0000000000016611
AUTHOR
Heinrich Wehrbein
A randomized clinical trial to evaluate the plaque removal efficacy of an oscillating-rotating toothbrush versus a sonic toothbrush in orthodontic patients using digital imaging analysis of the anterior dentition.
ABSTRACT Objective: To compare the plaque removal efficacy of an oscillating-rotating electric toothbrush with an orthodontic brush head versus a sonic toothbrush in adolescent patients with fixed orthodontic appliances. Materials and Methods: This was a randomized, examiner-blind, replicate single-use, two-treatment, four-period, crossover study with a washout period between visits of approximately 24 hours. Forty-four adolescent patients with fixed orthodontic appliances in both arches were randomized based on a computer-generated randomization schedule to one of four toothbrush treatment sequences. The primary outcome was plaque score change from baseline, measured using digital plaque i…
Perception of Occlusion, Psychological Impact of Dental Esthetics, History of Orthodontic Treatment and Their Relation to Oral Health in Naval Recruits
Abstract Objective: To investigate whether the oral health of young male adults was related to (1) the degree of self-perceived malocclusion, (2) the degree of experienced negative psychosocial impact of dental esthetics, and (3) the history of orthodontic treatment and its duration. Materials and Methods: The study subjects were 470 male naval recruits undergoing a routine dental health checkup. They answered the Perception of Occlusion Scale (POS) and Negative Impact of Dental Aesthetics Scale (NIDAS). The Approximal Plaque Index (API), the Sulcus Bleeding Index (SBI), and the number of decayed teeth (DT) and missing teeth (MT) were examined by a staff dentist. Statistical procedures were…
Bone-to-implant contact of orthodontic implants in humans--a histomorphometric investigation
The purpose of the present study was to evaluate the percentage of direct bone-to-implant contact (BIC) of orthodontic anchorage implants (Orthosystem) after active orthodontic treatment. Twenty orthodontic implants (diameter, 3.3 mm; length, 4 or 6 mm) were inserted for orthodontic anchorage in different anatomical regions of 18 adult patients (nine males, nine females) aged 18-63 years. Fifteen implants (one per patient) were placed in the mid-palatal area, one implant (one patient) in the retromolar area of the mandible, one in the retromolar area and the mid-palatal area (one patient), and two (bilaterally, one patient) in the zygomatic area. The duration of the unloaded healing period …
Bone quality in the midpalate for temporary anchorage devices.
Objective The aim of the present study was to quantitatively assess the bone quality of the palatal bone from an implantologic standpoint. Material and methods The material consisted of palatal tissue blocks of autopsy material from 22 subjects (19 male, three female), between 18 and 63 years of age. The specimens comprised the anterior part of median palate (APMP) from about 7 mm behind the incisive foramen (first premolar regions), the middle part of median palate (MPMP, second premolar region), and the posterior part of the median palate (PPMP, first molar region). They were prepared in the transversal plane using ground-thin-section technology. The midpalatal areas of the different part…
Root repair after injury from mini-screw
Mini-implants and mini-screws are commonly used in orthodontics to provide extra anchorage. One potential insertion site is between the roots in the alveolar process, which results in a risk of damaging the roots of neighbouring teeth. In an animal-experimental study, 20 mini-screws (bracket screw bone anchors, BSBAs) were inserted into the mandible of five beagle dogs. Each dog received two BSBAs in each lower quadrant, between the roots of the second and third, and third and fourth premolars. Sequential point labelling was performed every 6 weeks with vital stains, and apical X-rays were taken every 6 weeks. Radiographic examination demonstrated damage at three roots because of insertion …
Anatomic site evaluation of the palatal bone for temporary orthodontic anchorage devices.
