Dentistry and Orthodontics

A 26-year-old man with an aggressive periodontitis sought for orthodontic treatment to improve the appearance of his smile. He presented with generalised anterior spacing, missing lower left central incisor and deep traumatic bite. He was treated successfully with a combination of orthodontic and periodontal treatment. After 18 months of orthodontic treatment and follow up by the periodontist, his alignment of teeth was improved, a stable occlusion was achieved, and occlusal trauma was prevented. As a result, the patient's smile appearance and selfconfidence were improved. Orthodontic tooth movement is not only to correct the alignment of his teeth but also to improve the bone level especially at the anterior region. This case report shows the successful treatment outcome in aggressive periodontitis patient which requires good collaboration between the orthodontist and the periodontist.

The aim of this prospective study was to compare a fixed lingual orthodontic appliance with a commonly used aligner system, focusing on oral impacts and speech disturbances, during the first 3 months of orthodontic treatment. Two groups of adults were evaluated: 21 treated with Invisalign® and 26 with In-Ovation L® lingual brackets. Health-related quality of life questionnaires were used to assess the oral impacts, and speech samples were collected for speech evaluation by professionals. The levels of pain and painkiller intake were similar, increasing on the first day, and decreasing at 3 months. Subtle injuries on the lip and cheeks were initially reported in the aligner group. Lingual patients experienced more discomfort in swallowing and opening the mouth, tongue injuries and food residues, even at 3 months. The consonants “s” and “z” were mainly affected in both groups immediately after appliance insertion, but more often in the aligner group. These speech disturbances recovere...

The aim of this prospective study was to compare a fixed lingual orthodontic appliance with a commonly used aligner system, focusing on oral impacts and speech disturbances, during the first 3 months of orthodontic treatment. Two groups of adults were evaluated: 21 treated with Invisalign ® and 26 with In-Ovation L ® lingual brackets. Health-related quality of life questionnaires were used to assess the oral impacts, and speech samples were collected for speech evaluation by professionals. The levels of pain and painkiller intake were similar, increasing on the first day, and decreasing at 3 months. Subtle injuries on the lip and cheeks were initially reported in the aligner group. Lingual patients experienced more discomfort in swallowing and opening the mouth, tongue injuries and food residues, even at 3 months. The consonants "s" and "z" were mainly affected in both groups immediately after appliance insertion, but more often in the aligner group. These speech...

Background: The malocclusion indices have been used routinely by researchers to gather data regarding the prevalence of orthodontic treatment needs and trait. The scoring methods of malocclusal indices can be used to generate data regarding the actual load of the malocclusion which can be used for resource and fund allocation and identify the actual orthodontic treatment needs. This article will provide an insight to the various orthodontic indices and its specific indications.

In orthodontic practice various treatment modalities have been
presented for the treatment for the class II, div 1malocclusions.
Recently a large number of young adults have been seeking
shorter, cost effective and a non surgical correction of Class II
malocclusions and they accept dental camouflage as a treatment option to mask the skeletal discrepancy .This case report presents one such case, a 15years old growing male who has Class II div I malocclusion with sever maxillary incisor proclination, convex profile ,high mandibular plane angle, incompetent lips, increased overjet& overbite, over retained upper left deciduous canine ,impacted upper left canine and a supernumerary tooth in canine region. We considered the camouflage treatment by extracting the upper right first premolar, left impacted canine, deciduous canine
and supernumerary tooth. Following the treatment, a satisfactory result was achieved with an ideal, static and a functional occlusion, facial profile, acceptable smile, competent lip and stable treatment results.

Health care services in post-independent Zimbabwe have undergone turbulence with periods of seemingly significant improvements and other periods of definite decline. This thesis looks at health-care systems in general and in particular, the way in which they are reflected through the health-care system of Zimbabwean.  Ethical issues and challenges in health care can take many forms ranging from debates and discussions on the fairness or the lack thereof in the health-care reform process, the ethics of inter-professional relationships, the ethical problems with doctor-patient relationships, the state of advocacy in health matters, and patient rights, ethical perspectives influencing discourses on health systems, the ethics of health-care funding, and debates on access to health care. This thesis reflects on the complexities of the challenges, needs and reform requirements of the Zimbabwean situation.
A critical analysis of the ethical principles, their impact on the Zimbabwe health care system, using largely the principlist approach as enunciated by Beauchamp and Childress (2013), is conducted. Other moral theories such as the social contract theory is also discussed in some detail because of its important application to issues related to health care. A whole chapter is dedicated to the principle of distributive justice and its relevance and implications for the health care systems in general, but also with particular relevance to the situation in Zimbabwe.  Lack of or inadequate insurance is the biggest economic hurdle in accessing health care in many low income countries. There are two main arguments, which appear to support some sort of moral right to a health care funded by the government – “the collective social protection” and the “fair opportunity arguments” (Beauchamp & Childress, 2013). Both of these arguments are discussed in detail. Right to health and right health care are two concepts which confuse a lot of readers because they are close but refer to different dimensions of the concept of health. They are discussed with a particular emphasis on the ethical issues involving allocation of health resources, rationing and setting of priorities. This thesis winds up by looking at the possible solutions to the health crisis in Zimbabwe. The much-flaunted National Health Insurance, amongst other possible remedies, is analyzed. A list of recommendations is outlined, in the last chapter.


