Influence of Supplemental Written Information on Adolescent Anxiety,Motivation and Compliance in Early Orthodontic Treatment

Objectives:To test the null hypotheses that supplementation of verbal information with written information when obtaining consent to orthodontic treatment has no effect on (1) anxiety, motivation and apprehension related to treatment and (2) compliance in the early stages of fixed appliance therapy.Materials and Methods:Seventy-six adolescents who were due to start fixed appliance therapy were randomly allocated to receive verbal information only or verbal and written information before orthodontic treatment. Participants'' anxiety, motivation, and apprehension were assessed using a questionnaire that was completed prior to meeting the orthodontic clinician (T1), following consent to treatment (T2), and after 12 weeks of treatment (T3). Appointment attendance, appliance breakages, and periodontal scores were used as measures of patient compliance.Results:Sixty participants completed the study. At T2 there was no change in anxiety scores for either group (P  =  .412); however, increased motivation was detected in the group that had been given both written and verbal information (P  =  .049). At T3 both groups demonstrated similar reductions in anxiety (P  =  .311) and apprehension (P  =  .790) and similar levels of motivation (P  =  .756). A reduction in periodontal scores (P  =  .065), better appointment attendance (P  =  .732), and fewer breakages (P  =  .525) were reported in the group that was given additional information, although these changes were not statistically significant.Conclusions:Supplementation of verbal information with written information resulted in improved motivation for orthodontic treatment but had no statistically significant effect on anxiety, apprehension, or patient compliance.     

Plaque removal by worn toothbrush

BACKGROUND/AIMS: Assessment of the influence of toothbrush wear on plaque (PI) and gingival (GI) indexes. METHOD: 20 university students were recruited. PI and GI were recorded at the starting point (T0). Each subject received a toothbrush and toothpaste. 5 measurements of toothbrush were recorded to establish the initial size. The subjects were instructed to brush 3 x a day and to refrain from using other plaque removal aids. After 1 month (T1), the subjects were randomly divided into 2 groups: group no. 1 substituted the toothbrush at each monthly visit; group no. 2 brushed only with the toothbrush provided at T0. Recalls were scheduled after 1 (T1), 2 (T2) and 3 months (T3). PI, GI and an index of wear (WI) were calculated using 5 measurements of the toothbrush head and were recorded at recalls. RESULTS: From T0 to T3, a significant increase of PI was found within both groups. Non-significant differences, but very close to the significant level (p= 0.063), in group no. 1 and significant differences in group no. 2 of GI were found. No significant differences of PI and GI were found between groups. Increase of the WI was registered from T0 to T3 (p<0.001). CONCLUSION: Each individual is capable of maintaining low PI, even if using a toothbrush that shows evidence of wear.     

Usefulness of an app in improving oral hygiene compliance in adolescent orthodontic patients

Objective:To evaluate the influence of an app-based approach in a protocol for domestic oral hygiene maintenance in a group of adolescent patients wearing fixed multibracket appliances.Materials and Methods:Eighty adolescent patients scheduled to start an orthodontic multibracket treatment were randomly divided into two groups of 40. Plaque index (PI), gingival index (GI), white spots (WS), and caries presence were recorded in all patients, and they were instructed regarding domestic oral hygiene maintenance on the day of braces application (t₀) and every 3 months (t₁, t₂, t₃, t₄) during the first year of treatment. Study group (SG) patients were enrolled in a WhatsApp chat room–based competition and instructed to share monthly with the other participants two self-photographs (selfies) showing their oral hygiene status.Results:SG patient participation in the chat room was regular and active throughout the observation period. At t₂, t₃, and t₄, SG patients had significantly lower values of both PI and GI and a lower incidence of new WS and caries, compared with the control group.Conclusion:Integration of new “social” technologies in a standard oral hygiene motivation protocol is effective in improving compliance of adolescent patients and in improving their oral health status during orthodontic multibracket treatment.     

