rss_2.0Australasian Orthodontic Journal FeedSciendo RSS Feed for Australasian Orthodontic Journal Orthodontic Journal Feed of the shear bond strength of reconditioned metal brackets used in indirect bonding: an in vitro pilot study<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Objectives:</title> <p>This study aimed to compare the shear bond strength (SBS) related to surface treatment methods of debonded brackets before indirect rebonding and to evaluate changes in SBS related to sandblasting time.</p> </sec> <sec> <title style='display:none'>Methods:</title> <p>After brackets were debonded from a dental cast during an indirect bonding procedure, seven groups were assigned to conduct SBS tests. Sandblasted groups were sprayed with Al<sub>2</sub>O<sub>3</sub> for 3 s (Group II), 6 s (Group III), 9 s (Group IV), and 12 s (Group V). In Group VI, a no. 4 round low-speed bur was used to remove resin. In Group VII, the bracket base was coated with a plastic conditioner (Reliance, IL, USA) and Group I served as the control group.</p> </sec> <sec> <title style='display:none'>Results:</title> <p>The SBS of Group VII was not statistically different from that of the control group. The SBS of Group VI was not statistically different from that of Group II but higher than that of the control group (<italic>P</italic> &lt; 0.05). There was no statistical difference between Groups III, IV, and V, but was greater than the other groups (<italic>P</italic> &lt; 0.05).</p> </sec> <sec> <title style='display:none'>Conclusion:</title> <p>The group with surface treatment by sandblasting for more than 6 sec prior to indirect bonding recorded a higher SBS than the other groups. The SBS did not increase further even if the sandblasting time increased by more than 9 sec.</p> </sec> </abstract>ARTICLEtrue clear aligners every 10 days or 14 days ? A randomised controlled trial<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Objectives:</title> <p>To compare 10-day and 14-day change regimens to achieve orthodontic tooth movement (OTM) in patients wearing clear aligners and to determine their subsequent pain perception.</p> </sec> <sec> <title style='display:none'>Material and methods:</title> <p>A total of 175 clear aligner patients were assessed for eligibility. Seventy-two patients were randomly assigned to a 10-day group (<italic>N</italic> = 36) and a 14-day group (<italic>N</italic> = 36) and were instructed to change the appliances every 10 or 14 days, respectively. OTM efficacy and OTM variation between the actual and predicted OTM digital models measured by shell-to-shell deviation, as well as pain perception determined by a visual analog scale (VAS), were assessed at T0 (baseline, before the placement of the aligners), T1 (stage 8, after completion of aligners #8), and T2 (stage 16, after completion of aligners #16).</p> </sec> <sec> <title style='display:none'>Results:</title> <p>The 10-day and 14-day groups showed similar OTM efficacy at both T1 and T2 for all types of tooth movements (<italic>p</italic> &gt; 0.09 for all) and similar OTM shell-to-shell deviation at T1 (<italic>p</italic> = 0.06) and T2 (<italic>p</italic> = 0.22). The two groups also had similar VAS scores of pain perception throughout the study (<italic>p</italic> &gt; 0.05 for all).</p> </sec> <sec> <title style='display:none'>Conclusion:</title> <p>The 10-day and 14-day groups showed similar tooth movement and pain perception, suggesting that the clear aligners may be changed every 10 days without a significant compromise in the clinical efficacy of OTM and patient comfort.</p> </sec> <sec> <title style='display:none'>Trial registration:</title> <p>ChiCTR, ChiCTR-IOR-15007532. Registered 17 November 2015, <ext-link ext-link-type="uri" xmlns:xlink="" xlink:href=""></ext-link></p> </sec> </abstract>ARTICLEtrue levels of awareness of obstructive sleep apnoea amongst the Australian general public<abstract> <title style='display:none'>Abstract</title> <p><italic>Introduction:</italic> Despite the serious health implications associated with obstructive sleep apnoea, the condition remains under-diagnosed. This study aims to evaluate the awareness of the condition amongst the Australian community.</p> <p><italic>Methods:</italic> A total of 2016 respondents recruited from a web-based panel completed an online questionnaire which assessed awareness and experience of obstructive sleep apnoea and sleep-disordered breathing. The association between the level of awareness and various socio-demographic variables was analysed using uni- and multivariate analyses.