Comparative Evaluation of Various Lens and Ring Flash Combination for Intraoral Photography

BACKGROUND

Extraoral and intraoral dental photographs serve as preoperative records and document the entire treatment. Correctly composed orthodontic photographs are crucial for remote diagnosis and may serve as a bulwark against medicolegal challenges.

MATERIALS AND METHODS

In this prospective study, intraoral frontal photographs of patients with ideal occlusion were taken using two types of lenses (EF-S 18-55 mm f/3.5-5.6 IS STM lens (Canon, Tokyo, JP), SP 90 mm F/2.8 MACRO VC lens (Model F017 Tamron, NY, USA)) and two different ring flash systems (Meike FC-100 Macro Ring LED Light (Meike, China), Macro Ring flash Lite YN-14EX (Yongnuo digital, China)). The combination of lens and flash used was grouped into four groups. Twenty-eight intraoral photographs of patients were taken. An image quality assessment survey was distributed among two groups - 50 orthodontists and 50 other dental specialists.

RESULTS

The participants were asked to assess all the intraoral images and subjectively score them on a scale of one to ten, with one being very poor and ten being excellent, considering the sharpness, color, brightness, contrast, and overall quality of the image. The general dentists rated the images taken with a 90-mm macro lens and ring flash as the best quality photographs. Images obtained using an 18-55 mm lens and ring LED received significantly lesser scores and were graded good by dentists.

CONCLUSION

This combination of lens and flash may prove a valuable investment in the long-term aiding in excellent dental images for diagnosis and treatment monitoring.

Correlation Between Horizontal and Vertical Skeletal Components in Dental Malocclusions Among the Jazan Population

INTRODUCTION

The dentoskeletal morphology of various malocclusions has been analyzed in cephalometric studies. It is important to understand the vertical and horizontal components of orthodontic treatment. To provide accurate treatment, an orthodontist needs to understand the facial types of an individual. This study aims to evaluate a correlation between vertical and horizontal components of skeletal and dental malocclusion by assessing cephalometric radiographs of the population of Jazan province.

METHODS

The cephalometric radiographs of 267 eligible participants were assessed digitally. Fourteen skeletal and dental parameters were used to evaluate the association. Reliability was checked with the intra-class coefficient. Statistical analyses included descriptive statistics and Spearman's rho test. Statistical significance was set at P ≤ 0.05.

RESULTS

Correlations were found between anterior facial height (AFH), posterior facial height (PFH), FH ratio (Jarabak ratio), upper incisor to NA (U1-NA), lower incisor to NB (L1-NB), and upper incisor to the palatal plane (U1/PP). In dental class I, AFH (N-Me) had a strong positive correlation with L1-NB (0.300), U1/PP (0.164), and L1/MP (0.215). In dental class II, AFH negatively correlated with U1-NA (-0.735) and positively correlated with L1-NB (0.292), L1/MP (0.085), and U1-NA. PFH (S-Go) positively correlated with L1-NB (0.525) in class I but negatively correlated in class II. However, a negative relation was observed between all the vertical and horizontal components in class III.

CONCLUSION

This study suggests potential associations between vertical and horizontal components in developing skeletal and dental discrepancies.

Evaluation of scanning accuracy for two commercially available intraoral scanners in reproducing orthodontic bracket dimensions

OBJECTIVE

The aim of this study was to compare the scanning accuracy of two different intra-oral scanners- MEDIT i500 and TRIOS 3 shape in reproducing orthodontic bracket dimensions.

MATERIALS AND METHODS

This in vivo cross-sectional study comprised seven subjects with a full complement of permanent dentition without third molars. Complete arch scanning was carried out with two intraoral scanners, such as MEDIT i500, TRIOS 3 shape, after bonding with brackets. The control group consisted of bracket dimensions measured directly by using Vernier calipers before bonding. Bracket dimensions of three-dimensional (3D) images were measured by using OrthoAnalyzer software. The accuracy of intraoral scanning was investigated by comparing bracket dimensions among the three groups using One-way ANOVA and Post-Hoc Tukey HSD test, and by evaluating outcomes for each quadrant and an individual tooth in complete-arch scans.

RESULTS

When comparing bracket dimensions of 3D images with manual measurements using a traditional Vernier caliper, MEDIT i500 showed no significant difference when compared to the control group (p>0.05) in full arch scanning as well as the quadrant and single tooth scans in complete arch scanning. TRIOS 3 shape showed a significant difference when compared to the control and MEDIT i500 group (p<0.05) for all parameters.

