Orthodontics

21. WhatsApp ortho selfies

The integration of new social technologies in a standard oral hygiene motivation protocol is effective in improving compliance of adolescent patients and their oral health status during orthodontic multibracket treatment. So finds this research using an app-based approach. Eighty such patients were randomly divided into two equal groups. Plaque index (PI), gingival index (GI), white spots (WS), and caries presence were recorded and instruction was given regarding domestic oral hygiene maintenance on the day of braces application (t0) and every 3 months (t1, t2, t3, t4) during the first year of treatment. Study group (SG) patients were enrolled in a WhatsApp chat room-based competition and instructed to share monthly with the other participants two self-photographs (selfies) showing their oral hygiene status. SG patient participation in the chat room was regular and active throughout the observation period. At t2, t3, and t4, SG patients had significantly lower values of both PI and GI and a lower incidence of new WS and caries, compared with the control group.

Zotti F et al. Usefulness of an app in improving oral hygiene compliance in adolescent orthodontic patients. Angle Orthodontist 2016 86: 101-107.

Q Is it likely that a social media approach to improving oral health during fixed orthodontic treatment can succeed?
A Very unlikely
B Obviously ridiculous
C Yes, it has been shown to be effective
D Maybe

22. Root canal to prevent resorption

There is a lack of research to support the belief that root canal treatment can be considered for stopping or decreasing external apical root resorption (EARR). There is conflicting evidence as to whether root-filled teeth are more or less likely to experience EARR after orthodontic treatment. This study compared the degree of EARR of root-filled teeth with that of contralateral teeth with vital pulp after fixed orthodontic treatment. Thirty-five patients aged 25.23 +/- 4.92 years who had at least one root-filled tooth before orthodontic treatment had digital panoramic radiographs taken before and after orthodontic treatment which were used to measure the EARR. Root-filled teeth appear to be associated with significantly less EARR than are contralateral teeth with vital pulp. This study suggests that the possible complication of EARR in root-filled teeth may not be an important consideration in orthodontic treatment planning, and root canal treatment can be considered for stopping or decreasing EARR when severe EARR occurs during orthodontic treatment.

Lee YJ, Lee TY. External root resorption during orthodontic treatment in root-filled teeth and contralateral teeth with vital pulp: A clinical study of contributing factors. American J Orthodontics Dentofacial Orthopedics 2016 149: 84-91.

Q Which of the following is true using the results of this study?
A EARR is more likely in root-filled teeth
B EARR in root-filled teeth may not be an important consideration in orthodontic treatment planning
C Contralateral teeth with vital pulp are more likely to be susceptible to EARR
D Root canal treatment should never be considered for stopping or decreasing EARR

23. Does malocclusion mar lives?

The objective here was to describe oral health-related quality-of-life (OHRQoL) and the impact of malocclusions or orthodontic treatment need in a cohort of children in Swedish dental care. Two hundred and fifty-seven children (mean age = 11.5 years, SD = 0.8, range = 9.8-13.5 years) completed a questionnaire in conjunction with a clinical examination. In addition to malocclusions and orthodontic treatment need (based on the Index of Orthodontic Treatment Need-Dental Health Component), possible confounders (caries, enamel defects, dental trauma, headache and socio-economic markers) were recorded. Children also rated their own dental fear on the Children's Fear Survey Schedule-Dental Sub-scale (CFSS-DS). This cohort of children reported good self-perceived OHRQoL. Effects on OHRQoL from malocclusions or orthodontic treatment need were limited and inconsistent. Dental fear and headache were found to be more distinct impact factors on OHRQoL than were malocclusions or orthodontic treatment need.

Dimberg L et al. Oral health-related quality-of-life among children in Swedish dental care: The impact from malocclusions or orthodontic treatment need. Acta Odontologica Scand 2016 74:127-133.

Q What were the main impact factors which affected the children’s lives?
A Malocclusion
B Caries
C Headaches
D Fixed appliances

24. Adult ortho and perio

With the increase in orthodontic treatment in adults, clear aligner treatments are becoming more popular. The aim of this study was to evaluate the effect of orthodontic treatment on periodontal tissue and to compare orthodontic treatment with fixed appliances (FA) to clear aligner treatment (CAT) in periodontitis patients. A total of 35 adult patients who underwent orthodontic treatment after periodontal treatment with meticulous oral hygiene education, then had treatment with FA or CAT, and this study analysed patient outcomes depending on the treatment strategy. The overall plaque index, the gingival index, and probing depth improved after orthodontic treatment. Significant differences were found between the FA and CAT groups in probing depth, change in probing depth, and duration of treatment. However, no significant differences were found between the FA and CAT groups regarding the plaque index, changes in the plaque index, the gingival index, changes in the gingival index, or changes in the alveolar bone level.

Han JY. A comparative study of combined periodontal and orthodontic treatment with fixed appliances and clear aligners in patients with periodontitis. J Periodont Implant Sci 2016 45: 193-204.

Q In which category were significant differences found between the FA and CAT groups?
A Plaque index
B Gingival index
C Alveolar bone level
D None of the above