Multivariate analysis of oral mucosal ulcers during orthodontic treatment

BACKGROUND Orthodontic treatment can easily cause local soft tissue reactions in the oral cavity of patients under mechanical stress,leading to oral mucosal ulcers and affecting their quality of life.At present,only limited literature has explored the factors leading to oral ulcers in orthodontic treatment,and these research results are still controversial.AIM To investigate the current status and related factors of oral mucosal ulcers during orthodontic treatment,aiming to provide a valuable reference for preventing this disease in clinical practice.METHODS A total of 587 patients who underwent orthodontic treatment at the Peking University School of Stomatology and Hospital of Stomatology between 2020 and 2022 were selected and allocated to an observation or control group according to the incidence of oral mucosal ulcers during orthodontic therapy.A questionnaire survey was constructed to collect patient data,including basic information,lifestyle and eating habits,treatment details,mental factors,and trace element levels,and a comparative analysis of this data was performed between the two groups.RESULTS A logistic regression model with oral ulcers as the dependent variable was established.The regression results showed that age(≥60 years:odds ratio[OR]:6.820;95%confidence interval[CI]:2.226–20.893),smoking history(smoking:OR:4.434;95%CI:2.527–7.782),toothbrush hardness(hard:OR:2.804;95%CI:1.746–4.505),dietary temperature(hot diet:OR:1.399;95%CI:1.220–1.722),treatment course(>1 year:OR:3.830;95%CI:2.203–6.659),and tooth brushing frequency(>1 time per day:OR:0.228;95%CI:0.138–0.377)were independent factors for oral mucosal ulcers(P<0.05).Furthermore,Zn level(OR:0.945;95%CI:0.927–0.964)was a protective factor against oral ulcers,while the SAS(OR:1.284;95%CI:1.197–1.378)and SDS(OR:1.322;95%CI:1.231–1.419)scores were risk factors.CONCLUSION Age≥60 years,smoking history,hard toothbrush,hot diet,treatment course for>1 year,tooth brushing frequency of≤1 time per day,and mental anxiety are independent risk factors for oral mucosal ulcers.Therefore,these factors should receive clinical attention and be incorporated into the development and optimization of preventive strategies for reducing oral ulcer incidence.

Addressing mucosal ulcers during orthodontic treatment:An urgent call for preventive strategies

Mucosal ulcers are a common yet often overlooked complication during orthodontic treatment,significantly impacting patient comfort and compliance.This letter aims to highlight the prevalence,potential causes,and management strategies for mucosal ulcers in orthodontic patients.By reviewing recent literature and clinical observations,we underscore the necessity for proactive measures and tailored interventions to mitigate the incidence and severity of these lesions.Emphasizing the role of patient education and the use of protective devices,we call for a multidisciplinary approach to enhance patient care and treatment outcomes.This discussion is particularly relevant in the context of evolving orthodontic techniques and materials,which necessitate continuous adaptation of clinical practices to ensure patient safety and well-being.

Challenges and Motivating Factors of Orthodontic Treatment among Patients Attending Komfo Anokye Teaching Hospital

Background: Orthodontic treatment poses challenges such as discomfort, aesthetic concerns, dietary restrictions, time commitment, and financial considerations for patients. These challenges can deter individuals from pursuing treatment or cause anxiety during the process. However, patients are motivated by the desire to improve their appearance, boost self-confidence, and enhance oral health. They also value the long-term benefits of treatment, including improved dental function and overall well-being. Professional recommendations from dentists and orthodontists, along with social support from family and friends, further encourage patients to undergo treatment. Understanding these challenges and motivating factors is crucial for orthodontic professionals to tailor treatment plans and ensure positive experiences and successful outcomes for their patients. Objective: To determine the challenges and motivating factors of orthodontic treatment among patients attending Komfo Anokye Teaching Hospital. Method: The study was conducted at Komfo Anokye Teaching Hospital in Kumasi, Ghana, with a sample size of 60 orthodontic patients. Data was collected using self-administered questionnaires and analyzed using SPSS software. Ethical approval was obtained, and the findings were shared with stakeholders. Results: Findings showed a higher representation of females (63.3%) seeking orthodontic treatment. Common motivations for seeking orthodontic treatment included aesthetic Concerns (38.2%), misaligned teeth (28.1%) and recommendation from dentist (19.2%). Challenges reported included pain and discomfort (36.7%), difficulty chewing (15%), expensive treatment (14.4%) and missed appointments (11.7%). Factors motivating treatment continuation were visible improvements (30%), achieving optimal results (23%), reducing pain and discomfort (17%). External influences, such as family pressure, also played a role. Patients appreciated the support of healthcare providers during treatment but suggested better pain management and education. Conclusion: The study provided valuable insights into patient motivations, challenges and factors influencing satisfaction and adherence to orthodontic treatment at KATH.

