Patient Satisfaction with Orthodontic Treatment and Associated Factors

Objectives This study evaluated the satisfaction of patients receiving orthodontic treatment and the related factors probably affecting their level of satisfaction.Methods In this cross-sectional study, 193 patients who had finished their orthodontic treatment at the Department of Orthodontics of Shahid Beheshti Dental School, completed a researcher-made questionnaire on satisfaction with the process of treatment, treatment outcomes and its psychosocial benefits. The validity and reliability of the questionnaire were first verified. Descriptive statistics, t-test, one-way ANOVA and Pearson’s correlation test were used to assess the level of patient satisfaction, and the effects of gender, age, type of malocclusion, and type and duration of treatment on the level of satisfaction. Level of significance was set at 0.05.Results The frequency of patients who were highly satisfied with the final alignment of their teeth, esthetic facial appearance and smile attractiveness was 62.7%, 50.8% and 63.7%, respectively. Respondents gave the highest satisfaction score to smile attractiveness (1.62±0.53) and alignment of their teeth (1.61± 0.52) and the lowest score to the postgraduate student’s professional skills (0.79± 0.54). The mean total satisfaction score was 1.36 out of 2, which indicated that patient satisfaction with the orthodontic treatment was relatively high. Duration of treatment showed a weak (r=0.186) but significant (P=0.011) correlation with the level of satisfaction.Conclusion Generally speaking, patient satisfaction with the health services provided in the Department of Orthodontics of Shahid Beheshti Dental School was relatively high. No correlation was found between patient satisfaction and gender, type of malocclusion or type of treatmen

Galvanic Corrosion of Orthodontic Brackets and Wires in Acidic Artificial Saliva: Part II

Objective: Orthodontic wires should have high resistance against corrosion in the oral environment. Since the effect of pH on corrosion has been well recognized, this study sought to assess and compare the electrochemical corrosion of orthodontic brackets and wires of different brands in   acidic artificial saliva.Methods: This in vitro experimental study was conducted on 24 mandibular central incisor brackets of 4 manufacturers namely Dentaurum, American Orthodontics, Shinye and ORJ. The brackets were immersed in acidic artificial saliva along with stainless steel (SS) or NiTi 0.016 round wires for 28 days. All specimens were weighed before and after the experiment by a digital scale. After the experiment, the specimens were evaluated under a light stereomicroscope and specimens with corrosion were further assessed by scanning electron microscope (SEM) and energy-dispersive X- ray spectroscopy (EDX). Two-way ANOVA was used for statistical analysis.Results: The mean corrosion rate (CR) was -1.80, 0.11, 0.05 and -0.93 mpy for Dentaurum, American Orthodontics, Shinye and ORJ brackets, respectively in combination with NiTi wire; these values were 0.46, -0.71, 0.87 and -0.27 mpy, respectively in combination with SS wires; the differences in this regard were not statistically significant (p>0.05). Micrographs showed high corrosion in ORJ brackets followed by Shinye brackets. EDX showed that the combination of ORJ bracket with SS wire had the highest iron (Fe) content and the highest CR.Conclusion: SS brackets manufactured by Shinye and ORJ companies in combination with SS wires showed higher CR in acidic artificial saliva compared to other bracket/wire combinations

Effect of Universal Adhesive and Different Surface Pretreatments on Shear Bond Strength of Orthodontic Brackets to Amalgam Restorations: A Comparative Experimental Study

Objectives Many adult patients requiring orthodontic treatment have posterior restorations. Bracket bonding to dental restorations is a clinical challenge. The aim of this study was to compare the effect of universal adhesive with the conventional method on shear bond strength (SBS) of orthodontic brackets to amalgam restorations. Methods Ninety cavities were filled with admixed amalgam and divided into six groups (n=15) according to the surface pretreatment (no mechanical preparation, diamond bur preparation, and sandblasting) and type of bonding agent (alloy primer plus Transbond XT or universal adhesive). Mandibular central incisor brackets were bonded to the restoration surfaces. The primary outcome was the bond strength in megapascals (MPa) which was compared by two-way ANOVA. The mode of failure was the secondary outcome determined by determination of the adhesive remnant index (ARI). The Kruskal-Wallis and Mann-Whitney tests were used to compare the ARI scores among the groups. Results Among the groups with the conventional method, the sandblasted subgroup showed the highest SBS (P<0.05). The three subgroups of universal adhesive were not significantly different in terms of SBS (P=1). Overall, the highest SBS was noted in the sandblasted/conventional adhesive group. Conclusion The results demonstrated that sandblasting plus alloy primer and Transbond XT bonding agent could be recommended for bracket bonding to amalgam restorations. Further studies using other bonding agents are recommende