CONCLUSIONS

MEDIT i500 showed higher accuracy and better reproduction of orthodontic bracket dimensions than TRIOS 3 shape.

Sulfate-Reducing Bacteria in Patients Undergoing Fixed Orthodontic Treatment

OBJECTIVES

The oral microbiological environment may be implicated in the corrosion of orthodontic metals. This study aimed to examine the prevalence of sulfate-reducing bacteria (SRB) in orthodontic patients undergoing fixed appliance treatment.

METHODS

Sixty-nine orthodontic and 69 healthy non-orthodontic participants were enrolled in the study. Supragingival and subgingivaloral biofilm were collected and tested for the presence of SRB. The DNA extraction, polymerase chain reaction (PCR), and 16sRNA Sanger sequencing method was performed from the SRB-positive samples. The sequenced PCR products were analysed and compared with databases to identify the bacterial genus.

RESULTS

Amongst 69 orthodontic patients, characteristic black precipitates developed in 14, indicating the presence of iron sulfides which demonstrates the likelihood of SRB. Alternatively, 2 out of 69 showed the presence of SRB in healthy non-orthodontic participants (controls). Desulfovibrio spp was confirmed by analyses of 16sRNA sequencing, which revealed that the SRB prevalence was 20% in the examined participants with orthodontic appliances.

CONCLUSIONS

The prevalence of SRB was found to be significantly higher amongst orthodontic patients compared to non-orthodontic participants. Presence of stainless steel in the oral environment may have facilitated the colonisation of SRB.

The effect of clear aligners on speech: a systematic review

OBJECTIVE

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

RESULTS

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

CONCLUSION

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

CLINICAL SIGNIFICANCE

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

REGISTRATION

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

In-Vitro Assessment of the Corrosion Potential of an Oral Strain of Sulfate-Reducing Bacteria on Metallic Orthodontic Materials

AIM

Orthodontic literature is scant when it comes to microbial corrosion. The oral prevalence of many bacteria which are capable of causing microbial corrosion is reported in the dental literature. The aim of this study is to experimentally determine the corrosive potential of an oral strain of Sulfate-reducing bacteria.

MATERIALS AND METHODS

Stainless steel (SS) bracket, stainless steel archwire, NiTi archwire, Titanium molybdenum (TMA) archwire, and titanium miniscrew were immersed in five media which included Artificial saliva (group I), Sulfate rich artificial saliva (group II), API agar medium specific for SRB (group III), AS + API medium+ bacterial strain (group IV), SRAS+ API medium+ bacterial strain (group V). The materials were then subjected to Scanning electron microscopy and energy-dispersive X-ray analysis (EDX).

RESULTS

Materials in groups I, II, and III did not show any surface changes whereas materials in groups IV and V which contained the bacteria showed surface changes which were erosive patches suggestive of corrosion. EDX analyses were in line with similar findings.

CONCLUSION

This in vitro study suggested that the oral strain of Sulfate-reducing bacteria was able to induce corrosive changes in the experimental setup.

Evaluation of Orthodontic Mini-Implant Placement in the Maxillary Anterior Alveolar Region in 15 Patients by Cone Beam Computed Tomography at a Single Center in South India

BACKGROUND In this study, we aimed to evaluate orthodontic mini-implant placement in the maxillary anterior alveolar region by cone beam computed tomography (CBCT) in 15 patients at a single center in South India. MATERIAL AND METHODS A total of 15 CBCT scans of orthodontic patients after completion of leveling and aligning stage were included. The thickness of labial alveolar bone, labio-palatal bone, and inter-radicular distance between the maxillary central incisors (U1-U1), maxillary central and lateral incisor (U1-U2), and maxillary lateral incisor and canine (U2-U3) at vertical levels 4 mm, 6 mm, and 8 mm above the interdental cementoenamel junction were measured. Descriptive statistics, ANOVA, and Tukey post hoc tests were done to assess the differences among the groups. An independent t test was done to analyze differences by sex. RESULTS The thickness of cortical bone in the labial region was higher in the U2-U3 site than in the U1-U1 site, at a height of 4 mm. Also, there was a significant difference between 4 mm and 8 mm heights in the U2-U3 region. No significant difference was noted in bone dimensions among men and women and in the labio-palatal bone thickness among the different sites. The inter-radicular distance was the highest between the U2-U3 site, while it was the lowest in the U1-U2 site. CONCLUSIONS The findings from this center showed that when CBCT was used to evaluate orthodontic mini-implant placement in the maxillary anterior alveolar region, the U2-U3 and U1-U1 locations at heights between 6 mm to 8 mm apical to the interdental cementoenamel junction were optimal for placement of the mini-implants.