OPSOMMING
Gesondheidsorgdienste in post-onafhanklike Zimbabwe het turbulensie ondergaan met periodes van oënskynlik beduidende verbeteringe en ander tydperke van definitiewe afname. Hierdie tesis ontleed gesondheidsorgstelsels in die algemee, met spesiale verwysing na die gesondheidsorgstelsel van Zimbabwiese. Etiese kwessies en uitdagings in gesondheidsorg kan baie vorme van debatte aanneem, byvoordeeld besprekings oor die regverdigheid of die gebrek daaraan in die hervormingsproses vir gesondheidsorg, die etiek van interprofessionele verhoudings, die etiese probleme met doktor-pasiëntverhoudinge, die staat van voorspraak in gesondheidsake, pasiënt-regte, etiese perspektiewe wat diskoerse op gesondheidstelsels beïnvloed, die etiek van gesondheidsorgbefondsing en debatte oor toegang tot gesondheidsorg. Hierdie tesis bespreek die kompleksiteit van die uitdagings, behoeftes en hervormingsvereistes van die Zimbabwiese situasie. ‘n Kritiese analise van die etiese beginsels en die impak daarvan op die Zimbabwiese gesondheidsorgstelsel, word hoofsaaklik gebruik deur die beginsel-benadering van Beauchamp en Childress (2013). Ander morele teorieë soos die sosiale kontrakteorie word ook bespreek as gevolg van die belangrike toepassing daarvan op probleme wat verband hou met gesondheidsorg. 'n Hele hoofstuk word gewy aan die beginsel van distributiewe geregtigheid en die relevansie en implikasies daarvan vir die gesondheidsorgstelsels in die algemeen, maar ook met betrekking tot die situasie in Zimbabwe. Gebrek aan of onvoldoende versekering is die grootste ekonomiese struikelblok in die verkryging van gesondheidsorg in baie lae-inkomste lande. Daar is twee hoofargumente wat blykbaar 'n morele reg op 'n gesondheidsorg wat deur die regering befonds word - "die kollektiewe sosiale beskerming" en die "billike geleentheidargumente" (Beauchamp & Childress, 2013) - ondersteun. Albei hierdie argumente word breedvoerig bespreek. Reg op gesondheid en regte gesondheidsorg is twee konsepte wat baie lesers verwar omdat hulle betekenisse verwant is, maar hulle tog onderskeidelik verwys na verskillende dimensies van die konsep van gesondheid. Hulle word bespreek met spesifieke klem op die etiese kwessies wat die toekenning van gesondheidsbronne, rantsoenering en die opstel van prioriteite insluit. Hierdie tesis druk ook deur na moontlike oplossings vir die gesondheidskrisis in Zimbabwe. Die veelbelowende Nasionale Gesondheidsversekering, word onder andere ontleed. 'n Lys aanbevelings word in die laaste hoofstuk uiteengesit.

The terminology “serial extraction” in Orthodontics was first described in the late 1920’s when Kjellgren [1] decided to plan the extraction of certain deciduous and permanent teeth at early stages of the dentition development. Since the extractions are under taken at the transitional dentition. This type of treatment is defined as “Early Treatment” in Orthodontics [2]. The main indication for this treatment approach is for patients with severe crowding caused by tooth size arch discrepancies [3,4]. In other words, when maxillary and/or  mandibular  arches  cannot  accommodate  teeth,  extraction  becomes an interesting option. Although  this  treatment  option  has  been  used  for  almost  a  century  in  the  contemporary  orthodontics  it’s  indication  is  very  specific.  Since  it’s  an  irreversible  approach  (permanent  teeth are  early  extracted)  the  clinician  should  carefully  diagnosis  the  case  before  selecting  this  option.  In  addition,  as  time  passed  by,  orthodontics  specialty  has  dramatically  evolved  and  developed several  options  to  gain  space  instead  of  extracting  teeth.  On  the  other hand, the idea to early extract permanent teeth continues to be  an  interesting  treatment  option  in  clinical  orthodontics  mainly  in  severely  crowded  patients.  The  aim  of  this  paper  is  to  present  a case report of a ten-year-old male patient who presented severe crowding and treatment option was to extract four first premolars at early stages of the dentition development.

