AIM: To determine the prevalence of malocclusions and the need for orthodontic treatment in a sample of school-going adolescents in the Najran city, Kingdom of Saudi Arabia (KSA). METHODOLOGY: This cross-sectional study was conducted among 1094 school-going Saudi male adolescents. The age range of the sampled adolescents was 13–18 years, and none of them had any history of orthodontic treatment. A survey chart related to malocclusion was designed and filled up after clinical examination by a single experienced and calibrated examiner. The need for orthodontic treatment was assessed using the Index of Orthodontic Treatment Need (IOTN). RESULT: The present study's findings demonstrated 61.2% of the samples with Angle's Class I malocclusions, 27.5% with Class II, and 11.4% of samples with Class III malocclusion. A significant difference was observed between the different classes of malocclusion (P < 0.001). Most samples presented normal overjet, crossbite, and no reverse overjet, deep bite, or open bite. The number of samples with no treatment need was 573 (52.37%), with slight treatment in 185 (16.91%) samples, moderate treatment needs in 123 (11.24%) samples, and severe and extreme treatment needs were 109 (9.96%) and 104 (9.50%), respectively. A significant difference was observed between the samples with no or slight treatment need (grades 1 and 2), moderate need (grade 3), and definite treatment need (grades 4 and 5) (p < 0.001). CONCLUSION: The prevalence of malocclusion and IOTNs among the sample of school-going adolescents in the Najran city was 47.63%. However, 9.63% of those samples required immediate attention for orthodontic treatment.

OBJECTIVE: To compare and assess the coefficient of frictional resistance between nano-coated orthodontic brackets and orthodontic archwires with conventional orthodontic brackets and archwires METHODOLOGY: In this experimental study, 128 samples were divided into 4 groups consisting of 32 orthodontic wires and brackets in each group. The samples were randomly allocated into GROUP A- ZNO nanoparticle coated archwires and brackets, GROUP B ZNO nanoparticle coated bracket and conventional archwire, GROUP C-ZNO nanoparticle coated archwire and conventional bracket, and GROUP D- conventional archwire and bracket after positioning them on special jigs frictional resistance was studied and evaluated. Bon – Ferroni test was used for inter group comparison and one way ANOVA was used for intr-group comparison. RESULTS: The lowest mean frictional resistance is seen with Group A (nanocoated archwire with nanocoated bracket) N = 0.3401 ± 0.420; and highest with Group D (conventional brackets with conventional archwires) N = 0.8413 ± 0.60. a significant difference in mean frictional resistance was observed between the groups (P ≤ 0.01). The frictional resistance for the groups was in the following order from lowest to highest: group A < B < C < D. CONCLUSION: The study showed decreased friction in ZNO nanoparticle coated archwires and brackets than conventional archwires and brackets.

OBJECTIVE: To investigate the impact of platelet-rich plasma (PRP) on canine movement acceleration. METHODS: Randomized clinical trial split-mouth study with a double-blind design and controlled group on 31 orthodontic patients, which had been indicated bilateral maxillary first premolar extraction. Each patient recorded clinical features, analyzed lateral cephalometric film, and evaluated the acceleration on dental models at every specific interval. RESULT: The cumulative distance to the distal canines was larger for the PRP injection group than for the control group at three time points (4 weeks, 8 weeks, and 12 weeks), all of which were statistically significant. The PRP injection group's canine distal width increased from the first 4 weeks (ΔT1) to the highest in the middle 4 weeks (ΔT2 = 1.78 ± 0.11 mm/month), and then it gradually decreased in the last 4 weeks (ΔT3). The speed of the PRP-injected canine was faster than the control group by 1.51 times. CONCLUSION: PRP can accelerate the speed of canine movement in orthodontics and can be applied for severe cases, for example, impacted tooth retraction, molar protraction or retraction, and other cases.

INTRODUCTION: Anterior-posterior discrepancy assessment is a crucial component of orthodontic diagnosis and is often carried out using hard tissue cephalometric analysis. The purpose of this study was to compare the photographic Frankfort plane subnasale pogonion (FSA) angle with established cephalometric parameters to determine the accuracy of the angle in determining maxillomandibular anteroposterior discrepancies. MATERIALS AND METHODS: In this prospective study, a total of 60 subjects, 20 in each skeletal sagittal malocclusion, were included in the final sample based on the selection criteria. Both photographic and cephalometric records were taken, and the parameters assessed were the beta angle, Steiner's analysis, the ANB (A point- Nasion- B point) angle in the cephalograms, and the FSA angle in the profile photographs. Statistical analysis was done with SPSS software. The correlation between the measured parameters was assessed using Pearson's correlation test. RESULTS: A high positive and significant correlation between the FSA angle and beta angle (r = 0.793) was noted, and a high negative and significant correlation between the FSA angle and ANB angle (r = -0.848) was noted. CONCLUSION: The photographic FSA angle can be used as a reliable parameter to diagnose anteroposterior discrepancies.

OBJECTIVE: This study aims to identify the motivations behind orthodontic re-treatment in Saudi Arabia. MATERIALS AND METHODS: This is a cross-sectional study performed through a patient questionnaire. The questionnaire elicited data on the respondents' socio-demographic data, type of previous orthodontic treatment, retention, satisfaction level, and reasons for undergoing orthodontic re-treatment. RESULTS: Four hundred and nineteen responses were received during the study period from June to July 2022. The result showed a pre-dominant female predilection (83, 29%), with the majority belonging to the 21–25 age group (47.26%). Most participants had had one previous orthodontic treatment (77%), with an active treatment time of approximately 1–3 years (55.85%). There was no significant difference between the satisfaction of outcomes after the initial treatment and at the time of the survey. Most participants received retention appliances (69.45%) and were informed about the importance of appliances. The type of retention was mainly removable retainers (47.5%). Around one-third of the sample (31.98%) were interested in seeking orthodontic re-treatment, with self-motivation as the primary drive and improving the smile as the predominant reason. CONCLUSION: The study's findings show that a large portion of the population is seeking orthodontic re-treatment, which must be considered. Self-motivation was a driving force rather than external motivation. The most common reason for seeking orthodontic re-treatment was to improve their smile and the increased esthetic demand.

OBJECTIVES: This study aimed to compare and evaluate the effect of three staining solutions on the color stability of three different brands of esthetic archwires using a spectrophotometer and also to compare the fluorescence of esthetic archwires with extracted human teeth. MATERIALS AND METHODS: A total of 84 nickel–titanium (NiTi)-coated esthetic archwires with the same cross section and size (0.016 × 0.022″) were included. All samples were divided into four groups of 21 each, that is, group 1: artificial saliva (AS), group 2: coffee (C) solution, group 3: turmeric (T) solution, and group 4: chlorhexidine (CH) mouth rinse; each group was subdivided into three subgroups of seven each (Opal Classic (OC), Libral Rabbit Force (LRF), and Ortho Organizers (OO)). The baseline value (T0) was measured before immersion in the staining solution and then immersed in the staining solution for 21 days. The color measurements were recorded at different time intervals on the 7^th, 14^th, and 21^st days using a spectrophotometer. The fluorescence of archwires is tested in a dark atmosphere using a fluorescent black lamp. The data obtained were analyzed using descriptive statistics, analysis of variance (ANOVA), and post hoc Bonferroni test. RESULTS: A significant amount of color change in all three brands of archwires from day 0 to day 21 (p < 0.005) was observed, except for OC in the CH mouth rinse group (p = 0.230). The fluorescence of OO matches with the natural teeth. CONCLUSION: LRF showed the highest overall color change followed by OO and OC. Turmeric is the most chromogenic agent, followed by Coffee and CH mouth rinse.

OBJECTIVES: The aim of this study was to evaluate the correlation of the length of the lingual frenulum with the craniofacial morphology in adults. METHOD AND MATERIALS: The study comprised a total of 144 subjects, aged 18 to 28 years, divided into 3 groups (48 in each group), based on ANB angle i.e., Skeletal Class I, Skeletal Class II & Skeletal Class III. To measure the length of the lingual frenulum direct and indirect methods were used. A Lingual frenulum ruler was used for direct measurement and the differences between the maximum mouth opening reduction (MMOR) with and without the tip of the tongue touching the incisive papilla measurement were taken for the indirect method. A lateral cephalogram was collected from each subject and a cephalometric analysis was done to assess craniofacial morphology. Statistical analysis was done by ANOVA and the significance of the mean difference between (inter) the groups was done by Tukey's HSD (honestly significant difference) post hoc test after ascertaining normality by Shapiro-Wilk's test and homogeneity of variance between groups by Levene's test RESULTS: The lingual frenulum length and maximum mouth opening reduction were significantly increased in the Skeletal Class III subjects with a statistically significant value of P < 0.001 when compared with the Skeletal Class I and Skeletal Class II subjects. CONCLUSION: A balance in the teeth positioning is maintained by orofacial musculature and any disturbance which occurs in this, results in malocclusion. Malocclusion can result in a long lingual frenulum that pushes the mandibular anterior forwards. Hence, the malocclusion and lingual frenulum length relationship are essential to eliminate the erratic forces and to attain excellent results, following the elimination of malocclusion.

OBJECTIVES: This investigation aimed to evaluate the most common orthodontic urgencies, their management, and changes in routine biosafety measures and the total income of the dental office in South India during the COVID-19 pandemic. METHODS: A questionnaire was drafted using Google Forms with questions in four domains pertaining to orthodontic urgencies, biosafety measures, treatment duration, and income. After validation, this questionnairewas sent to 750 orthodontists via WhatsApp messenger (WhatsApp Inc, Menlo Park, Calif) over a period of 14 days.Descriptive statistics and comparisons were performed using independent t- and Chi-square tests. RESULTS: Majority of the orthodontists (62.3%) had closed their clinics only during the first lockdown. Many (63%) had scheduled urgent appointments along with routine limited patients per day. The most frequent urgencies were related to the breakage of brackets, archwires, molar tubes, bands, and temporary anchorage devices. Aligners were the least problematic. The treatment time was also prolonged. Telephonic advice and virtual assistance via WhatsApp messages/videos were found to be successful in the management of urgencies.Most orthodontists had strengthened their routine biosafety measures.The financial impact of this pandemic was considerable, with nearly 50% reduction in total income. CONCLUSIONS: Urgencies linked to preadjusted edgewise appliances, such as breakage of brackets and tubes, and archwire-related injuries were the most common. Prolongation of treatment time and negative financial impact were the other problems encountered during this pandemic. Drastic changes had occurred in routine biosafety measures, which prevented the spread of infection among orthodontists and patients.

AIM: The aim of the study was to evaluate and assess the influence of maxillary molar rotation on severity of dental class II malocclusion. MATERIALS AND METHODS: The study comprised of 4 different groups namely, 1/4th class II malocclusion, 2/4th class II malocclusion, 3/4th class II malocclusion and full class II malocclusion involving sample size of 20,15,16 and 12. The samples were subjected to digital evaluation of maxillary 1st permanent molar rotation using 4 parameters namely angle of Friel, Ricketts E-Line, angle of Henry and Premolar angle. RESULTS: The results were subjected to statistical analysis using one way ANOVA wherein group IV (Full class II malocclusion) exhibited a greater rotational value. On evaluation, angle of Friel exhibited a mean of 59.6±1.61 degrees, Ricketts E-Line was found to be 12.3±1.77mm while angle of Henry showed a mean of 19±3.19 degrees and premolar angle was 12.5±5.83 degrees. CONCLUSION: On evaluating molar rotation using angle of Friel, Ricketts E-Line, angle of Henry and premolar angle, full cusp class II malocclusion presented higher degree of mesiopalatal rotation maxillary molar rotation. With increasing mesiopalatal rotation, the severity of molar relation also increased from 1/4th to full class II. Hence the maxillary molar spatial position along the long axis majorly influences the molar relation wherein a full cusp class II molar relation exhibits higher degree of molar rotation.

Infection control is essential to protect both the doctor and the patient by preventing the spread of infectious diseases. There is no exception in the field of dentistry, particularly in orthodontics, where numerous appliances are used for a variety of functions and also because the mouth cavity has the highest concentration of bacteria of any body part. Through this systematic review, we aimed to assess the various methods of sterilization employed in an orthodontic setting. Using relevant keywords, reference searches, and citation searches, the databases such as PubMed, MEDLINE, Web of Science, Cochrane, and Scopus were all searched; a total of 206 documents were found, of which 113 were initially selected. The remaining 23 distinct papers were initially made available after 90 publications that were identical to or similar to one another were eliminated. The final selection was made from eight documents that met all inclusion and exclusion requirements. The existing methods of sterilization were found to be competent in dealing with the microorganisms found in a typical orthodontic setting. The chemical method of sterilization was the norm in most of the studies that we assessed, with glutaraldehyde and peracetic acid (PAA) being the most commonly employed compounds for disinfection. PROSPERO Registration Number: CRD42022380831.

A variety of metals and alloys are employed in the field of orthodontics, primary of which happen to be the construction of wires. Through this systematic review, we aimed to assess the various metallurgical characteristics of the said metals and alloys. Four hundred and eighty-two documents in total were found after a thorough search of the online journals, and 169 of the papers were initially chosen. Ultimately, 16 documents were selected that satisfied the necessary inclusion and exclusion criteria, primarily in vitro studies, literature reviews, and comparative analyses. NiTi alloy was found to be the most commonly used alloy in construction of orthodontic wires across all the studies that we had selected for our review. It also had better performance and consistency in terms of its usage as depicted by the meta-analysis performed, with stainless steel wires being a close second primarily due to its lesser cost compared to the former. Metallurgy and orthodontics are inextricably linked with one another. The various components of orthodontics such as wires, pliers, and other instruments utilize the metallurgical characteristics of metals and alloys that are specially prepared for the challenges of this field. PROSPERO Registration Number: CRD42022378444.

INTRODUCTION: The purpose of this study was to evaluate the amount of root resorption with mini implant-aided anchorage, with and without inducing the regional acceleratory phenomenon (RAP) in en masse retraction cases using cone-beam computed tomography (CBCT). METHODS: Thirty patients requiring therapeutic extraction of all first premolars were included in the study and randomly divided into two groups of fifteen patients each (groups I and II). Patients of both groups underwent retraction using mini implants. In patients of group II, the RAP was initiated before starting retraction. For each patient, CBCT of the maxillary and mandibular anterior region was taken before treatment and after retraction to evaluate root length changes. RESULTS: The amount of root resorption post-retraction was lesser in group II as compared to group I for the maxillary canine, mandibular canines, and mandibular lateral incisors. When the amount of root resorption was scored according to the Malmgren index, a greater percentage of teeth in group I (17.8%) showed root resorption of score of 3 as compared to group II (6.1%). CONCLUSION: The results of the study show that the RAP caused reduced root resorption, but its effect was localized to the area where it was induced. When mini implants are used for absolute anchorage during en masse retraction, the RAP can be induced to reduce the root resorption that results from increased treatment time associated with implant-aided retraction.

AIM: To translate the orthodontic experience questionnaire into Malayalam, an Indian language, and assess its validity and reliability in the Kerala population. MATERIALS AND METHODS: The original questionnaire, which was developed in English, was translated into Malayalam. Face validity was assessed, and minor changes were made, followed by a content validity assessment by an expert panel. The final version was given to 324 patients who marked their responses on a Likert scale. Internal consistency reliability was tested using Cronbach's alpha, and test-retest reliability was tested using the intraclass correlation coefficient. Principal component factor analysis was performed to regroup the valid items. RESULTS: The principal component factor analysis revealed three domains. Reliability assessed by Cronbach's alpha of the whole questionnaire was 0.799, and that of the three domains was 0.73, 0.71, and 0.71, respectively. The test-retest reliability was found to be good (0.798). CONCLUSION: The Malayalam version of the orthodontic experience questionnaire was found to be content valid with good reliability. To obtain a successful treatment result, an orthodontist must be aware of these and this questionnaire, with adequate validity and reliability, has been designed to achieve this in the Malayalam-speaking population.

AIM: To evaluate the shear strength of Orthocem and BracePaste polymerizable cement light-cured with light-emitting diode (LED) units with different wavelengths (Bluephase N) with their high power, low power, and soft start programs in the bonding of metal brackets. MATERIALS AND METHODS: In vitro experimental research was performed. Mini Roth 0.022 metal brackets (Roth Orthometric brackets) were used. The adhesives were placed on the metal brackets with Orthocem and BracePaste resin cement. To compare the average strengths, the analysis of variance (ANOVA) test was used (P < 0.05). RESULTS: The average shear strength was better with Bracepaste polymerizable cement compared to Orthocem cement in all its high power, low power, and soft star programs; the highest was Bracepaste with soft start of 26.52 MPa, and the lowest was Orthocem with soft start of 13.92 MPa. When evaluating the differences, it was found that these were statistically significant in all groups (P < 0.05). CONCLUSIONS: Differences were found in the shear strength of light-curing Orthocem and Bracepaste light-curing cement cured with LED units with different wavelengths in bonding metal brackets to the tooth in vitro.

