Turkish Journal of Orthodontics最新文献

Objective: The quality of orthodontic forces in aligners is mainly influenced by their mechanical properties. At present, there is insufficient information on how environmental factors affect the mechanical function of aligners, and studies have shown that patients do not pay enough attention to removing aligners while eating and drinking. Therefore, in this study, we investigated the effect of different chemicals on the mechanical properties of thermoplastic materials.

Methods: In this study, 175 thermoplastic samples from Easy-Vac gasket (3A Medes, Korea) were prepared, and their chemical composition, tensile strength, and hardness before and after exposure to solutions of orange juice, Cola, chlorhexidine mouthwash, and distilled water were measured. One-Way analysis of variance (ANOVA), Tamhane's test, and Tukey's test were used for statistical analysis.

Results: The tensile strength of the sheets increased with continuous exposure to orange juice and chlorhexidine mouthwash, and their hardness decreased with continuous exposure to carbonated beverages. There was no change in the chemical composition of the samples after exposure to different chemicals.

Conclusion: Although these changes are statistically significant, they do not have a significant effect on the result of aligner performance. Therefore, the only concern is the cariogenicity of orange juice and Cola during treatment with aligners and the administration of chlorhexidine mouthwash.

Expeditious strides in the fields of biomaterials, computer-aided design, and manufacturing have catapulted clear aligner therapy (CAT) to become a comprehensive orthodontic treatment modality. The efficiency of achieving planned tooth movement with clear aligners is a significant consideration while setting up the final treatment goals, as well as calculating treatment times and costs based on the available evidence. Contemporary research outcomes confirm that one of the most commonly reported clinical concerns with CAT is the discrepancy between the prescribed outcome in the digital treatment plan and the clinically achieved outcome from a given series of aligners. Inaccurate prediction of tooth movements may not only lead to a prolonged duration of aligner treatment with an additional need for refinement strategies; but it may also cause other concerns, such as patient burnout and increased potential for relapse. The authors of this paper have elucidated some of the critical elements that may help address this discrepancy between digitally prescribed and clinical outcomes based on an evidence-based approach with regard to the predictability and accuracy of CAT. A strong diagnostic acumen, judicious case selection, solid biomechanical understanding of various types of orthodontic tooth movements, a research framework that keeps pace with technological and material developments and provides evidence-based knowledge of the limitations of CAT; and above all, the ability of the clinician to continually innovate as per different clinical scenarios, all contribute to attaining treatment predictability, efficacy, and efficiency with CAT.

Objective: To investigate the most common retention practices, factors influencing the retention protocol, and the differences among orthodontists regarding retention practices.

Methods: An online validated questionnaire was anonymously sent to 3,000 orthodontic residents and clinicians. The survey consisted of 19 questions regarding the participants' demographics, prescribed retention appliances, factors affecting retention appliance choices, and adjunctive retention procedures. Descriptive statistics, Chi2 and Kendall's Tau-b tests were applied.

Results: Five hundred fifty-five orthodontic residents and clinicians, 53.3% males and 46.7% females, completed the survey, indicating a response rate of 18.5%. Although participants' demographics, type of treatment and pre-treatment malocclusion influence the choice of retention protocols, thermoplastic retainers (TR) were the most popular retention regime for the maxillary arch for both adults (47.4%) and adolescents (42.3%). Bonded retainers (BR) were the favored option for the mandibular arch (44.9% of adults and 40.7% of adolescents). The degree of arch expansion (64.1%) and the degree of interdigitation (50.1%) after treatment were the most influential factors for the choice of the preferred type of retainers by the respondents. 68.6% of the participants thought professional retention guidelines would be useful.

Conclusion: Thermoplastic retainers were the most common retention appliances for adults and adolescents in the maxilla. At the same time, BR was the most favored retainer in the mandibular arch, with clinical experience, practice setting, and malocclusion- and treatment-related factors influencing the type of the chosen appliance. The demographic differences and the uneven participation in the survey need to be considered while interpreting the findings of this study.

Objective: This study aimed to evaluate the accuracy of dental calcification stages in predicting the peak pubertal stage.

Methods: This retrospective study was conducted on panoramic and lateral cephalometric images of 406 female patients aged 9-14 years. The skeletal maturity and calcification stages of the mandibular canines, first premolars, second premolars, and second molars were determined using the Hassel-Farman and Demirjian (DI) methods, respectively. The prediction accuracy of the peak pubertal stage with the studied teeth was assessed using a receiver operating characteristic curve and the area under the curve (AUC). The DI stage of H was designated as the reference level, and Bayesian logistic regression analysis was used to assess the coinciding chance of each DI stage and peak pubertal stage.

