The effectiveness of two manual slim bristles toothbrushes among fixed orthodontic appliance patients

This research aimed to evaluate the oral hygiene status in fixed orthodontic appliance patients when using two different slim bristles toothbrushes and to assess patients’ toothbrush perception.Twenty six fixed orthodontic appliance patients participated in the six weeks prospective, crossover clinical trial. All patients used two different slim bristles toothbrushes (Toothbrush A and Toothbrush B) for two weeks each with a washout period in between. Gingival health and plaque value were assessed based on Löe & Silness Gingival Index and Silness & Löe Plaque Index at baseline, week 2, week 4 (washout) and week 6. At the end of the trial, patients’ toothbrush perception was assessed through questionnaire. All data were analysed using SPSS version 22.The mean age of the patients was 21.5 ± 4.3 years, with female predominant (n = 17, 65.4%). More than half were Malay (n = 15, 57.7%) and had tertiary education (n = 14, 53.8%). Patients could achieve good oral hygiene when using Toothbrush A (65.4%) and Toothbrush B (69.2%). However, the occurrence of gingivitis was significantly higher when using Toothbrush A (OR = 1.889, 95% CI = 1.207-2.957, p value < 0.05). Toothbrush B was felt to clean better (n = 14, 53.8%) while Toothbrush A was perceived to be easier to use (n = 14, 53.8%). Both toothbrushes maintained patients’ oral hygiene status. However, when using Toothbrush B, oral health status was better as it significantly reduced gingivitis occurrence compared to Toothbrush A. As for the toothbrush perception, most patients preferred Toothbrush A to be taken home

Diskrepansi saiz gigi intermaksila dan kesannya terhadap hasil rawatan ortodontik

Diskrepansi saiz gigi intermaksila (DSG) adalah ketidakseimbangan ukuran saiz gigi pesakit yang biasanya dirujuk kepada analisis Bolton. Ketidakseimbangan saiz ini juga mungkin boleh mempengaruhi hasil rawatan ortodontik. Justeru itu, kajian retrospektif ini dijalankan untuk mengkaji prevalens diskrepansi saiz gigi intermaksila (DSG) di luar 2 sisihan piawai (2 SP) daripada min Bolton dalam kalangan pesakit ortodontik dan menilai kesan DSG di luar 2 SP daripada min Bolton ke atas hasil rawatan ortodontik. Sebanyak 226 set model kajian pesakit ortodontik yang memenuhi kriteria pemilihan telah dipilih daripada 3077 kes ortodontik yang diperiksa. Analisis Bolton iaitu nisbah anterior dan nisbah keseluruhan, telah dilakukan ke atas setiap model pra-rawatan. Kes-kes yang dikenal pasti mempunyai DSG di luar 2 SP dinilai hasil rawatannya serta direkodkan teknik intervensi yang telah dijalankan untuk menambah baik hasil rawatan. Hasil kajian mendapati bahawa sebanyak 29.20% kes mempunyai DSG di luar 2 SP daripada min Bolton. Sejumlah 26.54% kes mempunyai nisbah anterior lebih daripada 2 SP. manakala 7.08% kes mempunyai nisbah keseluruhan lebih besar daripada 2 SP. Daripada jumlah kes yang mempunyai DSG di luar 2 SP, hasil rawatan ortodontik untuk kebanyakan kes ini (62.12%) adalah terjejas. Kesimpulannya, terdapat lebih daripada satu perempat pesakit ortodontik hadir dengan DSG di luar 2 SP daripada min Bolton yang boleh mempengaruhi hasil rawatan ortodontik. Teknik intervensi perlu dirancang sebaiknya untuk mencapai hasil rawatan yang memuaskan

Methods of delivering oral hygiene instructions among orthodontic patients: the past, current and future

This review paper aims to present the evolution in methods of delivering oral hygiene information to orthodontic patients. Orthodontic fixed appliance treatment confers numerous benefits to patients in terms of occlusion, function and aesthetics, but it is associated with unwanted consequences due to challenges in maintaining oral hygiene. The ways of delivering oral hygiene information to patients have progressed over the years. Recent years have seen an increase in the popularity of incorporating technology in delivering oral hygiene information and monitoring of oral hygiene practices. The use of video-based instructions to web-based platforms such as Massive Open Online Course (MOOC) and social media platforms such as YouTube, Instagram and TikTok have all become a mode of oral hygiene information conveyance. Mobile apps are now a popular means to keep track of oral care practices such as toothbrushing frequency. The active ingredients of oral care products have improved providing a greater anticariogenic and antiplaque effect to the user as have the design of toothbrushes and even dental floss. In the future, more advanced technology may be used, such as artificial intelligence (AI) and machine learning, to create intelligent machines that can help educate patients on oral health maintenance and improvement

