Journal of the World Federation of Orthodontists最新文献

In the treatment of orthodontic patients with idiopathic condylar resorption, symptoms of temporomandibular joint disorders and constantly changing occlusions caused by an instability of mandibular position make it difficult for orthodontists to confirm definitive orthodontic diagnosis and treatment plans. Therefore, these patients' temporomandibular joint (TMJ) structures need to be stabilized with splint therapy before active tooth movement to identify and maintain the true mandibular position. For some idiopathic condylar resorption patients, orthognathic surgery can cause further resorption on the vulnerable condyles of the mandible; thus, effective orthodontic camouflage treatment after joint stabilization should be considered. During the orthodontic camouflage treatment, adverse loads on the TMJ structures, which could change the position of condyles, should be avoided, and TMJ-friendly mechanics must be applied.

Temporary skeletal anchorage devices such as miniscrews are frequently used nowadays. Compared to miniplates, miniscrews are much less expensive and technically easier to place and remove; they are popular and can be easily placed by an orthodontist. Extra-alveolar miniscrews offer benefits compared to inter-radicular miniscrews, such as reduced risk of root damage and the lack of interference with the mesiodistal tooth movement. They are particularly useful for addressing anchorage loss issues and enabling specific tooth movements such as total arch maxillary and mandibular retraction, posterior distalization, molar protraction, molar intrusion, occlusal plane control, and midline correction. The present paper discusses the current biomechanics principles related to the use of extra-alveolar miniscrews placed in the infrazygomatic and mandibular buccal shelf.

This article examines the characteristics of hypodivergent craniofacial patterns and explores treatment modalities in response to these features. It discusses the impact of robust masticatory muscles, which produce heavy occlusal forces. In addition, it examines the use of Botox or splints to reduce gonial angles in individuals with a square face. A nonextraction treatment approach supported by temporary skeletal anchorage devices is recommended; however, if anatomical limitations persist, extraction may be necessary when arch expansion, molar distalization, incisor proclination, or interproximal reduction cannot create the necessary space. In hypodivergent cases where a nonextraction approach is impractical, a single-arch extraction strategy may be considered to prevent a reduction in the vertical dimension. Emphasizing esthetics, particularly maxillary incisor display, a protocol of total arch extrusion of the maxillary dentition assisted with temporary skeletal anchorage device, bite raisers, and interarch elastics is suggested.

Background

To determine the effect of silver and silver chitosan nanocoatings on monocrystalline ceramic, polycrystalline ceramic, and metallic brackets regarding friction, roughness, and antibacterial effect against Streptococcus mutans.

Methods

A total of 99 upper right premolar brackets with a 0.022 × 0.025 -inch slot were divided into three groups, each 33 according to coating material; the non-coated group, silver nanoparticles (AgNPs), and silver chitosan nanoparticles (Ag-CsNPs) groups. Each group was equally subdivided into the following three subgroups regarding bracket materials: monocrystalline ceramic, polycrystalline ceramic, and metallic brackets. A universal testing machine determined static friction on a custom-made acrylic jig. Then a profilometer machine was used to collect roughness data, and finally, the anti-cariogenic effect was measured with the disc diffusion technique's “minimum zone of inhibition” against Streptococcus mutans. Two-way ANOVA was used to compare data between groups and subgroups, followed by the Bonferroni test for multiple pair-wise comparisons.

Results

The nanocoating effect on ceramic brackets' static friction was non-significant. The AgNPs and Ag-CsNPs coated metallic group revealed a significant increase in static friction—a significant effect of the nanocoating in the surface roughness of monocrystalline and polycrystalline ceramic brackets. A significant favorable effect of AgNPs and Ag-CsNPs against Streptococcus mutans was observed.

Conclusions

AgNPs and Ag-CsNPs coats are unsuitable for decreasing friction in metallic brackets or improving roughness in polycrystalline ceramic brackets. Nano coating can improve roughness in monocrystalline ceramic brackets. Coating brackets with AgNPs and Ag-CsNPs has a tremendous antibacterial effect on Streptococcus mutans, a substantial factor in the incidence of dental caries.

Background

Although available evidence suggests that orthodontic appliances can impact quality of life, there is limited information on the impact of orthodontic appliances on sleep quality. This study aimed to compare sleep quality between patients undergoing orthodontic treatments using conventional fixed appliances and clear aligners.

Methods

Adult patients attending clinics in Saudi Arabia participated in this cross-sectional study. Sleep quality was assessed using the validated Arabic version of the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Statistical significance was determined using inferential analysis, with a P < 0.05 considered statistically significant.

Results

There were 69 patients included in the study. The average age of a patient (33.12 ± 8.1) who received the clear aligner was significantly higher than those who received the fixed appliance (27.7 ± 5.9) (P < 0.05). The variation in the average score of ESS because of the education level was found to be statistically significant (P < 0.05). No significant difference was observed between the mean average ESS and PSQI global scores across the two orthodontic treatment groups. The average sleep latency scores were significantly higher in females than males when analyzing the PSQI component score across sex (P < 0.05). In education, ESS, PSQI global, habitual sleep efficiency, the use of sleep medication, and daytime dysfunction had a positive, weak, but significant correlation.

Conclusions

Overall, this study concluded that regardless of the orthodontic appliances used, there was no statistically significant difference in sleep quality during the treatment.

