Accuracy and characteristics of cephalometric software programs for outcome prediction of orthognathic treatments: A review

Objectives: Several software programs have been designed for outcome prediction of orthodontic and surgical treatments. This study aimed to review the accuracy and characteristics of cephalometric software programs for outcome prediction of orthognathic surgeries.Methods: This study reviewed studies that compared cephalometric software programs in terms of accuracy and characteristics for outcome prediction of orthognathic surgeries. The results of studies regarding some two-dimensional (2D) and three-dimensional (3D) software programs for this purpose were collected and reported.Conclusion: Use of diagnostic software programs for prediction of treatment outcome is an inseparable part of orthognathic treatment. Some studies have reported acceptable diagnostic accuracy of these software programs and their optimal efficacy for guiding the patients towards accepting or rejecting a treatment. However, using the manual technique to demonstrate the outcome of orthognathic treatment is still efficacious. Several factors such as updating the primary versions, their compatibility with the new operating systems, education and customer service are important in continuation of use of these software programs

Comparison of Changes in Mandibular Third Molar Angulation Following First/Second Premolar Extraction versus Non-Extraction Orthodontic Treatments

Objective: Extraction of premolars is believed to affect the eruption of third molars. This comparative study aimed to assess the change in angulation of third molars following first/second premolar extraction versus non-extraction orthodontic treatments.Methods: This historical cohort study was conducted on patients assigned to three treatment groups: extraction of mandibular first premolars (group A), extraction of mandibular second premolars (group B) and non-extraction orthodontic treatment (group C). Each group included 30 third molars. Patients were in the age range of 11-19 years and the third molars were in Nolla’s6-8 stage of tooth development. Pre- and post-treatment panoramic radiographs were analyzed.Results: The angle between the long axis of the mandibular third molar and mandibular plane increased by 7 (2.2°) in group A and 5.2° in group B and the increase in both groups was statistically significant (p<0.05). Angular changes in group C were not statistically significant (p>0.05). The angle between the long axes of mandibular first and third molars decreased by 6.83 (0.3°) in group A. This reduction was statistically significant (p<0.05).Conclusion: In extraction orthodontic treatments (versus non-extraction treatments), mandibular third molars tend to straighten up and become upright so the risk of their impaction may be decreased

Comparison of Ketoprofen Gum and Ketoprofen Gel for Pain Relief after Activation of Orthodontic Appliances

Background and Aim: Pain control is important for both patients and clinicians in orthodontics. The researchers have used different modalities for this purpose, each having its own advantages and disadvantages. The aim of this study was to compare the efficacy of ketoprofen gum and gel for pain relief after activation of fixed ortho-dontic appliances. Materials and Methods: In this double-blind controlled randomized clinical trial, 115 patients between 14-29 years who had pain in previous sessions, were randomly divided into three experimental groups of ketoprofen chewing gum, ketoprofen gel and placebo chewing gum. All patients were instructed to use the gum and gel three times daily for three days after activation of fixed orthodontic appliances. Patients recorded their level of pain at two, six and 24 hours and two, three and seven days using a 5-score visual analogue scale (VAS). Two-way and repeated measures ANOVA were used to compare differences in the pain scores among the three groups. Results: Eighty-seven patients (54 women, 33 men) completed the questionnaires. The mean pain score decreased over time in both males and females in all groups (P0.05). Conclusion: Although ketoprofen chewing gum was more effective for pain relief, this difference did not reach statsitcial significance. The highest pain score was observed after six hours, and decreased thereafter. Key Words: Orthodontic Appliances, Pain, Ketoprofen, Ketoprofen topical gel, Chewing Gu

Efficacy of Ketoprofen and Benzocaine Chewing Gums for Reducing Orthodontic Pain

Background and Aim: Pain relief is important during orthodontic treatment. The aim of this study was to compare the efficacy of ketoprofen and benzocaine chewing gums for pain reduction during fixed orthodontic treatment. Materials and Methods: Thirty patients aged 15-25 years experiencing orthodontic pain were randomly divided into 3 groups, each receiving one of the experimental chewing gums namely ketoprofen, benzocaine and the placebo. Instructions were given to the pa-tients and they received the gums taking into account the washout period. Patients rec-orded their degree of pain perception at 2, 6 and 24 hours, and 2, 3 and 7 days using the visual analog scale (0-100). Friedman and Wilcoxon tests were used to compare the mean pain scores among the 3 groups. Results: The mean pain score decreased over time in both genders and all groups (p =0.017). The mean pain score recorded in benzocaine group was lower than that in the ketoprofen and placebo groups but a significant difference was only observed between benzocaine and the ketoprofen groups during the first two hours using Friedman and Wil-coxon tests (p=0.042). Compared to the control group, both ketoprofen and benzocaine chewing gums significantly decreased pain at all time points except for day 7. Conclusion: Ketoprofen and benzocaine gums were both significantly effective for or-thodontic pain reduction