Advancements  in  computer  systems  and  technologies  have
revolutionized the field of dentistry as well. These advancements
can be seen with the introduction and evolution of CAD/CAM
systems. The demand for such systems has grown dramatically
over the past decade and a large variety of different CAD/CAM
systems have been developed and marketed. The popularity of
these systems can be attributed to their efficiency of designing,
manufacturing and precision.

Objectives: The purpose of this paper is to provide a useful critical review relating to the effects of malocclusion on the physical, social, and psychological aspects of the Quality of Life (QoL) of patients. Methods: The information presented in previous articles was reviewed. They include reviews, meta-analyses, cross-sectional studies, retrospective and prospective longitudinal studies, and randomized controlled trials. These full-text English-language papers were studied to determine the effects of malocclusion on QoL. Results: Recent studies have found that malocclusion is associated with higher levels of dissatisfaction with appearance, and have the potential to negatively impact Oral Health Related Quality of Life (OHRQoL). However, due to the differences in study designs, population demographics studied, and methods of assessment of physical, social, and psychological health, the evidence needs more analysis. Conclusion: In recent years, attention to patient-centered assess...

3D printing has been admired as a cutting-edge technology, which will change manufacturing [1]. Recent advances in bioprinting technologies have enabled rapid manufacturing of medical models in many fields and areas. Recently in the field of dentistry, fused deposition modeling and Stereolithography 3D bioprinting techniques have been using in dental applications such as implants, the production of physical models for prosthodontics, orthodontics, and surgery [2,3]. This paper reviews the usage of fused deposition modeling and stereolithography 3D printing technologies and their various applications in dentistry and in maxillofacial surgery. 3D printing is transforming digital dentistry by extensively penetrating opportunities in diagnosis, treatment and education. The accel- erated research in this industry and optimism would open more doors to help revolutionize digital dentistry.

Keywords: Fused Deposition Modeling (FDM); Stereolithography (SLA); 3D Printing; Dentistry, Dental Devices

Effect of long-term orthodontic treatment on salivary nickel and chromium has not been quite assessed except in few retrospective studies with controversial results. The aim of this prospective study was to measure salivary levels of these ions during 1 year of orthodontic treatment. Saliva samples were collected from 20 orthodontic patients, before treatment (control) and 6 and 12 months later. Nickel and chromium concentrations were determined using atomic absorption spectrophotometry. Data were analyzed using one- and two-way repeated-measures ANOVA, Bonferroni, Friedman (α = 0.05), and Wilcoxon signed-ranks tests (α = 0.016). Average nickel level changed from 9.75 ± 5.02 to 10.37 ± 6.94 and then to 8.32 ± 4.36 μg/L in 1 year. Average chromium concentration changed from 3.86 ± 1.34 to 4.6 ± 6.11 and then to 2.04 ± 1.66 μg/L. Alterations in nickel values were not statistically significant [P = 0.468 (ANOVA)], but fluctuations in chromium levels were [P = 0.021 (Friedman)]. The dec...

• Crown angulation (tip) Normal occlusion is dependent upon proper distal crown tip, especially of the upper ant. teeth (longest crowns). Degree of tip of incisors, determines the amount of MD space they consume & has a considerable effect on post. occlusion as well as ant. esthetics.

Papageorgiou SN, G€ olz L, Jäger A, Eliades T, Bourauel C. Lingual vs. labial fixed orthodontic appliances: systematic review and meta-analysis of treatment effects. Eur J Oral Sci 2016; 00: 000–000. © 2016 Eur J Oral Sci The aim of this systematic review was to compare the therapeutic and adverse effects of lingual and labial orthodontic fixed appliances from clinical trials on human patients in an evidence-based manner. Randomized and prospective non-randomized clinical trials comparing lingual and labial appliances were included. Risk of bias within and across studies was assessed using the Cochrane tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Random-effects meta-analyses were conducted, followed by subgroup and sensitivity analyses. Six electronic databases were searched from inception to July 2015, without limitations. A total of 13 papers pertaining to 11 clinical trials were included with a total of 407 (34% male/66% female) patients. Compared with labial appliances, lingual appliances were associated with increased overall oral discomfort , increased speech impediment (measured using auditory analysis), worse speech performance assessed by laypersons, increased eating difficulty, and decreased intermolar width. On the other hand, lingual appliances were associated with increased intercanine width and significantly decreased anchorage loss of the maxillary first molar during space closure. Based on existing trials, there is insufficient evidence to make robust recommendations for lingual fixed orthodontic appliances regarding their therapeutic or adverse effects, as the quality of evidence was low.

