Journal & Issues

Volume 39 (2023): Issue 1 (January 2023)

Volume 38 (2022): Issue 2 (January 2022)

Volume 38 (2022): Issue 1 (January 2022)

Volume 37 (2021): Issue 2 (January 2021)

Volume 37 (2021): Issue 1 (January 2021)

Volume 36 (2020): Issue 2 (January 2020)

Volume 36 (2020): Issue 1 (January 2020)

Volume 35 (2019): Issue 2 (January 2019)

Volume 35 (2019): Issue 1 (January 2019)

Volume 34 (2018): Issue 2 (January 2018)

Volume 34 (2018): Issue 1 (January 2018)

Volume 33 (2017): Issue 2 (January 2017)

Volume 33 (2017): Issue 1 (January 2017)

Volume 32 (2016): Issue 2 (January 2016)

Volume 32 (2016): Issue 1 (January 2016)

Volume 31 (2015): Issue 2 (January 2015)

Volume 31 (2015): Issue 1 (January 2015)

Journal Details
Format
Journal
eISSN
2207-7480
First Published
01 May 1967
Publication timeframe
1 time per year
Languages
English

Search

Volume 36 (2020): Issue 1 (January 2020)

Journal Details
Format
Journal
eISSN
2207-7480
First Published
01 May 1967
Publication timeframe
1 time per year
Languages
English

Search

13 Articles
Open Access

AcceleDent Aura does not influence treatment duration or number of visits

Published Online: 20 Jul 2021
Page range: 2 - 8

Abstract

Abstract Background

Many techniques and appliances claim to reduce orthodontic treatment time, one of which is micro-vibration applied by the AcceleDent Aura appliance.

Objectives

The purpose of this study was to report compliance with AcceleDent Aura and to assess any effect on treatment duration, number of visits and bond failures.

Methods

Forty Class II adolescent subjects were randomly assigned to use the AcceleDent Aura appliance or no AcceleDent Aura device during orthodontic treatment with fixed appliances involving maxillary premolar extractions. Compliance was recorded by the AcceleDent Aura appliance and reported for the first 13 months. Overall treatment duration, the number of visits and number of bond failures were also recorded.

Results

AcceleDent compliance reduced over time from a mean 77.8% usage at the start to a mean of 39.5% by the thirteenth month. There was no difference in the number of bond failures between groups (p = 0.54) and there was no evidence that the use of the Acceledent Aura appliance influenced treatment duration (p = 0.26) or the number of visits (p = 0.56).

Conclusions

The AcceleDent Aura appliance had no significant effect on treatment duration, number of visits or the number of bond failures. Compliance with the appliance waned significantly over time.

Open Access

A clinically based review of patient and treatment characteristics in West Australian private orthodontic practices

Published Online: 20 Jul 2021
Page range: 9 - 19

Abstract

Abstract Objective

To describe patient and treatment characteristics in West Australian private orthodontic practices.

Methods

A quantitative retrospective cross-sectional study of patient records from private practices in Western Australia was conducted. Permission was sought to access clinical records of 100 most recently-treated patients at each participating practice. A sample of 3,200 patients (response rate 84%) was collected, representing approximately one-third of practices in Western Australia, and simple descriptive statistics were applied to assess patient and treatment characteristics.

Results

The majority of patients were female (58.5%), adolescent and had private health insurance (75.6%). The most common patient complaint was crowding (37.6%) and aesthetics (21.3%). Data analysis indicated that 31% of patients were self-referred and a similar proportion did not have a specific complaint. Adult females had a higher interest in aesthetic options. Over half of the patients (56%) received first phase treatment, and non-extraction orthodontics accounted for 61.6% of cases. Full fixed appliances were the most commonly prescribed device (94%). The acceptance rate of orthognathic surgery, when offered, was approximately 30%.

Conclusion

Clinical data relating to actual patient presentations provide an invaluable insight into the realities of private practice. The eventual course of treatment is often determined by the patient’s tolerances and expectations as much as a clinical recommendation.

Open Access

Oral Health Related Quality of Life (OHRQoL) outcomes at the time of orthodontic appliance removal and three months into retention

Published Online: 20 Jul 2021
Page range: 20 - 26

Abstract

Abstract Background

Oral health-related quality of life (OHRQoL) has become an important measure of orthodontic treatment outcome. However, it is unclear how long OHRQoL benefits manifest themselves following the removal of the orthodontic appliances.

Objectives

To investigate differences in OHRQoL recorded at the time of orthodontic appliance removal and three months into retention.

Setting and sample

Described is a prospective outcome study of 59 consecutive participants treated in a hospital-based clinic between 2015 and 2018. The patients comprised three groups: those who received orthognathic surgery (N = 15), those who had an orofacial cleft (N = 30) and those who had no-surgery/no-cleft (N = 14). Each individual completed an age-specific OHRQoL questionnaire that categorised them as either an adolescent (N = 37) or an adult (N = 22) participant.

