Risk factors for periodontal changes in adult patients with banded second molars during orthodontic treatment

Why orthodontists need to know about molar incisor hypomineralization

Molar incisor hypomineralization (MIH) is a systemic developmental qualitative defect of the enamel that affects 1-4 first permanent molars with or without incisor involvement. Enamel hypomineralization is identified visually as a demarcated opacity with a clear border with varying extensions and can be white, yellow, or brown. This opacity is characterized by a reduced quality of enamel that is of normal thickness but not fully mineralized. It is very common for the affected teeth to present with posteruptive breakdown, making them susceptible to caries, leading to their subsequent loss. Thus, MIH is a significant dental problem with clinical, economic, and psychosocial implications. The planned extraction of compromised teeth is a valid alternative to complex restorative treatment. Orthodontists' involvement is essential in developing effective treatment strategies for children affected by MIH, contributing to their oral health and well-being.

Porphyrin-associated fluorescence spectroscopy (Photogen®) for the optical diagnosis of dental biofilm in orthodontic treatment: an observational clinical trial

OBJECTIVE

This study assessed the presence of dental biofilm with fluorescence spectroscopy associated with porphyrin (Photogen®) in users of orthodontic appliances.

METHODS

This cross-sectional observational clinical trial included 21 patients with metallic orthodontic fixed appliances. The presence of biofilm was evaluated by fluorescence spectroscopy (Evince-MMÓptics. São Carlos-SP, Brazil) with a porphyrin photo-evidence device (Photogen®). Digital images of the buccal surface of the upper anterior teeth (central and lateral incisors and canines) without and with porphyrin were analyzed using the histogram R (red) function in ImageJ software. The results were analyzed using the maximum and mode values of the red pixels from the histograms. The statistical analysis considered the significance level of 5%.

RESULTS

The maximum values and modes of the red pixels were significantly higher in biofilms analyzed by porphyrin-associated optical spectroscopy compared to optical spectroscopy alone.

CONCLUSIONS

Porphyrin-associated fluorescence spectroscopy was able to detect dental biofilm in the oral environment of patients with orthodontic treatment. This method better evidenced the presence of biofilm on the buccal surfaces of the upper teeth compared to that observed with fluorescence spectroscopy without porphyrin.

Comparison of the efficacy of two-time versus one-time micro-osteoperforation on maxillary canine retraction in orthodontic patients: A split-mouth randomized controlled clinical trial

BACKGROUND

Micro-osteoperforation (MOP), a minimally invasive technique for accelerating the rate of orthodontic tooth movement has been research extensively, but with varied clinical results.

OBJECTIVE

To compare the efficacy of one-time versus two-time micro-osteoperforation on the rate of maxillary canine retraction, its influence on anchorage loss, canine angulation and the levels of interleukin (IL-1β) in gingival crevicular fluid (GCF).

MATERIALS AND METHODS

The split-mouth study included 16 patients in which the left and right sides were randomly allocated to the control side (one-time MOP) and experimental side (two-time MOP). MOP was performed on both sides distal to the maxillary canines and canine retraction was carried out using NiTi closed coil springs (150gm) and direct anchorage with miniscrew implants. The second MOP was performed on experimental side one month after the first MOP. The rate of canine movement was assessed using 3D model superimposition over a period of six months. The type of tooth movement, anchorage loss and levels of IL-1β were also evaluated.

RESULTS

Sixteen patients (mean age, 17.87±3.34 years) were analysed for a rate of canine retraction, anchorage loss, and type of tooth movement, while 15 patients were analysed for IL-1β. The rate was significantly higher on two-time MOP side after two months (P<0.001). No statistical difference was found in anchorage loss and controlled tipping of canines was observed. The IL-1β levels immediately after 2^nd MOP were significantly higher than 1^st MOP (P<0.001).

CONCLUSION

The two-time intervention of MOP is more efficacious than one-time MOP in accelerating tooth movement.

