bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of peripheral ossifying fibroma following micro-osteoperforation
Authors: Alshihri Abdulmonem , Salem Daliah , Lerman Mark A.
Published: September 2021

Background

Micro-osteoperforation (MOP) is a newly developed technique reported to accelerate orthodontic tooth movement.

Case presentation

The following case report discusses a peripheral ossifying fibroma (POF), as a reactive gingival nodule that developed eight weeks after a patient underwent transmucosal MOP at multiple sites in the mandible during orthodontic treatment.

Conclusion

The MOP procedure is a relatively new approach applied to orthodontics that may induce gingival reactive nodules. Clinicians should be aware of this possible sequela and inform patients of the potential risk.
The impact of orthodontic treatment on the dental occlusion and oral health-related quality of life of individuals with cleft lip and/or palate
Authors: Chapman Rebecca , Fowler Peter , Antoun Joseph , Page Lyndie Foster
Published: September 2021

Background

Children with cleft lip and/or palate (CL/P) are a special group of orthodontic patients. Oral health-related quality of life (OHRQoL) is an important aspect of treatment outcome that is becoming popular in its application in orthodontics, but its relationship with clinical treatment outcomes remains unclear.

Objectives

To compare OHRQoL and clinical treatment outcomes of a sample of children with cleft lip and/or palate and non-cleft children before and after orthodontic treatment in order to determine whether there is an association between the two outcome measures.

Methods

A prospective observational longitudinal study was conducted of 60 consecutive adolescent patients (33 CL/P and 27 non-cleft) who received orthodontic treatment at Christchurch Hospital, New Zealand. The two outcome measures were a self-reported OHRQoL outcome assessed by the short form 8 item Child Perception Questionnaire (CPQ-ISF 8) and an orthodontic treatment outcome assessed by the Peer Assessment Rating (PAR) index.

Results

Both CL/P and non-cleft groups had comparable pretreatment malocclusion severity with similar baseline and end of treatment OHRQoL. Although both groups showed similar improvements in OHRQoL following orthodontic treatment, the non-cleft group had significantly greater improvement in their PAR outcome. There was no association detected between OHRQoL and the PAR improvement.

Conclusion

Both study groups had similar OHRQoL changes following orthodontic treatment despite the non-cleft group having better orthodontic treatment outcomes. There is a lack of correlation between the patient’s self-assessment OHRQoL and clinically based orthodontic treatment outcomes.
A survey of retention and retainer practices of orthodontists in Australia
Authors: Meade Maurice J. , Dreyer Craig W.
Published: September 2021

Objective

To survey retention and retainer practices of orthodontists in Australia.

Methods

A pilot-tested e-survey was distributed to 502 eligible members of the Australian Society of Orthodontists (ASO). The questions addressed participant background information, preferred retainer and retention practices, retainer characteristics and factors influencing retainer choice. Statistical analyses were performed using PASWH version 18.

Results

The response rate was 58%. Thermoplastic retainers (TRs) were the most commonly chosen retainer in the maxilla (39.4%) and bonded retainers (BRs) were most commonly chosen in the mandible (38.5%). An initial period of full-time wear of removable retainers (RRs) was prescribed by 37.7–48.3%. ‘Night/sleeping with reducing frequency over time’ was the most commonly prescribed part-time RR wear practice (28.1-33.5%).

Indefinite retainer wear was recommended by 85.3-87.4% of orthodontists. Indefinite retainer checks were carried out by 19.1-19.8% of orthodontists while 28.9-43.6% were ‘not happy’ for general dental practitioners (GDPs) to continue retention checks. Adjunctive retention practices were used by 25.6-72.8%. Pre-fabrication TR sheet thickness of 1.0 mm (68%) and polypropylene co-polymer/ethylene material type (55.8%) were most commonly used. Vacuum-forming was the preferred mode of TR fabrication by 48.4%. ‘Stainless steel single strand round’ was the most commonly used BR material type (33.4%). BR bonded to 12-22 (bonded to four teeth) was the most common BR design in the maxilla (48.8%) and 33-43 (bonded to six teeth) was most commonly chosen for the mandible (81.5%). Inadvertent tooth movement associated with BRs was observed by 62%. The orthodontist factor that most influenced retainer choice was the nature of the pretreatment malocclusion (88%).

Conclusion

Although there is agreement that retention is indefinite, orthodontic retention practices and retainer characteristics vary considerably between orthodontists in Australia. Greater communication between orthodontists and GDPs is required to effectively manage retention over the long term.
Evaluation of the posterior airway space following orthopaedic treatment of mandibular deficient Class II malocclusion – a pilot study
Authors: Costello Christopher J , Sambevski John , Cheng Lam L , Darendeliler M. Ali
Published: September 2021

Background

The use of Twin Block therapy is a well-accepted functional treatment option for the correction of a Class II malocclusion. In addition to skeletal and dental changes, its use may also promote changes in airway structure and dimension, including the size of the posterior airway space (PAS). This may be of importance in reducing the risk of developing obstructive sleep apnoea syndrome (OSAS).

Materials and methods

Sixteen (16) subjects (eight females and eight males) underwent treatment of a Class II division 1 malocclusion via the use of a Sydney Bonded Twin Block (SBTB) appliance followed by full fixed orthodontic therapy (FFOA). Pretreatment (T1), post-twin block (T2) and post-fixed appliance (T3) lateral cephalograms were taken and skeletal and soft tissue landmarks were hand traced. A pairwise comparison was used to assess whether there were any significant differences in the cephalometric variables between each phase of treatment (T1, T2, T3).

