Dentistry and Orthodontics Research Papers (original) (raw)

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- Orthodontic Research, Dentistry and Orthodontics

As we see more adults entering comprehensive orthodontic treatment, we must be more attuned to the implications of periodontal issues. In this updated chapter, Robert Vanarsdall, Ignacio Blasi and Antonino Secchi review periodontal issues that impact orthodontic tooth movement. They describe periodontal "high risk" factors, mucogingival considerations, and problems with ectopic as well as ankylosed teeth. A new section on alveolar decortication and augmentation grafting has been added to address the increased use of these procedures designed to develop the alveolar housing and potentially increase the speed of tooth movement. Excellent clinical examples are pictured throughout the chapter.

- by Ignacio Blasi and +1
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- Orthodontics, Periodontics, Periodontology, Biomechanics in Orthodontics

A 26-year-old man with an aggressive periodontitis sought for orthodontic treatment to improve the appearance of his smile. He presented with generalised anterior spacing, missing lower left central incisor and deep traumatic bite. He was treated successfully with a combination of orthodontic and periodontal treatment. After 18 months of orthodontic treatment and follow up by the periodontist, his alignment of teeth was improved, a stable occlusion was achieved, and occlusal trauma was prevented. As a result, the patient's smile appearance and selfconfidence were improved. Orthodontic tooth movement is not only to correct the alignment of his teeth but also to improve the bone level especially at the anterior region. This case report shows the successful treatment outcome in aggressive periodontitis patient which requires good collaboration between the orthodontist and the periodontist.

The aim of this prospective study was to compare a fixed lingual orthodontic appliance with a commonly used aligner system, focusing on oral impacts and speech disturbances, during the first 3 months of orthodontic treatment. Two groups of adults were evaluated: 21 treated with Invisalign® and 26 with In-Ovation L® lingual brackets. Health-related quality of life questionnaires were used to assess the oral impacts, and speech samples were collected for speech evaluation by professionals. The levels of pain and painkiller intake were similar, increasing on the first day, and decreasing at 3 months. Subtle injuries on the lip and cheeks were initially reported in the aligner group. Lingual patients experienced more discomfort in swallowing and opening the mouth, tongue injuries and food residues, even at 3 months. The consonants “s” and “z” were mainly affected in both groups immediately after appliance insertion, but more often in the aligner group. These speech disturbances recovere...

- by Takis Kanarelis
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- Dentistry, Orthodontics, Quality of Life Studies, Quality of life

The aim of this prospective study was to compare a fixed lingual orthodontic appliance with a commonly used aligner system, focusing on oral impacts and speech disturbances, during the first 3 months of orthodontic treatment. Two groups of adults were evaluated: 21 treated with Invisalign ® and 26 with In-Ovation L ® lingual brackets. Health-related quality of life questionnaires were used to assess the oral impacts, and speech samples were collected for speech evaluation by professionals. The levels of pain and painkiller intake were similar, increasing on the first day, and decreasing at 3 months. Subtle injuries on the lip and cheeks were initially reported in the aligner group. Lingual patients experienced more discomfort in swallowing and opening the mouth, tongue injuries and food residues, even at 3 months. The consonants "s" and "z" were mainly affected in both groups immediately after appliance insertion, but more often in the aligner group. These speech...

- by Mishelle Maaz
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- Dentistry, Orthodontics, Dentistry and Orthodontics
- by Nasir Alhamlan
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- Orthodontics, Orthodontic Research, Malocclusion, Dentistry and Orthodontics

Background: The malocclusion indices have been used routinely by researchers to gather data regarding the prevalence of orthodontic treatment needs and trait. The scoring methods of malocclusal indices can be used to generate data regarding the actual load of the malocclusion which can be used for resource and fund allocation and identify the actual orthodontic treatment needs. This article will provide an insight to the various orthodontic indices and its specific indications.

In orthodontic practice various treatment modalities have been
presented for the treatment for the class II, div 1malocclusions.
Recently a large number of young adults have been seeking
shorter, cost effective and a non surgical correction of Class II
malocclusions and they accept dental camouflage as a treatment option to mask the skeletal discrepancy .This case report presents one such case, a 15years old growing male who has Class II div I malocclusion with sever maxillary incisor proclination, convex profile ,high mandibular plane angle, incompetent lips, increased overjet& overbite, over retained upper left deciduous canine ,impacted upper left canine and a supernumerary tooth in canine region. We considered the camouflage treatment by extracting the upper right first premolar, left impacted canine, deciduous canine
and supernumerary tooth. Following the treatment, a satisfactory result was achieved with an ideal, static and a functional occlusion, facial profile, acceptable smile, competent lip and stable treatment results.

