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

The Impact of Non-Extraction Orthodontic Treatment on the Oral-Health-Related Quality of Life between a Modified Aligner Appliance with Ni-Ti Springs and the Traditional Fixed Appliances: A Randomized Controlled Clinical Trial

Background and Objectives: To compare the oral-health-related quality of life (OHRQoL) outcomes between patients treated with modified Ni-Ti spring-based alignment appliances or conventional fixed appliances using the Oral Health Impact Profile 14 (OHIP-14), as well as the levels of satisfaction with the appliance appearance, treatment progress, and outcomes. Materials and Methods: Thirty-six patients (11 males, 25 females) were randomly divided into two groups: either the modified aligner appliance with Ni-Ti springs group (MAA) or the traditional fixed appliances group (FA). The allocation ratio was 1:1, and the randomization process was carried out by an independent investigator not involved in this study. Mild crowding cases were included in this study. The OHRQoL of patients was evaluated using the short-form Oral Health Impact Profile (OHIP-14) at five time points: before the treatment commencement (T0); 2 weeks (T1), 1 month (T2), and 2 months (T3) after the treatment initiation; and post-treatment (T4). The visual analog scale (VAS) was used to evaluate the patient satisfaction. Blinding was performed only during the outcomes assessment. Results: This randomized controlled trial had no dropouts, and the demographic characteristics of the groups were comparable. The MAA group experienced significantly greater functional limitations compared with the FA group at all three evaluation time points (T1, T2, and T3), as evidenced by the statistically significant p-values (p = 0.004, p = 0.001, and p < 0.001, respectively). The psychological disability in the MAA group was significantly lower than in the FA group at both T2 (p = 0.005) and T3 (p = 0.003). The patient satisfaction with the appliance appearance was significantly higher in the MAA group than in the FA group (p = 0.002). Conclusions: The OHRQoL improved in both the modified aligner appliance with Ni-Ti springs and fixed appliance groups after the treatment. Moreover, the functional limitations during the treatment were less severe in the FA group, while the psychological disability was lower, and the patient satisfaction with the appliance appearance was higher in the MAA group.

Quantitative light-induced fluorescence enables effective detection of orthodontic adhesive residues in diverse environments

BACKGROUND

Adhesive remnants post-orthodontic treatment might have deleterious effects on oral health, including enamel demineralization, plaque accumulation, and elevated risk of caries development. The aim of this study was to identify and characterize adhesive residues in an ex vivo environment rich in salivary microbiota using quantitative light-induced fluorescence (QLF) technology.

METHODS

Disc-shaped adhesive samples with thickness ranging from 800 to 100 µm were prepared using GC Ortho, GOTO, T Orthobond, and Transbond XT and subsequently evaluated utilizing a QLF system. Bovine teeth containing GC Ortho and GOTO adhesives and isolated human premolar teeth bonded with brackets were subjected to a 10-day incubation in an artificial saliva environment. Daily imaging was conducted using QLF during incubation. Data with ΔR > 30% and simple hygiene score (SHS) were obtained with a software for further analysis.

RESULTS

Fluorescence intensity exhibited significant differences among the four orthodontic adhesives (p < 0.05). Results of incubation in artificial saliva revealed that red fluorescence surrounding the adhesive on the tooth surface was distinctly observable from day five onwards, with ΔR > 30% and SHS levels higher than those of the control group without adhesive (p < 0.05). Observation of fluorescence images of isolated human premolar teeth with bonded brackets indicated that red fluorescence was primarily present around the brackets.

CONCLUSIONS

Application of QLF is efficacious in identifying and demarcating adhesive residues within an environment rich in salivary microbiota.

Evaluation of the Impact of Orthodontic Treatment on Patients' Self-Esteem: A Systematic Review

Malocclusion may affect interpersonal relationships, self-esteem (SE), and psychological well-being, weakening patients' psychological and social activities. Several studies investigated the effect of orthodontic treatment on these social and psychological aspects, such as SE. However, the direct relationship between SE and orthodontic treatment has not yet been confirmed. This systematic review aimed to evaluate the existing evidence in the literature concerning the influences of orthodontic treatment on patients' SE systematically and critically. An electronic search in the following databases was done in September 2022: PubMed®, Web of Science™, Scopus®, Embase®, GoogleTM Scholar, Cochrane Library databases, Trip, and OpenGrey. Then, the reference list of each candidate study was checked for any potentially linked papers that the electronic search might not have turned up. Inclusion criteria were set according to the population/intervention/comparison/outcome/study design (PICOS) framework. For the data collection and analysis, two reviewers extracted data separately. The risk of bias 2 (RoB-2) and the risk of bias in non-randomized studies (ROBINS-I) tools were used to assess the risk of bias for randomized controlled trials (RCTs) and non-RCTs, respectively. The grading of recommendations assessment, development and evaluation (GRADE) approach was employed to evaluate the quality of the evidence for each finding. Sixteen studies (five RCTs, seven cohorts, and four cross-sectional) were included in this review. Unfortunately, the results could not be pooled into a meta-analysis. Only six studies have reported an increase in SE after orthodontic treatment (P<0.05 in these studies). No agreement between the included studies was observed regarding the influence of fixed orthodontic treatment, gender, or age on SE. The quality of evidence supporting these findings ranged from very low to low. There is low evidence indicating that fixed orthodontic treatment can improve patients' SE. In addition, unclear data are available about the influence of patients' gender and age on SE after orthodontic treatment. Therefore, high-quality RCTs are required to develop stronger evidence about this issue.

