In-vitro assessment of the forces generated by lingual fixed retainers

The aim of this article was to assess the effect of wire adaptation on the lingual surfaces of mandibular anterior teeth with 3 types of lingual retainers on the development of vertical and labiolingual forces.

Long-term effectiveness of canine-to-canine bonded flexible spiral wire lingual retainers

The flexible spiral wire (FSW) canine-to-canine lingual retainer bonded to all 6 anterior teeth is a frequently used type of mandibular fixed retainer. This study aimed to assess the long-term effectiveness of FSW canine-to-canine lingual retainers in maintaining the alignment of the mandibular anterior teeth after orthodontic treatment.

Release of bisphenol-A from a light-cured adhesive bonded to lingual fixed retainers

Our aim was to quantitatively determine the bisphenol-A (BPA) released from a light-cured orthodontic adhesive used to bond lingual fixed retainers.

Evaluation of location and dimensions of lingual foramina using limited cone-beam computed tomography

To assess retrospectively the frequency and location of mandibular lingual foramina and their bony canals with limited cone-beam computed tomography.

Assessment of speech perception and communication skills in adolescents with cochlear implants for pre- and peri-lingual deafness

This study aimed to assess speech perception and communication skills in adolescents between ages 8 and 18 that received cochlear implants for pre- and peri-lingual deafness.

Severe complication of a bonded mandibular lingual retainer

Bonding a flexible spiral wire retainer to the lingual surfaces of all 6 anterior mandibular teeth is a commonly used type of retention. Complications are rare but can be serious enough to produce biologic damage. This article presents a serious complication of a lingual flexible spiral wire retainer. Four years after the orthodontic treatment, a 20-year-old man sought treatment for a broken flexible spiral wire retainer. The clinical examination showed about 35° of buccal root torque of that tooth. A cone-beam computed tomography image showed that the root and the apex of the tooth were almost completely out of the bone on its buccal side. Surprisingly, the tooth's vitality was preserved. The tooth was moved back, nearly to its original position; clinically, only a gingival recession remained. Orthodontists and dentists should be aware of possible complications of bonded retainers. Patients should be clearly informed how to detect problems at an early stage.

Survival of bonded lingual retainers with chemical or photo polymerization over a 2-year period: a single-center, randomized controlled clinical trial

INTRODUCTION The objective of this trial was to compare the survival rates of mandibular lingual retainers bonded with either chemically cured or light-cured adhesive after orthodontic treatment. METHODS Patients having undergone orthodontic treatment at a private orthodontic office were randomly allocated to fixed retainers placed with chemically cured composite or light-cured composite. Eligibility criteria included no active caries, restorations, or fractures on the mandibular anterior teeth, and adequate oral hygiene. The main outcome was any type of first-time lingual retainer breakage; pattern of failure (adapted adhesive remnant index scores) was a secondary outcome. Randomization was accomplished with random permuted blocks of 20 patients with allocation concealed in sequentially numbered, opaque, sealed envelopes. Blinding was applicable for outcome assessment only. Patients were reviewed at 1, 3, and 6 months and then every 6 months after placement of the retainer until completion of the study. Data were analyzed using survival analysis including Cox regression; sensitivity analysis was carried out after data imputation for subjects lost to follow-up. RESULTS Two hundred twenty patients (median age, 16 years; interquartile range, 2; range, 12-47 years) were randomized in a 1:1 ratio to either chemical or light curing. Baseline characteristics were similar between groups, the median follow-up period was 2.19 years (range, 0.003-3.64 years), and 16 patients were lost to follow-up. At a minimum follow-up of 2 years, 47 of 110 (42.7%) and 55 of 110 (50.0%) retainers had some type of failure with chemically cured and light-cured adhesive, respectively (log-rank test, P = 0.35). Data were analyzed on an intention-to-treat basis, and the hazard ratio (HR) was 1.15 (95% confidence interval [CI], 0.88-1.70; P = 0.47). There was weak evidence that age is a significant predictor for lingual retainer failures (HR, 0.96; 95% CI, 0.93-1.00; P = 0.08). Adhesive remnant index scoring was possible for only 66 of the 102 (64.7%) failures and did not differ between composites (Fisher exact test, P = 0.16). No serious harm was observed other than gingivitis associated with plaque accumulation. CONCLUSIONS The results of this study indicated no evidence that survival of mandibular lingual retainers differs between chemically and light-cured adhesives. The overall failure rate was 46.4%; however, this included any type of failure, which may have exaggerated the overall failure rate.