Penggunaan aplians penahan ortodontik boleh tanggal bagi pengekalan hasil rawatan ortodontik - ulasan

Fasa pengekalan adalah asas dalam rawatan ortodontik. Lebih kurang 70% pesakit mengalami kambuh semula selepas rawatan ortodontik. Risiko kambuh semula dapat dikurangkan dengan penggunaan aplians penahan yang sesuai dengan keadaan klinikal pesakit sebelum rawatan dan berdasarkan ciri-ciri aplians penahan. Apabila aplians penahan boleh tanggal diberi, tanggungjawab menjaga kestabilan gigi terletak pada pesakit. Idea terkini telah diusulkan bahawa aplians penahan yang boleh ditanggalkan harus dipakai selama-lamanya untuk mengekalkan hasil rawatan. Oleh itu, pemahaman terhadap ciri-ciri pengekalan aplians penahan gigi yang boleh ditanggalkan adalah penting untuk meningkatkan kepatuhan dan kepuasan pesakit. Artikel ini mengaji aplians penahan gigi yang boleh ditanggalkan dan fokus dalam perkara termasuk pilihan kegemaran di kalangan doktor pergigian, tahap penerimaan pesakit, keberkesanan aplians, kepatuhan pesakit, dan juga rejim fasa pengekalan. Pencarian artikel secara elektronik dilakukan di “PubMed/MEDLINE”, “ScienceDirect” dan “Scopus database”. Pencarian telah dilakukan hingga Jun 2020 menggunakan pelbagai kata kunci termasuk aplians penahan ortodontik, “Hawley”, terbentuk secara vakum dan pengekalan. Di antara 248 penerbitan yang dicari, sebanyak 56 penerbitan akhirnya dimasukkan. Dua puluh tujuh kajian adalah kajian jenis pemerhatian (6 prospektif; 16 keratan rentas, 4 retrospektif, dan 1 siri kes), 14 eksperimen, 14 artikel ulasan, dan satu pendapat. Walaupun terdapat banyak ulasan mengenai aplians penahan yang boleh ditanggalkan, kini terdapat beberapa artikel yang penting telah diterbitkan baru-baru ini. Bukan itu sahaja, garis panduan yang terkini mengenai rejim pengekalan juga sangat diperlukan

Orthodontic material usage among Malaysian orthodontists

Fixed orthodontic treatment requires the use of orthodontic brackets and archwires in order to correct malocclusions. The objective of this study was to evaluate the pattern of orthodontic material usages i.e. bracket and archwire among Malaysian orthodontists. A self-administered questionnaire was distributed to members of the Malaysian Association of Orthodontist. Data entry and statistical analysis was done using SPSS version 15.0. Descriptive statistics were used for analysis. Means and standard deviations were calculated for continuous variables, frequency and percentages for categorical variables. Thirty-four orthodontists responded to the survey, with 76% (n=26) were female and the mean age was 43.31 years (SD 8.76). Most respondents used conventional metal brackets (60%, n=60) and most bracket prescription used was MBT (56%, n=19). At levelling stage, most respondents used nickel titanium archwire (84.5%, n=47). Stainless steel archwire was the most favourable choice for retraction/space closure stage (73.9%, n=34). At finishing, most respondents (60.4%, n=29) preferred to use stainless steel wire in their cases. As a conclusion, specific types of orthodontic materials were preferred and used by Malaysian orthodontists in delivering orthodontic treatment

Pattern of crevicular alkaline phosphatase during orthodontic tooth movement: leveling and alignment stage

Bone formation has been associated with the presence of an enzyme called alkaline phosphatase (ALP). This longitudinal study was carried out to observe its activity in gingival crevicular fluid (GCF) during leveling and alignment stage of orthodontic fixed appliance treatment. Fourteen patients between the ages of 15 and 27 years old with moderate upper labial segment crowding were recruited from postgraduate orthodontic clinic. GCF from mesial and distal sites of upper canines were collected using endodontic paper point before the fixed appliance placement (week 0). The baseline level of ALP (week 0) acted as a control. Samplings of GCF were repeated at 1st, 2nd and 3rd week during orthodontic treatment. The activities of ALP were measured using spectrophotometer (405 nm). Paired sample t-test was used to assess the significance of difference over the 3 weeks. Although the results showed patterns of ALP activities on the test teeth throughout the 3 weeks of leveling and alignment stage, however the results were not significant (p >0.05) when compared to control. Therefore, it has been shown that there was no significant pattern of ALP activities in GCF in patients undergoing leveling and alignment stage of orthodontic treatment

