Complication of Type 1 Diabetes in Craniofacial and Dental Hard Tissue

Diabetes mellitus (DM) is a chronic systemic disease arisen under the conditions when the body cannot produce enough insulin or cannot use it effectively. Type 1 diabetes is caused by an autoimmune reaction, where the body’s defense system attacks the insulin-producing β-cells in the pancreas. Type 1 diabetes incidence has been rising all over the world, especially under the age of 15 years. There are strong premonitions of geographic difference; however, the overall annual increase in a number of affected population is estimated to be approximately 3%

A Bioactive Enamel Sealer Can Protect Enamel during Orthodontic Treatment: An In Vitro Study

Background: This study aimed to evaluate the effectiveness of an experimental bioactive enamel resin sealer in protecting the enamel adjacent to orthodontic brackets against erosion. Methods: Orthodontic brackets (n = 50) were bonded to freshly extracted, sound maxillary premolars using Transbond™ XT Primer (3M Unitek, Monrovia, CA, USA) and Transbond Plus Color Change adhesive (3M Unitek, USA). Five experimental groups (n = 10) had the following treatments applied: a resin bioactive sealer with 45S5 bioglass, 35% by weight; a resin sealer without bioactive glass; fluoride; the orthodontic sealer, Opal Seal (Opal-Orthodontics, South Jordan, UT, USA); and, in the control group, an untreated surface. All the specimens were stored for 18 min in 1% citric acid. All the specimens were examined by SEM and electron dispersive spectroscopy (EDS). The Wilcoxon signed-rank test was used to compare the enamel surfaces covered by the sealers before and after the acid challenge. Attenuated total reflectance Fourier transform infrared spectroscopy detected the degree of the experimental resins’ conversion to verify their suitability for clinical use. Results: The percentage of the bioactive resin sealer and Opal Seal groups’ protection against enamel erosion was 100%, which was significantly more than the other groups, p < 0.05. The degree of conversion for the bioactive and unfilled resins was 42.4% ± 3.6% and 48.57% ± 5%, respectively. Conclusion: The bioactive resin sealer and the Opal Seal both protected the enamel from erosion

Fluoride influences nickel-titanium orthodontic wires′ surface texture and friction resistance

Objectives: The aim of this study was to investigate the effects exerted by the acidulated fluoride gel on stainless steel and nickel-titanium (Ni-Ti) orthodontic wires. Materials and Methods: Sixty stainless steel and Ni-Ti orthodontic archwires were distributed into forty archwires used for in vitro study and twenty for in situ study. Fluoride was applied for 1 h in the in vitro experiment while it was applied for 5 min in the in situ experiment. The friction resistance of all wires with ceramic brackets before/after topical fluoride application was measured using a universal testing machine at 1 min intervals of moving wire. Moreover, surface properties of the tested wires before/after fluoride application and before/after friction test were examined by a scanning electron microscope (SEM). Dunnett′s t-test was used to compare frictional resistance of as-received stainless steel wires and Ni-Ti wires to the wires treated by fluoride in vitro and in situ (P < 0.05). Two-way ANOVA was used to compare the effect of fluoride application and type of wire on friction resistance in vitro and in situ (P < 0.05). Results: Ni-Ti wires recorded significantly high friction resistance after fluoride application when compared to stainless steel wires in vitro, P < 0.05. Fluoride application did not significantly affect the friction resistance of the tested wires in situ, P < 0.05. SEM observation revealed deterioration of the surface texture of the Ni-Ti wires after fluoride application in vitro and in situ. Conclusions: The in vitro fluoride application caused an increase in friction resistance of Ni-Ti wires when compared to stainless steel wires. In vitro and in situ fluoride application caused deterioration in surface properties of Ni-Ti wires

Dentoskeletal effects of the forsusTM fatigue resistance device in the treatment of class II malocclusion: A systematic review and meta-analysis

OBJECTIVE: The aim of this systematic review and meta-analysis is to quantitatively compare previous studies that evaluated skeletal and dentoalveolar effects of the ForsusTM Fatigue Resistance Device (FRD) in the treatment of Class II malocclusion with a matched untreated control group. MATERIALS AND METHODS: Four electronic searches PubMed, Web of Science, Cochrane Library, and Science Direct that were limited to articles on human studies comparing the effect of Forsus appliance with a matched control group in the treatment of Class II malocclusion from the year (2000–2017). An additional manual search was carried out by examining the references of the included articles, SEARCH terms included; Forsus and Class II malocclusion. The quality of the included studies was assessed using the modified methodological score for clinical trials. The data were analyzed using Michael Borenstein's Comprehensive Meta-Analysis Software (V3.3.070, Biostat, Inc., US). RESULTS: Seven studies were included comprising 273 participants (Forsus group = 142; control group = 131). The results indicated a statistical significant skeletal effect of the Forsus appliance on increasing the occlusal plane only (P < 0.001). The results also indicated a statistical significant (P < 0.001) dentoalveolar effects of the Forsus appliance on the following outcomes; protruding, proclining, and intruding lower incisors; retroclining upper incisors, distalizing and intruding upper molars, as well as reducing overjet and overbite. CONCLUSIONS: The ForsusTM showed positive effects on the maxillary incisors and first molars as well as overjet and overbite. However, multiple negative effects were reported on the occlusal plane and lower incisors that need to be considered when using such appliance in treating Class II malocclusion

