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.

BACKGROUND: Laser etching addresses the disadvantages of conventional acid etching technique, such as enamel decalcification and formation of white spot lesions. The aim of the present study was to evaluate and compare the shear bond strength (SBS), adhesive remnant index (ARI), and the surface characteristics of the samples treated with conventional acid etching and Er, Cr: YSGG laser etching with variable output power and time durations. METHODOLOGY: The study sample included 78 extracted teeth divided into six groups of 13 teeth each, and 3 samples from each group were utilized for analyzing etch patterns, and the remaining 10 teeth from each group were used for evaluating the shear bond strength. In Group I phosphoric acid etching was done, whereas in Group II– VI Laser etching 1.5 W/10 s, 1.5 W/15 s, 3 W/5 s, 3 W/10 s, 3 W/15 s. Statistical analysis for shear bond strength testing was performed using one-way ANOVA followed by Post HOC tests. RESULTS: The mean shear bond strength of Group I was 7.16 Mpa and Group III of 5.43 Mpa. Group II, IV, V, and VI had mean shear bond strength of 4.93 Mpa, 3.88 Mpa, 4.05 Mpa, and 4.88 Mpa, respectively. The ARI scores Group I had a significant number of samples with scores 2 other groups showed increased Score 0. The etch pattern of groups I, II, III showed the combined dissolution of both prism cores, and peripheries were seen. In group IV, the etching pattern was irregular with the pitted type of surface. In groups V and VI, relatively flat and smooth enamel surface was seen. CONCLUSION: The bond strength attained by laser etching (1.5 W/10 s and 1.5 W/15 s) was comparable to that obtained by the acid etching technique.

CONTEXT: Orthodontic miniscrew implants (OMIs) are widely used as anchorage alternatives, but recent studies revealed the corrosion behavior of OMIs when they come in contact with mouthwashes. The corrosion materials that are released can cause toxicity, allergy, and mutagenicity. AIMS: This study aims to analyze the cytotoxicity effects of OMIs exposed to different types of mouthwash using human gingival fibroblast (HGFs). SETTINGS AND DESIGN: Experimental laboratory research. METHODS AND MATERIAL: Twenty-eight samples of Ti alloy OMIs immersed separately in four groups of different types of mouthwash (chlorhexidine gluconate 0.2% mouthwash (CHX), fluoridated (sodium fluoride 0.2%) mouthwash, chitosan mouthwash 1.5%, and aquadest) for 28 d. Elution of each group and the mouthwash itself were added to the cell culture and incubated for 24 h. Changes in cell viability were performed by MTT Assay. STATISTICAL ANALYSIS USED: Data were tested for normality with Shapiro–Wilk, homogeneity with Levene test, and analyzed using an independent T-test (P < 0.05). RESULTS: The differences between the cytotoxicity of the elution of MIO and the mouthwash solution itself in the group of CHX and Fluoride were statistically significant (P < 0.05). No significant differences were found in the group of chitosan and aquadest (P > 0.05). CONCLUSIONS: The 1.5% chitosan mouthwash can be offered to patients with Ti alloy-based OMIs rather than the 0.2% chlorhexidine gluconate and 0.2% sodium fluoride mouthwashes.

OBJECTIVES: Thalassemia, one of the most widespread autosomal recessive disorders, is characterized by anomalies in the synthesis of hemoglobin beta chains and is frequently coupled with variable craniofacial characteristics. Thalassemic patients suffer from severe anemia, which triggers several defense mechanisms in the body, such as bone marrow expansion, which forces the bones to expand, resulting in craniofacial bone deformities. This study aims to assess and compare the orofacial dimensions of β-thalassemia patients with those of a control group across similar ages and gender. MATERIALS AND METHODS: Three hundred Iraqi individuals agreed to participate in this study (150 non-thalassemic and 150 thalassemic patients with an equal distribution of genders). A well-trained researcher carried out five anthropometric measurements by using an electronic digital caliper. Gender and group differences were tested using an independent sample t test. RESULTS: Mouth width showed clinical and statistically significant group differences among all measurements in the study group. CONCLUSIONS: All measurements except mouth width showed nonsignificant clinical group differences.