Results

The skeletal variables SNB and ANB revealed a significant change between T1-T2 (p < 0.01). The sagittal size of the nasopharynx (RPAS) also recorded a significant change between T1-T3 (p < 0.05). There was no significant change in the PAS at any stage of treatment. There was an average reduction in the ANB angle of 2° (p < 0.01) between T1-T3.

Conclusions

There was no significant change in the size of the PAS following SBTB treatment. However, an increase in RPAS was recorded following SBTB treatment which continued to improve during FFOA therapy.
Sexual dimorphism related to occlusal traits in Australian children
Authors: Ribeiro Daniela C , Dreyer Craig W. , Lähdesmäki Raija , Townsend Grant C
Published: September 2021

Background

The aim of the present study was to assess sexual dimorphism related to occlusal variables recorded from dental casts of Australian twins and to compare trends across primary (T1), mixed (T2) and permanent (T3) dentitions in the same individuals.

Methods

The sample comprised 22 males and 25 females selected at random from monozygotic pairs and 19 males and 19 females from dizygotic pairs. Overjet, overbite, midline deviation, midline diastema, primary and permanent molar relationship, and primary and permanent canine relationships were measured in millimetres using a digital calliper

Results

The mean values for overjet in males in the permanent dentition and for overbite in the mixed and permanent dentitions were significantly greater than those for females. The other occlusal traits showed no sexual dimorphism. Midline diastemata were most prevalent in the primary dentition while coincident midlines were most prevalent at all stages for both genders. In addition, a mesial step deciduous molar relationship was more prevalent on the right side and a flush terminal plane present on the left. Furthermore, a Class II permanent molar relationship was predominant in T1/T2, while a Class I relationship was most prevalent in the permanent dentition. Class II primary and permanent canine relationships were most common at all stages

Conclusions

Significant sexual dimorphism was found for overjet and overbite at several occlusal developmental stages but sexual dimorphism was not found for the other occlusal traits studied
The metal content of generic orthodontic brackets compared with proprietary brackets
Authors: Wishney Morgan , Savage Tom , Proschogo Nicholas , Petocz Peter , Darendeliler M. Ali
Published: September 2021

Background

With minimal manufacturer information, a variety of ‘generic’ orthodontic brackets are available online from overseas distributors. The present study investigated the metal composition of generic orthodontic brackets compared with two well-known ‘proprietary’ brands.

Materials and methods

Ranging in price from AU$2.99 to $65, five sets of different generic brackets were obtained directly from China via eBay (G1, G2…G5). Proprietary brackets were obtained from American Orthodontics (P1) and Rocky Mountain Orthodontics (P2). The 11, 12, 13 and 14 brackets from each set were liquefied in an acid solution and subjected to trace element analysis using inductively coupled plasma mass spectrometry (ICP-MS) and inductively coupled plasma optical emission spectroscopy (ICP-OES) with respect to nickel, chromium, iron, copper, molybdenum, manganese, cadmium, mercury, arsenic and lead. Statistical analysis investigated the compositional consistency within and between each brand.

Results

The composition of P1 and P2 agreed with the manufacturer’s data. The generic groups typically had low molybdenum and higher copper content and approximated either 17-4 or AISI304 stainless steels or a combination of both. No relationship between brand and consistency of manufacture could be identified. The cheapest bracket contained lead.

Conclusions

Generic and proprietary brackets showed differences in their metal composition that may have biocompatibility implications.
Effect of functional appliance therapy on the quality of life in skeletal Class II malocclusion
Authors: Imani Mohammad Moslem , Tabaii Elaheh Seyed , Jamshidi Saba , Arab Sepideh
Published: September 2021

Introduction

A Class II malocclusion is a common orthodontic problem that may affect social acceptance and the self-esteem of the patient. The aim of the present study was to evaluate the effect of functional appliance therapy on the oral health-related quality of life (OHRQOL) of patients presenting with a skeletal Class II malocclusion due to mandibular deficiency.

Methods

Forty-nine patients (11 to 14 years old) with a Class II malocclusion due to mandibular deficiency were included as the experimental group. A control group of 49 subjects was selected from school children without malocclusion. The Child Oral Impact on Daily Performance (Child-OIDP) index was administered, repeated and differences were evaluated following functional therapy using the Clark Twin Block appliance.

Results

At baseline, the most common oral impact on daily performance in the experimental group was emotional stability (35 patients, 71.4%) and smiling without shame (34 patients, 69.4%), which respectively decreased to 12.2% (six cases) and 20.4% (10 cases) after functional therapy. The mean (±SD) of the Child-OIDP Overall Impact score in the experimental group at baseline was 25.94 (±17.84), which significantly decreased to 2.77 (±2.09) after therapy (p < 0.001).

