Interest in dental esthetics has increased rapidly during the last few decades among both patients and dentists, and the creation of a natural dental appearance has become an important task in all ...fields of dentistry, especially in prosthodontics and restorative dentistry. The aim of this research was to investigate factors influencing a patient's decision to choose the type of treatment to improve dental esthetics.
A total of 700 Caucasian subjects participated in the cross-sectional study (261 men, 439 women, aged 18-86 years, mean age 46.2 +/- 18.6). The study included clinical examination and a self-administrated questionnaire based on self-perceived esthetics, satisfaction with the appearance of their maxillary anterior teeth and previous dental experience. Multiple logistic regression was used in statistical analysis.
Hiding teeth during smile was the most important predictor for choosing fixed prosthetic restorations (OR 9.1), followed by self-perceived bad fixed prosthesis, malpositioned teeth and female gender (OR 2.9, 2.4, and 1.5, respectively). The increase in satisfaction with dental appearance and previous orthodontic therapy reduced chances for seeking prosthetic therapy (each OR 0.4). The significant predictors for bleaching choosing were hiding teeth during smiling, already done bleaching, female gender, lower levels of satisfaction with dental appearance and the absence of the previous orthodontic therapy (OR 5.8, 2.4, 1.8, 0.5 and 0.4, respecitively). Hiding teeth during smile, self-perceived malposition and crowding, and lower levels of satisfaction, were significant predictors for choosing orthodontic treatment (OR 3.1, 2.4, 2.2 and 0.6, respectively). None of current dental statuses was statistically significant predictor for choosing prosthodontic, bleeching nor orthodontic therapy.
The psychological elements and female gender are the main predictors of seeking dental therapy. Understanding the prevalence of dissatisfaction with the present esthetics and desired treatments to improve esthetics can be a guide for strategies for intervention to improve esthetics.
Abstract The aim was to explore the predictive value of objective treatment need, impaired quality of life, and parental influence on orthodontic treatment demand in preadolescents and adolescents. A ...secondary goal was to validate 16-item Child Perceptions Questionnaire for the 11 - 14 year age group (CPQ11-14): item-impact and stepwise-regression short-forms. A convenience sample of 287 participants (55% female) was used for validation. Internal consistency, test-retest reliability, and convergent validity were evaluated. Predictors of treatment demand were explored in 197 orthodontic patients: 93 preadolescents (51% females), 104 adolescents (55% females). Hierarchical linear regression and multilevel logistic regression models were used to explore the predictive power of age, gender, objective treatment need, impaired quality of life and parental influence on treatment demand. CPQ11-14 regression short-form had acceptable psychometric properties. Significant linear predictors of treatment demand were impaired emotional well-being (EW) (β = 0.335, p = 0.002), parental influence (β = 0.221, p = 0.002), and malocclusion severity (β = 0.152, p = 0.025). In logistic regression, parental influence was revealed as the most important predictor of treatment demand in preadolescents, OR = 7.7 (95% confidence interval CI 2.4 - 25.1; p = 0.001); objective treatment need in adolescents, OR = 4.5 (95% CI 1.5 - 12.9; p = 0.006). The increase of impairment in EW by one scalar point increased treatment demand by 1.4 (95% CI 1.1 - 1.9; p = 0.017) in preadolescents; 1.3 (95% CI 1.0 - 1.7; p = 0.021) in adolescents. Greater parental agreement and motivation for treatment could result in higher preadolescents' cooperation. Orthodontic treatment in adolescents might be more effective with the patient-oriented approach.
Abstract Objective To assess gingival health and predictors of relapse related to braided-wire bonded retainers after the active phase of comprehensive orthodontic treatment. Materials and methods ...Fifty-one subjects were recruited in a prospective study of whom 42 were available for analysis after 2 years of retention (pre-therapeutic ages 11–18 years; 66% female). A rectangular wire retainer (0.027 × 0.011″) was bonded to the mandibular incisors. Little’s index of incisor irregularity; intercanine width; the accumulation of biofilm, calculus and gingivitis; and the incidence of retainer detachment, were recorded. Subjects were examined before orthodontic therapy, upon therapy completion, and after 2 years of retention. Results The incidence of retainer detachment over the 2 years was 27%. The post-treatment incidence of irregularity was 17%, and intercanine width reduction was 24%. Calculus accumulation increased significantly during retention ( p < 0.001) but not the extent of gingivitis. A multiple logistic regression demonstrated that an increase of mandibular intercanine width by ≥3 mm correspondingly increased the odds of relapse 14.3 times (95% confidence interval CI, 1.1–196.1; p = 0.046). Patients presenting with retainer failure were 10 times (95% CI 1.6–62.8; p = 0.014) more likely to experience relapse. Subjects who experienced relapse had retainer failure earlier than those without relapse (19 vs. 23 months; p = 0.003). The occurence of relapse was not related to a treatment change in incisor irregularity, the duration of treatment, the age of the patient, gender nor to a change of intercanine width during retention. Conclusion Post-treatment changes in the mandibular arch incorporating bonded retainers were not large, but were common. An increase in mandibular incisor irregularity during retention is mostly related to treatment-induced intercanine width expansion. The bonded retainer often detached and increased calculus accumulation.
