Quantitative and qualitative analyses of orthodontic-related videos on YouTube

ObjectivesTo investigate content of orthodontic-related videos on YouTube to improve the understanding of orthodontic patients'' perceptions and treatment experiences.Materials and MethodsA systematic search was conducted on YouTube on March 20, 2018, and updated on August 4, 2019, to identify all relevant videos using search terms “orthodontic,” “orthodontics,” “braces,” and “orthodontic braces.” The data set was captured from YouTube Data API (Application Programming Interface) and stored in an Excel database using a query function written in Python. All videos captured were viewed and categorized by three independent dental investigators using thematic analysis. The top 100 videos (by view count) related to patients'' treatment experience were further analyzed using discourse analysis.ResultsA total of 600 orthodontic videos were screened, and 546 were included in the study. Six main themes were identified: (1) individual review of orthodontic treatment (45.8%, n = 250), (2) entertainment (19.8%, n = 108), (3) education (18.3%, n = 100), (4) advertisements (6.6%, n = 36), (5) time lapse of orthodontic treatment (5.3%, n = 29), and (6) do-it-yourself orthodontics (4.2%, n = 23). Of the top 100 videos related to patient''s individual review of treatment, patients'' main focuses were on pain (24%), problems with chewing and swallowing (12%), and adhesive removal (10%).ConclusionsOrthodontic-related YouTube videos are diverse in nature. The most common video category was video providing an individual review of orthodontic treatment experience. Other popular video categories included entertainment, education, and advertisements. A range of do-it-yourself YouTube videos were also identified. YouTube may provide an opportunity for orthodontic professionals to disseminate health information.     

Lingual orthodontic treatment: A YouTube™ video analysis

Objectives:The aim of this study was to examine the quality of information offered for patients seeking information on lingual orthodontic treatment.Materials and Methods:YouTube™ was searched for videos about lingual orthodontic treatment using the key word “lingual braces” from the Google Trends application. One hundred and four videos were selected to be analyzed from the first 120 results. The video content was evaluated using a 10-point score, which was used for classifying low- and high-content video groups. The video information and quality index (VIQI) was applied to determine the quality of the videos. The Mann-Whitney U-test, Chi-square test, and logistic regression analysis were used, and the Pearson correlation coefficient was calculated for statistical evaluations.Results:We classified 32 videos as high-content and 72 as low-content. Most videos were uploaded by laypeople (58.7%, n = 61). Definition of lingual braces and psychological impact were the most commonly discussed topics (51.0%), followed by speech performance (47.1%), pain (44.2%), tongue soreness (37.5%), and biomechanics (14.4%). Compared to the low-content group, the high-content video group had a significantly higher mean number of views (19,867.41 vs 6720.08, P = .002) and more “likes” (135.88 vs 13.01, P < .001), “dislikes” (4.34 vs 0.81, P < .001), and “comments” (26.28 vs 5.31, P = .002). There was no difference in the total VIQI score between the groups (P = .009).Conclusions:The content of YouTube™ videos for lingual orthodontics was generally incomplete. Most videos mentioned psychological effects, but few videos discussed the biomechanics or procedure. Orthodontists should be aware of the information available on YouTube™.     

Twitter analysis of the orthodontic patient experience with braces vs Invisalign

Objective:To examine the orthodontic patient experience having braces compared with Invisalign by means of a large-scale Twitter sentiment analysis.Materials and Methods:A custom data collection program was created that collected tweets containing the words “braces” or “Invisalign” for a period of 5 months. A hierarchal Naïve Bayes sentiment analysis classifier was developed to sort the tweets into five categories: positive, negative, neutral, advertisement, or not applicable. Each category was then analyzed for specific content.Results:A total of 419,363 tweets applicable to orthodontics were collected. Users posted significantly more positive tweets (61%) than they did negative tweets (39%; P ≤ .0001). There was no significant difference in the distribution of positive and negative sentiment between braces and Invisalign tweets (P = .4189). Positive orthodontics-related tweets often highlighted gratitude for a great smile accompanied with selfies. Negative orthodontic tweets frequently focused on pain.Conclusion:Twitter users expressed more positive than negative sentiment about orthodontic treatment with no significant difference in sentiment between braces and Invisalign tweets.     

