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Jang EJ, Hong YJ, Jeong YH, Kim KE, Jo ES, Lee MJ, Yang SY. In vitro antifungal and physicochemical properties of polymerized acrylic resin containing strontium-modified phosphate-based glass. BMC Oral Health 2024; 24:775. [PMID: 38987748 PMCID: PMC11238486 DOI: 10.1186/s12903-024-04547-5] [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: 12/28/2023] [Accepted: 07/01/2024] [Indexed: 07/12/2024] Open
Abstract
Acrylic resins are widely used as the main components in removable orthodontic appliances. However, poor oral hygiene and maintenance of orthodontic appliances provide a suitable environment for the growth of pathogenic microorganisms. In this study, strontium-modified phosphate-based glass (Sr-PBG) was added to orthodontic acrylic resin at 0% (control), 3.75%, 7.5%, and 15% by weight to evaluate the surface and physicochemical properties of the novel material and its in vitro antifungal effect against Candida albicans (C. albicans). Surface microhardness and contact angle did not vary between the control and 3.75% Sr-PBG groups (p > 0.05), and the flexural strength was lower in the experimental groups than in the control group (p < 0.05), but no difference was found with Sr-PBG content (p > 0.05). All experimental groups showed an antifungal effect at 24 and 48 h compared to that in the control group (p < 0.05). This study demonstrated that 3.75% Sr-PBG exhibits antifungal effects against C. albicans along with suitable physicochemical properties, which may help to minimize the risk of adverse effects associated with harmful microbial living on removable orthodontic appliances and promote the use of various materials.
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Affiliation(s)
- Eun-Jee Jang
- Department of Dental Hygiene, Konyang University, 158 Gwanjeodong-ro, Seo-gu, Daejeon, 35365, Republic of Korea
| | - Ye-Ji Hong
- Department of Dental Hygiene, Konyang University, 158 Gwanjeodong-ro, Seo-gu, Daejeon, 35365, Republic of Korea
| | - Yoon-Ha Jeong
- Department of Dental Hygiene, Konyang University, 158 Gwanjeodong-ro, Seo-gu, Daejeon, 35365, Republic of Korea
| | - Kyoung-Eun Kim
- Department of Dental Hygiene, Konyang University, 158 Gwanjeodong-ro, Seo-gu, Daejeon, 35365, Republic of Korea
| | - Eun-Seo Jo
- Department of Dental Hygiene, Konyang University, 158 Gwanjeodong-ro, Seo-gu, Daejeon, 35365, Republic of Korea
| | - Myung-Jin Lee
- Department of Dental Hygiene, Division of Health Science, Baekseok University, Cheonan, 31065, Republic of Korea.
| | - Song-Yi Yang
- Department of Dental Hygiene, Konyang University, 158 Gwanjeodong-ro, Seo-gu, Daejeon, 35365, Republic of Korea.
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Higgins E, Garvey T, Burns A. The effect of text message reminders on compliance with Twin Block appliances: A randomised controlled trial. J Orthod 2024; 51:202-210. [PMID: 37528572 PMCID: PMC11141082 DOI: 10.1177/14653125231188378] [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: 02/15/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 08/03/2023]
Abstract
AIMS The aim of this study was to evaluate whether text reminders influence patient compliance with Twin Block appliances. The null hypothesis was that there was no statistically significant differences in Twin Block compliance between those who receive text reminders and those that do not. DESIGN Single-blind parallel randomised controlled clinical trial. SETTING Health Service Executive (HSE) orthodontic outpatient clinic in Dublin, Ireland. PARTICIPANTS A total of 59 patients aged 11-15 years with a 5a Index of Orthodontic Treatment Need (IOTN grade) starting treatment with Twin Block appliances. METHODS A computer-generated unstratified allocation sequence was used to randomise the participants into the control group (CG) or the text group (TG). Both groups were asked to wear their appliances full-time. In addition to the same verbal and written instruction received by the CG, the TG received text message reminders, every 3 days, to wear their appliances. The primary outcome measure was wear time reported by Theramon® sensors embedded in the appliances. Data on wear time were uploaded from the Theramon® sensors onto cloud software. Participants in both groups were asked to fill out wear diaries and submit these at each visit. Treating clinicians and the primary investigator were blinded to the allocation group. Participants were followed up for 4 months. Participants were not blinded to their treatment group. RESULTS In total, 29 participants were allocated to the CG and 30 to the TG. The data for 53 participants were analysed, 24 from the CG and 29 from the TG. The median hours/day of wear recorded using the Theramon® sensors was 13.77 (interquartile range [IQR] = 10.19) for the CG and 17.72 (IQR = 5.62) for the TG. The difference in wear time recorded was not statistically significant (P = 0.16). CONCLUSION The study concluded that text message reminders had no statistically significant influence on patient compliance with Twin Block appliances.
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Affiliation(s)
- Emily Higgins
- Orthodontic Department, Division of Public and Child Dental Health, Dublin Dental University Hospital, Trinity College Dublin, Ireland
| | - Thérèse Garvey
- Orthodontic Department, Division of Public and Child Dental Health, Dublin Dental University Hospital, Trinity College Dublin, Ireland
| | - Angus Burns
- Orthodontic Department, Division of Public and Child Dental Health, Dublin Dental University Hospital, Trinity College Dublin, Ireland
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Ong Q, Anwar H, El-Angbawi A. Contemporary Twin Block appliance wear protocols: A survey of UK orthodontists. J Orthod 2024; 51:70-78. [PMID: 37246461 DOI: 10.1177/14653125231176569] [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] [Indexed: 05/30/2023]
Abstract
OBJECTIVE This study was undertaken to determine contemporary trends in the use of the Twin Block appliance among UK orthodontists, including the wear time currently prescribed. In addition, the study explored if there had been any change in wear time prescribed, considering recent research evidence proposing part-time wear. DESIGN Cross-sectional, online survey. PARTICIPANTS Members of the British Orthodontic Society (BOS). METHODS The questionnaire was emailed to all BOS members in November 2021 and hosted on the QualtricsXM platform. The questionnaire was piloted for content validity and tested for reliability. RESULTS A response rate of 19% was attained. Nearly all (n = 244, 99%) participants used the Twin Block, and 90% (n = 218) prescribed full-time wear including/excluding eating. Although the majority (n = 168, 69%) had not made changes to their wear time prescriptions, nearly one-third (n = 75, 31%) had. Those who reported a change in their prescriptions currently prescribe less wear time than before, and commonly quoted 'research evidence' as the reason. A wide range in success rates (41%-100%) was reported, with patient compliance as the main reason for treatment discontinuation. CONCLUSION The Twin Block is a popular functional appliance among orthodontists in the UK, originally designed by Clark to be worn full time to maximise functional forces applied to the dentition. However, this wear regime may place considerable strain on patient compliance. Most participants prescribed full-time Twin Block wear excluding eating. Approximately one-third of orthodontists made changes to their wear time prescriptions during their practising career, and currently instruct less wear time than before.
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Affiliation(s)
- Queenie Ong
- Department of Orthodontics, University Dental Hospital of Manchester, Manchester, UK
| | - Hamza Anwar
- Department of Orthodontics, Wythenshawe Hospital, Manchester, UK
| | - Ahmed El-Angbawi
- Department of Orthodontics, University Dental Hospital of Manchester, Manchester, UK
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Cen X, Pan X, Wang R, Huang X, Zhao Z. The complex of tannic acid and cetylpyridinium chloride: An antibacterial and stain-removal cleaner for aligners. Am J Orthod Dentofacial Orthop 2024; 165:173-185. [PMID: 37906245 DOI: 10.1016/j.ajodo.2023.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 08/01/2023] [Accepted: 08/01/2023] [Indexed: 11/02/2023]
Abstract
INTRODUCTION Effective aligner hygiene is recognized as an important part of orthodontic treatments and oral hygiene. However, there is no effective cleansing method for removable aligners. METHODS In this study, we incorporated tannic acid (TA) with cetylpyridinium chloride (CPC) to develop the TA-CPC complex. The antibacterial properties of 15.8 mg/mL TA-CPC against Escherichia coli and Staphylococcus aureus were evaluated in vitro, which were compared with 5.1 mg/mL TA, 10.7 mg/mL CPC, a commercial denture cleansing solution (YA; 15 mg/mL), and water. As for the assessment of stain-removal ability, the aligners stained by coffee were soaked in cleansing solutions, and the color changes (ΔE∗) were calculated on the basis of the CIE L∗a∗b∗ color system, and the National Bureau of Standards system was used for the clinical interpretation of the color change. Atomic force microscope examination, tensile property assessment, and wavelength dispersive x-ray fluorescence analysis were performed to investigate the material compatibility of TA-CPC, and Cell Counting Kit-8 assay and live/dead assay were used to test the cytotoxicity of TA-CPC. RESULTS The results showed that TA-CPC had a positive zeta-potential, and cation-π interaction changed the chemical environments of the phenyl group in TA-CPC, resulting in greater inhibition zones of S. aureus and E. coli than other cleaners. The quantification of the biofilm biomass and the fluorescent intensities also reflected that the TA-CPC solution exhibited better antibacterial ability. As for the ability of stain removal, ΔE∗ value of group TA-CPC was 2.84 ± 0.55, whereas those of stained aligners immersed with deionized distilled water, TA, YA, and CPC were 10.26 ± 0.04, 9.54 ± 0.24, 5.93 ± 0.36, and 4.69 ± 0.35, respectively. The visual inspection and National Bureau of Standards ratings also showed that the color of stained aligners cleansed by TA-CPC was much lighter than those of the other groups. Meanwhile, TA-CPC had good compatibility with the aligner material and cells. CONCLUSIONS TA-CPC is a promising strategy to inhibit the formation of biofilms and remove the stains on the aligners safely, which may disinfect the aligners to improve oral health and help keep the transparent appearances of aligners without impacting the morphology and mechanical properties.
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Affiliation(s)
- Xiao Cen
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xuefeng Pan
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Rong Wang
- Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Zhejiang Engineering Research Center for Biomedical Materials, Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China.
| | - Xinqi Huang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Zhihe Zhao
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Nicita F, D'Amico C, Filardi V, Spadaro D, Aquilio E, Mancini M, Fiorillo L. Chemical-Physical Characterization of PET-G-Based Material for Orthodontic Use: Preliminary Evaluation of micro-Raman Analysis. Eur J Dent 2024; 18:228-235. [PMID: 37247624 PMCID: PMC10959632 DOI: 10.1055/s-0043-1764424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
OBJECTIVES Orthodontic treatment with clear thermoplastic aligners is in great demand by patients especially for aesthetics. Any alterations in the chemical composition of the thermoplastic material for aligners, subjected to the oral environment and exposure to various commonly used substances, could influence the desired orthodontic movement decreasing the predictability of the treatment. The objective of this study was to determine the chemical-physical characterization by micro-Raman spectroscopy of a thermoplastic material based on polyethylene terephthalate glycol (PET-G) used for the manufacture of Lineo aligners (Micerium Lab, Avegno, Italy) subjected to different staining beverages and cleaning agents. MATERIALS AND METHODS Twenty-two thermoformed PET-G samples were immersed to various substances of daily use for 10 and 15 days (coffee, tea, Coca-Cola, red wine, colloidal silver disinfectant, nicotine, artificial saliva, cigarette smoke, and different combinations of saliva with some of the previous solutions). Subsequently, the chemical-physical characterization was investigated by micro-Raman spectroscopy. RESULTS The analysis of the spectra acquired for all the specimens showed no difference in the exposure to the different solvents at 10 and 15 days. Furthermore, having ascertained the heterogeneous surface morphology of the PET-G material due to thermoforming, various deposits were present on all the samples whose consistency and concentration depended on the substance used. CONCLUSION The spectroscopic investigations have provided a precise and detailed analysis of the qualitative and structural data of the PET-G material under examination. No significant structural modifications of the thermoplastic polymer were found after immersion in different solutions in the exposure times adopted.