PURPOSE: To assess the impact of enamel surface treatment protocols and the types of adhesive materials on the shear bond strength (SBS) of brackets to eroded enamel substrate. MATERIALS AND METHODS: Eighty extracted premolars were randomly assigned to four main groups in which group C (no treatment) was the control group. The remaining groups were exposed to an erosion challenge through short-term acidic exposure to HCl solution (0.01 M, pH 2.3) for 30 s, with an agitation speed of 50 rpm at an environmental temperature of 25°C. The eroded enamel surface within each group was treated as follows: group N received no treatment; in group P, the eroded enamel was treated with 35% phosphoric acid (Ultradent Products, South Jordan, UT, USA) for 15 s, followed by a rinse for 10 s; and in group F, the eroded enamel was treated with fluoride gel (Bifluorid 12; Voco-GmbH, Cuxhaven, Germany) for 4 min. The brackets were bonded with either a resin composite adhesive (Transbond XT; light-cure adhesive, 3M Unitek, CA, USA) or resin-modified glass ionomer cement (Fuji Ortho LC-GC Corporation, Japan). The specimens were tested for SBS, and the bond failure was assessed according to the adhesive remnant index (ARI). Analysis of variance (ANOVA) and Tukey's post-hoc tests (P < 0.05) were used to compare the SBS of the groups. The ARI values between the groups were recorded. RESULTS: Statistically significant differences were found among the tested variables (P < 0.05). Group P showed the highest mean SBS values regardless of the type of adhesive used, and the difference was statistically significant (P < 0.05). The application of the fluoride gel showed no statistically significant improvement in SBS values. The failure mode distribution among the test groups indicated that failures at the adhesive–bracket interface were predominant in group C compared with the other study groups. CONCLUSIONS: Fluoride pretreatment, which was used to remineralize the eroded enamel surfaces before bonding, resulted in a decrease in the SBS of the orthodontic brackets in vitro compared with the other treated groups. The use of fluoride-releasing adhesive also enhances bonding to the eroded enamel surfaces.

OBJECTIVE: The main objective of this study is to get a wider and clearer idea about the relationship between sella turcica bridging and the type of dental anomalies related to size, shape, number, structure and eruption of teeth. MATERIALS AND METHODS: For the present study, 50 pretreatment lateral cephalometric radiographs showing complete sella turcica bridging were retrieved from the 500 existing case records of patients. The control group consisted of 50 pretreatment lateral cephalograms without sella turcica bridging retrieved from the same case records by using simple random sampling. After collection of the samples, retrospective study was performed with the analysis of patient records to assess any associated dental anomaly in patients with sella turcica bridging and patients without sella turcica bridging. Shafer's classification of morphological variations in size, shape, structure, number and eruption of teeth was used to analyze and group the dental anomalies. RESULTS: The incidence of dental anomalies related to number and size of teeth was found to be higher in cases with sella turcica bridging. CONCLUSION: Lateral cephalogram is used by orthodontist routinely for diagnosis and treatment planning; it can be used as a prediction tool for dental anomalies as well. Early detection of skeletal anomalies can be used to forecast the presence of dental anomalies later in life, which will help the clinician to adopt preventive measures.

Teledentistry has proven effective in practically all dental fields. It also allows access to inaccessible and underdeveloped locations. Better treatment outcomes were documented in patients treated by an orthodontist supervised by teledentistry than by a general dentist with minimal orthodontic experience alone. It may also help to focus referrals to specialists and weed out those who do not need them. But, on a critical note, a doctor-patient relationship is much more than a business transaction. A face-to-face initial consultation instills trust that a remote session cannot. Teledentistry includes professional networking of doctors. This contact includes digital information exchange, CPD programs, case discussions, and analysis that bring dentists from all around the world together to improve patient care. Teledentistry has not only spanned the distance between dentists worldwide, but has also served as a conduit between customer (patient) and manufacturer. This spawned Direct to Consumer (DTC) dentistry, sparking substantial debate among dentists worldwide. In DTC dentistry, inadequately trained customers conduct complex procedures on themselves with minimal guidance of a dentist. One of the major issues today is the general availability of clear aligners to patients without the requirement for an intermediary skilled orthodontist. The American Association of Orthodontists (AAO) has publicly questioned the validity of Smile Direct Club, a private firm that dominates the DTC industry. European Federation of Orthodontic Specialists Association, on the other hand, has sponsored a joint declaration with the representative orthodontic associations in Europe to highlight and alert patients about the potential risks of DTC products. Unfortunately, public shaming hasn't slowed commercialization of DTC firms. Teledentistry has been a boon for healthcare, but a nightmare for our profession, raising fundamental questions like what is the difference between a customer and a patient? Is dentistry a just another discipline of cosmetics? Is teledentistry making us less connected with our patients?