Premolar Extraction Affects Mandibular Kinematics

OBJECTIVES

 The practice of premolar extraction in orthodontics is controversial for its potential detrimental effects on the stomatognathic system. However, the ways in which premolar extraction affects mandibular function are still poorly understood. The purpose of this study was to assess the influence of premolar extraction on mandibular kinematics by evaluating axiographic tracings.

MATERIALS AND METHODS

 Forty-five orthodontically treated patients with premolar teeth extraction were compared with 45 paired untreated controls, selected for the absence of malocclusions. Systematic three-dimensional axiographic recordings of the mandibular movements were performed for protrusive-retrusive movements and speech. The transversal deviations and length of the movements were recorded for both sides along with the rotation angle during speech.

STATISTICAL ANALYSIS

 Differences between the axiographic variables were analyzed via the permutation test and Wilcoxon rank-sum test. Linear regression was performed to test whether axiographic parameters were predictive of group affiliation. Dot plots were used to explore the distribution of each of the axiographic outcomes, and isometric principal component analysis to assess the differences between the cumulative effects of premolar extraction on jaw motion.

RESULTS

 The mandibular lateral translation in protrusion-retrusion and speech, the amount of rotation as well as the length of mandibular movements during speech were significantly higher in the treated subjects than in the controls, while retral stability did not differ. The linear regression yielded significant results for the mandibular lateral translation in protrusion-retrusion. The isometric principal component analysis showed higher values of the axiographic variables for 11 out of 45 individuals in the study sample compared with the control group.

CONCLUSIONS

 Premolar extraction altered mandibular kinematics in at least 25% of the cases within our sample, and the transversal discrepancy between protrusive and retrusive tracings was even predictive of group affiliation. These results support the notion that the routine practice of premolar extraction as part of the orthodontic treatment should be discouraged. It is compelling to perform further studies to assess whether a disrupted kinematics of the mandible is associated to temporomandibular disorders.

Orthodontic treatment in periodontally compromised patients: a systematic review

OBJECTIVES

The aim of this systematic review was to examine the literature on aggressive and chronic periodontitis and orthodontics to clarify the therapy-relevant aspects of orthodontic treatment with altered biomechanics in periodontally compromised dentition.

MATERIALS AND METHODS

Literature searches were conducted in the electronic databases "PubMed" and "DIMDI" using the keywords "aggressive periodontitis AND ortho*," "aggressive periodontitis AND orthodontics," "chronic periodontitis AND ortho*," and "chronic periodontitis AND orthodontics" for the publication period from January 1990 to July 2022. In addition, a manual search was carried out in the selected trade journals "Community Dental Health," "European Journal of Oral Sciences," and "Parodontologie." Human clinical trials were included, whereas animal experimental studies, case reports, and reviews were generally excluded. The appropriate studies were selected, and the relevant data was tabulated according to different parameters, regarding the study design, the study structure, and the conduct of the study.

RESULTS

A total of 1067 articles were found in the preliminary electronic search. The manual search and review of all related bibliographies resulted in an additional 1591 hits. After the first screening, 43 articles were classified as potentially relevant and reviewed in their original form. After the suitability test, 5 studies with a total of 366 participants were included in the final evaluation. These included one randomized controlled trial and four low-evidence intervention studies. The studies were conducted in two university hospitals and three private practices. All participants underwent scaling and root plaining and periodontal surgery before the orthodontic treatment started. Mean probing pocket depth reduction before and after the interdisciplinary treatment was analyzed in all the included studies; mean difference in clinical attachment level in four of the studies was also included. All participants were enrolled in a continuous recall system. In all studies, orthodontic therapy in periodontally compromised patients improved function and esthetics, resulting in lower probing depths and clinical attachment gains.

CONCLUSIONS

Orthodontic treatment can be used for patients with reduced periodontal support to stabilize clinical findings and improve function and esthetics. The prerequisite for this is a profound knowledge of altered biomechanics and an adapted interdisciplinary treatment approach. Due to the large heterogeneity of the included studies and their limited methodological quality, the results obtained in this review must be considered critically. Further randomized controlled long-term studies with comparable study designs are necessary to obtain reliable and reproducible treatment results.