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Affiliation(s)
- Fabiana Nicita
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, via Consolare Valeria, Messina, Italy
| | - Cesare D'Amico
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, via Consolare Valeria, Messina, Italy
| | - Vincenzo Filardi
- D.A. Research and Internationalization, University of Messina, Via Consolato del mare 41, Messina, Italy
| | | | | | - Maura Mancini
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, via Consolare Valeria, Messina, Italy
| | - Luca Fiorillo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, via Consolare Valeria, Messina, Italy
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
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Atik E, Taner T, Aksu M. Is wear time of Hawley retainers measured with microsensors related to mandibular arch stability? J Orofac Orthop 2023:10.1007/s00056-023-00495-x. [PMID: 37731053 DOI: 10.1007/s00056-023-00495-x] [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: 04/14/2022] [Accepted: 08/02/2023] [Indexed: 09/22/2023]
Abstract
PURPOSE The aim of this study was to show a possible correlation between the mean wear time of Hawley retainers and long-term mandibular arch stability as assessed via wear time analysis with microsensors. METHODS This longitudinal retrospective study comprised 47 subjects (mean age 16.30 ± 1.06 years) having been treated with a nonextraction protocol and presenting moderate crowding at pretreatment. For retention, all patients were instructed to use a mandibular Hawley retainer for 12 months, and wear time was documented every 3 months during a posttreatment period of 6 months using TheraMon software. These individuals were divided into two groups. Those who adhered to a wear time equal to or more than 12 h/day (group 1A; N = 17) and those who complied for less than 12 h/day (group 2A; N = 30) were compared with respect to changes of the mandibular arch during the first 6 months of retention. Furthermore, a subgroup of 28 patients who completed a 12-month follow-up period were again divided into two groups: the individuals in group 1B (N = 12) adhered to a wear time equal to or more than 8 h/day, while those in group 2B (N = 16) complied for less than 8 h/day. Little's Irregularity Index, intercanine and intermolar widths, arch length, overjet, and overbite were measured on mandibular models taken at pretreatment (T0) and posttreatment (T1), as well as 6 months (T2) and 12 months (T3) after debonding. Pearson correlation test, independent samples t‑test, and Mann-Whitney U test were used for statistical evaluation. RESULTS From T1 to T2, group 1A and group 2A showed a significant relapse in intermolar width with a difference in the median value of 0.38 mm (p = 0.019). At the complete 12-month follow-up, the increase in Little's irregularity score was significantly greater in group 2B (2.54 ± 1.29 mm) than in group 1B (1.32 ± 1.03 mm; p = 0.012). The established wear time measurements showed significant negative correlations with the Little's irregularity score and overjet changes between T1 and T3 (p < 0.05). CONCLUSIONS The results emphasized that the use of a retainer should not fall below a level of at least 8 h/day.
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Affiliation(s)
- Ezgi Atik
- Department of Orthodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.
| | - Tulin Taner
- Department of Orthodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Muge Aksu
- Department of Orthodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
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Alhasyimi AA, Syahfik I. Growth Modification of Developing Class II Division 1 Malocclusion Using Myofunctional Appliances. Case Rep Dent 2023; 2023:8201195. [PMID: 37766810 PMCID: PMC10522433 DOI: 10.1155/2023/8201195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/19/2023] [Accepted: 08/26/2023] [Indexed: 09/29/2023] Open
Abstract
Background and Overview. Interceptive orthodontics is a phase of orthodontics that identifies and corrects potential malocclusions in the growing dentofacial complex. At this point, myofunctional appliances are a necessary component. A 9-year-old girl appeared with a Class II division 1, a 6 mm overjet, a 6 mm overbite, a V-shaped maxillary arch, as well as lip hypertonicity, and an overdeveloped maxilla. Myobrace® combines the dental alignment abilities of rigid and soft appliances. Its structure replicates a fixed appliance: the soft outer part acts as the orthodontic wire, whereas the inner hard part engages the teeth individually. After 12 months of treatment, facial photos and a cephalogram were taken, both of which demonstrated an enhancement to the patient's facial profile. Conclusions and Practical Implications. This case demonstrates that Myobrace® may be a simple and good choice to treat skeletal malocclusion with oral habit because of its greater compliance and favorable results. In certain instances, an early approach, taking into account patient preferences and compliance, is practical and should be considered in future treatment planning and research.
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Affiliation(s)
- Ananto Ali Alhasyimi
- Department of Orthodontics, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Alzoubi EE, Camilleri S, Al Muzian M, Attard N. The effect of tooth borne versus skeletally anchored Alt-RAMEC protocol in early treatment of Class III malocclusion: a single-centre randomized clinical trial. Eur J Orthod 2023; 45:517-527. [PMID: 37167546 DOI: 10.1093/ejo/cjad018] [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: 05/13/2023]
Abstract
TRIAL DESIGN This was a randomized, controlled trial designed to compare outcomes between the use of dental and skeletal anchorage, using the Face mask/Alternate Rapid Maxillary Expansion and Contraction (FM/Alt-RAMEC) protocol. METHODS AND PARTICIPANTS The study was carried out at Mater Dei Hospital, Malta and included prepubertal skeletal Class III malocclusion patients where the aetiology was primarily maxillary hypoplasia. INTERVENTIONS Two groups were assigned. Group I was treated with FM/Alt-RAMEC and group II was treated with skeletally anchored FM/Alt-RAMEC. Wear-time (WT) of the FM was monitored using TheraMon microsensors. Patients were instructed to wear the FM for 12-14 hours/day for 9 months. Changes were evaluated with lateral cephalograms and analysed with Wilcoxon and Mann-Whitney U tests. ANOVA was used to analyse the effect of gender on compliance parameters. Spearman's correlation coefficient was used to assess the correlation between compliance and skeletal changes. OBJECTIVE To compare the skeletal and dentoalveolar changes in patients treated with these two protocols. OUTCOMES The primary outcome was to assess skeletal and dentoalveolar outcomes in patients treated with skeletally anchored FM/RME and tooth-borne FM/RME; utilizing Alt-RAMEC protocol. The secondary outcome was compliance rate and adherence to FM wear among patients. RANDOMIZATION Randomizer software and the sealed envelope technique were used to randomly allocate patients 1:1 into either group I (tooth-borne FM/Alt-RAMEC) or group II (skeletally anchored FM/Alt-RAMEC). BLINDING It was not possible to blind to treatment allocation, but blinding was used when assessing the outcomes. RESULTS Numbers randomized and analysed. Thirty-five patients were allocated. Group I consisted of 18 subjects and group II consisted of 17 subjects. One patient in group I dropped out due to illness, so 17 subjects in each group completed the study. OUTCOMES Post-treatment changes in group I showed significant increases in SNA (2.10°), ANB (3.90°), Wits (4.70 mm), and overjet (5.40 mm). Group II showed significant increases in ANB (3.10°), Wits (3.20 mm), and overjet (4.50 mm). Wearing time for group I patients was 7.87 ± 2.88 hours/day and for group II was 6.98 ± 2.68 hours/day, with no significant difference between the groups. LIMITATIONS Lack of long-term follow-up post-treatment, making the conclusion applicable only in the short term. HARMS No harm was observed in both groups. CONCLUSION Despite the large difference between the measured and the patient-reported daily WT, both tooth-borne and skeletally anchored FM/Alt-RAMEC showed positive, similar, skeletal and dental effects. CLINICAL TRIAL REGISTRATION ISRCTN12197405.
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Affiliation(s)
- Emad Eddin Alzoubi
- Department of Child Dental Health and Orthodontics, University of Malta, Msida, Malta
| | - Simon Camilleri
- Department of Child Dental Health and Orthodontics, University of Malta, Msida, Malta
| | - Mohammed Al Muzian
- Department of Orthodontics, Faculty of Dentistry, University of Edinburgh, Edinburgh, UK
| | - Nikolai Attard
- Department of Restorative Dentistry, University of Malta, Msida, Malta
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Wafaie K, Mohammed H, Xinrui W, Zhou J, El Sergani AM, Yiqiang Q. Compliance with retainer wear using audiovisual integration and reminder: a randomized clinical trial. Sci Rep 2023; 13:8543. [PMID: 37237095 DOI: 10.1038/s41598-023-35686-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/22/2023] [Indexed: 05/28/2023] Open
Abstract
Active audiovisual representation of instructions ensures vibrant knowledge acquisition and improves acquaintance needed for self-care with retainer wear. The aim of this trial is to assess the impact of audiovisual instructions with additional weekly electronic reminder messages on improving adherence to instructed wear time of Hawley retainer, periodontal outcomes, and participants' experiences. Fifty-two participants (mean age 26.1 y) planned for removable retention, were randomly assigned to two parallel groups to receive either (1) audiovisual instructions with an additional weekly reminder, or (2) verbal instructions alone. Each participant received a Hawley retainer equipped with a TheraMon microsensor and was instructed to wear it for 22 h daily. Participants were monitored for adherence to the wear time after 3 (T1) and 6 months (T2), and had their periodontal health and experiences assessed at T2. Overall, the mean objectively measured daily wear time at T1 was 14.9 (± 4.9 h), and 14.3 (± 5.4 h) at T2. After 3 months, no significant differences were found between the groups (p = 0.065), however, a significant difference favoring better compliance with wear instructions was observed in the audiovisual group after 6 months (p = 0.033). A non-significant difference was observed between both groups regarding the gingival (p = 0.165) and plaque index scores (p = 0.173). Participants' experiences were similar in both groups, except for satisfaction with the way of delivering instructions, being favorably reported in the audiovisual group. Audiovisual instructions with weekly reminders seem to have a significant effect on patient compliance in the longer term.Trial registration: TCTR20230220002.
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Affiliation(s)
- Khaled Wafaie
- Department of Orthodontics, Faculty of Dentistry, First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Erqi District, Zhengzhou, Henan, China.
| | - Hisham Mohammed
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Wang Xinrui
- Department of Orthodontics, Faculty of Dentistry, First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Erqi District, Zhengzhou, Henan, China
| | - Jinshu Zhou
- Department of Orthodontics, Faculty of Dentistry, First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Erqi District, Zhengzhou, Henan, China
| | - Ahmed M El Sergani
- Department of Oral and Craniofacial Sciences, University of Pittsburgh School of Dental Medicine, Pittsburgh, USA
| | - Qiao Yiqiang
- Department of Orthodontics, Faculty of Dentistry, First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Erqi District, Zhengzhou, Henan, China.
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Gratsia S, Cocos A, Matsangas P, Shattuck N, Vastardis H. Cervical headgear therapy and sleep-related attributes. Am J Orthod Dentofacial Orthop 2023:S0889-5406(23)00104-X. [PMID: 37002113 DOI: 10.1016/j.ajodo.2022.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 12/01/2022] [Accepted: 12/01/2022] [Indexed: 06/19/2023]
Abstract
INTRODUCTION The study aimed to assess (1) the effect of the treatment with cervical headgear on patients' sleep-related attributes and well-being and (2) whether these sleep-related parameters (ie, sleep quality and quantity) were associated with patients' compliance during the orthodontic treatment. METHODS The study protocol was based on a prospective longitudinal quasi-experimental design. Participants (n = 26; 9 males; mean age, 12.4 ± 1.68 years) were patients in the Postgraduate Orthodontic Clinic, National and Kapodistrian University of Athens. All patients received treatment with a cervical headgear having an embedded TheraMon microsensor. Sleep was assessed by wrist-worn actigraphy for 59 ± 19 days. The Epworth Sleepiness Scale was used to assess average daytime sleepiness, whereas we used the Athens Insomnia Scale for insomnia symptoms. Oral health-related quality of life (OHRQOL) was assessed by the Oral Health Impact Profile (OHIP-14). RESULTS Patients slept on average 7.35 ± 0.42 h/d. Compared with the lowest sleep duration recommended for their age group, patients had an average chronic sleep deficit of 1.40 ± 0.49 h/d. Patients wore the headgear 90.9% of the days for 10.40 ± 4.17 h/d. However, only 7 (28%) patients reached or exceeded the wear-time recommendation of 12 h/d. In contrast, 2 (8%) patients wore headgear <5 h/d, 11 (44%) 5-10 h/d, and 12 (48%) patients wore headgear >10 h/d. Aggregated by participants, the median Epworth Sleepiness Scale score during the study was 3.40 (interquartile range [IQR], 4.85; range, 0.2-13.6), the median Athens Insomnia Scale score was 3.00 (IQR, 4.25; range, 0-7), and the median Oral Health Impact Profile score was 1.40 (IQR, 4.17; range, 0.0-20.8). Compared with patients who wore the orthodontic appliance >7.8 h/d, patients who wore it <7.8 h/d had worse average daytime sleepiness (P = 0.050) and worse OHRQOL (P = 0.019). CONCLUSIONS Orthodontic treatment with cervical headgear has no substantive negative effect on sleep attributes (quantity and quality), average daytime sleepiness and OHRQOL. However, poor compliance with orthodontic treatment seems to be associated with higher levels of daytime sleepiness.