Quantitative Light-induced Fluorescence-Digital as an oral hygiene evaluation tool to assess plaque accumulation and enamel demineralization in orthodontics

Objective:To assess the use of Quantitative Light-induced Fluorescence-Digital as an oral hygiene evaluation tool during orthodontic treatment.Materials and Methods:In this prospective, randomized clinical trial, 33 patients undergoing fixed orthodontic appliance treatment were randomly allocated to receive oral hygiene reinforcement at four consecutive appointments using either white light (WL) or Quantitative Light-induced Fluorescence-Digital (QLF) images, taken with a device, as visual aids. Oral hygiene was recorded assessing the QLF images for demineralization, by fluorescence loss (ΔF), and plaque coverage (ΔR30). A debriefing questionnaire ascertained patient perspectives.Results:There were no significant differences in demineralization (P  =  .56) or plaque accumulation (P  =  .82) between the WL and QLF groups from T0 to T4. There was no significant reduction in demineralization, ΔF, in the WL, or the QLF group from T0–T4 (P > .05); however, there was a significant reduction in ΔR30 plaque scores (P < .05). All the participants found being shown the images helpful, with 100% of the QLF group reflecting that it would be useful to have oral hygiene reinforcement for the full duration of treatment compared with 81% of the WL group (OR 2.3; P < .05).Conclusions:Quantitative Light-induced Fluorescence-Digital can be used to detect and monitor demineralization and plaque during orthodontics. Oral hygiene reinforcement at consecutive appointments using WL or QLF images as visual aids is effective in reducing plaque coverage. In terms of clinical benefits, QLF and WL images are of similar effectiveness; however, patients preferred the QLF images.     

Effectiveness of a motionless ultrasonic toothbrush in reducing plaque and gingival inflammation in patients with fixed orthodontic appliances

Objective:To compare the effectiveness of a motionless ultrasonic toothbrush to a manual toothbrush in reducing dental plaque, gingival inflammation, and mutans streptococci in patients with fixed orthodontic appliances.Materials and Methods:Twenty-five orthodontic patients were recruited to this crossover study. The patients were randomized into two groups starting with manual or motionless ultrasonic toothbrushes for 30 days. After a 30-day washout period, the patients switched to the other toothbrush type for 30 days. Plaque and gingival indices were evaluated by two calibrated-blinded examiners before and after each 30-day period of brushing. Salivary samples were also collected for quantification of mutans streptococci.Results:On the bracket side, the motionless ultrasonic toothbrush showed a significantly higher mean plaque index bracket score after 30-day usage than baseline (P = .049), while the manual toothbrush group showed no difference between the before and after brushing periods (P = .10). The changes in plaque index bracket score were significantly more favorable in the manual toothbrush group than in the ultrasonic toothbrush group (P = .04). In contrast, no difference was observed on the nonbracket side. There was no significant difference in the changes of gingival index or the numbers of mutans streptococci between the two groups.Conclusion:Manual toothbrushing performed better than brushing with the motionless ultrasonic toothbrush in plaque removal on the bracket side in orthodontic patients. However, no difference was observed in terms of gingival status and the numbers of mutans streptococci.     

A randomized clinical trial to evaluate the plaque removal efficacy of an oscillating-rotating toothbrush versus a sonic toothbrush in orthodontic patients using digital imaging analysis of the anterior dentition

Objective:To compare the plaque removal efficacy of an oscillating-rotating electric toothbrush with an orthodontic brush head versus a sonic toothbrush in adolescent patients with fixed orthodontic appliances.Materials and Methods:This was a randomized, examiner-blind, replicate single-use, two-treatment, four-period, crossover study with a washout period between visits of approximately 24 hours. Forty-four adolescent patients with fixed orthodontic appliances in both arches were randomized based on a computer-generated randomization schedule to one of four toothbrush treatment sequences. The primary outcome was plaque score change from baseline, measured using digital plaque imaging analysis.Results:Baseline plaque levels for both brush treatments were high, covering more than 50% of the tooth area. Effective plaque removal was observed with both brush treatments (P < .001); however, the reduction in plaque with the oscillating-rotating toothbrush was statistically significantly greater (P = .017) compared with the sonic toothbrush.Conclusions:The study provides evidence for more effective plaque-removing efficacy of the oscillating-rotating toothbrush versus the sonic toothbrush among orthodontic patients.     

The effect of changes in primary attending doctor coverage frequency on orthodontic treatment time and results

