Discomfort associated with Invisalign and traditional brackets: A randomized, prospective trial

ABSTRACT Objective: To evaluate differences in discomfort levels between patients treated with aligners and traditional fixed orthodontic appliances. Materials and Methods: This blinded, prospective, randomized equivalence two-arm parallel trial allocated 41 adult Class I nonextraction patients to either traditional fixed appliance (6 males and 12 females) or aligner (11 males and 12 females) treatment. Patients completed daily discomfort diaries following their initial treatment appointment, after 1 month and after 2 months. They recorded their levels of discomfort at rest, while chewing, and while biting, as well as their analgesic consumption and sleep disturbances. Results: Both treatment modalities demonstrated similar levels of initial discomfort. There were no significant sex differences. Patients in the traditional fixed appliances group reported significantly (P < .05) greater discomfort than patients in the aligner group during the first week of active treatment. There was significantly more discomfort while chewing than when at rest. Traditional patients also reported significantly more discomfort than aligner patients after the first and second monthly adjustment appointments. Discomfort after the subsequent adjustments was consistently lower than after the initial bonding or aligner delivery appointments. A higher percentage of patients in the fixed-appliance group reported taking analgesics during the first week for dental pain, but only the difference on day 2 was statistically significant. Conclusions: Patients treated with traditional fixed appliances reported greater discomfort and consumed more analgesics than patients treated with aligners. This trial was not registered.

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A clinical comparison of three aligning archwires in terms of alignment efficiency: A prospective clinical trial

The Angle Orthodontist ◽

10.2319/041414-274.1 ◽

2014 ◽

Vol 85 (3) ◽

pp. 434-439 ◽

Cited By ~ 10

Author(s):

Reem Sh. Abdelrahman ◽

Kazem S. Al-Nimri ◽

Emad F. Al Maaitah

Keyword(s):

Nonparametric Test ◽

Rate Of Change ◽

Orthodontic Appliances ◽

Initial Alignment ◽

Chi Square ◽

Fixed Appliance ◽

Irregularity Index ◽

Fixed Orthodontic Appliances ◽

Wilks Lambda ◽

The Difference

ABSTRACT Objectives: To clinically evaluate the effectiveness of three orthodontic aligning archwires in relation to tooth alignment speed during the initial alignment stage of treatment. Materials and Methods: A consecutive sample of 74 patients requiring lower only or upper and lower fixed orthodontic appliances were randomly allocated into three different archwires (0.014-inch superelastic nickel-titanium [NiTi], 0.014-inch thermoelastic NiTi, or 0.014-inch conventional NiTi). Good quality impressions were taken of the lower arch before archwire placement (T0) and at designated serial stages of alignment (every 2 weeks: T2, T4, T6, …, T16). The change in tooth alignment was measured in millimeters from the resultant casts using Little's irregularity index. Demographic and clinical differences among the three groups were compared with the chi-square or analysis of variance (ANOVA) test. The difference in the change of lower anterior tooth alignment over time among the three groups was explored with a Split Plot ANOVA (SPANOVA, or within- and between-groups ANOVA). The Kruskal-Wallis nonparametric test was used when data were not normally distributed. Results: The SPANOVA and Wilks Lambda Multivariate test confirmed that the wire type had no influence on the rate of change in alignment (P = .98). Conclusion: The three forms of NiTi wires were similar in terms of their alignment efficiency during the initial aligning stage of orthodontic fixed appliance therapy.

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Changes in Distribution of Dental Biofilm after Insertion of Fixed Orthodontic Appliances

Journal of Clinical Medicine ◽

10.3390/jcm10235638 ◽

2021 ◽

Vol 10 (23) ◽

pp. 5638

Author(s):

Urszula Kozak ◽

Agnieszka Lasota ◽

Renata Chałas

Keyword(s):

