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.

INTRODUCTION: Over the last years, zebrafish has gained prominence in the biomedical community. It is currently considered one of the best vertebrate animal models for various types of studies, such as toxicology and developmental biology. OBJECTIVE: The aim of this study was to conduct a literature review on the use of zebrafish in dentistry and whether this animal model could be a viable alternative for performing different types of studies in this area. METHODS: A literature search was performed using the PubMed, Lilacs, Embase, and Dentistry and Oral Sciences Source. The keywords used as search terms were zebrafish and dentistry. The selection criteria were articles published in English that used zebrafish as an animal model in dentistry, oral health, and craniofacial growth/development. RESULTS: The electronic search of literature yielded 421 articles. After the analysis of the abstracts, 29 articles were selected for an in-depth analysis and reading of the full text. CONCLUSIONS: All studies included in this review confirm zebrafish's excellence as an animal model for various types of dentistry studies, as well as assisting and complementing other studies involving mammals.

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.

BACKGROUND: Pharmacological means of anchorage control can improve patient compliance. Bisphosphonates could be helpful in orthodontic anchorage control if their actions could be localized to limit (or control) unwanted tooth movement while not interfering with the desired tooth movement. OBJECTIVE: This systematic review aimed to examine and evaluate the quality of all animal studies that reported the effect of locally administered bisphosphonate on limiting orthodontic tooth movement. DATA SOURCES: An electronic search was conducted in the PubMed-Medline, Scopus, Google Scholar, and Cochrane databases till May 2022, using the keywords anchorage, anchorage loss, molar movement, posterior tooth movement, incisor movement, incisor retraction, anterior retraction, unwanted tooth movement, tooth displacement, tooth movement forward, bisphosphonate, local bisphosphonate administration, bisphosphonate injection, and bbisphosphonate vestibular induction. Only studies involving localized bisphosphonate administration for anchorage purposes were taken into account. DATA SELECTION: Animal studies that simulated orthodontic tooth movement after localized injection of bisphosphonate and evaluated the rate of tooth movement were included in the review. DATA EXTRACTION AND ANALYSIS: The quality of the studies was assessed by using ARRIVE guidelines (Animal Research: Reporting of In Vivo Experiments). Bias in the studies was analyzed by SYRCLE's tool (Systematic Review Centre for Laboratory Animal Experimentation) for risk of bias. RESULTS: The search strategy yielded 925 titles. After screening, 908 articles were discarded because they did not fulfill the inclusion/exclusion criteria based on the title and abstract. The remaining 16 articles were read entirely, of which nine were excluded as they involved systemic administration of bisphosphonates. Finally, after careful consideration, seven papers that met our inclusion criteria were included in the qualitative analysis. The majority of studies were assessed to have an uncertain risk of bias, with just one deemed low risk of bias. CONCLUSION: This systematic review found that bisphosphonates limit orthodontic tooth movement around the application site without affecting adjacent sites. More potent bisphosphonates in smaller doses or less potent bisphosphonates in higher frequencies have been proposed to improve outcomes. However, the data quality is insufficient to recommend a protocol for bisphosphonate administration for anchoring control. Long-term studies evaluating various types, frequencies, and dosages of bisphosphonates are required to clarify the effects on orthodontic tooth movement. REGISTRATION NUMBER FOR PROSPERO: CRD42021224033

This article presents a novel idea for managing patients with anterior disc displacement without reduction that often develops in susceptible patients during routine orthodontic treatment. The patient was a 24-year-old male who presented with class I right molar and canine relationship and class III left molar and canine relationship on a class I skeletal base, complaining of bimaxillary crowding. The case was treated with fixed orthodontic appliance with maxillary expansion and unilateral mandibular extraction to eliminate the mandibular crowding. Due to a life crisis, the patient developed anterior disc displacement on the right joint. A maxillary occlusal splint was fabricated to reduce the symptoms and attempt to recapture the disc; however, this attempt failed. An attempt was then made to recapture the disc using occlusal pivots and elastics. The disc was eventually recaptured, and the patient resumed normal jaw function and mouth opening. This case report aims to demonstrate a new way to achieve stable occlusion in a patient who sustained disc displacement.