Conclusion

Functional therapy using the Clark Twin Block appliance had a significant effect in improving OHRQOL of children presenting with mandibular deficiency.
Treatment of identical twins with congenitally missing maxillary lateral incisors – a long-term follow-up
Authors: Wechsler Morris H. , Van Dong Phung
Published: September 2021

Congenitally missing upper lateral incisors can significantly alter the aesthetic appearance of a smile. The orthodontic challenge is to achieve acceptable facial aesthetics by restoring the dentition either by replacing the missing teeth or by substituting the canines for the lateral incisors. The present case report discusses the orthodontic treatment of two identical twin sisters with missing upper lateral incisors, in whom the spaces were reopened to accommodate prosthetic replacement. The rationale for this treatment alternative is discussed.
Dental age assessment in Caucasian subjects with third molar agenesis
Authors: Abu Alhaija Elham S. , Derbash Aftima A. , Al-Khateeb Susan N.
Published: September 2021

Background

Delayed dental development has been linked with tooth agenesis. Research aimed at dental age estimation in subjects with third molar agenesis has been minimal.

Objectives

To investigate the association between dental stage of development and third molar agenesis.

Materials and methods

A total of 700 orthopantomograms (OPTs) were obtained for this study. The age of the subjects ranged from 10 to 16 years (13.66 ± 1.50 years). The subjects were divided into two groups of which group 1 consisted of 350 patients (175 females and 175 males) with third molar agenesis and group 2 (control group) had all third molars present. The control group matched the study group for gender and chronological age (CA). Dental age (DA) was estimated from the OPTs using the Demirjian method for all included subjects.

Results

The mean CA and DA in the third molar agenesis group were 13.81 ± 1.60 years and 13.72 ± 1.65 years, respectively (p > 0.05). The mean CA and DA in the control group were 13.51 ± 1.38 years and 14.50 ± 1.12 years, respectively (t = 18.25, p > 0.000). CA-DA difference between the two groups was highly significant (t = 12.43, p > 0.000). Gender differences were not detected. Furthermore, no differences were noted in dental age compared with chronological age in cases of unilateral versus bilateral third molar agenesis or in one jaw versus two jaws (p > 0.05).

Conclusions

Dental development was delayed in subjects with third molar agenesis but the delay in dental age was not affected by the severity or site of agenesis.
Degradation and deformation of latex and non-latex orthodontic elastics
Authors: Oliveira Pedro Lima Emmerich , Matsumoto Mírian Aiko Nakane , Faria Gisele , Romano Fábio Lourenço
Published: September 2021

Background

Intermaxillary elastics are widely used in corrective orthodontic treatment particularly for the interdigitation of buccal segments and the correction of the midline. However, latex has been known to cause allergy, which may restrict elastic use. As alternative materials, non-latex elastics are available. However, clinicians must be aware of their mechanical properties, especially those of deformation and force degradation that affect these materials over time.

Objectives

The aim of this study was to compare force degradation and deformation of3/16” non-latex and latex elastics supplied by several manufacturers.

Materials and methods

Special acrylic plates were fabricated to incorporate orthodontic brackets to which elastics were attached and stretched to a distance of approximately 20 mm. The internal diameter and force magnitude of each elastic was measured at time intervals of 0, 24, 72 and 504 hours. The samples were stored in artificial saliva at room temperature during the entire experimental period.

Results

Latex elastics showed smaller and more uniform deformation than the non-latex elastics. The non-latex elastics showed greater degradation at all time intervals (p < 0.001). The Morelli brand delivered greater force than other brands for both the latex and non-latex elastics at all time intervals (p < 0.05). The G&H latex elastics showed greater force degradation in comparison with the other brands (p < 0.05). The evaluation of the Dentaurum and Orthopli non-latex elastics showed greater degradation (p < 0.05).

Conclusions

The non-latex elastics showed greater force degradation than the latex elastics. Of the latex elastics, G&H showed greater force degradation, and for the non-latex elastics, those made by Dentaurum and Orthopli degraded most.
The stability of occlusal plane rotation during orthognathic surgery
Authors: Bennett Samuel C.
Published: September 2021

Background

Considered rotation of the occlusal plane and the maxillomandibular complex during orthognathic surgery is an approach that enables optimisation of the functional and aesthetic outcomes of surgical-orthodontic treatment for the correction of a variety of dentofacial deformities.

Objectives

The objectives of this study are to: (1) retrospectively evaluate the stability of clockwise and anti-clockwise rotation of the occlusal plane during orthognathic surgery, and (2) compare the findings with the stability of orthognathic surgery in which no significant occlusal plane rotation occurs.

Aims and methods

Data were collected from a sample of 31 adult patients (22 females and nine males) treated by one orthodontist in private practice and at the University of Western Australia from 1992–2008. Patients received a Le Fort I osteotomy and BSSO to reposition the maxilla and mandible, respectively. The patients were separated into three groups defined by no occlusal plane rotation; clockwise occlusal plane rotation; or anti-clockwise occlusal plane rotation. Lateral cephalograms were taken at four time periods during treatment: T1 (pre-surgery), T2 (immediately post-surgery), T3 (six weeks post-surgery), and T4 (longest follow-up). The cephalograms were digitised and analysed using a customised cephalometric analysis (QuickCeph Studio, CA, USA) and landmarks were transferred via cranial base and maxillary superimpositions for each patient from T1 sequentially to T4.

Results

Clockwise rotation of the occlusal plane was highly stable one year following surgery and showed comparable results with cases treated without occlusal plane rotation. Anti-clockwise rotation of the occlusal plane was less stable and showed significant relapse of the occlusal plane angle towards the pre-surgical value during the post-surgical observation period.

