Dental implants are one of the established treatment protocols to replace/restore lost tooth/teeth structures. Ihde and Ihde redefined concept of strategic implantology based on immediate loading. The aim of present case series was to evaluate efficacy of strategic implants regarding primary stability, quality of bone, survival, and clinical success in long-term. The present case series included a total of 26 patients aged 40 to 70 years restored with strategic implants after an immediate loading protocol. On follow-up visits, clinical assessment of implant stability was done by absence of implant mobility and absence of pain and dysesthesia while radiographically, immediate postoperative crestal bone level was compared with that observed on follow-up visits. Also, integration of apical and/or crestal threads of implants were assessed radiographically for any signs of radiolucency along with healing of sockets and crestal bone levels in relation to abutment margins.

Ankyloglossia or tongue-tie is a condition present since birth that results in restricted movement of the tongue due to the attachment of the lingual frenulum. The condition affects breastfeeding, speaking, swallowing, occlusion, and proper tongue posture. Tongue ties vary in degree of severity from mild cases of mucus membrane bands to complete tongue ties where the tongue adheres to the floor of the mouth. Treatment options such as speech therapy, frenotomy,frenectomyhave all been suggested in the literature. Surgical correction often causes, bleeding,chances of infection, swelling, and relapse.A systemically healthy 23-year-old male patient who experienced difficulty in speech since childhood was referred for treatment to the dental clinic in September 2020. He was diagnosed with Kotlows class III tongue tie and angles class 3 malocclusion. Orthodontic correction and Functional frenuloplasty using a diode laser was carried out.In conjunction with it,orofacial myofunctional therapy was advised. Follow-up: The surgical procedure was uneventful. The patient was reviewed post-operatively at regular intervals every 3 months to check for relapse. This paper elaborates on the newer modes of diagnosis, orofacial myofunctional therapy, and lingual frenuloplasty with diode laser. This technique will help to overcome all the challenges of conventional tongue-tie treatments providing long-term excellent results.

INTRODUCTION: To evaluate the effect of orthodontic retraction force on thick and thin gingival biotypes of anterior teeth having grade I and II gingival recession with D1 and D2 alveolar bone densities by assessing the displacement of teeth and deformation in gingival tissue, along with evaluating the amount of equivalent stress on teeth and gingiva in finite element model. MATERIALS AND METHOD: Based on cone-beam computed tomography datasets, eight models (LC01–LC08) of maxilla with appliance assembly were created. A retraction load of 150 gm was applied on each model during the finite element analysis (FEA), and then values of teeth displacement, gingival deformation, and von Mises stress were evaluated. RESULT: All the models with D1 bone density (LC01–04) were showing gingival deformation, whereas models with D2 bone quality (LC05–08) give no significant outcome. The amount of von Mises stress for teeth and gingival tissue in each model was the same for both central and lateral incisors. CONCLUSION: All the models having D1 bone quality showed greater gingival deformation after applying retraction force, whereas in models with D2 bone density, deformation was not significant. Changes in gingival tissue are brought about by orthodontic treatment, which also helps to correct the periodontal defects; however, bone density plays a significant role in improving gingival recession.

OBJECTIVES: To compare nickel-titanium (NiTi) wires and clear aligners in the management of mandibular incisor crowding. METHODS: Seventy-two participants were arbitrarily alienated into two groups with 36 samples in each. Group I participants were treated with NiTi arch wires and group II participants with clear aligners. Malocclusion was evaluated using Little's irregularity index. A questionnaire was applied to record the discomfort levels. Patients were recalled regularly at four weeks, eight weeks, and twelve weeks. RESULTS: At baseline, the mean score was 2.91 mm and 2.72 mm; at 4 weeks, it was 1.64 mm and1.48 mm; at 8 weeks, it was 0.98 mm and1.0 mm; and at 12 weeks, it was 0.68 mm and 0.52 mm in groups I and II, respectively. The mean change in Little's irregularity index score at 4 weeks was 1.27 mm and 1.24 mm; at 8 weeks, it was 0.66 mm and 0.48 mm; and at 12 weeks, it was 0.30 mm and 0.48 mm in groups I and II, respectively. The disparity was not-considerable (p > 0.05). The mean discomfort score at baseline was 2.8 and 2.5; at 4 weeks, it was 2.4 and 2.0; at 8 weeks, it was 1.8 and 1.4; and at 12 weeks, it was 1.3 and 1.0 for groups I and II correspondingly. The disparity was non-significant (p > 0.05). CONCLUSION: From the present study, it was found that both NiTi wires and clear aligners were equally effective in managing mandibular anterior crowding cases.

OBJECTIVES: To evaluate and compare the shear bond strength of stainless-steel brackets using three different light curing units MATERIAL AND METHODS: Using three LED curing units (3M ESPE Elipar, Ivoclar bluephase, and Woodpecker I LED light cure), 120 precoated metal brackets (Gemini series, 3M Unitek) were cured. The shear bond strength was recorded using a universal testing machine. RESULT: The shear strength of the bracket in different light-curing systems was examined with ANOVA test. The mean shear strength of group A, group B, and group C were 16.03 ± 14.30 MPA, 16.86 ± 11.89 MPA, and 20.51 ± 19.40, respectively. The result of the analysis shows that there is a major difference in shear bond strength of these three different light-curing systems with F value = 3.94 and P value 0.04 CONCLUSION: We used three LED light-curing units with different intensities and manufacturing companies. The result showed that woodpecker I LED light had significantly highest mean SBS than the other two (Elipar LED curing light and 3M ESPE, Ivoclar bluephase).

OBJECTIVE: This study aimed to evaluate the clinical and histological administration of magnesium oxide (MgO) supplementation on orthodontic relapse and bone remodeling. MATERIALS AND METHODS: Twenty male albino rabbits were classified into four groups (five animals for each as two control (positive and negative), plus two experimental (low dose 40 mg/kg) and (high dose 80 mg/kg)/b.w. daily). An orthodontic force was applied (40 gm) to the lower incisors using modified orthodontic appliance adapted on the lower central incisors. During the period of retention, MgO was given orally. Relapse was estimated after appliance removal. A digital Calliper was used to compete the space between incisors' mesial tips of rabbits at six successive time points (0, 3, 7, 10, 15, and 21 days). Histologically, osteoblast, osteoclast, and osteocyte account were assessed. Data analyses were performed by SPSS using ANOVA and Tukay HSD (P ≤ 0.05) for statistically significant differences between groups. RESULTS: The high dose group had a lower relapse rate than the low dose and control groups. Histologically, the high dose group had more osteoblasts and osteocytes than low dose and control groups. While osteoclasts were significantly lower than the control group in low and high dose groups. CONCLUSIONS: MgO supplementation during an orthodontic retention phase, particularly at a level of high dose, clinically decreased orthodontic relapse in a rabbit model. Histologically, MgO has a significant effect on alveolar bone after the orthodontic retention period.

OBJECTIVE: The aim of this study was to investigate the stresses on mini-implant, cortical bone, and cancellous bone for maxillary molar distalization using an orthodontic implant in a finite element model for different angulations and depths of insertion. METHODS: A three-dimensional finite element method was used to simulate overall orthodontic tooth movements by using ANSYS software. The maxillary bone and the molars were reproduced using CT scan images and conversion of the same into STL file was done. Finite element model was generated and the effect of forces was studied on the model for different depths and angulations of mini-implant insertions. The distalization force was exerted by an open-coil spring and the direct skeletal anchorage was provided by a mini-implant. Mini-implants were placed in depths of 5 mm, 7 mm, and 9 mm inside the bone and insertion angles of 30°, 60°, and 90°. Stresses on mini-implant and extent of stress on the surrounding bone were assessed by the software. RESULTS: 1. Least stress was found when the mini-implant was inserted at an angle of 30°, as it is nearer to the stronger cortical bone. 2. As the length of the mini-implant increases, accompanied by the increase in the depth of insertion, a decrease in stress in the mini-implant, cortical bone, and cancellous bone was noticed. CONCLUSION: An increase in the insertion angle from 30° to 90° increases the stresses on both the implant and the cortical bone. A higher depth of thread in the bone helps in reducing the stress on the implant, cortical bone, and cancellous bone. This helps in improving the primary stability of the mini-implant and its life.

OBJECTIVES: The purpose of the study is as follows:

• To evaluate the dental and skeletal changes of the AdvanSync 2 appliance.
• To evaluate the soft tissue changes of the AdvanSync 2 appliance using photometric analysis.

METHODS: The sample size consisted of 15 patients who reported to the Department of Orthodontics, seeking fixed orthodontic treatment. The effects of the AdvanSync 2 appliance were measured at two intervals. RESULTS: After the nine months, P values were observed to be less than 0.5, therefore statistically significant for parameters such as Sella-Nasion-Point A (SNA), Condylion-Point A (CO-A), University of Witwatersrand, Condylion-Gnathion (C0-Gn), point A-Nasion-Point B (ANB), Upper incisor-Point A (UI-A) (degree), LI-B (mm), Lower lip to Esthetic plane (LL-E plane), nasolabial angle, mentolabial angle, facial angle, and L lip to the chin. P values were however observed to be greater than 0.5, therefore statistically insignificant for parameters such as sella-Nasion-Point B (SNB), Condylion –gonion (C0-Go), UI A (mm), LI B (mm), UL-EPL, H LINE, Frankfurt mandibular plane (FMA), nose tip angle, nasofrontal angle, nasomental angle, upper lip angle, and U lip to the chin. CONCLUSIONS: AdvanSync 2 appliance brought about a change in Class II malocclusions through Co-Gn, Co-Go, ANB, FMA, UI-A (degree), UI A (linear) LI B (linear), Upper lip to Esthetic plane, LL-E plane, Holdaway LINE, nose tip angle, nasolabial angle, mentolabial angle, nasofrontal angle, nasomental angle, facial angle, upper lip angle, U lip to chin, L lip to the chin after nine months of appliance delivery. MAIN POINTS:

1. AdvanSync 2 normalized class II by an increase in the length and body of the mandible.
2. AdvanSync 2 has a restraining effect on the growth of the maxilla.
3. AdvanSync 2 brings about positive soft tissue changes.
4. The major disadvantage is the proclination of the lower incisors.

OBJECTIVE: This study aimed to evaluate the effect of the local injection of injectable platelet-rich fibrin (i-PRF) on the eruption rate of the teeth and evaluation of the effect of i-PRF on the number of odontoblast, cementoblast, osteoblast, osteocyte, and osteoclast cells. MATERIALS AND METHODS: The samples consisted of 20 male albino rabbits and were divided randomly into the control group (5 rabbits) and i-PRF groups (15 rabbits) sub-divided into week 1, week 2, and week 3 sub-groups. The labial surface of lower right incisors was marked by drilling a hole at the level of the free gingival margin in the mid-line of each tooth with a small round bur, and the eruption rates were measured by measuring the distance from the most apical point of the free gingival margin and the center of the hole with a digital caliper. i-PRF was prepared by centrifuging autologous blood of each rabbit at 1000 rpm for 5 minutes; then the i-PRF layer was collected. The control group received no treatment, whereas i-PRF groups received i-PRF in the following manner: For week 1 groups, a single dose was given at 0 day; for week 2 groups, double doses were given at 0 and 7 days; and for week 3 groups, three doses were given at 0, 7, and 14 days. At the end of experiments for each group, animal scarification was performed, and histological steps were performed. RESULTS: There was a significant increase in the rate of tooth eruption in i-PRF groups when compared to the control group, and the eruption rate was increased in 107.3%, 144.7%, and 167.5% for week 1, week 2, and week 3, respectively. Concerning the histological finding, the i-PRF groups gave rise to a higher number of odontoblast, cementoblast, osteoblast, osteocyte, and osteoclast cells with a significant difference when compared to the control groups (P ≤ 0.05). CONCLUSIONS: Applying i-PRF significantly increased the rate of teeth eruption at all-time intervals. Platelet-rich fibrin injection can be an effective method for acceleration of teeth eruption.

