Stability and relapse after orthodontic treatment of deep bite cases—a long-term follow-up study

The purpose of this long-term follow-up study was twofold—firstly, to assess prevalence of relapse after treatment of deep bite malocclusion and secondly, to identify risk factors that predispose patients with deep bite malocclusion to relapse. Sixty-one former patients with overbite more than 50% incisor overlap before treatment were successfully recalled. Clinical data, morphometrical measurements on plaster casts before treatment, after treatment and at long-term follow-up, as well as cephalometric measurements before and after treatment were collected. The median follow-up period was 11.9 years. Patients were treated by various treatment modalities, and the majority of patients received at least a lower fixed retainer and an upper removable bite plate during retention. Relapse was defined as increase in incisor overlap from below 50% after treatment to equal or more than 50% incisor overlap at long-term follow-up. Ten per cent of the patients showed relapse to equal or larger than 50% incisor overlap, and their amount of overbite increase was low. Among all cases with deep bite at follow-up, gingival contact and palatal impingement were more prevalent in partially corrected noncompliant cases than in relapse cases. In this sample, prevalence and amount of relapse were too low to identify risk factors of relaps

Laboratory evaluation of orthodontic biomechanics: The clinical applications revisited

The aim of the present review is to discuss the current evidence on laboratory research for studying biomechanical aspects as related to orthodontics and critically appraise the amount of this research that can be translated to clinical level orthodontics. Finite element analyses (FEA) are used often in the field of Orthodontics. The reliability of FEA depends on the geometry of the structure, the material properties, and the loading configuration. The center of resistance is of fundamental importance for the evaluation of movement in Orthodontics. Most simulations for the assessment of the center of resistance involve FEA. Another series of experiments evaluate force and moment from several appliances during orthodontic movement. The Orthodontic Measurement and Simulation System is used in many of these studies. Especially for torque quantification, several bracket/archwire configurations have been tested on multiple devices, however biomechanical differences render difficult the direct comparison of the results. Further, friction during sliding mechanics has been extensively investigated in the laboratory. These ex-vivo friction research protocols show poor reliability, since several different mechanisms are involved in resistance to sliding. A critical appraisal of the literature revealed that in-vitro trials are no substitute for clinical testing and the results of most ex-vivo investigations should not be extrapolated in the clinical practice without skepticism. © 2017 Elsevier Inc

Adverse reactions to orthodontic materials

Adverse effects can arise from the clinical use of orthodontic materials, due to the release of constituent substances (ions from alloys and monomers, degradation by-products, and additives from polymers). Moreover, intraoral aging affects the biologic properties of materials. The aim of this review is to present the currently identified major adverse effects of the metallic and polymeric components found in orthodontic appliances and materials. Corrosion in metallic orthodontic attachments releases metal ions, mainly iron, chromium, and nickel. The latter has received the greatest attention because of its reported potential for an allergic response. The formation of an oxide layer may inhibit the outward movement of ions, thereby acting as an obstacle for release. Titanium alloys have superior corrosion resistance than stainless steel. The efficiency of polymerisation is considered an essential property for all polymers. A poor polymer network is susceptible to the release of biologically reactive substances, such as bisphenol-A (BPA), which is capable of inducing hormone-related effects. The close proximity of a light-curing tip to the adhesive, pumice prophylaxis after bonding, indirect irradiation and mouth rinsing during the first hour after bonding may decrease BPA release. The adverse effects of some orthodontic materials should be considered during material selection and throughout orthodontic treatment, in order to minimise possible undesirable implications. © 2017 Australian Dental Associatio

Fluctuation of bone turnover markers' levels in samples of gingival crevicular fluid after orthodontic stimulus: a systematic review.

BACKGROUND The aim of the present study was to provide an overview of gingival crevicular fluid (GCF) bone turnover markers (BTMs) concerning the physiology of orthodontic tooth movement (OTM) and assess their potential contributions to regulating bone remodeling, that could prove useful in designing future approaches to modulating orthodontic tooth movement. METHODS Multiple electronic databases (MEDLINE/PubMed, Ovid MEDLINE, Ovid Embase, LILACS, and Cochrane Library) were searched up to October 1st, 2020. Randomized controlled trials (RCTs), controlled clinical trials, observational studies of prospective and retrospective designs, and cross-sectional studies reporting on levels of BTMs in GCF were eligible for inclusion. The quality of the included RCTs was assessed per the revised Cochrane risk of bias tool for randomized trials (RoB 2.0), whereas the risk of bias of the included cohort studies was assessed using the Risk Of Bias In Non-randomized Studies of Interventions tool. RESULTS Five RCTs, 9 prospective cohort studies, and 1 cross-sectional study fulfilled the inclusion criteria. The risk of bias was deemed as high for the RCTs and 4 of the prospective studies and moderate for the rest of the studies. The following biomarkers for bone formation were assessed: bone alcaline phosphatase (BALP), alcaline phosphatase (ALP), and osteocalcin (OC). For bone resorption, the following BTMs were assessed: deoxypyridinoline (DPD) and pyridinoline (PYD), N-terminal telopeptide (NTX), osteopontin (OPN), and tartrate-resistant acid phosphatase (TRAP). The follow-up period ranged mainly from baseline to 45 days, although one study had an expanded follow-up period of up to 16 months. The results of the included studies comparing different BTMs were heterogeneous and qualitatively reported. CONCLUSIONS Current evidence continues to support the potential for BTMs to provide clinically useful information particularly for adjusting or standardizing the orthodontic stimulus. The present systematic review has retrieved studies of high, overall, risk of bias, and has unveiled a substantial clinical and methodological heterogeneity among included studies. Further data of the relationships between the clinical assays and the physiological or pre-analytical factors contributing to variability in BTMs' concentrations are required. SYSTEMATIC REVIEW REGISTRATION CRD42020212056

