ABSTRACT Background: Orthodontic relapse, commonly observed after treatment, arises from biological factors such as periodontal reorganization, soft tissue pressures, and growth-related changes. Despite the widespread use of various retention protocols, no consensus exists on the most effective approach, leading orthodontists to base their decisions on clinical experience and patient-specific factors. Aim:The aim of this study to investigate the retention protocols and relapse management strategies preferred by Turkish orthodontists following orthodontic treatment. Materials and Methods: A cross-sectional survey comprising 33 multiple-choice questions was distributed electronically to members of the Turkish Orthodontic Society,. Statistical analysis was ,employing Chi-square and Fisher’s exact tests to assess differences based on professional experience. Results: The majority of orthodontists applied retention protocols to all patients and recommended lifelong retention. Vacuum-formed retainers and bonded retainers were the most commonly used, particularly in the maxillary and mandibular arches, respectively. Less experienced orthodontists showed a higher tendency to prefer removable retainers and reported greater relapse in open bite and rotational cases. Fixed retainer materials, designs, and wire thickness preferences showed no significant variation across experience levels. Supracrestal fiberotomy and headgear were used more frequently by orthodontists with 5–10 years of experience. 73% percent of clinicians reported retreatment in up to 25% of relapse cases. Conclusions: While Turkish Orthodontists agree on the necessity of retention, substantial variability exists in protocol selection, relapse management, and follow-up practices. Professional experience of orthodontists influences certain clinical decisions and relapse outcomes. These findings emphasize the need for standardized, evidence-based guidelines to enhance consistency and long-term stability in orthodontic care.
Abstract Background: Class II malocclusion exhibits considerable skeletal and dental heterogeneity that is often inadequately described by Angle’s dental classification. Moyers’ cephalometric subclassification, based on horizontal and vertical skeletal–dental relationships, provides a more biologically meaningful framework for understanding Class II patterns. Population-specific evaluation of these subtypes is essential, as craniofacial morphology varies across ethnic groups. Aim: To determine the prevalence and distribution of Moyers’ horizontal and vertical Class II malocclusion subtypes in a Dravidian population and to evaluate their association with age and gender using cephalometric analysis. Materials and Methods: This retrospective study analyzed 455 pretreatment lateral cephalograms of Dravidian subjects diagnosed with Class II malocclusion. Cephalometric assessment was performed digitally using FACAD software with Steiner’s, McNamara’s, Wits, and Rakosi analyses. Each case was classified into Moyers’ horizontal (A–F) and vertical (1–5) subtypes by calibrated examiners. Frequency distribution was calculated, and Chi-square tests were used to assess associations of subtypes with age and gender. Results: Horizontal Subtype F was the most prevalent pattern, while Vertical Subtype 2 predominated among vertical patterns. A statistically significant association was observed between age and horizontal subtypes (p = 0.02), and between gender and horizontal subtypes (p = 0.04). No significant association was found between age or gender and vertical subtypes. Angle’s dental classification showed variable overlap with Moyers’ skeletal subtypes. Conclusion: The Dravidian population demonstrated a distinct distribution of Moyers’ Class II subtypes, emphasizing the influence of ethnic craniofacial characteristics. Moyers’ cephalometric classification provides superior diagnostic insight compared to Angle’s system and facilitates more individualized treatment planning.
In this study, the accuracy and reliability of two smartphone-based 3D Face scanning applications( Face App, Bellus 3D ) for soft tissue facial mapping to the direct facial measurements was evaluated.40 participants following inclusion and exclusion criteria were selected for the study. Each participant had six soft-tissue landmarks identified :glabella (Gb), subnasal (Sn), menton (Me),pronasale(pr) chelion right (ChR), and chelion left (ChL), exocanthion (ex), endocanthion (en) . 10 interlandmark distances were measured,both directly (manual group) and digitally (digital group) on the participant's 3D facial reconstruction. Digital callipers were used to take interlandmark measurements for the manual group. Three-dimensional facial reconstructions were captured for each participant in the digital group utilising a dual-structured light facial scanners (Bellus3D and Face App). Using open-source software, interlandmark measurements were taken (Meshlab; Meshlab). Out of the 10 anthropometric parameters considered for the study 5 of them found to be statistically significant and another 5 not statistically significant.The mean nose height, The mean Nasal Bridge Length, The mean mouth width, The mean Distance b/w Glabella – Sub-Nasale, The mean Distance b/w Pro-Nasale – Menton were the parameters which are statistically significant,at P=.04,.04.,.001,.02,.02 respectively.The results showed that compared with the Face App ,Bellus 3D is producing measurements closer to the one measured clinically .Thus compared to the Face App ,Bellus 3D is more accurate.