INTRODUCTION: Missing lateral incisors represent a common condition that normally requires specific anchorage conditions to be treated with space closure mechanics to protract upper teeth creating a proper occlusal relationship. CASE PRESENTATION: Two cases showing Class II malocclusion with missing lateral incisors in developing age are presented, both treated with the same approach of maximum anterior anchorage applied using the Bidimensional Technique system. Long-term follow-up of 10 years is shown. MANAGEMENT AND OUTCOME: Bidimensional technique is a modified edgewise technique that uses sliding mechanics for protraction of the posterior segments by placing vertically slotted brackets of different sizes on the anterior (.018” x 0.025”) and posterior teeth (.022” x 0.028”). When a .018” x .022” wire is inserted in the .018” x .025” brackets slot on the incisors, third-order control is created in the incisor segment while the wire is undersized in the rest of the arch. Lateral brackets have been positioned on the canines, while the canine brackets have been positioned on the first premolars respecting a differential bonding height able to produce canine extrusion and first premolars intrusion and proper torque expression. Full Class II molar relationship and Class I substituted canine relationship has been reached in both cases and kept stable in the long-term follow-up (10 years). DISCUSSION: The described approach provided anterior anchorage with more simple mechanics expressing the anterior torque with a full engagement concept and adding few auxiliaries (uprighting springs) which do not require compliance.

OBJECTIVES: This study aimed to evaluate the extent to which online communication can enhance patients' knowledge of orthodontic topics, as well as compare the effectiveness of images, video, and text messages as tools for delivering orthodontic information. MATERIALS AND METHODS: Two WhatsApp groups were created comprising 30 males and 33 females. The Google form template was used to formulate a 25-item questionnaire containing information related to orthodontic topics. At the beginning of the first stage, a link to the questionnaire was sent to the groups and their answers were given scores, which were referred to as (T1). During the second stage, a piece of daily information relevant to the field of orthodontics was sent to the groups over a 14-day period. On Day 15, the link to the previous questionnaire was sent again and the participants were asked to complete it for a second time. These answers were corrected, given scores, and labeled as (T2). Scores from the first and second stages were compared. RESULTS: There was a significant increase in the average total score from the first questionnaire (T1 = 15.3) to the second questionnaire (T2 = 17.9). All types of media formats were greatly effective in improving the patients' knowledge. Images proved to be the best tool for delivering information and were considerably more effective than video and text messages. CONCLUSION: This study indicates that WhatsApp as an online communication tool could be used to effectively enhance the knowledge of orthodontic patients. Images are the best method for delivering information to orthodontic patients.

OBJECTIVES: This study aimed to assess the perception of orthodontic staff members around clinical learning outcomes (LOs) of the undergraduate orthodontic curriculum with a focus on dental schools in Saudi Arabia. MATERIALS AND METHODS: Twenty-three LOs were formulated, all of which were associated with skills required in the undergraduate orthodontics course. Orthodontic staff members were invited to provide their opinion regarding the curriculum using a Likert scale, whereby participants could answer each question on a scale from “Strongly Agree” to “Strongly Disagree.” RESULTS: Sixty-one teaching staff members agreed to partake in this study. The highest level of agreement among the participants pertained to conducting systematic orthodontic intraoral and extraoral examinations (100%), followed by explaining causes for space loss (98.3%). The lowest level of agreement was regarding executing a treatment plan for non-skeletal cases (62.2%) followed by skills of fabrication and activation of removable appliances (77%). Around 67.1% of the academics refused to allow dental students to select and bond orthodontic brackets. CONCLUSION: It is time to amalgamate the objectives and create a unified national list of LOs for all orthodontic curriculums across the country without any distinction of knowledge or skills required at the undergraduate level.

