Search

Objectives: This review aimed to map taxonomy frameworks, descriptions, and applications of immersive technologies in the dental literature., Data: The Preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) guidelines was followed, and the protocol was registered at open science framework platform (https://doi.org/10.17605/OSF.IO/H6N8M)., Sources: Systematic search was conducted in MEDLINE (via PubMed), Scopus, and Cochrane Library databases, and complemented by manual search., Study Selection: A total of 84 articles were included, with 81 % between 2019 and 2023. Most studies were experimental (62 %), including education (25 %), protocol feasibility (20 %), in vitro (11 %), and cadaver (6 %). Other study types included clinical report/technique article (24 %), clinical study (9 %), technical note/tip to reader (4 %), and randomized controlled trial (1 %). Three-quarters of the included studies were published in oral and maxillofacial surgery (38 %), dental education (26 %), and implant (12 %) disciplines. Methods of display included head mounted display device (HMD) (55 %), see through screen (32 %), 2D screen display (11 %), and projector display (2 %). Descriptions of immersive realities were fragmented and inconsistent with lack of clear taxonomy framework for the umbrella and the subset terms including virtual reality (VR), augmented reality (AR), mixed reality (MR), augmented virtuality (AV), extended reality, and X reality., Conclusions: Immersive reality applications in dentistry are gaining popularity with a notable surge in the number of publications in the last 5 years. Ambiguities are apparent in the descriptions of immersive realities. A taxonomy framework based on method of display (full or partial) and reality class (VR, AR, or MR) is proposed., Clinical Significance: Understanding different reality classes can be perplexing due to their blurred boundaries and conceptual overlapping. Immersive technologies offer novel educational and clinical applications. This domain is fast developing. With the current fragmented and inconsistent terminologies, a comprehensive taxonomy framework is necessary., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Introduction: Mouthguards (MGs) have the potential to prevent contact sport-related dental injuries. However, varying perceptions of their effectiveness persist, influencing recommendations by dental professionals., Aim: To assess the attitudes, knowledge, and perceptions of orthodontists, other dental practitioners (general dentists and other dental specialists), and orthodontic patients involved in contact sports regarding the use of MGs., Methodology: A cross-sectional survey was designed to collect information from dental clinicians (orthodontists and other dental practitioners) and their orthodontic patients about using MGs during sports participation. A convenience sampling technique was used to recruit the participants for an online survey. A total of 107 (32 males/75 females) dental clinicians and 147 (75 males/72 females) orthodontic patients (mean age 17.5 ± 5.84 years) participated in the study. Pre-validated questionnaires, specifically designed for dental clinicians and orthodontic patients, were used. Data were analyzed using SPSS software (version 28.0; SPSS)., Results: Nearly 50% of dental clinicians have recently recommended MGs to their patients in their clinical practice out of which 59% preferred the stock type; 33% of dental clinicians enquired their patients about involvement in contact sports during initial visits. The majority of orthodontic patients acquired knowledge about MGs through the Internet. More than half of orthodontic patients expressed unwillingness to pay for MGs, and 89% of orthodontic patients found using MGs during contact sports uncomfortable., Conclusion: The findings provide valuable insights into the practices and attitudes of dental clinicians and orthodontic patients regarding MGs, their recommendations, and the comfort levels associated with using them during contact sports., (© 2024 The Authors. Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.)

Objective: To analyse the available evidence regarding the incidence and severity of white spot lesions (WSLs), plaque accumulation and salivary caries-associated bacteria(SCB) in clear aligners (CA) verses conventional fixed (CF) orthodontic appliances., Methods: Electronic searches of MEDLINE, Scopus, Embase, Google Scholar, Clinical trial registry, OpenGrey and ProQuest were done for all relevant studies. Eligibility criteria were; Randomized Controlled Trials and Non-Randomized Studies that compared the incidence and severity of WSLs, plaque accumulation and SCB between CA and CF appliances in patients undergoing orthodontic treatment. The risk of bias(ROB) and certainty of evidence was assessed independently by two reviewers using Cochrane's ROB and GRADEpro, respectively. Standardized mean difference (SMD) was used to estimate the effect size using STATA 17 software., Results: A total of 14 studies met the eligibility criteria, and eight were suitable for meta-analysis. The qualitative results showed lower incidence and severity of WSLs, plaque accumulation, and SCB in CA group compared to CF appliances. The pooled results showed significantly lower plaque accumulation(SMD - 1.58;95%CI:-2.57,0.58;p = 0.002) in CA compared to CF appliances., Conclusions: A moderate-quality evidence reveals less plaque accumulation and less SCB in CA, which might be related to the reduced incidence and severity of WSLs associated with CA when compared with CF appliances. However, the results of the present study should be interpreted with caution given the high ROB among some of the included studies as well as the marked heterogeneity across the studies., Clinical Relevance: For patients who can be treated with either CA or CF appliances, CA may be a better choice concerning oral health., Registration: Open Science Framework (DOI: https://doi.org/10.17605/osf.io/kcpvb )., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Purpose: Occlusal bite force (OBF) is the most important parameter in assessing biting efficiency. The aim of this study was to record OBF changes after surgical correction of high angle maxillary/mandibular (Max/Mand) class III patients and to compare these with that recorded in class III patients with average Max/Mand angle., Materials and Methods: Initially included were 42 patients with severe class III skeletal malocclusion who were scheduled for orthodontic surgery: group 1-22 patients with increased vertical relationship scheduled for bimaxillary surgery; group 2-20 patients with average vertical relationship scheduled for mandibular setback only. OBF measurements before surgery (T0), at debonding (T1) and at least 3 months after debonding (T2) were recorded using a portable occlusal force gauge. The following were also measured: maximum OBF (MOBF) achieved by the subject on each side, averaged OBF on each side (AOBF) and maximum OBF at the incisal region (MIOBF). At T2, only 33 patients (group 1: 17 and group 2: 16) were included in the analysis due to loss to follow-up., Results: MOBF increased significantly in group 1, while no significant changes were detected in group 2. MIOBF increased after surgical correction in both groups. Significant increase in MIOBF was observed at T1 (P < 0.001) followed by an insignificant decrease during the observation period (3-6 months after treatment; P > 0.05). The two groups differed significantly in MOBF at T1 and T2, while no statistically significant differences were detected between the groups for MIOBF changes at the various time intervals (P > 0.05). The number of posterior teeth with occlusal contacts increased in both groups. Relapse was detected in group 1 where the number of posterior teeth in contact decreased during the observation period (T1-T2)., Conclusion: OBF greatly improved after surgical correction of the vertical morphology. Correction of high angle mandibular prognathism improves oral function in addition to esthetics., (© 2021. Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Objectives: To compare blood flow (BF) changes of teeth subjected to orthodontic forces during curve of Spee (COS) leveling using different archwires (AW)., Material and Methods: Thirty subjects with COS > 5 mm were randomly assigned (1:1:1) into three groups based on the AW used: group 1: 0.017 × 0.025-inch stainless-steel (SS)AW, group 2: 0.019 × 0.025-inch SSAW, and group 3: 0.021 × 0.025-inch β-titanium (TMA)AW. In the 3 groups, a 5 mm-depth reverse COS was placed in the AWs. A laser Doppler flowmeter was used to measure BF at different time intervals (T0-T4)., Results: In the 3 AWs group, BF of all measured teeth was reduced 20 min after force application. Afterwards, the BF values started to increase until the baseline values were almost restored within 1 week. Differences in BF changes between the extrusion and intrusion subgroups were observed within groups 1 and 3 during the first 20 min of force application (P < 0.05). Similar BF changes were recorded using the 3 different AWs. BF changes were associated with tooth type and the amount of COS depth change., Conclusions: During CoS leveling, similar BF changes were recorded using the 3 different AWs. Tooth type and the amount of COS depth change were associated with BF changes within the first 20 min of force application. Greater BF reduction was found in premolars compared to incisors during the first 20 min of AW placement., Clinical Relevance: It is important to select a type of applied forces that minimally affect the BF. Intrusive forces appeared to have lower negative effects on the BF of teeth during COS leveling., Trial Registration: ClinicalTrial.gov (# NCT04549948)., (© 2023. The Author(s).)