Method

The OHRQoL questionnaires were completed at the time of appliance removal (T0) and again three months into retention (T1). The Child Perceptions Questionnaires (CPQ11-14-ISF8 and P-CPQ8) were used for adolescent participants and their parent/caregiver, respectively, while the short-form Oral Health Impact Questionnaire (OHIP-14) was used for the adults.

Results

The OHIP-14, CPQ11-14-ISF8 and P-CPQ8 detected improvements in overall and domain scores between T0 and T1 for all patient groups. Moderate effect sizes (0.2–0.7) were observed in all the domain, overall and group mean scores.

Conclusions

Post-treatment orthodontic OHRQoL outcomes improve over the three-month period following appliance removal. The use of these measures should be delayed beyond the immediate time of appliance removal to allow the benefits of orthodontic treatment to be appreciated.

Open Access

The long-term efficacy of rapid maxillary expansion and facemask therapy in Class III malocclusion

Published Online: 20 Jul 2021
Page range: 27 - 37

Abstract

Abstract Aim

The aim of the present study was to investigate the long-term efficacy of rapid maxillary expansion (RME) and facemask (FM) therapy in the treatment of Class III malocclusions by comparing Class III subjects treated by RME/FM mechanics with untreated Class III controls at the Western Australian public dental hospital.

Materials and methods

The lateral cephalograms of 42 (26 males, 16 females) Class III patients treated by RME/FM therapy were analysed and compared with a control sample comprised of 23 (14 males, 9 females) untreated Class III patients. Evaluations were carried out prior to facemask therapy and at a long-term follow-up period of approximately eight to nine years post-treatment. Statistical comparisons were performed using t-tests for unpaired data.

Results

At long-term follow-up, there were no statistically significant differences between the treated and control groups except in overjet, which was greater in the treated group (p < 0.05).

Conclusions

These results suggest that the short-term effects on the maxilla in RME/FM therapy are not maintained in the long term. Success in treatment is largely dependent on the patient’s skeletal growth pattern.

Open Access

Comparison of chewing gum and ibuprofen in alleviating orthodontic pain: a single centre, randomised clinical trial

Published Online: 20 Jul 2021
Page range: 38 - 44

Abstract

Abstract Background

The aim of the present three-arm parallel trial was to compare the effectiveness of chewing gum and ibuprofen in the control of orthodontic pain.

Methods

Patients to undergo orthodontic treatment at a private orthodontic clinic were randomly divided into three parallel groups, each of which took either a placebo, ibuprofen or chewing gum. The eligibility criteria included patients in the full permanent dentition with moderate crowding requiring the extraction of two mandibular and two maxillary premolars. The main outcome was the patient’s level of discomfort, which was assessed by a 0–10 numeric rating scale (NRS) at two hours, six hours, at bedtime, 24 hours, two days, three days and seven days after the placement of initial arch wires in four functions including chewing, biting, occluding back teeth, and occluding front teeth. Randomisation was accomplished according to the patient’s clinic entrance number and by using a table of random numbers. The patients in the placebo and ibuprofen groups were blinded to the type of medication used. The differences in the groups were analysed using repeated measures ANOVA.

Results

Sixty-six patients between 12 and 30 years were randomised in a 1:1:1 ratio. The pain questionnaire response rate was 100% in the three groups, but six patients were excluded and consequently 60 patients were analysed (N = 20 in each group). There was no significant difference between the chewing gum and ibuprofen groups during any oral function at any time point (p > 0.05). However, repeated measures ANOVA showed that patients in the placebo group experienced significantly higher pain scores compared with patients in the ibuprofen and chewing gum groups at two hours, six hours, at bedtime, at 24 hours and two days after initial arch wire placement (p < 0.05). No patient harm was observed in this study.

Conclusions

In contrast to the common orthodontic belief that gum chewing may lead to bracket breakage, it seems that chewing gum is as beneficial as medication for pain relief and can be a recommended alternative during orthodontic treatment.

Open Access

Facial soft tissue norms in Caucasians using an innovative three-dimensional approach

Published Online: 20 Jul 2021
Page range: 45 - 54

Abstract

Abstract Background and aim

Contemporary orthodontic and surgical treatment goals are primarily focussed on achieving optimal aesthetic soft tissue outcomes in three dimensions. It is important, therefore, to establish valid three-dimensional normative models to assist in clinical decision-making. Ideally, such models should be customised to a patient’s individual facial proportions. The aim of this study was to establish the most pleasing computer generated 3D facial form using a community-based sample population.

Methods

Three-dimensional facial surface data (3dMDface) were obtained from 375 young adult Caucasians (195 males and 180 females, all approximately 22 years old) without craniofacial anomalies, all of whom were participants in The Raine Study in Western Australia with participants from Generation 2. These data were used to generate seven faces that represented the variations in convexity distributed evenly around an average. The faces were subsequently rated by orthodontists, oral surgeons, plastic surgeons, dentists and laypeople for attractiveness.

