Microplastics: An orthodontic concern!
Vinod Krishnan
Published in issue: June 2024 p103-104
Microplastics have become a growing concern in orthodontics, particularly with the increased use of plastic-based materials such as clear aligners. The global awareness of plastic pollution, emphasized by initiatives like the United Nations’ 2024 legally binding agreement, highlights the urgency of this issue. The production of plastics, estimated at 400.3 million metric tons in 2022, poses a risk to both environmental and human health, as documented by the ‘Minderoo-Monaco Commission on Plastics and Human Health.’ These plastics release harmful chemicals and microplastics that can affect multiple organs and systems in the body.
Key Points on Orthodontic Microplastic Concerns:
- Microplastic Sources: Orthodontic products, including clear aligners, toothbrushes, and resin-based composite restorations, contribute to microplastic exposure. Studies show that clear aligners release microplastics, especially when exposed to mechanical friction.
- Health Implications: Microplastics can cause local irritation in the gastrointestinal tract, intestinal dysbiosis, inflammation, and potentially enter the bloodstream, leading to adverse health effects. Additionally, microplastics have been linked to cardiovascular risks.
- Research Gaps: Despite the documented risks, more research is needed to understand the long-term effects of microplastic exposure from orthodontic materials and to explore safer alternatives.
The orthodontic community must prioritize investigating the health and environmental impacts of clear aligner plastics, ensuring patient safety while mitigating the contribution to plastic pollution.
Biomechanics of conventional and miniscrew-assisted rapid palatal expansion
Shivam Mehta, Sarah Abu Arqub, Meenakshi Vishwanath, Madhur Upadhyay, Sumit Yadav
Published online: May 01, 2024 p105-112
Conventional rapid palatal expansion (RPE) and miniscrew-assisted rapid palatal expansion (MARPE) are techniques used to correct transverse maxillary deficiencies. RPE relies on anchoring to maxillary teeth, often leading to side effects like dental tipping and root resorption. MARPE, on the other hand, uses mini-implants for skeletal anchorage, reducing these dental side effects. Biomechanics, appliance design, and force application all play crucial roles in determining the outcomes of maxillary expansion. Understanding the differences in stress and strain between RPE and MARPE is essential for optimizing patient treatment and minimizing adverse effects.
Highlights:
- Biomechanical Principles: Key factors include the center of resistance, appliance system, and forces exerted during expansion.
- RPE Limitations: Conventional RPE can lead to unwanted dental side effects, such as molar tipping and bone loss.
- MARPE Advantages: MARPE distributes forces more evenly, offering better skeletal expansion with fewer dental complications.
- Appliance Variations: Differences between bone-anchored and hybrid MARPE designs impact stress distribution and treatment outcomes.
- Long-term Stability: Both RPE and MARPE face challenges in maintaining stability, with overexpansion and retention methods being crucial.
- Stress and Strain: MARPE typically generates forces that may fall below the threshold needed for extensive bone remodeling, affecting long-term efficacy.
- Clinical Implications: MARPE is preferable for cases with high anchorage needs, while RPE remains effective for younger patients with less interdigitation.
En masse retraction of anterior teeth through rapid periodontal distraction by a retraction screw: A randomized control trial
Hibu Dora, Mubasshir Ahmed Shaikh, Seema Gupta, Sameena Begum Maqhbool, Salim Shamsuddin, Saraswati Raghunath Kokate
Published online: March 21, 2024
p113-122
Patients often seek faster orthodontic solutions, making devices like HYCON important for evaluation. In this randomized control trial, the effectiveness of the HYCON device for en masse retraction of anterior teeth was compared with conventional nickel-titanium (NiTi) closed coil springs. The study involved 60 female patients, revealing that HYCON significantly reduced retraction time but required careful monitoring for root resorption. Findings highlight the advantages and drawbacks of rapid distraction methods in orthodontic treatment.
Highlights:
- Expedited Treatment: HYCON reduced retraction duration by 3 months compared to NiTi closed coil springs.
- Increased Retraction Rate: Anterior teeth moved almost twice as fast with HYCON, at an average of 1.6 mm/month.
- Anchorage Loss: Both groups experienced similar anchorage loss (2 to 2.5 mm), primarily in the first two months.
- Root Resorption: HYCON was associated with greater root resorption, necessitating close monitoring.
- Controlled Tipping: Both appliances achieved controlled tipping of anterior teeth with slight extrusion.
- Soft Tissue Changes: More pronounced alterations in lip and chin prominence were noted with HYCON use.
