dentistry University of Illinois Chicago Chicago Illinois USA
| | - Tarek Elshebiny
- Department of Orthodontics, School of Dental Medicine Case Western Reserve University Cleveland Ohio USA
| | - Juan Martin Palomo
- Department of Orthodontics, School of Dental Medicine Case Western Reserve University Cleveland Ohio USA
| | - Terry Sellke
- Department of Orthodontics, College of Dentistry University of Illinois Chicago Chicago Illinois USA
| | - Mohammed H. Elnagar
- Department of Orthodontics, College of Dentistry University of Illinois Chicago Chicago Illinois USA
- Department of Orthodontics, Faculty of Dentistry Tanta University Tanta Egypt
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20
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Kurt Demirsoy K, Türker G, Amuk M, Kurt G. How much should incisors be decompensated? periodontal bone defects during presurgical orthodontic treatment in class III double-jaw orthognathic surgery patients. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e133-e139. [PMID: 35263684 DOI: 10.1016/j.jormas.2022.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/02/2022] [Accepted: 03/04/2022] [Indexed: 05/16/2023]
Abstract
INTRODUCTION The aims of this study were to evaluate periodontal bone defects around the lower and upper incisors and to identify changes in the buccolingual inclination of the incisors during orthodontic decompensation in skeletal Class III orthognathic surgery patients. MATERIALS AND METHODS The sample consisted of 26 adults with skeletal Class III deformity who had undergone presurgical orthodontic treatment and orthognathic surgery. Lateral cephalograms obtained before orthodontic treatment and before surgery were used to determine the inclination and position changes of the incisors. Cephalometric measurements were taken using Dolphin Imaging 11.95. Three-dimensional images were generated from cone-beam computed tomography (CBCT) scans prior to surgery and used to detect periodontal bone defects, including fenestration (F) and dehiscence (D). RESULTS Intraclass correlation coefficients (ICC) were determined and the measurements showed high reproducibility. The cephalometric data showed normal distribution and there were no differences between genders in terms of cephalometric changes, dehiscence, fenestration, or coexistent (D-F/DF) formation. The patients presented maxillary incisor retroclination and mandibular incisor proclination, which was consistent with the tooth decompensation. CBCT assessment was performed for a total of 208 teeth; while 81 upper and 94 lower incisors had D-F/DF formation, 23 upper and 10 lower incisors were healthy. Statistically significant correlations were not found between the inclination degree of the incisors and D-F/DF formation. CONCLUSIONS Decompensation of incisors during presurgical orthodontic treatment increases the risk of periodontal defects. There is no linear relationship between the increase in the inclination degrees of incisors and D-F/DF formation.
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Affiliation(s)
- Kevser Kurt Demirsoy
- Department of Orthodontics, Faculty of Dentistry Nevşehir Hacı Bektaş Veli University, Nevşehir, Türkiye.
| | - Gökhan Türker
- Department of Orthodontics, Faculty of Dentistry, Mersin University, Mersin, Türkiye
| | - Mehmet Amuk
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Türkiye
| | - Gökmen Kurt
- Department of Orthodontics, Faculty of Dentistry, Bezmialem Foundation University, İstanbul, Türkiye
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Jiang K, Jiang LS, Li HX, Lei L. Periodontal-orthodontic interdisciplinary management of a “periodontally hopeless” maxillary central incisor with severe mobility: A case report and review of literature. World J Clin Cases 2022; 10:4550-4562. [PMID: 35663057 PMCID: PMC9125257 DOI: 10.12998/wjcc.v10.i14.4550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/03/2021] [Accepted: 03/26/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Treating periodontally hopeless teeth with advanced bone resorption and severe tooth mobility is a great challenge for both orthodontists and periodontists. Biofilm-induced periodontal inflammation and occlusal trauma-related inflammation may synergistically aggravate tooth mobility. This case report illustrates that even periodontally hopeless teeth can be saved and have long-term stability with comprehensive periodontal treatment to control periodontal inflammation and promote periodontal bone regeneration and intricate orthodontic mechanical control to correct cross bite and occlusal trauma.
CASE SUMMARY A 27-year-old female patient whose chief complaint was severe tooth mobility and discomfort of the maxillary incisor was diagnosed with severe aggressive periodontitis by clinical and radiographic examinations. To reduce tooth mobility and establish stable occlusion, we combined orthodontic treatment with periodontal therapy to preserve the tooth. Orthodontic treatment was performed after basic periodontal therapy and periodontal surgery. The loosened upper right central incisor was successfully retained, and the periodontal tissue remained stable during follow-up.
CONCLUSION Teeth with severe mobility and bone loss can be saved through interdisciplinary treatment when periodontal inflammation is strictly controlled.
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Affiliation(s)
- Ke Jiang
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, Jiangsu Province, China
| | - Li-Shan Jiang
- Department of Periodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, Jiangsu Province, China
| | - Hou-Xuan Li
- Department of Periodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, Jiangsu Province, China
| | - Lang Lei
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, Jiangsu Province, China
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Baeshen HA, Alsulaimani FF, Awadh W, Ageeli MA, Abullais SS, Alqahtani NA, Alshahrani MY, Hosmani J, Patil S. Comparative assessment of the cell-surface antigens and gene expression profiles of the gingival tissue biomarkers in subjects with fixed functional and removable functional orthodontic appliances. Saudi J Biol Sci 2022; 29:1789-1795. [PMID: 35280575 PMCID: PMC8913387 DOI: 10.1016/j.sjbs.2021.10.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/13/2021] [Accepted: 10/18/2021] [Indexed: 10/28/2022] Open
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Gingival Recessions and Periodontal Status after Minimum 2-Year-Retention Post-Non-Extraction Orthodontic Treatment. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031641] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The objectives of this study were to assess gingival recessions (GR) and periodontal status in patients previously treated with non-extraction orthodontic treatment and retention at a follow-up of a minimum of two years after the end of treatment. Data from patients aged between 16 and 35 years with a previous non-extraction orthodontic treatment and at least 2 years of retention and full records before and after treatment were collected. The casts were digitalized using the 3Shape TRIOS® intraoral scanner and the Viewbox4 software was used for the measurements. The following parameters were scored: inclination of the lower and upper incisors (IMPA and I^SN) and anterior crowding (Little index). The included patients were recalled for a clinical periodontal follow-up examination and the following parameters were evaluated: buccal and lingual GR (mm) of incisors and canines, bleeding of probing score, plaque score, and gingival phenotype. The digital cast analysis showed a mean Little index of 7.78 (SD 5.83) and 1.39 (SD 0.79), respectively, before and after treatment. The initial and final cephalometric analyses showed an I^SN of 103.53° and 105.78°(SD 7.21) and IMPA of 91.3°and 95.1°, respectively. At the follow-up periodontal visits, the patients showed an overall low oral hygiene with bleeding at probing in 66.6% and plaque in the anterior area in 76.2% of patients. From the total examined 240 teeth of the frontal sextants, three patients had GR (from 1 to 6.5 mm): in the upper arch two at canines and one at central incisor, whereas in the lower arch two at central and one at lateral incisors. The gingival phenotype was thick in 55% of cases. The lingual-to-lingual retainers at follow-up were present in 61.9% of patients. A slight increased risk for buccal GR development was found only in correlation with the presence of fixed retainer and thin gingival phenotype mainly in patients with gingivitis. Thus, non-extraction orthodontic treatment performed with controlled forces and biomechanics seems to not affect the development of GR or the periodontal health after retention.
