METHODS: YouTube videos were systematically acquired with 4 search terms. The top 50 videos per search term by the number of views were stored in a YouTube account. A set of inclusion/exclusion criteria were applied, videos were assessed for viewing characteristics, a 4-point scoring system (0-3) was applied to evaluate QOI in 10 predetermined domains, and a 3-point scoring system (0-2) was applied to evaluate COI. Descriptive statistical analyses and intrarater and interrater reliability tests were performed.
RESULTS: Strong intrarater and interrater reliability scores were observed. Sixty-three videos from the top 58 most-viewed DPs were viewed 1,395,471 times (range, 414-124,939). Most DPs originated from the United States (20%), and orthodontists (62%) uploaded most of the videos. The mean number of reported domains was 2.03 ± 2.40 (out of 10). The mean overall QOI score per domain was 0.36 ± 0.79 (out of 3). The "Placement of miniscrews" domain scored highest (1.23 ± 0.75). The "Cost of miniscrews placement" domain scored the lowest (0.03 ± 0.25). The mean overall QOI score per DP was 3.59 ± 5.64 (out of 30). The COI in 32 videos was immeasurable, and only 2 avoided using technical words.
CONCLUSIONS: The QOI related to temporary anchorage devices contained within videos provided by DPs through the YouTube Web site is deficient, particularly in the cost of placement. Orthodontists should be aware of the importance of YouTube as an information resource and ensure that videos related to temporary anchorage devices contain comprehensive and evidence-based information.
METHODS: Two sets of 3-dimensional facial photographs (1 male and 1 female) each comprised 7 images that showed different dentoskeletal relations (ie, Class I, bimaxillary protrusion, bimaxillary retrusion, maxillary protrusion, maxillary retrusion, mandibular protrusion, and mandibular retrusion). The sets of photographs were shown to 101 laypersons (age, 28.87 ± 6.22 years) and 60 patients seeking orthognathic treatment (age, 27.12 ± 6.07 years). They rated their esthetic perceptions of the photographs on the basis of a 100 mm visual analog scale (VAS) from 0 (very unattractive) to 100 (very attractive).
RESULTS: The dentoskeletal Class I facial profile was ranked as the most attractive profile. Female orthognathic judges selected the retrusive maxilla while male orthognathic judges and male and female laypersons ranked the mandibular protrusion profile as the least attractive profile for both females and males. A bimaxillary protrusive female profile was viewed as more attractive by the orthognathic male (P = 0.006) and female (P = 0.006) judges, compared with female layperson judges. After adjustment for age, no statistically significant interaction between sex and judges (P >0.10) for all VAS scores were detected. For the female bimaxillary protrusive profile, orthognathic patient judges assigned a mean VAS score of 9.174 points higher than layperson judges (95% confidence interval, 3.11-15.24; P = 0.003).
CONCLUSION: Dentoskeletal Class I facial profile was generally considered the most attractive profile in both sexes; male and female orthognathic patients preferred a bimaxillary protrusive female profile. A concave facial profile was perceived as least attractive in both sexes.
METHODS: Thirty adult participants (25 females and 5 males; mean age, 22.66 ± 3.27 years) with moderate upper labial segment crowding were randomly assigned into intervention and control groups using block randomization. All participants had first premolar extractions, bonded conventional fixed appliances, and 0.014-in, followed by 0.018-in nickel-titanium archwire placement for initial alignment. The intervention group received a 3-mm deep MOPs procedure under local anesthesia using a Propel device (Propel Ortho Singapore, Pte, Ltd, Winstedt Rd, Singapore) on the labial attached gingivae of maxillary incisors at monthly visits until complete alignment. Little's irregularity index was used to assess the overall changes and measure the change of tooth alignment of the 6 maxillary anterior teeth. Assessor blinding was employed.