Objectives: To understand the impact of the COVID-19 pandemic on orthodontic clinical services in Jordan., Materials and Methods: Google Forms electronic questionnaires were distributed between March and June 2021 using the WhatsApp platform of the Jordanian Orthodontic Society and via direct WhatsApp messages. The survey was identical and contemporaneous to that used in the United Kingdom., Results: The survey yielded 127 unique responses, giving a response rate of 53.1%. The factors that had the greatest impact on service delivery were government guidance (78%), patients' fear of attending (70.1%), and increased cross-infection measures (65.4%). The survey revealed that there had been a perceived deterioration in oral hygiene (60.3%) and levels of compliance (61.9%) in patients in active treatment even though patients in treatment were prioritized during the pandemic. Also, 56.8% of respondents felt clinical staff should be vaccinated and undergo regular testing for COVID-19. Orthodontists within Jordan were optimistic regarding the speed at which clinical services would return to pre-pandemic levels of activity with 32.5% anticipating this would take less than 6 months., Conclusions: Patients in active orthodontic treatment, during COVID-19, have been prioritized but at the expense of new and review patients. Respondents in Jordan felt COVID-19 would have ongoing effects on clinical care, professional practice, and society. Most respondents supported the vaccination of orthodontic staff and were optimistic about the effect of a vaccination program on restoring clinical services., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Orthodontic Science.)

Objectives: To assess the effect of piezocision on periodontal tissues and alveolar bone height and to detect lower second molar root resorption in piezocision-assisted mandibular second molar protraction compared to no-piezocision molar protraction., Materials and Methods: Twenty-one subjects (four males, 17 females, aged 22.43 ± 2.83 years) who presented with bilateral extraction of lower first molars were included. The patients were divided into two groups; Group 1: Piezocision-assisted molar protraction (right or left side of subjects) in which piezocision was performed immediately before lower second molar protraction and, Group 2: No-piezocision molar protraction in which lower second molar protraction was not surgically assisted. Plaque index (PI), gingival index (GI), periodontal pocket depth (PPD), width of keratinized gingiva (WKG), gingival recession (GR), lower second molar mesial root resorption, alveolar bone height, and mandibular bone height were recorded at T1 (immediately before molar protraction) and at T2 (after second molar space closure)., Results: In the piezocision-assisted molar protraction group, significant changes were detected in the WKG (P < .001), GR (P < .05), and the mandibular bone height (P < .001). Compared to the no-piezocision group, piezocision-assisted molar protraction resulted in an increased WKG (P < .001) and less second molar mesial root resorption (P < .01)., Conclusions: Piezocision does not have any detrimental effect on the periodontium and produces less root resorption., (© 0000 by The EH Angle Education and Research Foundation, Inc.)

Background: Large airway dimensions are associated with a rapid decline in the lung function and a higher risk of hospitalization. Therefore, the airway dimensions of healthy subjects who tested positive for coronavirus disease 2019 (COVID-19) may be associated with the severity of COVID-19 symptoms., Objectives: The objectives of this study were to measure the upper airway dimensions and the craniofacial skeletal parameters in patients who tested positive for COVID-19, to compare the upper airway dimensions and the craniofacial skeletal parameters between patients who developed no/mild symptoms and those with moderate-severe COVID-19 symptoms, and to assess any association of the skeletal relationships (anteroposterior (AP) and vertical) and the upper airway dimensions with the severity of COVID-19 symptoms in adult subjects., Material and Methods: A total of 204 orthodontic patients who tested positive for COVID-19 were evaluated. Of these, only 137 met the inclusion criteria. The sample was further subdivided into 2 groups based on the severity of symptoms: cases (moderate-severe symptoms; n = 56); and controls (asymptomatic/ mild symptoms; n = 81). The upper airway dimensions and the skeletal parameters were measured on lateral cephalograms. The nonparametric Mann-Whitney U test was used to detect differences between the cases and the controls. Binary logistic regression analysis was used to evaluate the association between the studied variables and the severity of symptoms., Results: The cases had a reduced lower face height (LFH) and a reduced perpendicular distance from the hyoid bone to the line connecting the anteroinferior limit of the 3rd cervical vertebra (C3) and the retrognathion point (RGN) (HH1) as compared to the controls. Regression analysis revealed a significant association of LFH (p = 0.013), the vertical airway length (VAL) (p = 0.002) and HH1 (p = 0.021) with the severity of COVID-19 symptoms., Conclusions: The types of malocclusion were similar in the cases and the controls. Patients with reduced LFH and VAL, and a superiorly positioned hyoid bone in relation to the mandible developed more severe COVID-19 symptoms.

Objective: To find out if there is any relationship between tooth size discrepancy (TSD) and skeletal anterior open bite (AOB) and to assess the correlation between the amount of AOB and TSD., Method: A total of 100 Class I subjects were included in this study (average age 15.21 ± 2.84 years). Fifty patients had skeletal AOB (>3 mm) and 50 subjects acted as controls and had a normal overbite. Teeth mesio-distal widths were measured using a digital caliper. Anterior, overall, and posterior TSD ratios were calculated. An independent t-test was employed to assess differences between groups and between genders. Pearson correlation coefficient was used to assess the correlation between the amount of AOB and TSD., Results: Significant differences in anterior (p = .038) and posterior (p = .015) TSD ratios were detected. In the skeletal AOB group, no significant gender differences were detected (p > .05), whereas in the normal bite and total sample group, males had smaller posterior teeth compared to females (p < .05). All the differences were smaller than 1 SD of Bolton's ratios. No significant correlation was found between the amount of AOB and TSD ratios (p > .05)., Conclusions: Skeletal AOB had larger anterior and smaller posterior mandibular teeth, but the differences were less than 1 SD of Bolton's ratios. Males have smaller mandibular posterior teeth than females. The amount of AOB is not correlated with the TSD ratios., (© 2022 The Authors. Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.)

Objective: To understand and compare the perceived impact and ongoing effects of the COVID-19 pandemic on orthodontic clinical services in the UK., Design: Descriptive cross-sectional survey., Setting: Online electronic questionnaire., Participants: Members of the British Orthodontic Society (BOS)., Methods: Electronic questionnaires were circulated between March and June 2021. The UK survey was distributed via emails from the BOS, Orthodontic Managed Clinical Networks and WhatsApp groups., Results: A total of 560 unique responses were received. There were more respondents who were aged over 50 years (52%) then respondents who were aged below 50 years (48%) with the median age range being 50-54 years (20%). The main causes of disruption to clinical practice were felt to be national restrictions (85%), increased cross-infection measures (84%), social distancing (80%) and professional guidance (80%). Respondents felt more negatively in their opinions regarding dentistry's preparedness for the pandemic (5%) and how dentistry coped in the crisis (35%), when compared to orthodontic services specifically (8% and 58%, respectively). The respondents were not confident about the potential beneficial effects of a vaccination programme on orthodontic clinical service provision (21%). Telephone consultations (84%) and video consultations (61%) were the main adaptations used by the respondents during the pandemic., Conclusions: Respondents felt that COVID-19 will have long-term societal, clinical and professional implications. The majority of our respondents supported the vaccination and weekly testing of the orthodontic team. Respondents felt that during the pandemic there had been a deterioration in care provision and were not optimistic about a vaccination programme restoring services to pre-pandemic levels of activity. During the pandemic, patients in active orthodontic treatment have been prioritised but at the expense of new and review patients, and as services recover respondents were concerned about the difficulty of arranging dental extractions.

