Background/purpose The formation of white spot lesions (WSLs) around fixed orthodontic attachments is a common complication during and following fixed orthodontic treatment, marking the result of a successfully completed treatment. This double-blind, randomized clinical trial study aims to investigate the varying effects of nano-silver, chlorhexidine (CHX) or fluoride mouthwashes on WSLs. Materials and methods Double-blind prospective randomized clinical trial, comprised of forty-two patients with mild to moderate crowding, were recruited for this study. Randomization and allocation to trial group were carried out by computer system in college of dentistry, university of Sulaimani from January 2020 to September 2020. The patients were divided into three groups (14 per group) according to the type of mouthwash used during the treatment (nano-silver, CHX or fluoride), using block randomization. The clinical examination for the presence of WSLs was recorded through visual examination of the upper and lower anterior teeth using the International Caries Detection and Assessment System (ICDAS II) score before bonding and at 30, 90 and 180 days after bonding of the upper and lower arches. Results The total number of patients was 42 (16 males and 26 females) with a mean age of 23.02 ± 3.841 (18–37) years old, distributed into three groups of 14 patients. There is significant difference in white spot lesions formation between the three groups; the mean of WSLs in nanosilver group is lower than CHX and fluoride group in 90 and 180 days of follow-up (P < 0.05). Conclusion Nano-silver mouthwash is more effective than CHX and fluoride mouthwash in reducing WSLs during orthodontic treatment.

Background and Objective: This study based on decoding of the original periodontal screening and recording (PSR) index by adding some additional clinical variables and preserving its simplicity. This study aimed to decode PSR index to reveal all the percentage of variables masked by each code in PSR index. Methods:In this interventional clinical study, PSR criteria were obtained from 50 participants plus decoding of each PSR code such as percentage of bleeding (Bl), calculus (Cal) and pocket depth (PD) in each sextant. Further modification of PSR was involved adding few extra variables such as stain (St), over-hanged restorations (Ov) and crowding (Cr) to each sextant. The average of PSR codes and following decoding in each subject was calculated and compared to show the percentage of masking. The study was conducted in B&R Dental Center (March-October 2019).Results: PSR index and decoding of the variables were collected from 50 subjects. PSR code 2 was the most prevalent code (62.61%) followed by code 1 (16.83%) and code 3 (10.1%). Furthermore, BI, St, Cal and Ov were the most frequent variables recorded among all sextants. Decoding of code 2, showed that 76.8% of BI was masked by PSR index. Whereas, PSR code 3 masked 96.2% of variables of PSR code 1 and 2 (BI, stain, calculus, over-hanged restoration and crowding). Finally, 98.6% of variables in PSR code 1, 2 and 3 were masked by PSR code 4. Conclusions:Decoding the PSR index by exposing the masked variables and adding few new variables will develop more informative and inclusive system of examination and diagnosis along with keeping the simplicity of the other indices of periodontal screening such as PSR index.

Purpose Patient compliance during orthodontic treatment has a significant effect on the aims, outcome, and duration of the treatment. The aim of this study is to evaluate the influence of reminders on enhancing orthodontic patient compliance. Patients and Methods Twenty-six subjects undergoing orthodontic treatment with fixed appliances were randomly assigned into two groups: control (Ct) and intervention (In) groups. The oral hygiene parameters of plaque index (PI), bleeding index (BI), and white spot lesion (WSL) with appointment adherence and bracket fracture were recorded at base line (T0), 2 months (T1), 4 months (T2), and 6 months (T3). In group participants received weekly reminders and subjects’ compliances were classified into poor, fair, and excellent compliance. Results Statistically significant differences were found in PI level at T2 between Ct and In groups (p-value = 0.006), whereas a non-significant difference was found for BI (p-value>0. 05). There was a statistically significant increase in WSL for the Ct group across the study time points (p-value = 0.03), while no significant change in WSL was detected for the In group (p-value>0.05). The compliance levels of In and Ct groups were excellent and fair, respectively. Conclusion The study suggests that weekly reminders can enhance the oral hygiene status in patients with orthodontic appliances (POA) and elevate the level of compliance to excellent. Registration number ClinicalTrials.gov NCT05331820.