The formation of white spot lesions (WSLs) around fixed orthodontic attachments is a common complication during and following fixed orthodontic treatment, marking the result of a successfully completed treatment. This double-blind, randomized clinical trial study aims to investigate the varying effects of nano-silver, chlorhexidine (CHX) or fluoride mouthwashes on WSLs. Double-blind prospective randomized clinical trial, comprised of forty-two patients with mild to moderate crowding, were recruited for this study. Randomization and allocation to trial group were carried out by computer system in college of dentistry, university of Sulaimani from January 2020 to September 2020. The patients were divided into three groups (14 per group) according to the type of mouthwash used during the treatment (nano-silver, CHX or fluoride), using block randomization. The clinical examination for the presence of WSLs was recorded through visual examination of the upper and lower anterior teeth using the International Caries Detection and Assessment System (ICDAS II) score before bonding and at 30, 90 and 180 days after bonding of the upper and lower arches. The total number of patients was 42 (16 males and 26 females) with a mean age of 23.02 ± 3.841 (18–37) years old, distributed into three groups of 14 patients. There is significant difference in white spot lesions formation between the three groups; the mean of WSLs in nanosilver group is lower than CHX and fluoride group in 90 and 180 days of follow-up (P < 0.05). Nano-silver mouthwash is more effective than CHX and fluoride mouthwash in reducing WSLs during orthodontic treatment.

Background: A promising improvement in orthodontic diagnostics is the use of convolutional neural networks (CNNs) to predict skeletal maturity using dental radiographic data, namely the calcification phases of the lower canine. Objectives: The purpose of this study is to improve the prediction of skeletal growth maturation through the use of sophisticated deep learning techniques, particularly CNNs, in the analysis of orthopantomography developmental markers. Methods: The CNN was trained and validated using the suggested model, which enables precise assessment of skeletal maturity across data collected from patients undergoing orthodontic and dental evaluations. By using a multiclass classification framework to classify the various stages of skeletal maturation. Results: CNN model predicting the development of the lower canine from the second molar provided a test accuracy of 97.50%, the model made it possible to automatically interpret radiographic features that were previously evaluated manually. Conclusions: CNN models can be trained to correctly identify the lower canine calcification stage, this helped clinicians with treatment planning and timing, especially with regard to growth modification, implant, prosthodontics approach and its clinical applicability. It guarantees ethical imaging procedures and optimizes clinical workflows by doing away with the necessity for further imaging.

Objective: Posterior bite raisers (PBRs) induce temporary posterior disocclusion during fixed orthodontic treatment but may affect pulp vitality under prolonged occlusal load. Objective: To compare pulpal responses to injectable nanohybrid composite PBRs and resin-modified glass ionomer cement (RMGIC) PBRs at two heights (1–2 mm; >2–4 mm) in relation to gender and age. Methods: Eighty patients (16- 40 years old, with a mean age of 22.9 ± 5.7 years and an equal male-to-female ratio were assigned to four groups according to the material and height of PBRs, with twenty patients in each group. Cold testing and electric pulp testing (EPT) were documented at baseline, 1 week, 1 month, 2 months, and 3 months. The outcomes were divided into two groups: sensibility (positive or negative), and the differences among the four groups were compared in relation to gender and age. Results: At 3 months, negative pulpal responses were observed only in the composite groups: >2–4 mm (15%) and 1–2 mm (5%). Material choice was the strongest independent predictor of EPT threshold change (P=0.008), with the composite associated with significantly decreased responsiveness. The interaction between material and height was highly significant (p=0.012), indicating a fivefold higher risk of negative sensibility responses with high-volume composite than with RMGIC. Younger patients showed greater susceptibility to pulpal changes (p=0.03). Conclusions: Composite PBRs, particularly at heights exceeding 2 mm, are associated with increased pulpal stress, whereas RMGIC demonstrates superior pulpal stability and is recommended for initial orthodontic phases to minimize adverse biological effects.