Introduction: This study investigated lateral incisor and canine morphology and dimensions, maxillary bone density, and volume in subjects with displaced maxillary canines., Methods: Cone-beam computed tomography images for 134 palatally displaced canines (PDCs), 57 buccally displaced canines (BDCs), and 87 nondisplaced canines (NDCs) were analyzed. Canine and lateral incisor dimensions, alveolar bone dimensions, and maxillary bone volume and density were measured., Results: The root length of BDCs was short compared with NDC and PDC groups. The lateral incisor was short in the PDC group compared with NDC and BDC groups. In the BDC group, maxillary bone volume was reduced compared with NDCs and PDCs. Significant differences were detected between BDC and PDC groups in bone density buccal to canines and between BDC and NDC groups in bone density distal to canines. The density of maxillary bone was the highest in the PDC group and the lowest in the BDC group compared with the NDC group. Eight variables were associated with the site of maxillary canine displacement: lateral incisor tip, alveolar bone density, alveolar bone width, bone density buccal to canine, canine width labiopalatally, maxillary bone volume, and canine midsagittal width., Conclusions: In PDCs, the maxillary lateral incisor was short, the canine root had a larger crown/root ratio, and maxillary bone volume was increased compared with NDCs. In BDCs, the canine root was shorter than NDCs and PDCs, maxillary bone volume was reduced compared with NDCs, and bone density at the buccal side was reduced compared with the PDC group., (Copyright © 2022 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Objectives: To investigate and compare the amount and rate of space closure and tooth tipping during orthodontic space closure toward a recent vs healed first premolar extraction site., Materials and Methods: The mandibular arches of 23 patients were included. Treatment plans included lower first premolar extractions. After reaching 0.019 × 0.025-inch stainless-steel archwires (SSAW), patients were subdivided into two groups (Group 1: space closure was carried out toward a healed first premolar extraction space and Group 2: space closure was carried out immediately after first premolar extraction). Elastomeric power chain from second molar to second molar was used to close lower extraction spaces. The following time points were defined: T1: just before space closure; T2-T4: 1-3 months after initial space closure. Records consisted of dental study models. The amount and rate of extraction space closure were evaluated at each time point., Results: In Group 1 (healed socket), a total amount of 1.98 mm (coronally) and 1.75 mm (gingivally) of space closure was achieved. The rate of space closure was 0.66 mm/month coronally and 0.58 mm/month gingivally. In Group 2 (recent socket), the total amount of space closure was 3.02 mm coronally and 2.68 mm gingivally. The rate of space closure was 1.01 mm/month coronally and 0.89 mm/month gingivally. Differences between the two groups were significant (P < .01). Tipping of adjacent teeth during space closure was similar in both groups (P > .05)., Conclusions: In the lower arch, the amount and rate of space closure toward a recent extraction site were higher than that toward a healed extraction socket with similar tipping of teeth in both groups., (© 2022 by The EH Angle Education and Research Foundation, Inc.)

Objectives: To assess the linear and angular cranial base measurements (Bjork polygon) in different anteroposterior (AP) skeletal relationships using Bjork-Jarabak analysis., Materials and Methods: Pretreatment lateral cephalograms of 288 (146 women, 142 men, mean ages 21.24 ± 2.72 years and 22.94 ± 3.28 years, respectively) adult patients were divided into Class I, II, and III skeletal relationships according to their ANB angle. Linear and angular measurements of Bjork polygon were measured and compared among different skeletal relationships. Analysis of variance was performed to detect the differences among groups. Independent-sample t-test was used to detect differences between men and women., Results: The Class II skeletal relationship has a significantly larger saddle angle than Class III does (P < .05), whereas Class III has a significantly larger gonial angle than Class II does (P < .05). The articular angle and sum of Bjork polygon angles were not significantly different among groups (P > .05). Anterior (N-S) and posterior (S-Ar) cranial base lengths were similar in the different AP skeletal relationships (P > .05). The ramal height and body of the mandible length were significantly larger in Class III compared with Class I and II (P < .05). Women had a significantly larger articular angle than men did (P < .05), although men had significantly larger linear measurements of Bjork polygon than women did (P < .05)., Conclusions: The Class III skeletal relationship has a smaller saddle angle and larger mandibular length and gonial angle. Men have a larger cranial base and mandibular linear measurements and a smaller articular angle compared with women., (© 0000 by The EH Angle Education and Research Foundation, Inc.)

Objectives: To evaluate and compare the initial changes in pulpal blood flow (PBF) between conventional and self-ligating fixed orthodontic brackets during leveling and alignment stage using 0.016 × 0.022 NiTi as alignment archwire., Materials and Methods: Twenty-two patients (16 females and 6 males) aged 19.00 ± 2.53 years who presented with mild lower arch crowding were selected to participate in the study. A split mouth study design was applied for each patient. The intervention (self-ligating brackets) was randomly allocated to the right or left side of the patient using the permuted random block size of 2 with 1:1 allocation ratio. Two different fixed appliance brackets were used in the lower arch (self-ligating brackets on one side and conventional brackets on the other side of the same patients. Two alignment archwires; 0.016″ NiTi and 0.016 × 0.022″ NiTi were used in this study. PBF was measured for the lower right and left sides using laser Doppler flowmetry at different time intervals (20 min, 24 h, 72 h, 1 week, and 1 month) RESULTS: PBF started to decrease 20 min after insertion of both archwires using both types of brackets. Maximum decrease was reached after 72 h of archwire insertion. After 1 week of force application, PBF started to increase to restore its original values after 1 month. Differences between the 2 groups were not significant (P > 0.05)., Conclusions: In both treatment groups, PBF reduced within 48 h. PBF started to increase after 1 week until it reached its original values after 1 month. Changes in PBF at the measured time intervals in the two groups were similar., Clinical Relevance: The use of 0.016 × 0.022″ NiTi immediately after 0.016″ NiTi for alignment does not produce any damaging effect on the teeth.