Oral Hygiene ◽

Dental Plaque ◽

General Health ◽

Control Group ◽

Orthodontic Appliances ◽

Fixed Appliance ◽

Dental Biofilm ◽

Supragingival Plaque ◽

Fixed Orthodontic Appliances ◽

The Impact

Good oral hygiene is an important factor in oral and general health, especially in orthodontic patients, because fixed appliances might impede effective oral hygiene and thus increase the risks of tooth decay, periodontal disease and general health complications. This study investigated the impact of fixed orthodontic appliances on the distribution of dental biofilm in teenagers. Supragingival plaque was assessed at T0, T1 and T2. The distribution of the biofilm was analyzed. Approximal Plaque Index (API) and Bonded Bracket Index (BBI) were used to measure the presence of dental plaque. After insertion of the fixed appliance, the dental plaque indices values in the orthodontically treated group were significantly higher (p < 0.05) than in the control group. Fixed orthodontic appliances caused significant changes in the distribution of the biofilm. This was characterized by the change of location of the dental plaque. In the orthodontic group, we observed an increase in the amount of the supragingival plaque on the vestibular surface of the teeth.

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Effect of fixed orthodontic appliances on nonmicrobial salivary parameters

The Angle Orthodontist ◽

10.2319/111317-773.1 ◽

2018 ◽

Vol 88 (6) ◽

pp. 806-811 ◽

Cited By ~ 1

Author(s):

Ioannis P. Zogakis ◽

Erez Koren ◽

Shlomit Gorelik ◽

Isaac Ginsburg ◽

Miriam Shalish

Keyword(s):

Orthodontic Treatment ◽

Statistical Significance ◽

Orthodontic Appliances ◽

Inclusion Criteria ◽

Reactive Protein ◽

Fixed Orthodontic Appliances ◽

Salivary Ph ◽

Orthodontic Patients ◽

The Difference ◽

Ph Decrease

ABSTRACT Objectives: To examine possible changes in the levels of salivary antioxidants, C-reactive protein (CRP), cortisol, pH, proteins, and blood in patients treated with fixed orthodontic appliances. Materials and Methods: Salivary samples from 21 orthodontic patients who met specific inclusion criteria were collected before the beginning of orthodontic treatment (T0; baseline), 1 hour after bonding (T1), and 4–6 weeks after bonding (T2). Oxidant-scavenging ability (OSA) was quantified using a luminol-dependent chemiluminescence assay. Cortisol and CRP levels were measured using immunoassay kits. pH levels and presence of proteins and blood in the samples were quantified using strip-based tests. Results: A significant decrease in salivary pH was observed after bonding (P = .013). An increase in oxidant-scavenging abilities during orthodontic treatment was detected, but the change was not statistically significant. Cortisol and CRP levels slightly increased after bonding, but the difference was small without statistical significance. Changes in the presence of proteins and blood were also insignificant. Conclusions: Exposure to fixed orthodontic appliances did not show a significant effect on salivary parameters related to inflammation or stress, with the exception of a significant but transient pH decrease after bonding.

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Long-term skeletal effects of high-pull headgear followed by fixed appliances for the treatment of Class II malocclusions

The Angle Orthodontist ◽

10.2319/091517-620.1 ◽

2018 ◽

Vol 88 (5) ◽

pp. 530-537

Author(s):

E. Erin Bilbo ◽

Steven D. Marshall ◽

Karin A. Southard ◽

Verrasathpurush Allareddy ◽

Nathan Holton ◽

...

Keyword(s):

Class Ii ◽

Class I ◽

Control Group ◽

Orthodontic Appliances ◽

Skeletal Changes ◽

Fixed Orthodontic Appliances ◽

Horizontal Growth ◽

Skeletal Effects ◽

Fixed Appliances

ABSTRACT Objectives: The long-term skeletal effects of Class II treatment in growing individuals using high-pull facebow headgear and fixed edgewise appliances have not been reported. The purpose of this study was to evaluate the long-term skeletal effects of treatment using high-pull headgear followed by fixed orthodontic appliances compared to an untreated control group. Materials and Methods: Changes in anteroposterior and vertical cephalometric measurements of 42 Class II subjects (n = 21, mean age = 10.7 years) before treatment, after headgear correction to Class I molar relationship, after treatment with fixed appliances, and after long-term retention (mean 4.1 years), were compared to similar changes in a matched control group (n = 21, mean age = 10.9 years) by multivariable linear regression models. Results: Compared to control, the study group displayed significant long-term horizontal restriction of A-point (SNA = −1.925°, P < .0001; FH-NA = −3.042°, P < .0001; linear measurement A-point to Vertical Reference = −3.859 mm, P < .0001) and reduction of the ANB angle (−1.767°, P < .0001), with no effect on mandibular horizontal growth or maxillary and mandibular vertical skeletal changes. A-point horizontal restriction and forward mandibular horizontal growth accompanied the study group correction to Class I molar, and these changes were stable long term. Conclusions: One phase treatment for Class II malocclusion with high-pull headgear followed by fixed orthodontic appliances resulted in correction to Class I molar through restriction of horizontal maxillary growth with continued horizontal mandibular growth and vertical skeletal changes unaffected. The anteroposterior molar correction and skeletal effects of this treatment were stable long term.