Comparison of Self-Perception of Esthetics and Orthodontic Treatment Needs among Dental and Non-Dental Students with Assessment by Orthodontist

Objectives: The present study was conducted to compare the self-perception of esthetics and wish for seeking orthodontic treatment among dental and non-dental students. The realistic orthodontic treatment needs were confirmed by expert orthodontist. Methods: A cross-sectional study was conducted among 255 male students (Dental—75, Medical—93 and Pharmacy—87 students). The questionnaire included 20 items covering dental esthetics self-perception (10 questions), self-confidence and psychological impact (5 questions), and the need for seeking orthodontic treatment (5 questions) on a five-point Likert scale. The realistic orthodontic treatment needs were confirmed by photographs using aesthetic component of IOTN and clinical examination for the participants and analysis of jaw models using Dental aesthetic index (DAI). Kruskal-Wallis ANOVA was used to check the significant difference between groups. Results: The overall average esthetic self-perception score for total sample was 3.83. The overall average psychological impact score for the whole sample was 2.67. The total percentage of participants who either agree or strongly agree with the question related to their perception of need for seeking orthodontic treatment was 70%. According to the assessment of orthodontic needs using AC-IOTN, 19.8% required definitive treatment. According to the assessment of orthodontic treatment needs based on DAI, 20.3% and 9.9% needed highly desirable (DAI 31 - 35) and definite need of treatment (DAI ≥ 36) respectively. Conclusion: It can be concluded that there was no difference between the esthetic perception of dental and non-dental students. The self-perception for seeking orthodontic treatment was over-reported by participants compared to real requirement as assessed by orthodontic specialist. Dental esthetics has no psychological impact on academic performance and self-confidence as perceived by study participants.

Oral Hygiene in the Presence of Orthodontic Therapy

Orthodontic treatment offers great advantages in improving facial and smile aesthetics, self-confidence and the function of the stomatognathic apparatus. The pursuit of these advantages makes use of orthodontic appliances that could be fixed or removable. However, it’s worth stating that these appliances interfere with tooth brushing, making it more difficult to brush teeth effectively. Orthodontics appliances therefore promote the accumulation of dental plaque, which results in both quantitative and qualitative changes in the oral microbiota, hence, exposing patients to several adverse effects such as White spot lesions, dental caries, periodontal pathologies and halitosis. For this reason, oral assessment of patients before, during and after treatment is necessary as well as oral hygiene instructions and motivation. Orthodontists therefore, should educate patients on oral and periodontal hygiene in order to control dental and periodontal complications. Prescriptions of plaque control materials adapted to each patient are done in order to optimize the final result and minimize unwanted complications.

Effect of low-level laser therapy on tooth-related pain and somatosensory function evoked by orthodontic treatment