Facts and myths regarding the maxillary midline frenum and its treatment: a systematic review of the literature

OBJECTIVE To systematically review the current literature on the maxillary midline frenum and associated conditions and complications, as well as the recommended treatment options. METHOD AND MATERIALS A detailed MEDLINE database search was carried out to provide evidence about the epidemiology, associated pathologies, and treatment options regarding the maxillary frenum. Of the 206 initially identified articles, 48 met the inclusion criteria. RESULTS The maxillary frenum is highly associated with a number of syndromes and developmental abnormalities. A hypertrophic frenum may be involved in the etiology of the midline diastema. There is also a tendency by orthodontists to suggest posttreatment removal of the frenum (frenectomy). Studies on the cause of gingival recession due to the maxillary frenum are inconclusive. An injured frenum in combination with other traumas and doubtful history might point to child abuse. The involvement of hyperplastic frena in the pathogenesis of peri-implant diseases remains uncertain. There seems to be a clinical interest regarding lasers for surgery for treatment of maxillary frena. The superiority of laser treatment in relation to conventional surgical methods has not yet been demonstrated in the literature. CONCLUSION A maxillary frenum is a clinical symptom in numerous syndromic conditions and plays a role in the development of the median midline diastema. Nevertheless, the contribution to gingival recession and peri-implant diseases in the region of the maxillary incisors is rather controversial. Laser techniques are reported as the method of choice for the surgical removal of frena; however, this needs to be substantiated by appropriate prospective controlled studies.

A comparative assessment of torque generated by lingual and conventional brackets

The aim of this study was to assess the effect of bracket type on the labiopalatal moments generated by lingual and conventional brackets. Incognito™ lingual brackets (3M Unitek), STb™ lingual brackets (Light Lingual System; ORMCO), In-Ovation L lingual brackets (DENTSPLY GAC), and conventional 0.018 inch slot brackets (Gemini; 3M Unitek) were bonded on identical maxillary acrylic resin models with levelled and aligned teeth. Each model was mounted on the orthodontic measurement and simulation system and 10 0.0175 × 0.0175 TMA wires were used for each bracket type. The wire was ligated with elastomerics into the Incognito, STb, and conventional brackets and each measurement was repeated once after religation. A 15 degrees buccal root torque (+15 degrees) and then a 15 degrees palatal root torque (-15 degrees) were gradually applied to the right central incisor bracket. After each activation, the bracket returned to its initial position and the moments in the sagittal plane were recorded during these rotations of the bracket. One-way analysis of variance with post hoc multiple comparisons (Tukey test at 0.05 error rate) was conducted to assess the effect on bracket type on the generated moments. The magnitude of maximum moment at +15 degrees ranged 8.8, 8.2, 7.1, and 5.8 Nmm for the Incognito, STb, conventional Gemini, and the In-Ovation L brackets, respectively; similar values were recorded at -15 degrees: 8.6, 8.1, 7.0, and 5.7 Nmm, respectively. The recorded differences of maximum moments were statistically significant, except between the Incognito and STb brackets. Additionally, the torque angles were evaluated at which the crown torque fell well below the minimum levels of 5.0 Nmm, as well as the moment/torque ratio at the last part of the activation/deactivation curve, between 10 and 15 degrees. The lowest torque expression was observed at the self-ligating lingual brackets, followed by the conventional brackets. The Incognito and STb lingual brackets generated the highest moments.

A comparative assessment of forces and moments generated by lingual and conventional brackets

The aim of this study was to assess the effect of bracket type on the labiopalatal forces and moments generated in the sagittal plane. Incognito™ lingual brackets (3M Unitek), STb™ lingual brackets (Light Lingual System; ORMCO), and conventional 0.018 inch slot brackets (Gemini; 3M Unitek) were bonded on three identical maxillary acrylic resin models, with a palatally displaced right lateral incisor. The transfer trays for the indirect bonding of the lingual brackets were constructed in certified laboratories. Each model was mounted on the orthodontic measurement and simulation system and ten 0.013 inch CuNiTi wires were used for each bracket type. The wire was ligated with elastomerics and each measurement was repeated once after re-ligation. The labiopalatal forces and the moments in the sagittal plane were recorded on the right lateral incisor. One-way analysis of variance and post hoc Scheffe pairwise comparisons were used to assess the effect on bracket type on the generated forces and moments. The magnitude of forces ranged from 1.62, 1.27, and 1.81 N for the STb, conventional, and Incognito brackets, respectively; the corresponding moments were 2.01, 1.45, and 2.19 N mm, respectively. Bracket type was a significant predictor of the generated forces (P < 0.001) and moments (P < 0.001). The produced forces were different among all three bracket types, whereas the generated moments differed between conventional and lingual brackets but not between lingual brackets.

Prevalence of tooth wear on buccal and lingual surfaces and possible risk factors in young European adults

To assess the prevalence of tooth wear on buccal/facial and lingual/palatal tooth surfaces and identify related risk factors in a sample of young European adults, aged 18-35 years. Calibrated and trained examiners measured tooth wear, using the basic erosive wear examination (BEWE) on in 3187 patients in seven European countries and assessed the impact of risk factors with a previously validated questionnaire. Each individual was characterized by the highest BEWE score recorded for any scoreable surface. Bivariate analyses examined the proportion of participants who scored 2 or 3 in relation to a range of demographic, dietary and oral care variables. The highest tooth wear BEWE score was 0 for 1368 patients (42.9%), 1 for 883 (27.7%), 2 for 831 (26.1%) and 3 for 105 (3.3%). There were large differences between different countries with the highest levels of tooth wear observed in the UK. Important risk factors for tooth wear included heartburn or acid reflux, repeated vomiting, residence in rural areas, electric tooth brushing and snoring. We found no evidence that waiting after breakfast before tooth brushing has any effect on the degree of tooth wear (p=0.088). Fresh fruit and juice intake was positively associated with tooth wear. In this adult sample 29% had signs of tooth wear making it a common presenting feature in European adults.

