Physical Therapy as first therapy to mandibular fracture in a pediatric patient

Mandibular fractures are the most common in children, however with a low incidence because of child anatomy. Among the sites, the condyle is one the most fracture site, being a dilemma to surgeons about your management. The treatment to condyle fracture can be a surgical approach or conservative management. Conservative treatment presents the IMF, appliances, soft diet, and physiotherapy as an option, and these treatments can be applied isolated or associated. Physical Therapy has been a few reported in the literature as isolated therapy, reported as complementing the surgical approach, or after orthodontic/appliances therapy. Promote early mandibular mobility is important to restore function and prevent future complications such as ankylosis. Instruments to perform physiotherapy are expensive and not accessible to the entire population. Therefore, the present study presents a case of a pediatric patient with condyle fracture treated with a soft diet and physiotherapy with wooden spatula.

Determination of Most Frequent Emergencies in Patients with Fixed and Removable Orthodontic Appliances at Tertiary Care Dental Hospital

OBJECTIVES: To determine the frequency of emergencies in patients with fixed and removable orthodontic appliances at tertiary care dental hospital. METHODOLOGY: A questionnaire was designed for this descriptive cross-sectional study to be filled by the clinician (L3/L4 FCPS resident) at the end of addressing every orthodontic emergency. Sampling was done under consecutive non-probability protocols. Descriptive statistics were applied to determine the frequency of different orthodontic emergencies, and Pearson’s chi-square test was applied to determine association of emergencies with gender and etiology of emergency (patient related vs operator related). Data was analyzed on SPSS version 20. RESULTS: A total of 175 patients reported with orthodontic emergencies. The sample comprised 38.3% males and 61.7% females. Most frequent orthodontic emergency reported was deboned brackets in fixed appliances, while the most common emergency in removable appliances was traumatic PNAM. A statistically significant association (Pearson’s Chi Square=4.74, Cramer’s V=0.165, p=0.029) was seen for removable and fixed appliance emergencies with males and females. CONCLUSION: Most frequent fixed appliance orthodontic emergencies were deboned brackets while for removable appliance emergencies were trauma due to PNAM. Emergencies with removable appliances were mostly due to the operator related factors, while in fixed appliances patient related factors were dominating.

Accuracy of full-arch digitalization for partially edentulous jaws — a laboratory study on basis of coordinate-based data analysis

Objectives To compare the accuracy (trueness and precision) of direct digitization of four different dental gap situation with two IOS (intraoral scanner). Materials and methods Four partially edentulous polyurethane mandible models were used: (1) A (46, 45, 44 missing), (2) B (45, 44, 34, 35 missing), (3) C (42, 41, 31, 32 missing), and (4) D (full dentition). On each model, the same reference object was fixed between the second molars of both quadrants. A dataset (REF) of the reference object was generated by a coordinate measuring machine. Each model situation was scanned by (1) OMN (Cerec AC Omnicam) and (2) PRI (Cerec Primescan AC) (n = 30). Datasets of all 8 test groups (N = 240) were analyzed using inspection software to determine the linear aberrations in the X-, Y-, Z-axes and angular deviations. Mann–Whitney U and two-sample Kolmogorov–Smirnov tests were used to detect differences for trueness and precision. Results PRI revealed higher trueness and precision in most of the measured parameters ($${\overrightarrow{V}}_{E}$$ V → E 120.95 to 175.01 μm, $$\overrightarrow{V}_{E}$$ V → E (x) − 58.50 to − 9.40 μm, $$\overrightarrow{V}_{E}$$ V → E (z) − 70.35 to 63.50 μm), while OMN showed higher trueness for $$\overrightarrow{V}_{E}$$ V → E (y) regardless of model situation (− 104.90 to 34.55 μm). Model D revealed the highest trueness and precision in most of the measured parameters regardless of IOS ($$\overrightarrow{V}_{E}$$ V → E 120.95 to 195.74 μm, $$\overrightarrow{V}_{E}$$ V → E (x) − 9.40 to 66.75 μm,$$\overrightarrow{V}_{E}$$ V → E (y) − 14.55 to 51.50 μm, $$\overrightarrow{V}_{E}$$ V → E (z) 63.50 to 120.75 μm). Conclusions PRI demonstrated higher accuracy in the X- and Z-axes, while OMN depicted higher trueness in the Y-axis. For PRI, Model A revealed the highest distortion, while for OMN, Model B produced the largest aberrations in most parameters. Clinical relevance Current results suggest that both investigated IOS are sufficiently accurate for the manufacturing of tooth-borne restorations and orthodontic appliances. However, both hardware specifications of IOS and the presence of edentulous gaps in the dental model have an influence on the accuracy of the virtual model dataset.