Galvanic Corrosion and Ion Release from Different Orthodontic Brackets and Wires in Acidic Artificial Saliva

Objective: Corrosion resistance is among the most important properties of metal alloys used in the oral cavity. Consumption of acidic foods reduces the salivary pH and intensifies the corrosion of brackets and orthodontic wires. This study aimed to compare electro galvanic corrosion of different orthodontic brackets and wires and determine the amount of ions released into acidic artificial saliva. Methods: In this in vitro experimental study, 24 mandibular incisor brackets of 4 different manufacturers (Dentaurum, American Orthodontics, Shinye and ORJ) with stainless steel (SS) or nickel-titanium (Ni-Ti) round wires 0.016 were immersed in acidic artificial saliva for 28 days and their potential difference with the reference electrode was recorded. The amount of released ions was measured in the solution using atomic absorption method. Data were analyzed using two-way ANOVA and repeated measures ANOVA.Results: The mean amount of ions released was not significantly different between groups (p>0.05). The potential difference of Shinye brackets coupled to SS wire was significantly lower than that of other combinations and was negative throughout the study. The potential difference of Dentaurum bracket-NiTi wire, ORJ bracket-NiTi wire, Shinye bracket-SS wire and ORJ bracket-SS wire combinations at the end of experiment was negative as well.Conclusion: The galvanic corrosion of Shinye bracket coupled to SS wire in acidic artificial saliva was greater than that of other bracket-wire combinations. The specimens were not significantly different in terms of the released ions

Removable Appliance For Oral Self-Mutilation In Lesch-Nyhan Syndrome. A Case Report

Objectives Lesch-Nyhan syndrome is a rare inherited disorder associated with self-harming behaviors, delayed mental and motor development, and disturbances such as dysarthria, choreoathetosis, and spasticity. Severe inflicted behaviors in Lesch-Nyhan syndrome often include chewing and biting of the lips or fingers, which often require management. Techniques to deal with these behaviors include using appliances that restrict the behavior or ultimately extracting the teeth. Case This case report presents a 6-year-old child with Lesch-Nyhan syndrome and self-mutilation. He had chronic wounds in his buccal mucosa due to severe biting. Two acrylic devices with anterior and posterior bite plates were designed for the maxillary and mandibular teeth. At the follow-up visits, the wounds had been healed, but due to shedding of the primary teeth, and poor patient cooperation, the appliance design was slightly changed. The design of the device used for the patient inspires similar devices for patients with self-mutilation behaviors. Conclusion Early diagnosis and management of patients suffering from self-injurious behaviors may improve oral health-related quality of life of these patients. Acrylic appliances seem to be effective to minimize injury and to enhance fast healing of oral lesions

Shear Bond Strength of Orthodontic Brackets to Composite Restorations Using Universal Adhesive

Statement of the Problem: The dental adhesives may have the potential to increase the bond strength of orthodontic brackets to composite resin and it would be highly desirable if adequate bracket-composite bond strength could be yielded by using these adhesives without the need for surface roughening. Purpose: The purpose of this study was to measure the shear bond strength (SBS) of metal brackets to composite restorations by use of a universal adhesive compared with a conventional adhesive. Materials and Method: In this in vitro, experimental study, 45 composite discs measuring 6 mm in diameter and 4 mm in thickness were fabricated and assigned to three groups (n=15). In the group 1, discs were etched with 37% phosphoric acid for 15 seconds and Scotchbond Universal was then applied. Discs were roughened by diamond bur in the group 2 and were subjected to the application of Scotchbond Universal. In the group 3, conventional adhesive (Single Bond 2) was applied after roughening the discs by diamond bur. Metal brackets were then bonded to discs and after thermocycling, the SBS was measured by an Instron machine. The mode of failure and adhesive remnant index (ARI) score were determined using stereomicroscope. Data were analyzed by SPSS version 18, one-way ANOVA, and the Kruskal Wallis test. Results: The surface roughening plus universal adhesive group showed the highest SBS (11.90 MPa) but according to one-way ANOVA, the difference in this regard among the three groups was not statistically significant (p= 0.94). Most samples showed ARI score of 4. Conclusion: Universal adhesive can provide sufficient bond strength as high as that provided by conventional adhesives for orthodontic bracket bonding to composite restorations even in absence of surface roughening by bur

