AIM: To evaluate the compliance of websites promoting proprietary orthodontic appliances available in the UK against advertising standards outlined by the Advertising Standards Authority Committee of Advertising Practice...AIM: To evaluate the compliance of websites promoting proprietary orthodontic appliances available in the UK against advertising standards outlined by the Advertising Standards Authority Committee of Advertising Practice (ASA CAP) Code. DESIGN: Cross-sectional study. SETTING: Websites promoting proprietary orthodontic appliances available in the UK, including fixed, removable and aligner systems sold as a complete system under a brand name. METHODS: A comprehensive, systematic approach was adopted, beginning with a 2020 scoping search on Google and social media platforms (Instagram and Facebook) to identify keywords. Keyword searches were conducted on Google in 2020, 2023 and 2025 to identify relevant websites. To ensure contemporary relevance, only websites identified in the final 2025 search were included for analysis. Raters underwent training and calibration before independently evaluating websites for compliance with advertising standards using bespoke judgement criteria derived from the ASA CAP Code, across four domains: comprehensiveness of treatment information; presentation of treatment information; objectivity of treatment information; and substantiation of claims. Discrepancies were resolved through group discussion to determine agreed scores. Data were analysed using descriptive and inferential statistics (Fleiss' kappa and Kruskal-Wallis tests). RESULTS: The 2025 search identified 970 websites, of which 39 met the inclusion criteria. Inter-rater reliability showed almost perfect agreement (kappa >0.9). Compliance varied significantly across domains: 45% of all claims provided comprehensive information, 54% had clear presentation, 38% maintained objectivity and only 4% of claims were substantiated with evidence. Nearly all websites (95%) omitted common risks and 92% failed to mention alternative treatments. Direct-to-consumer and tele-dentistry websites showed poorer compliance than dentist-delivered systems. CONCLUSIONS: Orthodontic appliance websites showed poor compliance with ASA CAP Code standards. The majority used descriptive language and words in place of numbers to quantify magnitude, alongside subjective content and unsubstantiated claims, with omissions of treatment risks. These findings raise significant concerns about online orthodontic advertising and its potential impact on informed patient decision-making.
Patients with hypodontia often undergo orthodontic treatment, with single tooth pontics often used to replace missing teeth. However, single tooth pontics can often rotate on the archwire, leading to compromised stabilit...Patients with hypodontia often undergo orthodontic treatment, with single tooth pontics often used to replace missing teeth. However, single tooth pontics can often rotate on the archwire, leading to compromised stability. 'Blocks of pontics' can provide prosthetic replacement during orthodontic treatment for patients with hypodontia, overcoming common issues with large edentulous spans. After impression taking, blocks of pontics can be waxed up and finished in acrylic. These can then be ligated to the archwire intraorally. Blocks of pontics can be life-changing, restoring adequate aesthetics and function, before multidisciplinary restorative management.
INTRODUCTION: During the course of orthodontic treatment, a proper hygiene protocol is advised to all patients. Maintenance of oral hygiene prevents potential damage to hard tissue along with soft tissue. Despite prevent...INTRODUCTION: During the course of orthodontic treatment, a proper hygiene protocol is advised to all patients. Maintenance of oral hygiene prevents potential damage to hard tissue along with soft tissue. Despite preventive oral hygiene measures during fixed orthodontic therapy, some patients develop white spot lesions (WSL), compromising aesthetics and posing a potential risk of developing a carious lesion. Tooth remineralisation using calcium, fluoride, phosphate and other biocompatible agents is a potential solution. AIMS: This study aimed to compare the remineralising potential of Remin Pro (hydroxyapatite), Sensodyne Pronamel (sodium fluoride) and Pur O3 Olive (ozonated olive oil) on artificially created WSLs using quantitative light-induced fluorescence (QLF) and polarised light microscopy (PLM). METHODOLOGY: An in vitro study was conducted over 1 year using 75 extracted premolars, divided into three groups (n = 25). Artificial carious lesions were created with a demineralising solution, followed by a 21-day pH cycling regime with respective agents. QLF assessed lesion volume (∆Q), fluorescence loss (∆F) and maximum fluorescence loss (∆F Max), while PLM was used to evaluate the enamel subsurface changes qualitatively. RESULTS: Statistically significant improvements were noted in ∆Q, ∆F and ∆F Max across all groups ( <0.001). Intergroup comparison revealed highly significant changes from pre-test to post-test ( = 0.001). There was no statistically significant difference in treatment effect between Remin Pro and Pur O3 Olive. CONCLUSION: Remin Pro demonstrated greater remineralisation potential compared to Sensodyne Pronamel and Pur O3 Olive under in vitro conditions. There was no statistically significant difference in treatment effect between Remin Pro and Pur O3 Olive.