Radiography of the hand & wrist is the commonest modality used to calculate bone age. Automated methods for evaluation of hand
and wrist radiographs are also being developed which reduce inter rater variability compared to manual methods. Non radiation
based techniques of visualizing hand & wrist bones such as ultrasonography for bone age calculation have been theorized but are not
as accurate as radiographic methods. MRI based methods are being developed but require more research. Dental age is an alternate
form of bone age determination, which also gives an estimate of skeletal maturity. The accurate age assessment is required for
applying correct treatment modality in pediatric patient as well as for forensic purpose. The hand wrist radiograph is considered to be
the most standardized method of skeletal assessment. In the present review we will discuss about the various methods of hand wrist
skeletal maturity assessment.

Communication is an essential element of the relationship between patient and dentist. Dental schools are required to ensure that undergraduates are adequately trained in communication skills yet little evidence exists to suggest what constitutes appropriate training and how competency can be assessed. This review aimed to explore the scope and quality of evidence relating to communication skills training for dental students. Eleven papers fitted the inclusion criteria. The review found extensive use amongst studies of didactic learning and clinical role-play using simulated patients. Reported assessment methods focus mainly on observer evaluation of student interactions at consultation. Patient involvement in training appears to be minimal. This review recommends that several areas of methodology be addressed in future studies, the scope of research extended to include intra-operative communication, and that the role of real patients in the development of communication skills be active rather than passive.

Background: Although the headgear appliance has been used extensively to correct anteroposterior discrepancies, its treatment effects have not yet been adequately assessed in an evidence-based manner. Objective: Aim of this systematic review was to assess the therapeutic and adverse effects of early headgear treatment from controlled clinical trials on human patients in an evidence-based manner. Search methods: An unrestricted electronic search of six databases from inception to December 2015. Selection criteria: Randomized and prospective non-randomized controlled trials assessing the effects of headgear treatment on human patients. Data collection and analysis: After duplicate study selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, random-effects meta-analyses of mean differences (MDs) and relative risks (RRs), including their 95% confidence intervals (CIs) were performed, followed by subgroup and sensitivity analyses. Results: A total of 18 unique studies with a total of 930 (56% male/44% female) patients were included. Headgear treatment was associated with a posterior translation of the anterior maxilla border in the short term, as seen by the mean annualized change in the SNA angle (MD = −1.63°/ year; 95% CI = −2.20 to −1.06°/year; high quality evidence) compared to untreated patients. This effect was independent of the rotation of the palatal plane and the inclination of the upper incisors, while a proportional relationship with the initial discrepancy in SNA was seen. The clinical significance of this improvement diminished in the long term, although only limited evidence existed. Additionally, early headgear treatment might decrease the risk of dental trauma during the following years (RR = 0.34; 95% CI = 0.14 to 0.80; moderate quality evidence). Low quality evidence on the effect of headgear on the rotation of the palatal plane, the nasolabial angle, the occlusal outcome, and signs of temporomandibular disorders precluded robust assessments, due to risk of bias, inconsistency, imprecision, and small-study effects. Conclusions: Based on existing trials, headgear is a viable treatment option to modify sagittal growth of the maxilla in the short term in Class II patients with maxillary prognathism. Registration: PROSPERO (CRD42015029837). Funding: None.