The terminology “serial extraction” in Orthodontics was first described in the late 1920’s when Kjellgren [1] decided to plan the extraction of certain deciduous and permanent teeth at early stages of the dentition development. Since the extractions are under taken at the transitional dentition. This type of treatment is defined as “Early Treatment” in Orthodontics [2]. The main indication for this treatment approach is for patients with severe crowding caused by tooth size arch discrepancies [3,4]. In other words, when maxillary and/or mandibular arches cannot accommodate teeth, extraction becomes an interesting option. Although this treatment option has been used for almost a century in the contemporary orthodontics it’s indication is very specific. Since it’s an irreversible approach (permanent teeth are early extracted) the clinician should carefully diagnosis the case before selecting this option. In addition, as time passed by, orthodontics specialty has dramatically evolved and developed several options to gain space instead of extracting teeth. On the other hand, the idea to early extract permanent teeth continues to be an interesting treatment option in clinical orthodontics mainly in severely crowded patients. The aim of this paper is to present a case report of a ten-year-old male patient who presented severe crowding and treatment option was to extract four first premolars at early stages of the dentition development.

Advancements in computer systems and technologies have
revolutionized the field of dentistry as well. These advancements
can be seen with the introduction and evolution of CAD/CAM
systems. The demand for such systems has grown dramatically
over the past decade and a large variety of different CAD/CAM
systems have been developed and marketed. The popularity of
these systems can be attributed to their efficiency of designing,
manufacturing and precision.

Objectives: The purpose of this paper is to provide a useful critical review relating to the effects of malocclusion on the physical, social, and psychological aspects of the Quality of Life (QoL) of patients. Methods: The information presented in previous articles was reviewed. They include reviews, meta-analyses, cross-sectional studies, retrospective and prospective longitudinal studies, and randomized controlled trials. These full-text English-language papers were studied to determine the effects of malocclusion on QoL. Results: Recent studies have found that malocclusion is associated with higher levels of dissatisfaction with appearance, and have the potential to negatively impact Oral Health Related Quality of Life (OHRQoL). However, due to the differences in study designs, population demographics studied, and methods of assessment of physical, social, and psychological health, the evidence needs more analysis. Conclusion: In recent years, attention to patient-centered assess...

- by Randa Abidia
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- Dentistry, Orthodontics, Dental Public Health, Medicine
- by Ignacio Blasi and +1
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- Orthodontics, Biomechanics in Orthodontics, Aesthetics in Orthodontics, Orthodontic Research

3D printing has been admired as a cutting-edge technology, which will change manufacturing [1]. Recent advances in bioprinting technologies have enabled rapid manufacturing of medical models in many fields and areas. Recently in the... more

- by Amir Fahimipour
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- Dentistry, Orthodontics, Print Culture, Laser

Minimally and Non-Invasive Approaches to Accelerate Tooth Movement:
Micro-osteoperforations. Patients are always attracted to decreasing the time it takes to complete orthodontic treatment. Recent advances in the understating of bone biology have been applied to a number of adjunctive techniques that in certain situations may reduce the time for certain tooth movements. In this new chapter, Ignacio Blasi looks at the use of micro-osteoperforations and the ability of these perforations to increase bone turnover rates, providing for increased speed of tooth movement. Studies have been done that demonstrate a localized positive effect on the speed of tooth movement.
Mechanical Vibration. Dubravko Pavlin presents information on the influence of low level mechanical vibration on orthodontic treatment, a technique borrowed from orthopedic colleagues. Some of the animal and human studies have reported increased rates of tooth movement and an ability to reduce pain perception when low level vibration therapy is used. Still other studies report no clinical effectiveness. While the jury is still out on this technique, clinical and basic science research into adjuncts that can influence biologic factors, are likely to bear fruit in the future.

- by Ignacio Blasi and +1
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- Orthodontics, Periodontics, Combined Orthodontic-Surgical Treatment, Orthodontist

Background: Although orthodontic white spot lesions (WSLs) are one of the most often and most evident adverse effects of comprehensive fixed appliance treatment, the efficacy of interventions for WSLs has not yet been adequately assessed in an evidence-based manner. Objective: Aim of this systematic review was to assess the therapeutic and adverse effects of interventions to treat post-orthodontic WSLs from randomized trials in human patients. Search methods: An unrestricted electronic search of eight databases from inception to May 2016. Selection criteria: Randomized controlled trials assessing any interventions for post-orthodontic WSLs on human patients. Data collection and analysis: After duplicate study selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, random-effects meta-analyses of mean differences (MDs), standardized mean differences (SMDs), and odds ratios (ORs), including their 95% confidence intervals (CIs) were performed, followed by subgroup and sensitivity analyses. Results: A total of 20 unique studies and a total of 942 (42 per cent male and 58% per cent female) patients were included, with an average age of 16.2 years and a mean number of 8.2 WSLs (range 2.2 to 45.4) per patient. These were allocated to adjunct treatment with casein phosphopeptide-stabilized amorphous calcium phosphate creams, external tooth bleaching, low-or high-concentration fluoride films, gels, mouthrinses or varnishes, resin infiltration, miswak chewing sticks, bioactive glass toothpastse, or to no adjunct treatment (i.e. conventional oral hygiene). The monthly use of fluoride varnish was the best supplement to improve WSLs in terms of lesion area (1 trial; MD = −0.80 mm 2 ; 95% CI = −1.10, −0.50 mm 2 ; P < 0.05; high quality) and enamel fluorescence (3 trials; SMD = −0.92; 95% CI = −1.32, −0.52; P < 0.05; high quality), followed by the use of fluoride film. WSL treatment did not provide a considerable improvement in their clinical evaluation (3 trials; OR = 0.97; 95% CI = 0.60, 1.56; P > 0.05; moderate quality), with imprecision due to small sample size being the main limitation of existing evidence. Conclusions: Based on the existing trials, interventions for post-orthodontic WSLs, mainly fluoride varnish, seem to be effective, but further research is needed to elucidate their clinical relevance. Registration: PROSPERO (CRD42016037538)

