Journal of Orthodontics最新文献

Objective: This cutting-edge report presents a technique for virtually preparing the orthodontic patient's model for fabrication of an individualised sports mouthguard.

Technique: Using the stereolithography (STL) file from an intraoral scan, a step-by-step guide to trim the model and prepare it for three-dimensional (3D) printing, using free software (Meshmixer; Autodesk Inc., San Francisco, CA, USA), is provided. This method employs a 3D drawing tool to create a buffer space between the teeth, orthodontic appliance and mouthguard material before printing. The purpose of the buffer space is to accommodate minor tooth movements, ensure proper protection and improve the mouthguard's lifespan.

Conclusion: Orthodontic patients should wear mouthguards during sports activities to protect orofacial structures. The proposed method successfully prepares a 3D-printed model with a buffer space, which can be used to fabricate an effective sports mouthguard. While familiarity with 3D-modelling software is required, this method can enhance mouthguard fabrication and minimise potential distortions inherent in traditional impression techniques using alginate or other materials.

Aim: This study assessed the optical properties of aligner surfaces post-cigarette smoke exposure.

Design: In-vitro experimental study.

Setting: Laboratory analysis of clear aligners subjected to cigarette smoke exposure at Federal University of Rio de Janeiro, Brazil.

Methods: A total of 20 plastic pieces from the labial surfaces of upper central incisors of Invisalign^® clear aligners were randomly divided into a control group (CG) and an experimental group (EG). The specimens were divided equally (n = 10): CG, stored in artificial saliva at 37°C ± 1°C for 14 days; and the EG, exposed to cigarette smoke using a sealed acrylic device with 10 cigarettes per cycle for 20 cycles. A spectrophotometer was used to evaluate changes in colour and light transmittance based on CIELab* colour parameters. Measurements were taken before (T0) and after (T1) exposure. The total colour difference (∆E) and National Bureau of Standards (NBS) were calculated. T-tests were used for comparisons at a significance level of 0.05.

Results: Statistically significant colour changes (P < 0.05) were observed at T1 in the EG (luminosity [L*] = 77.20 ± 3.33; difference along green-red axis [a*] = -1.57 ± 0.02; and difference along blue-yellow axis [b*] = 6.74 ± 0.55) compared to the CG. The mean ∆E* value at T1 was significantly higher in the EG (14.27 ± 2.72) compared to the CG (2.39 ± 0.56; P = 0.002). Light transmittance decreased significantly after cigarette smoke exposure (CG = 68.396 ± 8.683; EG = 59.538 ± 5.089; P = 0.012).

Conclusions: Cigarette smoke exposure significantly altered the optical properties of clear orthodontic aligners, affecting both colour and light transmittance.

Objective: To investigate the effect of different durations of post-curing ultraviolet (UV) light exposure on the compressive strength, amount of displacement and water absorbed by direct-printed aligners.

Design: An in-vitro randomised control trial.

Setting: Orthodontics laboratory in Maulana Azad Institute of Dental Sciences, New Delhi, India.

Methods: Dental LT V2 resin was used to print 30 aligners, which were divided into three groups and subjected to different post-print UV light exposures. Each group was subjected to compression loading of 1000 N to evaluate their load vs. displacement behaviour. The amount of water absorbed by aligners in each group was also evaluated. Data were analysed using one-way analysis of variance (ANOVA) and repeated measures ANOVA.

Results: The '60-min cure' group bore the maximum mean compressive load (1016.03 ± 37.27 N) and had the least mean displacement (2.87 ± 0.52 mm) and water absorption (0.18 g).The '40-min cure' group did not show significant results for any of the tests carried out.

Conclusion: Aligners subjected to 60 min of post-print UV light exposure were the most rigid and had highest compressive strength. Increasing the duration of post-UV light curing reduced the amount of water absorbed by the aligners. Since the '60-min cure' group was excessively rigid, a post-curing duration of 40 min is recommended to provide sufficient flexibility for comfortable daily use and wear.

Objectives: The aim of this research was to carry out a study of consultant orthodontists in the United Kingdom (UK) and Republic of Ireland (RoI), exploring the information provision for patients both considering and undergoing orthognathic treatment to help inform the development of decision support tools.

Design: A questionnaire-based study of consultant orthodontists in the UK and RoI through the British Orthodontic Society (BOS) Consultant Orthodontist Group.