Fluorescence-Aided Identification Technique (FIT) Improves Tooth Surface Clean-Up after Debonding of Buccal and Lingual Orthodontic Appliances

The aim of this study was to evaluate the use of fluorescence inducing light to aid the clean-up of tooth surfaces after bracket removal when using buccal or lingual orthodontic appliances. Two full sets of dental arches using extracted human teeth were assembled, with 14 teeth per arch. All teeth were bonded on their buccal and lingual surfaces. After debonding, a single blinded operator performed the tooth surface clean-up, as commonly performed in clinical practice; without the use of fluorescent light (non-FIT) and with two methods using fluorescent light to identify composite remnants on the tooth surfaces (FIT; OPAL and BRACE). Tooth surfaces were scanned before bonding and after clean-up, and the two scans were superimposed using the best-fit method. The results showed that the debonding method, type of tooth and type of tooth surface had a significant effect on the presence of composite remnants, enamel defects, and on debonding time. Contrary to the non-FIT method, there were no composite remnants after clean-up with the use of fluorescence inducing light. Clean-up time was significantly reduced on the buccal surfaces when using the FIT methods. On the lingual surfaces, the FIT methods resulted in larger enamel defects.

Causation of Oxidative Stress and Defense Response of a Yeast Cell Model after Treatment with Orthodontic Alloys Consisting of Metal Ions

Misaligned teeth have a tremendous impact on oral and dental health, and the most efficient method of correcting the problem is orthodontic treatment with orthodontic appliances. The study was conducted to investigate the metal composition of selected orthodontic alloys, the release of metal ions, and the oxidative consequences that the metal ions may cause in the cell. Different sets of archwires, stainless steel brackets, and molar bands were incubated in artificial saliva for 90 days. The composition of each orthodontic material and quantification of the concentration of metal ions released were evaluated. Metal ion mixtures were prepared to determine the occurrence of oxidative stress, antioxidant enzyme defense system, and oxidative damage to proteins. The beta titanium alloy released the fewest metal ions and did not cause oxidative stress or protein damage. The metal ions from stainless steel and the cobalt-chromium alloy can cause oxidative stress and protein damage only at high concentrations. All metal ions from orthodontic alloys alter the activity of antioxidant enzymes in some way. The determined amounts of metal ions released from orthodontic appliances in a simulated oral environment are still below the maximum tolerated dose, and the concentrations of released metal ions are not capable of inducing oxidative stress, although some changes in antioxidant enzyme activity were observed at these concentrations.

The duration of finishing and polishing of acrylic removable orthodontic appliances in the Dental Technology Study Program at Universitas Airlangga, Surabaya, Indonesia

Objective: This study was intended to quantify the duration of finishing and polishing of removable orthodontic appliances by Dental Technology Study Program students. Material and Methods: This descriptive observational study employed total sampling. Fifteen of 6th semester students participated in the study, each of them producing three removable orthodontic appliances with the duration of finishing and polishing being recorded. Data was analyzed descriptively. Results: The duration of the finishing and polishing of orthodontic plates by Dental Technology Study Program students varied widely from 9 to 420 minutes with a mean of 71.20 minutes, both between individual students and between the first, second and third orthodontic plates. Conclusion: It is concluded that the duration of finishing and polishing in the fabrication of an orthodontic plate by the students was between 9 and 420 minutes. The duration varied depending on the design of the appliances, the skill of the students in processing or when performing the finishing and polishing.

Does Clear Aligner Treatment Result in Different Patient Perceptions of Treatment Process and Outcomes Compared to Conventional/Traditional Fixed Appliance Treatment: A Literature Review

This study sought to systematically review the literature to determine whether clear aligner treatment results in different patient perceptions of treatment process and outcomes compared with conventional fixed appliance treatment. A systematic review was conducted to identify studies that examined differences in patient perceptions between clear aligners and conventional fixed appliance treatment. Studies were identified through searching relevant terms using PubMed and Embase. Following review of identified articles, key information about the studies including study design, setting, comparison groups, sample size/response rate, study location, primary outcomes, and statistical tests used were extracted. A total of 13 articles were identified that met the inclusion criteria for this study. These studies described a variety of outcomes which were divided into two broad categories: treatment process (pain, chewing, speech, daily routine, etc.) and treatment outcomes (satisfaction level, smile outcome perceptions, etc.). There was the strongest evidence that clear aligners had a positive impact with respect to treatment process compared with fixed orthodontic appliances. This study highlights that clear aligners may be effective for improving treatment-process-related outcomes among orthodontic patients. More studies need to be conducted to determine whether clear aligners have a beneficial impact with respect to treatment outcomes.