CLINICAL RELEVANCE

Patients with periodontal impairment can be successfully treated with orthodontics as part of interdisciplinary therapy. Orthodontic treatment has no negative impact on the periodontium; if minimal, controlled forces are used under non-inflammatory conditions.

Eating‐ and oral health‐related quality of life in patients under fixed orthodontic treatment

Objective

The eating problems and changes in the diet and dietary intake of patients under orthodontic treatment are of great importance, and the available studies on this topic are mostly qualitative. Thus, this study aimed to assess the oral health‐related quality of life (OHRQoL) and the eating‐related quality of life (ERQoL) of patients under fixed orthodontic treatment.

Materials and Methods

This prospective study evaluated 105 patients (65 males, 40 females) with a mean age of 26 ± 1.1 years, who required fixed orthodontic treatment. All participants filled out the Oral Health Impact Profile‐14 (OHIP‐14) questionnaire before treatment (T0), and at 1 (T1), 3 (T2), and 6 (T3) months after treatment, and the ERQoL questionnaire at 1 (T1), 3 (T2), and 6 (T3) months after treatment. Data were analyzed using repeated measures analysis of variance with Greenhouse–Geisser and Huynh‐Feldt corrections and Bonferroni test for pairwise comparisons (α = .05).

Results

The OHIP‐14 total score increased at T1 and decreased at T2 and T3, with significant differences between all four time points (p < .001). The ERQoL total score decreased over time, and significant differences were noted between all three time points (p < .001). No significant difference existed in OHRQoL or ERQoL with regard to gender at any time point (p > .05).

Conclusion

The reduction in OHRQoL due to fixed orthodontic treatment was temporary and improved over time. The eating problems also decreased with time.

Self-esteem and oral health-related quality of life of women with periodontal disease - A cross-sectional study

Aim

The aim of this study is to assess the effect of periodontal disease on self-esteem and oral health-related quality of life (OHRQoL) in women.

Materials and Methods

A cross-sectional study was conducted among 522 women (mean age - 38.92 ± 14.3 years). Oral hygiene status, plaque level, gingival inflammation, probing depth, and periodontal status were assessed. The self-esteem was assessed using a Rosenberg Self-esteem Scale, and the OHRQoL was measured using a 14-item oral health impact profile (OHIP-14) questionnaire.

Results

Younger, employed women with higher income had significantly better OHRQoL and self-esteem. Women with healthy periodontium had better OHRQoL. Probing depth and community periodontal index scores were found to have a significant positive correlation with most of the sub-scale items and total OHIP-14 score in women with low self-esteem. Women with good OHRQoL and normal self-esteem were seen to be maintaining significantly better oral hygiene. No such statistically significant difference was observed in women with low self-esteem. Multiple regression analysis for the prediction of OHIP-14 score indicated that the best model included probing depth as the only statistically significant predictor (P = 0.002).

Conclusion

Periodontal disease has a significant negative impact on self-esteem and OHRQoL in women.

Do Specific Craniomaxillofacial Features Correlate with Psychological Distress in Adult Pretreatment Orthodontic Patients? A Cephalometric Study

Purpose

To explore the relationship between craniomaxillofacial features and psychological distress among adult pretreatment orthodontic patients.

Methods

A group of 190 patients (95 males and 95 females) was included. Questionnaires including the Kessler psychological distress scale (K10) were sent to patients, and cephalograms were collected. Patients were divided into two groups according to K10 score: psychological distress group (score ≥ 20) and no psychological distress group (score < 20). Nineteen hard tissue and thirteen soft tissue parameters were traced on cephalograms to characterize the craniomaxillofacial features.

Results

There was no significant difference in gender or age distribution between the two groups. Male patients with psychological distress showed statistically significantly larger anterior facial height (AFH) (126.62 mm vs. 120.97 mm), upper lip length (25.11 mm vs. 23.26 mm), and smaller overbite (1.21 mm vs. 2.75 mm) than patients without psychological distress. Male patients with hyperdivergent pattern and open bite were more likely to have psychological distress. None of the parameters showed statistical differences across groups in females. Frankfort-mandibular plane angle (r = 0.235), Bjork's sum (r = 0.311), AFH (r = 0.322), overbite (r = −0.238), AFH/posterior facial height (r = 0.251), and upper anterior facial height (UAFH)/lower anterior facial height (LAFH) (r = −0.230) were correlated with K10 score in males. After adjusting gender and age, the AFH (B = 0.147) and UAFH/LAFH (B = −14.923) were significantly related with the K10 score.

Conclusion

Psychological distress was mainly correlated with hyperdivergent pattern, open bite, and larger lower anterior facial height proportion in pretreatment orthodontic patients. Orthodontists should be aware of the possible underlying psychological distress in patients with specific craniomaxillofacial features. Clinical assessment of psychological distress may need to take into account gender differences in patients.