</p> <p><italic>Results:</italic> The results of the questionnaire indicated that 50% and 70% of participants were unaware of adult and paediatric obstructive sleep apnoea. Socio-demographic variables including age, annual household income and education level significantly influenced a participant’s level of awareness. Approximately 8.3% of the participants had previously been diagnosed with obstructive sleep apnoea. However, 65% of participants exhibiting symptoms of daytime sleepiness had not sought health care. Paediatric sleep apnoea had been previously diagnosed in 7.1% of children residing in participant’s households but 49% of children with regular snoring had not been medically evaluated.</p> <p><italic>Conclusion:</italic> A deficiency exists in the awareness of sleep apnoea amongst the Australian general public. This is reflected in the discrepancy between the number of participants exhibiting potential symptoms and those who sought medical advice.</p> </abstract>ARTICLEtrue evaluate the rate of canine retraction and pain perception following micro-osteoperforation – a split-mouth clinical study<abstract> <title style='display:none'>Abstract</title> <p><italic>Objective:</italic> To evaluate the effectiveness and influence of micro-osteoperforation on the rate of canine retraction and patient pain perception.</p> <p><italic>Method:</italic> In this prospective split-mouth clinical trial, forty adult patients in the age range of 15-25 years (18 men and 22 women) requiring bilateral first premolar extraction and upper canine retraction involving maximum anchorage, were enrolled. Two groups of 20 patients each (Group-I and Group-II) were randomly assigned and were further subdivided into subgroups A and B according to the allocation of a maxillary quadrant. Group-I A and Group-II A were the experimental quadrants in which 3 micro-osteoperforations (MOPs) and 2 MOPs were performed, respectively, and Group-I B and Group-II B served as control quadrants. With the help of a mini-screw (1.6 mm diameter, 8 mm length), MOPs were created distal to the maxillary canine following which, canine retraction continued for three months. The collection of data was obtained from monthly plaster models. The primary outcomes were the rate of canine retraction per month and the total distance moved by the canines. The secondary outcomes were to assess patient pain following the MOP procedure.</p> <p><italic>Result:</italic> A significant increase in the rate of tooth movement was seen in Group-I A, whereas, in Group II, there was no significant difference in the movement rate between the subgroups A and B. In addition, Group-I A showed a significant increase in the rate of canine retraction compared to Group-II A. The patients did not report significant pain, nor discomfort nor other complications during or after the procedure.</p> <p><italic>Conclusion:</italic> Micro-osteoperforation appears to be an effective, comfortable, and safe procedure to accelerate tooth movement and significantly reduce the duration of orthodontic treatment.</p> </abstract>ARTICLEtrue evaluation of different clear aligner materials using MTT analysis<abstract> <title style='display:none'>Abstract</title> <p><italic>Backround:</italic> The in vitro cytotoxic effects of six different clear aligner materials were evaluated using the MTT analysis.</p> <p><italic>Methods:</italic> The clear aligner material samples [Duran (ScheuDental GmbH, Iserlohn, Germany), Zendura-Flx (Bay Materials LLC, Fremont, CA, USA), Taglus (Laxmi Dental Export Pvt. Ltd, Mumbai, India), Smart Track (Align Technology, San Jose, CA, USA), Zendura (Bay Materials LLC, Fremont, CA, USA), Essix C + (Essix<sup>®</sup> (Raintree Essix, Inc., 4001 Division St, Metairie, LA-USA)] were initially kept in a saline solution in airtight test tubes for 8 weeks at 37°C. According to the recommended ISO standards, the weights of the samples were divided by the volumes of the dilutions in the ratio of 0.1 g/ml. To evaluate the cytotoxicity of the samples, an MTT analysis was performed using a human gingival fibroblast cell line (HGF). To analyse the data, the Kruskal– Wallis test was applied (a=0.05).</p> <p><italic>Results:</italic> Zendura was the most cytotoxic material resulting in 67.3 ± 16.20% cell viability, followed by Smart Track with 87.6 ± 5.53% cell viability. While Duran, Essix C + had 92.6 ± 26.34% and 94.9 ± 8.54% cell viability, Zendura-Flx, Taglus had 106.9 ± 12.76% and 113.183 ± 7.45% cell viability, respectively.</p> <p><italic>Conclusion:</italic> While Zendura and Smart Track showed mild cytotoxicity, other materials showed greater cell viabilities. According to the ISO standards, the clinical use of each brand of aligners, except Zendura, may be considered reliable. Taking into account standard deviation, Zendura and Duran should be used with caution. The suppliers of aligners should adhere to the manufacturer’s recommendations since an increase in ion release might arise from material wear.