- Clinical Implications: HYCON is suitable for cases needing rapid retraction, but long-term follow-up and evaluation are recommended.
Increased susceptibility for nonsyndromic cleft lip with or without cleft palate by SLC19A1 80G>A genetic variation
Archana Patel, Nisha Sahu, Henu Kumar Verma, L.V.K.S. Bhaskar
Published online: February 22, 2024
p123-127
The SLC19A1 80G>A genetic variant has been investigated for its potential association with nonsyndromic cleft lip with or without cleft palate (NSCL/P). This meta-analysis compiled evidence from 10 studies and demonstrated a significant link, emphasizing the role of folate-related pathways in NSCL/P susceptibility.
Highlights:
- Craniofacial Development: NSCL/P arises from disruptions during early embryogenesis, affecting critical craniofacial pathways.
- Maternal Nutrition: Low folate levels during the periconceptional period have been linked to NSCL/P, highlighting the importance of maternal nutrition.
- SLC19A1 80G>A Variant: The meta-analysis found a significant association between the SLC19A1 80G>A genetic variant and increased NSCL/P risk.
- Genetic Models: The variant showed elevated risk in allelic, recessive, and dominant models across various populations.
- Ethnicity Impact: A significant association was noted in Asian populations, while no association was found in white and mixed populations.
- Future Assessment: The findings could help in assessing the risk of NSCL/P for future generations, contributing to better genetic counseling and preventive strategies.
Accuracy of Dolphin Imaging software in predicting soft tissue changes of Class II Division 1 incisor relationship treated by all first premolar extraction compared with post-treatment lateral cephalogram
Nikunj Maniyar, A.T. Prakash, H.C. Kiran Kumar, Puja C. Yavagal
Published online: March 18, 2024
p128-135
Patients often desire reliable visual predictions of orthodontic outcomes, making tools like Dolphin Imaging software essential for assessment. This study examined the accuracy of Dolphin Imaging software (version 11.95) in forecasting soft tissue changes for Class II Division 1 incisor relationships treated with first premolar extractions, comparing predictions to actual treatment results. The analysis highlighted both benefits and areas needing caution.
Highlights:
- Enhanced Communication: Dolphin Imaging software aids in patient education by providing visual treatment predictions.
- Vertical Accuracy: The software demonstrated greater accuracy in predicting changes in the vertical plane than the horizontal.
- Lip Prediction Bias: Upper and lower lip positions were frequently overestimated horizontally and underestimated vertically.
- Landmark Precision: Soft tissue nasion and A-point had the highest prediction accuracy, while soft tissue chin areas had the least.
- Clinical Use: The software can be a valuable educational tool but requires cautious use to manage expectations and ensure realistic outcome projections.
Unplanned tooth movement in deepbite correction with Invisalign: A retrospective study
Mais M. Sadek, Reem Alhashmi
Published online: February 23, 2024
p136-144
Unplanned tooth movements can complicate deepbite correction with Invisalign, affecting overall treatment predictability. This retrospective study aimed to analyze these movements, providing insights into their occurrence, magnitude, and potential implications.
Highlights:
- Unplanned Movements: Both linear and angular unplanned movements were observed, especially in posterior teeth.
- Angular Frequency: Angular movements were significantly more common than linear movements across all teeth.
- Posterior Predominance: Vertical, buccolingual, angulation, and inclination changes were more pronounced in posterior teeth.
- Vertical Impact: Anterior teeth showed less intrusion than anticipated, whereas posterior teeth experienced unexpected intrusion.
- Clinical Insight: Recognizing unplanned movements is crucial for enhancing aligner design and improving treatment outcomes.
Retrospective comparison of two different miniscrew-supported molar distalization methods applied in the buccal and palatal regions
Yavuz Selim Aslan, Mehmet Ali Yavan, Nihal Hamamci
Published online: March 23, 2024
p145-152
Miniscrew-supported distalization methods offer effective solutions for Class II malocclusions. This study compared the dentofacial effects of two techniques: miniscrew-supported pendulum (MSP) and infrazygomatic crest (IZC) miniscrews, highlighting their differences and effectiveness.
Highlights:
- Molar Distalization: Both MSP and IZC methods significantly achieved Class I molar relationships.
- Incisor Changes: The IZC group had greater retrusion and retroclination of the maxillary incisors compared to the MSP group.
- Overjet Reduction: A more substantial decrease in overjet was observed in the IZC group.
- Overbite Impact: While overbite increased in the IZC group, no significant difference was observed between the two groups.