: Objectives: The aim of the present study was to assess the micromorphologic characteristics of the palatal bone from an implantologic standpoint. Materials and Methods: The material consisted of tissue blocks of autopsy material from 22 subjects (18 males, three females) between 18 and 63 years of age. The specimens comprised the anterior median palatal region from 5 to 10 mm behind the incisive foramen. They were prepared in the transversal plane according to ground thin-section technology. The midpalatal area as well as an area of 3 mm bilateral to the midline were assessed, and a classification of quantitative palatal bone availability was developed. Results: The findings could be divi…
Development of a questionnaire for assessment of the psychosocial impact of dental aesthetics in young adults
The aim of this study was to develop a psychometric instrument for assessment of orthodontic-specific aspects of quality of life. The study subjects, 194 young adults aged 18-30 years, were interviewed using a pool of 23 items dealing with the psychosocial impact of dental aesthetics. Self- and interviewer-rating of the dental aesthetic appearance of each subject were carried out using the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN). Additionally, the Perception of Occlusion Scale and a modification of the Dental Aesthetic Index (DAI) were applied. Factorial analyses identified four measures within the item pool, namely Dental Self-Confidence, Social Impact, P…
The use of three-dimensional oral mucosa cell cultures to assess the toxicity of soldered and welded wires
The aim of the present study was to determine whether there is a difference in toxicity and loss of viability of three-dimensional (3D) reconstructed human oral epithelium (RHOE) cell cultures induced by point-welded (PW), laser-welded (LW), and silver-soldered (SiS) orthodontic wires. Three types of soldered stainless steel (SS) wires: PW, LW, and SiS were prepared ( n = 3) and subjected to multiple end-point analysis (MEA). Six pieces were cut from each wire. Each piece was placed on the triplicate cell cultures (RHOE model based on TR 146 cells). After 24 hours of topical exposure, the cell cultures were cut and stained with haematoxylin/eosin. Toxicity was assessed by evaluating the mor…
Do palatal implants remain positionally stable under orthodontic load? A clinical radiologic study.
Introduction The aim of this study was to determine the positional stability and success rate of palatally placed length-reduced temporary anchorage devices (LRTADs) (length, 4 or 6 mm). Methods Twenty-two patients (ages, 21-62 years; 14 women, 8 men) were enrolled in the study. Each received 1 LRTAD (Orthosystem, Straumann, Switzerland) placed in the midsagittal palate for multifunctional anchorage tasks. Standardized cephalograms were taken directly after implant placement and at the end of treatment to analyze any implant movements. The cephalometric tracings were superimposed on anterior nasal spine to posterior nasal spine in posterior nasal spine to analyze changes in implant angulati…
Comparative assessment of plaque removal and motivation between a manual toothbrush and an interactive power toothbrush in adolescents with fixed orthodontic appliances: A single-center, examiner-blind randomized controlled trial
Introduction The objective of this 2-arm parallel trial was to determine the plaque removal efficacy (main outcome) and the motivation assessment (secondary outcome) comparing a manual versus an interactive power toothbrush in orthodontic patients. Methods Sixty adolescents with fixed orthodontic appliances in both arches were randomized in a 1:1 ratio in this parallel, randomized, examiner-blind controlled clinical trial. Eligibility criteria included at least 16 natural teeth, 1-6 “focus care areas,” plaque score of ≥1.75, no severe caries, gingivitis and periodontitis, no dental prophylaxis, no smoking, no antibiotics, and no chlorhexidine mouth rinse. Subjects were to brush unsupervised…
Dental trait anxiety and pain sensitivity as predictors of expected and experienced pain in stressful dental procedures.