Efficiency of Upper Arch Expansion with the Invisalign System

ObjectivesTo investigate the efficiency and movement pattern of upper arch expansion using Invisalign aligners. The correlation between the amount of designed expansion and the efficiency of bodily expansion was evaluated, as were the initial molar torque and efficiency of bodily expansion.Materials and MethodsTwenty Chinese adult patients who underwent arch expansion with Invisalign aligners were included in this study. Records of pretreatment (T0 stage) and immediately after completing the expansion phase (T1 stage) were collected, including digital models and cone-beam computed tomography. Dolphin 3D, Geomagic Studio 12.0, and Meazure software were employed to measure data and calculate differences between the expected and actual outcomes.ResultsThere were significant differences between the expected and actual expansion amounts (P< .05). The average expansion efficiencies of the upper canine crown, first premolar crown, second premolar crown, and first molar crown were 79.75 ± 15.23%, 76.1 ± 18.32%, 73.27 ± 19.91%, and 68.31 ± 24.41%, respectively. The average efficiency of bodily expansion movement for the maxillary first molar was 36.35 ± 29.32%. Negative correlations were found between preset expansion amounts and the efficiency of bodily expansion movement (P < .05), and between initial maxillary first molar torque and efficiency of bodily expansion movement (P < .05).ConclusionsAligners could increase the arch width, but expansion was achieved by tipping movement. The evaluation of initial position and preset of sufficient root-buccal torque of posterior teeth were necessary due to the lower efficiency of bodily buccal expansion by the Invisalign system.     

Orthodontically induced external apical root resorption in patients treated with fixed appliances vs removable aligners

Objective:To determine whether orthodontic treatment with removable aligners vs fixed orthodontic appliances is associated with a different frequency of orthodontically induced external apical root resorption (OIEARR) when genetic, radiographic, and clinical factors are accounted for.Materials and Methods:Three hundred seventy-two orthodontic patients treated with removable aligners (Invisalign) or fixed appliances were genetically screened for interleukin 1B gene (IL1B) (rs1143634), interleukin 1 receptor antagonist gene (IL1RN) (rs419598), and osteopontin gene (SPP1) (rs9138/rs11730582). Twelve clinical variables, potentially associated with OIEARR, were also considered. Subjects were divided according to the presence of radiographically determined OIEARR (>2 mm). The association between OIEARR and appliance type, and radiographic, clinical and genetic factors, was assessed using backward stepwise conditional logistic regression. Odds ratios (ORs) and 95% confidence intervals (CIs) were reported.Results:Reliability of the methods was adequate. Clinical case complexity (American Board of Orthodontics [ABO] Discrepancy Index) (OR: 1.032; 95% CI: 1.005–1.061; P = .021) and extent of incisor apical displacement in the sagittal plane (OR: 1.478; 95% CI: 1.285–1.699; P = .001) were associated with an increased OIEARR risk. After adjusting for associations between clinical/radiographic/genetic factors, there were no statistically significant differences with respect to OIEARR or type of orthodontic appliance used, whether removable aligners or fixed appliances (OR: 1.662; 95% CI: 0.945–2.924; P = .078). Only subjects homozygous for the T allele of IL1RN (rs419598) were more prone to OIEARR during orthodontic treatment (OR: 3.121; CI: 1.93–5.03; P < .001).Conclusions:A similar OIEARR predisposition was identified using either removable aligners (Invisalign) or fixed appliances.     