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

A review on the applications of nanotechnology in orthodontics

Objective (s): Nanotechnology has gained importance in recent years due to its ability in the enhancement of materials properties and other specifications such as antimicrobial properties. Nano-sized materials have been applied in various fields of dentistry. Nanotechnology can be employed in orthodontics to enhance the quality of treatment. In the current study, a comprehensive review is carried out on the applications of nanotechnology in orthodontics. Materials and Methods: In the first step, various databases such as Scopus, Google Scholar and Pubmed were searched by using appropriate keywords for the present study. Afterwards, the related resources were selected to be reviewed. Finally, the key findings of the reviewed studies were represented and summarized. Results: Based on the reviewed researches, nanotechnology is applicable in various aspects of orthodontics. By using nanotechnology, improved properties in mechanical and medical specifications are achievable. For instance, by using nano coating in archwires, the friction force between components can be reduced and facilitate its motion. In addition, adding some types of nano particles to the composites resulted in improvement in tensile and shear bond strength. Antimicrobial properties of specific nano particles such as silver makes them favorable for reducing microorganisms in orthodontics treatment. Moreover, nanotechnology can be used in nano-identation test to assess the tools employed in orthodontics. Conclusion: nanotechnology can be broadly employed in orthodontics to achieve better treatment including improved strength of utilized materials, more accurate positioning and reduced microorganisms

The Effect of Root Coating with Titanium on Prevention of Root Resorption in Avulsed Teeth; An Animal Study

Introduction: Tooth avulsion is a real dental emergency. If immediate replantation is not performed, the avulsed tooth may be lost due to inflammatory or replacement resorption. This animal study aimed to evaluate the bone response to the titanium coating of the root surface as an artificial barrier, and prevention of resorption of avulsed teeth. Methods and Materials: This experimental study was conducted on four male dogs. The dogs were randomly divided into two groups for assessment at two and eight weeks. Four teeth were extracted in each animal. The root surfaces of the test group were coated with a titanium layer using the Electron Beam Deposition system. After 24 h, replantation of the teeth was performed. Two animals were sacrificed after two weeks and the remaining dogs were killed after eight weeks. The presence of inflammation, inflammatory resorption, replacement resorption, periodontal regeneration, periapical granuloma and ankylosis were evaluated through histological analyses. Results: Inflammatory root resorption was not present in any tooth except one tooth in the coated group after eight weeks. Replacement resorption was noted just in three of the non-coated teeth after two weeks and two teeth after eight weeks. The McNemar's test revealed that the frequency of replacement resorption in the non-coated group was significantly higher than the coated group (P=0.031). Conclusion: Based on the results of this study, it seems that coating the root surfaces of avulsed teeth with titanium may control the replacement root resorption.Keywords: Avulsion; Root Resorption; Titanium Coatin

Effect of Three Different Remineralizing Agents on White Spot Lesions; AnIn Vitro Comparative Study

Background and Aim: White spot lesions (WSLs) are common occurrence following orthodontic treatment, this study sought to compare the remineralizing potential of fluoride, MI Paste Plus (CPP-ACP-F) and Remin Pro for treatment of WSLs. Materials and Methods: This in vitro study was conducted on 56 sound human premolars that extracted for orthodontic purposes. Teeth were cleaned and their roots were cut, then the crowns were mounted in acrylic resin. Teeth surfaces were coated with nail varnish except for a 3×4mm window on the buccal surface. In order to create WSLs, all samples were immersed in demineralizing solution for 10 days. After surface hardness was measured using a Vickers microhardness tester, teeth were randomly divided into four groups. In control group (group 1) no remineralizing agent was used while, groups 2 to 4, were treated with0.05% sodium fluoride (NaF), MI Paste Plus, and Remin Pro paste respectively, for five minutes every 12hours. After each treatment, specimens were immersed in freshly prepared artificial saliva. At the end of 28 days, surface microhardness was measured again and changes were statistically analyzed using analysis of covariance (ANCOVA). Results: The mean changes in surface microhardness of MI Paste Plus, NaF and Remin Pro groups was significantly higher than control group (P˂0.001, P˂0.001 and P0.046 respectively). Conclusion: MI Paste Plus, 0.05% NaF mouthwash, and to a lesser extent Remin Pro were efficient for treatment of WSLs comparing to the artificial saliva