OBJECTIVE: To evaluate the chemical and dimensional changes of metallic and nickel-free metallic brackets in vitro and ex vivo, regarding oxidation, tie-wing deformation and surface roughness. DESIGN: A split-mouth, in v...OBJECTIVE: To evaluate the chemical and dimensional changes of metallic and nickel-free metallic brackets in vitro and ex vivo, regarding oxidation, tie-wing deformation and surface roughness. DESIGN: A split-mouth, in vitro and ex vivo controlled clinical trial. METHODS: A total of 34 adult participants, aged 20-35 years, underwent conventional orthodontic treatment. The right upper central incisor carried the metallic bracket and the left upper central incisor carried the nickel-free metallic bracket. At the 120th day of treatment with a 0.018-inch steel alignment wire, the upper central incisor brackets were removed (ex vivo) and compared with unused brackets (in vitro), distributed into four groups (n = 34): group 1 = in vitro metallic brackets; group 2 = ex vivo metallic brackets; group 3 = in vitro nickel-free metallic brackets; and group 4 = ex vivo nickel-free metallic brackets. Analyses were performed using scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM) to assess slot dimensions and surface irregularity (roughness), respectively, and by energy dispersive spectroscopy (EDS) for oxidation. Analyses were performed with a significance level of 5%. RESULTS: Evaluation of composition showed that ex vivo nickel-free and metallic brackets had higher percentages of oxygen (O) and carbon (C), lower percentages of niobium (Nb) and chromium (Cr) ( <0.05), and no significant difference in the percentage of iron (Fe) ( >0.05). Brackets showed no dimensional changes when comparing in vitro and ex vivo conditions. Ex vivo metallic brackets had increased roughness compared to in vitro metallic brackets. CONCLUSIONS: The oral environment promoted corrosion in both metallic and nickel-free brackets. Nickel-free brackets did not have rougher surfaces than metallic brackets, and there were no dimensional changes after use in participants.
OBJECTIVE: To assess the influence of varying degrees of gingival display on perception of smile aesthetics judged by orthodontists, dentists and lay people. DESIGN: Cross-sectional study. SETTING: Barts and the London,...OBJECTIVE: To assess the influence of varying degrees of gingival display on perception of smile aesthetics judged by orthodontists, dentists and lay people. DESIGN: Cross-sectional study. SETTING: Barts and the London, School of Medicine and Dentistry, Queen Mary University of London, UK. PARTICIPANTS: Three groups of raters comprising 25 orthodontists, 25 dentists and 25 lay people. METHODS: Videos in increments of 1.5 mm of the final lip position ranging from 3 mm incisal coverage to 7.5 mm of gingival display were produced. Three rater groups assessed the attractiveness of smile videos using a visual analogue scale (VAS). Multiple regression analysis was undertaken, and images were compared using the Tukey HSD method. RESULTS: The intraclass correlation coefficient (ICC) was 0.65% (95% confidence interval 0.59-0.71), indicating moderate intra-rater reliability. The highest ranking for female videos was with 1.5 mm of incisal coverage, with no significant difference between 3 mm of incisal coverage and 3 mm of gingival exposure. For the male videos, the highest ranking was 0 mm of gingival show, with no significant difference between 1.5 mm of incisal coverage and 1.5 mm of gingival exposure. There was a significant drop in the scores with further increase in gingival exposure, with more than 6 mm being rated very low aesthetically. Video rating was not influenced by rater group (female: = 0.60; male: = 0.06), rater gender (female: = 0.17, male: = 0.74) or rater age (female: = 0.16, male: = 0.25). CONCLUSION: There is a significant difference in the perception of smile aesthetics with varying amounts of gingival show. There is a clear threshold of acceptance up to 3 mm of gingival display for the female videos and 1.5 mm in for the male videos, after which the aesthetics of the smile decline with increments of increasing gingival display. No significant differences were observed in the perception of smile aesthetics with varying amounts of gingival show between orthodontists, dentists and lay people.