Scanning electron microscopy evaluation of aligner fit on teeth

Objectives:The fitting of aligners on anchorage teeth is a crucial factor in clear aligner orthodontics. The purpose of this experimental study was to evaluate the fitting of two aligner systems, Invisalign and CA-Clear Aligner, using scanning electron microscopy (SEM).Materials and Methods:Passive aligners (Invisalign and CA-Clear Aligner) were adapted on resin casts obtained by stereolithography (STL) files of a patient, and then sectioned buccolingually. Upper and lower central incisors, upper and lower first premolars, and upper and lower first molars were the regions analyzed. Representative microphotographs of sections were taken with a scanning electron microscope (SEM); a total of 160 micrometric measurements were obtained and analyzed with ANOVA tests.Results:Invisalign provided an overall better fit on lower incisors (F = 11.48, P = .0095) and on lower molars (F = 19.93, P = .0012). Considering the different regions, Invisalign provided better fit at the gingival edge of the buccal aspect on lower incisors (F = 11.33, P = 0.0056) and at the gingival edge of the lingual aspect on upper premolars (F =5.34, P = 0.0047). On the upper molars, Invisalign provided better fit at the gingival edge of the buccal aspect, while CA-Clear Aligner provided better fit at the buccal maximum convexity, on the buccal cusp, on the occlusal groove and at the palatal cusp. On lower molars, Invisalign showed a more accurate fit at the buccal aspect points.Conclusions:Invisalign and CA-Clear Aligner exhibited comparable fit on anchorage teeth. Invisalign provided better fit at the gingival edges of aligners, while the CA-Clear Aligner provided better fit on complex occlusal surfaces.     

Quality of life in an adolescent orthodontic population:: Invisalign versus fixed appliances

ObjectivesTo investigate adolescent orthodontic patient experiences and quality of life with fixed appliances compared to Invisalign.Materials and MethodsAdolescent patients in active treatment with Invisalign or fixed appliances for a minimum of 6 months were provided with the Child Oral Health Impact Profile-Short Form 19 questionnaire, along with additional items of interest that were assessed separately. Pearson''s χ² test was used to compare responses (P < .05), and unpaired t-tests (P < .05) were used to test for differences in mean satisfaction, quality of life, and domain scores.ResultsIn total, 74 patients (37 in each treatment group) participated. Overall, no significant differences were noted in the mean quality of life, satisfaction, or domain scores between the two groups. A significant difference was noted in the time taken to adjust to appliances, with the Invisalign group demonstrating faster adaptation. Additionally, the fixed appliance group was 3.8 times more likely to report missing school because of their appliance (95% confidence interval [CI]: 1.2, 12.5) and 2.7 times more likely to report having difficulty eating certain foods (95% CI: 1.1, 7.1). When the sample of females between the ages of 14 and 18 was analyzed, the Invisalign group reported feeling attractive more often than the fixed appliance group.ConclusionsBoth treatment groups were generally very satisfied with their treatment modality. The overall quality of life of adolescent orthodontic patients undergoing treatment with fixed appliances and Invisalign for a minimum of 6 months was similar.     

Evaluating YouTube as a Patient Information Source for the Risks of Root Canal Treatment

IntroductionYouTube is one of the most used social media platforms for health care information. Misinformation and poor educational content on this platform can exacerbate public anxiety and fear of root canal treatment. This study aimed to investigate the quality of videos examining risks of root canal treatment on YouTube.MethodsYouTube was searched using a combination of keywords relating to endodontic complications to replicate goal-orientated browsing. Video quality was assessed using a modified DISCERN score and global quality score by 2 authors independently. Manifest quantitative content analysis was used to capture information about the video and extent of interactions. The 10 most viewed videos were further analyzed in terms of the messaging and format of the videos.ResultsThe mean overall quality of the videos was relatively low (2.20). Videos produced by regulatory bodies had the highest mean score (3.00) and the shortest mean length (2 minutes 23 seconds) but had the fewest views and interactions. The poorest quality videos (mean 1.5) were produced by nonclinicians and news/media, which tended to be longer (mean 8 minutes 49 seconds) and received more engagement. Across all videos, information related to patient decision making tended to be poorly presented.ConclusionsThe dental community, particularly institutions and organizations, need to strategically create engaging videos to redress patients’ concerns about root canal treatment. This can counterbalance the existing misleading information and improve access to evidence-based content, which will ultimately affect patient decision making.     