Background: Orthognathic surgery, including procedures such as Le Fort I osteotomy and genioplasty, is performed to correct craniofacial discrepancies and malocclusions. However, these procedures may lead to complications such as changes in dental pulp response and tooth discoloration. Objective: This systematic review aims to evaluate the evidence regarding the dental pulp response and the incidence of discoloration following orthognathic procedures. Methods: Relevant studies investigating pulp blood flow, pulp sensibility, and dental discoloration after orthognathic surgery were reviewed. Observational studies, case reports, and clinical investigations on pulp response and discoloration in patients undergoing procedures such as Le Fort I osteotomy were included. Results: Pulp blood flow in anterior teeth significantly drops immediately after surgery, often leading to negative pulp sensibility tests in the first days and weeks post-operatively. Recovery of pulp sensibility occurs gradually, with some teeth regaining a positive response within three months. Dental discoloration occurs in approximately 3.5-5% of cases after orthognathic procedures, mainly due to vascular impairment or mechanical injury to the apical region. Discoloration may present early, sometimes as a dark pink hue, and is often reversible; however, persistent discoloration combined with loss of pulp sensibility may indicate pulpal necrosis, warranting root canal therapy and non-vital bleaching as effective management. Patients should be informed of these potential complications preoperatively. Conclusion: Orthognathic surgery can acutely affect pulp vitality and pose a risk of dental discoloration via vascular or mechanical trauma. Most cases resolve with conservative dental management. Awareness and monitoring are critical for early identification and appropriate treatment to ensure satisfactory esthetic and functional outcomes.
Background : Transverse maxillary discrepancies often develop due to altered skeletal growth patterns influenced by prolonged oral habits and impaired orofacial muscle function. Traditional methods like Rapid Maxillary Expansion (RME) and Slow Maxillary Expansion (SME), have been widely used, particularly in younger patients. MARPE is a minimally invasive, micro-implant–supported expansion technique designed to achieve skeletal maxillary widening in adolescents and adults. The objective of this review was to critically appraise and synthesize the evidence comparing mini-screw–assisted rapid palatal expansion (MARPE) with conventional rapid palatal expansion (RPE) in terms of skeletal expansion, dentoalveolar changes, and periodontal effects. Materials and Methods: Electronic and manual searches were performed based on predefined PICO eligibility parameters. Risk of bias was assessed using the ROB-2 tool for randomized controlled trials and the ROBINS-I tool for non-randomized studies. The evidence was then synthesized narratively to evaluate skeletal, dentoalveolar, and periodontal outcomes. Results : Six studies were included, most with low to moderate risk of bias. MARPE showed higher skeletal effectiveness, with midpalatal suture opening rates of 84–100% and consistently greater increases in nasal width compared with conventional RPE. Dentoalveolar changes were smaller with MARPE, with molar inclination ranging from 1.3° lingual to 3.9° buccal, lower than in tooth-borne expanders. Periodontal findings also favored MARPE, with studies reporting less buccal bone and alveolar height loss, indicating improved preservation of supporting structures. Conclusion: The review indicates that MARPE is an effective non-surgical option for maxillary expansion in late adolescents, offering greater skeletal expansion with fewer dentoalveolar and periodontal side effects than conventional expanders. However, the predominance of studies with moderate risk of bias underscores the need for higher-quality research to confirm these findings.