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Clinical effectiveness of clear aligner treatment compared to fixed appliance treatment: an overview of systematic reviews. Clin Oral Investig 2022; 26:2353-2370. [PMID: 34993617 DOI: 10.1007/s00784-021-04361-1] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 12/29/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To evaluate the available evidence regarding clinical effectiveness of clear aligner treatment (CAT). MATERIALS AND METHODS A comprehensive literature search was conducted for systematic reviews investigating effectiveness of CAT published up to July 15, 2021. This was accomplished using different electronic databases. No language restriction was applied. Screening, quality assessment, and data extraction were performed by two authors independently. Information was categorized and narratively synthesized for the key findings from moderate and high-quality reviews. RESULTS A total of 361 potentially eligible reviews were identified. After excluding the non-relevant/low-quality reviews, 18 systematic reviews were included. CAT was found to be effective for mild to moderate malocclusions, and was associated with inferior outcomes when treating severe cases or with achieving specific tooth movements. There were conflicting results regarding treatment duration; however, CAT may be associated with shorter treatment in mild to moderate cases. Relapse was greater with CAT, while periodontal health was better. The risk of root resorption tended to be lower with CAT. Regarding pain, the results were unclear, although CAT was found to be more comfortable and associated with a reduced impact on eating and chewing. CONCLUSIONS The level of evidence regarding CAT is moderate; hence, further high-quality randomized clinical trials are required. Evidence supports use of aligners as an alternate to fixed appliances in patients with mild-to-moderate malocclusion but not in severe cases. Advancement in technology could enhance the accuracy of CAT in delivering planned outcomes. CLINICAL RELEVANCE CAT can be used effectively for selected cases with mild to moderate malocclusion. REGISTRATION PROSPERO registration number: CRD42021246855.
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Feres MFN, Vicioni-Marques F, Romano FL, Roscoe MG, Souza VMD, Torneri AL, Bueno-Silva B. Streptococcus mutans adherence to conventional and self-ligating brackets: an in vitro study. Dental Press J Orthod 2021; 26:e212019. [PMID: 34932711 PMCID: PMC8690864 DOI: 10.1590/2177-6709.26.6.e212019.oar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 08/31/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Although self-ligating brackets presumably provide better hygiene conditions, no consensus has been reached so far. OBJECTIVE Therefore, the objective of this study was to evaluate, in an in vitro experimental design, the adherence of Streptococcus mutans (SM) in self-ligating and conventional brackets of different manufacturers and ligature types. METHODS Four commercial brands of maxillary premolar metal brackets were tested (Abzil®; Morelli®; 3M Unitek®; and GAC®). Each one was subdivided into three groups, which varied according to the type of ligature and bracket model (metallic, elastic, and self-ligating), totalizing twelve groups, composed of six brackets each. Previously sterilized brackets were initially immersed in saliva for one hour, and subsequently washed and added in a bacterial suspension, maintained in aerobiosis for 72 hours. The adhered bacteria were then separated and quantified by colony forming units (CFU/mL) counting after 48 hours of growth. The groups were compared by Kruskal-Wallis and Dunn post-hoc tests (p< 0.05). RESULTS Regardless of the commercial brand, self-ligating brackets had significantly less CFU/mL. However, according to comparisons performed within each commercial brand, only Abzil® self-ligating brackets had significantly lower biofilm adhesion. Among all of the self-ligating models, GAC® brackets presented the highest bacterial adhesion rate. CONCLUSIONS Self-ligating brackets are likely to present lower rates of biofilm adhesion. Particularly, Abzil® and GAC® self-ligating brackets are less likely to accumulate biofilm. Although such results are derived from an in vitro study, practitioners might acknowledge findings concerning bacterial adhesion as one of the relevant features to be considered during bracket selection.
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Affiliation(s)
- Murilo Fernando Neuppmann Feres
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil (Ribeirão Preto/SP, Brazil)
| | - Fernanda Vicioni-Marques
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil (Ribeirão Preto/SP, Brazil)
| | - Fábio Lourenço Romano
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil (Ribeirão Preto/SP, Brazil)
| | - Marina Guimarães Roscoe
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Biomateriais e Biologia Oral (São Paulo/SP, Brazil)
| | | | - Aline Lira Torneri
- Universidade de Guarulhos, Programa de Pós-Graduação, Mestrado em Ortodontia (Guarulhos/SP, Brazil)
| | - Bruno Bueno-Silva
- Universidade de Guarulhos, Programa de Pós-Graduação, Mestrado em Ortodontia (Guarulhos/SP, Brazil)
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Gehlot M, Sharma R, Tewari S, Kumar D, Gupta A. Effect of orthodontic treatment on periodontal health of periodontally compromised patients: A randomized controlled clinical trial. Angle Orthod 2021; 92:324-332. [PMID: 34882193 DOI: 10.2319/022521-156.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 10/01/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To evaluate the effect of fixed orthodontic treatment on periodontal parameters in periodontally compromised adult orthodontic patients. MATERIALS AND METHODS This was a prospective, randomized, controlled clinical trial. Thirty-six periodontally compromised adult patients (mean age: 29.67 ± 4.8 years) were randomly allocated to either test (perio-ortho) or control group (perio). After periodontal stabilization in both groups, orthodontic treatment was started in the test group, whereas the control group remained on periodontal maintenance only. Evaluation and comparison of clinical parameters (plaque index [PI]; gingival index [GI]; bleeding on probing [BOP]; probing depth [PD]; clinical attachment level [CAL]) of both groups was assessed at three time intervals: T0 (base line), T1 (at start of orthodontic treatment), and T2 (1 year after start of orthodontic treatment). Radiological parameters (alveolar bone levels [ABL]) were recorded using CBCT at T1 and T2. RESULTS Intragroup analysis showed statistically significant improvement in all clinical and radiological periodontal parameters in both groups (P ≤ .05). Intergroup comparison revealed improvement in the periodontal parameters was not statistically significant between the groups (P ≥ .05). Subgroup analysis showed reduction in the number of moderate and severe periodontitis sites in both groups with significant more gains in ABL in the test group compared to the control group. CONCLUSIONS Orthodontic treatment after periodontal stabilization does not have any detrimental effect on periodontal health in adult periodontally compromised orthodontic patients and may add to the benefits achieved by periodontal treatment alone.
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Taxonomic Analysis of Oral Microbiome during Orthodontic Treatment. Int J Dent 2021; 2021:8275181. [PMID: 34745264 PMCID: PMC8568516 DOI: 10.1155/2021/8275181] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 10/18/2021] [Indexed: 12/31/2022] Open
Abstract
Background Orthodontic appliances induce significant changes in the oral microbiome, but this shift in microbial composition has not been well established by the available evidence yet. Objectives To perform a systematic review of existing literature in order to assess the taxonomic microbial changes in orthodontic patients during Fixed Appliance Treatment (FAT) and Clear Aligner Treatment (CAT), using next-generation sequencing (NGS) technique of the bacterial 16S rRNA gene. Search Methods and Selection Criteria. The search for articles was carried out in PubMed, including articles published in English until May 2021. They included every human study report potentially relevant to the review. Data Collection and Analysis. After duplicate study selection and data extraction procedures according to the PICOS scheme, the methodological quality of the included papers was assessed by the Swedish Council on Technology Assessment in Health Care Criteria for Grading Assessed Studies (SBU) method. Results The initial search identified 393 articles, 74 of which were selected by title and abstract. After full-text reading, six articles were selected according to inclusion criteria. The evidence quality for all the studies was moderate. Conclusions Orthodontic treatment seems to transiently affect the composition of subgingival microbiome, although not salivary, maintaining a stable microbial diversity. Different results were found in the shift of microbiome between plaque and saliva, depending on the type of orthodontic treatment. This review should be interpreted with some caution because of the number, quality, and heterogeneity of the included studies.
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Patient First: Surgery First and More. J Craniofac Surg 2021; 32:e751-e754. [PMID: 34727451 DOI: 10.1097/scs.0000000000007766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION The success of surgery first approach has been defined by the number of advantages offered and is definitively determined by the satisfaction of the patients themselves. The strength of this protocol resides in its philosophy that puts the patient at the center of the whole diagnostic-therapeutic process. The compliance of the patient, its happiness and comfort are the best guarantee of a good final results. While pursuing this philosophy we have wondered whether there was way to increase the comfort of surgery first approach even more and to make it even more appealing for the patients. For these reasons, we have decided to work on a preliminary protocol in order to reduce or even eliminate the use of orthodontic braces and wires during perioperative stages. Materials and Methods: No orthodontic braces or wires are bonded on the teeth before surgery. Intraoperatory intermaxillary fixation (IMF) is carried out with the use of IMF screws which are positioned at the beginning of the operation on the edge between keratinized and nonkeratinized gingiva. Once the osteotomies are performed IMF with IMF screws is carried out on the planned occlusion with the use of surgical splints.Discussion and Conclusions: In selected cases the postsurgical orthodontic treatment can be carried out with the use of clear aligners, completely eliminating the need of braces and wires with an additional level of comfort.