Reliability of Frankfort Horizontal Plane with True Horizontal Plane in Cephalometric Measurements

INTRODUCTION

The purpose of the study is to determine reliability of true horizontal (TH) plane with Frankfort horizontal (FH) plane in cephalometric measurements.

MATERIALS AND METHODS

One hundred lateral cephalograms were collected and traced using FACAD software, all cephalometric measurements which included FH plane as reference planes were used in this study. Cephalometric tracing was done with FH plane as reference plane and another set of measurements with TH plane as reference plane was done. Statistical tests were done using independent sample t-test (p <0.05).

RESULTS

Results of an independent t-test revealed a statistically insignificant difference that was observed for all the parameters assessed (p <0.05). Both angular and linear measurements showed an insignificant difference between FH and TH.

CONCLUSION

Within the limitations of the study, the results show that the FH plane is closest and as reliable as the TH plane. The variation of FH was least for all the parameters assessed.

Neural networks for classification of cervical vertebrae maturation: a systematic review

OBJECTIVE

To assess the accuracy of identification and/or classification of the stage of cervical vertebrae maturity on lateral cephalograms by neural networks as compared with the ground truth determined by human observers.

MATERIALS AND METHODS

Search results from four electronic databases (PubMed [MEDLINE], Embase, Scopus, and Web of Science) were screened by two independent reviewers, and potentially relevant articles were chosen for full-text evaluation. Articles that fulfilled the inclusion criteria were selected for data extraction and methodologic assessment by the QUADAS-2 tool.

RESULTS

The search identified 425 articles across the databases, from which 8 were selected for inclusion. Most publications concerned the development of the models with different input features. Performance of the systems was evaluated against the classifications performed by human observers. The accuracy of the models on the test data ranged from 50% to more than 90%. There were concerns in all studies regarding the risk of bias in the index test and the reference standards. Studies that compared models with other algorithms in machine learning showed better results using neural networks.

CONCLUSIONS

Neural networks can detect and classify cervical vertebrae maturation stages on lateral cephalograms. However, further studies need to develop robust models using appropriate reference standards that can be generalized to external data.

Evaluation of Mesiodistal Root Angulation of Permanent Incisors, Canines, and First Pre-Molars by Orthopantomogram Dental Imaging Findings in 296 Children Aged 6-14 Years

Background

Early pre-eruptive inclination changes of the first premolar (FP) and its associative changes with canine (C) inclination are important to predict canine impaction. This study aimed to evaluate the mesiodistal root angulation of permanent lateral incisors (LI), canines, and first molars by orthopantomogram dental imaging in 296 children ages 6–14 years at a single center in India.

Material/Methods

The total number of participants was 296, with equal numbers of boys and girls divided into 4 age groups: 6–8 years, 8–10 years, 10–12 years, and 12–14 years. Angles between lateral incisor, erupting canine, and first pre-premolar with midline were measured on an orthopantomogram (dental imaging which includes all the teeth with TMJ). The angle between the erupting C with LI and erupting C with FP was measured. Pearson’s correlation was also evaluated between the movement of the erupting canine with lateral incisor and erupting canine with erupting first premolar.

Results

There was a significant difference in the angular values of different age groups (P≤0.05). The movements between LI, C, and FP were moderately correlated boys and girls aged 6–12 years.

Conclusions

The findings from this study showed that in boys and girls aged 6–14 years, eruption of the upper canine tooth was synchronized with eruption of the LI and FP.

Evaluating the Effect of Denosumab in Preventing Anchorage Loss: A Split-mouth Randomized Controlled Trial

AIM

The trial was focused on assessing the effect of Denosumab in preventing anchorage loss during en-masse anterior retraction and evaluating its effect on the retraction.

MATERIALS AND METHODS

This was a split-mouth randomized controlled trial. Ten subjects were randomly allocated with equal probability for Denosumab and control interventions in the contralateral quadrants using computer-generated randomization sequence. During the start of retraction, Denosumab (5 mg/0.2 mL) and injectable sterile water were administered locally on the intervention and control sides, respectively. Lateral cephalograms taken during the start of retraction and later in the 3rd and 6th months into retraction were used to evaluate anchorage loss and retraction. Independent sample t-test and Mann-Whitney U test compared anchorage loss and retraction between the two groups in the maxilla and mandible. Paired t-test and Wilcoxon signed-rank test assessed the anchorage loss and retraction during the first and the second 3 months of retraction.