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Affiliation(s)
- Sofia Gratsia
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
| | | | | | | | - Heleni Vastardis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
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Lynch NM, Shroff B, Carrico CK, Sawicki V, Sabol M, Lindauer SJ. Clear aligner therapy in the mixed dentition: Indications and practitioner perspectives. Am J Orthod Dentofacial Orthop 2023:S0889-5406(23)00073-2. [PMID: 36898898 DOI: 10.1016/j.ajodo.2022.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 11/01/2022] [Accepted: 11/01/2022] [Indexed: 03/11/2023]
Abstract
INTRODUCTION This study evaluated current trends and perspectives among orthodontists regarding clear aligner therapy in the mixed dentition (CAMD), including insights into perceived indications, compliance, oral hygiene, and other factors. METHODS An original, 22-item survey was mailed to a randomized, nationally representative sample of practicing orthodontists (n = 800) and a specific, randomized subsample of high-aligner-prescribing orthodontists (n = 200). Questions assessed respondents' demographic information, experience with clear aligner therapy, and perceived advantages and disadvantages of CAMD compared with fixed appliances (FAs). Responses were compared using McNemar's chi-square and paired t tests to assess CAMD vs FAs. RESULTS One thousand orthodontists were surveyed, and 181 (18.1%) responded over 12 weeks. CAMD use was less common than mixed dentition FAs, but most respondents predicted an increase in their future CAMD use (57.9%). Among respondents using CAMD, the number of patients with mixed dentition treated with clear aligners was significantly lower than the number of total patients with clear aligners (23.7% vs 43.8%; P <0.0001). Fewer respondents considered skeletal expansion, growth modification, sagittal correction, and habit cessation feasible indications for CAMD compared with FAs (P <0.0001). Perceived compliance was similar for CAMD and FAs (P = 0.5841), but perceived oral hygiene was significantly better with CAMD (P <0.0001). CONCLUSIONS CAMD is an increasingly common treatment modality for children. Most surveyed orthodontists reported limited indications for CAMD compared with FAs but perceived noticeable benefits for oral hygiene with CAMD.
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Affiliation(s)
- Nicholas M Lynch
- Department of Orthodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Va
| | - Bhavna Shroff
- Department of Orthodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Va.
| | - Caroline K Carrico
- Department of Dental Public Health and Policy, School of Dentistry, Virginia Commonwealth University, Richmond, Va
| | - Vincent Sawicki
- Department of General Practice, School of Dentistry, Virginia Commonwealth University, Richmond, Va
| | - Morgan Sabol
- Department of General Practice, School of Dentistry, Virginia Commonwealth University, Richmond, Va
| | - Steven J Lindauer
- Department of Orthodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Va
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Prasad S, Arunachalam S, Boillat T, Ghoneima A, Gandedkar N, Diar-Bakirly S. Wearable Orofacial Technology and Orthodontics. Dent J (Basel) 2023; 11:dj11010024. [PMID: 36661561 PMCID: PMC9858298 DOI: 10.3390/dj11010024] [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: 09/05/2022] [Revised: 12/19/2022] [Accepted: 12/30/2022] [Indexed: 01/12/2023] Open
Abstract
Wearable technology to augment traditional approaches are increasingly being added to the arsenals of treatment providers. Wearable technology generally refers to electronic systems, devices, or sensors that are usually worn on or are in close proximity to the human body. Wearables may be stand-alone or integrated into materials that are worn on the body. What sets medical wearables apart from other systems is their ability to collect, store, and relay information regarding an individual's current body status to other devices operating on compatible networks in naturalistic settings. The last decade has witnessed a steady increase in the use of wearables specific to the orofacial region. Applications range from supplementing diagnosis, tracking treatment progress, monitoring patient compliance, and better understanding the jaw's functional and parafunctional activities. Orofacial wearable devices may be unimodal or incorporate multiple sensing modalities. The objective data collected continuously, in real time, in naturalistic settings using these orofacial wearables provide opportunities to formulate accurate and personalized treatment strategies. In the not-too-distant future, it is anticipated that information about an individual's current oral health status may provide patient-centric personalized care to prevent, diagnose, and treat oral diseases, with wearables playing a key role. In this review, we examine the progress achieved, summarize applications of orthodontic relevance and examine the future potential of orofacial wearables.
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Affiliation(s)
- Sabarinath Prasad
- Department of Orthodontics, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 50505, United Arab Emirates
- Correspondence:
| | - Sivakumar Arunachalam
- Orthodontics and Dentofacial Orthopedics, School of Dentistry, International Medical University, Kuala Lumpur 57000, Malaysia
| | - Thomas Boillat
- Design Lab, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 50505, United Arab Emirates
| | - Ahmed Ghoneima
- Department of Orthodontics, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 50505, United Arab Emirates
| | - Narayan Gandedkar
- Discipline of Orthodontics & Paediatric Dentistry, School of Dentistry, University of Sydney, Sydney, NSW 2006, Australia
| | - Samira Diar-Bakirly
- Department of Orthodontics, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 50505, United Arab Emirates
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Accuracy of thermal microsensors embedded in orthodontic retainers of different material composition and thickness: An in vitro study. AUSTRALASIAN ORTHODONTIC JOURNAL 2023. [DOI: 10.2478/aoj-2023-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
Abstract
Objectives: The present research aimed to assess the accuracy and precision of the TheraMon® microsensor embedded in different thicknesses of Hawley retainers (HR) for comparison with vacuum formed retainers (VFR).
Methods: Thirty microsensors contained within different thicknesses and composition of retainers were divided into three equal groups: Group A thick coverage HR (3 mm), Group B thin coverage HR (1 mm), and Group C VFR (1 mm). The microsensors were immersed in thermostatic water at a controlled temperature of 35°C, which corresponds to the average intra-oral temperature. After 1 week, data were gathered using the TheraMon® client software and analysed using ANOVA and Turkey’s HSD tests.
Results: All TheraMon® microsensors were functional and produced uninterrupted recordings during the 1-week test period. Thermal detection differed between the three removable retainer groups. A near accurate thermostatic water detection was noticed with the thin HR with a mean temperature of 34.81 ± 0.04°C, followed by VFR 34.77 ± 0.09°C, and finally the thick HR 34.73 ± 0.05°C (ANOVA p-value = 0.025). A between-group comparison showed a significant mean difference (MD) between the thin and thick HR groups (MD: 0.08, p-value = 0.01). However, there were no significant differences between VFR and neither the thick Hawley (MD: 0.04, p-value = 0.27) nor the thin Hawley group (MD: -0.03, p-value = 0.39).
Conclusion: A removable retainer’s variation in material thickness and composition could induce small but detectable changes in the precision of thermal detection by TheraMon® microsensors.
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Venkatasubramanian P, Jerome MS, Ragunanthanan L, Maheshwari U, Vijayalakshmi D. Color stability of aligner materials on exposure to indigenous food products: An in-vitro study. J Dent Res Dent Clin Dent Prospects 2022; 16:221-228. [PMID: 37560499 PMCID: PMC10407867 DOI: 10.34172/joddd.2022.035] [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: 08/12/2022] [Accepted: 12/03/2022] [Indexed: 08/11/2023] Open
Abstract
Background In the recent day, there has been an exponential growth in the usage of clear aligners for orthodontic treatment. As with any removable appliance, the compliance of patients to remove it during ingestion of food is, at times, poor. Thus, the stability of the clear aligner to be "clear" becomes questionable. This in-vitro study examined how the clear aligners changed colour on exposure to various indigenous food products used in everyday life. Methods Aligners from 5 different companies (K Line, Clearbite Aligners, The Aligner Company, iAligners and MaxDent CA Digital) were exposed for 12 hours and 24 hours to various indigenous substances (tea, green tea, coffee, turmeric, saffron and Kashmiri red chili powder) and a control solution (distilled water) in-vitro. The color change was assessed with the help of VITA Easyshade compact colorimeter based on Commission Internationale de I'Eclairage L*a*b* color system. Values were then modified to NBS units for clinical relevance. Results The hue of the transparent aligners was noticed to change in a statistically meaningful way when exposed to turmeric, saffron, Kashmiri red chili powder and coffee in decreasing order and mild color change in tea and green tea at both 12 hours and 24 hours intervals. Conclusion Aligners are prone to color change when exposed to indigenous foods that contain staining properties.
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Affiliation(s)
- Priyanka Venkatasubramanian
- Department of Orthodontics and Dentofacial Orthopaedics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education & Research, Mylapore, Chennai, India
| | - Mary Sanjana Jerome
- Department of Orthodontics and Dentofacial Orthopaedics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education & Research, Mylapore, Chennai, India
| | - Lokamithra Ragunanthanan
- Department of Orthodontics and Dentofacial Orthopaedics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education & Research, Mylapore, Chennai, India
| | - Uma Maheshwari
- Department of Orthodontics and Dentofacial Orthopaedics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education & Research, Mylapore, Chennai, India
| | - Devaki Vijayalakshmi
- Department of Orthodontics and Dentofacial Orthopaedics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education & Research, Mylapore, Chennai, India
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Kravitz ND, Dalloul B, Zaid YA, Shah C, Vaid NR. What percentage of patients switch from Invisalign to braces? A retrospective study evaluating the conversion rate, number of refinement scans, and length of treatment. Am J Orthod Dentofacial Orthop 2022; 163:526-530. [PMID: 36539316 DOI: 10.1016/j.ajodo.2022.03.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/01/2022] [Accepted: 03/01/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION This retrospective clinical study aimed to determine what percentage of patients switched from Invisalign to braces to finish treatment. We also examined the number of refinement scans per treatment and the estimated vs actual length of treatment. METHODS Records from 500 patients (average age 33.6 years) that started with Invisalign Full or Invisalign Teen were gathered from 2 orthodontic offices and evaluated. Data was collected from the doctors' consultation notes, treatment notes, and Invisalign Web site databases. There were 2 independent variables: gender (male and female) and age groups (aged <20 years, 20-30 years, and >30 years). RESULTS One in every 6 patients (17.2%) switched from Invisalign to braces. Invisalign treatment required an average of 2.5 refinement scans, and only 6.0% of patients could complete their treatment without a single refinement scan. The average length of Invisalign treatment was 22.8 months, this was 5.1 months more than the estimated length. The average number of aligners was 64.1, but for the patients that switched to braces, the average number of aligners was 80.6 plus an additional 6.9 months of braces. There was no statistical difference between gender or age group and the conversion to braces. However, patients in the oldest age group had a significantly greater number of refinement scans. CONCLUSIONS We are likely overestimating an office's efficiency using Invisalign. On average, an Invisalign patient will require approximately 2-3 refinement scans and 2 years of treatment, and there should be a reasonable expectation that braces may be needed.
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Affiliation(s)
| | | | | | | | - Nikhilesh R Vaid
- Adjunct Professor, Department of Orthodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, India
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Effect of electronic reminders on patients' compliance during clear aligner treatment: an interrupted time series study. Sci Rep 2022; 12:16652. [PMID: 36198717 PMCID: PMC9534859 DOI: 10.1038/s41598-022-20820-5] [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: 01/07/2022] [Accepted: 09/19/2022] [Indexed: 12/02/2022] Open
Abstract
Patient compliance is relevant to achieving therapeutic goals during clear aligner therapy (CAT). The aim of this study was to evaluate the efficacy of remote electronic (e-)reminders and e-feedback on compliance during CAT using an interrupted time series (ITS) analysis. We used routinely collected mobile application data from a German healthtech company (PlusDental, Berlin). Our primary outcome was self-reported compliance (aligner wear time min. 22 h on 75% of their aligners were classified as fully compliant, min. 22 h on 50–74.9% of their aligners: fairly compliant; min. 22 h on < 50% of their aligners: poorly compliant). E-reminders and e-feedback were introduced in the 1st quarter of 2020. Compliance was assessed at semi-monthly intervals from June-December 2019 (n = 1899) and June-December 2020 (n = 5486), resulting in a pre- and post-intervention group. ITS and segmented regression modelling were used to estimate the effect on the change in levels and trends of poor compliance. Pre-intervention, poor compliance was at 24.47% (95% CI: 22.59% to 26.46%). After the introduction of e-reminders and e-feedback (i.e., post-intervention), the percentage of poorly compliant patients decreased substantially, levelling off at 9.32% (95% CI: 8.31% to 10.45%). E-reminders and e-feedback were effective for increasing compliance in CAT patients. Clinical Significance: Orthodontists and dentists may consider digital monitoring and e-reminders to improve compliance and increase treatment success.