Klasifikasi Karies Gigi G.V. Black - Pada kesempatan ini saya akan memberikan pembagian / Klasifikasi Karies Gigi G.V. Black.  Klasifikasi Karies Gigi G.V. Black ini digunakan untuk menentukan perawatan pasien.
http://adifkgugm.blogspot.co.id/2013/08/klasifikasi-karies-gigi-menurut-gv-black.html

Alumina has received considerable attention and has been historically well-accepted as biomaterials for dental and medical applications. This article reviews the applications of this material in dentistry. It presents a brief history, dental applications and methods for improving the mechanical properties of alumina-based materials. It also offers perspectives on recent research aimed at the further development of alumina for clinical uses, at their evaluation and selection, and very importantly, their clinical performance. This article also stated about the Functionally Graded Materials (FGMs) which has been conceived as a new material design approach to improve performance compared to traditional homogeneous and uniform materials. This technique allows the production of a material with very different characteristics within the same material at various interfaces. The importance of the FGM concept in biological applications and functions was highlighted. Fundamentally, the combination of mechanical properties and biocompatibility are very important factors in application of any biomaterial to medical or dental fields. The characteristics of the surface govern the biocompatibility of the material, and the mechanical strength is determined by the average mechanical strength of the materials. However, the fabrication of FGMs is most often hindered by the variation of elastic, plastic, thermal, chemical, and kinetic properties within the composite. Across a material interface, these discontinuities in material properties lead to the formation of residual stresses. Despite these challenges, compositional gradient structures offer significant benefits. Notable research literature is highlighted regarding (1) applications of alumina in various fields in dentistry; (2) improvement of the mechanical properties of alumina by microstructural manipulation, FGM as well as composite formulations involving metallic, intermetallic elements and bioceramics.

Background: Permanent canines are amongst the teeth most affected by impaction and ectopic eruption. Although impacted canines are often subjected to surgical exposure and alignment with either the open or the closed technique for many decades, their treatment effects have not yet been systematically asssessed. Objectives: The aim of this systematic review was to critically assess whether significant differences exist in the outcomes of the open or closed surgical exposure of impacted canines. Search methods: An unrestricted electronic search of nine databases from inception to December 2016 was performed. Selection criteria methods: Included were randomized or prospective non-randomized studies comparing open versus closed exposure of impacted canines in human patients. Data collection and analysis: After duplicate study selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, random-effects meta-analyses of mean differences (MDs) and odds ratios (ORs), including their 95 per cent confidence intervals (CIs) were performed, followed by subgroup and sensitivity analyses. Results: A total of eight unique studies and a total of 433 (30.1% male/59.9% female) patients were included, with an average age of 15.2 years and a total of 453 impacted canines (48.6% and 51.4% in the open and closed exposure, respectively). Open exposure of impacted canines was associated with reduced duration of canine alignment (two studies; MD = –2.14 months; 95% CI = –4.23 to –0.05 months; P < 0.05; moderate heterogeneity and moderate quality) and lower odds of tooth ankylosis (one study; OR = 0.15; 95% CI = 0.03–0.83; P < 0.05; low quality) compared to closed exposure; both findings being independent of canine localization. However, initial alignment of palatally impacted canines took overall significantly longer than labially impacted canines (8.87 versus 4.17 months). Conclusions: Based on existing evidence, open surgical exposure seems to be superior in treatment duration and ankylosis risk over the closed technique. Due to the limited number of small included trials, further research is needed for robust clinical recommendations. Registration: PROSPERO (CRD42016051916).

Patients wearing orthodontic appliances experience varying degrees of pain and discomfort during the course of orthodontic therapy. Pain is one of the main factors responsible for the rejection of orthodontic treatments. Pain control is, therefore, crucial for both patients and orthodontists. In this review, an attempt is made to summarize the information regarding pain associated with orthodontic treatment, and to address questions orthodontists and patients or their parents may ask from the clinical point of view. Also, current orthodontic pain management procedures are presented. Data collection was performed by three reviewers independently. Using evidences found in the literature, an understanding of the causes as well as an overview of recent management procedures used in reducing orthodontic pain is provided. During orthodontic treatment, pain prevention and management should be given priority because heightened uncertainty in patients and parents can create a negative impact of emotional and confidence levels on the patient-parent-orthodontists.