RESULTS: There was no statistically significant difference in the median overall alignment duration between MOPs and control groups (139 days [95% confidence interval, 115.32-161.83] vs 143 days [95% confidence interval, 107.12-179.74]; hazard ratio, 0.829; P = 0.467). The MOPs procedure had no significant effect on the alignment duration (P = 0.657) and no overall significant difference in alignment improvement percentage among 2 groups on the basis of time (F = 2.53; P = 0.124). No harm was encountered.
CONCLUSIONS: The application of MOPs is no more effective in accelerating initial orthodontic alignment than conventional treatment.
TRIAL REGISTRATION: This trial was registered at the ISRCTN registry with the study ID ISRCTN15080404.
PROTOCOL: https://doi.org/10.1186/ISRCTN15080404.
FUNDING: This work was supported by the Postgraduate Trust Fund, Faculty of Dentistry, Universiti Teknologi MARA.
METHODS: Dissolution kinetics of CHX-HMP were firstly explored using spectroscopy and a colorimetric phosphate assay. Elastomeric ligatures were categorized into 3 groups-acetone-conditioned, ethanol-conditioned, and as received-and were then immersed in 5 mM CHX-HMP suspension or 5 mM chlorhexidine digluconate solution and rinsed. CHX release was measured over 8 weeks, and the effects of conditioning and immersion on elastomeric force and extension at rupture and surface topography were investigated.
RESULTS: CHX-HMP exhibited a gradual equilibration that had not reached equilibrium within 8 weeks, releasing soluble CHX and a mixture of polyphosphate and orthophosphate. CHX digluconate-treated ligatures showed no CHX release, whereas CHX-HMP-treated ligatures showed varying degrees of release. As received, CHX-HMP-treated ligatures showed a modest release of CHX up to 7 days. Acetone conditioning did not enhance CHX-HMP uptake or subsequent CHX release and caused a deterioration in mechanical properties. Ethanol conditioning enhanced CHX-HMP uptake (6×) and led to a sustained CHX release over 8 weeks without affecting mechanical properties.
CONCLUSIONS: Within the inherent limitations of this in-vitro study, CHX-HMP led to a sustained release of CHX from orthodontic elastomeric ligatures after ethanol conditioning. Conditioned and coated elastomeric ligatures may ultimately find application in the prevention of white spot lesions in orthodontic patients.
METHODS: In 24 participants, 140-200 g of force was applied for mandibular canine retraction. Three MOPs were made according to the scheduled intervals of the 3 different groups: group 1 (MOP 4 weeks), group 2 (MOP 8 weeks), and group 3 (MOP 12 weeks) directly at the mandibular buccal cortical bone of extracted first premolars sites. Cone-beam computed tomography scans were obtained at the 12th week after MOP application. Computed tomography Analyzer software (version 1.11.0.0; Skyscan, Kontich, Belgium) was used to compute the trabecular alveolar BV/TV ratio.
RESULTS: A significant difference was observed in the rate of canine movement between control and MOP. Paired t test analysis showed a significant difference (P = 0.001) in the mean BV/TV ratio between control and MOP sides in all the frequency intervals groups. However, the difference was significant only in group 1 (P = 0.014). A strong negative correlation (r = -0.86) was observed between the rate of canine tooth movement and the BV/TV ratio at the MOP side for group 1 and all frequency intervals together (r = -0.42).
CONCLUSIONS: The rate of orthodontic tooth movement can be accelerated by the MOP technique with frequently repeated MOPs throughout the treatment.
METHODS: Electronic database and hand search of English literature in PubMed, Cochrane Central Register of Controlled Trials, Embase, Web of Science, and clinical trial.gov, with author clarification were performed. The selection criteria were randomized controlled trial (RCT) comparing MOPs with conventional treatment involving both extraction and nonextraction. Cochrane's risk of bias tool and Grading of Recommendations Assessment, Development and Evaluation approach were used for quality assessment. Studies were analyzed with chi-square-based Q statistic methods, I2 index, fixed-effects, and random-effects model. Quantitative analysis was done on homogenous studies using Review Manager.