A prevailing hypothesis suggests that exaggerated pain expectations in dentally anxious and pain-sensitive patients might usually be disconfirmed by a lower level of pain experienced during treatment. The present study was conducted to investigate whether this contention also holds during stressful dental procedures. Patients reporting high and low levels of dental fear and of pain sensitivity were compared in their expected and experienced pain and in the concordance between the two measures. Participants were 97 patients undergoing extraction and root canal treatment. The measuring instruments used were the Dental Anxiety Scale (DAS), the Pain Sensitivity Index (PSI), affective and sensor…
Analyzing the teeth next to the alveolar cleft: Examination and treatment proposal prior to bone grafting based on three-dimensional versus two-dimensional diagnosis—A diagnostic study
Abstract Purpose The objective was to evaluate the diagnostic and prognostic value of three-dimensional (3D) cone beam computed tomography (CBCT) on information about the cleft and alignment of cleft neighboring teeth. Materials and methods Panoramic X-rays, small-volume CBCTs, and study casts of 20 patients with a total of 22 alveolar clefts were analyzed prior to secondary bone grafting. Six maxillofacial surgeons and 6 orthodontists rated the following parameters: visibility of alveolar cleft expansion, position and probability of alignment of cleft neighbored teeth. Two-dimensional (2D) X-rays and casts were rated first; CBCT and casts followed at least 4 weeks later. Radiologic bone he…
Toxicity of used orthodontic archwires assessed by three-dimensional cell culture
The aim of the present study was to determine whether used orthodontic wires made of different materials cause toxicity and loss of viability on three-dimensional (3D) cell cultures. Three types of orthodontic wires, stainless steel, Nitinol, and TMA (n = 9) which had been used clinically in fixed appliances for a period of 1 month, were retrieved at random from five patients. Both upper and lower archwires were collected and subjected to two different protocols: to assess toxicity, two pieces of each wire were placed on 3D cell cultures (reconstituted human epithelium); to investigate the possibility of cell damage, the 3-(4,5-dimethylthiazol-2-yl)2,5-diphenyl tetrazolium bromide (MTT) ass…
A randomized controlled trial of a power brush/irrigator/mouthrinse routine on plaque and gingivitis reduction in orthodontic patients
ABSTRACT Objectives: To assess plaque and gingivitis reduction in orthodontic patients after 4 weeks' use of an oscillating-rotating power brush, irrigator, and mouthrinse. Materials and Methods: This was a randomized, examiner-blind, clinical trial comparing plaque and gingivitis outcomes for an experimental power brush/irrigator/mouthrinse oral hygiene routine vs a dental prophylaxis followed by regular manual brushing (positive control). Fifty-one participants with fixed orthodontic appliances in the upper and lower jaw and a minimum of 15 gingival bleeding sites were randomly assigned to experimental or positive control treatment. Both groups were instructed to use their products at lea…
Development of a questionnaire measuring treatment concerns in regular dental patients
– Objectives: The aim of this study was to develop an instrument measuring core concerns about dental treatment guided by Reiss’ expectancy theory of fear. This would include the content domains of injury, somatic reaction and interpersonal concerns, to study the underlying factorial structure, and to determine the test quality of the resulting subscales. Methods: A total of 555 regular dental patients answered the item pool. Subsamples filled in the Dental Anxiety Scale (DAS) (n = 346) and the Anxiety-Present Scale of the state-form of the State-Trait Anxiety Inventory (STAI-S) (n = 187). A second sample (n = 89) was used to determine test-retest reliability and bias for social desirabi…
Efficacy of 3 toothbrush treatments on plaque removal in orthodontic patients assessed with digital plaque imaging: a randomized controlled trial.
Good oral hygiene is a challenge for orthodontic patients because food readily becomes trapped around the brackets and under the archwires, and appliances are an obstruction to mechanical brushing. The purpose of this study was to compare plaque removal efficacy of 3 toothbrush treatments in orthodontic subjects.This was a replicate-use, single-brushing, 3-treatment, examiner-blind, randomized, 6-period crossover study with washout periods of approximately 24 hours between visits. Forty-six adolescent and young adult patients with fixed orthodontics from a university clinic in Germany were randomized, based on computer-generated randomization, to 1 of 3 treatments: (1) oscillating-rotating …
Approximal plaque and gingival sulcus bleeding in routine dental care patients: relations to life stress, somatization and depression.
