Mechanical Properties and Clinical Significance of Orthodontic Wires

Orthodontic treatment is usually conducted by applying forces to certain teeth to move them into a targeted position. Orthodontic wires have been reported to be the primary modalities used in fixed-appliances-based orthodontic treatment to induce favorable tooth movement events. Accordingly, acquiring adequate knowledge about these approaches' clinical applications and biochemical behavior is essential when planning for a successful orthodontic treatment. Orthodontic wires are widely used and are mainly composed of composites, polymers, alloys and metals. Accordingly, the physical properties and clinical application of orthodontic wires vary based on their composition. In this context, it was recommended that achieving favorable outcomes of orthodontic treatment obliges clinicians to decide the best orthodontic wire and treatment plan based on the chemical properties and related clinical applications of each wire. Therefore, wires that tend to produce increasing stiffness gradually are generally used. However, it should be noted that no ideal wire exists. Therefore, favoring the application of a wire over the other should be based on the intended outcomes and stage of the treatment process.

The effect of orthodontic treatment with fixed appliances on sleep quality in adults and adolescents in Saudi Arabia using Pittsburgh sleep quality index

Objectives: The aim of this study was to investigate the effect of pain caused by orthodontic fixed appliances on sleep quality of participants using the Pittsburgh Sleep Quality Index (PSQI). Materials and Methods: A previously validated Arabic version of PSQI was electronically distributed through different social media platforms and in waiting areas of orthodontic offices. Eligibility criteria included healthy adults and adolescents with orthodontic fixed appliances and with no systemic conditions that may affect sleep. The cut-off point used to determine poor sleep quality was (>5). Results: Three hundred and eighteen participants were included in the final analysis (28.9% males and 71.1% females). Both males and females with orthodontic fixed appliances had poor sleep quality with (Mean = 6.48, SD = 2.85, P = 0.000) for males, and (Mean = 7.18, SD = 2.87, P = 0.000) for females. Comparing males and females, we found that females scored higher than males in both subjective sleep quality and PSQI global score. Conclusion: Individuals undergoing orthodontic treatment with fixed appliances have poor sleep quality. Females undergoing orthodontic treatment tend to have poorer sleep quality compared to males.

Determination of Most Frequent Emergencies in Patients with Fixed and Removable Orthodontic Appliances at Tertiary Care Dental Hospital

OBJECTIVES: To determine the frequency of emergencies in patients with fixed and removable orthodontic appliances at tertiary care dental hospital. METHODOLOGY: A questionnaire was designed for this descriptive cross-sectional study to be filled by the clinician (L3/L4 FCPS resident) at the end of addressing every orthodontic emergency. Sampling was done under consecutive non-probability protocols. Descriptive statistics were applied to determine the frequency of different orthodontic emergencies, and Pearson’s chi-square test was applied to determine association of emergencies with gender and etiology of emergency (patient related vs operator related). Data was analyzed on SPSS version 20. RESULTS: A total of 175 patients reported with orthodontic emergencies. The sample comprised 38.3% males and 61.7% females. Most frequent orthodontic emergency reported was deboned brackets in fixed appliances, while the most common emergency in removable appliances was traumatic PNAM. A statistically significant association (Pearson’s Chi Square=4.74, Cramer’s V=0.165, p=0.029) was seen for removable and fixed appliance emergencies with males and females. CONCLUSION: Most frequent fixed appliance orthodontic emergencies were deboned brackets while for removable appliance emergencies were trauma due to PNAM. Emergencies with removable appliances were mostly due to the operator related factors, while in fixed appliances patient related factors were dominating.

Detailed three-dimensional orthodontic tooth repositioning to improve restorative outcome:

ABSTRACT The case describes the interdisciplinary treatment of a 23-year-old woman with a Class III malocclusion, missing an upper right lateral incisor, abrasion of the maxillary incisal edges, anterior gingival margin discrepancies, and gingival recession. Initially, the patient was treated with fixed appliances combined with orthognathic surgery. The extraction of the upper left lateral incisor and bilateral canine substitution plan was chosen. At the end of the surgical and orthodontic treatment, the restorative treatment with six veneers was accomplished to improve smile esthetics. Despite the missing lateral incisors, the patient showed a natural, good-looking final result. A symmetric incisal plane was established, a functional occlusion with average vertical and horizontal overlap was set, and the bone scallop and consequently the gingival margins were leveled. The interdisciplinary approach hid all of the initial esthetic defects of the case. The result highlights how to obtain a remarkable improvement of the smile outcome with a well-functioning masticatory system.

