Prevalence of Dental Malocclusions in Different Geographical Areas: Scoping Review

DetSegDiff: A joint periodontal landmark detection and segmentation in intraoral ultrasound using edge-enhanced diffusion-based network

Individuals with malocclusion require an orthodontic diagnosis and treatment plan based on the severity of their condition. Assessing and monitoring changes in periodontal structures before, during, and after orthodontic procedures is crucial, and intraoral ultrasound (US) imaging has been shown a promising diagnostic tool in imaging periodontium. However, accurately delineating and analyzing periodontal structures in US videos is a challenging task for clinicians, as it is time-consuming and subject to interpretation errors. This paper introduces DetSegDiff, an edge-enhanced diffusion-based network developed to simultaneously detect the cementoenamel junction (CEJ) and segment alveolar bone structure in intraoral US videos. An edge feature encoder is designed to enhance edge and texture information for precise delineation of periodontal structures. Additionally, we employed the spatial squeeze-attention module (SSAM) to extract more representative features to perform both detection and segmentation tasks at global and local levels. This study used 169 videos from 17 orthodontic patients for training purposes and was subsequently tested on 41 videos from 4 additional patients. The proposed method achieved a mean distance difference of 0.17 ± 0.19 mm for the CEJ and an average Dice score of 90.1% for alveolar bone structure. As there is a lack of multi-task benchmark networks, thorough experiments were undertaken to assess and benchmark the proposed method against state-of-the-art (SOTA) detection and segmentation individual networks. The experimental results demonstrated that DetSegDiff outperformed SOTA approaches, confirming the feasibility of using automated diagnostic systems for orthodontists.

Numerical Simulation of Maxillary Anterior Teeth Retraction Utilizing Power Arms in Lingual Orthodontic Technique

AIMS

It was the scope of this study to explore the biomechanical implications of retraction force application point modifications in lingual orthodontics, aiming to mitigate the bowing effect and enhance anchorage stability in the anterior teeth.

METHODS

Using the FE method on an idealized maxillary model, en masse retraction was simulated using a modified lingual fixed appliance including edgewise lingual brackets, a 0.017″ × 0.025″ mushroom-shaped archwire, and power arms between lateral incisors and canines, with a transpalatal arch (TPA) connecting the first molars. Applying bilateral retraction forces of 1.5 N at twelve positions, initial tooth displacements during space closure were evaluated.

RESULTS

Shifting power arms gingivally did not effectively counteract palatal tipping of incisors but reduced posterior and palatal tipping of canines with a power arm length of 11.3 mm preventing posterior tipping. Apically displacing the TPA retraction force increased mesiobuccal rotation while preventing mesial molar tipping for retraction forces applied 12.6 mm from the archwire.

CONCLUSIONS

Apically shifting retraction forces can mitigate vertical bowing effects in lingual orthodontics, yet it also highlights the challenges in maintaining torque in the anterior teeth. Further research and clinical validation are essential in order to confirm these results, emphasizing the complexity and need for advanced biomechanical strategies in personalized lingual orthodontic treatments.

Lateral cephalometric parameters among Arab skeletal classes II and III patients and applying machine learning models

BACKGROUND

The World Health Organization considers malocclusion one of the most essential oral health problems. This disease influences various aspects of patients' health and well-being. Therefore, making it easier and more accurate to understand and diagnose patients with skeletal malocclusions is necessary.

OBJECTIVES

The main aim of this research was the establishment of machine learning models to correctly classify individual Arab patients, being citizens of Israel, as skeletal class II or III. Secondary outcomes of the study included comparing cephalometric parameters between patients with skeletal class II and III and between age and gender-specific subgroups, an analysis of the correlation of various cephalometric variables, and principal component analysis in skeletal class diagnosis.

METHODS

This quantitative, observational study is based on data from the Orthodontic Center, Jatt, Israel. The experimental data consisted of the coded records of 502 Arab patients diagnosed as Class II or III according to the Calculated_ANB. This parameter was defined as the difference between the measured ANB angle and the individualized ANB of Panagiotidis and Witt. In this observational study, we focused on the primary aim, i.e., the establishment of machine learning models for the correct classification of skeletal class II and III in a group of Arab orthodontic patients. For this purpose, various ML models and input data was tested after identifying the most relevant parameters by conducting a principal component analysis. As secondary outcomes this study compared the cephalometric parameters and analyzed their correlations between skeletal class II and III as well as between gender and age specific subgroups.

RESULTS

Comparison of the two groups demonstrated significant differences between skeletal class II and class III patients. This was shown for the parameters NL-NSL angle, PFH/AFH ratio, SNA angle, SNB angle, SN-Ba angle. SN-Pg angle, and ML-NSL angle in skeletal class III patients, and for S-N (mm) in skeletal class II patients. In skeletal class II and skeletal class III patients, the results showed that the Calculated_ANB correlated well with many other cephalometric parameters. With the help of the Principal Component Analysis (PCA), it was possible to explain about 71% of the variation between the first two PCs. Finally, applying the stepwise forward Machine Learning models, it could be demonstrated that the model works only with the parameters Wits appraisal and SNB angle was able to predict the allocation of patients to either skeletal class II or III with an accuracy of 0.95, compared to a value of 0.99 when all parameters were used ("general model").

CONCLUSION

There is a significant relationship between many cephalometric parameters within the different groups of gender and age. This study highlights the high accuracy and power of Wits appraisal and the SNB angle in evaluating the classification of orthodontic malocclusion.