Rejuvenation of the ageing face and the role of orthodontics: Guidelines for management

The article reviews the ageing changes of the midfacial and maxillary bones, the mandible, the overlaying soft tissues and the smile, and presents clinical guidelines aiming to rejuvenate older faces by means of orthodontic therapy. With regard to the ageing changes, the maxillary skeleton appears to rotate clockwise inferior to the orbit and becomes retrusive, and as a general pattern the midface contracts and deteriorates with age. Resorption below the mental foramen, reduction in alveolar height, loss of bone at the chin region, and relative increase in size and shape are signs of an aged mandible. Epidermal thinning and decrease in collagen in combination with the effect of gravity and various external factors contribute to the ageing of the skin. Atrophy of the superficial and deep fat, changes in ligamentous tissues and changes in muscle structure, position and tone, all contribute to the stigmata of the aged face. In the article, two late adulthood orthodontic cases are discussed as examples, and general guidelines for orthodontic management of the older face aiming at reversing the 'shrinkage' of the tissues by restoring the facial shape and tightening the soft tissue mask are described. The possible mechanisms explaining the changes observed on the faces of the clinical cases are also discussed. A properly planned and executed orthodontic intervention reversing changes from the inside-out before embarking on cosmetic surgery might have a synergistic effect multiplying the benefits for adult patients.

Effects of orthodontic treatment on body mass index, food habits and self-esteem of patients: A prospective single-arm cohort study

Objectives

During orthodontic treatment, patients are often apprehensive about reduced food intake and loss of body weight. Body mass index (BMI) assessment is an inexpensive, easy method for screening and studying changes in weight categories. This research aimed to determine whether long-term changes in BMI, self-esteem, and food habits occur in patients during the first year of orthodontic treatment.

Methods

BMI was calculated for 120 patients undergoing orthodontic treatment. Data were collected at baseline, and after the end of the first, second, third, sixth, and twelfth months. Rosenberg's self-esteem scale was used for scoring self-esteem. The Food Habit Assessment Scale was used to study changes in eating habits. Statistical analysis was performed with repeated measures ANOVA followed by Tukey HSD post-hoc test for BMI scores and Kruskal–Wallis test followed by Dunn's multiple comparison post-hoc tests for the Rosenberg scale and food habits questionnaire.

Results

At the end of 12 months, 43.4% of patients had a decrease in BMI, 45.8% had a mild to moderate increase in BMI, and 10.8% of patients maintained their BMI levels. The changes were not statistically significant. Self-esteem changes were statistically significant for both genders. Changes in food habits were also significant.

Conclusion

BMI decreased for the first 3 months and gradually recovered by the end of the first year of treatment. Self-esteem scores showed a significant improvement in both genders. Patients reverted to pre-treatment food habits by the end of the year.

Comparison of pain perception, anxiety, and impacts on oral health-related quality of life between patients receiving clear aligners and fixed appliances during the initial stage of orthodontic treatment

BACKGROUND AND OBJECTIVES

Clear aligner is an advanced orthodontic method with benefits of comfort, aesthetics, and convenience. This study aimed to compare pain perception, anxiety, and impacts on oral health-related quality of life (OHRQoL) between adult patients receiving clear aligners and fixed appliances during the initial stage of orthodontic treatments.

MATERIAL AND METHODS

The two groups were well matched by ages, gender, and levels of malocclusion severity. Pain perception, anxiety, and OHRQoL were assessed through visual analogue scale, state-trait anxiety inventory, and oral health impact profile-14 (OHIP-14), respectively. And the comparison of above scores was performed by two-way analysis of variance.

RESULTS

A total of 110 patients (55 pairs) were enrolled in this study. Orthodontic pain levels peaked on the first day and decreased gradually afterwards in both groups, which were significantly higher in the fixed group on the first, second, fourth, and fifth days. Likewise, anxiety levels peaked on the first day and decreased thereafter, with significant difference on the 1st, 3d, 5th, 7th, and 14th days. Moreover, the OHIP-14 scores increased and peaked on the first day and then gradually decreased for both groups, which were also significantly higher in the fixed group on the 1st, 7th, and 14th days.

LIMITATIONS

More malocclusion types should be used for group matching. The effect of exclusion of small groups should be taken into consideration in sample size calculation. Income was significantly unbalanced between two groups due to higher cost of clear aligners, and random assignment of treatment modalities was unfeasible.

CONCLUSIONS

Patients treated with clear aligners experienced lower pain levels, less anxiety, and higher OHRQoL as compared to those receiving fixed appliances.

Impact of oral-health-related quality of life and self-esteem on patients with missing maxillary lateral incisor after orthodontic space closure: a single-blinded, randomized, controlled trial

BACKGROUND

The maxillary lateral incisor is one of the teeth most likely to suffer agenesis, resulting in spacing between the central incisor and the canine.

OBJECTIVE

To compare maxillary lateral incisor agenesis with space closure treatment versus non-treatment based on measurements of the self-perceived oral-health-related quality of life (OHRQoL) and self-esteem of the participants.

