Iranian Journal of Orthodontics
Volume:18 Issue: 1, Jun 2023

This study aimed to assess the frequency of using clear aligners by orthodontists and their perspective in this respect.

This descriptive-analytical study evaluated 86 orthodontists practicing in Iran in 2021. An online questionnaire was designed by an expert panel to collect information regarding the frequency of use of clear aligners (CA) by orthodontists, their satisfaction rate with this treatment approach, their perception of CA's advantages and disadvantages and the challenges they encountered while using CA. The results were analyzed by descriptive analysis methods and regression analysis.

Eighty-six orthodontists filled out the questionnaire. Less than one-third of participants reported using CA, and the majority of them reported using it for less than 10% of their patients. Of those not using CA, 75% were interested in using them. The mean satisfaction score with CA was 9.26 out of 20. The main reason for not using CA was difficult access to reputable companies and suboptimal quality of work of the available laboratories. The majority of orthodontists stated that CA could not be used for cases with impacted teeth, orthognathic surgery patients, and syndromic, cleft lip and palate patients. The main shortcoming of CA was perceived to be in the space closure phase, and their cost was 50-100% higher than regular orthodontic treatment. Older orthodontists were less interested in using CA while faculty members were more interested.

The frequency of use of clear aligners by Iranian orthodontists is low and their satisfaction rate with this approach is <50%.

The primer-containing composites, which eliminate the bonding step, decrease clinical time and securely attach the bracket to the tooth. Given the significant role of bonding in the bond strength of orthodontic adhesives, this study aims to investigate the effect of using a universal bond with two types of primer-containing composites on the bond strength of these composites.

Sixty healthy premolars were collected and divided into four equal groups: GC Ortho Connect composite, GC Ortho Connect composite with a universal bond, OrthoCem composite, and OrthoCem composite with a universal bond. The shear bond strength was measured using a universal testing machine, and the residual adhesive index was measured using a stereomicroscope at a 10x magnification.

The shear bond strengths of the GC Ortho Connect group without a universal bond, the GC Ortho Connect group with a universal bond, the OrthoCem group with a universal bond, and the OrthoCem group without a universal bond were calculated to be 21.54, 12.88, 12.37, and 11.68 MPa, respectively. The analysis of variance (ANOVA) showed that the GC Ortho Connect group without a universal bond had a significantly higher shear bond strength than the other groups. The results also indicated that the universal bond reduced the shear bond strength in the GC Ortho Connect composite (p-value <0.001) and had no significant effect on the shear bond strength of the OrthoCem composite (p-value=1.000).

While the application of a universal bond considerably diminishes the shear bond strength in the GC Ortho Connect composite, it does not exert a significant influence on the OrthoCem composite. This suggests that the effectiveness of a universal bond may be dependent on the specific composite used, necessitating further investigations into optimizing bonding methods for different composite materials in orthodontics.

We have reported a case of a 17-year-old patient with impaction of element 2.1 and severe incisors crowding and the treatment plan involved traction of the impacted teeth.

First, rapid maxillary expansion was performed. Then elements 1.4, 2.4, 3.4, and 4.4 were extracted to dissolve the crowding, and the fixed appliances were bonded. A NiTi coil spring was used to open the needed space for traction, and surgical exposure of the tooth for bonding a traction device was done. After the tooth erupted in the oral cavity, overlay mechanics was used to align and level it.

Despite being challenging, the conservative treatment resulted in satisfactory outcomes, and the objectives were achieved, restoring the patient's aesthetics and function.

After correct planning of the case, the impacted central incisor was pulled, restoring the patient's function and aesthetics, with good preservation of the supporting structures.

Considering that post-graduate residents are directly connected to the physical and mental health of diverse populations within society, evaluating and monitoring their mental health could improve the overall health level of societies. This study aimed to evaluate the mental health of post-graduate residents of the Mashhad Dental School in the academic year of 2019-2020.