Correlation of the Upper Nasolabial Angle With Skeletal Patterns and Nasal Morphology in Indian Adults: An Observational Study

INTRODUCTION

The upper nasolabial angle (UNLA) is an important determinant in clinical diagnosis and treatment planning. Therefore, the primary objective of this study was to assess the correlation between various skeletal parameters and nasal morphology in an Indian cohort, particularly UNLA. The secondary objectives were to evaluate sex differences in nasal morphology, optimal cut-off values of the UNLA for skeletal malocclusions, and differences in nasal morphology in different skeletal malocclusions.

MATERIALS AND METHODS

This retrospective study used 162 pre-treatment lateral cephalometric records of patients with skeletal Class I, Class II, and Class III relationships. Group 1 consisted of 68 skeletal Class I patients (ANB angle of 2-40), Group 2 consisted of 68 skeletal Class II patients (ANB angle > 40), and Group 3 consisted of 26 skeletal Class III patients (ANB angle of less than 20). Each group was further subdivided according to the growth pattern into low (horizontal), average, and high (vertical) growers. The angle between the sella-nasion plane and mandibular plane (SN-GoGn angle) was used to further divide the groups according to their growth pattern into a horizontal growth pattern (SN-GoGn angle < 280), an average growth pattern (SN-GoGn angle of 28-360), and a vertical growth pattern (SN-GoGn angle > 360). The study sample was also divided into males and females to assess gender differences. Spearman's correlation coefficient, multinomial logistic regression analysis, Mann-Whitney U test, and Kruskal-Wallis tests were used. Receiver operating characteristic curves were used to obtain the optimal cut-off values for UNLA.

RESULTS

The UNLA showed a positive correlation with the sagittal position of the maxilla and a negative correlation with the sagittal position of the mandible and palatal plane (PP) inclination angle. Statistically significant sex differences were observed in nasal length, nasal depth, and lower anterior facial height. The optimal cut-off values for the UNLA angle in the class II skeletal pattern were ≥ 200, 16-200 for skeletal class I, and ≤ 160 for skeletal class III patients. None of the skeletal and nasal parameters were reliable predictors of the skeletal pattern type.

CONCLUSION

The present study showed that the UNLA increased in the skeletal class II pattern with the downward inclination of the PP. Patients with skeletal class III malocclusion had an upward-canted nasal tip.

Prevalence of malocclusions and parafunctional habits in pediatric patients with developmental dyslexia

Objective

The study aimed to assess the prevalence of dental malocclusion, orthodontic parameters, and parafunctional habits in children with developmental dyslexia (DD).

Methods

Forty pediatric patients (67.5% boys and 32.5% girls, mean age: 11.02 ± 2.53 years, range: 6-15 years) with DD were compared with 40 age- and sex-matched healthy participants for prevalence of dental malocclusion, orthodontic parameters, and parafunctional habits. Dental examinations were performed by an orthodontist.

Results

Pediatric patients with DD exhibited a significantly higher prevalence of Angle Class III malocclusion (22.5% vs. 5.0%, P = 0.024), deep bite (27.5% vs. 7.5%, P = 0.019), midline deviation (55.0% vs. 7.5%, P < 0.0001), midline diastemas (32.5% vs. 7.5%, P = 0.010), wear facets (92.5% vs. 15.0%, P < 0.0001), self-reported nocturnal teeth grinding (82.5% vs. 7.5%, P < 0.0001), nail biting (35.0% vs. 0.0%, P < 0.0001), and atypical swallowing (85.0% vs. 17.5%, P < 0.0001) compared to that in healthy controls.

Conclusions

Pediatric patients with DD showed a higher prevalence of Class III malocclusion, greater orthodontic vertical and transverse discrepancies, and incidence of parafunctional activities. Clinicians and dentists should be aware of the vulnerability of children with dyslexia for exhibiting malocclusion and encourage early assessment and multidisciplinary intervention.

The Role of Malocclusion and Oral Parafunctions in Predicting Signs and Symptoms of Temporomandibular Disorders-A Cross-Sectional Study

BACKGROUND

The aim of this study was to examine to what extent malocclusion and parafunctional habits contribute to the development of signs and symptoms associated with temporomandibular disorders (TMD) in schoolchildren with mixed dentition in Croatia in a sample of 338 children, aged 9 to 15 years.

METHODS

TMD signs and symptoms assessed by the clinician were joint function and pain, masticatory muscles tenderness, range of mandibular motion, and joint sounds. To evaluate subjective symptoms and parafunctions, children and parents were asked about the presence of headaches, jaw locking, temporomandibular joint (TMJ) sounds, pain during mouth opening, or bruxism, as well as parafunctions like biting pencils or nails, chewing hard candies or ice, daily gum chewing, opening bottles with teeth, engaging in jaw play, thumb-sucking, and clenching/grinding teeth.

RESULTS

At least one symptom of a TMD was pronounced in 142 participants (42.0%). The most commonly reported parafunction was pencil or nail biting, present in 25.1% of participants. Class II malocclusion increased the likelihood by 2.6 times, pencil or nail biting by 2.34 times, and clenching/grinding teeth by 8.9 times that the subject would exhibit at least one TMD symptom.

CONCLUSIONS

Every child with mixed dentition should undergo a brief examination of the TMJ, especially in cases of Class II malocclusion, pencil or nail biting, and teeth clenching or grinding, as these have all been identified as significant risk factors that increase the likelihood of experiencing TMD symptoms. This highlights the need for proactive screening and assessment by healthcare providers to reduce the risk and prevalence of TMDs in affected children and ensure timely diagnosis and treatment.

