Vertical gingival display changes associated with upper premolars extraction orthodontic treatment : a prospective clinical trial

Extraction of upper bicuspids have been anecdotally blamed to increase the vertical gingival display (VGD) anteriorly. However, the extraction may be needed in some cases in order to correct the underlying orthodontic problem. Objectives: To investigate and compare vertical gingival display (VGD) changes associated with upper (first vs second) premolars extraction during orthodontic treatment. Design: A prospective clinical trial. Setting: Postgraduate dental teaching clinics at Jordan University of Science and Technology (JUST). Sample population: Sixty orthodontic patients were included in the study. They were treated with upper first or second premolars extraction according to the underlying problem and the individualized treatment plan of each patient. Records (radiographs, study casts and clinical photographs) were taken for all subjects pre- and post- orthodontic treatment. Outcome measures: Pre- and post-treatment VGD, lip length in static and dynamic positions and the amount of upper teeth retractions were recorded. The paired and the independent t- test were used to detect differences within/between groups. Factors affecting VGD were investigated using backward stepwise linear regression analysis. In both static and dynamic captures, VGD increased after orthodontic treatment in both premolars extraction groups. Pre- and post-treatment variables differed significantly in groups 1 and 2. VGD changes were similar in both treatment groups. A significant association was found between VGD change during orthodontic treatment and upper canine retraction (P<0.001), pre-treatment ANB angle (P<0.01) and upper incisor retraction(P<0.05). The amount of anterior VGD increases after upper premolars extraction. The increase in VGD after first and second premolars extractions was comparable. The increase in VGD after orthodontic treatment is associated with the amount of canine retraction, pre-treatment ANB and the amount of incisor retraction

Efficacy of lower arch leveling, lower incisors' root resorption, and pain associated with the correction of curve of Spee using different orthodontic archwires: a randomized clinical trial.

To compare between 3 archwires (AWs) for leveling curve of Spee (COS) in terms of efficacy of reduction, external apical root resorption (EARR), pain experienced, and the lower arch dimensional changes during COS leveling. Randomized clinical trial. Jordan University of Science and Technology Postgraduate dental clinics. Fifty-three subjects with COS > 5 mm were included in this study. The subjects were randomly divided into three groups based on the AW used: group 1, 0.017 × 0.025-inch stainless-steel (SS) AW; group 2, 0.019 × 0.025-inch SS AW; and group 3, 0.021 × 0.025-inch β-titanium (TMA) AW. The intervention was randomly allocated using the permuted random block size of 3 with a 1:1:1 allocation ratio. In the three groups, a 5-mm depth reverse COS was placed in the AWs. The following time points were defined for COS assessment: T1, before interventional leveling AW placement; and T2-T7, 1-6 months after interventional leveling AW placement. Records consisted of dental study models and periapical (PA) radiographs. Pain scores were recorded using visual analogue scale. Patients were followed up on a monthly basis until COS  0.05). Higher pain scores were reported by group 2 subjects during the first 24 h. Arch length and width increased significantly in groups 2 and 3 (P < 0.05). In all groups, COS leveling was achieved by lower incisor intrusion and proclination and lower molar extrusion. All investigated AWs were effective in leveling COS with minimal lower incisors' EARR (< 1 mm). COS was leveled by lower incisors' intrusion and proclination and lower molar extrusion. Pain scores were the highest in group 2 during the first 24 h. The 3 investigated leveling AWs were effective for the leveling COS and at the same time safe on the roots of the lower anterior teeth.Open Access funding provided by the Qatar National Library. The study was supported by the Deanship of Research at Jordan University of Science and Technology, research grant number (436/2018)

Tooth size discrepancy in orthodontic patients with skeletal anterior open bite.

To find out if there is any relationship between tooth size discrepancy (TSD) and skeletal anterior open bite (AOB) and to assess the correlation between the amount of AOB and TSD. A total of 100 Class I subjects were included in this study (average age 15.21 ± 2.84 years). Fifty patients had skeletal AOB (>3 mm) and 50 subjects acted as controls and had a normal overbite. Teeth mesio-distal widths were measured using a digital caliper. Anterior, overall, and posterior TSD ratios were calculated. An independent t-test was employed to assess differences between groups and between genders. Pearson correlation coefficient was used to assess the correlation between the amount of AOB and TSD. Significant differences in anterior (p = .038) and posterior (p = .015) TSD ratios were detected. In the skeletal AOB group, no significant gender differences were detected (p > .05), whereas in the normal bite and total sample group, males had smaller posterior teeth compared to females (p  .05). Skeletal AOB had larger anterior and smaller posterior mandibular teeth, but the differences were less than 1 SD of Bolton's ratios. Males have smaller mandibular posterior teeth than females. The amount of AOB is not correlated with the TSD ratios.This study was supported by the Deanship of Research/Jordan University of Science and Technology (grant number 20140241)

Comparison of second molar protraction using different timing for piezocision application: A randomized clinical trial.

