Bracket Failure in Orthodontic Patients: The Incidence and the Influence of Different Factors

Failure of brackets is a common problem in orthodontics. This affects the treatment time, cost, and compliance of the patient. This study was conducted to estimate the bracket failure rate and the related factors for the long term. Methodology. This ambidirectional cohort study included 150 nonsyndromic orthodontic patients undergoing fixed appliance therapy for the last two years. The same patients were followed for 7 months. Different variables related to bracket failure were evaluated. The available data were analyzed descriptively, and the Kaplan-Meier estimate was used to measure the bracket survival rate from the date of bonding to failure. Results. A total of 180 bracket bond failures in the 150 included patients (52.2% males and 47.8% females) with a median age of 17 years (range 10-25 years). 69% of brackets failures were reported within the first 6 months after bonding. About 58.3% of bracket failure was noticed in adolescent patients before the age of 18 years. The majority of the cohort (81.1%) has good oral hygiene. The failure rate in patients with normal overbite was 41.1%, in decreased overbite cases was 15%, while in deep bite cases the failure rate was 43.9% with a statistically significant difference. Adults show less bracket failure (41.7%) than adolescent patients (58.3%). More bracket failure was noted in the lower arch (55%) than the upper arch (45%), and there were more bond failures posteriorly (61%) than on the anterior teeth (39%). Majority (41.1%) of the bracket failed on round NiTi wires. Conclusion. The bracket failure rate was 6.4%, with most bracket failure occurring in the first 6 months after bonding with individual difference. There was more incidence of bond failure in an increased overbite, adolescents, lower arch, posterior teeth, and lighter alignment wires.

Oral piercings and orthodontic treatment: A questionnaire-based national survey

Objective: To obtain opinions from orthodontic colleagues nationally on how they currently manage orthodontic patients with oral piercings. The secondary objectives were to assimilate the national opinions from the survey and attempt to generate educational material as an advice sheet and a patient information leaflet for the professionals and the patients respectively for the British Orthodontic Society (BOS). Design: Cross-sectional survey. Setting: Primary and secondary care orthodontic providers. Participants: Members of the BOS. Methods: An electronic questionnaire was developed and circulated to members of the BOS to obtain their opinions on the effects of oral piercings on their patients’ orthodontic treatment ‘journey’. In addition, the need for the development of informative material around the management of orthodontic treatment and appliances in patients with oral piercings was explored. Results: A total of 110 responses were received. However, only 88 respondents out of 110 attempted all the questions within the survey. There were 22 respondents who attempted it partially. We did include these partial responses well while analysing the results, since many of these offered personalised comments in the free-text boxes within the survey. Conclusion: The most common general complications associated with oral piercings were inflammation of the surrounding tissue and enamel/dentine wear. Moreover, orthodontic complications, reported commonly, were inadequate oral hygiene maintenance, entanglement with the orthodontic appliance causing damage and interference with retainers. Most respondents expressed the need for the development of a web-based patient information leaflet and an advice sheet as educational tool, both of which have been proposed to and agreed by the BOS before submission of this publication.

Ectopic Eye Tooth Management: Photobiomodulation / low-level Laser Emission Role in Root Resorption After Fixed Orthodontic Treatment

The orthodontic treatment brings numerous benefits and, in most cases, the benefits outweigh the possible disadvantages. Root resorption (RR) is a common adverse phenomenon associated with orthodontic treatment. This study evaluates the role of low-level laser emission / Photobiomodu-lation (LE/P) in quantitative measurements of root resorption (QRR). The application of LE/P was done after each orthodontic activation with 4 types of treatment intervention (TI) on the RR after fixed orthodontic treatment (FOT) of the upper arch with ectopic eye tooth/teeth [EET]. 32 Orthodontic patients scheduled for FOT were selected and assigned to the 4 groups. These were LE/P+Self ligating bracket (SLB), LE/P+Conventional bracket (CB), Non-Photobiomodulation (non-LE/P)+SLB, and non-LE/P+CB. Standard management stages of FOT were followed in the maxilla. Each patient received a single application of LE/P labially/buccally and palatally, a total of 5 different points during each activation or appointment. The main outcome measure was QRR in maxillary anteriors before and after FOT assessed via cone-beam computed tomography (CBCT) using 3D OnDemand software. Insignificant QRR was found between before and after FOT in SLB, CLB, and LE/P, non-LE/P groups (p > 0.05). QRR in the SLB vs CB and LE/P vs non-LE/P group was significantly different in 11, 13, and 23 (p < 0.05). QRR in the LE/P+SLB group (p < 0.05) was significantly different in 11, 13, and 23 than that in the other groups. The most severe QRR was found on the 13 (0.88 ± 0.28mm and 0.87±0.27mm) and 23 (1.19 ± 0.14 mm and 1.16±0.13mm) in the CB and non-LE/P group (p < 0.001). LE/P+SLB showed highly significant superior outcome (p < 0.001) in relation to non-LE/P+CB, the QRR of 23 were 0.813± 0.114mm and 1.156± 0.166mm respectively. Significantly higher amount of QRR found in EET patients after FOT treated with the CB, non-LE/P, and non-LE/P+CB system and warrants further investigation to explore potential specific causes.

