The impact of personality on adult patients' adjustability to orthodontic appliances

Influence of elastomeric and steel ligatures on periodontal health during fixed appliance orthodontic treatment: a systematic review and meta-analysis

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).

Oral Health-Related Quality of Life throughout Treatment with Clear Aligners in Comparison to Conventional Metal Fixed Orthodontic Appliances: A Systematic Review

BACKGROUND

Orthodontic clear aligners constitute an alternative and increasingly used orthodontic treatment modality, offering enhanced esthetics with potential consequences regarding patients' oral health-related quality of life (OHRQoL).

OBJECTIVE

Summarize and systematically evaluate existing evidence on the OHRQoL of patients treated with orthodontic clear aligners compared to treatment with conventional metal, fixed appliances.

SEARCH METHODS

We searched without limitations six databases and searched manually the reference lists of relevant studies up to the end of October 2022.

SELECTION CRITERIA

We looked for data from prospective studies that compared OHRQoL, using instruments that had undergone full psychometric validation, between orthodontic patients with clear aligners and labial, fixed, metal orthodontic appliances.

DATA COLLECTION AND ANALYSIS

We extracted the data from the located studies, and we assessed the risk of bias with the Cochrane Collaboration suggested tools. The quality of available evidence was based on the GRADE approach.

RESULTS

Three studies were identified. OHRQoL was impacted less by clear aligners compared to treatment with conventional labially placed, fixed, metal appliances. The exploratory meta-regression, with the time point of assessment as predictor, did not reveal any statistically significant effect. The quality of the available evidence ranged from very low to low.

CONCLUSIONS

According to the exploratory synthesis of the limited available dataset, treatment with clear aligners could be associated with better OHRQoL ratings compared to treatment with conventional labially placed, metal, fixed appliances. However, the quality of the presented evidence renders further high-quality studies warranted to be able to reach safer conclusions.

The effect of clear aligners on speech: a systematic review

OBJECTIVE

To assess the effect of clear aligners on the speech of patients undergoing orthodontic therapy through a systematic review of the literature. Search methods and selection criteria: The protocol of this systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) CRD42021278694. An electronic search of the Scopus, Embase, Pubmed, and Web of Science databases was done for papers published between January 2000 till September 2021. Studies that evaluated speech difficulties in patients undergoing orthodontic treatment with clear aligners using objective and subjective analyses were included. The evaluated primary outcome was speech difficulties. Secondary outcomes were time to adaptation and recovery from speech difficulties. Study quality was assessed based on the Cochrane Handbook for Systematic Reviews of Interventions Handbook guidelines and ROBINS-I tool.

RESULTS

Two hundred and eighty-three articles were screened to identify seven studies (n = 332 patients) that assessed speech difficulty with aligners, of which two were randomized trials. Meta-analysis was not performed due to the heterogeneity in the study designs. Five studies compared speech difficulty with aligners to fixed appliances. Two studies showed a moderate risk of bias and five studies had a serious risk of bias. Level of evidence was downgraded to low due to the methodological insufficiencies and risk of bias in the studies. All seven studies reported that aligners could influence the clarity and delivery of speech, similar to fixed appliances. Various phonemes were affected including /s/,/z/,/zh/,/sh/,/th/,/ch/ on wearing aligners. Errors in articulation of consonants and sibilants were noted with lisping and speech impairment. These speech difficulties were temporary and most patients recovered in 7-14 days while few patients took 30-60 days to recover.

CONCLUSION

The likelihood of speech difficulties appears high with clear aligners. However, patients adapt quickly and speech returns to normal. The results of this review must be interpreted with caution and more well-designed randomized trials examining long-term effects of aligners on speech are indicated.

CLINICAL SIGNIFICANCE

Orthodontists should counsel patients opting for clear aligner treatment of the potential transient speech difficulties.

REGISTRATION

The protocol for this systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) CRD42021278694.

Changing clear aligners every 10 days or 14 days ? A randomised controlled trial

Objectives:

To compare 10-day and 14-day change regimens to achieve orthodontic tooth movement (OTM) in patients wearing clear aligners and to determine their subsequent pain perception.

Material and methods:

A total of 175 clear aligner patients were assessed for eligibility. Seventy-two patients were randomly assigned to a 10-day group (N = 36) and a 14-day group (N = 36) and were instructed to change the appliances every 10 or 14 days, respectively. OTM efficacy and OTM variation between the actual and predicted OTM digital models measured by shell-to-shell deviation, as well as pain perception determined by a visual analog scale (VAS), were assessed at T0 (baseline, before the placement of the aligners), T1 (stage 8, after completion of aligners #8), and T2 (stage 16, after completion of aligners #16).

