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PubMed2004

Initial biofilm formation of Streptococcus sobrinus on various orthodontics appliances.

Biofilms accumulate on hard and soft surface in the oral cavity. Accumulation of biofilms on orthodontic appliance bear scientific and clinical interest. The objection of this study was to examine the formation of dental biofilm by Streptococcus sobrinus on different types of orthodontics appliances, using a model consisting of host and bacterial constituents. The adsorption pattern of saliva to the orthodontics appliances was determined by means of gel electrophoresis coupled with computerized densitometry techniques. The amount of salivary proteins adsorbed onto the surfaces was measured using the Bradford method. Sucrose-dependent bacterial adhesion to the saliva-coated orthodontics appliances was tested by radioactive-labelled S. sobrinus. Our results show different adsorption patterns of salivary proteins to the various orthodontic appliances as modules, brackets, springs and intra oral elastics. Modules and brackets demonstrated the most affinity to salivary proteins. A surface dependent adhesion profile was recorded, showing a high affinity of albumin and amylase to modules. Bacterial accumulation was the highest on modules compared with springs which demonstrated the least bacterial adhesion. Our study demonstrates the specificity of biofilm formation on the different orthodontic appliances. Formation of a variety of dental biofilms has a significant impact on the progression of dental diseases associated with orthodontic treatment.

Adsorption↗
PubMed2000

Influence of orthodontic appliances on myofunctional therapy.

Various removable and fixed orthodontic appliances were rated by interview and questionnaire by 42 myofunctional therapists in the Hamburg area with respect to their influence during myofunctional therapy. The Nance holding arch was given the most negative rating of all appliances covering the palate area. For the active plate, marking the rest position of the tongue by roughening the acrylic surface or by reproducing the palatal relief was considered beneficial. The quadhelix expansion device and Hyrax palatal expander were rated as unfavorable because of their positioning in the palatal area. Among the functional appliances, Fränkel's function regulator was given the best rating. Regular fixed appliances (brackets, bands) were not considered a disturbance. Habit reminders (plates and spurs) were given a very negative rating by ca. 80% of the therapists because they disturbed the myofunctional exercises and led to adaptive dysfunctions. Since many patients with dysfunction of the orofacial musculature undergo simultaneous myofunctional and orthodontic therapy, treatment planning and choice of orthodontic appliances should be carefully coordinated.

Attitude of Health Personnel↗
PubMed1991

Cementation of a fixed orthodontic appliance.

Cementation of a fixed orthodontic appliance requires careful attention to detail. Certain procedures can be used to improve fit of the stainless steel band and enhance the cementing procedure. This paper outlines a technique for cementation that optimizes the chances for an ideal long-term band-cement-tooth bond.

Cementation↗
PubMed2004

Advances in fixed appliance orthodontics.

In 1992, Postlethwaite wrote an article for Dental Update entitled 'Advances in fixed appliance design and use'. In the subsequent years there have been, as in most dental specialties, huge advances in materials. These have resulted in improved efficiency, convenience and simplicity in using fixed appliance orthodontics. This article is intended to be an update in these advances over the last 10 years.

Dental Cements↗
PubMed2006

Siwak as a oral hygiene aid in patients with fixed orthodontic appliances.

OBJECTIVES: The aims of this study were to compare the mechanical efficacy of Siwak in plaque control and gingival health conditions in subjects wearing fixed orthodontic appliances compared with standard and orthodontic toothbrushes. METHODS: Forty male patients with a mean age of 17.20+/-4.01 years, wearing fixed orthodontic appliances were included in this study. Following a session of scaling and polishing, which established a situation with minimal gingival inflammation and close to zero amounts of dental plaque, all patients were instructed to use a standard soft toothbrush for 1 week after which they were randomly and equally allocated to one of four groups: (i) a manual toothbrush group; (ii) an orthodontic toothbrush group; (iii) a Siwak group; and (iv) a combination of Siwak and an orthodontic toothbrush group. All patients were instructed to brush their teeth three times a day. All patients were scored for plaque and gingivitis 1 week after scaling and polishing and 2 weeks following group assignment. RESULTS: A similar effect of Siwak to that of soft and orthodontic toothbrushes with respect to plaque control in patients with fixed orthodontic appliances was found. It was the combined use of Siwak and orthodontic toothbrush that provided the best plaque control in such patients. Gingival condition was better in the Siwak groups whether used solely or in combination with an orthodontic toothbrush. CONCLUSION: The use of Siwak promotes gingival health in patients with orthodontic appliances.