Conclusion

Clockwise rotation of the occlusal plane during orthognathic surgery appears highly stable. Anti-clockwise occlusal plane rotation during orthognathic surgery appears less stable. Further studies are needed to evaluate the longer-term stability of clockwise and anti-clockwise rotation of the occlusal plane during surgical-orthodontic treatment.
Orofacial findings and serial extraction procedure in Noonan syndrome
Authors: Potrubacz Maciej Iancu , Chimenti Claudio , Marchione Laura , Tepedino Michele
Published: September 2021

The case of an 8-year-old female affected by Noonan syndrome is presented. The orofacial findings comprised a skeletal Class III malocclusion, transverse maxillary deficiency, a long face and severe tooth size-arch length discrepancy. The interceptive orthodontic approach focused on addressing the patient’s problems while keeping treatment as simple as possible. Management consisted of rapid maxillary expansion and serial extractions in the mandible. Treatment alternatives and results are discussed and a one-year follow-up is provided.
Comprehensive periodontal/orthodontic treatment of bimaxillary dentoalveolar protrusion caused by posterior bite collapse due to periodontal disease
Authors: Konno Masahiro , Iijima Masahiro , Kado Takashi , Furuichi Yasushi , Mizoguchi Itaru
Published: September 2021

Background

Increased mobility of teeth in adult patients with advanced periodontal disease causes posterior bite collapse, which is characterised by mesial inclination of the molars and vertical dimension loss, often resulting in bimaxillary dentoalveolar protrusion.

Aim

A case is reported of successful comprehensive periodontal/orthodontic treatment of a 51-year-old woman presenting with bimaxillary dentoalveolar protrusion accompanied by severe crowding in the mandibular arch and flaring of the maxillary anterior teeth as a result of posterior bite collapse due to periodontal disease.

Method

Miniplates and fixed appliances were used to upright the mandibular molars and create space for the retraction of the anterior teeth. Prior to orthodontic treatment, the patient underwent periodontal therapy to create a healthy oral environment. The treatment outcomes, including the periodontal condition, were stable 24 months after the conclusion of active orthodontic care.

Results and conclusion

The outcome demonstrates that anchorage control with miniplates is advantageous for the treatment of bimaxillary dentoalveolar protrusion and posterior bite collapse due to periodontal disease.
Multicentre evaluation of impacted and transmigrated canines: a retrospective study
Authors: Avsever Hakan , Gunduz Kaan , Akyol Mesut , Orhan Kaan
Published: September 2021

Objectives

The present multicentre study assessed the prevalence and patterns of impacted and transmigrated maxillary and mandibular canines in a Turkish subpopulation.

Methods

The study identified 1625 patients who had impacted teeth from a group of 10,700 patients (referred to three university hospitals between January 2014 and December 2015) and examined the accompanying records, panoramic and periapical radiographs, and cone-beam computed tomographic images (if available). An impacted canine was considered to be transmigrated when at least part of the tooth had crossed the midline.

Results

Out of 1625 patients, 163 (10.0%) had impacted canines (comprising a total of 170 affected teeth). Impacted canines were found in the maxilla in 114 patients (69.9%) and 49 patients (30.1%) showed mandibular canine impaction. Thirty-eight patients (2.3%) had transmigrated canines, of which twenty (52.6%) were located in the mandible, while 18 (47.4%) were found in the maxilla. No significant difference was evident between the genders, the site (right/left) and the impacted/transmigrated canines (p > 0.05). However, it was determined that canine impaction was significantly more frequent in the maxilla than in the mandible (p < 0.05). In addition, of the 38 patients presenting with transmigrated canines, eight (21.6%) had a history of alpha thalassemia.

Conclusions

Canine transmigration occurs in both the mandible and maxilla. The prevalence of impacted/transmigrated canines in the studied population was 10.0% and 2.3%, respectively. The mechanism of transmigration of maxillary canines remains unclear and requires further investigation. However, a possible correlation with genetic disorders (like alpha thalassemia) should not be overlooked.
Effects of mechanical vibration on root resorption in the rat molar induced by a heavy orthodontic force
Authors: Yeoh Ping Ping , Cheng Lam L. , Papadopoulou Alexandra K. , Darendeliler M. Ali
Published: September 2021

Background

Orthodontically-induced inflammatory root resorption (OIIRR) is an unwelcome side effect of orthodontic treatment. Mechanical vibration has been suggested as a preventative measure but evidence is limited. The aim of this study was to investigate whether whole body mechanical vibration has a positive influence on OIIRR.

Material and methods

Thirty-six 10-week-old Wistar rats were divided into three groups, which received either 30 Hz vibration, 60 Hz vibration or no vibration to serve as a control group. A heavy mesial force of 100 g was applied to the left maxillary first molar using nickel-titanium closed-coil springs. The right maxillary first molar served as an internal control. The vibration groups received 30 Hz or 60 Hz of whole body vibration for 10 minutes per day for 14 days. A volumetric analysis of the extent of root resorption on the mesial-buccal root of the first maxillary molar was examined using micro-computed tomography.

Results

When compared with the control group, the animals that received 30 Hz (p = 0.21) and 60 Hz (p = 0.16) of mechanical vibration did not show a statistically significant reduction in OIIRR. The results did not show a statistically significant difference in the extent of OIIRR between 30 Hz and 60 Hz vibration groups (p = 0.78).

