Undoubtedly, diagnosing and managing infections is one of the most challenging issues for orofacial clinicians. As a result of the diversity of symptoms, complicated behavior, and sometimes confusing nature of these conditions, it has become increasingly difficult to diagnose and treat them. It also highlights the need to gain a deeper insight into the orofacial microbiome as we try to improve our understanding of it. In addition to changes in patients’ lifestyles, such as changes in diet, smoking habits, sexual practices, immunosuppressive conditions, and occupational exposures, there have been changes in patients’ lifestyles that complicate the issue. Recent years have seen the development of new infection treatments due to the increased knowledge about the biology and physiology of infections. This review aimed to provide a comprehensive overview of the types of infections in the mouth, including the types that viruses, fungi, or bacteria may cause. It is important to note that we searched the published literature in the Scopus, Medline, Google Scholar, and Cochran databases from 2010 to 2021 using the following keywords: “Orofacial/Oral Infections,” “Viral/Fungal/Bacterial Infections”, “Oral Microbiota” And “Oral Microflora” without limiting our search to languages and study designs. According to the evidence, the most common infections in the clinic include herpes simplex virus, human papillomavirus, Candida albicans, Aspergillus, Actinomycosis, and Streptococcus mutans. The purpose of this study is to review the new findings on characteristics, epidemiology, risk factors, clinical manifestations, diagnosis, and new treatment for these types of infectious diseases.

Background. As the prevalence of such oral diseases as dental caries and periodontal problems increases during fixed orthodontic treatment, patient education is an essential aspect of any such treatment. Two methods have been proposed for this purpose: direct education in a clinic (the conventional method); and education using social media, such as the Telegram application (a type of teledentistry). Objectives. The aim of this study was to evaluate the effect of teledentistry as an educational tool on the oral health status of patients undergoing fixed orthodontic treatment at the first 3 follow-up visits. Material and methods. Sixty participants were enrolled from patients whose fixed orthodontic treatment was to begin at a dental clinic in Tehran, Iran. They were randomly assigned to one of 2 trial arms. At the end of the 1st appointment, one of the groups was educated in person about maintaining oral hygiene during treatment, and an educational clip was sent to the members of the other group via the Telegram application. During the next 3 follow-up appointments, plaque index (PI), bleeding on probing (BOP), and gingival color and consistency were analyzed for each patient to assess their oral hygiene compliance during treatment. Result. There was a statistically significant difference in PI and BOP between the 2 groups at the 3rd and 4th appointments; however, gingival color and consistency did not differ significantly with regard to the manner of education (p > 0.05). Patient age did not have a considerable effect on the oral health status in either group (p > 0.05). Conclusions. Teledentistry is an effective and efficient method to improve oral hygiene in patients undergoing fixed orthodontic treatment.

The surgery-first approach (SFA), which proceeds without presurgical orthodontic treatment, is assumed to shorten the treatment course because the direction of post-surgical orthodontic tooth movement conforms to the normal muscular forces. Moreover, the regional acceleratory phenomenon (RAP), evoked by surgery, helps in tooth alignment and compensation in a faster way. Although SFA has definite advantages, especially in class III individuals, there is a lack of data about its indications in patients with facial asymmetry. In this article, we reviewed recently published articles on the treatment of asymmetric patients using the SFA. Different aspects, including the three-dimensional assessment of stability in different planes, approaches for fabrication of a surgical splint, predictability of the results, skills needed for bimaxillary surgery, indications as the treatment of choice for condylar hyperplasia, and combination with distraction osteogenesis in candidates with severe asymmetries were found to be the main topics discussed for patients presenting with facial asymmetry

