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"Orthodontic"
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Dicusses the physiology and functions of your teeth and how best to keep them in optimum condition.
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Upper lip changes on smiling in the vertical dimensions
Background: An attractive smile is considered as a valuable asset. As esthetically acceptable smile can never be created by beautiful teeth only, to establish harmony among teeth, lips and gingival display, pre-treatment evaluation of upper lip changes on smiling in the vertical dimensions helps the Orthodontists to determine the parameters that constitute an esthetically acceptable smile or pretty smile. Appropriate knowledge of soft tissue function and aesthetic help orthodontists to obtain stable and aesthetically appealing treatment results. Methods: The study was conducted on Ninety-six (96) participants (48 men, 48 women; aged 20 to 35). For each subject, nine (9) measurements of upper lip position and maxillary incisor crown height at rest and in maximum smile were recorded from their photographs. The photographic records were analyzed with the software for Windows, Digimizer medicalc 4.2.2. The individual measurements were correlated with sex distribution. Results: Relaxed and smiling external upper lip length and resting internal upper lip length was shorter in the women than in the men. Resting vermilion height and the maxillary central incisor height was also lesser in females than in males. The mean maxillary central incisor display at rest was greater in the women than in the men. Conclusion: Data from this study clearly indicated sexual dimorphisms in upper lip length, maxillary central incisor display and labial vestibular insertion. J Bangladesh Coll Phys Surg 2026; 44: 17-25
Journal Article
Orthodontic treatment with extraction of ectopic canine replaced by premolar
Ectopic mandibular canines are a rare condition that has been little documented in the literature, and their treatment can be challenging for clinicians. Case report: The present article reports on the treatment of an ectopic mandibular canine (43) located transversely to the midline in the chin region in an upright patient with Class II malocclusion with biprotrusion and severe crowding. It was decided to extract the ectopic canine in the lower arch, together with the removal of three premolars, to correct the crowding without prejudice to the inclination of the incisors. As well as correcting the negative discrepancy, extraction treatment can also improve facial balance and profile. Results: After two years’ follow-up, the case is stable with satisfactory results. Conclusion: Clinicians must use their judgement to consider if orthodontic traction of a tooth in the lower arch is feasible or outweighs its cons. The replacement of a canine by the premolar in the lower arch can be achieved without aesthetic or functional compromise.
Journal Article
Perception of Smile Aesthetics between Orthodontists and Moroccan Patients
One of the main goals of orthodontic management is to achieve a beautiful smile. However, beauty has both objective and subjective dimensions. This study aims to evaluate the factors that affect the perception of the smile in patients consulting for orthodontic treatment about the vision of their practitioners. Fifty orthodontic patients and 30 orthodontists evaluated the degree of attractiveness of 16 photographs of the smile. Dental, gingival and labial parameters were used. Statistical analyses of the level of perception of each group were performed. The Student t-test and the Chi-square test were used to compare the attractive and unattractive smile parameters. The perception of smile aesthetics between orthodontists and orthodontic patients has shown a significant difference (P < 0.05). Orthodontists were more analytical in judging variables like smile arc, alterations of the gingival display and the palatal inclination of the maxillary incisors.
Journal Article
Salivary levels of cariogenic bacterial species during orthodontic treatment with thermoplastic aligners or fixed appliances: a prospective cohort study
BackgroundFixed orthodontic appliances might be associated with intraoral adverse effects on enamel, due to plaque accumulation and their colonization by oral microbes. At the same time, the demand for esthetic alternatives to orthodontic treatment, like thermoplastic aligners, is growing. However, thermoplastic aligners may behave differently intraorally than fixed appliances in terms of bacterial colonization and biofilm formation. Therefore, the aim of this prospective cohort study was to assess the salivary prevalence of the cariogenic bacteria Streptococcus mutans, Lactobacillus acidophilus, and Streptococcus sanguinis among adolescents treated orthodontically with thermoplastic aligners or fixed appliances.MethodsThirty adolescent patients (17 girls/13 boys; mean age 13.8 years old) were assigned to treatment with either (i) self-ligating fixed appliances with nickel-titanium archwires or (ii) aligners constructed from clear transparent polyethylenterephthalat-glycol copolyester (PET-G) thermoplastic sheets. Whole stimulated saliva was collected from each patient at three time points: at baseline (before bonding and initiation of orthodontic therapy or before insertion of the thermoplastic aligners), after 2 weeks, and after 1 month. A simplified plaque index, a simplified gingival index, and the decayed, missing, and filled teeth (DMFT) index were assessed from the clinical examination of the patients. Microbiological analysis of salivary bacteria was performed by quantitative polymerase chain reaction, followed by descriptive and inferential statistics at the 5% level.ResultsAlthough patients treated with aligners had significantly lower plaque and gingivitis scores throughout treatment compared to patients treated with fixed appliances, no significant difference could be found between the S. mutans counts of the two groups at any time through treatment (P > 0.05). On the other hand, patients treated with aligners had significantly lower salivary S. sanguinis counts at all time points than patients treated with fixed appliances (P < 0.05). Finally, almost no L. acidophilus were identified in the collected saliva samples in either of the treated samples.ConclusionsWithin the limitations of this study, there were no differences in the salivary counts of S. mutans or L. acidophilus among adolescent patients treated for 1 month with thermoplastic aligners or self-ligating appliances. On the other hand, patients treated with aligners had lower salivary levels of S. sanguinis compared to those treated with self-ligating appliances.