Assessment of the Relationship between Antero-Posterior Dental Malocclusions, Body Posture Abnormalities and Selected Static Foot Parameters in Adults

Objectives: This study aimed to find if a relationship exists between antero-posterior malocclusions and the level of musculoskeletal disorders in adults, including body posture and static foot analysis. Methods: In all, 420 participants were recruited through convenience sampling (Kraków University students and patients of a local dentist's practice). Following general medical interviews, dental examinations and consideration of inclusion and exclusion criteria, 90 healthy volunteers (ages 19-35) were enrolled and assigned to three groups (n = 30) based on occlusion type (Angle's molar Class I, II or III). The research procedure involved occlusion and temporomandibular disorder assessment conducted by a dental specialist. Comprehensive morphological measurements of body asymmetry were performed using the Videography 2D package and FreeSTEP software, which calculated the parameters determined from anterior, posterior and lateral projection photos. Foot loading distribution was analyzed using the FreeMED baropodometric platform. Results: Significant differences were demonstrated in the positioning of the head, cervical and lumbar spine in the sagittal plane among individuals with the analyzed occlusal classes (p < 0.05). Individuals with Angle's Class II exhibited significantly greater forward head positions and greater depths of cervical and lumbar lordosis compared with individuals with Class III or Class I. Those with overbites had higher forefoot loading. The Class III individuals exhibited greater L-R displacement, indicating a larger angle of displacement of the centers of the right and left feet relative to the lower edge of the measurement platform, suggesting pelvic rotation. Conclusions: An inclination for concurrent occurrences of malocclusions and posture deviations in the sagittal plane was observed. An interdisciplinary approach involving dentistry and physiotherapy specialists which utilizes tools for comprehensive posture assessment is crucial for diagnosing and treating such conditions.

Microbiological Analysis of Plaque and Its Composition in Three Patient Groups under Different Orthodontic Treatments

BACKGROUND

This article analyzes differences in microbiological parameters and periodontal health conditions among three patient groups: those undergoing conventional orthodontic treatment with fixed appliances, patients undergoing orthodontic treatment with clear aligners, and a control group receiving no treatment.

MATERIALS AND METHODS

In this study, 60 patients were enrolled. The microbiological analysis employed a qualitative and semi-quantitative methodology of bacterial morphotype analysis.

RESULTS

The analyses revealed a significant difference in favor of clear oral and periodontal health aligners. This could be attributed to better bacterial biofilm removal and reduced mechanical stress on the periodontal ligament, factors facilitated by the ease of clear aligner removal. Significant differences (p-value < 0.05) were observed for the Full-Mouth Plaque Score, Full-Mouth Bleeding Score, Plaque Index, and periodontal health assessment measurements.

CONCLUSIONS

Although overall hygiene appears to be improved in patients in the aligners group compared to those treated with conventional orthodontic appliances, there are no statistically significant results regarding plaque composition. Microbiological aspects will be further addressed using more specific techniques in the follow-up of this research.

Verification of the accuracy of dynamic navigation for conventional and mouthpiece methods: in vivo study

BACKGROUND

Dynamic navigation for implant placement is becoming popular under the concept of top-down treatment. The purpose of this study is to verify the accuracy of a dynamic navigation system for implant placement.

METHODS

Implant placement was performed on 38 patients using 50 implant fixtures. Patients in group C were treated using a conventional method, in which thermoplastic clips were fixed to the teeth, and patients in group M were treated using thermoplastic clips fixed to a mouthpiece attached to the teeth. The groups were compared to verify whether an accuracy difference existed. A treatment planning support program for dental implants was used to superimpose the postoperative computed tomography data on the preoperative implant design data to measure the entry point, apex point, and angular deviation.

RESULTS

The accuracy of group C was 1.36 ± 0.51 mm for entry point, 1.30 ± 0.59 mm for apex point, and 3.20 ± 0.74° for angular deviation. The accuracy of group M was 1.06 ± 0.31 mm for the entry point, 1.02 ± 0.30 mm for the apex point, and 2.91 ± 0.97° for angular deviation. Significant differences were observed in the entry and apex points between the two groups.

CONCLUSIONS

The results indicate that group M exhibited better accuracy than group C, indicating that the stability of the thermoplastic clip is important for ensuring the accuracy of the dynamic navigation system. No previous studies have verified the accuracy of this system using the mouthpiece method, and additional data is required to confirm its accuracy for dental implant placement. The mouthpiece method improves the accuracy of implant placement and provides a safer implant treatment than the conventional method.

TRIAL REGISTRATION

University hospital Medical Information Network Clinical Trials Registry (UMIN-CTR), Registration Number: UMIN000051949, URL: https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view_his.cgi on August 21, 2023.

Effects of premolar extraction and orthodontic treatment in adolescents - a retrospective cephalometric study

OBJECTIVES

To evaluate the cephalometric effects of premolar extraction on skeletal and dental parameters, and on the soft tissues, in patients subsequently treated with fixed appliances. Prevalence and severity of external apical root resorption due to premolar extraction were also examined.

MATERIALS AND METHODS

The dental records of 79 patients treated with fixed appliances were retrieved (groups: extraction, n = 19; non-extraction, n = 60). Pre- and post-treatment statuses of skeletal, dentoalveolar, and soft tissue variables were analyzed on lateral cephalograms to determine change. Periapical radiographs of the maxillary incisors were assessed for external apical root resorption using the Levander & Malmgren index. The t-test, Mann-Whitney U test, chi-squared test, and Kruskal-Wallis test were used to analyze the data. Significance was set at p < .05.

RESULTS

Changes in the protrusion and proclination of the incisors and in lip position were significantly different between the groups. Prevalence of external apical root resorption in the two groups was similar.

CONCLUSIONS

Our findings suggest that extraction therapy affects dentoalveolar traits but not jaw position, nor the risk of root resorption, in patients treated with fixed appliances.

East Asian and Southern European craniofacial class III phenotype: two sides of the same coin?

