Fouad El Sharaby

OBJECTIVES: To assess the effect of low-level laser therapy (LLLT) on overall leveling and alignment time of mandibular anterior crowding and associated pain after initial archwire placement.

MATERIALS AND METHODS: Thirty-two females (18-25 years) with mandibular anterior crowding were randomly allocated into laser and control groups. Eligibility criteria included Angle Class I molar relationship and Little's irregularity index (LII) from 4 to 10 mm. Randomization was accomplished with a computer-generated random list. A 0.014-inch copper-nickel-titanium (Cu-NiTi) wire was inserted immediately after bonding of 0.022-inch Roth brackets followed by 0.016-inch Cu-NiTi, 0.016 × 0.022-inch NiTi then 0.017 × 0.025-inch stainless steel wire after completion of alignment. In-Ga-As laser was applied to the mandibular anterior segment in the laser group on days 3, 7, and 14, then at 1 month followed by every 2 weeks until completion of leveling and alignment. Visual analogue scale questionnaires were completed by each patient over 7 days from initial archwire placement. Digital models were used to monitor changes in the irregularity index. Blinding was applicable for outcome assessors only.

RESULTS: The mean time for leveling and alignment was significantly lower in the laser compared to the control group (68.2 ± 28.7 and 109.5 ± 34.7 days, respectively). The laser group displayed a significantly higher mean alignment improvement percentage as well as lower pain scores compared to the control group.

CONCLUSIONS: Within the constraints of the current study, LLLT has a potential for acceleration of anterior segment alignment as well as reduction of the pain associated with placement of initial archwires.

OBJECTIVES: To compare canine retraction using NiTi closed coil springs vs elastomeric chains comprehensively in a split-mouth randomized controlled trial.

MATERIALS AND METHODS: The canines in 64 quadrants were randomly retracted into the first premolar extraction spaces using NiTi closed coil springs or elastomeric chains, in the maxilla and mandible. The retraction force was 150 g. Cone beam computed tomography scans and study models were obtained before the start of canine retraction and 6 months later. The rate and total amount of canine retraction, canine rotation, tipping, and root resorption were evaluated. A visual analogue scale was used to evaluate patients' pain experience.

RESULTS: The two methods were statistically similar for dental changes, rate of canine retraction, and root resorption. However, patients reported significantly more days of pain with the elastomeric chain compared to the NiTi closed coil springs.

CONCLUSIONS: Within the constraints of the current study, using either NiTi closed coil springs or elastomeric chains as force delivery systems for canine retraction results in no significant difference in the rate of canine retraction, tipping, rotation, or root resorption. Pain experience during retraction using elastomeric chains is more significant yet needs further investigation.

OBJECTIVES: To compare the root resorption resulting from miniscrew-supported maxillary posterior dentoalveolar intrusion using two different force magnitudes.

MATERIALS AND METHODS: Adult patients with skeletal open bite, indicated for maxillary posterior dentoalveolar intrusion, were recruited and randomly assigned to the comparison or intervention groups. The comparison group involved applying 200 g of intrusive force per segment, which measured 20 g per root, while this force was 400 g per segment in the intervention group, measuring 40 g per root.

RESULTS: Twenty participants were included in the final analysis after 2 patients dropped out, 1 in each group, to end up with 10 subjects (200 roots) per group. There was statistically significant root resorption of 0.84 ± 0.96 mm and 0.93 ± 1.00 mm in the comparison and the intervention groups, respectively. However, there was no statistically significant difference between the groups.

CONCLUSIONS: Root resorption inevitably took place in association with orthodontic intrusion. However, increasing the magnitude of the intrusive force did not increase the amount of root resorption, either statistically or clinically.

OBJECTIVE: To investigate the effect of local injection of platelet-rich plasma (PRP) on the rate of orthodontic tooth movement.

MATERIALS AND METHODS: Sixteen female patients were randomly allocated in a split-mouth study design to receive PRP injections with CaCl2 activating solution on one side (intervention side) while the other side received CaCl2 injection only (control side). Canine retraction was performed on 0.017 × 0.025-inch stainless steel archwire applying 1.5 N retraction force. PRP and CaCl2 injections were done at 0, 3, and 6 weeks. The duration of the study was 4 months. Data were collected from digitized models. Assessment of pain accompanying the procedure was done using a visual analogue scale.

RESULTS: The rate of canine retraction was faster on the intervention side in the first 2 months, with a statistically significant difference in the first month (P = .049). On the other hand, the rate was statistically significantly slower on the intervention side in the third month following cessation of PRP injections (P = .02). Pain increased following injections on both sides.

CONCLUSIONS: PRP showed a positive potential to accelerate the rate of tooth movement when injected in the first 2 months. Repeated injections of PRP to maintain a steady rate of accelerated tooth movement warrant further investigation.

OBJECTIVES: To compare the effects of two different force magnitudes on maxillary posterior segment intrusion using mini-screws. The null hypothesis was that there would be no difference between the two force magnitudes.

MATERIALS AND METHODS: Adult patients with skeletal open bite and a dental open bite ranging from 3 to 8 mm were recruited for this trial. The comparator group had 200 g of intrusive force applied for posterior segment intrusion, whereas 400 g of force was applied in the intervention group. Primary outcomes were the amount of posterior teeth intrusion and anterior open bite closure.