- by Spyridon Papageorgiou and +1
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- Orthodontics, Evidence Based Medicine, Clinical Trials, Clinical Trial
- by Nasir Alhamlan
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- Orthodontics, Dentistry and Orthodontics, Research In Orthodontics
- by Nasir Alhamlan
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- Dentistry and Orthodontics

Students are inspired to take up dentistry for factors related to security, social and professional status, financial rewards, better quality of life, and for working with people. The period of internship is the most suitable period to plan the future strategy by setting up professional goals for an appropriate career path. The number of options after graduating dentistry is many and choosing the best option that will satisfy passion as well as income, having an overall professional goal will enable to secure a bright and secure future in dentistry. In many instances parents take up the decision to place their children in dentistry based on their knowledge and then it is the turn of the children to put in their best efforts to succeed in life as they are matured enough to judge the need of their souls. Earning money as well as serving the people who are in need must be the vision of every graduating student. Dentistry gives a secured platform to take up the field of specialized interest and even if it fails to succeed there are always diverse options. The articles located, extracted and reviewed were relevant studies published in English language from selected websites and dental journals published online. This review article makes an attempt to focus on the different career paths available for students to pursue after their Bachelor graduation in dentistry. Key message: The responsibility in life does not just end as an Intern but it is miles to go. Dentistry gives a secured platform to take up the field of specialized interest and even if it fails to succeed there are always other options after graduation.

- by Dr. Vindha Paul and +2
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- Management, Dentistry, Dental Surgery, Pedodontics (Pediatric Dentistry)

Effect of long-term orthodontic treatment on salivary nickel and chromium has not been quite assessed except in few retrospective studies with controversial results. The aim of this prospective study was to measure salivary levels of these ions during 1 year of orthodontic treatment. Saliva samples were collected from 20 orthodontic patients, before treatment (control) and 6 and 12 months later. Nickel and chromium concentrations were determined using atomic absorption spectrophotometry. Data were analyzed using one- and two-way repeated-measures ANOVA, Bonferroni, Friedman (α = 0.05), and Wilcoxon signed-ranks tests (α = 0.016). Average nickel level changed from 9.75 ± 5.02 to 10.37 ± 6.94 and then to 8.32 ± 4.36 μg/L in 1 year. Average chromium concentration changed from 3.86 ± 1.34 to 4.6 ± 6.11 and then to 2.04 ± 1.66 μg/L. Alterations in nickel values were not statistically significant [P = 0.468 (ANOVA)], but fluctuations in chromium levels were [P = 0.021 (Friedman)]. The dec...

- by fariborz amini
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- Dentistry, Biotechnology, Heavy metal monitoring and analysis, Adolescent
- by Nasir Alhamlan
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- Dentistry, Dentistry and Orthodontics

Papageorgiou SN, G€ olz L, Jäger A, Eliades T, Bourauel C. Lingual vs. labial fixed orthodontic appliances: systematic review and meta-analysis of treatment effects. Eur J Oral Sci 2016; 00: 000–000. © 2016 Eur J Oral Sci The aim of this systematic review was to compare the therapeutic and adverse effects of lingual and labial orthodontic fixed appliances from clinical trials on human patients in an evidence-based manner. Randomized and prospective non-randomized clinical trials comparing lingual and labial appliances were included. Risk of bias within and across studies was assessed using the Cochrane tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Random-effects meta-analyses were conducted, followed by subgroup and sensitivity analyses. Six electronic databases were searched from inception to July 2015, without limitations. A total of 13 papers pertaining to 11 clinical trials were included with a total of 407 (34% male/66% female) patients. Compared with labial appliances, lingual appliances were associated with increased overall oral discomfort , increased speech impediment (measured using auditory analysis), worse speech performance assessed by laypersons, increased eating difficulty, and decreased intermolar width. On the other hand, lingual appliances were associated with increased intercanine width and significantly decreased anchorage loss of the maxillary first molar during space closure. Based on existing trials, there is insufficient evidence to make robust recommendations for lingual fixed orthodontic appliances regarding their therapeutic or adverse effects, as the quality of evidence was low.