Results: The AUC range of studied teeth was 0.84-0.92 in predicting peak pubertal stage (all p<0.001). In the canines and first premolars, the coinciding chance of peak pubertal stage and stage H was significantly higher than that in other stages [p<0.05, odds ratio (OR) ≤0.14]. In the second premolars and second molars, the chance of peak pubertal stage coinciding with stages H and G did not significantly differ (p>0.05); however, the chance of stage G coinciding with peak pubertal stage in the second molars was higher than in stage H (OR=4.59).

Conclusion: Stage H in all studied teeth and stage G in the second premolars and second molars predict peak pubertal stage with high accuracy. Considering that stage H is the end of tooth calcification stages and the accuracy of predicting stage G of second molar teeth is higher than the above stage, estimating the peak pubertal stage is recommended by the second case.

Objective: To compare the consistency of two interproximal reduction (IPR) methods in terms of the amount of planned and performed IPR during clear aligner therapy (CAT).

Methods: Thirty-four patients who received IPR using hand-operated abrasive strips (Group 1, 20 patients, 162 teeth) and motor-driven 3/4 oscillating segmental disks (Group 2, 14 patients, 134 teeth) during CAT were included in this preliminary study. The consistency between the planned and performed IPR amounts was evaluated within and between groups for teeth and quadrants.

Results: In Group 1, the amount of IPR performed on teeth numbers 22 and 43 and in the upper left quadrant was found to be statistically less than that of planned. On the other hand, the amount of performed IPR was statistically higher on tooth number 44 and in the upper right quadrant, whereas it was statistically less on tooth number 33 when compared with the planned amount in Group 2. The inconsistency between the planned and performed IPR amounts were statistically significant only in Group 1 and for teeth numbers 11, 21, 32, 33, and 43. No significant difference was found when the same parameter was compared between the groups.

Conclusion: The consistency of IPR was found to be better with the motor-driven oscillating disk system than with the hand-operated IPR strip system.

Objective: This study aimed to evaluate the quality, reliability, and content usefulness of videos created by orthodontists on clear orthodontic aligners.

Methods: Videos were screened using YouTube^TM by conducting a search for "Invisalign". After a preliminary evaluation of the first 250 results, 61 videos that met the selection criteria were scored and their length, days since upload, and numbers of views, likes, dislikes, and comments were recorded. These data were used to calculate the interaction index and viewing rate. Video reliability was assessed using a five-item modified DISCERN index, and video quality was assessed using the Video Information and Quality Index. A 10-item content usefulness index was created to determine the usefulness of the video content. Descriptive statistics of the parameters were calculated, and correlation coefficients were calculated to evaluate the relationships between the parameters.

Results: The mean reliability score was 2.75±1.02 (out of 5), and the total quality score was 11.80±3.38 (out of 20). The total content usefulness index was quite low, with a mean score of 2.52±2.14 (out of 10). Interaction index and viewing rate were positively correlated with reliability score (r=0.463, p<0.01; r=0.295, p<0.05) and total quality score (r=0.365, p<0.01; r=0.295, p<0.01, respectively). The reliability score was positively correlated with the total quality score (r=0.842, p<0.01) and total content usefulness index (r=0.346, p<0.01).

Conclusion: Videos about orthodontic aligner treatment have average reliability and quality but largely insufficient content.

Objective: The aim of this study was to determine how orthodontists utilize the social media application Instagram for health communication.

Methods: Four Turkish keywords were manually searched on the Instagram platform on February 12, 2022: "orthodontist" (ortodontist), "orthodontics" (ortodonti), "orthodontic specialist" (ortodonti uzmanı), and "doctor of orthodontist" (ortodonti doktoru). A total of 195 orthodontist accounts matching the inclusion criteria were divided into two groups: public and private. Profile information analyses were performed, and the results for public and private accounts were compared. Public accounts were further divided by gender and whether they shared a company name in their profiles. Groups were compared according to post content and type of patient photo. Statistical analysis involved the Shapiro-Wilk test, an Independent Samples t-test, the Mann-Whitney U test, and chi-square and Kappa tests.