The presence of nickel could modify bacterial behavior and susceptibility to antimicrobial agents. Adhesion and biofilm formation on orthodontic archwires can be a source of bacterial colonization ...and possible health hazards. Staphylococcus aureus was subjected to exposure and adaptation to various sub-inhibitory concentrations of nickel. Five strains of bacteria adapted to nickel in concentrations of 62.5–1000 μg/mL were tested for adhesion and biofilm formation on nickel-titanium archwires. Archwires were previously incubated in artificial saliva. Bacteria were incubated with orthodontic wire with stirring for 4 h (adhesion) and 24 h (biofilm formation). The number of adherent bacteria was determined after sonication and cultivation on the Muller-Hinton agar. Disk diffusion method was performed on all bacteria to assess the differences in antimicrobial susceptibility. Bacteria adapted to lower concentrations of nickel adhered better to nickel-titanium than strains adapted to higher concentrations of nickel (p < 0.05). Biofilm formation was highest in strains adapted to 250 and 500 μg/mL of nickel (p < 0.05). The highest biofilm biomass was measured for strains adapted to 250 μg/mL, followed by those adapted to 1000 μg/mL. Bacteria adapted to lower concentrations of nickel demonstrated lower inhibition zone diameters in the disk diffusion method (p < 0.05), indicating increased antimicrobial resistance. In conclusion, bacteria adapted to 250 μg/mL of nickel ions adhered better, demonstrated higher biofilm formation and often had higher antimicrobial resistance than other adapted and non-adapted strains.
The purpose was to compare the treatment effects of functional appliances activator-headgear (AH) and Twin Block (TB) on skeletal, dental, and soft-tissue structures in class II division 1 ...malocclusion with normal growth changes in untreated subjects. The sample included 50 subjects (56% females) aged 8–13 years with class II division 1 malocclusion treated with either AH (n=25) or TB (n=25) appliances. Pre- and posttreatment lateral cephalograms were evaluated and compared to 50 untreated class II division 1 cases matched by age, gender, ANB angle, and skeletal maturity. A paired sample, independent samples tests and discriminant analysis were performed for intra- and intergroup analysis. Treatment with both appliances resulted in significant reduction of skeletal and soft-tissue facial convexity, the overjet, and the prominence of the upper lip in comparison to untreated individuals (p<0.001). Retroclination of maxillary incisors and proclination of mandibular incisors were seen, the latter being significantly more evident in the TB group (p<0.05). Increase of effective mandibular length was more pronounced in the TB group. In conclusion, both AH and TB appliances contributed successfully to the correction of class II division 1 malocclusion when compared to the untreated subjects with predominantly dentoalveolar changes.
The aim of this study was to quantify the changes in glucose concentration in unstimulated saliva samples mixed with finely crushed salted sticks or oat meal using a readily available portable ...glucometer.
Glucose measurements were taken every 10 min during a 1 h monitoring period, for a total of 14 saliva samples mixed with test foods. Salivary amylase activity was measured immediately after saliva collection (T0) and after 1h (T60). Level of salivary amylase activity was correlated with an increase in glucose concentration.
We observed significant differences in the rate of increase in glucose concentration between the two different test foods, with salted sticks leading to greater increase in glucose concentration. No significant association was found between salivary amylase activity and the rate of increase in glucose concentration. The mean level of amylase activity at T60 was higher than that at T0, but this difference was not significant.
This pilot study presents glucose release rate characteristics from specific food particles mixed with saliva in vitro suggesting that the same process takes place in the oral cavity. However, the characteristics of this process when occurring in the mouth would expectedly be modified by different factors such as rinsing effect of salivary flow, oral temperature, etc. Prolonged release of low molecular carbohydrates such as maltose and glucose from food particles can be considered cariogenic and therefore unfavorable for individuals with other risk factors contributing to the development of dental caries.
