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Introduction: Digital scanning, treatment planning, 3-dimensional imaging, and printing are changing the practice of orthodontics. These tools are adopted with the hope that treatment becomes more predictable, efficient, and effective while reducing adverse outcomes. Digital tools are impacting care, but knowledge of nationwide adoption trends and motivators is incomplete., Methods: We aimed to identify adoption decision-makers, information sources, incentives, and barriers through the first nationwide survey of American Association of Orthodontics members on their technology adoption habits, needs, and outcomes. Data were assessed using descriptive and bivariate analyses. The survey was developed from a comprehensive qualitative interview phase as part of a mixed methodology study., Results: Responses (n = 343) revealed orthodontists make adoption decisions on the basis of advice from other dentists and company representatives while rarely consulting staff or research literature. Continuing education and meetings are most effective at disseminating information to practicing doctors, whereas journals generate less impact. Key adoption incentives include added capabilities, practice efficiency, ease of implementation, and performance, whereas cost is the main barrier to purchase. Early adopters with larger practices charge higher fees than other adopters to support the costs of technologies. Treatment outcome is not a primary adoption incentive for specific technologies., Conclusions: Orthodontists positively perceive the influence of intraoral scanning, cone-beam computed tomography imaging, 3-dimensional printing, computer-aided design-computer-aided manufacturing archwires, and clear aligner therapy on their practice and patient care. The orthodontic technological transformation is underway, and knowledge of adoption can guide our transition into modern practice, in which digital tools are effective adjuncts to the specialists' expertise., (Copyright © 2021. Published by Elsevier Inc.)

Introduction: Orthodontic residents face challenges unparalleled to their predecessors, including competitive marketplaces, rising debt burdens, and changing demographics that have contributed to the shift in initial career choice from owner to employee. We aim to understand factors important to orthodontists at different career stages and the impact on job satisfaction through a sequential mixed methodology study., Methods: Semistructured interviews were conducted with 25 orthodontic residents and practitioners. A survey was developed from qualitative findings that explored career decision-making of orthodontic residents and practicing orthodontists, with descriptive and bivariate statistical analyses (n = 343 orthodontists and 185 residents)., Results: Graduating orthodontic residents are choosing employment over ownership as their initial job, prioritizing high income to offset the educational debt. The majority of residents report thinking about their debt very often to all of the time and find it very to extremely stressful. Current residents have long-term goals of ownership, whereas practicing doctors of both genders became owners at equal frequencies. However, on average, women earn $119,000 less per year and report being the primary family caretaker more often than men., Conclusions: Excellent patient care, work-life balance, and sufficient income are the most important drivers for career choices and job satisfaction for orthodontists of all ages. Despite debt, most residents and working orthodontists report a high level of job satisfaction and would recommend the field of orthodontics to others., (Copyright © 2021 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Objectives: To (1) introduce a novel machine learning method and (2) assess maxillary structure variation in unilateral canine impaction for advancing clinically viable information., Materials and Methods: A machine learning algorithm utilizing Learning-based multi-source IntegratioN frameworK for Segmentation (LINKS) was used with cone-beam computed tomography (CBCT) images to quantify volumetric skeletal maxilla discrepancies of 30 study group (SG) patients with unilaterally impacted maxillary canines and 30 healthy control group (CG) subjects. Fully automatic segmentation was implemented for maxilla isolation, and maxillary volumetric and linear measurements were performed. Analysis of variance was used for statistical evaluation., Results: Maxillary structure was successfully auto-segmented, with an average dice ratio of 0.80 for three-dimensional image segmentations and a minimal mean difference of two voxels on the midsagittal plane for digitized landmarks between the manually identified and the machine learning-based (LINKS) methods. No significant difference in bone volume was found between impaction ([2.37 ± 0.34] [Formula: see text] 10 4 mm 3 ) and nonimpaction ([2.36 ± 0.35] [Formula: see text] 10 4 mm 3 ) sides of SG. The SG maxillae had significantly smaller volumes, widths, heights, and depths ( P < .05) than CG., Conclusions: The data suggest that palatal expansion could be beneficial for those with unilateral canine impaction, as underdevelopment of the maxilla often accompanies that condition in the early teen years. Fast and efficient CBCT image segmentation will allow large clinical data sets to be analyzed effectively.