Results: The number of posts (96.06±149.30 vs. 195.36±248.51) and followers (1,250.56±2,347.47 vs. 4,071.43±6,557.63) were higher for public accounts. The number of followers (3,171.62±4,645.08 vs. 5,472.57±8,595.99) and daily posts (0.17±0.37 vs. 0.23±0.43) were higher for accounts with a company name. In the content analysis, posts on clear aligners (1.51±4.74 vs. 6.60±18.60, p<0.05) and patient and company advertisements were more common (0.49±1.85 vs. 3.70±10.70, p<0.05) for accounts with a company name.

Conclusion: While public orthodontist accounts commonly promote fixed mechanics as a treatment option, accounts with a company name adopt a different approach, emphasizing the sharing of information about clear aligners.

Objective: This study aimed to systematically review the effect of lithium on orthodontic tooth movement (OTM).

Methods: The focus question was "does lithium have an effect on OTM?" A systematic search was conducted using indexed databases and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. The quality assessment of the selected studies was performed according to the systematic review center for laboratory animal experimentation.

Results: Five of the initially identified 656 articles fulfilled the eligibility criteria and were selected for this review. The studies reported that lithium administration lowered the rate of OTM by inducing a reduction in the number of osteoclasts and possibly inhibiting osteoclastogenesis. These studies further showed an increase in bone density and bone volume by promoting the Wnt/ß-catenin signaling pathway and osteoblastogenesis. It was also noted that lithium reduced orthodontically induced root resorption during experimental OTM. Further, standardized studies are warranted to understand the impact of lithium in OTM. Overall, the risk of bias for 3 studies was very high, high in 1 study, and moderate in 1 study.

Conclusion: On an experimental level in animals, lithium decreased the rate of OTM during the active treatment phase by increasing bone density and bone volume and reducing root resorption. In addition, lithium may enhance alveolar bone formation during orthodontic retention. Clinically, this may impact the orthodontic treatment duration in patients receiving lithium, and further studies are needed to understand the true impact of lithium on OTM.

Objective: This study compared third molar angulation and eruption status in Class I and II malocclusions after orthodontic treatment with and without first premolar extractions.

Methods: The sample comprised 93 patients divided into four groups: Group 1, Class I malocclusion treated with first premolar extractions; Group 2, Class I malocclusion treated without extractions; Group 3, Class II malocclusion treated with first premolar extractions; and Group 4, Class II malocclusion treated without extractions. Panoramic radiographs were used to evaluate the third molar mesiodistal angulations at T1 (pretreatment), T2 (posttreatment), and T3 (long-term posttreatment). Third molar eruption status was assessed in dental casts. Intergroup angulations and eruption status comparisons were performed using one-way analysis of variance (ANOVA), followed by Tukey's test and Kruskal-Wallis test, respectively.

Results: Significantly greater mesial angulation and percentage of erupted right maxillary third molars were observed in the Class I extraction group. Significantly greater eruption status of the right mandibular third molars was observed in the Class I and Class II malocclusion extraction groups.

Conclusion: Class I and II malocclusion extraction treatment exhibited more favorable angulations and a greater number of erupted third molars than non-extraction treatment. The non-extraction groups exhibited a greater percentage of unerupted third molars.

Objective: The objective of the present study was to evaluate the effectiveness of transcutaneous electrical nerve stimulation (TENS) therapy on pain during the debonding procedure.

Methods: A placebo-controlled, randomized split - mouth study was conducted on 30 orthodontic patients. The right and left anterior teeth in the maxilla and mandible were randomly allocated to the control and experimental groups (EG) and were stimulated. TENS application was made through a modified electrode probe that was used from an ammeter. The control group (CG) received the mechanical application of the device with no current, whereas the EG received progressively increasing current from 0.1 mA to the point where the patient experienced a mild tingling sensation for 60 s for each tooth. This was followed by a debonding procedure using an orthodontic debonding plier. Pain perception was recorded on a numerical rating scale after debonding each tooth.

Results: The mean pain score was higher in the CG than in the EG, and the difference between the two groups was significant (p=0.001). The pain score was higher in the mandibular teeth than in the maxillary teeth, and the difference between the two groups was also significant (p=0.021). Pain score was higher in female subjects than in male subjects, and the difference between the two groups was significant (p=0.015).

Conclusion: The application of TENS therapy results in pain reduction during the debonding procedure. The female subjects experienced more pain. Higher pain scores were recorded for the mandibular anterior teeth than for the maxillary teeth.