Introduction: The objective of this prospective randomized clinical trial was to investigate the relationship between clear aligner (CA) therapy and the development of white spot lesions and compare it with orthodontic fixed appliance (FA) therapy., Methods: This was a prospective randomized clinical trial. The setting was the postgraduate orthodontic clinic at Jordan University of Science and Technology. A total of 49 patients (39 female, 10 male; mean age ± standard deviation, 21.25 ± 3 years) who required orthodontic treatment with either FAs or CAs were randomly allocated into 1 of 2 study groups. Eligibility criteria included healthy patients of both sexes (age range 17-24 years), Class I malocclusion with mild-to-moderate crowding (≤5 mm), nonextraction treatment plan, and optimum oral hygiene before treatment as determined by clinical examination. The participants were randomly assigned to a study group according to a simple randomization method using a coin toss by the patient; the text or tail side of the coin indicated treatment with CA (group 1), and the head side of the coin indicated orthodontic treatment with FA (group 2). Blinding was applicable for outcome assessment only. CA therapy was performed for group 1 and FA for group 2. Quantitative light-induced fluorescence (QLF) images were taken before treatment (T 0 ) and 3 months later (T 1 ). The QLF images were then analyzed to assess the research outcomes. The main outcome was the mean amount of fluorescence loss (ΔF). Number of newly developed lesions, deepest point in the lesion (ΔF Max ), lesion area (pixels), and plaque surface area (ΔR 30 ) were measured as secondary outcomes. Descriptive statistics and comparison within and between groups were calculated., Results: In total, 42 of the 49 participants recruited completed the study (19 in the CA group and 23 in the FA group). The mean amount of fluorescence loss was 0.4% for the CA group (P = 0.283) and 1.2% for the FA group (P = 0.013). The difference between the 2 groups was significant (confidence interval [CI], -1.8 to -0.4; P = 0.002). The mean increase in lesion area was 82.2 pixels for the CA group (P <0.001) and 9.3 pixels for the FA group (P = 0.225). The difference between the 2 groups was significant (CI, -117 to -75.0; P <0.001). ΔR 30 was 1.2% for the CA group and 10.9% for the FA group (CI, 6.847-12.479; P <0.001). The number of newly developed lesions in the CA group was 6 lesions/patient and 8.25 in the FA group (P = 0.039). No serious harm on the oral health of the participants in the 2 study groups was observed other than mild gingivitis associated with plaque accumulation. No serious harm was reported by any of the participants., Conclusions: Orthodontic treatment with CAs and FAs caused enamel demineralization. The CA group developed larger but shallower white spot lesions, whereas the FA group developed more new lesions with greater severity, but they were smaller in area. More plaque accumulation was found in the FA group compared with the CA group., Registration: NCT04107012., Protocol: The protocol was published after trial commencement., (Copyright © 2020 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Objectives: To assess the effects of piezocision on the rate of mandibular second molar protraction., Materials and Methods: Thirty-one subjects (average age: 22.26 ± 5.63 years) who presented with at least one extracted mandibular first molar were selected to participate in the study. The subjects were subdivided into one of two groups, 22 molars each: group 1, where piezocision was performed immediately before molar protraction and group 2, where molar protraction was performed with no piezocision. Piezocision was performed by making two vertical incisions mesial and distal to the extraction space, and bone cuts were done with a length up to the mucogingival line at a depth of 3 mm. The rate of second molar protraction, duration of space closure, and level of interleukin-1-β (IL-1β) in gingival crevicular fluid (GCF) during the first month of space closure were recorded., Results: During the first 2 months after surgery, the rates of second molar protraction were 1.26 ± 0.12 mm/month and 0.68 ± 0.19 mm/month in the piezocision and no piezocision groups, respectively (P < .001). Duration of lower first molar space closure was 9.61 ± 0.98 months in the piezocision group and 10.87 ± 1.52 months in the no piezocision group (P < .01). The level of IL-1β in GCF was higher in the piezocision group compared to the no piezocision group, up to 1 week after surgery (P = .02)., Conclusions: Although piezocision doubled the rate of second molar protraction during the first 2 months after surgery, overall second molar protraction was increased by only 1 month., (© 2020 by The EH Angle Education and Research Foundation, Inc.)

Introduction: Incisor root resorption associated with palatally displaced canine (PDC-IRR) is an important phenomenon that might alter the orthodontic treatment plan. The aims of this study were to investigate the prevalence and characteristics of PDC-IRRs, to compare PDC-IRR and PDC-No-IRR groups, to identify predictors for PDC-IRR, and to produce a valid PDC-IRR prediction model using discriminant function analysis., Methods: Cone-beam computed tomography images for 107 palatally displaced canines (PDCs) and 51 fully erupted nondisplaced canines (NDC) were analyzed for the presence of incisor root resorption (IRR). The PDCs were divided into 2 groups: PDC-IRR (52 canines) and PDC-No-IRR (55 canines). The 3 groups were compared, and the following variables were measured: canine follicle size, contact with adjacent incisors, associated dental abnormalities, sector analysis, canine vertical relation to adjacent root, lateral incisor angulation and inclination, canine angulation and distance to reference planes (dental midline, midpalatal suture, occlusal plane, pterygoid vertical plane, and lateral incisor), and space available for canine in the dental arch. Discriminant functional analysis was used to produce a discriminant function equation to predict PDC-IRR., Results: Root resorption affected 74% of lateral incisors adjacent to PDCs and 25.5% of lateral incisors adjacent to NDCs. IRR was located lingually in 41% of PDCs and in the mid and apical thirds in 89%. In the PDC-IRR group, 94.2% of canines were in contact with adjacent roots compared with 23.6% in the PDC-No-IRR group (P <0.001). Canine follicle size was >2 mm in 42% of PDC subjects. Overall mean value of follicle width in PDC canines was 1.79 ± 1.06 mm. Peg-shaped lateral incisors were recorded in 19% of PDC subjects compared with 4% in NDCs (P = 0.012). The stepwise analysis using cone-beam computed tomography records produced a discriminant function based on 3 variables. The analysis correctly predicted the outcome in 83% of subjects. The variables contributing to the prediction equation were canine contact with adjacent incisors, size of canine dental follicle, and the presence of peg-shaped lateral incisor., Conclusions: Canines in contact with adjacent incisor roots was the only risk factor detected for PDC-IRR. Very good predictive discrimination (83%) emerged for PDC-IRR subjects. Predictors of PDC-IRR were canine contact with adjacent incisor, size of canine dental follicle, and presence of peg-shaped lateral incisor., (Copyright © 2019 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Aim: To evaluate the occlusal bite force (OBF) changes 6 months after placement of preformed metal crowns PMCs on primary molars in children., Method: Twenty-two subjects (aged 5.08 ± 0.92 years) participated and completed OBF records. Each patient received eight PMCs on their primary molars. OBF was recorded using a battery-operated portable type of OBF gauge at different time intervals: before placement, 1 week-, 1 month-, 2 months-, 3 months-, and 6 months after PMCs placement (T0-T5). A second group consisted of 22 caries-free children matched for age and gender were selected as a control sample and received no dental treatment. OBF was recorded in these subjects at T0 and T5 (6 months after)., Results: OBF was reduced the first week after placement of PMCs. However, the OBF was restored and reached its original value at T4. At the 6-month recall visit (T5), maximum occlusal bite force (MOBF) was 148% and 136% of pre-treatment value on right and left sides, respectively. The mean MOBF difference between T5 and T0 was statistically significant (70.83N and 54.67N on the right and left sides respectively, p < 0.000)., Conclusion: OBF decreased 1 week after placement of PMC restoration and started to increase after 1 month reaching 136-140% of its original value after 6 months.

Introduction: Our objectives were to assess the force degradation of orthodontic latex elastics over 48 hours in vivo and to study the relationship between the amount of mouth opening and the degree of force decay., Methods: Fifty-two orthodontic patients wearing fixed appliances using Class II elastics were asked to wear premeasured-force 3/16-in heavy and medium intermaxillary elastics. The force amounts were measured and compared at different time intervals., Results: Fifty percent of the force was lost after 3.9 hours for the medium elastics and after 4.9 hours for the heavy elastics. A continuous significant force drop in all elastics was seen at all time intervals (P <0.05, P <0.001). There was greater force loss in the heavy elastics compared with the medium elastics in vivo at all time intervals (P <0.001); the rates of force loss, however, were similar., Conclusions: Fifty percent of force degradation occurred in the first 4 to 5 hours. Because of breakage and for oral hygiene purposes, orthodontic elastics should be changed daily; otherwise, elastics can be used for 48 hours. Force decay of the elastics was correlated to the lateral distance between the maxillary canine and the mandibular first molar in occlusion., (Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Objective: To compare personality traits, attitude toward orthodontic treatment, and pain perception and experience before and after orthodontic treatment., Materials and Methods: One hundred subjects (50 male and 50 female) were included in this study. The mean (SD) age was 17.5 (2.05) years at T1 and 19.15 (2.32) years at T2. The instruments for data collection were questionnaires that included assessment of patients' personality traits, attitudes toward orthodontic treatment, and pain perception/experience. Subjects completed the questionnaires at two different times: before orthodontic treatment (T1) and after fixed orthodontic treatment (T2). Subjects were treated by fixed orthodontic appliances for an average (SD) period of 18.64 (0.35) months. Paired sample t-test and chi-square test were used to detect any differences., Results: Significant changes in personality traits were detected after orthodontic treatment irrespective of gender. Neuroticism, openness, agreeableness, and conscientiousness scores were improved (P < .001). A positive attitude toward orthodontic treatment was reported at T1 (4.31 [±1.26]) and improved at T2 (3.98 [±1.16]) irrespective of gender (P < .05). The average (SD) expected pain score (T1) was 4.73 (1.88) and the average (SD) experienced pain score (T2) was 4.63 (1.58). Significant difference in the expected and experienced pain scores was not detected (P  =  .11)., Conclusions: Personality traits and attitude toward orthodontic treatment improved after orthodontic treatment. Reported actual pain experience during orthodontic treatment was similar to that expected before treatment.