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Velcro Ties in Early Postoperative Pediatric Tracheostomy Care: A Systematic Review and Meta-analysis

Otolaryngology ◽

10.1177/0194599820964727 ◽

2020 ◽

pp. 019459982096472

Author(s):

Brent A. Chang ◽

Joshua Gurberg ◽

Erin Ware ◽

Kimberly Luu

Keyword(s):

Meta Analysis ◽

Prospective Trial ◽

Final Analysis ◽

Cochrane Central Register ◽

Limited Data ◽

Cochrane Database ◽

Central Register ◽

Significant Difference ◽

Randomized Prospective Trial ◽

The Difference

Objective To systematically review the literature to determine the difference in complications between standard twill and Velcro ties following pediatric tracheostomy. Data Sources MEDLINE, Embase, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, Web of Science, and CINAHL Plus were searched up to August 2020. Review Methods Two authors independently screened articles for eligibility. Retrospective and prospective studies were included as long as there was a direct comparison between twill and Velcro ties. Quantitative and qualitative analysis was performed. The main outcomes were skin-related complications and accidental decannulation. Results Three studies were included in the final analysis: 1 randomized prospective trial and 2 retrospective studies. There were 238 patients total (137 twill, 101 Velcro). Combined analysis showed skin-related complications in 23% of the Velcro group and 44% of the twill group. Meta-analysis for skin-related complications showed no significant difference when comparing Velcro with standard twill ties (risk ratio, 0.53 [95% CI, 0.24-1.17]; P = .12, n = 238 participants from 3 studies, I2 = 66%). Accidental decannulation rates were overall low and comparable between groups (1.0% of twill, 1.4% of Velcro). Conclusion Based on limited data, skin-related complications were not statistically different between Velcro and twill ties. Accidental decannulation is rare with Velcro and standard twill ties, and both are viable options following pediatric tracheostomy.

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Effective multidisciplinary approach for treatment of traumatized maxillary incisors and hypodontia

Orthodontic Update ◽

10.12968/ortu.2020.13.1.6 ◽

2020 ◽

Vol 13 (1) ◽

pp. 6-9 ◽

Cited By ~ 1

Author(s):

Mustafa Elhussein ◽

Jonathan J O'Dwyer ◽

Jonathan Sandler

Keyword(s):

Case Report ◽

Multidisciplinary Team ◽

Alveolar Bone ◽

Treatment Modalities ◽

Orthodontic Appliances ◽

Team Approach ◽

Missing Teeth ◽

Multidisciplinary Team Approach ◽

Fixed Orthodontic Appliances ◽

The Aesthetic

Fractured and missing teeth within the aesthetic zone have always posed a clinical challenge for the dental team. Management and treatment requires the input from a number of dental specialists to guarantee a high quality result. A case report is presented to demonstrate an effective combined orthodontic/restorative approach that fully restored aesthetics and function. The report is of a 14-year-old girl who traumatized her maxillary central incisors, in a dentition that was already compromised as she had congenital absence of her maxillary left lateral incisor. Using fixed orthodontic appliances, the fractured teeth were extruded to bring the fracture line above the level of the alveolar bone. This movement allowed an immediate aesthetic improvement, using stainless steel prefabricated posts and composite resin buildups, which also facilitated further orthodontic tooth movement. Teeth, that would otherwise have been extracted, were salvaged and, utilizing a multidisciplinary team approach, a reasonable long-term prognosis has resulted. CPD/Clinical Relevance: This case report aims to demonstrate how a multidisciplinary team approach in Orthodontics can be utilized for management of severely handicapped dentitions that have sustained dental injury. It is not the aim of this case report to discuss the treatment of dental injuries but to demonstrate and provide an overview of the possible treatment modalities that can be effective in restoring function and aesthetics, with special consideration given to missing teeth and subgingival crown fractures within the aesthetic zone.