Radiography of the hand & wrist is the commonest modality used to calculate bone age. Automated methods for evaluation of hand
and wrist radiographs are also being developed which reduce inter rater variability compared to manual methods. Non radiation
based techniques of visualizing hand & wrist bones such as ultrasonography for bone age calculation have been theorized but are not
as accurate as radiographic methods. MRI based methods are being developed but require more research. Dental age is an alternate
form of bone age determination, which also gives an estimate of skeletal maturity. The accurate age assessment is required for
applying correct treatment modality in pediatric patient as well as for forensic purpose. The hand wrist radiograph is considered to be
the most standardized method of skeletal assessment. In the present review we will discuss about the various methods of hand wrist
skeletal maturity assessment.

- by Dr. Anuj S Parihar
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- Dentistry, Orthodontics, Orthodontic Research, Dentistry and Orthodontics

Communication is an essential element of the relationship between patient and dentist. Dental schools are required to ensure that undergraduates are adequately trained in communication skills yet little evidence exists to suggest what constitutes appropriate training and how competency can be assessed. This review aimed to explore the scope and quality of evidence relating to communication skills training for dental students. Eleven papers fitted the inclusion criteria. The review found extensive use amongst studies of didactic learning and clinical role-play using simulated patients. Reported assessment methods focus mainly on observer evaluation of student interactions at consultation. Patient involvement in training appears to be minimal. This review recommends that several areas of methodology be addressed in future studies, the scope of research extended to include intra-operative communication, and that the role of real patients in the development of communication skills be active rather than passive.

- by Anna Madill
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- Dentistry, Orthodontics, Communication, Teaching and Learning

INTRODUCCION Y GENERALIDADES ORTODONCIA
INTRODUCCIÓN A LA CEFALOMETRÍA

- by Andrea Go
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- Dentistry, Orthodontics, Dentistry and Orthodontics, CIRUJANO DENTISTA

Background: Although the headgear appliance has been used extensively to correct anteroposterior discrepancies, its treatment effects have not yet been adequately assessed in an evidence-based manner. Objective: Aim of this systematic review was to assess the therapeutic and adverse effects of early headgear treatment from controlled clinical trials on human patients in an evidence-based manner. Search methods: An unrestricted electronic search of six databases from inception to December 2015. Selection criteria: Randomized and prospective non-randomized controlled trials assessing the effects of headgear treatment on human patients. Data collection and analysis: After duplicate study selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, random-effects meta-analyses of mean differences (MDs) and relative risks (RRs), including their 95% confidence intervals (CIs) were performed, followed by subgroup and sensitivity analyses. Results: A total of 18 unique studies with a total of 930 (56% male/44% female) patients were included. Headgear treatment was associated with a posterior translation of the anterior maxilla border in the short term, as seen by the mean annualized change in the SNA angle (MD = −1.63°/ year; 95% CI = −2.20 to −1.06°/year; high quality evidence) compared to untreated patients. This effect was independent of the rotation of the palatal plane and the inclination of the upper incisors, while a proportional relationship with the initial discrepancy in SNA was seen. The clinical significance of this improvement diminished in the long term, although only limited evidence existed. Additionally, early headgear treatment might decrease the risk of dental trauma during the following years (RR = 0.34; 95% CI = 0.14 to 0.80; moderate quality evidence). Low quality evidence on the effect of headgear on the rotation of the palatal plane, the nasolabial angle, the occlusal outcome, and signs of temporomandibular disorders precluded robust assessments, due to risk of bias, inconsistency, imprecision, and small-study effects. Conclusions: Based on existing trials, headgear is a viable treatment option to modify sagittal growth of the maxilla in the short term in Class II patients with maxillary prognathism. Registration: PROSPERO (CRD42015029837). Funding: None.

- by Spyridon Papageorgiou
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- Orthodontics, Clinical Trials, Clinical Trial, Meta-Analysis (Statistics)

Alumina has received considerable attention and has been historically well-accepted as biomaterials for dental and medical applications. This article reviews the applications of this material in dentistry. It presents a brief history, dental applications and methods for improving the mechanical properties of alumina-based materials. It also offers perspectives on recent research aimed at the further development of alumina for clinical uses, at their evaluation and selection, and very importantly, their clinical performance. This article also stated about the Functionally Graded Materials (FGMs) which has been conceived as a new material design approach to improve performance compared to traditional homogeneous and uniform materials. This technique allows the production of a material with very different characteristics within the same material at various interfaces. The importance of the FGM concept in biological applications and functions was highlighted. Fundamentally, the combination of mechanical properties and biocompatibility are very important factors in application of any biomaterial to medical or dental fields. The characteristics of the surface govern the biocompatibility of the material, and the mechanical strength is determined by the average mechanical strength of the materials. However, the fabrication of FGMs is most often hindered by the variation of elastic, plastic, thermal, chemical, and kinetic properties within the composite. Across a material interface, these discontinuities in material properties lead to the formation of residual stresses. Despite these challenges, compositional gradient structures offer significant benefits. Notable research literature is highlighted regarding (1) applications of alumina in various fields in dentistry; (2) improvement of the mechanical properties of alumina by microstructural manipulation, FGM as well as composite formulations involving metallic, intermetallic elements and bioceramics.

