Effects of Low-Level Diode Laser on the Level of Interleukin 1-Beta in the Gingival Crevicular Fluid and the Incidence of Gingivitis Caused by the Use of Orthodontic Separators: A Randomized Clinical Trial

Background: In recent years, there has been an increased tendency for using dental lasers for the treatment of soft tissue problems. The aim of this study was to evaluate the effect of low-level diode laser (980 nm) on the level of interleukin 1 beta (IL-1β) in the gingival crevicular fluid (GCF) and the incidence of initial gingivitis caused by the use of orthodontic separators. Methods: In this randomized clinical trial, 30 patients, who were beginning a fixed orthodontic treatment without gingivitis, were randomly assigned to control and diode laser radiation (980 nm wavelength, 3 J of energy, a density of 3 J/cm2 , a power of 0.2 W, and at a distance of 1 cm away from the tissue for 15 seconds on the buccal and palatal sides of the tooth) groups. The gingival index (GI) and bleeding on probing (BOP) were measured at the beginning of the study and one week after the treatment. The level of IL-1β was evaluated using an enzyme-linked immunosorbent assay at the beginning of the study and one week after the placement of the separator. Finally, the inter-group and intra-group statistical analyses were performed using independent and paired t tests, and P<0.05 was considered as the significance level. Results: The evaluation of clinical variables in the entire mouth showed a slight clinical improvement in the experimental group although there was no significant difference between the two groups. No significant difference was observed between intra-group and inter-group evaluations of clinical indices in the studied specific teeth. Eventually, no difference was found between the two groups in terms of IL-1β changes. Conclusions: In general, the single-diode laser radiation session is not effective in the treatment of gingivitis in patients undergoing orthodontic treatment. Thus, it is recommended to perform frequent laser radiation sessions in further studies.

Floss abrasion: a cautionary tale

Background The Hall technique for placement of preformed metal crowns is widely used in the UK for the management of decayed primary molar teeth. The creation of space is achieved by the placement of orthodontic separators adjacent to the tooth requiring restoration. Highlighting the first reported case of an abrasion caused by dental floss, this communication describes the clinical findings of an 8-year-old patient following placement of orthodontic separators. Case report An 8-year old boy attended the University Dental Hospital of Manchester for placement of orthodontic separators prior to restoration URE, ULE, LLE, and LRE with preformed metal crowns using the hall technique. The following week he presented with a 2cm abrasion to his right cheek, which had been caused by dental floss used in placement of the orthodontic separators. Follow up Conservative advice was given and the lesion had resolved completely at a 2-week review. Conclusion This case is a timely reminder of the importance of adequate lip retraction and soft tissue management during placement of orthodontic separators.

Pain in Separation of the Molars among the Orthodontic patients

Introduction: Pain has been the most common and foremost reason for discontinuing the orthodontic treatment. The patients usually experience pain in Orthodontic treatment during separator placement, wire placement, headgear wear, and rapid palatal expansion. Placement of orthodontic separators (brass wire, elastomeric, spring-type steel separators, and latex elastics) results in a painful experience. Therefore the purpose of the study is to assess the pain perception among the patients seeking orthodontic treatment. Methods: This study was carried out amongst 120 (53 male and 67 female) patients seeking orthodontic treatment. Elastomeric separators were placed mesially and distally to the first molars and the participants were given a self-administrated Universal pain assessment Tool to document perceived pain and pain upon chewing, using a visual analog scale for seven days. Total scores were calculated and descriptive statistics in the form of a number (mean) and percentage were calculated. Results: This study showed a mean score for perceived pain of each day to be 7.16, 7.1, 6.05, 4.67, 3.69, 2.88, and 2.27 respectively with a mean of 4.831 +/- 1.273. Similarly, the mean score for pain on chewing was 8.21, 7.53, 6.62, 5.19, 4.38, 3.65, and 3 with a mean of 5.5119 +/- 1.269. Conclusions: There was a significant difference in pain perception among the male and female participants, females having higher pain perception. There was a significant difference in pain perception between the Adolescent and Adult in both normal life and during eating.

EVALUATION OF ECTOPIC ERUPTION IN TEETH’S OF CHILDRENS FROM 5 TO 12 YEARS AGE GROUP

Treatment is advised to guide the tooth into a more favorable path of eruption to minimize damage to affected dentition, preserve arch length, and to maintain function. Without intervention, sequelae can include premature loss of the anteriorly affected tooth, tipping and rotation of the ectopic molar, space loss and malocclusion. Treatment will depend upon the severity of the impaction. Mildly to moderately impacted molars can be guided easily with elastic orthodontic separators. More severe impactions require more complex treatment options, including potential extraction of the anteriorly affected tooth, removable or fixed appliances, or surgical uprighting. The present study was planned for evaluation of Evaluation of Ectopic Eruption in Teeth’s of Childrens from 5 to 12 Years Age Group. The present study was planned in Department of Orthodontics, Patna Dental College and Hospital, Patna. Total 50 childrens referred to Department of Orthodontics were evaluated for the ectopic eruptions. All the radiographs were compared in each patient, along all the usual followup time. To rule out the possibility of error due to radiographic magnification, the crown measurements in bitewing radiographs and in dental casts were compared, and no significant differences were present. Early intervention of ectopically erupting first permanent molars is very crucial to avoid complex orthodontic treatment later on. Ectopic eruption of individual teeth tend to occur as often bilaterally as unilaterally in the same arch, except for mandibular central incisors, first molars and mandibular canines. Early diagnosis and interception of ectopically erupting teeth will allow us in preventing more complicated malocclusions in future. Keywords: Eruption problems, Ectopic eruption, Permanent teeth, etc.

Perception of Pain resulting from Orthodontic Separators in Orthodontic Patients Visiting Dental Department at a Private Hospital

Pain is a response, which varies from one individual to another. Factors such as age, gender, magnitude of force applied, emotional status, individual pain threshold, etc., might affect pain. Patients who desire for orthodontic treatment are often afraid of having pain and discomfort during various stages of orthodontic treatment. This has become one of the most commonly reported complaint and reason for discontinuing orthodontic treatment. This study aims at examining the intensity of pain in orthodontic patients’ experience following the insertion of separators attending Department of Orthodontics in Nepal Medical College. Eighty six patients (26 males and 60 females) who came to department of orthodontics for fixed orthodontic treatment were selected with age range of 15-26 years. Elastomeric separators were placed mesially and distally to the upper and lower first permanent molars in all patients. Following placement of separator, the patients were given self‑administrated questionnaires and they were properly instructed on how to answer the questions. Descriptive statistics of different factors for pain perception were assessed using SPSS 16. Most of the patients had pain on second day of separator placement and among them females experienced more pain than males. Then pain slowly decreased after day 3 and disappeared after day 5. More females experienced continuous type of pain and took analgesics compared to males. Results showed that pain began a few hours after application of orthodontic force and lasted for around 5 days. Most of the patients reported pain during eating and chewing on second day and had to change their food habits into softer one. Younger age group patients experienced more pain compared to older age groups.