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Krüsi A, Dritsas K, Kalimeri E, Kloukos D, Gkantidis N. Association of Craniofacial Patterns with the Curve of Spee and the Time Required for Orthodontic Levelling. Dent J (Basel) 2022; 10:dj10090175. [PMID: 36135170 PMCID: PMC9498079 DOI: 10.3390/dj10090175] [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: 07/26/2022] [Revised: 09/08/2022] [Accepted: 09/14/2022] [Indexed: 11/24/2022] Open
Abstract
The curve of Spee (CoS) is an important parameter for an individualized treatment plan. The available information regarding a potential association of the depth of the curve of Spee with various skeletal craniofacial characteristics is conflicting and it is also unknown whether certain craniofacial parameters affect the duration of the levelling phase of orthodontic treatment. A prospective sample of 32 patients with mild to moderate crowding that underwent orthodontic treatment with full fixed appliances was used to study these topics. The craniofacial characteristics were captured on pre-treatment lateral cephalometric radiographs and measurements of the CoS were performed on the initial 3D digital dental models using the Viewbox 4 software. Non-parametric statistics and Spearman’s correlations were applied. Weak negative correlations were detected between the CoS depth and the SNA and SNB angles. There was no other association between the CoS and craniofacial parameters, including various anteroposterior measurements. Furthermore, there was no significant association of any craniofacial parameter with the duration of the levelling. Contrary to certain clinical beliefs, it can be argued that the craniofacial characteristics are not associated with the CoS and the time required for its levelling in subjects with moderate pre-treatment CoS depth.
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Affiliation(s)
- Annina Krüsi
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland
| | - Konstantinos Dritsas
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland
| | - Eleni Kalimeri
- Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force and VA General Hospital, GR-115 25 Athens, Greece
| | - Dimitrios Kloukos
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland
- Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force and VA General Hospital, GR-115 25 Athens, Greece
| | - Nikolaos Gkantidis
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland
- Correspondence:
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18
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Frilund E, Sonesson M, Magnusson A. Patient compliance with Twin Block appliance during treatment of Class II malocclusion: a randomized controlled trial on two check-up prescriptions. Eur J Orthod 2022; 45:142-149. [PMID: 35968672 PMCID: PMC10065135 DOI: 10.1093/ejo/cjac046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Compliance is crucial for the treatment outcome with removable appliances. Previous studies on treatment with the Twin Block appliance have focused on effectiveness in relation to other treatment methods or wear-time. Studies on different check-up intervals to improve compliance seem to be lacking. OBJECTIVES To compare the impact of two different check-up prescriptions on patient compliance and treatment outcome during treatment with Twin Block. TRIAL DESIGN Two-arm parallel group, single-centre, randomized controlled trial. MATERIALS AND METHODS Seventy-three patients, 38 boys, and 35 girls, mean age 11.2 years, were included and block-randomized into two groups treated with a Twin Block appliance. Group 1 was called for check-up visit every sixth week and group 2 every fourth week. Compliance was evaluated with a TheraMon® microsensor, moulded into the appliance, measuring wear-time. Overjet, overbite, and molar relationships were assessed on study casts before and after treatment. The treatment outcomes were analysed on an intention-to-treat basis. RESULTS In group 1, the reduction of overjet was 5.2 mm and the mean wear-time was 6.9 hours. In group 2, the reduction was 4.7 mm and the wear-time was 6.1 hours. Seventy-four per cent of the patients presented an overjet of 4 mm or less. Wear-time did not correlate to age, gender, or severity of malocclusion. HARMS No harm was observed in any patient. Lateral open bites were registered during treatment but were normalized at the end of the treatment. LIMITATIONS The trial was a single-centre study and long-term effects were not evaluated. CONCLUSIONS During treatment with the Twin Block appliance, a 4-week check-up interval did not improve treatment outcome or increase wear-time, compared to a 6-week check-up interval. The mean wear-time was 6.5 hours per day, even if the recommendation was 12 hours. CLINICAL TRIAL REGISTRATION NCT05155774.
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Affiliation(s)
- Erik Frilund
- Department of Orthodontics, The Institute for Postgraduate Dental Education, Jönköping, Sweden.,Centre for Oral Health, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Mikael Sonesson
- Centre for Oral Health, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Department of Orthodontics, Section 4, University of Malmö, Malmö, Sweden
| | - Anders Magnusson
- Department of Orthodontics, The Institute for Postgraduate Dental Education, Jönköping, Sweden.,Centre for Oral Health, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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Nahajowski M, Lis J, Sarul M. Orthodontic Compliance Assessment: A Systematic Review. Int Dent J 2022; 72:597-606. [PMID: 35961844 PMCID: PMC9485511 DOI: 10.1016/j.identj.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 07/09/2022] [Accepted: 07/11/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives The aim of this review was to determine whether the type of removable appliance, as well as the age and sex of the patient, may affect the extension or reduction of wear time by assessing the correlation between the mean actual and orthodontist-recommended wear times. Methods Randomised case control trials, cohort studies, case series, observational studies, reviews, and retrospective analyses were identified. The quality of the studies was assessed using the Cochrane Collaboration Tool and modified Newcastle-Ottawa Scale. The electronic databases Embase, PubMed, Scopus, and Web of Science were reviewed, and 542 articles were obtained, of which 31 were qualified for qualitative synthesis. The data from 1674 participants were collected and a weighted average was determined for the mean wear time of each appliance. Results Regardless of the type of extra- or intraoral appliances, mean wear time was shorter than recommended, although patients using intraoral appliances cooperated more. The best compliance was noted for Schwarz appliances (73.70%) and plate retainers (85%). There was no evidence of an influence of patients’ age and sex on compliance during treatment. Conclusions The considerable inconsistency and imprecision of articles could affect the reliability of the results. Previous studies analysing the effectiveness of treatment with removable appliances based on an arbitrarily assumed average wear time need to be revised in order to verify the actual wear time with the use of microsensors.
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Affiliation(s)
- Marek Nahajowski
- Department of Integrated Dentistry, Wroclaw Medical University, Wroclaw, Poland.
| | - Joanna Lis
- Department of Orthodontics and Dentofacial Orthopedics, Wroclaw Medical University, Wroclaw, Poland
| | - Michał Sarul
- Department of Integrated Dentistry, Wroclaw Medical University, Wroclaw, Poland
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Factors Influencing Appliance Wearing Time during Orthodontic Treatments: A Literature Review. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12157807] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This review aims to analyze the multiple factors affecting patients’ level of compliance (how much they wear removable devices/clear aligners) during orthodontic treatments and to investigate the available methods and devices to monitor the appliance wearing time and to improve it. A literature search was conducted on electronic databases (Pubmed, Scopus, and Google Scholar). The results of the present study suggest that compliance indicators may misestimate the intraoral wearing time. Compliance is affected by patient-related factors (age, personality traits, the importance of personal appearance, self-perception of malocclusion), appliance-related factors (visibility, pain/discomfort), and clinician-related factors (trust, clear and complete communication, motivation). The motivation of pre-pubertal patients is mostly external, while adolescents/young adults have intrinsic motivation for orthodontic treatment. Patients’ self-reports tend to overestimate the appliance wearing time. Even if there is a lack of evidence, teledentistry might improve patients’ awareness of being monitored, thus increasing the time for which orthodontic devices are worn. Compliance is a key factor for clear aligner treatments, but high-quality studies focusing on this aspect are missing. Further studies should focus on how to handle the lack of cooperation and how to increase compliance in order to maximize the treatment’s results.
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Sangalli L, Savoldi F, Dalessandri D, Visconti L, Massetti F, Bonetti S. Remote digital monitoring during the retention phase of orthodontic treatment: A prospective feasibility study. Korean J Orthod 2022; 52:123-130. [PMID: 35321951 PMCID: PMC8964474 DOI: 10.4041/kjod.2022.52.2.123] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/27/2021] [Accepted: 11/03/2021] [Indexed: 01/24/2023] Open
Abstract
Objective To evaluate if a remote digital monitoring system added at the end of orthodontic treatment could positively influence the retention phase by reducing the occurrence of misfit of removable appliances, number of emergency appointments (EA), and orthodontic relapse. Methods Twenty-seven patients who completed active orthodontic treatment were divided into the study and control groups. In addition to the standard chairside follow-up appointments at month 1 (T1), month 3 (T2), month 6 (T3), the study group patients were monitored using Dental Monitoring® with monthly intra-oral scans. Occurrence of misfit of removable retainers, number of EAs, and intercanine width change were recorded for both groups. Differences in EAs and retainer fit were assessed using the chi-square test. Intra-group and inter-group differences in the intercanine width were assessed with Friedman test and Mann–Whitney U test, respectively (α = 0.05). Results The study group showed a significantly lower occurrence of misfit of removable retainers (p = 0.027) compared to the control group. No significant inter- and intra-group difference was found in the EAs and intercanine width change at each time-point. Conclusions Integrating remote monitoring systems, such as Dental Monitoring®, to the retention phase of the orthodontic treatment may lower the occurrence of misfit of removable retainers. However, a small sample size and a short observation period limit the strength of this evidence. These preliminary results tentatively suggest that remote monitoring technologies may be beneficial, especially during the COVID-19 pandemic, when the regularity of in-office visits might be disrupted.
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Affiliation(s)
- Linda Sangalli
- Dental School, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.,Department of Oral Health Science, Division of Orofacial Pain, College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - Fabio Savoldi
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Domenico Dalessandri
- Dental School, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Luca Visconti
- Dental School, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Francesca Massetti
- Dental School, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Stefano Bonetti
- Dental School, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
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22
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Nahajowski M, Lis J, Sarul M. The Use of Microsensors to Assess the Daily Wear Time of Removable Orthodontic Appliances: A Prospective Cohort Study. SENSORS 2022; 22:s22072435. [PMID: 35408050 PMCID: PMC9003140 DOI: 10.3390/s22072435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/18/2022] [Accepted: 03/19/2022] [Indexed: 11/19/2022]
Abstract
Orthodontic treatment with removable appliances is still common in children and adolescents. However, their effectiveness depends primarily on the patients’ compliance. Currently, it is possible to check the daily wear time (DWT) of the removable appliances using special microsensors. The aim of this prospective cohort study was to assess the degree of patients’ compliance depending on the type of removable appliance used. In total, 167 patients (87 F, 80 M) were enrolled in the study and were treated with block appliances (Klammt, Twin-Block), Schwarz plates, and block appliances in combination with headgear. All patients were followed up for 6 months with the mean daily wear time checked at followup visits using TheraMon® microsensors fitted in the appliances. It has been shown that the type of appliance influences the patients’ compliance. The DWT for the Twin Block was significantly longer compared to the DWT for the other appliances. Girls have been shown to wear removable appliances better than boys. It has been proven that the majority of patients do not follow the orthodontist’s recommendations, wearing removable appliances for just over half of the recommended time. Microsensors can be used for objective verification of patients’ compliance, which allows for a reliable assessment of the effectiveness of treatment with removable appliances.
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Affiliation(s)
- Marek Nahajowski
- Department of Integrated Dentistry, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland;
- Clinic of Orthodontics, Academic Policlinic of Stomatology, Krakowska 26, 50-425 Wroclaw, Poland;
- Correspondence:
| | - Joanna Lis
- Clinic of Orthodontics, Academic Policlinic of Stomatology, Krakowska 26, 50-425 Wroclaw, Poland;
- Department of Orthodontics and Dentofacial Orthopedics, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland
| | - Michał Sarul
- Department of Integrated Dentistry, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland;
- Clinic of Integrated Dentistry, Academic Policlinic of Stomatology, Krakowska 26, 50-425 Wroclaw, Poland
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İshakoğlu S, Çokakoğlu S. Evaluation of relapse with thermoplastic retainers equipped with microsensors. Angle Orthod 2022; 92:340-346. [PMID: 35076691 DOI: 10.2319/072221-578.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 11/01/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To examine relapse with thermoplastic retainers equipped with microsensors 1 year after treatment. MATERIALS AND METHODS A total of 42 patients (29 females, 13 males) treated with four premolar extractions were included in this study. Thermoplastic appliances equipped with TheraMon microsensors (Handelsagentur Gschladt, Hargelsberg, Austria) were used to assess daily wear time (DWT), and the patients were monitored at 2-month intervals for a period of 12 months. At the end of the follow-up, the following two groups were formed based on the mean DWT: short wear time (SWT; <9 h/d) and long wear time (LWT; ≥9 h/d). Digital models were constructed before treatment (T0), at debonding (T1), and 6 months (T2) and 12 months (T3) after debonding. Little's Irregularity Index (LII) and the intercanine and intermolar widths, arch lengths, overjet, and overbite were calculated based on the digital models. Data were analyzed statistically. RESULTS Irregularity and overjet increased, whereas transverse measurements and arch lengths decreased with time in both groups. During the retention period, overbite decreased in the SWT group but increased in the LWT group. There were significant differences between groups only in mandibular irregularity. The LII values of the SWT group were significantly higher than those of the LWT group for the T1-T2 and T1-T3 time intervals (P < .05). CONCLUSIONS A mean DWT less than 9 hours/day was inadequate for controlling irregularity within clinically acceptable limits. A wear time of at least 9 h/d is recommended for the maintenance of mandibular anterior alignment.