- by Ahmed A. Madfa
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- Dentistry, Orthodontics, Prosthodontics, Orthopedic Surgery

Calculus is one of the predisposing factors

- by widowati witjaksono
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- Dentistry and Orthodontics

Background: Permanent canines are amongst the teeth most affected by impaction and ectopic eruption. Although impacted canines are often subjected to surgical exposure and alignment with either the open or the closed technique for many decades, their treatment effects have not yet been systematically asssessed. Objectives: The aim of this systematic review was to critically assess whether significant differences exist in the outcomes of the open or closed surgical exposure of impacted canines. Search methods: An unrestricted electronic search of nine databases from inception to December 2016 was performed. Selection criteria methods: Included were randomized or prospective non-randomized studies comparing open versus closed exposure of impacted canines in human patients. Data collection and analysis: After duplicate study selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, random-effects meta-analyses of mean differences (MDs) and odds ratios (ORs), including their 95 per cent confidence intervals (CIs) were performed, followed by subgroup and sensitivity analyses. Results: A total of eight unique studies and a total of 433 (30.1% male/59.9% female) patients were included, with an average age of 15.2 years and a total of 453 impacted canines (48.6% and 51.4% in the open and closed exposure, respectively). Open exposure of impacted canines was associated with reduced duration of canine alignment (two studies; MD = –2.14 months; 95% CI = –4.23 to –0.05 months; P < 0.05; moderate heterogeneity and moderate quality) and lower odds of tooth ankylosis (one study; OR = 0.15; 95% CI = 0.03–0.83; P < 0.05; low quality) compared to closed exposure; both findings being independent of canine localization. However, initial alignment of palatally impacted canines took overall significantly longer than labially impacted canines (8.87 versus 4.17 months). Conclusions: Based on existing evidence, open surgical exposure seems to be superior in treatment duration and ankylosis risk over the closed technique. Due to the limited number of small included trials, further research is needed for robust clinical recommendations. Registration: PROSPERO (CRD42016051916).

Patients wearing orthodontic appliances experience varying degrees of pain and discomfort during the course of orthodontic therapy. Pain is one of the main factors responsible for the rejection of orthodontic treatments. Pain control is, therefore, crucial for both patients and orthodontists. In this review, an attempt is made to summarize the information regarding pain associated with orthodontic treatment, and to address questions orthodontists and patients or their parents may ask from the clinical point of view. Also, current orthodontic pain management procedures are presented. Data collection was performed by three reviewers independently. Using evidences found in the literature, an understanding of the causes as well as an overview of recent management procedures used in reducing orthodontic pain is provided. During orthodontic treatment, pain prevention and management should be given priority because heightened uncertainty in patients and parents can create a negative impact of emotional and confidence levels on the patient-parent-orthodontists.

- by Mohammed Nahidh
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- Dentistry and Orthodontics

Abstract
Purpose Although several prescriptions and techniques exist for comprehensive fixed appliance treatment, their treatment effects have not yet been adequately assessed in an evidence-based manner. The aim of this systematic review was to assess the therapeutic and adverse effects of various prescriptions or techniques for orthodontic appliances from randomized clinical trials on human patients.
Methods Eight databases were searched up to July 2016 for randomized trials assessing any orthodontic prescriptions or techniques in human patients. After elimination of duplicate studies, data extraction, and risk of bias assessment according to the Cochrane guidelines, random effects meta-analyses with mean differences (MD) and their 95% confidence intervals (CIs) were performed.
Results Compared to Roth preadjusted appliances, both Begg and modified Begg appliances were associated with statistically significantly worse occlusal outcome assessed with Peer Assessment Review (PAR) scores (1 trial, MD 3.1 points, 95% CI 1.9–4.3 points and 1 trial, MD 2.4 points, 95% CI 1.2–3.6 points, respectively) with low quality of evidence, due to bias and imprecision. Compared to a partially programmed fixed orthodontic appliance, a fully programmed appliance was associated with a statistically significant, but clinically irrelevant increase in treatment duration (1 trial, MD 2.4 months, 95% CI 0.6–4.2 months), supported by high quality of evidence. However, caution is needed in the interpretation of these results as only a limited number of small trials with methodological issues were available.
Conclusions Based on existing trials, there is limited evidence to support any robust clinical recommendation
regarding the prescriptions or techniques for fixed orthodontic appliances.
Registration: PROSPERO (CRD42016042727).
Funding: None.

