Management of a Patient with Angle Class I Malocclusion with Anterior Crossbite and Maxillary Central Diastema Caused by High Attachment of the Maxillary Labial Frenulum

Maxillary Central diastema is common and normal for the growth and development of the anterior segment. If the central diastema persists after the eruption of the permanent cuspids, the orthodontist should clarify the etiology and establish a treatment plan. This case report discusses a 22-year-old woman with anterior crossbite and central diastema due to a high maxillary labial frenulum attachment. Treatment was performed using a fixed orthodontic appliance with a posterior bite raiser. Frenectomy was performed at the end of the orthodontic treatment.

COMPARISON FOR CARICA PAPAYA AND GENGIGEL LEAVES EXTRACTION FOR GINGIVITIS HEALING EFFECTIVENESS IN ORTHODONTIC APPLICATION

Background: Gingivitis is the infection disease with tooth loss effect. Using fixed orthodontic appliance in dentistry can give gingivitis impact with its’ designed way. To determine the effectiveness of papaya leaf extraction and gengigel in gingivitis treatment with fixed orthodontic application in letrature review explanation Methods: Literature searching with Science Direct, NCBI (PubMed), and Google Scholar databases and getting 530 articles. Articles are screened to be 67 articles and selected by inclusion and exclusion criteria getting 37 articles. 37 Articles are ready to be analysed. Results:There is effectiveness of papaya leaf extract and gengigel in patients using fixed orthodontic appliances for giving anti inflammation effect, wound healing and enhance blood circulation. Conclusion: The conclusion is papaya and gengigel leaf extraction giving gingivitis healing effect in fixed orthodontic treatment

Interdisciplinary Orthodontic Treatment to Reestablishment Smile Function and Aesthetics

Extrusive tooth movements are an important resource in orthodontic treatment and allow the manipulation of teeth and periodontal tissues. They can be performed quickly or slowly, depending on the patient’s need. Rapid extrusion is indicated for cases in need of prosthetic preparation or restoration, where the bone and gingival tissues are intact, such as horizontal and oblique fractures, coronary or external root resorption, iatrogenic perforations (trepanations) and the presence of subgingival caries. The aim of this study is to describe the treatment of a patient who had a coronary fracture of the right upper central incisor, with a limit located 1 mm above the level of the bone crest. Rapid orthodontic extrusion was performed, to restore biologic distances and allow the preparation for prosthesis. It started with partial differentiated bonding of a fixed orthodontic appliance to the upper arch, to allow for a 3mm orthodontic extrusion. At the end of the extrusion, periodontal surgery was performed to increase the clinical crown and endodontic treatment. After these procedures, the case was concluded with the fixed prosthesis installation. The realization of an integrated planning allowed the restoration of aesthetics, with preservation of the functional periodontal limits for the patient. Keywords: Tooth Movement Techniques. Orthodontic Extrusion. Crown Lengthening. ResumoOs movimentos dentários extrusivos constituem um recurso importante no tratamento ortodôntico e permitem a manipulação dos dentes e dos tecidos periodontais. Eles podem ser realizados de forma rápida ou lenta, dependendo da necessidade do paciente. A extrusão rápida está indicada para casos com necessidade de preparo protético ou restauração, onde os tecidos ósseo e gengival encontram-se íntegros, tais como fraturas horizontais e oblíquas, reabsorções coronárias ou radiculares externas, perfurações iatrogências (trepanações) e presença de cárie subgengival. O objetivo deste trabalho é descrever o tratamento de uma paciente que apresentava fratura coronária do incisivo central superior direito, com limite localizado 1mm acima do nível da crista óssea. Realizou-se extrusão ortodôntica rápida, com a finalidade de restabelecer as distâncias biológicas e permitir o preparo para prótese. Iniciou-se com colagem diferenciada parcial de aparelho ortodôntico fixo no arco superior, para permitir a extrusão ortodôntica de 3mm. Ao término da extrusão, realizou-se cirurgia periodontal para aumento da coroa clínica e tratamento endodôntico. Após esses procedimentos, o caso foi finalizado com a instalação da prótese fixa. A realização de um planejamento integrado permitiu o restabelecimento da estética, com preservação dos limites periodontais funcionais para a paciente.Palavras-chave: Técnicas de Movimentação Dentária. Extrusão Ortodôntica. Aumento da Coroa Clínica.

Diet and orthodontics- A review

During the course of fixed orthodontic therapy, patients should be instructed to eat specific food stuffs and beverages in order to maintain good health for the dentition and supporting structures and prevent frequent attachment debonding that prolong the treatment duration. After searching and collecting articles from 1930 till July 2021, the current review was prepared to emphasize various types of foods that should be taken during the course of fixed orthodontic therapy and to explain the effect of various food stuffs and beverages on the growth and development of craniofacial structures, tooth surfaces, root resorption, tooth movement, retention and stability after orthodontic treatment and the effect on the components of fixed orthodontic appliance.