SUBJECTS AND METHODS

A total of 44 people, aged 17-49 years, with missing lateral incisors were randomly assigned to two groups (n = 22 in each)-a treated group in which the space was orthodontically closed (TG) and a control group that remained untreated (CG). Randomization was performed by a researcher who was not involved in the clinical part of the study. The outcomes were assessed using the Oral Health Impact Profile and Rosenberg's Self-Esteem Scale, which were applied before (phase 1) and after (phase 2) the orthodontic treatment in the TG, and at baseline (phase 1) and 12 months after (phase 2) in the CG. All the data were blindly evaluated, supporting the single-blinded design of the study.

RESULTS

All participants finished the randomized controlled trial, and the demographic characteristics were similar between the groups. In phase 1, the levels of self-esteem and OHRQoL at baseline were similar (P = 0.079, P = 0.693, respectively). In phase 2, the self-esteem scores of the CG decreased and the OHRQoL increased (P = 0.005, P < 0.001, respectively), while self-esteem increased in the TG and the OHRQoL decreased (P < 0.001). The CG had lower scores than the TG for self-esteem, but the opposite was observed for OHRQoL (P < 0.001).

LIMITATIONS

Information bias may have occurred. Since the questionnaires could not have been applied at the same time in both groups, the time difference between the two assessments may have led to random and systematic error.

CONCLUSIONS

The spacing resulting from missing maxillary lateral incisors had a negative impact on the OHRQoL and self-esteem of the participants, while orthodontically closing those spaces had a positive impact on those aspects.

CLINICAL TRIAL REGISTRATION

This study was not registered.

PROTOCOL

The protocol was not published before trial commencement.

Orthodontic retreatment: positive effects on the patient’s self-esteem and quality of life

Introduction:

An increasing percentage of the world’s population has had access to orthodontic treatment within the last few decades. Consequently, a larger number of patients seeking for correction of their malocclusions, nowadays, present with a history of previous orthodontic therapy. Orthodontists performing retreatments in their practice may have to face additional difficulties, and one of them is treating individuals that may be even more demanding for excellent results and efficient treatments.

Objectives:

This manuscript discusses the challenges faced when performing orthodontic retreatments. It illustrates a two-phase retreatment of a pre-adolescent and the ortho-surgical retreatment of a young adult with high demands for fast and exceptional results. Finally, this paper elaborates on the positive impacts that these retreatments had on the patients’ self-esteem and quality of life.

Comparison of Oral Health Impact Profile (OHIP-14) Values in Cancer Survivor Patients Treated Orthodontically with Either Rapid or Standard Duration Protocols of Treatment-A Prospective Case-Control Study

BACKGROUND

The aim of the study was to compare the oral-health-related quality of life (OHRQoL) between cancer survivors: with rapid orthodontic treatment (TX) (up to 12 months) and standard TX (orthodontic treatment time longer than 16 months).

METHODS

There were 76 cancer survivors (48 women and 28 men) allocated into groups with rapid (36 people) or standard (40 people) duration of TX. OHRQoL was assessed on the basis of Oral Health Impact Profile (OHIP-14) values, measured before TX, 2 weeks and 3 months after the onset of TX, and after the end of TX. A repeated ANOVA test was used to check the statistical significance between the scores.

RESULTS

There were no significant differences regarding the OHIP-14 values between the examined groups at all stages of the examination. Both groups presented significant (p < 0.001) improvement of the values of OHRQoL at the end of TX comparing to the values achieved before the onset of TX.

CONCLUSIONS

Duration of orthodontic treatment by itself had no impact on oral-health-related quality of life.

Novel Orthodontic Cement Comprising Unique Imidazolium-Based Polymerizable Antibacterial Monomers

White spot lesions (WSLs) can develop quickly and compromise the successful outcome of the orthodontic treatment. Orthodontic bonding cement with the capability to prevent or mitigate WSLs could be beneficial, especially for patients with high risk of caries. This study explored novel mono- and di-imidazolium-based polymerizable antibacterial monomers and evaluated orthodontic cement compositions comprising such novel monomers. Their antibacterial potentials, mechanical properties, and shear bond strength (SBS) to bovine enamel were investigated. Statistical tests were applied to SBS and mechanical tests (one-way ANOVA and Tukey’s test). For antibacterial resins C (ABR-C) and E (ABR-E), their minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) against cariogenic Streptococcus mutans bacterial strain UA159 were found to be 4 μg/mL and 8 μg /mL, respectively. The loss of dry mass from completely demineralized dentin beams in buffer solutions pre-dipped into ABR-C and ABR-E resins is much less than that in control buffer (artificial saliva) only. For unfilled resins comprising up to 12 wt % ABR-C, no significant decreases in flexural strength or modulus were observed. For experimental cements incorporating 1–4 wt % ABR-C, there was no drastic compromise to the SBS to enamel except for 3 wt % ABR-C. Furthermore, their SBS was all comparable to the commercially available orthodontic cements. The ISO-22196 antimicrobial test against S. aureus showed significant levels of antibacterial effects—up to over 5 logs of microorganism reduction exhibited by ABR-C-containing experimental cements. The imidazolium-based polymerizable monomers could be utilized to functionalize orthodontic bonding cement with steady antibacterial activity and develop a potential strategy to counteract WSLs.

