Fixed Orthodontic Retentions from Orthodontists’ Perspectives (A Qualitative Study)

Objective: This study aimed to investigate orthodontists' perspectives and experiences with fixed orthodontic retention, emphasizing its effectiveness, challenges, and recommended practices. It aimed to uncover the factors that influence the selection and management of fixed retainers and their impact on patient care. Methods: To select experienced orthodontists, a qualitative study design with purposive sampling was employed. Structured interviews were conducted with 15 participants, and verbal responses were recorded using phone sound recorders. The recordings were transcribed verbatim and analyzed through thematic analysis. Data collection and analysis were carried out simultaneously to ensure data saturation, which was reached after 15 interviews. Results: Thematic analysis identified eight key themes: perceptions of fixed retainers, patient compliance and education, technological and practical considerations, long-term outcomes and follow-up, treated malocclusion types, professional development and continuing education, multidisciplinary collaboration, and patient-centered care. Fixed retainers are generally regarded as effective for maintaining alignment, particularly in cases where patient compliance is less critical, making them preferable to removable retainers in specific scenarios. However, concerns were noted regarding potential drawbacks, such as maintenance challenges, increased plaque accumulation, and difficulties achieving long-term success. Enhancing compliance and retainer effectiveness requires educational initiatives and technological advancements. The type of malocclusion significantly influences the choice of fixed retainers, especially in cases involving generalized spacing or severe rotations. Ongoing professional development, multidisciplinary collaboration, and patient-centered strategies are essential for providing tailored treatment plans and improving patient satisfaction. Conclusions: This study highlights the complex dynamics of fixed orthodontic retention and introduces Structured-Self-Reply (SSR) interviews as a novel qualitative data collection method. Successful retention strategies necessitate integrating advanced technology, patient education, consideration of malocclusion types, and multidisciplinary collaboration. Addressing these elements can lead to improved patient outcomes and greater overall effectiveness of orthodontic treatment. Future research should explore cost-effective retention methods, long-term outcomes, and approaches to enhance patient adherence to retention protocols

Assessment of the Effect of the Degree of Root Canal Taper on the Fracture Resistance of Endodontically Treated Teeth: An In Vitro Study

Objective: To evaluate and compare the fracture resistance of endodontically treated mandibular premolars using two different root canal preparation tapers. Methods: Eighty extracted single canal mandibular premolars were used. The specimens were sectioned for 13-mm roots. Then, all samples were randomly divided into four root canal preparation groups (n=20). Group 1 (n=20): Unprepared (control group). Group 2: A. (n=10) and B.(n=10), preparations with RACE EVO (FKG Dentaire SA, La Chaux de Fonds, Switzerland) rotary instruments up to size 30 taper 0.04, and size 30 taper 0.06, respectively, without obturation. Group 3 (n=20) and Group 4 (n=20): preparations with RACE EVO rotary instruments up to size 30 taper 0.04 and size 30 taper 0.06, respectively, then obturated with AH plus sealer by single cone obturation technique. Mechanical vertical compression testing with a universal testing machine exposed the samples to axial forces. Testing continued at 1 mm/min until samples shattered. The results were statistically analyzed by One-way ANOVA (p 0.05). Results: Different root canal taper preparations did not alter the fracture resistance of endodontically treated teeth in this study. G 1 had the strongest fracture resistance (898.00 N), whereas G 4 had the lowest (763.00 N). The groups did not vary statistically (P 0.05). Conclusions: Root fracture resistance was unaffected by root canal preparation tapers. Conversely, the taper 0.06 preparations group had the least fracture resistance. The most unrepairable type III fractures were in taper 0.06 preparations

Evaluation of Root Canal Morphology of Maxillary Permanent Premolars in Iraqi Subpopulations by Cone-Beam Computed Tomography

Objective: The aim of the present study is to assess the root and root canal morphology of maxillary first premolars (MFP) and maxillary second premolars (MSP) using cone beam computed tomography (CBCT) in an Iraqi subpopulation. Methods: One thousand five hundred and forty-eight maxillary permanent premolars (774 MFP and 774 MSP) from 387 CBCT scans with 182(47.03%) males and 205 (52.97%) females. The number of roots, orifices, and canal configuration were analyzed as frequencies and percentages using Vertucci’s classification. A Chi-square test was used to find the effect of gender and location on number of canals, orifices and root canal anatomy. Results: Most of the MFP had two roots (%60.9) and two orifices (87.6%) compared to MSP which had more one root (85.5%) and one orifice (73.8%). There was significant relation of gender to the number of the roots in both MFP and MSP (p 0.05), with single root premolars more frequent in females. In regard to Vertucci’s classification, type IV was the most frequent configuration in MFP (58.8%), whereas in MSP, type I configuration recorded the highest percentage (64.3%). Conclusions: Good knowledge of the root canal configuration is one of the most significant factors for successful root canal treatment. Most MFP had two roots, with Type IV being the most predominant canal configuration, whereas the majority of MSP had one root with Type I canal configuration