Background

To compare the effectiveness and efficiency of orthodontic treatment (OT) with standard versus computer-aided design and computer-aided manufacturing (CAD/CAM) indirect bonding of conventional brackets.

Methods

This retrospective study examined two groups: standard indirect bonding group (12 males, 13 females; mean age 12.21 ± 0.52 years), and digital indirect bonding group (11 males, 14 females; mean age 12.76 ± 1.32 years), treated via a CAD/CAM indirect bonding system. Conventional brackets were used in both groups. Pretreatment and post-treatment records were acquired for all subjects. Weighted Peer Assessment Rating (W-PAR) index was used to assess the effectiveness of OT, in conjunction with five angular cephalometric measurements (ANB°, Sn-GoGn°, U1-PP°, IMPA° and FMA°) and comparatively analyzed using generalized mixed-effects models and post hoc test. Treatment efficiency was assessed in terms of the numbers of bracket repositionings, archwire bends, accidental bracket debondings, appointments and treatment months. Comparative analysis of efficiency was performed using the asymptotic Wilcoxon–Mann–Witney test. Statistical significance was set at 5%.

Results

Total W-PAR and W-PAR component scores decreased significantly during treatment for both groups and in a similar way. Cephalometric measures ANB° and IMPA° significantly decreased and increased, respectively. Significantly fewer bracket repositionings, number of appointments and treatment months were recorded in group digital indirect bonding.

Conclusions

Although both methods investigated were effective to achieve good outcomes, CAD/CAM indirect bonding method increased the efficiency of OT, when conventional brackets are used.

Background

Improving bracket placement accuracy through computer-aided design and a bracket navigation set supported by augmented reality (AR).

Methods

A technical workflow was developed for implementing AR-assisted orthodontic bracket positioning through a smartphone application. This innovative approach eliminates the need for three-dimensional radiation imaging or physical guides, making it a safe and convenient option for clinical use by overlapping the digitally planned bracket position over the patient clinical crown for a precise recommendation of bracket positioning.

Results

It was found that it is achievable and can be easily recognized from all view angles, and this proves that new techniques with new opportunities could be considered.

Conclusions

AR smartphone applications can potentially be used for the accurate placement of dental brackets; thus, such applications show promise for use in the field of orthodontics.

Background

There is significant international variation in the postgraduate orthodontic training. The aim of this study was to obtain information relating to the design, content, and delivery of formal postgraduate orthodontic training internationally. Moreover, we aimed to evaluate the perception of orthodontists towards their training as well as identifying factors associated with an improved level of satisfaction.

Methods

A 42-question survey was sent to orthodontists worldwide via SurveyMonkey. The survey was circulated on orthodontic Facebook groups and through other digital channels including Instagram.

Results

A total of 168 respondents completed all sections of the questionnaire. The vast majority believed programme length was appropriate (n = 150; 89%). Most respondents were confident with their research skills and in their ability to diagnose and treatment plan. Social media was frequently accessed by the respondents for the purposes of orthodontic education (n = 83; 49%). A high proportion (n = 70; 42%) did not treat any clear aligner cases during postgraduate training with many having experience using Invisalign^TM only. The majority of respondents across the regions had training in buccal miniscrew insertions. Exposure to three-dimensional printing during residency was limited.

Conclusions

The study offers an overview of the structure, content, and modes of delivery in orthodontic postgraduate training internationally. While satisfaction levels are good, there is a disparity in terms of exposure to certain techniques internationally. Further training in the modern diagnostic approaches and mechanics may improve satisfaction with postgraduate training.

Background

Investigating the possible changes in patients’ expectations of and satisfaction with the orthodontic treatment outcomes when they were given the three-dimensional digital prediction of their teeth alignment before the beginning of treatment.

Methods

A prospective non-controlled single-group clinical trial was conducted on 28 (18 females, 10 males, mean age: 20.68 ± 1.91 years) patients with Class I malocclusion and moderate dental crowding who required a nonextraction orthodontic treatment. Patients were given the expectations questionnaire on their first visit (T0). Then, patients were shown a three-dimensional digital setup–created by Orthoanalyzer software (3Shape, Copenhagen, Denmark)–of the proposed treatment results before orthodontic treatment (T1) and received two questionnaires, the second expectations questionnaire and the satisfaction with the proposed changes questionnaire. Treatment was then initiated using the fixed appliances and completed. After debonding, a question about patients’ satisfaction with the achieved changes was completed (T2).

Results

Patients’ expectations level significantly increased after watching the predicted alignment of teeth compared with the initial levels in terms of chewing ($\overline{x}$ = 5.54 and $\overline{x}$= 6.71), speech ($\bar{x}$ =5.93 and $\overline{x}$= 6.93), and oral hygiene improvement ($\bar{x}$= 7.93 and $\overline{x}$=8.61 ± 1.06; at T0 and T1, respectively). The remaining items showed no significant differences between the two assessment times. Patients had a higher level of satisfaction at the end of treatment than after watching the proposed outcome. There were significant statistical differences in the items related to teeth appearance ($\overline{x}$= 9.12 and $\overline{x}$= 9.60 at T1 and T2, respectively), and teeth engagement ($\overline{x}$= 8.92 and $\overline{x}$= 9.40 at T1 and T2, respectively)

Conclusions

Watching the predicted alignment outcome increased patients’ expectations of chewing, speech, and oral hygiene improvement compared with the initially recorded levels. Patients were more satisfied with the final result than what was recorded after