RESULTS: Eight RCTs were included for the qualitative analysis. Meta-analysis of 2 homogenous studies indicated insignificant effect with MOPs (0.01 mm less OTM; 95% CI, 0.13-0.11; P = 0.83). No difference (P >0.05) was found in anchorage loss, root resorption, gingival recession, and pain.
CONCLUSIONS: Meta-analysis of 2 low-risk of bias studies showed no effect with single application MOPs over a short observation period; however, the overall evidence was low. The quality of evidence for MOP side effects ranged from high to low. Future studies are suggested to investigate repeated MOPs effect over the entire treatment duration for different models of OTM and its related biological changes.
TRIAL REGISTRATION NUMBER: PROSPERO CDR42019118642.
METHODS: This study included 3 groups with 15 orthodontic patients in each. The control group included patients who had no probiotic treatment, the subjects in the kefir group consumed 2 × 100 ml of kefir (Atatürk Orman Ciftligi, Ankara, Turkey) per day, and the subjects in the toothpaste group brushed their teeth with toothpaste with probiotic content (GD toothpaste; Dental Asia Manufacturing, Shah Alam, Selangor, Malaysia) twice a day. Samples were collected at 3 times: beginning of the study, 3 weeks later, and 6 weeks later. The salivary flow rate, buffer capacity, and Streptococcus mutans and Lactobacillus levels in the saliva were evaluated. Chair-side kits were used to determine the S mutans and Lactobacillus levels.
RESULTS: A statistically significant decrease was observed in the salivary S mutans and Lactobacillus levels in the kefir and toothpaste groups compared with the control group (P <0.05). A statistically significant increase was observed in the toothpaste group compared with the control and kefir groups in buffer capacity. Changes in the salivary flow rate were not statistically significant.
CONCLUSIONS: The regular use of probiotics during fixed orthodontic treatment reduces the S mutans and Lactobacillus levels in the saliva.
METHODS: Sixteen New Zealand white rabbits, 20 to 24 weeks old, were randomly divided into 4 experimental groups. Modified hyrax expanders were placed across their interfrontal sutures and secured with miniscrew implants located bilaterally in the frontal bone. The hyrax appliances were activated as follows: group 1 (control), 0.5-mm per day expansion for 12 days; group 2, 1-mm instant expansion followed by 0.5 mm per day for 10 days; group 3, 2.5-mm instant expansion followed by 0.5 mm per day for 7 days, and group 4, 4-mm instant expansion followed by 0.5 mm per day for 4 days. After 6 weeks of retention, sutural separation and sutural bone modeling were assessed by microcomputed tomography and quantified. Statistical analysis was performed using Kruskal Wallis and Mann-Whitney U tests and the Spearman rho correlation (P <0.05).
RESULTS: Median amounts of sutural separation ranged from 2.84 to 4.41 mm for groups 1 and 4, respectively. Median bone volume fraction ranged from 59.96% to 69.15% for groups 4 and 3, respectively. A significant correlation (r = 0.970; P <0.01) was observed between the amounts of instant expansion and sutural separation.
CONCLUSIONS: Pending histologic verifications, our findings suggest that the protocol involving 2.5 mm of instant expansion followed by 0.5 mm per day for 7 days is optimal for accelerated sutural expansion. When 4 mm of instant expansion was used, the sutural bone volume fraction was decreased.