OBJECTIVE: To evaluate the changes in surface morphology of two different types of mini-implants after clinical en masse retraction using scanning electron microscopy. MATERIAL AND METHODS: Fifty mini-implants of Dentos (Korea, Absoanchor, BH-1817-08) and Orlus (Korea, Yesanchor, C-1817) were inserted in patients in a split-mouth design who required en masse anterior retraction and absolute anchorage. Surface characteristics of mini-implants such as pitch (distance between consecutive threads), flank width (distance between root and crest), and taper were studied using scanning electron microscope (FEI nanosem450) before and after clinical use. RESULTS: Statistically significant difference (p value = 0.003) was found in a mean reduction of pitch dimension among the two groups with a mean difference of 25.000 μm. Also, a statistically significant difference was noted (p value = 0.001) in a mean reduction of flank width among Dentos implants as compared to Orlus implants. A statistically significant difference (p = 0.001) was seen in the mean reduction of taper dimension among Dentos group (0.0140 ± 0.02271) as compared to the Orlus group (0.0810 ± 0.05152). CONCLUSION: A marked reduction in surface morphology such as the pitch, flank width, and taper of both mini-implants after retrieval was observed. Dentos group of mini-implants displayed better dimensional stability post-retrieval as compared to the Orlus group of mini-implants. All the mini-screws showed milling defects in form of scratches on observation under scanning electron microscopy despite a smooth appearance to the naked eye.

OBJECTIVE: To assess the optimal intervals of exposure of low-level LASER therapy (LLLT) that would optimally accelerate orthodontic tooth movement. Second objective was to quantitatively analyze the difference in the time taken for alignment of anterior teeth with and without the application of LASER. MATERIALS AND METHODS: PROSPERO database registry was done (CRD42020196472) and review was conducted based on PRISMA guidelines. A search was systematically conducted in five major electronic databases without restrictions up to June 2020 along with a hand search of selected journals. The quality of evidence was assessed using the Grading of Recommended Assessment, Development, and Evaluation tool, risk of bias using Cochrane risk of bias tool, and meta-analysis was carried out using RevMan 5.4 software. RESULTS: Ten randomized controlled trials which met the inclusion criteria were evaluated and tabulated. A random-effects meta-analysis demonstrated that there is a statistically significant increase in the orthodontic tooth movement when patients were exposed to minimum of four intervals of LLLT in the first month, at P =0.03 by a standard mean difference of 0.46 mm with an overall heterogeneity of I² = 0% at 95% confidence interval. There was a statistically highly significant reduction in the number of days taken for alignment of anterior teeth with the application of LASER (P < .00001). CONCLUSION: Application of LLLT for minimum of four irradiations in the first month has yielded better results in accelerating orthodontic tooth movement than application of LLLT once a month.

OBJECTIVE: To determine the prevalence of dilaceration in a sample of patients presenting for initial orthodontic care. METHODS: Examining radiographs from a random sample of orthopantomogram images was used to acquire the data. In all, 2,801 dental records were evaluated at Oman Dental College (ODC), Oman. A dental X-ray processing software was utilized to view the images. A tooth was classified as having a mesial/distal dilaceration if its long axis exhibited an angle of 90 degrees or greater. Dilacerated roots in the buccal/lingual direction were diagnosed by observing the appearance of a spherical opaque area with a dark shadow in its central region, projected by the apical foramen, which gave the root canal a “bull's-eye” appearance. RESULTS: Dilacerations were found in 17.32% of the records examined. The maxillary second molars (22.71%) were the most commonly affected, followed by the mandibular third molars and mandibular lateral incisors (21.90% and 17.23%, respectively). The central incisors and canines were the least affected, with dilaceration affecting less than 0.2% of the teeth. The mandible was found to have more dilacerations than the maxilla (53.78% and 46.22%, respectively). 61.03% of dilacerations occurred in molars, 43.12% of which occurred in third molars. CONCLUSION: Dilaceration is a notable dental anomaly that can affect any tooth, with some teeth being more affected than others. Dilaceration in maxillary second molars and mandibular lateral incisors is more common in the population of this study than in other populations reported in the literature. Recognizing the condition will allow for more effective orthodontic treatment.

OBJECTIVES: The objective of the study is to test whether the local injection of i-PRF may affect osteoblast, blood vessels and new bone formation in surgically expanded mid palatal suture using maxillary skeletal expander. MATERIALS AND METHODS: Eighteen adult male local breed dogs were divided randomly into three groups: group I (control), includes the expansion with maxillary skeletal expander that was done without corticotomy and i-PRF. Group II, involves the expansion that was done with mid palatal corticotomy but without i-PRF injection. Group III, has the expansion that was done with mid palatal corticotomy and has injection with 2 ml of i-PRF. Each group consisted of 6 dogs which were subdivided into 3 dogs. Three dogs were sacrificed after 15 days and the other 3 dogs were sacrificed after 45 days. The number of osteoblast, blood vessels and new bone formation percentage were statistically analyzed using Sigma plot platform. Mean and standard error, ANOVA and Duncan were performed among the different groups. Values of P ≤ 0.05 were considered significant. RESULTS: After expansion, the i-PRF group demonstrated a considerable increase in the amount of new bone in the mid-palatal suture at 15 and 45 days compared with other 2 groups which were indicated by highest percentages of new bone formation (29.30% of 15 days and 76.55% at 45 days) if compared to control group which were (7.72% at 15 days and 22.30% at 45 days). The corticotomy groups were in between, 15.33% and 46.84% respectively. Moreover the number of osteoblasts was higher in corticotomy with i-PRF group on 15 days and decreased on 45 days than the other two groups, while the blood vessels were highest in this group than the other two groups both on 15 and 45 days. CONCLUSION: I-PRF enhanced the production of osteoblast, blood vessels, and new bone in the surgically expanded mid palatal suture.

OBJECTIVE: A novel technique, named the MH setup (MH is an abbreviation for the author's name), was developed to provide an accurate yet simplified method to produce custom-made brackets without bonding errors. This setup aimed to simplify the treatment and eliminate the finishing phase, so that the orthodontist was able to provide better care with less time and lower costs. MATERIALS AND METHODS: The setup was performed in two major steps: direct bonding on the cast followed by cutting and setting the teeth into precise positions using brackets. The first set of brackets, bonded directly onto casts, oriented the teeth by setting them ideally into wax rims with full control over first-, second-, and third-order bends. The fully engaged archwire used allowed for precise control over the arch symmetry and form. Setting teeth in wax allowed the clinician to refine the occlusion and correct any minor errors that arose during the initial bonding. The second set of brackets, mounted on the fully engaged archwire, featured custom-made composite bases. The transfer tray combined the benefits of its soft inner and hard outer layers, providing control over bonding and later ease of peeling from the brackets. RESULTS: The patient was satisfied with a full bonding procedure lasting 15 min that remained simple without unnecessary stress. The clinician was confident that the procedure allowed the precise positioning of brackets and simple bonding for all teeth in the arch, combined with the elimination of the finishing phase. CONCLUSION: The MH technique offered a simple, precise, and inexpensive improvement to the Kesling wax setup. The process allowed for precise bonding without errors or expensive armamentarium. The brackets were transformed into custom-made prescriptions and could be used with labial or lingual techniques. The method allowed for teeth addition, trimming, or overcorrection according to the clinician's preferences. The MH setup facilitated visualization of the treatment objectives with precise locations and the opportunity to revise the treatment plan or to discuss further options with the patient.

OBJECTIVES: To understand the impact of the COVID-19 pandemic on orthodontic clinical services in Jordan. MATERIALS AND METHODS: Google Forms electronic questionnaires were distributed between March and June 2021 using the WhatsApp platform of the Jordanian Orthodontic Society and via direct WhatsApp messages. The survey was identical and contemporaneous to that used in the United Kingdom.^[9] RESULTS: The survey yielded 127 unique responses, giving a response rate of 53.1%. The factors that had the greatest impact on service delivery were government guidance (78%), patients' fear of attending (70.1%), and increased cross-infection measures (65.4%). The survey revealed that there had been a perceived deterioration in oral hygiene (60.3%) and levels of compliance (61.9%) in patients in active treatment even though patients in treatment were prioritized during the pandemic. Also, 56.8% of respondents felt clinical staff should be vaccinated and undergo regular testing for COVID-19. Orthodontists within Jordan were optimistic regarding the speed at which clinical services would return to pre-pandemic levels of activity with 32.5% anticipating this would take less than 6 months. CONCLUSIONS: Patients in active orthodontic treatment, during COVID-19, have been prioritized but at the expense of new and review patients. Respondents in Jordan felt COVID-19 would have ongoing effects on clinical care, professional practice, and society. Most respondents supported the vaccination of orthodontic staff and were optimistic about the effect of a vaccination program on restoring clinical services.

OBJECTIVE: The aim of this 2-arm parallel study was to evaluate the alignment efficiency of heat-activated nickel-titanium (NiTi-TE) and superelastic nickel titanium (NiTi-PSE) archwires over the first 3 months of orthodontic treatment and compare these groups. SETTING AND SAMPLE POPULATION: Randomized, double-blind, controlled, single-center trial in 52 patients with fixed orthodontic appliances from an orthodontic graduate program in the permanent dentition and moderate crowding in the lower arch. MATERIAL AND METHODS: Patients were randomly allocated to one of two interventions: NiTi-TE and NiTi-PSE archwires, 0.014-inch (3M Unitek™, CA, USA) with a follow-up period of 3 months. The primary outcome was the alignment efficiency determined by the reduction in Little's irregularity index (mm), measured in three points, T0: before the start of orthodontic treatment, T1: 1 month later, T2: 2 months later, T3: 3 months later. Data were analyzed using independent sample t tests and repeated measures ANOVA. RESULTS: 52 patients (NiTi-TE n = 26; NiTi-PSE n = 26) were randomized and analyzed (average age: 21.73; standard deviation (SD): 6.07; average lower anterior irregularity: 5.20; SD: 0.76) for intention-to-treat (ITT) analysis. No statistically significant differences between the groups were found (mean of the differences: T1: 0.20; 95% CI: –0.558; 0.958; T2: 0.49: 95% CI: –0.339; 1.319; T3: 0.33; 95% CI: –0.308; 0.968). The resolution of crowding with each of the wires was significant (P < 0.0001) at all times. Twelve participants (2 treated with NiTi-TE and 10 treated with NiTi-PSE) lost follow-up due to face-to-face dental-procedures restrictions during the COVID-19 pandemic, the missing data was imputed. CONCLUSIONS: NiTi-TE and NiTi-PSE wires of 0.014-inch were similar in their clinical efficiency for the resolution of crowding during the first 3 months of orthodontic treatment. REGISTRATION: Clinical Trials NCT03256279.

OBJECTIVES: The study aimed to compare the effects of quadhelix and nickel-titanium (NiTi) expander appliances on lower facial height, to quantify, and evaluate dentoalveolar and orthopedic changes in transverse plane, respectively, to estimate the difference in changes between these two appliances. MATERIALS AND METHODS: Twenty patients, ten for the quadhelix and NiTi expander in the two-appliance group, respectively, participated in this study. A total of 8 readings, 1 for clinical facial height, 2 for model analysis, and 5 for posteroanterior cephalometric analysis were recorded. The statistical tests used were, Student's unpaired and paired t-tests. RESULTS: Both appliances individually, produced statistically highly significant (p < 0.01) expansion every month in both premolar and molar areas with more uniform expansion for quadhelix and less expansion in NiTi palatal expander in the premolar region initially. The skeletal to dental change ratio showed that there was more dental change than skeletal with no inter-appliance differences statistically while assessing the PA cephalometric readings. CONCLUSIONS: This study infers that both appliances are equally efficacious maxillary expanders, which are primarily dentoalveolar and not skeletal (p < 0.05).

AIM: The aim of this in-vitro study was to observe and analyze the various enamel surface changes that occur due to laser debonding of metal and ceramic brackets, done by means of Er, Cr:YSGG laser. MATERIALS AND METHODS: 90 extracted premolars were randomly allocated into one of six groups with 15 teeth each. The groups represent metal brackets (Groups A1, A2, A3) and ceramic brackets (Groups B1, B2, B3). Each sub-group represents the mode of debonding used in the study. Debonded teeth were analyzed under scanning electron microscopy (SEM) at 80X and at 1000X magnification at three sites. The adhesive remnant index (ARI) scores were analyzed and the presence of enamel damage was observed. RESULT: ARI showed high score in Groups A1 and B1. SEM images of large composite remnants at the site of bracket in Groups A1 and B1 at the site of bracket and multiple enamel microcracks and fractures at interface and enamel adjacent to bracket in Groups A1 and B1. SEM images of minimal composite remnants at the site of bracket in Groups A2, A3, B2, and B3 and little to no presence of enamel microcracks or fractures at interface and enamel adjacent to bracket in Groups A2, A3, B2, and B3. CONCLUSION: The use of Er, Cr:YSGG laser in orthodontic practice, especially in the debonding procedures of orthodontic brackets provide quality care to patient with minimal post-treatment damages.

