Abdullah M. Aldrees

Diagnosing the severity of buccal caries lesions in governmental and private orthodontic patients at debonding, using the ICDAS-II and the DIAGNOdent Pen

OBJECTIVES To clinically evaluate the prevalence of buccal caries and white spot lesions (WSLs) at debonding in governmental and private orthodontic patients, using the International Caries Detection and Assessment System (ICDAS-II) and the DIAGNOdent Pen, and to study the correlation between the two methods. MATERIALS AND METHODS A cross-sectional study was carried out on the nonextracted premolars and anterior teeth of 89 orthodontic patients. They were recruited into two groups based on the treatment center they attended: governmental group (G; n=45) and private group (P; n=44). Immediately after debonding, the examination of buccal caries and WSLs on premolars and anterior teeth was carried out using the ICDAS-II and the DIAGNOdent Pen. Cross-tabulation was applied to study the correlation between the ICDAS-II index and the DIAGNOdent Pen by calculating the Spearman correlation coefficient. RESULTS The G group showed a significantly higher (P<.0001) prevalence of WSLs and/or buccal caries compared to that of the P group based on evaluation by the two methods. Based on ICDAS-II, 43% of the patients in the P group and 9% in the G group were free from any WSLs. In the G group, 22% of the patients had ≥16 LESIONS, whereas there were none for the P group. The Spearman correlation coefficient between the two methods was .71. CONCLUSIONS The prevalence of caries and/or WSLs at debonding was significantly higher in the G group compared to the P group. The clinical index (ICDAS-II) showed a good correlation with the DIAGNOdent Pen.

Lateral cephalometric norms for Saudi adults: A meta-analysis

Orthodontic diagnosis and treatment planning require careful evaluation of the patients cephalometric values and comparison to known population cephalometric means or norms. Despite the availability of several published studies on Saudi cephalometric norms, Caucasian norms are still referred to when Saudi patients are treated. To reach a consensus between these studies and to establish more accurately cephalometric norms for Saudis, a meta-analysis of the relevant literature was performed. Electronic database (PubMed), Saudi Dental Journal and Master theses were searched for studies reporting cephalometric values of normal male and female Saudi adults with numerical data and 8 studies with a total sample size of 485 met the inclusion criteria. A meta-analysis with results from these studies was completed. The combined mean estimates and SD of common cephalometric measurements were calculated. The data included in this comprehensive meta-analysis were compared with Caucasian norms and results indicated that Saudis have distinct cephalometric features. Saudis tend to have slightly more convex profiles and more proclined incisors than the Caucasians. These findings confirm the previously published results and should serve as more accurate reference values that were drawn from a large sample size.

Do customized orthodontic appliances and vibration devices provide more efficient treatment than conventional methods

The incorporation of technological advances in the field of clinical orthodontics to increase treatment efficiency has led to the development of customized appliances (Insignia®), archwires (Suresmile®), and the production of devices to enhance tooth movement (Acceledent®). This review presents a comprehensive study of the literature concerning these products, and analyzes the available evidence of their efficiency. To date, one pilot study has evaluated the efficiency of the Insignia® system, three retrospective studies have assessed the efficiency of the Suresmile® system, and a few Acceledent® reports have described its effect on treatment time. Critical appraisal of the reviewed papers revealed that the efficiency of the Insignia® system cannot be confirmed based on the available evidence, while the use of Suresmile® can reduce overall treatment time in simple cases. The acceleration of tooth movement by Acceledent® devices has not yet been confirmed.