OBJECTIVES

The skeletal class III phenotype is a heterogeneous condition in populations of different ethnicities. This study aimed to analyse the joint and ethnicity-specific clustering of morphological features in skeletal class III patients of Asian and European origins.

MATERIALS AND METHODS

This cross-sectional study involved South Korean and Spanish participants who fulfilled the cephalometric, clinical, and ethnic-related selection criteria. Radiographic records were standardised, calibrated, and measured. A total of 54 skeletal variables were selected for varimax factorial analysis (VFA). Subsequently, a cluster analysis (CA) was performed (mixed method: k-means and hierarchical clustering). Method error and precision were assessed using ICC, Student's t-test, and the Dahlberg formula.

RESULTS

A total of 285 Korean and Spanish participants with skeletal class III malocclusions were analysed. After performing VFA and CA, the joint sample revealed three global clusters, and ethnicity-specific analysis revealed four Korean and five Spanish clusters. Cluster_1_global was predominantly Spanish (79.2%) and male (83.01%) and was characterised by a predominantly mesobrachycephalic pattern and a larger cranial base, maxilla, and mandible. Cluster_2_global and Cluster_3_global were mainly South Korean (73.9% and 75.6%, respectively) and depicted opposite phenotypes of mandibular projection and craniofacial pattern.

CONCLUSIONS

A distinct distribution of Spanish and South Korean participants was observed in the global analysis. Interethnic and interethnic differences were observed, primarily in the cranial base and maxilla size, mandible projection, and craniofacial pattern.

CLINICAL RELEVANCE

Accurate phenotyping, reflecting the complexity of skeletal class III phenotype across diverse populations, is critical for improving diagnostic predictability and future personalised treatment protocols.

Skeletal and dental effects of serial extractions performed with or without maxillary expansion-A retrospective controlled study

OBJECTIVES

The study aimed to compare severe crowding treatment's skeletal and dental effects by serial extractions or maxillary expansion and serial extractions in the mixed dentition phase.

SETTING AND SAMPLE POPULATION

The retrospective controlled study included lateral cephalograms of 78 subjects aged 8.5 ± 1.4 years, 52 consecutively treated because of severe crowding, and 26 untreated controls matched for baseline age and observational period.

METHODS

Subjects were clustered according to the treatment modality, either serial extraction (EX) or expansion and extraction (EXP-EX) group. Sagittal and vertical skeletal as well as dental cephalometric parameters were assessed at baseline and after the eruption of all permanent posterior teeth, and group comparisons were performed.

RESULTS

Both treatment modalities significantly affected the vertical skeletal parameters in terms of decreasing the mandibular and occlusal plane inclination and increasing the facial height index. A distinct treatment effect on the gonial angle was observed, with a significant decrease in its superior part observed in both extraction groups. The annualized changes in the superior part of the gonial angle significantly differ (P = .036) between the Control (-0.04 ± 0.6), EX (-0.44 ± 0.6) and EXP-EX (-0.34 ± 0.5) groups. Upper and lower incisor inclination did not change significantly in any of the groups; however, the interincisal angle at follow-up was significantly smaller in the Control compared with both treated groups.

CONCLUSIONS

Serial extractions and a combination of maxillary expansion and serial extractions have similar significant skeletal effects, mainly affecting vertical cephalometric parameters if performed during the pre-pubertal growth phase.

Application of Artificial Intelligence in Orthodontics: Current State and Future Perspectives

In recent years, there has been the notable emergency of artificial intelligence (AI) as a transformative force in multiple domains, including orthodontics. This review aims to provide a comprehensive overview of the present state of AI applications in orthodontics, which can be categorized into the following domains: (1) diagnosis, including cephalometric analysis, dental analysis, facial analysis, skeletal-maturation-stage determination and upper-airway obstruction assessment; (2) treatment planning, including decision making for extractions and orthognathic surgery, and treatment outcome prediction; and (3) clinical practice, including practice guidance, remote care, and clinical documentation. We have witnessed a broadening of the application of AI in orthodontics, accompanied by advancements in its performance. Additionally, this review outlines the existing limitations within the field and offers future perspectives.

Narrating the Genetic Landscape of Human Class I Occlusion: A Perspective-Infused Review

This review examines a prevalent condition with multifaceted etiology encompassing genetic, environmental, and oral behavioral factors. It stands as a significant ailment impacting oral functionality, aesthetics, and quality of life. Longitudinal studies indicate that malocclusion in primary dentition may progress to permanent malocclusion. Recognizing and managing malocclusion in primary dentition is gaining prominence. The World Health Organization ranks malocclusions as the third most widespread oral health issue globally. Angle's classification system is widely used to categorize malocclusions, with Class I occlusion considered the norm. However, its prevalence varies across populations due to genetic and examination disparities. Genetic factors, including variants in genes like MSX1, PAX9, and AXIN2, have been associated with an increased risk of Class I occlusion. This review aims to provide a comprehensive overview of clinical strategies for managing Class I occlusion and consolidate genetic insights from both human and murine populations. Additionally, genomic relationships among craniofacial genes will be assessed in individuals with Class I occlusion, along with a murine model, shedding light on phenotype-genotype associations of clinical relevance. The prevalence of Class I occlusion, its impact, and treatment approaches will be discussed, emphasizing the importance of early intervention. Additionally, the role of RNA alterations in skeletal Class I occlusion will be explored, focusing on variations in expression or structure that influence craniofacial development. Mouse models will be highlighted as crucial tools for investigating mandible size and prognathism and conducting QTL analysis to gain deeper genetic insights. This review amalgamates cellular, molecular, and clinical trait data to unravel correlations between malocclusion and Class I phenotypes.