AIMS: To evaluate the effect of adding vanillin nanoparticles on the antimicrobial and mechanical properties of the orthodontic adhesive. MATERIALS AND METHODS: Transbond XT orthodontic adhesive (3M Unitek, Monrovia, California, USA) was modified with 1% and 2% vanillin nanoparticles. The chemical composition and degree of chemical conversion in orthodontic adhesive before and after adding vanillin nanoparticles to orthodontic adhesive were measured using Fourier transformation infrared spectroscopy (FTIR). Mechanical properties of unmodified orthodontic adhesive (UMOA) and 1% and 2% vanillin-modified orthodontic adhesive (VMOA) were assessed in shear bond strength (SBS) and tensile bond strength (TBS). The antimicrobial properties were evaluated using a Mueller–Hinton plate swapped with streptococcus mutans. The zone of bacterial inhibition for UMOA, 1% VMOA, and 2% VMOA was measured. Descriptive statistics, multiple comparisons, one-way ANOVA, and post hoc Duncan's test were used to compare among the results. RESULTS: FTIR showed no chemical conversion of 1% VMOA and 2% VMOA. There was significant streptococcus mutans growth inhibition in 1% VMOA and 2% VMOA compared to UMOA. No significant difference in streptococcus mutans growth inhibition in 1% VMOA and 2% VMOA. The SBS decreased significantly in 1% VMOA compared to UMOA. In addition, SBS decreased insignificantly when comparing 1% VMOA and 2% VMOA. TBS significantly reduced in 2% VMOA compared with UMOA. In addition, there was no significant difference in TBS between UMOA and 1% VMOA, and 1% VMOA and 2% VMOA, respectively. CONCLUSIONS: The 1% VMOA has improved antimicrobial properties and kept mechanical properties of orthodontic adhesive within the acceptable level.

OBJECTIVES: Temporary anchorage devices (TADs) are skeletal anchorage devices. They are minimally invasive and placed by the orthodontist to prevent unwanted tooth movement. This study evaluated the survival rate of orthodontic TADs at 6 months. This study also assessed the effect of age, gender, side, site, dental arch of placement, and length of the TADs on its survival rate. MATERIALS AND METHODS: Ethical approval was obtained from the Health Research Ethics Committee of the hospital. The study sample comprised orthodontic patients who required the placement of TADs during treatment at a private dental facility in Lagos. Data for the study were obtained from the case files of the study subjects and included the subjects' age, gender, date of placement of the TADs, the site, side and arch of placement, the length of the TADs, and the survival rate of 6 months after placement. RESULTS: We reviewed 90 placed TADs and observed a survival rate of 88.9%. Most TAD failures occurred in the first month of placement (p = 001). There was no observable statistically significant effect of all other variables assessed (age, gender, arch, site, side, or implant length) on the survival rate of the TADs. CONCLUSIONS: The survival rate of TADs was high. Most TAD failures significantly occurred within one month of placement. There was no significant association between all other clinical variables and orthodontic mini-implant survival.

OBJECTIVE: Sodium fluoride (NaF) is commonly used in oral hygiene products, leading to corrosion and reduced archwire properties. In addition, ion release can cause allergies and become toxic to the oral environment. This research aimed to observe the Nickel (Ni) and Copper (Cu) ions released that affected initial corrosion as deflection and surface roughness changed in the Copper-Nickel-Titanium (CuNiTi) archwire. MATERIAL AND METHODS: The total samples were 54 copper-nickel-titanium (CuNiTi-Tanzo, American orthodontic®) archwires immersed in three solutions. Artificial saliva was used in the control group NaF 0.05%, and a NaF 0.15% solution was used in the intervention groups (n = 6). The groups were divided into three observation times (two, four, and six weeks). Cu and Ni ions released, deflection, the surface roughness of the archwires, and solution acidities were recorded and analyzed. RESULTS: Ni and Cu ion release and surface roughness of the CuNiTi archwires significantly increased as the NaF concentration increased. The Ni ion release improved along the immersion period; the opposite was true for the Cu ion release. The solutions became more alkaline after the CuNiTi archwires were immersed. The pH and the archwires' deflections of the three solutions did not show significant differences. CONCLUSION: The NaF increased Cu-Ni ion release and surface roughness but not the deflection force of the CuNiTi. The increase was affected by the concentration and duration of immersion.

OBJECTIVES: In order to assess the changes in tooth orthodontic adhesive interface microleakage after applying a caries resin penetrated to the sound enamel tooth surface in different storage media. MATERIALS AND METHODS: A total of 60 human maxillary first premolars (orthodontic extraction) were collected by random separation of the teeth into two equal groups. The control group was classified into three subgroups (n = 10) (control in deionized water, control in milk, and control in energy drink), while the experimental one (treated with ICON) was categorized into three subgroups (n = 10) (ICON in deionized water, ICON in milk, and ICON in energy drink) incubation phase lasted three weeks in total. RESULTS: A one-way analysis of variance (ANOVA) yielded a significant difference between all experimental subgroups (ICON in deionized water, ICON in milk, and ICON in energy drink) and control subgroups (control in deionized water, control in milk, and control in energy drink). The control group in the energy drink subgroup had the highest mean microleakage value when compared to the other subgroups, whereas the resin-infiltrated group in deionized water had the lowest mean value. According to the results of the T-test, ICON pre-treatment tooth samples had significantly lower mean values of microleakage than non-ICON tooth samples. CONCLUSIONS: The adhesive system (control group) revealed that a resin infiltrate on a sound enamel surface prior to orthodontic bracket bonding reduced bracket tooth interface microleakage in all examined samples. The ICON-infiltrated surface was discovered to provide a secondary preventive strategy against white spot lesion development by reducing microleakage under brackets.

OBJECTIVE: To compare the shear bond strength (SBS) of brackets bonded to three different types of ceramic surfaces (feldspathic ceramic, lithium disilicate ceramic, and zirconia), conditioned with either hydrofluoric acid or sandblasting, using Assure^® Plus All bonding agent. MATERIALS AND METHODS: A total of 72 monolithic CAD/CAM ceramic specimens were divided into six groups of 12 samples. Three groups (G1: feldspathic ceramic, G3: lithium disilicate ceramic, G5: zirconia surfaces) were conditioned with 9.6% hydrofluoric acid, while the remaining three (G2, G4, G6; with ceramic type in the same order as the previous three groups) were prepared with 50 μm aluminum oxide sandblasting. Premolar brackets were bonded using light-cured Assure^® Plus All. The SBS and adhesive remnant index (ARI) were recorded and submitted to inferential analysis using one-way analysis of variance and Kruskal–Wallis tests, respectively. The significance level was set at 5% (P ≤ 0.05). RESULTS: The mean SBS values for the three different ceramic groups conditioned with hydrofluoric acid (G1: 7.2 ± 1.5 MPa, G3: 9.3 ± 2.3 MPa, G5: 8.5 ± 2.0 MPa) were significantly higher than those obtained for the groups prepared by sandblasting before bonding (G2: 7.5 ± 1.8 MPa, G4: 4.4 ± 2.0 MPa, G6: 4.3 ± 2.8 MPa). CONCLUSIONS: The hydrofluoric acid treatment produced a favorable SBS for all three examined ceramic types before bracket bonding with Assure^® Plus All. In comparison, sandblasting yielded a satisfactory SBS only with feldspathic surfaces. Furthermore, the ARI indicated a higher frequency of mixed-adhesive failures except for lithium disilicate conditioned with sandblasting. Therefore, using hydrofluoric acid is likely to be especially recommended when the clinician is not aware of the brand of ceramic restorative material.

BACKGROUND AND PURPOSE: The soft-tissue layer and facial skeleton influence the harmony and equilibrium of the face. The evaluation of the patient's structural and soft-tissue features is one of the most crucial steps in preparing for the diagnosis and treatment of oral-maxillofacial orthodontics. Clinicians can intervene with the proper treatment at the proper time to achieve the best results by being aware of the traits and variations of soft tissue at various developmental stages and in various races. To obtain a consistent treatment result in terms of function and aesthetically pleasing results, patients, and forecast, the growth that may take place after the orthopedic therapy has concluded. OBJECTIVE: To examine the soft-tissue features of the oral-maxillofacial area in Vietnamese adults (aged 18–25 years) by evaluating cephalometric radiographs. MATERIALS AND METHODS: In a cross-sectional descriptive study, 85 students from Can Tho University of Medicine and Pharmacy took part. Students' lateral cephalograms were taken in compliance with the sample requirements. RESULTS: Men's lip protrusion (4.30 ± 0.71) was higher than women's (3.88 ± 0.97) (P = 0.024 <.05) and men's (-4.88 ± 0.93) chin lip groove depth was higher than women's (-4.24 ± 0.93) (P = 0.002), both with a P value of. 05. CONCLUSIONS: The study identified a statistically significant difference in the protrusion of the top lip and the depth of the cleft lip between the male and female, demonstrating that the soft-tissue features of Vietnamese students were distinct from those of other races.

AIM: This study aimed to assess Iraqi university students' oral health-related quality of life (OHRQoL) according to sociodemographic variables and compare dental and non-dental students. METHODS: A cross-sectional study was carried out for students in multiple Iraqi universities from June 15, 2022, to July 15, 2022. A total of 771 individuals participated in the study using an online questionnaire. A pre-tested and validated Arabic version of the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) was adopted as an evaluation tool. A P value of less than 0.05 was considered statistically significant. Reliability analysis was conducted using Cronbach's alpha. RESULT: Cronbach's alpha score for the overall scales was 0.942, indicating excellent internal consistency. There were 69.8% (n = 538) dental students in the total sample. A significant difference was found between dental and non-dental students in the total PIDAQ scores and other subscale domains (P < 0.05). Statistically significant differences in means were also noted in the residency (P = 0.005) and household income of students (P = 0.000). CONCLUSIONS: This study shows the reliability of the PIDAQ scale for assessing the psychological impact of dental aesthetics on undergraduate Iraqis. It was found that the perception of OHRQoL varies between dental and non-dental university students, and according to socioeconomic status and residency.

OBJECTIVES: The study aims to measure the mandibular condylar height (CH), ramus height (RH), total height (CH+RH), asymmetry index, and condylar volume (Cvol) in individuals with different anteroposterior and vertical skeletal discrepancies. MATERIALS AND METHODS: The study sample consisted of 131 subjects (60 females and 71 males) with a mean age of 35.06 ± 12.79 years. Pre-existing CBCT images were divided into groups according to the anteroposterior and vertical skeletal discrepancies. The investigator analyzed the data using t-tests to assess the mandibular bilateral sides of the individuals and gender differences. The mean difference between groups was determined using a one-way analysis of variance (ANOVA). The Chi-square test was used to study the association between the asymmetry index and groups. RESULTS: Each individual's bilateral sides exhibited statistically significant differences in CH, RH, and Cvol (P = 0.033, P = 0.039, P = 0.005, respectively), but not in CH+RH (P = 0.458). There were, however, statistically significant gender differences in CH+RH (P < 0.001). Skeletal Class III and hypodivergent groups revealed the highest linear and volumetric values compared to other groups. The asymmetry index was increased in CH (P = 0.006) and Cvol (P = 0.002) in skeletal Class II subjects. CONCLUSIONS: Significant differences in CH, RH, and Cvol were found on the right and left sides of the same individual. This study found increased linear and volumetric values in males, skeletal Class III, and hypodivergent subjects. Class II individuals had an increased CH and Cvol asymmetry index. This study highlights in-depth knowledge of mandibular asymmetry, which is extremely important to achieve an accurate diagnosis and provide the best treatment outcome.

OBJECTIVES: To evaluate the level of oral hygiene awareness and practice among orthodontic patients that have fixed appliances and investigate the differences in awareness as per age, gender, and education qualification. MATERIALS AND METHODS: A cross-sectional study with 250 patients was included. A questionnaire was used to collect information regarding the patient's oral hygiene. RESULTS: The level of awareness and oral hygiene practice was significantly higher among females, with a consistent stepwise increase toward older ages. Also, increased with higher education level, longer duration since getting the appliance, and receiving instructions from the orthodontist. CONCLUSIONS: Oral hygiene instructions received by the orthodontist play an important role in the patient's awareness level. Also, many predictors have a significant effect on the patient's cooperation in practicing oral hygiene measures.

OBJECTIVE: The shortage of health care professionals in rural areas contributes toward discriminatory health care delivery. The present study was planned with a similar intent and aimed to evaluate the perception of dental students regarding their future in rural areas. MATERIALS AND METHODS: The present study was designed as a cross-sectional study comprising of a 30-item questionnaire survey instrument distributed among a total of 550 dental students while the results obtained were subjected to statistical analysis. Statistical analysis was done using SPSS version 12.0 (SPSS Inc., Chicago, IL, USA). Independent student's t-test and one-way analysis of variance (ANOVA) were used for comparison among the variables while the Chi-square test was used to determine the association between the variables. P < 0.05 was considered statistically significant. RESULTS: No significant difference was observed in the attitude based on gender (P = 0.43), although, a statistically significant difference was observed in the attitude of students based on the year of their education with a positive attitude toward rural dental practice generally noted in the first year Bachelor of Dental Surgery (BDS) students which significantly declined with the increasing level of education (P = 0.01). CONCLUSIONS: Dental students were more influenced by the negative aspects of rural dental practice though they had, in their mind, a positive approach for the same at the beginning of their education, but this significantly declined with the increasing level of their education.

OBJECTIVES: The objectives of the study was to assess and compare the cranial base morphology in long face and short face. METHODOLOGY: The study comprises 64 individuals (32 in each group). Group I consists of individual's with long face and group II comprises individuals with short face. Individuals were classified into groups with the help of lateral cephalometric parameters like Gonial Angle, Anterior facial height, Posterior facial height, Jarabak's Ratio, and Y-axis. Linear and angular measurement in the cranial base was taken. RESULT: The results showed statistically significant difference in Sella-Nasion, Sella-Basion and Nasion-Sella-Basion between the two groups. Sella-Spinoethmoidal suture, Nasion-Spinoethmoidal suture, Spinoethmoidal suture-Sella-Basion, Frankfurt Horizontal-Sella-Nasion, Frankfurt horizontal-Sella-Basion, Frankfurt horizontal-Sella-Spinoethmoidal suture showed no statistically significant difference among the groups. CONCLUSION: The study concluded that individuals with long face have a greater Sella-Nasion, Sella-Basion, Nasion-Sella-Basion compared to individuals with short face.

OBJECTIVES: This study aimed to investigate the correlation of gonial angle and three linear measurements on OPG and lateral cephalograms and their effects on the different facial patterns using the OneCeph android app. METHOD: About 90 pre-treatment digital lateral cephalograms and OPGs of 90 patients were selected and divided into 3 categories, based on their growth patterns. The OPGs and lateral cephalograms were uploaded on the OneCeph android app. After calibrating using One linear measurement i.e. length of extracted premolar for OPG and ruler in radiograph for lateral cephalogram, Gonial angle (Ar- Go-Me), ANS-Me (LAFH), U1-NF, L1-MP were measured. The data were collected, tabulated, and subjected to statistical analysis using the SPSS software (version 20.0). The level of significance was kept at 5%. RESULTS: Values for parameters were highest in the vertical growth pattern followed by average and horizontal in both cephalogram and OPG. Upon comparison of lateral cephalogram and OPG, no significant difference was observed in gonial angle and a significant difference in LAFH and L1-MP in all three growth patterns with OPG scores greater than cephalometric tracing. The interclass coefficient test indicated almost perfect agreement for the gonial angle between the two methods. A substantial agreement was seen for U1-NF on lateral cephalogram and OPG in the vertical group. Also, a fair agreement in the vertical and horizontal group was observed in Lower anterior mandibular height. CONCLUSION: Vertical parameters such as gonial angle and maxillary anterior dental height can be accurately determined on an OPG by the OneCeph application.

AIM AND OBJECTIVE: To evaluate and compare the position of the tongue from rest to centric occlusion in subjects with skeletal class II division 1 and skeletal class II division 2 malocclusions with subjects of skeletal class II normal occlusion. MATERIAL AND METHODS: The study was conducted on 30 individuals equally divided into three groups of skeletal class II division (div) 1, skeletal class II div 2, and skeletal class I normal occlusion. The study was conducted on two lateral cephalograms for each subject: one taken at rest and one in centric occlusion. RESULTS: On evaluation of tongue posture, a statistically significant difference was observed at the middle portion of the tongue in class II div 1 malocclusion, and at the posteromedial portion of the dorsum of the tongue in class II div 2 skeletal malocclusions as the tongue moved from rest to centric occlusion. While statistically significant differences were found between class II div 2 malocclusion and class I normal occlusion, no statistically significant differences were observed between class II div 1 and class II div 2 malocclusions. CONCLUSION: Tongue position was observed to be the same in both class II div 1 and class II div 2 malocclusions, with no statistically significant differences. However, a great change was seen in the tongue position from rest to centric occlusion.

AIMS AND OBJECTIVES: To derive a new horizontal plane which can be a suitable alternative to Frankfurt horizontal plane (FH plane). MATERIALS AND METHODS: 200 pre-treatment lateral roentogenic cephalograms from patient records in the department of orthodontics and dentofacial orthopaedics were traced. The landmarks were identified and marked and the measurements were carried out. Patients with all skeletal relationships were included in the study. The angle formed between the lines connecting anatomic porion, orbitale and machine porion was measured and tabulated. Dimorphism between the genders if any was also evaluated. RESULTS: The mean angulation between the planes from the anatomic porion to orbitale to machine porion (PoA-Or-PoM) in our sample is 3.14 ± 2.17°. PoA to Or to PoM angulation for males is 2.57° and for females is 3.4°. CONCLUSIONS: SIDS plane also called as derived FH plane given here is a reliable and easily reproducible alternative to the FH plane.