BACKGROUND: Orthodontic tooth movement is often time-consuming and can cause patient discomfort. Various techniques to accelerate tooth movement such as micro-osteoperforation and platelet-rich plasma (PRP) have been extensively researched. PRP is an autologous component rich in growth factors and mediators that promote cell proliferation and differentiation, essential for orthodontic tooth movement. Freeze-drying PRP enhances its shelf life and clinical applicability. AIM: The present study aims to evaluate the efficacy of lyophilised platelet-rich plasma (LPRP) and microosteoperforation (MOP) in accelerating canine retraction in patients with class I bimaxillary protrusion undergoing fixed orthodontic treatment. MATERIALS AND METHODS: This randomized split-mouth clinical trial was conducted at the Department of Orthodontics and Dentofacial Orthopaedics, Rajas Dental College and Hospitals, Tirunelveli. Nine patients with Class I bimaxillary protrusion were randomly assigned to receive either MOP or LPRP on the contralateral side. Tooth movement was assessed at one-and two-months post-intervention using dental cast. Statistical analysis of the data was performed, with a p-value of < 0.05 considered statistically significant. RESULTS: The mean age of the participants was 21.00 +/- 1.94 years with a total of 9 participants with 4 males and 5 females. It can be observed that in both the groups, the rate of canine retraction at three different time interval was highly significant (p<0.001) but minimal differences was seen between LPRP and MOP groups which was not statistically significant. CONCLUSION: This study demonstrated that both MOP and LPRP showed accelerated tooth movement over the course of two months ,while the difference between the two groups was not statistically significant. Future studies to further validate these findings with larger sample sizes are recommended.
Background: Class II malocclusion exhibits considerable skeletal and dental heterogeneity that is often inadequately described by Angle's dental classification. Moyers' cephalometric subclassification, based on horizontal and vertical skeletal-dental relationships, provides a more biologically meaningful framework for understanding Class II patterns. Population-specific evaluation of these subtypes is essential, as craniofacial morphology varies across ethnic groups. Aim: To determine the prevalence and distribution of Moyers' horizontal and vertical Class II malocclusion subtypes in a Dravidian population and to evaluate their association with age and gender using cephalometric analysis. Materials and Methods: This retrospective study analyzed 455 pretreatment lateral cephalograms of Dravidian subjects diagnosed with Class II malocclusion. Cephalometric assessment was performed digitally using FACAD software with Steiner's, McNamara's, Wits, and Rakosi analyses. Each case was classified into Moyers' horizontal (A-F) and vertical (1-5) subtypes by calibrated examiners. Frequency distribution was calculated, and Chi-square tests were used to assess associations of subtypes with age and gender. Results: Horizontal Subtype F was the most prevalent pattern, while Vertical Subtype 2 predominated among vertical patterns. A statistically significant association was observed between age and horizontal subtypes (p = 0.02), and between gender and horizontal subtypes (p = 0.04). No significant association was found between age or gender and vertical subtypes. Angle's dental classification showed variable overlap with Moyers' skeletal subtypes. Conclusion: The Dravidian population demonstrated a distinct distribution of Moyers' Class II subtypes, emphasizing the influence of ethnic craniofacial characteristics. Moyers' cephalometric classification provides superior diagnostic insight compared to Angle's system and facilitates more individualized treatment planning.
AIM: To evaluate and compare the various general, morphologic and positional factors that influence the disimpaction of maxillary buccal and palatal canine impactions in humans belonging to the South Indian population. MATERIALS AND METHODS: The sample involving 14 subjects was divided into two groups, based on the position of the impacted maxillary canine. G1 consisting of eight patients with palatal canine impaction and G2 consisting of six patients with buccal canine impaction was conducted. The general, morphologic and positional factors were compared between the two groups, G1 and G2. Several angular and linear measurements were made to determine the canine position in the maxilla and were compared between the groups. Mann Whitney U test and Chi Square test was performed Binary logistic regression was done to predict an association between the various parameters and a favourable outcome following dis-impaction. RESULTS: The difference in frequency of canine impaction was statistically significant between G1 and G2 with unilateral impactions present in four samples in both the groups and bilateral impactions present in four samples in G1 and two samples in G2 [p = 0.5]. A statistically significant existed between the groups with respect to the position of the impacted canine with the adjacent teeth with the crown of the canine located on the palatal or distal aspect of the anterior teeth in G1 compared to the palatal, buccal and distal aspect in G2 [p=0.04]. Other parameters did not have a statistically significant difference between the two groups. CONCLUSION: There was no difference between buccal and palatal impactions with respect to the general, morphologic and positional factors for most of the parameters except for the of frequency of canine impaction and the position of tip of crown to the adjacent tooth.