Effectiveness of Salvadora persica extracts against common oral pathogens

Objective The purpose of this study was to evaluate the antibacterial activity of ethanol and hexane extracts of Salvadora persica against common oral pathogens. Materials and methods Well diffusion, Minimum Inhibition Concentration (MIC), Minimum Bactericidal Concentration (MBC), and Broth microdilution tests were used to determine the optimum antimicrobial concentrations of S. persica extracts against Streptococcus mutans (S. mutans), Streptococcus sanguis (S. sanguis), and Streptococcus salivarius (S. salivarius) over 1, 3, 6, 12, and 24 h. Chlorhexidine (CHX) 0.2% was used as a positive control. Results The findings showed that the microbial activity of both extracts was concentration-dependent. Ethanol extract of S. persica at 25, 50, and 100 mg/ml had more growth inhibitory effect against all isolates compared to hexane extract. In addition, ethanol extract at 8 mg/ml (MBC value) was able to eradicate the growth of all isolates. S. sanguis and S. salivarius were very sensitive to hexane extract and required 4 mg/ml (MBC value) for their eradication while S. mutans was the most resistant (MBC = 8 mg/ml).The statistical findings of CFU counts showed no significant difference (p = 1.000) in antibacterial effectiveness between the two extracts against all isolates. A significant decline overtime in CFU counts was noted, except at 12 h and 24 h where no significant difference (p = 0.793) was observed and was comparable to CHX. Conclusion Ethanol and hexane extracts of S. persica were found to exhibit maximum antimicrobial activity against S. mutans, S. sanguis and S. salivarius at high concentrations.

Influence of bimaxillary protrusion on the perception of smile esthetics.

Objectives: To evaluate the impact of bimaxillary protrusion on smile esthetics as perceived by dental professionals and laypersons. Methods: One hundred and fifty evaluators, equally distributed into their respective panels (orthodontists, general dentists, and laypersons), participated in this cross-sectional study conducted in April to December 2012 in Riyadh, Saudi Arabia. The patient sample consisted of 14 female patients divided equally into 2 groups: bimaxillary protrusion patients, and patients who have had 4-premolar extraction treatment. Two standardized photographs (frontal and three-quarter close-up smile views), and a lateral cephalogram were taken for each patient. The evaluators were asked to rate the attractiveness of each photo according to a 100-mm visual analog scale. These esthetic ratings were correlated with the patients’ cephalometric measurements. Results: The bimaxillary protrusion group was rated significantly as less attractive than the treatment group by each evaluator panel. Panel comparison showed that laypeople were less receptive of bimaxillary protrusion than dental professionals. Frontal and three-quarter views of the same smiles were not similarly rated for esthetic perceptions. Correlational analysis revealed that the dentoalveolar measurement with the highest significant negative correlation to the smile esthetics was the upper incisors to palatal plane (U1-PP) angle. Conclusion: Patients with bimaxillary protrusion were found to be less attractive than patients who were treated for the condition. This was especially evident among the laypersons. An increase in the upper incisor inclination, as well as a decrease in the interincisal angle compounds the bimaxillary effect.

Hard and soft tissue correlations in facial profiles: a canonical correlation study

Background The purpose of this study was to analyze the relationship between facial hard and soft tissues in normal Saudi individuals by studying the canonical correlation between specific hard tissue landmarks and their corresponding soft tissue landmarks. Methods A retrospective, cross-sectional study was designed, with a sample size of 60 Saudi adults (30 males and 30 females) who had a class I skeletal and dental relationship and normal occlusion. Lateral cephalometric radiographs of the study sample were investigated using a series of 29 linear and angular measurements of hard and soft tissue features. The measurements were calculated electronically using Dolphin® software, and the data were analyzed using canonical correlation. Results Eighty-four percent of the variation in the soft tissue was explained by the variation in hard tissue. Conclusion The position of the upper and lower incisors and inclination of the lower incisors influence upper lip length and lower lip position. The inclination of the upper incisors is associated with lower lip length.

Orthodontic treatment and referral patterns: A survey of pediatric dentists, general practitioners, and orthodontists

Objective This study aims to assess the orthodontic diagnostic skills, referral patterns, and the perceptions of orthodontic benefits of pediatric and general dentists in comparison with orthodontists. Materials and methods Two online surveys were e-mailed to pediatric dentists, general dentistry practitioners, and orthodontists registered as members of the Saudi Dental Society and the Saudi Orthodontic Society. The surveys included questions about the type of orthodontic treatment provided, referral trends, and timing; presumed benefits associated with successful orthodontic treatment; and diagnosis and treatment plans of seven cases representing different malocclusions. Results In total, 25 orthodontists, 18 pediatric dentists, and 14 general practitioners completed the survey. Only 38.8% of pediatric dentists and 7.1% of general practitioners reported that they practiced orthodontics clinically. The perceptions of the three groups toward the benefits of orthodontic treatment were comparable in the psychosocial areas. However, the orthodontists perceived significantly lesser effects of orthodontic treatment on the amelioration of temporomandibular disorder (TMD) symptoms. Pediatric dentists tended to rate the need and urgency of treatment higher, while general practitioners tended to rate the need of treatment lower. The selected treatment plans for three early malocclusion cases showed the greatest discrepancies between the orthodontists and the other two groups. Conclusions The orthodontists consistently and significantly downplayed the perceived benefit of orthodontic treatment to reduce TMD symptoms. Also, while there was a similarity in the diagnosis, there were notable differences in the proposed treatment approaches, perceived treatment need, and timing of intervention between the three groups of practitioners.