Objective:To determine whether changes in primary attending (PA) doctor coverage frequency caused an increase in orthodontic treatment time or a decrease in the quality of treatment results in a postgraduate orthodontic clinic. The effect of T1 Peer Assessment Rating (PAR) scores on PA doctor coverage frequency, treatment times, and results was also evaluated.Materials and Methods:A sample of 191 postorthodontic subjects was divided into three groups based on PA doctor coverage (high, medium, or low). Treatment times, treatment results, and other variables were compared between the three PA coverage groups. Additionally, the sample was divided into three groups based on T1 PAR scores. Attending coverage frequency, treatment times, and results were compared between the T1 PAR groups.Results:No statistically significant differences were found in treatment time (P  =  .128) or results (P  =  .052). There were no statistically significant differences in the mean scores for T1 PAR (P  =  .056), T2 PAR (P  =  .602), patient age at T1 (P  =  .747), total appointments (P  =  .128), missed appointments (P  =  .177), or cancelled appointments (P  =  .183). Statistically significant differences were found between the low T1 PAR group and the medium and high T1 PAR groups (attending coverage, P  =  .008; results, P < .001; treatment time, P  =  .001).Conclusions:Under the conditions of this study, variations in PA doctor coverage frequency did not lengthen orthodontic treatment or reduce the quality of treatment results. Low T1 PAR scores were associated with less PA coverage, less change in PAR, and shorter treatment times.     

Influence of active reminders on oral hygiene compliance in orthodontic patients

Objective: To determine if text message reminders regarding oral hygiene compliance have an influence on the level of compliance within an orthodontic population.Materials and Methods:In this prospective, randomized, controlled clinical trial, 42 orthodontic patients were assigned to a text message or control group. Parents of patients assigned to the text message group received a reminder text message one weekday each week. Oral hygiene compliance was measured using bleeding index (BI), modified gingival index (MGI), and plaque index (PI), and visual examination of white spot lesion (WSL) development at baseline (T0), two appointments after baseline (T1), and four appointments after baseline (T2).Results:BI, MGI, and PI scores were significantly lower in the text message group than in the control group at T2.Conclusion:A text message reminder system is effective for improving oral hygiene compliance in orthodontic patients.     

Does clinical experience affect the reproducibility of cervical vertebrae maturation method?

Objective:To assess interobserver and intraobserver reproducibility of the cervical vertebrae maturation method (CVMM) among three panels of judges with different levels of orthodontic experience (OE).Materials and Methods:Fifty individual lateral cephalograms of good quality with complete visualization of cervical vertebrae 1 to 4 were selected. Thirty clinicians, divided according to their OE into three groups (junior group, JU, OE ≤ 1 year; postgraduate group, PG, 2 ≤ OE ≤ 4 years; specialist group, SP, OE ≥ 7 years), evaluated the cephalograms in two sessions (T₁ and T₂) at 3 weeks apart. Kendall''s W and weighted Cohen''s kappa (κ) coefficients were performed to assess interobserver and intraobserver agreement. The level of significance was set as P < .05. For both the interobserver and the intraobserver datasets, the percentage of perfect agreement (PPA) and the number of stages apart for each disagreement were calculated.Results:Kendall''s W at T₁ was SP  =  0.61, PG  =  0.70, and JU  =  0.87; at T₂ it was SP  =  0.78, PG  =  0.85, and JU  =  0.86. The percentage of total interobserver perfect agreement (Inter-PPA) was 42.3% at T₁ and 46.3% at T₂. The JU group had the highest Cohen''s κ coefficient at 0.78, while the PG and SP had coefficients of 0.64 each. The percentage of total intraobserver perfect agreement (Intra-PPA) was 54.2%.Conclusions:The reproducibility of the method was not improved by the level of orthodontic experience. The group with the lowest level of orthodontic experience had the best performance.     

Effectiveness of a sonic toothbrush in maintenance of dental implants

Abstract. This study assessed the efficacy of a sonic and a manual toothbrush in reducing plaque and gingivitis around dental implants. Subjects were randomly assigned to either sonic (n=16) or manual (n=15) study groups. Groups were balanced according to baseline levels of plaque and gingivitis. The plaque (PI), gingival (GI), and bleeding (BI) indices as well as probing depths were determined at baseline, and at 4, 8, 12, and 24 week follow-up visits. Mean scores per person were calculated for each clinical parameter. Oral hygiene habits, compliance and acceptance were also evaluated over the study period. Within group comparisons from baseline throughout the study, as well as between group comparisons (i.e., sonic versus manual), were determined. Overall, plaque, gingival, and bleeding indices in both groups were lower at each follow-up visit when compared to the baseline. Within group comparisons demonstrated that both the sonic toothbrush subjects and the manual toothbrush subjects had significantly lower PI. GI. and BI scores at each post-baseline visit (4, 8, 12, and 24 weeks) than at baseline (p<0.005), In addition, the sonic toothbrush subjects also had significantly lower probing depths at each post-baseline visit than at baseline (p<0.005). Between group comparisons demonstrated that the sonic toothbrush subjects over time had significantly lower PI and BI scores around dental implants than the manual toothbrush subjects (Repeated measures MANOVA; PI, p=0.01; BI, p= 0.017). The sonic toothbrush subjects had lower GI scores and reduced probing depths over time when compared to manual toothbrush subjects but these scores were not statistically significant (GI; probing depth, p > 0.05). No implant problems (e.g., loose screws) were attributable to the sonic toothbrush. Relevant to oral hygiene habits, subjects in both groups demonstrated a high level of compliance with their assigned toothbrush. Overall, the results of this study demonstrated that sonic toothbrushing significantly reduced plaque, gingival inflammation and bleeding, and probing pocket depths around implants over the 6-month trial period. It is concluded that sonic brushing is an effective means of dental implant maintenance.     