Gingival proliferative growth - stress and cytoarchitecture related with fixed and mobile orthodontic therapy

The fixed orthodontic measures taken induce significant stress to the gingival growth process during arch wire maneuvers of aligning and leveling. We observed, for a period of one to four years, fixed orthodontic devices in 80 human subjects. From these, we selected 44 subjects (22 women and 22 men) where the inflammatory process exhibited following the orthodontic fixed treatment, and with vacuum-formed orthodontic retainers (VFR) succeeding to fixed treatment. Samples were collected from each patient and histological and immunohistochemical (IHC) methodology was made to analyze the cytoarchitecture. Statistics were made after one-way analysis of variance (ANOVA), with the Bonferroni’s correction. The IHC examination performed in the early stage revealed the presence in the inflammatory infiltrate of CD8-type T-lymphocytes, and of dendritic cells in large numbers. The examination performed in the late stage revealed the presence in the inflammatory infiltrate of CD20-type B-lymphocytes, which are mature cells capable of immunoglobulin synthesis, their activation being an important step in the maturation of the antibody response. The stress generated by arch wires in both genders was significantly higher than in the case of VFR. This observation was pointed out also by the cytohistological investigation outcome but was also based on an original scale conceived by our research team, following gingival hyperplasia evaluation. Also, with statistical significance, the comparative obtained values for men (p=0.01) and for women (p=0.001) illustrate clinical observations, allowing to affirm that, in our case, men were more stressed in bearing arch wire devices (AWD) and VFR, in comparison with women.

Conservative treatment in adult patient with reimplanted anterior teeth after traumatic avulsion with extensive bone loss: an 8-year follow-up

INTRODUCTION

Orthodontic treatment in patients with traumatized teeth is a condition that needs good planning in order to achieve satisfactory results.

OBJECTIVE

To discuss approaches to orthodontic treatment of malocclusions associated with trauma followed by avulsion of anterior teeth, reimplanted after a short period of time.

CASE REPORT

The treatment started with the distalization of upper posterior teeth, with the aid of mini-implants and sliding jigs, followed by the inclusion of anterior teeth in the arch, followed by intrusion of these teeth.

RESULTS

With the treatment, improved mobility of the anterior teeth was achieved, with better insertion into bone tissue. The most important factor for satisfactory treatment and a good prognosis for avulsion is the time the tooth remains outside the socket. Orthodontic treatment in patients with traumatized teeth is not contraindicated; however, clinical and radiographic aspects must be considered.

CONCLUSION

Among the feasible orthodontic treatment options, the conservative approach can be a very favorable treatment alternative.

Comparison of the efficacy of different periodic periodontal scaling protocols for oral hygiene in adolescents with fixed orthodontic appliances: A prospective cohort study

INTRODUCTION

The purpose of this reseach was to compare the effects of different periodic periodontal scaling protocols on the periodontal health of adolescents with fixed orthodontic appliances by assessing the aspartate aminotransferase (AST) and alkaline phosphatase (ALP) levels in gingival crevicular fluid and periodontal clinical indexes in a prospective cohort study.

METHODS

Forty-eight adolescents were divided into 3 groups according to the interval of periodontal scaling (group A: once a month; group B: once every 3 months; group C: once every 6 months). The AST and ALP levels in the gingival crevicular fluid were measured before orthodontic treatment (T₀) and at 1 (T₁), 3 (T₂), 6 (T₃), and 9 (T₄) months during orthodontic treatment. Periodontal clinical indexes (plaque index [PI], gingival index [GI], and probing depth) were also assessed.

RESULTS

At T₂, significantly lower AST and ALP levels were observed in group A than in groups B and C (P <0.05). At T₃ and T₄, lower AST and ALP levels were detected in groups A and B than in group C (P <0.05), and there was no significant difference between the A and B groups at T₄ (P >0.05). At T₂, the PI and GI were increased in groups B and C compared with group A, and at T₃ and T₄, significantly lower PI and GI values were observed in groups A and B than in group C (P <0.05).

CONCLUSIONS

Periodontal scaling promotes the oral hygiene of adolescents undergoing fixed orthodontic treatment, and periodontal scaling protocols administered monthly and once every 3 months are better for controlling periodontal health than treatments administered once every 6 months.

Evaluation of bond strength of molar orthodontic tubes subjected to reinforcement with flowable and bonding resins

OBJECTIVE

The goal was to evaluate the adhesive shear bond strength (SBS) of orthodontic tubes bonded to molar teeth and reinforced with Transbond XT (3M Science, St. Paul, MN, USA) and flowable resin.

MATERIALS AND METHODS

In all, 120 molar teeth, previously extracted from patients with a mean age of 30 were included. Orthodontic molar tubes were bonded on the vestibular surface of these teeth with one of two types of adhesive (Transbond XT [3M Science, St. Paul, MN, USA] or Orthobond [Morelli, Sorocaba, Brazil]). Each of these groups was subsequently divided into four further groups: control and those subjected to the use of resin reinforcement on the occlusal surface of the bonded tubes with one of three materials (Transbond XT, Tetric N Flow [Ivoclar Vivadent, Ellwangen, Germany], Z 350 Flow [3M Science, St. Paul, MN, USA]). SBS and adhesive remnant index tests were performed to evaluate bond strength and type of fracture of the tubes bonded with the different methods.