Background: Orthodontic relapse is a common clinical challenge following orthodontic treatment and may occur due to biological factors such as periodontal reorganization, soft-tissue pressures, and craniofacial growth changes. Although various retention protocols are widely used, there is still no universal consensus regarding the most effective retention strategy. Aim: The aim of this study was to investigate the retention protocols and relapse management strategies preferred by orthodontists in T & uuml;rkiye following orthodontic treatment. Materials and Methods: A national cross-sectional survey consisting of 33 multiple-choice questions was distributed electronically to members of the Turkish Orthodontic Society using an online survey platform. A total of 100 orthodontists responded, corresponding to a 10% response rate. Statistical analyses were performed using Chi-square and Fisher's exact tests to evaluate differences according to professional experience. Results: Retention protocols were applied to all patients by 94% of orthodontists, and 74% recommended lifelong retention. Vacuum-formed retainers and bonded retainers were the most commonly used appliances in maxillary and mandibular arches, respectively. Less experienced orthodontists showed a significantly higher tendency to prefer removable retainers in non-extraction Class I crowding cases (p = 0.015). Overall, 87% of orthodontists reported encountering relapse in their clinical practice, most frequently in tooth rotation and anterior open-bite cases (p = 0.006, p = 0.034, respectively). Retreatment was reported in <= 25% of patients in 73% of relapse cases. Conclusions: Orthodontists in T & uuml;rkiye widely recognize the importance of retention; however, substantial variability exists in retention protocols and relapse management strategies. Professional experience appears to influence certain clinical decisions, highlighting the need for standardized evidence-based retention guidelines.
Objectives: To evaluate and compare the changes in the WALA ridge and the distance from the FA point to the WALA ridge in the mandibular arch of patients treated with a conventional fixed appliance and a Damon selfligating appliance. Materials and Methods: The investigation included pre-and post-treatment mandibular study models of 63 subjects, with 33 subjects in Group I (MBT prescription) and 30 subjects in Group 2 (Damon Self-Ligating appliance). Reference planes were generated on the maxillary study model and the WALA ridge, and FA points were marked on the mandibular models. Scanning of models was performed using a 3-dimensional laser scanner. The changes in WALA ridge position and the distances between the FA point and the WALA ridge were assessed using a dental cast analysis software. Results: There was a significantly greater increase in WALA ridge dimensions in Group 2 (P<0.001) relative to Group 1. Intergroup comparison of changes in FA-WALA distances revealed buccal movement of all teeth in Group 1, except for the central incisor and first premolar. In contrast, buccal movement was noted only in the first molar region in Group 2. However, this variation among the groups was not statistically significant (P>0.05). Conclusions: There was a significant increase in WALA ridge dimensions with the Damon self-ligating appliance relative to the conventional fixed appliance, demonstrating that the WALA ridge is not immutable.
Introduction: Recent developments have transformed dentistry from traditional workflow to a digital workflow. Face scan is one such advancement to study the facial soft tissues. This study was done to compare facial measurements obtained using two smart phone-based 3D facial scan applications with clinical measurements. Methodology: In this prospective study, forty participants meeting the inclusion and exclusion criteria were selected. Three-dimensional facial reconstructions were captured for each participant in the digital group utilising dual-structured light facial scanners (Bellus3D and Face App). Clinical measurements were taken using Digital callipers. Using open-source software, inter landmark measurements were taken (Meshlab). Measurement differences were evaluated by comparing the direct measurement with the two digital measurements. Results: Measurements made with Bellus 3D were closer to the clinical values, for five parameters. (mean nose height (P=.04), the mean nasal bridge length (P=.04), the mean mouth width (P=.001), the mean distance between glabella-sub-nasale (P=.02), the mean distance between pro-nasale-menton. (P=.002) Conclusion: Bellus 3D app produced measurements comparable to the clinical measurements in comparison to Face app.
