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Objective: The objective of this systematic review and meta-analysis was to compare powered and manual toothbrushes for oral hygiene maintenance in orthodontic patients., Methods: Electronic databases, including MEDLINE, Scopus, Google scholar, PubMed, Web of Science, the Cochrane Oral Health Group's Trials Register, and CENTRAL, were searched without language restrictions. Randomized clinical trials directly comparing manual and powered toothbrushing including patients with fixed orthodontic appliances reporting predefined outcomes with a follow-up period of at least 4 weeks were included. Using predefined data extraction forms, 2 authors independently undertook data extraction with conflict resolution by the third author. Quality assessment was based on the Cochrane Risk of Bias tool, and overall evidence base was assessed using the Grading of Recommendations Assessment, Development and Evaluation system. A random effects meta-analysis combined the treatment effects across studies., Results: Five trials were considered appropriate for inclusion in the meta-analysis with 8 trials excluded. There are slight differences in plaque index reduction of 0.05 (-0.04, 0.13) and 0.11 (-0.10, 0.33) at 4 week and 8 week follow up, respectively, favoring manual toothbrushing, but this was not statistically significant. There are slight differences in gingival index reduction of -0.02 (-0.06, 0.02) and -0.01 (-0.05, 0.02) at 4 week and 8 week follow up, respectively, favoring powered brushing, but again, this was not statistically significant. The overall quality of evidence was very low to moderate for the primary outcomes., Conclusions: Using manual or powered tooth brushing with fixed orthodontic appliances does not reduce plaque or gingival indexes at 4 weeks and 8 weeks. This conclusion is, however, based on low quality of evidence from few studies. Greater standardization of the methodology used is desirable in future trials to increase our confidence in these findings., (Copyright © 2020 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: The objective was to study the growth spurt of Class I subjects, focusing on the ability to predict the peak of the growth spurt of the maxillary (Co-A) and mandibular (Co-Pog) lengths from the maturational changes of the cervical vertebrae., Methods: The longitudinal lateral cephalographs of 14 males (ages, 10-15 years) and 12 females (ages, 9-14 years) were selected from the Craniofacial Growth Studies Legacy Collection of the American Association of Orthodontists Foundation. The cephalographs were taken at regular 1-year intervals. A cervical vertebral maturation (CVM) method that divided skeletal maturation into 6 stages was used for growth prediction. Growth increments calculated for the annual age intervals were used to examine the diagnostic performance of the CVM method., Results: In males, the most peaks for Co-Pog were detected in the CVM3-CVM4 interval in 7 males (50%); for Co-A, the most peaks were found in the CVM2-CVM3 interval in 7 males (50%). In females, the most peaks for both Co-Pog and Co-A were seen in the CVM2-CVM3 interval in 7 females (58%) and in 6 females (50%), respectively. The fewest peaks were detected in CVM4-CVM5 for both males and females., Conclusions: In Class I subjects with balanced anteroposterior jaw relationships, presence of CVM3 would indicate the peak of the growth spurt, and CVM2 would mean that the peak has not yet arrived. During CVM2, the shapes of cervical vertebrae 3 and 4, whether trapezoid or horizontal rectangular, would indicate whether the subject is in the early CVM2 or is about to be in CVM3., (Copyright © 2018 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: Our objective was to investigate skeletal maturation of female and male subjects from different racial groups by comparing the cervical vertebrae maturation (CVM) stages., Methods: The study included 3 racial groups: white, African American, and Hispanic subjects. Each group was subdivided into female and male. The age range of the subjects was between 7 and 18 years. The sample included 60 lateral cephalographs for each subgroup. Skeletal maturation of the cervical vertebrae was assessed according to a method that described 6 CVM stages., Results: Racial differences were evident in the mean ages of CVM stages 2, 3, 4, and 5 (P = 0.002; P = 0.003; P = 0.001; and P = 0.001, respectively) among females; among males, only stage 3 was different (P = 0.001). Sex differences in the mean ages of stages 1, 2, and 3 in Hispanic subjects (P <0.001), and in stages 2 and 3 in African American subjects (P = 0.019 and P <0.001) and white subjects (P = 0.004 and P <0.001) were detected., Conclusions: In both sexes, racial differences were not apparent between whites and African Americans, but differences were evident between Hispanics vs both whites and African Americans. Sex differences were apparent between the sexes in each of the 3 ethnic groups in CVM stages 2 and 3. No sex differences were detected in stages 4, 5, or 6 in any of the 3 racial groups. It is recommended to consider racial and sex differences when using the CVM stage as a skeletal maturation indicator., (Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: Our objective was to evaluate the effect of the diameter of the archwire on tooth alignment with different bracket-archwire combinations., Methods: The materials included 2 categories of orthodontic brackets (1) conventional ligating brackets (Victory Series [3M Unitek, Monrovia, Calif], Mini-Taurus [Rocky Mountain Orthodontics, Denver, Colo], and Synergy [Rocky Mountain Orthodontics]) and (2) self-ligating brackets (SmartClip [3M Unitek], a passive self-ligating bracket; Time3 [American Orthodontics, Sheboygan, Wis], an active self-ligating bracket; and SPEED [Strite Industries, Cambridge, Ontario, Canada], an active self-ligating bracket). All brackets had a nominal 0.022-in slot size. The brackets were combined with Therma-Ti 0.014-in and Therma-Ti 0.016-in titanium memory archwires (American Orthodontics). The archwires were tied to the conventional brackets with both stainless steel ligatures (0.010 in) and elastomeric rings. Each bracket-archwire combination was tested 20 times with the orthodontic measurement and simulation system built in a temperature-controlled chamber where the temperature was kept at 37°C (±1°C) during testing. The malocclusion simulated in the study represented a maxillary central incisor displaced 2 mm gingivally (x-axis) and 2 mm labially (z-axis)., Results: The incisogingival corrections achieved by the 0.014-in archwire combined with the brackets used ranged from 40% to 95%; the corrections by the 0.016-in wire were 55% to 95%. The labiolingual corrections achieved by the 0.014-in archwire combined with the brackets used ranged from 10% to 100%, and the corrections of the 0.016-in archwires ranged from 15% to 100%., Conclusions: Increasing the diameter from 0.014 to 0.016 in increased the correction achieved by up to 15% in certain bracket-archwire combinations, but it decreased the correction by up to 25% in other combinations., (Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: Our objective was to investigate the effect of archwire cross-section increases on the levels of force applied to teeth during complex malalignment correction with various archwire-bracket combinations using an experimental biomechanical setup., Methods: The study comprised 3 types of orthodontic brackets: (1) conventional ligating brackets (Victory Series [3M Unitek, Monrovia, Calif] and Mini-Taurus [Rocky Mountain Orthodontics, Denver, Colo]), (2) self-ligating brackets (SmartClip, a passive self-ligating bracket [3M Unitek]; and Time3 [Rocky Mountain Orthodontics, Denver, Colo] and SPEED [Strite Industries, Cambridge, Ontario, Canada], both active self-ligating brackets), and (3) a conventional low-friction bracket (Synergy [Rocky Mountain Orthodontics]). All brackets had a nominal 0.022-in slot size. The brackets were combined with 0.014-in and 0.016-in titanium memory wires, Therma-Ti archwires (American Orthodontics, Sheboygan, Wis). The archwires were tied to the conventional brackets with both stainless steel ligatures of size 0.010-in and elastomeric rings. A malocclusion of the maxillary central incisor displaced 2 mm gingivally (x-axis) and 2 mm labially (z-axis) was simulated., Results: The forces recorded when using the 0.014-in archwires ranged from 1.7 ± 0.1 to 5.0 ± 0.3 N in the x-axis direction, and from 1.2 ± 0.1 to 5.5 ± 0.3 N in the z-axis direction. When we used the 0.016-in archwires, the forces ranged from 2.6 ± 0.1 to 6.0 ± 0.3 N in the x-axis direction, and from 2.0 ± 0.2 to 6.0 ± 0.4 N in the z-axis direction. Overall, the increases ranged from 16.0% to 120.0% in the x-axis and from 10.4% to 130.0% in the z-axis directions., Conclusions: Increasing the cross section of the wire increased the force level invariably with all brackets. Wires of size 0.014 in produced relatively high force levels, and the force level increased with 0.016-in wires., (Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: The force applied to the teeth is a variable of orthodontic treatment that can be controlled. Poor control of the applied force can lead to adverse biologic effects as well as undesirable tooth movements. The selected archwire-bracket combination is a primary determining factor in the force level applied to a tooth during orthodontic treatment. The aim of this research was to use an experimental biomechanical setup to measure forces generated during complex orthodontic tooth movements with various archwire-bracket combinations., Methods: The materials consisted of 3 types of 0.022-in slot orthodontic brackets: (1) conventional brackets (Victory Series [3M Unitek, Monrovia, Calif] and Mini-Taurus [Rocky Mountain Orthodontics, Denver, Colo]), (2) self-ligating brackets (SmartClip [3M Unitek] and Time3 [American Orthodontics, Shegoygan, Wis]), and (3) a conventional low-friction bracket (Synergy [Rocky Mountain Orthodontics]); and 4 archwire types: (1) 0.012-in stainless steel (3M Unitek), (2) 0.0155-in coaxial (Advanced Orthodontics [Näpflein, Düsseldorf, Germany]), (3) 0.012-in Orthonol (Rocky Mountain Orthodontics), and (4) 0.012-in Thermalloy (Rocky Mountain Orthodontics). Stainless steel ligatures and elastomeric rings were used. The materials were used in different combinations in a simulated malocclusion that represented a maxillary central incisor displaced 2 mm gingivally (x-axis) and 2 mm labially (z-axis)., Results: The lowest forces were measured when the brackets were combined with either the coaxial or the Thermalloy archwires; the forces ranged from 3.4 ± 0.2 to 0.7 ± 0.1 N in the x-axis direction, and from 4.5 ± 0.3 to 0.5 ± 0.1 N in the z-axis direction. The highest forces were measured in combination with stainless steel archwires; the forces ranged from 6.3 ± 0.3 to 3.0 ± 0.1 N in the x-axis direction, and from 6.3 ± 0.3 to 1.7 ± 0.1 N in the z-axis direction., Conclusions: We recommend 0.0155-in coaxial and 0.012-in Thermalloy archwires for leveling and alignment. Elastomeric rings, when used with conventional brackets, increased the force applied to the teeth., (Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)