A randomized clinical trial comparing mandibular incisor proclination produced by fixed labial appliances and clear aligners

Objective:To compare the mandibular incisor proclination produced by fixed labial appliances and third generation clear aligners.Materials and Methods:Patients underwent a course of orthodontic treatment using either fixed labial appliances or clear aligners (Invisalign). Mandibular incisor proclination was measured by comparing pretreatment and near-end treatment lateral cephalograms. Eligibility criteria included adult patients with mild mandibular incisor crowding (<4 mm) and Class I skeletal bases (ANB, 1–4°). The main outcome was the cephalometric change in mandibular incisor inclination to the mandibular plane at the end of treatment. Eligible patients picking a sealed opaque envelope, which indicated their group allocation, was used to achieve randomization. Data was analyzed using a Welch two-sample t-test.Results:Forty-four patients (mean age, 26.4 ± 7.7 years) were randomized in a 1:1 ratio to either the fixed labial appliance or the clear aligner group. Baseline characteristics were similar for both groups: Fixed appliance mean crowding was 2.1 ± 1.3 mm vs clear aligner mean crowding, 2.5 ± 1.3 mm; pretreatment mean mandibular incisor inclination for the fixed appliance group was 90.8 ± 5.4° vs 91.6 ± 6.4° for the clear aligner group. Fixed appliances produced 5.3 ± 4.3° of mandibular incisor proclination. Clear aligners proclined the mandibular incisors by 3.4 ± 3.2°. The difference between the two groups was not statistically significant (P > .05).Conclusion:There was no difference in the amount of mandibular incisor proclination produced by clear aligners and fixed labial appliances in mild crowding cases.     

YouTube™ as an information resource for orthognathic surgery

Objective: To investigate video content on YouTube? related to orthognathic surgery.

Materials and methods: YouTube? was searched using the terms: orthognathic surgery; orthodontic surgery; jaw surgery; jaw corrective surgery. Inclusion criteria included English language; primary content orthognathic surgery and acceptable audio-visual quality. Videos were sorted into the top 50 for each search term by view-count and into an overall top 60 from the four searches. The following parameters were recorded for each video: number of views; likes; dislikes; source; primary intention. Each was classified according to information content as ‘excellent’, ‘moderate’ or ‘poor’. A pre-determined list of orthognathic surgery-related information domains was also evaluated.

Results: The top 60 videos had a combined total of 6,986,141 views. Videos predominantly involved patients describing their personal experience (41.67%) with the majority positively biased (61.67%). Only 9.17% of videos were classified as having excellent general information content and 55.83% were rated as poor. Surgical procedures were described in 45% whilst the need for pre- and post-surgical orthodontics was discussed in 33% and 16%, respectively. Post-operative paraesthesia was discussed in 17.5% of videos outcome.

Conclusions: Video content on YouTube? relating to orthognathic surgery is substandard and patients should be advised to view it with caution.     

Outcome assessment of orthodontic clear aligner vs fixed appliance treatment in a teenage population with mild malocclusions

ObjectiveTo assess the efficacy and efficiency of treatment in adolescents presenting with mild malocclusions, comparing outcomes using clear aligners to fixed appliances.Materials and MethodsPatients identified retrospectively and consecutively from one private practice had been treated with either clear aligners (Invisalign, Align Technology, Santa Clara, Calif) or fixed appliances (0.022 Damon, Ormco, Orange, Calif; n = 26/group). Assessments of occlusion were made using the American Board of Orthodontics Discrepancy Index (DI) for initial records and Cast-Radiograph Evaluation (CRE) for final records. Number of appointments, number of emergency visits, and overall treatment time were determined from chart reviews. Data were analyzed using Pearson''s correlation, Wilcoxon rank tests, unpaired t-tests, and Chi-square tests, with significance set to P ≤ .05.ResultsPretreatment, the aligner and fixed groups showed no significant difference in overall severity (DI: 11.9 ± 5.3 vs 11.6 ± 4.8) or in any individual DI category. Posttreatment scores showed finishes for the aligner group had fewer discrepancies from ideal relative to the fixed appliance group (CRE: 30.1 ± 8.3 vs 37.0 ± 9.3; P < .01). Patients treated with aligners had fewer appointments (13.7 ± 4.4 vs 19.3 ± 3.6; P < .0001), fewer emergency visits (0.8 ± 1.0 vs 3.6 ± 2.5; P < .0001), and shorter overall treatment time (16.9 ± 5.7 vs 23.4 ± 4.4 months; P < .0001).ConclusionsOutcomes for treatment of mild malocclusions in adolescents showed equivalent effectiveness of clear aligners compared to fixed appliances, with significantly improved results for clear aligner treatment in terms of tooth alignment, occlusal relations, and overjet. Assessment of the number of appointments, number of emergency visits, and overall treatment time showed better outcomes for treatment with clear aligners.     

