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.