Setting: Data collected using an online survey platform (Qualtrics^® XM).

Results: A final sample of 56 respondents was achieved with an estimated response rate of 28%. All respondents (100%) said their patients routinely attended an orthognathic multidisciplinary team (MDT) clinic before commencing any active treatment. The majority (98.21%) of respondents said they utilised nationally available resources produced by the BOS, with the most commonly used resource being the BOS 'Your Jaw Surgery' online resource. When considering the benefits of treatment that were routinely discussed, the three most commonly selected responses were improvement in occlusion (92.86%), improvement in facial aesthetics (91.07%) and improvement in dental aesthetics (83.93%). There were nine orthodontic risks that were routinely discussed by more than 90% of respondents, including pain and discomfort, duration of treatment and long-term commitment to retainer wear, alongside 11 surgical risks, including permanent and temporary paraesthesia or dysaesthesia of the lips/chin/tongue, and postoperative pain.

Conclusion: From the responses received, patients considering orthognathic treatment routinely attend an orthognathic MDT clinic before commencing active treatment. Information is provided with nationally available resources and consultant orthodontists routinely discuss risks and benefits of the orthodontic and surgical treatment with prospective patients to help them make informed decisions regarding their care.

Objective: To evaluate the content and quality of videos created by artificial intelligence (AI) video generator platforms, specifically focused on oral hygiene maintenance and dietary advice for orthodontic patients.

Methods: This mixed-method study evaluated five AI video generation platforms: InVideo, VEED.IO, VideoGen, Lumen5 and Steve.AI. A standardised base prompt was used across all platforms, with minor modifications to accommodate each tool's limitations and functionality. Two orthodontists assessed the content of the voice-overs and captions using a checklist for oral hygiene (OHC) and dietary advice (DAC), as well as the Global Quality Scale (GQS) for overall quality. Descriptive analysis evaluated the consistency between voice-over, captions and visuals. A thematic qualitative analysis was conducted, and quantitative comparisons of checklist scores across platforms were made using non-parametric tests.

Results: All videos were rated poorly, each receiving a GQS score of 2, indicating limited usefulness for patient education. VideoGen recorded the highest OHC score, while Steve.AI (Live) recorded the lowest. For the DAC, Lumen5 achieved the highest score, whereas InVideo and VEED.IO obtained the lowest. However, the score between all the platforms for DAC and OHC were not statistically different (P > 0.05). Although flossing advice and fluoride toothpaste recommendations were generally included, key details, such as brushing duration and specific dietary instructions, were often missing. Many videos also contained irrelevant or inaccurate visuals. Thematic analysis identified three main themes: oral hygiene maintenance, dietary advice and orthodontic appointments.

Conclusion: This study found that AI video generation platforms produce content of poor quality and relevance for oral hygiene maintenance and dietary advice for orthodontic patients.

Objective: To assess the type, number and outcome of remote appointments in Orthodontics and Oral and Maxillofacial Surgery (OMFS) in one acute hospital trust and to establish whether remote appointments carried out during the Covid-19 pandemic were successful in saving a face-to-face appointment.

Design: Service evaluation.

Setting: Orthodontic and OMFS departments at Buckinghamshire Healthcare NHS Trust.

Method: A retrospective service evaluation was carried out, analysing the types, numbers and outcomes of remote appointments in Orthodontics and OMFS over a nine-month period (March-December 2020) during the Covid-19 pandemic in one hospital trust. Data were collected from the trust online booking system and departmental spreadsheets and recorded on Microsoft^® Excel.

Results: A total of 901 remote appointments were analysed, 42% (n = 387) of which were Orthodontic and 58% (n = 523) OMFS. Low failure to attend rates were seen in both specialties (3% (n = 18) OMFS; 6% (n = 21) Orthodontics). Retainer reviews accounted for 83% (n = 315) of all Orthodontic remote appointments and the most common outcome of remote appointments was discharge after attendance (49% n = 189). New patient consultations accounted for 41% (n = 212) of OMFS remote appointments and the most common outcomes were Oral Medicine review (31% n = 162) and discharge following attendance (20% n = 103). Remote platforms saved a follow-up face-to-face appointment in 92% (n = 352) of Orthodontic appointments, compared to 81% (n = 421) for OMFS remote appointments.