</p> </abstract>ARTICLEtrue of white spot lesions during clear aligner therapy: a systematic review<abstract> <title style='display:none'>Abstract</title> <p><italic>Objectives:</italic> To determine if an association exists between the prevalence of white spot lesions (WSLs) and orthodontic treatment using clear aligners.</p> <p><italic>Methods:</italic> Electronic databases were searched with no restrictions on year. Article selection criteria included human clear aligner studies conducted during the permanent dentition and with a full description of the applied technique and oral hygiene status.</p> <p><italic>Results:</italic> The search strategy resulted in a total of 4177 articles. After title and abstract screening, 156 relevant articles were identified from which five remained after the application of the exclusion criteria. The articles were mostly classified as having a low risk of bias.</p> <p><italic>Conclusions:</italic> Clear aligner therapy induces a lower development rate of new WSLs than orthodontic treatment by fixed appliances. In patients who have poor oral hygiene and/or existing WSLs, clear aligner treatment could be recommended.</p> </abstract>ARTICLEtrue of architectural changes in mandibular trabecular and cortical bone pattern after functional treatment<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Purpose:</title> <p>To assess the changes in mandibular trabecular and cortical bone following functional appliance treatment through fractal dimension (FD) and cortical thickness (CorT) measurements.</p> </sec> <sec> <title style='display:none'>Material and methods</title> <p>The study was performed on 45 mandibular retrognathia cases. While the treatment group (T) comprised 30 patients treated using a functional appliance for one year during puberty, the control group (C) consisted of 15 patients who did not receive any orthodontic treatment due to insufficient oral hygiene. FD and CorT analyses were bilaterally evaluated for each mandible. FD measurements were performed on the condylar process, the antegonial notch, and ramus regions on panoramic radiographs. A paired <italic>t</italic>-test was applied for group analysis, before (T1) and after treatment (T2) and, correspondingly, before (C1) and after (C2) controls. In addition, an independent <italic>t</italic>-test was used to determine differences between the treatment (∆<italic>T</italic> = T2−T1) and the control group (∆<italic>C</italic> = C2−C1).</p> </sec> <sec> <title style='display:none'>Results</title> <p>Statistically significant differences were found in the treatment group between the initial and post-treatment FD values of the right (<italic>p</italic> &lt; 0.05) and left condyles (<italic>p</italic> &lt; 0.05), and the CorT measurements on the right (<italic>p</italic> &lt; 0.01) and the left sides (<italic>p</italic> &lt; 0.05). There was no statistically significant difference in FD parameters in the control group and a significant difference was only found in the left CorT (<italic>p</italic> &lt; 0.05). A comparison of the treatment and control groups revealed that the changes in FD and CorT measurements were not statistically significantly different between the groups (<italic>p</italic> &gt; 0.05).</p> </sec> <sec> <title style='display:none'>Conclusion:</title> <p>Mandibular protraction appliances do not produce trabecular bone alteration in the mandibular condyles, the antegonial notch and ramus over a 12-month time period.</p> </sec> </abstract>ARTICLEtrue, dentoalveolar, and buccal bone changes using hybrid and tooth-borne expanders for RME and SARME in different growth stages<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Objective</title> <p>To compare the skeletal, dentoalveolar and buccal bone thickness of tooth–bone-borne (Hybrid-H) and tooth-borne (TB) maxillary expanders used for rapid maxillary expansion (RME) in early and late adolescents and for surgically-assisted RME (SARME) in young adults.</p> </sec> <sec> <title style='display:none'>Materials and methods:</title> <p>This two-centre clinical study included initial and 6 months post-retention CBCT records of 60 patients (27 males, 33 females; mean age 15.7 ± 3.75 years). The cohort was divided into two groups according to the expander type (H or TB) and subdivided into a further three groups determined by cervical vertebrae maturation stages: early adolescents (EA), late adolescents (LA), and young adults (A). EA and LA patients underwent RME and young adults received a SARME.