To compare second molar protraction between early, late and no piezocision groups. Forty subjects with bilaterally extracted mandibular first molars were selected to participate in the study. Subjects were subdivided into two groups: piezocision and no piezocision. The piezocision group was further subdivided into two subgroups: early piezocision (piezocision performed immediately before second molar protraction) and late piezocision (piezocision performed three months after starting molar protraction). In the no piezocision group, molar protraction was done without surgery. The intervention (piezocision group and timing of piezocision/side within group) was randomly allocated using the permuted random block size of 2, with 1:1 allocation ratio. The amount of second molar protraction, duration of space closure and anterior anchorage loss were measured. A repeated measures analysis of variance was conducted to define the differences between the measured variables at the different time intervals. Differences between groups were assessed using ANOVA test. No difference was detected between early and late piezocision groups in the amount of molar protraction at the end of space closure. Duration of complete space closure was 9 and 10 months in the piezocision and no piezocision groups. Anchorage loss was similar between the three studied groups. Early and late piezocision have similar effect and both increased the amount of second molar protraction temporarily in the first 2-3 months after surgery. Duration of mandibular first molar space closure was reduced by one month when piezocision was applied. Anchorage loss was similar in the three groups

Cranial base measurements in different anteroposterior skeletal relationships using Bjork-Jarabak analysis.

To assess the linear and angular cranial base measurements (Bjork polygon) in different anteroposterior (AP) skeletal relationships using Bjork-Jarabak analysis. Pretreatment lateral cephalograms of 288 (146 women, 142 men, mean ages 21.24 ± 2.72 years and 22.94 ± 3.28 years, respectively) adult patients were divided into Class I, II, and III skeletal relationships according to their ANB angle. Linear and angular measurements of Bjork polygon were measured and compared among different skeletal relationships. Analysis of variance was performed to detect the differences among groups. Independent-sample t-test was used to detect differences between men and women. The Class II skeletal relationship has a significantly larger saddle angle than Class III does (P .05). Anterior (N-S) and posterior (S-Ar) cranial base lengths were similar in the different AP skeletal relationships (P > .05). The ramal height and body of the mandible length were significantly larger in Class III compared with Class I and II (P < .05). Women had a significantly larger articular angle than men did (P < .05), although men had significantly larger linear measurements of Bjork polygon than women did (P < .05). The Class III skeletal relationship has a smaller saddle angle and larger mandibular length and gonial angle. Men have a larger cranial base and mandibular linear measurements and a smaller articular angle compared with women.The study was funded by the Deanship of Research/Jordan University of Science and Technology (grant No. 2015-491)

A comparative assessment of the amount and rate of orthodontic space closure toward a healed vs recent lower premolar extraction site.

To investigate and compare the amount and rate of space closure and tooth tipping during orthodontic space closure toward a recent vs healed first premolar extraction site. The mandibular arches of 23 patients were included. Treatment plans included lower first premolar extractions. After reaching 0.019 × 0.025-inch stainless-steel archwires (SSAW), patients were subdivided into two groups (Group 1: space closure was carried out toward a healed first premolar extraction space and Group 2: space closure was carried out immediately after first premolar extraction). Elastomeric power chain from second molar to second molar was used to close lower extraction spaces. The following time points were defined: T1: just before space closure; T2-T4: 1-3 months after initial space closure. Records consisted of dental study models. The amount and rate of extraction space closure were evaluated at each time point. In Group 1 (healed socket), a total amount of 1.98 mm (coronally) and 1.75 mm (gingivally) of space closure was achieved. The rate of space closure was 0.66 mm/month coronally and 0.58 mm/month gingivally. In Group 2 (recent socket), the total amount of space closure was 3.02 mm coronally and 2.68 mm gingivally. The rate of space closure was 1.01 mm/month coronally and 0.89 mm/month gingivally. Differences between the two groups were significant (P .05). In the lower arch, the amount and rate of space closure toward a recent extraction site were higher than that toward a healed extraction socket with similar tipping of teeth in both groups.This study was supported by the Deanship of Research/Jordan University of Science and Technology (Grant number 53/2019)