Non-surgical periodontal therapy effectively improves patient-reported outcomes: A systematic review

AIM

Modern lifespan oral health research focuses on understanding the impact of periodontitis (or therapy) on clinical and patient-based outcome measures to provide effective care, improve patient safety according to the quality standards. For better targeted intervention and effective disease management, this systematically review aimed to investigate the relationship between non-surgical periodontal therapy and patient-based outcomes using OHIP-14.

METHODS

Seven Databases were searched for studies on patient-based outcomes responses to periodontal treatment. The time-period defined from search was from January 1977 to January 2019. Two independent reviewers carried out data search, selection of studies, data extraction and quality assessment using Mixed Method Appraisal Tool. Prospective cohort studies, intervention studies and observational studies written in English demonstrating non-surgical periodontal therapy response on the patient-reported outcomes (using Oral Health Impact Profile 14) were included in the review.

RESULTS

Thirteen studies were included in the review, which comprised of three randomised control trials, nine case series, and one was a quasi-experimental study. Eleven out of the 13 studies reported significant improvement in OHIP-14 scores amongst participants who had undergone non-surgical periodontal therapy. Physical disability, psychological discomfort and functional limitation were domains that improved significantly after non-surgical periodontal therapy in these studies. Physical pain was a common finding in short-term follow-up but improved significantly in long-term follow-up studies.

CONCLUSION

Based on clinical and patient-based outcomes measurement, it is recommended that non-surgical periodontal therapy is a "gold standard" approach towards improving patient-based outcomes, reducing co-morbidities and enhancing patient safely immediately and in long term.

The effect of viewing idealised smile images versus nature images via social media on immediate facial satisfaction in young adults: A randomised controlled trial

Introduction:

The objective of this randomised controlled trial (RCT) is to investigate the effect of a social networking site (SNS) on body dissatisfaction, facial and smile dissatisfaction, and face-related discrepancy, and whether these effects differ from the use of appearance-neutral Instagram images. We also aimed to investigate whether there are trends in increased self-reported use of social media and increased body dissatisfaction, facial and smile dissatisfaction, and face-related discrepancy.

Methods:

Undergraduate students were randomly allocated to an experimental group with idealised smile images or to a control group with neutral nature images. They completed pre-exposure questionnaires, then perused for 5 min their allocated images on individual Apple iPads via the Instagram application. Participants then completed the post-exposure surveys. The main outcome was facial dissatisfaction. Body dissatisfaction and total facial and body dissatisfaction were secondary outcomes. Simple randomisation was achieved with a computerised random number generator. Data were analysed using repeated measures ANOVA and multivariate regression analyses.

Results:

A total of 132 participants (mean age = 20.50 ± 2.21 years) were randomised to either the experimental group with idealised smile images (n=71) or the control group with neutral nature images (n=61). Baseline characteristics were similar between groups and no participants were lost. Exposure to ‘ideal’ facial images on social media decreases facial satisfaction (95% confidence interval [CI] = 0.85–1.05; P < 0.0001). Individuals with high baseline self-discrepancy scores are less satisfied with their facial features and body appearance (95% CI = 0.04–1.16; P = 0.036).

Conclusion:

This study shows that viewing SNSs with high visual media reduces satisfaction with facial appearance in the short term in men and women. This effect is greater in those with high self-discrepancy scores. Increased media usage was not correlated with increased dissatisfaction. Wearing braces or having had braces was shown not to influence post-exposure dissatisfaction.

Orthodontic treatment with passive eruption and mesialization of semi-impacted mandibular third molar in an adult with multiple dental losses

Objective:

This article describes the orthodontic treatment performed on an adult patient with multiple dental losses.

Case report:

A female patient, 20 years and 4 months old, presented with the following conditions: absence of teeth #26, #35, #36 and #46; semi-impacted tooth #48; inclined molars adjacent to an edentulous space; canines and premolars in a Class II relationship; a convex profile; biprotrusion; and forced lip sealing.

Results:

Space in the region of tooth #26 was closed, as well the space of tooth #46; tooth #48 erupted and followed mesial movement passively; space of the region of tooth #35 was maintained for the placement of a dental implant; uprighting of tooth #37 was obtained. Aesthetic and functional goals of the treatment were achieved. Results remained stable 10 years after the end of the treatment.