Comparison of shear bond strength to clinically simulated debonding of orthodontic brackets: An in vitro study

Objectives: To assess in vitro the quantitative and qualitative debonding behavior of the AEZ debonding plier, compared to shear debonding force, in debonding orthodontic metal brackets. Materials and Methods: Thirty-two extracted premolars bonded with metal brackets were randomly divided into two equal groups according to the type of simulated debonding method; compressive bond strength (CBS) group using AEZ debonding plier (Ormco Corporation, USA) attached to the Instron machine, and shear bond strength (SBS) group using regular Instron attachments. All teeth were subjected to debonding forces, and debonding strength was assessed. The buccal surfaces were then examined, under a stereomicroscope, and adhesive remnants were scored using adhesive remnant index (ARI). Debonding strengths comparison was performed using the independent sample t-test. ARI score comparison was performed using the Mann-Whitney U-test. Correlation between debonding strength and ARI scores was performed using the Spearman correlation. Results: There was no significant difference in mean debonding strength between the SBS (M = 6.17 ± 0.77 MPa) and CBS (M = 6.68 ± 1.67 MPa) groups (P > 0.05). The CBS group showed significantly less adhesive remnants than the SBS group (P < 0.05); 62.5% of CBS group had ARI score 1, whereas 68.8% of SBS group had ARI score 3. No significant correlation between ARI and debonding strength was found (P < 0.05). Conclusion: SBS was found to produce similar debonding strength to the AEZ debonding plier in vitro. However, the AEZ debonding plier resulted in less adhesive remnant which is of great advantage for reducing chair-time during cleanup after debonding brackets

The Efficiency of Fluoride Bioactive Glasses in Protecting Enamel Surrounding Orthodontic Bracket

Objectives. The aim of this study was to evaluate the protective effect of using four different fluoride bioactive enamel sealers against an acidic erosion challenge. Materials and Methods. A sample of 50 freshly extracted sound upper premolars had their buccal surface bonded to 50 orthodontic brackets using Transbond PLUS color change adhesive; the first four groups had four compositions of fluoride bioactive glasses based on 37 mol% SiO2, 43.9-53.9 mol% CaO, 6.1 mol% P2O5 and CaF2, and 0-10 mol% of Na2O applied to their surfaces and the fifth group served as control (which was not treated by any bioactive sealer). All specimens were challenged by 1% citric acid for 18 minutes which was stirred by a magnetic stirrer. The enamel surfaces next to the orthodontic brackets were examined by SEM. The Wilcoxon signed-rank test was used to compare the area covered by the fluoride bioactive pastes before/after erosion (p<0.05). Samples from the layer formed on top of the examined teeth were tested before/after erosion to be examined by the attenuated total reflectance Fourier-transform infrared spectroscopy (FTIR/ATR). Results. The FTIR/ATR test showed that fluoride bioactive pastes’ applications resulted in the formation of a hydroxyapatite-rich layer; the SEM analysis showed that the aforementioned layer significantly resisted erosion challenge when compared to the control group (p<0.05). Conclusions. Fluoride bioactive pastes can efficiently protect the enamel surfaces next to orthodontic brackets from acidic erosion challenges

A Novel Evaluation Method for Detecting Defects of the Bonded Orthodontic Bracket-Tooth Interface

Background. Orthodontic patients are at high risk to develop caries. This study is introducing a clinical method detecting interfacial defects between ceramic brackets and enamel utilizing optical coherent tomography in addition to using the nanoleakage expression in vitro test. Methods. Transbond XT primer and moisture insensitive primer (MIP) were bonded to 75 human premolar enamel surfaces and divided into (XTD), (MIPD), and (MIPW) groups. The (XTD) and (MIPD) groups had ceramic brackets bonded to dry enamel surfaces using TransBond and moisture insensitive primers, respectively, while the (MIPW) samples were bonded to moist enamel using moisture insensitive primer. All specimens were examined under crosspolarization optical coherence tomography. Debonding forces of the brackets to 45 teeth (15 teeth/group). 30 bonded specimens (15 specimens/group) were cross-sectioned to detect the nanoleakage expression using scanning electron microscope equipped with energy-dispersive spectroscopy (SEM/EDS). The degree of conversion of the specimens in the experimental groups was tested using attenuated total reflectance Fourier transform infrared spectroscopy (FTIR/ATR). Results. Optical coherence tomography detected the interfacial defects between the ceramic brackets and tooth structure. One way ANOVA showed that (XTD) and (MIPD) groups recorded significantly higher bond strength values and less nanoleakage expression when compared to MIPW (p>0.05). Conclusions. Optical coherence tomography can be utilized to detect interfacial adhesive-tooth defects. Dry enamel surfaces improve the quality of the enamel/primer interface (200 words)