Results:

The 10-day and 14-day groups showed similar OTM efficacy at both T1 and T2 for all types of tooth movements (p > 0.09 for all) and similar OTM shell-to-shell deviation at T1 (p = 0.06) and T2 (p = 0.22). The two groups also had similar VAS scores of pain perception throughout the study (p > 0.05 for all).

Conclusion:

The 10-day and 14-day groups showed similar tooth movement and pain perception, suggesting that the clear aligners may be changed every 10 days without a significant compromise in the clinical efficacy of OTM and patient comfort.

Trial registration:

ChiCTR, ChiCTR-IOR-15007532. Registered 17 November 2015, https://www.chictr.org.cn/showproj.aspx?proj=12500

Comparison of the psychosocial impact on patients affected by cranio facial anomalies between traditional orthodontic brackets and aligners

OBJECTIVES

Malocclusion affects the psychological wellness and social interaction, impacting negatively on adolescents' quality of life and self-esteem. Facial attractiveness is mostly based on the esthetics of the smile and patients seek orthodontic treatment mainly to improve aesthetics. The aim of this prospective clinical study is to compare the psychosocial impact of aligners (AL) and fixed appliances (FA) as orthodontic treatments in patients affected by craniofacial anomalies (CFA).

METHODS

100 syndromic Caucasian patients with CFA followed in two different hospitals were divided in two groups: 50 patients treated with AL and 50 patients treated with FA. The two groups were matched for gender, age and CFA and filled out a modified psychosocial impact of dental aesthetics questionnaire (mPIDAQ).

RESULTS

Patients affected by CFA treated with AL reported a better psychosocial impact than patients treated with FA, showing higher esthetic self-perception and self-esteem, lower social interaction impairments, and lower physical/practical disturbances.

CONCLUSIONS

The results of this study suggest that AL could be a valid alternative, especially in complex patients with CFA. Since AL application requires more cooperative patients the orthodontist should dedicate more time to motivate the patient to adhere to the treatment schedule.

The effect of time on mechanical properties of biocompatible photopolymer resins used for fabrication of clear dental aligners

Clear dental aligners are used for treating orthodontic anomalies (misaligned teeth, inappropriate contact between upper and lower teeth etc.), minor irregularities and bruxism. Using additive manufacturing technologies clear dental aligners are made of biocompatible photopolymer, using a vat photopolymerization technology. One of problems in application is the change of aligner material properties after production, including strength and elongation at failure. This can cause different sequence of tooth displacement which will not correspond to the planned therapy. In this paper three types of material testing are conducted i.e., tensile, compressive and three-point bending testing on specimens of 1 (24 h), 3 (72 h), 5 (120 h) and 7 (168 h) days old. Mechanical properties, such as tensile, compressive and flexural strength and strain at failure are monitored in order to show the effect of time on biocompatible photopolymer resin.

The effect of vestibular, lingual, and aligner appliances on the quality of life of adult patients during the initial stages of orthodontic treatment

Background

Patient quality of life (QoL) during orthodontic treatment is an important consideration that requires greater academic investigation as greater focus is placed on enhancing patient experience. Quality of life (QoL) was assessed in three orthodontic appliance groups, i.e., vestibular, lingual, and aligners during the initial stages of treatment. The sample was comprised of 117 adult patient-subjects distributed into 3 groups: vestibular (n = 41), lingual (n = 37), and aligner (n = 39). A WHOQOL-BREF questionnaire surveyed four domains (physical health, psychological health, social relationships, and environment).

Results

Mean scores for domain 1, physical health, showed that the aligner group (28.1) had significantly greater scores than that of the vestibular (22.7) or lingual (22) groups. Domain 2, psychological health, demonstrated significant differences (P < 0.001) between all groups, with the aligner group scoring the highest (23.2), followed by the lingual (18.4) and vestibular (15.2) groups. Domain 3, social relationship, showed that aligner (10.9) and lingual (10.2) scores were significantly greater (P < 0.001) than those of the vestibular group (7.8). Domain 4, environment, displayed significant differences between all groups, with the aligner group scoring highest (32.1), followed by the lingual group (29.3), and lastly the vestibular group (26.4). Overall, the highest mean score was obtained by the aligner group (23.1) and the lowest mean score was by the vestibular group (18). The mean domain scores for all three groups were significantly different (P ≤ 0.005) from each other (Table 2).