Adolescent↗
PubMedDate not supplied

Limiting factors in orthodontic treatment: 1. Factors related to patient, operator and orthodontic appliances.

UNLABELLED: Owing to a shortage in the orthodontic work force in the United Kingdom, many general dental practitioners carry out orthodontic treatment in selected cases. Orthodontic treatment may not always be successful as a result of various factors. Some of these limiting factors are related to the practitioner, others to the patient, the orthodontic appliances used and sometimes to the underlying biology. It is essential that practitioners are aware of these limitations. The aim of this two part article is to describe some of the practical aspects that need to be considered. CLINICAL RELEVANCE: General dental practitioners and novice orthodontic practitioners may get into difficulties by embarking upon an orthodontic treatment which may not be feasible owing to various limitations of orthodontic treatment.

Age Factors↗
PubMed1983

Maximum forces and deflections from orthodontic appliances.

The maximum bending moment of an orthodontic wire is an important parameter in the design and use of an orthodontic appliance. It is the wire property that determines how much force an appliance can deliver. A bending test which allows direct measurement of the maximum bending moment was developed. Data produced from this test are independent of wire length and configuration. The maximum bending moment, percent recovery, and maximum springback were determined for round and rectangular cross sections of stainless steel, nickel-titanium, and beta-titanium wires. The data suggest the need for more specifically defining maximum moment and maximum springback. Three maximum bending moments are described: Me, My, and Mult. My and Mult are clinically the most significant. Appliances that are required to have no permanent deformation must operate below My. Appliances that exhibit marked permanent deformation may be used in some applications and, if so, higher bending moments can be produced. In order of magnitude, the maximum bending moment at yield is largest in stainless steel, beta-titanium, and nickel-titanium for a given cross section. Nickel-titanium and beta-titanium have significantly larger springback than stainless steel determined at the moment at yield. Nickel-titanium did not follow the theoretical ratio between ultimate bending moment and the bending moment at yield, exhibiting a very large ratio. The study supports the hypothesis that most orthodontic appliances are activated in a range where both plastic and elastic behavior occurs; therefore, the use of yield strengths for calculation of force magnitude can lead to a significant error in predicting the forces delivered.

Dental Alloys↗
PubMed1988

Treatment of adults with lingual orthodontic appliances.

With the advent of lingual orthodontic treatment, an alternative became available to the adult patient who preferred to avoid the unesthetic appearance of conventional orthodontic appliances. The newer brackets and archwires described in this article, in combination with the proven technique developed by the author and others, has made lingual orthodontic treatment a practical reality. The appliance has been shown to be as effective as labial counterparts in correcting all types of malocclusions. New laboratory and indirect bonding techniques have eliminated the need for intricate wire bending and have reduced patient chair time and overall treatment time. Because of the premature introduction of early lingual appliances, many dental practitioners mistakenly believe that lingual treatment is less effective than labial treatment. As more examples of successful treatment are seen, dental practitioners will be more apt to refer patients to orthodontists proficient in this technique. Many graduate orthodontic programs now are teaching this technique to their residents. About 3000 patients currently are starting treatment with lingual appliances each year. This represents only about 1 per cent of adult patients. It is projected that this slowly will climb to about 10 per cent of adult orthodontic treatment over the next 5 years. The increased cost of this treatment, coupled with the resistance on the part of many orthodontists to learn the new technique, seem to be the limiting factors.

Adolescent↗
PubMed2006

The impact of fixed orthodontic appliances on daily life.