Microstructural and mechanical characterization of contemporary lingual orthodontic brackets.

OBJECTIVES To investigate the composition and the microstructural and mechanical characterization of three different types of lingual brackets. MATERIALS AND METHODS Incognito™ (3M Unitek), In-Ovation L (DENTSPLY GAC) and STb™ (Light Lingual System, ORMCO) lingual brackets were studied under the scanning electron microscope employing backscattered electron imaging and their elemental composition was analysed by energy-dispersive X-ray microanalysis. Additionally, Vickers hardness was assessed using a universal hardness-testing machine, and the indentation modulus was measured according to instrumented indentation test. Two-way analysis of variance was conducted employing bracket type and location (base and wing) as discriminating variable. Significant differences among groups were allocated by post hoc Student-Newman-Keuls multiple comparison analysis at 95% level of significance. RESULTS Three different phases were identified for Incognito and In-Ovation L bracket based on mean atomic number contrast. On the contrary, STb did not show mean atomic contrast areas and thus it is recognized as a single phase. Incognito is a one-piece bracket with the same structure in wing and base regions. Incognito consists mainly of noble metals while In-Ovation L and STb show similar formulations of ferrous alloys in wing and base regions. No significant differences were found between ferrous brackets in hardness and modulus values, but there were significant differences between wing and base regions. Incognito illustrated intermediate values with significant differences from base and wing values of ferrous brackets. CONCLUSIONS/IMPLICATIONS Significant differences exist in microstructure, elemental composition, and mechanical properties among the brackets tested; these might have a series of clinical implications during mechanotherapy.

Gray matter volume differences specific to formal thought disorder in schizophrenia

Formal thought disorder (FTD) is one of the main symptoms of schizophrenia. To date there are no whole brain volumetric studies investigating gray matter (GM) differences specifically associated with FTD. Here, we studied 20 right-handed schizophrenia patients that differed in the severity of formal thought disorder and 20 matched healthy controls, using voxel-based morphometry (VBM). The severity of FTD was measured with the Scale for the Assessment of Thought, Language, and Communication. The severity was negatively correlated with the GM volume of the left superior temporal sulcus, the left temporal pole, the right middle orbital gyrus and the right cuneus/lingual gyrus. Structural abnormalities specific for FTD were found to be unrelated to GM differences associated with schizophrenia in general. The specific GM abnormalities within the left temporal lobe may help to explain language disturbances included in FTD.

Optimal sites for orthodontic mini-implant placement assessed by cone beam computed tomography

OBJECTIVES: To determine (1) the optimal sites for mini-implant placement in the maxilla and the mandible based on dimensional mapping of the interradicular spaces and cortical bone thickness and (2) The effect of age and sex on the studied anatomic measurements. MATERIAL AND METHODS: The cone beam computed tomography images of 100 patients (46 males, 54 females) divided into two age groups (13-18 years), and (19-27 years) were used. The following interradicular measurements were performed: (1) Buccolingual bone thickness; (2) Mesiodistal spaces both buccally and palatally/lingually; and (3) Buccal and palatal/lingual cortical thicknesses. RESULTS: In the maxilla, the highest buccolingual thickness existed between first and second molars; the highest mesiodistal buccal/palatal distances were between the second premolar and the first molar. The highest buccal cortical thickness was between the first and second premolars. The highest palatal cortical thickness was between central and lateral incisors. In the mandible, the highest buccolingual and buccal cortical thicknesses were between the first and second molars. The highest mesiodistal buccal distance was between the second premolar and the first molar. The highest mesiodistal lingual distance was between the first and second premolars. The highest lingual cortical thickness was between the canine and the first premolar. The males and the older age group had significantly higher buccolingual, buccal, and palatal cortical thicknesses at specific sites and levels in the maxilla and the mandible. CONCLUSIONS: A clinical guideline for optimal sites for mini-implant placement is suggested. Sex and age affected the anatomic measurements in certain areas in the maxilla and the mandible.

Design of removable partial dentures: a survey of dental laboratories in Greece

The aim of this study was to compare data on design and fabrication methods of removable partial dentures (RPDs) in two major cities in Greece. A questionnaire was sent to 150 randomly selected dental technicians. The participation rate was 79.3%. The anterior palatal strap, the lingual bar, and the Roach-type clasp arm designs were preferred. Half of the RPDs fabricated were retained using precision attachments. Differences between the two cities were observed in types of major maxillary connectors used, types of attachments and impression materials used, as well as the design of distal-extension RPDs. Postdoctoral education was found to have an impact on RPD fabrication. Despite the differences observed, design and fabrication of RPDs followed commonly used principles.