Low-level laser therapy(LLLT) may have an effect on the pain associated with orthodontic treatment. The aim of this study was to evaluate the effect of LLLT on pain and somatosensory sensitization induced by orthodontic treatment. Forty individuals(12–33 years old; mean ± standard deviations: 20.8 ± 5.9 years) scheduled to receive orthodontic treatment were randomly divided into a laser group(LG) or a placebo group(PG)(1:1). The LG received LLLT(810-nm gallium-aluminium-arsenic diode laser in continuous mode with the power set at 400 mW, 2 J·cm–2) at 0 h, 2 h, 24 h, 4 d, and 7 d after treatment, and the PG received inactive treatment at the same time points. In both groups, the non-treated side served as a control. A numerical rating scale(NRS) of pain, pressure pain thresholds(PPTs), cold detection thresholds(CDTs), warmth detection thresholds(WDTs), cold pain thresholds(CPTs), and heat pain thresholds(HPTs) were tested on both sides at the gingiva and canine tooth and on the hand. The data were analysed by a repeated measures analysis of variance(ANOVA). The NRS pain scores were significantly lower in the LG group(P = 0.01). The CDTs,CPTs, WDTs, HPTs, and PPTs at the gingiva and the PPTs at the canine tooth were significantly less sensitive on the treatment side of the LG compared with that of the PG(P < 0.033). The parameters tested also showed significantly less sensitivity on the nontreatment side of the LG compared to that of the PG(P < 0.043). There were no differences between the groups for any quantitative sensory testing(QST) measures of the hand. The application of LLLT appears to reduce the pain and sensitivity of the tooth and gingiva associated with orthodontic treatment and may have contralateral effects within the trigeminal system but no generalized QST effects. Thus, the present study indicated a significant analgesia effect of LLLT application during orthodontic treatment.Further clinical applications are suggested.

Reliability assessment and correlation analysis of evaluating orthodontic treatment outcome in Chinese patients

This study aimed to assess the reliability of experienced Chinese orthodontists in evaluating treatment outcome and to determine the correlations between three diagnostic information sources. Sixty-nine experienced Chinese orthodontic specialists each evaluated the outcome of orthodontic treatment of 108 Chinese patients. Three different information sources： study casts （SC）, lateral cephalometric X-ray images （LX） and facial photographs （PH） were generated at the end of treatment for 108 patients selected randomly from six orthodontic treatment centers throughout China. Six different assessments of treatment outcome were made by each orthodontist using data from the three information sources separately and in combination. Each assessment included both ranking and grading for each patient. The rankings of each of the 69 judges for the 108 patients were correlated with the rankings of each of the other judges yielding 13 873 Spearman rs values, ranging from -0.08 to ＋0.85. Of these, 90% were greater than 0.4, showing moderate-to-high consistency among the 69 orthodontists. In the combined evaluations, study casts were the most significant predictive component （R2=0.86, P〈0.000 1）, while the inclusion of lateral cephalometric films and facial photographs also contributed to a more comprehensive assessment （R2=0.96, P〈0.000 1）. Grading scores for SC＋LX and SC＋PH were highly significantly correlated with those for SC＋LX＋PH （r（SC＋LX）vs.（SC＋LX＋PH）=0.96, r（SC＋PH）vs.（SC＋LX＋PH）=0.97）, showing that either SC＋LX or SC＋PH is an excellent substitute for all three combined assessment,

Factors Influencing Subjective Orthodontic Treatment Need and Culture-related Differences among Chinese Natives and Foreign Inhabitants

Aim The aim of this survey was to compare Chinese natives and foreign inhabitants in Chengdu, China, with respect to： （1） attitudes towards dental appearance, （2） subjective orthodontic treatment need, and （3） the main factors influencing orthodontic treatment need. Methodology A total of 522 subjects, including 227 foreign inhabitants and 295 Chinese natives in Chengdu participated in the survey. A simple random sampling method was adopted and a face-to-face interview was conducted at some public sites using a questionnaire. Data was entered by two persons synchronously using Epidata 3.0, and SPSS 13.0 was used to analyze these data. Results 89.0% of foreign inhabitants were satisfied with their teeth compared to only 46.8% of Chinese natives. Females were more dissatisfied with their teeth than males. Chinese natives put improving appearance as the top priority （55.9%） for seeking orthodontic treatment; however, in foreign inhabitants, the main reason for seeking treatment was to improve masticatory function（44.1%）, followed by ＂to be pretty＂ （35.2%）. The importance of well-aligned teeth and self-perception of psychosocial impact of malocclusion were the same two main factors influencing subjective orthodontic treatment need （P〈0.05） in foreign inhabitants and Chinese natives. Sub- jective orthodontic treatment need between the two target groups was significantly different （P〈0.05）. Conclusion （1） It was very common that Chinese natives were dissatisfied with their dental appearance, and their subjective orthodontic treatment needs were high. （2） There were some differences in orthodontic treatment motives between the two target groups. （3） There were differences in subjective orthodontic treatment needs between foreign inhabitants and Chinese natives. However, the prominent influential factors were almost the same. There may be benefit to understanding subjective orthodontic needs of different races.