Objective: To systematically review available in vivo evidence from animal and human studies evaluating the antimicrobial efficacy, biocompatibility, and durability of metallic nanoparticle-coated orthodontic materials, excluding all in vitro research. Methods: Electronic searches were performed in PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, Ovid, and ClinicalTrials.gov for studies published from January 2015 to August 2025, supplemented by manual and grey-literature searches. Eligible studies included in vivo animal or human investigations assessing surface coatings of orthodontic components—brackets, archwires, ligatures, elastomeric modules, or aligners—with metallic or metal-oxide nanoparticles (Ag, TiN, TiO 2 , N-TiO 2 , ZnO, Au). Primary outcomes were antimicrobial efficacy (CFU, qPCR, or biofilm indices); secondary outcomes included biocompatibility (ion release, cytotoxicity, mucosal response) and coating durability. Quality appraisal used SYRCLE, RoB 2, and ROBINS-I tools; evidence certainty was graded using GRADE. Registration: OSF ( https://doi.org/10.17605/OSF.IO/5CZSG ). Results: Of 1,499 records, eight in vivo studies met the inclusion criteria—six human and two animal. Nanoparticles evaluated were Ag, TiN, TiO 2 , N-TiO 2 , ZnO, and Au. All demonstrated reduced Streptococcus mutans or related bacterial loads compared with uncoated controls. Silver coatings produced early antibacterial effects but released trace Ag + (0.16–0.35 ppb). TiO 2 and TiN coatings reduced bacterial adhesion up to four weeks but showed partial delamination (~60%). N-doped TiO 2 extended efficacy to 60 days, while ZnO coatings-maintained suppression and enamel protection for 12 months despite early surface degradation. Gold nanoclusters exhibited short-term antibacterial and excellent biocompatibility in animal models. Biocompatibility was acceptable across studies, but durability and long-term stability were inconsistently assessed. Meta-analysis was precluded by heterogeneity of outcomes and timepoints. Overall risk of bias ranged from low to serious; certainty of evidence was low to moderate. Conclusions: In vivo data indicate short-term antibacterial and biocompatible benefits of metallic nanoparticle coatings on orthodontic materials; however, evidence for coating durability and long-term safety is limited. Well-designed randomized clinical trials with standardized microbial, biocompatibility, and durability outcomes are essential for clinical translation.
Background: Oral hygiene and treatment compliance are critical for successful orthodontic outcomes. Despite their importance, patient non-adherence remains a significant challenge, contributing to complications such as plaque accumulation, gingivitis, and delayed treatments. Digital health interventions, including mobile apps, telemonitoring, and gamified platforms, offer innovative approaches to address these issues. Objective: This systematic review evaluates the effectiveness of digital health interventions in improving oral hygiene and treatment compliance among orthodontic patients, compared to traditional methods. Methods: A comprehensive search was conducted across databases including MEDLINE, Cochrane Library, EMBASE, and Scopus. Peer-reviewed randomized controlled trials (RCTs) and controlled clinical trials (CCTs) assessing digital health tools in orthodontics were included. Data were extracted and analyzed descriptively, focusing on outcomes such as Plaque Index (PI), Gingival Index (GI), compliance rates, and patient engagement. Results: Seven studies involving 504 participants aged 10–36 years were included. Digital tools demonstrated consistent improvements in oral hygiene, with significant reductions in PI and GI. Gamified apps, motivational protocols via social platforms, and telemonitoring enhanced compliance and reduced white spot lesions. However, short study durations and variability in interventions limited long-term effectiveness assessments. Conclusion: Digital health interventions show promise in enhancing orthodontic care by improving oral hygiene and compliance. Further research with standardized methodologies, long-term follow-up, and cost-effectiveness analyses is needed to validate their integration into routine practice.