Results and conclusion

Age, sex and occupation did not influence the preference among the various faces. The average face was rated as the most attractive. For males, a slightly concave profile and for females a slightly convex profile was preferred. The present study suggested that orthodontic/surgical treatment of Caucasians should be directed towards achieving an average facial form.

Open Access

Orthodontic knowledge and referral patterns: a survey of paediatric specialists and general dental practitioners

Published Online: 20 Jul 2021
Page range: 55 - 61

Abstract

Abstract Introduction

Early diagnosis and referral is essential in order to provide the best orthodontic care. Paediatric specialists (PSs) and general dental practitioners (GDPs) are usually the first dental professionals to diagnose a malocclusion.

Aim

To evaluate the knowledge and approach of PSs and GDPs in the management of children in reference to the timing of referral and early orthodontic intervention.

Methods

A survey assessed referral patterns and the respondents’ orthodontic knowledge regarding treatment timing and indications for early treatment in the early and late mixed dentition.

Results

One hundred and seventeen dentists participated in the study, of whom 79 were GDPs and 38 were PSs. The average total accuracy score in a 27-knowledge questionnaire was 68.6%, resulting in a statistically significant difference between the PSs and the GDPs. This difference arose from confusion regarding the prevention of maxillary permanent canine impaction and the need for a leeway space maintainer.

Conclusions

The GDPs and the PSs had a sound knowledge of orthodontics and a reasonable referral pattern, although the knowledge of PSs was significantly higher than that of the GDPs. There is a need for further education regarding orthodontic treatment needs and timing both in undergraduate/postgraduate training as well as in professional continuing education programs.

Open Access

Trends in surgical-orthodontic management of Class III malocclusions in Western Australia

Published Online: 20 Jul 2021
Page range: 62 - 68

Abstract

Abstract Aim

The aim of this retrospective cohort study was to identify trends in the surgical-orthodontic management of skeletal Class III malocclusions in Western Australia between 1985 and 2016.

Methods

The records of 225 patients (132 females, 93 males) who received combined surgical-orthodontic correction of their Class III malocclusion between 1985 and 2016 were retrospectively assessed. The subjects were divided into three groups according to surgery type: Group (1) maxillary advancement only; Group (2) mandibular setback only; Group (3) two-jaw surgery.

Results

A trend towards two-jaw surgery for Class III correction was observed. Between 1985 and 2016, 123 patients (55%) were treated via two-jaw surgery; 97 patients (43%) were treated via maxillary advancement alone and five patients (2%) were treated via mandibular setback alone. Between 2011 and 2016, 61% were treated via two-jaw surgery; 37% were treated via maxillary advancement surgery; 2% were treated via mandibular setback surgery. Gender affected surgery type: two-jaw surgery (60% female); maxillary advancement (62% female); mandibular setback (17% female). A greater proportion of females received Class III surgical management in comparison with males (59:41).

Conclusion

Two-jaw surgery is the most common procedure for the surgical correction of skeletal Class III malocclusions in Western Australia. Of the single jaw procedures, isolated maxillary advancement surgery is more common than mandibular setback procedures.

Open Access

Developmental stage specific ANB reference values based on a longitudinal sample of untreated Caucasian subjects

Published Online: 20 Jul 2021
Page range: 69 - 74

Abstract

Abstract Objectives

The study aimed to assess the longitudinal changes in the ANB angle before and after adolescence, and determine Class I normative values for childhood and adolescent Caucasian patients based on cervical vertebral maturation stages (CVMS) and gender.

Setting and sample population

The sample included 71 (41 females and 30 males) untreated Caucasian subjects who took part in a growth study between 1959 and 1976.

Materials and methods

Lateral cephalometric radiographs were analysed at CVMS1 (childhood) and again at CVMS4-5 (adulthood). A paired sample t-test was used to analyse ANB angle differences between the two time points. Subjects who were skeletally and dentally Class I at adulthood (51 subjects) had their radiographs at CVMS1 (childhood) and CVMS2-3 (adolescence) used to establish Caucasian normative values for those stages. Data were also analysed for gender and skeletal classification differences.

Results

There was a statistically significant decrease in ANB value (2.3°) from CVMS1 to CVMS4-5 in the combined sample as well as the skeletal Class I and Class III groups (2.5° and 3.3° for Class I and Class III subjects, respectively). The reduction was smaller and not statistically significant in Class II individuals (1.5°). In Class I individuals, ANB values were 4.68° (SD:1.76°) at CVMS1, 2.86° (SD:1.18°) at CVMS2-3, and 2.13° (SD:0.99°) at CVMS4-5. No significant gender differences were found.

Conclusions

Statistically significant decreases in the ANB angle can be expected between childhood and adulthood in Class I and Class III patients but not Class II untreated subjects. Adult normative values should not be used for children.