</p> </sec> <sec> <title style='display:none'>Results:</title> <p>The hybrid-designed appliance increased the internal skeletal maxillary width and nasal width more than the TB-designed appliance anteriorly in EA and posteriorly in SARME young adults. The TB expanders tipped and expanded the first premolars more than the Hybrid SARME expanders in young adults and caused a greater reduction in buccal alveolar bone thickness at the level of the first premolars and molars at the three growth stages.</p> </sec> <sec> <title style='display:none'>Conclusion</title> <p>The hybrid expanders, with relatively greater skeletal and nasal widening potential and fewer dentoalveolar side effects, were a favourable alternative to tooth-borne expanders for RME in the early and late adolescents, and for SARME in young adults.</p> </sec> </abstract>ARTICLEtrue III malocclusion with traumatic unilateral maxillary central incisor loss treated using orthodontic miniscrews: a case report<abstract> <title style='display:none'>Abstract</title> <p>The present article reports the successful non-extraction orthodontic treatment using miniscrew anchorage in a patient who presented with maxillary left central incisor loss and unstable jaw movements. The chief complaints of the 23-year-old female patient were her protruding teeth and crowding of the mandibular anterior segment. The patient lost her maxillary left central incisor as a result of a traumatic injury during childhood. However, the crown was saved and attached to the adjacent teeth. The patient was diagnosed with a skeletal Class III and Angle Class III dental malocclusion. The jaw movements determined by a 6 degrees of freedom jaw movement recording system were unstable and irregular. Miniscrew anchorage was applied for distalisation of the maxillary right dentition and the mandibular dentition during non-extraction treatment. The maxillary left dentition was mesialised using miniscrew anchorage to close the space as a result of the lost maxillary left central incisor. After an active treatment duration of 36 months, the patient achieved a Class II molar relationship on the left side, a Class I on the right side, an optimal overjet and overbite, and a pleasing facial profile. Despite the asymmetric molar relationships, functionally stable and smooth jaw movements were established. The skeletal, occlusal and functional stability remained satisfactory after a 2-year retention period. In conclusion, miniscrew anchorage was valuable in supporting asymmetric tooth movement during non-extraction appliance treatment in a patient who presented with traumatic unilateral tooth loss.</p> </abstract>ARTICLEtrue comparison of SureSmile, Insignia, and Invisalign, in treating non-extraction cases of mild to moderate crowding: a prospective clinical trial<abstract> <title style='display:none'>Abstract</title> <p><italic>Objectives:</italic> To compare the ability of SureSmile<sup>TM</sup>, Insignia<sup>TM</sup> and Invisalign<sup>TM</sup> to achieve predicted intra-arch tooth positions and further compare their objective grading scores for alignment/rotations, marginal ridge relationships and buccolingual inclination.</p> <p><italic>Materials and methods:</italic> The study was a prospective clinical trial of 145 arches from 44 females and 29 males (54 SureSmile<sup>TM</sup> arches, 35 Insignia<sup>TM</sup> arches, and 56 Invisalign<sup>TM</sup> arches). All arches were treated by a non-extraction approach and had ≤7 mm of crowding and 45° of tooth rotation. The manufacturer’s recommendations were followed for each group and the final scans were acquired before refinements, rebonding, or wire bending. The virtual set-ups were superimposed on the final scans and the coordinates of 34 landmarks per arch were compared. One hundred and twenty-six end-of-participation arches were suitable for 3D printing and were compared using the American Board of Orthodontics Objective Grading Scores (OGS) for alignment/ rotations, marginal ridge relationships, and buccolingual inclination.