AIMS: This study aimed to evaluate the bond strength of light- and chemical-cure adhesive systems over six months. MATERIALS AND METHODS: A total of 144 sound human maxillary first and second premolars were randomly divided into six groups according to the adhesive type (i.e., Transbond XT and Unite) and evaluation time. The groups were T0 (24-h group without thermocycling), T1 (24-h group with thermocycling), T2 (1-month group), T3 (2-month group), T4 (4-month group), and T5 (6-month group). The bond strength was then measured and the data were analyzed by SPSS software (version 23) through the independent t-test and one-way ANOVA. A P value less than 0.05 was considered statistically significant. RESULTS: The results of this study showed that shear bond strength of chemical-cure orthodontic adhesive (Unite, 15.37 MPa) at all-time points was significantly 1.37 times higher than that of the Transbond XT light-cure adhesive (11.15 MPa). Moreover, shear bond strength of self-cure adhesive (Unite) 1 month after debonding showed a significant difference with the 24-h group without thermocycling (P = 0.002), 24-h group with thermocycling (P = 0.008), and 6-month group (P = 0.016). The highest shear bond strength in both adhesives was observed at one month. Furthermore, the shear bond strength of Transbond XT light-cure adhesive one month after debonding showed a significant difference with the 24-h group without thermocycling (P = 0.000) and 24-h group with thermocycling (P = 0.000), as well as with the 2-month (P = 0.008), 4-month (P = 0.000), and 6-month groups (P = 0.016). CONCLUSION: Unite self-cure adhesive compared to Transbond XT light-cure adhesive has higher bond strength and is recommended for rebonding brackets in patients with multiple rebonds.

BACKGROUND: Maxillary canine is the second most common tooth that gets impacted after III molars. Early pre-eruptive inclination changes of first premolar and its associative changes with canine inclination are an important factor that predicts the fate of maxillary canines. Hence, a cross-sectional study was planned to evaluate the normal pre-eruptive mesiodistal inclinations of maxillary permanent canine, first premolar, and lateral incisor in children aged 6–14 years using orthopantomogram. MATERIALS AND METHODS: The total number of participants was 296. Each group of boys and girls consisted of 37 participants in each of the age groups 6–8 years, 8–10 years, 10–12 years, and 13–14 years, making up a total of 148 boys and 148 girls. Routine clinical examination was conducted, and orthopantomograph was taken for radiographic examination. Orthopantomographs of all these participants were collected. Inclination of lateral incisor, inclination of canine, and inclination of premolar with midline were measured on the orthopantomogram. Also, the angles between the canine with lateral incisor and canine with first premolar were measured. Pearson correlation was also evaluated between the movement of canine with lateral incisor and canine with first premolar. RESULTS: All the mean angles related to lateral incisor, canine, and first premolar with midline were recorded. Also, the angles between the canine with lateral incisor and the canine with first premolar were recorded. The movements between lateral incisor, canine, and first premolar were moderately correlated from 6 to 12 years of age. CONCLUSION: The eruption of canine from the floor of the nose till it erupts has its synchronized influence on the lateral incisor and the first premolar.

OBJECTIVES: To assess the oropharyngeal airway in Iranian female young adults with different skeletal patterns using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: This descriptive, cross-sectional study evaluated 105 CBCT scans of female patients between 18 and 35 years retrieved from the archives of a radiology clinic. The images were evaluated in axial, sagittal, and frontal sections. In the axial plane, the maximum and minimum cross-sectional area (CSA) of the airways at the oropharynx, minimum width (anteroposteriorly), and minimum depth (laterally) were measured using Mimics Medical software. The oropharyngeal volume was measured by NemoFAB software. The values were compared among the groups with different sagittal, vertical, and transverse patterns. The correlation of indices with airway measurements was analyzed using Monte Carlo Chi-square and Pearson's correlation coefficient. RESULTS: No significant difference was noted in oropharyngeal airway dimensions and volume among cases with different skeletal sagittal, vertical, and transverse patterns (P > 0.05) except for class III patients with normal transverse pattern in whom maximum CSA in low-angle group was larger than that in normal-angle group (P < 0.05) and class I normal-angle patients in whom maximum CSA in transverse normal group was smaller than that in constriction group (P < 0.05). CONCLUSIONS: Oropharyngeal dimensions were not significantly different in Iranian female young adults with different skeletal patterns.

OBJECTIVE: To evaluate in-vitro surface characteristics and frictional properties of orthodontic stainless steel and beta-titanium archwires after surface modification with different concentrations and coating time of titanium oxide (TiO₂) nanoparticles by Sol-gel dip coating method. MATERIALS AND METHODS: The experiment was carried out with 4 different concentrations (1:2, 1:4, 1:6, and 1:8) and three different dipping durations (24 hours, 48 hours, and 72 hours) over ten main test groups of SS and TMA archwires with uncoated wires acting as control in both dry and wet conditions. Phase analysis and surface characterization of TiO₂ was analyzed by X-ray Diffractometry, surface evaluation with the help of scanning electron microscopy (SEM), and frictional characteristics were evaluated. RESULTS: Among all the concentrations 1:6 ratio with 48 hours of dipping duration showed better surface characteristics. A statistically significant difference in frictional coefficient was observed in both SS and TMA wires than their respective controls (p = 0.001). Intragroup comparison among SS and TMA groups showed that groups with 1:6 ratio and 48 hours dipping duration had least frictional coefficient in both dry and wet conditions (p = 0.001). Intergroup comparison between SS and TMA showed that SS group had significantly reduced friction than TMA (p = 0.001) except in few groups. CONCLUSION: TiO₂ nanoparticle with a concentration ratio of 1:6 and 48 hours dipping duration is recommended for surface modification of orthodontic archwires.

OBJECTIVE: The Brodie bite (BRB) is a rare posterior crossbite affecting the transverse occlusal relationship with the palatal cusps of the upper molars, biting into the vestibule and outside the buccal cusps of the lower molar teeth. The BRB is a highly challenging orthodontic problem and is an extreme form of scissors bite. Patients with this problem present with facial deformity and inability to chew on the affected side. The problem is usually not identified until it becomes severe. This study aimed to identify the prevalence of BRB among untreated orthodontic patients in two geo-political zones in Nigeria. METHODS: A total of 1,041 untreated orthodontic patients who presented to two different orthodontic centres located in two geo-political zones (South/South-Benin City and North Central-Abuja, Nigeria) over a 3-year period were evaluated for the presence of BRB. The transverse dimension of the occlusion was examined for the presence of a crossbite or scissors bite. The molar teeth were used as the reference point for occlusion with Angle's classification of malocclusion. Four groups were identified, namely, teeth in occlusion (TIO) (Angle's Classes I, II or III malocclusion served as the control group), scissors or lingual crossbite (LCB), buccal crossbite (BCB) and BRB. A posterior crossbite was confirmed when the upper molar teeth were biting outside the buccal groove of the lower molar teeth either lingually or buccally. A BRB was identified when the palatal cusps of the upper molars were biting into the buccal vestibule of the lower jaw, with the deviation of the face to that side. Statistical analyses were performed using SPSS version 21; frequencies were determined for the variables, and cross-tabulations between the variables were established. P values < 0.05 were considered significant. RESULTS: The overall prevalence of BRB in this study was 0.6% (six patients). The values in the South/South (Benin City) were 997 untreated orthodontic patients, with a prevalence of 0.5% (five patients). The North Central (Abuja) zone had a total of 44 untreated orthodontic patients, with a prevalence of 2.3% (one patient). Unilateral BRB was seen in five patients (80%), and bilateral BRB was seen in one patient (20%). The condition was more prevalent among women (four patients, 80%) and on the right side (three patients, 60%). Angle's relationship in Classes I, II and III (TIO or control group) was seen in 911 patients (87.5%). The LCB and BCB groups comprised 39 (3.8%) and 85 patients (8.1%), respectively. Posterior crossbite was seen in 130 patients (12.5%). CONCLUSION: The prevalence of BRB in this study was found to be 0.6%, with the condition being more prevalent in women and on the right side.

Contemporary orthodontics entails using advanced materials and devices, simplifying the process of tooth movement. It is well documented that orthodontic materials are subjected to various fluctuations and stresses in the oral environment, such as salivary pH, dietary habits, temperature changes, and masticatory loads. These changes reduce bonding materials' longevity, plasticize resin polymers, and reduce elastic properties. In addition, the corrosion of orthodontic appliances in the oral environment has concerned clinicians for some time. This is focused on two principal issues: whether corrosion products are absorbed into the body and cause either localized or systemic effects, and the results of corrosion on the physical properties and the clinical performance of orthodontic appliances. Recently, another major concern is the potential release of bisphenol-A from materials containing polymers such as thermoplastic aligners and resins, which is known to induce xenoestrogenicity and cytotoxicity when the tissue level exceeds the daily recommended intake. However, most of these findings are based on in vitro studies that suffer from serious drawbacks such as failure to replicate the exact oral environment and process during orthodontic treatment. Therefore, developing clinically relevant methods should be the goal of future research related to the aging of orthodontic materials. The purpose of this review is to outline the impact of the oral environment on contemporary orthodontic materials.

AIM: To evaluate the effect of three different reconditioning techniques on the shear bond strength (SBS) of rebonded brackets. MATERIALS AND METHODS: Forty-five orthodontic brackets were bonded to human premolar teeth using Transbond^TMXT. After debonding, the samples were randomly assigned into equal groups to assess three techniques for the removal of residual adhesive from bracket bases: in Group A, each bracket base was sandblasted with aluminum oxide; in Group B₁, each base was cleaned superficially with a greenstone bur; and in Group B₂, the bases were thoroughly abraded with a greenstone bur. Subsequently, brackets were rebonded and the SBS and the adhesive remnant index (ARI) were determined. Data were analyzed using one-way analysis of variance (ANOVA), plus Tukey and Kruskal–Wallis post-hoc tests (P ≤ 0.05). RESULTS: The average SBSs were: Group A, 11.75 (±4.83) MPa; Group B₁, 8.22 (±4.01) MPa; and Group B₂, 7.54 (±2.85) MPa. No statistically significant differences in SBS were found between Groups A and B₁ (P = 0.051) and Groups B₁ and B₂ (P = 0.885), but there was a significant difference between Groups A and B₂ (P = 0.016). Regarding ARI scores, there were statistically significant differences between Groups A and B₂ (P < 0.001) and between B₁ and B₂ (P = 0.014), but not between Groups A and B₁ (P = 0.068). CONCLUSION: All reconditioning methods were found to have a positive effect, but the sandblasting technique performed best. Brackets reconditioned by sandblasting and superficial grinding mainly showed mixed-type failure, while in samples thoroughly reconditioned by greenstone bur, bonding failure occurred predominantly at the adhesive/bracket interface.

AIM: To explore the potential effect of locally applied 1% Curcumin on myeloperoxidase (MPO) enzymatic activity in gingival crevicular fluid (GCF) and on the periodontal status during the initial phase of orthodontic tooth movement. SETTINGS AND DESIGN: Forty patients (26 females and 14 males) aged 12-25 years who required fixed orthodontic treatment were randomly divided into two equal groups. The control and test groups were similar in the various baseline parameters, including standard oral hygiene protocol. Moreover, 1% Curcumin gel was applied around mandibular anterior teeth in the test group twice daily, from three days before to 14 days after the placement of archwires. MPO activity and periodontal status were recorded at five different time points; before placement of archwire (baseline), immediately after placement of archwire, 2 hours, 7 days, and 14 days later. STATISTICAL ANALYSIS USED: The data were analyzed using the paired t-test for intra-group differences and the unpaired t-test for intergroup differences at five different time points. Statistical significance in the intragroup and intergroup difference of Plaque and Gingival index was calculated using the unpaired t-test. RESULTS: Maximum MPO enzymatic activity in GCF was observed two hours after the placement of the archwire. MPO activity decreased slightly on the seventh day, but values were still elevated as compared to baseline. However, MPO activity came back to the values similar to baseline on day 14 in the control group and significantly lower than the baseline in the test group. The inter-group differences in clinical periodontal parameters were non-significant. CONCLUSIONS: The locally applied 1% Curcumin gel appears to decrease the MPO activity in GCF on the 14^th day after placement of the archwires. However, clinical periodontal status in the initial phase of tooth movement is unaffected by curcumin if patients adhere to good plaque control.

