ABSTRACT Objectives To evaluate the association of patient- and parent-perceived treatment motivation and oral health-related quality of life (OHRQoL) with clear aligner (CA) compliance comprehensively among children and adolescents. Materials and Methods Children and adolescents aged 8–17 years undergoing CA treatment were enrolled. Participants completed a questionnaire comprising sociodemographic characteristics and treatment motivation, the Child Oral Health Impact Profile (COHIP), and the CA compliance scale. Statistical analyses included descriptive statistics, Mann-Whitney U -test, Kruskal-Wallis H -test, Bonferroni post hoc test, Wilcoxon signed-rank test, and binary logistic regression. Results A total of 140 questionnaires was analyzed. Among compliance indicators (out of five), appointment adherence scored the highest (4.66 ± 0.65), while chewie use scored the lowest (3.26 ± 1.19). Regarding treatment motivation, parents reported significantly higher treatment need than did patients themselves ( P < .001). However, only patient-perceived treatment need and total COHIP score were significant predictors of CA compliance ( P < .05), whereas parent-perceived treatment need was not ( P > .05). Regarding patient-perceived treatment need, compared with the very needed group, the needed , neutral , and not needed groups were only 32.5%, 19.2%, and 3.1%, respectively, as likely to achieve better overall compliance. Each 1-point increase in the total COHIP score corresponded to a 3.0% higher probability of better CA compliance. Conclusions Greater patient-perceived treatment need and higher OHRQoL predict better CA compliance among children and adolescents, whereas parent-perceived treatment need does not. Clinicians should emphasize patients’ own perceived needs and mitigate the negative impacts of CA treatment on OHRQoL to enhance compliance.
Abstract Objectives To identify the influence of anatomical characteristics and tooth movement–related variables on root length change in maxillary first molars undergoing orthodontic intrusion for anterior open-bite correction. Materials and Methods A total of 216 roots from 36 patients (mean age, 21.8 ± 2.7 years) with anterior open bite treated with either temporary anchorage device–supported fixed appliances (n = 17) or clear aligners (n = 19) was analyzed retrospectively. Cone-beam computed tomography images of the maxillary first molars were obtained at baseline (T0) to quantify initial root length, tooth inclination, and root-sinus proximity distance, and at 6 months of treatment (T1) to quantify vertical displacement, inclination change, and root length change. Multilevel linear mixed-effects regression analyses were performed to account for clustering of multiple roots within individuals (α = 0.05). Results Prior to model adjustment, clear aligners demonstrated significantly less root length change than fixed appliances ( P < .05). Multilevel regression analysis demonstrated that initial root-sinus proximity distance and initial root length were independently associated with root length change ( P < .001 and P < .01, respectively), whereas appliance type and tooth movement-related variables were not ( P > .05). Conclusions Root length changes during maxillary molar intrusion were influenced by anatomical factors rather than appliance type or tooth movement-related variables.
Abstract Objectives To compare 3-year mandibular alignment after clear aligner therapy between an annually renewed nighttime removable polyurethane retention protocol and fixed canine-to-canine lingual retention. Materials and Methods Patient-level data were reanalyzed from a retrospective private-practice cohort. Here, 87 adult nonextraction patients with end-of-treatment (T0) and 3-year (T4) numeric mandibular Little’s irregularity index values and complete covariates were included. Allocation was clinical, not randomized. The fixed protocol used a mandibular canine-to-canine multistrand wire; the removable protocol used maxillary and mandibular polyurethane retainers prescribed for approximately 8 hours nightly at least 5 nights per week, renewed annually. The primary analysis used baseline-adjusted analysis of covariance with heteroscedasticity-consistent robust standard errors. Results Eighty-seven patients were analyzed (48 fixed, 39 removable). In the primary adjusted model, the removable protocol was associated with lower T4 mandibular Little’s irregularity index (adjusted difference = −0.81 mm; 95% confidence interval [CI] = −1.37, −0.26; P = .004). Median regression was consistent (−0.73 mm; 95% CI = −1.22, −0.25; P = .003). The mixed-effects time × group interaction favored the removable protocol but was not statistically significant. Conclusions The annually renewed nighttime removable polyurethane protocol was associated with better mandibular anterior alignment at 3 years than fixed canine-to-canine retention. The 0.81-mm adjusted difference (approximately 24% lower residual irregularity) was consistent across robust and distribution-resistant analyses, supporting this protocol as a clinically credible retention option while prospective confirmation remains warranted.
Objectives:To assess the effects of lithium on orthodontically induced root resorption (OIRR) and orthodontic tooth movement (OTM) and elucidate the underlying mechanisms in an osteoporotic rat model. Materials and Methods:Thirty 10-week-old female Wistar rats were randomly assigned to ovariectomized (OVX) or sham-operated (Sham) groups. Four weeks post-surgery, each group was further divided to receive either lithium (Li: 0.64 mM/kg) or saline via daily intraperitoneal injection. Orthodontic force was applied for 14 days using a closed-coil spring to move the maxillary first molar mesially. OTM was analyzed using micro-computed tomography on day 14. Histological analysis evaluated OIRR, apoptotic cells, osteoclasts, and odontoclasts. Immunohistochemical staining was used to assess the expression of receptor-activated nuclear factor-kappa B ligand and osteoprotegerin. Results:OIRR was significantly higher in the OVX group than Sham groups. Lithium markedly suppressed OIRR in OVX rats to levels comparable to the Sham + Li group. Lithium significantly reduced the number of apoptotic cells on day 3, decreased the number of odontoclasts, and increased osteoprotegerin expression by day 14. It also prevented excessive tooth tipping without affecting the overall distance of tooth movement, promoting a shift from tipping to bodily movement in the OVX group. Conclusions:In an osteoporotic rat model, lithium effectively suppressed OIRR and promoted bodily tooth movement without reducing OTM distance, suggesting the therapeutic potential of lithium in patients with osteoporosis.