Early treatment of Class III malocclusion provides an improvement in facial appearance and corrects the reverse bite. Orthopedic protraction of maxilla is considered best approach in growing Class III patients with maxillary deficiency. Present case report describes the management of a growing 10-year-old boy with skeletal Class III malocclusion using facemask therapy (Phase 1) followed by fixed orthodontic treatment (Phase 2) based upon cephalometric prognostic findings of growth treatment response vector (GTRV). With the successful orthopedic phase of maxillary protraction with facemask therapy for 7 months of period, a significant improvement in profile had been achieved along with the correction in reverse overjet. This was followed by retention with chin cup therapy for a period of 20 months. After a period of 20 months retention, a fixed orthodontic treatment was started with the objective to achieve stable functional occlusion. After 11 months of treatment with fixed appliance therapy a stable functional occlusion was achieved. The patient was placed on Hawleys retainer in maxillary arch and bonded fixed spiral wire (FSW) retainer in mandibular arch. Successful management of growing Class III patient was done using facemask and fixed orthodontic therapy based upon cephalometric prognostic findings of growth treatment response vector (GTRV).

OBJECTIVE: To evaluate the effects of silver nano particles (AgNPs) added on Nano-Bond adhesive system (NBA) and its effect on shear bond strength (SBS) of orthodontic brackets attached to enamel at different thermal cycles and cyclic loading. MATERIALS AND METHODS: Forty extracted premolar teeth for orthodontic reasons were divided randomly into two main groups (20 teeth in each group). Group A: the brackets were bonded by NBA without additives. Group B: the brackets were bonded by NBA containing AgNPs with concentration 0.05%. Every group was further subdivided into 4 subgroups according to teeth subjected or not subjected to thermocycling and cyclic loading. SBS was tested using Lloyd universal testing machine. One-way analysis of variance (ANOVA) was used for testing the significance between the means of tested groups. RESULTS: Shear bond strength of Nano-Bond adhesive system with AgNPs showed significantly highest mean SBS (20.25 MPa) than Nano-Bond adhesive system without additives (15.64 MPa, P = 0.001). The SBS increased in Group B with AgNPs compared to Group A in all the conditions tested. Group A1 and B1 with zero thermal cycling and cyclic loading exhibited highest mean SBS. CONCLUSIONS: These results indicate addition of AgNPs significantly increased the shear bond strength of Nano-Bond adhesive system.

Introduction: Orthodontic appliances complicate daily oral hygiene maintenance and enhance the formation of microbial biofilm on tooth surfaces and orthodontic appliances. Objective: This trial was conducted to assess the effect of reminders on oral hygiene of patients during removable orthodontic treatment. Methods: In this 2-arm parallel randomized controlled trial, 66 orthodontic patients with removable maxillary appliance were randomly allocated with 1:1 ratio to message reminders and the control group. The patients in the messaging group received one or two message reminders and educational videos weekly during the course of treatment. A single blinded examiner measured the plaque index (PI), gingival index (GI), and dental caries index of patients in both groups at baseline (T0) and one (T1), three (T2), and six (T3) months after the first day of treatment to assess their oral hygiene status during treatment. Results: A total of 30 patients in control group and 28 in reminder group completed the study. The PI and GI scores were increased neither in control group nor in message reminder group during T0 and T1, significantly. The PI and GI scores in message reminder group were significantly lower than those in the control group at T2 (PI: P = 0.001, GI: P = 0.003) and T3 (PI: P = 0.024, GI: P = 0.022). Slight significant increasing in the PI and GI score were found during T2 and T3 in message reminder group. Caries index showed no significant difference between two groups during study. Conclusion: It seems that reminders can efficiently promote oral hygiene of patients undergoing removable orthodontic treatment.