Background: Resin infiltration (RI) has been used to treat white spot lesions (WSLs) and minimize caries development. The non-cavitated initial carious lesions can be filled with resin to prevent further caries progression. Long-term effects of RI have been reported but there is a need to systematically review the literature. Aim and objectives: To systematically search, collate, and assess the literature on treatment effectiveness and stability with RI technique for the management of WSLs in orthodontic patients over a six to twenty-four-month follow-up period. Materials and methods: A literature search was performed from January 2019 to December 2023 in four electronic databases (PubMed, Cochrane library, Google Scholar and Scopus). Studies including patients with permanent dentition treated for WSLs during or after orthodontic treatment, with at least 6 months of followup were only included in the review. Risk of bias assessment was done using the Cochrane ROB-2 tool for randomized clinical trials (RCTs) and the ROBINS-I tool for non-RCTs. GRADE assessment was done for the certainty of evidence of the included studies. A random effects model was used to perform the meta-analysis of the color change and area of lesion regression. Results: Eight studies including six RCTs and two non-RCTs were included. Treatment with RI showed significant lesion area regression and negligible color change over 6–24 months. The meta-analysis showed no significant difference in lesion area between RI and CPP-ACP at 12 months(effect size z = 1.42), and a significant improvement in color change at 6 months (effect size z=4.38, favoring RI over micro abrasion, with no heterogeneity. (I2 = 0%). Conclusion: This systematic review based on strong evidence reports that RI is an effective treatment for WSLs, with significant improvement in color and lesion area regression. Moreover, its effectiveness was maintained over six months, hence it is stable and long-lasting.
Aim: To compare the rate and efficiency of Niobium-Titanium-Tantalum Zirconium archwire (Gummetal), Copper Nickel Titanium archwire (CuNiTi) and conventional nickel titanium archwire (NiTi) on initial alignment. Materials And Methods: A single-center randomized controlled clinical trial was conducted in 33 fully erupted dentition patients and Little's Irregularity Index (LII) >2 mm. Patients were randomly assigned to three groups (n=11 each) treated with 0.014-inch NiTi, CuNiTi, or Gummetal archwires. Impressions were taken at baseline (T0) and at 3-week intervals for 4 times (T1-T4). LII, Intercanine width (ICW) and intermolar width (IMW) were measured and analyzed using SPSS v20.0 with Repeated Measures ANOVA, Bonferroni post-hoc, and Chi-square tests with p value <0.05 as statistical significance. Results: All groups showed statistically significant reduction in LII from T0 to T4 (p<0.001). Group 1 showed a decrease from 3.76 +/- 0.75 to 1.02 +/- 0.53, Group 2 from 3.74 +/- 0.64 to 0.90 +/- 0.25, and Group 3 from 3.04 +/- 0.59 to 1.33 +/- 0.66. ICW increased significantly in all groups: Group 1 from 25.93 +/- 2.86 to 26.58 +/- 2.78 (p<0.001), Group 2 from 25.59 +/- 2.68 to 26.64 +/- 2.76 (p < 0.001), and Group 3 from 25.79 +/- 2.86 to 26.52 +/- 2.83 (p=0.008). IMW changes were significant in Group 2 (40.76 +/- 2.66 to 41.11 +/- 2.63, p<0.001) and Group 3 (40.95 +/- 2.61 to 41.11 +/- 2.63, p<0.001), but not in Group 1 (41.01 +/- 2.64 to 41.08 +/- 2.62, p=0.136). Intergroup comparison revealed no statistically significant difference in LII, ICW, or IMW (p >= 0.051). Conclusions: CuNiTi and NiTi archwires were more effective in initial alignment and mild arch expansion than Gummetal, making them preferable for early orthodontic correction.