Conclusion: When appropriately triaged, the majority of remote appointments do save a face-to-face visit, and there is a place for remote platforms in both specialties going forward. However further research is required in the post-pandemic era to ascertain the full long-term applicability of remote Orthodontic and OMFS appointments.

The use of clear aligners is gaining popularity among orthodontists as well as other dental professionals worldwide. Very frequently, interproximal reduction (IPR) of the enamel in the anterior teeth is required during orthodontic treatment with aligners. The available methods for anterior IPR have some basic inherent disadvantages that can potentially interfere with their daily use. A novel bur intended for use with a high-speed turbine is presented. It was developed specifically for the IPR of anterior teeth. This new design can overcome most of the shortcomings of traditional techniques. It performs IPR effectively, efficiently, safely and without causing patient discomfort.

Aim: To compare microleakage beneath ceramic and metal brackets prepared with either acid etching or laser conditioning.

Design: An in vitro study.

Setting: Department of Orthodontics, Faculty of Dentistry, Suez Canal University, Ismailia, Egypt.

Methods: A total of 40 intact human premolars were selected and divided into four equal groups. The groups received the same adhesive-application procedures with different surface treatments and type of brackets: groups 1 (AM) and 3 (AC) underwent phosphoric acid etching; groups 2 (LM) and 4 (LC) underwent laser enamel conditioning using a Er,Cr:YSGG laser. Metal brackets were then bonded to the teeth in groups 1 (AM) and 2 (LM) and ceramic brackets in groups 3 (AC) and 4 (LC). Subsequently, they were placed in fuchsin dye solution. Each premolar was sectioned longitudinally in the occluso-gingival direction at right angles to the brackets. The dye penetration depth was calculated using a stereomicroscope. Microleakage was measured along the enamel-adhesive interface at each section's gingival and occlusal levels. For group comparisons, the Tukey test was utilised as a post hoc test to determine statistical significance between groups. The independent sample t-test was utilised for comparing both subgroups.

Results: The results demonstrated significantly more microleakage under metal and ceramic brackets bonded to enamel prepared with laser conditioning than with acid etching at both the gingival and occlusal surfaces and in total. The AC group exhibited the lowest amount of microleakage, but the LC group demonstrated the highest amount of microleakage.

Conclusion: The ceramic bracket group treated with acid etching exhibited the lowest level of microleakage. Microleakage values on the gingival and occlusal surfaces were higher in both bracket types for the laser etched groups.

Objective: To compare the levels of interleukin (IL)-1 beta (IL-1β), alpha (IL-1α), receptor antagonist (IL-1Ra), IL-10 and IL-13 in peri-mini-screw crevicular fluid (PMCF) between unloaded and immediately loaded mini-screws during orthodontic treatment.

Design: Single-centre paired split-mouth controlled trial.

Participants: Patients who required at least two mini-screws as a part of their orthodontic treatment at orthodontic clinic of School of Dentistry of Ribeirão Preto, University of São Paulo (USP) were recruited.

Methods: A total of 40 mini-screws were inserted into the interradicular alveolar bone in 16 patients. Using the coin toss method, each mini-screw was randomly allocated into one of two groups: a control group of unloaded (n = 20) and a group of immediately loaded mini-screws (n = 20). Immediately postoperatively, a continuous load in the range of 150-200 cN was applied to the mini-screws allocated to the loaded group. The PMCF was collected in four experimental times: immediately postoperatively (and on load time, to mini-screws allocated into the loaded group) and 7, 14 and 21 days postoperatively. Biomarker levels were measured using Multiplex Microsphere Immunoassays and compared between groups and covariates using statistical tests that accounted for multiple observations per participant (alpha =5%).

Results: No mini-screws were lost. There was a progressive and statistically significant increase of the biomarker's levels in the two groups during the experimental times (P <0.001). The biomarker levels were significantly higher in the immediately loaded group compared to the unloaded group at all time points (P <0.05), except for IL-10 after 7 days postoperatively.

Conclusion: Although all biomarker levels were statistically higher in the immediately loaded group at all experimental time points in comparison with the unloaded group, no mini-screws were lost. This suggests a balanced and normal adaptive bone response to the mechanical stress of immediate loading, with no negative impact on clinical outcomes.