OBJECTIVE: To explore early treatment practices and perceptions among members of the American Association of Orthodontists (AAO). DESIGN: Cross-sectional survey. PARTICIPANTS: Members of the AAO. METHODS: An electronic q...OBJECTIVE: To explore early treatment practices and perceptions among members of the American Association of Orthodontists (AAO). DESIGN: Cross-sectional survey. PARTICIPANTS: Members of the AAO. METHODS: An electronic questionnaire was pre-piloted and circulated via email to members of the AAO. The survey questions covered respondent demographics, clinical experience, preferred timing of intervention, treatment approaches and clinicians' perceptions with regard to early interceptive treatment. Descriptive statistics were performed. RESULTS: A total of 228 responses were obtained (response rate = 5.12%). Treatment was commonly timed using dental age (61%) and pubertal signs (61.8%). Several problems were treated in the mid-mixed dentition phase (8-9 years) including posterior crossbite (51.3%) increased overjet (41.7%), crowding (39.5%), space loss (41.23%) and anterior open bite (37.3%). Commonly reported treatment approaches included the use of sectional fixed appliances for treatment of anterior crossbite (81.6%), rapid palatal expander for treatment of posterior crossbite (63.6%) and anterior bite plane for deep overbite correction (62.7%). Herbst appliance (42.1%) and facemask (89%) were commonly prescribed for early correction of Class II and III, respectively. Lingual and palatal arches were commonly used to preserve arch length. The majority of respondents (60.1%) were proponents of two-phase orthodontic treatment. CONCLUSIONS: Early orthodontic treatment in the mid-mixed dentition stage was widely advocated for orthodontic intervention. Various malocclusions, including posterior and anterior crossbite, increased overjet, crowding, space loss and anterior open bite, were reported to be commonly addressed during this phase. Popular treatment approaches included sectional fixed appliances, Herbst appliance, facemask, rapid palatal expanders and anterior bite planes.
OBJECTIVE: To compare the levels of interleukin (IL)-1 beta (IL-1β), alpha (IL-1α), receptor antagonist (IL-1Ra), IL-10 and IL-13 in peri-mini-screw crevicular fluid (PMCF) between unloaded and immediately loaded mini-sc...OBJECTIVE: To compare the levels of interleukin (IL)-1 beta (IL-1β), alpha (IL-1α), receptor antagonist (IL-1Ra), IL-10 and IL-13 in peri-mini-screw crevicular fluid (PMCF) between unloaded and immediately loaded mini-screws during orthodontic treatment. DESIGN: Single-centre paired split-mouth controlled trial. PARTICIPANTS: Patients who required at least two mini-screws as a part of their orthodontic treatment at orthodontic clinic of School of Dentistry of Ribeirão Preto, University of São Paulo (USP) were recruited. METHODS: A total of 40 mini-screws were inserted into the interradicular alveolar bone in 16 patients. Using the coin toss method, each mini-screw was randomly allocated into one of two groups: a control group of unloaded (n = 20) and a group of immediately loaded mini-screws (n = 20). Immediately postoperatively, a continuous load in the range of 150-200 cN was applied to the mini-screws allocated to the loaded group. The PMCF was collected in four experimental times: immediately postoperatively (and on load time, to mini-screws allocated into the loaded group) and 7, 14 and 21 days postoperatively. Biomarker levels were measured using Multiplex Microsphere Immunoassays and compared between groups and covariates using statistical tests that accounted for multiple observations per participant (alpha =5%). RESULTS: No mini-screws were lost. There was a progressive and statistically significant increase of the biomarker's levels in the two groups during the experimental times ( <0.001). The biomarker levels were significantly higher in the immediately loaded group compared to the unloaded group at all time points ( <0.05), except for IL-10 after 7 days postoperatively. CONCLUSION: Although all biomarker levels were statistically higher in the immediately loaded group at all experimental time points in comparison with the unloaded group, no mini-screws were lost. This suggests a balanced and normal adaptive bone response to the mechanical stress of immediate loading, with no negative impact on clinical outcomes.