AIM: The study was conducted to assess the changes in bone density before and after performing accelerated orthodontic maxillary canine retraction by microosteoperforations (MOPs). MATERIALS AND METHODS: Forty patients (120 cone-beam computed tomography [CBCT] images) within the age group of 15 to 25 years undergoing fixed orthodontic treatment with bilateral maxillary first premolar extraction were enrolled in this study. The right and left sides of the maxillary jaw in the same patients were selected as experimental and control sites. To accelerate the tooth movement, MOPs were performed distal to the canine root in the extraction space under local anesthesia with a miniscrew. Thereafter, the maxillary canine retraction was initiated using a NiTi closed coil spring. The CBCT images were taken and evaluated at the following time intervals: 1 week before MOPs(T0);1 week after MOPs(T1);3 weeks after MOPs(T2). RESULTS: A statistically significant reduction in bone density was observed at the center of resistance of canine on the experimental site (after MOPs) at 1 week and 3 weeks (T0-T1 = 0.000,0.115; T1-T2 = 0.0025,0.0117), whereas a statistically non-significant difference was found 1 week before and 3 weeks later in the control group. CONCLUSION: Accelerated orthodontics by MOPscan result in a substantial reduction in bone density during canine retraction, leading to an increase in the tooth movement rate, hence lowering the overall orthodontic treatment time.

OBJECTIVES: The decision to pursue orthodontic treatment is influenced by a variety of cosmetic, functional, and social reasons. This study compared the factors that influence adults' decisions before orthodontic treatment versus parents' decisions prior to their children's orthodontic treatment in Jeddah city, Saudi Arabia. MATERIALS AND METHODS: A cross-sectional survey was distributed to the patients of orthodontic clinics of King Abdulaziz University in addition to a private orthodontic clinic in Jeddah city, Saudi Arabia. The survey consisted of two versions of a questionnaire: one for adults and one for children's parents. The survey inquired about the participants' demographics, factors that led to the necessity of treatment, and considerations before opting for orthodontic treatment. The factors influencing the decision-making process of adults were compared to that of parents using the Chi-square test. RESULTS: A total of 417 subjects participated, 331 adults and 86 parents. The majority of the respondents in both groups were females. When compared to children, adults were more aware of the necessity for orthodontic treatment (78.5% of adults vs. 41.9% of children). The primary motivation for adults and parents to begin orthodontic treatment was to improve their esthetic appearance (58.6% and 87.2%), whereas functional concerns were less frequently reported (12.1% and 15.1%). Adults relied on less trustworthy sources of information about orthodontic treatment options, whereas parents relied on more dependable sources. CONCLUSIONS: The main reason for opting for orthodontic treatment in Jeddah city, Saudi Arabia was esthetic for both adults and children.

OBJECTIVE: The purpose of this study was to investigate the size and shape variations of hard tissue patterns in different skeletal relations in Malaysian Malay subjects using the two-dimensional geometric morphometrics method. MATERIALS AND METHODS: A total of 188 lateral cephalograms of adult Malay subjects (aged between 18 and 40 years) with Class I, II, and III skeletal relations were collected. Ten two-dimensional hard tissue landmarks were applied on lateral cephalograms which underwent landmark application and shape analyses as Procrustes ANOVA analysis, principal component analysis, canonical variate analysis, and discriminant function analysis. Statistical analyses were performed to find the mean and variance of each landmark using one-way ANOVA. The raw data from shape analysis were used to calculate the link between landmarks. RESULTS: Skeletal relations showed 16 Principal Components which indicated that variances existed in 16 different dimensions. In Procrustes ANOVA, the Centroid size was significantly different in genders and skeletal relations (P < 0.01). Canonical variate analysis showed the highest Mahalanobis distances and Procrustes distances between Class II and III among skeletal relations and between gender groups (P < 0.0001). Discriminant function analysis showed the classification was mostly accurate, especially for Class II and Class III with success rates of 90.6% and 83.3%, respectively, after cross-validation. The statistical analysis showed significant differences (P < 0.05) in hard tissue landmarks. CONCLUSION: There were different ANB angles in different skeletal relations. The GMM could be used as an alternative tool for diagnosis and treatment planning for craniofacial shape evaluations for future orthodontists and maxillofacial surgeons.

