Effect of orthodontic treatment on periodontal health of periodontally compromised patients:: A randomized controlled clinical trial

ObjectivesTo evaluate the effect of fixed orthodontic treatment on periodontal parameters in periodontally compromised adult orthodontic patients.Materials and MethodsThis was a prospective, randomized, controlled clinical trial. Thirty-six periodontally compromised adult patients (mean age: 29.67 ± 4.8 years) were randomly allocated to either test (perio-ortho) or control group (perio). After periodontal stabilization in both groups, orthodontic treatment was started in the test group, whereas the control group remained on periodontal maintenance only. Evaluation and comparison of clinical parameters (plaque index [PI]; gingival index [GI]; bleeding on probing [BOP]; probing depth [PD]; clinical attachment level [CAL]) of both groups was assessed at three time intervals: T0 (base line), T1 (at start of orthodontic treatment), and T2 (1 year after start of orthodontic treatment). Radiological parameters (alveolar bone levels [ABL]) were recorded using CBCT at T1 and T2.ResultsIntragroup analysis showed statistically significant improvement in all clinical and radiological periodontal parameters in both groups (P ≤ .05). Intergroup comparison revealed improvement in the periodontal parameters was not statistically significant between the groups (P ≥ .05). Subgroup analysis showed reduction in the number of moderate and severe periodontitis sites in both groups with significant more gains in ABL in the test group compared to the control group.ConclusionsOrthodontic treatment after periodontal stabilization does not have any detrimental effect on periodontal health in adult periodontally compromised orthodontic patients and may add to the benefits achieved by periodontal treatment alone.     

The Role of Oral Health in the Acquisition and Severity of SARS-CoV-2: A Retrospective Chart Review

ObjectiveStudies have shown that gingival crevices may be a significant route for SARS-CoV-2 entry. However, the role of oral health in the acquisition and severity of COVID-19 is not known.DesignA retrospective analysis was performed using electronic health record data from a large urban academic medical center between 12/1/2019 and 8/24/2020. A total of 387 COVID-19 positive cases were identified and matched 1:1 by age, sex, and race to 387 controls without COVID-19 diagnoses. Demographics, number of missing teeth and alveolar crestal height were determined from radiographs and medical/dental charts. In a subgroup of 107 cases and controls, we also examined the rate of change in alveolar crestal height. A conditional logistic regression model was utilized to assess association between alveolar crestal height and missing teeth with COVID-19 status and with hospitalization status among COVID-19 cases.ResultsIncreased alveolar bone loss, OR = 4.302 (2.510 – 7.376), fewer missing teeth, OR = 0.897 (0.835–0.965) and lack of smoking history distinguished COVID-19 cases from controls. After adjusting for time between examinations, cases with COVID-19 had greater alveolar bone loss compared to controls (0.641 ± 0.613 mm vs 0.260 ± 0.631 mm, p < 0.01.) Among cases with COVID-19, increased number of missing teeth OR = 2.1871 (1.146– 4.174) was significantly associated with hospitalization.ConclusionsAlveolar bone loss and missing teeth are positively associated with the acquisition and severity of COVID-19 disease, respectively.     

The adjunct effectiveness of diode laser gingivectomy in maintaining periodontal health during orthodontic treatment: A randomized controlled clinical trial

Objective:To evaluate the effectiveness of diode laser gingivectomy as an adjunct to nonsurgical periodontal treatment in the management of periodontal health among patients receiving fixed orthodontic appliance therapy (FOAT).Materials and Methods:Thirty patients undergoing FOAT with gingival enlargement were block randomized into two treatment groups. The test group received diode laser gingivectomy (940-nm diode laser, ezlase, Biolase Technology Inc) as an adjunct to nonsurgical periodontal treatment. The control group received nonsurgical periodontal treatment only. For both groups, five periodontal parameters were assessed at baseline, 1 month, 3 months, and 6 months: Plaque Index, Gingival Index, bleeding on probing, probing pocket depth, and Gingival Overgrowth Index. Intra- and intergroup variations in the periodontal parameters were determined over time.Results:Both groups showed statistically significant improvements in periodontal health over the study period (P < .05). However, significant improvements in periodontal health were evident earlier among the test group subjects (P < .05). The magnitude of improvement in periodontal health compared to baseline was greater in the test group than in the control group for Gingival Overgrowth Index at 1 month (P < .001) and 3 months (P < .05), Gingival Index at 3 months (P < .05) and 6 months (P < .05), and probing pocket depth at 1 month (P < .05).Conclusions:Nonsurgical periodontal management with or without the adjunct use of lasers can be effective in the management of gingival health problems among patients receiving FOAT. The adjunctive use of lasers can produce an earlier and greater improvement in gingival health.     

Effect of frequent laser irradiation on orthodontic pain: A single-blind randomized clinical trial

Objective:To analyze the effect of low-level laser therapy (LLLT) on perception of pain after separator placement and compare it with perceptions of control and placebo groups using a frequent irradiation protocol.Materials and Methods:Eighty-eight patients were randomly allocated to a laser group, a light-emitting diode (LED) placebo group, or a control group. Elastomeric separators were placed on the first molars. In the laser and LED groups, first molars were irradiated for 30 seconds every 12 hours for 1 week using a portable device. Pain was marked on a visual analog scale at predetermined intervals. Repeated measure analysis of variance was performed for statistical analysis.Results:The pain scores of the laser group were significantly lower than those of the control group up to 1 day. The pain scores in the LED group were not significantly different from those of the laser group during the first 6 hours. After that point, the pain scores of the LED group were not significantly different from those of the control.Conclusions:Frequent LLLT decreased the perception of pain to a nonsignificant level throughout the week after separator placement, compared with pain perception in the placebo and control groups. Therefore, LLLT might be an effective method of reducing orthodontic pain.     