Abstract
Purpose Although several prescriptions and techniques exist for comprehensive fixed appliance treatment, their treatment effects have not yet been adequately assessed in an evidence-based manner. The aim of this systematic review was to assess the therapeutic and adverse effects of various prescriptions or techniques for orthodontic appliances from randomized clinical trials on human patients.
Methods Eight databases were searched up to July 2016 for randomized trials assessing any orthodontic prescriptions or techniques in human patients. After elimination of duplicate studies, data extraction, and risk of bias assessment according to the Cochrane guidelines, random effects meta-analyses with mean differences (MD) and their 95% confidence intervals (CIs) were performed.
Results Compared to Roth preadjusted appliances, both Begg and modified Begg appliances were associated with statistically significantly worse occlusal outcome assessed with Peer Assessment Review (PAR) scores (1 trial, MD 3.1 points, 95% CI 1.9–4.3 points and 1 trial, MD 2.4 points, 95% CI 1.2–3.6 points, respectively) with low quality of evidence, due to bias and imprecision. Compared to a partially programmed fixed orthodontic appliance, a fully programmed appliance was associated with a statistically significant, but clinically irrelevant increase in treatment duration (1 trial, MD 2.4 months, 95% CI 0.6–4.2 months), supported by high quality of evidence. However, caution is needed in the interpretation of these results as only a limited number of small trials with methodological issues were available.
Conclusions Based on existing trials, there is limited evidence to support any robust clinical recommendation
regarding the prescriptions or techniques for fixed orthodontic appliances.
Registration: PROSPERO (CRD42016042727).
Funding: None.

Review Soft tissue changes following extraction vs. nonextraction orthodontic fixed appliance treatment: a systematic review and meta-analysis Konstantonis D, Vasileiou D, Papageorgiou SN, Eliades T. Soft tissue changes following extraction vs. nonextraction orthodontic fixed appliance treatment: a systematic review and meta-analysis. Eur J Oral Sci 2018; 00: 1–13. © 2018 Eur J Oral Sci The aim of this systematic review was to assess the effect of systematic extraction protocols during orthodontic fixed appliance treatment on the soft tissue profile of human patients. Nine databases were searched until December 2016 for controlled clinical studies including premolar extraction or nonextraction treatment. After elimination of duplicate studies, data extraction, and risk-of-bias assessment according to the Cochrane guidelines, random-effects meta-analyses of mean differences (MD) or standardized mean differences (SMD) and their 95% CIs were performed, followed by subgroup, meta-regression, and sensitivity analyses. Extraction treatment was associated with increased lower lip retraction (24 studies; 1,456 patients; MD = 1.96 mm), upper lip retraction (21 studies; 1,149 patients; MD = 1.26 mm), nasolabial angle (21 studies; 1,089 patients; MD = 4.21°), soft-tissue profile convex-ity (six studies; 408 patients; MD = 1.24°), and profile pleasantness (three studies; 249 patients; SMD = 0.41). Patient age, extraction protocol, and amount of upper incisor retraction during treatment were significantly associated with the observed extraction effects, while the quality of evidence was very low in all cases due to risk of bias, baseline confounding, inconsistency, and imprecision. Although tooth extractions seem to affect patient profile, existing studies are heterogenous and no consistent predictions of profile response can be made.

Objectives Aim of this systematic review was to assess the effect of orthodontic treatment with fixed appliances on the tooth color of patients. Methods Nine databases were searched up to May 2017 for clinical cohort studies on the effect of fixed appliance treatment on tooth color. After elimination of duplicate studies, data extraction, and risk of bias assessment according to the Cochrane guidelines, random effects meta-analyses of mean differences (MD) or means and their 95% confidence intervals (CIs) were performed, followed by GRADE (Grading of Recommendations Assessment, Development and Evaluation) assessment of the quality of evidence. Results Three nonrandomized and one randomized study with a total of 138 patients (46% male, 54% female) with average age of 15.7 years were included. Tooth color of treated patients was significantly altered during or after orthodontic treatment (4 studies; average of 3.2 E units; 95% CI = 2.0–4.4 E units), which was more than the variation among controls (1 study; MD = 1.9 E units; 95% CI = 1.7–2.2 E units). However, the quality of evidence was very low, due to the inclusion of nonrandomized studies, bias, and imprecision. Re-analysis of raw study data indicated that significant differences in clinically discernable treatment-induced color changes were seen between chemically and light-cured adhesives and among the various tooth categories. Conclusion Existing evidence of very low quality indicates that orthodontic treatment might be associated with alterations of tooth color, which are however not consistently clinically discernible. Treatment-induced color alterations might be dependent on bonding material and tooth type, but evidence supporting this is weak.

A compiled summary of the implications of severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2)
infection and coronavirus disease 2019 (COVID-19) on
orthodontic treatment, management, and provision of
emergency orthodontic treatment during the critical times
of COVID-19 lockdown and for the future to come. The
orthodontic practise post lockdown would never be the
same as before, but adequate measures to maintain and
prevent further transmission can pave a long way in
management of such epidemic and safety of healthcare
professionals.
Emergency orthodontic treatment can be provided by
following a set of guidelines with the observance of strict
protection protocols of the patients involved and
environmental disinfection becomes crucial in order to
minimize the risk of cross infection. It is necessary to reevaluate the orthodontic activities taking into account the challenges in terms of contagion containment. The end of
the lockdown period will mark the beginning of new
approach and management in orthodontic treatment.
Keywords: SARS-CoV-2, COVID-19, Coronavirus,
Dental management, Cross-infections, orthodontics.