Impact of molar teeth distalization by clear aligners on temporomandibular joint: a three-dimensional study

BACKGROUND

Maxillary molar distalization is a common technique used in the non-extraction treatment of Angle Class II malocclusion that can effectively correct the molar relationship and create spaces for anterior teeth alignment. However, this approach may also impact the temporomandibular joint (TMJ) due to predictable changes in the posterior vertical dimension. Despite its widespread use, Class II malocclusions correction by molar distalization with clear aligners has not been investigated for their effects on the TMJ. Therefore, this study aimed to analyze the impact of sequential molar distalization using clear aligners on the TMJ.

METHODS

Three-dimensional CBCT scans of 23 non-growing patients (7 males, 16 females; mean age 29.8 ± 4.6 years) with skeletal class I or II malocclusion and a bilateral molar class II relationship treated by sequential upper molars distalization with orthodontic clear aligners (Invisalign, Align Technology, San Josè, Ca, USA). A total of 46 joints were examined before and after molar distalization using Anatomage InvivoDental 6.0.3. Linear and angular measurements of the mandibular joint were measured, including joint parameters, inclination, position, and the dimension of the condyle and articular fossa. In addition, 3D volumetric spaces of the joint were analyzed. All data were statistically analyzed by paired T test to determine the differences between the pre-and post-orthodontic procedures.

RESULTS

No statistically significant differences were found in all primary effects resulting from maxillary molars distalization by clear aligners on TMJ components measurements and joint spaces between T0 and T1. Meanwhile, statistically significant differences were observed in the linear position of the upper molars and the molar relationship parameter with at least P ≤ 0.05.

CONCLUSION

Treatment by sequential upper molars distalization with clear aligners does not lead to significant TMJ parameters changes in condyle and fossa spaces, dimensions, and positions.

Anti-Peri-implantitis Bacteria's Ability of Robusta Green Coffee Bean (Coffea Canephora) Ethanol Extract: An In Silico and In Vitro Study

OBJECTIVE

 This study was aimed to investigate RGCBE extract as antioxidant and anti-peri-implantitis bacteria through in vitro study and its potential as antioxidant, antibacterial, anti-inflammatory, antibone resorption, and proosteogenic through in silico study.

MATERIALS

AND METHODS:  Absorption, distribution, metabolism, excretion and toxicity prediction, molecular docking simulation, and visualization of chlorogenic acid (CGA) and coumaric acid (CA) as anti-inflammatory, antioxidant, and antibacterial were investigated in silico. Inhibition zone by diffusion method, minimum inhibitory concentration (MIC), and minimum bactericidal concentration (MBC) of RGCBE extract against Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Fusobacterium nucleatum (Fn), and Prevotella intermedia (Pi) were done.

STATISTICAL ANALYSIS

the analysis of variance (ANOVA) difference test, and the post-hoc Tukey's Honest Significant Different (HSD) with a different significance value of p<0.05 RESULTS:  GCA and CA compounds are good drug molecules and it has low toxicity. Chlorogenic acid have higher binding activity than coumaric acid to tumor necrosis factor (TNF)-α, nuclear factor (NF)-κB, receptor activation NF-κB (RANK) and its ligand (RANKL), interleukin (IL)-6, IL-10, runt related transcription factor (RUNX2), receptor activator nuclear Kappa beta Ligand-osteoprotegrin osteocalcin (RANKL-OPG), osteocalcin, nuclear factor associated T-cell 1 (NFATc1), tartate resistant acid phosphatase (TRAP), peptidoglycan, flagellin, dectin, Hsp70, and Hsp10 protein. RGCB ethanol extract has high antioxidant ability and it has MIC, MBC, and inhibit the growth of Aa, Pg, Fn, and Pi at 50% concentration with significantly different (p=0.0001 and<0.05).

CONCLUSION

 RGCB ethanol extract has high antioxidant ability and 50% RGCB ethanol extract may act as strong anti-peri-implantitis bacteria in vitro. In addition, CGA in RGCB potential as antioxidant, antibacterial, anti-inflammatory, antibone resorption, and proosteogenic in silico.

Prevalence of malocclusions under conditions of prolonged introduction of systemic fluorides in variable concentrations: Literature review

The pathogenesis of malocclusions, which are common among the population of  all  countries, is  well represented in the professional literature. The occurrence of  malocclusions is associated with genetic and various environmental factors. Among the latter, fluorides which affect the prevalence of some dental diseases are of particular interest. However, there are few publications reflecting the frequency of malocclusion among the population in the regions with different levels of fluoride in drinking water. This problem seems to be significant in the context of the increasing impact of fluorine compounds on human health, including dental health.

The aim of the study. To analyze the literature on the frequency of malocclusion among the population living in conditions of variable fluoride content in drinking water. A manual search of domestic and foreign literature was performed in the search databases PubMed, Medline and Google Scholar. From the initial list of publications, eighteen articles that met the inclusion criteria for the study were selected for analysis. We revealed significant variability of the research results. Some authors note a higher prevalence of malocclusions among the population under conditions of increased fluoride intake, others note a lower one, and still others did not reveal any differences between the values obtained in both samples. Most of the assessed publications did not methodologically meet modern international standards, and therefore were of little evidence.

The literature data do not provide grounds for an unambiguous assessment of fluorine compounds as an environmental factor that indirectly affects the process of occlusion formation in humans and animals.

The review did not allow to make a definitive conclusion on the possible impact of  systemic fluorides on the prevalence and pattern of malocclusion in humans and animals. It requires the implementation of studies that comply with the principles of evidence-based medicine. 

Bracket Bond Failures: Incidence and Association with Different Risk Factors-A Retrospective Study

BACKGROUND

Bracket bonding failure is one of the relevant problems in fixed orthodontics therapy, which affects the total treatment and quality of treatment results. The purpose of this retrospective study was to evaluate the frequency of bracket bond failure and find out risk factors.