</p> <p><italic>Results:</italic> No statistically significant differences were identified in the mean deviation between the target and achieved the position of the anterior landmarks within the treatment groups. The exception was the Suresmile group which had greater vertical discrepancies in the position of the labial CEJ. Although the mean differences between the target and achieved anterior landmark positions for all groups were under 0.5 mm, the range of maximum discrepancy was between 0.7 mm and 4.1 mm. The Insignia<sup>TM</sup> system showed significantly greater deviation in upper posterior landmark positions in the transverse and sagittal dimensions, and lower posterior landmarks in the transverse dimension. However, this was due to the Insignia<sup>TM</sup> initial set-ups being wider. There was no statistically significant difference between the three systems in combined intra-arch OGS. However, the Invisalign<sup>TM</sup> system had a significantly poorer alignment/rotation score than the SureSmile<sup>TM</sup> group. The Insignia<sup>TM</sup> system performed better in achieving buccolingual tooth inclination compared to Suresmile<sup>TM</sup>, and the Invisalign<sup>TM</sup> system performed better than the Suresmile<sup>TM</sup> system in the marginal ridge score.</p> <p><italic>Conclusions:</italic> The three systems were comparable in achieving the predicted tooth positions of the anterior teeth in non-extraction, mild-to-moderate, crowded cases. Large discrepancies requiring operator intervention were common within the three systems. Although the three systems had no statistically significant difference in overall intra-arch OGS scores, there were significant differences in the score components.</p> </abstract>ARTICLEtrue morphology and its influence on OSA severity and surgical intervention: a retrospective study<abstract> <title style='display:none'>Abstract</title> <p><italic>Introduction:</italic> The aim was to assess the relationship between airway morphology and surgical intervention in a cohort of patients presenting with increased body mass index (BMI) and a confirmed diagnosis of obstructive sleep apnoea (OSA). A secondary aim was to revisit the relationship between morphology and OSA severity.</p> <p><italic>Methods:</italic> A retrospective analysis was conducted of pre-operative maxillofacial 3D-CT scans of thirty-two patients with a confirmed diagnosis of OSA who received treatment from an ear nose and throat specialist (ENT). Lateral cephalograms were imported into Quick Ceph Studio (Quick Ceph Systems Inc, San Diego, CA, USA) after which linear and angular measurements of selected hard and soft tissues were obtained. 3D-CT images were loaded into the software program 3dMDVultus (3dMD) which permitted 3D visualisation of the airway. Measurements were repeated 3 times on the images of six patients after an interval of two weeks to establish the intraclass correlation coefficient (ICC) for intra-examiner accuracy and reliability. Logistic regression was applied to determine the relationships between morphology, OSA and surgical treatments.</p> <p><italic>Results:</italic> A positive correlation was found between age and the apnoea-hypopnea index (AHI). Morphological measurements of the airway did not exhibit a positive relationship with OSA severity. Posterior airway space at the level of the uvula and tongue, the length of the soft palate and position of the hyoid bone were significantly associated with BMI. No variables were found to be correlated with uvulopalatopharyngoplasty (UPPP) surgery. Notwithstanding, airway length and posterior airway space at the level of the uvula tip were significantly associated with tongue channelling.</p> <p><italic>Conclusions:</italic> Radiographic airway assessment is an invaluable and opportunistic tool for screening OSA but requires judicial use in its prescription and interpretation. There is little correlation between OSA severity and airway morphology and between surgical intervention and morphology. Additional factors need to be considered before a treatment modality is considered and is best managed in a multidisciplinary setting.</p> </abstract>ARTICLEtrue effect of third molars on maxillary molar distalisation using a miniscrew-supported 3D® maxillary bimetric distalising arch<abstract> <title style='display:none'>Abstract</title> <p><italic>Objectives:</italic> The aim of the present study was to investigate the effect of third molars on the efficiency and biomechanics of a novel miniscrew-supported 3D<sup>®</sup> Maxillary Bimetric Distalising Arch (3D-MBDA).</p> <p><italic>Methods:</italic> Twenty-three patients, whose third molars were either extracted at the beginning of treatment (Group 1, <italic>n</italic> =11) or retained (Group 2, <italic>n</italic> =12), were included in the study. Lateral cephalometric films and dental casts, taken at the beginning (T0) and at the end of upper molar distalisation (T1), were analysed to study the differences between groups.