Aim: To assess the effectiveness of zygomatic anchorage for the intrusion of maxillary pos- terior teeth. Method: A male patient, 20 years 5 months of age, with 3-mm anterior open bite with excessive maxillary posterior growth, was accepted for treatment. Titanium mini- plates were fixed bilaterally to the zygomatic buttress area and 200 g of force was applied unilaterally with 9-mm nickel-titanium coil springs between the vertical extension of the miniplate and the first molar buccal tube. Later, the zygomatic site was used for maxillary canine distalization. Results: The maxillary posterior teeth were intruded effectively and the canines were distalized bodily, without anchorage loss, with the help of zygomatic anchor- age. The patient was advised to maintain good oral hygiene throughout the treatment. This noninvasive surgical procedure eased and reduced the operation time and did not require headgear wear nor anterior box elastics for anterior open bite correction. Conclusion: The zygomatic area was found to be a useful anchorage site for the intrusion of the molars over a short period of time. Long-term stability of the bite closure should be assessed in future studies. World J Orthod 2002;3:147–153.

Various treatment strategies are adopted to correct a Class II malocclusion depending on the age, the amount of remaining growth and severity of malocclusion. Single arch extraction of the lowers is rarely done in a Class II malocclusion. The following case report describes an alternate treatment approach of an adolescent Class II patient treated with a combination of headgear, fixed functional appliance (forsus), and single arch extraction only in the lower arch. The case was finished in a Class III molar and a Class I canine relationship. The results were stable in 3 years follow‑up.

Introduction: Aim of this study was to assess the registration of orthodontic systematic reviews in PROSPERO. Method: Seven databases were searched for orthodontic systematic reviews published in 2012-2016. After duplicate study selection and data extraction, descriptive statistics, followed by chi-square/Fisher exact tests were calculated. Finally, bivariable/multivariable regression with relative risks (RR) and 95% confidence intervals (CIs) was used. Results: A total of 182 orthodontic systematic reviews were identified, 37 (20.3%) of which were registered in PROSPERO, with registration rates ranging from 4.3% in 2012 to 37.0% in 2016. Differences in review registration were found according to publication year, geographic origin, multicentre status, funding, and journal category. After controlling for confounders, each additional year was associated with increased registration probability (RR = 1.51; 95% CI = 1.19– 1.93). Reviews from South America were more likely to be registered than reviews from Europe (RR = 1.49; 95% CI = 1.06–2.11). Finally, reviews published in orthodontic specialty journals were more likely to be registered than reviews in general dentistry journals (RR = 1.87; 95% CI = 1.02– 3.49). Conclusions: A small percentage of orthodontic systematic reviews was registered a priori, although improvement signs have been seen since the initiation of PROSPERO.

Background: Although Rapid Maxillary Expansion (RME) has been used for over a century, its effect on upper airways has not yet adequately been assessed in an evidence-based manner. Objective: To investigate the volumetric changes in the upper airway spaces following RME in growing subjects by means of acoustic rhinometry, three-dimensional radiography and digital photogrammetry. Search methods: Literature search of electronic databases and additional manual searches up to February 2016. Selection criteria: Randomized clinical trials, prospective or retrospective controlled clinical trials and cohort clinical studies of at least eight patients, where the RME appliance was left in place for retention, and a maximum follow-up of 8 months post-expansion. Data collection and analysis: After duplicate data extraction and assessment of the risk of bias, the mean differences and 95 per cent confidence intervals (CIs) of upper airway volume changes were calculated with random-effects meta-analyses, followed by subgroup analyses, meta-regressions, and sensitivity analyses. Results: Twenty studies were eligible for qualitative synthesis, of which 17 (3 controlled clinical studies and 14 cohort studies) were used in quantitative analysis. As far as total airway volume is concerned patients treated with RME showed a significant increase post-expansion (5 studies; increase from baseline: 1218.3 mm 3 ; 95 per cent CI: 702.0 to 1734.6 mm 3), which did not seem to considerably diminish after the retention period (11 studies; increase from baseline: 1143.9 mm 3 ; 95 per cent CI: 696.9 to 1590.9 mm 3). Limitations: However, the overall quality of evidence was judged as very low, due to methodological limitations of the included studies, absence of untreated control groups, and inconsistency among studies. Conclusions: RME seems to be associated with an increase in the nasal cavity volume in the short and in the long term. However, additional well-conducted prospective controlled clinical studies are needed to confirm the present findings.