OBJECTIVE: Lower face soft tissue thickness and dentoskeletal features form the lower facial profile. Sagittal skeletal malocclusions with varying degrees of soft tissue thickness in males and females were herein examined using soft tissue cephalometric radiography. METHODS: Based on their dentoskeletal correlations, a total of 160 lateral cephalometric radiographs of adult males and females (n = 80) seeking orthodontic treatment were classified as class I (n = 40), class II division 1 (n = 40), class II division 2 (n = 40), or class III (n = 40). Holdaway analysis was used to assess soft tissue thickness in seven linear parameters. RESULTS: In class I, class II division 1, class II division 2, and class III dentoskeletal connections, males exhibited larger soft tissue thickness. They have an average lower lip thickness, chin depth H, and depth V for class I males. Males and females differed from one another when it came to the thicknesses of the upper and the lower lips. These lip thicknesses as well as the chin's width differed more between men and women in class II division 1. Except for upper lip strain, all measures in the class II division 2 sample males demonstrated a greater significance. In the class III sample, males also demonstrated more significance than females. CONCLUSION: Males with various sagittal skeletal malocclusions demonstrated a significant difference in lower soft tissue thickness (characterized as thicker lower facial soft tissue) compared to female patients in class I, class II division 1, class II division 2, and class III malocclusions.

OBJECTIVE: MH cortical screws were designed to combine the advantages of thick mini-implants with the versatility of micro-screws while avoiding the disadvantages of both. MATERIALS AND METHODS: An MH cortical screw (MH is an abbreviation for the author's name) was made from titanium material. The screw has a 3 mm-long amphora-shaped shank of 2 mm thickness at its thinnest and 3 mm at its thickest part. Uniform 4 mm diameter threads blend into a 1 mm cutting tip. An external hexagonal head with side retentive ligature holes and a central hole for attachments was fabricated on a saucer-shaped gingival collar. Multiple attachments have been prepared for amending to the central hole. RESULTS: The shank design allowed cortical plate retention. The uniform threads and the amphora design provided maximum primary and secondary stability, respectively. The self-drilling tip allowed for a flapless technique, while the hexagonal head with side holes facilitated screwdriver control and allows for ligature wire anchorage. Cleats and buttons facilitated the use of elastics and springs, together with bracket-heads and eyelets for titanium molybdenum alloy and nickel-titanium wires inclusion. Adjustable hooks and chains provided versatility of line of action. Cover screws to retain extra-tissue mini-plates applied skeletal anchorage and long-term retention with flapless manipulations. CONCLUSION: MH cortical screws are a novel and important introduction to orthodontic anchorage. They combine primary and secondary stability with avoidance of root damage together with insertions into attached gingiva only. Multiple and versatile attachments allow for the application of biomechanical techniques according to the clinician's preferences. Extra-tissue mini-plates facilitate maximum anchorage for skeletal control and long-term retention without surgery.

OBJECTIVE: To assess the influence of obstructive sleep apnea on self-perceived dental appearance and need for orthodontic treatment. MATERIALS AND METHODS: A self-administered questionnaire was used in a random sample of a general adult population in Makkah region, Saudi Arabia. A total of 1014 participants completed the questionnaires, which included the STOP-BANG questionnaire, Oral Aesthetics Subjective Impact Score questionnaire, and Aesthetic Component of Index of Orthodontic Treatment Need questionnaire. Descriptive statistics and Chi-square tests were used to compare differences between the groups. RESULTS: Overall, 6.5% (66/1014) of the participants were classified as being at high risk of OSA of which 71.2% were males and 28.8% were females (P < 0.001), 57.6% were >50 years of age, 90.9% had obesity, and 81.8% had an enlarged neck circumference. But only 10.1% of the participants reported that they snore loudly. A positive self-perception of dental esthetics was found in 42 (6.2%) and 518 (76.6%) participants at high and low risk of OSA, respectively. Furthermore, of the participants in the high- and low-risk groups, 4.2% and 66.7% considered themselves in need of orthodontic treatment, respectively. CONCLUSIONS: The prevalence rate of people at intermediate to high risk of OSA was 26% of the general population and being at high risk of OSA had no influence on self-perceived dental esthetics and need for orthodontic treatment.

OBJECTIVE: To evaluate the efficacy of non-aerosol producing restorative self-etching primers (SEPs) as a substitute for conventional orthodontic bonding primers and to analyze the extent of residual composite on the tooth post-debonding. MATERIALS AND METHODS: Eighty-four extracted human premolars were randomly divided into seven groups based on the adhesive and the bonding protocol used. The study comprised Prime and Bond one select (Dentsply), G-Premio Bond (GC), which were each divided into three subgroups based on the method used for moisture control and the control group (Transbond XT conventional total etch). The three methods for moisture control in study groups were: without drying, air-drying with the use of a three-way syringe, and with the use of blotting paper. Shear bond strength (SBS) was tested using a universal testing machine (UTM), and after debonding, the enamel surface of each tooth was examined under 10× magnification to evaluate adhesive remaining index (ARI) scores. RESULTS: Groups 2A (Prime and Bond; without drying) & 1 (Transbond XT) had the lowest and highest SBS values, respectively (P = 0.001). Comparison of ARI between the control group and group 2b (Prime and Bond; air-drying with 3 in 1) showed a significant difference (P = 0.041). Comparison of ARI between control group and group 2c (Prime and Bond; blotting paper) showed a significant difference (P = 0.017). Rest all other comparisons were non-significant. CONCLUSIONS: Transbond XT had SBS values higher than the self-etch groups. Among the self-etch groups, G-Premio Bond had higher SBS values when the traditional methods of air-drying were followed. Use of blotting paper for drying that produced variable SBS values can be an effective alternative method. G-Premio Bond with its adequate bond strength under manufacturer's instruction seems promising in this regard.

OBJECTIVE: The objective of the present study was to evaluate and compare primary and secondary implant stability of conical endosteal implants placed using osseodensification osteotomy and conventional osteotomy techniques. MATERIALS AND METHODS: The present invivo study was designed as a prospective, observational study in which a total of 26 endosteal implants were placed in the posterior edentulous regions of upper and lower jaws in 13 patients divided into two groups, Group A and Group B. In Group A, implants were placed using osseodensification osteotomy technique while in Group B, conventional osteotomy technique was used. Primary implant stability was measured in both groups immediately after implant placement while secondary implant stability was measured in both groups at an interval of 4 months. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 20.00 (SPSS Inc., Chicago, IL, USA) while an independent t-test, also, called Student's t-test was used to conduct the analysis. RESULTS: The mean value of primary implant stability in Group A was found to be 74.5 as against that in Group B which was 62.08 (P-value 0.001). Likewise, the mean value of secondary implant stability in Group A after 4 months' interval was 70.92 while in Group B, it was found to be 63.69 (P-value 0.001). CONCLUSIONS: The dental implants placed with the osseodensification technique showed higher mean primary and secondary implant stability values when compared to implants placed by the conventional technique.

OBJECTIVES: This study was aimed to compare the stability of stainless steel and titanium miniscrew implants of the same diameter and length during en masse retraction of maxillary and mandibular anterior teeth. MATERIALS AND METHODS: Forty miniscrew implants (1.3 mm diameter and 8 mm length) were placed in 10 patients (20 titanium and 20 stainless steel). Stability was checked at insertion (T0), at one month (T1), and at sixth months (T2) and the amount of retraction was recorded in millimeters. RESULTS: Titanium and stainless steel implants were equally stable at the time of insertion. At T1, three titanium miniscrew implants showed grade 2 mobility, whereas seven stainless steel miniscrew implants showed grade 2 mobility. For T2, none of the titanium miniscrew implants had grade 2 mobility while four stainless steel miniscrew implants resulted in grade 2 mobility. Both had an equal frequency of grade 3 and grade 4 mobility. However, the difference in the stability was not statistically significant. No statistical significance was found when the amount of retraction achieved by titanium and stainless steel miniscrew implants was compared between the maxillary and mandibular arches. CONCLUSION: Both titanium and stainless steel miniscrew implants provide good anchorage and remain stable during en masse retraction of maxillary and mandibular anterior teeth. Thus, both miniscrews are clinically effective.

INTRODUCTION: This study aimed to identify the intra-arch risk factors for palatally displaced canine by comparing the maxillary transverse dimensions, palatal depth (PD), and arch length (AL) of the subjects with and without impacted canine using cone-beam computed tomography (CBCT). METHODS: In this prospective case–control study, 79 CBCT images of gender- and skeletal feature-matched subjects (25 cases and 54 controls) were compared. Based on the CBCT images, maxillary transverse widths at four levels (molar basal, molar alveolar, premolar basal, and premolar alveolar), maxillary PD, and maxillary AL were measured. Group comparisons were assessed using analysis of variance (ANOVA), followed by post-hoc Scheffe's test, and risk factors were identified using univariate and multivariate logistic regression. RESULTS: The impacted canine group showed significantly smaller molar alveolar width, premolar alveolar width, PD, and greater AL compared to the control group (P = 0.046, P < 0.001, P = 0.003, and P = 0.001, respectively). No significant difference was observed in the molar and premolar basal width measurements between the two groups. Multivariate analysis showed that impacted maxillary canine was influenced by premolar alveolar width (odds ratio (OR): 0.669), PD (OR: 0.532), and AL (OR: 1.739). CONCLUSION: Intra-arch risk factors, such as reduced maxillary premolar transverse alveolar width, PD, and greater AL, are associated with palatally displaced canine.

INTRODUCTION: To evaluate, by cone-beam computed tomography (CBCT), the change in thickness and height of the alveolar bone and interdental septum in the anterior mandible after orthodontic treatment for dental crowding using tooth extraction. MATERIAL AND METHODS: The sample consisted of 48 mandibular incisors from adult patients who presented with Class I malocclusion and required orthodontic treatment with the extraction of mandibular premolars. CBCT images were taken before starting the treatment (T1) and three months after treatment (T2). The following measurements were evaluated: width and height of the alveolar bone and the interdental septum, the distance between the cementoenamel junction and the bone ridges (F-CEJ-MBC and L-CEJ-MBC), as well as the vertical positioning and inclination of the incisor, using the Lingual Plane as the reference point. The paired Student's t-test and Pearson correlation were used with a significance level of 5%. RESULTS: A significant increase was observed in the distance L-CEJ-MBC, which shows the appearance of bone dehiscence. The degree of dental crowding was not a risk factor for the development of dehiscence. The decrease in the incisor inclination and intrusion was related to the formation of dehiscence on the lingual surface. CONCLUSION: The variation in the incisor's inclination and intrusion during the treatment of dental crowding using tooth extraction are related to the formation of bone dehiscence on its lingual surface.

INTRODUCTION: Over the last years, zebrafish has gained prominence in the biomedical community. It is currently considered one of the best vertebrate animal models for various types of studies, such as toxicology and developmental biology. OBJECTIVE: The aim of this study was to conduct a literature review on the use of zebrafish in dentistry and whether this animal model could be a viable alternative for performing different types of studies in this area. METHODS: A literature search was performed using the PubMed, Lilacs, Embase, and Dentistry and Oral Sciences Source. The keywords used as search terms were zebrafish and dentistry. The selection criteria were articles published in English that used zebrafish as an animal model in dentistry, oral health, and craniofacial growth/development. RESULTS: The electronic search of literature yielded 421 articles. After the analysis of the abstracts, 29 articles were selected for an in-depth analysis and reading of the full text. CONCLUSIONS: All studies included in this review confirm zebrafish's excellence as an animal model for various types of dentistry studies, as well as assisting and complementing other studies involving mammals.

BACKGROUND AND OBJECTIVES: Fixed space maintainers are often used following primary tooth loss. In this process, selection of a proper band size for stainless steel crowns (SSCs) is often performed by trial and error, which increases the chairside time and risk of contamination of the tried bands with saliva, blood, and gingival crevicular fluid, necessitating their subsequent sterilization. This study is aimed at determining the proper size of prefabricated bands for all SSCs of primary second molars. MATERIALS AND METHODS: In this cross-sectional study, seven examiners, including three orthodontists and four pediatric dentists attempted to select the proper band size for 24 primary second molar SSCs (3M). They selected the proper band size for each size of SSC six times in three sessions. The significance of all selected choices was carried out using the test of proportions. RESULTS: The most commonly selected bands for EU2, EU3, EU4, EU5, EU6, and EU7 SSCs were sizes 31+, 32+, 34, 35+, 37, and 38, respectively, and the proper bands for EL2, EL3, EL4, EL5, EL6, and EL7 SSCs were sizes 30, 31+, 32+, 33+, 35 and 36+, respectively. The difference in the frequency ratio of different choices for all sizes of SSCs was significant (P < 0.05). CONCLUSION: The current study determined the proper band size for all SSCs of primary maxillary and mandibular second molars. This information can help dental clinicians in selecting the proper band size for SSCs without trial and error.

