scholarly journals The Radiological Assessment of Root Features and Periodontal Structures in Endodontically Treated Teeth Subjected to Forces Generated by Fixed Orthodontic Appliances. A Prospective, Clinical Cohort Study

2021 ◽  
Vol 10 (10) ◽  
pp. 2078
Author(s):  
Katarzyna Pustułka ◽  
Agata Trzcionka ◽  
Arkadiusz Dziedzic ◽  
Dariusz Skaba ◽  
Marta Tanasiewicz

The various side effects of orthodontic treatment with fixed orthodontic appliances (FOAs) and their impact on apical and periodontal structures have been widely reported. However, the existing data is not yet conclusive. Aims and objectives: To investigate the status of roots and periodontium in endodontically treated teeth that have undergone orthodontic treatment with the use of FOAs and to evaluate their impact on apical/periodontal structures. Material and methods: The prospective clinical cohort study initially involved 69 participants aged 16–40, without underlying systemic conditions, who received orthodontic treatment with ligatureless FOA systems due to different types of mild and moderate malocclusions. To meet the required criteria, 88 teeth in 34 patients were assessed clinically and radiologically. Participants had at least one tooth treated endodontically while the corresponding tooth from the same anatomical group on the opposite side was vital and intact (a ‘split-mouth’ approach). Four cohorts were allocated: Group IA consisted of 15 teeth, treated utilising the principles of modern endodontics, that were subjected to orthodontic forces no less than six months after completing the root canal obturation. Group I consisted of 13 similarly endodontically treated teeth, which commenced orthodontic treatment at least six months after the completed endodontic therapy. Group II contained 16 teeth treated by conventional endodontic methods and the control group, Group III, contained 44 clinically and radiologically intact teeth (incisors and premolars) with vital and sound dental pulp. The response of apical and periodontal structures to FOAs was determined by data collected from intraoral periapical radiographs taken within the course of five consecutive appointments during the orthodontic treatment. Results: No statistically significant differences were observed in susceptibility to FOA-induced external apical root resorption (EARR) between combined Groups IA + IB and II. An association was, however, demonstrated, between the occurrence of EARR and the degree of expansion of the periodontal ligament (PDL) space, regardless the method of root canal treatment. Cumulative data revealed a positive correlation between the width of the PDL space and the stage of FOA treatment (the third and the fourth appointment). The subtle changes in radiological length of roots have been observed (min 0 mm/max 0.38 mm), particularly between the second and third appointment in Group II (p < 0.05). Conclusions: The standard orthodontic therapy with FOAs is a safe option with predictable outcome for persons who have recently received endodontic therapy. The anterior teeth, predominantly incisors, were more susceptible to minimal EARR than premolars, which suggests that the rate of EARR occurrence may depend upon the original morphology of the apical portion of the root. The use of additional orthodontic forces increases the risk of EARR and is associated with a higher incidence of radiologically detected PDL space widening.

Author(s):  
A. G. Skubitskaya ◽  
I. V. Firsova ◽  
S. V. Poroyskyi ◽  
O. G. Strusovskaya

Relevance. The high necessity in orthodontic treatment among young patients and the use of fixed orthodontic appliances for the treatment of dental pathology are the factors that initiate inflammatory periodontal processes. Timely diagnosis and optimal preventive and treatment procedures can prevent or stop the inflammatory periodontal complications which could have developed during the orthodontic treatment. One of the effective methods for the prevention and treatment of inflammatory periodontal diseases is the use of targeted antimicrobial agents based on medicinal plants that have specific antimicrobial activity against periodontal pathogens. Purpose – to study the effectiveness of the dental gel with barberry extract for the treatment of plaque-induced gingivitis in orthodontic patients during the active phase of the treatment with fixed appliances.Materials and methods. The study included 60 patients (35 women and 25 men) aged 18 to 35 years who had presented for the orthodontic care. The patients undergoing orthodontic treatment with fixed appliances were randomly divided into two groups. In group I, the patients were prescribed applications of a dental gel with barberry extract; in group II, this medication was not prescribed. The clinical condition of the periodontium was assessed with periodontal indices PMA, SBI and OHI-S. The immune status was evaluated by the level of secretory IgA, interleukins (IL-1β and IL-4) and tumor necrosis factor-α (TNF-α). The patients were followed up during 1 month of treatment. The results were statistically processed with Statsoft Statistica 8.0 and Graph Pad Prism 5.0.Results. In group II, the production of immunoglobulin IgA, pro- and anti-inflammatory cytokines was impaired after a month of treatment, associated with a significant deterioration in the oral hygiene status and an increase in PMA (by 3 times), SBI (by 5.3 times) indices. In group II, the oral fluid concentrations of IL-1β, IL-4 and TNF-α significantly differed from those in group I as of the 7th day of the observation period and indicated suppression of the mucosal immunity. Clinical and immune parameters of the group I patients improved and were comparable with the control by the end of the observation month.Conclusions. Patients with dental abnormalities are at risk of developing inflammatory periodontal diseases. The results of the immunological tests, performed during the treatment with the use of a dental gel with barberry extract, demonstrated the recovery of the local immunity, as evidenced by the elevation of secretory immunoglobulin A in saliva and improvement of cytokine profile parameters.