METHODS

A total of 101 patients with an age range of 11-56 years were included in this retrospective study and treated for a mean period of 30.2 months. Inclusion criteria were: males and females with permanent dentition and completed orthodontic treatment in both fully bonded dental arches. Risk factors were calculated using binary logistic regression analysis.

RESULTS

The overall bracket failure rate was 14.65%. The bracket failure rate was significantly higher in the younger patients' group (p = 0.003). In most cases, patients experienced bracket failures in the first month of the treatment. Most of the bracket bond failures occurred on the left lower first molar (29.1%) and were twice as common in the lower dental arch (66.98%). Patients with increased overbite had an increased likelihood of bracket loss (p = 0.042). Class II malocclusion increased the relative risk of bracket failure, while Class III decreased the rate of bracket failure, but the difference was not statistically significant (p = 0.093).

CONCLUSIONS

The bracket bond failure rate was higher in younger patients than in older patients. Brackets placed on mandibular molars and premolars had the highest failure rate. Class II was associated with an increased bracket failure rate. Increased overbite statistically significantly increases bracket failure rate.

Orthodontic treatment of children with anterior open bite and posterior crossbite: An analysis of the stomatognathic system

Dental malocclusions are deviations from normalities due to the inadequate growth and development of the dental arch which provides functional changes to the stomatognathic system. The aim of this longitudinal study was to evaluate the electromyographic activity (EMG) the masseter and temporalis muscles, strength of the orofacial tissues and occlusal force of children with anterior open bite (n = 15) and posterior crossbite (n = 20), 7 days after the removal of the orthodontic apparatus. A fixed horizontal palatal crib was used in the treatment of anterior open bite and the fixed appliances Hyrax or MacNamara was used in the treatment of posterior crossbite. EMG of the masticatory muscles was recorded using an electromyograph with wireless sensors during mandibular tasks. Habitual chewing was assessed using the integral of the linear envelope of the electromyographic signal in the masticatory cycles. The strength of the tongue and facial muscles was measured using the Iowa Oral Pressure Instrument. T-Scan was used to analyze the force of occlusal contact. Molar bite force was measured by digital dynamometer. Significant differences (p < 0.05) were found in the EMG data of the masseter and temporalis muscles in the static and dynamic mandibular tasks. There were no significant difference in strength of orofacial tissues, occlusal contact force and molar bite force 7 days after the removal of the orthodontic apparatus. The results of this study suggest that the orthodontic treatment of anterior open bite and posterior crossbite in children promoted functional alteration in the electromyographic activity of masseter and temporalis muscles.

COMPARATIVE STUDY OF BIOTOLERANCE CHARACTERISTICS OF DIFFERENT GELS COMPOSED OF BENZYDAMINE AND FLAVONOIDS THAT WERE DEVELOPED FOR TREATMENT OF PERIODONTAL DISEASES IN ORTHODONTIC PATIENTS

OBJECTIVE

The aim: Different gels composed of benzydamine and flavonoids that were developed for treatment of periodontal diseases in the orthodontic patients will be compared regarding their effects on survival of mammalian cells of various tissue origin and their DNA intactness.

PATIENTS AND METHODS

Materials and methods: Effect of different variants of patented gel composition «Benzidaflaziverdine» including a gel base and «Proteflazid®» containing flavonoids and benzydamine hydrochloride in powder form («T-Sept®») towards survival (MTT) of murine BALB-3T3 fibroblasts, J774.2 macrophages, human HaCaT keratinocytes was studied. Their effect on nativity of DNA of J774.2 macrophages was evaluated using DNA-comet assay.

RESULTS

Results: Three gel compositions were used. Sample 1 was prepared on gel basis including benzydamine in liquid form and demonstrated inhibitory effect towards pseudonormal murine BALB-3T3 fibroblasts and murine J774.2 macrophages, however, normal human НаСаТ keratinocytes were resistant to its action. Sample 2 included BH in powder form and it did not affect significantly НаСаТ keratinocytes аnd BALB-3T3 fibroblasts, but it suppressed J774.2 macrophages. Sample 3 («Benzidaflaziverdine») was developed and patented by us as a gel composed of benzydamine in powder form and flavonoid drops «Proteflazid®». It did not suppress tested mammalian cells and was not genotoxic (measured as % of DNA in comet tail and Olive Tail Moment) for murine J774.2 macrophages.

CONCLUSION

Conclusions: Inclusion of flavonoids in gel composition «Benzidaflaziverdine» blocked cytotoxic and genotoxic actions of benzydamine. Developed gel com¬position might be efficient in clinical periodontology, in particular, for treatment of periodontal diseases in orthodontic patients.

Who Seeks Clear Aligner Therapy? A European Cross-National Real-World Data Analysis

A key step prior to clear aligner therapy (CAT) is the clinical examination and case selection, which includes understanding the specific orthodontic problem to be managed and the wider evaluation of oral health. Seeking CAT may further differ along sociodemographic parameters or across countries, as may perceived orthodontic treatment needs and oral health. We aimed to characterize patients seeking CAT across five European countries. Anonymized real-life data from one large CAT provider (DrSmile, Berlin, Germany) was retrospectively sampled for the period 1 November 2021−31 December 2021. A total of 15,015 patients (68.4% females, 31.6% males, with an age range of 18−81 years, median 30.0 years) were included. The cross-national comparison revealed a significant difference in gender distribution (p < 0.001/Chi-square), with the highest proportion of males in Italy (434/1199, 36.2%) and the lowest in Poland (457/1600, 28.6%); generally, more females sought CAT. The largest motivational factor in all countries for seeking CAT was crowding, in both males and females. By and large, patients paid out of pocket for CAT. The prevalence of caries, periodontitis, and craniomandibular dysfunction as well as the numbers of missing teeth were generally low, albeit with significant differences between sociodemographic groups and countries for caries and periodontitis. Patients seeking CAT showed a low prevalence in oral conditions but differed in their sociodemographic characteristics across countries. Dentists and orthodontists should consider these country-specific differences when planning CAT.