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Salvesen BF, Grytten J, Rongen G, Koldsland OC, Vandevska-Radunovic V. Periodontal status in long-term orthodontic retention patients up to 10 years after treatment - a cross-sectional study. Acta Odontol Scand 2021; 79:623-629. [PMID: 33971102 DOI: 10.1080/00016357.2021.1921842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To assess periodontal status in long-term orthodontic retention patients and investigate possible risk indicators. MATERIALS AND METHODS Plaque index (PI), gingival index (GI), probing pocket depth (PPD), gingival recessions (GR) and calculus were recorded in 211 patients with or without fixed retainers. RESULTS Periodontal parameters were within the limits of clinically healthy periodontium. The use of fixed retainers was associated with higher PI in the maxilla (ß = 1.10 [0.37]; p <.05). Older age was associated with higher PI in the mandible (ß = 0.27 [0.11]; p <.05). Smoking was associated with gingival bleeding on both palatal (ß = 0.63 [0.16]; p < .01) and labial sides in the maxilla (ß = 0.46 [0.20]; p <.05). Smoking was also associated with increased prevalence of GR in the mandible (ß = 0.24 [0.07]; p <.01), while use of snuff had similar effect on the labial side in the maxilla (ß = 0.35 [0.08]; p <.01). Higher age (ß = 0.05 [0.02]; p <.05) and the presence of a retainer (ß = 0.23 [0.07]; p < .05) were associated with calculus accumulation on the lingual side in the mandible. CONCLUSION The present observational study suggest that long-term fixed retainers alone have no detrimental effect on the periodontium. Additional factors may increase the risk of plaque deposits and increased probing pocket depths. Further prosepective studies are needed to confirm the present outcome.
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Affiliation(s)
- Barbro Fostad Salvesen
- Section of Orthodontics, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Jostein Grytten
- Section for Community Dentistry, University of Oslo, Oslo, Norway
- Department of Obstetrics and Gynecology, Institute of Clinical Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Gunnar Rongen
- Section for Community Dentistry, University of Oslo, Oslo, Norway
| | - Odd Carsten Koldsland
- Section of Periodontology, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
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Hou J, Qian Y, Ma G, Gao H, Yang J, Fan J. Effect of Orthodontic Treatment on Anterior Tooth Displacement in Patients with Periodontal Disease: A Meta-Analysis. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:8761215. [PMID: 34754410 PMCID: PMC8572632 DOI: 10.1155/2021/8761215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/13/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To systematically evaluate the effect of orthodontic treatment (ODT) on anterior tooth displacement (ATD) in patients with periodontal disease. METHODS PubMed, Web of Science, Embase, China National Knowledge Infrastructure, and Wanfang databases were electronically searched for relevant literature studies on ODT and basic treatment for ATD in patients with periodontal disease, and then the related journals and reference lists of the included studies were manually searched. The search time was set from January 2010 to May 2021. Stata 16.0 software was used for meta-analysis. RESULTS Totally, 783 articles were retrieved, and finally, 14 studies were included. The effective rate of basic treatment combined with OTD was significantly higher than that of basic treatment alone (OR = 7.27, 95% CI: 3.76, 14.04). Specifically, the combined treatment led to lower values of periodontal pocket depth (SMD = -2.30, 95% CI: -2.94, -1.66), anterior overjet (SMD = -2.75, 95% CI: -3.72, -1.78), anterior overbite (SMD = -2.13, 95% CI: -3.16, -1.10), and periodontal bleeding index (SMD = -4.25, 95% CI: -5.48, -3.03) compared with those of basic treatment alone. CONCLUSION Compared with basic treatment, ODT combined with basic treatment is more effective for patients with periodontal disease-caused ATD and can also improve the clinical symptoms of patients.
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Affiliation(s)
- Jia Hou
- Department of Stomatology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou City, Jiangsu Province 215004, China
| | - Yunzhu Qian
- Department of Stomatology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou City, Jiangsu Province 215004, China
| | - Guowu Ma
- Department of Stomatology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou City, Jiangsu Province 215004, China
| | - Huan Gao
- Department of Stomatology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou City, Jiangsu Province 215004, China
| | - Jianxin Yang
- Department of Stomatology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou City, Jiangsu Province 215004, China
| | - Jianlin Fan
- Department of Stomatology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou City, Jiangsu Province 215004, China
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Schröder A, Stumpf J, Paddenberg E, Neubert P, Schatz V, Köstler J, Jantsch J, Deschner J, Proff P, Kirschneck C. Effects of mechanical strain on periodontal ligament fibroblasts in presence of Aggregatibacter actinomycetemcomitans lysate. BMC Oral Health 2021; 21:405. [PMID: 34407790 PMCID: PMC8371899 DOI: 10.1186/s12903-021-01761-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 08/04/2021] [Indexed: 01/30/2023] Open
Abstract
PURPOSE Many adult orthodontic patients suffer from periodontitis, which is caused by oral pathogens such as the gram-negative Aggregatibacter actinomycetemcomitans (Agac). Like orthodontic tooth movement, periodontitis is associated with inflammation and alveolar bone remodelling thereby affecting orthodontic treatment. Interactions of both processes, however, are not sufficiently explored, particularly with regard to oxidative stress. METHODS After preincubation with Agac lysate for 24 h periodontal ligament fibroblasts (PDLF) were either stretched or compressed for further 48 h simulating orthodontic forces in vitro. We analysed the expression of genes and proteins involved in the formation of reactive oxygen species (NOX-4, ROS) and nitric oxide (NOS-2), inflammation (TNF, IL-6, PTGS-2) and bone remodelling (OPG, RANKL). RESULTS Agac lysate elevated the expression of NOX-4, NOS-2, inflammatory IL-6 and PTGS-2 and the bone-remodelling RANKL/OPG ratio during compressive, but not tensile mechanical strain. Agac lysate stimulated pressure-induced inflammatory signalling, whereas surprisingly ROS formation was reduced. Pressure-induced downregulation of OPG expression was inhibited by Agac lysate. CONCLUSIONS Agac lysate impact on the expression of genes and proteins involved in inflammation and bone remodelling as well as ROS formation, when PDLF were subjected to mechanical forces occurring during orthodontic tooth movement.
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Affiliation(s)
- Agnes Schröder
- Department of Orthodontics, University Hospital Regensburg, Regensburg, Germany.
| | - Julia Stumpf
- Department of Orthodontics, University Hospital Regensburg, Regensburg, Germany
| | - Eva Paddenberg
- Department of Orthodontics, University Hospital Regensburg, Regensburg, Germany
| | - Patrick Neubert
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - Valentin Schatz
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - Josef Köstler
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - Jonathan Jantsch
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - James Deschner
- Department of Periodontology and Operative Medicine, University Medicine Mainz, 55131, Mainz, Germany
| | - Peter Proff
- Department of Orthodontics, University Hospital Regensburg, Regensburg, Germany
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Marya A, Steier L, Karobari MI, Venugopal A. Benefits of Using Fluorescence Induced Theragnosis in Fixed Orthodontic Therapy: Status, Technology and Future Trends. Dent J (Basel) 2021; 9:90. [PMID: 34436002 PMCID: PMC8393472 DOI: 10.3390/dj9080090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/23/2021] [Accepted: 07/28/2021] [Indexed: 01/05/2023] Open
Abstract
Dental biofilm is often found to be the source of bacteria that releases toxins, peptides, lipopolysaccharides as well as organic acids, which lead to gingival inflammation and tooth caries. Further, the persistent plaque may result in the continued destruction of the surrounding soft and hard tissues. During fixed orthodontic therapy, arch-wires, brackets, and elastic modules have been shown to be sites of significant plaque accumulation, making it difficult for a patient to maintain proper oral hygiene. The problem most dentists face is that they cannot visualize this biofilm completely to be able to carry out efficient plaque removal. Visual assessment is, to date, the most common method for plaque visualization, and various indexes have been demonstrated to be sufficient for quantification of the amount of plaque present. However, the problem is that visual assessments are inconsistent, operator dependent and often subjective, which can lead to inconsistency in results. Fluorescence is one such method that can be explored for its use in effective plaque identification and removal. Literature has it that dentists and patients find it particularly useful for monitoring oral hygiene status during treatment. Fluorescence has the capability of offering clinical orthodontists and researchers a new method of detection of demineralization during orthodontic treatment, furthermore, for efficient removal of orthodontic adhesive cements, fluorescent light may be used in conjunction with high-speed burs to deliver fast, less time consuming, and safer results. The benefit of direct visual treatment using fluorescence enhanced theragnosis is that the patient receives controlled and guided therapy. It has multiple benefits, such as early diagnosis of caries, biofilm identification, and even helps to achieve improved treatment outcomes by better resin selection for esthetic procedures.