Background: The aim of this study was to evaluate orthodontists' reported experiences with clear aligner therapy and fixed appliances, with particular emphasis on treatment discontinuation, compliance, and conversion to alternative treatment modalities. By analyzing the collected responses, the study seeks to clarify the key contributors to patient discontinuation. Methodology: A cross-sectional survey was distributed to orthodontists in T & uuml;rkiye who actively provided clear aligner therapy. Eligibility required orthodontic training and clinical practice in T & uuml;rkiye. A priori power analysis determined a sample size of 134 respondents. Clinicians reported aligner-related outcomes based on clinical records. Data was analyzed using descriptive statistics and Chi-square tests (SPSS v25, p < 0.05). Results: Among the orthodontists, 31.34% (42/134) with more than 10 years of experience reported having over 100 ongoing cases, and 9.70% (13/134) had completed more than 100 clear aligner (CAT) treatments. Treatment discontinuation was predominantly attributed to patient abandonment (63.43%, 85/134), while 31.34% (42/134) of patients transitioned to alternative fixed appliance therapy. Additionally, 5.22% (7/134) of patients who discontinued aligner therapy completed their treatment through restorative dental procedures. 46.27% (62/134) of patients who discontinued treatment had exhibited poor oral hygiene, non-compliance, or motivational issues prior to withdrawal. Among surveyed orthodontists, 45.52% (61/134) reported challenges with CAT planning, while 58.96% (79/134) handled the planning independently. Significant correlation was found between limited clinical experience (1-5 years) and higher discontinuation rates (9.68%, 13/134; p = 0.006). Strong correlation was identified between orthodontists treating 1-10 patients and having more than five discontinuations (3.13%, 4/134; p = 0.009). Discontinuation rates were notably higher among patients under 18 years (65%, 87/134). Conclusions: Orthodontists reported higher discontinuation and conversion rates in clear aligner therapy, emphasizing the importance of realistic treatment planning, regular monitoring, and continued professional education. Standardized tracking systems may provide more precise insights into factors associated with treatment discontinuation.
Introduction: The objective was to compare the cervical spine postural changes after treatment with fixed and removable functional appliances. Methods and Analysis: A retrospective study with pre and post lateral cephalograms of 60 patients was planned. They were divided into three groups- fixed functional appliance, removable functional appliance and a control group which involved camouflage mechanics. Cervical spine posture and airway were assessed. The craniocervical angulation changes were correlated to changes in ANB, mandibular parameters and airway. Results: Amongst the cervical spine postural variables, only the sella-nasion to odontoid process tangent (SNOPT) showed significant changes (Twin block/control, p=0.041). Removable and fixed functional appliances brought about a reduction in the SN-OPT. However, this was not statistically significant (Herbst/control=0.184; Herbst/Twin block, p=0.761). Control group revealed an increase in the SN-OPT and this difference was significant between Twin block and control group (p=0.041). There were significant variations in the SNB (p=0.000) and ANB (Herbst/control, p=0.003; Twin block/control, p=0.001) between both Herbst and Twin block groups when compared with control group. However, there were no significant differences between the Herbst and Twin block groups (SNB, p=0.333;ANB,p=0.974). There were no significant differences in the mandibular length and the mandibular plane angle between the three groups (mandibular length, p=0.206; mandibular plane angle, p=0.788). Changes in superior, middle and inferior pharyngeal airway were not significantly different between the three groups (p=.537; p=.354; p=.110 respectively). Conclusion: The functional appliances did not affect significant changes in the cervical spine posture. There were no significant differences between fixed and removable functional appliances.
Introduction: Fixed orthodontic treatment increases the oral microbial count, leading to a series of oral health problem. Incorporating products containing antimicrobial effects into the orthodontic materials reduces the escalation of harmful effects of these pathogens. Pycnogenol (R), an extract from the bark of French pine tree (Pinus pinaster Aiton) is a major constituent of over 1000 dietary supplements and variety of other products worldwide, used for treating various illness. However, its potential in orthodontics remains to be explored. Materials and Methods: Pycnogenol (R) extract was prepared and coated onto the orthodontic modules. Drug loading and drug release kinetics was studied using UV visual spectrometry. The coated modules were subjected to antimicrobial testing against common oral pathogens. SEM imaging was done to analyse the surface coating of the orthodontic modules. Results: The antimicrobial activity for S. mutans, E. coli, and S. aureus were studied at 1, 8, and 24 hours. The mean rank obtained from MIC showed that there is a highly significant difference between the bacterial groups in all the time duration. Direct agar diffusion test showed profound zone of inhibition of 20 mm for S. mutans. Additionally, Pycnogenol (R) coated modules also demonstrates antimicrobial activity against E. coli and S. aureus. Conclusion: Increased microbial adhesion to orthodontic appliances and modules causes a sequelae of oral health problems. Pycnogenol (R) is a potent antioxidant possessing antimicrobial and anti-inflammatory properties. The study exhibits the release of the Pycnogenol (R) from the modules after coating and the coated modules also demonstrate antimicrobial activity.