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Zhang X, Al-Moghrabi D, Pandis N, Shah S, Fleming PS. The effectiveness of a bespoke mobile application in improving adherence with removable orthodontic retention over 12 months: A randomized controlled trial. Am J Orthod Dentofacial Orthop 2021; 161:327-337. [PMID: 34801348 DOI: 10.1016/j.ajodo.2021.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/01/2021] [Accepted: 09/01/2021] [Indexed: 11/01/2022]
Abstract
INTRODUCTION The primary aim was to analyze the effect of providing a mobile application (My Retainers) on adherence with removable retention. METHODS Eighty-four participants planned for thermoplastic retainers were randomly allocated to 2 groups. The intervention group was given access to a bespoke mobile application, while the control group was not given access. Baseline data were obtained at the removal of orthodontic appliances with follow-up at 3 months, 6 months, 9 months, and 12 months. The primary outcome was objectively assessed retainer wear recorded using a TheraMon microelectronic sensor (MC Technology GmbH, Hargelsberg, Austria). Secondary outcomes were stability and periodontal implications. RESULTS The objectively assessed wear time at 12 months was low in both groups, being marginally higher in the intervention (median, 3.09 h/d; interquartile range, 8.1) than the control group (median, 1.44 h/d; interquartile range, 9.22) with no between-group statistical difference (P = 0.30, 95% confidence interval [CI], -3.91 to 1.19). No statistically significant difference was identified between the groups in terms of stability and periodontal outcomes. Improvement in plaque scores (P <0.0001; 95% CI, -0.20 to 0.15) and bleeding on probing (P <0.0001, 95% CI, -0.23 to -0.12) was noted over time with no periodontal attachment loss detected over the study period. CONCLUSIONS Provision of the mobile application did not lead to improved adherence with thermoplastic retainer wear. Similarly, no benefit in respect of either occlusal stability or periodontal health was observed over the 12-month study period. Further novel approaches to improve adherence with retainer wear and oral hygiene measures are required. REGISTRATION NCT03224481. PROTOCOL Not published. FUNDING This work was supported by funding from the European Orthodontic Society.
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Affiliation(s)
- Xu Zhang
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Dalya Al-Moghrabi
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia; Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopaedics, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Seema Shah
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Padhraig S Fleming
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.
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Kutay C, Kılıçoğlu H, Sayar G. Comparison of objective wear time between monoblock and twin-block appliances measured by microsensor. Angle Orthod 2021; 91:749-755. [PMID: 34319376 DOI: 10.2319/021421-128.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 05/01/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To assess the objective compliance levels in skeletal Class II patients with mandibular retrognathia wearing monoblock and twin-block appliances. MATERIALS AND METHODS A prospective clinical study was conducted with 30 patients between 10 and 15 years old who were equally divided into two study groups. Group 1 was treated with monoblock, and group 2 was treated with twin-block appliances. The patients were instructed to wear their appliance for 15 hours per day. Wear times were monitored by a microsensor. (TheraMon; MCTechnology, Hargelsberg, Austria) for an average of six appointments. Patients were also instructed to record their wear times on a chart, and this record was admitted as subjective wear time. Statistical analysis was performed with the data derived from both the patients' charts and the monitoring records. RESULTS The mean wear time by the patients was 10.67 ± 3.93 hours, which was less than the 15 hours prescribed by the orthodontist, with no difference between the two appliances (P > .05). The regular use rate, which included the days with a wear time of 8 hours or more per day, was 75%. Compliance levels decreased by 35% throughout the six control appointments. Patients declared that their wear time was more than their objective wear time by an average of 3.76 hours. CONCLUSIONS Despite their different designs, there was no significant difference between the monoblock and twin-block appliances in terms of compliance.
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Dritsas K, Alharbi M, Kouvelis G, Kloukos D, Gkantidis N. Effect of the timing of second molar bonding on the duration of the mandibular arch levelling: a randomized clinical trial. Eur J Orthod 2021; 44:203-209. [PMID: 34226926 DOI: 10.1093/ejo/cjab046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
INTRODUCTION This study investigated the effect of the timing of second molar bonding on the time required for the levelling of the mandibular dental arch. TRIAL DESIGN Single-centre two-arm parallel randomized clinical trial using random permuted blocks. Allocation concealment was achieved through sealed envelopes. There was blinding in outcome assessment, but not of patient or operator. METHODS Thirty-six patients (12-18 years old) with mild to moderate crowding and fully erupted mandibular second molars were assigned randomly (1:1 ratio) in two groups. Group A started fixed orthodontic treatment by bracket bonding in both jaws. Initial wire was 0.014" NiTi. Lower second molar tubes were bonded at the time of 0.016" x 0.022" NiTi wire placement. Group B was same as Group A, but second lower molars were bonded at the first appointment. Placement of the 0.017" x 0.025" stainless steel wire in the mandibular arch was considered the primary endpoint of the trial, indicating the completion of the levelling phase. The days required from bonding to the endpoint comprised the main outcome. Non-parametric statistics were applied. RESULTS There were two dropouts in each group. The compared groups had similar baseline characteristics regarding age, sex, overjet, overbite, space in the dental arch, average Curve of Spee (CoS), and maximum CoS. Group A tended to require more days for levelling (median: 203 days) than Group B (median: 168 days). However, this difference was not statistically significant (P = 0.128). From the tested occlusal factors, only initial overjet was found to be moderately associated with the days required to complete levelling of the mandibular arch (r = 0.45, P = 0.009). CONCLUSIONS In the frame of the current study, the duration of the levelling phase of orthodontic treatment with fixed appliances was not affected by the timing of second molar inclusion in the appliance. Future research could aim in cases with deep CoS to generalize the present findings and in larger sample sizes.
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Affiliation(s)
- Konstantinos Dritsas
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Switzerland
| | - Majed Alharbi
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Switzerland
| | - Georgios Kouvelis
- Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force General Hospital, Athens, Greece.,Department of Orthodontics, Faculty of Dentistry, Aristotle University of Thessaloniki, Greece
| | - Dimitrios Kloukos
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Switzerland.,Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force General Hospital, Athens, Greece
| | - Nikolaos Gkantidis
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Switzerland
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Robotic Applications in Orthodontics: Changing the Face of Contemporary Clinical Care. BIOMED RESEARCH INTERNATIONAL 2021; 2021:9954615. [PMID: 34222490 PMCID: PMC8225419 DOI: 10.1155/2021/9954615] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/02/2021] [Indexed: 11/18/2022]
Abstract
The last decade (2010-2021) has witnessed the evolution of robotic applications in orthodontics. This review scopes and analyzes published orthodontic literature in eight different domains: (1) robotic dental assistants; (2) robotics in diagnosis and simulation of orthodontic problems; (3) robotics in orthodontic patient education, teaching, and training; (4) wire bending and customized appliance robotics; (5) nanorobots/microrobots for acceleration of tooth movement and for remote monitoring; (6) robotics in maxillofacial surgeries and implant placement; (7) automated aligner production robotics; and (8) TMD rehabilitative robotics. A total of 1,150 records were searched, of which 124 potentially relevant articles were retrieved in full. 87 studies met the selection criteria following screening and were included in the scoping review. The review found that studies pertaining to arch wire bending and customized appliance robots, simulative robots for diagnosis, and surgical robots have been important areas of research in the last decade (32%, 22%, and 16%). Rehabilitative robots and nanorobots are quite promising and have been considerably reported in the orthodontic literature (13%, 9%). On the other hand, assistive robots, automated aligner production robots, and patient robots need more scientific data to be gathered in the future (1%, 1%, and 6%). Technological readiness of different robotic applications in orthodontics was further assessed. The presented eight domains of robotic technologies were assigned to an estimated technological readiness level according to the information given in the publications. Wire bending robots, TMD robots, nanorobots, and aligner production robots have reached the highest levels of technological readiness: 9; diagnostic robots and patient robots reached level 7, whereas surgical robots and assistive robots reached lower levels of readiness: 4 and 3, respectively.
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Al-Moghrabi D, Barber S, Fleming PS. Removable retention: enhancing adherence and the remit of shared decision-making. Br Dent J 2021; 230:765-769. [PMID: 34117436 DOI: 10.1038/s41415-021-2951-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/08/2020] [Indexed: 11/09/2022]
Abstract
Patient adherence to removable retainer wear is integral to the long-term success of retention regimes. We discuss the factors influencing removable retainer wear, the methods of gauging wear levels, approaches to enhance adherence and the quality of online available information concerning retention. The potential value of patient involvement in approaches to retention within a shared decision-making framework and motivational interviewing are also highlighted.
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Affiliation(s)
- Dalya Al-Moghrabi
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia; Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
| | - Sophy Barber
- Orthodontic Department, Leeds Dental Institute, Clarendon Way, Leeds, UK
| | - Padhraig S Fleming
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Moreno-Fernández A, Iranzo-Cortés JE, Paredes-Gallardo V, García-Sanz V, Tarazona-Álvarez B, Almerich-Silla JM, Bellot-Arcís C, Montiel-Company JM. Effectiveness of removable appliances with temperature sensors in orthodontic patients: a systematic review and meta-analysis. Eur J Orthod 2021; 44:134-145. [PMID: 34100070 DOI: 10.1093/ejo/cjab033] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND/OBJECTIVE Patient compliance during orthodontic treatment is one of the factors that most affects success in the final result. The use of removable appliances is frequent at an early age and the monitoring of its use is essential to assess the collaboration of the patient. The aim of this study was to establish the effectiveness of microsensors included in removable appliances during orthodontic treatment or in the retention phase to enable a reliable and individualized follow-up of the patient. SEARCH METHODS The article search was carried out in various electronic databases and journals without any language restrictions. SELECTION CRITERIA Studies using microsensors into removable appliances were selected with the key selection criterion of a minimum follow-up of 4 weeks. DATA COLLECTION AND ANALYSIS The quality of the studies included was evaluated using the Cochrane scale for the randomized controlled trials and the Newcastle Ottawa Scale for control-case, cohort, and transversal studies. The mean of the differences with a 95% confidence interval was expressed for the continuous data. RESULTS Twenty-nine full-text articles were analysed and included in the qualitative synthesis. In general, the mean daily wear time of removable appliances measured objectively was less than the time that the professional had predetermined. CONCLUSIONS The use of microsensors as an objective measurement method enhances communication and boosts confidence in the orthodontist-patient relationship. More random clinical studies with temperature sensors are needed to establish to what extent they influence the orthodontic outcome. REGISTRATION PROSPERO (CRD42019120525).
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Adobes-Martin M, Montoya-Morcillo ML, Zhou-Wu A, Garcovich D. Invisalign treatment from the patient perspective: A Twitter content analyses. J Clin Exp Dent 2021; 13:e376-e382. [PMID: 33841737 PMCID: PMC8020322 DOI: 10.4317/jced.57835] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/02/2020] [Indexed: 11/05/2022] Open
Abstract
Background Understanding patient perspective is a key factor in improving treatment satisfaction. The aim of the present study is to qualitatively describe the content of Twitter posts related to the treatment with Invisalign in order to get a better understanding of patient experience. Material and Methods Tweets were prospectively collected during a period of four weeks from public available posts on Twitter using Awario™ a bespoke social media monitoring tool. After applying the pertinent inclusion and exclusion criteria the selected posts were analysed by three investigators using thematic analysis. Specific themes and subthemes were developed. Results A total of 1564 tweets were analysed; three mayor themes were identified: Pre-treatment related, Treatment related and Patient/clinician relationship. Pre-treatment posts were mainly positive and underlined patients' expectations, while in the treatment phase an almost equal number of positive and negative posts were found. The positive post were about the satisfaction with treatment and the improvement of self-esteem. The negative ones were related to pain, compliance, the impact on diet and pronunciation. Conclusions The present study provides a better understanding of patients' experience during clear aligners treatment. Increasing the awareness of the clinicians can improve their ability to face problems related to the orthodontic treatment and to provide to their patients better professional advices and counselling. Key words:Social media, twitter, clear aligners, Invisalign, orthodontics.