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Affiliation(s)
- Anand Marya
- Department of Orthodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh 12211, Cambodia
- Department of Orthodontics, Saveetha Institute of Medical and Technical Sciences, Saveetha Dental College, Saveetha University, Chennai 600077, India;
| | - Liviu Steier
- Department of Restorative Dentistry, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Mohmed Isaqali Karobari
- Conservative Dentistry Unit, Health Campus, School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia;
| | - Adith Venugopal
- Department of Orthodontics, Saveetha Institute of Medical and Technical Sciences, Saveetha Dental College, Saveetha University, Chennai 600077, India;
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Papageorgiou SN, Antonoglou GN, Michelogiannakis D, Kakali L, Eliades T, Madianos P. Effect of periodontal-orthodontic treatment of teeth with pathological tooth flaring, drifting, and elongation in patients with severe periodontitis: A systematic review with meta-analysis. J Clin Periodontol 2021; 49 Suppl 24:102-120. [PMID: 34327710 PMCID: PMC9290963 DOI: 10.1111/jcpe.13529] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 07/25/2021] [Indexed: 12/28/2022]
Abstract
Aim To assess the beneficial and adverse effects on the dental and periodontal issues of periodontal–orthodontic treatment of teeth with pathological tooth flaring, drifting, and elongation in patients with severe periodontitis. Materials and methods Nine databases were searched in April 2020 for randomized/non‐randomized clinical studies. After duplicate study selection, data extraction, and risk‐of‐bias assessment, random‐effect meta‐analyses of mean differences (MDs) and their 95% confidence intervals (CIs) were performed, followed by subgroup/meta‐regression analyses. Results A total of 30 randomized and non‐randomized clinical studies including 914 patients (29.7% male; mean age 43.4 years) were identified. Orthodontic treatment of pathologically migrated teeth was associated with clinical attachment gain (−0.24 mm; seven studies), pocket probing depth reduction (−0.23 mm; seven studies), marginal bone gain (−0.36 mm; seven studies), and papilla height gain (−1.42 mm; two studies) without considerable adverse effects, while patient sex, gingival phenotype, baseline disease severity, interval between periodontal and orthodontic treatment, and orthodontic treatment duration affected the results. Greater marginal bone level gains were seen by additional circumferential fiberotomy (two studies; MD = –0.98 mm; 95% CI = –1.87 to −0.10 mm; p = .03), but the quality of evidence was low. Conclusions Limited evidence of poor quality indicates that orthodontic treatment might be associated with small improvements of periodontal parameters, which do not seem to affect prognosis, but more research is needed.
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Affiliation(s)
- Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Georgios N Antonoglou
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, Department of Periodontology, Faculty of Dentistry, University Complutense, Madrid, Spain
| | - Dimitrios Michelogiannakis
- Division of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, New York, USA
| | - Lydia Kakali
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Phoebus Madianos
- Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
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Nogueira AVB, Marcantonio CC, de Molon RS, Leguizamón NDP, Silva RCL, Deschner J, Cerri PS, Cirelli JA. Experimental models of orthodontic tooth movement and their effects on periodontal tissues remodelling. Arch Oral Biol 2021; 130:105216. [PMID: 34365145 DOI: 10.1016/j.archoralbio.2021.105216] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 06/28/2021] [Accepted: 07/24/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The present study aimed to compare two different models of orthodontic tooth movement (OTM) in rats by evaluating tooth movement efficiency and periodontal tissues remodelling. DESIGN Fifteen animals were randomly distributed into 3 groups: control group (untreated); ligature appliance (LA) as experimental OTM using a closed coil spring fixed around maxillary first molar by steel ligature; occlusal appliance (OA) as experimental OTM using a closed coil spring attached on the occlusal surface of the maxillary first molar. After 15 days, all animals were euthanized, and the maxilla of each animal was collected for qPCR, micro-computed tomography, and histological analyses. RESULTS Interleukin-1 beta, interleukin-6, and tumor necrosis factor-alpha gene expressions were significantly upregulated in the animals of the LA group as compared to the other groups. No significant difference was observed in tooth displacement between both methods. The LA group presented higher linear bone loss and lower values of bone volume fraction, bone mineral density, trabecular number and increased values of trabecular separation compared to the other groups. The birefringent collagen content in the tension side of the periodontal ligament contained significantly lower collagen content in the LA group than in the control group. Furthermore, on the pressure side, the collagen content was significantly lower in the LA and OA groups than in the control group. CONCLUSIONS The OA group presented little or no deleterious effect on periodontal tissues compared to the LA group, suggesting its use may be more reliable for OTM induction in rats for 15 days.
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Affiliation(s)
- Andressa V B Nogueira
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University - UNESP, 14801-903, Araraquara, São Paulo, Brazil; Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University, 55131, Mainz, Germany.
| | - Camila C Marcantonio
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University - UNESP, 14801-903, Araraquara, São Paulo, Brazil.
| | - Rafael S de Molon
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University - UNESP, 14801-903, Araraquara, São Paulo, Brazil.
| | - Natalia D P Leguizamón
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University - UNESP, 14801-903, Araraquara, São Paulo, Brazil.
| | - Renata C L Silva
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University - UNESP, 14801-903, Araraquara, São Paulo, Brazil.
| | - James Deschner
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University, 55131, Mainz, Germany.
| | - Paulo S Cerri
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, School of Dentistry at Araraquara, São Paulo State University - UNESP, 14801-903, Araraquara, São Paulo, Brazil.
| | - Joni A Cirelli
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University - UNESP, 14801-903, Araraquara, São Paulo, Brazil.
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Soheilifar S, Khodadadi H, Naghdi N, Farhadian M. Does a diluted chlorhexidine-based orthodontic mouthwash cause less discoloration compared to chlorhexidine mouthwash in fixed orthodontic patients? A randomized controlled trial. Int Orthod 2021; 19:406-414. [PMID: 34049835 DOI: 10.1016/j.ortho.2021.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 05/01/2021] [Accepted: 05/05/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Chlorhexidine gluconate is currently the most effective oral antimicrobial agent against microorganisms, but discoloration of the teeth prevents its long-term use and can reduce patient cooperation. In this study, the effect of chlorhexidine and a diluted chlorhexidine-based, fluoride, cetylpyridinium and vitamin added mouth rinse (Orthokin) on stain index in fixed orthodontic patients was compared. MATERIALS AND METHODS This study was performed as a double blind randomized controlled trial on 50 patients undergoing fixed orthodontic treatment in the age group of 14-30 years. The patients were categorized as two groups of chlorhexidine and Orthokin mouth rinses and were asked to use mouthwash for eight weeks. Groups were matched according to colouring food consumption. Extrinsic staining index was assessed by modified Loben technique. Data was analysed by SPSS software. P value was set to be 0.05. RESULTS In the chlorhexidine group, the stain extent index and overall stain index were increased significantly at 8 weeks (P<0.001 and P=0.002, respectively). However, the increase in stain intensity index was insignificant (P=0.07). In Orthokin group, the changes in stain extent, stain intensity and overall stain were insignificant (P=0.66, P=1.000, P=0.47, respectively). CONCLUSION According to the results of the present study, chlorhexidine mouthwash causes more staining of teeth compared to Orthokin mouthwash. It seems that lower concentrations of chlorhexidine can be prescribed to orthodontic patients. Although these compounds are effective in sense of oral hygiene, they do not cause significant discoloration.