</p> <p><italic>Results:</italic> Crown distalisation of the first molars was similar between the groups; however, root distalisation, both at the trifurcation and apex levels, intrusion at the mesiobuccal cusp tip, and the distalisation rate were significantly higher in Group 1. The resultant tipping of the first molars in both groups was mesially-directed, unlike the usual distal tipping. The second molars distalised more, displaced less vestibularly and rotated mesiobuccally in Group 1, whereas they demonstrated a significantly higher vestibular displacement and distobuccal rotation in Group 2. The mean distalisation time was significantly shorter in Group 1 when compared to Group 2. The miniscrew success rate was 95.5% for Group 1 and 91.7% for Group 2.</p> <p><italic>Conclusion:</italic> The miniscrew-supported 3D-MBDA was found to have greater effects on root distalisation and the final inclination of the molars. The third molars were associated with limited root movement, unfavourable displacement of the second molars, as well as a slower distalisation rate. Therefore, the extraction of third molars prior to distalisation is recommended, especially when the miniscrew-supported 3D-MBDA is the appliance choice.</p> </abstract>ARTICLEtrue and reproducibility of a tripoding method in point registration-based 3D superimposition software compared to a conventional cephalometric method<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Objective:</title> <p>The present study aimed to assess the validity and reproducibility of a tripoding reference method for digital study cast superimposition to measure maxillary tooth movement.</p> </sec> <sec> <title style='display:none'>Methods:</title> <p>This retrospective study used 30 treated orthodontic cases which required premolar extractions. Pre- and post-treatment cephalograms were conventionally superimposed, while digitised study casts were superimposed using point registration-based software (Materialise 3-matic Research 12.0) and a tripoding method. This method involved superimposing the digital study casts using the medial two-thirds of the third palatal rugae, and the bilateral depression of the greater palatine foramen as references. Incisor and molar orthodontic tooth movements in the vertical and horizontal planes were measured using the Pancherz analysis for cephalograms and Materialise 3-matic software for the digitised study casts. Validity and agreement were assessed by a paired <italic>t</italic> test and a Bland-Altman analysis while reproducibility was assessed by an intraclass correlation coefficient (ICC) and a paired <italic>t</italic> test. Clinical significance was set at 2 mm.</p> </sec> <sec> <title style='display:none'>Results:</title> <p>The paired <italic>t</italic> tests found no statistically significant differences (<italic>p</italic> &gt; 0.05) in tooth movements between the cephalometric and digitised cast measurements, and between the same measurement methods. However, the Bland-Altman analysis showed the 95% limits of agreement were greater than 2 mm but less than 4.3 mm for all measurements. The ICC showed all measurements had good to excellent reproducibility.</p> </sec> <sec> <title style='display:none'>Conclusion:</title> <p>The tripoding method is a valid and reliable method to superimpose the maxillary study casts for measuring incisor and molar orthodontic movements but it is not interchangeable with the Pancherz analysis.</p> </sec> </abstract>ARTICLEtrue Editorial report: early class III correction using titanium dental implants and facemask therapy: a 24-year follow-up<abstract> <title style='display:none'>Abstract</title> <p>The management of a Class III malocclusion in the mixed dentition presents with many challenges, in particular, the post-treatment growth-related changes which can continue into adulthood. This case report describes the multidisciplinary management of a 9-year-old female using titanium dental implants, rapid maxillary expansion and a Delaire facemask. Pre-treatment, post-treatment and long-term follow-up records of the patient are presented.</p> </abstract>ARTICLEtrue of treatment options for Class III malocclusions in adult patients based on cephalometric values: a systematic review<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Objective</title> <p>The present systematic review aimed to determine cephalometric values that may be used as a guide in deciding between orthodontic camouflage and orthognathic surgery to treat a Class III malocclusion in adults. In addition, a secondary aim was to identify treatment complications and aesthetic perceptions by laypersons/orthodontists.