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Affiliation(s)
- Milagros Adobes-Martin
- Professor, Department of Orthodontics, Universidad Europea de Valencia. Spain. Department of Pediatric dentistry, Dental School, University of Valencia, Valencia, Spain
| | | | - Angel Zhou-Wu
- Professor, Department Orthodontics, Universidad Europea de Valencia. Spain
| | - Daniele Garcovich
- Professor, Department of Orthodontics, Universidad Europea de Valencia. Spain
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Zhang J, Yang Y, Han X, Lan T, Bi F, Qiao X, Guo W. The application of a new clear removable appliance with an occlusal splint in early anterior crossbite. BMC Oral Health 2021; 21:36. [PMID: 33478458 PMCID: PMC7818763 DOI: 10.1186/s12903-021-01393-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 01/11/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The effectiveness of anterior crossbite treatment in preschool-aged children depends on the treatment design and patient compliance. Common early treatment appliances with steel wires and acrylic resin can bring about numerous problems, such as toothache, sore gums and mucous membrane injury. The aim of this study was to propose a new clear removable appliance to provide preschool-age children with an improved experience of early occlusal interference treatment. METHODS Appliances were designed with the help of 3-dimensional (3D) digital reconstruction oral models and fabricated using 3D printing technology and the pressed film method. Then, the mechanical properties of the original dental coping sheet and thermoformed aligners were assessed in a simulated intraoral environment. Preschool-age participants who displayed anterior crossbite were recruited in this study. Records (photographs and impressions) were taken before the treatment (T1), during the treatment (T2) and at the end of the treatment (T3). The effects of treatment were evaluated by clinical examination and questionnaires. RESULTS Normal degrees of overbite and overjet in the primary dentition were achieved using this new appliance. Dental and soft tissue relationships were improved. Questionnaires showed that the safety evaluation, degree of comfort and convenience grades of the appliance were all relatively high. CONCLUSION This explorative study demonstrates that our new clear removable appliance is able to correct early-stage anterior crossbite in a safe, comfortable, convenient and efficient way. Thus, it is a promising method to correct a certain type of malocclusion, and its clinical use should be promoted in the future.
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Affiliation(s)
- Jiayu Zhang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Sec. Ren Min Nan Road, Chengdu, 610041, Sichuan Province, People's Republic of China
- National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Sec. Ren Min Nan Road, Chengdu, 610041, Sichuan Province, People's Republic of China
- National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Sec. Ren Min Nan Road, Chengdu, 610041, Sichuan Province, People's Republic of China
- Department of Pediatric Dentistry, West China School of Stomatology, Sichuan University, No. 14, 3rd Sec. Ren Min Nan Road, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Yuzhi Yang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Sec. Ren Min Nan Road, Chengdu, 610041, Sichuan Province, People's Republic of China
- National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Sec. Ren Min Nan Road, Chengdu, 610041, Sichuan Province, People's Republic of China
- National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Sec. Ren Min Nan Road, Chengdu, 610041, Sichuan Province, People's Republic of China
- Department of Pediatric Dentistry, West China School of Stomatology, Sichuan University, No. 14, 3rd Sec. Ren Min Nan Road, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Xue Han
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Sec. Ren Min Nan Road, Chengdu, 610041, Sichuan Province, People's Republic of China
- National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Sec. Ren Min Nan Road, Chengdu, 610041, Sichuan Province, People's Republic of China
- National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Sec. Ren Min Nan Road, Chengdu, 610041, Sichuan Province, People's Republic of China
- Department of Pediatric Dentistry, West China School of Stomatology, Sichuan University, No. 14, 3rd Sec. Ren Min Nan Road, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Tingting Lan
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Sec. Ren Min Nan Road, Chengdu, 610041, Sichuan Province, People's Republic of China
- National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Sec. Ren Min Nan Road, Chengdu, 610041, Sichuan Province, People's Republic of China
- National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Sec. Ren Min Nan Road, Chengdu, 610041, Sichuan Province, People's Republic of China
- Department of Pediatric Dentistry, West China School of Stomatology, Sichuan University, No. 14, 3rd Sec. Ren Min Nan Road, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Fei Bi
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Sec. Ren Min Nan Road, Chengdu, 610041, Sichuan Province, People's Republic of China
- National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Sec. Ren Min Nan Road, Chengdu, 610041, Sichuan Province, People's Republic of China
- National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Sec. Ren Min Nan Road, Chengdu, 610041, Sichuan Province, People's Republic of China
- Department of Pediatric Dentistry, West China School of Stomatology, Sichuan University, No. 14, 3rd Sec. Ren Min Nan Road, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Xiangchen Qiao
- Chengdu Renjitiancheng Biotechnology Limited Corporation, Chengdu, People's Republic of China
| | - Weihua Guo
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Sec. Ren Min Nan Road, Chengdu, 610041, Sichuan Province, People's Republic of China.
- National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Sec. Ren Min Nan Road, Chengdu, 610041, Sichuan Province, People's Republic of China.
- National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Sec. Ren Min Nan Road, Chengdu, 610041, Sichuan Province, People's Republic of China.
- Department of Pediatric Dentistry, West China School of Stomatology, Sichuan University, No. 14, 3rd Sec. Ren Min Nan Road, Chengdu, 610041, Sichuan Province, People's Republic of China.
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Yan D, Liu Y, Che X, Mi S, Jiao Y, Guo L, Li S. Changes in the Microbiome of the Inner Surface of Clear Aligners After Different Usage Periods. Curr Microbiol 2021; 78:566-575. [PMID: 33392671 DOI: 10.1007/s00284-020-02308-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 11/24/2020] [Indexed: 10/22/2022]
Abstract
Clear aligners are removable orthodontic appliances that cover the tooth surface. The microbial composition and pH of the inner surface of aligners directly affect the enamel health. In this study, eight subjects who used the same type of clear aligners were instructed to brush their teeth normally and to not clean their aligners until sampling. Saliva and the contents of the inner surface of the aligners (liquid and plaque) were collected at 0 h (T0), 4 h (T4), 8 h (T8), 12 h (T12), and 24 h (T24) after usage, and pH values and microbial compositions were measured. The microbial composition was analyzed with 16S rRNA gene sequencing, and changes were assessed based on operational taxonomic unit abundance. The pH, alpha diversity values, and abundance of specific microbes on the inner surface of the aligners gradually decreased from T0 to T24 (P < 0.05). An insignificant increase in microbial community beta diversity was observed from T0 to T24. Principal component analysis revealed that the microbial composition at T0 was different from at T12 and T24. The relative abundances of phylum Firmicutes (P < 0.01), orders Lactobacillales and Bacteroidales (P < 0.05), and genus Streptococcus and species Streptococcus infantis increased significantly, while those of genera Actinomyces and Rothia and species Rothia aeria decreased significantly at T24 (P < 0.05). These findings reveal that uncleaned aligners might lead to enamel damage, especially after continuous usage for 12 h. Thus, clear aligners should be cleaned after 12 h of usage or at least within 24 h of usage.
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Affiliation(s)
- Dong Yan
- Department of Orthodontics, Beijing Stomatological Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yi Liu
- Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Beijing Stomatological Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Xiaoxia Che
- Department of Orthodontics, Beijing Stomatological Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Sicong Mi
- Department of Orthodontics, Beijing Stomatological Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yao Jiao
- Department of Orthodontics, Beijing Stomatological Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Lijia Guo
- Department of Orthodontics, Beijing Stomatological Hospital, Capital Medical University, Beijing, People's Republic of China.
| | - Song Li
- Department of Orthodontics, Beijing Stomatological Hospital, Capital Medical University, Beijing, People's Republic of China.
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Barros SE, Siqueira SP, Janson G, Chiqueto K. Short-term efficacy of vacuum-formed maintainer for deciduous second molar space maintenance in the mixed dentition: A single-centre, randomized controlled clinical trial. Orthod Craniofac Res 2020; 24:502-510. [PMID: 33352006 DOI: 10.1111/ocr.12460] [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: 10/23/2020] [Revised: 12/07/2020] [Accepted: 12/16/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To compare the efficacy of vacuum-formed and banded space maintainers for deciduous second molar space maintenance during the mixed dentition. SETTING AND SAMPLE POPULATION The study sample comprised thirty children in the mixed dentition (age range, 5.9 to 9.8 years) with early loss of at least one deciduous second molar. METHODS This was a parallel-group, randomized, active-controlled clinical trial. Patients were randomly allocated to space maintenance performed with vacuum-formed or banded space maintainers with a 1:1 allocation ratio. The main outcome was any change in mesiodistal width of the extraction space. Secondary outcomes included the lingual rolling or axial rotation of the permanent first molar adjacent to the extraction site and extrusion of the antagonist tooth. Dental casts were obtained before appliance installation (T0), after 3 months (T1) and after 6 months (T2). Digital dental casts were measured using Dolphin 3D software. Chi-square, t test or Mann-Whitney and ANOVA or Friedman test were used for intra- and intergroup comparisons (P < .05). RESULTS Baseline characteristics were similar between groups except for chronological age. Statistically, but not clinically significant space loss (mean, 0.32 mm; SD, ± 0.39) occurred with the vacuum-formed space maintainer only at the first trimester (T0-T1). Lingual rolling and axial rotation of the first permanent molar were not significant, as well as extrusion of the antagonist tooth. CONCLUSIONS The results of this study suggested that both tested devices were effective in maintaining space after early extraction of the deciduous second molar over a period of 6 months.
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Affiliation(s)
- Sérgio Estelita Barros
- Division of Orthodontics. Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Simone Pinheiro Siqueira
- Division of Orthodontics. Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Guilherme Janson
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil
| | - Kelly Chiqueto
- Division of Orthodontics. Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Naseri N, Baherimoghadam T, Bassagh N, Hamedani S, Bassagh E, Hashemi Z. The impact of general self-efficacy and the severity of malocclusion on acceptance of removable orthodontic appliances in 10- to 12-year-old patients. BMC Oral Health 2020; 20:344. [PMID: 33256680 PMCID: PMC7706242 DOI: 10.1186/s12903-020-01293-2] [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: 04/01/2020] [Accepted: 10/22/2020] [Indexed: 11/22/2022] Open
Abstract
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.
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Affiliation(s)
- Navid Naseri
- Department of Orthodontic, School of Dentistry, Shiraz Branch, Islamic Azad University, Shiraz, Iran
| | - Tahereh Baherimoghadam
- Department of Orthodontic, School of Dentistry, Shiraz Branch, Islamic Azad University, Shiraz, Iran.
| | - Niloofar Bassagh
- Department of Orthodontic, School of Dentistry, Shiraz Branch, Islamic Azad University, Shiraz, Iran
| | - Shahram Hamedani
- Oral and Dental Disease Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elmira Bassagh
- Department of Counseling Center, Shiraz University of Medical Science, Shiraz, Iran
| | - Zahra Hashemi
- Department of Pediatric Dentistry, School of Dentistry, Yasuj University of Medical Sciences, Yasuj, Iran
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Porojan L, Vasiliu RD, Porojan SD, Bîrdeanu MI. Surface Quality Evaluation of Removable Thermoplastic Dental Appliances Related to Staining Beverages and Cleaning Agents. Polymers (Basel) 2020; 12:polym12081736. [PMID: 32756439 PMCID: PMC7464035 DOI: 10.3390/polym12081736] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 07/30/2020] [Accepted: 08/01/2020] [Indexed: 01/04/2023] Open
Abstract
(1) Background: Thermoplastic materials are not inert and subject to changes in the oral environment, which affect their surface quality. Color stability and topographic characteristics of clear thermoplastic appliances are critical considerations. The study aimed to evaluate the optical changes and surface topography of different thermoplastic materials related to staining beverages and cleaning agents. (2) Methods: Thermoplastic polyethylene terephthalate glycol (PET-G) material specimens were selected for the study: S (Duran, Scheu-Dental GmbH, Iserlohn, Germany), D (Biolon, Dreve Dentamid GmbH, Unna, Germany), and B (Crystal, Bio Art Dental Equipment, Sao Carlos, Brazil). Four different media were involved for immersion: coffee (C) and black tea (T) at 55 °C, Coca-Cola (K) at 5 °C, and distilled water (W) at 22 °C. As for cleaning, chemical options and mechanical brushing were selected (P-powder, T-tablets, and X-brushing). Color changes, and mean surface roughness were measured at 24 h, 48 h, and after 7 days. Statistical analysis was performed. After the testing period, atomic force microscopy (AFM) analyses and SEM images were registered in order to characterize the surface topography. (3) Results: Quantitative color change evaluations revealed a slight change in color after 24 h and an extremely marked change after 48 h, respective 7 days. Mean roughness values are kept below the clinically acceptable limit of 0.20 µm for all samples. Related to mean nanoroughness values Sa, and 3D evaluations of the surface quality, Biolon samples have demonstrated the most constant behavior, while Crystal samples are visibly influenced by water immersion. Related to the cleaning method, the topography of Duran samples was influenced by mechanical brushing. (4) Conclusions: Nanoscale investigations provided high accuracy and more realistic surface quality examinations of the examined samples compared to profilometry. Both SEM and AFM should be used for a more detailed description of the surface topography.
