Altuhafy M, et al. J Dent Anesth Pain Med. 2024 Jun;24(3):145-159. https://doi.org/10.17245/jdapm.2024.24.3.145

Objective: The objective was to compare the shear bond strength (SBS) and the adhesive remnant index (ARI) amongst six orthodontic bracket groups. Materials and Methods: Three-dimensional printed polycrystalline alumina brackets (3DBs), ceramic brackets (CBs), and metal brackets (MBs), divided into six groups, were bonded to bovine incisors using different bonding procedures. The SBSs were obtained using a universal testing machine, and the ARIs were assessed with a stereomicroscope. The statistical analyses included one-way analysis of variance (ANOVA) for SBS differences and Fisher’s exact test to show ARI differences amongst the groups (p < 0.05). Results: No significant differences (p > 0.05) were measured amongst the SBSs of the 3DB groups (12.3 MPa, 12.6 MPa, 12.3 MPa, 11.0 MPa, respectively). The latter four groups generally had significantly lower SBSs (p < 0.001) than the conventional bracket groups, CB and MB (16.9 MPa and 19.3 MPa, respectively). Also, there was no significant difference in SBSs for the CB and MB groups (p > 0.05). A high ARI for CBs and MBs (2) indicated that more than 50% of the adhesive remained on the enamel surface. The four 3DB groups had no residual adhesive or less than 50% adhesive on the enamel surface after debonding (ARI scores 0 and 1). A significant difference in ARI levels existed across the types of brackets (p < 0.05). Conclusion: Three-dimensional printed polycrystalline alumina brackets exhibited adequate SBS values for successful bonding. However, the values were lower compared to those for conventional ceramic and metal brackets. The majority of the adhesive remnant for the 3D-printed brackets was mainly located on the bracket base.

Aim: Patients with Beckwith-Wiedemann syndrome (BWS) often present with macroglossia and aberrant dentoskeletal features, which may increase the prevalence of malocclusion and complicate conventional orthodontic management (OM). The aim was to comprehensively review the available literature regarding the OM of patients with BWS. Materials and Methods: Indexed databases were searched until February 2023. Clinical studies that addressed the dentoskeletal manifestations and OM of patients with BWS were included. A literature search was performed in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Results: Notably, 8 out of 2,664 initially-identified studies were included. Six of the studies were case reports/case series and two were retrospective clinical studies. A total of 35 patients with BWS who received orthodontic treatment (OT) were included. Common dentoskeletal and soft tissue traits included the presence of macroglossia, obtuse gonial angle, and anterior open bite. Some form of maxillary transverse discrepancy was found in nine patients. The OT modalities that were utilized included extraoral appliances, functional appliances, removable appliances, interarch elastics, and fixed appliances. The outcome of the OT was reported as successful in five studies. The follow-up, as reported by three studies, ranged from 8 months to 6 years, and the results of the OT were maintained. Adjunct interdisciplinary therapeutic procedures included glossectomy, oral physiotherapy, and orthognathic surgery. Conclusion: Based upon limited available evidence, OT in conjunction with tongue reduction surgery and/or myofunctional therapy can be successfully performed in children with BWS to manage various dentoskeletal discrepancies.

(1) Objectives: To estimate the impact of chewing bite wafers in reducing pain associated with fixed orthodontic treatment (OT) compared with conventional analgesic drugs (CADs) (Ibuprofen or Acetaminophen). (2) Materials and methods: Unrestricted and manual searching was achieved up to November 2023 and PRISMA guidelines were followed. Randomized controlled trials (RCTs) were included. Meta-analyses were conducted using a random-effects model. The available evidence quality was considered using the GRADE approach. (3) Results: Seven RCTs were included. Five RCTs used the Visual Analog Scale for self-reported pain assessment, while two RCTs used the Numeric Rating Scale. Four RCTs had a high RoB, and three RCTs had a moderate RoB. Separate meta-analyses were performed by pooling quantitative data from two RCTs that compared self-reported orthodontic pain between the bite wafer and Ibuprofen groups and three RCTs that compared the bite wafer and Acetaminophen groups for the different timepoints after orthodontic treatment. None of the timepoints individually indicated a significant difference in pain scores between the bite wafer and control groups, except on day 3, indicating significantly lower pain scores in the bite wafer versus the Acetaminophen groups. The overall level of evidence was very low. (4) Conclusions: Chewing bite wafers is possibly a useful option for CADs to relieve pain during early fixed OT.