This study aimed to analyse the immunohistochemical profile of inflammatory infiltrates in the gingival tissue of patients undergoing orthodontic treatment in relation to patients’ titanium and/or ...nickel allergy status. Patients with gingival enlargement received initial periodontal therapy, followed by external gingivectomy in the case of persistent gingival enlargement. The sample included 44 patients (22 had metal allergic sensitisation). Histopathological changes were assessed, and an immunohistochemical analysis was performed on formalin-fixed and paraffin-embedded gingival samples using antibodies against CD1a, CD3, CD4, CD8, CD20, CD68, and CD138. Computer-assisted image analysis was performed to evaluate the positive cell count in the gingival tissue. The gingiva of the sensitised patients was characterised by the absence of multifocal inflammatory infiltrates (p < 0.05), while pronounced exocytosis and band-like inflammatory infiltrates were more frequently observed in sensitised patients. In addition, there was an increase in Langerhans cells and T-helper lymphocytes and a decrease in naïve T-lymphocytes, cytotoxic T-lymphocytes, macrophages, and plasma cells in the sensitised subjects compared to non-sensitised. However, the differences were only statistically significant for macrophages, with a moderate effect size (82.8 vs. 133.9; p = 0.041; r = 0.308). The absence of multifocal inflammation appears to be the most characteristic histopathological feature of the gingiva of sensitised patients. Although their gingiva presented certain characteristics of late hypersensitivity immune reactions the observed changes imply dominant irritative effect e.
Aim
The study aimed to evaluate to which extent self-reported symptomatology, age, and sex are predictors of titanium and nickel allergic sensitization in patients in treatment with fixed orthodontic ...appliances.
Methods
The study analyzed 228 subjects aged 11–45 years (median 18, interquartile range 16–22); 68% of them were females, and 52% were adolescents. The allergic sensitization testing included epicutaneous patch test to titanium, titanium dioxide, titanium oxalate, titanium nitride, and nickel sulfate. The questionnaire on symptoms potentially linked to titanium and nickel sensitization was used.
Results
Prevalence of the allergic sensitization to titanium in patients undergoing orthodontic treatment was 4% (2% only to titanium without nickel) while to nickel 14% (12% nickel without titanium). Hypersensitivity to both metals at the same time was present in 2% of subjects. Sensitization to nickel was more common in females than in males (17 vs. 8%) and much more common in adults than in adolescents with small effect size (20 vs. 8%;
p
= 0.013). Sensitization to titanium was more common in females than in males (6 vs. 1%) with no difference in age. Multiple logistic regression analysis revealed that adult age increases the odds for being sensitized to nickel for 2.4 × (95% CI 1.1–5.6;
p
= 0.044) while watery eyes for 3.7 × (95% CI 1.2–11.1;
p
= 0.022). None of the symptoms were significant predictors of titanium sensitization.
Conclusion
Allergic sensitization to titanium and nickel are not very frequent in orthodontic patients, and self-reported symptomatology is a weak predictor of those sensitizations.
This study aimed to analyse the effect of chlorhexidine digluconate (CHX DG) mouthwash on the adhesion of oral bacteria to orthodontic appliances. The interactions of four bacteria (S. mutans, A. ...actinomycetemcomitans, S. oralis, and V. parvula) with two alloys (stainless steel SS and nickel-titanium NiTi) and three CHX DG solutions (commercial products Curasept and Perio Plus, and pure CHX DG, all with 0.12% active substance) were tested. The adhesive effect on the orthodontic wires was evaluated after 24 h for S. oralis and after 72 h for the other bacteria. The minimum bactericidal concentration of the solution for each bacterial strain was determined using the dilution method to test the antibacterial action. Salivary-pretreated orthodontic archwires were exposed to minimal bactericidal concentrations of solution and bacteria. Commercial antiseptic products, especially Perio Plus, showed a better inhibition of bacterial adhesion to both alloys than pure CHX DG solution (p < 0.05). A. actinomycetemcomitans was most inhibited in the adhesion of all bacteria by the CHX DG products. A greater inhibition of streptococci adherence was observed on SS, while that of A. actinomycetemcomitans was observed on NiTi. V. parvula inhibition was product-dependent. Although there were differences between the strains and the tested agents, it can be concluded that Perio Plus most effectively inhibited the adhesion of all tested bacteria to the SS and NiTi alloys. A. actinomycetemcomitans was most sensitive to all tested agents, while S. mutans showed the highest resistance. The effectiveness of the tested agents was better on NiTi alloys.
The aims of this study were: (a) to determine if the presence of probiotic bacteria in an aging medium, that is, artificial saliva in this study, has relevant effects on the surface roughness and the ...chemical composition of two main alloys used in dentistry (NiTi and stainless steel SS) and (b) in the case of NiTi, if these effects are influenced by the coating of the alloy (rhodium and titanium nitride). Atomic force microscopy and Raman spectroscopy were used to study the surface morphology and identify metal oxides formed on the surface of the alloys. Experiments demonstrated that the probiotic bacteria Lactobacillus reuteri can induce processes that alter some features of the surface such as roughness and chemical composition. The effect is dependent on the type of alloy and coating. The bacteria increased roughness in the case of uncoated NiTi more than saliva alone (pH = 4.8). Probiotic bacteria tend to decrease the corrosive influence of saliva on NiTi when the alloy is coated with rhodium or titanium nitride and this effect was also evidenced on SS. Raman spectroscopy confirmed that only SS samples are prone to oxidation processes, predominantly associated with exposure to saliva rather than probiotic bacteria.
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