OBJECTIVE: i) To develop a measure of the impact of fixed orthodontic appliances on daily life. ii) To assess the impact of fixed appliances over time after initial appliance placement. iii) To investigate factors that may influence the impact of fixed appliances (age, gender and socioeconomic status). RESEARCH DESIGN: Questionnaire. CLINICAL SETTING: University Dental Hospital and Hope Hospital, Manchester. SAMPLE: Sixty-six patients, whose orthodontic appliances had just been placed. Twenty-eight patients whose orthodontic appliances were in place for at least six months were used for the reliability study. METHOD: The Impact of Fixed Appliances Questionnaire was developed using standard qualitative methods and pre-tested on 10 patients. This resulted in a questionnaire with nine conceptual impact sub-scales: aesthetic, functional limitation, dietary, oral hygiene, maintenance, physical, social, time constraints and travel/cost. The questionnaire was piloted on 66 patients, at the first, second and third visits after their fixed appliance had been placed, to assess the impact of fixed appliances over time. Questionnaire reliability, over a one-month time interval, was assessed on 40 patients who had been in treatment for at least six months. MAIN OUTCOME MEASURE: Impact of fixed appliances on daily life. RESULTS: The internal reliability of the questionnaire ranged from moderate to very good (Cronbach's alpha 0.56-0.89). Test-retest reliability was stable for most subscales (intra-class correlation coefficient 0.26-0.65). The questionnaire was said to have face validity and also content validity because of the method of questionnaire development through interviewing children with fixed appliances. None of the subscales scores reduced over time except aesthetic impact (p< 0.05) but this was probably not a clinically significant change. Age was the predominant variable to influence the impact of fixed appliances with younger children being less affected during their daily life (p<0.05). CONCLUSIONS: The questionnaire developed in this study is a reliable tool for assessing the impact of fixed appliances on the daily life of children. It is unlikely that the impact of fixed appliances on daily life reduces as the patient progresses through treatment. Younger patients are probably more adaptable to treatment with fixed appliances, in terms of reduced impact on daily life, so arguably treatment should be started as early as possible. This information could also be used to educate, reassure and motivate patients at the start of treatment.

Adolescent↗
PubMed1982

The effect of orthodontic appliances on the distribution of Candida and plaque in adolescents.

The site prevalence and intra-oral density of Candidal organisms may be increased by local factors including prostheses. However, whether significant changes in Candidal carriage occurs with denture wearing is not clearly established. This study employed the imprint culture technique to assess the effects of fixed and removable orthodontic appliances on oral carriage, site prevalence and intra-oral density of Candida in adolescents. Moreover, alterations in plaque distribution were measured. Groups of 12-16 year olds without or wearing fixed and removable appliances were studied. Imprint cultures were taken from six intra-oral sites and colony counts recorded after 48 hours incubation on selective media. Plaque scores were recorded from non-appliance and removable appliance wearers. The prevalence of Candidal carriage in the groups was not significantly different being 46 per cent of non-appliance, 51 per cent of fixed appliance and 52 per cent of removable appliance wearers. However, the prevalence of Candidal recovery at some sites and Candidal densities at all sites were significantly increased in both fixed and removable appliance wearers. Thus orthodontic appliances may predispose to Candidal proliferation in oral carriers. However, the results do not permit the conclusion that appliances may change non-carriers of Candida to carriers. Plaque distribution was significantly altered in removable appliance wearers when compared with non-appliance wearers as a result of increases in palatal plaque scores. These findings again emphasize the particular need for oral hygiene instruction in patients wearing appliances or partial prostheses.

Adolescent↗
PubMed1997

Perceptions of orthodontic appliances among grade seven students and their parents.