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

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

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

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

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

OBJECTIVES: The purpose of the study is as follows:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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.

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: 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.

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.

OBJECTIVES: The aim of the present study was to investigate the trends in the use of fixed appliance and accelerated orthodontics to decrease the treatment duration. Further, this study aimed to assess the effect of demographic factors on the participant's choice of treatment modality. METHODS: This was a cross-sectional study in the form of questionnaire-based online survey especially designed and distributed to 265 orthodontists via email. The questions aimed to collect basic information about the participants and respondents' choices for decreasing the treatment duration. The data were analyzed according to gender, level of academic education and years of clinical experience using Chi-square test. RESULTS: A response rate of 85.2% was reported. Most of the orthodontists aimed to reduce the treatment duration by the biomechanical (66.8%) and surgical approaches (27.4%). The use of sliding mechanics (69.4%) and one-step retraction was more common (66.3%). MBT bracket prescription was more prevalent (51.7%), followed by Roth (41.1%). Conventional brackets were used more than self-ligating brackets, and aesthetic brackets were avoided by one third of the respondents. NiTi wires were the most commonly used wires during the alignment stage (44.2%). However, the effect of gender, years of clinical experience and specialty level of education showed some effects on the use of certain techniques and clinical practice of the respondents. CONCLUSIONS: Most of the orthodontists aimed to decrease orthodontic treatment duration by using biomechanical and surgical approaches. Gender and clinical experience to a certain extent affected the participants' choice during orthodontic treatment.

OBJECTIVES: This study was aimed at assessing the knowledge and awareness of orthodontists and orthodontic residents in Nigeria about the COVID-19 pandemic and the appropriate infection control measures required to mitigate its spread in orthodontic practice. MATERIALS AND METHODS: It was a cross-sectional descriptive study of orthodontists and orthodontic residents. Ethical approval for the study was obtained from the Institutional Review Board. Data collection was via an online questionnaire designed using Google forms and these were sent to the phone numbers of study participants. Data analysis was done using Statistical Package for Social Sciences version 20. RESULTS : A total of 73 respondents with a mean age of 43.41 ± 9.21 years participated in the study. About 90% of the respondents had a very good knowledge of COVID-19, including its etiology, modes of transmission, signs, and symptoms. However, very few respondents were aware of the less common symptoms such as skin rash (16.4%) and red eyes (26%). Over 80% of the respondents knew the appropriate measures to take to prevent the spread of the virus in the dental clinic, in addition to the appropriate personal protective equipment (PPE) to use. CONCLUSION: The respondents had a very good knowledge of the basic epidemiology of COVID-19 and the means of prevention of its transmission in the dental clinic. However, there was limited knowledge of the less common symptoms of the infection. In addition, majority of the respondents had a very good idea of the appropriate PPE to be used.

OBJECTIVE: To provide a cost-saving innovative audience response system (ARS) that permits typing texts and compare its efficiency to the paper-based method in case-based learning (CBL). MATERIALS AND METHODS: Orthodontic clinical cases were presented to 149 undergraduate dental students for discussion among teammates. Responses were collected using ARS-based and paper-based. ARS was constructed from an online survey platform (Google forms) then QR code was created for easy and fast access. Students used their cellphones to scan code, view questions, discuss, type, and submit answers within 10 minutes. Feedbacks were collected using a feedback survey. Outcome measures included the number of words, spelling mistakes, time required by the instructor to read submissions, and activity time compliance. RESULTS: The average number of words submitted by females in ARS-based 47 ± 8 was significantly higher than 35 ± 16 paper-based, and male ARS-based 36 ± 18 (P < 0.05). ARS-based submissions required significantly less time to read compared to paper-based among whole group, females, males (P < 0.001, P < 0.05, P < 0.001), respectively. Spelling mistakes were lower 1 ± 1 in ARS-based compared to paper-based 2 ± 2. The ARS-based first submission was (-4.28) minutes before the deadline, while paper-based last submission was (+2.19) minutes after (P < 0.05). ARS-based submissions were 12.5 seconds faster to read than paper-based (P < 0.001). Out of 56.4% of respondents, 63.1% preferred using ARS-based and 80% agreed that it provided immediate feedback, with high overall satisfaction. CONCLUSIONS: This innovated ARS was found to facilitate CBL. It is superior in time and cost-saving to paper-based and other ARSs. It could be useful in distance learning especially during the COVID-19 pandemic.

OBJECTIVE: This study aimed to test the intra and inter-rater reliability, reproducibility, and validity of a new guide called the “Cone Beam Computed Tomography-Maxillary Canine Impaction (CBCT-MCI),” designed to assess the position, severity, and predictability of the maxillary canine impaction (MCI) treatment intervention using Cone Beam Computed Tomography (CBCT). MATERIALS AND METHODS: This study is a retrospective radiographic review of 44 patients with unilateral or bilateral MCI. A total of 56 maxillary impacted canines' CBCT radiographs were analyzed using the new CBCT-MCI guide, with each of its 10 items scored. The total scores of the 10 items were then compared to a scale to predict the best treatment intervention of MCI: normal spontaneous eruption, surgical-orthodontic traction, or surgical extraction. Radiologists and orthodontists have developed, tested, and retested the CBCT-MCI guide on the same 56 maxillary impacted canines using CBCT radiographs to check its reliability and reproducibility using the Kappa coefficient. Furthermore, the validity of this guide was tested by comparing the predicted best treatment intervention with the actual treatment administered to the assessed impacted maxillary canine using the Kappa coefficient and percentage of agreement using cross-tabulation. RESULTS: The result of this study showed significantly strong Kappa values of intra-rater agreement (k = 0.91, (P < 0.0001) and inter-rater agreement (k = 0.84, P < 0.0001). Furthermore, testing the relationship between the two MCI treatment interventions using cross-tabulation, the agreement percentages between the predicated and actual treatment plans of the assessed MCI ranged between 70% and 95.5% with a significantly strong Kappa value (k = 0.82, P < 0.0001). CONCLUSIONS: This study suggests that the CBCT-MCI guide is capable of producing accurate, reliable, and reproducible results in assessing and predicting the type of orthodontic treatment intervention of MCI in a simple, quick, and efficient way.

OBJECTIVE: To evaluate the surface topography and roughness of orthodontic arch wire materials, including low-friction titanium molybdenum alloy (TMA), conventional TMA, and stainless-steel arch wires. MATERIALS AND METHODS: The surface topography was evaluated using atomic force microscopy (AFM). A total of 24 wire specimens were used for the AFM scans {8 low-friction TMA (TMA-Low), 8 conventional TMA (TMA-C), and 8 stainless steel (SS)} (Ormco, Orange, CA, USA), measuring 0.016 × 0.022 inches. The conventional and low-friction TMA arch wires served as the test groups, while the stainless-steel arch wire served as the control group. RESULTS: Surface roughness evaluation using AFM revealed that the highest mean of all three roughness parameters was found in the TMA-C group followed by the TMA-Low and SS arch wires in descending order. Pairwise comparison of the mean values showed that the mean value of the SS arch wire material is statistically significantly lower than the mean values of the other two arch wire materials (TMA-C and TMA-Low). However, there was no statistically significant difference in the mean values of TMA-C and TMA-Low arch wires. CONCLUSION: The SS arch wire showed the smoothest surface topography among the alloys and had statistically significantly lower roughness values than the TMA-C and TMA-Low groups. Low-friction TMA arch wire is still considered to be inferior to stainless steel arch wire.

OBJECTIVE: To search the effects of Curve of Spee (COS) flatting on the stresses and displacement on the different mandible landmarks and lower teeth during posterior teeth loading using three-dimensional (3D) finite element analysis. MATERIALS AND METHODS: Three-dimensional hemi mandibular model was created from real selected mandible. The lower teeth was aligned originally in a curved form with 2.4 mm depth at the cusp tip of the second premolar. Another replica with flat aligned teeth was formed to confirm the analysis by up righting premolars and molars. A load was applied at mesio-buccal cusp of the lower first molar on both models, and the resultant stresses and displacements on the mandibular landmarks and the lower teeth were tested. RESULTS: Von mises over the mandible was higher in flat than in curve model. The highest stress levels were detected at the Mesio-buccal cusp tip of first molar for flat and curved simulation (5053, 3304) Mpa respectively. Mesio-distally, the teeth displacement was higher in curve model than in flat one. The maximum distal displacement, in flat model, was seen in central and lateral incisors. While, in curve model, the maximum distal displacement was grasped within first and second premolars. CONCLUSIONS: Flatting the COS magnify the stresses over whole mandible and reduce lower teeth displacement mesio-distally. We speculated that the readjustment of the COS after orthodontic treatment could reduce the stress and displacements on the lower anterior teeth and decrease the lower anterior teeth crowding relapse.

OBJECTIVES: To develop and test the validity and reliability of an Arabic version of the psychosocial impact of dental aesthetics questionnaire (PIDAQ). MATERIALS AND METHODS: The original English version was translated into Arabic, back-translated, pre-tested, and cross-culturally adapted before being administered to 205 individuals aged between 18–30 years from Medina, Saudi Arabia. Cronbach's alpha coefficient was used to test internal consistency, and the intraclass correlation coefficient (ICC) was used to assess test–retest reliability. Construct validity was assessed using factor analysis, and convergent validity was tested by comparing PIDAQ scores to the aesthetic components of the Dental Aesthetic Index (DAI) and Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN-AC), while discriminant validity was assessed by comparing PIDAQ scores to participants' self-evaluation of orthodontic treatment need. Gender and age differences in the PIDAQ score were assessed. RESULTS: Cronbach's alpha coefficient was 0.940, corrected item-total correlation coefficients were between 0.509 and 0.719, and the ICC was 0.937. Principal component factor analysis extracted three domains, and factor loading ranged from 0.563 to 0.843. Total PIDAQ score and subscale scores had significant correlations with the DAI and IOTN-AC. The questionnaire discriminated well between participants who had a perceived need for orthodontic treatment and those with no perceived need. There were no significant age or gender differences in participants' PIDAQ scores. CONCLUSIONS: The Arabic version of the PIDAQ had excellent psychometric properties with sufficient reliability and validity to be used for the assessment of the orthodontic-related quality of life in young Arab adults.

OBJECTIVE: To assess the practice of using orthodontic brackets as tooth decorations among dental offices and patients in Jeddah, Saudi Arabia. MATERIALS AND METHODS: The study was a cross-sectional survey using 2 questionnaires. The first included 14 doctor questions where 300 dental offices in Jeddah, Saudi Arabia were contacted by phone. The second questionnaire included 22 patient questions where 50 patients who currently have or have had decorative braces answered the questions online. RESULTS: Out of 250 dental offices that responded, 91 offices (36.4%) answered “yes” to offering decorative braces. Most dentists use metal brackets (96.3%) on both the upper and lower arches (98.8%) and ligate a wire (83.8%) using colored elastomeric ligatures. Out of 50 patients who answered the patient questions, 28 patients (56%) were females and the mean age was 19.84 years (±2.32). 37 (74%) patients reported that their decorative braces were not placed by dentists and mostly by over the counter glue. Finally, 62% reported they were not satisfied, and 84% said they would not recommend getting decorative braces to their family and friends. CONCLUSION: Our results indicate that the use of decorative braces is prevalent, and most are not being placed by dentist. As healthcare providers, we are obliged to educate the public of potential harm that can result when decorative braces are used, to hopefully limit the spread of this unfortunate practice.

OBJECTIVE: To evaluate the orthodontic treatment outcome among patients with non-syndromic unilateral cleft lip and palate using the Peer Assessment Rating (PAR) index. MATERIALS AND METHODS: The retrospective study comprised a sample of 80 patients with unilateral cleft lip and palate (39 males and 41 females) with complete pretreatment and posttreatment orthodontic records. The patients were divided into two groups according to the treatment modalities. Group 1 (n = 55), nonsurgical (consisted of patients treated with comprehensive orthodontics) and Group 2 (n = 25), surgical (with presurgical orthodontics followed by maxillary advancement orthognathic surgery). PAR score was evaluated on pretreatment and posttreatment study models for both groups. RESULTS: The mean percentage change for the weighted PAR score of Group 1 and Group 2 was 76.79 ± 20.27% and 82.37 ± 11.38%, respectively. Out of the total sample of 80 cases; 62 (77.5%) cases were “greatly improved,” 16 (20%) cases were “improved,” and 2 (2.5%) showed “worse/no improvement.” Nearly 72.5% of cases in Group 1 and 88% in Group 2 were greatly improved. CONCLUSIONS: The reduction in PAR score in both groups was satisfactory as more than 70% of the patients were in the greatly improved category. The results of the PAR index revealed a high occlusal outcome of orthodontic treatment rendered by the department for patients with unilateral cleft lip and palate.

OBJECTIVE: To compare demineralization around orthodontic brackets cured by conventional method and transillumination method. MATERIALS AND METHOD: Sixty freshly extracted human premolar teeth were divided into four groups. Group 1: Brackets bonded with conventional method of bonding by curing labially for 40 sec. Group 2: Brackets bonded with transillumination method of bonding for 50 sec. Group 3: Brackets bonded with conventional method of bonding by curing labially for 20 sec followed by 30 sec of transillumination. Group 4: Brackets bonded with transillumination method of bonding for 30 sec followed by labial curing for 20 sec. Ground sections were prepared of each tooth and microleakage was evaluated using a binocular microscope at 40× magnification (Olympus BX53) and an image was taken using a digital camera (Olympus EPL3) connected to the microscope. The images were analyzed using Magnus Pro Image software. Scores were assigned to different degrees of microleakage at the demineralization zone around enamel-adhesive-bracket complex at the occlusal, middle, and gingival margins using linear measurement tool. Data obtained was subjected to statistical analysis using SPSS software (Version 20.0). Level of significance was kept at 5%. Intragroup comparison was done using Kruskal-Wallis test followed by Mann-Whitney U-tests for pairwise comparison. RESULTS: Group 4 showed least mean demineralization in occlusal, middle, and cervical areas as compared to other groups and the results were statistically significant (P < 0.05). CONCLUSION: Transillumination can be employed as a method synergistically with conventional curing to achieve minimum amount of demineralization during fixed orthodontic treatment.

OBJECTIVE: To determine the frequency of congenitally missing maxillary lateral incisors (LIs) and to find out its variability in relation to gender. MATERIALS AND METHODS: A retrospective study was carried out between January 2017 and December 2017. Orthopantomographs (OPGs) and lateral cephalographs record search of all orthodontic adolescent patients aged 12 to 18 years were taken from the archival records of the department. Orthopantomographs helped to diagnose the presence of unilateral/bilateral maxillary lateral incisors while the ANB angle was calculated from the lateral cephalographs to divide the subjects into various skeletal malocclusions. STATISTICAL ANALYSIS USED: The statistical analysis was done using the Statistical Package for Social Sciences (SPSS version 17.0). The frequencies were compared with the help of the Chi-square test. P<0.05 was considered statistically significant. RESULTS: The frequency of missing upper laterals among the male patients was 0.9%, however, 2.8% of the female patients were having missing maxillary lateral incisors. Based on gender, 62.16% had a bilateral expression of missing upper laterals, 16.21% had left unilateral expression, and 21.62% had right unilateral expression. Furthermore, skeletal class I malocclusion had a prevalence of 54.16% of bilateral missing lateral incisors in upper arch as compared to 40% of left unilateral expression and 37.5% of right unilateral expression whereas in skeletal class II malocclusion, the prevalence of right unilateral expression was 37.5% as compared to bilateral expression which was 33.33%. The left unilateral expression in skeletal class II malocclusion was found to be only 20%. The highest prevalence of missing laterals in skeletal class III malocclusion was left unilateral expression which was around 40%. The prevalence of right unilateral expression was 25% whereas the bilateral absence of upper laterals in skeletal class III malocclusion was 12.5%. CONCLUSION: The prevalence rate for congenitally missing upper lateral incisors in the orthodontic adolescent population aged 12 to 18 years was found to be 3.77% in the present study while females were found to have a greater percentage of agenesis of the upper lateral incisors (2.8%) as compared to the males (0.9%).

OBJECTIVE: The study aimed to assess the accuracy and reliability of five cephalometric parameters in diagnosing class III malocclusion in Saudi and Yemeni population. MATERIAL AND METHODS: A cross-sectional, descriptive study in which total 60 lateral cephalograms (30 of Saudi and 30 of Yemeni population) of Class III malocclusion were hand-traced. ANB angle, Wits appraisal, Beta angle, W angle, and Yen angle were measured. The validity, reliability, sensitivity, and positive predictive values (PPVs) of these parameters were calculated. RESULTS: In Saudi population, a strong correlation was found between ANB angle and Wits appraisal (r = 0.892, P < 0.05), ANB and Beta angle showed highest sensitivity (0.933) followed by Wits appraisal (0.900), and ANB angle showed the highest PPV (0.965) followed by Beta angle (0.933) and Wits appraisal (0.931). In Yemeni population, a strong correlation was found between ANB angle and Wits appraisal (r = 0.887, P < 0.05), ANB angle and W angle showed highest sensitivity (0.966) followed by Wits appraisal (0.933), whereas W angle showed the highest PPV (1.00) followed by ANB angle (0.966) and Wits appraisal (0.933). CONCLUSION: In Saudi population, ANB angle and Beta angle, whereas in Yemeni population, ANB angle and W angle are the most valid cephalometric indicators to accurately assess the class III malocclusion. ANB angle in the Saudi population and W angle in the Yemeni population have the highest PPV in correctly diagnosing class III malocclusion.