Difference in Using Protrusion Face Mask before or after Rapid Palatal Expansion in Skeletal Class III Children: A Preliminary Study

Treatment of third-class malocclusions often presents a challenge for orthodontists. Skeletal disharmony is often associated with dental malposition. There are several therapeutic choices, including the use in combination of transverse expansion of the maxilla with rapid palatal expander (RPE) and posterior-anterior traction with a Delaire face mask (FM). The purpose of the study is to verify whether there are significant differences in the treatment outcome in the case of use of a face mask followed by a palatal expander or with the sequence of these auxiliaries reversed. Subject and Methods: The two groups were both made up of 13 patients, subdivided into group A, i.e., those whose sequence involved the use of extraoral traction first and then the disjunctor, and those with an inverted sequence in group B. Some cephalometric parameters and dento-skeletal characteristics were evaluated pre-treatment (t0) and at the end of therapy (t1). Results: Considering the T1-T0 of group A (Delaire + rapid palatal expander), the evaluation of the results obtained in this work allows us to observe how within group A there is a significant improvement in the Witts and Nanda indices and facial convexity. Group B (treated with the palate disjunctor sequence followed by traction with Delaire's mask) showed a significant improvement in ANB, in AoBo, and AppBpp values and in convexity. The two groups were comparable, and no statistically significant difference was highlighted. Discussion: The early therapy of the third skeletal classes by means of a rapid palate expander and face mask is effective. There is no statistically significant difference in the two groups who performed the therapy in reverse mode. This suggests that the clinician should choose the treatment sequence based on the skeletal and occlusal conditions of their patients at the start of treatment. Conclusion: Early therapy of third skeletal classes with sagittal expansion using a rapid palate expander can be performed earlier or later than posterior-anterior traction with a Delaire mask.

Prevalence of temporomandibular disorders and its association with malocclusion in children: A transversal study

This study investigated the prevalence of temporomandibular disorders (TMDs) in a sample of children and adolescents and evaluated the correlation with occlusal variables. TMD signs and symptoms were recorded in 411 subjects (age range 7-15 years), divided into two groups: 214 subjects treated in Chieti (Italy) CG group and 197 in Murcia (Spain) MG group. Once the Angle dental class was identified, it was recorded if there were signs and symptoms of temporomandibular disorders (TMDs) and occlusal interferences. The percentages of signs and symptoms were compared to determine the differences among the groups for TMDs, bruxism, joint sounds, deviation during the opening, reduced opening/lateral/protrusive movements, malocclusions, and myofascial pain. There is no statistically significant difference between the two groups (χ² = 1.057, p > 0.05). Subjects with Angle Class I (37.37%), deep bite (43.43%), and increased overjet (41.41%) showed a higher prevalence of TMD symptoms.

Effects on Muscular Activity after Surgically Assisted Rapid Palatal Expansion: A Prospective Observational Study

The study aims to investigate the modifications in the temporalis and the masseter activity in adult patients before and after SARPE (Surgically Assisted Rapid Palatal Expansion) by measuring electromyographic and electrokinesographic activity. 24 adult patients with unilateral posterior crossbite on the right side were selected from the Orthodontic Department of the University of Milan. Three electromyographic and electrokinesographic surface readings were taken respectively before surgery (T0) and 8 months after surgery (T1). The electromyographic data of both right and left masseter and anterior temporalis muscles were recorded during multiple tests: standardized maximum voluntary contraction (MVC)s, after transcutaneous electrical nerve stimulation (TENS) and at rest. T0 and T1 values were compared with paired Student’s t-test (p < 0.05). Results: Significant differences were found in the activity of right masseter (p = 0.03) and right temporalis (p = 0.02) during clench, in the evaluation of right masseter at rest (p = 0.03), also the muscular activity of masseters at rest after TENS from T0 to T1 (pr = 0.04, pl = 0.04). No significant differences were found in the activity of left masseter (p = 0.41) and left temporalis (p = 0.39) during clench and MVC, in the evaluation of left masseter at rest (p = 0.57) and in the activity during MVC of right masseter (p = 0.41), left masseter (p = 0.34), right temporalis (p = 0.51) and left temporalis (p = 0.77). Results showed that the activity of the masseter and temporalis muscles increased significantly after SARPE during rest and clenching on the side where the cross-bite was treated.

Biomechanical Effects of Different Miniplate Thicknesses and Fixation Methods Applied in BSSO Surgery Under Two Occlusal Conditions

Purpose

Finite element analysis (FEA) was used to evaluate the effects of different thicknesses, numbers, and positions of the miniplate applied in bilateral sagittal split osteotomy (BSSO) under two occlusal conditions.

Methods

An FEA model of the mandibles was constructed and combined with different thicknesses (0.6 or 1 mm), number (one or two), positions (upper or lower) of a miniplate and was divided into six models. In addition, external forces were applied to the muscles to simulate the intercuspal position (ICP) and right unilateral molar clench. This study used the reaction force of the temporomandibular joints and the stress of the mandible as observation indexes.

Results

The results of this study show that, under ICP, the 0.6 mm lower model generated greater TMJ force reaction compared to the 0.6 mm upper model. The same trend was seen in the 1 mm lower model compared to the 1 mm upper model. Regarding the stress of the bone on the screw-implanted sites, under ICP, screw 10 showed greater stress than screw 2, and screw 11 showed greater stress than screw 3. The stress values of the miniplates showed, under ICP, point 1-c was greater than point 3-c, and point 1-b was greater than point 3-b.