Review Soft tissue changes following extraction vs. nonextraction orthodontic fixed appliance treatment: a systematic review and meta-analysis Konstantonis D, Vasileiou D, Papageorgiou SN, Eliades T. Soft tissue changes following extraction vs. nonextraction orthodontic fixed appliance treatment: a systematic review and meta-analysis. Eur J Oral Sci 2018; 00: 1–13. © 2018 Eur J Oral Sci The aim of this systematic review was to assess the effect of systematic extraction protocols during orthodontic fixed appliance treatment on the soft tissue profile of human patients. Nine databases were searched until December 2016 for controlled clinical studies including premolar extraction or nonextraction treatment. After elimination of duplicate studies, data extraction, and risk-of-bias assessment according to the Cochrane guidelines, random-effects meta-analyses of mean differences (MD) or standardized mean differences (SMD) and their 95% CIs were performed, followed by subgroup, meta-regression, and sensitivity analyses. Extraction treatment was associated with increased lower lip retraction (24 studies; 1,456 patients; MD = 1.96 mm), upper lip retraction (21 studies; 1,149 patients; MD = 1.26 mm), nasolabial angle (21 studies; 1,089 patients; MD = 4.21°), soft-tissue profile convex-ity (six studies; 408 patients; MD = 1.24°), and profile pleasantness (three studies; 249 patients; SMD = 0.41). Patient age, extraction protocol, and amount of upper incisor retraction during treatment were significantly associated with the observed extraction effects, while the quality of evidence was very low in all cases due to risk of bias, baseline confounding, inconsistency, and imprecision. Although tooth extractions seem to affect patient profile, existing studies are heterogenous and no consistent predictions of profile response can be made.

Objectives Aim of this systematic review was to assess the effect of orthodontic treatment with fixed appliances on the tooth color of patients. Methods Nine databases were searched up to May 2017 for clinical cohort studies on the effect of fixed appliance treatment on tooth color. After elimination of duplicate studies, data extraction, and risk of bias assessment according to the Cochrane guidelines, random effects meta-analyses of mean differences (MD) or means and their 95% confidence intervals (CIs) were performed, followed by GRADE (Grading of Recommendations Assessment, Development and Evaluation) assessment of the quality of evidence. Results Three nonrandomized and one randomized study with a total of 138 patients (46% male, 54% female) with average age of 15.7 years were included. Tooth color of treated patients was significantly altered during or after orthodontic treatment (4 studies; average of 3.2 E units; 95% CI = 2.0–4.4 E units), which was more than the variation among controls (1 study; MD = 1.9 E units; 95% CI = 1.7–2.2 E units). However, the quality of evidence was very low, due to the inclusion of nonrandomized studies, bias, and imprecision. Re-analysis of raw study data indicated that significant differences in clinically discernable treatment-induced color changes were seen between chemically and light-cured adhesives and among the various tooth categories. Conclusion Existing evidence of very low quality indicates that orthodontic treatment might be associated with alterations of tooth color, which are however not consistently clinically discernible. Treatment-induced color alterations might be dependent on bonding material and tooth type, but evidence supporting this is weak.

- by Spyridon Papageorgiou
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- Orthodontics, Dental Research, Meta-Analysis (Statistics), Bone and tooth

A compiled summary of the implications of severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2)
infection and coronavirus disease 2019 (COVID-19) on
orthodontic treatment, management, and provision of
emergency orthodontic treatment during the critical times
of COVID-19 lockdown and for the future to come. The
orthodontic practise post lockdown would never be the
same as before, but adequate measures to maintain and
prevent further transmission can pave a long way in
management of such epidemic and safety of healthcare
professionals.
Emergency orthodontic treatment can be provided by
following a set of guidelines with the observance of strict
protection protocols of the patients involved and
environmental disinfection becomes crucial in order to
minimize the risk of cross infection. It is necessary to reevaluate the orthodontic activities taking into account the challenges in terms of contagion containment. The end of
the lockdown period will mark the beginning of new
approach and management in orthodontic treatment.
Keywords: SARS-CoV-2, COVID-19, Coronavirus,
Dental management, Cross-infections, orthodontics.

- by Jayashree Manikandan
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- Dentistry and Orthodontics, Esthetic Dentistry

Aim: To assess the effectiveness of zygomatic anchorage for the intrusion of maxillary pos- terior teeth. Method: A male patient, 20 years 5 months of age, with 3-mm anterior open bite with excessive maxillary posterior growth, was accepted for treatment. Titanium mini- plates were fixed bilaterally to the zygomatic buttress area and 200 g of force was applied unilaterally with 9-mm nickel-titanium coil springs between the vertical extension of the miniplate and the first molar buccal tube. Later, the zygomatic site was used for maxillary canine distalization. Results: The maxillary posterior teeth were intruded effectively and the canines were distalized bodily, without anchorage loss, with the help of zygomatic anchor- age. The patient was advised to maintain good oral hygiene throughout the treatment. This noninvasive surgical procedure eased and reduced the operation time and did not require headgear wear nor anterior box elastics for anterior open bite correction. Conclusion: The zygomatic area was found to be a useful anchorage site for the intrusion of the molars over a short period of time. Long-term stability of the bite closure should be assessed in future studies. World J Orthod 2002;3:147–153.