OBJECTIVE: To evaluate the skeletal, dental and soft tissue cephalometric changes by addition of daytime Class III elastics to the Alternate Rapid Maxillary Expansion-Constriction (AltRAMEC) and Reverse Headgear (RH) protocol in skeletal Class III patients with maxillary retrusion. Material and Methods: 54 patients with maxillary retrusion and CVMI (Cervical vertebral maturity index) <CS3 were randomly allocated to an AltRAMEC/RH group (group 1) and AltRAMEC/RH/Class III elastics group (group 2). Each group underwent 5 weeks of AltRAMEC using bonded RME (Rapid Maxillary Expansion) appliance, followed by reverse headgear therapy with a Petit type facemask for 4-5 months. The protraction so obtained was maintained by the use of daytime Class III elastics in group 2. A total of twenty skeletal, dental and soft tissue parameters were evaluated by a blinded examiner. Results were evaluated statistically. Results: Significant forward movement of the maxilla with counter-clockwise rotation, improved intermaxillary relationships, downward and backward movement of the mandible, and favourable soft tissue changes were observed in both the groups under study. The results were more pronounced in group 2. Increase in vertical dimensions, proclination of maxillary and retroclination of mandibular incisors was also observed. Statistically significant differences were present between the two groups for all of the maxillary and mandibular skeletal, intermaxillary and two of the soft tissue parameters tested; while the differences were not found to be significant for dental parameters. Conclusion: Addition of Class III elastics to the AltRAMEC/RH protocol yielded more pronounced, favourable and statistically significant results.

OBJECTIVE: To compare airway widths among skeletal Class I malocclusion patients with different vertical facial patterns. MATERIAL AND METHODS: A total of 103 lateral cephalograms of skeletal Class I patients (mean age of 20 ± 2.3 years) with no history of orthodontic treatment, trauma, facial syndromes, or nasopharyngeal dysfunction were included. Based on the Frankfort–mandibular plane angle measurements, the sample was divided into three groups: low-angle, high-angle, and normal-angle groups. Upper and lower pharyngeal airway widths were measured as described by McNamara. The analysis of variance test was performed to compare the means of groups. Pairwise comparisons were performed using Tukey's post-hoc test. Differences were considered statistically significant at P < 0.05. RESULTS: ANOVA showed a significant mean difference between the groups for both the upper and lower airway widths withP values of 0.011 and 0.003, respectively. Tukey Pairwise comparisons showed the upper airway width to be significantly narrower in the high-angle group compared to the normal-angle (P = 0.021) and low-angle groups (P = 0.013). Furthermore, the lower airway width in the high angle group was significantly narrower than the normal angle (P = 0.020) and low-angle groups (P = 0.017). There were no statistically significant differences between normal and low angle groups. CONCLUSIONS: The upper and lower pharyngeal widths in the Class I high-angle group were significantly narrower than those in the normal-angle and low-angle groups.

OBJECTIVE: To compare dental and skeletal ages among African American (AA), Caucasian (C) and Hispanic (H) subjects (chronological ages 9 to 15-years). MATERIAL AND METHODS: A total of 168 subjects (9 to 15 years old) were equally divided into AA, C, and H groups, with an equal number of males and females. Each group was divided equally into 7 chronological age-groups, ranging from 9 to 15 years. Dental age was determined from panoramic radiographs as primary, early mixed, late mixed, or permanent dentition (scored as 1-4). Skeletal age was calculated from hand-wrist radiographs using Fishman's Skeletal Maturation Index (SMI 1-11). One-way analysis of variance and Tukey's test were used to compare skeletal and dental ages among AA, C and H subjects; and AA, C and H subjects in each chronological age-group. The two-sample t-test was used to compare SMI and dental age among females and males. RESULTS: Skeletal and dental age were not significantly different between AA, C and H subjects. Mean SMI was higher in females than males; and there were no significant gender differences regarding dental age. Mean SMI and dental age were significantly different among AA, C and H subjects in the 12-year-old and 11-year-old age groups, respectively. CONCLUSIONS: Dental and skeletal maturation are fairly similar among AA, C and H subjects (aged 9 to 15 years).

OBJECTIVE: This study aimed to assess the feasibility of reusing nickel–titanium (NiTi) alloy wires after 6 weeks of intraoral use by evaluating the changes in the load-deflection properties and surface characterization of these alloy wires after cold sterilization by immersion in 2% of acidic glutaraldehyde for 10 h. MATERIAL AND METHODS: Twenty wires each in three groups of G1-as-received wires (ARW), G2-unsterilized used wires, and G3-sterilized used wires (SUW) were tested by the three-point bending test and scanning electron microscopy (SEM). The data were subjected to statistics, one-way analysis of variance, and Bonferroni posthoc test for comparison. RESULTS: Recycling of NiTi wires produced statistically insignificant changes in both the loading and unloading properties of the wires. The forces needed to twist the used wires, that is, G2-(UUW) and G3-(SUW) were lower than G1-(ARW), suggesting lowering of the stiffness of the wires. Superelasticity is well-maintained by G2-(UUW) and G3-(SUW) although there is an insignificant lowering of the forces exerted by them during loading and unloading. SEM demonstrated no increase in the pitting of surfaces in both G2-(UUW) and G3-(SUW); multiple areas were seen to be more smoothened over G2-(UUW) and G3-(SUW) NiTi wires surfaces. CONCLUSION: The findings of this study support the reuse of NiTi wires after 6 weeks of use in oral conditions followed by cold sterilization by immersion in 2% acidic glutaraldehyde for 10 h.

OBJECTIVES: To analyze the craniofacial morphology in child patients and adolescents by evaluating the skeletal cephalometric profile of the HIV infected patients in this age group and comparing them with the HIV-negative controls. MATERIALS AND METHODS: The present study was a planned case-control study which included 25 HIV-positive adolescent patients aged between 10 and 18 years (the study group) who were compared with 25 age- and sex-matched HIV-negative adolescent controls (the control group). All the patients had been HIV infected via a vertical transmission with positive serology confirmed in two different tests and had been kept on HAART since they were born. The diagnostic aids used for orthodontic documentation included facial photographs, digital orthopantomographs, lateral teleradiographs, and study models. RESULTS: With reference to the methodologies used for taking the cephalometric values, all the methods used were in strong agreement with each other for almost all the variables studied and had high intra-class correlation coefficient values except Co-A, SN.ANSPNS, and SNB which, too, had a good agreement of 60%. Nevertheless, the agreement was positive for these variables, too, since the P values obtained were found to be statistically significant (P < 0.05). CONCLUSION: Most of the measurements in the HIV-infected adolescents were found to be similar to the ones obtained for the HIV-negative controls, although, the study results highlighted the significance of further studies to be conducted in this regard, especially, the longitudinal study designs wherein the said variables can be studied on a follow-up basis in longitudinal studies to have an idea of the exact changes observed and their pattern in the included groups.

OBJECTIVES: To evaluate the perception of esthetics and the attractiveness of the smile, in frontal view, with mandibular asymmetry, through the eye-tracking. MATERIALS AND METHODS: OGAMA software and The Eye Tribe Tracker hardware were used to obtain eye tracking in certain areas of interest on the face. To simulate asymmetry, Photoshop® image editing software was used to create a vertical reference line to the midline of the face and make it symmetrical with control of the angulation relative to another horizontal reference line passing through the vertices. Then, the lower third of the face added asymmetries or deviations, starting from zero, with increments of 2 by 2 degrees up to 6 degrees. The study included 60 laypeople, 30 males and 30 females, without any knowledge about the study, showing good vision, and not having used drugs with the possibility of influencing cognitive or motor skills. RESULTS: From the heat map in cases of mandibular asymmetry, it is possible to visualize that for both sexes the evaluators evaluated with a certain degree of similarity mainly when the deviations presented with 6 degrees. The trajectory of the male and female gaze in cases with asymmetry shows that in cases with a magnitude of 6 degrees, the raters traced mainly in the region of the mouth with little transition in the eye region and mainly in the areas of interest considered as “other.” In the images presented with a magnitude of up to 4 degrees, they were traced in the general image. CONCLUSIONS: The perception of laypeople from mandibular asymmetry to the right in females presented a higher perception when compared to males with mandible asymmetry to the left.

OBJECTIVES: To assess the effect of malocclusion on the self-esteem of adolescents. MATERIALS AND METHODS: This cross-sectional study evaluated 496 student aged between 12 and 14 tears old living in Shiraz city. The level of self-esteem was determined using the Rosenberg self-esteem scale (RSES). To assess the degree of malocclusion, Index of Orthodontic Treatment Need- Dental Health Component (IOTN-DHC) was used. The Spearman's correlation coefficient was calculated to assess the correlation of malocclusion and self-esteem. The mean of IOTN-DHC and total score of RSES in different age groups were analyzed using the Kruskal–Wallis test. The mean IOTN-DHC and total score of RSES were compared between the two municipal districts and males and females using the Wilcoxon test and independent t-test, respectively. RESULTS: A significant but weak correlation was noted between IOTN-DHC and self-esteem (r = 115/0, P = 04/0), while IOTN-DHC subscale: space shortage, dental missing, overjet, overbite, and crossbite had nonsignificant correlation with self-esteem. The socioeconomic status of adolescents significantly affected their self-esteem (P < 0.001). CONCLUSIONS: Weakly significant correlation between mild malocclusion and dental self-esteem.

OBJECTIVES: To assess the knowledge level and attitude of the Saudi population about the use of a dental implant as a treatment option for replacing the missing teeth. MATERIALS AND METHODS: This cross-sectional study adopted a quantitative approach and used an online questionnaire to collect data. Nine hundred and five participants were recruited as per the inclusion criteria (above 18 years of age, know how to read and write, and technology literate). The collected data were analyzed statistically using IBM Statistical Package for Social Sciences (SPSS) software. RESULTS: A low level of knowledge about teeth replacement methods (56%) was recorded among the participant, while 44.4% of them had heard about implant, bridges, and dentures. The oral hygiene of the participants was considered good (59.3%). The main source of information, reported by the participants, was the dentist (53.4%). The knowledge about dental implants was found to be significantly the highest (P = 0.02) among the highly educated participant who had completed postgraduate studies. CONCLUSION: There is a need for introducing comprehensive orientation programs, conducted by dentists, to communicate knowledge about dental implants. The social campaigns and official information programs should be instigated for improving the knowledge of the patients. Structured programs should be also introduced at an academic level, for enhancing the knowledge related to replacing missing teeth and dental implants.

OBJECTIVE: To assess the gingival parameters in the clear aligner treatment versus the three other types of brackets, i.e., conventional metal, conventional ceramic, and metal self-ligating. MATERIALS AND METHODS: Eighty patients coming for regular appointments undergoing orthodontic treatment were included. They were further divided into four groups with 20 patients in each: Group one underwent conventional brackets (CB) treatment; Group two had conventional ceramic brackets (CCB); Group three was treated with self-ligating (SL) brackets; Group four underwent with clear aligner (CA) treatment. Inclusion criteria were any patient with a minimum age of 18 years having Class II, Class III skeletal relationship, undergoing orthodontic treatment for at least 6 months with fixed orthodontic appliances (FOA) on both arches. While smokers, pregnant, diabetics, or those taking medication affecting gingival health or having cardiovascular diseases were excluded. Also excluded were patients who used antiseptic solutions or mouthwash during the past 6 months, underwent any periodontal treatments in the past 6 months, or who had fixed bridges and crowns or extensive restorations close to the gingival margins. Seven indices, namely plaque index, gingival index, gingival bleeding index, sulcus bleeding index, papillary bleeding index, basic periodontal examination index, and bleeding on probing index, were recorded for all groups. RESULTS: Mean age for Group 1 with CB was 26.65 ± 5.15 years, whereas it was 27.65 ± 8.15 years for Group 2 with CCB, and 26.85 ± 5.19 for Group 3 with SB. Group-4 with CA treatment had a mean age of 26.85 ± 4.83 years. Multivariate analysis and a Bonferroni correction was performed (P = 0.008). CA treatment has better periodontal parameter values compared with the CB and the CCB groups, and no significance difference with the SL brackets group. CONCLUSION: CA treatment has better periodontal indices levels compared to other types of orthodontic treatments such as CB and the CCB groups; no significant difference with the SL brackets group. Importance should be given to oral hygiene instructions before, during, and after the treatment.

OBJECTIVE: To assess the prevalence of malocclusion and orthodontic treatment needs in a Saudi sample of Jeddah city. MATERIALS AND METHODS: A cross-sectional (descriptive) study was performed in 2017 among 3016 subjects (1507 females and 1509 males) selected according to stratified random sampling design. The inclusion criteria were Saudi students aged between 14-18 years with no craniofacial deformities or syndromes and no orthodontic treatment carried out. Malocclusion was assessed using the modified Bjork et al. system, and Angle's classification and orthodontic treatment need to be evaluated by using the IOTN (DHC). Descriptive, associations and gender differences were assessed by one-way ANOVA, Chi-square, and Fisher exact tests. Data was analyzed using STATA version 13.0 (StataCorp, College Station, Texas, USA). Statistical significance was set at P < 0.05. RESULTS: Approximately 12% of the participants had normal occlusion, 57% had Class I malocclusion, 17% had Class II malocclusion, and 14% had Class III malocclusion. The highest prevalence of malocclusion traits was for displacement, followed by a crossbite. The IOTN results revealed slight need for orthodontic treatment in (n = 795-26%) moderate/borderline in (n = 1166-39%), and great need in (n = 1055-35%). Class II and III malocclusion, OJ, reverse overjet, scissor bite, open bite, midline discrepancies, and crowding were significantly higher in males than females (P < 0.05). CONCLUSION: Overall, there was a high prevalence of malocclusion and high orthodontic treatment need. The most common malocclusion was Class I. The most common orthodontic treatment need was moderate to borderline.

OBJECTIVE: To evaluate the effects of different adhesion promoters, namely, Enhance LC, Ortho Solo, Assure Universal Bonding Resin and deproteinizing agents such as 5.25% NaOCl, 10% papain gel on the shear bond strength of orthodontic brackets. MATERIALS AND METHOD: The present study was approved by the Ethics Committee of Teerthanker Mahaveer Dental College and Research Centre, affiliated to Teerthanker Mahaveer University, Moradabad, India. Around 150 extracted sound human upper bicuspids were taken and divided into six groups. Group 1 control (37% H₃PO₄), Group 2 (37% H₃PO₄+ Ortho Solo), Group 3 (37% H₃PO₄+ Assure Universal Bonding Resin), Group 4 (37% H₃PO₄+ Enhance LC), Group 5 (5.25% NaOCl + 37% H₃PO₄), and Group 6 (10% papain gel + 37% H₃PO₄). In all the groups (n = 150) orthodontic metal brackets were bonded with Transbond^TM XT and all the samples were subjected for evaluation of shear bond strength using Instron universal testing machine at a cross speed of 0.5 mm/min. The bracket failure mode was examined using Adhesive Remnant Index (ARI). The Kruskal-Wallis test and the Mann-Whitney test were used to compare the shear bond strength. The Chi-square test was used to determine significant differences in the ARI scores among the groups. The significance for all statistical tests was P < 0.05. RESULTS: Mean values of shear bond strength showed statistically significant differences between the evaluated groups (P < 0.005). The lowest and highest shear bond strength was attributed to Group 1 (control) and Group 2 (Ortho Solo), respectively. No statistically significant difference was noted for the mean ARI scores between control, adhesion promoters, and deproteinized group (P < 0.05). CONCLUSION: It was concluded that adhesion promoters and deproteinizing agents can be used to enhance the shear bond strength of orthodontic brackets. Among all the groups Ortho Solo showed the highest bond strength when used with Transbond^TM XT.

OBJECTIVE: To evaluate the antimicrobial property of cetylpyridinium chloride (CPC) when polymerized with cold cure acrylic and to assess the duration of its release from modified acrylic. MATERIALS AND METHODS: CPC was added in different concentrations (0%, 2.5%, 5%, and 10%) to cold cure acrylic resin and 180 acrylic discs were prepared. These were divided into four groups of 45 each depending on the concentration of CPC. The antimicrobial property of the modified acrylic for Streptococcus mutans was tested using disc diffusion assay in agar. The duration of release of CPC from self-cure acrylic was tested with optical density reading of solutions by ultraviolet spectrophotometer. The effect of addition of CPC on diametral tensile strength (DTS) of acrylic was tested using UTM (Instron) and the effect of water aging on modified acrylic was compared with unaged specimens. RESULTS AND CONCLUSION: The normality of the data was checked by Shapiro–Wilktest, and as the data failed to show normal distribution, inferential statistics were performed using nonparametric tests of significance. Antimicrobial activity of modified acrylic increased with increase in CPC concentration. Greatest CPC release was observed on the seventh day with a decrease in release from 7 to 180 days. There was a decrease in the diametral strength of the modified resin and water aging had a significant effect on the DTS of the modified resin.