A survey of 468 Grade Seven students and 437 parents in the North Brisbane region was undertaken to determine perceptions of orthodontic appliances. Based on responses to statements on the survey, a Perception Score was created for both students and parents in relation to both fixed and removable appliances. Both students and parents had more negative perceptions of fixed appliances than of removable appliances. Fixed appliances were perceived to attract more teasing, to cause more problems in the maintenance of oral hygiene and to be more painful than a removable plate. Respondents also felt that children would have to be more careful about what they eat when wearing fixed appliances. Approximately forty per cent of students and parents did not know whether teeth could be damaged by orthodontic appliances nor whether the appliances would cause discomfort. Parents had significantly more negative perceptions of both types of orthodontic appliances than did the students. The Perceptions scores were not significantly influenced by whether the students attended a private or public sector dentist, the frequency of dental visits, any history of orthodontic treatment, nor by the parents' level of education and their occupations. A forewarning about experiences of orthodontic appliances would better prepare patients and assist operators in providing the community with a more comprehensive orthodontic service.

Adolescent↗
PubMed2005

Recolonization of mutans steptococci on teeth with orthodontic appliances after antimicrobial therapy.

The aim of the present study was to compare the recolonization pattern of mutans streptococci on densely colonized teeth with and without fixed orthodontic appliances after treatment with a 40 per cent chlorhexidine (CHX) varnish (EC 40, Explore). Healthy subjects free of carious lesions requiring fixed orthodontic appliance treatment but with high bacterial mutans streptococci saliva counts were recruited (n = 10). For baseline registration, plaque from buccal sites was sampled and cultivated on Dentocult strips. Following professional tooth cleaning, CHX varnish was applied to all teeth for 8 minutes. Subsequently, orthodontic brackets and bands were inserted in either the upper or lower arch. Eight weeks after varnish application the degree of recolonization with mutans streptococci was reassessed on the buccal sites. Statistical analysis showed that recolonization with mutans streptococci was significantly higher (P < 0.05) on teeth with orthodontic appliances. The results indicate that the use of fixed orthodontic appliances creates artificial environments suitable for the proliferation of mutans streptococci after CHX varnish suppression.

Analysis of Variance↗
PubMed1993

Cytotoxic and antibacterial effects of orthodontic appliances.

The cytotoxic and antibacterial effects of orthodontic appliances were assessed. Metallic devices used in orthodontics, such as molar bands, brackets, and archwires were tested by the agar overlay cytotoxicity test with mouse fibroblast cells. The same devices were tested for antibacterial effect with Streptococcus mutans and S. sanguis. The multicomponent devices, which are bonded with silver- and copper-based brazing alloys, were more cytotoxic than the single-component devices, probably because copper is more cytotoxic than nickel. The devices had a definite, but low, antibacterial effect, as compared with the 0.05% chlorhexidine positive control. A cytotoxic effect of the devices per se might contribute to a localized gingivitis. It is uncertain whether orthodontic devices have any significant inhibitory effect on dental plaque viability.

Animals↗
PubMed1998

Toothbrushing forces in children with fixed orthodontic appliances.

The aim of this investigation was to determine whether toothbrushing forces are influenced by wearing fixed orthodontic appliances. Thirty children, (10 males, 20 females) with planned fixed appliance therapy and aged 10-15 years, were recruited to the study. No subject had previously worn an orthodontic appliance. At baseline, each subject brushed their teeth in their usual way, unsupervised. The toothbrush used was a purpose-designed electronic instrument that measured the force applied to the brush and transmitted force data by radio to a remote PC. After toothbrushing, subjects had orthodontic brackets fitted. Toothbrushing was repeated at 2 and 14 weeks after baseline, and brushing forces recorded. There were no significant differences between the measurements made at baseline and those made at 2 and 14 weeks. There were no differences between males and females in the forces used at any time point. It was concluded that toothbrushing forces are unaffected by placing fixed orthodontic appliances in children. The brushing forces recorded were comparable with those previously found by other investigators.

Adolescent↗
PubMed1983

Enhancement of Streptococcus mutans colonization by direct bonded orthodontic appliances.

Patients undergoing orthodontic therapy were evaluated for longitudinal changes in relative S. mutans numbers in plaque at discrete sites on the tooth surface associated with direct bond appliances. There was a significant linear increase in the percentage of S. mutans in the total streptococci isolated from the last pre-bracket sample through the last bracket sample.

Adolescent↗