OBJECTIVES: to evaluate the effectiveness of piezocision in enhancing retention when performed after orthodontic tooth movement. METHODS: Four mature goats had their second incisors removed bilaterally. For each goat, the two sides of the mandible were either treated with piezocision or served as a positive control. Using fixed orthodontic appliance, the first and third incisors on each side were approximated and then retained in place for two weeks. Relapse was measured by the amount of space developed between the approximated incisors after six weeks from the end of the retention period. The periodontal ligament of all incisors was assessed histologically with micro computed tomography and regular hematoxylin and eosin staining. RESULTS: A significantly less relapse was observed in the piezocision group than in the control group (p ≤ 0.05). Bone formation occurs in the vicinity and periphery of the periodontal ligament and thus results in the narrowing of the periodontal ligament. CONCLUSION: A protocol of post-orthodontic retention involving piezocision can be promising to enhance stability of orthodontic treatment outcome.

INTRODUCTION: The demand by dental practitioners for adhesives led to the innovation of newer self-etched universal adhesive systems. The objectives were to evaluate the shear bond strength (SBS) of metal brackets bonded with Optibond eXTRa Universal self-etch adhesive and Transbond XT primer and also to assess the adhesive remnant index (ARI). MATERIALS AND METHODS: A total of 100 extracted human premolar tooth samples were divided into 2 groups (n = 50) according to the adhesive system employed: Transbond XT (3M Unitek) and Optibond eXTRa Universal (KaVo Kerr). In group A, Transbond XT primer was applied, and in group B, Optibond eXTRa was applied, and metal brackets (American Orthodontics) were bonded with the Transbond XT adhesive, followed by photopolymerization with LEDition. The samples were preserved in artificial saliva for 30 days. SBS was tested using a universal testing machine (DAK Series7200, India). The ARI was assessed at 10× magnification under a stereomicroscope (Meiji Techno, Japan). The SBS scores were subjected to independent sample t-test and ARI scores to Pearson's Chi-square test. RESULTS: The mean SBS and standard deviation of Transbond XT is 12.11 ± 2.6 MPa and that of Optibond eXTRa Universal is 11.36 ± 2.8 MPa, revealing a statistically nonsignificant difference. Transbond XT displayed higher ARI scores and was statistically significant (P = 0.001). CONCLUSION: The Optibond eXTRa Universal adhesive appears to be preferable for orthodontic bonding as it exhibited clinically acceptable SBS and performed better in terms of the ARI.

OBJECTIVES: Fixed functional appliances (FFA) have been used for correction class II malocclusion but cause proclination of teeth. Recently, few studies have advocated the use of skeletal anchorage along with FFAs to prevent this side effect. The purpose of the study was to evaluate the stress distribution and displacements produced by miniplate anchored Forsus-fatigue resistant device on the maxilla, mandible, and the dentition in a Class II malocclusion patient by finite element analysis. MATERIALS AND METHODS: Cone beam computed tomography of a class II division 1 patient indicated for FFA was used to construct a 3D finite element model using MIMICS 8.11 and Hypermesh 13.0 software. Various material properties, boundary, and loading conditions were then applied. The model was analyzed for principal stress and von Mises stress in maxilla, mandible, and their dentition using ANSYS 12.1 software. RESULTS: In the mandible, maximum principal and von Mises stresses were seen in the cortical bone area in the symphyseal region, whereas mandibular teeth showed comparatively lesser stresses. In the maxilla, higher principal and von Mises stresses were seen in the maxillary molar region compared to the maxillary cortical bone. The entire mandible was displaced antero-inferiorly, whereas the maxilla showed a postero-superior displacement. CONCLUSION: Using skeletally anchored FFA results in more stresses and displacements in the skeletal structures compared to the dentition.

OBJECTIVE: Cranial base parameters exhibit wide variations. This study evaluated cranial base morphological characteristics of class II and class I malocclusions to identify risk factors for class II skeletal malocclusions. METHODS: In this cross-sectional study, we recruited 30 class I adults and 30 class II adults and collected their lateral cephalograms. The cranial base length was calculated by measuring the base of the skull by determining the length of sella-to-nasion, basion to pterygomaxillary fissure, and pterygomaxillary fissure to point A. The cranial base angle was measured by the angle formed by the basion, sella, and nasion, and the base of the angle, which connects the basion and nasion, was measured. RESULTS: The independent t-test for combined values showed no significant differences in one angular and five linear measures between groups. However, one angular measurement was positively correlated when men and women in class I and class II groups were analyzed separately. CONCLUSION: Male patients with class II patterns exhibited larger cranial base angles than did those with class I patterns. Our study suggested that cranial base features have a minimal role in the development of class II malocclusions.

OBJECTIVE: This study aimed to evaluate the factors that influence lip change through the results of tooth anterior retraction by fixed orthodontic treatment in Vietnamese adult patients with a convex facial profile. MATERIALS AND METHODS: This prospective study included 32 Vietnamese adults who have convex facial profiles. Digital software measurements according to Arnett's analysis and the superimposition method were performed to evaluate the changes in dentoskeletal structures, and soft tissue variables included lip change. A multiple logistic regression model was applied with various explanatory variables to analyze the correlation. RESULTS: The study revealed a strong correlation of lip change at the site of the cervical point and incisal edge of the upper incisors, and the cervical position demonstrated a stronger correlation. The ratio between lip change and incisor retraction in patients is approximately 1:2.3 at the incisal edge and 1:1.3 at the cervical point. CONCLUSION: Lip change was associated with incisor retraction at the cervical and incisal edge, but it did not correlate with the rotation axis of the upper incisors.

AIMS: To evaluate the proportion and completeness of reporting apriori sample size estimation (SSE) in research articles published in the Journal of Orthodontic Science (JOS) and the Journal of Indian Orthodontic Society (JIOS). MATERIALS AND METHODS: All online research articles published in both journals from 2012 to 2020 were screened. Those reporting apriori SSE were analyzed for the study design and completeness of SSE reporting (outcome parameter and assumptions, Type I error, Power/type II error, one or two-tailed test, the method used, justifications for assumptions, adjustments in sample size, and the target sample size). Chi-square or Fisher exact test was used to analyze the differences between the journals in the proportions of articles reporting these characteristics. RESULTS: Twenty articles (13.2%) in JOS and 24 (8.3%) in JIOS, have reported apriori SSE [χ² (1, N = 440) = 2.573, P=0.10]. Non-clinical and quasi-experimental studies formed nearly two-thirds of articles reporting SSE in JOS. Quasi-experimental (34%), randomized controlled trials (28%), and cross-sectional studies (24%) formed the bulk of articles reporting SSE in JIOS. Type II error/power was the most frequently reported characteristic in both (75% and 95.8% in JOS and JIOS, respectively), and the number of tails was the least (5% and 0%, respectively). More articles in JOS than JIOS reported the outcome variable used [65% vs. 12.5%, χ² (1, N = 44) = 12.99, P<.001] and provided justifications for the assumptions [70% vs 33.3%, χ² (1, N = 44) = 5.86, P = 0.01]. CONCLUSION: The extent and completeness of reporting apriori SSE are suboptimal in these journals and require prompt and stringent curative measures.

INTRODUCTION: The accurate diagnosis of vertical skeletal abnormalities presents several challenges. Specific cephalometric parameters can be effectively used for this purpose; however, their diagnostic utility has not been fully ascertained. This study examined the effectiveness of two novel cephalometric parameters in diagnosing vertical dysplasia. METHODS: Orthodontic patients were divided into three study groups: average growth group (AGG), horizontal growth group (HGG), and vertical growth group (VGG). The efficacies of the sum of the angles (maxillary, mandibular, and ramal) and the height ratio (lower anterior facial height [LAFH]/upper anterior facial height [UAFH]) in identifying the different growth patterns were examined. Receiver operating characteristic curves were used to quantitatively assess diagnostic precision. RESULTS: A total of 150 patients were included and divided equally among the 3 study groups. The ramal and mandibular angles varied across AGG, HGG, and VGG; however, the maxillary angle and the sum of these three angles did not vary significantly. There was a significant difference in LAFH, UAFH, and their ratios among the three groups. The height ratio had a sensitivity of 88% and 92% for the diagnosis of VGG and HGG, respectively, with cutoff values of 46 and 34, respectively (P < 0.001). CONCLUSIONS: The height ratio values varied considerably according to facial growth patterns, suggesting its utility as a diagnostic tool for skeletal dysplasia with greater reliability for positive treatment outcomes.

OBJECTIVES: To assess the adaptability and validity of the Arabic version of the Malocclusion Impact Questionnaire (MIQ-AR) in patients seeking orthodontic treatment. MATERIALS AND METHODS: This cross-sectional survey was conducted on a convenience sample of 77 Arabic speaking, healthy, 10–16-year-old children, selected based on their personal perception of “needing braces.”. The participants completed the MIQ-AR and the Child Perceptions Questionnaire for children aged 11–14 (CPQ11-14), answered two global questions, and had their Index of Orthodontic Treatment Need, Dental Health Component (IOTN.DHC) scores recorded. Construct validity was examined by measuring the correlation between the MIQ-AR score and the responses to the two global questions. Criterion validity was examined by measuring the correlation between the MIQ-AR and both the IOTN.DHC and CPQ11-14 scores. RESULTS: Moderate positive correlations were observed between the MIQ-AR scores and the first (ρ = 0.320, P < 0.001) and second global questions (ρ = 0.388, P < 0.001). A strong positive correlation was found between the total CPQ11-14 and MIQ-AR scores (ρ = 0.597, P < 0.001). A positive gradient was observed between the MIQ-AR scores and IOTN.DHC scores. CONCLUSION: Our results indicate that the MIQ-AR is a valid tool for measuring oral health-related quality of life in patients with malocclusion, with good psychometric parameters. These preliminary findings require further testing in various settings involving a larger and more diverse sample.

Context: Besides environmental factors, genetic factors play an important role in the etiology of malocclusion. Polymorphisms of the Myosin 1H gene in orofacial muscle fibers are thought to influence the growth and development of the mandible. Growth hormone receptors are present on the growth of cartilage, especially the condyle of the mandible. The polymorphisms of the growth hormone receptor have an effect on the growth and development of the mandible. The potential of the Myosin 1H and P561T genes as bioindicators in aiding diagnosis of malocclusion is quite good based on the available literature. However, until now there has been no research that has observed genetic analysis on polymorphism-based malocclusion of the Myosin 1H and P561T genes in the Indonesian population. Aims: To determine the relationship between polymorphisms of Myosin 1H and P561T genes, towards the growth and development of the mandible in malocclusion cases. Settings and Design: Subjects were patients aged 17--45 years old with skeletal malocclusions who were undergoing or were about to undergo orthodontic treatment at RSGM-FKG UI (Universitas Indonesia's Dental Hospital), with 50 people in each group. Methods and Material: Malocclusions were determined based on radiographic analysis of the initial cephalometry using the Stainer method. DNA samples were extracted from buccal swabs and blood cells in Class I and II malocclusion while nail clippings and hair follicles extracts were used in Class III malocclusion. DNA sequence amplification was carried out using Polymerase Chain Reaction, while Genetic Polymorphism Analysis of Myosin 1H and P561T genes was performed with Restriction Fragment Length Polymorphism. Statistical Analysis Used: Pearson Chi-Square was used to analyze the Myosin 1H gene, while the Fisher Exact Test was used to analyze the P561T gene. Results: A relationship between Myosin 1H gene polymorphism and Class I, II, and III skeletal malocclusion was found. There was no correlation between P561T gene polymorphism and Class I, II, and III skeletal malocclusion. Conclusions: Myosin 1H gene polymorphism is one of the risk factors for Class I, II, and III malocclusion. Extraction of DNA from hair follicles gave good results in terms of DNA quality and was a relatively easier sampling method compared to blood cell purification and buccal swabs.

