Efficacy of cleaning tablets for removable orthodontic appliances

Objectives

The purpose of this study was to test the cleaning effect of three commercially available effervescent tablet products on acrylic resin surfaces compared to water as control medium.

Methods

A total of 20 volunteers were instructed to wear a vacuum-formed maxillary splint continuously for 96 h. Each splint incorporated four resin discs in the palate area. Each of these PMMA (polymethyl methacrylate) discs was split into two specimens which were analyzed upon removing the splint after the 4-day period. One specimen per disc was analyzed uncleaned and one after cleaning, using one of the investigated tablet products according to the manufacturer’s recommendations or water as control medium. The outcomes of cleaning were evaluated with the modified ortho-phthaldialdehyde (OPA) method by determining the amounts of surface protein.

Results

Significant differences in relative (%) protein removal were noted between all three tablet products and water, and fittydent super® was significantly more effective in removing biofilm than Kukis®. No significant differences were observed between fittydent super® and NitrAdine® Ortho&Junior? or NitrAdine® Ortho&Junior? and Kukis®.

Conclusion

The modified OPA method proved to be successful in examining protein-containing contaminations on the specimens, and the effervescent products tested were more effective than pure water in removing contaminants from orthodontic appliances. These results are, however, confined to soft plaque not older than 4 days.

     

The contemporary use of removable orthodontic appliances

Although apparently simple and efficient to use, removable appliances are no longer the appliance of choice for comprehensive orthodontic treatment in the permanent dentition. Their mechanical properties result in simple tipping of teeth, therefore multiple simultaneous tooth movements with apical control are not possible. It is for these and other reasons that removable appliances are usually only indicated for specific interventions in the mixed dentition, and as an adjunct to more complex fixed appliance treatment. Removable appliances, once popular because of their case of use, are no longer seen as the appliance of choice. This article discusses the rationale behind this statement and indicates cases suitable for removable appliance treatment.     

Microbial contamination of laboratory constructed removable orthodontic appliances

Objectives

This study aims to determine whether laboratory constructed removable orthodontic appliances are free from microbial contamination prior to clinical use and to evaluate the dental hospital cross-infection procedures to ensure that patient-derived contamination does not enter the construction process, thereby propagating a cycle of cross-contamination.

Materials and methods

The construction process of removable orthodontic appliances from three individuals was evaluated at every stage, from impression to final delivery of the appliance using molecular microbiological techniques. The bacterial profiles at each stage of appliance construction were obtained using denaturing gradient gel electrophoresis, along with the bacterial profiles of the three participants’ saliva. This enabled the bacterial profiles found at each stage of construction to be compared directly with the saliva of the person for whom the appliance was being constructed. Bacteria were identified at each stage using 16S rDNA PCR amplification and sequence phylogeny.

Results

There was no evidence of bacterial cross-contamination from patients to the laboratory. The current process of disinfection of impression appears to be adequate. Contamination was found on the final removable appliances (0.97?×?10²–1.52?×?10³ cfu ml^?1), and this contamination occurred from within the laboratory itself.

Conclusions

Every effort is made to reduce potential cross-infection to patients and dental professionals. Newly constructed removable appliances were shown not to be free from contamination with bacteria prior to clinical use, but this contamination is environmental. Further studies would be required to determine the level of risk this poses to patients.

Clinical significance

Dental professionals have a duty of care to minimise or eradicate potential risks of cross-infection to patients and other members of the team. To date, much less attention has been paid to contamination from the orthodontic laboratory, so contamination and infection risks are unknown.     

无托槽隐形矫技术中附件粘接的临床体会

目的：介绍无托槽隐形矫治技术中常用的辅助装置—＂附件＂的临床粘接技巧,包括粘接中需要注意的问题,供大家分享交流。方法：选取无托槽隐形矫治器17例,根据临床矫治设计方案共需粘结96个附件。所有操作均为四手操作。结果：所有病例均取得很好的附件外观形态,模板脱位顺利,附件与矫治器贴合。4例附件于矫治过程中脱落,须重新进行粘结。结论：此种附件粘接技巧完全满足临床应用。     

The role of removable orthodontic appliances in the investigation and management of patients with hypernasal speech

The hospital-based orthodontist is involved with the management of cleft palate patients. Removable orthodontic appliance therapy as an adjunct to speech problems is described and discussed. The literature is reviewed and the investigation and management of speech problems related to palate-pharyngeal incompetence and hypernasal speech is outlined.     

Effects of orthodontic treatment with aligners and fixed appliances on speech:: A randomized clinical trial

ObjectivesTo evaluate effects of orthodontic treatment with aligners and conventional fixed appliances on production of speech.Materials and MethodsThis was a parallel, randomized clinical trial. Patients with Angle Class I malocclusion, moderate crowding, and no speech impairment were randomly allocated to two groups: patients with orthodontic aligners (OAs; n = 20; mean age = 23.60 ± 5.65 years) and those with conventional fixed appliances (n = 20; mean age = 20.56 ± 4.51 years) and treated at the University of North Parana''s clinic in Londrina, Brazil. Evaluation of speech production was performed semiobjectively by a speech therapist (myofunctional orofacial examination) and subjectively (self-assessment) at five time points: baseline, immediately after insertion of appliances, and subsequently at 3, 30, and 180 days after insertion. For intergroup comparison, independent t, χ², Fisher exact, and Mann-Whitney tests were used; for intragroup comparison, the Friedman test was applied (α = 5%).ResultsIn the semiobjective evaluation, patients with OAs exhibited a change in production of speech production, compared with patients with fixed appliances, immediately and 3 days after insertion of appliances (P < .001). Thirty days after insertion, the groups were similar (P = .487), an outcome that was unchanged at 180 days. However, in the self-assessments, patients in both groups reported significant speech difficulties immediately and 3 days after insertion of appliances, but such impairment was no longer perceived at 30 days or 180 days.ConclusionsAlthough the speech therapist identified changes in speech production at the start of treatment in the OA group only, patient self-assessments demonstrated that orthodontic treatment, regardless of the type of appliance used, interfered with their perception of speech.