OBJECTIVE: In this study, various micro-osteoperforation (MOP) approaches were designed and their impacts on dentoalveolar structures were evaluated during maxillary canine distalisation in clear aligner (CA) treatment u...OBJECTIVE: In this study, various micro-osteoperforation (MOP) approaches were designed and their impacts on dentoalveolar structures were evaluated during maxillary canine distalisation in clear aligner (CA) treatment using a three-dimensional (3D) finite element method (FEM). DESIGN: A 3D analysis was conducted of displacements and stresses in canine distalisation with various MOP approaches in CA. SETTING: Computational study. METHODS: In CA treatment, a FEM model was created to simulate distalisation of the maxillary canine by extraction of the first premolar. A total of 12 MOP approach designs were simulated for variations in the location, number and distance of the MOPs. MOP was not applied in one model; a total of 13 models were created. Canine and aligner displacement, and stresses on the periodontal ligament (PDL) were calculated under 0.24 CA activation. RESULTS: The effect of MOPs on canine displacement was non-significant. The movement was observed as tipping. Localisation, MOP-canine distance and MOP depth parameters did not affect canine and aligner displacement. Canine and aligner displacement was the same across all models. Moreover, the compression stresses within the PDL were minimal and showed no significant variations among the models, whereas the tensile stresses displayed only minor differences. CONCLUSION: MOPs did not alter the biomechanical responses of dentoalveolar structures concerning the canine and aligner but had a small and non-clinically significant effect on PDL.
OBJECTIVE: To compare the quality of orthodontic clinical photographs taken with a mirrorless camera and a smartphone compared with those taken with a digital single lens reflex (DSLR) camera. METHODS: This cross-section...OBJECTIVE: To compare the quality of orthodontic clinical photographs taken with a mirrorless camera and a smartphone compared with those taken with a digital single lens reflex (DSLR) camera. METHODS: This cross-sectional study involved six participants (models), each of whom had five extra-oral and five intra-oral photographs taken using a DSLR (Canon 70D), a mirrorless camera (Canon RP) and a smartphone (iPhone 14 Pro), resulting in a total of 180 photographs. Four orthodontists served as assessors, evaluating the quality of each photograph based on image clarity, colour accuracy and lighting. They categorised the photographs as 'good' (no errors), 'acceptable' (some errors) or 'unacceptable', while also noting any specific errors observed. Statistical analysis was conducted using Fisher's exact test and Pearson's chi-square test. All statistical tests were interpreted at a significance level of 5%. RESULTS: Compared to the DSLR camera, the photographs taken with the mirrorless camera were of identical quality, with 100% of photographs rated as good for each camera. For the smartphone camera, 41.7% were assessed as good and 58.3% as acceptable, which was significantly less ( < 0.001) than for the DSLR (100% good). For smartphone intra-oral photographs, the majority of 'upper occlusal' and 'lower occlusal' photographs were classified as 'good' (62.5%), while the remaining 37.5% were rated as 'acceptable'. In contrast, for 'right buccal' and 'left buccal' photographs, the majority of photographs (87.5%) were categorised as 'acceptable', with only 12.5% rated as 'good'. CONCLUSION: In conclusion, although DSLR and mirrorless cameras consistently produce high-quality orthodontic photographs suitable for all clinical and professional purposes, smartphone cameras fall short in photographic quality. Given their lower resolution and pixel count, smartphone-captured photographs may be adequate for clinical records but are not recommended for large-format applications.
BACKGROUND: Clear aligner therapy (CAT) has become a popular choice among patients seeking orthodontic treatment. However, CAT is not optimal for certain types of tooth movements. This case report illustrates a hybrid ap...BACKGROUND: Clear aligner therapy (CAT) has become a popular choice among patients seeking orthodontic treatment. However, CAT is not optimal for certain types of tooth movements. This case report illustrates a hybrid approach combining CAT with power arms to achieve controlled space closure after lower incisor extraction. CASE PRESENTATION: A fit and healthy man presented with a Class 1 malocclusion on a Class 1 skeletal base with bimaxillary protrusion, slightly increased vertical proportions, and mild crowding in the upper and lower arches. He was concerned about his 'irregular lower front teeth and inability to clean them'. INTERVENTION: Lower incisor extraction treated with clear aligner therapy (CAT). RESULTS: The patient's malocclusion was successfully treated with CAT and the extraction of a lower incisor, achieving satisfactory root parallelism for the teeth adjacent to the extraction space. The patient reported satisfaction with the treatment results. CONCLUSION: Power arms can be considered a useful adjunct to CAT for minimising unwanted tipping in lower incisor extraction cases. Further research on more complex cases and a larger sample size is warranted to validate the findings of this case report and explore long-term stability.