Residual stress analysis of fixed retainer wires after in vitro loading: Can mastication-induced stresses produce an unfavorable effect?

The aim of the present study was to compare four different types of fixed canine-to-canine retainer regarding the maximum and residual force system generated on a canine during the intrusive in vitro loading of the rest of the anterior teeth. Retainers constructed from Ortho-FlexTech gold chain 0.038×0.016-inch (rectangular, 0.96×0.40 mm), Tru-Chrome® 7-strand twisted 0.027-inch (round, 0.68 mm diameter) steel wire, and Wildcat 0.0175-inch (round, 0.44 mm) and 0.0215-inch (round, 0.55 mm) 3-strand Twistflex steel wire bonded on the anterior teeth of an acrylic resin model, installed in the Orthodontic Measurement and Simulation System. The force system on the canine was recorded during the loading of the anterior teeth as well as the residual force system at the same tooth after the unloading. During maximum loading, the gold chain exerted the lowest and the 0.0215-inch archwire the highest force and moment magnitude. Residual forces and moments were exerted on the canine after the unloading in all retainer types, i.e., the evaluated fixed retainers were not passive after in vitro vertical loading. The lowest magnitude was measured in gold chain retainers and the highest in cases of the high formable/low yield strength 0.027-inch archwire. This fact may explain the unexpected movements of teeth bonded on fixed retainers detected long-term in vivo. © 2015 by De Gruyter 2015

Mechanical properties of contemporary orthodontic adhesives used for lingual fixed retention

The aim of the present study was to test the mechanical properties of different adhesives used in orthodontics for fixed retainers and to investigate their possible interrelations. Specimens of six different adhesive resins were prepared: Transbond XT, Transbond LR and an experimental BPA-free orthodontic adhesive, as well as IPS Empress Direct (IPS-ED), ZNano and Accolade. The mechanical properties tested were Martens hardness (HM), indentation modulus (EIT), the ratio of elastic to total work, commonly known as elastic index (ηIT) and Vickers hardness (HV). These properties were determined using instrumented indentation testing according to ISO 14577-2002. The results of the aforementioned properties were statistically compared with one-way ANOVA-test and Student-Newman-Keuls multiple comparison test at a=0.05, while possible correlations among the properties tested were analyzed by Pearson correlation. Significant differences were identified among all the materials tested for HM, with Transbond LR presenting the highest value. This resin presented the highest EIT too. Significant EIT differences were identified among the materials and only ZNano and IPS-ED showed no significant differences for this property. Transbond LR and ZNano showed higher HV values. ZNano demonstrated the highest elastic index. Pearson analysis showed a strong positive correlation between HM and EIT (0.970), HM and HV (0.837), and EIT and HV (0.695), while a weak negative correlation was found between EIT and elastic index (-0.505). The materials tested demonstrated significant differences in their mechanical properties, and thus differences in their clinical performance are anticipated. © 2017 2017 Walter de Gruyter GmbH, Berlin/Boston

Craniofacial shape in patients with beta thalassaemia: a geometric morphometric analysis

The shape of the craniofacial complex of patients with beta thalassaemia was evaluated using geometric morphometrics on lateral cephalometric radiographs and was compared with matched controls. The beta thalassaemia group consisted of 40 patients (16 females, 24 males, mean age 33.4). Each patient was matched by age and gender to two controls (32 females, 48 males, mean age 33.1). The 120 lateral cephalometric radiographs were digitized and traced with 15 curves, 10 landmarks and 117 sliding semi-landmarks. These landmarks were subjected to Procrustes superimposition and principal component analysis in order to describe shape variability of the cranial base, maxilla and mandible, as well as of the entire craniofacial complex for each sex. The first 4 principal components accounted for 50% of the total sample’s variability. The beta thalassaemia group was significantly different in overall shape to the control group for both sexes. Similar findings were noted for the maxilla, the mandible and the cranial base. The main differences were related to smaller mandibular body for the thalassaemia group, midface protrusion and decrease in posterior face height. The shape of the craniofacial complex in these patients is prone to be more convex and hyperdivergent. © 2021, The Author(s)