Conclusions

Overall, patients undergoing Aligner therapy reported the overall highest QoL scores, followed by lingual and vestibular groups.

The impact of general self-efficacy and the severity of malocclusion on acceptance of removable orthodontic appliances in 10- to 12-year-old patients

Background

The patients’ acceptance of a treatment plan and their subsequent cooperation play a crucial role in achieving the best results in orthodontic treatments. Evidences show some personality traits such as general self-efficacy (GSE) and some dental traits such as severity of malocclusion are correlated with motivation of orthodontic treatment. These factors may predict the patients’ compliance and acceptance in using removable orthodontic appliances. This cross sectional study was conducted to assess the correlation of GSE and the severity of malocclusion with patients’ acceptance in using removable orthodontic appliances.

Methods

This study recruited 50 patients aged 10–12 years who required removable orthodontic appliances. The severity of malocclusion was determined using the index of orthodontic treatment need (IOTN) before the onset of treatment and GSE of participants were assessed using GSE scale self-report. The acceptance questionnaire was proposed to the patients on first (T1), third (T2), and sixth (T3) month after the delivery of the appliance.

Results

The GSE score had a statistically significant correlation with the total score of the acceptance questionnaire, subscale score of satisfaction with the appliance during eating and oral hygiene practice, duration of usage of the appliance, and interest in using it (P < 0.05). The IOTN had no significant correlation with the acceptance questionnaire.

Conclusions

Our findings substantiate the role of the GSES, concurrently declining the role of the IOTN in prediction of 10–12-year-old children’s acceptance and cooperation in treatment of malocclusion with removable appliances.

Colorimetric and spectrophotometric measurements of orthodontic thermoplastic aligners exposed to various staining sources and cleaning methods

Background

Manufacturers of orthodontic aligners suggest that users remove appliances every time they consume solid foods or any drink (except water). This is to avoid a color change within the clear thermoplastic material of which they are made. However, limited quantitative evidence exists to guide users and practitioners in this regard. Herein, we evaluated the color stability of the polymer forming three different American brands of aligners and the stain-removal potential of two cleansers to provide such guidelines.

Methods

The removable appliances (300 specimens, 100 per brand) were exposed to different staining agents common in a regular diet (coffee, black tea, red wine, cola) or to a control solution in vitro over 12 h or 7 days. The three brands evaluated were Invisalign®, ClearCorrect® and Minor Tooth Movement®. These were then cleaned by using either Invisalign® cleaning crystals or the Cordless Sonic Cleaner combined with a Retainer Brite® tablet. The CIELAB color space approach was used to compare color changes (ΔE) in aligners before immersion (T0), after a 12-h exposure (T1), after a 7-day exposure (T2) and after cleaning (T3). Statistical methods (Levene’s test, ANOVA, Brunner-Langer model, Tukey’s range test and t-test) were used to identify interactions between the brands themselves or between the brands and the cleaning methods. Statistical analyses were performed at the .05 significance level.

Results

A 12-h or 7-day exposure to instant coffee or red wine significantly colored the Invisalign® aligners compared to the two other brands. Black tea created an important extrinsic color change for all three brands after 7 days. Clinically, both cleaning methods showed a better efficacy in removing stains from black tea compared to other staining agents.

Conclusions

The Invisalign® aligners were more prone to pigmentation than the ClearCorrect® or the Minor Tooth Movement® devices after an exposure to coffee or red wine. Black tea caused important stains on the surface of the three tested brands. Both cleansing methods performed similarly.

Clear aligner treatment: different perspectives between orthodontists and general dentists

Purpose

To evaluate differences between orthodontists and general dentists in experience with clear aligners (CA), patients’ demand and perception, types of patients, and malocclusion treated with CA and to compare the two groups of clinicians not using CA in their practice.

Methods

A Web-based survey was developed and sent to the 129 members of the European Aligner Society and randomly to 200 doctors of dental surgery by e-mail. They responded on demographics and to one of two different parts for clinicians using CA or not using CA. Statistical analysis was performed with SAS EGv.6.1.

Results

The response rate was 74%. Among the total of respondents, the majority reported utilizing CA in their practice with a greater percentage of orthodontists (P = 0.0040). Overall, orthodontists learned more about CA during academic seminars comparing to general dentists, and they treated more class I with crowding (P = 0.0002) and with open bite (P = 0.0462). The majority of patients treated with CA were female and adults with a full-time employment, and the patients’ knowledge about CA treatment was mainly provided by information from external media advertising. For respondents not using CA, orthodontists were more likely to report that CA limit treatment outcomes, whereas general practitioners were reported not having enough experience to use them.