OBJECTIVE: This study aims to facilitate a surgeon's preoperative assessment by detecting the prevalence, location, and course of the mandibular incisive canal (MIC) in our population. METHODOLOGY: A retrospective study was conducted at King Saud University, Riyadh, Saudi Arabia. A total of 93 cone-beam computed tomography (CBCT) scans of patients aged 18–50 years were taken. The images were reformatted from the sagittal sections to para-sagittal sections at premolars, canines, lateral incisors, and central incisors measured to the distance of MIC to the tooth apex, to the inferior border of the mandible, to the buccal cortex, and to the lingual cortex. RESULTS: MIC among the patients was found to be present in 96.8% of the total subjects. Prevalence between genders showed that it was present in 97.9% of the male patients and 95.5% of the female patients. The average distance from the buccal cortex is 4.88, the lingual cortex is 5.54, inferior border is 9.94, and root apices is 7.67. The age-wise and gender-wise comparison of a mean distance of MIC to the different surfaces in the different cross-sections showed that there is no correlation, and there is a significant correlation, respectively. CONCLUSION: The detection of the MIC presence and location using CBCT should be earnestly considered for surgical procedures that are intended to be done in the interforaminal region.

OBJECTIVES: This study aimed to evaluate the visual facial perception in response to scars associated with repaired cleft lip (CL) on a male adolescent model, as assessed by eye-tracking technology. MATERIAL AND METHODS: Unilateral and bilateral facial images of repaired CL on the upper lip and nasal asymmetry were added to an image of a male adolescent model, using Photoshop CS5 software. 40 laypeople eye movements were tracked by an infrared sensor of the Eye Tribe hardware in conjunction with OGAMA software. An analysis of variance was used to identify differences in total fixation time for the added areas of interest. A visual analog scale of attractiveness with a questionnaire were also incorporated into the study. Statistical analysis was performed using a significance level of P < 0.05. RESULTS: Significant differences were noted between the image with no scar and the image featuring a unilateral scar for total fixation time associated with the right eye (p = 0.002) and right nose area (p = 0.003), in addition to the numbers of fixations for the right eye (p = 0.005) and right nose area (p = 0.007). Comparing the image with no scar with the image featuring a bilateral scar showed a significant difference only for the number of fixations on the right eye (p = 0.005). The heatmaps and fixation point maps for both the unilateral and bilateral scar images indicated increased fixation for the scar areas. For the image with no scar, increased fixation was captured for the right eye area. Pearson's correlation coefficient test showed a moderate positive (p = 0.692) relationship when comparing to unilateral and bilateral cleft scars. CONCLUSIONS: The participating laypeople perceived the cleft-repaired faces and did not perceive any difference in attractiveness between the images featuring the unilateral and bilateral postsurgical clefts and lip scarring.

OBJECTIVE: The purpose of this study was to describe the dentofacial morphology of Yemeni adults. MATERIALS AND METHODS: The lateral cephalograms of 100 Yemeni adults (50 males, 50 females) were included in the study. All subjects were born to Yemeni parents and grandparents. They all had Class I occlusions with minor or no crowding, well-aligned upper and lower dental arches, good facial harmony, all teeth present except third molars, and no history of orthodontic therapy or maxillofacial surgery. Five angular and eighteen linear measurements were analyzed to determine the soft tissue, skeletal, and dental features. The differences for each measurement between Yemeni males and females were calculated using unpaired t–tests. RESULTS: Significant sexual and racial differences were found for three linear parameters in the skeletal analysis, one angle, and four linear dental measurements, and for all soft tissue linear parameters. Yemeni adults showed a tendency to a facial pattern of Class II, convex profile, reduced prominence of chin, increased lower facial height, and a clockwise rotation of the mandibular plane angle. CONCLUSION: Yemeni adults have different dentofacial parameters when compared to other racial standards, and these differences could aid in diagnosis and treatment planning.