Objectives: To describe the frictional forces (FF) that constrain wire sliding in the initial alignment phase of treatment using a new term, the ‘‘constraining force'' (CF), and to hypothesize that CF is dependent on two factors: the hyperelastic behavior of archwires and the specific type of tooth geometric malalignment present.Materials and Methods: A laboratory device that simulates the four distinct malalignment types (inout, rotation, tipping, and vertical step) was used to couple with an Instron testing apparatus. Incremental CF data for the four types of malalignment were recorded. Each type had five trials perincrement of severity, from which the CF was averaged using 0.016-inch copper-nickel-titanium (CuNiTi) archwires.Results: Two types of friction curves were obtained: a traditional step function response and a power regression response. For all malalignment types, increasing degrees of irregularity increased power regression responses and CF. A severity turning point, displayed as a sudden increase in CF, occurred for each malalignment. The rotation type of malalignment yielded the lowest CF, while the vertical step type resulted in the highest CF.Conclusions: The data infer a hypothesis that malrotation type having weak CF might act as a limiting factor in the alignment phase to unravel the neighboring teeth. Future investigations to compare clinical and bench data can help explain more fully the constraints impeding alignmentresolution and the factors governing the ability to bring malaligned teeth into alignment. (Angle Orthod. 2018;88:67–74.)

This study evaluated the shear bond strength (SBS) of orthodontic brackets bonded to teeth using a diode-pumped solid state (DPSS) laser of 473 nm with various light intensity and light-curing settings. For the study, a total of 150 extracted human teeth were divided into ten groups. In the control group, the brackets were bonded to the teeth using a quartz-tungsten-halogen (QTH) light with an intensity of 900 mW/cm(2). In the experimental groups, the brackets were bonded using a DPSS laser with three different light intensities and light-curing times. The same bracket type and adhesive were used in all groups throughout the study. Statistical analysis was performed to compare the SBS, and adhesive remnant index (ARI) among the groups. As results, brackets bonded using the DPSS laser with an intensity of 700 mW/cm(2) for 40 s (totally) showed a slightly higher SBS (12.2 ± 1.8 MPa) than that of those bonded using a QTH light (control; 11.6 ± 1.6 MPa). The SBS values linearly increased with increasing energy density (light intensity × light-curing time) of the DPSS laser (R = 0.95, p < 0.001). However, the SBS values among the test groups were similar regardless of the difference in light-curing conditions. A comparison of the ARI scores among the groups suggested a similar bracket failure mode. [ABSTRACT FROM AUTHOR]

White spot lesions (WSLs), a side effect of orthodontic treatment, can result in reversible and unaesthetic results. Graphene oxide (GO) with a bioactive glass (BAG) mixture (BAG@GO) was added to Low-Viscosity Transbond XT (LV) in a ratio of 1, 3, and 5%. The composite's characterization and its physical and biological properties were verified with scanning electron microscopy (SEM) and X-ray diffraction (XRD); its microhardness, shear bond strength (SBS), cell viability, and adhesive remnant index (ARI) were also assessed. Efficiency in reducing WSL was evaluated using antibacterial activity of S. mutans. Anti-demineralization was analyzed using a cycle of the acid-base solution. Adhesives with 3 wt.% or 5 wt.% of BAG@GO showed significant increase in microhardness compared with LV. The sample and LV groups showed no significant differences in SBS or ARI. The cell viability test confirmed that none of the sample groups showed higher toxicity compared to the LV group. Antibacterial activity was higher in the 48-h group than in the 24 h group; the 48 h test showed that BAG@GO had a high antibacterial effect, which was more pronounced in 5 wt.% of BAG@GO. Anti-demineralization effect was higher in the BAG@GO-group than in the LV-group; the higher the BAG@GO concentration, the higher the anti-demineralization effect. [ABSTRACT FROM AUTHOR]

The author discusses the result of a study which evaluates the vertical positions of anterior teeth on smile esthetics determined by the Japanese and Korean orthodontists and orthodontic patients. The author states that the anterior teeth's vertical positions were assessed after digital modification in 1-millimeter (mm) increments, from 5mm upper lip coverage to 5mm gingival exposure. He notes that orthodontists and the female patients shared the same preference in the smile evaluation.