RESULTS: Twenty-two subjects were randomized to include 11 participants in each group. One participant dropped out in each group, leaving us with 10 subjects to be analyzed per group. There was statistically significant posterior teeth intrusion of 2.42 ± 2.06 and 2.26 ± 1.87 mm for the comparator and intervention groups, respectively, with no difference between them. Statistically significant open bite closure was achieved in both groups, measuring 2.24 ± 1.18 and 3.15 ± 1.06 mm in the comparator and intervention groups, respectively, with no difference between them.

CONCLUSIONS: Both the 200 g and 400 g intrusive forces yielded similar outcomes in terms of posterior teeth intrusion and anterior open bite closure.

AIM: Acceleration of orthodontic tooth movement has gained a massive interest to decrease the total treatment time. Local pharmacological agents might be used for that purpose as a practical, effective and inexpensive alternative. A systematic review was achieved to evaluate the evidence in that topic.

METHODS: A search was conducted on electronic databases including PubMed, Lilacs, Web of Science (Thompson Reuters), EMBASE (OvidSP), and Cochrane Database of Systematic Reviews (Wiley) in addition to hand searching of relevant journals till June 2018. Only studies written in English were utilised. Publications were selected, assessed systematically and graded by two observers according to Bondemark grading system.

RESULTS: Only two human studies were found investigating the effect of Relaxin and Prostaglandins in the rate of orthodontic tooth movement. No obvious side effects were reported. Relaxin showed no increase in the rate of tooth movement while prostaglandin showed a marked increase in the rate of orthodontic tooth movement.

CONCLUSION: There is below moderate evidence showing no effect of relaxin on orthodontic tooth movement, while inconclusive evidence was found regarding Prostaglandin in the acceleration of orthodontic tooth movement. More prospective well-conducted clinical trials are needed to reach a proper conclusion regarding the local pharmacological agents which can be safely used to accelerate orthodontic tooth movement.

OBJECTIVE: The aim of current systematic review was to evaluate the efficiency of the vibrating devices in accelerating orthodontic tooth movement.

METHODS: A systemic unrestricted search was done in three electronic databases up to July 2018. A manual search was also performed. Eligibility criteria included Randomized clinical trials (RCTs), quasi randomized clinical trials and prospective controlled trials (CCTs) comparing the rate of the tooth movement with and without vibrating devices. The study characteristics and data extraction of the vibrating device group and control group were performed by two reviewers independently.

RESULTS: Seven articles were eligible to be included in the qualitative analysis. Three of them were included in meta analysis. One hundred and five patients received vibrating device to accelerate orthodontic treatment while forty-nine patients received shame device and seventy-eight patients were control group.

CONCLUSION: There was no significant difference between vibrating devices group and control group. There is no evidence that vibrating appliances are effective in acceleration of orthodontic tooth movement.

BACKGROUND: Intrusion of maxillary incisors is the treatment of choice to correct deep bite problem in gummy smile patients.

AIM: The objective of this study was to compare the effectiveness and efficiency of miniscrew-supported intrusion versus intrusion arch for treatment of deep bite.

METHODS: The study sample consisted of 30 post pubertal patients (21 females and 9 males) with an age range from 17 to 29. They were divided into 2 groups (15 subjects in each group). Group 1 underwent maxillary incisor intrusion using miniscrews, and in group 2 intrusive arch was used. Pre and post-treatment lateral cephalometric x-rays and study models were made to evaluate the demo-skeletal effects. During the study period, no other intervention was attempted. Paired t-test was used to study the changes after treatment.

RESULTS: The mean amount of overbite correction was 2.6 ± 0.8 (0.49 mm per month) in the miniscrew-supported intrusion group and 2.9 ± 0.8 (0.60 mm per month) in the intrusive arch group. No statistically significant difference was found in the extent of maxillary incisor intrusion between the two systems. The two intrusion systems were statistically different in the extent of incisor proclination, as an intrusive arch group tended to proline upper incisors more than miniscrews-supported intrusion group.

CONCLUSION: Both systems successfully intruded the 4 maxillary incisors almost with no loss to the sagittal and vertical anchorage, although intrusive arch tended to proline upper incisors significantly.

OBJECTIVES: To evaluate the effect of platelet-rich plasma (PRP) on the rate of orthodontic tooth movement.

METHODS: The sample comprised six skeletally mature male mongrel dogs. The maxillary second premolar in each dog was extracted bilaterally. PRP was prepared and injected around the first premolar in one randomly selected maxillary quadrant while the other quadrant served as the control. Coil springs (150 g) were used to distalize the first premolars for 63 days using TAD as anchorage.

RESULTS: Total maxillary tooth movement was significantly faster on the experimental than on the control side.

CONCLUSION: Local injection of PRP in the present animal study resulted in accelerated orthodontic tooth movement with no obvious clinical or microscopic side effects.

The aim of this article is to introduce a new concept of bracket positioning with special consideration to root axes. Cone-beam computed tomography imaging and computer-aided manufacturing were used to produce stereolithographic trays for indirect-direct bonding.