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Affiliation(s)
- Sepideh Soheilifar
- Department of Orthodontics, Dental Implant Research Centre, Hamedan university of medical sciences, Hamadan, Iran
| | | | - Navid Naghdi
- Oral and maxillofacial surgery department, Dental Implant Research Centre, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Farhadian
- Department of biostatistics, School of public health and research centre for health sciences, Hamadan University of Medical Sciences, Hamadan, Iran
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Martin C, Celis B, Ambrosio N, Bollain J, Antonoglou GN, Figuero E. Effect of orthodontic therapy in periodontitis and non-periodontitis patients: a systematic review with meta-analysis. J Clin Periodontol 2021; 49 Suppl 24:72-101. [PMID: 33998045 DOI: 10.1111/jcpe.13487] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 04/23/2021] [Accepted: 04/27/2021] [Indexed: 11/29/2022]
Abstract
AIM To answer these PICO questions: #1: In adult patients with malocclusion, what are the effects of orthodontic tooth movement (OTM) on clinical attachment level (CAL) changes in treated periodontitis patients with a healthy but reduced periodontium compared to non-periodontitis patients? #2: In adult patients with treated periodontitis and malocclusion, which is the efficacy of skeletal anchorage devices compared to conventional systems in terms of orthodontic treatment outcomes? MATERIAL AND METHODS Seven databases were searched until June 2020 looking for randomized, non-randomized trials and case series. Mean effects (ME) and 95% confidence intervals (CIs) were calculated. RESULTS Twenty-six studies with high risk of bias were included. PICO#1: In 26 patients without periodontitis and in 69 treated periodontitis patients, minimal changes in periodontal outcomes were reported after orthodontic therapy (p>0.05). A significant CAL gain (mm) (ME=3.523; 95% CI [2.353; 4.693]; p<0.001) was observed in 214 patients when periodontal outcomes were retrieved before a combined periodontal and orthodontic therapy. PICO#2: Orthodontic variables were scarcely reported and objective assessment of the results on orthodontic therapy were missing. CONCLUSIONS Based on a small number of low-quality studies, in non-periodontitis and in stable treated periodontitis patients, OTM had no significant impact on periodontal outcomes.
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Affiliation(s)
- Conchita Martin
- Department of Dental Clinical Specialties, Complutense University of Madrid, Madrid, Spain.,BIOCRAN (Craniofacial Biology: Orthodontics and Dentofacial Orthopedics) Research Group, Complutense University of Madrid, Madrid, Spain
| | - Beatriz Celis
- Department of Dental Clinical Specialties, Complutense University of Madrid, Madrid, Spain
| | - Nagore Ambrosio
- Department of Dental Clinical Specialties, Complutense University of Madrid, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, Complutense University of Madrid, Madrid, Spain
| | - Juan Bollain
- Department of Dental Clinical Specialties, Complutense University of Madrid, Madrid, Spain
| | - Georgios N Antonoglou
- Department of Dental Clinical Specialties, Complutense University of Madrid, Madrid, Spain
| | - Elena Figuero
- Department of Dental Clinical Specialties, Complutense University of Madrid, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, Complutense University of Madrid, Madrid, Spain
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The "Prosthetic Orthodontic Approach": An Application of the Biologically Oriented Preparation Technique Protocol. Case Rep Dent 2021; 2021:5533160. [PMID: 33981461 PMCID: PMC8088386 DOI: 10.1155/2021/5533160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/27/2021] [Accepted: 03/31/2021] [Indexed: 11/17/2022] Open
Abstract
In this study, three cases involving patients who required multidisciplinary treatment for the aesthetic and functional rehabilitation of the maxillary or mandibular arch are described. In particular, an indication for preprosthetic orthodontic treatment, such as orthodontic extrusion, tooth realignment, correction of malocclusion, and diastemata closure, was present in all cases. Preprosthetic orthodontic treatment to resolve these issues before the restorative procedures was proposed; however, all patients refused preprosthetic orthodontic treatment. Thus, to restore aesthetics and function, solely a feather-edge prosthetic protocol has been used. The biologically oriented preparation technique was used to prepare the teeth that were moved in the established direction by preparing the abutment more on one side than the opposite. This so called “prosthetic orthodontic approach” allowed resolving clinical issues that would typically require preprosthetic orthodontic treatment, such as complete clinical crown loss, occlusal vertical dimension loss, tooth misalignment, malocclusion, tooth agenesis, and severe multiple diastemata. The degree of reciprocal movement of the prepared teeth achievable through this approach was minor and not comparable to a traditional wide-range orthodontic movement. Besides, the technique resulted in a modification of the gingival tissues and improvement of their thickness although it is unclear what effect this technique has on the gingival biotype. None of the patients had prosthetic or periodontal complications for at least 12 months following the procedure. Gingival health was excellent, and the prosthetic procedure did not affect the pulp survival of the vital teeth. The biologically oriented preparation technique used with a prosthetic orthodontic approach can effectively manage complicated cases without the need for preprosthetic orthodontics.
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Agusto M, Salman A, Parker D, Choi D, Schincaglia GP. Root Coverage Predictability in the Treatment of Gingival Recessions on Mandibular Anterior Teeth. JDR Clin Trans Res 2021; 7:224-233. [PMID: 33899565 DOI: 10.1177/23800844211009437] [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] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Mandibular anterior teeth are most frequently affected by gingival recession. However, data regarding mucogingival treatment aimed at root coverage in this specific location are limited. OBJECTIVE The purpose of this study was to systematically review the scientific literature and to use the meta-analytic approach to address the following focused question: "What is the effectiveness of different surgical approaches on clinical and patient-related outcomes in the treatment of buccal gingival recessions on mandibular anterior teeth?" METHODS Studies were located by searching 3 electronic databases (Medline, Scopus, and Cochrane databases) and cross-referencing. Randomized and nonrandomized studies including at least 1 arm involving the use of pedicle flaps and/or free soft tissue grafts in the treatment of gingival recessions (recession type [RT] 1 and RT2) located on the buccal aspects of mandibular centrals, laterals and canines, were included in the analysis. Primary outcome was mean root coverage (mRC), expressed in percentage, based on a 3- to 12-mo follow-up observation. A Bayesian single-arm network meta-analysis was performed to identify a treatment hierarchy of the different surgical techniques. RESULTS Sixteen studies, with a total of 23 arms, were included in the quantitative analysis. The greatest mRC is associated with laterally positioned flap (LPF) + connective tissue graft (CTG) (91.2%) and tunnel (TUN) + CTG (89.4%), whereas LPF alone, coronally advanced flap (CAF) + CTG, and free gingival graft (FGG) showed lower mRC (79.1%, 78.9%, and 68.5% respectively). TUN + CTG provides significantly greater mRC compared to CAF+CTG. No difference among the procedures could be observed in terms of keratinized tissue width gain. CONCLUSIONS Treatment hierarchy generated by an arm-based network meta-analysis model suggested that tunnel and laterally positioned flap, both in combination with connective tissue graft, may provide the greatest mean root coverage in the treatment of mandibular anterior recessions. KNOWLEDGE TRANSFER STATEMENT The results of the present systematic review can be used by clinicians when deciding which approach to adopt when treating buccal gingival recessions on mandibular anterior teeth. In particular, procedures based on a laterally positioned flap or a tunneling technique, both in combination with connective tissue graft, seem to be the most predictable therapeutic decision.