OBJECTIVES: To investigate the effectiveness of mini-implant (MI)-facilitated micro-osteoperforations (MOPs) in accelerating mandibular anterior teeth alignment. MATERIALS AND METHODS: Thirty teenage patients with mandibular crowding (Little's irregularity index between 4 and 6 mm) were randomly allocated to either “experimental” group (micro-osteoperforation assisted alignment) or “control” group (conventional orthodontics). Blinding was done at the data analysis stages. Six MOPs were performed using MI on the labial aspect in the mandibular anterior region. The primary outcome was the overall treatment time needed to complete alignment of mandibular anterior teeth. The secondary outcomes were to compare the marginal bone height loss and volumetric root resorption around mandibular incisors along with subject's perception of pain, comfort and satisfaction. RESULTS: There was statistically significant difference in the total treatment duration for complete alignment of mandibular incisors. The completion of cases in experimental group was 43.93% times faster than the control group. There were no statistically significant differences in volumetric root resorption and marginal alveolar bone height loss around mandibular incisors as well as pain perception between the two groups. CONCLUSIONS: MI-facilitated MOPs accelerated tooth movement significantly upto nine weeks without any significant pain and discomfort, with no increase in root resorption and marginal alveolar bone height loss.

OBJECTIVES: To compare the accuracy of the linear measurements made on pre- and posttreatment three-dimensional (3D) scanned digital models with conventional plaster study models. MATERIALS AND METHODS: The study was conducted on pre- and posttreatment study models of 132 patients. A 3D model scanner was used to scan the plaster models to form 3D digital models. The measurements were made on the plaster models using digital Vernier calipers, and the 3D digital models were assessed for similar measurement using a software of the model scanner. The intraclass correlation for intraoperator error showed good correlations between the measurements made on conventional plaster models and digital models. RESULTS: Although the comparison of the linear measurements made by conventional and digital methods on both pre- and posttreatment study models using intraclass coefficient showed a good correlation, analysis of variance showed significant mean differences in the measurements of multiple variables in both the groups. The number of variables showing significant differences was more in the pretreatment group. The measurements obtained by Vernier calipers were generally higher than those of scanned pre- and posttreatment study models. CONCLUSION: The linear measurements made by conventional and digital methods showed statistically significant mean differences. The accuracy of recording can be affected by the severity of pretreatment malocclusion, but the deviations were not large enough to contradict the use of the digital models for orthodontic records.

OBJECTIVES: To evaluate and compare the effect of different enamel deproteinizing agents on topographic features of enamel and shear bond strength before acid etching. MATERIALS AND METHOD: In total, 120 sound human maxillary premolars were taken and divided into three groups: Group 1 control (37% phosphoric acid (H₃PO₄), Group 2, (5.25% Sodium Hypochlorite (NaOCl)+ 37% H₃PO_4, and Group 3, (10% Papain gel + 37% H₃PO₄). These groups were further divided into A and B subgroups. In subgroups 1A, 2A, and 3A (n30) topographic features were evaluated using Scanning electron microscope (SEM) at different magnifications. Insub-groups 1B, 2B, and 3B (n90) metal brackets were bonded with Transbond™ XT, and all the samples were subjected for Shear Bond Strength (SBS) evaluation using universal testing machineat a cross speed of 0.5 mm²/min. The failure mode was analyzed using adhesive remnant index (ARI).Statistical analysis was done using one-way ANOVA for the shear bond strength, and Kruskal-Wallis test followed by Mann-Whitneywas performed for ARI scores. RESULTS: SEM showed predominance of type 3 etching pattern in control Group (1A) and type 1 and type 2 in deproteinizedGroups (2A and 3A).Mean values of shear bond strength showed statistically significant differences between evaluated groups (P < 0.005).The lowest and highest shear bond strength was attributed to Group 1B (Control) and 3B (10% papain gel), respectively. Statisticallysignificant differences were noted for the mean ARI scores between control and deproteinized group (P < 0.05). CONCLUSION: 10% papain geland 5.25% NaOCl can be used as deproteinizing agents on enamel surface before acid etchingto enhance the shear bond strength of orthodontic brackets.

OBJECTIVES: To investigate pain intensity, interleukin-1β and prostaglandin E₂ values in saliva during initial orthodontic treatment among varying age groups and their correlation between these mediators. MATERIALS AND METHODS: Twenty healthy patients distributed equally in age and gender groups were chosen. Unstimulated saliva was collected before the placement of orthodontic fixed appliance (T₀), 1 hour after the placement of the appliance with 0.014” nickel titanium archwire (T₁), 1 month after the first visit (T₂), and 1 hour after the placement of 0.016” nickel titanium archwire (T₃). The saliva samples were then analyzed for prostaglandin E₂ and interleukin-1β using enzyme-linked immunosorbent assay. Pain intensity was measured using a numerical rating scale. RESULTS: Prostaglandin E₂ and interleukin-1β levels had increased at T₁ followed by a drop at T₂ and a subsequent increase at T₃. The prostaglandin E₂ and interleukin-1β levels were higher in adults than children. There was an insignificant correlation between the interleukin-1β and prostaglandin E₂ changes in all the patients. No significant differences were seen in pain scores between adults and children. Insignificant correlation was seen between pain scores and prostaglandin E₂ and interleukin-1β. CONCLUSION: Prostaglandin E₂ and interleukin-1β can be detected in saliva and are increased in during the initial orthodontic treatment but are higher in adults than children. Pain intensity was not significantly different between adults and children.

OBJECTIVES: Previous reports have shown that high-frequency vibration can increase bone remodeling and accelerate tooth movement. The aim of this study was to evaluate the effects of high-frequency vibration on treatment phase tooth movement, and post-treatment bone density at initiation of retention, with cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Thirty patients with initial Class I skeletal relationships, initial minimum-moderate crowding (3–5 mm), treated to completion with clear aligners and adjunctive high-frequency vibration, (HFV group) or no vibration, (Control group) were evaluated. The patients were instructed to change aligners as soon as they become loose. Changes in bone density associated with orthodontic treatment were evaluated using i-CAT cone-beam computed tomography (CBCT) and InVivo Anatomage^® software to quantify density using Hounsfield units (HU) between treated teeth in 10 different regions. HU values were averaged and compared against baseline (T1) and between the groups at initiation of retention (T2). RESULTS: The average time for aligner change was 5.2 days in the HFV group, and 8.7 days in the control group (P = 0.0001). There was significant T1 to T2 increase of HU values in the upper arch (P = 0.0001) and the lower arch (P = 0.008) in the HFV group. There was no significant change in average HU values in the upper (P = 0.83) or lower arches (P = 0.33) in the control group. The intergroup comparison revealed a significant difference in the upper, (P = 0.0001) and lower arches (P = 0.007). CONCLUSION: High-frequency vibration adjunctive to clear aligners, allowed early aligner changes that led to shorter treatment time in minimum-moderate crowded cases. At initiation of retention, the HFV group demonstrated statistically significant increase as compared with pre-treatment bone density, whereas control subjects showed no significant change from pre-treatment bone density.

OBJECTIVES: This study aimed to evaluate how dental practitioners and laypersons differ in their perception of altered smile aesthetics based on viewing images of a digitally manipulated smile. MATERIALS AND METHODS: A photograph with close to ideal smile characteristics was selected and digitally manipulated to create changes in buccal corridor space (BCS), midline diastema, gingival display, and midline shift. These altered images were rated by two groups: dental practitioners and lay persons using a visual analogue scale. The mean ± standard deviation (SD) of both groups were calculated and the Student's t-test was used to identify any statistically significant differences between the groups. Data analysis was done using the Statistical Package for Social Science (version 23.0; SPSS Inc., Chicago, Illinois, USA). RESULTS: The dentists were more sensitive to changes in the midline shift than laypeople and provided lower scores. There were no significant differences between the two groups when the gingival display alteration was ≤3 mm. However, for gingival display of 4 mm and 5 mm, there was significant difference between the two groups, with dentist rating them poorer as compared with the laypeople (P < 0.001). Dentists were more sensitive than the laypeople for midline diastema of 2 mm and 3 mm (P < 0.001 and P = 0.005 respectively). Changes in the BCS had minimal impact on the overall esthetic score for both the groups. CONCLUSIONS: Perception of smile esthetics differed between dentists and laypersons.

BACKGROUND: This study was undertaken to evaluate the enzyme activity profiles in human saliva and gingival crevicular fluid (GCF) in accelerated tooth movement when compared with normal orthodontic tooth movement (OTM) in extraction cases. MATERIALS AND METHODS: Twenty patients who required premolar extractions were treated with MBT mechanotherapy. They were divided into two equal groups: conventional (Group I) and corticotomy (Group II) which was performed on both the jaw sides before initiating retraction. GCF was collected from mesial and distal aspects of canine before initiation of retraction and at 7^th, 14^th, 21^st, and 28^th days, and then at fifth and sixth weeks and third and sixth months after retraction. A total of 5 mL of unstimulated saliva was collected from the subjects after 90 min of nonoral activity (subjects were refrained from eating and drinking). RESULTS: The results showed that in Group I, the peak of aspartate aminotransferase (AST) and alkaline phosphatase (ALP) enzyme activity occurred on the 14^th day of force application. In Group II, the enzyme activity progressively increased from day 0 to 6 weeks, peaking at the sixth week, and then a decline in enzyme activity was observed on third and sixth months. When ALP and AST activities in GCF and saliva were compared between Groups I and II, no statistically significant difference was observed on days 0, 7, and 14. CONCLUSION: Corticotomy-accelerated tooth movement is a promising technique that has many applications in orthodontic treatment of adults as it helps overcome many of the current limitations of this treatment. The enzymatic activity signifies osteoclastic and osteoblastic activities, so ALP and AST from the saliva and GCF may potentially be used as biomarkers for monitoring corticotomy-assisted OTM.

INTRODUCTION: Motivation for orthodontic treatment among adolescents has been linked with patients' response during treatment. Parents have also been seen to be influencing factors in patient motivation. This study investigates the motivation for orthodontic treatment among patients and their parents/guardians. MATERIALS AND METHODS: Data were obtained from 100 orthodontic children (41 boys, 59 girls), with a mean age of 11.9 years, in the age range of 7–17 years, and with parents/guardians from three public hospitals. Recruitment focused on patients and their parents at their initial screening appointment and those scheduled for regular orthodontic treatment. Data were collected by the use of survey forms for both patients and parents. Data were analyzed using Epi info^TM version 3.5.1. RESULTS: Children were more motivated to have orthodontic treatment than their parents before treatment, however parents showed greater motivation for their children to have orthodontic treatment than did the children during treatment. Children on treatment were less motivated than those who have not started treatment. Using braces was more important to children than their parents. Parents of children on treatment were more motivated for their children to have orthodontic treatment than parents of children who were not yet on treatment. Children undergoing orthodontic treatment were not willing to have extractions as part of their treatment, while parents did not have much objections (P = 0.001). Parents were willing to comply with dietary instructions imposed on their children. (P = 0.45). Pretreatment, children were more willing to brush after meals than the ones undergoing treatment (0.010). CONCLUSION: Parents of children on treatment were more motivated for their children to have orthodontic treatment than parents of children who were not yet on treatment. Children on treatment were less motivated during treatment.

OBJECTIVE: To evaluate the incidence of malocclusion and requirement for orthodontic treatment in the Saudi region of Hail city. MATERIALS AND METHODS: 520 Saudi participants between 7 and 12 years from Hail city were used in the research, all of whom were selected using a simple randomization method. For every participant, various malocclusion variables such as molar, canine, and incisor relationship, overjet, overbite, open bite, cross bite, scissor cross bite, and the score for the orthodontic treatment need [Index of Orthodontic Treatment Need (IOTN)] were recorded. A light source was used for examination, in addition to mouth mirrors, a calibrated ruler, and a portable dental chair. RESULTS: The prevalence of class I molar relationship was 70.4%, with class II being 21.3% and class III being 8.3%. As for the incisor relationships, class I was found at a prevalence of 72.5%, class II at 19.8%, and class III at 7.7%. Additionally, the following malocclusion characteristics were also found: deep overbite (>4 mm) (16.2%), increased overjet (>4 mm) (14.4%), posterior cross bite (13.3%), anterior open bite (7.7%), anterior cross bite (5.2%), scissor bite (4%), and posterior open bite (0.6%). A total of 4.4% were identified as requiring orthodontic treatment. Grades 1 and 2 were 25.5% and 58.5%, respectively. There was a significant relationship found between grades 3 and 4, and the anterior open bite, cross bite, and scissor bite. CONCLUSION: This research showed that class I malocclusion was most dominant, followed by classes II and III, respectively. When the Hail city school pupils in the study were assessed for IOTN index, grades 3 and 4 were found to be highly related to anterior open bite, cross bite, and scissor bite.

OBJECTIVE: The aim of this study was to compare the efficiency of canine retraction using modified Marcotte and T-loop retraction springs. MATERIALS AND METHODS: Twenty-four subjects with a treatment plan involving bilateral extractions of upper first premolars were included in the study. A split-mouth design was used to randomly allocate opposite quadrants to either modified Marcotte spring (MS) or T-loop spring (TLS) for canine retraction. Cephalometric radiographs and models were used to measure the rate of canine retraction (primary outcome) and compare the angular/rotational changes in the canines and anchorage loss in molars (secondary outcomes) following retraction. Subjective assessment of pain and discomfort was compared using visual analog scale (VAS). Paired and independent t-tests were used to evaluate changes. RESULTS: The mean amount and rate of retraction of the canine were found to be significantly higher for MS (3.56 ± 0.696 mm and 1.188 ± 0.232 mm, respectively) when compared with TLS (2.125 ± 0.472 mm and 0.71 ± 0.157 mm, respectively). Distopalatal rotation of the canine was also significantly lesser for MS (2.42°±1.868°) than TLS (5.65° ±2.84°, P < 0.001). However, the amount of anchorage loss and canine tipping were significantly higher for MS. Statistically significant higher values in the VAS score for TLS indicated greater discomfort. CONCLUSION: MS exhibited increased rate of retraction and rotation control when compared with TLS during sectional canine retraction. Patient comfort was better for MS as evidenced by the VAS scores. However, the amount of tipping and anchorage loss obtained with MS were significantly higher than TLS.

OBJECTIVE: The aim of this study was to investigate the effect of intraoral conditions and fluoride mouthwashes on mechanical properties and surface characteristics of different types of titanium molybdenum alloy (TMA) wires. MATERIALS AND METHODS: Three types of TMA wires of dimension 0.017” × 0.025” [1. Standard TMA (TMA), 2. ion-implanted, low-friction TMA (LF) and 3. Colored, Honey Dew TMA (HD)] were tested in three conditions as three groups; A) Control (as received), B) No fluoride (following intraoral use without fluoride) and C) Fluoride (following intraoral use with fluoride rinses). Surface roughness was evaluated using 3D Optical Profilometer. Three point bending tests were done to evaluate load deflection characteristics (LDR), ultimate tensile strength (UTS), and Young's modulus (E). Statistical evaluation was done using one-way analysis of variance (ANOVA), Bonferroni multiple comparison, and paired t-tests. RESULTS: Control group TMA exhibited significantly higher surface roughness, peak height, and LDR as well as lower UTS and E when compared to LF and HD (P < 0.001). In nonfluoride group, the surface roughness and LDR increased significantly for all three types of wires (P < 0.001). The UTS and E showed a significant decrease (P < 0.001). Additional use of fluoride mouthwashes (fluoride group) further increased surface roughness and LDR and decreased the UTS and E (P < 0.001). CONCLUSION: The ion-implanted LF/HD varieties had better surface smoothness, lower LDR, higher UTS, and higher E than standard TMA in the control group, pointing towards a better efficiency of these wires. Intraoral conditions significantly increased surface roughness and deteriorated mechanical properties of all types of TMA wires. With the use of daily fluoride mouthwashes, the deterioration was much worse.

OBJECTIVES: To systematically investigate and critically appraise the quality of the currently available literature regarding the morphological, postural, and functional changes observed in individuals following glossectomy. MATERIALS AND METHODS: A search without restrictions in eight databases (including grey literature) and hand searching from inception until March 2018 was performed. Data on morphological, postural, and functional changes after glossectomy were reviewed. Methodological quality was evaluated using the risk of bias in nonrandomized studies of intervention tool. RESULTS: Out of 835 initially identified unique records, only three articles following patients for 1 year after glossectomy fulfilled the selection criteria. Overall, no significant morphological, postural, and functional changes were observed. Only the distance between the dorsum and the nasal line increased and the freeway space decreased significantly. CONCLUSIONS: Overall, no significant differences were noted in the medium term, in terms of dentofacial structures adaptation and tongue function following glossectomy. Further research is warranted in order to elucidate the consequences of the altered oral environment.

OBJECTIVES: Leptin, a polypeptide which is related to body fat regulation, is also found to have a role in the inflammatory reaction. The aim of this study is to assess the concentration of leptin in Gingival Crevicular Fluid (GCF) during orthodontic force application and to correlate its concentration to rate of tooth movement. METHODS: Twenty orthodontic patients (10 males and 10 females) were selected for the study. Leptin concentration was measured at T0, before force application; T1, one hour after force application; T2, one day after force application; T3, one week after force application; T4, one month after force application. GCF was collected using filter paper strips from the distal aspect of gingival sulcus of the right maxillary canine distalized by an active lace-backs of tooth movement was measured on dental casts, before and one month after force application. One-way ANOVA with Bonferroni correction and Pearson's correlation test were used to analyze the data. RESULTS: The mean GCF leptin concentration increased from T0 to T1, rose to a peak at T2, then declined to a minimum value at T3 and then increased to a value at T4, closer to the base line value (T0), and it was statistically significant (P < 0.05). There was positive correlation of the overall mean leptin concentration to rate of tooth movement (correlation coefficient = 0.634). CONCLUSION: There was a biphasic change in GCF leptin concentration during one cycle of orthodontic force application. There was a positive correlation between the GCF leptin concentration and rate of tooth movement.