Objectives: Previous research on relations between life stress and periodontal conditions was often based on indicators of periodontal destruction history and stimulus-specific measures of life stress. The present study was undertaken to compare patients showing different degrees of gingival sulcus bleeding with patients without signs of bleeding, using an instrument measuring cognitive impacts of events and assessing reported symptoms of depression and somatization. Additionally the patient groups were compared with regard to dental status and dental visiting behaviour. Analog comparisons were conducted in patients with different degrees of approximal plaque. Materials and Methods: 140 rou…
Oral health-related quality of life in orthodontics: a cross-sectional multicentre study on patients in orthodontic treatment
Summary Objective This study aimed to assess oral health-related quality of life (OHRQoL) in relation to associated covariates in orthodontic patients of different age groups (children, adolescents, and adults) in a cross-sectional study. Methods A total of 898 subjects (50.6% females, 49.4% males; mean age 16.89 years) undergoing orthodontic treatment anonymously completed the German version of the Oral Health Impact Profile (OHIP-G14) to assess OHRQoL in addition to completing 23 other items. Descriptive, exploratory statistical analysis and multiple linear regression modelling were performed. Results The mean score of the OHIP-G14 was 8.3 for the 6- to 11-year olds, 8.9 for the 12- to 17…
Primary loading of palatal implants for orthodontic anchorage--a pilot animal study.
Summary Objectives This study aimed at evaluating the clinical performance and osseointegration of short orthodontic implants immediately loaded with orthodontic forces. Material and methods The investigation was designed as an experimental animal study. Eight palatal implants of the Ortho-system® were immediately loaded with 100 cN after palatal insertion in 4 female german shepherd dogs. Xylene orange and calcein green were used for polychrome sequential labelling. Histological preparation utilized the cutting and grinding technique. Outcome variables were clinical implant success, histological osseointegration and bone-to-implant contact rates. Results All (8/8) implants were clinically …
Anxiety sensitivity as predictor of pain in patients undergoing restorative dental procedures
Abstract – Objectives: The personality disposition to anxiety sensitivity refers to beliefs about negative consequences of bodily arousal. The concept has recently been successfully applied in research on chronic pain conditions. The present study investigated whether anxiety sensitivity interacts with dental fear to increase expected and experienced pain during routine dental treatment. Methods: Subjects were 97 patients undergoing dental procedures of excavation and filling. Anxiety dispositions were measured by the Anxiety Sensitivity Index and the Dental Anxiety Scale. Expected and experienced pain were assessed by affective and sensory verbal descriptor scales and a numerical rating…
Molar distalization with pendulum appliances in the mixed dentition: effects on the position of unerupted canines and premolars.
Introduction: The pendulum appliance allows for rapid molar distalization without the need for patient compliance. Its efficiency has been confirmed in a number of clinical studies. However, the potential interactions and positional changes between the deciduous molars used for dental anchorage and the erupted and unerupted permanent teeth have yet to be clarified when this appliance is used for molar distalization in the mixed dentition. Methods: Twenty-nine patients in the mixed dentition each received a modified pendulum appliance with a distal screw and a preactivated pendulum spring for bilateral distalization of the maxillary molars. The patients were divided into 4 groups based on de…
Osseointegration of miniscrews: a histomorphometric evaluation.
SUMMARY Mini-implants and miniscrews are commonly used in orthodontics to provide additional temporary intraoral anchorage. Partial osseointegration represents a distinct advantage in orthodontic applications, allowing effective anchorage to be combined with easy insertion and removal. This article reports the histomorphometric fi ndings of the osseointegration of bracket screw bone anchors (BSBAs). In an experimental animal study, four BSBAs were inserted in the alveolar process of the lower jaw in each of fi ve male beagle dogs, aged 6.5 months from the same mother. Eleven screws were lost during the study, nine of them due to lack of primary stability. One screw was removed at the end of…