Assessment of Gingival Health Status among Patients with Fixed Orthodontic Appliance

Fixed orthodontic appliances corrupt plaque removal, proper oral hygiene, and gingival health so periodontal evaluation is important to be checked in every appointment. The aim of the present study was to assess gingival health among patients with a fixed orthodontic appliance. A clinical comparative study conducted on 25 patients with an aged ranged from 15 to 25 years. Clinical parameters included plaque index (PI), gingival index (GI), and bleeding on probing (BOP) were recorded at base line before starting orthodontic treatment and after 1 month of treatment. A double paired t-test was applied to the data collected for statistical analysis. The mean value of PI (1.11), GI (1.155), and BOP (0.600) scores was increased after placement of fixed orthodontic appliance, but with no statistically significant difference with base line for PI (P-value = 0.596), GI (P-value = 0.355), and BOP (P-value = 0.256), respectively. Regarding age group, mean PI (1.46), GI (1.22), and BOP (0.875) were increased with increasing age, patients who age’s ≥20 showed statistical significant difference for gingival and plaque means P-value = 0.006 and P-value = 0.03) for ≥20, respectively. The finding of this study had shown that patients with fixed orthodontic appliances had non-significant increase in the mean value of plaque, gingival, and BOP indices scores. All mean scores were increased with increasing age, but with non-significantly for BOP only.

Comparative Evaluation of Effect of Excessive Adhesive Flash Formed from Two Orthodontic Adhesives on Clinical Periodontal Status of Patients Undergoing Fixed Orthodontic Appliance Therapy

BACKGROUND Increased accumulation of dental plaque and inflammatory response during treatment is due to the appearance of new retentive places around the components of fixed appliances attached to the teeth. During bonding procedures, there is certain amount of adhesive left on the tooth surface invariably around the margins between bracket and enamel interface called excessive adhesive flash (EAF), which may act as a plaque retentive area. We wanted to evaluate and compare the effect of EAF formed from two different orthodontic bonding adhesives on clinical periodontal status of patients undergoing fixed orthodontic appliance therapy. METHODS 20 patients indicated for treatment with fixed stainless steel preadjusted edgewise appliance were selected for the study. A split mouth design was followed where each patient’s teeth were divided into 2 groups; Group A: Teeth of right side bonded with non-tooth coloured orthodontic adhesive resin (Transbond XT Plus) – 1st and 4th quadrants; Group B: Teeth of left side bonded with tooth-coloured orthodontic adhesive resin (Transbond XT) - 2nd and 3rd quadrants. Clinical periodontal status was assessed by measuring Muhlemann modified papillary bleeding index, Turesky Gilmore Glickman modification of Quigley Hein Plaque Index, and a modification of the Orthodontic Plaque Index, before bonding (T0) and 1 week after bonding the appliance (T1). RESULTS Readings at T1 had significantly increased compared to T0 indicating increased plaque retention. However, difference between the indices for both groups at T1 was not statistically significant. CONCLUSIONS The excessive adhesive flash is a site for increased plaque accumulation, irrespective of the composite being tooth coloured or non-tooth coloured. KEY WORDS EAF, Adhesives, Split Mouth

Identification of bone morphogenetic protein 4 in the saliva after the placement of fixed orthodontic appliance

Background This study was conducted in order to explore the effects of orthodontic tooth movement (OTM) on the changes of salivary proteome. This prospective observational pilot study recruited 12 healthy teenage boys with malocclusion treated with a fixed orthodontic appliance and 6 appropriate control participants. Saliva samples were collected a day before and at 0, 2, 7, and 30 days after initialization of treatment, corresponding to the initial, lag, and post-lag phases of OTM. Pooled samples were analyzed by liquid chromatography-mass spectrometry, ELISA, and Western blotting. To date, there is no published data on the presence of BMP molecules or their antagonists in the saliva or in the gingival cervical fluid related to orthodontic conditions. Results A total of 198 identified saliva proteins were classified based on their functional characteristics. Proteins involved in bone remodeling were observed exclusively 30 days post appliance placement, including bone morphogenetic protein 4 (BMP4), a BMP antagonist BMP-binding endothelial regulator, insulin-like growth factor-binding protein 3, cytoskeleton-associated protein 4, and fibroblast growth factor 5. Based on the analysis of protein interactions, BMP4 was found to have a central position in this OTM-related protein network. Conclusions The placement of a fixed orthodontic appliance induced occurrence of proteins involved in bone remodeling in the saliva at a time corresponding to the post-lag period of OTM. Limitations of this study include a relatively small sample size, limited time of monitoring patients, and the lack of interindividual variability assessment.

Adjunctive orthodontic management of a missing upper right central incisor in a 12-year-old male using a fixed orthodontic appliance

This article presents a successful orthodontic management of a 12-year-old male using a fixed orthodontic appliance (straight wire technique). His orthodontic treatment was hinged on creating enough space to accept an artificial tooth, correcting the horizontal and vertical relationships of the upper incisors to the lower and the midline shift. Ultimately, an esthetic smile was achieved; function and self-esteem were improved when the artificial tooth was finally fixed.