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Affiliation(s)
- Liliana Porojan
- Department of Dental Prostheses Technology (Dental Technology), “Victor Babeș” University of Medicine and Pharmacy Timișoara, Romania, Eftimie Murgu Sq. no. 2, 300041 Timișoara, Romania;
| | - Roxana-Diana Vasiliu
- Department of Dental Prostheses Technology (Dental Technology), “Victor Babeș” University of Medicine and Pharmacy Timișoara, Romania, Eftimie Murgu Sq. no. 2, 300041 Timișoara, Romania;
- Correspondence: ; Tel.: +40-745225523
| | - Sorin-Daniel Porojan
- Department of Oral Rehabilitation (Dental Technology), “Victor Babeș” University of Medicine and Pharmacy Timișoara, Romania, Eftimie Murgu Sq. no. 2, 300041 Timișoara, Romania;
| | - Mihaela-Ionela Bîrdeanu
- National Institute for Research and Development in Electrochemistry and Condensed Matter, 300569 Timisoara, Romania;
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Bernard G, Rompré P, Tavares JR, Montpetit A. Colorimetric and spectrophotometric measurements of orthodontic thermoplastic aligners exposed to various staining sources and cleaning methods. Head Face Med 2020; 16:2. [PMID: 32070379 PMCID: PMC7027305 DOI: 10.1186/s13005-020-00218-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/12/2020] [Indexed: 11/25/2022] Open
Abstract
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.
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Affiliation(s)
- Gabrielle Bernard
- Department of Oral Health - Orthodontics Section, Faculty of Dental Medicine, Université de Montréal, Québec, Canada
| | - Pierre Rompré
- Department of Oral Health - Orthodontics Section, Faculty of Dental Medicine, Université de Montréal, Québec, Canada
| | - Jason Robert Tavares
- CREPEC, Department of Chemical Engineering, Polytechnique Montréal, P.O. Box 6079, Stat. Centre-Ville, Montréal, Québec, H3C 3A7, Canada.
| | - Andrée Montpetit
- Department of Oral Health - Orthodontics Section, Faculty of Dental Medicine, Université de Montréal, Québec, Canada
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Treatment compliance of adolescent orthodontic patients with headgear activator and twin-block appliance assessed prospectively using microelectronic wear-time documentation. Eur J Orthod 2020; 42:180-186. [DOI: 10.1093/ejo/cjaa001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Summary
Background
Success of orthodontic removable appliance treatment relies on patient compliance. The aim of this quantitative and qualitative study was to explore the compliance and self-reported experience of adolescents in orthodontic treatment with headgear activator (HGA) or twin-block (TB) appliance.
Materials/methods
The study group comprised 52 adolescents with a mean age of 12.6 (±1.3) years at the start of the treatment. The patients were treated at a free-of-charge public dental clinic. Participants were randomly allocated to two equal groups to be treated with either HGA or TB. Patient compliance was evaluated as appliance wear time and subjective experience. Appliance wear time was recorded with Theramon® microchip, and the self-reported subjective experience using a questionnaire.
Results
In total, 30 patients completed the treatment during the follow-up period. HGA was worn on average 7 hours per day and TB 9 hours per day by those patients, who successfully completed the treatment. During a mean observation period of 13 months (range 7–23 months), the mean actual wear time was 43 per cent less than the advised 12 or 18 hours per day in the whole patient group, and 55 per cent in those patients, who completed the treatment. Compliance level was unrelated to the appliance type.
Limitations
Study assessed a relatively small number of patients.
Conclusions/implications
Adolescent patients wear HGA and TB less than advised. Individual variation in treatment adherence is considerable. Thereby, microelectronic wear-time documentation can be a cost-effective mean of identifying non-compliance.
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Al-Moghrabi D, Pandis N, McLaughlin K, Johal A, Donos N, Fleming PS. Evaluation of the effectiveness of a tailored mobile application in increasing the duration of wear of thermoplastic retainers: a randomized controlled trial. Eur J Orthod 2019; 42:571-579. [DOI: 10.1093/ejo/cjz088] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Summary
Background
The ‘My Retainers’ mobile application is a patient-informed intervention designed to enhance removable retainer wear and associated patient experiences during the retention phase.
Objectives
To evaluate the effect of receiving the ‘My Retainers’ application on objectively assessed thermoplastic retainer (TPR) wear time, stability, periodontal outcomes, patient experiences, and knowledge related to retainers.
Materials and methods
Eighty-four participants planned for removable retention with TPRs were assigned either to receive the ‘My Retainers’ application or to control not receiving electronic reminders during the 3-month period. Randomization was based on computer-generated random numbers and allocation was concealed using opaque, sealed envelopes. The primary outcome was objectively assessed retainer wear recorded using an embedded TheraMon® micro-electronic sensor. Secondary outcomes, including irregularity of the maxillary and mandibular incisors, plaque levels, bleeding on probing and probing depth, were assessed at baseline and 3-month follow-up; and analysed using a series of mixed models. Experiences and knowledge related to orthodontic retainers were recorded using questionnaires. The outcome assessor was blinded when possible.
Results
Receipt of the mobile application resulted in slightly higher median wear time (0.91 hours/day); however, this difference was not statistically significant (P = 0.56; 95% confidence interval [CI]: −2.19, 4.01). No significant differences were found between the treatment groups in terms of stability (P = 0.92; 95% CI: −0.03, 0.04), plaque levels (P = 0.44; 95% CI: −0.07, 0.03), bleeding on probing (P = 0.61; 95% CI: −0.05, 0.03) and probing depth (P = 0.79; 95% CI: −0.09, 0.07). Furthermore, similar levels of patient experiences (P = 0.94) and knowledge related to retainers (P = 0.26) were found. However, marginally better levels of knowledge were identified in the intervention group. No harms were observed.
Limitations
A relatively short follow-up period with the study confined to a single-center in a university-based hospital.
Conclusions
Provision of the bespoke ‘My Retainers’ application did not lead to an improvement in adherence with TPR wear over a 3-month follow-up period. Further refinement and research are required to develop and investigate means of enhancing adherence levels.
Clinical registration
NCT03224481.
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Affiliation(s)
- Dalya Al-Moghrabi
- Centre for Oral Bioengineering, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK
- Department of Preventive Dental Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Nikolaos Pandis
- Department of Orthodontics, Dental School, Medical Faculty, University of Bern, Switzerland; Private practice, Corfu, Greece
| | - Kieran McLaughlin
- Centre for Oral Bioengineering, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK
| | - Ama Johal
- Centre for Oral Bioengineering, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK
| | - Nikolaos Donos
- Centre for Oral Immunobiology and Regenerative Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK
| | - Padhraig S Fleming
- Centre for Oral Bioengineering, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK
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Vagdouti G, Karvouni E, Bitsanis E, Koletsi D. Objective evaluation of compliance after orthodontic treatment using Hawley or vacuum-formed retainers: A 2-center randomized controlled trial over a 3-month period. Am J Orthod Dentofacial Orthop 2019; 156:717-726.e2. [DOI: 10.1016/j.ajodo.2019.07.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 07/01/2019] [Accepted: 07/01/2019] [Indexed: 11/26/2022]
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Colonna A, Lombardo L, Siciliani G, Bracci A, Guarda-Nardini L, Djukic G, Manfredini D. Smartphone-based application for EMA assessment of awake bruxism: compliance evaluation in a sample of healthy young adults. Clin Oral Investig 2019; 24:1395-1400. [DOI: 10.1007/s00784-019-03098-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 09/22/2019] [Indexed: 12/24/2022]
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Al-Moghrabi D, Colonio Salazar FB, Johal A, Fleming PS. Factors influencing adherence to vacuum-formed retainer wear: A qualitative study. J Orthod 2019; 46:212-219. [DOI: 10.1177/1465312519851196] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To explore factors influencing adherence to vacuum-formed retainer wear over a minimum period of four years. Design: A qualitative study based on a randomised controlled trial assessing the effectiveness of orthodontic retainers. Setting: Institute of Dentistry, Queen Mary University of London. Participants: Fifteen participants wearing vacuum-formed retainers for at least four years. Methods: One-to-one semi-structured interviews were undertaken on a criterion-based purposive sample of participants wearing vacuum-formed retainers. The interviews were audio-recorded, transcribed verbatim and analysed using Framework Methodology. Results: High self-reported levels of adherence in the early stages of retention were linked to a desire to maintain orthodontic outcomes and the negative perception of potential post-treatment changes. However, adherence typically reduced over time due to a combination of factors including the negative impact of retainers on quality of life and pragmatic issues related to retainer wear. Network support was found to be important in the short and long term, with instances of self-directed wear and negative beliefs concerning the importance of retainer wear and predisposition to post-treatment changes. Lack of follow-up appointments and immaturity of participants prompted independent decisions to cease retainer wear. Conclusions: Six key influencers of prolonged adherence with vacuum-formed retainer wear were identified. Future strategies to improve adherence should account for these while also being responsive to time elapsed since debond and patient age.
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Affiliation(s)
- Dalya Al-Moghrabi
- Centre for Oral Bioengineering, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- College of Dentistry, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Fiorella Beatriz Colonio Salazar
- Centre for Oral Bioengineering, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Dental Institute, King’s College London, London, UK
| | - Ama Johal
- Centre for Oral Bioengineering, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Padhraig S Fleming
- Centre for Oral Bioengineering, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Ghazal ARA, Idris G, Hajeer MY, Alawer K, Cannon RD. Efficacy of removing Candida albicans from orthodontic acrylic bases: an in vitro study. BMC Oral Health 2019; 19:71. [PMID: 31046747 PMCID: PMC6498590 DOI: 10.1186/s12903-019-0765-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 04/15/2019] [Indexed: 12/23/2022] Open
Abstract
Background This study evaluated the efficacy of four methods in removing Candida albicans from the acrylic base material used to fabricate removable orthodontic appliances. Methods Heat-processed bars of orthodontic acrylic were incubated in a suspension of C. albicans for 2 h at 37 °C. Samples were allocated into five groups (five bars per group) according to the cleaning method: (1) manual brushing using a toothbrush; (2) soaking in a commercial denture cleaning solution; (3) soaking in a commercial mouthwash solution; (4) using an ultrasonic cleaner; and (5) soaking in distilled water as a negative control. Yeast remaining attached to the bars after cleaning were removed by vortexing in growth medium and plated on Sabouraud dextrose agar. The reduction in yeast colony count after cleaning was calculated and expressed as the number of colony forming units per acrylic bar (CFU/bar). The experiment was carried out three times. Results All four cleaning methods resulted in a significant decrease in viable yeast cells associated with the acrylic bars compared to the control group. The mean percentage reduction in viable yeast cells affected by the cleaning methods was: brushing 89.9%; chlorhexidine 95.8%; ultrasonic cleaning 99.9%; and denture tablet 100%. Conclusions All four methods evaluated in this study were effective, to some extent, in removing C. albicans from orthodontic acrylic samples. The most effective, and readily available, cleaning method was the use of commercial denture sterilizing tablets.
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Affiliation(s)
| | - Ghassan Idris
- Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - Mohammad Y Hajeer
- Department of Orthodontics, University of Damascus Dental School, Damascus, Syria
| | - Karam Alawer
- Research microbiology Laboratory, Hama University, Hama, Syria
| | - Richard D Cannon
- Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
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Wouters C, Lamberts TA, Kuijpers-Jagtman AM, Renkema AM. Development of a clinical practice guideline for orthodontic retention. Orthod Craniofac Res 2019; 22:69-80. [PMID: 30771260 PMCID: PMC6850190 DOI: 10.1111/ocr.12302] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 01/31/2019] [Accepted: 02/02/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To develop a clinical practice guideline (CPG) for orthodontic retention (OR). MATERIALS AND METHODS The CPG was developed according to the AGREE II instrument and EBRO (Dutch methodology for evidence-based guideline development). Reporting was done according the RIGHT statement. A Task Force developed clinical questions regarding OR. To answer these questions, a systematic literature search in PubMed and EMBASE was performed. Two independent researchers identified and selected studies, assessed risk of bias using Cochrane RoB tool and rated quality of evidence using GRADE. The Task Force formulated considerations and recommendations after discussing the evidence. The concept CPG was sent for commentary to all relevant stakeholders. RESULT One systematic review-with 15 studies-met the inclusion criteria. In case of low evidence and lack of outcome measures, expert-based considerations were developed. Over four meetings, the Task Force reached consensus on considerations and recommendations, after which the concept CPG was ready for the commentary phase. After processing the comments, the CPG was presented to the Dutch Association of Orthodontists, whereafter authorization followed. LIMITATIONS The paucity of evidence-based studies concerning OR and the reporting of measurable patient outcomes. CONCLUSION This CPG offers practitioner recommendations for best practice regarding OR, may reduce variation between practices and assists with patient aftercare. A carefully chosen retention procedure for individual patients, combined with clear information and communication between orthodontist, dentist and patient will contribute to long-term maintenance of orthodontic treatment results.