Open Access

The effect of electro-thermal treatment of stainless steel arch wire on mechanical properties and cell proliferation

Published Online: 20 Jul 2021
Page range: 75 - 86

Abstract

Abstract Background

Electric resistance heat treatment may be performed on orthodontic arch wires, but it remains unclear whether this procedure reliably provides better mechanical properties or whether an austenite phase transition affords less cytotoxicity and less arch wire width change.

Methods

Stainless steel (SS) arch wires of 0.017 × 0.025 and 0.019 × 0.025 inches in size were heat-treated using a spot welder for eight seconds at power settings of 2, 4, 6 and 8. The surface morphology, coefficient of friction (COF), flexural modulus, cytotoxicity, austenitic content, colour change and arch width of the samples were subsequently analysed.

Results

The COF, flexural modulus and austenitic content of the orthodontic SS arch wires increased after heat treatment. SS wires appearing brownish-yellow and blue exhibited higher flexural moduli. The heat treatment of the SS wires did not significantly increase arch wire width or cause cytotoxicity.

Conclusions

Electric resistance heat treatment of SS arch wires is a feasible method to improve the flexural modulus without widening the arch wire and increasing cytotoxicity. The colour of the wire helps determine the heating status, and the maximum flexural modulus of the wires is obtained when the colour changes to brownish-yellow.

Open Access

Clinical use of orthodontic mini-implants for intrusion and retraction: a systematic review

Published Online: 20 Jul 2021
Page range: 87 - 100

Abstract

Abstract Background

Bimaxillary dental protrusion is common in many ethnic groups and is generally treated by the extraction of all first premolars. However, temporary anchorage devices (TADs) are currently gaining popularity and most studies have focused on anchorage loss, treatment duration, mini-implant success and failure rates, pain, discomfort and root resorption. Few studies have focused on the clinical effectiveness of implants for the intrusion and retraction of anterior teeth.

Objectives

To assess the clinical use of orthodontic mini-implants for the intrusion and retraction of anterior teeth.

Methods

A systematic review of articles selected from PUBMED and Google Scholar was carried out to determine the clinical use of orthodontic mini-implants for anterior tooth intrusion and retraction. Additional studies were hand searched to identify and include clinical trials, prospective and retrospective studies, while excluding finite element method (FEM) studies and case reports. A total of 598 articles were identified, of which 37 papers met the inclusion criteria and, following the elimination of duplicates, 20 articles were selected.

Results

Orthodontic mini-implants are more efficient for intrusion and retraction when compared to conventional intraoral and extra-oral anchorage devices. A greater amount of intrusion and retraction is achieved when mini-implants are placed between the first and second premolars without using any specific intrusive mechanics.

Conclusion

The present review highlights the clinical effectiveness of orthodontic mini-implants for anterior tooth intrusion and retraction and the results suggest that orthodontic mini-implants are more effective than other conventional methods of anchorage reinforcement.

Open Access

Detection methods of orthodontically induced inflammatory root resorption (OIIRR): a review

Published Online: 20 Jul 2021
Page range: 101 - 107

Abstract

Abstract Background

Orthodontically induced inflammatory root resorption (OIIRR) is unwelcome iatrogenic damage associated with orthodontic treatment. Patients with a high risk of developing OIIRR are commonly monitored using radiographic techniques. Alternative, more sensitive methods using biological markers facilitate the early detection of OIIRR, which can minimise root surface damage and allow the timely cessation of orthodontic treatment in order to facilitate a reparative process.

Aim

The present review examines the current use of 2D and 3D radiographic techniques to detect and quantify OIIRR and, further, evaluates the latest literature on alternative detection methods of OIIRR.

Method

Published studies were searched electronically throughout PubMed, Scopus and ScienceDirect using keywords including ‘root resorption’, ‘OIIRR’, ‘radiograph’ and ‘biological markers’.

Results

The detection methods for OIIRR were divided into radiographic and biological marker methods. Orthopantomogram (OPG) and periapical radiography are currently the most widely used radiographic methods to detect and monitor OIIRR as they are readily available in most dental clinics, cost effective and have a relatively low radiation dose. However, the radiographic methods are not only subject to standardisation and magnification issues, but also require repeated radiation exposure to patients. Therefore, published research into the potential for biological markers as a safer and more sensitive alternative for the early detection of OIIRR was reviewed.

Conclusion

The result of the review highlights the potential for the use of biological markers in the early detection of OIIRR as a relatively safer and more sensitive alternative to conventional radiographic methods.