Conclusion

Mechanical vibration at 30 Hz and 60 Hz, when applied in an experimental model of whole body vibration, showed no significant effect on either physiological root resorption or OIIRR in rat molars loaded by a heavy orthodontic force.
Alveolar bone height and thickness assessed by CBCT
Authors: García-Sanz Verónica , Paredes-Gallardo Vanessa , Montiel-Company José María , Gandía-Franco José Luis , Bellot-Arcís Carlos
Published: September 2021

Objectives

To seek information regarding the relationship between the quantity of alveolar bone and the angle and sagittal position of the incisors. This was to be further determined in relation to the basal bones and facial pattern with the aim of establishing a predictive model based on the study of a lateral cephalogram.

Methods

The distance from the cemento-enamel junction to the labial alveolar crest and the bone thickness half-way along the root of the most prominent upper and lower incisor were measured in a sample of 100 cone beam computed tomography (CBCT) scans of patients aged between 15 and 34 years. Lateral cephalograms of the patients were extracted from the scans and used to measure the buccolingual angle and antero-posterior position of the incisors in addition to the facial pattern of each patient.

Results

A correlation was found between bone thickness around the upper incisor and the variables of the incisal angle and its sagittal position. The inclination of the lower incisor (IMPA) was related to cortical bone thickness. The cemento-enamel junction to alveolar crest measurement (bone height) was related to the antero-posterior position of the lower incisor in men. The facial pattern was unrelated to any of the variables.

Conclusions

The angle and sagittal position of the upper and lower incisors were associated with alveolar bone thickness in men. Only the antero-posterior position of the lower incisor was related to its alveolar bone height. In women, only the angle of the lower incisor was associated with bone thickness.
Effects of hybrid-Hyrax, Alt-RAMEC and miniscrew reinforced heavy Class III elastics in growing maxillary retrusive patients. A four-year follow-up pilot study
Authors: Papadopoulou Alexandra K. , Dalci Oyku , Petocz Peter , Darendeliler M. Ali
Published: September 2021

Introduction

The aim of this study was to evaluate the short- and long-term effects of hybrid-Hyrax, Alt-RAMEC and applied, miniscrew reinforced, heavy intermaxillary elastics on a modified lingual arch in growing skeletal Class III patients.

Methods

Fifteen subjects (seven male, eight female) were included, with an average age of 12.52 ± 0.94 years, of cervical vertebrae maturation (CVM) stage CS2-CS4 and skeletal Class III malocclusions due to a retrognathic maxilla. Nine weeks of Alt-RAMEC were followed by eight to nine weeks of maxillary protraction with heavy 400 gm Class III elastics worn 24 h/day. Treatment was finalised with orthodontic fixed appliances. Cone beam computed tomographic (CBCT) scans were taken initially (T1), at the end of maxillary protraction (T2) and four years after active orthopaedic treatment (T3). Cephalometric measurements were performed on reconstructed lateral cephalograms and the differences between time intervals were calculated using an analysis of variance (ANOVA).

Results

A positive overjet was achieved in all but one subject. From T1 to T2, A point advanced 3.12 ± 3.42 mm and from T2 to T3 advanced a further 2.21 ± 3.49 mm. Significant initial increases in SNA of 1.05° ± 1.10° (p = 0.004), ANB of 2.71° ± 1.01° (p = 0.00), Wits of 4.49 ± 2.21 mm (p = 0.00) and overjet of 4.90 ± 1.66 mm (p = 0.00) were accomplished and maintained without significant changes in the vertical dimension. Upper and lower incisor inclinations were not affected by the protraction protocol but significantly increased (U1-PP: 8.39° ± 5.59°) between T2 and T3. SNB decreased initially by 1.67° ± 1.34° (p = 0.00) but relapsed due to residual mandibular growth and a counterclockwise rotation of the mandibular plane.

Conclusion

The hybrid-Hyrax Alt-RAMEC combined with miniscrew reinforced heavy Class III elastics resulted in a favourable and stable Class III correction.
Severe open bite with mandibular asymmetry treated using micro-implant anchorage
Authors: Liao Jing , He Shushu , Hu Zhiai , Zou Shujuan
Published: September 2021

Background

This case report describes the orthodontic treatment of a 20 year-old female who presented with a severe anterior open bite, increased lower facial height and mandibular asymmetry. The patient was diagnosed with a Class I skeletal pattern but a Class III dental relationship, an anterior and unilateral posterior open bite, a canted posterior occlusal plane, a clockwise rotation and vertical growth pattern of the mandible incorporating a chin deviation to the right.

Aim

The aim of treatment was to correct identified adverse oral habits, improve the facial profile and mandibular asymmetry, provide a satisfactory occlusion and restore TMJ health, which could not be guaranteed.

Methods

An occlusal splint was used in the first stage of treatment to intrude the posterior teeth, eliminate the occlusal disturbance and control the adverse oral habits. Two micro-implant anchorage devices were placed on the buccal and lingual sides of the left buccal segment to further intrude the left posterior teeth. MEAW technology was used after aligning and levelling the teeth.