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Affiliation(s)
- M Agusto
- Department of Periodontics, School of Dentistry, West Virginia University, Morgantown, WV, USA
| | - A Salman
- Department of Periodontics, School of Dentistry, West Virginia University, Morgantown, WV, USA
| | - D Parker
- Division of Population Health Sciences, University of Alaska Anchorage, Anchorage, AK, USA
| | - D Choi
- Department of Periodontics, School of Dentistry, West Virginia University, Morgantown, WV, USA
| | - G P Schincaglia
- Department of Periodontics, School of Dentistry, West Virginia University, Morgantown, WV, USA.,School of Dentistry, University of Ferrara, Ferrara, Italy
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Tietmann C, Bröseler F, Axelrad T, Jepsen K, Jepsen S. Regenerative periodontal surgery and orthodontic tooth movement in stage IV periodontitis: A retrospective practice-based cohort study. J Clin Periodontol 2021; 48:668-678. [PMID: 33555608 DOI: 10.1111/jcpe.13442] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/23/2020] [Accepted: 01/27/2021] [Indexed: 12/17/2022]
Abstract
AIM Evaluation of the effectiveness of regenerative treatment of intra-bony defects in combination with consecutive orthodontic tooth movements in stage IV periodontitis. MATERIAL AND METHODS A total of 526 intra-bony defects in 48 patients were analysed after regenerative therapy using collagen-deproteinized bovine bone mineral with or without collagen membrane or enamel matrix derivative followed by orthodontic tooth movement initiated 3 months after surgery. Changes in radiographic bone levels (BL) and probing pocket depths (PPD) were evaluated after 1 year and up to 4 years. RESULTS Tooth loss amounted to 0.57%. Mean BL gain was 4.67 mm (±2.5 mm) after 1 year and 4.85 mm (±2.55 mm) after up to 4 years. Mean PPD was significantly reduced from 6.00 mm (±2.09 mm) at baseline to 3.45 mm (±1.2 mm) after 1 year, and to 3.12 mm (±1.36 mm) after 2-4 years. Pocket closure (PPD ≤4 mm) was accomplished in 87% of all defects. Adjunctive antibiotic therapy did not show any statistically significant impact on treatment outcomes. CONCLUSIONS Within the limits of this retrospective study design, the findings suggest that the combination of regenerative treatment and consecutive orthodontic tooth movements resulted in favourable results up to 4 years.
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Affiliation(s)
| | | | | | - Karin Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
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Kamran MA, Qasim M, Udeabor SE, Hameed MS, Mannakandath ML, Alshahrani I. Impact of riboflavin mediated photodynamic disinfection around fixed orthodontic system infected with oral bacteria. Photodiagnosis Photodyn Ther 2021; 34:102232. [PMID: 33631380 DOI: 10.1016/j.pdpdt.2021.102232] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 02/15/2021] [Accepted: 02/19/2021] [Indexed: 12/20/2022]
Abstract
PURPOSE The aim of this laboratory study was to investigate the amount of bacterial destruction through riboflavin mediated photodynamic therapy (PDT) around fixed orthodontic devices by using the two strains of bacteria Streptococcus mutans and Streptococcus sanguinis. MATERIALS AND METHODS A total of 80 metallic brackets were divided into four groups consisting of 20 brackets each. Group-I: riboflavin + LED irradiation; Group-II: riboflavin alone; Group-III: immersion in 0.2 % chlorhexidine gluconate solution and Group-IV: not submitted to any treatment. All metallic brackets were immersed in the standard bacterial solutions and incubated at 48 h. All samples were subjected to MTT assay for microbial cell viability testing after treatment. After 24 h of incubation, biofilms adhered on the mesh of metallic brackets after treatment were assessed by confocal laser microscopy. The total CFU/mL was estimated, and the results were log-transformed (log10) and analyzed using one-way analysis of variance and Tukey-Kramer test. P-value was set to <0.05 that indicated statistical significance. RESULTS The samples from group-IV showed the highest amount of relative biofilm viability compared to any other group while group-I (PDT) showed the least viability of the two bacterial strains studied (p < 0.05). Group-I showed no significant difference when compared with group-III (chlorhexidine) (p > 0.05). The biofilms on the samples from group-II and group-IV were largely viable indicating thick green staining across the mesh of the brackets. Among the group-III samples, there were predominantly dead cells as compared to the live cell staining. A considerable amount of red staining was observed with noticeable less green staining in group-I samples. CONCLUSION This laboratory investigation revealed that riboflavin mediated PDT significantly reduced the amounts of S. mutans and S. sanguinis around the orthodontic brackets.
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Affiliation(s)
- Muhammad Abdullah Kamran
- Department of Pediatric and Orthodontic Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia.
| | - Muhammad Qasim
- Department of Restorative Dental Sciences (Operative Dentistry), College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Samuel Ebele Udeabor
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Mohammad Shahul Hameed
- Department of Diagnostic Sciences and Oral Biology, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Master Luqman Mannakandath
- Department of Oral Diagnosis and Oral Biology, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Ibrahim Alshahrani
- Department of Pediatric and Orthodontic Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
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Ashfaq M, Sadiq A, Sukhia RH, Fida M. Association of hard and soft tissue factors with gingival recession in orthodontically treated patients: A retrospective study. Int Orthod 2020; 19:60-66. [PMID: 33388278 DOI: 10.1016/j.ortho.2020.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/10/2020] [Accepted: 12/11/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Orthodontic treatment is thought as a contributory factor in the development of recession. The objective of this study was to determine the factors associated with a gingival recession in patients who underwent orthodontic mechano-therapy. MATERIAL AND METHODS A retrospective chart review of 72 post-orthodontic cases done at the dental clinics of Aga Khan University hospital that were treated from 2009 to 2017. After evaluating dental records patients were recruited based on inclusion and exclusion criteria. Patients were divided into two groups based on the presence or absence of gingival recession on posttreatment photographs. Patients in each group were further assessed on the following factors: (1) Lower incisor inclination (IMPA). (2) Tissue thickness on the facio-lingual dimension. (3) Alveolar bone height. (4) Alveolar bone thickness. RESULTS The mean age of patients at the start of treatment was 16.56±5.66years. Gingival recession was found in 40.3% of our patients while 59.7% of patients had no recession found after orthodontic treatment. Univariable logistic regression was applied for factors associated with a gingival recession following orthodontic treatment which showed that the odds ratio of gingival recession in thin gingival biotype are 14.4 times more than in thick gingival biotype. Multivariable regression analysis showed that the cases had 10.2 times more recession in thin biotype than those in the thick gingival biotype while adjusting for pre- and posttreatment alveolar heights following orthodontic treatment and with a confidence interval [95% CI=2.69 to 38.40]. CONCLUSIONS It was concluded from this study that 40% of patients developed gingival recession in one or more teeth during orthodontic treatment. Among different factors pre-treatment, gingival biotype of patients and male gender were the factors that were more associated with the development of gingival recession.
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Affiliation(s)
- Muhammad Ashfaq
- Aga Khan University & Hospital, Department of Surgery, Karachi, Pakistan
| | - Ali Sadiq
- Aga Khan University & Hospital, Department of Surgery, Karachi, Pakistan.
| | - Rashna H Sukhia
- Aga Khan University & Hospital, Department of Surgery, Karachi, Pakistan
| | - Mubassar Fida
- Aga Khan University & Hospital, Department of Surgery, Karachi, Pakistan
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Bernhardt O, Krey KF, Daboul A, Völzke H, Splieth C, Kocher T, Schwahn C. Association between coronal caries and malocclusion in an adult population. J Orofac Orthop 2020; 82:295-312. [PMID: 33337523 PMCID: PMC8384790 DOI: 10.1007/s00056-020-00271-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 10/22/2020] [Indexed: 01/18/2023]
Abstract
Purpose Only a few but conflicting results have been reported on the association between malocclusions and caries. We investigated this association using data from the population-based cross-sectional Study of Health in Pomerania (SHIP). Methods Sagittal, vertical and transversal intermaxillary relationship, space conditions and sociodemographic parameters of 1210 dentate subjects (median age 30 years, interquartile range 25–35 years) were collected. Caries was assessed with the Decayed-Missing-Filled Surfaces index but analyzed as ordered outcome (four levels: sound, enamel caries, caries, tooth loss) in ordinal multilevel models, taking into account subject, jaw, and tooth level simultaneously. Results Anterior open bite ≤3 mm (odds ratio [OR] = 2.08, 95% confidence interval [CI]: 1.19–3.61), increased sagittal overjet of 4–6 mm (OR = 1.31, CI: 1.05–1.64), distal occlusion of ½ premolar width (OR = 1.27, CI: 1.05–1.53) and distal 1 premolar width (OR = 1.31, CI: 1.06–1.63) were associated with adjusted increased odds for a higher outcome level (caries). Anterior spacing (OR = 0.24, CI: 0.17–0.33), posterior spacing, (OR = 0.69, CI: 0.5–0.95), posterior crowding (OR = 0.57, CI: 0.49–0.66) and buccal nonocclusion (OR = 0.54, CI: 0.33–0.87) were associated with a lower outcome level (caries). Conclusion The results from this population-based study suggest that a connection between caries and malocclusion exists to a limited extent in young adults. The associations with caries are contradictory for several malocclusion variables. Distal occlusion (OR = 1.31, CI: 1.06–1.63) and related skeletal anomalies displayed positive associations with caries whereas crowding did not. Orthodontic treatment of anterior crowding would probably not interfere with caries experience. These aspects should be considered for patient information and in treatment decisions.