Open Access

Growth-enabling modified Groper appliance for the replacement of permanent maxillary incisors: Report of two cases

Published Online: 20 Jul 2021
Page range: 108 - 113

Abstract

Abstract

The aim of this case report is to introduce a modified Groper appliance that enables transverse growth of the maxilla in addition to improving the aesthetics of patients with missing anterior teeth. Patient 1 was a 16-year-old young woman in the late stages of growth who presented with a congenitally missing maxillary lateral incisor. Patient 2 was a nine-year-old girl missing both of her maxillary central incisors due to trauma. The missing teeth were replaced by artificial acrylic teeth bonded onto growth-enabling, maxillary, fixed palatal space maintainers. A tube was soldered onto one of the arch wires of the maintainer and the opposite arch wire was threaded into this tube, allowing it to slide until the patient completed growth. Intermolar width increased by approximately 1.9 mm in Patient 1 and 2.6 mm in Patient 2 over the three-year review period. The in-tube mechanical design of the device allowed transverse growth of the maxilla without interference during and throughout long-term wear.

13 Articles
Open Access

AcceleDent Aura does not influence treatment duration or number of visits

Published Online: 20 Jul 2021
Page range: 2 - 8

Abstract

Abstract Background

Many techniques and appliances claim to reduce orthodontic treatment time, one of which is micro-vibration applied by the AcceleDent Aura appliance.

Objectives

The purpose of this study was to report compliance with AcceleDent Aura and to assess any effect on treatment duration, number of visits and bond failures.

Methods

Forty Class II adolescent subjects were randomly assigned to use the AcceleDent Aura appliance or no AcceleDent Aura device during orthodontic treatment with fixed appliances involving maxillary premolar extractions. Compliance was recorded by the AcceleDent Aura appliance and reported for the first 13 months. Overall treatment duration, the number of visits and number of bond failures were also recorded.

Results

AcceleDent compliance reduced over time from a mean 77.8% usage at the start to a mean of 39.5% by the thirteenth month. There was no difference in the number of bond failures between groups (p = 0.54) and there was no evidence that the use of the Acceledent Aura appliance influenced treatment duration (p = 0.26) or the number of visits (p = 0.56).

Conclusions

The AcceleDent Aura appliance had no significant effect on treatment duration, number of visits or the number of bond failures. Compliance with the appliance waned significantly over time.

Open Access

A clinically based review of patient and treatment characteristics in West Australian private orthodontic practices

Published Online: 20 Jul 2021
Page range: 9 - 19

Abstract

Abstract Objective

To describe patient and treatment characteristics in West Australian private orthodontic practices.

Methods

A quantitative retrospective cross-sectional study of patient records from private practices in Western Australia was conducted. Permission was sought to access clinical records of 100 most recently-treated patients at each participating practice. A sample of 3,200 patients (response rate 84%) was collected, representing approximately one-third of practices in Western Australia, and simple descriptive statistics were applied to assess patient and treatment characteristics.

Results

The majority of patients were female (58.5%), adolescent and had private health insurance (75.6%). The most common patient complaint was crowding (37.6%) and aesthetics (21.3%). Data analysis indicated that 31% of patients were self-referred and a similar proportion did not have a specific complaint. Adult females had a higher interest in aesthetic options. Over half of the patients (56%) received first phase treatment, and non-extraction orthodontics accounted for 61.6% of cases. Full fixed appliances were the most commonly prescribed device (94%). The acceptance rate of orthognathic surgery, when offered, was approximately 30%.

Conclusion

Clinical data relating to actual patient presentations provide an invaluable insight into the realities of private practice. The eventual course of treatment is often determined by the patient’s tolerances and expectations as much as a clinical recommendation.

Open Access

Oral Health Related Quality of Life (OHRQoL) outcomes at the time of orthodontic appliance removal and three months into retention

Published Online: 20 Jul 2021
Page range: 20 - 26

Abstract

Abstract Background

Oral health-related quality of life (OHRQoL) has become an important measure of orthodontic treatment outcome. However, it is unclear how long OHRQoL benefits manifest themselves following the removal of the orthodontic appliances.

Objectives

To investigate differences in OHRQoL recorded at the time of orthodontic appliance removal and three months into retention.

Setting and sample

Described is a prospective outcome study of 59 consecutive participants treated in a hospital-based clinic between 2015 and 2018. The patients comprised three groups: those who received orthognathic surgery (N = 15), those who had an orofacial cleft (N = 30) and those who had no-surgery/no-cleft (N = 14). Each individual completed an age-specific OHRQoL questionnaire that categorised them as either an adolescent (N = 37) or an adult (N = 22) participant.

Method

The OHRQoL questionnaires were completed at the time of appliance removal (T0) and again three months into retention (T1). The Child Perceptions Questionnaires (CPQ11-14-ISF8 and P-CPQ8) were used for adolescent participants and their parent/caregiver, respectively, while the short-form Oral Health Impact Questionnaire (OHIP-14) was used for the adults.

Results

The OHIP-14, CPQ11-14-ISF8 and P-CPQ8 detected improvements in overall and domain scores between T0 and T1 for all patient groups. Moderate effect sizes (0.2–0.7) were observed in all the domain, overall and group mean scores.

