Objective:This study aimed to compare the clinical outcomes of indirect- and direct-bonding techniques for bracket placement in orthodontic treatment, focusing on the influence of operator experience. Methods:A total of 153 patients were quasi-randomly assigned to the indirect- or direct-bonding group, of whom 124 were analyzed. Clinical outcomes in the two groups were compared and further stratified by operator experience (1-3 years vs. 4-6 years). The evaluated parameters included total treatment duration, chair time, discomfort during bonding (visual analogue scale scores), plaque control record, bracket failures, intentional reattachments, and post-treatment occlusal index (CR-Eval scores). Results:In procedures performed by operators with 1-3 years of experience, the indirect-bonding group demonstrated significantly shorter treatment duration, shorter chair time, fewer intentional reattachments, and better post-treatment occlusal outcomes than the direct-bonding group. However, bracket failure rates were significantly higher in the indirect-bonding group, regardless of operator experience. In procedures performed by operators with 4-6 years of experience, most parameters showed no significant intergroup differences. Conclusions:The indirect-bonding technique improved treatment efficiency and quality, with potential advantages for less-experienced operators. However, attention to technique is essential to minimize bracket failures. These findings support the incorporation of indirect bonding in clinical training programs.
Objective:To examine the associations of fixed orthodontic treatment with oral health-related quality of life (OHRQoL) and self-esteem (SE) in relation to sex and premolar extraction status. Methods:Adult patients undergoing fixed orthodontic treatment at a private orthodontic practice from 2010 to 2021 were included. Pre- and posttreatment OHRQoL and SE were evaluated using the Orthognathic Quality of Life Questionnaire (OQLQ) and Rosenberg Self-Esteem Scale (RSE), respectively. Outcomes were compared by sex and premolar extraction status. Results:A total of 358 patients (mean age: 26.98 years), including 250 female patients (69.8%) and 206 patients (57.5%) who underwent premolar extraction, were evaluated in this study. Before treatment, male patients had higher OHRQoL and SE than female patients (OQLQ score: 20.25 vs. 25.77, P < 0.001; RSE score: 31.99 vs. 30.06, P < 0.001). After treatment, OHRQoL improved in both sexes (P < 0.001) and SE improved in female patients (P < 0.001), although the between-sex difference was not significant. Male patients maintained higher OHRQoL and SE than female patients posttreatment (OQLQ score: 12.56 vs. 16.79, P < 0.001; RSE score: 32.44 vs. 30.94, P = 0.001). Pretreatment OHRQoL and SE in the extraction group were lower than those in the non-extraction group (OQLQ score: 25.82 vs. 21.78, P = 0.005; RSE score: 30.21 vs. 31.23, P = 0.018), but these differences became non-significant posttreatment (P > 0.05). Conclusions:After orthodontic treatment, OHRQoL improved in both sexes and SE improved in female patients, although the clinical significance of these changes was uncertain. In the extraction group, OHRQoL and SE were initially lower than those in the non-extraction group but showed no significant intergroup differences after treatment.
Objective:To evaluate the three-dimensional movements of ectopically erupted maxillary canines (EEMCs) during orthodontic leveling and alignment with continuous archwires. Methods:Eight patients with EEMCs were treated with a 0.014-inch CuNiTi archwire fully seated in self-ligating maxillary brackets. Seven intraoral scans were obtained per patient from baseline (T1) to 12 weeks thereafter (T2-T7). Geometric morphometric analysis incorporating principal component analysis (PCA) examined the (1) positional and angular changes of the EEMC and adjacent teeth and (2) alterations in the triangular relationship formed by the brackets of the lateral incisors, canines, and premolars. Results:The PCA revealed consistent EEMC extrusion, despite differences in the initial conditions, with the canines reaching apicocoronal alignment with the neighboring teeth after 12 weeks. All EEMCs showed uprighting. The triangular bracket configuration changed systematically, with the distance between the lateral incisor and premolar increasing as the canine was extruded. Conclusions:Despite the small sample size, this brief report revealed a consistent space-opening effect and EEMC uprighting during alignment.
Objective:This retrospective study evaluated the short- and long-term dentoalveolar effects and the long-term stability of tooth-tissue-borne (TTB) and bone-tissue-borne (BTB) rapid maxillary expansion (RME) appliances in growing patients. Methods:Individuals treated with TTB-RME (n = 20; 12 males, 8 females; mean age at T1: 12.44 ± 0.75 years) and those treated with BTB-RME (n = 20; 10 males, 10 females; mean age at T1: 12.86 ± 0.80 years), for a total sample of 40 patients, were retrospectively evaluated. Digital models were analyzed at four different time points: before treatment (T1), 3 months after expansion (T2), at the end of fixed orthodontic treatment (T3), and at long-term follow-up (T4). Maxillary arch width, palatal area, and palatal volume were measured. Longitudinal changes were analyzed using a mixed-design analysis of variance (ANOVA). Results:RME led to statistically significant increases in all evaluated parameters for both groups. A mixed-design ANOVA revealed significant main effects of time for all parameters (all P < 0.001) and significant main effects of Group for intercanine width, second interpremolar width, intermolar width, palatal area, and palatal volume (P < 0.05), whereas no significant Group × Time interaction was detected for any variable. Conclusions:Both TTB-RME and BTB-RME produced significant increases in maxillary transverse dimensions in growing patients, with no significant difference between the two appliances in the pattern of longitudinal changes.
Objective:The skeletal pattern of a Class II malocclusion can increase the probability of problems with oronasal function. This study aimed to analyze the relationship between the clinical effects of dentofacial orthopedics and oral function in deficient mandibles with proclined maxillary incisors during puberty. Methods:Of 120 randomized participants, 63 with complete records were included in the final analysis (median age: 12 years; 38% females). Subjects were treated with the Sander bite jumping appliance (BJA; n = 34) or the twin block appliance (TB; n = 29) with a maxillary expansion jackscrew. The growth effect was monitored by comparisons with the findings in 63 historical untreated Class II cases. Palatal scans and cephalograms were analyzed before and at one-year intervals after treatment. Both the children and their parents reported oral symptoms and functional limitations (FLs). Results:Palatal volume increased in both appliance groups (BJA: 860.3 mm3 [95% confidence interval (CI): 481.6-1,150.1] and TB: 958.9 mm3 [95% CI: 555.1-1,446.3]) in comparison with the untreated group (287.0 mm3 [95% CI: 193.4-426.5]; P < 0.001). However, the treatment did not affect airways. In comparison with the untreated group, the treated groups showed greater mandibular length and reduced overjet (P ≤ 0.002). No linear correlations were found between changes in dentofacial, palatal, or airway characteristics and changes in oral function. However, the palatal volume of the treated children who experienced improvement in FLs increased more than that of those who showed no FL improvement (1,220.6 mm3 [95% CI: 772.6-1,616.4] and 760.5 mm3 [95% CI: 491.6-1,002.1]; P = 0.035). Conclusions:Both appliances promoted mandibular growth and increased oral space, but did not significantly influence the measured upper airway widths.