Objectives: The aim of this study was to determine the occlusal bite force (OBF) changes, at the incisal and molar regions, after orthodontic treatment with functional appliance therapy in preadolescent subjects., Materials and Methods: OBF was measured for patients (17 females and 16 males) before and after the treatment with Andresen functional appliance for an average period of 9 months (mean age was 11.8±1.1 years). Three variables were registered; maximum OBF at molar region and the average of three readings at the molar (AOBF) and incisal regions (IOBF). The same variables were measured in two occasions for a matching non-treated control group with a period of 9 months between the two measurements., Results: No significant changes were seen in the OBF measured parameters in the control group. There was a reduction in all measured parameters. The mean reduction in maximum OBF was 76.1±12.4 N (P < 0.001), 58.5±13.0 N in AOBF (P < 0.001), and 69.3±11.6 N IOBF (P < 0.001)., Conclusions: Treatment with functional appliance caused a significant reduction in OBF immediately after treatment., (© The Author 2014. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Aim: To investigate the effect of acid etching procedure on the remineralisation of white spot lesions (WSL) which had undergone an initial phase of arrest, and to compare between the effect of fluoride and/or CPP-ACP on remineralisation before and after acid etching., Study Design: In vitro study., Methods: WSL were prepared in vitro on 130 human enamel slabs which were allocated into four experimental groups (N = 30) and one control group (N = 10). Changes in mineral content were registered weekly by Quantitative Light Induced Fluorescence QLF. When changes had arrested (after 8 weeks), the enamel surface of 20 slabs in each group were acid etched. The remineralisation process was continued until it slowed down again (after 5 weeks)., Results: Mean fluorescence gain was 13.7 ± 0.9% in the fluoride group, 16.5 ± 1.1% in the CPP-ACP group, and 11.4 ± 1.2% in the combination of fluoride and CPP-ACP group., Conclusions: There was a tendency toward better remineralisation after acid etching but this did not reach a significant level; the effect of etching was more pronounced in the presence of fluoride. Although CPP-ACP seemed to give a steadier rate of remineralisation over time when compared with fluoride, the overall remineralisation in the regimens was similar. In this model, combined treatment of fluoride and CPP-ACP did not have an extra benefit over the fluoride or CPP-ACP alone.

Objective: To determine the most common maxillary and mandibular arch form and size in primary dentition stage., Material and Methods: Four hundred thirty five preschool children were included in this study with an age range of 3.5-5.5 years old. Dental casts were digitized and landmarks for the measurements were identified and marked on each model. Ten points were determined on the dental arch. Measurements of the x and y coordinates of the 10 points of each dental cast image were plotted on a computer software to obtain the polynomial function that best describes the curve corresponding to the dental arch form., Results: Three arch forms were observed; square, oval and tapered. The most common arch form observed in the primary dentition was the oval form (52%) followed by the square and tapered arch forms (29% and 19%, respectively). Gender differences were not detected. In the maxilla, the most common arch form was the oval (58.4%) arch whereas the square arch form (46.7%) was the most common in the mandible. The medium size arch form was the most common size in both mandible (83%) and maxilla (71.5%) and for the total sample (77%). Differences in arch form size distribution were detected (P<0.000). Small size arch form was more common in females compared to males in the maxilla and total sample (P<0.000). Intercanine width was significantly smaller in the tapered arch form compared to oval arch form (P=0.048). In both arches, intercanine and intermolar widths were significantly larger in males compared to females., Conclusions: The most common arch forms in the maxilla and mandible were the medium sized oval and square forms, respectively. Intercanine width was the smallest in the tapered arch form. Intercanine and intermolar widths were affected by gender.

Objective: To assess the morphology and dimensions of mandibular symphysis (MS) in different anteroposterior jaw relationships and to investigate whether craniofacial parameters have any correlation with its shape and/or dimensions., Materials and Methods: Lateral cephalograms of subjects with Class I, Class II, and Class III skeletal relationships were traced. Several craniofacial and MS parameters were measured. MS parameters were compared between the three groups using analysis of variance and were correlated with the craniofacial parameters using the Pearson correlation coefficient., Results: Larger angle of concavity of the chin, more inclination of the alveolar bone toward the mandibular plane, and larger MS dimensions and area (P < .001) were found with a Class III skeletal relationship compared to Class I and Class II relationships. The Pearson correlation coefficient between Id-Me and AFH was r  =  0.83 and between Id-Me and LAFH it was r  =  0.81., Conclusions: The dimensions and configuration of MS in the Class III relationship were different than those in Class I and Class II relationships; the alveolar part of MS compensated for the skeletal relationship in the Class III pattern. MS dimensions were strongly correlated to anterior facial dimensions.

Aim: To assess the effect of different bracket base conditioning method on shear bond strength (SBS) of rebonded brackets., Materials and Methods: Eighty brackets were bonded to freshly extracted premolar teeth using light cured composite adhesive. SBS was measured for 20 random samples as control group (G1). After debonding, 60 debonded brackets were allocated randomly into three groups of bracket base conditioning methods to remove the remaining adhesives. G2: bracket base cleaned with slow speed round carbide bur (CB), G3: cleaned with ultrasonic scaler (US), G4: cleaned with sandblasting (SB). After that, brackets were rebonded in the same manner as frst bonding and SBS was measured. Modifed adhesive remnant index (ARI) was recorded for all groups., Results: SBS for new brackets was 11.95 MPa followed by 11.65 MPa for G2, 11.56 MPa for G4 and 11.04 MPa for G3 group. There were no statistically signifcant differences between all groups (p = 0.946). In all groups, failure mode showed that the majority of adhesive composite remained on the bracket base with ARI of 4. There was no statistically signifcant difference between all groups in ARI (p = 0.584)., Conclusion: In-offce methods; slow speed CB and US are effective, quick and cheap methods for bracket base cleaning for rebonding.

This study was carried out to record maximum occlusal bite force (MOBF) among different dentition stages in children and to study the relation of occlusal bite force to weight, height, and gender. A total of 1011 children (500 females and 511 males) aged from 3 to 18 years were examined. The subjects were divided into 5 groups according to their dentition stage as the following:- early primary dentition stage (100 males and 100 females, average age was 3.37 ± 0.23 years), late primary dentition stage (104 males and 100 females, average age was 5.86 ± 1.15 years), early mixed dentition stage (100 males and 100 females, average age was 8.15 ± 0.67 years), late mixed dentition stage (100 males and 100 females, average age was 9.97 ± 0.86 years ), and permanent dentition stage (107 males and 100 females, average age was 14.03 ± 2.14 years). Occlusal bite force was measured using a hydraulic occlusal force gauge. The means of MOBF for the different dentition stages were:- 176 N in early primary stage, 240 N in late primary stage, 289 N in early mixed stage, 433 N in late mixed stage, and 527 N in the permanent dentition stage, respectively. Gender differences were detected in groups 2, 3 and 4. Height and age significantly correlated with the MOBF in all dentition stage groups except group 1. In conclusion, the MOBF increased with age. Age, gender, and height were significant predictors of the MOBF.