Evaluation of YouTube videos about smile design using the DISCERN tool and Journal of the American Medical Association benchmarks

Statement of problemYouTube contains many videos on health-related topics. “Smile Design” is one that is frequently searched on YouTube. Whether YouTube can be considered useful for patients seeking information on smile design is unclear.PurposeThe purpose of this study was to assess and validate the features of the most popular YouTube videos on smile design.Material and methodsIn September 2019, the keyword “smile design” was searched on YouTube in North America using a virtual private network (VPN). The top 100 videos in a constantly updated list were recorded. The DISCERN instrument (Quality Criteria for Consumer Health Information) and the benchmarks established by the Journal of the American Medical Association (JAMA) were used to evaluate these 100 videos. A spreadsheet (Excel v2016; Microsoft Corp) was used to process statistical data, calculated as mean and frequency.ResultsOf the 100 videos identified, some were excluded as duplicates (11), irrelevant (4), and not presented in English (7). No video met all the JAMA criteria. Adherence to authorship and currency principles was observed in each video, and those adhering to attribution and disclosure principles were categorized as “good.” The average DISCERN score for the 78 included videos was fair (39.6 points); all videos scored poor or fair—very poor, good, or excellent scores were not found.ConclusionsThe quality of information on YouTube videos relating to smile design was only fair. Patients should use smile design information found on YouTube with caution. When professionals upload a video to YouTube, they should use evaluation tools as a quality guide.     

Effects of Invisalign (G5) with virtual bite ramps for skeletal deep overbite malocclusion correction in adults

ObjectivesTo investigate the skeletal and dentoalveolar effects of Invisalign''s G5 protocol with virtual bite ramps in the treatment of adults with skeletal deep bites.Materials and MethodsThis retrospective study was conducted on consecutively treated adults presenting with skeletal deep bites as defined by the Overbite Depth Indicator (ODI). Subjects were divided into 2 groups: Invisalign group (n = 24) treated with the Invisalign G5 protocol and a full fixed appliance (FFA) group (n = 24) treated with edgewise FFAs and matched to the Invisalign group by ODI, sex, type of malocclusion, and non-extraction treatment. Pretreatment (T₁) and post–comprehensive treatment (T₂) lateral cephalograms were obtained and analyzed.ResultsBoth the Invisalign and FFA groups showed significant changes from T₁ to T₂ in ODI and other skeletal and dentoalveolar measurements. The mean change in ODI was −1.5° (P < .001) for the Invisalign group and −2.0° (P < .001) for the FFA group. The mean decrease in overbite was 1.3 mm (P < .001) and 2.0 mm (P < .001) for the Invisalign and FFA groups, respectively. The mean increase in mandibular plane angle (Sn-GoGn) was 0.65° (P = .003) for the Invisalign group and 1.15° (P < .001) for the FFA group. When the groups were compared with each other, both ODI (P = .03) and overbite (P = .003) were significantly different in addition to other measurements.ConclusionsAlthough FFA treatment had more apparent skeletal changes for deep bite adult patients when compared with Invisalign, both systems were effective in opening deep bites at dentoalveolar and skeletal levels.     