Orthodontic simulation system with force feedback for training complete bracket placement procedures

Background A virtual system that simulates the complete process of orthodontic bracket placement can be used for pre-clinical skill training to help students gain confidence by performing the required tasks on a virtual patient.Methods The hardware for the virtual simulation system is built using two force feedback devices to support bi-manual force feedback operation.A 3D mouse is used to adjust the position of the virtual patient.A multi-threaded computational methodology is adopted to satisfy the requirements of the frame rate.The computation threads mainly consist of the haptic thread running at a frequency of>1000Hz and the graphic thread at>30Hz.The graphic thread allows the graphics engine to effectively display the visual effects of biofilm removal and acid erosion through texture mapping.Using the haptic thread,the physics engine adopts the hierarchy octree collision-detection algorithm to simulate the multi-point and multi-region interaction between the tools and the virtual environment.Its high efficiency guarantees that the time cost can be controlled within 1 ms.The physics engine also performs collision detection between the tools and particles,making it possible to simulate paint and removal of colloids.The surface-contact constraints are defined in the system;this ensures that the bracket will not divorce from or embed into the tooth during the adjustment of the bracket.Therefore,the simulated adjustment is more realistic and natural.Results A virtual system to simulate the complete process of orthodontic bracket bonding was developed.In addition to bracket bonding and adjustment,the system simulates the necessary auxiliary steps such as smearing,acid etching,and washing.Furthermore,the system supports personalized case training.Conclusions The system provides a new method for students to practice orthodontic skills.

Modified orthodontic treatment of substitution of canines by first premolars:A case report

BACKGROUND Canines are the most important teeth in the dentition.Usually,doctors choose to remove premolars rather than canines.Canine extraction is extremely rare in orthodontic treatment.However,dentists sometimes encounter situations in which canines require extraction due to defects caused by improper medical treatment.CASE SUMMARY The present study reports a case of a class II adult patient treated with the extraction of maxillary canines and right mandibular second premolar.After postactive treatment for 28 mo,then the canines were substituted by the upper first premolar,a satisfactory occlusal was established,the lips were competent,and the profile was improved.Intraoral pictures and X-ray data retrieved 3 years after the end of orthodontic treatment demonstrated the possibility of canine extraction and premolar substitution of canines in function and beauty.CONCLUSION The extraction of canines and substitution by first premolars could be a feasible orthodontic treatment.

Evaluation of the Influence of Fixed Orthodontic Treatment Duration on the Severity of Inflammatory Gingival Enlargement (Fixed Orthodontic Induced Gingival Enlargements) and Some Properties of Saliva

Background: Inflammatory gingival enlargement is a more common clinical feature with orthodontic therapy than other features. Therefore, this study was designed to the evaluation of the influence of fixed orthodontic treatment duration on the severity of inflammatory gingival enlargement (fixed orthodontic induced gingival enlargements) and some properties of saliva. Material and Methods: The sample size comprised 145 patients undergoing fixed orthodontic treatment for at least 6 months aged 13 - 32 years. They were divided according to orthodontic treatment duration into three groups. Group I (n = 47) included the patients who were treated for less than 6 months, group II (n = 51) included the patients who were treated for a period of 6 - 12 months, and group III (n = 47) included the patients who were managed for more than 12 months. Data were obtained from the outpatient clinics, college of dentistry, King Khalid University, Abha, Saudi Arabia, and some dental centers in Sana’a city, the Republic of Yemen. This study was conducted from October 2021 G to January 2022 G. Clinical examination was done for plaque index (PLI), gingival index (GI), and gingival enlargement indexes (GEI). Saliva was collected in sterile test tubes then salivary flow and pH were measured. Statistical analysis was done with SPSS (version 23) and ANOVA test to evaluate the impact of orthodontic treatment duration on the severity of inflammatory gingival enlargement and some properties of saliva. Results: The statistical analysis demonstrated the highest mean plaque index (PLI) was among groups III and I participants whereas, the highest mean gingival index and mean gingival enlargement were among groups II and III participants. The present study revealed an increase in salivary flow with decreased salivary pH values with an increase in orthodontic therapy duration. There were statistically significant differences in clinical findings and salivary flow and pH values were observed in the comparison between groups I, II and III except PLI (p Conclusion: There was a higher inflammatory gingival enlargement associated with a higher plaque index in patients under orthodontic treatment for more than 12 months more than the patients for less than 6 months and the patients for a period of 6 - 12 months. There were correlations between an increase of salivary flow and pH values and an increase of other variables in this study, such as plaque index, gingival index, and gingival enlargement index with an increased orthodontic therapy duration.