Comparative Evaluation of Polishing-Induced Enamel Surface Roughness: An In Vitro Study

Objective: This study was formulated to examine the effect of different polishing modalities and observing the amount of enamel surface roughness induced by each of these polishing devices. Methods: Fifty- five bovine central incisors were used in the study. The design of the study includes 5 groups and each group contains 11 samples: Group 1 Aquacare air polisher; Group 2 Rotary and rubber cap using ACCLEAN polishing paste; Group 3 Prophy-Mate Neo; Group 4 Rotary and rubber cap using Pumice; Group 5 AIRFLOW EMS. Lastly, all the air-polishing groups were standardized by polishing the samples for 5 seconds at 90° at 4mm distance. Enamel surface roughness was measured both pre and post-polishing by profilometry and atomic force microscopy. Results: Profilometry and atomic force microscopy readings showed that all the study groups except pumice rotary polishing group, showed statistically significant differences in intragroup comparison at p 0.05. On the other hand, ANOVA analysis showed that only the Prophy-Mate Neo group showed statistically significant difference in inter-group comparison (p 0.05). Regarding AFM observations in inter-group comparison, both Prophy-Mate Neo and EMS groups showed statistically significant differences compared to the study groups. Conclusions: This in vitro study finds that of the five different polishing modalities utilized in this study, the rotary polishing technique using pumice as the polishing agent caused the least enamel surface roughness. On the other hand, Prophy-Mate Neo and Airflow EMS caused the highest levels of enamel surface roughness induction

Evaluation of Dental Students’ Learning Skill Throughout Repeated Practicing in Recording Preliminary Impressions: An Experimental Study

Objective: This study aims to assess whether repeated attempts at taking alginate impressions improve the manual skills of dental students by measuring the error percentage of each preliminary impression and comparing these percentages across multiple trials to evaluate skill progression. Methods: Twenty dental students from the fifth-year stage were selected randomly to participate in the study. Each student took five alginate impressions after receiving a demonstration that included audio and video presentations to reinforce previously acquired knowledge. Error areas were highlighted using a red pen and then identified and quantified using Adobe Photoshop. Error areas have been deliberately identified to calculate the accuracy of each impression. The null hypothesis was that there would be no significant variation in the error percentages of preliminary impressions across the students' trials. Results: The study's results revealed an improvement in the students' manual skills in taking impressions after repeated trials. Even though the fifth trial had the lowest median error percentage, the difference in group means was not statistically significant. Conclusions: Repeated impression-taking improves dental students' manual skills, lowering error percentages in subsequent trials. Furthermore, the use of digital technologies in dental education facilities breaks skill acquisition down into more straightforward steps to detect and correct the errors

Morphometric Analysis of Mental Foramen Using Cone Beam Computed Tomography in a Sample of the Erbil Population

Objective: This study aims to analyze the mental foramen (MF) morphometric characteristics using Cone Beam Computed Tomography and compare its location based on gender differences in the Erbil population. Methods: The study included 52 Cone-Beam Computed Tomography scans. The following aspects were assessed: the position of the mental foramen (MF) in relation to the lower teeth, the distance of the mental foramen from the midline of the mandible, the distance of the mental foramen from the inferior border of the mandible, and the vertical and transverse distances of the mental foramen. Results: The study identified significant gender differences in the location of the mental foramen. Males had a greater distance from the mental foramen to the midline of the mandible on the left side (25.49 mm vs. 24.04 mm) and a greater distance from the mental foramen to the inferior border of the mandible on the right side (14.03 mm vs. 12.84 mm). The transverse distance of the mental foramen was also larger in males on the left side (4.47 mm vs. 3.84 mm). The mental foramen was most located between the first and second premolars. Significant differences were observed in the mental foramen’s position between the right and left sides. Conclusions: The findings highlight significant gender-based variations in the location of the mental foramen, which can influence clinical approaches in dental and surgical procedures

Comparison of Quality of Root Canal Obturation in Single-Rooted Teeth Performed by Undergraduate Students Using Manual and Rotary Methods (Cross-Sectional Study)

Objective: The study aimed to reveal the influence of different root canal instrumentation methods (manual and rotary) on the features of root canal obturation, as well as determine which method gives the superior quality of obturation. Methods: A total of 165 case sheets of endodontically treated teeth (incisors, canines, and single-rooted premolars) were included in our samples from the outpatients in the University of Sulaimani, College of Dentistry, each with the radiograph of the treated tooth attached to it. The case sheets were separated into manual and rotary groups. The evaluation was done for three parameters (homogeneity, taperness and length of filling material). Results: The results show a statistically significant (p 0.05) relationship between manual and rotary instrumentation regarding all three parameters evaluated. There is a higher ratio of adequate length of filling material, adequate homogeneity, and adequate taperness in rotary instrumentation than in manual instrumentation. Conclusions: This study concludes that rotary NiTi instrumentation improves the quality of root canal obturation regarding the 3 parameters. The findings advocate for the inclusion of rotary NiTi instruments in the undergraduate dental curriculum to enhance endodontic treatment outcomes. In the future, more resources are needed regarding the homogeneity of the obturation by different instrumentation and obturation techniques