Cytotoxicity assessment of different clear aligner systems: An in vitro study

ObjectivesTo evaluate and compare the cytotoxicity of multiple clear aligner systems (Invisalign, Eon, SureSmile, and Clarity).Materials and MethodsA cytotoxicity assessment was carried out by immersing three sets of aligners from the included four systems in normal saline for 1 month at 37°C. The solutions were then diluted to three different concentrations (5%, 10%, and 20% volume/volume). Gingival fibroblasts were exposed to the solution after being seeded to 96-well microplates for 48 hours, and the medium was substituted with an MTT solution (MTT: 3-[4,5-dime- thylthiazol-2-yl]-2,5-diphenyltetrazolium bromide). Optical density was then measured to determine cell viability and evaluate cytotoxicity subsequently.ResultsCytotoxicity comparison showed no statistically significant difference among the four included systems. However, when cell viability of each system was compared with the control, a significant difference was reported at the 10% and 20% solution concentrations. The Clarity system had the lowest toxicity across all solution concentrations.ConclusionsThe thermoplastic materials used by all tested systems (Invisalign, Eon, SureSmile, and Clarity) presented some degree of toxicity (slight to moderate), with statistically significant mean differences compared with the control.     

Forces and moments delivered by novel,thinner PET-G aligners during labiopalatal bodily movement of a maxillary central incisor: An in vitro study

Objective:To evaluate whether overloading of teeth can be avoided by utilizing aligners with reduced thicknesses of 0.4 mm or 0.3 mm.Materials and Methods:The experimental setup included an acrylic maxillary jaw model with tooth 11 separated and fixed via a 3-D force-moment transducer to a hexapod for experimental movement. Aligners tested were fabricated on duplicate stone models using commercially available polyethylene terephthalate glycol (PET-G) foils with thicknesses between 0.5 and 0.75 mm, and novel 0.4-mm- and 0.3-mm-thick foils. With the test aligner seated, 11 was bodily displaced in a labiopalatal direction in the range of ±0.25 mm while all six force-and-moment components exerted on this tooth were registered.Results:With the thinnest commercially available 0.5-mm aligner, median forces of −7.89 N and 8.37 N were measured for the maximum 0.25-mm movement of 11 in a labial and palatal direction, respectively. In comparison, force values were 35% and 71% lower for the novel aligners with a thickness of 0.4 mm and 0.3 mm, respectively.Conclusions:Novel “leveling” aligners with reduced thickness may reduce overloading of individual teeth during aligner therapy. Due to form instability of 0.3-mm aligners, we suggest a novel sequence of 0.4–0.5–0.75 mm for aligner systems using several foil thicknesses for load graduation within single setup steps. This would combine low stiffness of the initial aligner and relatively constant load increases throughout the treatment.     

Differences in finished case quality between Invisalign and traditional fixed appliances:: A randomized controlled trial

ObjectivesTo compare the treatment and posttreatment effects of Invisalign aligners that incorporated SmartForce features and attachments to traditional fixed appliances.Materials and MethodsThis randomized controlled trial included 66 patients, 32 aligners, and 34 fixed-appliance patients. The median ages of the aligner and braces patients were 26.7 (interquartile range [IQR]: 9.8) and 25.9 (IQR: 16.6) years, respectively. Pretreatment occlusion was assessed using the ABO Discrepancy Index. Posttreatment (T1) and 6-month retention (T2) occlusions were quantified using the ABO Objective Grading System (OGS) scores.ResultsThe braces group finished treatment significantly (P < .001) earlier (0.4 years) than the aligner group. The median DI scores for the aligner and braces groups were 4.5 and 7.0, respectively, which was a statistically significant (P = .015), but clinically insignificant, difference. There were no statistically significant between-group differences for the total OGS scores or any of the individual component scores at debond (T1) or after 6 months of retention (T2). During the posttreatment period, alignment and overjet worsened significantly in the aligner group, while buccolingual inclinations and occlusal relations improved. Over the same period, alignment worsened in the braces group and buccolingual inclinations improved. There was no statistically significant between-group difference in posttreatment changes of the total OGS scores.ConclusionsWhile patients with simple malocclusions require 4.8 months longer treatment times with aligners than traditional braces, the treatment and 6-month posttreatment occlusal outcomes are similar.     