Results

Satisfactory overbite, overjet and molar relationships were obtained and the facial profile greatly improved after orthodontic treatment, the outcome of which was stable at 24 months’ review.
Effect of bromelain and papain gel on enamel deproteinisation before orthodontic bracket bonding
Authors: Pithon Matheus Melo , Campos Matheus Souza , da Silva Coqueiro Raildo
Published: September 2021

Aim

To test the hypothesis that enamel surface deproteinisation with different concentrations of bromelain in association with 10% papain increases the shear bond strength (SBS) of brackets bonded with orthodontic composite and resin modified glass ionomer cement (RMGIC).

Materials and methods

Orthodontic brackets were attached according to the following protocols to 195 bovine incisors, which were acquired and divided into 13 groups: 1) Transbond XT (TXT) according to the manufacturer’s recommendations; 2) Deproteinisation with 3% bromelain (BD) plus 10% papain and TXT; 3) 6% BD plus 10% Papain and TXT; 4) RMGIC, without enamel deproteinisation and without acid etching; 5) RMGIC, with 3% BD plus 10% papain and without acid etching; 6) RMGIC, with 6% BD plus 10% papain and without acid etching; 7) attachment using RMGIC following etching with polyacrylic acid; 8) 3% BD plus 10% papain, attachment using RMGIC and etching with polyacrylic acid; 9) 6% BD plus 10% papain, and attachment using RMGIC following etching with polyacrylic acid; 10) etching with 37% phosphoric acid and attachment using RMGIC; 11) 3% BD plus 10% papain, etching with 37% phosphoric acid and attachment using RMGIC; 12) 6% BD plus 10% papain, etching with 37% phosphoric acid and attachment using RMGIC; 13) deproteinisation with 2.5% sodium hypochlorite (NaOCl), etching with polyacrylic acid and RMGIC. After bonding, the brackets were removed by a universal mechanical testing machine, which recorded shear bond strength at failure. The material remaining on the tooth was assessed using the adhesive remnant index (ARI).

Results

Deproteinisation with 3% and 6% bromelain gel plus papain significantly increased the shear bond strength (p < 0.05), when acid etching was performed with phosphoric acid, followed by primer application and attachment using Transbond XT (Group 3) and when attached with RMGIC without etching. Deproteinisation with 6% bromelain gel plus papain significantly increased (p < 0.05) the ARI score only when attachment was performed using RMGIC, without etching (Group 6).

Conclusions

Deproteinisation with bromelain associated with papain in a gel increased the shear bond strength and is recommended before orthodontic bracket attachment.
A comparison of the sagittal and vertical dentofacial effects of maxillary expansion produced by a memory screw and a hyrax screw
Authors: Halicioğlu Koray , Yavuz İbrahim
Published: September 2021

Aim

The aim of the present study was to investigate and compare the cephalometric effects of a conventional Hyrax expansion screw and a memory screw on the skeletal and dentoalveolar structures and soft tissues of the face.

Methods

Thirty-two patients with a maxillary transverse deficiency were divided into two groups. A memory-screw group included 17 patients (nine females and eight males), while a Hyrax-screw group was comprised of 15 patients (eight females and seven males). The mean ages of the subjects in the memory-screw and Hyrax-screw groups were 13.00 ± 1.29 and 12.58 ± 1.50 years, respectively. Lateral cephalograms were taken of the patients at the beginning of the treatment (T1), at the end of expansion (T2) and retention periods (T3). The mean expansion period was 7.76 ± 1.04 days in the memory-screw group and 35.46 ± 9.39 days in the Hyrax-screw group. The Shapiro-Wilk Normality test was used to determine whether the investigated parameters were homogeneous. To determine the treatment changes within the groups, a paired t-test and Wilcoxon Signed Rank test were applied to the homogeneous and non-homogeneous parameters, respectively. A comparison between the groups was carried out using the Student’s t-test for homogeneous parameters and the Mann-Whitney U test for all others.

Results

A results summary indicates that mid-palatal sutural opening and subsequent important skeletal and dental expansions were obtained in all patients. The maxilla moved anteriorly and inferiorly in both groups while the mandible rotated inferiorly and posteriorly but to a greater extent in the memory-screw group.

Conclusion

The newly-developed memory expansion screw takes advantage of rapid and slow maxillary expansion protocols. The suture is opened and the maxilla expanded with relatively lighter forces over a shorter time. The RME using the memory screw resulted in similar sagittal and vertical changes to those produced by the Hyrax screw.
Comparison of traditional orthodontic polishing systems with novel non-orthodontic methods for residual adhesive removal
Authors: Andrews John , Hagan Joseph L. , Armbruster Paul C. , Ballard Richard W.
Published: September 2021

Background

Following the debonding of orthodontic brackets, the removal of residual adhesive from the enamel surface is required. Published adhesive removal protocols present conflicting advice.

Aims

The present study evaluated the surface roughness of enamel after debonding and instrumentation with non-traditional orthodontic polishing systems.

Methods

The facial aspects of 35 extracted human incisor teeth were scanned with a surface profilometer for surface roughness prior to the bonding of orthodontic brackets. After debonding, residual adhesive was removed with a 12-fluted titanium carbide bur. The teeth were randomly divided into seven groups (N = 5 per group) and the enamel surface was polished with one of seven products. All samples were re-scanned for surface roughness and subjectively evaluated via SEM.

Results

There was no significant difference in enamel surface roughness between the groups when compared using surface profilometry. Visual observations from the SEM evaluations demonstrated differences in the enamel surface at the microscopic level that were not detected by profilometric analysis.

