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(1) Background: This study aimed to compare patient-reported outcome measures when accelerating en masse retraction between the piezocision procedure and the subsequent application of low-level laser therapy (FC+LLLT), with the piezocision alone (FC), and in a control group. (2) Methods: A three-arm randomized controlled trial (RCT) was conducted involving 60 patients (41 females and 19 males) with Class II division I malocclusion. The en masse retraction was performed using NiTi closed coil springs attached to miniscrews. The LLLT was performed using an 808 nm Ga-Al-As diode laser. Patient responses regarding pain, discomfort, swelling, and chewing difficulties were reported at ten assessment points. (3) Results: The greatest pain levels were observed 24 h after the application of force during the first and third months of retraction. The mean pain, discomfort, swelling, and chewing difficulties were significantly smaller in the control group than in the FC and FC+LLLT groups. High satisfaction levels were reported in all three groups (p < 0.05). (4) Conclusions: The accelerated en masse retraction via piezocision, followed by a small course of LLLT, was accompanied by significantly fewer pain, discomfort, and chewing difficulties than the control group. LLLT is a valuable addition to piezocision, with an improved patient experience. [ABSTRACT FROM AUTHOR]

Introduction: Bone-Anchored Intermaxillary Traction (BAIMT) is a relatively new method for class III treatment in growing patients, therefore evidence about their acceptably as well as the levels of pain, discomfort and functional impairments among orthodontic patients is still lacking. Aim: To evaluate levels of pain, discomfort and acceptance between the BAIMT system and a commonly used treatment modality in the correction of Class III malocclusion. Materials and Methods: Two-arm parallel-group randomised controlled trial was conducted at the Department of Orthodontics, Al-Baath University Dental School. Fifty-six patients who met the inclusion criteria were distributed randomly and equally into two groups: the bone-anchored intermaxillary traction group (the BAIMT group with a mean age of 11.3 years) and the removable mandibular retractor group (the RMR group with a mean age of 11.5 years). A special questionnaire (originally designed by Sergl) was used and included six questions regarding patients' feelings of appliancerelated tension/pressure, pain, impaired speech, swallowing difficulty, oral constraint and lack of confidence in public. This questionnaire was administered at T1 (1 day), T2 (1 week), T3 (6 weeks), T4 (3 months) and T5 (6 months) following appliance initial wear. Results: Fifty-one patients were included in the analysis (BAIMT group: 26; RMR group: 25). Patients treated with the BAIMT system had higher levels of pressure, tension (p<0.001) and pain (p<0.001) compared to those in the control group. No statistically significant differences were found between the two groups in relation to impaired swallowing, whereas the RMR caused more constraint in mandibular movements (p<0.05) and more speech impairment (p<0.001) in addition to increased levels of lack of confidence (p<0.001). Conclusion: The BAIMT system caused more pain than the RMR but the levels of pain gradually decreased especially after one week following application. RMR caused more mandibular restriction and more speech impairment because of the presence of the reverse bow, and it caused relatively high levels of social avoidance and lack of confidence for the patient. [ABSTRACT FROM AUTHOR]

Introduction: CBCT imaging recently has become a very common diagnostic tool in the orthodontic literature. Recent research work has shown that CBCT imaging would give additional information regarding the volumetric assessment of the craniofacial structures. However, the previous published work has not considered the impact of the anterior-posterior skeletal classification and the vertical skeletal pattern on the volumetric assessment of the maxillary and mandibular bones. Aim: To evaluate maxillary and mandibular volumes (MxV and MdV, respectively) in hyper-divergent skeletal Class II (CII) and normo-divergent skeletal Class I (CI) patients and to investigate any possible correlation between CBCT derived lateral cephalometric variables and the calculated volumes. Materials and Methods: CBCT images of 60 patients (30 patients: CI, 30 patients: CII) were obtained and processed with Mimics® 17 software (Materialise, NV, Belgium). the Three dimensional models of both jaws were reconstructed and the related volumes were calculated using a novel approach. CBCT based cephalograms were also derived and linear and angular measurements of the craniofacial complex were obtained. Significance tests were based on t-tests (alpha set at 5%) and Pearson's correlation coefficients were calculated. Results: No significant differences were detected between the two groups in the MxV (p=0.435) and the MdV (p=0.507). In the CI group, no or weak correlations were found between the volumetric measurements and the 2D variables. In the CII group, there was a strong correlation between both MxV and MdV and both the posterior facial height (r=0.60, 0.78 respectively) and the facial height index (r=0.62, 0.72 respectively). A negative moderate correlation was found between both MxV and MdV and the mandibular plane angle (r=-0.48,-0.44 respectively) and Bjork's sum (r=-0.48,-0.44 respectively). Conclusion: There were no significant differences in the MxV and MdV between CI and CII skeletal patterns. Some cephalometric variables had moderate to strong correlation with the MxV and MdV in the CII group. [ABSTRACT FROM AUTHOR]