Objectives: Minimizing the frictional force between orthodontic wire and brackets is imperative to safely obtain a more favorable result by applying lower loads. Several methods have been proposed for this purpose such as changing the wire shape/size, changing the bracket design, and coating wires with different materials. This study aimed to assess the effect of zirconium oxide (ZrO2) nano-coating on frictional resistance of three types of orthodontic wires. Materials and Methods: This in vitro, experimental study evaluated 42 pieces of nickel-titanium (NiTi), stainless steel (SS), and beta-titanium (TMA) orthodontic wires, and 42 maxillary canine brackets. The samples were divided into six groups with and without ZrO2 nano-coating. The nano-coating was applied on the wires using the sol-gel technique. The presence of ZrO2 nano-coating was evaluated by scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX). The surface roughness of the samples was evaluated using atomic force microscopy (AFM). The brackets and wire had a 5° angle relative to each other. The static and kinetic friction of the samples were evaluated in the presence of artificial saliva and occlusogingival movements in a universal testing machine. Data were analyzed by the Shapiro–Wilk's test, one-way ANOVA, Kruskal–Walli's test, Mann–Whitney U test, independent t-test, and Tukey's test. Results: ZrO2 nano-coating was only observed on TMA wires. The surface roughness of coated NiTi and SS wires had no significant difference from that of non-coated wires (P > 0.05). However, this difference was significant for TMA wires with and without the coating (P < 0.05). The static and kinetic friction were not significantly different between wires with and without coating (P > 0.05). Conclusions: ZrO2 nano-coating could only be applied on TMA wires, and had no significant efficacy for reduction of static or kinetic friction of TMA wires.

Aim: To assess the chemical composition and oral biofilm formation on different types of commercially available clear orthodontic retainer materials (CORM). Materials and Methods: Four types of CORM commercially available were used (Clear advantage series I (CAS1), Clear advantage series II (CAS2), Endure (ES), and CENTRI FORM-clear rigid material (CFCRM)). Circular samples (12 mm diameter) of each CORM were prepared for (n = 40). Unstimulated saliva from twenty volunteers was collected. Fourier Transformation Infrared Spectroscopy (FTIR) was used for the evaluation of the chemical composition of CORM. For the quantitative assessment of oral biofilm formation, samples of each CORM were incubated for twenty-four hours, and crystal violet assay (CVA) was utilized. The degree of absorbance was measured using a spectrophotometer at 570 nm. For qualitative evaluation of oral formation, the samples of each CORM were incubated for 24 hours, and viable biofilm cells stained by acridine orange were examined under a fluorescent microscope. Results: FTIR findings showed that CAS2 was made of polypropylene and ES is made of polyvinyl chloride, while others were made of co-polyester. CVA results confirmed that CAS2 showed the lowest biofilm formation, which differs significantly compared to CAS1, CFCRM, and ES. No significant difference in biofilm formation was detected between CAS1, CFCRM, and ES. Viable biofilm cells staining by acridine orange showed that CAS2 demonstrated smaller microcolonies of viable biofilm cells compared with CAS1, CFCRM, and ES, which confirmed the result obtained by CVA. Conclusions: CAS2 showed anti-microbial activities with a decrease the in vitro biofilm formation, which may be related to its chemical composition.

OBJACTIVE: The authors introduced a novel wire system aiming to achieve optimal goals of tooth movement without multiple wire changes or sophisticated wire bending. MATERIALS AND METHODS: The system was composed of a single wire for all phases of treatment. The archwire was composed of NiTi coil springs connecting delta-shaped segments of 0.018˝ × 0.025˝ Titanium Molybdenum Alloy (TMA) segments to fit the 0.018˝ × 0.025˝ bracket slot, or 0.022˝ × 0.028˝ TMA segments to fit the 0.022˝ × 0.028˝ bracket slot. The coil spring was closed and packed in design. The coil-spring loops were constructed with 3 mm lumen. The wires were designed in three sagittal forms and the system provided nine forms of archwires. RESULTS: The wire systems have been an important component of treatment since the development of orthodontic science. Over time, the philosophy has evolved from endorsing wire bending to straight-wire treatment and then to custom-made archwires. CONCLUSION: This wire system was designed to be used as a “single-wire for the case” across all stages of treatment to achieve the ideal goals without any biological damage.

OBJECTIVES: This study evaluated differences in concentration of dentin sialoprotein (DSP) in gingival crevicular fluid (GCF) relating to orthodontically induced inflammatory root resorption (OIIRR) at the initial stage of orthodontic treatment using self-ligating and conventional preadjusted brackets. MATERIALS AND METHODS: Eighteen patients were assigned to three groups of equal size. Two experimental groups received non-extraction orthodontic treatment using passive self-ligating or conventional preadjusted bracket. The control group included patients without orthodontic treatment. GCF was collected from five proximal sites of maxillary anterior teeth at subsequent intervals: immediately prior to orthodontic treatment (T0), and at three and 12 weeks after initiation of treatment (T1 and T2). DSP concentration was evaluated by enzyme-linked immunoabsorbent assay and the differences in DSP levels were analyzed between and within groups. RESULTS: There were no significant differences in DSP levels within both experimental groups and the control group during T0-T1-T2 (P ≥ 0.05). A significant difference of DSP concentration was found between the conventional preadjusted bracket and the control group at T2 (P = 0.038). However, it was thought to be clinically insignificant. CONCLUSION: The study showed no significant difference in DSP concentration at the initial stage of orthodontic treatment with either self-ligating or conventional preadjusted bracket.

BACKGROUND: Pharmacological means of anchorage control can improve patient compliance. Bisphosphonates could be helpful in orthodontic anchorage control if their actions could be localized to limit (or control) unwanted tooth movement while not interfering with the desired tooth movement. OBJECTIVE: This systematic review aimed to examine and evaluate the quality of all animal studies that reported the effect of locally administered bisphosphonate on limiting orthodontic tooth movement. DATA SOURCES: An electronic search was conducted in the PubMed-Medline, Scopus, Google Scholar, and Cochrane databases till May 2022, using the keywords anchorage, anchorage loss, molar movement, posterior tooth movement, incisor movement, incisor retraction, anterior retraction, unwanted tooth movement, tooth displacement, tooth movement forward, bisphosphonate, local bisphosphonate administration, bisphosphonate injection, and bbisphosphonate vestibular induction. Only studies involving localized bisphosphonate administration for anchorage purposes were taken into account. DATA SELECTION: Animal studies that simulated orthodontic tooth movement after localized injection of bisphosphonate and evaluated the rate of tooth movement were included in the review. DATA EXTRACTION AND ANALYSIS: The quality of the studies was assessed by using ARRIVE guidelines (Animal Research: Reporting of In Vivo Experiments). Bias in the studies was analyzed by SYRCLE's tool (Systematic Review Centre for Laboratory Animal Experimentation) for risk of bias. RESULTS: The search strategy yielded 925 titles. After screening, 908 articles were discarded because they did not fulfill the inclusion/exclusion criteria based on the title and abstract. The remaining 16 articles were read entirely, of which nine were excluded as they involved systemic administration of bisphosphonates. Finally, after careful consideration, seven papers that met our inclusion criteria were included in the qualitative analysis. The majority of studies were assessed to have an uncertain risk of bias, with just one deemed low risk of bias. CONCLUSION: This systematic review found that bisphosphonates limit orthodontic tooth movement around the application site without affecting adjacent sites. More potent bisphosphonates in smaller doses or less potent bisphosphonates in higher frequencies have been proposed to improve outcomes. However, the data quality is insufficient to recommend a protocol for bisphosphonate administration for anchoring control. Long-term studies evaluating various types, frequencies, and dosages of bisphosphonates are required to clarify the effects on orthodontic tooth movement. REGISTRATION NUMBER FOR PROSPERO: CRD42021224033

This article presents a novel idea for managing patients with anterior disc displacement without reduction that often develops in susceptible patients during routine orthodontic treatment. The patient was a 24-year-old male who presented with class I right molar and canine relationship and class III left molar and canine relationship on a class I skeletal base, complaining of bimaxillary crowding. The case was treated with fixed orthodontic appliance with maxillary expansion and unilateral mandibular extraction to eliminate the mandibular crowding. Due to a life crisis, the patient developed anterior disc displacement on the right joint. A maxillary occlusal splint was fabricated to reduce the symptoms and attempt to recapture the disc; however, this attempt failed. An attempt was then made to recapture the disc using occlusal pivots and elastics. The disc was eventually recaptured, and the patient resumed normal jaw function and mouth opening. This case report aims to demonstrate a new way to achieve stable occlusion in a patient who sustained disc displacement.

Early treatment of Class III malocclusion provides an improvement in facial appearance and corrects the reverse bite. Orthopedic protraction of maxilla is considered best approach in growing Class III patients with maxillary deficiency. Present case report describes the management of a growing 10-year-old boy with skeletal Class III malocclusion using facemask therapy (Phase 1) followed by fixed orthodontic treatment (Phase 2) based upon cephalometric prognostic findings of growth treatment response vector (GTRV). With the successful orthopedic phase of maxillary protraction with facemask therapy for 7 months of period, a significant improvement in profile had been achieved along with the correction in reverse overjet. This was followed by retention with chin cup therapy for a period of 20 months. After a period of 20 months retention, a fixed orthodontic treatment was started with the objective to achieve stable functional occlusion. After 11 months of treatment with fixed appliance therapy a stable functional occlusion was achieved. The patient was placed on Hawleys retainer in maxillary arch and bonded fixed spiral wire (FSW) retainer in mandibular arch. Successful management of growing Class III patient was done using facemask and fixed orthodontic therapy based upon cephalometric prognostic findings of growth treatment response vector (GTRV).

OBJECTIVE: To evaluate the effects of silver nano particles (AgNPs) added on Nano-Bond adhesive system (NBA) and its effect on shear bond strength (SBS) of orthodontic brackets attached to enamel at different thermal cycles and cyclic loading. MATERIALS AND METHODS: Forty extracted premolar teeth for orthodontic reasons were divided randomly into two main groups (20 teeth in each group). Group A: the brackets were bonded by NBA without additives. Group B: the brackets were bonded by NBA containing AgNPs with concentration 0.05%. Every group was further subdivided into 4 subgroups according to teeth subjected or not subjected to thermocycling and cyclic loading. SBS was tested using Lloyd universal testing machine. One-way analysis of variance (ANOVA) was used for testing the significance between the means of tested groups. RESULTS: Shear bond strength of Nano-Bond adhesive system with AgNPs showed significantly highest mean SBS (20.25 MPa) than Nano-Bond adhesive system without additives (15.64 MPa, P = 0.001). The SBS increased in Group B with AgNPs compared to Group A in all the conditions tested. Group A1 and B1 with zero thermal cycling and cyclic loading exhibited highest mean SBS. CONCLUSIONS: These results indicate addition of AgNPs significantly increased the shear bond strength of Nano-Bond adhesive system.

Introduction: Orthodontic appliances complicate daily oral hygiene maintenance and enhance the formation of microbial biofilm on tooth surfaces and orthodontic appliances. Objective: This trial was conducted to assess the effect of reminders on oral hygiene of patients during removable orthodontic treatment. Methods: In this 2-arm parallel randomized controlled trial, 66 orthodontic patients with removable maxillary appliance were randomly allocated with 1:1 ratio to message reminders and the control group. The patients in the messaging group received one or two message reminders and educational videos weekly during the course of treatment. A single blinded examiner measured the plaque index (PI), gingival index (GI), and dental caries index of patients in both groups at baseline (T0) and one (T1), three (T2), and six (T3) months after the first day of treatment to assess their oral hygiene status during treatment. Results: A total of 30 patients in control group and 28 in reminder group completed the study. The PI and GI scores were increased neither in control group nor in message reminder group during T0 and T1, significantly. The PI and GI scores in message reminder group were significantly lower than those in the control group at T2 (PI: P = 0.001, GI: P = 0.003) and T3 (PI: P = 0.024, GI: P = 0.022). Slight significant increasing in the PI and GI score were found during T2 and T3 in message reminder group. Caries index showed no significant difference between two groups during study. Conclusion: It seems that reminders can efficiently promote oral hygiene of patients undergoing removable orthodontic treatment.