Color stability and force decay of clear orthodontic elastomeric chains: An in vitro study.

OBJECTIVE To compare the percentage force decay of clear and semi-clear elastomeric chain products from eight different manufacturers and to evaluate the amount of discoloration after immersion in colored dietary media of the same elastomeric chain products. MATERIAL AND METHODS An in vitro study was designed using an electronic force gauge to measure six samples from each of 19 types of elastomeric chains stretched for a period of four weeks. A spectrophotometer was used to measure the color of each specimen (10 of each type) at baseline and after being soaked in a dietary medium (coffee, tea, cola, and wine in 250 ml amounts) for 72 h. RESULTS There was a significant difference in the percentage of the lost initial force between all the tested E-chains (P<0.001). ANOVA shows a significant difference in the amount of discoloration between the E-chain types (P<0.001). Semi-clear (tooth-color/pearl/obscure) E-chain types (TP-ToothC, OrthO-Pearl, GAC-SiliPearl, 3M-Obscure) present significantly less change in color than clear E-chains of the same brand (TP-Clear, OrthoO-Clear, GAC-SiliClear, 3M-Clear). CONCLUSIONS Significant differences in the mean percentage force decay between the 19 studied clear elastomeric chain types were present. AO-Memory and Ormco maintained most of their original force at the end of the four-week interval. Significant differences in discoloration also exist between the various types of E-chains. TP Orthodontics (Tooth-Colored, SuperSlick, Clear) and Ortho Organizers (Pearl) showed the least discoloration.

The effect of static and dynamic testing on orthodontic latex and non-latex elastics

Abstract The purpose of this study was to test the force decay properties of different kinds of orthodontic elastics after subjecting them to static and cyclic testing. Latex and non-latex elastics obtained from GAC, American Orthodontics and Ortho-Organizers were used in a sample size of 10 elastics per group. Static testing involved stretching the elastics three times the internal diameter, while in cyclic testing, the elastics were stretched up to 50 mm to simulate maximum mouth opening. Elastic forces generated were measured using the Instron testing machine and recorded in grams. Elastics on average lose 10% and 12% as a result of static test and 30% and 35% as result of cyclic test for latex and non-latex brands respectively, and most of the force loss occurs during the first half hour and after the first 10 cycles. This difference in force loss between latex and non-latex elastics could be due to the different structure and composition of the polymer involved. There are no significant differences between different groups of latex elastics in terms of force loss or even between the different groups of the non-latex elastics under static testing, however, under cycling testing differences between the groups were detected. Forces generated by the elastics are different from the manufacturers’ labeled forces.

Intensity of pain due to separators in adolescent orthodontic patients

Objective: To investigate the intensity of pain adolescent orthodontic patients experience following the insertion of separators. Materials and Methods: Elastomeric separators were placed mesially and distally to the first molars in 62 adolescents (20 male, 42 female, age 12–15 years), and the participants were given self-administrated questionnaires to document perceived pain, pain upon chewing, and the severity of pains affecting daily life, using a visual analog scale for seven days. Results: The mean perceived pain scores out of 100 on the first 3 days were 54.6 ± 32.7, 51.7 ± 29.9, and 32.3 ± 28.4, respectively; chewing pain scores were: 61.9 ± 35.3, 52.6 ± 30.4, and 39.5 ± 32.1, respectively; the pains affecting daily life scores were 24.9 ± 35.5, 21.1 ± 30.9, and 11.9 ± 23.7, respectively. A Kruskal–Wallis test showed a statistically significant difference in the reported pain between the three studied parameters. A Mann–Whitney U-test showed an insignificant difference between male and female adolescents. Conclusion: Pain perception varies among adolescent patients, but it decreases significantly after the first 2 days, with no gender differences.