Conclusions

The present study found no statistically significant difference in mean enamel smoothness change from pretreatment to post-treatment between the seven polishing methods studied via profilometer surface reading measurements. An SEM analysis showed visual differences in enamel striations viewed at 1000× magnification in a comparison of traditional versus non-traditional polishing methods.
Cephalometric assessment of soft tissue morphology of patients with acromegaly
Authors: Bavbek Nehir Canigur , Tuncer Burcu Balos , Tuncer Cumhur , Gungor Kahraman , Ozkan Cigdem , Arslan Emre , Altinova Alev Eroglu , Akturk Mujde , Toruner Fusun Balos
Published: September 2021

Aim

To assess the sagittal soft tissue morphology of patients with acromegaly in comparison with a healthy control group.

Methods

Twenty-seven patients with acromegaly (11 male, 16 female; mean age 47.3 ± 11.5 years) and 30 healthy subjects (15 male, 15 female; mean age 42.2 ± 17.4 years) were included in the study. Linear and angular measurements were made on lateral cephalograms to evaluate soft tissue and skeletal characteristics. The intergroup comparisons were analysed with the Student’s t-test.

Results

Facial convexity (p < 0.01) and the nasolabial angle (p < 0.001) were reduced in patients with acromegaly, whereas nose prominence (p < 0.01), upper lip sulcus depth (p < 0.01), upper lip thickness (p < 0.01), basic upper lip thickness (p < 0.01), lower lip protrusion (p < 0.05), mentolabial sulcus depth (p < 0.05) and soft tissue chin thickness (p < 0.001) were increased. Anterior cranial base length (p < 0.05), the supraorbital ridge (p < 0.01), the length of the maxilla and mandible (p < 0.001, p < 0.01, respectively) were significantly increased, and mandibular prognathism was an acromegalic feature (p < 0.05).

Conclusion

Acromegalic coarsening and thickening of the craniofacial soft tissues was identified from lateral cephalograms, which may therefore contribute to early diagnosis when evaluated together with other changes caused by the disease.
Effects of strontium ranelate on sutural bone formation: a histological and immunohistochemical study
Authors: Karataş Orhan H. , Toy Ebubekir , Demir Abdullah , Toy Hatice , Kozacioğlu Sümeyye
Published: September 2021

Aim

Rapid maxillary expansion is performed to correct a skeletal transverse deficiency of the maxilla, which is a frequently- encountered orthodontic anomaly. Strontium ranelate (SrR) is a novel agent that has a dual action, involving anti-resorptive and bone-forming effects. The aim of this study was to evaluate the effects of systemically applied SrR on osteoblastic bone formation after maxillary expansion on the mid-palatal suture of rats using histological and immunohistochemical tests.

Materials and methods

A total of 24 Wistar rats were randomly divided into two equal groups. In all animals, five-day inter- premaxillary expansion was applied and maintained for a seven-day retention period, during which 625mg/kg/day SrR diluted with saline solution was administered orally to the experimental group. The rats were sacrificed and the tissues prepared for histological and immunohistochemical examinations after the retention period.

Results

Osteoblastic activity and the width of the blood vessels in the suture area were significantly increased in the SrR group compared with the control group (p < 0.05). Ossification was also observed to be active under light microscopy by staining with hematoxylin and eosin in the experimental group. Immunohistochemical labelling performed using osteonectin, osteocalcin, TGF-β and VEGF antibodies revealed significant immunoreactivity in the experimental group (p < 0.05).

Conclusion

It may be concluded that SrR contributed to stimulatory osteogenesis in the expansion region. Therefore, a retention period may be shortened and relapse possibly reduced, following the application of SrR after the expansion.
A comparative evaluation of ion release from different commercially-available orthodontic mini-implants – an in-vitro study
Authors: Ananthanarayanan Venkateswaran , Padmanabhan Sridevi , Chitharanjan Arun B.
Published: September 2021

Background

Titanium alloy mini-implants have become popular in recent times and have been extensively used and studied. Although corrosion resistance of orthodontic materials has always been of concern, this property has been the least explored. The present study aimed to assess the composition, surface characterisation and corrosion resistance of five commercially available mini-implants by assaying ion release in artificial saliva.

Methods

Ten mini-implants each from five companies were obtained: Group 1 – AbsoAnchor (Dentos Inc, South Korea); Group 2 – Microimplant Anchorage System (MIA, Biomaterials Korea); Group 3 – The Orthodontic Mini Anchorage System (TOMAS, Dentaurum, Germany); Group 4 – mini-implants (Denticon, Maharashtra, India); Group 5 – orthodontic mini-implants (J.J.Orthodontics, Kerala, India). One mini-implant from each group was subjected to characterisation and surface microstructure analysis using Energy Dispersive Atomic Spectrometry (EDAX) and Scanning Electron Microscope (SEM), respectively. Ten miniimplants were immersed for 30 days in Fusayama-Meyer artificial saliva solution and the release of titanium, aluminium and vanadium ions was detected with Inductively Coupled Plasma - Optical Emission Spectrometry (ICP-OES). The Kruskal-Wallis test was used for multi-variate analysis. In order to determine the significant differences between the groups on independent samples, the Mann-Whitney U test (bi-variate analysis) was applied.