AIM: The study was conducted to assess the changes in bone density before and after performing accelerated orthodontic maxillary canine retraction by microosteoperforations (MOPs). MATERIALS AND METHODS: Forty patients (120 cone-beam computed tomography [CBCT] images) within the age group of 15 to 25 years undergoing fixed orthodontic treatment with bilateral maxillary first premolar extraction were enrolled in this study. The right and left sides of the maxillary jaw in the same patients were selected as experimental and control sites. To accelerate the tooth movement, MOPs were performed distal to the canine root in the extraction space under local anesthesia with a miniscrew. Thereafter, the maxillary canine retraction was initiated using a NiTi closed coil spring. The CBCT images were taken and evaluated at the following time intervals: 1 week before MOPs(T0);1 week after MOPs(T1);3 weeks after MOPs(T2). RESULTS: A statistically significant reduction in bone density was observed at the center of resistance of canine on the experimental site (after MOPs) at 1 week and 3 weeks (T0-T1 = 0.000,0.115; T1-T2 = 0.0025,0.0117), whereas a statistically non-significant difference was found 1 week before and 3 weeks later in the control group. CONCLUSION: Accelerated orthodontics by MOPscan result in a substantial reduction in bone density during canine retraction, leading to an increase in the tooth movement rate, hence lowering the overall orthodontic treatment time.

OBJECTIVES: The decision to pursue orthodontic treatment is influenced by a variety of cosmetic, functional, and social reasons. This study compared the factors that influence adults' decisions before orthodontic treatment versus parents' decisions prior to their children's orthodontic treatment in Jeddah city, Saudi Arabia. MATERIALS AND METHODS: A cross-sectional survey was distributed to the patients of orthodontic clinics of King Abdulaziz University in addition to a private orthodontic clinic in Jeddah city, Saudi Arabia. The survey consisted of two versions of a questionnaire: one for adults and one for children's parents. The survey inquired about the participants' demographics, factors that led to the necessity of treatment, and considerations before opting for orthodontic treatment. The factors influencing the decision-making process of adults were compared to that of parents using the Chi-square test. RESULTS: A total of 417 subjects participated, 331 adults and 86 parents. The majority of the respondents in both groups were females. When compared to children, adults were more aware of the necessity for orthodontic treatment (78.5% of adults vs. 41.9% of children). The primary motivation for adults and parents to begin orthodontic treatment was to improve their esthetic appearance (58.6% and 87.2%), whereas functional concerns were less frequently reported (12.1% and 15.1%). Adults relied on less trustworthy sources of information about orthodontic treatment options, whereas parents relied on more dependable sources. CONCLUSIONS: The main reason for opting for orthodontic treatment in Jeddah city, Saudi Arabia was esthetic for both adults and children.

OBJECTIVE: The purpose of this study was to investigate the size and shape variations of hard tissue patterns in different skeletal relations in Malaysian Malay subjects using the two-dimensional geometric morphometrics method. MATERIALS AND METHODS: A total of 188 lateral cephalograms of adult Malay subjects (aged between 18 and 40 years) with Class I, II, and III skeletal relations were collected. Ten two-dimensional hard tissue landmarks were applied on lateral cephalograms which underwent landmark application and shape analyses as Procrustes ANOVA analysis, principal component analysis, canonical variate analysis, and discriminant function analysis. Statistical analyses were performed to find the mean and variance of each landmark using one-way ANOVA. The raw data from shape analysis were used to calculate the link between landmarks. RESULTS: Skeletal relations showed 16 Principal Components which indicated that variances existed in 16 different dimensions. In Procrustes ANOVA, the Centroid size was significantly different in genders and skeletal relations (P < 0.01). Canonical variate analysis showed the highest Mahalanobis distances and Procrustes distances between Class II and III among skeletal relations and between gender groups (P < 0.0001). Discriminant function analysis showed the classification was mostly accurate, especially for Class II and Class III with success rates of 90.6% and 83.3%, respectively, after cross-validation. The statistical analysis showed significant differences (P < 0.05) in hard tissue landmarks. CONCLUSION: There were different ANB angles in different skeletal relations. The GMM could be used as an alternative tool for diagnosis and treatment planning for craniofacial shape evaluations for future orthodontists and maxillofacial surgeons.

OBJECTIVE: To investigate the effect of antioxidants on shear bond strength of brackets bonded to bleached enamel with and without titanium dioxide nanoparticles (Lase Peroxide Lite). MATERIALS AND METHODS: One hundred and five human maxillary premolars were randomly divided into seven groups (n = 15). Group I served as control, in group II-A bleaching was performed with Opalescent Boost. In group II-B and C, bleaching was performed with Opalescent Boost followed by application of 5% grape seed and 10% green tea extracts, respectively. Group III-A bleaching was performed with Lase Peroxide Lite. Group III-B and III-C bleaching was performed with Lase Peroxide Lite followed by application of 5% grape seed and 10% green tea extracts, respectively. Brackets were bonded with composite resin and cured with light emitting diode (LED) light. Shear bond strength of brackets was tested with a Universal testing machine. RESULTS: There was statistically significant difference in the shear bond strength among the seven groups included in the study. There is a statistically significant decrease in shear bond strength in group II-A (8.2 ± 1.6 Mpa), group III-A (8.6 ± 2.1 Mpa) when compared with group I-A (15.9 ± 1.4 Mpa). Among all experimental groups, group II-A showed the lowest mean shear bond-strength values (8.2 ± 1.6 Mpa) (P < 0.005). Group III-C (14.9 ± 2.2 Mpa) has significantly higher shear bond strength. CONCLUSION: Bleaching reduced the shear bond strength of brackets below acceptable level while application of grape seed and green tea extracts has recovered the shear bond strength.

OBJECTIVE: The study was conducted to evaluate the relationship of various cephalometric skeletal patterns in the vertical and anteroposterior planes with intercanine width in untreated orthodontic patients. METHOD AND MATERIAL: This study included dental cast and cephalometric radiographs of 100 patients (69 females and 31 males) of the age range 13 to 33 years. Skeletal parameters including SNA, SNB, SNMP angles were found from lateral cephalometric radiographs. Intercanine widths including upper intercanine widths (UICW) and lower intercanine widths (LICW) were measured by a digital caliper. RESULTS: The correlation of intercanine width with SNA, SNB, and SNMP angles was analyzed by applying Pearson correlation coefficient. According to statistical analysis, the only insignificant correlation was analyzed between UICW with SNB and LICW with SN-MP. CONCLUSIONS: The overall result showed statistically significant relationship of various cephalometric skeletal patterns in the sagittal and vertical planes with intercanine width.

INTRODUCTION: A person's ability to recognize a beautiful face is innate, but translating this into defined treatment goals is a challenge for clinicians. AIM: To determine if faces considered esthetic and pleasing in the young North Indian population (both males and females) exhibit similar cephalometric measurements as used for ideal treatment and successful results. MATERIALS AND METHOD: A panel of five judges evaluated a set of one frontal, one frontal during smiling, and one profile extra-oral photograph of 160 students (80 females and 80 males) on a five-point attractiveness scale. For each photographic set, the mean and final scores were calculated. Once the sample was assessed, 60 subjects (30 females and 30 males) with the highest final facial aesthetic score were selected and cephalometric analysis was performed. The obtained data were subjected to statistical analysis using SPSS 20 software. RESULTS: Both males and females with class I skeletal jaw bases were found to be attractive. The females with short faces; mild facial convexity and lower lip closer to the esthetic line were found to be attractive. The males with a prominent chin, straight profile, prominent nose, increased upper lip thickness, upper lip length, and lower lip length were found to be attractive. CONCLUSION: The faces considered attractive in this study fulfilled most of the cephalometric norms commonly used for the diagnosis and treatment planning except for a few inconsistencies which may be attributed to the gender and demographic origin.

Ingestion is the entry of a substance into the human organism, which occurs by taking it through the mouth into the gastrointestinal tract. One of the adverse events that may happen during the course of an orthodontic treatment is the ingestion of orthodontic appliances. The present review aims to investigate the literature regarding the ingestion of orthodontic appliances. An electronic search was carried out in order to identify case reports of ingestion of foreign objects related to orthodontic treatment in PubMed, Scopus, and Web of Science until July 2019.Nineteen articles were retrieved. In these articles, ingestion had occurred inadvertently, due to patients' or orthodontists' errors. Some of the most commonly ingested appliances were molar bands, segments of wire, and expansion keys. It is likely that patients with a specific medical background are more prone to ingestion of orthodontic appliances. Special precautions need be taken in order to avoid such incidents. These precautions are analyzed in three categories: general, those related to fixed appliances, and those related to removable appliances.

OBJECTIVE: To compare the effects of comprehensive orthodontic treatment on palatal area, volume, inter-canine and inter-molar width in patients with Unilateral Cleft Lip and Palate (UCLP) using scanned models of the maxillary arch. DESIGN: Retrospective cohort study. SETTING: Tertiary setting. PATIENTS: Two hundred and ten plaster study models of 70 patients with Unilateral Cleft Lip and Palate (Study group SG) and Control Group (n = 70) were scanned using Maestro 3D Dental scanner. The study groupwas further divided into subgroups; Subgroup I: treated with orthodontic treatment only (non-surgical), Subgroup II: patientsmanaged with combined orthodontics and orthognathic surgery (either maxillary advancement or maxillary distraction), Subgroup A: age >14 years and Subgroup B: age <14 years. INTERVENTIONS: Comprehensive orthodontic and Orthosurgical treatment MAIN OUTCOME MEASURES: Pre- and post-treatment scanned maxillary models of the study group were compared for palatal area and volumeand intercanine and intermolar width. The palatal dimensions of post-treatment scanned models were also compared to that of the control group. RESULTS: The Palatal area and volume, intercanine and intermolar width were significantly higher in the post-treatment as compared to pre-treatment study models (P < 0.01). The measurements ofthe maxillary arch were significantly higher in the control group compared to the post-treatment measurements of the study group. The increase in palatal area and volume was greater in Subgroup I and A compared to Subgroup II and B patients, respectively. CONCLUSION: The 3-Dimensional palatal dimensions in UCLP group improved after orthodontic treatment but were still not comparable to the normal subjects. The patients with age >14 years showed more improvement in the maxillary arch.

AIMS: The primary purpose of the present trial was to evaluate the effect of low-frequency (30Hz) vibrations on the rate of canine retraction. SETTING AND DESIGN: Single-center, split mouth prospective randomized controlled clinical trial METHODS AND MATERIAL: 100 screened subjects (aged18–25 years) were selected; out of which 30 subjects having Class I bimaxillary protrusion or Class II div 1 malocclusion, requiring upper 1^st premolar therapeutic extractions, were selected for the study. A split-mouth study design was prepared for the maxillary arch of each selected individual and was randomly allocated into vibration and nonvibration side (control) groups. A customized vibratory device was fabricated for each subject to deliver low-frequency vibrations (30 Hz). Scanned 3D models were prepared sequentially to assess the amount of tooth movement from baseline (T0),(T1), (T2), (T3), and (T4)-4^th month of canine retraction. STATISTICAL ANALYSIS USED: Independent “t” test. RESULTS: There was no statistically significant differencein the rate of individual canine retraction among the experimental and control groups when the intergroup comparison was done using independent “t” test at T1-T0, (P = 0.954), T2-T1 (P = 0.244), T3-T2 (P = 0.357), and T4-T3 (P = 0.189). CONCLUSION: The low-frequency vibratory stimulation of 30 Hz using a customized vibratory device did not significantly accelerate the rate of orthodontic tooth movement. TRIAL REGISTRATION: Registered at ctri.nic.in (CTRI/2019/05/019043).

OBJECTIVE: To determine the relationship between the dimensions of the maxillary arch and vertical facial morphology within the Proto-Malay race. DESIGN: A cross-sectional study. SETTING: Orthodontics Department, Faculty of Dentistry, Universitas Sumatera Utara, Medan, Indonesia. PARTICIPANTS: Proto-Malay individuals aged ≥18 years without orthodontic treatment history (n = 104). METHODS: Lateral cephalometric radiographs and maxillary study model were obtained from 104 subjects who had never received orthodontic treatment (45 males and 59 females), aged 18 years, belonging to the Proto-Malay race, with skeletal class I malocclusion, normal overjet and overbite, and complete dentition (except the third molar). The vertical facial morphology was obtained by measuring the Jarabak's ratio on lateral cephalometric radiographs by using CorelDRAW. The study model was used to measure the dimensions of the maxillary arch, which are intercanine width, intermolar width, arch length, and palatal height, by using the Korkhaus modification device. RESULTS: The results showed a significant positive correlation between intercanine and intermolar width and a negative correlation between arch length and palate height with vertical facial morphology in the male and female groups within the Proto-Malay race. CONCLUSION: There is a relationship between the maxillary arch dimension with vertical facial morphology in the male and female groups in the Proto-Malay race.