A comparison of two orthodontic aesthetic indices Ali Borzabadi-Farahani, Faezeh Eslamipour and Imaneh Asgari 37 The effects of non-extraction orthodontic treatment on the vertical dimension: a comparison of a dolichofacial and a mesofacial group

Nanoparticles (NPs) are insoluble particles smaller than 100 nm in size and the set of technologies that enables manipulation of these particles on an atomic, molecular and supra molecular scale is termed as 'Nanotechnology'. Applications of nanotechnology are being ventured in various domains including health care and have also carved their way into various specialties of dentistry. This article presents an insight into various types of nanoparticles and their application in the field of Orthodontics. The various tests performed when using nanoparticles, to detect the physical and biological properties of the new material, are also summarized for easy referral.

Low friction bracket systems reduce friction over conventional brackets. Friction is the resistive force between one objet against another one during contact motion. Together with binding and notching , friction is responsible for the sliding resistance observed in orthodontics throughout alignment, level and space closure stages. It has been said high friction may prevent the attainment of optimal force levels in the supporting tissues. Laboratory studies show that friction is lower in low friction bracket systems and in well designed ones binding is more important in resistance to sliding. Clinical studies support the view that resistance to sliding is the same in low friction brackets and conventional one and friction has a little clinical influence. A controlled clinical studies systematic review conclude at this stage there is insufficient high-quality evidence to support the use of low friction fixed orthodontic appliances over conventional appliance systems or vice versa. In regard to actual evidence the reduction of friction by actual low friction bracket systems do not show clinical significance.

Many techniques were developed for enamel polishing after orthodontic bracket debonding to keep the enamel surface as smooth as possible to pretreatment condition, in addition to many bracket adhesives used for orthodontic brackets bonding. This study aimed to compare the effect of two different adhesive materials and polishing protocols on enamel surface roughness after debonding of orthodontic brackets. Forty maxillary premolars were divided into four groups, orthodontic brackets were bonded using two different adhesive materials (Resilience LC Orthodontic Adhesive from Orthotechnology and Bisco Ortho bracket paste LC from Bisco). After brackets debonding adhesive remnants were removed using carbide bur followed by either Enhance Finishing tip then Prisma Gloss Polishing Cup with Prisma Gloss Polishing Paste or High Shine Enamel Polisher and Astropol green polishing cups. Then Atomic force microscope was used to evaluate surface roughness parameters among groups. The roughness data were statistically analyzed with Tukey post hoc test. Results showed significantly lower surface roughness parameters with Bisco Ortho bracket paste group compared with Resilience LC Orthodontic Adhesive group when both were polished with Enhance Finishing tip and Prisma Gloss Polishing Paste. Additionally, significantly lower Sz (Ten points height) value was seen with Bisco Ortho bracket paste group polished with Enhance Finishing tip and Prisma Gloss Polishing Paste in comparison with Resilience LC Orthodontic Adhesive polished with High Shine Enamel Polisher and Astropol green polishing cups. Pre-mounted, aluminum oxide impregnated, cured urethane dimethacrylate resin finishers tips (Enhance finishing tips) with a fine-grit aluminum-oxide polishing paste (Prisma Gloss Polishing Paste) could produce smoother enamel surface than 5 micron diamond grit suspended in resilient silicone tip (high shine enamel polisher) followed by Multiple-use polishing cups consist of silicone rubber and silicon carbide particles (Astropol green polishing cups) when Bisco Ortho bracket paste LC used. Experimental article (J Int Dent Med Res 2020; 13(1): 86-90)

Introduction: Self-ligating brackets are the last technological innovation in orthodontics. Many advantages have
been said they have over the conventional brackets.
Development: Friction is the resistive force between one
object against another one during perpendicular motion.
Together with binding and notching, friction is responsible for the sliding resistance observed in orthodontics
through out alignment, level and space closure stages.
Dental arch expansion from low forces, treatment time
and the comparison to traditional brackets were considered
a benefit as well as periodontal indexes and produced white
spots. Patient’s discomfort was taken into consideration
during orthodontic treatment with both types of brackets
and the save of time.
Conclusions: Except for this last factor during the arch
insertion and adjustment, there are no advantages based
on present evidence between self-ligating and conventional brackets.