Assessment of orthodontic treatment needs using a modified aesthetic scale

Early treatment of orthodontic problems is important to ensure the best outcome and to avoid social stigmatization. Treatment is often prioritized based on scales such as the Index of Orthodontic Treatment Need (IOTN). Unfortunately, the conventional aesthetic component of IOTN measurement is slanted towards Caucasian malocclusions. Thus, Asian children find it particularly difficult to rate their appearance on this scale and therefore treatment may be wrongly prioritized. This study aimed to assess the use of a newly modified aesthetic scale in assessing orthodontic treatment need in adolescent. A total of 522 16-year old children were recruited. The subjects as well as the examiner rated the subject’s own dentition according to the conventional scale of aesthetic component of IOTN and the newly modified aesthetic scale. Questionnaire was given to assess the practicality of the two scales. When conventional scale was used, subjects and examiner tends to rate more to the no/slight treatment need category. However, when the newly modified scale was applied, the rating has skewed to the moderate/great need treatment category in both subjects and examiner. Moderate inter-agreement between examiner and subjects were detected when using the modified scale while poor agreement was found when using the conventional scale. Moreover, subjects found the modified scale to be easier and faster to use and more relevant to their own dentition. In conclusion, the newly modified aesthetic scale can be suggested as a better tool in assessing level of orthodontic treatment need in adolescent

Clinical and microbiological evaluation of stabilised periodontal patients undergoing early stage of orthodontic treatment

Orthodontic treatment may affect the equilibrium of oral microbiota which plays a major role in aetiology of periodontal disease. This prospective clinical study aimed to assess the periodontal health and microbiological profile of healthy (Group 1) and stabilised periodontal (Group 2) patients throughout three months of orthodontic treatment. Upper and lower fixed orthodontic appliances were bonded. Periodontal health was assessed using plaque score (PS), bleeding on probing (BOP) and pocket depth (PD). 29 sites were taken for subgingival plaque sampling. Plaque samples were inoculated on Trypticase Soy Blood Agar (TSBA) and Trypticase Soy Bacitracin Vancomycin (TSBV) agar for assessment of aerobe, anaerobe, black pigmented bacteria (BPB) and Aggregatibacter actinomycetemcomitans. All the measurements were taken before bonding (T0), 1 week (T1), 1 month (T2) and 3 months post-bonding (T3). Generally, periodontal health in both groups were almost similar. After 1 week, the number of aerobes was significantly higher in Group 1 (88%) while the anaerobes were significantly higher in Group 2 (45%). A. actinomycetemcomitans was higher in Group 1 at T0 and T1 but was significantly higher in Group 2 at T3. BPB was minimal at all time with no significant difference. Thus, during the first 3-month of orthodontic treatment, there were significant changes in the number of aerobes-anaerobes in both healthy and stabilised periodontal patients. Pathogenic bacteria would increase during early treatment of orthodontics

Crevicular Alkaline Phosphatase Activity and Rate of Tooth Movement of Female Orthodontic Subjects under Different Continuous Force Applications

Purpose. This study is aimed to compare the effects of two different orthodontic forces on crevicular alkaline phosphatase activity, rate of tooth movement, and root resorption. Materials and Methods. Twelve female subjects of class II division 1 malocclusion participated. Maxillary canines with bonded fixed appliances acted as the tested teeth, while their antagonists with no appliances acted as the controls. Canine retraction was performed using nickel titanium coil spring that delivered forces of 100 gm or 150 gm to either side. Crevicular fluid was analyzed for ALP activity, and study models were casted to measure tooth movements. Root resorption was assessed using periapical radiographs before and after the force application. Results. ALP activity at the mesial sites peaked at week 1 for 150 gm group with significant differences when compared with the 100 gm group. Cumulative canine movements were significantly greater in the 150 gm force (2.10 ± 0.50 mm) than in the 100 gm force (1.57 ± 0.44 mm). No root resorption was in the maxillary canines after retraction. Conclusions. A force of 150 gm produced faster tooth movements and higher ALP activity compared with the 100 gm group and had no detrimental effects such as root resorption