Conclusion

In the case of BSSO mandibular advancement surgery, implanting the miniplate at the upper position can reduce the force on the TMJ and the stress on the distal segment of the mandible. The miniplate can also resist the tensile stress more effectively. In addition, implanting two miniplates with thinner sizes may be an alternative in clinical practice.

Prevalence of Orthodontic Malocclusions in Healthy Children and Adolescents: A Systematic Review

The purpose of this study was to systematically review the literature regarding the prevalence of malocclusion and different orthodontic features in children and adolescents. Methods: The digital databases PubMed, Cochrane, Embase, Open Grey, and Web of Science were searched from inception to November 2021. Epidemiological studies, randomized controlled trials, clinical trials, and comparative studies involving subjects ≤ 18 years old and focusing on the prevalence of malocclusion and different orthodontic features were selected. Articles written in English, Dutch, French, German, Spanish, and Portuguese were included. Three authors independently assessed the eligibility, extracted the data from, and ascertained the quality of the studies. Since all of the included articles were non-randomized, the MINORS tool was used to score the risk of bias. Results: The initial electronic database search identified a total of 6775 articles. After the removal of duplicates, 4646 articles were screened using the title and abstract. A total of 415 full-text articles were assessed, and 123 articles were finally included for qualitative analysis. The range of prevalence of Angle Class I, Class II, and Class III malocclusion was very large, with a mean prevalence of 51.9% (SD 20.7), 23.8% (SD 14.6), and 6.5% (SD 6.5), respectively. As for the prevalence of overjet, reversed overjet, overbite, and open bite, no means were calculated due to the large variation in the definitions, measurements, methodologies, and cut-off points among the studies. The prevalence of anterior crossbite, posterior crossbite, and crossbite with functional shift were 7.8% (SD 6.5), 9.0% (SD 7.34), and 12.2% (SD 7.8), respectively. The prevalence of hypodontia and hyperdontia were reported to be 6.8% (SD 4.2) and 1.8% (SD 1.3), respectively. For impacted teeth, ectopic eruption, and transposition, means of 4.9% (SD 3.7), 5.4% (SD 3.8), and 0.5% (SD 0.5) were found, respectively. Conclusions: There is an urgent need to clearly define orthodontic features and malocclusion traits as well as to reach consensus on the protocols used to quantify them. The large variety in methodological approaches found in the literature makes the data regarding prevalence of malocclusion unreliable.

Orthognathic correction and corticobasal implant-supported prostheses as a treatment modality for partial edentulism with mandibular prognathism: A case report and review of literature

Introduction

Mandibular prognathism manifests as elongation of the mandible in the anteroposterior direction, resulting in a sunken appearance of the middle third of the face and sad look of the eyes. It adversely affects esthetics, function, and oral health, reducing the patients' self-esteem. It therefore presents a significant challenge.

Presentation of case

A 23-year-old woman presented with prognathic features characterized by mandibular protrusion, maxillary retrusion, a prominent chin, and reduce self-esteem. Intraoral examination revealed multiple extracted teeth, severe fracture of the crown at 23, mobility of the fixed prosthesis on 13, 14, 15, and 16, a root stump of 18, and periodontally compromised teeth (31, 32, 33, 41, and 42).

A multidisciplinary team formulated the following treatment plan: stage 1, orthognathic osteotomy to retrude the mandible at 34 and 44; stage II, fabrication of transitional acrylic partial dentures; and stage III: fabrication of definitive corticobasal implant-supported prostheses. The patient was delighted with the treatment and complied with the oral hygiene instructions and follow-up program. After 7 years of function, the patient presented without complaints and exhibited significant improvement in oral health, self-esteem, and quality of life.

Discussion

The management of mandibular prognathism requires a multidisciplinary approach. The treatment implemented was considered the optimal option that aligned with the recommendations of several researchers to reduce facial disfigurement and rehabilitate the edentulous state.

Conclusion

The use of corticobasal implant-supported prostheses for the rehabilitation of patients with partial edentulism can significantly improve the treatment outcome following orthognathic surgery in cases with mandibular prognathism.

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Mandibular prognathism may adversely affect the patient’s esthetic and function and quality of life.

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Orthodontic surgery can improve the patient esthetic without replacing the missing dentition

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The patient was rehabilitated using corticobasal implant-supported prostheses.

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The esthetics, function, and oral hygiene improved significantly.

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This treatment modality enhances the patient’s self-esteem and improves the patient’s quality of life.

Effect of Lactobacillus reuteri on Gingival Inflammation and Composition of the Oral Microbiota in Patients Undergoing Treatment with Fixed Orthodontic Appliances: Study Protocol of a Randomized Control Trial

The effect of probiotics in improving or maintaining oral health in orthodontic patients is understudied. The aim of this study is to evaluate the effect of probiotic administration in addition to tooth brushing on clinical gingival inflammation, plaque formation, subgingival microbiota composition, and salivary biomarkers of inflammation in adolescents with fixed orthodontic appliances. The present study is a 6-month, double-blind, two-arm, placebo-controlled, single-center trial, in which 116 adolescent volunteers aged 12-16 years will be recruited from the patients of the orthodontics clinic of the University Hospital of Lille, France. Subjects who meet the eligibility criteria will be allocated to one of the following groups: (i) control: two placebo lozenges per day for 90 days together with regular oral hygiene, (ii) test: two probiotic lozenges per day for 90 days together with regular oral hygiene. Clinical assessment and biological sample collection will be performed at baseline, 3 and 6 months. In addition, compliance outcomes and adverse events will be monitored.