Factors associated with long-term patient satisfaction

Objective:To identify factors associated with patient satisfaction at least 5 years after orthodontic treatment.Materials and Methods:A total of 209 orthodontic patients were included in the study. All subjects were treated with upper and lower fixed orthodontic appliances. Dental casts (n  =  627) were examined using the Peer Assessment Rating (PAR) Index pretreatment (T1), at the end of treatment (T2) and at a long-term follow-up (mean, 8.5 years; T3). At T3, a Dental Impact on Daily Living questionnaire was used to assess the long-term effects of orthodontic treatment on daily living and satisfaction with the dentition. Multiple regression analyses were used to quantify associations between patient satisfaction and changes produced by the orthodontic treatment (PAR T2-T1), posttreatment stability (PAR T3), age at the start of treatment (T1), treatment duration (T2-T1), gender, and extraction.Results:Orthodontic treatment produced a significant improvement of 94.2% in the PAR Index (T2-T1), but this change was not associated with the level of satisfaction when the patient was questioned at least 5 years after treatment. Regression analysis showed that satisfaction was significantly associated only with the long-term posttreatment PAR index (r²  =  0.125, P < .0001). No significant association was observed with the severity of malocclusion at the beginning (PAR-T1) or end of the orthodontic treatment (PAR-T2), age at T1, the amount of time taken during orthodontic treatment, gender, or extraction.Conclusions:Over the long term, patient satisfaction is slightly associated with the stability of the orthodontic treatment regardless of the initial occlusal condition or the final result of the orthodontic treatment.     

Camouflage effects following resin infiltration of postorthodontic white-spot lesions in vivo: One-year follow-up

Objective:To assess camouflage effects by concealment of postorthodontic white-spot lesions (WSLs) to sound adjacent enamel (SAE) achieved over 12 months with resin infiltration (Icon, DMG, Hamburg, Germany).Methods: Twenty subjects (trial teeth n_teeth = 111) who had received resin infiltration treatment of noncavitated postorthodontic WSLs were contacted for a 1-year follow-up assessment of CIE-L*a*b* colors (T12). Color and lightness (CIE-L*a*b*) data for WSLs and SAE were compared to baseline data assessed before infiltration (T0) and those assessed after 6 months (T6), using a spectrophotometer. The target parameter was the difference between the summarized color and lightness values (ΔE_WSL/SAE). Intergroup (WSL, SAE) and intertime comparisons (T0 vs T6, T12) were performed using paired t-tests at a significance level of α = 5%.Results:Nine subjects (trial teeth n_teeth = 49; male/female ratio 5/4; age range 13–19 years) were available at T12. After the highly significant reduction of ΔE_WSL/SAE discrepancies between T0 and T6, analysis of 12-month records revealed color and lightness discrepancy of WSL vs SAE that was significantly decreased compared with baseline, indicating an assimilation of WSL color to SAE appearance after infiltration, while an additional reduction of discrepancies between T6 and T12 was not significant.Conclusion:As color and lightness characteristics of the Icon infiltrant as well as the esthetic camouflage effects achieved by WSL infiltration were not altered significantly or clinically relevant after 12 months, the method of resin infiltration can be recommended for an enduring esthetic improvement of postorthodontic WSL. (Angle Orthod. 2015;85:374–380.)     