RESULTS

In the maxilla, Denosumab was effective in preventing anchorage loss with a p-value of 0.001 whereas it was not effective in the mandible (p-value-0.172). A significant reduction in anchorage loss was observed with Denosumab in the second 3 months of retraction compared to the first 3 months. There was no significant difference in the retraction among both groups.

CONCLUSION

Denosumab was effective in minimizing the anchorage loss in the maxilla without affecting the anterior retraction.

CLINICAL SIGNIFICANCE

Denosumab can be effectively used for reinforcing anchorage in the maxilla during en-masse anterior retraction.

Taurodontism in the first permanent molars in Van der Woude syndrome compared to isolated cleft palate

OBJECTIVES

To analyse prevalence, pattern, and severity of taurodontism in individuals with Van der Woude syndrome (VWS) exhibiting cleft palate and compare with aged-matched non-syndromic cleft palate (NSCP) and non-cleft controls.

MATERIALS AND METHODS

One hundred and seventy-eight dental panoramic tomographs (DPTs) (105 girls and 73 boys) consisting of 42 VWS patients (x¯=8.55±1.02 years), 42 NSCP patients (x¯=8.59±1.02 years), and 94 normative non-cleft children (x¯=8.79±1.16 years) were assessed and their first permanent molars evaluated. Measurement 3 of the taurodontism index developed by Shifman and Chanannel with the Tulensalo modification was used. Prevalence, pattern, and severity were compared between groups. Statistical differences were determined by one-way analysis of variance and Fisher test. Repeatability was calculated by Cohens Kappa test.

RESULTS

The prevalence of taurodontic molars was 59.5% in VWS, 45.2% in NSCP, and 26.6% in non-cleft controls. The prevalence and severity of taurodontism in VWS and NSCP were significantly higher than in non-cleft children in all first permanent molars. There was no significant difference in prevalence and severity between VWS and NSCP. The odds for having taurodontism in the VWS group was approximately double compared to the NSCP group. Most of the taurodontic molars showed hypotaurodontism and taurodontism occurred bilaterally more frequently than unilaterally.

CONCLUSION

This study shows a higher prevalence of taurodontism in VWS and NSCP. Most taurodontic molars are hypotaurodontic and most occur bilaterally.

Dental age, agenesis, and morphological anomalies in individuals with Van der Woude syndrome and isolated cleft palate

OBJECTIVES

To analyse the differences between dental age and chronological age and dental anomalies in individuals with Van der Woude syndrome (VWS) and compare with non-syndromic cleft palate (NSCP) and non-cleft controls.

MATERIALS AND METHODS

In total, 204 oral panoramic radiographs (118 girls and 86 boys) consisting of 51 VWS patients (age x̅ = 8.17 ± 1.34 years), 51 NSCP patients (age x̅ = 8.09 ± 1.41 years), and 102 normative non-cleft children (age x̅ = 8.62 ± 1.24 years) were collected. Dental stages were assessed by the Demirjian method, with the local dental maturity index as reference. Dental anomalies including agenesis were investigated. Statistical differences were determined by One-way ANOVA and regression. Repeatability was calculated by an intra-class correlation test and 95% confidence interval.

RESULTS

The difference between dental age and chronological age of the VWS group (0.12 years) and the NSCP group (0.09 years) was significantly lower than the non-cleft group (0.40 years) (P = 0.002). There was no significant difference between the VWS and NSCP groups (P = 0.885). Hypodontia was more prevalent in both the VWS group (37.25%, P = 0.0001) and the NSCP group (19.60%, P = 0.035) compared with the non-cleft group (5.88%). The odds for hypodontia in the VWS group were approximately double compared with the NSCP group. In VWS patients, the most commonly missing teeth were the permanent second premolars and the maxillary permanent laterals incisors. Peg-shaped teeth had a prevalence of 13.70% in VWS patients.

CONCLUSIONS

In VWS and NSCP patients compared with non-cleft children, the difference in dental age compared with chronological age decreased. Hypodontia occurs at a high prevalence in VWS and NSCP patients compared with non-cleft children.