Objective: To compare arch perimeter and teeth size, number, and shape between the two sides of the dental arch-the canine displacement side (DS) and the nondisplacement side (NDS)-in subjects with unilateral palatally displaced canine (PDC)., Materials and Methods: Orthopantomograms (OPTs) of 240 subjects with unilateral PDC and 240 OPT matching controls were used. Additionally, study casts of 100 study subjects and 100 controls were used. The age of subjects ranged between 14 and 25 years. Dental casts were digitized and several parameters were recorded., Results: The transverse width from midpalatal line to the buccal segment and the palatal area on the DS was larger than that in the NDS (P < .05 to .001), with no difference in tooth size between both sides. Maxillary second premolars, canines, and lateral incisors in the PDC group were smaller than those in control group. Peg-shaped lateral incisors were significantly more frequent in the study group (P < .001)., Conclusions: The transverse width of the DS was larger than that of the NDS. Both sides were generally smaller than those of the control group. Tooth size in the DS was comparable to that in the NDS but smaller than those of the control group. A missing or peg-shaped lateral incisor was the most common reported anomaly.

Objectives: To evaluate the acceptability of different intra-oral and extra-oral orthodontic appliances, to rank orthodontic appliances from the most to the least attractive and to investigate the factors that may affect the acceptance of orthodontic treatment., Subjects: A random sample of 800 students (schoolchildren and university students) were invited to participate in this study and a total of 688 students were included (86%)., Methods: A self-administrated structured questionnaire was constructed for the purpose of this study., Results: More than one-half in each age group (53%) claimed that they would accept to have orthodontic treatment. Acceptance of the different orthodontic appliances was affected by gender, age and type of school. Removable appliance was reported as the most acceptable and facemask was reported as the least acceptable orthodontic appliances. Majority of subjects ranked ceramic and facemask appliances as the most and the least attractive orthodontic appliances, respectively. The predictor variables for the acceptance of orthodontic treatment were perceived demand for orthodontic treatment, perceived positive effect of orthodontic treatment and expected benefits from orthodontic treatment., Conclusions: Removable appliance was the most acceptable orthodontic appliance whereas ceramic appliance was ranked as the most attractive one. Facemask was the least acceptable and the least attractive option.

Aim: This was to compare shear bond strength (SBS) of brackets bonded to deciduous teeth with that of permanent teeth, to evaluate the effect of increasing etching time on the SBS of brackets bonded to deciduous teeth and to evaluate the modes of bond failure after de-bonding., Study Design: ex vivo study., Materials and Methods: A total of 120 freshly extracted human maxillary teeth were divided into six groups of 20 teeth each as follows: Group 1, permanent canines with 15-second etching time; Group 2, first premolars with 15-second etching time; Group 3, deciduous canines with 15-second etching time; Group 4, deciduous first molars with 15-second etching time; Group 5, deciduous canines with 30-second etching time; Group 6, deciduous first molars with 30-second etching time. After bonding, all specimens were thermocycled from 5 °C to 55 °C and back to 5 °C 500 times. The modified ARI was used to determine the mode of bond failure., Statistics: Comparison between groups was performed using Univariate General Linear Model (UGLM) and chi-squared tests., Results: SBS for permanent and deciduous teeth etched for 15 seconds averaged 106.60 ± 34.69 N and 96.90 ± 28.51 N, respectively. SBS for deciduous teeth etched for 15 seconds (91.90 ± 32.90 N and 101.80 ± 23.12 N for canines and molars respectively) and 30 seconds (110.40 ± 30.11 N and 94.20 ± 25.74 N for canines and molars, respectively). No significant differences were recorded between the different groups. Bond failure at the enamel-adhesive interface occurred more frequently in the deciduous teeth groups, while failure at bracket-adhesive interface occurred more frequently in the permanent teeth group., Conclusion: SBS of brackets bonded to deciduous teeth was comparable to that of permanent teeth.

Objective: To determine how orthodontic treatment with first premolar teeth extracted and the associated arch dimensional changes in bimaxillary proclination patients affect the upper airway dimensions., Materials and Methods: Pre- and postorthodontic treatment cephalograms and dental casts of 40 bimaxillary proclination patients (ages ranged between 18 and 23 years) were used for this study. Patients were all treated with extraction of the four first premolars. Cephalometric radiographs were used to measure airway dimensions, and dental casts were used to measure the changes in the arch dimensions. A paired t-test was used to detect differences at P < .05., Results: The results showed statistically significant reductions in tongue length (P < .05), posterior adenoids thickness (AD2-H) (P < .05), upper and lower incisor inclination, and lower incisor to A-Pog line (P < .001). Considering the dental cast results, statistically significant reductions in upper arch length, lower arch length, and lower intermolar width were also found (P < .001). The only statistically significant increase was recorded for the upper intercanine width (P < .001)., Conclusions: Extraction of the first premolars for the treatment of bimaxillary proclination does not affect upper airway dimensions despite the significant reduction in tongue length and arch dimensions.

Introduction: The aims of this study were to investigate the relationship between dental age and maxillary canine displacement with 2 methods, to study differences in dental development between the displaced and nondisplaced sides, and to investigate sex differences in dental development in the studied groups., Methods: Two hundred forty subjects were recruited for this study. They were divided into 2 groups: the palatally displaced canine group (87 girls, 33 boys) and the buccally displaced canine group (81 girls, 39 boys). Dental ages were assessed by using the 2 methods., Results: Delayed dental development was associated with subjects with palatally displaced canines only, whereas those with buccally displaced canines had comparable dental development to that of the control group. Sex differences in the 3 groups were found; girls had more pronounced delayed dental development in all groups according to both methods. With unilateral palatally displaced canines, the displacement side showed delayed dental development compared with the side of nondisplacement (P = 0.002). The development rates of the displaced and nondisplaced sides were comparable in the subjects with unilateral buccally displaced canines., Conclusions: Palatal and buccal canine displacements are 2 distinct entities; delayed dental development plays a role in the etiology of palatal canine displacement, but not in buccal canine displacement., (Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

Retromolar space has long been identified as a major factor in the aetiology of mandibular third molar impaction. The aims of this study were to compare mandibular third molar space between the different antero-posterior (A-P) skeletal patterns, between erupted and impacted third molars in the different A-P skeletal patterns, and to report on the status of third molar eruption/impaction among the studied subjects. A total of 432 mandibular third molars in 270 subjects (132 females and 138 males) were investigated from dental pantomograms (DPTs) and lateral cephalograms (LC). The average age for the total sample was 20.80 ± 2.03 years. The subjects were divided into three groups according to their ANB angle as follows: skeletal Class I (144 third molars in 90 subjects), skeletal Class II (145 third molars in 95 subjects), and skeletal Class III (143 third molars in 85 subjects). Each group was subdivided into impacted and erupted subgroups. DPT and LC were traced and the following variables were measured: retromolar space width, third molar width and angulation, β angle, second molar angulation, mandibular length, and gonial angle. Independent t-test, analysis of variance, and chi-square test were used for statistical analysis. Retromolar space width in the Class III subjects was smaller than in the Class I subjects (P < 0.05). Mandibular third molars were recorded as impacted in 26, 32, and 42 per cent of the Class I, II, and III subjects, respectively (P < 0.001). The impacted groups had a reduced retromolar space width, increased β angle, and reduced third molar angulation in all A-P skeletal patterns. Class III subjects showed increased mandibular third molar impaction with reduced retromolar space width.