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Affiliation(s)
- Cleo Wouters
- Department of Dentistry, Section of Orthodontics and Craniofacial Biology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Toon A Lamberts
- Knowledge Institute of the Federation of Medical Specialists, Utrecht, The Netherlands
| | - Anne Marie Kuijpers-Jagtman
- Department of Dentistry, Section of Orthodontics and Craniofacial Biology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anne Marie Renkema
- Department of Dentistry, Section of Orthodontics and Craniofacial Biology, Radboud University Medical Center, Nijmegen, The Netherlands
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Vasilakos G, Koniaris A, Wolf M, Halazonetis D, Gkantidis N. Early anterior crossbite correction through posterior bite opening: a 3D superimposition prospective cohort study. Eur J Orthod 2019; 40:364-371. [PMID: 29059287 DOI: 10.1093/ejo/cjx074] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objectives To assess the effectiveness, clinical performance, and potential adverse effects of early anterior crossbite correction through opening of the bite. Subjects and methods The sample consisted of 16 consecutive patients (8.0 ± 0.9, range: 6.2-9.3 years) with dental anterior crossbite in the mixed dentition who were treated through posterior bite opening. Patients were prospectively followed until a minimum of 6 months post-treatment and there were no drop-outs. Results In 14 patients (87.5 per cent), the anterior crossbite was corrected. Results remained stable without any retention regime. Active treatment of the successfully treated cases lasted 2.5 months (range: 0.6-8.9). Crossbite correction of central incisors was achieved by a 2.05 mm (range: 0.97-5.45) forward movement and 9.25° (range: 2.32-14.52°) buccal inclination of the crowns (P < 0.05). The antagonists showed spontaneous adaptation of their position in the opposite direction (P < 0.05). No important adverse effects were recorded. Limitations This was a non-comparative controlled study, on a limited sample. Conclusions Bite opening is a promising, simple, and non-compliance approach for early dental anterior crossbite correction. The technique of 3D superimposition and analysis of digital models used here, allowed precise evaluation of single tooth movement in all three planes of space.
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Affiliation(s)
- Georgios Vasilakos
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Switzerland.,Department of Orthodontics and Dentofacial Orthopedics, Friedrich Schiller University of Jena, Germany.,Private practice, Cologne, Germany
| | | | - Michael Wolf
- Department of Orthodontics and Dentofacial Orthopedics, Friedrich Schiller University of Jena, Germany
| | - Demetrios Halazonetis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Greece
| | - Nikolaos Gkantidis
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Switzerland
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Al Rahma WJ, Kaklamanos EG, Athanasiou AE. Performance of Hawley-type retainers: a systematic review of randomized clinical trials. Eur J Orthod 2019; 40:115-125. [PMID: 28549122 DOI: 10.1093/ejo/cjx036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background Although post-treatment changes are almost inevitable, and retention has long been recognized as one of the most critical and routine problems faced by orthodontists, there remains a lack of certainty regarding the parameters of any definitive retention protocol following orthodontic treatment. Objective To investigate the performance of the Hawley-type retainers. Search methods Search without restrictions in 15 databases and hand searching until December 2016. Selection criteria Randomized clinical trials comparing the performance of Hawley-type retainers to other removable appliances or comparing different Hawley-type retainers' wearing schedules. Data collection and analysis Following study retrieval and selection, data extraction and individual study risk of bias assessment using the Cochrane Risk of Bias Tool took place. The overall quality of the available evidence was assessed with the Grades of Recommendation, Assessment, Development, and Evaluation approach. Results Finally, 10 studies were identified involving 854 individuals, followed for up to 1 year after debonding. Eight studies compared subjects using Hawley and clear thermoplastic retainers; another compared Hawley to positioner and, finally, one trial involved individuals allocated to different Hawley appliance wearing schedules. Three studies were considered as being of low, four of unclear, and three of high risk of bias. In general, few differences were observed between the Hawley and other removable retainers regarding outcomes relevant to maxillary and mandibular dental arch measurements, dental arch relationships and occlusal contacts, speech evaluation, patient reported outcomes, adverse effects, and problems related to the appliances, as well as economic evaluation related outcomes. Moreover, no differences were observed between the compared Hawley wearing schedules. Overall, the quality of the available evidence was considered low. Conclusions Given the overall quality of the available evidence and the multitude of parameters, which may have affected the results of the included trials, good practice would suggest further research in the respective field in order to increase both the quantity and quality of information available. Registration PROSPERO (CRD42015029279). Funding No funding was received for the present systematic review.
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Affiliation(s)
- Wafa Jaber Al Rahma
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Eleftherios G Kaklamanos
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Athanasios E Athanasiou
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
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Charavet C, Le Gall M, Albert A, Bruwier A, Leroy S. Patient compliance and orthodontic treatment efficacy of Planas functional appliances with TheraMon microsensors. Angle Orthod 2018; 89:117-122. [PMID: 30080129 DOI: 10.2319/122917-888.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To assess patient compliance and treatment efficacy of preventive expansion treatment with removable Planas functional appliances using an integrated microsensor. MATERIALS AND METHODS Wear time (WT) and behavior of 69 patients undergoing treatment with Planas functional appliances were assessed and analysed using TheraMon microsensors (Gschladt, Hargelsberg, Austria). Patients were followed up for a period of 9 months, and visits were made every 3 months to download WT data from the microsensor and to assess wearing behavior. From individual WT graphs,10 parameters were derived to characterize compliance for each patient. Treatment efficacy was measured by eight parameters determining the level of expansion after 9 months of treatment. RESULTS Patients wore their device on average 15.8 ± 5.2 h/d. WT was unrelated to age and gender, but it was positively influenced by patient habits when keeping appliances during eating, sports, care and handling. Treatment efficacy in terms of intercanine and intermolar expansion was 4.4 ± 1.9 mm and 4.6 ± 2.0 mm for the maxilla, and 5.3 ± 2.0 mm and 4.7 ± 2.3 mm for the mandible, respectively. Efficacy was negatively affected by poor compliance (WT < 9 h/d) and by high variability of within-subject WT recordings. CONCLUSIONS Perfect compliance is not necessary to achieve treatment success, but patients should exhibit sufficient wear time to allow maxillary expansion to occur. The TheraMon microsensor offers a new perspective and aid to individualize treatment prescriptions.
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Fleming PS, Al-Moghrabi D, Fudalej P, Pandis N. Orthodontic pain: The use of non-pharmacological adjuncts and its effect on compliance. Semin Orthod 2018. [DOI: 10.1053/j.sodo.2018.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Schott TC, Menne D. How patient-selected colors for removable appliances are reflected in electronically tracked compliance (wear times and wear behavior). Angle Orthod 2018; 88:458-464. [PMID: 29583018 DOI: 10.2319/101617-700.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES A broad spectrum of colors for removable appliances, intended to optimize acceptance of treatment and patient cooperation, have been available on the dental market for years. This is the first study to analyze how patient-selected colors are reflected in wear times and wear behavior of removable appliances. MATERIALS AND METHODS The study included 117 children (55 girls and 62 boys) who were treated with active removable plate or functional appliances. All patients were offered to choose from 11 different colors, which were pooled into six groups (black, blue, green, yellow, pink, red) for analysis, or to combine any two to four colors ("multicolored" group) for their appliances. All appliances featured a built-in microsensor (TheraMon; MC Technology, Hargelsberg, Austria) for objective wear-time tracking. Differences between wear times were analyzed using pairwise t tests and Tukey correction. RESULTS The longest median wear times were recorded in the blue and green groups (≈11 h/d) and the shortest ones in the red and pink groups (≈9 h/d), but they were not significantly influenced by the patient-selected colors. The median wear times involved an age-related decrease by 0.56 h/y that was statistically significant ( P = .00005). No gender-specific patterns of wear behavior were observed. CONCLUSIONS Patient-selected colors for removable appliances can presumably improve acceptance of treatment, but they are not associated with statistically significant improvements in wear time or wear behavior.
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Pavani CC, Sundfeld D, Schott TC, Bertoz A, Bigliazzi R, Sundfeld RH. Home Dental Bleaching Monitored With Microelectronic Sensors to Record the Wearing Times of an Acetate Tray/Bleaching Product. Oper Dent 2018. [PMID: 29513636 DOI: 10.2341/17-108-s] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The present case study quantifies the clinical wearing time of an acetate tray/bleaching product during home dental bleaching. The patient was instructed to use a 10% carbamide peroxide gel for 6-8 hours each day for 20 days. The wearing time of the tray was measured by a microsensor from TheraMon microelectronic system (Sales Agency Gschladt, Hargelsberg, Austria) completely embedded in the tray so that the clinician would be informed as to the precise time the tray was placed in the mouth. Evaluation of the daily printout during dental bleaching demonstrated that the patient did not correctly follow the clinician's instructions as to the wearing time of the tray. Recording the wearing time of dental bleaching agents can be beneficial for both dental professional and patient to obtain a more effective treatment according to the patient's needs and expectations.
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Fukaya S, Kanzaki H, Miyamoto Y, Yamaguchi Y, Nakamura Y. Possible alternative treatment for mandibular asymmetry by local unilateral IGF-1 injection into the mandibular condylar cavity: Experimental study in mice. Am J Orthod Dentofacial Orthop 2017; 152:820-829. [PMID: 29173861 DOI: 10.1016/j.ajodo.2017.05.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 05/01/2017] [Accepted: 05/01/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The purpose of this study was to investigate whether a local unilateral IGF-1 injection into the mandibular condylar cavity can induce unilateral endochondral mandibular growth without any systemic adverse effects. METHODS Seventy-five 3-week-old male Jcl:ICR mice were used in this study. The mice were divided into 2 groups: control group (n = 22) and IGF-1 group (n = 53). In the IGF-1 group, human IGF-1 was injected into the right mandibular condylar cavity, and phosphate-buffered saline solution was injected into the left cavity, 3 times per week for 10 weeks. RESULTS There was no significant difference in body weight, serum human IGF-1 concentration, and soft tissue thickness of the cheeks including the masseter muscles between the 2 groups. Unilateral IGF-1 injection induced a lateral shift of the mandible to the contralateral side, and microcomputed tomogtraphy analysis showed that unilateral IGF-1 injection induced endochondral growth in the condyle. Col2, Ihh, and Runx2 were extensively upregulated by the local unilateral IGF-1 injection in real-time reverse transcription polymerase chain reaction analysis. Proliferation marker KI67, IGF-1 signaling molecule AKT1, and chondrogenic differentiation marker Col2 were strongly expressed in the IGF-1 injected condyle by immunohistochemistry. Vital labeling showed that the distance between the labels was increased in the IGF-1 injection group compared with that of the control group. CONCLUSIONS The results verified in this study indicated that local unilateral IGF-1 injection into the mandibular condylar cavity successfully induced unilateral endochondral mandibular growth in mice without any systemic adverse effects. Thus, local unilateral IGF-1 injection into the mandibular condylar cavity could be a useful alternative for mandibular asymmetry therapy during the growth period. However, additional experimental and clinical studies will be necessary to prove the real effect of this new therapy.
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Affiliation(s)
- Sari Fukaya
- Department of Orthodontics, School of Dental Medicin, Tsurumi University, Yokohama, Japan
| | - Hiroyuki Kanzaki
- Department of Orthodontics, School of Dental Medicin, Tsurumi University, Yokohama, Japan
| | - Yutaka Miyamoto
- Department of Orthodontics, School of Dental Medicin, Tsurumi University, Yokohama, Japan
| | - Yuki Yamaguchi
- Department of Orthodontics, School of Dental Medicin, Tsurumi University, Yokohama, Japan
| | - Yoshiki Nakamura
- Department of Orthodontics, School of Dental Medicin, Tsurumi University, Yokohama, Japan.
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