This study was conducted as a descriptive-analytical investigation that involved distributing  SCL-90 questionnaires among post-graduate residents at the Mashhad University of Medical Sciences. The questionnaires were provided in both paper and online formats. The mental health state of each participant was assessed based on the scores they received in four categories: no mental disorder (0-0.99), mild mental disorder (1-1.99), moderate mental disorder (2-2.99), and severe mental disorder (3-3.99). The collected data was analyzed using the Mann-Whitney and Kruskal-Wallis tests with the aid of the software SPSS (version 20).

A total of 82 questionnaires were completed by the residents and analyzed. According to the total score, 29.3% (24 subjects) of the post-graduate residents reported having some degree of mental disorder: 28% (23 subjects) reported having a minor disorder, and 1.2% one subject) reported a moderate disorder, and no residents with serious disorders. The average score of mental disorder of the residents was 0.48±0.77. The SCL-90 dimension obsessive-compulsive was the highest at 48.8% and the dimension morbid fear was only 11%. In this study, no significant relationship was observed between any of the variables of marital status, major, or entry year with the total mental health score (P<0.05).

According to the results of the research, about one-third of the specialty residents of the Mashhad Dental School suffer from some kind of mental disorder.

Following maxillary impaction, the mandible rotates around a center. Inaccurate determination of mandibular rotation can have profound effects on orthognathic surgical treatment planning and final surgical outcome. The present study determined the relationship between the cephalometric characteristics of candidates for maxillary impaction surgery using sagittal and vertical locations of the center of rotation of the mandible.

In a descriptive and cross-sectional trial, 36 candidates for LeFort I maxillary impaction surgery were selected. Two lateral cephalograms were obtained in open and closed mouth positions. The center of rotation of the mandible was determined by the Reuleaux technique. Cephalometric measurements of the patients with the determined center of mandibular rotation locations (regions 1 and 4 of the coordinate axis) were done and the results were subjected to the student t-test.

The center of mandibular rotation was located in region 1 of the coordinate axis in 17 (50%) and in 17 (50%) in the 4th region of the coordinate axis. Statistically significant differences existed regarding the MP-SN (p<0.006), CO-GO (p<0.006), and CO-GN (p<0.04) at two regions of 1 and 4 for the center of rotation of the mandible in the coordinate axis.

With the decreased length of the ramus and increased inclination of the plane, the center of rotation of the mandible tended to be situated at region 1 of the coordinate axis, and together with the increased length of the ramus and decreased plane inclination, the center of mandibular rotation tended to be located at region 4 of the coordinate axis.

Traditional orthognathic surgery typically requires prolonged and extensive orthodontic treatment prior to surgery, followed by a shorter postoperative orthodontic phase. The pre-surgical orthodontic period is lengthy and can lead to a decline in facial aesthetics due to decompensation. Consequently, patients’ mental health could decline and they could lose confidence as a result of these changes. To address the issue of deteriorating facial soft tissues during early decompensation and to reduce the risk of unstable postoperative occlusion, the surgery-first approach (SFA) or minimal pre-surgical orthodontics (MPO) has been introduced. MPO is designed to minimize occlusal interference and enhance arch coordination for surgery, thereby increasing the predictability of surgical outcomes.

Case Description:

 An 18-year-old male patient with skeletal class III malocclusion and an anterior open bite was treated using MPO. A modified trans-palatal arch (TPA) was applied before surgery to rectify a projected post-surgical buccal scissor-bite involving the maxillary second molar. After achieving this correction, the patient underwent bi-jaw surgery.

This approach, in contrast to the conventional method, involved brief orthodontic tooth movement without negatively impacting the patient's profile or decompensation. The patient was highly satisfied and delighted with the outcome.

BDD is a psychiatric diagnosis in the spectrum of obsessive compulsive disorder wherein the patient has a damaging mental preoccupation with a slight deficiency in his physical appearance. Awareness of this disease and its symptoms is essential for proper diagnosis and management of the patient.

