Diagnosis,etiology,questionnaire,temporomandibular disorder,treatment

Background/Aim: Root resorption is one of the most common consequences of orthodontic treatment. However, its mechanism, etiology factors, diagnostic methods and the possibility of root repair remain controversial topics. The aim of this paper is to provide an updated review of the current literature concerning the orthodontically induced root resorption. Material and Methods: A literature search was performed using Google Scholar, PubMed and Scopus search engines covering the period January 1930 until June 2019 corresponding to articles investigating the mechanism, etiology, methods of interpretation of root resorption and the stages of root repair. Results: The mechanism of orthodontically induced root resorption involves an interaction between several molecular signaling pathways, which result in the resorption of both cementum and dentin by odontoclasts/cementoclasts. Root resorption can be the result of both treatment and patient-related factors. The main risk factors include prolonged orthodontic treatments, heavy forces, specific tooth movements, method of force application, systemic/genetic factors and aberrant root morphology. Nevertheless, root resorption is repaired to some extend by cellular cementum. Conclusions: Orthodontically root resorption is an unavoidable complication mainly due to its multifactorial etiology. However, its severity can be minimized with careful planning and radiographic monitoring.

Objectives: To evaluate and compare the efficiency of orthodontic treatment and surgical uprighting of first and second mandibular molars. Materials and Methods: An electronic literature search in PubMed, Science Direct, Embase, Scopus, Web of Science, Cochrane Library, LILACS, and Google Scholar, as well as a hand search was conducted by two independent researchers to identify relevant articles up to January 2022. In addition, a manual search was done that included article reference lists, grey literature, and dissertations. The risk of bias of the included prospective and retrospective studies was assessed with the Risk Of Bias Tool In Non-randomized Studies of Interventions (ROBINS-I) assessment tool. Results: A total of six nonrandomized clinical trials (non-RCT) evaluating the efficiency of mandibular molar orthodontic and/or surgical uprighting were included. The quality analysis showed certain defects of the Non-RCTs included and, according to the criteria used, the majority of the articles were judged to be of moderate quality. Conclusions: Based on the evidence, orthodontic and surgical uprighting appear to be effective treatment methods for mandibular molars. Surgical uprighting may be associated with more complications than orthodontic uprighting. However, the existing literature on the subject is limited, heterogeneous, and methodologically limited. Therefore, the outcomes should be interpreted carefully.

This study explores orthodontists’ perspectives on risks associated with orthodontic treatment, as described by Greek and Slovak orthodontists. Informed by the foundational importance of effective communication of risk perspectives in health sciences, particularly in facilitating valid consent and shared decision-making, this research addresses gaps identified in the literature concerning the consistent communication of potential treatment risks based on demographic and cultural characteristics. This study identifies 15 potential critical risks during orthodontic treatment. These risks include root resorption; temporary undesired changes to the occlusion; sleep difficulties; not achieving an ideal result; development of black triangles between teeth; taking additional X-rays; speech difficulties; using a protective splint during sports; duration of treatment; number of visits; transmission of infectious diseases; and swallowing orthodontic appliances. A questionnaire, distributed electronically to orthodontists in Greece (N1 = 570) and Slovakia (N2 = 210) from September 2022 to December 2022, aimed to assess risk communication practices, taking into consideration socio-demographic factors, such as country, gender, age, and academic-degree-related variations. A total of 168 valid questionnaires (91 from Slovakia and 77 from Greece) were obtained, indicating significant disparities in the risks emphasized and preferred forms of consent. The Greek orthodontists focused more on the risks involved, such as relapse, root resorption, temporal occlusal changes, and failure of desired movement, while the Slovak practitioners tended to be more interested in sleeping difficulties, temporal occlusal changes, and not achieving an ideal result. They also obtained written or digital consent from patients or their parents/guardians more frequently than the Greek team. Male orthodontists discussed specific risks more frequently, including relapse and extractions, whereas females preferred written or digital consent. PhD-trained orthodontists prioritized certain risks, indicating the need for tailored approaches. This study underscores the dynamic nature of risk assessment in orthodontic practice, emphasizing its ethical and strategic dimensions. The findings advocate for tailored risk communication strategies that recognize individual, contextual, and cultural factors, and the need for an orthodontic informed consent protocol for a tailored communication approach for patients to elevate the standard of care in European orthodontics. The reliance on digital tools reflects contemporary trends in enhancing patient understanding, thereby supporting ongoing innovation in orthodontic practices.