OBJECTIVE: To investigate the effect of antioxidants on shear bond strength of brackets bonded to bleached enamel with and without titanium dioxide nanoparticles (Lase Peroxide Lite). MATERIALS AND METHODS: One hundred and five human maxillary premolars were randomly divided into seven groups (n = 15). Group I served as control, in group II-A bleaching was performed with Opalescent Boost. In group II-B and C, bleaching was performed with Opalescent Boost followed by application of 5% grape seed and 10% green tea extracts, respectively. Group III-A bleaching was performed with Lase Peroxide Lite. Group III-B and III-C bleaching was performed with Lase Peroxide Lite followed by application of 5% grape seed and 10% green tea extracts, respectively. Brackets were bonded with composite resin and cured with light emitting diode (LED) light. Shear bond strength of brackets was tested with a Universal testing machine. RESULTS: There was statistically significant difference in the shear bond strength among the seven groups included in the study. There is a statistically significant decrease in shear bond strength in group II-A (8.2 ± 1.6 Mpa), group III-A (8.6 ± 2.1 Mpa) when compared with group I-A (15.9 ± 1.4 Mpa). Among all experimental groups, group II-A showed the lowest mean shear bond-strength values (8.2 ± 1.6 Mpa) (P < 0.005). Group III-C (14.9 ± 2.2 Mpa) has significantly higher shear bond strength. CONCLUSION: Bleaching reduced the shear bond strength of brackets below acceptable level while application of grape seed and green tea extracts has recovered the shear bond strength.

OBJECTIVE: The study was conducted to evaluate the relationship of various cephalometric skeletal patterns in the vertical and anteroposterior planes with intercanine width in untreated orthodontic patients. METHOD AND MATERIAL: This study included dental cast and cephalometric radiographs of 100 patients (69 females and 31 males) of the age range 13 to 33 years. Skeletal parameters including SNA, SNB, SNMP angles were found from lateral cephalometric radiographs. Intercanine widths including upper intercanine widths (UICW) and lower intercanine widths (LICW) were measured by a digital caliper. RESULTS: The correlation of intercanine width with SNA, SNB, and SNMP angles was analyzed by applying Pearson correlation coefficient. According to statistical analysis, the only insignificant correlation was analyzed between UICW with SNB and LICW with SN-MP. CONCLUSIONS: The overall result showed statistically significant relationship of various cephalometric skeletal patterns in the sagittal and vertical planes with intercanine width.

INTRODUCTION: A person's ability to recognize a beautiful face is innate, but translating this into defined treatment goals is a challenge for clinicians. AIM: To determine if faces considered esthetic and pleasing in the young North Indian population (both males and females) exhibit similar cephalometric measurements as used for ideal treatment and successful results. MATERIALS AND METHOD: A panel of five judges evaluated a set of one frontal, one frontal during smiling, and one profile extra-oral photograph of 160 students (80 females and 80 males) on a five-point attractiveness scale. For each photographic set, the mean and final scores were calculated. Once the sample was assessed, 60 subjects (30 females and 30 males) with the highest final facial aesthetic score were selected and cephalometric analysis was performed. The obtained data were subjected to statistical analysis using SPSS 20 software. RESULTS: Both males and females with class I skeletal jaw bases were found to be attractive. The females with short faces; mild facial convexity and lower lip closer to the esthetic line were found to be attractive. The males with a prominent chin, straight profile, prominent nose, increased upper lip thickness, upper lip length, and lower lip length were found to be attractive. CONCLUSION: The faces considered attractive in this study fulfilled most of the cephalometric norms commonly used for the diagnosis and treatment planning except for a few inconsistencies which may be attributed to the gender and demographic origin.

Ingestion is the entry of a substance into the human organism, which occurs by taking it through the mouth into the gastrointestinal tract. One of the adverse events that may happen during the course of an orthodontic treatment is the ingestion of orthodontic appliances. The present review aims to investigate the literature regarding the ingestion of orthodontic appliances. An electronic search was carried out in order to identify case reports of ingestion of foreign objects related to orthodontic treatment in PubMed, Scopus, and Web of Science until July 2019.Nineteen articles were retrieved. In these articles, ingestion had occurred inadvertently, due to patients' or orthodontists' errors. Some of the most commonly ingested appliances were molar bands, segments of wire, and expansion keys. It is likely that patients with a specific medical background are more prone to ingestion of orthodontic appliances. Special precautions need be taken in order to avoid such incidents. These precautions are analyzed in three categories: general, those related to fixed appliances, and those related to removable appliances.