OBJECTIVE: Esthetic enhancement plays an important role in orthodontic treatment. This study was conducted on females as most girls have their growth spurt at a younger age than boys do, so their demand to facial esthetics, especially those who have residual growth of mandible producing class III effect, requires full understanding to smile features helping in diagnosis and treatment planning for maximum patient satisfaction. MATERIALS AND METHODS: This study was conducted on 30 skeletal Class III and Class I female adults (18–30 years old) who were divided equally into two groups comprising 15 each. Two frontal digital photographs were taken for each subject, one at rest and the other in the posed smile position. Photographs were taken for each subject in the natural head position by a Canon EOS 1200 D camera set on a tripod at a distance of 1.5 m. The incisogingival height of the right maxillary central incisor was clinically measured using a vernier caliper to the nearest 0.1 mm. Photographs were uploaded on Photoshop software for standardization and then uploaded on the Digital Smile Design software (DSD) where the actual incisogingival height of the central incisor was used for automatic calibration. Esthetic components at rest and on smiling were measured for both groups; all linear variables were measured to the nearest 0.1 mm. RESULTS: Class III females tended to have wider smile widths, less gingival display, longer chin heights, shorter lower vertical dimensions, and a higher percentage of nonconsonant and flat smile arcs than Class I subjects. CONCLUSIONS: The components of the smile should be considered as a guide to help in planning and designing the mechanics during comprehensive orthodontic treatment.

AIMS: This study searched the effects of fluoridated toothpaste on the enamel surface of deciduous molars eroded by different pediatric liquid medicaments which were encircled by orthodontic bands by gravimetric analysis method. MATERIALS AND METHODS: A suitable orthodontic band was used to band each of the 110 non-carious exfoliated deciduous molars, and stored in artificial saliva. These teeth were divided randomly into fluoridated and non-fluoridated groups (50 teeth each), and 10 teeth were used as negative controls. The enamel surface of the fluoridated group was swabbed with fluoridated toothpaste for 5 minutes twice daily. Each group was subdivided into five clusters of 10 teeth each according to the type of medication used which included paracetamol, Adol, amoxicillin, Medazole (ME), and Viton (VI) according to a specific immersion cycle. The erosion induced in the enamel for all the teeth was evaluated by gravimetric analysis for different intervals. RESULTS: The results showed that the weight loss increased with increasing exposure to liquid medication for all groups, but this increase was smaller in the fluoridated group. The highest mean weight loss after 28 days was in VI, and the lowest was in ME (0.145 [0.005] mg; 0.08 [0.008] mg), respectively. CONCLUSION: The fluoridated toothpaste significantly reduced medically eroded enamel by oral medical syrups. The gravimetric method is valid for the detection of erosion on banded deciduous molars.

OBJECTIVES: The purpose of this study was to evaluate the accuracy and reliability of Mobile Application-Based Software for chair side cephalometric analysis. MATERIALS AND METHOD: Pretreatment lateral cephalograms of 20 patients (10 males and 10 females) were selected randomly and were traced manually and also using Application-based software (One Ceph). 20 angular and three linear parameters were measured both manually and with the software in all the patients. Inter and intra-operator reliability of one ceph was evaluated and the measured parameters were statistically compared with the manual method (Gold Standard). RESULT: The accuracy of angular and linear values was compared for all 23 parameters and our results showed no significant difference in the two methods used for most of the measurements. Three of the measurements [Angle of convexity (N-A; A-Pog); ANB angle; Upper Incisor to NA (Angular)] did show a statistically significant difference though these were clinically irrelevant. CONCLUSION: Application-based cephalometric analysis can be an effective clinical diagnostic tool for chair-side cephalometric evaluation of orthodontic patient.