Results and conclusion

All groups showed machining defects but surface pitting after immersion was mostly evident in Group 4. Although the composition of all the implants was comparable, there was a statistically significant difference in the Ti, Al and V release between Group 4 – the group with maximum release – and Group 2, the group with least release.
Orthodontists and the thyroid gland
Authors: Godfrey Keith
Published: September 2021

This paper questions the adequacy of orthodontists’ full appreciation of the issues associated with the routine prescription of extraoral radiography, particularly that related to a high risk of thyroid gland exposure to ionising radiation. There does not appear to be adequate application of the ALARA principle in the consideration of justifiable options to minimise the cumulative effects of radiation exposure in young patients.
Short-term treatment effects of the quad-helix appliance on dentofacial morphology of hyperdivergent patients
Authors: Endo Saori , Yamada Wataru , Shundo Isao , Kobayashi Yoshiki , Komatsuzaki Akira , Endo Toshiya
Published: September 2021

Objectives

The purpose of this study was to evaluate the effects of short-term expansion treatment using the quad-helix appliance on dentofacial morphology in orthodontic patients presenting with a hyperdivergent facial pattern.

Methods

The treatment group consisted of 40 patients with a hyperdivergent facial pattern, who were treated for maxillary incisor crowding with a quad-helix appliance during the mixed dentition period. Lateral cephalograms taken at the start (T0) and end (T1) of the treatment were obtained as a course of care. A similar number of patients, who possessed the same type of facial pattern and who remained untreated, were assigned to a control group. Two consecutive lateral cephalograms of each untreated patient were taken at the same time points as T0 and T1. All cephalograms were traced, analysed and compared between the two groups.

Results

The treatment changes as a result of the quad-helix appliance were expressed in an upward rotation of the mandible (2.34°) and distal tipping and impeded mesial movement of the maxillary first molars. Significant differences were evident between the treatment and control groups.

Conclusion

Quad-helix appliance treatment can be appropriate for significantly decreasing the mandibular plane angle in hyperdivergent patients presenting with moderate maxillary incisor crowding and a positive overjet and overbite.
True intrusion of maxillary first molars with zygomatic and palatal miniscrew anchorage: a case report
Authors: Tripathi Tulika , Kalra Shilpa , Rai Priyank , Faraz Farrukh , Singh Navneet
Published: September 2021

The intrusion of the maxillary first molar is indicated when occlusal clearance is needed for prosthetic rehabilitation. Maxillary molar intrusion may be undertaken using skeletal anchorage systems to avoid complicated mechanics delivered by conventional intra-oral fixed appliances. In the present case report, the efficient use of orthodontic miniscrew anchorage by applying simple mechanics for true maxillary first molar intrusion is described. This was followed by the rehabilitation of the mandibular first molar spaces with implant prostheses. A 16-year-old female patient had masticatory difficulty due to the bilateral overeruption of the maxillary first molars and carious mandibular first molars. True intrusion of each maxillary first molar was achieved using zygomatic and palatal paramedian miniscrews placed in line with the central axis of the teeth. Simultaneously, alignment of the upper arch was achieved via fixed appliance therapy. Using two orthodontic miniscrews to intrude each maxillary molar, orthodontic treatment was simplified by eliminating the need for miniplate placement by extensive surgery and the creation of intra-oral multiunit anchorage. Masticatory efficiency was improved by increasing the occlusal table with prosthetic rehabilitation of the mandibular first molar spaces with dental implant prostheses.
The effect of topical fluoride varnish on the shear bond strength of orthodontic brackets
Authors: Thuy-Huy Nhan Ruby , Xu Xaoming , Yu Qingzhao , Ballard Richard , Armbruster Paul
Published: September 2021

Aim

The present study examined the effect of topical fluoride treatment on the shear bond strength (SBS) of orthodontic brackets using single-dose fluoride varnishes and assessed according to different post-application times and the pattern of debond.

Methods

Of the 105 extracted human mandibular premolars used in the study, 70 were subjected to the SBS test and the remaining 35 to the Adhesive Remnant Index (ARI) test. The teeth were divided into a control group and six test groups: Kolorz®ClearShieldTM 5%NaFl varnish Day 1, 8, and 15; and VanishTM 5%NaFl varnish Day 1, 8, and 15. The samples were coated with their respective varnish, following which, brackets were bonded. Each specimen was subjected to a shear force in a universal testing machine until failure. Data were analysed using the analysis of variance (ANOVA).

Results

At all time intervals, the mean SBS of the Vanish groups was not significantly different from the control group, and the shear strength in the ClearShield groups was significantly higher than the control and Vanish groups, except at Day 8 (no difference). For the same bonding material, there was no significant difference in mean SBS over different time intervals. ARI scores showed no significant difference between the groups.

Conclusion

The application of single-dose fluoride varnish, irrespective of the length of time between the fluoride treatment and bonding procedure, does not negatively affect the shear bond strength of orthodontic brackets.
The orthodontic extraction of permanent molars: a literature review
Authors: Chua Emilia S.L. , Felicita A. Sumathi
Published: September 2021

The most common cause of dental crowding is the presence of an arch-length – tooth-size discrepancy. Conventional methods of gaining space in orthodontics involve the extraction of teeth, often premolars. However, there are a number of clinical situations in which the extraction of permanent molars might be considered. This paper highlights the indications, advantages, disadvantages and timing of the extraction of the first, second and third permanent molars in the treatment of a crowded malocclusion.