OBJECTIVES: This study aimed at evaluating the effect of using a 45S5 bioglass paste and a topical fluoride as protective agents against acidic erosion (resembling acidic beverage softdrinks intake) for enamel surrounding orthodontic brackets. MATERIALS AND METHODS: Sample of 21 freshly extracted sound incisor and premolar teeth was randomly divided into three equal groups: a bioglass group (Bioglass) (NovaMin, 5-mm average particle, NovaMin Technology), a Fluoride group (Fluoride) (Gelato APF Gel, Keystone Industries), and a control group (Control). Orthodontic brackets were bonded to the utilized teeth usingMIP (Moisture Insensitive Primer) and Transbond PLUS color change adhesive. All specimens were challenged by 1% citric acid for 18 min. The top enamel surfaces next to the orthodontic brackets were examined by SEM-EDS. Wilcoxon Signed-Rank test was used to compare the area covered by the 45S5 bioglass paste before/after erosion P < 0.05. RESULTS: 45S5 bioglass paste application resulted in the formation of an interaction layer that significantly resisted erosion challenge P < 0.05. The fluoride and control specimens showed signs of erosion of the enamel next to the orthodontic brackets (P < 0.05). CONCLUSION: 45S5 bioglass paste can efficiently protect the enamel surfaces next to orthodontic brackets for acidic erosion challenges.

OBJECTIVES: To determine whether the modification of dental occlusion, without molar extraction, affected the gustatory papillae located in the tongue of growing rats. MATERIALS AND METHODS: Five-week-old male Wistar rats were randomly divided into an anterior bite plate (ABP) group and a control group. Under general anesthesia, ABPs were placed on the occlusal surfaces of the maxillary incisors, while metal caps covered the mandibular incisal edges of the rats in the ABP group. The control group rats underwent a sham operation. The rats in both groups were euthanized 14 days after the procedure. The circumvallate papillae and taste buds were analyzed by immunohistochemical methods, and the fungiform papillae were observed and counted after immersion of the tongue in 1% methylene blue. RESULTS: Two weeks after ABP insertion and mandibular incisal cap placement, the gustatory papillae exhibited morphological and structural changes. The rats in the ABP group had exhibited significantly fewer fungiform papillae, and narrower circumvallate papillae, with greater trench depths, larger trench profile areas, smaller taste bud profile areas, lower ratios of the taste bud profile area to the trench profile area, and more taste buds than those in the control group. CONCLUSIONS: Our findings support the association between occlusal and taste functions and provide a basis for further studies on the gustatory function. In conclusion, loss of molar occlusion, resulting from the ABP and metal cap insertion, altered the peripheral gustatory receptors in the growing rats.

OBJECTIVE: To evaluate the maxillary canine retraction rate and anchorage loss with active and passive self-ligating brackets (SLBs). MATERIALS AND METHODS: The study was conducted on 10 patients whose age ranged from 14–20 years. The patients had minimal to no crowding with a dental protrusion of maxillary incisor that required the extraction of maxillary first premolars and retraction of canines. The maxillary canines had to be in a good alignment and level before treatment to ensure that canine retraction had started from the same point bilaterally. A cone beam computed tomography (CBCT) had been taken for each patient's maxilla before treatment initiation and after complete canine retraction. Using nickel titanium, close-coil spring canine retraction on both sides and the rate of canine movement was measured. RESULTS: The patients were checked every 2 weeks to measure the retraction rate and ensure that a constant force (150 g) was being delivered to both canines. The pre- and post-canine retractions CBCT were superimposed to evaluate the pattern and rate of canine movement and anchorage loss. The result of this study showed no statistically significant difference between the two groups. CONCLUSION: The type of SLB, either active or passive, does not affect the rate or type of canine movement during its retraction in the orthodontic extraction cases, and the anchorage loss of the upper molars was nearly the same in both type.

OBJECTIVE: To evaluate the status of occlusion among school children in city of Abha, Saudi Arabia. MATERIALS AND METHODS: The current study was based on the clinical examination of 1998 Saudis (mean age 14.13 ± 0.99 years) who were randomly selected by a multi-stage random sampling technique from the city of Abha. The occlusal parameters recorded in this study were molar and canine relationships, overbite, overjet, crowding, spacing, anterior open bite, anterior crossbite, posterior crossbite, and scissors bite using gloves, light source, mouth mirror, and ruler. RESULTS: Class I molar relationship was observed in 1219 (61%) of the total sample, while Class II and III molar relationships were observed in 326 (16.3%) and 154 (7.7%), respectively. Class I–III canine relationships were seen in 1255 (62.8%), 231 (11.6%), and 112 (5.6%) of the sample, respectively. Normal overbite was found in 1490 (74.6%) of cases, while 1515 (75.8%) had normal overjet. The most prevalent malocclusion trait was crowding (26.6%), followed by spacing (20.6%), increased overjet (19.5%), increased overbite (19.4%), posterior crossbite (8.5%), and anterior open bite (6.1%). CONCLUSIONS: Crowding was the highest occlusal trait in frequency followed by spacing, increased overjet, and increased overbite. Class I molar and canine relationships, normal overjet, and normal overbite were frequent findings among Saudi adolescents in Abha city.

AIMS: To determine the association and level of agreement between young adults' perception of orthodontic treatment need (subjective need) and the orthodontists' assessment of treatment need (normative objective need). METHODOLOGY: For this study, 670 students [280 males and 390 females; mean age (standard deviation) of 15.32 (1.81) years] were selected from public and private schools from different demographic areas of Jeddah city, Saudi Arabia, and divided into two age groups (12–15 years) and (16–19 years). All the participants were examined, and the Index of Orthodontic Treatment Need (IOTN) components [dental health component (DHC) and aesthetic component (AC)] were recorded. RESULTS: Kappa statistics showed a statistically significant but fair agreement between clinician AC (CAC) and student AC (SAC) assessments in both age groups (k = 0.343 and 0.334, respectively; P < 0.001), whereas Spearman's correlation coefficient showed a statistically significant but moderate association (r = 0.487 and 0.517, respectively; P < 0.001). The degrees of agreement were 76.4% and 76.7% at the no-need and mild-need levels of treatment, respectively. There was a statistically significant but weak association between the subjective and normative needs (SAC and IOTN-DHC) in both age groups (r = 0.336 and 0.360, respectively; P < 0.001). However, the degrees of agreement were 58.9% and 61.5% at the no-need and mild-need levels of treatment, respectively. CONCLUSION: Significant but weak positive association was found between the normative and subjective orthodontic treatment needs, indicating a lack of understanding of the nature of malocclusion and its consequences. Thus, promoting further knowledge and awareness of malocclusion are indicated.

OBJECTIVE: To evaluate the effect of different surface treatments and bonding modalities on the shear bond strength (SBS) between metallic orthodontic brackets and zirconia crowns. MATERIALS AND METHODS: Sixty zirconia specimens were computer-aided design/computer-aided manufacturing milled, sintered, glazed, and embedded in acrylic resin. The specimens were divided into three groups according to the surface treatment applied: C: no surface treatment (control), S: sandblasted with 50 μm Al₂O₃, and D: Sof-Lex disc roughening. Each group was further subdivided into two subgroups according to the resin cement used: P: Clearfil Ceramic Primer + Panavia F2.0 (Kuraray) and R: RelyX U200 (3M/ESPE). Metallic orthodontic brackets were bonded to the labial surface of the specimens. All specimens underwent thermocycling. SBS test was applied using a universal test machine at a cross head speed of 1 mm/min. Data were analyzed using Mann–Whitney test (α = 0.05). RESULTS: Subgroup SP showed the highest SBS (20.8 ± 4.8 MPa), followed by subgroups SR (16.7 ± 4.6 MPa), DP (12.3 ± 2.8 MPa), and DR (11.6 ± 3 MPa). However, all specimens in the control group underwent debonding during thermocycling. The different surface treatment groups showed highly significant differences (P < 0.05), whereas the resin cement subgroups showed no significant differences (P > 0.05). CONCLUSION: SBS between glazed zirconia crowns and metallic brackets strongly depended on the surface treatment applied. Sandblasting achieved the highest SBS. Roughening with Sof-Lex disc proved to be a reliable surface treatment modality for glazed zirconia. Bonding to untreated glazed zirconia surfaces led to bond failure. Both resin cements yielded strong SBS results.

OBJECTIVE: Using the cast-radiograph evaluation (CRE) score of the American Board of Orthodontics (ABO), the purpose of this study was 1) to find the post-treatment discrepancies that contributed to low-quality outcomes and 2) to identify if there might be any correlation between cephalometric changes and post-treatment discrepancies. MATERIALS AND METHODS: About 200 records submitted for the Thai Board of Orthodontics examination were analyzed. Overall, 23 parameters of the CRE scores and 12 cephalometric changes were collected. Based on the total CRE score, the cases were classified into three categories: pass (score <20), undetermined (score 20–30), and fail (score >30). Kruskall–Wallis was used to analyze the differences of mean CRE scores among these three categories. In addition, the cases were further classified into fixed appliance, two-phase and orthognathic surgery groups. Correlation tests were carried out to determine if there might be any association between cephalometric changes and CRE parameters. RESULTS: Significant differences of mean CRE scores were found for all CRE components except interproximal contacts. Significant correlation coefficients with the total CRE scores were found for all parameters except interproximal contacts. Significant moderate association was found between lower incisor changes and CRE scores in the two-phase and orthognathic surgery group. CONCLUSIONS: In order to improve treatment outcome quality, the top four parameters that orthodontists should pay attention to are occlusal contacts, occlusal relationship, marginal ridges, and alignment and rotations. Cephalometric changes were not suitable as weighting factors for total CRE scores.

OBJECTIVE: To determine the prevalence of malocclusion and orthodontic treatment need in a sample of Omani adolescents aged 11–16 years. MATERIALS AND METHODS: The total sample included 854 adolescents with 387 boys and 467 girls between the age of 11 and 16 years with no previous orthodontic treatment history. The study design was cross-sectional. The parameters studied were skeletal relationship, lip competency, teeth impactions, missing teeth, contact point displacement, crowding, spacing, incisors and molars classification, overjet, overbite, crossbite, oral hygiene and caries. The Index of Orthodontic Treatment Need (IOTN) was used to study the need for orthodontic treatment for the total sample. RESULTS: There was a high prevalence of Class I jaw relationship (86.2%). About 81.6% of the sample studied had Class I molar relationship and 73.8% had Class I incisors relationship. About 61.4% of the sample had no contact displacement, while 5.2% had contact displacement >4 mm. Severe crowding in the maxilla was found in 2.3% while spacing was found in 24.2%. Around 11% of the sample studied had Class II div 1 incisors relationship, 13.5% Class III and only 1.8% had Class II div 2 incisors relationship. Only 8.6% of the sample studied had an overjet >6 mm while 16.3% had a deep bite and 0.2% had anterior open bite of >4 mm. Teeth impaction was found in 11.7% while permanent missing teeth was present in 1.8%. The results showed that 13.9% had a very great need for treatment while 43.2% of the sample did not need any treatment. CONCLUSION: Among the Omani adolescents, there was a high prevalence of Class I jaw relations and Class I molar relationship. The prevalence of malocclusion and treatment need in Omanis shows some variation when compared to other ethnicities.

OBJECTIVES: To evaluate the possible change in teeth lengths as an indicator of orthodontically induced tooth root resorption (OITRR) after high-frequency mechanical vibration (HFV) treatment concurrent with Invisalign Smart Track® aligners as evaluated by cone beam computed tomography (CBCT). MATERIALS AND METHODS: The sample, composed of 30 patients with an average age of 26 ± 11 years and Class I malocclusion with an initial anterior crowding ranging from 3 to 5 mm, was divided equally into two groups; Group I received adjunctive high-frequency mechanical vibration (HFV); Group II, the control, did not receive adjunctive mechanical treatment. The maxillary incisor's teeth lengths were measured using Mimics software before (T1) and after (T2) treatment. All data were analyzed using Student's t-test. Reliability testing was completed by randomly selecting 10 patients' CBCTs, and their teeth lengths were measured twice by the same investigator over a 15-day interval and compared confirming intra-operator accuracy. RESULTS: The control group showed a statistically significant decrease in tooth lengths compared to the HFV group which showed nonstatistically significant change of tooth lengths. CONCLUSION: Patients treated with HFV showed minimum tooth length changes after treatment, which may indicate that HFV can reduce OITRR with treatment using clear aligners.

OBJECTIVE: To our knowledge, no study has compared the facial and dental morphology of adult Latin and Japanese populations. The purpose of this study was to assess differences in the facial and dental morphology between adult Spanish and Japanese women with Class I malocclusion using lateral cephalograms. MATERIALS AND METHODS: The lateral cephalograms of 33 adult Spanish and 33 adult Japanese women were traced and digitized by a single investigator. All patients satisfied the following criteria: female sex; age 18–35 years; skeletal Class I malocclusion (ANB angle, 2°–5°; angle Class I malocclusion; arch length discrepancy, −10 to + 10 mm; overjet, 1–5 mm; overbite, 1–5 mm); absence of congenital anomalies, significant facial asymmetry, or congenitally missing teeth, with the exception of the third molars; significant temporomandibular joint problems; severe crowding; and no history of orthodontic treatment. RESULTS: Eleven and six angular measurements for the skeletal and dental hard tissues, respectively, were computed in accordance with previous studies. The results showed that Japanese women had significant maxillary and mandibular protrusion, clockwise mandibular rotation, greater labial tipping of incisors, and a smaller interincisal angle compared with Spanish women. CONCLUSION: At the time of orthodontic treatment planning, it is important to consider the facial and dental morphological characteristics of individual ethnic groups to achieve satisfactory outcomes and retention. The findings of this study provide valuable information that will aid in orthodontic treatment planning for adult Spanish and Japanese women.

OBJECTIVE: To determine the mean soft tissue facial profile for Circassian adults as determined by Legan–Burstone cephalometric analysis. MATERIALS AND METHODS: 71 lateral cephalometric radiographs for nongrowing Circassian adults with normal occlusion were traced and accurately measured. RESULTS: With regard to facial form analysis, Circassian adults showed higher facial convexity angle, retruded mandible, and obtuse lower face–throat angle. When compared with lip form norms, Circassians showed increased nasolabial angle, deeper mentolabial sulcus, and increased maxillary incisor exposure. Comparison between men and women showed that mentolabial sulcus depth was significantly increased in Circassian men compared with Circassian women. CONCLUSION: The results of this study showed that soft tissue facial profiles for Circassians and Caucasians are different in certain values. Such differences should be taken into account when formulating a treatment plan for Circassian patients seeking orthodontic treatment and orthognathic surgery.

CONTEXT: The purpose of this study was to evaluate the accuracy and reliability of tooth length measurements using conventional and cone-beam computed tomography (CBCT) imaging techniques. AIM: The aim of this study was to assess the accuracy and reliability of various tooth length measurements made on CBCT scans and conventional imaging techniques [intraoral periapical radiograph (IOPA) and orthopantomogram (OPG)]. SETTINGS AND DESIGN: This is an in-vitro comparative study. SUBJECTS AND METHODS: In total, 50 extracted single-rooted premolar teeth were mounted on the dry human mandible. For each extracted tooth, measurements for tooth length, crown length, and root lengths were taken with a Vernier caliper and using three imaging modalities: CBCT, OPG, and IOPA radiographs. The measurements were compared with the gold standard (Vernier caliper). STATISTICAL ANALYSIS USED: One-way analysis of variance was used to compare mean values between the groups that are Vernier caliper, CBCT, IOPA, and OPG. The multiple comparisons of means of tooth length, root length, and crown length were done by Bonferroni test. RESULTS: A significant difference in the tooth length measurements was seen between the measurements taken by CBCT and IOPA and between IOPA and OPG. But, no significant difference was seen between any other groups. The highly significant difference was seen between the root length measurements taken by IOPA and OPG and by CBCT and OPG. However, no significant difference was seen between any other groups. No significant difference was seen in between the crown length measurements taken by Vernier caliper and CBCT and between IOPA and OPG. However, a significant difference was seen between all the groups. CONCLUSIONS: Among the radiographic techniques, CBCT was found to be the most accurate in measuring the tooth, root, and crown lengths.