Conclusion:

The modified helical loop could be effectively used in orthodontic mechanics to close edentulous spaces. Passive semi-impacted mandibular third molar eruption and mesialization can occur in adults when proper space is provided.

Impact of Orthodontic Treatment Complexity on Oral Health-Related Quality of Life in Turkish Patients: A Prospective Clinical Study

Objective

The study aimed to evaluate the relationship between orthodontic treatment complexity and oral health-related quality of life (OHRQoL) and to assess the impact of malocclusion and orthodontic treatment on OHRQoL in orthodontic patients with regard to gender and age.

Methods

This prospective clinical study included 102 patients aged 13-35 years who were referred to the orthodontic department. The impact of orthodontic treatment complexity was assessed using the Index of Complexity, Outcome and Need (ICON). The Turkish version of the Oral Health Impact Profile (OHIP-14) was used to examine the subjects for OHRQoL before and after treatment. The before and after treatment data (T1 and T2, respectively) were tested using a paired t-test, and one-way analysis of variance (ANOVA) with the Bonferroni test was used to assess the differences in OHIP-14 across groups, as defined by the ICON. The cross-sectional comparisons between genders and age groups before and after treatment were tested using the Student's t-test. The level of significance was set to a p value of 0.05.

Results

Patients with moderate treatment complexity reported a significantly negative impact on the psychological disability domain compared to the difficult treatment complexity. OHRQoL improved after treatment. Females showed statistically significant and highest scores on the physical pain domain compared to males. Adults showed a statistically significant negative impact on the psychological domains before treatment as well as a statistically significant positive impact on the psychological disability domain after treatment compared to adolescents (p<0.05).

Conclusion

Orthodontic treatment improves OHRQoL, and orthodontic treatment complexity does not seem to have an impact on OHRQoL.

Psychological impact of orthodontic treatment on quality of life - A longitudinal study

OBJECTIVE

(1) To assess the psychosocial, functional and aesthetic changes in young adults pre- and post-orthodontic treatment. (2) To assess the changes in quality of life in individuals having malocclusion before and after orthodontic appliance therapy. (3) To evaluate the effect of severity of malocclusion pre- and post-orthodontic treatment on quality of life among males and females.

MATERIALS AND METHODS

This longitudinal study included a convenience sample of 18.1 to 25.3-year-old young adults (n=400). The self-perception of dental aesthetics pre- and post-treatment related to gender variations and severity of malocclusion (Angle's class I, II, III) were also assessed using the Psychosocial Impact of Dental Aesthetics Questionnaire with additions (PIDAQ) according to the needs of Indian ethnic group. Cronbach alpha of each domain at baseline score and Wilcoxon signed ranked test was carried out.

RESULTS

Statistically positive psychosocial impacts were observed after orthodontic treatment for the six PIDAQ domains (P<0.001 for all six domains). There was a similar influence of gender and severity on the improvement of scores over the period in all the domains though males showed the least psychological impact on matrimonial concerns both pre- and post-treatment. The severity of malocclusion showed a difference only in functional concerns. There was less improvement in class III malocclusion group as compared to class I and class II groups.

DISCUSSION

Orthodontic treatment has a positive psychological impact, as there was a significant improvement in self-esteem and social interaction of the individuals. Significant changes occurred in functional and aesthetic domain measures of quality of life in orthodontically treated cases. The severity of malocclusion has a negative impact on the quality of life and a significant improvement in the quality of life was observed before and after orthodontic treatment with no gender difference.

A randomized clinical trial of the effectiveness of 0.018-inch and 0.022-inch slot orthodontic bracket systems: part 2-quality of treatment

OBJECTIVE

To compare the quality of orthodontic treatment between 0.018-inch and 0.022-inch slot bracket systems.

SUBJECTS AND METHODS

Eligible participants aged 12 years or over were allocated to the 0.018-inch or 0.022-inch slot MBT appliance (3M-Unitek, Monrovia, California, USA) using block randomization in groups of 10. Outcome measures included: 1. ABO cast-radiograph evaluation (CR-EVAL), 2. peer assessment rating (PAR) scores, 3. incisor inclination, and 4. patient perception using the Index of Orthodontic Treatment Need aesthetic component (IOTN AC) and three validated questionnaires before, during and after treatment. Parametric tests [independent samples t-test and two-way analysis of variance (ANOVA)] and non-parametric tests (chi-square with Fisher's exact tests and Mann-Whitney U-test) assessed differences between groups (P < 0.05).

RESULTS

Of the 187 participants randomized (1:1 ratio), 34 withdrew or were excluded (protocol deviations or poor cooperation). There were 77 patients in the 0.018-inch slot group and 76 patients in the 0.022-inch slot group (overall mean age: 19.1 years). Baseline characteristics were similar between groups (P > 0.05). The mean total ABO CR-EVAL scores were 34.7 and 34.5; mean percentage PAR score reduction 74.1 per cent and 77.1 per cent; mean change for maxillary incisor inclination 2.9 degrees and 1.6 degrees and for mandibular incisor inclination 2.7 degrees and 1.4 degrees for the 0.018-inch and 0.022-inch groups, respectively. Improvement in patient perception of aesthetics after treatment was statistically significant for both groups (P < 0.05). However, there were no statistically significant differences between the two treatment groups for ABO CR-EVAL, percentage PAR score reduction, incisor inclination, and patient perception of treatment (P > 0.05). No adverse events were observed during treatment.