Mesiodistal dimensions of teeth in Serbian orthodontic patients with hypodontia

Introduction/Objective. Hypodontia is a common dental anomaly that occurs either in a non-syndromic form or as a part of various syndromes. It is considered a multifactorial condition with genetic, epigenetic and environmental influences, the interplay of which can lead to various anomalies in tooth size and number. The aim of this study was to assess mesiodistal tooth dimensions in Serbian hypodontia orthodontic patients and compare them to healthy controls using digital study models. Methods. Fifty subjects (30 females, 20 males) divided into two groups - 25 with hypodontia (15 females, 10 males) and 25 gender-matched controls (15 females, 10 males) were included in the study. Alginate impressions were taken and plaster models poured, digitized and imported into the software where mesiodistal dimensions were obtained. Results. Intra-operator reliability was high. All teeth in the hypodontia group had smaller mesiodistal dimensions compared to controls. Statistical significance was noted for all teeth except for upper canines. No statistically significant differences were found between males and females in neither the hypodontia nor the control group, except for lower canines, which were significantly smaller in both hypodontia and control females. The most commonly missing teeth were upper lateral incisors, and lower and upper premolars. Conclusion. Hypodontia group presented with smaller mesiodistal dimensions compared to controls. The greatest difference in mesiodistal dimensions was found in upper lateral incisors and lower first molars. Lower canines were significantly larger in males compared to females in both groups.

Alveolar Bone Morphotype in Orthodontic Patients

Orthodontic treatments have been described as a risk factor for the development of gingival recessions. This descriptive and cross-sectional study was performed to evaluate the alveolar bone morphotype of the upper and lower anterior of 33 orthodontic treatment of candidate patients. The images were obtained from a high-resolution cone beam computerised tomography. Then, the thickness of the alveolar bone plate of teeth was measured in six levels, recording the presence of dehiscences and fenestrations. A total of 2,334 sites were evaluated. The average thickness of the maxillary alveolar bone at the buccal surface was 0.70, 0.62 and 1.43 mm at the cervical, middle and apical levels, respectively, while in the mandibular teeth it was 0.53, 0.50 and 2.96 mm. At the palatal and lingual surfaces, the bone was thicker than the buccal except at the apical level of the mandible. Most of the examined sites were measured less than 1 mm (n = 1,235, 52.9%), associated with high prevalence of bone dehiscences (57.6%) and fenestrations (33.3%), particularly in skeletal Class III patients. The observed bone morphotype involved a high vulnerability to bone resorption, and the subsequent gingival recession occurrence, face to orthodontic movements.

Dental Psychological Stress or Phobia among Orthodontic Patients of Mardan

Objective: To assess the psychological stress or phobia due to dental procedure among patients. Study Design: Descriptive cross-sectional study Place and Duration of Study: Department of Orthodontic, Bacha Khan College of Dentistry/Medical Teaching Institute, Mardan from 1st January 2020 to 31st August 2021. Methodology: One hundred and twenty patients coming for orthodontal treatment with age between 12-31 years were enrolled. The demographic and psychological stress information was recorded. Results: There were more females (65%) than males (35%). The mean age was 15.5±3.2 years. About 82.5% patients reported high level of psychological stress or phobias towards dental treatments while 19.1% were those who had moderate psychological stress or phobias. Majority of the patient’s fear of pain was between 12-17 years. Patients having highest anxiety also belonged to the same group Conclusion: Dental phobias and fears are widespread among patients seeking dental treatments. Orthodontists should recognize the dental phobias and fears so they efficiently interconnect with the patients. Key words: Orthodontic treatment, Pain, Dental phobia