Conclusions

Post-treatment orthodontic OHRQoL outcomes improve over the three-month period following appliance removal. The use of these measures should be delayed beyond the immediate time of appliance removal to allow the benefits of orthodontic treatment to be appreciated.

Open Access

The long-term efficacy of rapid maxillary expansion and facemask therapy in Class III malocclusion

Published Online: 20 Jul 2021
Page range: 27 - 37

Abstract

Abstract Aim

The aim of the present study was to investigate the long-term efficacy of rapid maxillary expansion (RME) and facemask (FM) therapy in the treatment of Class III malocclusions by comparing Class III subjects treated by RME/FM mechanics with untreated Class III controls at the Western Australian public dental hospital.

Materials and methods

The lateral cephalograms of 42 (26 males, 16 females) Class III patients treated by RME/FM therapy were analysed and compared with a control sample comprised of 23 (14 males, 9 females) untreated Class III patients. Evaluations were carried out prior to facemask therapy and at a long-term follow-up period of approximately eight to nine years post-treatment. Statistical comparisons were performed using t-tests for unpaired data.

Results

At long-term follow-up, there were no statistically significant differences between the treated and control groups except in overjet, which was greater in the treated group (p < 0.05).

Conclusions

These results suggest that the short-term effects on the maxilla in RME/FM therapy are not maintained in the long term. Success in treatment is largely dependent on the patient’s skeletal growth pattern.

Open Access

Comparison of chewing gum and ibuprofen in alleviating orthodontic pain: a single centre, randomised clinical trial

Published Online: 20 Jul 2021
Page range: 38 - 44

Abstract

Abstract Background

The aim of the present three-arm parallel trial was to compare the effectiveness of chewing gum and ibuprofen in the control of orthodontic pain.

Methods

Patients to undergo orthodontic treatment at a private orthodontic clinic were randomly divided into three parallel groups, each of which took either a placebo, ibuprofen or chewing gum. The eligibility criteria included patients in the full permanent dentition with moderate crowding requiring the extraction of two mandibular and two maxillary premolars. The main outcome was the patient’s level of discomfort, which was assessed by a 0–10 numeric rating scale (NRS) at two hours, six hours, at bedtime, 24 hours, two days, three days and seven days after the placement of initial arch wires in four functions including chewing, biting, occluding back teeth, and occluding front teeth. Randomisation was accomplished according to the patient’s clinic entrance number and by using a table of random numbers. The patients in the placebo and ibuprofen groups were blinded to the type of medication used. The differences in the groups were analysed using repeated measures ANOVA.

Results

Sixty-six patients between 12 and 30 years were randomised in a 1:1:1 ratio. The pain questionnaire response rate was 100% in the three groups, but six patients were excluded and consequently 60 patients were analysed (N = 20 in each group). There was no significant difference between the chewing gum and ibuprofen groups during any oral function at any time point (p > 0.05). However, repeated measures ANOVA showed that patients in the placebo group experienced significantly higher pain scores compared with patients in the ibuprofen and chewing gum groups at two hours, six hours, at bedtime, at 24 hours and two days after initial arch wire placement (p < 0.05). No patient harm was observed in this study.

Conclusions

In contrast to the common orthodontic belief that gum chewing may lead to bracket breakage, it seems that chewing gum is as beneficial as medication for pain relief and can be a recommended alternative during orthodontic treatment.

Open Access

Facial soft tissue norms in Caucasians using an innovative three-dimensional approach

Published Online: 20 Jul 2021
Page range: 45 - 54

Abstract

Abstract Background and aim

Contemporary orthodontic and surgical treatment goals are primarily focussed on achieving optimal aesthetic soft tissue outcomes in three dimensions. It is important, therefore, to establish valid three-dimensional normative models to assist in clinical decision-making. Ideally, such models should be customised to a patient’s individual facial proportions. The aim of this study was to establish the most pleasing computer generated 3D facial form using a community-based sample population.

Methods

Three-dimensional facial surface data (3dMDface) were obtained from 375 young adult Caucasians (195 males and 180 females, all approximately 22 years old) without craniofacial anomalies, all of whom were participants in The Raine Study in Western Australia with participants from Generation 2. These data were used to generate seven faces that represented the variations in convexity distributed evenly around an average. The faces were subsequently rated by orthodontists, oral surgeons, plastic surgeons, dentists and laypeople for attractiveness.

Results and conclusion

Age, sex and occupation did not influence the preference among the various faces. The average face was rated as the most attractive. For males, a slightly concave profile and for females a slightly convex profile was preferred. The present study suggested that orthodontic/surgical treatment of Caucasians should be directed towards achieving an average facial form.

Open Access

Orthodontic knowledge and referral patterns: a survey of paediatric specialists and general dental practitioners

Published Online: 20 Jul 2021
Page range: 55 - 61

Abstract

Abstract Introduction

Early diagnosis and referral is essential in order to provide the best orthodontic care. Paediatric specialists (PSs) and general dental practitioners (GDPs) are usually the first dental professionals to diagnose a malocclusion.