OBJECTIVE: To compare the effects of comprehensive orthodontic treatment on palatal area, volume, inter-canine and inter-molar width in patients with Unilateral Cleft Lip and Palate (UCLP) using scanned models of the maxillary arch. DESIGN: Retrospective cohort study. SETTING: Tertiary setting. PATIENTS: Two hundred and ten plaster study models of 70 patients with Unilateral Cleft Lip and Palate (Study group SG) and Control Group (n = 70) were scanned using Maestro 3D Dental scanner. The study groupwas further divided into subgroups; Subgroup I: treated with orthodontic treatment only (non-surgical), Subgroup II: patientsmanaged with combined orthodontics and orthognathic surgery (either maxillary advancement or maxillary distraction), Subgroup A: age >14 years and Subgroup B: age <14 years. INTERVENTIONS: Comprehensive orthodontic and Orthosurgical treatment MAIN OUTCOME MEASURES: Pre- and post-treatment scanned maxillary models of the study group were compared for palatal area and volumeand intercanine and intermolar width. The palatal dimensions of post-treatment scanned models were also compared to that of the control group. RESULTS: The Palatal area and volume, intercanine and intermolar width were significantly higher in the post-treatment as compared to pre-treatment study models (P < 0.01). The measurements ofthe maxillary arch were significantly higher in the control group compared to the post-treatment measurements of the study group. The increase in palatal area and volume was greater in Subgroup I and A compared to Subgroup II and B patients, respectively. CONCLUSION: The 3-Dimensional palatal dimensions in UCLP group improved after orthodontic treatment but were still not comparable to the normal subjects. The patients with age >14 years showed more improvement in the maxillary arch.

AIMS: The primary purpose of the present trial was to evaluate the effect of low-frequency (30Hz) vibrations on the rate of canine retraction. SETTING AND DESIGN: Single-center, split mouth prospective randomized controlled clinical trial METHODS AND MATERIAL: 100 screened subjects (aged18–25 years) were selected; out of which 30 subjects having Class I bimaxillary protrusion or Class II div 1 malocclusion, requiring upper 1^st premolar therapeutic extractions, were selected for the study. A split-mouth study design was prepared for the maxillary arch of each selected individual and was randomly allocated into vibration and nonvibration side (control) groups. A customized vibratory device was fabricated for each subject to deliver low-frequency vibrations (30 Hz). Scanned 3D models were prepared sequentially to assess the amount of tooth movement from baseline (T0),(T1), (T2), (T3), and (T4)-4^th month of canine retraction. STATISTICAL ANALYSIS USED: Independent “t” test. RESULTS: There was no statistically significant differencein the rate of individual canine retraction among the experimental and control groups when the intergroup comparison was done using independent “t” test at T1-T0, (P = 0.954), T2-T1 (P = 0.244), T3-T2 (P = 0.357), and T4-T3 (P = 0.189). CONCLUSION: The low-frequency vibratory stimulation of 30 Hz using a customized vibratory device did not significantly accelerate the rate of orthodontic tooth movement. TRIAL REGISTRATION: Registered at ctri.nic.in (CTRI/2019/05/019043).

OBJECTIVE: To determine the relationship between the dimensions of the maxillary arch and vertical facial morphology within the Proto-Malay race. DESIGN: A cross-sectional study. SETTING: Orthodontics Department, Faculty of Dentistry, Universitas Sumatera Utara, Medan, Indonesia. PARTICIPANTS: Proto-Malay individuals aged ≥18 years without orthodontic treatment history (n = 104). METHODS: Lateral cephalometric radiographs and maxillary study model were obtained from 104 subjects who had never received orthodontic treatment (45 males and 59 females), aged 18 years, belonging to the Proto-Malay race, with skeletal class I malocclusion, normal overjet and overbite, and complete dentition (except the third molar). The vertical facial morphology was obtained by measuring the Jarabak's ratio on lateral cephalometric radiographs by using CorelDRAW. The study model was used to measure the dimensions of the maxillary arch, which are intercanine width, intermolar width, arch length, and palatal height, by using the Korkhaus modification device. RESULTS: The results showed a significant positive correlation between intercanine and intermolar width and a negative correlation between arch length and palate height with vertical facial morphology in the male and female groups within the Proto-Malay race. CONCLUSION: There is a relationship between the maxillary arch dimension with vertical facial morphology in the male and female groups in the Proto-Malay race.