OBJECTIVE: To investigate the impact of appliance removal on oral microbial diversity, composition, and abundance using metagenomic sequencing. It aims to identify the core microbiome and assess changes between mid-treat...OBJECTIVE: To investigate the impact of appliance removal on oral microbial diversity, composition, and abundance using metagenomic sequencing. It aims to identify the core microbiome and assess changes between mid-treatment and 2 weeks after debonding to understand the relationship between orthodontic therapy and oral health better. METHODS: This longitudinal cohort study recruited 26 patients undergoing fixed orthodontic treatment between January 2022 and June 2023. Saliva samples were collected at two predefined time points: mid-treatment (T0, defined as before appliance removal) and 2 weeks after debonding (T1). Microbial DNA was extracted and the V1-V3 hypervariable regions of the 16S rRNA gene were sequenced using Illumina NovaSeq. Bioinformatics analysis was performed using QIIME and the SILVA database to evaluate microbial diversity and composition at T0 and T1. Beta diversity metrics and statistical tests, including PERMANOVA and Wilcoxon signed-rank tests, were applied to identify significant differences ( < 0.05). Effect sizes with 95% confidence intervals (CIs) were reported. RESULTS: The analysis revealed significant shifts in microbial diversity and composition between T0 and T1. A total of 189 species across 63 genera were identified, with Firmicutes, , Proteobacteria, Actinobacteria, and as dominant phyla. Genera such as (↑ 12.4%, 95% CI = 10.1-14.7) and (↑ 9.8%, 95% CI = 7.6-11.3) increased after debonding, while (↓ 10.2%, 95% CI = 8.1-12.0) and (↓ 7.9%, 95% CI = 6.3-9.2) decreased. Beta diversity analysis confirmed a statistically significant microbial community shift ( < 0.05). CONCLUSION: This study demonstrated significant microbial shifts between mid-treatment and 2 weeks after debonding, including increases in potentially pathogenic genera and alterations in the core microbiome. These findings indicate microbial changes persist for at least 2 weeks after appliance removal. Further research with pre-treatment baselines and extended follow-up is required to better define the long-term trajectory of these changes.