Maxillary arch development with Invisalign system:: Analysis of expansion dental movements on digital dental casts

ObjectivesTo evaluate tooth movements during maxillary arch expansion with clear aligner treatment.Materials and MethodsThe study group included 28 subjects (16 females, 12 males, mean age 31.9 ± 5.4 years) collected prospectively from January 2018 to May 2019. Inclusion criteria were European ancestry, posterior transverse discrepancy of 3–6 mm, permanent dentition stage, presence of second permanent molars, mild or moderate crowding, and good compliance with aligners. Treatment protocol included nonextraction strategies, application of Invisalign clear aligner system, and no auxiliaries other than Invisalign attachments. Linear and angular measurements were performed before treatment (T1), at the end of treatment (T2), and on final virtual models (T2 ClinCheck). A paired t-test was used to compare T2-T1 and T2-T2 ClinCheck changes. The level of significance was set at 5%.ResultsStatistically significant differences were found for all measurements, except for ones at the upper second molars. The greatest increase in maxillary width was detected at the upper first and second premolars: +3.5 mm for the first premolar and +3.8 mm for the second premolar at T2. Comparison of T2-T1 angular outcomes showed statistically significant changes in the inclinations of all teeth except for the second permanent molars. T2-T2 ClinCheck showed significant differences for both linear and angular measurements for maxillary canines, resulting in poor predictability.ConclusionsMaxillary arch development revealed a progressive reduction of the expansion rate and buccal tipping in the anterior, lateral, and posterior regions, with the greatest net increase at the first and second premolars. Clinical attention should be paid to maxillary canine movements, and overcorrection should be planned for them during dentoalveolar expansion.     

The nature and accuracy of Instagram posts concerning marketed orthodontic products:: A cross-sectional analysis

ObjectivesTo scrutinize claims contained within Instagram posts related to six popular marketed orthodontic products.Materials and MethodsThree hundred publicly available Instagram posts were identified using the following Instagram hashtags: #carrieremotion, #damonbraces, #invisalign, #acceledent, #propelorthodontics, and #myobrace. Pilot coding was undertaken on a subset of claims (n = 50) and a coding guide was developed. The associated claims were categorized under 24 recognized themes and their accuracy assessed on a five-point scale.ResultsOf 1730 posts screened, 300 were included for analysis. The majority of posts were based on photographs (n = 244, 81.3%) with the remainder (n = 56, 18.7%) including videos. Half of the posts involved a picture of the product in isolation (n = 150, 50%), with clinical cases presented in a minority (n = 99, 33%). Overall, 472 claims were included with treatment duration being the most frequent theme (n = 125, 26.5%). In terms of accuracy, most of the claims were judged to be “false” (n = 283, 60%) with less than 2% considered “objectively true.”ConclusionsMost of the claims relating to six popular marketed orthodontic products concerned treatment duration. The vast majority of these claims were not supported by evidence and were judged to be false. Efforts should be made to promote the provision of accurate orthodontic information and to verify marketing claims on social media platforms.     

Color fading of the blue compliance indicator encapsulated in removable clear Invisalign Teen® aligners

Objective:To evaluate the color fading in aqueous solutions of the blue dot wear-compliance indicators of the Invisalign Teen® System outside the oral cavity.Materials and Methods:The compliance indicators in the Invisalign Teen aligners were tested for color resistance in various aqueous models with no saliva involved.Results:Color fading was observed as a function of time, pH, and temperature while compliance indicators were stored in drinking water or sour soft drinks and in conjunction with the use of cleaning tablets and a dishwasher. The findings of color fading were consistent with the color changes observed when the aligners were being worn by patients. Color fading, notably as observed in connection with acidic soft drinks and cleaning techniques, introduces uncertainty into the assessment of actual patient compliance, as reflected by the fading colors of compliance indicators.Conclusion:Compliance indicators are not immune to simple intentional or unintentional manipulations. Therefore, they can best show an estimate of wear time but cannot be recommended as objective wear-time indicators.