OBJECTIVE: To assess the enamel surface damage and residual adhesive remnant [adhesive remnant index (ARI)] on extracted premolars after debonding the ceramic brackets using three different debonding techniques, with optical coherence tomography (OCT). METHODS: Ninety extracted premolars were bonded with ceramic brackets and divided into three groups of 30 teeth each based on debonding techniques used. Twenty-four hours later, they were debonded using three different debonding techniques: debonding pliers, ultrasonic scalers, and Er-YAG laser. A baseline scan was obtained prior to bonding using OCT. The teeth were evaluated for the adhesive remnant on the tooth surface using ARI score, and the amount of enamel surface damage was evaluated using OCT. RESULTS: We observed that the use of ultrasonic scalers as a debonding technique led to greater incidence of enamel surface damage as measured in OCT. The ARI scores with debonding pliers and laser were significantly greater than that of scaler debonding. CONCLUSIONS: Results of this in vitro study confirmed that use of ultrasonic scalers as a debonding technique led to significantly greater incidence of enamel surface damage when compared to the other two debonding techniques. The ARI scores on the tooth surface using debonding pliers and laser were significantly greater than that of the scaler debonding technique.

OBJECTIVES: Impacted canine (IC) is a dental anomaly that varies in its frequency according to the population of interest. The aim of this study is to investigate the frequency and distribution pattern of maxillary ICs (MxIC) and mandibular ICs (MnIC) in the population of Al-Madinah, Saudi Arabia. MATERIALS AND METHODS: A cross-sectional retrospective study of all patients attended Taibah University Dental Hospital, Madinah, Saudi Arabia. Inclusion criteria were individuals aged 15 years and older and no history of orthodontic treatment or craniofacial syndromes. Patients with incomplete dental records or missing/distorted Orthopantomograph (OPG) were excluded. All OPGs were taken using standardized equipment. Data were explored for frequency and pattern of canine impaction both in the maxilla and the mandible and statistically tested to detect significant differences. RESULTS: A total of 7466 individuals fulfilled the inclusion criteria with mean age of 37.43 ± 14.5 years. Of the total sample, 173 individuals had at least one IC. MxIC alone occurred in 86.71% of the cases, while MnIC occurred in 8.67%. The remaining 4.62% had at least one IC in each jaw. Unilateral IC occurred in 89.2% of the cases with left-side predominance in the maxilla. CONCLUSION: In this sample, the frequency of MxIC was 2.1% and MnIC was 0.3%. Almost equal distribution of IC occurred between females and males (IC Odds ratio F:M 1:1.08). Further studies are required to investigate the potential association of IC incidence with other predictor variables.

OBJECTIVE: The authors invented an innovation in the bracket design; that targeted to fulfill the aim of Dr. Andrews for a true straight wire technique. MATERIALS AND METHODS: The use of the ball and socket design together with the ability to relocate the position of the slot in three dimensions enhances the control and precision of individual teeth. RESULTS: The revolutionary bracket eliminated any wire bending in the initial, intermediate or finishing stages of fixed orthodontic treatment. This was achieved together with complete 3D control on individual teeth positions to achieve the finest occlusion for individual patients. CONCLUSIONS: That system allowed for a true straight wire mechanics with no wire bending. The design could be used labially or lingually without the need of indirect bonding techniques. Additionally, any adjustments could be performed intraorally with simple pressure.

Objective: Connections between craniocervical posture (CCP) and changes in teeth position have already been demonstrated; however, the defined pathway of relationship is still not clear. The aim of this study was to evaluate CCP modifications after rapid maxillary expansion therapy using rapid palatal expansion therapy (REP)/McNamara appliances. Materials and Methods: A consecutive series of 35 subjects, aged between 6 and 14 years, with no prior history of orthodontic treatment, and requiring skeletal expansion of the upper arch, were selected and analyzed. All patients were treated with REP or Mcnamara appliance: the active phase of 15 days and retaining phase of 6 months. Cephalometric analysis was carried out before (T0) and after (T1) orthodontic therapy evaluating changes in the craniofacial area and those related to CCP. The obtained data were statistically analyzed for the pre-post changes. Results: No statistically significant difference emerged indicating a modification in the CCP measured at T0 and T1 (P > 0.05). Patients treated with the McNamara appliance, compared to those treated with REP, showed a higher value of the angle OPT ^ Ver (P = 0.021), and a lower measure of the angles CVT^EVT (P = 0.035) and EVT^Ver (P = 0.023). Furthermore, patients treated with REP showed a higher hyoid angle value than those treated with McNamara (P = 0.047). Conclusion: This study did not reveal any relationship between the application of palatal expansion therapy and changes in CCP.