This cross-sectional study was performed on 86 patients who underwent orthognathic surgery. A demographic information questionnaire, Yale-Brown Obsessive Compulsive Scale modified for the BDD questionnaire, BDI-II questionnaire (Depression Scale) and Beck Anxiety Scale questionnaire were completed by patients to assess BDD disorder, depression, and anxiety. Data were described using appropriate statistical tables and graphs to express indicators and frequency distribution. Shapiro-Wilk, Mann-Whitney, Kruskal-Wallis, and Fisher tests were used to analyze the data.

This study was performed on 86 patients with a mean age of 23.19±4.5 years. The percentage of BDD in women (20%) was higher than in men (14%), but this difference was not statistically significant (p=0.685). The prevalence of depression was significantly higher (p<0.001) in patients with BDD (53%) than in those without this disorder (11%). The prevalence of anxiety was significantly higher (p<0.001) in patients with BDD (67%) than in those without this disorder (23%). With increasing age, the BDD scores decrease slightly, but this difference was not statistically significant (p=0.113).

The prevalence of BDD in the study population was 17.4%. The high prevalence of the disorder in orthognathic surgery patients compared to the general population requires the serious attention of dentists to this disorder.

The purpose of this questionnaire study was to determine what criteria lead potential orthodontic patients to choose a direct-to-consumer aligner company, orthodontist, or general dentist in north Gujarat, India.

A total of 100 potential orthodontic patients from the general population in north Gujarat participated in the study. Google Forms was used to send the questionnaire, and the data was recorded. Participants’ views on the type of provider they would prefer for their orthodontic treatment were tabulated. Data was entered in the software SPSS (v. 20.0) and statistical analysis was performed (p<0.05).

A total of 58 females and 42 males from the general population (100 potential orthodontic patients) in north Gujarat responded to the questionnaire. The participants (45%) held the opinion that a direct-to-consumer aligner company could offer better cost of treatment, 62% of participants preferred an orthodontist for better quality of treatment, 56% of participants preferred a direct-to-consumer aligner company because they felt that it would be more convenient, and 49% of participants preferred an orthodontist because they felt they would offer better follow-up after orthodontic treatment.

Participants tended to prefer orthodontists because they felt they would receive better quality of treatment and follow-up, and more treatment options such as aesthetic treatment. However, they preferred direct-to-consumer aligner companies because of their convenience, lower cost, shorter treatment duration, and better customer service. For their child's orthodontic care, parents typically choose an orthodontist.

Space closure after extraction of teeth is one of the most challenging steps in orthodontic treatments. Nickel-titanium close coil springs are used as a superior appliance in the said field for space closure, but high expenses associated with them have pushed dentists toward using elastomeric chains. This study was planned to compare nickel-titanium to one of the newest reinforced types of elastomeric chains – Super Slick.

This research was planned as a prospective analytical study with a split-mouth design, and was performed on 11 randomly selected participants referring to the specialty clinic of Guilan University of Medical Sciences. After leveling and alignment, patients were referred for simultaneous extraction of first premolars. For closing the space after extraction, randomly, the nickel-titanium close coil spring was assigned to one quadrant and the Super Slick elastomeric chain to the other. Patients were followed-up every month for three months, and in every session using a digital caliper the rate of space closure resulting from extraction of first premolars was measured from the distogingival wing of the canine bracket to the mesiogingival wing of the second premolar bracket. The monthly rate of space closure was calculated in millimeters, and the results regarding Super Slick Chains and nickel-titanium springs were compared and statistically analyzed using the t-test and nonparametric tests.

Based on the results of the t-test, the rate of the premolars extraction space closure in the first month, second month, and third month showed no significant differences between Super Slick elastomeric chains (1.82±0.27) and nickel-titanium close coil springs (1.90±0.4). Also, based on the said test, the general speed of space closure during the three months was not meaningfully different (p=0.489).