RESULTS

The use of resin reinforcement with Transbond XT significantly increased the SBS of tubes bonded with both materials. Flowable composites did not increase the SBS when used as a reinforcement. Less than 50% of the adhesive remained on the vestibular surface after the SBS test in most samples of all groups.

CONCLUSION

Transbond XT orthodontic adhesive and Orthobond adhesive had appropriate bonding strengths for clinical use. Furthermore, the use of a resinous reinforcement with Transbond XT significantly increased the SBS of tubes bonded. However this technique with flowable adhesives (Tetric N Flow and Z350 Flow) did not significantly increase SBS when orthodontic tubes were bonded with Transbond XT or Orthobond.

Effects of a self-ligating appliance for orthodontic treatment of severe adult periodontitis

This study was conducted to investigate the short-term effects of a self-ligating appliance for orthodontic treatment of severe adult periodontitis. Thirty patients diagnosed as severe periodontitis were recruited at Nanjing Stomatological Hospital, P. R.China, between January 2012 and January 2016. General clinical and demographic data were collected from the patients, all of whom were treated with a self-ligating appliance. Probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP) and plaque index (PI) were measured before appliance placement, and at 1 and 3 months after appliance placement, respectively. Results showed the rate of tooth loss, mean PPD, mean CAL and the BOP ratio were more favorable in healthy subjects than in the patients. Smokers accounted for a significantly higher proportion of the patients in comparison with the healthy subjects. Clinical outcomes revealed that both the mean PPD and mean CAL were significantly decreased compared with the baseline (P < 0.05). Furthermore, the percentage of BOP, PI and bone mineral density were also significantly decreased at 1 month after treatment (P < 0.05). The volume of gingival crevicular fluid, as well as the levels of alkaline phosphatase, aspartate aminotransferase and glutathione peroxidase, were significantly increased in the first month after treatment, being decreased at 2 months, and finally returning to normal in the third month. In summary, orthodontic treatment using a self-ligating appliance can apparently improve the periodontal condition of patients with severe adult periodontitis.

Impact of Orthodontic Treatment on Periodontal Tissues: A Narrative Review of Multidisciplinary Literature

The aim of this review is to describe the most commonly observed changes in periodontium caused by orthodontic treatment in order to facilitate specialists' collaboration and communication. An electronic database search was carried out using PubMed abstract and citation database and bibliographic material was then used in order to find other appropriate sources. Soft and hard periodontal tissues changes during orthodontic treatment and maintenance of the patients are discussed in order to provide an exhaustive picture of the possible interactions between these two interwoven disciplines.

Combined Periodontal, Orthodontic, and Prosthetic Treatment in an Adult Patient

A 41-year-old man had a significant loss of bone and supporting tissues with pathologic migration of several teeth and several missing teeth. He was treated with an interdisciplinary therapeutic protocol that included nonsurgical periodontal therapy based on strict control of supragingival plaque, subgingival periodontal therapy, orthodontic and endodontic treatment, and replacement of restorations. The orthodontic therapy was performed in a severely reduced bone support and the presence of pathological tooth migration after periodontal disease control. The interdisciplinary treatment protocol was the key to achieve a significant improvement in his facial and dental esthetics, masticatory function, and quality of life.

Survival analysis of brackets and tubes: A twelve-month assessment

OBJECTIVE

To compare the clinical performance of brackets bonded to anterior and posterior teeth, including second molars.

MATERIALS AND METHODS

One operator, using the straight-wire technique, bonded metallic brackets to the teeth of 127 consecutive patients. All patients were observed for 12 months during their regular orthodontic appointments. Bracket failures were recorded and summarized for statistical analysis. The Cox proportional hazards regression analysis was performed to evaluate bracket failure rates.

RESULTS

Statistically significant differences in survival rates were observed between molar tubes and anterior brackets (P < .05). Twelve-month failure rates of incisor, canine, premolar, and molar brackets were 3.6, 1.6, 4.8, and 11.6%, respectively. The first and second molar did not show significant difference in bond failure. Young patients (age <18 years) showed a higher failure rate than old patients (≥18 years).

CONCLUSIONS

Brackets directly bonded to the buccal surfaces of molars failed significantly more often than those directly bonded to anterior teeth or premolars, but showed acceptable failure rate especially in adult patients. Bonding on second molars seems to be as reliable as bonding on the first molars.