OBJECTIVE: To compare the efficacy of Icon resin infiltration and Clinpro XT varnish on remineralization of white spot lesions using a polarized light microscope (PLM). MATERIALS & METHODS: Artificial white spot lesions were created on a sample of 40 extracted human premolar teeth by immersing in a demineralizing solution. All samples were randomly allocated to two groups of 20 each; Group A: Icon resin infiltration and Group B: Clinpro XT varnish. Teeth were sectioned along the buccolingual plane using a diamond disc. Specimens were observed under the PLM (4× magnification) at three deepest measurements and their averages were calculated to obtain the mean penetration depth. The data obtained were analyzed using SPSS software (version 22.0). Independent samples t-test and group statistics were used to compare the two groups. In all statistical tests, the significance level was set at 5% (P < 0.05). RESULTS: Both Icon resin infiltration and Clinpro XT groups showed a statistically significant difference (P = 0.00) in the penetration depth. Icon resin infiltration group showed a significantly higher penetration depth (24.46 μm) compared to the Clinpro XT group (12.34 μm). Group A showed a greater mean penetration depth (17.07 ± 4.35 μm) when compared to group B (7.68 ± 1.81 μm). CONCLUSION: Icon resin infiltration showed a significantly higher penetration depth and is more effective on remineralization of white spot lesions when compared to Clinpro XT varnish.

OBJECTIVE: To evaluate the surface roughness and ion release of silver-soldered joints by using two polishing methods. METHODS: 174 orthodontic bands with and without silver-soldered joints were evaluated and divided into three groups: two experimental, with different polishing methods (SP1 and SP2), and one control (SS) composed of bands without silver solder. For ionic release, 50 bands of each group were immersed in saline solution and submitted to atomic absorption spectrophotometry to quantify the amount of Fe, Ni, Cr (in all the three groups), Ag, Cu, Cd, and Zn (in the two experimental groups). A rugosimeter was employed to verify the surface roughness. RESULTS: Ni and Cr were released in higher amounts after soldering. Cd, Ag, Zn, and Cu may be released from silver-soldered bands independently of the polishing method employed. Ag was released in higher amounts from the soldered bands that presented higher surface roughness. CONCLUSIONS: Differences exist in relation to the surface roughness of silver-soldered bands when distinct polishing methods are used. Toxic ions may be released from silver soldered joints and higher surface roughness may cause higher ionic release.

OBJECTIVES: The objective of this study is to determine whether submucosal local injection of i-PRF may affect orthodontic relapse by increasing bone density, which further leads to reducing orthodontic relapse. MATERIALS AND METHODS: Forty-five adult male albino rabbits were randomly divided into three groups: group I (control) with 15 rabbits injected with 200 μl of phosphate-buffered saline (PBS), group II with 15 rabbits injected with 200 μl of i-PRF, and group III of 15 rabbits inject with 400 μl of i-PRF. The lower incisors of rabbits moved distally by a modified orthodontic appliance for 2 weeks; then, the appliance was maintained in position to retain the gaining space for 2 weeks. During the retention period, each group was injected with the specific drug every 7 days. After the retention period, teeth were allowed to relapse by removal of the orthodontic appliance. The results were evaluated by measuring the amount of orthodontic relapse and bone density. The statistical analysis performed by ANOVA and Duncan (P < 0.05 was considered significant). RESULTS: I-PRF groups showed a significant reduction in the amount of relapse at 10, 13, 17, and 20 days compared to the control group, indicated by the highest percentage of relapse for the control group at the end of the study (20 days); it was (90.4%) in compared to lowest percentage of relapse for i-PRF groups—they were 61.2% and 59.9%, respectively. CONCLUSION: Results indicated that i-PRF has the potential to enhance the stability of teeth after orthodontic tooth movement and could have the ability to reduce relapse, probably by increasing the alveolar bone density.