OBJECTIVE: To comparatively evaluate the ability of three different customized lingual appliance systems in achieving predicted results with respect to the mesiodistal crown tip, labiolingual crown inclination, in–out position of Maxillary permanent anterior teeth, and Maxillary arch form. METHODS: Three commercial houses: Incognito, iLingual 3D, and Lingual matrix were analysed in this study. The final sample size consisted of 42 cases. Fourteen digital prediction and posttreatment models of the maxillary arch were provided by three orthodontic offices each using a different system. Discrepancies between the prediction and posttreatment model in mesiodistal tip, labiolingual inclination, in–out position of anterior teeth, and arch form were analyzed. RESULTS: Incognito displayed the highest accuracy in all parameters except for in–out positioning. Lingual Matrix showed greater precision in achieving planned mesiodistal positions than labiolingual inclination while it was just the opposite for iLingual 3D. All three systems proved to be clinically reliable in achieving the predicted in–out positions of permanent Maxillary anterior teeth. CONCLUSION: These systems were considerably accurate in achieving planned treatment goals with minute deviations from the predicted value.

OBJECTIVE: Stainless steel and nickel-titanium wires are commonly used in fixed orthodontic appliances. Orthodontists often prescribe fluoride gel to avoid demineralization of teeth. This study investigated the effect of acidulated phosphate fluoride gel on the tensile properties, surface morphology and surface chemical composition of stainless steel and nickel-titanium wires. METHODS: Forty samples of stainless steel and nickel-titanium wires were examined, twenty for each type. Each wire type was divided into four subgroups. The first subgroup was not immersed in fluoride gel and considered as control, while the other three subgroups were immersed in 10 mL of fluoride gel for different periods of time. Then, the wires were removed from the gel, rinsed in a distilled water and left to dry. The ultimate tensile force of each wire was measured using a tensile testing machine. Scanning electron microscope (SEM) and energy-dispersive X-ray spectroscopy (EDX) were used to examine the control and 24 h immersed subgroups. RESULTS: One-way analysis of variance ANOVA showed that there were no significant differences in the ultimate tensile forces between control and fluoride-treated subgroups (P = 0.172 for SS wires and P = 0.672 for NiTi wires). However, changes in the surface morphology and elemental composition of wires were shown by the SEM and EDX. CONCLUSIONS: Although immersion of stainless steel and nickel-titanium wires in the fluoride gel did not affect their tensile properties, however, surface deterioration was evident. So, further investigations are recommended to study the effect of these changes on the oral health of patients.

OBJECTIVES: The aim of the study was to clinically evaluate and compare 0.016-inch superelastic nickel–titanium (NiTi) and 0.016-inch heat-activated nickel–titanium (NiTi) archwires in terms of alignment efficiency, root resorption, and pain intensity. METHOD: A total of 20 patients requiring fixed orthodontic treatment, having Little's irregularity index of 5–8, and requiring first premolar extractions were recruited. They were randomly allocated to receive two different archwires (0.016-inch superelastic NiTi or 0.016-inch thermoelastic NiTi). Good-quality impressions were taken of the lower arch before archwire placement (T0) and at every month after that till the alignment was complete. The rate of tooth alignment was measured on casts by determining Little's irregularity index. The pain experienced by the patient was assessed 24 hours and 1 week after the placement of the archwire on a visual analogue scale. Cone beam computed tomographic radiographs of lower anterior teeth were taken before and after alignment to assess root resorption. Data obtained were subjected to statistical analysis using the SPSS software (version 20.0). The level of significance was kept at 5%. RESULTS: The repeated measures ANOVA indicated that there was no significant difference in the aligning efficiency of superelastic and heat-activated NiTi wires. (p = 0.45). The Mann Whitney U test showed that superelastic NiTi wires had statistically significant higher VAS scores than heat-activated NiTi at 24 hours and 1-week interval (p < 0.05). Student's t-test indicated greater root resorption with superelastic NiTi but the difference was not statistically significant. CONCLUSION: Both the wires showed similar aligning efficiency and resulting root resorption. Superelastic NiTi was observed to produce more pain compared to heat-activated NiTi in the aligning phase.