The effect of benzocaine and ketoprofen gels on pain during fixed orthodontic appliance treatment : a randomised, double-blind, crossover trial

Aims: To compare the analgesic effect of topical benzocaine (5%) and ketoprofen (1.60 mg/ml) after 2 mm activation of 7 mm long delta loops used for maxillary en-masse orthodontic space closure. Subjects and methods: Twenty patients (seven males, 13 females, 15–25 years of age, mean age of 19.5 years) participated in a randomised crossover, double-blind trial. After appliance activation, participants were instructed to use analgesic gels and record pain perception at 2, 6, 24 hours and 2, 3 and 7 days (at 18.00 hrs), using a visual analogue scale ruler (VAS, 0–4). Each patient received all three gels (benzocaine, ketoprofen, and a control (placebo)) randomly, but at three different appliance activation visits following a wash-over gap of one month. After the first day, the patients were instructed to repeat gel application twice a day at 10:00 and 18:00 for three days. The recorded pain scores were subjected to non-parametric analysis. Results: The highest pain was recorded at 2 and 6 hours. Pain scores were significantly different between the three groups (Kruskal–Wallis test, p 0.05). Conclusion: A significant pain reduction was observed following the use of ketoprofen when tested against a control gel (placebo). The highest pain scores were experienced in patients administered the placebo and the lowest scores in patients who applied ketoprofen gel. Benzocaine had an effect mid-way between ketoprofen and the placebo. The highest pain scores were recorded 2 hours following force application, which decreased to the lowest scores at after 7 days

Orthopedic effects of splint high-pull headgear — a cephalometric appraisal

Objective: The purpose of this study was to investigate the orthopedic effect of maxillary splint high-pull head gear appliance on maxillary complex. Design: Retrospective study. Settings: Patients under treatment in the Department of Orthodontics, Azad University, during one year period from November 2003 to March 2004. Subjects: Lateral cephalometric radiograph of 26 patients (11 boys and 15 girls, with a mean age of 11.3 years) treated with splint high-pull headgear appliance was compared with a similar control group of 26 individuals (11 boys and 15 girls with a mean age of 12.6 years). Main outcome measures: The result of the present study showed that the treated group more closely approximated Class I cephalometric values after treatment, whereas the control group with a Class II skeletal pattern did not necessarily become “less Class II” due to growth. Results: Point A was held efficiently in the treated group (S–A = 0.4 mm) whereas in the control group it had relocated downward and forward 2.00 mm along sella–point A (S–A) line. Also, the relocation of the point A in the horizontal (X-axis) and vertical (Y-axis) planes confirmed these findings. No rotational changes of palatal plane were recorded in the treated group. Mandibular skeletal changes were similar to the control group. Maxillary dentition was relocated more posteriorly. Conclusions: It was concluded that the maxillary splint with high-pull headgear in the present study held the maxilla in position without any rotational changes of the palatal plane. Therefore, a normal skeletal relationship was achieved in the treated group through a combination of maxillary basal bone and dentoalveolar growth inhibition and a normal expression of mandibular growth

The effects of various surface treatments on the shear bond strengths of stainless steel brackets to artificially-aged composite restorations.

Objective: To compare the shear bond strengths (SBS) of stainless steel brackets bonded to artificially-aged composite restorations after different surface treatments. Methods: Forty-five premolar teeth were restored with a nano-hybrid composite (Tetric EvoCeram), stored in deionised water for one week and randomly divided into three equal groups: Group I, the restorations were exposed to 5 per cent hydrofluoric acid for 60 seconds; Group II, the restorations were abraded with a micro-etcher (50 μm alumina particles); Group III, the restorations were roughened with a coarse diamond bur. Similar premolar brackets were bonded to each restoration using the same resin adhesive and the specimens were then cycled in deionised water between 5 °C and 55 °C (500 cycles). The shear bond strengths were determined with a universal testing machine at a crosshead speed of 1 mm/min. The teeth and brackets were examined under a stereomicroscope and the adhesive remnants on the teeth scored with the adhesive remnant index (ARI). Results: Specimens treated with the diamond bur had a significantly higher SBS (Mean: 18.45 ± 3.82 MPa) than the group treated with hydrofluoric acid (Mean: 12.85 ± 5.20 MPa). The mean SBS difference between the air-abrasion (Mean: 15.36 ± 4.92 MPa) and hydrofluoric acid groups was not significant. High ARI scores occurred following abrasion with a diamond bur (100 per cent) and micro-etcher (80 per cent). In approximately two thirds of the teeth no adhesive was left on the restoration after surface treatment with hydofluoric acid. Conclusion: Surface treatment with a diamond bur resulted in a high bond strength between stainless steel brackets and artificially-aged composite restorations and was considered to be a safe and effective method of surface treatment. Most of the adhesive remained on the tooth following surface treatment with either the micro-etcher or the diamond bur