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Microbiological Evaluation of Octenidine Dihydrochloride Mouth Rinse after 5 Days' Use in Orthodontic Patients

The Angle Orthodontist ◽

10.2319/062008-322.1 ◽

2009 ◽

Vol 79 (4) ◽

pp. 766-772 ◽

Cited By ~ 13

Author(s):

Alev Aksoy Dogan ◽

Emel Sesli Cetin ◽

Emad Hüssein ◽

Ali Kudret Adiloglu

Keyword(s):

Inhibitory Effect ◽

Oral Bacteria ◽

Lactobacillus Species ◽

Orthodontic Appliances ◽

Cariogenic Bacteria ◽

Fixed Orthodontic Appliances ◽

Octenidine Dihydrochloride ◽

Orthodontic Patients ◽

Fixed Appliances

Abstract Objective: To determine the absolute and relative antibacterial activity of octenidine dihydrochloride (OCT) against total and cariogenic bacteria in saliva samples of patients with fixed orthodontic appliances during 5 days of usage. Materials and Methods: The study group consisted of 5 male and 13 female subjects who were selected from patients in the Clinic of Orthodontics. Each patient was given physiologic saline (PS), chlorhexidine gluconate (CHX), polyvinylpyrrolidone-iodine complex (PVP-I), and OCT every morning for 5 days, each separated by a 2-week interval. Total and cariogenic bacteria in saliva samples of orthodontically treated patients with fixed appliances were collected during 5 days of usage. Unstimulated saliva was collected as a baseline sample. Saliva samples were collected at 15 minutes, and on the second, third, and fifth day after rinsing the mouth with any of the solutions for 30 seconds, and bacterial counts were detected. Results: OCT showed an ultimate reduction of total viable oral bacteria, Lactobacillus species, and Streptococcus mutans in vivo. OCT also had a significantly greater inhibitory effect than 0.2% CHX and 7.5% PVP-I, from the beginning of the study until the fifth day after the orthodontic appliances were bonded (P < .1). Conclusions: OCT compared favorably with respect to CHX and PVP-I complex in orthodontically treated patients with fixed appliances (P ≤ .1).

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Clinical and immunological studies of periodontal inflammatory complications at orthodontic treatment using fixed appliances

Kazan medical journal ◽

10.17816/kmj1461 ◽

2014 ◽

Vol 95 (1) ◽

pp. 80-82

Author(s):

G R Khaliullina ◽

S L Blashkova

Keyword(s):

Immune Response ◽

Orthodontic Treatment ◽

Inflammatory Diseases ◽

Periodontal Diseases ◽

Orthodontic Appliances ◽

Periodontal Inflammation ◽

Fixed Orthodontic Appliances ◽

Fixed Appliances ◽

Orthodontic Devices

The review of clinical and immunologic studies of periodontal inflammatory diseases is presented. At present, the most effective tools for treatment of malocclusions are fixed orthodontic appliances (dental braces), but the use of fixed appliances complicates the oral hygiene, predisposes to periodontal and gum inflammation. The rate of complications diagnosed during orthodontic treatment stays high. The principles of periodontal inflammatory diseases (gingivitis, periodontitis) treatment are closely related with the causes and mechanisms of periodontal inflammation. Patients who receive orthodontic treatment using braces should be treated as a group with a high risk for inflammatory periodontal diseases. The orthodontic devices stimulate the directed reorganization of periodontal structures achieving optimal aesthetic and functional standards. Physiology of periodontium restructuring is largely determined by the local and general health before, during and after the orthodontic treatment. This article surveys the mechanisms of periodontal damage, highlighting the important role of immune response. So far, only anecdotal descriptions of immune response on the stages of orthodontic treatment are published.