Considering that there was not a significant difference in the rate of space closure between elastomeric chains and nickel-titanium close coil springs during the three months of the study, it can be concluded that with time, the strength of the reinforced elastic chains for retraction of canine teeth is similar to that of the nickel-titanium springs. A look at the results shows that the claims of the manufacturers of reinforced elastic chains regarding force conservation are not very far from reality.

The present study was designed to investigate the degree of achievement of the educational goals of Mashhad Dental School's educational program from the perspective of basic sciences students in the academic year 2018-2019. By examining the current situation, it is possible to improve the educational quality of the program.

To measure the achievement of educational goals, a checklist and a questionnaire were prepared based on the educational headings in the dental education regulations approved by the Ministry of Health and Medical Education and approved by the school of Dentistry. After classification, the desired information was evaluated descriptively using SPSS-20 software and the chi-square statistical test.

Significant differences did not exist between the two sexes regarding the achieved goals, except for the dental material basics course. The achieved goals were not significantly different between the students with “A “average score and other students in any of the courses. Also, significant differences were not found in any courses in the realized goals between students with different interests in the field of dentistry.

Fulfillment of educational goals is lower in the less applicable courses for the field of dentistry in the basic sciences, which indicates the necessity of curriculum revision to achieve higher quality education.

The aim of this study was to assess the association between malocclusion, self-perception, self-esteem, and socio-demographic factors among primary schoolchildren in Dar es Salaam, Tanzania.

This was an analytical cross-sectional study that involved children aged 10-12 years from primary schools in Dar es Salaam. A questionnaire was used to obtain information about the participants’ socio-demographics, self-perception and self-esteem. Clinical examination was done to determine their occlusal statuses. Data were analyzed using SPSS software (version 22.0), and Chi-square test and logistic regression model were used to assess statistically significant differences between variables. P<0.05 was considered as significant.

A total of 620 schoolchildren participated in this study. The overall prevalence of malocclusion was 66.5%. Undesirable self-perception was reported in 34.0% and self-esteem issues in 30.0% of the schoolchildren. Significantly, many participants with less educated fathers had malocclusion compared with their counterparts (p=0.002). Furthermore, most children with malocclusion perceived themselves negatively and reported lower self-esteem compared with those who had no malocclusion (78.7% vs. 21.3%, p=0.000 and 75.8% vs. 24.2%, p=0.001, respectively). In the logistic regression model, the presence of malocclusion remained as a significant determinant of schoolchildren perceiving themselves negatively and reporting lower self-esteem (OR: 2.4, CI: 1.62-3.54, p= 0.000 and OR: 1.82, CI: 1.23-2.7, p= 0.003, respectively).

The presence of malocclusion was associated with children's negative self-perception and lower self-esteem. Malocclusion prevention and early interventions in children are highly recommended.

The aim of this study was to determine the level of awareness and knowledge of family physicians regarding oral and maxillofacial evaluations and orthodontic treatment.

The survey was designed as 21 questions and sent to family physicians in Turkiye. The participants were asked about their age, gender, place of work, years of experience, regions evaluated during the routine examination, and level of orthodontic awareness and knowledge.

A total of 400 family physicians completed the survey. There was a significant difference in the referral rate of family physicians working in university hospitals (p<0.01), years of experience (p<0.001), whether evaluating the head and neck region (p<0.05), and the jaw positions during a routine examination (p<0.001) and for those who performed an intraoral examination and who checked dental crowding (p<0.001). When evaluating the head and neck region and dental crowding in routine examinations, a significant difference was found in the number of experienced family physicians (p<0.05).

Awareness of the facial profile and having orthodontic knowledge was relatively high in the family physicians who participated in our study; however, their number of oral and maxillofacial evaluations were found to be low in routine examinations. It would be beneficial to organize seminars, conferences, and symposiums to increase the awareness and knowledge of family physicians on the oral and maxillofacial region and how to conduct efficient orthodontic evaluations.