</p> </sec> <sec> <title style='display:none'>Methods</title> <p>Without a language restriction, an electronic search of six databases and a hand search of three orthodontic journals were performed until September 2021. All studies comparing orthodontic camouflage and orthognathic surgery in Class III malocclusion patients, were included. Data extraction was carried out independently by two authors with disagreement resolved by a third author. The risk of bias related to individual studies was appraised using a modified version of the STROBE checklist. The results were summarised qualitatively, and no meta-analysis was undertaken due to the high heterogeneity between the studies.</p> </sec> <sec> <title style='display:none'>Results</title> <p>With the quality of evidence ranging from moderate to high, six retrospective studies were included. A cephalometric analysis comprising the Holdaway angle, overjet, the Wits appraisal, lower incisor inclination, the maxillary-mandibular ratio, overbite, gonial angle and an additional combination were used as a guide. No treatment complications were reported. One study examined the perception of facial profile attractiveness in borderline surgical Class III malocclusions and found no difference in outcome and significant improvements in both camouflage and surgical groups.</p> </sec> <sec> <title style='display:none'>Conclusion</title> <p>The existing evidence is insufficient to identify a cephalometric parameter threshold in deciding between orthodontic camouflage and orthognathic surgery. PROSPERO database protocol no. CRD42020165164.</p> </sec> </abstract>ARTICLEtrue uprighting using a newly designed segmental wire: a case report<abstract> <title style='display:none'>Abstract</title> <p>The ectopic eruption path of a permanent molar can cause incomplete emergence through interference by an adjacent tooth, early loss of a primary molar, or an arch length discrepancy. It is clinically important to determine the appropriate appliance that may easily be placed for the considered application of a molar corrective force. A newly designed appliance is introduced for the distal uprighting of an ectopically erupting molar and supported by two case presentations. The current technique of using a segmental wire incorporating double-sided hooks may easily and effectively resolve this problem.</p> </abstract>ARTICLEtrue of exaggerated claims in the abstracts of systematic reviews reporting accelerated orthodontic tooth movement: a meta research analysis<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background</title> <p>The latest trend in scientific literature review is to scrutinise the practices of false or biased reporting of findings, which is rightly termed as ‘spin’. In recent years, accelerated tooth movement has gained attention from the orthodontic community, but the findings still remain unclear and controversial.</p> </sec> <sec> <title style='display:none'>Objectives</title> <p>To estimate the frequency of distorted claims and over-interpretation of abstracts of systematic reviews related to accelerated orthodontic tooth movement. The objective was to differentiate the type of claim and to determine its prevalence.</p> </sec> <sec> <title style='display:none'>Methods</title> <p>A literature search was performed using the Cochrane library and the top five most prominent orthodontic journals for systematic reviews on accelerated orthodontics were identified by applying appropriate key words. According to pre-set selection criteria, only systematic reviews published between January 2010 and September 2021 were included. The selected articles were scrutinised for the assigned exclusion criteria. The articles were finally scanned for false claims by two independent reviewers. The identified claims fell into either the categories of misleading interpretation, misleading reporting or misleading extrapolation. The obtained data were tabulated and analysed using the one-way ANOVA statistical test to indicate the difference between the different types of reported claims.</p> </sec> <sec> <title style='display:none'>Results</title> <p>There were 98 systematic reviews identified in total, of which 59 articles met the selection criteria and 39 articles were excluded. Of the 59 included articles, 38 systematic reviews had exaggerated claims. Twenty-two of the reported claims came under the misleading reporting category, 10 fell under the misleading interpretation category and 6 came under the misleading extrapolation category. The difference noted between the reporting prevalence of different types of claim was statistically significant (<italic>P</italic> &lt; 0.001). In misleading reporting, it was noted that most of the systematic reviews refrained from reporting the adverse effects of treatment.