Various treatment strategies are adopted to correct a Class II malocclusion depending on the age, the amount of remaining growth and severity of malocclusion. Single arch extraction of the lowers is rarely done in a Class II malocclusion. The following case report describes an alternate treatment approach of an adolescent Class II patient treated with a combination of headgear, fixed functional appliance (forsus), and single arch extraction only in the lower arch. The case was finished in a Class III molar and a Class I canine relationship. The results were stable in 3 years follow‑up.

Introduction: Aim of this study was to assess the registration of orthodontic systematic reviews in PROSPERO. Method: Seven databases were searched for orthodontic systematic reviews published in 2012-2016. After duplicate study selection and data extraction, descriptive statistics, followed by chi-square/Fisher exact tests were calculated. Finally, bivariable/multivariable regression with relative risks (RR) and 95% confidence intervals (CIs) was used. Results: A total of 182 orthodontic systematic reviews were identified, 37 (20.3%) of which were registered in PROSPERO, with registration rates ranging from 4.3% in 2012 to 37.0% in 2016. Differences in review registration were found according to publication year, geographic origin, multicentre status, funding, and journal category. After controlling for confounders, each additional year was associated with increased registration probability (RR = 1.51; 95% CI = 1.19– 1.93). Reviews from South America were more likely to be registered than reviews from Europe (RR = 1.49; 95% CI = 1.06–2.11). Finally, reviews published in orthodontic specialty journals were more likely to be registered than reviews in general dentistry journals (RR = 1.87; 95% CI = 1.02– 3.49). Conclusions: A small percentage of orthodontic systematic reviews was registered a priori, although improvement signs have been seen since the initiation of PROSPERO.

Background: Although Rapid Maxillary Expansion (RME) has been used for over a century, its effect on upper airways has not yet adequately been assessed in an evidence-based manner. Objective: To investigate the volumetric changes in the upper airway spaces following RME in growing subjects by means of acoustic rhinometry, three-dimensional radiography and digital photogrammetry. Search methods: Literature search of electronic databases and additional manual searches up to February 2016. Selection criteria: Randomized clinical trials, prospective or retrospective controlled clinical trials and cohort clinical studies of at least eight patients, where the RME appliance was left in place for retention, and a maximum follow-up of 8 months post-expansion. Data collection and analysis: After duplicate data extraction and assessment of the risk of bias, the mean differences and 95 per cent confidence intervals (CIs) of upper airway volume changes were calculated with random-effects meta-analyses, followed by subgroup analyses, meta-regressions, and sensitivity analyses. Results: Twenty studies were eligible for qualitative synthesis, of which 17 (3 controlled clinical studies and 14 cohort studies) were used in quantitative analysis. As far as total airway volume is concerned patients treated with RME showed a significant increase post-expansion (5 studies; increase from baseline: 1218.3 mm 3 ; 95 per cent CI: 702.0 to 1734.6 mm 3), which did not seem to considerably diminish after the retention period (11 studies; increase from baseline: 1143.9 mm 3 ; 95 per cent CI: 696.9 to 1590.9 mm 3). Limitations: However, the overall quality of evidence was judged as very low, due to methodological limitations of the included studies, absence of untreated control groups, and inconsistency among studies. Conclusions: RME seems to be associated with an increase in the nasal cavity volume in the short and in the long term. However, additional well-conducted prospective controlled clinical studies are needed to confirm the present findings.

Aim: The validity of meta-analysis is dependent upon the quality of included studies. Here, we investigated whether the design of untreated control groups (i.e. source and timing of data collection) influences the results of clinical trials in orthodontic research. Materials and methods: This meta-epidemiological study used unrestricted literature searching for meta-analyses in orthodontics including clinical trials with untreated control groups. Differences in standardized mean differences (ΔSMD) and their 95% confidence intervals (CIs) were calculated according to the untreated control group through multivariable random-effects meta-regression controlling for nature of the interventional group and study sample size. Effects were pooled with random-effects synthesis, followed by mixed-effect subgroup and sensitivity analyses. Results: Studies with historical control groups reported deflated treatment effects compared to studies with concurrent control groups (13 meta-analyses; ΔSMD = −0.31; 95% CI = −0.53, −0.10; P = 0.004). Significant differences were found according to the type of historical control group (based either on growth study or clinical archive; 11 meta-analyses; ΔSMD = 0.40; 95% CI = 0.21, 0.59; P < 0.001). Conclusions: The use of historical control groups in orthodontic clinical research was associated with deflation of treatment effects, which was independent from whether the interventional group was prospective or retrospective and from the study's sample size. Caution is warranted when interpreting clinical studies with historical untreated control groups or when interpreting systematic reviews that include such studies.