OBJECTIVES: The aim of this research was to carry out a study of consultant orthodontists in the United Kingdom (UK) and Republic of Ireland (RoI), exploring the information provision for patients both considering and un...OBJECTIVES: The aim of this research was to carry out a study of consultant orthodontists in the United Kingdom (UK) and Republic of Ireland (RoI), exploring the information provision for patients both considering and undergoing orthognathic treatment to help inform the development of decision support tools. DESIGN: A questionnaire-based study of consultant orthodontists in the UK and RoI through the British Orthodontic Society (BOS) Consultant Orthodontist Group. SETTING: Data collected using an online survey platform (Qualtrics XM). RESULTS: A final sample of 56 respondents was achieved with an estimated response rate of 28%. All respondents (100%) said their patients routinely attended an orthognathic multidisciplinary team (MDT) clinic before commencing any active treatment. The majority (98.21%) of respondents said they utilised nationally available resources produced by the BOS, with the most commonly used resource being the BOS '' online resource. When considering the benefits of treatment that were routinely discussed, the three most commonly selected responses were improvement in occlusion (92.86%), improvement in facial aesthetics (91.07%) and improvement in dental aesthetics (83.93%). There were nine orthodontic risks that were routinely discussed by more than 90% of respondents, including pain and discomfort, duration of treatment and long-term commitment to retainer wear, alongside 11 surgical risks, including permanent and temporary paraesthesia or dysaesthesia of the lips/chin/tongue, and postoperative pain. CONCLUSION: From the responses received, patients considering orthognathic treatment routinely attend an orthognathic MDT clinic before commencing active treatment. Information is provided with nationally available resources and consultant orthodontists routinely discuss risks and benefits of the orthodontic and surgical treatment with prospective patients to help them make informed decisions regarding their care.
OBJECTIVES: To establish how orthodontics is currently co-delivered by orthodontic therapists (OTs) and supervising clinicians (SCs), and to explore both sets of clinicians' perceptions of these working arrangements. DES...OBJECTIVES: To establish how orthodontics is currently co-delivered by orthodontic therapists (OTs) and supervising clinicians (SCs), and to explore both sets of clinicians' perceptions of these working arrangements. DESIGN AND SETTING: Cross-sectional survey using an online questionnaire. PARTICIPANTS: General Dental Council (GDC)-registered OTs and specialist or non-specialist dentists who supervise OTs and work in the UK. METHODS: A link to the online questionnaire was emailed to all members of the British Orthodontic Society and Orthodontic National Group and was posted in two Facebook groups. Reminder emails and Facebook posts were sent. RESULTS: A total of 161 responses were received from 89 SCs and 72 OTs. Most worked in primary care as their main clinical role. Most OTs in primary care provided a mix of NHS and private care. Appointments with OTs were most likely to be supervised every other visit, with more frequent supervision reported by SCs, and by clinicians in secondary care. Remote supervision of some kind was reported by 63% of OTs. Different barriers and enablers to effective working practices were suggested by OTs and SCs. OTs reported improved patient satisfaction as the main consequence of their utilisation in the orthodontic workforce while SCs described improved clinical efficiency. CONCLUSIONS: OTs reported improved patient satisfaction as the main consequence of their utilisation, whereas SCs described improved clinical efficiency. Some OTs felt that SCs should be more readily available and that OTs should have more autonomy. SCs would prefer more time to supervise and provide prescriptions.
AIM: This study assessed the optical properties of aligner surfaces post-cigarette smoke exposure. DESIGN: In-vitro experimental study. SETTING: Laboratory analysis of clear aligners subjected to cigarette smoke exposure...AIM: This study assessed the optical properties of aligner surfaces post-cigarette smoke exposure. DESIGN: In-vitro experimental study. SETTING: Laboratory analysis of clear aligners subjected to cigarette smoke exposure at Federal University of Rio de Janeiro, Brazil. METHODS: A total of 20 plastic pieces from the labial surfaces of upper central incisors of Invisalign clear aligners were randomly divided into a control group (CG) and an experimental group (EG). The specimens were divided equally (n = 10): CG, stored in artificial saliva at 37°C ± 1°C for 14 days; and the EG, exposed to cigarette smoke using a sealed acrylic device with 10 cigarettes per cycle for 20 cycles. A spectrophotometer was used to evaluate changes in colour and light transmittance based on CIELab* colour parameters. Measurements were taken before (T0) and after (T1) exposure. The total colour difference (∆E) and National Bureau of Standards (NBS) were calculated. T-tests were used for comparisons at a significance level of 0.05. RESULTS: Statistically significant colour changes ( < 0.05) were observed at T1 in the EG (luminosity [L*] = 77.20 ± 3.33; difference along green-red axis [a*] = -1.57 ± 0.02; and difference along blue-yellow axis [b*] = 6.74 ± 0.55) compared to the CG. The mean ∆E* value at T1 was significantly higher in the EG (14.27 ± 2.72) compared to the CG (2.39 ± 0.56; = 0.002). Light transmittance decreased significantly after cigarette smoke exposure (CG = 68.396 ± 8.683; EG = 59.538 ± 5.089; = 0.012). CONCLUSIONS: Cigarette smoke exposure significantly altered the optical properties of clear orthodontic aligners, affecting both colour and light transmittance.