METHODS: Patients in the permanent dentition requiring maxillary and mandibular fixed orthodontic treatment with a preadjusted edgewise appliance were eligible for inclusion. Patients attending 4 hospital departments (United Kingdom and Italy) were randomly allocated to 1 of 4 treatment interventions: (1) BioCosmetic (Forestadent, Pforzheim, Germany), 0.017 in; (2) Titanol (Forestadent), 0.016 in; (3) TP Aesthetic (TP Orthodontics, La Porte, Ind), 0.014 in; and (4) Tooth Tone (Ortho Organizers, Calsbad, Calif) 0.016 in. Block randomization with block sizes of 4 and 8 was used to ensure an allocation ratio of 1:1:1:1. The primary outcome was alignment efficiency determined by the reduction in Little's irregularity index (mm). Secondary outcomes were color change using the Commission Internationale de L'Eclairage L*a*b* system and percentage of coating loss. Blinding was only applicable to outcome assessment of alignment efficiency. Regression models with Sidak's multiple comparison of means were used to analyze the data.
RESULTS: One hundred fifty patients (300 dental arches) were allocated to the treatment interventions, including 61 male and 89 female subjects with a mean age of 16.60 years. The average duration of follow-up was 63.65 days. Baseline characteristics for the archwire groups were similar. One patient was lost to follow-up. Five percent (n = 15) of the archwires fractured: BioCosmetic, 5.3% (n = 4); Titanol, 6.8% (n = 5); TP Aesthetic, 5.3% (n = 4); and Tooth Tone, 2.7% (n = 2). We analyzed 283 dental arches for alignment efficiency. There was no statistically significant difference for mean reduction in irregularity between the archwire groups (P = 0.627): BioCosmetic (n = 71), 3.86 mm (95% CI, 3.31-4.41); Titanol (n = 69), 4.51 mm (95% CI, 4.00-5.02); TP Aesthetic (n = 71), 4.13 mm (95% CI, 3.49-4.78); and Tooth Tone (n = 72), 4.21 mm (95% CI, 3.89-4.46). There was a statistically significant difference between archwire groups for color change (P = 0.001) and percentage of coating loss (P = 0.001), with BioCosmetic performing best in both parameters.
CONCLUSIONS: There was no difference between the archwires for alignment efficiency. BioCosmetic performed statistically significantly better than did the other groups for both color change and coating loss.
REGISTRATION: This trial was registered with the East Midlands NHS Research Ethics Committee (12/EM/0190).
PROTOCOL: The protocol was not published before trial commencement.
METHODS: Twenty-two patients (11 male, 11 female; mean age, 19.8 ± 3.1 years) with Angle Class II Division 1 malocclusion were recruited for this split-mouth clinical trial; they required extraction of maxillary first premolars bilaterally. After leveling and alignment with self-ligating brackets (SmartClip SL3; 3M Unitek, St Paul, Minn), a 150-g force was applied to retract the canines bilaterally using 6-mm nickel-titanium closed-coil springs on 0.019 x 0.025-in stainless steel archwires. A gallium-aluminum-arsenic diode laser (iLas; Biolase, Irvine, Calif) with a wavelength of 940 nm in a continuous mode (energy density, 7.5 J/cm2/point; diameter of optical fiber tip, 0.04 cm2) was applied at 5 points buccally and palatally around the canine roots on the experimental side; the other side was designated as the placebo. Laser irradiation was applied at baseline and then repeated after 3 weeks for 2 more consecutive follow-up visits. Questionnaires based on the numeric rating scale were given to the patients to record their pain intensity for 1 week. Impressions were made at each visit before the application of irradiation at baseline and the 3 visits. Models were scanned with a CAD/CAM scanner (Planmeca, Helsinki, Finland).
RESULTS: Canine retraction was significantly greater (1.60 ± 0.38 mm) on the experimental side compared with the placebo side (0.79 ± 0.35 mm) (P <0.05). Pain was significantly less on the experimental side only on the first day after application of LLLI and at the second visit (1.4 ± 0.82 and 1.4 ± 0.64) compared with the placebo sides (2.2 ± 0.41 and 2.4 ± 1.53).
CONCLUSIONS: Low-level laser irradiation applied at 3-week intervals can accelerate orthodontic tooth movement and reduce the pain associated with it.