- by Vasiliki Koretsi and +1
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- Orthodontics, Meta-Analysis (Statistics), Meta-Analysis and Systematic Review, Meta-analysis (Social Sciences)
- by Vahid Rakhshan
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- Dentistry, Orthodontics, Dental Research, Dental Anthropology

Nanoparticles (NPs) are insoluble particles smaller than 100 nm in size and the set of technologies that enables manipulation of these particles on an atomic, molecular and supra molecular scale is termed as 'Nanotechnology'. Applications of nanotechnology are being ventured in various domains including health care and have also carved their way into various specialties of dentistry. This article presents an insight into various types of nanoparticles and their application in the field of Orthodontics. The various tests performed when using nanoparticles, to detect the physical and biological properties of the new material, are also summarized for easy referral.

- by Anam Mushtaq
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- Nanoparticles, Nanotechnology, Dentistry and Orthodontics

Low friction bracket systems reduce friction over conventional brackets. Friction is the resistive force between one objet against another one during contact motion. Together with binding and notching , friction is responsible for the sliding resistance observed in orthodontics throughout alignment, level and space closure stages. It has been said high friction may prevent the attainment of optimal force levels in the supporting tissues. Laboratory studies show that friction is lower in low friction bracket systems and in well designed ones binding is more important in resistance to sliding. Clinical studies support the view that resistance to sliding is the same in low friction brackets and conventional one and friction has a little clinical influence. A controlled clinical studies systematic review conclude at this stage there is insufficient high-quality evidence to support the use of low friction fixed orthodontic appliances over conventional appliance systems or vice versa. In regard to actual evidence the reduction of friction by actual low friction bracket systems do not show clinical significance.

- by Daniel Segovia
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- Dentistry and Orthodontics, Ortodoncia

Many techniques were developed for enamel polishing after orthodontic bracket debonding to keep the enamel surface as smooth as possible to pretreatment condition, in addition to many bracket adhesives used for orthodontic brackets bonding. This study aimed to compare the effect of two different adhesive materials and polishing protocols on enamel surface roughness after debonding of orthodontic brackets. Forty maxillary premolars were divided into four groups, orthodontic brackets were bonded using two different adhesive materials (Resilience LC Orthodontic Adhesive from Orthotechnology and Bisco Ortho bracket paste LC from Bisco). After brackets debonding adhesive remnants were removed using carbide bur followed by either Enhance Finishing tip then Prisma Gloss Polishing Cup with Prisma Gloss Polishing Paste or High Shine Enamel Polisher and Astropol green polishing cups. Then Atomic force microscope was used to evaluate surface roughness parameters among groups. The roughness data were statistically analyzed with Tukey post hoc test. Results showed significantly lower surface roughness parameters with Bisco Ortho bracket paste group compared with Resilience LC Orthodontic Adhesive group when both were polished with Enhance Finishing tip and Prisma Gloss Polishing Paste. Additionally, significantly lower Sz (Ten points height) value was seen with Bisco Ortho bracket paste group polished with Enhance Finishing tip and Prisma Gloss Polishing Paste in comparison with Resilience LC Orthodontic Adhesive polished with High Shine Enamel Polisher and Astropol green polishing cups. Pre-mounted, aluminum oxide impregnated, cured urethane dimethacrylate resin finishers tips (Enhance finishing tips) with a fine-grit aluminum-oxide polishing paste (Prisma Gloss Polishing Paste) could produce smoother enamel surface than 5 micron diamond grit suspended in resilient silicone tip (high shine enamel polisher) followed by Multiple-use polishing cups consist of silicone rubber and silicon carbide particles (Astropol green polishing cups) when Bisco Ortho bracket paste LC used. Experimental article (J Int Dent Med Res 2020; 13(1): 86-90)

Introduction: Self-ligating brackets are the last technological innovation in orthodontics. Many advantages have
been said they have over the conventional brackets.
Development: Friction is the resistive force between one
object against another one during perpendicular motion.
Together with binding and notching, friction is responsible for the sliding resistance observed in orthodontics
through out alignment, level and space closure stages.
Dental arch expansion from low forces, treatment time
and the comparison to traditional brackets were considered
a benefit as well as periodontal indexes and produced white
spots. Patient’s discomfort was taken into consideration
during orthodontic treatment with both types of brackets
and the save of time.
Conclusions: Except for this last factor during the arch
insertion and adjustment, there are no advantages based
on present evidence between self-ligating and conventional brackets.

- by Daniel Segovia
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- Orthodontics, Biomechanics in Orthodontics, Dentistry and Orthodontics, Ortodoncia
- by Ali Borzabadi-Farahani
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- Orthodontics, Hypodontia, Dentistry and Orthodontics, Implantolology