OBJECTIVE: This study was carried to study the prevalence of dental anomalies and treatment modalities/planning among the orthodontic patients. MATERIALS AND METHODS: A total of 370 orthodontic records including their pre-treatment orthopantomographs (OPG) and study models of orthodontic patients in permanent dentition who attended dental clinic were assessed for impaction, hypodontia, supernumerary, supraocclusion, infraocclusion, and any other anomalies excluding the third molars. The association of anomalies with gender status and racial status was analyzed using Pearson's Chi-square test. A P value of <0.05 is considered as significant. The confidence interval at 95% (CI) was set. RESULTS: Among the 370 subjects, 105 (28.4%) presented with at least one anomaly. Eighty-five (23%) demonstrated a single anomaly and 20 (5.4%) with more than one anomaly. The most prevalent anomaly was impaction (14.32%), followed by hypodontia (7.03%). The less common anomalies were microdontia (1.08%), dilacerations (0.27%), and generalised enamel hypoplasia (0.27%). Maxillary right lateral incisors and canines were the most common affected teeth and these are located on the maxillary right quadrant. It was evident that dental anomalies were statistically dependant on race (P = 0.025), but independent of gender. The most common treatment planned for these patients was fixed appliance. CONCLUSIONS: Impaction was predominant among 28.4% subjects observed with anomaly and most patients with anomaly are treated with fixed appliances (49%). CLINICAL RELEVANCE: These anomalies play a great role in occlusion and alignment in treatment planning and relapse for orthodontic treatment.

BACKGROUND: The association between maxillary development and vector relationships is used in the field of plastic surgery, but the validity of this principle has not been tested yet. AIM: The aim of this study is to determine whether visual classification of anterior malar projection using vector relationships is supported by cephalometric analysis. MATERIALS AND METHODS: Normal, healthy 40 subjects aged 10–15 years with no history of orthodontic treatment, craniofacial syndromes, or trauma formed the study group. These subjects based on the visual assessment of vector relationship (positive and negative) were divided into 2 groups (Group A and Group B), consisting of 20 subjects each. Vectors were drawn on the profile photographs. Sella–Nasion–Orbitale (SNO) angle were traced using the Nemoceph software. The relationship of anterior malar projection obtained from profile photograph and lateral cephalogram were compared. The data obtained were subjected to statistical analysis. RESULTS: Skeletal differences between the positive and negative vector groups based on SNO angles were statistically significant (P < 0.001). SNO angulations in the negative vector group were smaller than the positive vector group by an average of 5.9°. CONCLUSIONS: Visual assessment of vector relationship can be effectively used to classify anterior malar projection. This also helps in diagnosing maxillary hypoplasia and executes different treatment modalities.

AIM: The value of gonial angle indicates the range of steepness as well as the direction of mandibular growth. Exact measurement of right (R) and left (L) gonial angles from a lateral cephalometric radiograph is challenging due to the superimposition of both sides. Thus, the aim of the present study was to assess the potential of determining accurate measurement of R and L gonial angles by employing orthopantomographs (OPGs) and to compare the findings with the measurements obtained from lateral cephalometric radiographs. MATERIALS AND METHODS: A total of 125 standardized panoramic as well as lateral cephalometric radiographs of Libyan subjects were obtained from the orthodontic clinical records (36 males and 89 females). Mandibular inclination was computed by averaging the R and L gonial angles produced by drawing tangents to the inferior border of the mandible and to the distal aspect of the ascending ramus and the condylon on each OPG. Moreover, similar steps were followed to extract the gonial angle from the cephalometric radiographs. RESULTS: Student's paired t-tests revealed no significant discrepancies between the R and L gonial angle values extracted from the OPG (123.88° ± 6.53° and 123.27° ± 6.55°) at P = 0.0.070. The mean values of the gonial angle (average of the R and L mean values) extracted from the OPG (123.58° ± 6.38°) and cephalometric radiographs (125.14° ± 6.23°) were not significantly different (P = 0.084). Furthermore, Pearson's correlation coefficient revealed strong correlation between the value of the gonial angle measured in the cephalometric radiograph and the mean value extracted from the OPG (r = 0.897 at P < 0.001). CONCLUSION: OPGs are as useful as lateral cephalometric radiographs in the assessment of mandibular inclination and steepness in Libyan subjects. They have the added advantage of reducing patient exposure to radiation by cutting the number of radiographs required during diagnosis.

OBJECTIVES: This study was designed to explore whether force magnitude would influence incisor torque control and the overall outcome in patients with bimaxillary protrusion who need mass incisor retraction. MATERIALS AND METHODS: Forty-one female patients (aged > 15 years) with bimaxillary protrusion requiring mass incisor retraction were selected. Two sliding mechanics were utilized, with the elastic group receiving a light force of ~100 g by wearing elastics and the power chain group receiving a moderate force of ~250 g by power chain. Lateral cephalograms obtained before and after treatment were traced and measured. RESULTS: Patients in both groups displayed maxillary protrusion with a similar skeletal class II tendency. A longer treatment time was found in the elastic group. No difference in the distance of incisor tip movement was observed between the two groups; however, a larger inclination of upper incisors was found in the elastic group, indicating less loss of torque. In addition, larger reduction in Sella-Nasion-A and A-Nasion-B angle was observed in the elastic group, which was accompanied by a larger ratio of upper lip retraction to upper incisor retraction as well as more upper lip retraction. CONCLUSIONS: Sliding mechanics with elastics to generate light forces can achieve better torque control with more reduction in skeletal and soft tissue protrusion.

OBJECTIVES: The objective of this study was to compare the shear bond strength (SBS) of new and rebounded orthodontic brackets bonded to the buccal sound and cleaned enamel surfaces using two orthodontic adhesives: resin-modified glass-ionomer (RMGI) and resin-composite. MATERIALS AND METHODS: Forty premolars were randomly allocated into four groups, 10 teeth/group. New and rebonded brackets were bonded to sound and cleaned enamel surface, and then were subjected to thermocycling. The bond strength was determined using a universal testing machine at a crosshead speed of 1 mm/min. Remaining adhesives on enamel after bracket debonding was scored independently by two investigators who were not aware of the four different groups, using adhesive remnant index (ARI). RESULTS: There was a statistical significant difference in SBS of the four groups (P = 0.005). SBS values were significantly higher with cleaned enamel surfaces after adhesive removal compared to sound enamel. SBS was significantly higher for rebonded brackets, when compared with the new brackets. No significant difference was found between the two adhesives types. The level of agreement between the two raters was higher toward the classification of higher categories of ARI (scores 5 and 6) with agreement percentage 91.7% and 100%, respectively. There was more adhesive remained among resin-composite groups. CONCLUSIONS: The bond strength of debonded sandblasted stainless-steel brackets was higher than new brackets. Resin-composite and RMGI orthodontic adhesives used in this study exhibited sufficient SBS values for bonding brackets to sound and cleaned enamel and comparable to each other.

OBJECTIVES: The purpose of this pilot study was to evaluate the root lengths of upper incisors as an indication of the degree of orthodontically-induced apical root resorption following treatment with Smart Track® aligners and compare it with two different fixed orthodontic appliances – regular and Damon brackets – using cone-beam computerized tomography (CBCT). MATERIALS AND METHODS: The sample comprised 33 patients with class I malocclusion and 4–6 mm crowding divided in 3 groups; Group I: 11 patients treated with Smart Track® aligners, group II: 11 patients treated with Damon brackets, and group III: 11 patients with regular brackets. Maxillary incisors teeth lengths were assessed using Dolphin imaging software before and after treatment. All data were analyzed using analysis of variance and t-test. RESULTS: All groups showed statistically significant root resorption, 0–1.4 mm for clear aligners, 0.1–2.3 mm for Damon, and 0–2.5 mm for regular brackets group. However, cases treated with fixed appliance in general showed significantly higher resorption than those treated with Smart Track® aligners (P < 0.05). CONCLUSION: Orthodontically-induced root resorption, as evaluated by root length, is an inevitable drawback with different orthodontic techniques. However, the use of Smart Track® aligners showed less root resorption relative to regular fixed appliances.

OBJECTIVE: To assess and compare the changes in pharyngeal airway space dimensions following orthodontic treatment of skeletal class II and class III facial deformities with premolar extraction. MATERIALS AND METHODS: Sixty pre and posttreatment lateral cephalometric radiographs of patients who underwent fixed orthodontic treatment with premolar extraction were collected. The sample was divided into two groups – 32 patients with skeletal class II and 28 patients with skeletal class III malocclusion. Both groups were subdivided into growing patients (<16 years old) and adults (>16 years old). Nasopharyngeal, palatopharyngeal, and glossopharyngeal airway space dimensions were measured in the pretreatment (T0) and posttreatment (T1) cephalometric radiographs using Dolphin Imaging 11.7 software. Two-way, repeated-measures analysis of variance was used to assess the in-treatment changes. RESULTS: Nasopharyngeal airway dimension showed similar significant increase in class II (P = 0.042) and class III (P = 0.049) patients from T0 to T1, whereas palatopharyngeal and glossopharyngeal dimensions were insignificantly decreased in both groups. However, both malocclusions followed the same pattern of changes in relation to airway dimensions. In addition, no significant statistical difference was found in the airway spaces between growing and adult patients. CONCLUSIONS: Extraction of premolars did not affect the pharyngeal dimensions except those of the nasopharynx, which showed a significant increase after extraction in both groups.

OBJECTIVE: To assess the knowledge of, demand for, and need for the orthodontic specialty in comparison to other dental fields in a sample of Saudi males. MATERIALS AND METHODS: A multiple choice questionnaire was designed to assess participants' knowledge interest, demand, and need for treatment in the following dental specialties: orthodontics, periodontics, prosthodontics, endodontics, and restorative dentistry. Subjects desiring clinical examination underwent further assessment to document their actual needs. In addition to the subjects' age, the frequencies of tooth brushing, dental pain, treatment seeking, and routine checkup were collected. Descriptive statistics and Pearson's Chi-square test were applied to compare the percentages of the knowledge of, demand for, and need for each dental discipline. The significance level was set at P < 0.05. RESULTS: A total of 1566 Saudi males completed the initial survey of dental knowledge, and 1406 subjects then completed the needs checklist. For the assessment of treatment needed, a total of 177 Saudi males were examined. The average age was 31.25 years (±13.44) and 30.61 years (±10.21) for the surveyed and examined groups, respectively. Subjects' interest in orthodontic knowledge (25%) and demand (27.6%) were not significantly different (P = 0.113), unlike the highly significant difference in the need counterpart (62.5%, P < 0.001). Highly significant differences (P < 0.001) were detected between the three outcome frequencies (knowledge interest, demand, and need) within all dental disciplines, except for the endodontic group where there was no significant difference detected (P = 0.625). Further analysis for the differences between each possible pairing of the three outcomes is highlighted. CONCLUSIONS: Subjects' knowledge of orthodontics approximated their treatment demand. However, orthodontic need was significantly much higher. Different patterns of distinction for other dental specialties were detected and described.

INTRODUCTION: The purpose of this study is to evaluate the validity of a free-access software package (ITK-SNAP) in segmenting and measuring the volume of upper airway spaces secondary to rapid maxillary expansion (RME). MATERIALS AND METHODS: Sixteen participants who required RME were recruited for this study. Preoperative (T1) and 6-month postoperative (T2) cone-beam computed tomographic scans of all participants were analyzed. OnDemand3D software packages was used for superimposition and orientation of the images, while ITK-SNAP software was used to measure the volume of airway spaces. At week one (W1), all volumetric measurements were carried out by one examiner and repeated after 1 week (W2). Paired t-test, the interclass correlation coefficient, and Dahlberg coefficients of reliability were used to assess the reproducibility. RESULTS: Student's t-test showed no significant difference between the W1 and W2 set of measurements (P > 0.05). Coefficients of reliability were above 95% and intraclass correlation coefficient ranged from 0.99 to 1.000, which altogether confirmed the satisfactory reproducibility of the measurements. CONCLUSIONS: ITK-SNAP software package is a reliable and cost-effective method to segment and measure upper airway changes subsequent to RME.

INTRODUCTION: It has been reported that Class II, division 2 maxillary central incisors frequently demonstrate increased collum angles, which indicates an excessive palatal “bend” of the crown. However, evidence supporting such observation is mostly derived from radiographic studies. OBJECTIVE: The objective of this study was to evaluate and compare the collum angle of maxillary central incisors in Class I, Class II, division 1, and Class II, division 2 cases using cone-beam computed tomography. MATERIALS AND METHODS: Forty-eight consecutive orthodontic cases (16 Class I, 16 Class II, division 1, and 16 Class II, division 2 malocclusion) with cone-beam computed tomography as part of their initial diagnostic records were evaluated. Cross-sections including maxillary right and left central incisors were used to calculate the angulation between the crown and root long axes (collum angle). Comparisons between groups were performed using analysis of variance for multiple and post-hoc Tukey for paired analyses. RESULTS: Mean collum angle observed in Class II, division 2 cases was significantly larger (5.2 ± 1.3°) than the ones obtained for Class I (1.1 ± 4.2°) (P = 0.034) or Class II, division 1 cases (0.1 ± 0.7°) (P = 0.014). CONCLUSIONS: Our findings suggest that Class II, division 2 individuals demonstrate accentuated lingual inclination of the maxillary central incisor crown compared to the other types of malocclusion studied here. Such morphological feature indicates the need for better tooth movement planning, especially in regard to root palatal torqueing of the maxillary central incisors.

OBJECTIVE: The aim of this systematic review and meta-analysis is to quantitatively compare previous studies that evaluated skeletal and dentoalveolar effects of the Forsus^TM Fatigue Resistance Device (FRD) in the treatment of Class II malocclusion with a matched untreated control group. MATERIALS AND METHODS: Four electronic searches PubMed, Web of Science, Cochrane Library, and Science Direct that were limited to articles on human studies comparing the effect of Forsus appliance with a matched control group in the treatment of Class II malocclusion from the year (2000–2017). An additional manual search was carried out by examining the references of the included articles, SEARCH terms included; Forsus and Class II malocclusion. The quality of the included studies was assessed using the modified methodological score for clinical trials. The data were analyzed using Michael Borenstein's Comprehensive Meta-Analysis Software (V3.3.070, Biostat, Inc., US). RESULTS: Seven studies were included comprising 273 participants (Forsus group = 142; control group = 131). The results indicated a statistical significant skeletal effect of the Forsus appliance on increasing the occlusal plane only (P < 0.001). The results also indicated a statistical significant (P < 0.001) dentoalveolar effects of the Forsus appliance on the following outcomes; protruding, proclining, and intruding lower incisors; retroclining upper incisors, distalizing and intruding upper molars, as well as reducing overjet and overbite. CONCLUSIONS: The Forsus^TM showed positive effects on the maxillary incisors and first molars as well as overjet and overbite. However, multiple negative effects were reported on the occlusal plane and lower incisors that need to be considered when using such appliance in treating Class II malocclusion.

AIM OF THE STUDY: The main objective of the present study was to investigate the level of job satisfaction among professional orthodontists in relation to some significant intrinsic and extrinsic factors that generally affect their performance. MATERIALS AND METHODS: A cross-sectional study was conducted among orthodontists working in the Kingdom of Saudi Arabia using an online survey questionnaire through Survey Monkey. A total of 161 responses were received; among those, 57.8% of the respondents were Saudi and 42.2% were non-Saudi. RESULTS: On an overall satisfaction basis, a majority of orthodontists (80.7%) were satisfied with orthodontics as their profession irrespective of their gender. Only 4.4% showed dissatisfaction, whereas the remaining 14.9% were moderately satisfied with orthodontics as a profession. In-depth analysis revealed that a majority of the respondents (56.2%) showed reservations over having ample time for their family life. 52.8% of the respondents strongly agreed that they are assigned significant paperwork. Likewise, 66.5% of the orthodontists showed moderate to dissatisfaction over time adherence by the patients. CONCLUSION: The findings of the present investigations depicted a higher level of passion and commitment among the male and female respondents for the profession in spite of the fact that they do not have adequate time for their personal life. The working efficiency of orthodontists may be significantly enhanced by sparing them from too much paperwork and ensuring that their patients appear on time.

OBJECTIVES: The aim of the study was to assess the association and correlation between the overjet and muscle activity (the masseter and temporalis muscles) in patient with Class II malocclusion in different genders using surface electromyography (sEMG). MATERIALS AND METHODS: The overjet (measured clinically) and electromyographical activity (rest, chew, post chew rest, clench and post clench rest) of the masseter and temporalis muscle of class II malocclusion patient were assessed in 18 patients (3 males and 15 females) from the School of Dental Science, Hospital University Sains Malaysia. RESULTS: The results were compared by simple linear regression test to evaluate the association between overjet and muscle activity in different genders. Class II malocclusion patients with increased overjet group showed significant association with masseter muscle activity on chewing stage (P = 0.005, F = 6.081 and adj-R² = 0.473). Left temporalis muscle in class II malocclusion showed a significant linear association (P = 0.014, F = 0.812 and adj-R²= −0.034) with gender during clench. CONCLUSION: In conclusion, class II malocclusion patient with increased overjet can affect masticatory muscle function and as well as clench force may differ in gender.

OBJECTIVES: A skeletal anterior open-bite is a challenging malocclusion for the orthodontist due to the difficulty and instability of correction. Treatment options for the adult patient include extractions, anterior extrusion with intermaxillary elastics, posterior intrusion using skeletal anchorage, occlusal adjustment, and orthognathic surgery. Patient compliance plays a key role in posttreatment stability. The present case report demonstrates the orthodontic treatment of an adult patient who presented with a complex open-bite malocclusion. MATERIALS AND METHODS: Treatment involved the placement of four miniscrews to assist intrusion of maxillary molars by applying posterior vertical maxillary elastics and extrusion of the anterior segments using anterior vertical interarch elastics. RESULTS: Ideal intercuspation was successfully achieved and good stability was maintained during 3 years following treatment. CONCLUSION: The intrusion of the maxillary molars with miniscrews is an interesting option in selected cases of skeletal anterior open bite. The retention protocol should be specific in these cases.