Conclusions

There were some significant differences between orthodontists and general dentists mainly in experience and case selection for clinicians using CA as well as in the reasons provided for not using CA in their practice.

Electronic supplementary material

The online version of this article (10.1186/s40510-019-0263-3) contains supplementary material, which is available to authorized users.

Adverse effects of lingual and buccal orthodontic techniques: A systematic review and meta-analysis

INTRODUCTION

The aim of this systematic review was to assess the prevalence of adverse effects associated with lingual and buccal fixed orthodontic techniques.

METHODS

Two authors searched the PubMed, EMBASE, Cochrane Library, and LILACS databases up to October 2014. Agreement between the authors was quantified by the Cohen kappa statistic. The following variables were analyzed: pain, caries, eating and speech difficulties, and oral hygiene. The Newcastle-Ottawa scale was used to assess risk of bias in nonrandomized studies, and the Cochrane Collaboration's tool for assessing risk of bias was used for randomized controlled trials.

RESULTS

Eight articles were included in this systematic review. Meta-analysis showed a statistically greater risk of pain of the tongue (odds ratio [OR], 28.32; 95% confidence interval [95% CI], 8.60-93.28; P <0.001), cheeks (OR, 0.087; 95% CI, 0.036-0.213; P <0.0010), and lips (OR, 0.13; 95% CI, 0.04-0.39; P <0.001), as well as for the variables of speech difficulties (OR, 9.39; 95% CI, 3.78-23.33; P <0.001) and oral hygiene (OR, 3.49; 95% CI, 1.02-11.95; P = 0.047) with lingual orthodontics. However, no statistical difference was found with respect to eating difficulties (OR, 3.74; 95% CI, 0.86-16.28; P = 0.079) and caries (OR, 1.15; 95% CI, 0.17-7.69; P = 0.814 [Streptococcus mutans] and OR, 0.67; 95% CI, 0.20-2.23; P = 0.515 [Lactobacillus]).

CONCLUSIONS

This systematic review suggests that patients wearing lingual appliances have more pain, speech difficulties, and problems in maintaining adequate oral hygiene, although no differences for eating and caries risk were identified. Further prospective studies involving larger sample sizes and longer follow-up periods are needed to confirm these results.

Colour stabilities of three types of orthodontic clear aligners exposed to staining agents

The aim of this study was to evaluate and compare the colour stabilities of three types of orthodontic clear aligners exposed to staining agents in vitro. Sixty clear orthodontic aligners produced by three manufacturers (Invisalign, Angelalign, and Smartee) were immersed in three staining solutions (coffee, black tea, and red wine) and one control solution (distilled water). After 12-h and 7-day immersions, the aligners were washed in an ultrasonic cleaner and measured with a colourimeter. The colour changes (ΔE*) were calculated on the basis of the Commission Internationale de I'Eclairage L*a*b* colour system (CIE L*a*b*), and the results were then converted into National Bureau of Standards (NBS) units. Fourier transformation infrared (FT-IR) spectroscopy and scanning electron microscopy (SEM) were conducted to observe the molecular and morphologic alterations to the aligner surfaces, respectively. The three types of aligners exhibited slight colour changes after 12 h of staining, with the exception of the Invisalign aligners stained with coffee. The Invisalign aligners exhibited significantly higher ΔE* values (ranging from 0.30 to 27.81) than those of the Angelalign and Smartee aligners (ΔE* values ranging from 0.33 to 1.89 and 0.32 to 1.61, respectively, P<0.05). FT-IR analysis confirmed that the polymer-based structure of aligners did not exhibit significant chemical differences before and after the immersions. The SEM results revealed different surface alterations to the three types of aligner materials after the 7-day staining. The three types of aesthetic orthodontic appliances exhibited colour stability after the 12-h immersion, with the exception of the Invisalign aligners stained by coffee. The Invisalign aligners were more prone than the Angelalign and Smartee aligners to pigmentation. Aligner materials may be improved by considering aesthetic colour stability properties.

Impact of orthodontic treatment on self-esteem and quality of life of adult patients requiring oral rehabilitation

OBJECTIVE

To evaluate whether orthodontic treatment in adults requiring oral rehabilitation is effective for increasing patients' self-esteem and quality of life (QoL).