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Affiliation(s)
- Olaf Bernhardt
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pediatric Dentistry, University Medicine Greifswald, Walther-Rathenau-Str. 42a, 17475, Greifswald, Germany.
| | - Karl-Friedrich Krey
- Department of Orthodontics, University Medicine Greifswald, Walther-Rathenau-Str. 42a, 17475, Greifswald, Germany
| | - Amro Daboul
- Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University Medicine Greifswald, Walther-Rathenau-Str. 42a, 17475, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Walther-Rathenau-Str. 48, 17475, Greifswald, Germany
| | - Christian Splieth
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pediatric Dentistry, University Medicine Greifswald, Walther-Rathenau-Str. 42a, 17475, Greifswald, Germany
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pediatric Dentistry, University Medicine Greifswald, Walther-Rathenau-Str. 42a, 17475, Greifswald, Germany
| | - Christian Schwahn
- Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University Medicine Greifswald, Walther-Rathenau-Str. 42a, 17475, Greifswald, Germany
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Effects of maxillary incisor inclination on dentoalveolar changes in class II division 1 and 2 non-extraction treatment for Caucasian children - A retrospective study using CBCT. Int Orthod 2020; 19:51-59. [PMID: 33309514 DOI: 10.1016/j.ortho.2020.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/31/2020] [Accepted: 11/12/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The objective of this study was to investigate the effects of maxillary central incisor (U1) inclination changes on alveolar bone and root length in the 20 Class II division 1 and 20 Class II division 2 (CII div1, CII div2) Caucasian adolescents treated without extraction. MATERIAL AND METHODS Forty U1s from each group were assessed for root length and alveolar variables at the crestal, mid-root, and apical levels using sagittal sections obtained from CBCT images pre- and post-treatment. Mixed MANOVAs, Repeated measures MANOVAs, Pearson correlations, and regression analyses were performed. RESULTS The facial bone height did not change significantly after an average of 15 degrees of proclination in the CII div2 group, whereas a statistically significant decrease in the palatal bone height was noted. However, in the CII div1 group, a statistically significant reduction in the facial and palatal bone height was observed with mild crown retroclination. Both groups had a significant decrease in total bone thickness at all levels, more decrease in the CII div2 group after treatment. No statistically significant difference in root length was observed between the groups during treatment. CONCLUSIONS The findings support that the flaring of retroclined U1s as a process for normalizing U1 inclination did not harm the facial alveolar bone height in the CII div2 non-extraction treatment. Crown proclination itself was not correlated to the amount of root resorption in Class II div1&2 non-extraction treatments in adolescents.
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Abstract
BACKGROUND Although several researchers have analyzed the dental identity of patients experience with corrective methods using fixed and removable appliances, the consequences stay debatable. This meta-analysis intended to verify whether the periodontal status of removable appliances is similar to that of the conventional fixed appliances. METHODS Relevant literature was retrieved from the database of Cochrane library, PubMed, EMBASE, and CNKI until December 2019, without time or language restrictions. Comparative clinical studies assessing periodontal conditions between removable appliances and fixed appliances were included for analysis. The data was analyzed using the Stata 12.0 software. RESULTS A total of 13 articles involving 598 subjects were selected for this meta-analysis. We found that the plaque index (PLI) identity of the removable appliances group was significantly lower compared to the fixed appliances group at 3 months (OR = -0.57, 95% CI: -0.98 to -0.16, P = .006) and 6 months (OR = -1.10, 95% CI: -1.60 to -0.61, P = .000). The gingival index (GI) of the removable appliances group was lower at 6 months (OR = -1.14, 95% CI: -1.95 to -0.34, P = .005), but the difference was not statistically significant at 3 months (OR = -0.20, 95% CI: -0.50 to 0.10, P = .185) when compared with that of the fixed appliances group. The sulcus probing depth (SPD) of the removable appliances group was lower compared to the fixed appliances group at 3 months (OR = -0.26, 95% CI: -0.52 to -0.01, P = .047) and 6 months (OR = -0.42, 95% CI: -0.83 to -0.01, P = .045). The shape of the funnel plot was symmetrical, indicating no obvious publication bias in the Begg test (P = .174); the Egger test also indicated no obvious publication bias (P = .1). CONCLUSION Our meta-analysis demonstrated that malocclusion patients treated with the removable appliances demonstrated a better periodontal status as compared with those treated with fixed orthodontic appliances. However, the analyses of more numbers of clinical trials are warranted to confirm this conclusion.
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Calniceanu H, Stratul SI, Rusu D, Jianu A, Boariu M, Nica L, Ogodescu A, Sima L, Bolintineanu S, Anghel A, Milicescu S, Didilescu A, Roman A, Surlin P, Solomon S, Tudor M, Rauten AM. Changes in clinical and microbiological parameters of the periodontium during initial stages of orthodontic movement in patients with treated severe periodontitis: A longitudinal site-level analysis. Exp Ther Med 2020; 20:199. [PMID: 33123229 PMCID: PMC7588781 DOI: 10.3892/etm.2020.9329] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 08/14/2020] [Indexed: 12/02/2022] Open
Abstract
Applying orthodontic braces makes oral hygiene difficult and increases plaque accumulation, frequently resulting in gingival inflammation. In patients with previous severe periodontitis, this inflammation overlaps with the pre-existing inflammatory challenge and can lead to further progression of periodontal attachment loss. The aim of this study was to assess longitudinal site-level changes as mirrored by clinical and microbiological parameters during the initial remodeling of alveolar bone and the periodontal ligament, produced as an effect of light orthodontic forces in adult patients with severe periodontal disease that underwent standard (non-surgical and conventional surgical) periodontal therapy. Thirteen patients with previously treated severe generalized periodontitis were given fixed orthodontic appliances for re-alignment of teeth misaligned or displaced during the course of periodontitis. Before insertion of orthodontic appliances and at 2, 4, and 6 months of treatment, periodontal clinical parameters were recorded in the same deepest residual pocket of at least 3 mm in each patient. The same pocket was sampled at baseline and after 6 months of orthodontic treatment for the frequency of positive detection of Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Tanerella forsythia (Tf), Treponema denticola (Td). An average reduction in Pocket Depth by 0.2 mm at the end of the assessment period was identified. The only clinical parameter with statistically significant improvement was bleeding on probing. The frequency of detection of Aa, Pg, Pi, and Tf was not significantly different between baseline and 6 months of treatment, while a marginally significant increase of Td was found. There were no significant differences in the clinical parameters or microflora in the initial phase of orthodontic treatment in patients with reduced periodontal support. By correlating clinical and microbiological data, we concluded that the presence of periopathogens do not negatively influence periodontal health during orthodontic treatment in adult patients treated for severe periodontitis.