Transforming Adolescent Smiles:Correcting Skeletal Mandibular Retrusion and Bimaxillary Protrusion with Clear Aligners

Maxillary protrusion combined with mandibular retraction is a highly prevalent but extremely complex maxillofacial deformity that can have a serious negative impact on patients’facial aesthetics and mental health.The traditional orthodontic treatment strategy often involves extracting 4 first premolars and conventional fixed techniques,combined with mini-implant screws,to retract the anterior teeth and improve facial protrusion.In recent years,an invisible orthodontic technique,without brackets,has become increasingly popular.However,while an invisible aligner has been used in some cases with reasonable results,there remain significant challenges in achieving a perfect outcome.This case report presents an adolescent patient with bimaxillary protrusion and mandibular retrognathia.Based on the characteristics of the invisible aligners and the growth characteristics of the adolescent’s teeth and jawbone,we designed precise three-dimensional tooth movement and corresponding resistance/over-correction for each tooth,while utilizing the patient’s jawbone growth potential to promote rapid development of the mandible,accurately and efficiently correcting bimaxillary protrusion and skeletal mandibular retrognathia.The patient’s facial aesthetics,especially the lateral morphology,have been greatly improved,and various aesthetic indicators have also shown significant changes,and to the patient’s great benefit,invasive mini-implant screws were not used during the treatment.This case highlights the advantages of using invisible aligners in adolescent maxillary protrusion combined with mandibular retraction patients.Furthermore,comprehensive and accurate design combined with good application of growth potential can also enable invisible orthodontic technology to achieve perfect treatment effects in tooth extractions,providing clinical guidance for orthodontists.

Generalized periodontitis treated with periodontal,orthodontic,and prosthodontic therapy:A case report

BACKGROUND Generalized periodontitis is a severe periodontal disease characterized by rapid periodontal destruction in healthy persons.This case report describes the treatment of a severe crowding,large overjet,and occlusal collapse due to the loss of anterior guidance with generalized periodontitis.CASE SUMMARY A 35-year-old female patient with a chief complaint of crowding and maxillary protrusion was diagnosed with generalized periodontitis by clinical and radiographic examinations.To improve crowding and overjet,orthodontic treatment was performed after basic periodontal therapy.Severely damaged upper right lateral incisor and left canine were extracted,and lower right first premolar and left second premolar were also removed to treat severe crowding.After orthodontic treatment,periodontal flap surgery for upper left molars and guided tissue regeneration for the lower left second molar was performed.Then,a dental implant was inserted in the upper left canine legion.The esthetics of the maxillary anterior tooth was improved by prosthetic restorations.The treatment result showed a well-improved occlusion with proper anterior guidance and healthy periodontal tissue after a retention period of 10 years.CONCLUSION Periodontal,orthodontic,and prosthodontic treatments are extremely useful to improve function and stable periodontal tissue for generalized periodontitis.