Aim

To evaluate the knowledge and approach of PSs and GDPs in the management of children in reference to the timing of referral and early orthodontic intervention.

Methods

A survey assessed referral patterns and the respondents’ orthodontic knowledge regarding treatment timing and indications for early treatment in the early and late mixed dentition.

Results

One hundred and seventeen dentists participated in the study, of whom 79 were GDPs and 38 were PSs. The average total accuracy score in a 27-knowledge questionnaire was 68.6%, resulting in a statistically significant difference between the PSs and the GDPs. This difference arose from confusion regarding the prevention of maxillary permanent canine impaction and the need for a leeway space maintainer.

Conclusions

The GDPs and the PSs had a sound knowledge of orthodontics and a reasonable referral pattern, although the knowledge of PSs was significantly higher than that of the GDPs. There is a need for further education regarding orthodontic treatment needs and timing both in undergraduate/postgraduate training as well as in professional continuing education programs.

Open Access

Trends in surgical-orthodontic management of Class III malocclusions in Western Australia

Published Online: 20 Jul 2021
Page range: 62 - 68

Abstract

Abstract Aim

The aim of this retrospective cohort study was to identify trends in the surgical-orthodontic management of skeletal Class III malocclusions in Western Australia between 1985 and 2016.

Methods

The records of 225 patients (132 females, 93 males) who received combined surgical-orthodontic correction of their Class III malocclusion between 1985 and 2016 were retrospectively assessed. The subjects were divided into three groups according to surgery type: Group (1) maxillary advancement only; Group (2) mandibular setback only; Group (3) two-jaw surgery.

Results

A trend towards two-jaw surgery for Class III correction was observed. Between 1985 and 2016, 123 patients (55%) were treated via two-jaw surgery; 97 patients (43%) were treated via maxillary advancement alone and five patients (2%) were treated via mandibular setback alone. Between 2011 and 2016, 61% were treated via two-jaw surgery; 37% were treated via maxillary advancement surgery; 2% were treated via mandibular setback surgery. Gender affected surgery type: two-jaw surgery (60% female); maxillary advancement (62% female); mandibular setback (17% female). A greater proportion of females received Class III surgical management in comparison with males (59:41).

Conclusion

Two-jaw surgery is the most common procedure for the surgical correction of skeletal Class III malocclusions in Western Australia. Of the single jaw procedures, isolated maxillary advancement surgery is more common than mandibular setback procedures.

Open Access

Developmental stage specific ANB reference values based on a longitudinal sample of untreated Caucasian subjects

Published Online: 20 Jul 2021
Page range: 69 - 74

Abstract

Abstract Objectives

The study aimed to assess the longitudinal changes in the ANB angle before and after adolescence, and determine Class I normative values for childhood and adolescent Caucasian patients based on cervical vertebral maturation stages (CVMS) and gender.

Setting and sample population

The sample included 71 (41 females and 30 males) untreated Caucasian subjects who took part in a growth study between 1959 and 1976.

Materials and methods

Lateral cephalometric radiographs were analysed at CVMS1 (childhood) and again at CVMS4-5 (adulthood). A paired sample t-test was used to analyse ANB angle differences between the two time points. Subjects who were skeletally and dentally Class I at adulthood (51 subjects) had their radiographs at CVMS1 (childhood) and CVMS2-3 (adolescence) used to establish Caucasian normative values for those stages. Data were also analysed for gender and skeletal classification differences.

Results

There was a statistically significant decrease in ANB value (2.3°) from CVMS1 to CVMS4-5 in the combined sample as well as the skeletal Class I and Class III groups (2.5° and 3.3° for Class I and Class III subjects, respectively). The reduction was smaller and not statistically significant in Class II individuals (1.5°). In Class I individuals, ANB values were 4.68° (SD:1.76°) at CVMS1, 2.86° (SD:1.18°) at CVMS2-3, and 2.13° (SD:0.99°) at CVMS4-5. No significant gender differences were found.

Conclusions

Statistically significant decreases in the ANB angle can be expected between childhood and adulthood in Class I and Class III patients but not Class II untreated subjects. Adult normative values should not be used for children.

Open Access

The effect of electro-thermal treatment of stainless steel arch wire on mechanical properties and cell proliferation

Published Online: 20 Jul 2021
Page range: 75 - 86

Abstract

Abstract Background

Electric resistance heat treatment may be performed on orthodontic arch wires, but it remains unclear whether this procedure reliably provides better mechanical properties or whether an austenite phase transition affords less cytotoxicity and less arch wire width change.

Methods

Stainless steel (SS) arch wires of 0.017 × 0.025 and 0.019 × 0.025 inches in size were heat-treated using a spot welder for eight seconds at power settings of 2, 4, 6 and 8. The surface morphology, coefficient of friction (COF), flexural modulus, cytotoxicity, austenitic content, colour change and arch width of the samples were subsequently analysed.