Digital Assessment of Transverse Maxillary Arch Measurements for Predicting Arch Length: Implications for Early Orthodontic Diagnosis and Preventive Dentistry

Objective: The aim of this study was to investigate the possible correlation between the maxillary dental arch length and three other transverse linear measurements on three-dimensional digital models for developing a predictive model to be applied in early orthodontic diagnosis and prevention of the possible future malocclusion. Methods: A sample of 108 digital models of maxillary dental arches was derived from the scanned images belonging to orthodontic patients aged 18 to 25 years in Sulaimani City. Transverse dimensions and arch length were digitally measured, and the data were analyzed with the Statistical Package for the Social Sciences (SPSS, V. 25). Results: A pilot study was conducted to assess the reliability of measurements between conventional and digital methods for evaluating dental arch dimensions. The results showed no statistically significant differences between the two approaches. No significant gender differences were found in regard to the measurements. Correlation analysis demonstrated no significant relationship between dental arch length and inter-molar width (rho = 0.028, p = 0.776), inter-premolar width (rho = 0.004, p = 0.965), or inter-canine width (rho = 0.046, p = 0.638). However, significant positive correlations were observed among the three transverse arch dimensions: inter-molar and inter-premolar widths (rho = 0.687), inter-molar and inter-canine widths (rho = 0.682), and inter-premolar and inter-canine widths (rho = 0.926). Conclusions: Within the study’s limitations, no significant correlations were found between arch length and transverse linear measurements; therefore, a predictive model could not be established. Although inter-premolar and inter-molar widths showed statistically significant correlations, they did not contribute meaningfully to predicting arch length. Personalized evaluation using digital tools remains essential for accurate orthodontic planning and prevention of future malocclusion

Cone Beam Computed Tomography Evaluation of the Clinical Correlation between the Stature of the Patient and Tooth Anatomic Odontometry in Iraqi Subpopulation (A Cross-sectional Study)

Objective: The odontometric assessment of teeth has been considered as crucial for the identification of individuals due to its correlation with body stature. This investigation aims to collect odontometric data on the anatomical dimensions of both mandibular and maxillary anterior and posterior teeth, and to correlate these variables with stature and gender within the Iraqi subpopulation using cone-beam computed tomography analysis. Methods: This prospective study involved 826 participants, comprising 370 females (44.8%) and 456 males (55.2%), categorized into two height groups: short and tall, based on average height thresholds. Odontometric data, including total tooth length, root length, crown length, and crown width measurements, were recorded via Cone-beam computed tomography. Additionally, physical stature was measured using standardized anthropometric techniques. Statistical analysis was performed using Student's t-test. Results: Overall, the findings indicate a positive and statistically significant correlation between all odontometric measurements and stature for both genders, with p-values less than 0.05. Notably, maxillary canines exhibited the strongest correlation with stature, followed by maxillary first molars. In contrast, lower central incisors for males and lower second premolars for females showed the weakest correlation. The correlation for crown width was strongest for maxillary canines and mandibular first molars, while lateral incisors and maxillary second molars presented the weakest correlation. Comparing the dimensions of corresponding right and left side teeth revealed some variations, with a few patients displaying differences exceeding 0.45 mm. At the same time, differences were found to be statistically insignificant for the majority of other teeth, with maximum variations reaching only 0.08 mm between contralateral teeth. Furthermore, significant sexual dimorphism was also observed, with male teeth presenting significantly greater dimensions than female teeth, except in the lower central incisors. Conclusions: The current clinical study highlights the presence of significant sexual dimorphism and confirms a positive and significant relationship between individual stature and tooth dimensions across both genders

Cone Beam Computed Tomography Evaluation of the Styloid Process Length Variations in a Sample Group of the Iraqi Population

Objective: The scarce literature data on the mean length of the styloid process in the Iraqi population gave rise to the need for this study to determine the mean length of the styloid process in an Iraqi subpopulation, highlighting the possible importance in clinical and surgical conditions considered. Methods: Cone-Beam Computed Tomography (CBCT) images of 229 Iraqi patients comprising 73 males (31.1%) and 156 females (68.9%), with a mean age of 40.48 ±16.326, were included in this retrospective study. The data obtained were transformed into SPSS v25, and descriptive and inferential analyses were performed. Results: The mean length of the styloid process in males was found to be 26.16 ±1.08324mm on the right side and 26.42±1.12595mm on the left side, while the mean length of styloid process in females was found to be 26.13±1.12595mm on the right side and 26.15±0.74133mm on the left side. Conclusions: There was no statistically significant difference in the length of the styloid process between the two sex groups (p 0.05) or between the right and left sides of each sex group (p 0.05)