Aim: To evaluate and compare the efficacy of Ozonated Olive Oil Gel, Chlorhexidine gel, and Amflor (Fluoridated) mouthwash on reducing the count of Streptococcus mutans and Lactobacillus in patients undergoing fixed orthodontic therapy evaluated at different time intervals. Methods: Sixty patients undergoing orthodontic treatment were randomly divided into three groups (n = 20) based on antimicrobial agents used (Group 1: Ozonated olive oil gel; Group 2: Chlorhexidine gel; Group 3: Fluoridated mouthwash). Elastomeric modules from brackets were collected at T₀ (Fresh samples) and T₁ (2^nd week) and T₂ (4^th week) for assessment of the microbial growth. These collected modules were cultured and evaluated for the presence of Streptococcus Mutans and Lactobacilli and numbers of colonies were counted at each interval. Data obtained was subjected to statistical analysis using SPSS software (Version 20.0). Level of significance was kept at 5%. Intra-group and inter-group comparison between pretreatment, 2^nd week and 4^th week was done for each group using Wilcoxon signed rank test and Mann–Whitney U test. Results: There was presence of Streptococcus Mutans and Lactobacilli during orthodontic treatment which progressively increased from T_o to T₁ and then declined from T₁ to T_2. The colony counts were maximum for Fluoridated mouthwash and least for Chlorhexidine and the results were statistically significant (P < 0.05). Conclusion: All three antimicrobial agents used were effective against Streptococcus mutans and Lactobacillus. Chlorhexidine proved to be more efficacious whereas Fluoridated mouthwash proved to be least effective against both Streptococcus mutans and Lactobacillus bacteria.

BACKGROUNDS: Bleaching procedure can be companied before, during, or after orthodontic treatments. However, the risk of compromised bond strength of brackets to bleached enamels is in debate. This study tried to evaluate the shear bond strength (SBS) of bonded metal brackets to the previously bleached enamels. MATERIALS AND METHODS: In this in vitro study, 60 extracted, sound, human premolars were mounted vertically in cylindrical molds. The samples were randomly divided into four groups (n = 15): Control (C); at-home bleached by 20% carbamide peroxide (HB); in-office bleached by 45% carbamide peroxide (OB); and in-office bleached by 40% hydrogen peroxide activated with diode laser (L-OB). Sixty stainless steel brackets were bonded by no-primer adhesive resin (OrthoCem). Then SBS of bonded brackets was measured after 5000 thermal cycles at 5°C and 55°C. Finally, the collected data were analyzed by one-way ANOVA, and Tukey HSD tests by using SPPS software at a significant level of 0.05 (α = 0.05). RESULTS: Group C showed significantly higher SBS values (all P < 0.001); however, there were no significant differences in SBS compared to other tests' groups with each other (all P > 0.05). CONCLUSION: The SBS of bonded orthodontic brackets were compromised after bleaching with 20% and 40% of carbamide peroxide. Diode laser activation may not eliminate the negative effect of bleaching agents on SBS of bonded orthodontic brackets, neither.

AIM: To evaluate the stress changes in the maxilla during fixed functional appliance use using three-dimensional finite element method (FEM) stress analysis. SETTINGS AND SAMPLE POPULATION: A three-dimensional finite element model of the maxilla was constructed using the images generated from the cone-beam computed tomography of a patient treated for Class II malocclusion with a fixed functional orthodontic appliance. The FEM was used to study the stress changes seen in the maxilla, which were evaluated in the form of highest von Mises stress and maximum principal stress before and after the application of fixed functional appliance. RESULTS: Higher areas of stress were seen in the model of the maxilla with the fixed functional appliance (140 MPa) compared to that in the resting stage (58.99 MPa). CONCLUSIONS: An increase in the maximum principal stress and von Mises stress in the posterior regions of the maxilla and maxillary teeth was seen. The stresses seen were double than that without the appliance. A high distalization force on the maxilla was seen with the fixed functional appliance.