Photo activated disinfection efficiency of low-intensity laser and comprehensive prevention of caries and gingivitis in adolescents using bracket system

It is very important to study the problem of caries and gingivitis in adolescents who are beingtreated for orthodontic pathology with bracket systems.The method of combined treatmentwhich incorporates the use of medicine and laser therapy has been proved effective in cariesprevention.This research aims to study clinical aspects of the effectiveness of the combinedinfuence of the low-intensity laser"OPTODAN"with a wavelength of 0.85μm(Scientific De-velopment and Production Center*VEND",Saratov,Russia)in carries prevention.The researchalso aims to study the disinfection method of PAD with"FotoSan"("CMS Dental",Denmark,with a wavelength of 625-635 nm,where toluidine blue is used as photosensitizer molecules)combined with regular measure to prevent gingivitis in adolescents being treated for orthodonticpathology with bracket systems.This paper presents the results of 1.5 years of clinical study of 60i2-13-year-old children.They were examined before and after the orthodontic treatment:theirdecayed,missing,flle teeth(DMFT),decayed,missing,flle tooth surfaces(DMFS)index andhygiene status(OHI-S)were calculated,gum inflammations were detected.Before the ortho-dontic treatment,their mouths were sanitized.After orthodontic appliances were placed,thechildren were randomly divided into two groups of 30 each.Children of the first group,whilebeing treated with braces,took traditional preventative measures against gum inflammation andcaries:occupational hygiene,local antiseptics(0.05%chlorhexidine solution),the use of remi.neralizing and phosphorus containing applications four times a year.The children of the secondgroup,along with the traditional scheme of preventive measures,were treated with the devices"FotoSan"and*Optodan".Results of clinical examination of the second group have accuratelyproved decrease in the growth of dental caries intensity and surface caries intensity(ADMFT,ADMFS)and in gingivitis level at the end of the orthodontic treatment.So the results of ourclinical research have proved the efectivenesof laser therapy and comprehensive prevention ofcaries and gingivitis in adolescents using bracket system.

Insight into orthodontic appliance induced pain:Mechanism,duration and management

Most of the orthodontic patients experience pain during treatment and this significantly influences their attitudes and the approach towards treatment. A number of factors that influence pain response include age, gender, personal pain threshold, mood and stress level of the person, cultural differences and types of orthodontic treatment. Pain is a often overlooked subject by orthodontists, it is nevertheless important to understand the source and mechanism of the pain that occurs during treatment, as well as the methods for managing and controlling this pain. This review attempts to overview the mechanism, duration and current management strategies of orthodontic treatment.

Oral health-related quality of life between Chinese and American orthodontic patients: A two-center cross-sectional study

Background:Although oral health-related quality of life(OHRQoL)in orthodontic patients has been assessed in the past,to date,no study has compared the OHRQoL between two nations.We aimed to compare the OHRQoL between Chinese and American orthodontic patients.Methods:We conducted a two-center questionnaire-based cross-sectional study among patients who underwent orthodontic treatments at the Chinese PLA General Hospital(PLAGH)in Beijing,China and Massachusetts General Hospital(MGH)in Boston,Massachusetts,United States.Candidate variables included the participating center,patients’age,sex,Angle’s classification of malocclusion,evaluation stage,and appliances used.The primary outcome was patients’OHRQoL assessed with the Oral Health Impact Profile-14(OHIP-14).Descriptive statistics,stratification,and univariate and multivariate analyses were performed.Results:The average age was lower for PLAGH patients than for MGH patients(21.1±7.9 vs.33.1±14.6 years,P<0.001).The most common type of malocclusion was Angle’s Class III malocclusion at PLAGH(39%)and Class I malocclusion at MGH(59.5%).Clear aligners were used in 34.1%and 2.7%of the patients at MGH and PLAGH,respectively.OHIP-14 scores were lower for PLAGH patients than for MGH patients(18.4±4.7 vs.22.3±7.4,P<0.001),particularly in functional limitation,psychological discomfort/disability,and handicap.Univariate regression analysis demonstrated that participating center,age,Class I malocclusion,and the use of clear aligners were significantly associated with overall OHIP-14 scores.Multivariate regression analysis demonstrated that patients at PLAGH were associated with lower OHIP-14 scores(coefficient:-3;95%CI:-5,-1.3;P=0.001),and age was positively associated with OHIP-14 scores(coefficient:0.1;95%CI:0.004,0.13;P=0.038).Conclusion:Chinese orthodontic patients had lower OHIP-14 scores,indicating a higher OHRQoL than American patients.In addition to the younger age,this difference may be attributed to the different ethical,cultural,educational,and socioeconomic background of Chinese and American orthodontic patients.