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Antimicrobial resistance of bacterial strains in patients undergoing orthodontic treatment with and without fixed appliances

The Angle Orthodontist ◽

10.2319/120720-990.1 ◽

2021 ◽

Author(s):

Bruno Andrade Pellissari ◽

Gabriela Sergini Pereira Sabino ◽

Roberto Nepomuceno de Souza Lima ◽

Rogério Heládio Lopes Motta ◽

Selly Sayuri Suzuki ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Orthodontic Treatment ◽

Bacterial Resistance ◽

Control Group ◽

Orthodontic Appliances ◽

Bacterial Strains ◽

Fixed Orthodontic Appliances ◽

Fixed Appliances ◽

Group 2 ◽

Group 1

ABSTRACT Objectives To identify microorganisms isolated from patients wearing fixed orthodontic appliances and to evaluate the resistance of isolated bacterial strains to different antimicrobials. Materials and Methods Seventeen healthy patients wearing a fixed orthodontic appliance (group 1) and six nonwearers (group 2, control group) were evaluated. The biofilm that formed around the orthodontic brackets was collected, and the samples were then plated in a chromogenic medium (chromIDT, bioMérieux). Colony-forming units (CFUs) were isolated and inoculated in blood-agar medium. Automated biochemical tests (VITEK 2, bioMérieux) were carried out to identify the genus and species of the microorganisms and the resistance provided by 43 drugs (37 antibacterial and 6 antifungal). Results The most prevalent microbial genera identified in group 1 were Streptococcus (24.0%), Staphylococcus (20.0%), Enterobacter (12.0%), Geobacillus (12.0%), and Candida (12.0%), and the most frequent species were Enterobacter cloacae complex (13.6%) and Staphylococcus hominis (13.6%). In group 2, the most prevalent genera were Streptococcus (57.1%), Staphylococcus (14.2%), Sphingomonas (14.2%), and Enterobacter (14.2%). With regard to antimicrobial resistance, 14 of 19 (74%) isolated bacterial strains were found to be resistant to at least 1 of the tested antimicrobials. Conclusions The findings of the present study suggest that patients undergoing orthodontic treatment with fixed appliances have a more complex biofilm with a higher level of bacterial resistance.

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Microbiological Changes and Caries-Preventive Effect of an Innovative Varnish Containing Chlorhexidine in Orthodontic Patients

Caries Research ◽

10.1159/000486140 ◽

2018 ◽

Vol 52 (4) ◽

pp. 272-278 ◽

Cited By ~ 3

Author(s):

Lídia Lipták ◽

Krisztina Szabó ◽

Gábor Nagy ◽

Sándor Márton ◽

Melinda Madléna

Keyword(s):

Dental Arch ◽

Risk Category ◽

Orthodontic Appliances ◽

White Spot Lesions ◽

Preventive Effect ◽

Fixed Appliance ◽

Fixed Orthodontic Appliances ◽

Orthodontic Patients ◽

The Mean ◽

The Right

The aim of this study was to investigate the effects of Cervitec Plus® on the level of mutans streptococcus (SM) and lactobacillus (LB) colonies and the development of white spot lesions (WSLs) in patients with fixed orthodontic appliances. Informed consent was obtained from 32 volunteers (age 16.5 ± 2.75 years). At baseline, levels of the bacterial colonies were determined in saliva and plaque using a chairside test (CRT Bacteria, Ivoclar-Vivadent, Schaan, Liechtenstein), and the number of WSLs was registered. After placing the fixed appliance, Cervitec Plus® or placebo varnishes (Ivoclar-Vivadent, Schaan, Liechtenstein) were applied monthly around the brackets and tubes, randomly in the right or left (test and placebo) quadrants of the same dental arch. SM and LB colonies in saliva and the SM colonies in plaque were determined on 11–21, 13–23, 15–25, and 16–26 teeth monthly over a 6-month period. At the sixth month, the number of new WSLs was determined. By the end of the study, compared with baseline, the ratio of saliva samples belonging to the low-risk category was significantly higher (p ≤ 0.01) from the 2nd month regarding the SM (76 vs. 52%) and LB (69 vs. 52%); reduction of SM in plaque was significantly greater on the test than placebo sides (6.69 ± 1.71 and 4.45 ± 1.60, respectively; p ≤ 0.01). The mean number of new WSLs was significantly lower in the test (0.06 ± 1.60) than in the placebo quadrants (1.13 ± 1.50, p ≤ 0.01). Conclusion: Monthly use of Cervitec Plus® could result in a significant improvement in oral health of orthodontic patients.

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