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This study evaluates the preferences of dentists regarding the interdisciplinary treatment of patients with gingival recession (GR) and a thin periodontal phenotype, based on their specialization. A cross-sectional study was conducted among Polish dentists, between May and October 2022, using an online survey. The dentists were first asked to provide details regarding their specialization and the length of their professional career. In the second part of the survey, they responded to questions about the preferred timing of a consultation and soft tissue augmentation in patients who planned to undertake orthodontic treatment (OT). Moreover, factors undermining the decision-making process regarding soft tissue augmentation and the methods used for the evaluation of periodontal tissues were assessed. In total, 554 dentists completed the survey, among whom 328 were orthodontists and 226 were periodontists/oral surgeons. A third of the surveyed periodontists/oral surgeons (33%) reported that they receive referrals from orthodontists prior to OT and 39% of orthodontists indicated that they refer patients for soft tissue augmentation before commencing OT. The majority of periodontists/oral surgeons (51%) and the most significant proportion of orthodontists (45%) agreed that the ideal timing of soft tissue augmentation is dependent on each specific case. Both groups of surveyed dentists considered “planned tooth movement” as the most important factor in clinical decision-making. Among the periodontists/oral surgeons, the most popular methods to assess periodontal tissues were: 3D radiological examination, the visual method, and gingival transparency with the use of a periodontal probe. On the other hand, the surveyed orthodontists preferred the visual method, followed by 2D radiological examination, and then by 3D radiological examination. The majority of surveyed periodontists/oral surgeons and orthodontists agreed that the ideal timing of soft tissue augmentation in patients undertaking orthodontic treatment should be decided on a case-by-case basis, with planned tooth movement being the determining factor.

Periodontal patients may face orthodontic problems because of bone support loss, such as maxillary incisor proclination, spacing, rotation, extrusion, pathologic tooth migration (PTM) or traumatic occlusion. Orthodontic treatment is therefore an element within the comprehensive treatment of periodontitis after the periodontal condition has stabilized. The presence of fixed appliances (FAs) promotes the accumulation of bacterial biofilm and impedes hygiene procedures. The increasing popularity of clear aligner (CA) treatment is due to the convenience of use, less discomfort, better esthetics, easier hygiene, lower failure rate, and shorter, less frequent visits. Therefore, the question arises whether treatment with aligners is a good solution for periodontal patients. To answer this question, the PubMed/Medline, Cochrane Library and EMBASE databases were searched using the following keywords: periodontitis, orthodontic treatment, clear aligners, multibracket orthodontic appliances, fixed appliance, root resorption, gingival recession and pathologic tooth migration. The search strategy identified 18 relevant studies. A total of 1090 participants took part in the analyzed studies. The available literature was analyzed in terms of the occurrence of root apex resorption, the possibility of treating pathologic tooth migration, the occurrence of gingival recession, periodontal health status and occlusal stability in patients treated with CAs and FAs. Despite statistically significant differences in terms of Plaque Index (PI), probing depth (PD), apical root resorption and gingival recession favor the use of CAs. However, these values are mostly of no clinical significance. It is possible to treat PTM with CAs, but it is limited by the high degree of tooth mobility and incisor inclination. Obtaining perfect occlusion is comparably difficult in both CA and FA treatment. When planning orthodontic treatment in patients with reduced periodontium, the use of both CAs and FAs should be considered. The choice of method would ultimately depend on the patient’s dental condition.

The case report presents an interdisciplinary treatment of a 65-year-old patient in whom an improper zirconium oxide-based prosthetic crown on tooth 21 resulted in occlusal trauma, causing displacement and extrusion of the tooth as well as its increased mobility to the second degree according to the Miller scale. The change in the position of tooth 21 led to the displacement of the teeth in the lower arch. The traumatic occlusion was eliminated with a short clear aligner treatment of fourteen aligners (seven basic and seven additional) of both arches followed by aligner retention. The treatment lasted 140 days. A clinical improvement in the periodontal condition and long-term increased stabilization of the loose tooth was obtained. After one year of retention, the tooth is still stable, and no sign of periodontal disease or recurrence of the occlusal trauma is noticeable.

Background: Atomic force microscopy imaging was used to study the structural topography of enamel crystals in healthy and affected enamel. The correlation of topographic images with nanomechanical properties allows for the assessment of morphology and properties at the micro- and nano-meter level in three dimensions simultaneously. Methods: A total of 60 premolars were treated like teeth during orthodontic bonding and debonding procedures. Every stage was observed in AFM. Surface roughness, image surface area difference, mean Young’s modulus, and mean adhesion force (the force of attraction between the scanning blade and the surface averaged over the image) were determined for the following areas: the central part of the surface, responsible for load transmission; the top of the surface, subject to the most abrasive wear; the lower part of the surface, responsible for the transport of fluids. Results: The highest roughness occurred on the etched surface—average 63 nm, followed by the intact enamel—8.3 nm, cleaned enamel—7.0 nm, and the resin-coated surface—5.4 nm. Conclusion: Etching increases enamel roughness and reduces hardness. Resin reduces roughness of the etched surface and increases hardness. The intact enamel has the highest hardness. The enamel smoothness is greater after polishing than in the intact enamel.

Background: Orthodontic elastics are used in orthodontic treatment with fixed braces. The effect of class I elastics on changing gingiva temperature as a periodontal component was investigated. Methods: To evaluate the temperature changes, objective and automatic classifiers were used to determine the sensitivity and specificity of the measurement. Results: Before putting on the elastics, the average gingival temperature of all 120 patients was 34.72 ± 0.7548 °C. Putting on the elastics for 10 min slightly increased the temperature to 34.81 ± 0.5938 °C; however, this is not a statistically significant change (p > 0.05). Conclusion: It is concluded that putting an elastic band on does not significantly affect the gingiva temperature change. The use of class I elastics in orthodontic treatment in patients with healthy periodontium does not significantly change the periodontal temperature, which indirectly proves the production of safe orthodontic forces that can be used in the clinic. The use of artificial intelligence in the assessment of the temperature of the gingiva makes it possible to exclude factors that may disturb the objective thermographic analysis.

Interference with live tooth tissue during dental treatment affects the temperature within the pulp. The pulp is sensitive to temperature changes, which can cause its inflammation. The aim of this study was to analyze the dynamics of pulp chamber temperature changes in response to the enamel cleaning procedure after orthodontic treatment. In the presented in vitro studies, by using a thermal imaging camera, the change in the temperature of the vestibular wall of the pulp chamber of the incisors and premolars was assessed as a function of time under the influence of polishing the enamel with the silicone rubber and aluminum oxides used during the debonding procedure after completion of orthodontic treatment with fixed appliances. The relationship between dentin density and enamel from changing the chamber temperature was evaluated by using Micro computed tomography, microtomography (micro-CT). The maximum achieved tooth surface temperature during polishing was 52.34 °C without water cooling and 43.15 °C using water cooling. The time after which a safe pulp temperature of 40 °C was obtained without water cooling was 29.4 s, while the time with water cooling was 34.6 s. The correlation between the maximum and average temperature achieved and the density of the teeth was analyzed based on micro-CT scans. No correlation between enamel or dentin density and rise in temperature was found.