OBJECTIVE: To assess the enamel surface damage and residual adhesive remnant [adhesive remnant index (ARI)] on extracted premolars after debonding the ceramic brackets using three different debonding techniques, with optical coherence tomography (OCT). METHODS: Ninety extracted premolars were bonded with ceramic brackets and divided into three groups of 30 teeth each based on debonding techniques used. Twenty-four hours later, they were debonded using three different debonding techniques: debonding pliers, ultrasonic scalers, and Er-YAG laser. A baseline scan was obtained prior to bonding using OCT. The teeth were evaluated for the adhesive remnant on the tooth surface using ARI score, and the amount of enamel surface damage was evaluated using OCT. RESULTS: We observed that the use of ultrasonic scalers as a debonding technique led to greater incidence of enamel surface damage as measured in OCT. The ARI scores with debonding pliers and laser were significantly greater than that of scaler debonding. CONCLUSIONS: Results of this in vitro study confirmed that use of ultrasonic scalers as a debonding technique led to significantly greater incidence of enamel surface damage when compared to the other two debonding techniques. The ARI scores on the tooth surface using debonding pliers and laser were significantly greater than that of the scaler debonding technique.

OBJECTIVES: Impacted canine (IC) is a dental anomaly that varies in its frequency according to the population of interest. The aim of this study is to investigate the frequency and distribution pattern of maxillary ICs (MxIC) and mandibular ICs (MnIC) in the population of Al-Madinah, Saudi Arabia. MATERIALS AND METHODS: A cross-sectional retrospective study of all patients attended Taibah University Dental Hospital, Madinah, Saudi Arabia. Inclusion criteria were individuals aged 15 years and older and no history of orthodontic treatment or craniofacial syndromes. Patients with incomplete dental records or missing/distorted Orthopantomograph (OPG) were excluded. All OPGs were taken using standardized equipment. Data were explored for frequency and pattern of canine impaction both in the maxilla and the mandible and statistically tested to detect significant differences. RESULTS: A total of 7466 individuals fulfilled the inclusion criteria with mean age of 37.43 ± 14.5 years. Of the total sample, 173 individuals had at least one IC. MxIC alone occurred in 86.71% of the cases, while MnIC occurred in 8.67%. The remaining 4.62% had at least one IC in each jaw. Unilateral IC occurred in 89.2% of the cases with left-side predominance in the maxilla. CONCLUSION: In this sample, the frequency of MxIC was 2.1% and MnIC was 0.3%. Almost equal distribution of IC occurred between females and males (IC Odds ratio F:M 1:1.08). Further studies are required to investigate the potential association of IC incidence with other predictor variables.

OBJECTIVE: The authors invented an innovation in the bracket design; that targeted to fulfill the aim of Dr. Andrews for a true straight wire technique. MATERIALS AND METHODS: The use of the ball and socket design together with the ability to relocate the position of the slot in three dimensions enhances the control and precision of individual teeth. RESULTS: The revolutionary bracket eliminated any wire bending in the initial, intermediate or finishing stages of fixed orthodontic treatment. This was achieved together with complete 3D control on individual teeth positions to achieve the finest occlusion for individual patients. CONCLUSIONS: That system allowed for a true straight wire mechanics with no wire bending. The design could be used labially or lingually without the need of indirect bonding techniques. Additionally, any adjustments could be performed intraorally with simple pressure.

Objective: Connections between craniocervical posture (CCP) and changes in teeth position have already been demonstrated; however, the defined pathway of relationship is still not clear. The aim of this study was to evaluate CCP modifications after rapid maxillary expansion therapy using rapid palatal expansion therapy (REP)/McNamara appliances. Materials and Methods: A consecutive series of 35 subjects, aged between 6 and 14 years, with no prior history of orthodontic treatment, and requiring skeletal expansion of the upper arch, were selected and analyzed. All patients were treated with REP or Mcnamara appliance: the active phase of 15 days and retaining phase of 6 months. Cephalometric analysis was carried out before (T0) and after (T1) orthodontic therapy evaluating changes in the craniofacial area and those related to CCP. The obtained data were statistically analyzed for the pre-post changes. Results: No statistically significant difference emerged indicating a modification in the CCP measured at T0 and T1 (P > 0.05). Patients treated with the McNamara appliance, compared to those treated with REP, showed a higher value of the angle OPT ^ Ver (P = 0.021), and a lower measure of the angles CVT^EVT (P = 0.035) and EVT^Ver (P = 0.023). Furthermore, patients treated with REP showed a higher hyoid angle value than those treated with McNamara (P = 0.047). Conclusion: This study did not reveal any relationship between the application of palatal expansion therapy and changes in CCP.

OBJECTIVE: To compare the efficacy of Icon resin infiltration and Clinpro XT varnish on remineralization of white spot lesions using a polarized light microscope (PLM). MATERIALS & METHODS: Artificial white spot lesions were created on a sample of 40 extracted human premolar teeth by immersing in a demineralizing solution. All samples were randomly allocated to two groups of 20 each; Group A: Icon resin infiltration and Group B: Clinpro XT varnish. Teeth were sectioned along the buccolingual plane using a diamond disc. Specimens were observed under the PLM (4× magnification) at three deepest measurements and their averages were calculated to obtain the mean penetration depth. The data obtained were analyzed using SPSS software (version 22.0). Independent samples t-test and group statistics were used to compare the two groups. In all statistical tests, the significance level was set at 5% (P < 0.05). RESULTS: Both Icon resin infiltration and Clinpro XT groups showed a statistically significant difference (P = 0.00) in the penetration depth. Icon resin infiltration group showed a significantly higher penetration depth (24.46 μm) compared to the Clinpro XT group (12.34 μm). Group A showed a greater mean penetration depth (17.07 ± 4.35 μm) when compared to group B (7.68 ± 1.81 μm). CONCLUSION: Icon resin infiltration showed a significantly higher penetration depth and is more effective on remineralization of white spot lesions when compared to Clinpro XT varnish.

OBJECTIVE: To evaluate the surface roughness and ion release of silver-soldered joints by using two polishing methods. METHODS: 174 orthodontic bands with and without silver-soldered joints were evaluated and divided into three groups: two experimental, with different polishing methods (SP1 and SP2), and one control (SS) composed of bands without silver solder. For ionic release, 50 bands of each group were immersed in saline solution and submitted to atomic absorption spectrophotometry to quantify the amount of Fe, Ni, Cr (in all the three groups), Ag, Cu, Cd, and Zn (in the two experimental groups). A rugosimeter was employed to verify the surface roughness. RESULTS: Ni and Cr were released in higher amounts after soldering. Cd, Ag, Zn, and Cu may be released from silver-soldered bands independently of the polishing method employed. Ag was released in higher amounts from the soldered bands that presented higher surface roughness. CONCLUSIONS: Differences exist in relation to the surface roughness of silver-soldered bands when distinct polishing methods are used. Toxic ions may be released from silver soldered joints and higher surface roughness may cause higher ionic release.

OBJECTIVES: The objective of this study is to determine whether submucosal local injection of i-PRF may affect orthodontic relapse by increasing bone density, which further leads to reducing orthodontic relapse. MATERIALS AND METHODS: Forty-five adult male albino rabbits were randomly divided into three groups: group I (control) with 15 rabbits injected with 200 μl of phosphate-buffered saline (PBS), group II with 15 rabbits injected with 200 μl of i-PRF, and group III of 15 rabbits inject with 400 μl of i-PRF. The lower incisors of rabbits moved distally by a modified orthodontic appliance for 2 weeks; then, the appliance was maintained in position to retain the gaining space for 2 weeks. During the retention period, each group was injected with the specific drug every 7 days. After the retention period, teeth were allowed to relapse by removal of the orthodontic appliance. The results were evaluated by measuring the amount of orthodontic relapse and bone density. The statistical analysis performed by ANOVA and Duncan (P < 0.05 was considered significant). RESULTS: I-PRF groups showed a significant reduction in the amount of relapse at 10, 13, 17, and 20 days compared to the control group, indicated by the highest percentage of relapse for the control group at the end of the study (20 days); it was (90.4%) in compared to lowest percentage of relapse for i-PRF groups—they were 61.2% and 59.9%, respectively. CONCLUSION: Results indicated that i-PRF has the potential to enhance the stability of teeth after orthodontic tooth movement and could have the ability to reduce relapse, probably by increasing the alveolar bone density.

BACKGROUND: White spot lesions (WSL) are an unsightly and a rather frequent drawback of orthodontic treatment. The complex design of fixed orthodontic appliances (FAs) makes it difficult to perform proper oral hygiene, which amounts to white spot lesions being three times more prevalent in patients wearing orthodontic appliances. As clear thermoplastic aligners (CAs) are removable appliances, it has been speculated that they allow better oral hygiene maintenance and thus less incidence of WSLs. OBJECTIVES: This evidence-based scoping review aims to identify the scope and nature of the evidence on white spot lesions during orthodontic clear aligner therapy. TYPES OF STUDIES REVIEWED: Strategic and thorough search of the literature for randomized Controlled Trials, Case-Control, Cohort studies, Case reports, full research articles, and review papers on humans published in English in five major databases was undertaken till July 2021 using free text and Medical Subject Headings (MESH) terms, followed by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to identify five studies for data extraction. RESULTS: Evidence was summarized for study characteristics, diagnostic methods for the detection of white spot lesions, and incidence of white spot lesions during clear aligner therapy. The literature supports that orthodontic treatment with CAs was associated with a low incidence of WSLs when compared with fixed mechanotherapy, with a major role of patient education, motivation, and compliance in maintaining oral hygiene. PRACTICAL IMPLICATIONS: The general perception is that clear aligners are more hygienic and show no incidence of white spot lesions. However, our scoping review supports that WSLs can occur with this form of orthodontic treatment also. WSLs in clear aligners could be attributed to the practice of having composite attachments that cover a significant portion of the tooth surface. Thus, regardless of the type of appliance used, a periodic reinforcement by the orthodontist to maintain oral hygiene is necessary for patient motivation, allowing for better oral hygiene practice, and as a result, leads to prevention of WSLs.

INTRODUCTION: Protraction therapy for maxillary deficiency in the treatment of skeletal class III malocclusion involves the use of facemask. Conventionally facemask has been anchored to the maxillary dentition, which is responsible for some of the counter-productive effects of facemask therapy including backward and downward rotation of the chin, increase in the lower anterior facial height, proclination of maxillary incisors, retroclination of mandibular incisors apart from mesialization of maxillary molars with extrusion and decreased overbite. AIM: The aim of this article is to highlight the nuances of Bone-Anchored Maxillary Protraction (BAMP) including a literature review, which is comprehensive and narrative and comparing the different techniques involved such as type 1 BAMP versus type 2 BAMP and BAMP versus facemask. MATERIALS AND METHODS: A computerized search was performed in electronic databases such as PubMed, PubMed Central, Cochrane, Embase, DOAJ, and Google scholar using key words such as “bone-anchored maxillary protraction” and “BAMP.” The search was confined to articles in English published till March 2021. Forty-seven case-controlled, cross-sectional, retrospective and prospective studies, as well as systematic reviews and meta-analysis were included in this article, which were limited to human subjects. A hand search of the reference lists of the included articles was also carried out to include missed out articles. CONCLUSION: To overcome these drawbacks, BAMP was introduced, which causes both maxillary protraction, restraint of mandibular growth with minimal dentoalveolar changes. BAMP is used widely nowadays in the treatment of skeletal class III malocclusion.

This systematic review was aimed to test the null hypothesis that coating of orthodontic wires with nanoparticles does not affect the frictional properties at bracket--wire interface. Electronic database searches were performed up to September 2020. In vitro studies were considered for reviewing process. Study selection, data extraction, risk of bias assessment was performed during reviewing process. Only qualitative analyses of included literature were done due to the presence of heterogeneity among the studies. Out of 1,068 retrieved records, nine studies satisfied the inclusion criteria and included in this review. Studies were assessed at low risk to high risk of bias according to certain parameters. Wide variety of nanoparticles were used for surface coating of orthodontic wires of variable sizes, shapes, and materials like stainless steel, NiTi, and TMA and placed into the slots of different types of orthodontic brackets to evaluate the alteration in frictional and other mechanical properties. Most of the studies clearly indicate that coating with nanoparticles decreases the friction between wire and bracket interface under specified in vitro conditions. Furthermore, among the nine included studies, only two considered evaluation of effect of coated brackets on frictional and other mechanical properties and results were heterogeneous. The null hypothesis is rejected and it is concluded that the wires coated with nanoparticles might offer a novel opportunity to substantially reduce frictional resistance at bracket--wire interface during tooth movement. Further studies are necessary to strengthen the evidence regarding effect of coated brackets on frictional properties.