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Affiliation(s)
- Horia Calniceanu
- Department of Periodontology, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Stefan-Ioan Stratul
- Department of Periodontology, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Darian Rusu
- Department of Periodontology, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Alexandru Jianu
- Department of Periodontology, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Marius Boariu
- Department of Endodontics, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Luminita Nica
- Department of Endodontics, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Alexandru Ogodescu
- Department of Paedodontics, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Laurentiu Sima
- Department of Surgery-1, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Sorin Bolintineanu
- Department of Anatomy, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Andrei Anghel
- Department of Biochemistry, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Stefan Milicescu
- Department of Prosthodontics, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Andreea Didilescu
- Department of Embryology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Alexandra Roman
- Department of Periodontology, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania
| | - Petra Surlin
- Department of Periodontology, University of Craiova, 200585 Craiova, Romania
| | - Sorina Solomon
- Department of Periodontology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | | | - Anne Marie Rauten
- Department of Orthodontics, University of Craiova, 200585 Craiova, Romania
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Lombardo L, Palone M, Scapoli L, Siciliani G, Carinci F. Short-term variation in the subgingival microbiota in two groups of patients treated with clear aligners and vestibular fixed appliances: A longitudinal study. Orthod Craniofac Res 2020; 24:251-260. [PMID: 32965768 DOI: 10.1111/ocr.12427] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/26/2020] [Accepted: 08/29/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate the subgingival microbiological changes during the first six months of therapy with clear aligners (CAs) and fixed appliances (FAs). The null hypothesis was that there would be no microbiological differences between the two. SETTING/SAMPLE Two groups of patients to be treated, respectively, with CAs (14 patients; 9 females and 5 males; mean age 21 years ± 0.25) and FAs (13 patients; 8 females and 5 males; mean 14 years ± 0.75) were consecutively recruited. MATERIALS AND METHODS Subgingival microbiological samples were obtained at the right upper central incisor and right first molar at four different time points: before appliance fitting (T0), and at 1 month (T1), 3 months (T3) and 6 months (T6) thereafter. Total bacterial load (TBL) and counts of the bacteria Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Fusobacterium nucleatum, Campylobacter rectus, Treponema denticola and Tannerella forsythia were determined using real-time PCR. RESULTS Total bacterial load did not vary in the CA group, while a significant increase was detected after 3 and 6 months of treatment in the FA group. Unlike red complex species, C rectus and F nucleatum were often detected: levels remained stable in the CA group but increased progressively in the FA group. CONCLUSION The type of orthodontic appliance influences the subgingival microbiota. TBL increased in the FA group but not in the CA group, although the levels of the individual periodontal pathogenic bacteria species did not significantly increase during the observation period.
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Affiliation(s)
- Luca Lombardo
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - Mario Palone
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - Luca Scapoli
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Giuseppe Siciliani
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - Francesco Carinci
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
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Abela S, Bister D. Minimum intervention in orthodontics. Br Dent J 2020; 229:467-471. [DOI: 10.1038/s41415-020-2152-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 08/11/2020] [Indexed: 11/09/2022]
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Do malocclusion and orthodontic treatment impact oral health? A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop 2020; 157:738-744.e10. [PMID: 32487303 DOI: 10.1016/j.ajodo.2020.01.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 01/01/2020] [Accepted: 01/01/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Currently, there is limited evidence on the effects of malocclusion on oral health and whether the correction of malocclusion results in an improvement in oral health. In this review, we examined the evidence from randomized controlled trials and prospective cohort studies to provide information on any association between malocclusion and oral health and the effects of orthodontic treatment. METHODS We conducted this review in 2 parts: (1) we looked at the impact of malocclusion on oral health, and (2) we reviewed the evidence on the effect of orthodontic treatment on oral health. We searched for randomized controlled trials and prospective cohort studies. The searches were completed for articles published between January 1, 1990 and October 8, 2018 and covered Medline via Ovid, Embase, and the Cochrane Database of Systematic Reviews. References of included articles and previous systematic reviews were hand-searched. No language restrictions were applied. Two members of the study team assessed the quality of the studies using the Appraisal Tool for Cross-Sectional Studies to appraise the quality of studies in part 1. The assessment was performed at the study level. Two authors assessed each study independently, with a third author consulted when a disagreement occurred. For studies in part 2, we used the Newcastle-Ottawa scale to assess the risk of bias. When studies were included in a Cochrane review, we incorporated the risk of bias assessment. We developed data extraction forms for each area of oral health under investigation (trauma, quality of life, caries, and periodontal disease). Each author piloted the form, and we held discussions to inform any necessary refinements. We extracted data from studies into 2 × 2 tables, which provided a binary analysis of malocclusion vs the outcome of interest. If these data were not available from the published paper, then studies were not included in the meta-analysis. The authors were contacted when possible to request data in this format. RESULTS For part 1 of the study, we identified 87 studies. The overall quality was low. We could not include any of the data into an analysis because of a large variation in the nature of the studies, data collected, and outcome measures that were selected. For part 2 of the study, we found 7 studies; however, there were similar deficiencies in the data as in part 1, and thus, we could not reach any strong conclusions. CONCLUSIONS Overall, there is an absence of published evidence regarding the effects of malocclusion on oral health and the impact of orthodontic treatment on oral health.
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Kirschneck C, Wolf F, Cieplik F, Blanck-Lubarsch M, Proff P, Schröder A. Impact of NSAID etoricoxib on side effects of orthodontic tooth movement. Ann Anat 2020; 232:151585. [PMID: 32818660 DOI: 10.1016/j.aanat.2020.151585] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/03/2020] [Accepted: 07/22/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVES The non-steroidal anti-inflammatory drug etoricoxib is the most highly selective inhibitor of cyclooxygenase-2 available (344:1) and has been approved for postoperative pain therapy following dental interventions in Europe. At clinically relevant doses it has been reported to only have marginal effects on the velocity of orthodontic tooth movement (OTM). Its effects on associated dental root resorptions, osteoclastogenesis, trabecular number in the alveolar bone and periodontal bone loss during OTM, however, have not yet been investigated. MATERIAL AND METHODS 40 male Fischer344 rats were divided into four groups: 1.5ml tap water/day p.o. (control, 1), additional 7.8mg/kg/day etoricoxib (normal dose) for three (2) or seven (3) days/week and 13.1mg/kg/day (high dose) for seven days/week, respectively (4). After a week of premedication, OTM in anterior direction of the first left upper molar was performed for 28 days by means of a nickel-titanium coil spring (0.25N). We quantified OTM-associated dental root resorptions, osteoclastogenesis, trabecular number and periodontal bone loss by histomorphometrical, histochemical and μCT analyses of the disected tooth-bearing upper jaw sections. RESULTS After 28 days of OTM, associated reduction of trabecular number seemed to be slightly alleviated by high doses of etoricoxib, whereas no significant other etoricoxib effects in the doses administered could be detected regarding OTM-induced or -associated dental root resorptions, osteoclastogenesis or periodontal bone loss. CONCLUSIONS Dental root resorptions, osteoclastogenesis and periodontal bone loss during OTM in rats were not significantly affected by etoricoxib in the clinically relevant dosages investigated with only a slight inhibitory effect on bone remodelling to be expected at high dosages. Etoricoxib is therefore not suitable for the prevention of these detrimental effects, but could be a suitable analgesic during OTM, as it has been reported not to affect tooth movement.
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Affiliation(s)
| | - Franziska Wolf
- Department of Orthodontics, University Hospital Regensburg, Germany
| | - Fabian Cieplik
- Department of Operative Dentistry and Periodontology, University Hospital Regensburg, Germany
| | | | - Peter Proff
- Department of Orthodontics, University Hospital Regensburg, Germany
| | - Agnes Schröder
- Department of Orthodontics, University Hospital Regensburg, Germany
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Comparative assessment of mouse models for experimental orthodontic tooth movement. Sci Rep 2020; 10:12154. [PMID: 32699355 PMCID: PMC7376195 DOI: 10.1038/s41598-020-69030-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 06/15/2020] [Indexed: 12/11/2022] Open
Abstract
Animal experiments are essential for the elucidation of biological-cellular mechanisms in the context of orthodontic tooth movement (OTM). So far, however, no studies comparatively assess available mouse models regarding their suitability. OTM of first upper molars was induced in C57BL/6 mice either via an elastic band or a NiTi coil spring for three, seven or 12 days. We assessed appliance survival rate, OTM and periodontal bone loss (µCT), root resorptions, osteoclastogenesis (TRAP+ area) and local expression of OTM-related genes (RT-qPCR). Seven days after the elastic bands were inserted, 87% were still in situ, but only 27% after 12 days. Survival rate for the NiTi coil springs was 100% throughout, but 8.9% of the animals did not survive. Both methods induced significant OTM, which was highest after 12 (NiTi spring) and 7 days (band), with a corresponding increase in local gene expression of OTM-related genes and osteoclastogenesis. Periodontal bone loss and root resorptions were not induced at a relevant extent by neither of the two procedures within the experimental periods. To induce reliable OTM in mice beyond 7 days, a NiTi coil spring is the method of choice. The elastic band method is recommended only for short-term yes/no-questions regarding OTM.
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