Interaction between deglutition,tongue posture,and malocclusion: A comparison of intraoral compartment formation in subjects with neutral occlusion or different types of malocclusion

Objective:To test the null hypothesis of no significant difference in terms of intraoral pressure curve characteristics assessed simultaneously at the subpalatal space (SPS) and the vestibular space (VS), during different oral postures, between four groups with either an Angle Class II/1 (II1), Angle Class II/2 (II2), anterior open bite (O) malocclusion, or a neutral occlusion control group (I).Materials and Methods:Intraoral pressure recordings were performed simultaneously in the VS and SPS of 69 consecutive subjects (n_II1  =  15; n_II2  =  17; n_O  =  17; n_I  =  20; mean age/standard deviation 18.43/6.60 years). Assessments included defined sections of open mouth posture (OMP, 30 seconds), anteriorly closed mouth condition (60 seconds), dynamics by a tongue-repositioning maneuver (TRM, 60 seconds), swallowing, and positive pressure generation (PP, 10 seconds). Interactions of malocclusion, compartment location, and posture on pressure curve characteristics were analyzed by Kruskal-Wallis and Mann-Whitney U-tests, adopting an α level of 5%.Results:Globally significant group differences were detected at the VS (plateau duration and median peak heights during TRM; area under pressure curve [AUC] during PP) and SPS (AUC during TRM and PP). Subjects with anteriorly nonopen dental configurations (groups I and II2) were able to keep negative pressure levels at the VS for longer time periods during TRM, compared to groups O and II1.Conclusions:The null hypothesis was rejected for mean VS plateau durations and peak heights and for SPS AUC. Negative pressures at the VS may stabilize outer soft tissues passively and may explain the dental arch form shaping effect by mimic muscles.     

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.     

Effect of posterior impaction and setback of the maxilla on retropalatal airway and velopharyngeal dimensions after two-jaw surgery in skeletal Class III patients

Objective:To evaluate the changes in retropalatal airway and velopharyngeal dimensions after posterior impaction (PI) only or PI and setback (PI/SB) of the maxilla in patients with skeletal Class III undergoing two-jaw surgery.Materials and Methods:Subjects consisted of 60 Class III patients treated with two-jaw surgery. They were divided into two groups: group 1 (n  = 30; PI of the maxilla; mean  =  2.6 mm) and group 2 (n = 30; PI/SB of the maxilla; mean  =  2.8 mm and 1.8 mm, respectively). Using three dimensional computed tomography images taken 1month before surgery (T0) and at least 6 months after surgery (T1), retropalatal airway volume, minimum cross-sectional area, and lateral and anteroposterior (AP) dimensions of minimum cross-sectional area, soft palate angle, soft palate length, and pharyngeal depth were measured. A paired t-test and independent t-test were used for statistical analysis.Results:Group 1 showed increase in retropalatal airway volume and minimum cross-sectional area (P < .01 and P < .05, respectively). Group 2 exhibited decrease in retropalatal airway volume, minimum cross-sectional area, and lateral and AP dimensions of minimum cross-sectional area (all P < .01). Although groups 1 and 2 showed an increase in soft palate length (P < .01 and P < .001, respectively), pharyngeal depth significantly increased only in group 1 (P < .01). Groups 1 and 2 were significantly different in retropalatal airway volume, minimum cross-sectional area, and AP dimension (P < .05, P < .001, and P < .05, respectively).Conclusion:Because the direction of surgical movement in the maxilla can determine the changes in the retropalatal airway and velopharyngeal dimensions, it is recommended that clinicians investigate whether patients suffer from sleep-related breathing disorders before performing PI/SB of the maxilla.     

Efficacy of an electric toothbrush on plaque control compared to two manual toothbrushes

Objectives: This study aimed to compare an electric toothbrush with two manual toothbrushes, in their relative efficacy to control plaque. Design: Randomised clinical trial. Setting: Kerman Dental School, Iran. Participants: Forty‐five volunteer dental students were randomly assigned to one of three groups. All subjects received a baseline plaque assessment using O’Leary plaque index, and then a prophylaxis to achieve the plaque index of zero. Subjects were trained to brush twice daily, with their assigned device and return after 1 week and then after 2 weeks for plaque assessment. Chi‐squared and ANOVA were mainly used. Main outcome measure: Plaque assessment using O’Leary plaque index. Results: Although Jordan toothbrush consistently resulted in lower plaque indices compared to both manual toothbrushes, those differences were not statistically significant, F(2, 42) = 2.45, P = 0.10. Plaque reduction from week 1 to week 2 was significant in Jordan Power group (60%, from 13.46 to 5.44, P = 0.010) and Panbehriz Classic group (53%, from 20.92 to 9.91, P = 0.007). Conclusion: The results of this study shows no evidence of statistically significant difference in respect to plaque control, between Jordan Power electric toothbrush and either of Oral‐B Advantage or Panbehriz Classic manual brushes in a group of dental students after 2 weeks.     