MATERIALS AND METHODS

The sample consisted of 102 adult patients (77 women and 25 men) aged between 18 and 66 years (mean, 35.1 years) requiring oral rehabilitation and orthodontic treatment simultaneously. Rosenberg's Self-Esteem (RSE) Scale and a questionnaire about QoL based on the Oral Health Impact Profile (OHIP-14) were used to determine self-esteem and QoL scores retrospectively. Questionnaires were carried out in two stages, T1 (start of treatment) and T2 (6 months after). To compare score changes between T1 and T2, the data obtained from the RSE Scale were evaluated with paired t tests, and data from the quality-of-life questionnaire were assessed by applying descriptive statistics.

RESULTS

The results showed a statistically significant increase in self-esteem (P < .001) and a great improvement on patients' QoL.

CONCLUSIONS

Orthodontic treatment causes a significant increase in self-esteem and QoL, providing psychological benefits for adult patients in need of oral rehabilitation.

Usefulness of an app in improving oral hygiene compliance in adolescent orthodontic patients

OBJECTIVE

To evaluate the influence of an app-based approach in a protocol for domestic oral hygiene maintenance in a group of adolescent patients wearing fixed multibracket appliances.

MATERIALS AND METHODS

Eighty adolescent patients scheduled to start an orthodontic multibracket treatment were randomly divided into two groups of 40. Plaque index (PI), gingival index (GI), white spots (WS), and caries presence were recorded in all patients, and they were instructed regarding domestic oral hygiene maintenance on the day of braces application (t0) and every 3 months (t1, t2, t3, t4) during the first year of treatment. Study group (SG) patients were enrolled in a WhatsApp chat room-based competition and instructed to share monthly with the other participants two self-photographs (selfies) showing their oral hygiene status.

RESULTS

SG patient participation in the chat room was regular and active throughout the observation period. At t2, t3, and t4, SG patients had significantly lower values of both PI and GI and a lower incidence of new WS and caries, compared with the control group.

CONCLUSION

Integration of new "social" technologies in a standard oral hygiene motivation protocol is effective in improving compliance of adolescent patients and in improving their oral health status during orthodontic multibracket treatment.

Differences in psychological traits between lingual and labial orthodontic patients: perfectionism, body image, and the impact of dental esthetics

OBJECTIVE

To examine some of the patients' psychological traits in relation to their levels of perfectionism and their body image, and to discover whether these differ between lingual and labial orthodontic patients.

MATERIALS AND METHODS

A cross-sectional study was designed with a consecutive sample of 80 patients attending a private orthodontic office. Three questionnaires were used to assess the patients' body image and level of perfectionism. The mean age was 33 years. The men numbered 32 and the women 48. The validated Spanish version of the Psychosocial Impact of Dental Aesthetic Questionnaire (PIDAQ) was used to assess the psychosocial impact of their dental esthetics. The Multidimensional Perfectionism Scale (MPS) was used to assess how perfectionist the patients were. A version of the Multidimensional Body-Self Relations Questionnaire (MBSRQ) was used for assessment of their body image. Student's t-test was used to compare the means and 95% confidence intervals (P < .05), and a logistic regression model was used for multivariate analysis.

RESULTS

The PIDAQ (55.4 vs 60, P  =  .218) and MBSRQ (128.7 vs 125.9, P  =  .523) results of the patients who chose lingual orthodontics did not differ significantly from those who opted for labial orthodontics. However, the MPS scores of the lingual orthodontic patients were significantly higher (95.9 vs 86.3, P  =  .044), and high social class, over 30 years of age, and perfectionist traits were significant independent variables in this group.

CONCLUSIONS

This pilot study may indicate that lingual orthodontic patients are more perfectionists than labial orthodontic patients.

Lingual orthodontic treatment: what is the current evidence base?

As the number of adults that seek orthodontic treatment continues to grow, so too is the popularity of lingual fixed appliances. Although the aesthetic advantages associated with these systems are obvious, for some orthodontists, there has been a reluctance to offer lingual-based treatment to their patients. This is often based upon the perceived problems associated with lingual braces, relating to discomfort and difficulties with speech for the patient, and problems in using these appliances for the orthodontist. Although some of these factors have been investigated, the current evidence base is weak, possibly due to the fact that these are evolving appliance systems. Among the studies that have been carried out to date, pain and discomfort for the patient appears to be similar following the placement of labial or lingual appliances, although the onset can be earlier with lingual brackets and the location different, with the tongue more frequently being involved. Customized lingual brackets may be associated with less pain than pre-fabricated. In addition, patients do seem to be more likely to experience difficulties with speech and mastication when fitted with a lingual appliance. However, there is some evidence that the lingual surfaces of the teeth are more resistant to early demineralization and caries. Little data exist regarding treatment outcome and ease of use for the orthodontist, either between lingual or labial appliances or between different lingual systems. Further research is required to investigate the efficiency of lingual appliance systems, both for the patient and orthodontist.