BACKGROUND: White spot lesions (WSL) are an unsightly and a rather frequent drawback of orthodontic treatment. The complex design of fixed orthodontic appliances (FAs) makes it difficult to perform proper oral hygiene, which amounts to white spot lesions being three times more prevalent in patients wearing orthodontic appliances. As clear thermoplastic aligners (CAs) are removable appliances, it has been speculated that they allow better oral hygiene maintenance and thus less incidence of WSLs. OBJECTIVES: This evidence-based scoping review aims to identify the scope and nature of the evidence on white spot lesions during orthodontic clear aligner therapy. TYPES OF STUDIES REVIEWED: Strategic and thorough search of the literature for randomized Controlled Trials, Case-Control, Cohort studies, Case reports, full research articles, and review papers on humans published in English in five major databases was undertaken till July 2021 using free text and Medical Subject Headings (MESH) terms, followed by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to identify five studies for data extraction. RESULTS: Evidence was summarized for study characteristics, diagnostic methods for the detection of white spot lesions, and incidence of white spot lesions during clear aligner therapy. The literature supports that orthodontic treatment with CAs was associated with a low incidence of WSLs when compared with fixed mechanotherapy, with a major role of patient education, motivation, and compliance in maintaining oral hygiene. PRACTICAL IMPLICATIONS: The general perception is that clear aligners are more hygienic and show no incidence of white spot lesions. However, our scoping review supports that WSLs can occur with this form of orthodontic treatment also. WSLs in clear aligners could be attributed to the practice of having composite attachments that cover a significant portion of the tooth surface. Thus, regardless of the type of appliance used, a periodic reinforcement by the orthodontist to maintain oral hygiene is necessary for patient motivation, allowing for better oral hygiene practice, and as a result, leads to prevention of WSLs.

INTRODUCTION: Protraction therapy for maxillary deficiency in the treatment of skeletal class III malocclusion involves the use of facemask. Conventionally facemask has been anchored to the maxillary dentition, which is responsible for some of the counter-productive effects of facemask therapy including backward and downward rotation of the chin, increase in the lower anterior facial height, proclination of maxillary incisors, retroclination of mandibular incisors apart from mesialization of maxillary molars with extrusion and decreased overbite. AIM: The aim of this article is to highlight the nuances of Bone-Anchored Maxillary Protraction (BAMP) including a literature review, which is comprehensive and narrative and comparing the different techniques involved such as type 1 BAMP versus type 2 BAMP and BAMP versus facemask. MATERIALS AND METHODS: A computerized search was performed in electronic databases such as PubMed, PubMed Central, Cochrane, Embase, DOAJ, and Google scholar using key words such as “bone-anchored maxillary protraction” and “BAMP.” The search was confined to articles in English published till March 2021. Forty-seven case-controlled, cross-sectional, retrospective and prospective studies, as well as systematic reviews and meta-analysis were included in this article, which were limited to human subjects. A hand search of the reference lists of the included articles was also carried out to include missed out articles. CONCLUSION: To overcome these drawbacks, BAMP was introduced, which causes both maxillary protraction, restraint of mandibular growth with minimal dentoalveolar changes. BAMP is used widely nowadays in the treatment of skeletal class III malocclusion.

This systematic review was aimed to test the null hypothesis that coating of orthodontic wires with nanoparticles does not affect the frictional properties at bracket--wire interface. Electronic database searches were performed up to September 2020. In vitro studies were considered for reviewing process. Study selection, data extraction, risk of bias assessment was performed during reviewing process. Only qualitative analyses of included literature were done due to the presence of heterogeneity among the studies. Out of 1,068 retrieved records, nine studies satisfied the inclusion criteria and included in this review. Studies were assessed at low risk to high risk of bias according to certain parameters. Wide variety of nanoparticles were used for surface coating of orthodontic wires of variable sizes, shapes, and materials like stainless steel, NiTi, and TMA and placed into the slots of different types of orthodontic brackets to evaluate the alteration in frictional and other mechanical properties. Most of the studies clearly indicate that coating with nanoparticles decreases the friction between wire and bracket interface under specified in vitro conditions. Furthermore, among the nine included studies, only two considered evaluation of effect of coated brackets on frictional and other mechanical properties and results were heterogeneous. The null hypothesis is rejected and it is concluded that the wires coated with nanoparticles might offer a novel opportunity to substantially reduce frictional resistance at bracket--wire interface during tooth movement. Further studies are necessary to strengthen the evidence regarding effect of coated brackets on frictional properties.

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

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

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

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

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

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