The purposes of this study were to rate the attractiveness of different smile variables, to compare the perception of Jordanian laypeople, general practitioners, and orthodontists to altered smile aesthetics, and to identify the threshold where different variables begin to impair smile aesthetics. A smiling photograph of a female dental student was selected and digitally manipulated to create changes in buccal corridor space (BCS), the amount of gingival display, and the midline diastema. These altered images were rated by three groups of Jordanians: 200 laypeople (100 females and 100 males), 200 general practitioners (100 females and 100 males), and 160 orthodontists (40 females and 120 males). Smile aesthetics scores were calculated and comparisons between groups were performed using the univariate general linear model. The results showed that profession and gender affected BCS and midline diastema attractiveness ratings (P<0.001). Wide BCSs, a gingival display of more than 2 mm, and the presence of a midline diastema of any size were rated as unattractive by all groups.

The aims of this study were to evaluate the effectiveness of a lower lingual holding arch (LLHA) in maintaining arch length, and to compare the effectiveness of two LLHAs made of two different gauges (0.9 and 1.25 mm) of stainless steel (SS) wire. The sample comprised 44 subjects (24 males and 20 females) who for various reasons attended orthodontic clinics at Jordan University of Science and Technology Dental Teaching Center. The subjects were randomly divided into two treatment groups. The first group contained 20 subjects (12 males/8 females, average age 10.76 ± 0.75 years). The LLHA used in this group was made of 0.9 mm SS wire. The second group comprised 24 subjects (12 males/12 females, average age 10.57 ± 0.54 years). The LLHA used in this group was made of 1.25 mm SS wire. The third group consisted of 23 subjects (15 males/8 females, average age 10.63 ± 0.66 years) who served as the control. The records consisted of lateral cephalograms, dental pantomograms, and study casts. Paired t-test, analysis of variance, and chi-square tests were used to determine whether significant differences existed between the groups. In both treatment groups, the lower incisors proclined and moved forward, and space loss of the lower primary second molar occurred. The LLHA made of 0.9 mm SS was superior to that made of 1.25 mm SS in terms of arch length preservation.

Objective: To investigate the relationship between personality traits and a person's attitude toward orthodontic treatment and perception of pain during orthodontic treatment., Materials and Methods: The sample consisted of two groups: group 1 consisted of 200 untreated subjects (100 males, 100 females; average age, 21.50 +/- 3.35 years), and group 2 consisted of 200 treated subjects (100 males, 100 females; average age, 20.92 +/- 2.48 years). The instrument for data collection was a questionnaire that included assessment of patients' personality profiles, pain expectation for untreated subjects, pain experience for treated subjects, and attitudes toward orthodontic treatment., Results: Gender, treatment status, and personality traits did not affect subjects' average attitude toward orthodontic treatment, whereas gender was the only variable that affected subjects' average pain perception (P < .01). The average attitude score in subjects who experienced pain during orthodontic treatment was 5.06 +/- 1.43, compared to 4.32 +/- 1.35 for subjects who did not experience pain (P < .001). The average pain perception scores in treated subjects with previous knowledge of orthodontic treatment was 5.29 +/- 1.94, compared to 6.07 +/- 1.95 in subjects who did not have previous knowledge of orthodontic treatment (P < .01)., Conclusions: Personality traits did not affect attitude toward orthodontic treatment and pain perception/experience during orthodontic treatment. A more positive attitude was found in patients who experienced less pain during orthodontic treatment.

The aims of this study were to evaluate the shear bond strength (SBS) of metal and ceramic brackets bonded to two different all-ceramic crowns, IPS Empress 2 and In-Ceram Alumina, to compare the SBS between hydrofluoric acid (HFA), phosphoric acid etched, and sandblasted, non-etched all-ceramic surfaces. Ninety-six all-ceramic crowns were fabricated resembling a maxillary left first premolar. The crowns were divided into eight groups: (1) metal brackets bonded to sandblasted 9.6 per cent HFA-etched IPS Empress 2 crowns; (2) metal brackets bonded to sandblasted 9.6 per cent HFA-etched In-Ceram crowns; (3) ceramic brackets bonded to sandblasted 9.6 per cent HFA-etched IPS Empress 2 crowns; (4) ceramic brackets bonded to sandblasted 9.6 per cent HFA-etched In-Ceram crowns; (5) metal brackets bonded to sandblasted 37 per cent phosphoric acid-etched IPS Empress 2 crowns; (6) metal brackets bonded to sandblasted 37 per cent phosphoric acid-etched In-Ceram crowns; (7) metal brackets bonded to sandblasted, non-etched IPS Empress 2 crowns; and (8) metal brackets bonded to sandblasted, non-etched In-Ceram crowns. Metal and ceramic orthodontic brackets were bonded using a conventional light polymerizing adhesive resin. An Instron universal testing machine was used to determine the SBS at a crosshead speed of 0.1 mm/minute. Comparison between groups was performed using a univariate general linear model and chi-squared tests. The highest mean SBS was found in group 3 (120.15 +/- 45.05 N) and the lowest in group 8 (57.86 +/- 26.20 N). Of all the variables studied, surface treatment was the only factor that significantly affected SBS (P < 0.001). Acid etch application to sandblasted surfaces significantly increased the SBS in groups 1, 2, 5, and 6. The SBS of metal brackets debonded from groups 1, 3, and 5 were not significantly different from those of groups 2, 4, and 6. All debonded metal brackets revealed a similar pattern of bond failure at the adhesive-restorative interface. However, ceramic brackets had a significantly different adhesive failure pattern with dominant failure at the adhesive-bracket interface. Ceramic fractures after bracket removal were found more often in groups 1-4. No significant difference in ceramic fracture was observed between the IPS Empress 2 and In-Ceram groups.

This study was carried out to record maximum occlusal bite force (MBF) in Jordanian students with three different facial types: short, average, and long, and to determine the effect of gender, type of functional occlusion, and the presence of premature contacts and parafunctional habits on MBF. Sixty dental students (30 males and 30 females) were divided into three equal groups based on the maxillomandibular planes angle (Max/Mand) and degree of anterior overlap: included short-faced students with a deep anterior overbite (Max/Mand < or = 22 degrees), normal-faced students with a normal overbite that served as the controls (Max/Mand = 27 +/- 5 degrees), and long-faced students with an anterior open bite (Max/Mand > or = 32 degrees). Their age ranged between 20 and 23 years. MBF was measured using a hydraulic occlusal force gauge. Occlusal factors, including the type of functional occlusion, the presence of premature contacts, and parafunctional habits, were recorded. Differences between groups were assessed using a t-test and analysis of variance. The average MBF in Jordanian adults was 573.42 +/- 140.18 N. Those with a short face had the highest MBF (679.60 +/- 117.46 N) while the long-face types had the lowest MBF (453.57 +/- 98.30 N; P < 0.001). The average MBF was 599.02 +/- 145.91 in males and 546.97 +/- 131.18 in females (P = 0.149). No gender differences were observed. The average MBF was higher in patients with premature contacts than those without, while it did not differ in subjects with different types of functional occlusion or in the presence of parafunctional habits.

Objective: To assess periodontal parameters in a Jordanian population in individuals with three different facial types., Materials and Methods: Forty-five dental students (ages 20-26 years) with short, average, and long face heights were divided into three equal groups. The plaque index, gingival index, gingival thickness, width of keratinized gingiva, and width of attached gingiva were measured in each group. Occlusal factors, including the dynamic occlusion and the presence or absence of premature contacts were recorded. Differences among the three groups were assessed using Student's t-test, chi-square test, and analysis of variance (ANOVA) test., Results: No differences were present in the plaque index, gingival index, gingival attachment, width of attached and keratinized gingiva and gingival thickness between the subjects in the three groups studied. None of the subjects in the long face group had canine guidance dynamic occlusion., Conclusions: There were no differences in the periodontal parameters between the different dentofacial vertical patterns, but there was a difference in the canine guidance dynamic occlusion.