OBJECTIVE: To evaluate the content and quality of videos created by artificial intelligence (AI) video generator platforms, specifically focused on oral hygiene maintenance and dietary advice for orthodontic patients. ME...OBJECTIVE: To evaluate the content and quality of videos created by artificial intelligence (AI) video generator platforms, specifically focused on oral hygiene maintenance and dietary advice for orthodontic patients. METHODS: This mixed-method study evaluated five AI video generation platforms: InVideo, VEED.IO, VideoGen, Lumen5 and Steve.AI. A standardised base prompt was used across all platforms, with minor modifications to accommodate each tool's limitations and functionality. Two orthodontists assessed the content of the voice-overs and captions using a checklist for oral hygiene (OHC) and dietary advice (DAC), as well as the Global Quality Scale (GQS) for overall quality. Descriptive analysis evaluated the consistency between voice-over, captions and visuals. A thematic qualitative analysis was conducted, and quantitative comparisons of checklist scores across platforms were made using non-parametric tests. RESULTS: All videos were rated poorly, each receiving a GQS score of 2, indicating limited usefulness for patient education. VideoGen recorded the highest OHC score, while Steve.AI (Live) recorded the lowest. For the DAC, Lumen5 achieved the highest score, whereas InVideo and VEED.IO obtained the lowest. However, the score between all the platforms for DAC and OHC were not statistically different ( > 0.05). Although flossing advice and fluoride toothpaste recommendations were generally included, key details, such as brushing duration and specific dietary instructions, were often missing. Many videos also contained irrelevant or inaccurate visuals. Thematic analysis identified three main themes: oral hygiene maintenance, dietary advice and orthodontic appointments. CONCLUSION: This study found that AI video generation platforms produce content of poor quality and relevance for oral hygiene maintenance and dietary advice for orthodontic patients.
OBJECTIVE: This cutting-edge report presents a technique for virtually preparing the orthodontic patient's model for fabrication of an individualised sports mouthguard. TECHNIQUE: Using the stereolithography (STL) file f...OBJECTIVE: This cutting-edge report presents a technique for virtually preparing the orthodontic patient's model for fabrication of an individualised sports mouthguard. TECHNIQUE: Using the stereolithography (STL) file from an intraoral scan, a step-by-step guide to trim the model and prepare it for three-dimensional (3D) printing, using free software (Meshmixer; Autodesk Inc., San Francisco, CA, USA), is provided. This method employs a 3D drawing tool to create a buffer space between the teeth, orthodontic appliance and mouthguard material before printing. The purpose of the buffer space is to accommodate minor tooth movements, ensure proper protection and improve the mouthguard's lifespan. CONCLUSION: Orthodontic patients should wear mouthguards during sports activities to protect orofacial structures. The proposed method successfully prepares a 3D-printed model with a buffer space, which can be used to fabricate an effective sports mouthguard. While familiarity with 3D-modelling software is required, this method can enhance mouthguard fabrication and minimise potential distortions inherent in traditional impression techniques using alginate or other materials.