OBJECTIVES: The objective of this study was to evaluate the use of survival analysis in cyclic fatigue testing in orthodontic bracket bonding. MATERIALS AND METHODS: We used 100 extracted bovine lower incisors (50 orthodontic brackets and 50 eyelet brackets). Each set of brackets was further divided by etching technique (25 total-etch and 25 self-etch). Cyclic fatigue testing was performed at a crosshead speed of 2 mm/min using an up-and-down method. Kaplan–Meier survival data analyses and Cox regression analyses were performed. RESULTS: Survival analysis proved to be a simple methodology and revealed that the etching technique was not a statistically significant predictor for survival of orthodontic bracket bonding with either tensile or shear cyclic forces at P > 0.05. In tensile cyclic loading, high mechanical loading after controlling for the etching technique is a statistically significant predictor for lower survival of the orthodontic bracket bond at P < 0.001. CONCLUSIONS: Both etching techniques (total-etch and self-etch) are equally efficient in bonding orthodontic brackets. High mechanical loading is an important predictor of bond failure when applying tensile cyclic forces. Finally, survival analysis is a simpler alternative method to analyze orthodontic bracket bonding subjected to cyclic tensile and shear forces and gives similar results to other complicated methods.

Objectives: This retrospective study aimed to evaluate the dentoalveolar, skeletal, and soft tissue effects obtained with bone-anchored pendulum appliance in patients with Class II malocclusion. Materials And Methods: A total of 18 patients (4 male, 14 female) at a mean pretreatment age of 14.0 years (+1.08) were enrolled in this study. All patients were treated with the bone-anchored pendulum appliance for an average duration of 4.8 months. Only the active distalization period was evaluated with predistalization and postdistalization lateral cephalograms. Skeletal, dentoalveolar, and soft tissue variables were obtained. Based on these variables, the treatment effects were evaluated with dependent t-test. Results: Correction of Class II molar relationship resulted from distal movement of 3.45 mm and tipping of 11.24° of the first maxillary molars. The premolars were distalized accompanying the molars. Conclusions: The bone-anchored pendulum appliance proved to be an effective method for distalization of maxillary molars in cases that require maximum anchorage, avoiding reciprocal mesial movement of premolars and incisors.

Objectives: To compare orthodontic elastics with different force extension characteristics, thereby aiming to reduce the orthodontist's inventory for elastics. Materials And Methods: Thirty nonextraction class I models were used to determine extension distances. Light, medium, and heavy forced Latex elastics of size 1/4 and 3/16 (from three manufacturers) were used. Thirty elastics from each pack were selected, for a total sample size of 540 elastics. Elastic force was measured at three extensions: three times the lumen (A), first molar to opposing canine (B), and second molar to opposing canine distance (C). Force values were compared with the analysis of variance followed by the post hoc Scheffe test. Results: Mean distance for extensions B and C were 22.3 and 38.7 mm, respectively. There was a continuous but significant increase in the force of 1/4 elastics when stretched from A to extension C. A significant increase in the force level of 3/16 elastics was only noted when stretched from A to B. Overall, 1/4 elastics had a wider range of force coverage in the extensions used, compared to 3/16 elastics. Conclusions: The use of 1/4 elastics is sufficient to cover the range of forces in orthodontic treatment.

Objective: Testing of methods to enhance the shear bond strength (SBS) between orthodontic metal brackets and amalgam by sandblasting and different primers. Materials And Methods: Three hundred samples of amalgam restorations (KerrAlloy^®) were prepared in self-cured acrylic blocks, polished, and divided into two groups: nonsandblasted and sandblasted. Each group was divided into five subgroups with different primers used in surface treatment methods, with a control group of bonded brackets on human mandibular incisors. Following the surface treatments, mandibular incisor brackets (Unitek^®) were bonded on the amalgam with adhesive resin (Transbond XT^®). The SBS of the samples was tested. The adhesive remnant index (ARI) and failure modes were then determined under a stereo-microscope. Two-way analysis of variance, Chi-square, and Kruskal–Wallis tests were performed to calculate the correlations between and among the SBS and ARI values, the failure modes, and surface roughness results. Results: There were statistically significant differences of SBS among the different adhesive primers and sandblasting methods (P < 0.05). The sandblasted amalgam with Assure Plus^® showed the highest SBS (P < 0.001). Samples mainly showed an ARI score = 1 and mix-mode failure. There was a statistically significant difference of surface roughness between nonsandblasted amalgam and sandblasted amalgam (P < 0.05), but no significant differences among priming agents (P > 0.05). Conclusions: Using adhesive primers with sandblasting together effectively enhances the SBS between orthodontic metal brackets and amalgam. The two primers with the ingredient methacryloxydecyl dihydrogen phosphate (MDP) monomer, Alloy Primer^® and Assure Plus^®, were the most effective. Including sandblasting in the treatment is essential to achieve the bonding strength required.

Introduction: Esthetics plays an essential role in orthodontic treatment. The psychological effects of malocclusion are an inspiration to improve one's esthetics and seek treatment. Objectives: This study aimed to assess relationships between self-esteem and malocclusion severity and type in adolescents using a self-esteem measurement scale and the index of treatment need (IOTN) and to investigate the influence of age, sex, and school type in these relationships. Materials And Methods: Adolescent students aged 12–19 years randomly selected from four private and two governmental schools were enrolled for this study. After completing the self-esteem questionnaire, participants were examined by researchers to evaluate malocclusion severity and type using the IOTN. Results: The sample consisted of 886 participants: 558 females (62.9%) and 328 males (37.1%) with a mean age of 16 years. Chi-square analysis showed that 17.1% of males and 31% of females showed low levels of self-esteem, with a statistically significant difference (P < 0.001). Cases with multiple malocclusions showed significantly lower self-esteem (P = 0.018) compared with single-category malocclusion. Anterior teeth spacing, crowding, and overjet malocclusion showed the highest percentages of low self-esteem. Conclusions: The present study supports that malocclusion has negative effects on self-esteem; multiple malocclusions with spacing, crowding, and overjet had the greatest effects.

OBJECTIVE: The aim of this study was to evaluate the histological responses of cementum, root dentin, and pulp following intentional root injuries caused via self-tapping and self-drilling miniscrews. MATERIALS AND METHODS: Fourteen patients (with a mean age of 15.7 years and age range of 14–18 years) who were scheduled for the extraction of all four first premolars as part of their orthodontic treatment plan participated in this study. The roots of the right and the left quadrants' first premolars were designedly injured using self-tapping miniscrews and self-drilling miniscrews, respectively. Teeth were extracted eight weeks after the injury. Cementum repair was assessed through histological examinations. RESULTS: In this study, 40 teeth (75.4%) showed reparative cementum formation and 13 teeth (24.5%) showed no repair. There was no significant difference between the two groups regarding the formation of reparative cementum (P = 0.3). In all examined teeth, the inflammatory response of the pulp to the cold test was within the normal range. CONCLUSION: This study showed that in most cases, the healing of cementum was observed eight weeks after the injury and the two methods of miniscrew insertion showed no significant difference when it comes to the healing process.

OBJECTIVE: To investigate the effect of different intracoronal bleaching methods on the shear bond strength and site of failure of ceramic brackets. MATERIALS AND METHODS: Sixty freshly extracted human maxillary incisors were randomly divided into four groups (n = 15). Endodontic access cavity was prepared and root canals were filled, root fillings were removed 2mm apical to the cementoenamel junction, and a 2-mmthick layer of glass ionomer cement base was applied. Group 1 served as the control. Intracoronal bleaching was performed with 35% carbamide peroxide in group 2, sodium perborate in group 3, and 37.5% hydrogen peroxide in group 4. The teeth were immersed in artificial saliva for 4 weeks before bracket bonding. Ceramic brackets were bonded with composite resin and cured with LED light. After bonding, the shear bond strength of the brackets was tested with a universal testing machine. The site of bond failure was determined by modified ARI (Adhesive Remnant Index). RESULTS: The highest value of shear bond strength was measured in control group (18.67 ± 1.59 MPa), which was statistically significant from groups 2,3, and 4. There was no significant difference between groups 2 and 4. The lowest shear bond strength was measured in group 3. ARI scores were not significant from each other. CONCLUSIONS: Intracoronal bleaching significantly affected the shear bond strength of ceramic brackets even after 4 weeks of bleaching. Bleaching with sodium perborate affects shear bond strength more adversely than does bleaching with other agents like hydrogen peroxide and carbamide peroxide.

Objectives: The present study was conducted to evaluate the effect of nanosized aluminum trioxide (Al₂O₃) particles when added to the Nano-Bond adhesive system and its effect on the microshear bond strength of nanocomposite resin to dentin. Materials And Methods: A newly developed adhesive (Nano-Bond) and one type of light-cured resin restorative material (nanocomposite resin) were used in this study. The occlusal surfaces of extracted human molar teeth were ground perpendicular to the long axis of each tooth to expose a flat dentin surface. The adhesives were applied to the dentin surfaces according to manufacturers' instructions. The nanocomposite resin was then placed and light cured for 40 s. After immersion in water at 37°C for 24 h, the specimens were subjected to thermocycling before testing, and a microshear bond test was carried out. The recorded bond strengths (MPa) were collected, tabulated, and statistically analyzed. A one-way analysis of variance and Tukey's tests were used to test for significance between the means of the groups; statistical significance was assumed when the P ≤ 0.05. Results: The mean microshear bond strength of the Nano-Bond adhesive system containing nanosized Al₂O₃at a concentration of 2% was 23.15 MPa (Group B), which was significantly greater than that of the Nano-Bond adhesive system without additives (15.03 MPa, Group A). Conclusions: These results indicate that nanosized Al₂O₃added to the Nano-Bond adhesive system at a concentration of 2% increases the microshear bond strength.

Objective: To study the impact of orthodontic treatment on the quality of life in two patient groups, one treated with the twin block appliance and the other with fixed appliances. Materials and Methods: Ninety-eight patients, aged between 10 and 16 years, were recruited in the fixed (20 males and 29 females) or functional (29 males and 20 females) treatment groups. The oral health-related quality of life (OHRQoL) was measured before treatment and followed up at the end of the treatment. The instrument used to measure OHRQoL was a modified self-administered short version of the English Oral Health Impact profile (OHIP-16[E]) questionnaire. Results: OHRQoL worsened at the initial stages of the treatment. The overall score of OHRQoL reduced significantly at the end of the treatment in both groups. Both groups showed comparable improvements in OHRQoL as the treatment progressed (analysis of variance test P = 0.05). Conclusions: The OHRQoL patterns, during the treatment with fixed and twin block appliances, were very similar. This suggests that the functional appliance's impact on the QoL may be overestimates by clinicians. OHRQoL improved significantly with both fixed and functional appliances by the end of the treatment. The OHRQoL trends observed during the study can be communicated to patients and used to increase patients' compliance since they are made aware of the whole treatment process.

Objectives: The aim of the present systematic review was to assess the effect of functional appliances on the airway dimensions in patients with skeletal Class II malocclusion. Materials And Methods: Articles were identified through a literature survey carried out through the following databases: (1) PUBMED, (2) Google Scholar, (3) The Cochrane Library, (4) Embase, (5) Lilac, and (6) Web of Scholars. The systematic review analyzed 12 articles comprising removable functional appliances, 3 articles with fixed functional appliances, and 2 articles having both fixed and removable functional appliances. Results: Qualitative assessment was done for all the 17 studies. The effect of functional appliances in the dimensions of three airway spaces – nasopharynx, oropharynx, and hypopharynx were analyzed. Conclusions: Significant increase in the dimensions of nasopharynx and oropharynx was observed with Activator. Significant increase in the nasopharynx and hypopharynx (male patients) was observed with Bionator. Insignificant increase in the oropharynx was observed with the same. Significant increase in the oropharynx and hypopharynx was observed with Twin Block. Insignificant increase in the nasopharynx was observed with the same. Significant increase was observed only in the hypopharynx for Frankel II. Decreased or insignificant change was observed with FMA, MPA IV, and Herbst appliances.

Objective: This study was aimed to evaluate the dental age in Saudi children from panoramic radiographs using the Demirjian method to estimate their chronological age. Materials And Methods: This retrospective cross-sectional study consisted of 1902 panoramic radiographs of 955 boys and 947 girls between the ages of 3–17 years. All children were placed in the age group closest to their chronological age. The dental age was scored on all seven left mandibular teeth by calibrated examiners. Bivariate analyses using the t-test and Pearson correlation were performed. Results: There was significant difference in both boys and girls in all the age groups between their chronological age and dental age. Even though there was a slight overestimation in boys in some age groups and slight underestimation in girls in some groups, correlation analysis showed that there was a highly significant correlation between the chronological age and dental age for both boys (r² = 0.96, P < 0.001) and girls (r² = 0.98, P < 0.001). Moreover, correlation analyses for each age group showed a significant correlation between the chronological age and the dental age, using the Demirjian method, in most age groups (P < 0.01). When comparing the maturation score between boys and girls, the Student's t-test showed that there were no statistical differences between boys and girls in most age groups. Conclusion: Saudi boys and girls living in the western region of Saudi Arabia exhibited similar pattern of dental development when compared to the Demirjian method. Hence, the Demirjian method could be used as reference in children from the western region of Saudi Arabia.

Aim: The aim of this study was to evaluate sexual dimorphism in nasal proportions of Class I and Class II skeletal malocclusions in adults. Materials And Methods: The sample comprised 120 patients (females 18 years and above and males 21 years and above), with no history of previous orthodontic treatment or functional jaw orthopedic treatment. They were divided into different groups based on point A-Nasion-point B (ANB) angle and gender. Groups I and II included 30 males and 30 females with skeletal class I malocclusion (ANB 0–4 degrees). Groups III and IV included 30 males and 30 females with skeletal class II malocclusion, respectively (ANB above 4 degrees). Results: In regards to the comparison between males and females (Class I + Class II), nasal length (P < 0.001), nasal depth 1 (P < 0.001), nasal depth 2 (P < 0.001), nasobasal angle (P < 0.001), soft tissue convexity angle (P < 0.001), and nasal bone length (P < 0.008) were found to be statistically significant. Nasobasal angle was found to be significantly higher in females than in males (Class I) (P < 0.001). Nasolabial angle was prominent in class I males than in class I females (P < 0.001). Soft tissue convexity angle of Class I participants was significantly lower than that of Class II participants (P < 0.001), whereas nasobasal angle and nasomental angle of Class I participants were found to be significantly higher than that of Class II participants (P < 0.001). Conclusion: Sexual dimorphism was found in various nasal parameters. Significant amount of differences was found in the nasal proportions of Class I and Class II (male and female) participants.

Objectives: To investigate the effect of using osteogenic induced gingival fibroblasts (OIGFs) and low intensity pulsed ultrasound (LIPUS) on root resorption lacunae volume and cementum thickness in beagle dogs that received orthodontic tooth movement. Materials and Methods: Seven beagle dogs were used, from which gingival cells (GCs) were obtained and were induced osteogenically to produce OIGFs. Each third and fourth premolar was randomly assigned to one of the five groups, namely, LIPUS, OIGFs, bone morphogenetic protein-2 (BMP-2), OIGFs + LIPUS, and control. All groups received 4 weeks of bodily tooth movement, then LIPUS-treated groups received LIPUS for 20 min/day for 4 weeks, and OIGFs groups received an injection of OIGFs near the root apex. Microcomputed tomography analysis was used to calculate root resorption lacunae volume and histomorphometric analysis was performed to measure the cementum thickness of each root at 3 root levels on compression and tension sides. Results: There was no significant difference in resorption volume between the treatment groups. OIGFs + LIPUS increased cementum thickness (P > 0.05) in third premolars near the apex, and LIPUS increased cementum thickness (P > 0.05) in fourth premolars near the apex. Furthermore, BMP2 increased cementum thickness at the coronal third at the compression side. Conclusion: OIGFs, LIPUS, and BMP-2 can be potential treatments for orthodontically induced root resorption, however, improvements in experimental design and treatment parameters are required to further investigate these repair modalities.

Objectives: To establish the overall and anterior Bolton ratio among a sample of Qatari population and to investigate whether there is a difference between males and females, as well as to compare the result obtained by Bolton. Materials and Methods: The current study consisted of 100 orthodontic study participants (50 males and 50 females) with different malocclusions and age ranging between 15 and 20 years. An electronic digital caliper was used to measure the mesiodistal tooth width of all maxillary and mandibular permanent teeth except second and third molars. The Student's t-test was used to compare tooth-size ratios between males and females and between the results of the present study and Bolton's result. Results: The anterior and overall ratio in Qatari individuals were 78.6 ± 3.4 and 91.8 ± 3.1, respectively. The tooth size ratios were slightly greater in males than that in females, however, the differences were not statistically significant (P > 0.05). There were no significant differences in the overall ratio between Qatari individuals and Bolton's results (P > 0.05), whereas statistical significant differences were observed in anterior ratio (P = 0.007). Conclusions: Within the limitation of the limitations of the present study, definite conclusion was difficult to establish. Thus, a further study with a large sample in each malocclusion group is required.