OBJECTIVE: The purpose of this split-mouth single-centered, parallel-group, randomized clinical trial was to evaluate the efficiency of corticotomy-facilitated orthodontics in rapid canine retraction. METHODS: The sample consisted of 10 patients (15–25 years old) requiring extraction of the maxillary first premolars with subsequent canine retraction. The patients' right sides were randomly assigned to either the corticotomy (experimental) or control groups. Corticotomy cuts and perforations were performed and canine retraction was initiated bilaterally with closed-coil nickel-titanium springs that applied 150 g of force. The following variables were examined till the end of canine retraction on both sides: Rate of canine retraction, canine root resorption, and patient perception of the procedure. The rate of canine retraction was assessed every month using study models while root resorption was evaluated using CBCT. Patient's perception was evaluated using a 100 mm VAS. RESULT: Mean time taken for full completion of canine retraction: 5.7 months (test) and 7.1 months (control). Mean root resorption: 0.53 ± 0.10 (control) and 0.24 mm ± 0.10 (test). Mean VAS scores: 16 ± 3.94 (24 hours) and 2 ± 2.58 (1 week) at control side and 46.50 ± 6.69 (24 hours) and 2 ± 2.58 (1 week) at test. CONCLUSION: There was an overall reduction in the time taken for canine retraction with corticotomy; however, an increase in the rate of canine retraction in the corticotomy-facilitated method was evident only for the first four months, compared to the conventional method. Less root resorption was observed in corticotomy-facilitated method than conventional method. Pain perception was more for corticotomy-facilitated method than conventional method at 24 hours, but similar after one week.

OBJECTIVES: The present study aimed to assess the level of mothers' knowledge toward cleft lip and palate and their experience concerning presurgical orthopedic management. MATERIALS AND METHODS: This was a cross-sectional study where the mothers were invited to complete a self-administered validated and reliable questionnaire. The questionnaire included questions that aimed to assess mother's knowledge related to the most prevalent aspects of cleft lip and palate anomaly itself and additionally, questions associated with presurgical orthopedic treatment as an adjunct therapy. Descriptive statistics were used to define the characteristics of the study variables. Chi-square test was utilized to assess relationships between categorical variables. RESULTS: Totally, 145 mothers completed the survey (response rate was 73%). Forty-six (46%) of the mothers provided an incomplete or improper definition of the anomaly and 35 (24%) claimed that they know the cause of the anomaly. The majority of mothers did not identify family history as a risk factor; consanguinity was identified in 29% (n = 42). Of the total, 58 mothers (40%) agreed that dental management of CLP requires teamwork and the majority (n = 126, 87%) recognized the plastic surgeon as the most important specialist. Mothers aged 20-30 years old (n = 42, 53%), and those who are university graduates (n = 38, 48%), as well as employed mothers (n = 52, 66%) have in general a higher degree of knowledge regarding cleft lip and palate (P < 0.001). More than half of the mothers (n = 70, 57%) reported that presurgical orthopedic treatment was useful and needed for their infants. CONCLUSIONS: Most of the mothers reported a high level of knowledge about cleft lip and palate and they experienced the usefulness of the orthopedic appliances for their infants. However, there was uncertainty in some parts such as definition, diagnosis, causes, and risk factors for cleft lip and palate. Therefore, understanding the causes of cleft lip and palate, as well as comprehensive education concerning the essential role of the orthopedic appliances to improve cleft lip and palate are crucial for mothers to improve their infants' quality of life.

Since the World Health Organization broadened its definition of health, beyond biological boundaries, to include physical, emotional, and social wellbeing. Oral health-related quality of life (OHRQoL) became common outcome measure in clinical trials and epidemiological studies in Dentistry and Medicine. It is not surprising, therefore, to see quality of life as one of the programs of the Saudi 2030 vision. That said, it can be difficult to interpret the findings of OHRQoL research if the measures used were not appropriately adapted and validated in the population being studied. In this review article, the concept of cross-cultural adaptation of OHRQoL and its use in the Saudi context, as applied to orthodontic research, was discussed. An electronic search in PubMed and MEDLINE databases was conducted. A second search was conducted to locate methodological papers discussing cross-cultural adaptation and translations. Appraisal of relevant research was conducted to provide a better understanding of the process of adapting OHRQoL measures to assess the impact of malocclusion and dentofacial abnormalities on quality of life. This review pointed out important methodological concerns that warrant considerations during the translation and adaptation of OHRQoL measures.