The inherent surface porosities of ceramic brackets can enhance bacterial plaque accumulation. This study assessed the in-vitro effect of photodynamic therapy (PDT) with two photosensitizers (PSs) on Streptococcus mutans (S. mutans) load around metal and ceramic brackets bonded to enamel. In this in vitro experimental study, 48 sound premolars extracted for orthodontic reasons were randomly assigned to two groups (n = 24) for bonding to metal and ceramic brackets. After bracket bonding, the tooth-bracket assemblies were inoculated with S. mutans, and each group was randomly divided into three subgroups (n = 8) of control, PDT with toluidine blue O (TBO) and 635 nm laser, and PDT with indocyanine green (ICG) and 808 nm laser. The colony count was quantified in each subgroup, and analyzed by repeated measures ANOVA. Ceramic brackets showed a significantly higher colony count than metal brackets in the control subgroup by 7.057 log10 CFUs/mL (P < 0.05). PDT, irrespective of PS type, significantly decreased the bacterial count around both ceramic (by 7.616 log10 CFUs/mL in the ICG and 7.594 log10 CFUs/mL in the TBO subgroup) and metal (by 7.512 log10 CFUs/mL in the ICG and 7.505 log10 CFUs/mL in the TBO subgroup) brackets (P < 0.05). The difference in bacterial count was not significant between the ceramic and metal bracket groups after PDT (P = 0.541 for ICG and P = 0.101 for TBO). Within the limitations of this in vitro study and as an attempt to predict what might happen in vivo, the results showed that PDT significantly decreased the bacterial load around metal and ceramic brackets bonded to enamel, irrespective of the type of PS. Thus, PDT may be considered as a possibly efficient strategy to minimize the bacterial load especially around ceramic brackets.

Introduction: White spots are a common complication of orthodontic treatment. Several prevention methods such as fluoride therapy and laser irradiation have been proposed, but there is still no conclusive evidence. Therefore, this study aimed to evaluate the combined application of diode laser and fluoride varnish in preventing white spots. Methods: Thirty-nine sound human premolars were extracted for orthodontic purposes and randomly divided into three groups of thirteen teeth each (C: Control, FV: fluoride varnish (5% sodium fluoride), and FV+L: fluoride varnish+980 nm diode laser (2 W)). The freshly extracted teeth were disinfected in a 0.5% chloramine T solution and stored in saline at room temperature. Each tooth was coated with nail polish, leaving a 2×3 mm2 window on the midbuccal. Surface treatments were applied, and primary Vickers microhardness was evaluated in the gingival sections. Then, the samples were immersed in alternating demineralizing (6 hours/day) and remineralizing (18 hours/day) solutions and incubated at 37 °C for 9 days to produce artificial caries. Afterward, the samples were immersed in a remineralizing solution for one day. Finally, secondary microhardness was measured. The data were analyzed using one-way ANOVA. Results: The primary microhardness was higher in groups C and FV than in group FV+L. The lowest secondary microhardness was recorded in group C, and there was no significant difference between the other two groups. The change in microhardness was greater in group C, while no difference was observed between the FV and FV+L groups. Conclusion: Within the limitations of this study, the combined application of laser irradiation and fluoride varnish may not improve white spot lesion (WSL) prevention compared to the use of fluoride varnish alone.

Introduction: Ceramic brackets have gained increasing popularity among dental clinicians and orthodontic patients but friction is a major concern when using them. This study sought to assess the effects of diode and Nd:YAG (neodymium-doped yttrium aluminum garnet) laser irradiation on friction forces between two types of ceramic brackets and rhodium-coated esthetic archwires. Methods: Thirty polycrystalline and 30 poly-sapphire brackets were divided into 6 groups (n=10) as follows: (I) control polycrystalline brackets (no laser irradiation), (II) polycrystalline brackets subjected to diode laser irradiation, (III) polycrystalline brackets subjected to Nd:YAG laser irradiation, (IV) control poly-sapphire brackets (no laser irradiation), (V) poly-sapphire brackets subjected to diode laser irradiation, and (VI) poly-sapphire brackets subjected to Nd:YAG laser irradiation. The bracket slots were laser-irradiated on a custom-made table. Sixty 5-cm pieces of rhodium-coated archwires were used for the friction test in a universal testing machine at a speed of 10 mm/min. Ten brackets from the six groups underwent scanning electron microscopy (SEM), X-ray diffraction (XRD) and energy-dispersive X-ray spectroscopy (EDX). Results: The frictional resistance value of polycrystalline brackets was significantly higher than that of poly-sapphire brackets, irrespective of laser type (P0.05). Conclusion: It appears that diode and Nd:YAG laser irradiation cannot significantly decrease the friction. Future studies are warranted on different laser types with variable exposure.