Results

The COF, flexural modulus and austenitic content of the orthodontic SS arch wires increased after heat treatment. SS wires appearing brownish-yellow and blue exhibited higher flexural moduli. The heat treatment of the SS wires did not significantly increase arch wire width or cause cytotoxicity.

Conclusions

Electric resistance heat treatment of SS arch wires is a feasible method to improve the flexural modulus without widening the arch wire and increasing cytotoxicity. The colour of the wire helps determine the heating status, and the maximum flexural modulus of the wires is obtained when the colour changes to brownish-yellow.

Open Access

Clinical use of orthodontic mini-implants for intrusion and retraction: a systematic review

Published Online: 20 Jul 2021
Page range: 87 - 100

Abstract

Abstract Background

Bimaxillary dental protrusion is common in many ethnic groups and is generally treated by the extraction of all first premolars. However, temporary anchorage devices (TADs) are currently gaining popularity and most studies have focused on anchorage loss, treatment duration, mini-implant success and failure rates, pain, discomfort and root resorption. Few studies have focused on the clinical effectiveness of implants for the intrusion and retraction of anterior teeth.

Objectives

To assess the clinical use of orthodontic mini-implants for the intrusion and retraction of anterior teeth.

Methods

A systematic review of articles selected from PUBMED and Google Scholar was carried out to determine the clinical use of orthodontic mini-implants for anterior tooth intrusion and retraction. Additional studies were hand searched to identify and include clinical trials, prospective and retrospective studies, while excluding finite element method (FEM) studies and case reports. A total of 598 articles were identified, of which 37 papers met the inclusion criteria and, following the elimination of duplicates, 20 articles were selected.

Results

Orthodontic mini-implants are more efficient for intrusion and retraction when compared to conventional intraoral and extra-oral anchorage devices. A greater amount of intrusion and retraction is achieved when mini-implants are placed between the first and second premolars without using any specific intrusive mechanics.

Conclusion

The present review highlights the clinical effectiveness of orthodontic mini-implants for anterior tooth intrusion and retraction and the results suggest that orthodontic mini-implants are more effective than other conventional methods of anchorage reinforcement.

Open Access

Detection methods of orthodontically induced inflammatory root resorption (OIIRR): a review

Published Online: 20 Jul 2021
Page range: 101 - 107

Abstract

Abstract Background

Orthodontically induced inflammatory root resorption (OIIRR) is unwelcome iatrogenic damage associated with orthodontic treatment. Patients with a high risk of developing OIIRR are commonly monitored using radiographic techniques. Alternative, more sensitive methods using biological markers facilitate the early detection of OIIRR, which can minimise root surface damage and allow the timely cessation of orthodontic treatment in order to facilitate a reparative process.

Aim

The present review examines the current use of 2D and 3D radiographic techniques to detect and quantify OIIRR and, further, evaluates the latest literature on alternative detection methods of OIIRR.

Method

Published studies were searched electronically throughout PubMed, Scopus and ScienceDirect using keywords including ‘root resorption’, ‘OIIRR’, ‘radiograph’ and ‘biological markers’.

Results

The detection methods for OIIRR were divided into radiographic and biological marker methods. Orthopantomogram (OPG) and periapical radiography are currently the most widely used radiographic methods to detect and monitor OIIRR as they are readily available in most dental clinics, cost effective and have a relatively low radiation dose. However, the radiographic methods are not only subject to standardisation and magnification issues, but also require repeated radiation exposure to patients. Therefore, published research into the potential for biological markers as a safer and more sensitive alternative for the early detection of OIIRR was reviewed.

Conclusion

The result of the review highlights the potential for the use of biological markers in the early detection of OIIRR as a relatively safer and more sensitive alternative to conventional radiographic methods.

Open Access

Growth-enabling modified Groper appliance for the replacement of permanent maxillary incisors: Report of two cases

Published Online: 20 Jul 2021
Page range: 108 - 113

Abstract

Abstract

The aim of this case report is to introduce a modified Groper appliance that enables transverse growth of the maxilla in addition to improving the aesthetics of patients with missing anterior teeth. Patient 1 was a 16-year-old young woman in the late stages of growth who presented with a congenitally missing maxillary lateral incisor. Patient 2 was a nine-year-old girl missing both of her maxillary central incisors due to trauma. The missing teeth were replaced by artificial acrylic teeth bonded onto growth-enabling, maxillary, fixed palatal space maintainers. A tube was soldered onto one of the arch wires of the maintainer and the opposite arch wire was threaded into this tube, allowing it to slide until the patient completed growth. Intermolar width increased by approximately 1.9 mm in Patient 1 and 2.6 mm in Patient 2 over the three-year review period. The in-tube mechanical design of the device allowed transverse growth of the maxilla without interference during and throughout long-term wear.

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