Development and accuracy of artificial intelligence-generated prediction of facial changes in orthodontic treatment:a scoping review

Artificial intelligence(AI)has been utilized in soft-tissue analysis and prediction in orthodontic treatment planning,although its reliability has not been systematically assessed.This scoping review was conducted to outline the development of AI in terms of predicting soft-tissue changes after orthodontic treatment,as well as to comprehensively evaluate its prediction accuracy.Six electronic databases(PubMed,EBSCOhost,Web of Science,Embase,Cochrane Library,and Scopus)were searched up to March 14,2023.Clinical studies investigating the performance of AI-based systems in predicting post-orthodontic soft-tissue alterations were included.The Quality Assessment of Diagnostic Accuracy Studies-2(QUADAS-2)and Joanna Briggs Institute(JBI)appraisal checklist for diagnostic test accuracy studies were applied to assess risk of bias,while the Grading of Recommendation,Assessment,Development,and Evaluation(GRADE)assessment was conducted to evaluate the certainty of outcomes.After screening 2500 studies,four non-randomized clinical trials were finally included for full-text evaluation.We found a low level of evidence indicating an estimated high overall accuracy of AI-generated prediction,whereas the lower lip and chin seemed to be the least predictable regions.Furthermore,the facial morphology simulated by AI via the fusion of multimodality images was considered to be reasonably true.Since all of the included studies that were not randomized clinical trials(non-RCTs)showed a moderate to high risk of bias,more well-designed clinical trials with sufficient sample size are needed in future work.

Tough adhesion and antifouling poly(vinyl alcohol)hydrogel coating on the arch wire for antibacterial adhesion

The arch wire(AW)plays an important role in providing continuous force,aligning the teeth,and excellent dental arch stability for orthodontic treatment.However,the high friction performance of the AW surface can increase bacterial adhesion and colonization,leading to oral hygiene problems.Herein,a simple method is developed to modify the surface of the orthodontic wire with a poly(vinyl alcohol)(PVA)hydrogel coating,which can improve the lubricity and antibacterial adhesion of the AW and prevent the oral hygiene problems caused by itself.The PVA hydrogel coating can toughly adhere to the surface of the AW and remarkably reduce the friction performance of the AW,and then its friction coefficient in water can reach 0.005.Under the action of brushing and bending,the PVA hydrogel coating possesses superior ultralubrication and hardly affects the mechanical properties of the stainless-steel substrate.Moreover,the PVA hydrogel coating can significantly inhibit bacterial adhesion on the surface of the AW,thereby reducing bacterial colonization and maintaining oral hygiene while correcting the shape of the mouth and jaw.Therefore,the PVA hydrogel coating exhibits tough adhesion and good antibacterial adhesion while maintaining the mechanical properties of the AW,and it is a promising antifouling coating for improving the performance of the AW.

Perceived aesthetic impact of malocclusion in 16-24 year-old adults in the rural areas of India

Aim:The purpose of this study was to assess the self-perception of patients toward their dental appearance using the aesthetic component(AC)of index of orthodontic treatment need(IOTN)index and whether age and gender had any influence on it.Methods:A cross-sectional study was carried out to assess the perceived esthetic impact of malocclusion in 16–24 year-old subjects selected from the rural population of Faridabad,Haryana,India.The sample was divided into two groups,older adolescents and younger adults,and the AC of the IOTN index was applied.Results:The results showed that most subjects scored themselves as having an attractive dentition with no need for orthodontic treatment(60.91%).Gender-wise differences were not found to be statistically significant in relation to the perceived needs(P=0.095),whereas age-wise differences were found to be statistically significant in relation to the perceived needs(P<0.001).Conclusion:While the age seemed to have an impact on the perceived esthetic impact of malocclusion,the gender did not seemingly influence this self-perception.