This study was undertaken to measure the shear bond strength (SBS) of stainless steel brackets bonded to different ceramic surfaces, to compare the SBS of the different ceramics with each other and with conventional ceramo-metal porcelains, and to determine the mode of failure for each group following debonding. A total of 60 ceramic crowns were constructed on extracted teeth and divided into three equal groups as follows: In-Ceram ceramic crowns, IPS-Impress ceramic crowns, and conventional ceramo-metal porcelain. Standard edgewise metal premolar brackets were bonded to the prepared porcelain surfaces. After bonding, all samples were tested in shear mode on an Instron universal testing machine. Statistical analysis was undertaken using analysis of variance, LSD, and chi-squared tests. The results showed that the SBS for the ceramo-metal and the In-Ceram groups were comparable, with mean values of 80.54 +/- 13.44 N and 78.87 +/- 13.47 N, respectively. The IPS-Impress group showed the weakest SBS which averaged 67.40 +/- 8.99 N. This was significantly lower than that of the conventional ceramo-metal porcelain (P < 0.001) and the In-Ceram surface (P < 0.01). The mode of failure in the ceramo-metal group was between the porcelain surface and adhesive and in the other two ceramic groups, between the brackets and adhesive (P < 0.001). The SBS of orthodontic brackets to the three tested ceramic surfaces were adequate for orthodontic use.

Objectives: The aims of this study were to compare the mechanical efficacy of Siwak in plaque control and gingival health conditions in subjects wearing fixed orthodontic appliances compared with standard and orthodontic toothbrushes., Methods: Forty male patients with a mean age of 17.20+/-4.01 years, wearing fixed orthodontic appliances were included in this study. Following a session of scaling and polishing, which established a situation with minimal gingival inflammation and close to zero amounts of dental plaque, all patients were instructed to use a standard soft toothbrush for 1 week after which they were randomly and equally allocated to one of four groups: (i) a manual toothbrush group; (ii) an orthodontic toothbrush group; (iii) a Siwak group; and (iv) a combination of Siwak and an orthodontic toothbrush group. All patients were instructed to brush their teeth three times a day. All patients were scored for plaque and gingivitis 1 week after scaling and polishing and 2 weeks following group assignment., Results: A similar effect of Siwak to that of soft and orthodontic toothbrushes with respect to plaque control in patients with fixed orthodontic appliances was found. It was the combined use of Siwak and orthodontic toothbrush that provided the best plaque control in such patients. Gingival condition was better in the Siwak groups whether used solely or in combination with an orthodontic toothbrush., Conclusion: The use of Siwak promotes gingival health in patients with orthodontic appliances.

Objectives: The aim of this study was to investigate any association between irregular teeth and periodontal breakdown among children who attend dental clinics regularly., Methods: The subjects were 80 children (39 females and 41 males) with a mean age of 12.38 +/- 0.75 years. Each subject had an alginate impression in the mandibular arch, periapical radiographs for the lower incisor teeth and clinical examination for periodontal health. Plaque accumulation, gingival condition and probing depth, bone level and status of lower incisor teeth contact areas were recorded. Spearman correlation test was used to observe any relationship between the clinical variables., Results: The average probing depth, gingival index and plaque index scores in the subjects studied were 1.3 +/- 0.25, 0.99 +/- 0.28 and 1.17 +/- 0.52 respectively. The average number of sites with labiolingual displacement with mesiodistal overlap was 1.81 +/- 1.30 and those without mesiodistal overlap was 1.39 +/- 1.10. The average number of contact areas with spacing was 0.59 +/- 1.23. The correlation observed between irregularity and periodontal health indicated no association between the number and type of displacement and plaque accumulation, gingivitis, attachment loss and alveolar bone level., Conclusion: There was no association between irregularity of teeth and periodontal diseases in presence of good oral hygiene.

The objective of this study was to identify factors that may affect patients' satisfaction with their dentition after orthodontic treatment. Fifty patients (20 males and 30 females; mean age 20.7 +/- 4.2 years) who successfully had finished fixed orthodontic treatment were included in the study. All subjects were treated with upper and lower fixed orthodontic appliances for an average duration of 19 +/- 4 months and were in retention stage (6-12 months) with upper Hawley and lower fixed bonded retainers. Dental Impact on Daily Living questionnaire was used to assess the effect of orthodontic treatment on daily living and satisfaction with the dentition in the study sample. The NEO Five Factor inventory was used to assess personality profiles in the study sample. Comparisons between groups were made using chi-square test. Personality traits were found to be correlated with patients' satisfaction with their dentition after orthodontic treatment. Higher neuroticism scores had a significant negative relationship with total satisfaction with the dentition (P < .05). Age, sex, and pretreatment orthodontic treatment need had no relationship with the patient's satisfaction. Patients treated nonextraction showed more dissatisfaction with their dentition (P < .05). In orthodontically treated patients, higher neuroticism scores were associated with lower levels of satisfaction with the dentition.

The objectives of this study were to determine the mean mesiodistal tooth width of the dentition, Bolton anterior and overall ratios, arch length, and arch width in the different malocclusions in a Jordanian sample. The mesiodistal tooth width, arch width, and length were measured on a total of 140 orthodontic models of school students aged 13-15 years of different occlusal relationships (Class I, Class II division 1, Class II division 2, and Class III malocclusions). Anterior and overall Bolton ratios were calculated. The mean and standard deviation were calculated. Student's t-test and analysis of variance were used for the statistical analysis. The results show that (1) females have smaller teeth than males; (2) Class III malocclusion showed larger teeth than the rest of the other occlusal categories; (3) no statistically significant differences were found in Bolton ratios between the different malocclusions; (4) Class II division 1 showed the narrowest maxillary arch compared with the other types of malocclusion; (5) the mandibular intercanine width was significantly larger in Class III group than in Class II division 1 and Class II division 2 groups; (6) the maxillary arch was significantly longer in Class II division 1 than in Class II division 2; and (7) the mandibular arch of both Class II categories was significantly shorter than Class III malocclusion group. In conclusion, tooth size differences were found between right and left sides, between females and males, and between the different malocclusions. Arch width and length also showed differences among the different malocclusions.

Aims: To test the reliability of the Moyers charts and the Tanaka and Johnston equations in Jordanians and to derive coefficients of correlation between the combined mesiodistal widths of the four permanent mandibular incisors and the combined widths of the canine and premolars of the maxillary and mandibular quadrants., Methods: The dental models of the dentition of 130 male and 96 female Jordanian subjects (age range is 14-16 years) with complete permanent dentition were randomly selected. The mesiodistal width of the four permanent mandibular incisors, maxillary and mandibular canines, and premolar teeth were measured using a vernier gauge caliper to the nearest 0.1 mm. The actual teeth measurements were then compared with the predicted values derived from the Tanaka and Johnston equations and Moyers probability tables. Correlation and linear regression analyses were performed between the predicted and actual tooth size for Jordanian children and standard regression equations were developed., Results: Except for the maxillary arch in male subjects, Tanaka and Johnston regression equations underestimated the mesiodistal widths of permanent canines and premolars. On the other hand, there were no statistically significant differences between actual mesiodistal widths of canines and premolars and the predicted widths from Moyers charts at the 65% and 75% level for the lower and upper arches in male subjects and at the 85% level for the upper and lower arches in female subjects. For the newly developed regression equations, the correlation coefficients between the sum of the mandibular four incisors and the sum of the canine and premolars were 0.60 (for lower) and 0.51 (for upper) in male subjects and 0.59 and 0.64, respectively, in female subjects., Conclusions: (1) Tanaka and Johnston prediction method was not accurate when applied to a Jordanian population. (2) Moyers method for prediction can be used for Jordanian children at different probability levels for male and female subjects.