Activation and installation of orthodontic appliances temporarily impairs mastication: A systematic review with meta-analysis

ABSTRACT Objectives To investigate the masticatory (masticatory performance, bite force, swallowing threshold, muscle activity, and questionnaires) and nutritional (nutrient intake) impacts of the activation and/or installation of different orthodontic appliances (fixed labial, lingual appliances, and clear aligners). Materials and Methods Six electronic databases and gray literature were searched (up to May 2021) for relevant studies evaluating mastication and nutrition after activation/installation of orthodontic appliances. This review followed PRISMA guidelines and was registered at PROSPERO (CRD42020199510). The risk of bias (RoB 2 and ROBINS-I) and evidence quality Grading of Recommendations Assessment, Development, and Evaluation were analyzed. Results Of 4226 recorded and screened, 15 studies were finally included. Masticatory performance (standardized mean difference [SMD]: 1.069; 95% coefficient interval [CI]: 0.619 to 1.518) and bite force (SMD: -2.542; 95% CI: -4.867 to -0.217) reduced in the first 24 to 48 hours of fixed labial appliance installation/activation, but they were both normalized after 30 days (P > .05). The swallowing threshold remained constant (P > .05). Nutritional intake was rarely reported but showed copper (P = .002) and manganese (P = .016) reductions, with higher calorie and fat intake (P < .05). Lingual appliances impacted chewing more than labial, and clear aligner wearers reported fewer chewing problems (P < .001). Low to very low levels of evidence were found. Conclusions Based on low to very low levels of evidence, mastication was reduced during the first 24 to 48 hours of fixed labial appliance activation/installation, but it was transitory (up to 30 days). Due to insufficient data, the nutritional impact of orthodontic appliances was not conclusive.

Changes in Distribution of Dental Biofilm after Insertion of Fixed Orthodontic Appliances

Good oral hygiene is an important factor in oral and general health, especially in orthodontic patients, because fixed appliances might impede effective oral hygiene and thus increase the risks of tooth decay, periodontal disease and general health complications. This study investigated the impact of fixed orthodontic appliances on the distribution of dental biofilm in teenagers. Supragingival plaque was assessed at T0, T1 and T2. The distribution of the biofilm was analyzed. Approximal Plaque Index (API) and Bonded Bracket Index (BBI) were used to measure the presence of dental plaque. After insertion of the fixed appliance, the dental plaque indices values in the orthodontically treated group were significantly higher (p < 0.05) than in the control group. Fixed orthodontic appliances caused significant changes in the distribution of the biofilm. This was characterized by the change of location of the dental plaque. In the orthodontic group, we observed an increase in the amount of the supragingival plaque on the vestibular surface of the teeth.

Postoperative Stability of Patients Undergoing Orthognathic Surgery with Orthodontic Treatment Using Clear Aligners: A Preliminary Study

Backgrond: Until now, there have been many studies on the postoperative stability of orthognathic patients treated with traditional fixed orthodontic appliances. Recently, the use of clear aligners as orthodontic appliances has increased in orthodontic treatment for aesthetic and patient convenience. The aim of this preliminary study was to investigate the stability and characteristics of patients undergoing orthognathic surgery using clear aligners. Patients and Methods: This study was performed on patients who underwent orthognathic surgery by one surgeon at Pusan National University Dental Hospital from April 2017 to August 2021. A comparative study was conducted on five patients treated with clear aligners during orthodontic treatment and ten patients treated with traditional fixed appliances as a control group. Postoperative skeletal changes and recurrence were evaluated by cone beam computed tomography and lateral cephalometric radiographs taken two days postoperatively and six months postoperatively. Several measurement variables were used to confirm the presence or absence of recurrence, preoperative and postoperative orthodontic treatment period, and the number of extracted teeth. Results: Postoperative stability for six months after surgery was not significantly different between the clear aligner group and the traditional fixed appliance group. The preoperative orthodontic treatment period was also shorter in the clear aligner group, and the number of extracted premolar teeth and impacted teeth were also fewer in the clear aligner group, but there was no significant difference. Conclusions: Orthodontic treatment using clear aligners continues to develop, and it is believed that there is no limit to what can be accomplished during orthodontic surgery accompanied by clear aligners.