</p> </sec> <sec> <title style='display:none'>Conclusion</title> <p>The prevalence of exaggerated claims is high in the abstracts of systematic reviews related to accelerated orthodontic tooth movement. It is recommended that a clinician critically assess the claims presented in systematic reviews which are considered to be the hallmark articles of evidence-based practice. Orthodontists should be careful when applying the findings in clinical practice.</p> </sec> </abstract>ARTICLEtrue evaluation of surface characteristics comparing WaterLase (Biolase) with tungsten carbide burs for composite removal: a pilot study<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Introduction</title> <p>The present ex-vivo study was designed to evaluate the surface roughness and analyse potential adhesive remnants on the enamel surface after composite removal using either an Er:YSGG WaterLase (WL) (Biolase<sup>®</sup>, Irvine, CA, USA) or a tungsten carbide (TC) bur (Alston, England, UK).</p> </sec> <sec> <title style='display:none'>Methods</title> <p>An <italic>in vitro</italic> study was designed using 21 extracted lower premolars. Pre-coated stainless steel brackets (3M Unitek, Monrovia, CA, USA) were bonded on all of the teeth except one, which served as a control. The teeth were allocated into two groups: Group 1 (<italic>n</italic> = 5), removal of composite with a TC bur. Group 2 (<italic>n</italic> = 15), removal of composite using the WL. Scanning electron microscope (SEM) imaging and Energy Dispersive X-ray Spectroscopy (EDS) were used to determine the surface roughness and atomic composition of the surfaces.</p> </sec> <sec> <title style='display:none'>Results</title> <p>Group 1 had a median damage depth of 17.6 µm with a range between 11.5 µ m and 28.7 µ m. Group 2 had a median damage depth of 166.3 µ m, with a range between 86.6 to 263.1 µ m. The depth differences between the two groups were statistically significant (<italic>p</italic> &lt; 0.001, Mann–Whitney test). The atomic composition of the WL group was similar to sound enamel. The TC group showed a quantitative increase in carbon and silicone by 38.2% and 11.5%, respectively, a decrease in oxygen by 44.1% and an absence of phosphorous and calcium.</p> </sec> <sec> <title style='display:none'>Conclusion</title> <p>WL is efficient at removing composite from the enamel surface but could result in increased enamel surface roughness in comparison with conventional TC burs.</p> </sec> </abstract>ARTICLEtrue extraction practices: a cross-sectional survey of orthodontists in Australia<abstract> <title style='display:none'>Abstract</title> <sec id="j_aoj-2022-0013_s_006"> <title style='display:none'>Objective</title> <p>To survey Australian-based orthodontists regarding their opinions on their extraction practices.</p> </sec> <sec id="j_aoj-2022-0013_s_007"> <title style='display:none'>Method</title> <p>A pilot-tested electronic-questionnaire was distributed to 465 members of the Australian Society of Orthodontists. Questions pertained to their demographic details, current extraction rates, changes in prescribed orthodontic extraction patterns over the past 5 to 10 years and the factors that may have influenced decisions.</p> </sec> <sec id="j_aoj-2022-0013_s_008"> <title style='display:none'>Results</title> <p>A response rate of 35.05% was recorded. Orthodontists estimated that they extracted permanent teeth in 21.03% and 22.06% of recently treated adults and children/adolescents presenting with a Class I malocclusion. Respondents were less comfortable carrying out non-extraction treatment in child/adolescent patients (15.4%) than in adult patients (34.7%) when crowding was greater than 6 mm. Most orthodontists (55.89%) who had practiced for more than 5 years believed that the number of patients that were treated by extractions was unchanged over the past 5 to 10 years while 34.55% believed that the proportion had decreased. More experienced orthodontists tended to report increased rather than decreased extraction rates (<italic>p</italic> = 0.0102). Most of those (88.1–93.17%) who reported decreased extraction rates considered facial aesthetics had a moderate/major influence on their extraction decisions. The increased use of ‘combined’ interproximal reduction (IPR) and arch lengthening in children/adolescents (55.8%) and IPR in adults (85%) was reported by those whose extraction rates had decreased.</p> </sec> <sec id="j_aoj-2022-0013_s_009"> <title style='display:none'>Conclusions</title> <p>Orthodontists extracted permanent teeth in just over 20% of their patients who presented with a Class I malocclusion. Most orthodontists considered that their extraction rates had not changed over the past 5 to 10 years. The increased use of IPR with or without arch lengthening procedures, was reported by those whose extraction rates had decreased over the same time period.</p> </sec> </abstract>ARTICLEtrue