2017 ◽  
Vol 96 (5) ◽  
pp. 547-554 ◽  
Author(s):  
H.F. Saloom ◽  
S.N. Papageorgiou ◽  
G.H. Carpenter ◽  
M.T. Cobourne

Obesity is a widespread chronic inflammatory disorder characterized by an increased overall disease burden and significant association with periodontitis. The aim of this prospective clinical cohort study was to investigate the effect of obesity on orthodontic tooth movement. Fifty-five adolescent patients (27 males, 28 females) with a mean (SD) age of 15.1 (1.7) years and mean (SD) body mass index (BMI) of 30.2 (3.5) kg/m2 in obese and 19.4 (2.2) kg/m2 in normal-weight groups were followed from start of treatment to completion of tooth alignment with fixed orthodontic appliances. Primary outcome was time taken to complete tooth alignment, while secondary outcomes included rate of tooth movement and change in clinical parameters (plaque/gingival indices, unstimulated whole-mouth salivary flow rate, gingival crevicular fluid biomarkers). Data collection took place at baseline (start of treatment: appliance placement), 1 h and 1 wk following appliance placement, and completion of alignment. Results were analyzed by descriptive statistics followed by generalized estimating equation regression modeling. There were no significant differences between groups in time taken to achieve tooth alignment (mean [SD] 158.7 [75.3] d; P = 0.486). However, at 1 wk, initial tooth displacement was significantly increased in the obese group ( P < 0.001), and after adjusting for confounders, obese patients had a significantly higher rate of tooth movement compared with normal-weight patients (+0.017 mm/d; 95% confidence interval, 0.008–0.025; P < 0.001) over the period of alignment. Explorative analyses indicated that levels of the adipokines leptin and resistin, the inflammatory marker myeloperoxidase (MPO), and the cytokine receptor for nuclear factor kappa-B ligand (RANKL) were significantly different between obese- and normal-weight patients and associated with observed rates of tooth movement. This represents the first prospective data demonstrating a different response in obese patients compared with normal-weight patients during early orthodontic treatment. These differences in the response of periodontal tissues to orthodontic force in the presence of obesity have potential short- and long-term clinical implications.


2017 ◽  
Vol 18 (7) ◽  
pp. 587-590
Author(s):  
Mohil M Asnani ◽  
Md Jalaluddin ◽  
Vinod Goyal ◽  
Zuber A Naqvi ◽  
Bhaskar Gupta ◽  
...  

ABSTRACT Intorduction Patients usually undergo orthodontic treatment for achieving ideal interocclusal relationship between the dental tissue and bony tissue along with improving the speech, mastication, and facial esthetic appearance. Literature quotes paucity in the studies evaluating the effect of orthodontic treatment on the periodontal health of endodontically treated teeth. Hence, we planned the present study to assess the effect of orthodontic treatment on the periodontal health of endodontically restored tooth. Materials and methods The present study included assessment of 80 patients who underwent orthodontic treatment. All the patients were divided broadly into two study groups: groups I and II. Group I included patients with the absence of endodontically treated teeth, while group II included patients which maxillary central incisors were resorted endodontically. Examination of the periodontal health of the patients was done using the community periodontal index of treatment need (CPITN) around the selected teeth. All the values were recorded during the preorthodontic time, postorthodontic time, and after the first 6 months of starting of the orthodontic treatment. All the results were recorded separately and analyzed. Results In the groups I and II, 28 and 25 patients respectively, had score of 1, while 10 patients in group I and 12 patients in group II had score of 2. Nonsignificant results were obtained while comparing the CPITN score in between the two study groups when measured at the pre-, intra-, and postortho time. Conclusion In patients undergoing orthodontic treatment, having endodontically resorted teeth, no difference exists in relation to the periodontal health. Clinical significance Orthodontic treatment can be safely carried in patients with endodontically restored teeth. How to cite this article Jalaluddin M, Goyal V, Naqvi ZA, Gupta B, Asnani MM, Sonigra HM. Assessment of the Effect of Orthodontic Treatment on the Periodontal Health of Endodontically Restored Tooth. J Contemp Dent Pract 2017;18(7):587-590.