Efficacy of Glass Ionomer Cements for Prevention of White Spot Lesions During Orthodontic Banding: A Randomized Clinical Trial

Objectives: This study aimed to compare the incidence of white spot lesions (WSLs) around orthodontic bands following the application of two glass ionomer (GI) cements namely GC Gold Label and GC Fuji Plus for six to 12 months. Materials and Methods: A total of 186 permanent first molars of orthodontic patients requiring banding of at least two permanent first molars were chosen. The teeth were examined for caries and presence of WSLs by visual inspection and by DIAGNOdent (scores 0-29). Orthodontic bands were randomly cemented to the right or left molars using GC Gold Label or GC Fuji Plus GI cements. Samples were randomly divided into three groups and bands were removed after six, nine and 12 months in groups 1, 2 and 3, respectively. The teeth were then examined for caries and presence of WSLs by visual inspection. DIAGNOdent was used on the buccal and lingual surfaces to determine the presence of WSLs. The data were statistically analyzed using one-way ANOVA, multivariate repeated measures ANOVA, the Kruskal Wallis and the Mann-Whitney tests. Results: Totally 174 teeth were evaluated. DIAGNOdent scores were not significantly different before cementation and after removal of bands in buccal and lingual surfaces of the teeth in the two cement groups. Lesions simulating WSLs were seen in 21 out of 174 teeth but DIAGNOdent scores were not indicative of caries. Conclusion: Remarkable WSLs were not detected visually or by DIAGNOdent at six, nine or 12 months following the cementation of bands with two GI cements

The effect of 810-nm low-level laser therapy on pain caused by orthodontic elastomeric separators

The purpose of this study was to assess the effect of 810-nm (DMC Equipamentos, Sao Carlos, Brazil) continuous wave low-level laser therapy (LLLT) on the pain caused by orthodontic elastomeric separators. Thirty-seven orthodontic patients (12 male and 25 female, aged 11–32 years, mean age = 24.97 years) participated in the study, including 20 subjects aged 18 years or more, and 17 under 18 years of age. Four elastomeric separators (Dentarum, Springen, Germany) were placed for the first permanent molars (distal and mesial), either for maxillary (22 patients) or mandibular (15 patients) arches; one quadrant was randomly selected and used as a placebo group (received no laser irradiation). After separator placement for each quadrant, patients received 10 doses (2 J/cm2, 100 mW, 20 s) of laser irradiation on the buccal side (at the cervical third of the roots), for distal and mesial of the second premolars and first permanent molars, as well as distal of second permanent molars (five doses). The same procedure was repeated for the lingual or palatal side (five doses). After 24 h, patients returned to the clinic and received another 10 doses of laser irradiation on the same quadrant. Postseparation pain level recorded on a 10-cm visual analog scale for both jaws immediately (hour 0), and after 6, 24, 30 h, as well as on days 3, 4, 5, 6, and 7. Significant differences in the pain perception (PP) were found between the laser and placebo groups at 6, 24, 30 h, and day 3 of the experiment (P < 0.05). Friedman’s test of multiple comparisons revealed significant differences in the PP among various time intervals for laser (chi-square = 173.407, P = 0.000) and placebo (chi-square = 184.712, P = 0.000) groups. In both groups, pain was highest at 6 and 30 h after placing elastomeric separators. No gender differences were observed in both groups. More pain was recorded in the mandible (P < 0.05) at 24 (laser group) and 30 h (both groups) after starting the experiment. The PP was significantly higher (P < 0.05) for the group aged 18 years or more, only at days 3 [both groups] and 4 [laser group only] of the experiment. The 810-nm continuous wave LLLT significantly reduced the PP in the first 3 days after orthodontic separation. However, the mean postseparation PP in both groups was low and wide ranges of PP scores were observed