Clear Aligners in Patients with Amelogenesis and Dentinogenesis Imperfecta

Dentinogenesis imperfecta (DI) and amelogenesis imperfecta (AI) are hereditary abnormalities of dental hard tissues. Dental abnormalities may also be accompanied by symptoms of disorders such as osteogenesis imperfecta. AI and DI have a significant burden on socializing, function, and comfort; therefore, frequent screening and accurate diagnosis is the cornerstone of managing such conditions. Both AI and DI could be treated with many strategies, including restorative, prosthetic, periodontal, surgical, and orthodontics treatment. The interdisciplinary combination of orthodontic, prosthodontic, and periodontic treatment has been proven to improve the prognosis of AI and DI. Regarding orthodontic treatment, the most difficult element of orthodontic therapy may be maintaining a high level of motivation for what might be a prolonged form of treatment spanning several years. There are many forms of orthodontic management for AI and DI, including removable appliances, functional appliances, and fixed appliances. Clear aligner therapy (CAT) contains a broad range of equipment that works in different ways, has different construction processes, and is compatible with different malocclusion procedures. The application of CAT in patients with AI and DI is favorable over the fixed applicants. However, the available evidence regarding the application of CAT in AI is weak and heterogeneous. In this review, we discussed the current evidence regarding the application of clear CAT in patients with AI and DI.

Comparing occlusal contact quality after aligner and fixed appliance treatment using computerized occlusal analysis during 6 months of retention

Objective Less than ideal contacts have been reported following aligner therapy, which is believed will resolve with settling, despite settling improving occlusal balance has not been scientifically confirmed. The aim of this study was to compare the outcome quality of occlusal contacts in patients treated with fixed appliances or clear aligners. Methods 39 orthodontic patients (14 treated with aligners; 25 with fixed appliances) were evaluated with a digital occlusal analysis system (T-scan10 ™), assessing Maximum Intercuspation contact simultaneity, symmetry, and relative force distribution. The Occlusion Time, the Right/Left force percentage (%R/L), the Anterior/Posterior contact ratio (RAP), and the anteroposterior Center of Force (COF) locations were recorded at treatment completion, and 3 and 6 months after. Results No significant differences in measured occlusal contact quality parameter were found between groups at treatment completion or follow-up (OT, %R, RAP nor COF position). The COF moved posteriorly and remained stable after 3 months, near to the first molar, but was located more anterior in females (p= 0.01). 10 patients finished treatment with marked asymmetry, (%R/L > 50±10%), especially in the fixed appliance group (9/25 =3 6%) versus the aligner group (1/14 = 7%). 1/3 of all patients (both groups combined) after 6 months retention had %R/L imbalances > 50±10%. Conclusions Occlusal contacts were comparable at completion of treatment with aligners or brackets and after 3-6 months of retention. Contacts increased in the posterior region with time, but settling did not improve marked asymmetry in all patients.

Differences in finished case quality between Invisalign and traditional fixed appliances:

ABSTRACT Objectives To compare the treatment and posttreatment effects of Invisalign aligners that incorporated SmartForce features and attachments to traditional fixed appliances. Materials and Methods This randomized controlled trial included 66 patients, 32 aligners, and 34 fixed-appliance patients. The median ages of the aligner and braces patients were 26.7 (interquartile range [IQR]: 9.8) and 25.9 (IQR: 16.6) years, respectively. Pretreatment occlusion was assessed using the ABO Discrepancy Index. Posttreatment (T1) and 6-month retention (T2) occlusions were quantified using the ABO Objective Grading System (OGS) scores. Results The braces group finished treatment significantly (P < .001) earlier (0.4 years) than the aligner group. The median DI scores for the aligner and braces groups were 4.5 and 7.0, respectively, which was a statistically significant (P = .015), but clinically insignificant, difference. There were no statistically significant between-group differences for the total OGS scores or any of the individual component scores at debond (T1) or after 6 months of retention (T2). During the posttreatment period, alignment and overjet worsened significantly in the aligner group, while buccolingual inclinations and occlusal relations improved. Over the same period, alignment worsened in the braces group and buccolingual inclinations improved. There was no statistically significant between-group difference in posttreatment changes of the total OGS scores. Conclusions While patients with simple malocclusions require 4.8 months longer treatment times with aligners than traditional braces, the treatment and 6-month posttreatment occlusal outcomes are similar.