A comparative study of two different clear aligner systems

Background

This study aims to compare the ‘Nuvola®’ system with ‘Fantasmino®’ system, examine their material properties, and define the indications for use of the aligners.

Methods

Two groups of patients were selected and were respectively treated with Nuvola® aligner and Fantasmino® system.

Results

The goal of treatment has been achieved with the two systems.

Conclusions

The two types of aligners have shown differences during the treatment. Fantasmino® system has elastic properties of high performance, but its size does not encourage compliance throughout the day. Nuvola® system determines good tooth movement and its size facilitates the patient’s collaboration. In both aligner systems, difficulties were found in the correction of torque information and rotations.

Comparison of adverse effects between lingual and labial orthodontic treatment

OBJECTIVE

To compare adverse effects between labial and lingual orthodontic treatments through a systematic review of the literature.

MATERIALS AND METHODS

The protocol of this systematic review (CRD42012002455) was registered in the International Prospective Register of Systematic Reviews (PROSPERO). An electronic search was conducted in PubMed, Embase, Web of Science, CENTRAL, SIGLE, ProQuest Dissertations & Theses, and ClinicalTrial.gov for articles published between January 1980 and December 2012. Primary outcomes included pain and caries; secondary outcomes were eating difficulty, speech difficulty, oral hygiene, and treatment duration. Meta-analyses were conducted in Comprehensive Meta-Analysis version 2.2.064.

RESULTS

Six studies were included, two randomized controlled trials and four clinical controlled trials; of these, four were medium quality and two were low quality in terms of the risk of bias. Five of the six outcomes were evaluated in the included studies, and treatment duration was not; pain, eating difficulty, speech difficulty were statistically pooled. Meta-analysis revealed that the pooled odds ratios were 1.20 (95% confidence interval [CI]  =  0.30-4.87) for overall pain, 32.24 (95% CI  =  14.13-73.55) for pain in tongue, 0.08 (95% CI  =  0.04-0.18) for pain in cheek, 0.11 (95% CI  =  0.03-0.42) for pain in lip, 3.59 (95% CI  =  1.85-6.99) for eating difficulty, and 8.61 (95% CI  =  3.55-20.89) for speech difficulty. Sensitivity analysis showed consistent results except for eating difficulty. No publication bias was detected.

CONCLUSIONS

The likelihood of overall pain was similar between the two modalities. Patients who underwent lingual orthodontic treatment were more likely to suffer from pain in the tongue and less likely to suffer from pain in the cheek and lip. Lingual orthodontic treatment increased the likelihood of speech difficulty. Eating difficulty, oral hygiene, caries, and treatment duration could not be compared in this systematic review.

Personality traits as a potential predictor of willingness to undergo various orthodontic treatments

Objective:

To establish an association between patient personality traits and potential willingness to undergo various orthodontic treatments.

Materials and Methods:

One hundred adolescent individuals aged 12–16 years completed an anonymous electronic questionnaire via Survey Monkey. The 24-item questionnaire contained three major sections: patient demographics, a modified Big Five Inventory (BFI)-10 personality index, and a willingness to undergo treatment assessment. Multiple-variable linear regression analyses were used to determine the associations among age, gender, ethnicity, and the five personality traits simultaneously with willingness to undergo treatment. Statistical significance was set at P ≤ .05.

Results:

Ninety-six of the 100 individuals were included in the statistical analysis. Age, ethnicity, and gender failed to correlate with potential willingness to undergo orthodontic treatment. Several personality dimensions within the modified BFI-10 (agreeableness, conscientiousness, and neuroticism) were significantly associated with willingness to undergo various orthodontic treatments (P ≤ .05). Agreeableness demonstrated positive correlations with five treatment modalities, while both conscientiousness and neuroticism exhibited negative associations with a single treatment modality. Openness and extraversion were the only personality dimensions that failed to associate with any of the treatment modalities. Four of the nine treatment modalities had no association with patient demographics or a patient's personality dimensions.

Conclusions:

Personality traits are useful in predicting a patient's potential willingness to participate in various orthodontic treatments. The agreeableness dimension provided the most utility in predicting patient willingness. Age, ethnicity, and gender were not significant in predicting patient willingness.