OBJECTIVE: To develop a protocol for locating the Xi point using three-dimensional (3D) cone-beam computed tomography (CBCT) and to evaluate the linear distance between the Xi point and the mandibular foramen on the CBCT...OBJECTIVE: To develop a protocol for locating the Xi point using three-dimensional (3D) cone-beam computed tomography (CBCT) and to evaluate the linear distance between the Xi point and the mandibular foramen on the CBCT image. STUDY DESIGN: A retrospective cross-sectional study. STUDY SETTING: The study was conducted on standardised CBCT records of 35 patients aged >18 years (13 men, 22 women). The CBCT scans were analysed using Dolphin 3D 11.9 software. METHODS: The Xi point was constructed on the right and left lateral views of the ramus using the four points R1, R2, R3 and R4 based on Ricketts' analysis. The mandibular foramina were located on CBCT and the linear distance from the mandibular foramen to the Xi points were recorded. RESULTS: The 3D Xi point was located on the lateral surface of the mandibular ramus superior and distal to mandibular foramen. The mean distance of the Xi point from the mandibular foramen was 2.3 ± 1.46 mm on right side and 2.3 ± 1.53 mm on left side. CONCLUSION: The study identified the accuracy of Xi point construction and its linear relation to the mandibular foramen. Xi point validation in relation to the mandibular foramen serves as a guide for inferior alveolar nerve course identification. The results of the study also find applications in bone screw placement and growth prediction.
OBJECTIVE: To test the validity and reliability of The Spacing Index (TSI). DESIGN: A single-centre diagnostic study. SETTING: Orthodontic Department, Tameside and Glossop Integrated Care NHS Foundation Trust, Manchester...OBJECTIVE: To test the validity and reliability of The Spacing Index (TSI). DESIGN: A single-centre diagnostic study. SETTING: Orthodontic Department, Tameside and Glossop Integrated Care NHS Foundation Trust, Manchester, UKMethods:TSI was outlined based on the principle of mild spacing (0-4 mm), moderate spacing (5-8 mm) and severe spacing (>8 mm). A total of 53 anonymised study models were selected as a convenience sample of patients attending hypodontia multidisciplinary clinics. A range of cases with different amounts of spacing in each arch was chosen. Each model was measured by ML-C in millimetres using calibrated Vernier callipers and then subdivided to give the gold standard spacing TSI categorisation of mild, moderate or severe. Two test raters (CB and NM) then visually assessed the same study models and rated the spacing as mild, moderate or severe. Comparison of the gold standard rating and the test rating was made to assess the validity of TSI. The reliability of the index was assessed by both the gold standard and test raters 2 weeks later. RESULTS: The weighted kappa score was 0.79 (substantial agreement) between the gold standard rater and the test raters for the mild, moderate and severe TSI categories. The weighted kappa scores were greater than 0.80, demonstrating almost perfect intra-observer reliability over time. CONCLUSION: The proposed TSI has been shown to be valid and reliable and could be used to categorise spacing during routine orthodontic assessment.
The use of clear aligners is gaining popularity among orthodontists as well as other dental professionals worldwide. Very frequently, interproximal reduction (IPR) of the enamel in the anterior teeth is required during o...The use of clear aligners is gaining popularity among orthodontists as well as other dental professionals worldwide. Very frequently, interproximal reduction (IPR) of the enamel in the anterior teeth is required during orthodontic treatment with aligners. The available methods for anterior IPR have some basic inherent disadvantages that can potentially interfere with their daily use. A novel bur intended for use with a high-speed turbine is presented. It was developed specifically for the IPR of anterior teeth. This new design can overcome most of the shortcomings of traditional techniques. It performs IPR effectively, efficiently, safely and without causing patient discomfort.
OBJECTIVE: To investigate young people's experience of retainer wear in the immediate term and at 6 months after appliance removal, and to explore the factors affecting retainer wear adherence. DESIGN: Qualitative study....OBJECTIVE: To investigate young people's experience of retainer wear in the immediate term and at 6 months after appliance removal, and to explore the factors affecting retainer wear adherence. DESIGN: Qualitative study. SETTING: Orthodontic departments at two teaching hospitals in Yorkshire, UK. PARTICIPANTS: A total of 12 participants aged 13-18 years were recruited using a purposive sampling approach. METHODS: Data collection occurred through one-to-one, virtual, photo-elicitation interviews at two time points (immediate and 6 months) with data analysed using interpretative phenomenological analysis (IPA). RESULTS: Three overarching themes were developed to describe young people's experience of orthodontic retention: immediate experience and expectation of retainers; the process of adaptation; and motivating factors. Barriers to adherence were mostly ascribed to daytime wear, despite normalisation of retainers in young people's lives. Interventions to help individuals overcome the initial adaptation phase and self-manage their foreseen problems of forgetfulness include routines and reminders, which seem to be less important at 6 months. At both time points, internal and external motivation significantly contribute to retainer adherence, with compensatory changes in behaviour being more important at 6 months. CONCLUSIONS: Understanding early experiences of retainer wear can help clinicians to provide timely and well-targeted interventions and information. Co-constructing unique adherence strategies may help to overcome the initial adaptation phase, with particular emphasis on understanding the individual.