Background: To evaluate the effectiveness of two minimally invasive surgical procedures in the acceleration of canine retraction: piezocision and laser-assisted flapless corticotomy (LAFC). Methods: Trial design: A single-centre randomized controlled trial with a compound design (two-arm parallel-group design and a split-mouth design for each arm). Participants: 36 Class II division I patients (12 males, 24 females; age range: 15 to 27 years) requiring first upper premolars extraction followed by canine retraction. Interventions: piezocision group (PG; n = 18) and laser-assisted flapless corticotomy group (LG; n = 18). A split-mouth design was applied for each group where the flapless surgical intervention was randomly allocated to one side and the other side served as a control side. Outcomes: the rate of canine retraction (primary outcome), anchorage loss and canine rotation, which were assessed at 1, 2, 3 and 4 months following the onset of canine retraction. Also the duration of canine retraction was recorded. Random sequence: Computer-generated random numbers. Allocation concealment: sequentially numbered, opaque, sealed envelopes. Blinding: Single blinded (outcomes’ assessor). Results: Seventeen patients in each group were enrolled in the statistical analysis. The rate of canine retraction was significantly greater in the experimental side than in the control side in both groups by two-fold in the first month and 1.5-fold in the second month (p < 0.001). Also the overall canine retraction duration was significantly reduced in the experimental side as compared with control side in both groups about 25% (p ≤ 0.001). There were no significant differences between the experimental and the control sides regarding loss of anchorage and upper canine rotation in both groups (p > 0.05). There were no significant differences between the two flapless techniques regarding the studied variables during all evaluation times (p > 0.05). Conclusions: Piezocision and laser-assisted flapless corticotomy appeared to be effective treatment methods for accelerating canine retraction without any significant untoward effect on anchorage or canine rotation during rapid retraction. Trials registration: ClinicalTrials.gov (Identifier: NCT02606331 ). [ABSTRACT FROM AUTHOR]

Introduction: The evaluation of flapless corticision in conjunction with the conventional treatment in the non-extraction decrowding of lower anterior teeth has not been performed yet in any randomised clinical trial, particularly in terms of treatment time and periodontal indices. Aim: The aim of the study was to compare the duration of leveling and alignment of mild and moderate crowding cases in the lower dental arch between the corticision-assisted fixed orthodontic treatment and the traditional method; and to compare the periodontal indexes between the two groups. Materials and Methods: A parallel-group Randomised Controlled Clinical Trial (RCT) was conducted on 60 patients (mean age 2 1.40±1.63 years). Patients were randomly assigned to either the corticision group or the control group (30 each). Immediately after fixed appliance bonding, three radiographicguided incisions were performed on the labial surfaces of the alveolar bone between lower anterior teeth by reinforced scalpels and mallets in order to accelerate alignment for patients in the corticision group. Patients in the control group were treated with conventional orthodontics. The outcome measures were the overall time needed for leveling and alignment, periodontal parameters such as Plaque Index (PI), Probing Depth (PD), Gingival Index (GI), and the width of the attached gingiva. Results: The overall treatment time was significantly shorter in the corticision group than the control group. The average leveling and alignment period for the corticision group was 116.46±15.97 days, while it was 159.69±13.76 days in the control group. Comparing the groups, a significant reduction of about 27% was found in the leveling and alignment duration of the corticision group. There were no significant differences in the periodontal parameters (PI, PD, GI, the width of attached gingiva) at the end of leveling and alignment phase in both the groups. Conclusion: Corticision seems to be an effective method to accelerate leveling and alignment in cases of mild and moderate crowding. It did not cause negative effect on the periodontal tissues. [ABSTRACT FROM AUTHOR]

Introduction: Periodontal pain caused by elastomeric separators is a very common problem in the commencement of orthodontic treatment. Previous studies have shown good results in reducing this pain by Low Level Laser Therapy (LLLT) and different protocols of application have been suggested in the literature. Aim: This trial aimed to evaluate LLLT on managing orthodontic pain caused by elastomeric separators and to compare single versus double irradiation in possible pain reduction. Materials and Methods: A clinical randomized compound (parallel-group and split-mouth design) trial was conducted on 36 patients between 12 and 26 years of age. Elastomeric separators were placed at the mesial and distal surfaces of the first molars in one jaw (upper or lower) for each patient and in only one side of the mouth (the other side served as the placebo side).The trial had two groups: the first group received single irradiation of LLLT [Gallium Aluminum Arsenide (GaAlAs): 830 nm, 4J/cm2, 100mW] immediately after separators insertion, where as the second group received double irradiation immediately after separators insertion and after 24hours. All patients were instructed to rate the level of pain at 1, 6, 24, 48, 96 hours on a Visual Analog Scale (VAS). The student 't' tests, repeated measures ANOVA and LSD post-hoc tests were employed. Results: LLLT was successful in reducing post-separation pain when the experimental side was compared to the placebo side at all assessment times in each group (p<0.05). There were no statistically significant differences between single and double irradiation groups in terms of pain reduction (p>0.05). Conclusion: GaAlAs LLLT application reduced early orthodontic pain caused by elastomeric separators by single or double irradiation. [ABSTRACT FROM AUTHOR]