Effects of self-ligating and conventional brackets on halitosis and periodontal conditions

Objective:To evaluate the effects of fixed orthodontic treatment with steel-ligated conventional brackets and self-ligating brackets on halitosis and periodontal health.Materials and Methods:Sixty patients, at the permanent dentition stage aged 12 to 18 years, who had Angle Class I malocclusion with mild-to-moderate crowding were randomly selected. Inclusion criteria were nonsmokers, without systematic disease, and no use of antibiotics and oral mouth rinses during the 2-month period before the study. The patients were subdivided into three groups randomly: the group treated with conventional brackets (group 1, n  =  20) ligated with steel ligature wires, the group treated with self-ligating brackets (group 2, n  =  20), and the control group (group 3, n  =  20). The periodontal records were obtained 1 week before bonding (T1), immediately before bonding (T2), 1 week after bonding (T3), 4 weeks after bonding (T4), and 8 weeks after bonding (T5). Measurements of the control group were repeated within the same periods. The volatile sulfur components determining halitosis were measured with the Halimeter at T2, T3, T4, and T5. A two-way repeated measures of analysis of variance (ANOVA) was used to compare the groups statistically.Results:No statistically significant group × time interactions were found for plaque index, gingival index, pocket depth, bleeding on probing, and halitosis, which means three independent groups change like each other by time. The risk of tongue coating index (TCI) being 2 was 10.2 times higher at T1 than at T5 (P < .001). Therefore, the probability of higher TCI was decreased by time in all groups.Conclusions:The self-ligating brackets do not have an advantage over conventional brackets with respect to periodontal status and halitosis.     

Impact of wearing fixed orthodontic appliances on quality of life among adolescents: Case-control study

Objective:To investigate the impact of wearing a fixed orthodontic appliance on oral health-related quality of life (OHRQoL) among adolescents.Materials and Methods:A case-control study (1∶2) was carried out with a population-based randomized sample of 327 adolescents aged 11 to 14 years enrolled at public and private schools in the City of Brumadinho, southeast of Brazil. The case group (n  =  109) was made up of adolescents with a high negative impact on OHRQoL, and the control group (n  =  218) was made up of adolescents with a low negative impact. The outcome variable was the impact on OHRQoL measured by the Brazilian version of the Child Perceptions Questionnaire (CPQ_11–14) – Impact Short Form (ISF:16). The main independent variable was wearing fixed orthodontic appliances. Malocclusion and the type of school were identified as possible confounding variables. Bivariate and multiple conditional logistic regressions were employed in the statistical analysis.Results:A multiple conditional logistic regression model demonstrated that adolescents wearing fixed orthodontic appliances had a 4.88-fold greater chance of presenting high negative impact on OHRQoL (95% CI: 2.93–8.13; P < .001) than those who did not wear fixed orthodontic appliances. A bivariate conditional logistic regression demonstrated that malocclusion was significantly associated with OHRQoL (P  =  .017), whereas no statistically significant association was found between the type of school and OHRQoL (P  =  .108).Conclusions:Adolescents who wore fixed orthodontic appliances had a greater chance of reporting a negative impact on OHRQoL than those who did not wear such appliances.     

Autotransplantation of Teeth in 215 Patients: A Follow-up Study

Objective:To evaluate the success rate of autotransplantation of teeth in consecutive patients and to analyze factors affecting the outcome.Materials and Methods:The subjects consisted of 215 consecutive patients (101 women and 114 men; aged 9.1–56.4 years, median age 15.2 years [P₁₀  =  11.4, P₉₀  =  19.7]) who had undergone transplantation of a total of 269 teeth, all by the same surgeon. In patients with multiple transplants, only the first transplant was included, to ensure that all transplanted teeth were independent units. The transplants were recorded as unsuccessful if the tooth had been extracted or was surviving but with root resorption or ankylosis. The interval between transplantation and final follow-up was a median 4.8 years (P₁₀  =  2.0, P₉₀  =  5.5) for successful transplants and a median of 2.4 years (P₁₀  =  0.4, P₉₀  =  7.7) for unsuccessful transplants.Results:One-hundred seventy-five (81%) of the transplantations were recorded as successful and 40 (19%) as unsuccessful. Twenty-five teeth had been extracted and 15 had survived but did not fulfill the criteria for success.Conclusions:The success rate of 215 consecutively transplanted teeth was 81%. The highest success rate was for transplantation of premolars to the maxillary incisor region (100%). Complications at surgery such as difficult extraction, deviant root anatomy, or damaged root periodontium affected the outcome. During growth, a successful transplant preserves alveolar bone.