Journal Article
Salivary pH Changes and Biofilm Formation During Active Orthodontic Treatment with Clear Aligners and Fixed Appliances
Objective: To examine salivary pH changes and the plaque formation in two different orthodontic treatments clinically. Methods: The study sample included 40 patients, who were divided into two groups according to the type of orthodontic appliance: Group CA, (n=15) clear aligners; Group FT, (n=25) fixed appliances. Group FT received both metal (FT/SS) and elastic ligatures (FT/EM) for 2 weeks respectively to test the effect of ligature type also. Salivary pH values, plaque index, and plaque percentage were measured at T0 (after scaling and polishing) and T1 (after 2 weeks). pH was measured with a digital caliper (HI 2211 pH/ORP Meter) and plaque was identified by a discoloring agent (Tri Plaque ID Gel). The Paired t-test, Independent t-test, Anova test and Pearson Correlation tests were used in the statistical analysis. Results: There was significant decrease in salivary pH values after two weeks of metal ligature in FT/SS. Plaque index and plaque percentage parameters showed significant incremental changes between groups with the least increase in CA, followed by FT/SS and FT/EM respectively. Conclusion: Different types of orthodontic treatment and ligatures significantly effected salivary pH and the amount of plaque formation during orthodontic treatment. Aligners had the least effect on salivary pH and plaque formation while fixed treatment with elastic ligature affected the most. Therefore, aligner treatment may be more beneficial for patients with compromised oral hygiene.
Journal Article
Salivary concentrations of Streptococcus mutans and Lactobacilli during an orthodontic treatment. An observational study comparing fixed and removable orthodontic appliances
Aim This study aimed to investigate salivary concentrations of Streptococcus mutans (S. mutans) and some Lactobacilli, and plaque index (PI) in patients wearing fixed versus removable orthodontic appliances. Methods A sample of 90 orthodontic patients (56 males and 34 females) was included in the study: 30 subjects (aged 21.5±1.5 years) were treated with removable clear aligners (CA), while for other 30 cases (aged 23.3±1.6 years) a fixed multibrackets appliance (MB) were utilized, and 30 patients (aged 18.2 ±1.5 years) wearied a removable positioner (RP). Salivary concentrations of S. mutans and Lactobacilli and PI were evaluated prior to start of the orthodontic treatment, after 3 months and 6 months. Results After 6 months, 40% of MB patients (12 subjects over 30) showed a concentration of S. mutans associated to high risk of developing tooth decay (CFU/ml>105), differently from participants wearing removable appliances (odds ratio = 5.05; 95% C.I. = 1.72‐14.78; chi‐square = 9.64; p = 0.0019). The same trens was observed for the concentration of Lactobacilli (odds ratio = 4.33; 95% C.I. = 1.53‐12.3; chi‐square = 8.229; p = 0.004). In addition, over the duration of the study, CA patients maintained PI at 0 level, while MB patients experienced a statistically significant increasing trend of PI over time, and their PI became clinically/statistically relevant after 6 months, respect to CA and RP patients. Conclusions Comparing all the data, while, after 6 months, only about 10% of CA patients and 13.3% of RP patients achieved a microbial colonization which may lead to high risk of caries development, about 40% of MB patients ‐ and 20% after 3 months ‐ showed a high level of vulnerability to developing caries, which require additional strategies for plaque control and microbial colonization to be employed.
Journal Article