2018 ◽  
Vol 88 (6) ◽  
pp. 806-811 ◽  
Author(s):  
Ioannis P. Zogakis ◽  
Erez Koren ◽  
Shlomit Gorelik ◽  
Isaac Ginsburg ◽  
Miriam Shalish

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.


2021 ◽  
Vol 15 (2) ◽  
Author(s):  
Mahsa Esfehani ◽  
Bahareh Mohammad Zahraiee ◽  
Sepideh Arab ◽  
Fatemeh Hajmanoochehri ◽  
Mohammadtaghi Vatandoust

Objectives: This study was aimed to assess salivary sodium and potassium concentrations in patients with fixed orthodontic appliances. Methods: In this case-control study, saliva samples (5 cc) were collected from 13 patients with fixed orthodontic appliances before, and 1 week, 1 month and 3 months after the beginning of the orthodontic treatment using the spitting method. Saliva samples were also collected from 10 healthy individuals as controls. The saliva samples were centrifuged at 3000 rpm for 10 minutes and the salivary sodium and potassium concentrations were measured by spectrophotometry. Data were analyzed using independent and paired t-tests. P-value < 0.05 was considered as significant. Results: The salivary sodium and potassium concentrations were almost the same in both groups at baseline (P > 0.05). A significant reduction in sodium and an increase in potassium levels were noted in the case group at 1 week compared with baseline (P < 0.001). At 1 week, the potassium concentration was significantly higher and the sodium concentration was significantly lower in the case group (P < 0.01). The salivary sodium significantly increased while the salivary potassium significantly decreased at 1 month compared with 1 week (P < 0.001). The differences with the control group were also significant (P < 0.05). No significant differences were noted between the two groups at 3 months (P > 0.05). Conclusions: Time has a significant effect on the release profile of sodium and potassium ions from orthodontic appliances. The salivary sodium and potassium concentrations returned to their normal pretreatment values within 3 months after the start of fixed orthodontic treatment.


2014 ◽  
Vol 08 (03) ◽  
pp. 373-380 ◽  
Author(s):  
Fatma Boke ◽  
Cagri Gazioglu ◽  
Sevil Akkaya ◽  
Murat Akkaya

ABSTRACT Objective: The aim of this retrospective study was to evaluate the relationship between orthodontic treatment and gingival health. Materials and Methods: A total of 251 patients among whom 177 were girls and 74 were boys, recruited from the records pool of the Department of Orthodontics, Faculty of Dentistry, University of Gazi, were included in the study. Patients’ treatments have been completed by postgraduate students during the period between 2006 and 2012. Patients’ folders were analyzed according to their age, treatment time, and the type of orthodontic treatment. Intra-oral photographs were analyzed, and the presence or absence of visible plaque, visible inflammation, and gingival recession were recorded, and incisor inclinations analyzed on lateral cephalometric films, before and after orthodontic treatment. Results: No statistically significant difference was found in patients treated with functional appliances before and after treatment. In patients treated with fixed orthodontic appliances, visible plaque, visible inflammation, and gingival recession showed significant increases after treatment, gingival biotype did not show any significant difference. Positive correlation was found between lower incisor position and gingival recession in patients treated with fixed appliance and extraction. And also cuspids were the teeth with the highest prevalence of gingival recession. Conclusion: Considering the relationship between orthodontic treatment and gingival health, cooperation among patients, orthodontists, and periodontists is important.