BACKGROUND: Torque control of maxillary incisors remains a biomechanical limitation of clear aligner therapy. Auxiliaries such as attachments and power ridges have been proposed to enhance torque expression; however, quantitative evidence comparing their isolated biomechanical effects is limited. This finite element method (FEM) study aimed to predict and compare torque expression of the maxillary central incisor using clear aligners without auxiliaries, with vertical rectangular attachments, and with power ridges. MATERIALS AND METHODOLOGY: A three-dimensional FEM model was constructed from CBCT and intraoral scan data of a patient with normal occlusion. Three models were analyzed: Group I (aligner without attachment), Group II (aligner with vertical rectangular attachment), and Group III (aligner with power ridge). A palatal force of 1.89 N was applied to simulate incisor torque. Displacement patterns along x, y, and z axes and stress distribution within the periodontal ligament (PDL) and alveolar bone were evaluated. RESULTS: Vertical displacement was minimal and clinically insignificant in all groups. Labio-lingual displacement differed markedly: Group III demonstrated the greatest palatal crown and root displacement, indicating superior torque expression, followed by Group II, while Group I showed inadequate root control. Peak PDL stress was highest in the power ridge model (19.62 MPa), moderate with rectangular attachments (14.67 MPa), and lowest without attachments (13.48 MPa). CONCLUSION: Power ridges significantly enhance torque expression of maxillary central incisors and have significant biomechanical advantage and force transmission compared with rectangular attachments or no attachment designs. Vertical rectangular attachments offer limited torque improvement, whereas aligners without auxiliaries are biomechanically insufficient for effective torque control.
Background: Accurate diagnosis is essential for effective treatment planning and achieving successful outcomes in orthodontics. Limited research has explored the use of pretreatment diagnostic records by orthodontists in Saudi Arabia. This study aimed to evaluate the diagnostic records routinely used by orthodontists in Saudi Arabia and to examine demographic trends influencing their diagnostic practices. Methods: A computer-based questionnaire was completed by 194 orthodontists practicing in Saudi Arabia. The survey collected demographic information and data on the routine use of diagnostic records including, photographs, panoramic radiographs, lateral cephalograms, full-mouth intraoral radiographs, cone beam computed tomography (CBCT) scans, conventional study models, and digital models. Descriptive statistics were used to summarize response frequencies. Demographic variations in diagnostic record utilization were analyzed using Pearson's chi-square and Fisher's Exact tests with Holm-Bonferroni adjustment for multiple comparisons. Results: The most frequently used diagnostic records among participating orthodontists were photographs and panoramic radiographs, reported by 94.3% of respondents. Lateral cephalometric radiographs were used by 91.2% and CBCT was utilized by 10.8%. Conventional study models were employed by 66.5% of orthodontists, while 25.3% used digital models. Significant demographic differences were observed, particularly in the type of study models used. More experienced orthodontists were significantly more likely to use digital study models (P = 0.01), as were orthodontists practicing exclusively in private practice (P = 0.003), and those in urban areas (P = 0.003). Conclusion: Photographs, panoramic radiographs, and lateral cephalograms were the most frequently used diagnostic records. The use of digital study models remains emerging. Orthodontists' demographics appear to influence their diagnostic record selection. This study provides valuable baseline data on the diagnostic practices of orthodontists in Saudi Arabia and offers a reference point for future longitudinal studies and international comparisons.
