Pulpal blood flow changes and pain scores related to using superelastic 0.018-inch nickel titanium as the first orthodontic alignment archwire: A prospective clinical trial

Background: Optimal orthodontic force results in maximum rate of tooth movement without tissue damage. Even though starting orthodontic treatment with a thicker archwire may shorten treatment duration, the evidence on the effect of using 0.018-inch NiTi as the first alignment archwire on pulpal blood flow (PBF) status is still scarce. Objectives: to record PBF changes and pain scores associated with using 0.018-inch NiTi as the first alignment archwire during fixed orthodontic treatment. Methodology: Patients were selected from subjects attending postgraduate orthodontic teaching clinics at Jordan University of Science and Technology. In total, forty healthy patients who exhibited mild lower arch crowding were included. A split-mouth trial design was used. Each patient received two archwire sizes at one time joined in the midline by crimpable hook and applied in the lower arch. Patients were assigned into one of two groups based on archwire sizes used. Group 1: 0.014-inch and 0.018-inch NiTi (Six males, 14 females aged 19.4±1.33 years) and Group 2: 0.016-inch and 0.018-inch NiTi (Seven males, 13 females aged 19.6±1.45 years). The archwire size group was randomly allocated with a 1:1 allocation ratio. A Laser Doppler Flowmeter was used to measure PBF at different time intervals (T0-T5). Pain scores were recorded using a visual analogue scale (VAS). A repeated measures ANOVA and a post-hoc Bonferroni comparison tests were conducted to examine differences at the different time points before and during orthodontic alignment. Results: For all studied archwire sizes, PBF decreased 20 minutes after their placement. Most PBF changes occurred within 24hours and continued to decrease until 72 hours after archwire placement where the maximum reduction was reached. Eventually, normal values were reverted within 1 month. PBF changes were similar between all alignment – groups. Conclusions: Initial orthodontic alignment with 0.018-inch NiTi does not cause irreversible changes to pulpal vasculature or produces higher pain scores.The study was supported by the deanship of research at Jordan University of Science and Technology, research grant number (39/2018)

The effect of intraoral aging of the working stainless steel archwire on the rate of premolar extraction space closure: a randomized clinical trial

Objectives: The aims of this study were to investigate the effect of the working archwire intra-aging on the rate of upper first premolar space closure and to measure frictional resistance during space closure. Methods: A total of 28 subjects participated in this study. All patients were treated by upper first premolar extraction. Subjects were subdivided into 2 groups: non-replacement side: consisted of the right or left sides of the upper arch where space closure was done using the same 0.019 × 0.025-inch SS; replacement side: comprised the other side of the subjects where the working archwire was replaced with a new one each visit. The working archwire in the upper arch was split into 2 halves (new archwire on one side and old one on the other side); each one-half was connected to the other in the midline by a joining shim. Elastomeric chain was used to close extraction spaces. The amount of space closure (mm) was recorded each visit for 3 months. Results: In the non-replacement side, the rate of upper space closure was 0.80 mm/month coronally and 0.75 mm/month gingivally. In the replacement side, it was 0.69 mm/month coronally and 0.67 mm/month gingivally (p > 0.05). Mean frictional force for the non-replacement side was 3.58 ± 1.20 N, and it was 2.43 ± 1.21 N for the replacement side (p < 0.01). Conclusions: Intraoral archwire aging has no effect on the rate of upper premolar space closure/month although frictional resistance of the aged archwire was higher than of the new one. Clinical relevance No need to replace 0.019 × 0.025-inch SS every visit during space closure to overcome corrosion and frictional resistance.The study was supported by the Deanship of Research at Jordan University of Science and Technology (research grant number 53/2019)

Evaluation of maxillary sinus dimensions and volume using cone beam computed tomography in patients with unilaterally displaced palatal and buccal maxillary canines

Objectives: To evaluate and compare the maxillary sinus (MS) dimensions and volume in unilaterally displaced palatal and buccal maxillary canines. Methods: CBCT images for 133 patients were included in the study. Maxillary canines were unilaterally displaced palatally in 83 patients (PDCs) and buccally in 50 patients(BDCs). The following variables were measured: canine position in relation to MS walls, MS pneumatization and MS dimensions and volume. Results: MS was extended to the incisor region in 10% and 13% and to the canine region in 48% and 23% in BDCs and PDCs subjects, respectively. In BDC subjects, maxillary canine crown tip was more laterally (24.23 mm compared to 22.93 mm (p < 0.05)) and closer vertically (5.82 mm compared to 9.58 mm (p < 0.001)) to the MS, maxillary canine root tip was closer to the MS anterior (0 mm compared to 1.64 mm (p < 0.05)) and lateral (19.70 mm compared to 22.02 mm (p < 0.001)) walls and the MS volume (11.57mm3 compared to 9.09 mm3 (p < 0.001)) was increased in the displaced side compared to the non-displaced side. In PDC subjects, a significant difference between the displaced and non-displaced sides was detected in the vertical (3.28 mm compared to 5.89 mm (p < 0.001)) and lateral (21.63 mm compared to 24.25 mm (p < 0.001)) position of maxillary canine to the MS wall, the anterior (− 0.84 mm compared to 1.13 mm (p < 0.05)) and lateral (20.48 mm compared to 22.44 mm (p < 0.001)) position of canine root tip to the MS and the MS volume (7.71mm3 compared to 9.14mm3 (p < 0.001)). PDC sides differed from BDC sides in the lateral and vertical position of canine crown tip to MS and in MS volume. PDC showed negative association with MS volume and anteroposterior skeletal relationship and a positive association with MS height. Conclusions: PDCs subjects have a reduced MS volume and BDCs subjects have an increased MS volume. PDCs are associated with reduced MS volume, increased MS height and Class III skeletal relationship.Open Access funding provided by the Qatar National Library. This study was supported by the Deanship of Research/ Jordan University of Science and Technology (Grant number 431/2018)

Second mesiobuccal canal segmentation with YOLOv5 architecture using cone beam computed tomography images

The objective of this study is to use a deep-learning model based on CNN architecture to detect the second mesiobuccal (MB2) canals, which are seen as a variation in maxillary molars root canals. In the current study, 922 axial sections from 153 patients’ cone beam computed tomography (CBCT) images were used. The segmentation method was employed to identify the MB2 canals in maxillary molars that had not previously had endodontic treatment. Labeled images were divided into training (80%), validation (10%) and testing (10%) groups. The artificial intelligence (AI) model was trained using the You Only Look Once v5 (YOLOv5x) architecture with 500 epochs and a learning rate of 0.01. Confusion matrix and receiver-operating characteristic (ROC) analysis were used in the statistical evaluation of the results. The sensitivity of the MB2 canal segmentation model was 0.92, the precision was 0.83, and the F1 score value was 0.87. The area under the curve (AUC) in the ROC graph of the model was 0.84. The mAP value at 0.5 inter-over union (IoU) was found as 0.88. The deep-learning algorithm used showed a high success in the detection of the MB2 canal. The success of the endodontic treatment can be increased and clinicians’ time can be preserved using the newly created artificial intelligence-based models to identify variations in root canal anatomy before the treatment.This work has been supported by Eskisehir Osmangazi University Scientific Research Projects Coordination Unit under grant number 202045E06