Quality, effectiveness and outcome of blended learning in dental education during the COVID pandemic: Prospects of a post-pandemic implementation

Abstract: BackgroundBlended learning is growing in popularity particularly following the emergence of COVID-19 pandemic. One of the fields that the pandemic has substantially affected is dental education. Purpose: The aim of this study was to evaluate the quality and effectiveness of the online dental education. Students’ perceptions and experiences of blended learning were also investigated. Methods: A 28-question online survey was designed to gauge students’ perceptions of the effect of blended learning on their academic performance. Results: 314 participants in preclinical and clinical years completed the questionnaire (223 females and 91 males). The majority of students (89%) believed that clinical and practical courses cannot be given by the internet. In terms of students’ opinion in the assessment process, more females (65.8%) preferred traditional exams than males (50.5%) (p < 0.05). Most clinical students (83%) preferred a combination of online and traditional teaching compared to 72% of preclinical students (p < 0.05). Clinical year students were more willing to communicate electronically with their classmates and instructors. The majority of dental students (65%) reported that future dental courses should be blended. Conclusions: In the pandemic era, blended learning, should become the preferred method of education whereby theoretical knowledge is delivered through online tutorials and clinical training is resumed on-site, to ensure competency of dental graduates while maintaining safety of the dental team. Current facilities and course designs should be improved in order to improve students’ experiences with blended learning

Dental age estimation of Jordanian children: applicability of Demirjian method

ABSTRACT Objectives: To evaluate the accuracy of Demirjian method in estimating the chronological age of male and female Jordanian children and to establish a new dental age curve if the Demirjian method was not found to be accurate. Methods: Orthopantomograms (OPTs) of 1374 Caucasian Jordanian children (684 females and 690 males) aged 4 to16 years were selected and the dental age was determined by Demirjian method. The chronological ages of the children were obtained by subtracting their birthdates from the date of taking the radiograph. The OPTs were obtained from Archives of Dental Teaching Clinics /XXX and other private orthodontic practices in Irbid and Amman. Results: Demirjian method overestimated chronological age in female and male subjects aged 4 to 8 years. Afterwards, the method underestimated chronological age in females aged 9-11 years and 14-16 years. In male subjects, chronological age was underestimated in subjects aged 9-12 years and 15-16 years. New the dental age curves for Jordanian females and males were constructed. The constants for the quadratic model for the new curves were (b0=-25.341, b1=17.557, b2=-0.623) for females and (b0=-29.809, b1=17.396, b2=-0.595) for males. Conclusion: Demirjian method overestimated the chronological age of Jordanians below the age of 8 years and underestimated the age of Jordanians above 8 years. A new DA standard for Jordanian children was developed and tested for accuracy

Evaluation of maxillary canine root and maxillary bone thickness and density in patients with displaced maxillary canines: A cone-beam tomography study

IntroductionThis study investigated lateral incisor and canine morphology and dimensions, maxillary bone density, and volume in subjects with displaced maxillary canines. MethodsCone-beam computed tomography images for 134 palatally displaced canines (PDCs), 57 buccally displaced canines (BDCs), and 87 nondisplaced canines (NDCs) were analyzed. Canine and lateral incisor dimensions, alveolar bone dimensions, and maxillary bone volume and density were measured. ResultsThe root length of BDCs was short compared with NDC and PDC groups. The lateral incisor was short in the PDC group compared with NDC and BDC groups. In the BDC group, maxillary bone volume was reduced compared with NDCs and PDCs. Significant differences were detected between BDC and PDC groups in bone density buccal to canines and between BDC and NDC groups in bone density distal to canines. The density of maxillary bone was the highest in the PDC group and the lowest in the BDC group compared with the NDC group. Eight variables were associated with the site of maxillary canine displacement: lateral incisor tip, alveolar bone density, alveolar bone width, bone density buccal to canine, canine width labiopalatally, maxillary bone volume, and canine midsagittal width. ConclusionsIn PDCs, the maxillary lateral incisor was short, the canine root had a larger crown/root ratio, and maxillary bone volume was increased compared with NDCs. In BDCs, the canine root was shorter than NDCs and PDCs, maxillary bone volume was reduced compared with NDCs, and bone density at the buccal side was reduced compared with the PDC group