OBJECTIVE: To investigate the effect of different durations of post-curing ultraviolet (UV) light exposure on the compressive strength, amount of displacement and water absorbed by direct-printed aligners. DESIGN: An in-...OBJECTIVE: To investigate the effect of different durations of post-curing ultraviolet (UV) light exposure on the compressive strength, amount of displacement and water absorbed by direct-printed aligners. DESIGN: An in-vitro randomised control trial. SETTING: Orthodontics laboratory in Maulana Azad Institute of Dental Sciences, New Delhi, India. METHODS: Dental LT V2 resin was used to print 30 aligners, which were divided into three groups and subjected to different post-print UV light exposures. Each group was subjected to compression loading of 1000 N to evaluate their load vs. displacement behaviour. The amount of water absorbed by aligners in each group was also evaluated. Data were analysed using one-way analysis of variance (ANOVA) and repeated measures ANOVA. RESULTS: The '60-min cure' group bore the maximum mean compressive load (1016.03 ± 37.27 N) and had the least mean displacement (2.87 ± 0.52 mm) and water absorption (0.18 g).The '40-min cure' group did not show significant results for any of the tests carried out. CONCLUSION: Aligners subjected to 60 min of post-print UV light exposure were the most rigid and had highest compressive strength. Increasing the duration of post-UV light curing reduced the amount of water absorbed by the aligners. Since the '60-min cure' group was excessively rigid, a post-curing duration of 40 min is recommended to provide sufficient flexibility for comfortable daily use and wear.
OBJECTIVE: To examine the palatal bone thickness in a cohort of Portuguese patients representing various age groups to identify optimal insertion sites for enhancing the stability of orthodontic micro implants (MIs). To...OBJECTIVE: To examine the palatal bone thickness in a cohort of Portuguese patients representing various age groups to identify optimal insertion sites for enhancing the stability of orthodontic micro implants (MIs). To ascertain whether there are any age- or sex-related variations in palatal bone thickness. DESIGN: Retrospective observational study. METHOD: A total of 50 cone-beam computed tomography (CBCT) scans of patients aged 12-51 years (23 boys/men and 27 girls/women) were analysed. The CBCT scans were grouped according to age and sex. The palatal bone thickness was measured at five points: 4, 8, 12, 16 and 20 mm posterior to the incisive foramen (IF) and at 3, 6 and 9 mm lateral to the midpalatal suture (MPS). A total of 750 regions of interest were evaluated (15 for each of 50 patients). Two-way analysis of variance (ANOVA) and Student's -tests were employed for data analysis, with a significance level of < 0.05. RESULTS: The greatest thickness of palatal bone was found to be at 4 mm posterior to the ІF and 9 mm lateral to the MPS in all investigated groups, with a mean thickness of 12.29 ± 2.00 mm for girls/women and 13.59 ± 2.31 mm for boys/men; 13.30 ± 2.38 mm for adolescents and young adults, and 12.27 ± 2.03 mm for adults. Significant statistical differences were identified between male and female individuals and between different age groups (ANOVA, < 0.05). CONCLUSION: Palatal bone thickness varied with sex and age; thus, these factors must be considered when selecting the appropriate length of MIs. In general, girls/women had a thinner palatal bone than boys/men. The palatal bone was significantly thicker in the adolescent and young adult age group (12-25 years) than in the adult age group (27-51 years). In addition, bone thickness decreased posteriorly within each sagittal section.
Ectopic eruption of the first permanent molar is prevalent in children, with a reported prevalence of up to 6%. Treatment options usually range from passive observation to active correction with orthodontic appliances li...Ectopic eruption of the first permanent molar is prevalent in children, with a reported prevalence of up to 6%. Treatment options usually range from passive observation to active correction with orthodontic appliances like separators or distalising devices. This study outlines the step-by-step procedure for creating a 'pistol spring' system, which delivers a consistent, sustained force, reducing the need for frequent reactivation. The system is easy to fabricate, well-tolerated and enhances treatment efficiency, improving patient compliance and reducing chair-side time. The 'pistol spring' offers a cost-effective, time-efficient solution for managing ectopic first molars, particularly in paediatric patients with limited appointment availability.