2019 ◽  
Vol 7 (1) ◽  
pp. 21 ◽  
Author(s):  
Mohammad Imani ◽  
Hamid Mozaffari ◽  
Mazaher Ramezani ◽  
Masoud Sadeghi

Nickel and chromium ions released from fixed orthodontic appliances may act as allergens. This study aimed to systematically review the effect of fixed orthodontic treatment on salivary levels of these ions by doing a meta-analysis on cross-sectional and cohort studies. The Web of Science, Scopus, Cochrane Library, and PubMed databases were searched for articles on salivary profile of nickel or chromium in patients under fixed orthodontic treatment published from January 1983 to October 2017. A random-effect meta-analysis was done using Review Manager 5.3 to calculate mean difference (MD) and 95% confidence interval (CI), and the quality of questionnaire was evaluated by the Newcastle–Ottawa scale. Fourteen studies were included and analyzed in this meta-analysis. Salivary nickel level was higher in periods of 10 min or less (MD = −11.5 µg/L, 95% CI = −16.92 to −6.07; P < 0.0001) and one day (MD = −1.38 µg/L, 95% CI = −1.97 to −0.80; P < 0.00001) after initiation of treatment compared to baseline (before the insertion of appliance). Salivary chromium level was higher in periods of one day (MD = −6.25 µg/L, 95% CI = −12.00 to −0.49; P = 0.03) and one week (MD = −2.07 µg/L, 95% CI = −3.88 to −0.26; P = 0.03) after the initiation of treatment compared to baseline. Corrosion of fixed orthodontic appliances leads to elevated salivary nickel and chromium concentrations early after initiation of orthodontic treatment. Randomized clinical trials controlling for factors affecting the saliva composition are recommended on a higher number of patients and among different ethnicities.


2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Anand Marya ◽  
Adith Venugopal ◽  
Nikhilesh Vaid ◽  
Mohammad Khursheed Alam ◽  
Mohmed Isaqali Karobari

Fixed orthodontic treatment has been compromised at many levels during the pandemic period, as clinics underwent a prolonged lockdown and patients could not be treated regularly. With the end of the pandemic nowhere in sight, may be it is time to put newer tools, such as clear aligner therapy, for better use. Fixed orthodontic appliances by nature are not always self-limiting, which, if left unmonitored over a long period may cause undesirable side effects, pain, and discomfort. The undesired tooth movements that may occur with arch wire-guided mechanics in addition to problems with cut wires or removed brackets may be minimized with the use of aligners. While the benefits of using aligners are for all to see, they do require extensive planning and careful evaluation of the progress. This article reviews the advantages of using aligners during the pandemic period and how it can be beneficial in helping orthodontists resume their practice.


Author(s):  
Hayder F Saloom ◽  
Roshanak Boustan ◽  
Jadbinder Seehra ◽  
Spyridon N Papageorgiou ◽  
Guy H Carpenter ◽  
...  

Summary Introduction This prospective clinical cohort study investigated the potential influence of obesity on orthodontic treatment outcome. Methods A prospective cohort of adolescent patients undergoing routine fixed appliance treatment were recruited into normal-weight or obese groups based upon body mass index (BMI) centile and followed up until the completion of treatment. Primary outcome was treatment duration, and secondary outcomes included treatment outcome (occlusal change measured using peer assessment rating [PAR]), appointment characteristics, and compliance measures. Results A total of 45 patients mean age 14.8 (1.6) years were included in the final analysis. The normal-weight group included 23 patients with mean BMI 19.4 (2.4) kg/m2 and the obese group 22 patients with mean BMI 30.5 (3.8) kg/m2. There were no significant differences in baseline demographics between groups, except for BMI and pre-treatment PAR. The normal-weight group had a mean pre-treatment PAR of 25.6 (8.3) and the obese 33.3 (11.8) giving the obese group a more severe pre-treatment malocclusion (P = 0.02). There were no significant differences in treatment duration between groups (P = 0.36), but obese patients needed less time per each additional baseline PAR point compared to normal weight (P = 0.02). Obese patients also needed less appointments compared to normal-weight patients (P = 0.02). There were no significant differences between groups for appointment characteristics or compliance. Finally, obese patients were more likely to experience a great PAR reduction than normal-weight patients (relative risk = 2.6; 95% confidence interval = 1.2–4.2; P = 0.02). Conclusions There were no significant differences in treatment duration between obese and normal-weight patients. Obesity does not appear to be a risk factor for negative orthodontic treatment outcome with fixed appliances.


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