Effect of fluoride dentifrices on white spot lesions during orthodontic treatment: A randomized trial

Objectives:To determine the effect of Clinpro 5000, Clinpro Tooth Crème, and MI-Paste Plus on the formation of white spot lesions in patients undergoing orthodontic treatment.Materials and Methods:Three prospective groups with 40 patients undergoing orthodontic treatment in each group were evaluated (total recruitment = 120 subjects). The selected product was brushed on for 2 minutes twice daily for 4 months. Subjects were reviewed for 4 months on a monthly basis. The Enamel Decalcification Index (EDI) was used to determine the number of white spot lesions per surface at each visit.Results:100 subjects (35 using Clinpro 5000, 32 using Clinpro Tooth Crème, and 33 using MI Paste Plus) completed the study. The data lend strong support for Clinpro 5000 providing superior protection against enamel decalcification when compared to Clinpro Crème, and mixed support when compared to MI Paste Plus.Conclusions:The use of Clinpro 5000, Clinpro Crème, and MI paste Plus all have a reduction effect on white spot lesions when compared to studies reported previously. Clinpro 5000 has a marginally better effect than the two other test pastes. The results of this study can be used by clinicians when deciding the effectiveness of using fluoride dentifrice products to prevent white spot lesions in their orthodontic practice (ClinicalTrials.gov ID: {"type":"clinical-trial","attrs":{"text":"NCT03440996","term_id":"NCT03440996"}}NCT03440996).     

Alveolar bone response to light-force tipping and bodily movement in maxillary incisor advancement: A prospective randomized clinical trial

Objective:To compare alveolar bone thickness and height changes between untreated incisors (control), incisors advanced with light-force tipping, and incisors advanced with bodily movement mechanics.Materials and Methods:Forty-three subjects (aged 9.49 ± 1.56 years) with anterior crossbite were allocated into an untreated group (control), tipping group, or bodily movement group. Lateral cephalograms were taken before advancement (T₀) and after obtaining normal overjet (T₁). Changes in labial and palatal alveolar bone thickness and height surrounding maxillary incisors were evaluated with limited field-of-view cone-beam computed tomography before advancement (CT₀) and 4 months after normal overjet was obtained (CT₁). Wilcoxon matched-pairs signed-rank and Kruskal-Wallis one-way ANOVA tests were used to compare changes within and between groups, as appropriate. The significance level was set at .05.Results:Labial alveolar bone thickness at the midroot and apical levels were significantly decreased in the bodily movement group (P < .05). However, between groups, there was no statistically significant difference in labial bone thickness changes at any level. Palatal and total alveolar bone thickness at the midroot and apical levels were significantly decreased in the tipping group compared with the control and bodily movement groups (P < .05). Neither labial nor palatal bone height changes were significantly different among groups.Conclusions:Maxillary incisor advancement with light-force tipping and bodily movement in growing patients resulted in labial alveolar bone thickness and labial and palatal alveolar bone height changes that were similar to the untreated group.     

正畸牙移动早期牙根吸收的临床研究

目的 应用锥体束计算机断层(Cone beam computed tomography,CBCT)技术分析正畸牙移动早期牙根吸收的发生情况及其影响因素.方法 选择108例正畸患者,432颗上切牙,治疗前及治疗5～9个月,平均(6.9±1.24)个月后分别拍摄上颌4个切牙CBCT.记录患者性别、初诊年龄、拔牙与否、安氏分...     

应用锥形束CT浅析牙周基础治疗对慢性牙周炎牙槽骨骨量的影响

目的:应用锥形束CT及Simplant软件测量分析不同类型、不同年龄段的慢性牙周炎患者,经过牙周基础治疗后牙槽骨的骨量恢复情况,以期为进一步治疗计划的制定提供临床依据。方法:采用单纯随机抽样法选取2012年2月~2013年2月就诊于中国医科大学附属口腔医院的慢性牙周炎患者50例,其中轻度牙周炎患者15例,中度牙周炎患者18例,重度牙周炎患者17例。采用Simplant软件及t检验观测并比较基线及牙周基础治疗后6个月慢性牙周炎个体的牙槽骨缺损程度,是否进行了统计学分析,请简要补充统计方法及检验水准。结果:不同年龄、不同病损程度的慢性牙周炎患者治疗后6个月与治疗前相比, 牙槽骨高度和相对骨密度均有改善。<50岁的轻度、中度牙周炎患者治疗后6个月的牙槽骨密度均显著高于治疗前(P<0.05),牙槽骨距釉牙骨质界的缺损高度均有降低,但与治疗前相比差异均无统计学意义;重度牙周炎患者治疗前后牙槽骨密度和牙槽骨缺损高度均有改善但差异均无统计学意义。随着年龄的增长,牙槽骨缺损高度及相对骨密度的改善程度呈下降趋势且治疗前后差异无统计学意义;前磨牙及磨牙的近中、远中位点治疗后6个月牙槽骨缺损高度及相对骨密度较其他位点改善明显(P<0.05)。结论:牙周基础治疗在一定程度上可有效改善慢性牙周炎的牙槽骨缺损高度和相对骨密度;锥形束CT及Simplant软件的应用有助于评估治疗前后牙槽骨骨量的变化。     

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.