[Multi-colored, plastic orthodontic appliances].
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The cariostatic effect of a fluoride releasing bonding agent was investigated and compared with a conventional composite based material in connection with bonding of orthodontic brackets in 22 homologous pairs of premolars. All subjects had malocclusions requiring orthodontic treatment with fixed appliances and extraction of at least two premolars. 6-13 weeks prior to extraction, orthodontic brackets were bonded to the labial surfaces of the extraction teeth with either a glass ionomer cement or a bis-GMA resin. Initially, the children were instructed in tooth brushing and the regular use of fluoride. After extraction, the bonded teeth were stained and evaluated in a stereo-microscope regarding the incidence and extension of initial enamel demineralisation. The zone of intact enamel adjacent to the bracket base and bonding material was measured in a stereo-microscope at four predetermined locations with the aid of an electronic ruler and scored according to four categories. The incidence of enamel demineralisation adjacent to glass ionomer bonded and composite bonded brackets was 68% and 77% respectively. In 12 pairs of premolars however, the demineralisation appeared to a lesser extent on the enamel around the brackets was generally wider when glass ionomer cement was used compared to the composite resin. These differences were statistically significant (p < 0.05) mesially and distally, but non-significant cervically and incisally. The results indicate that bonding with glass ionomer cement may have a local cariostatic effect in children requiring fixed orthodontic appliances.
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The dental study casts of 150 consecutively completed removable appliance cases were examined before and after orthodontic treatment using the PAR index. Eighty-nine per cent were classified either as 'improved' or 'greatly improved'. Of the 16 cases classified as 'worse, no different', six were mixed dentition cases with limited treatment objectives (which were successfully achieved) and three were permanent dentition cases where only one tooth was being aligned. Using predefined criteria removable appliances were shown to be most effective in treating cross-bites, ectopic tooth position, anterior spacing, and overjet, and less effective in treating crowding, rotations, and molar relationships.
Fifty-one patients were enrolled in this study to explore the treatment effects of material stiffness and frequency of appliance change when using clear, sequential, removable appliances (aligners). Patients were stratified based on pretreatment peer assessment rating (PAR) scores and need for extractions. They were randomized into 4 treatment protocols: 1-week activation with soft material, 1-week activation with hard material, 2-week activation with soft material, and 2-week activation with hard material. Patients continued with their protocols until either the series of aligners was completed, or until it was determined that the aligner was not fitting well (study end point). Weighted PAR score and average incisor irregularity (AII) indexes were used to measure pretreatment and end-point study models, and average improvement was compared among the 4 groups. In addition to the evaluation of the 4 treatment groups, comparisons were made of the individual components of the PAR score to determine which occlusal components experienced the most correction with the aligners. The percentages and absolute extraction space closures were evaluated, and papillary bleeding scores before and during treatment were compared. Although no statistical difference was observed between the 4 treatment groups, a trend was noted with the 2-week frequency having a larger percentage of reduction in weighted PAR and AII scores, and greater extraction space closure. Anterior alignment was the most improved component, and buccal occlusion was the least improved. When analyzed by type of extraction, incisor extraction sites had a significantly greater percentage of closure than either maxillary or mandibular premolar extraction sites. A statistically significant decrease in mean average papillary bleeding score was found during treatment when compared with pretreatment scores, although this difference was not clinically significant.
Most dental patients are treated in the supine position, enhancing the risk of accidental aspiration or swallowing of foreign objects. This article presents a case report of an orthodontic patient who accidentally ingested a section of orthodontic wire and coil spring from a fixed expansion device placed in the maxillary dental arch. Some guidelines for the prevention of such occurrences in the practice and at home, and possible courses of remedial action, are discussed.
This study aimed to assess the prevalence of functional occlusal contacts in cases treated to a Class I incisor relationship by upper and lower fixed appliance therapy. Helkimo's dysfunction indices were used by one examiner to assess mandibular mobility, clinical dysfunction and occlusal status. One-hundred-and-eighty-eight subjects participated in three UK orthodontic centres; Cardiff, Newport and Liverpool. The results show that RCP (CR)-ICP (CO) discrepancies occurred in 33 (18 per cent) cases, non-working side contacts were present in 31 per cent and posterior contacts on protrusion occurred in 44 (23 per cent) subjects. These interferences were significantly more frequent in cases treated by postgraduate students compared with those treated by staff clinicians (P < 0.05). An overbite greater than 2.4 mm resulted in a highly significant reduction in the occurrence of non-working side contacts and posterior protrusive contacts (P < 0.001). The prevalence of functional occlusal discrepancies in this UK sample of orthodontic cases is similar to that reported in the American literature.
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