LIMITATIONS

It was impossible to blind clinicians or patients to allocation and oral hygiene and periodontal outcomes were not assessed.

CONCLUSIONS

There were no statistically or clinically significant differences in the quality of occlusal outcomes, incisor inclination and patient perception of treatment between 0.018-inch and 0.022-inch slot bracket systems.

REGISTRATION

The trial was registered with ClinicalTrials.gov on 5 March 2014, registration number: NCT02080338.

PROTOCOL

The protocol was published at DOI: 10.1186/1745-6215-15-389.

Changes in Soft Tissue Profile After Orthodontic Treatment With and Without Extraction: A Systematic Review and Meta-analysis

OBJECTIVE

The objective of this systematic review and meta-analysis was to evaluate the soft tissue changes in adult orthodontic patients who received extraction treatment in comparison to their counterparts who received nonextraction orthodontic treatment.

METHODS

Electronic databases (CENTRAL-Cochrane Register of Controlled Trials, PubMed, Embase, EBESCOhost, LILACS, and Google Scholar) were searched up to March 2015. Handsearching was performed too. The selection process included controlled trials (prospective or retrospective and randomized or nonrandomized) on adult patients receiving orthodontic extraction treatment compared within the same study to a group treated without extraction. The outcomes of interest were the changes in linear and angular cephalometric measurements specific for soft tissue profile. Studies which fulfilled the selection criteria were retrieved. They were assessed for methodological quality based on a validated checklist. Studies of moderate to high quality were included.

RESULTS

Of the nine full texts which fulfilled the selection criteria, 5 were eligible for the quantitative analysis; they scored a moderate quality. Meta-analysis showed a significant increase regarding the nasolabial angle, upper lip thickness, labrale superioris to E-Line, and labrale inferioris to E-line in the extraction group, suggesting the flattening of the profile following extraction treatment.

CONCLUSION

A significant retraction of the lips and an increase in the nasolabial angle are associated with extraction protocols, but the degree to which these changes are considered detrimental/beneficial to the profile could be affected by different factors. Since these finding are based on studies of moderate quality, future research with well-conducted methodologies are highly recommended.

The Effect of Orthodontic Intervention on Mental Health and Body Image

AIM:

Physical health especially oral and dental health can play a leading role in individuals’ mental health status. Therefore, determining the relationship between orthodontics, mental health, and body image can provide solutions for the development of treatment services and provision of greater accessibility of communities to them.

METHODS:

The present study was natural experimental research conducted to determine the relationship between orthodontic treatment, mental health, and body image. To conduct this research, individuals referring to orthodontic clinics in the city of Kermanshah and meeting the inclusion criteria in the study were selected using convenience sampling method and then they were assessed before and after undergoing orthodontics via the standardised Goldberg’s General Health Questionnaire (GHQ) and Multidimensional Body-Self Relations Questionnaire (MBSRQ).

RESULTS:

The mean scores of mental health problems in the study participants reduced and such a difference calculated by Wilcoxon signed-rank test with a 95% confidence level was significant (P = 0.001). Moreover, all the subscales of GHQ in the study participants showed a significant decrease after orthodontics compared to the stage before that (P < 0.05). The mean score of MBSRQ before orthodontics was equal to 171.78 and this value reached 172.51 after that, indicating individuals’ increased scores and their high levels of satisfaction with their body image. Nevertheless, the given difference was trivial, and it was not statistically significant (P = 0.751).

CONCLUSIONS:

The results of the present study showed that orthodontic treatment could significantly increase mental health status in the clients and also improve multidimensional attitudes towards body image.

Protein-mediated anti-adhesion surface against oral bacteria

Biomedical materials, such as orthopedic biomaterials, have a great impact on improving life quality and self-esteem of human beings. However, the usage of fixed appliances during dental treatment often increases the difficulty of oral cleaning and enlarges the adhesion opportunity of oral bacteria. Furthermore, the existing anti-adhesion coatings, such as polyethylene glycol derivatives and zwitterionic polymers, have not been universally accepted in the oral environment due to their intrinsic problems. Herein, inspired by the anti-adhesion capability of bovine serum albumin, we report a facile protein-based anti-bacterial surface, showing excellent anti-adhesion performance toward oral bacteria. This protein-mediated anti-adhesion strategy may provide a promising clue for developing new anti-bacterial biomaterials, such as dental fixed appliances, restorative materials and medical mouthwashes.