Background Clear aligner treatment has become popular over recent years. It is necessary to identify methods by which we could avoid the bowing effect in extractions with clear aligner. The present study was to identify the appropriate method to design torque movement involving the upper anterior teeth of extraction cases, in order to maintain or improve the axis and torque of the upper anterior teeth with a clear aligner during movement and closure of the extraction space. Results As the height of the power ridge increased, the rotation angle of the upper central incisor in the sagittal direction decreased gradually and the location of the rotation center changed significantly; the rotation center moved in the apical direction and then changed to the crown side. The highest von-Mises stress of the upper central incisor root, periodontal ligaments, and alveolar bone, showed little change as the power ridge height increased. When the axial inclination of the upper central incisor was normal (U1-SN = 105°), the tendency of movement for the upper central incisor approached translation with a power ridge height of 0.7 mm (corresponding distorted angle: 5.8415). When the axial inclination of the upper central incisor was oversized (U1-SN = 110°), the axial inclination of the upper central incisor reduced to normal following completion of the anterior segment retraction with a power ridge of 0.4 mm (corresponding distorted angle: 3.4265). Conclusion Analysis indicates that pure palatal tipping movement of the upper anterior teeth is generated without torque control, thus resulting in the bowing effect. The required torque control of the upper anterior teeth with oversize axial inclination is weaker than that of the upper anterior teeth with normal axial inclination because limited torque loss is expected for oversize axial inclination teeth. Variation sensitivity of the rotation center should be considered carefully due to biological problems when designing translation of the upper anterior teeth with normal axial inclination.
Introduction The effects of upper-molar distalization using clear aligners in combination with Class II elastics for anchorage reinforcement have not been fully investigated yet. The objective of this study is to analyze the movement and stress of the whole dentition and further explore guidelines for the selection of traction methods. Methods Three-dimensional (3D) finite element models are established to simulate the sequential molar distalization process, including the initial distalization of the 2nd molar (Set I) and the initial distalization of the 1st molar (Set II). Each group set features three models: a control model without Class II elastics (model A), Class II elastics attached to the tooth by buttons (model B), and Class II elastics attached to the aligner by precision cutting (model C). The 3D displacements, proclination angles, periodontal ligament (PDL) hydrostatic stress and alveolar bone von Mises stress in the anterior area are recorded. Results In all of the models, the maxillary anterior teeth are labial and mesial proclined, whereas the distal moving molars exhibit distal buccal inclination with an extrusion tendency. With the combination of Class II elastics, the anchorage was effectively reinforced; model C demonstrates superior anchorage reinforcement with lower stress distribution in comparison with model B. The upper canines in model B present an extrusion tendency. Meanwhile, the mandibular dentition in models B and C experience undesired movement tendencies with little discrepancy from each other. Conclusions Class II elastics are generally effective for anchorage reinforcement as the upper-molar distalization is performed with clear aligners. Class II elastics attached to an aligner by precision cutting is a superior alternative for maxillary anchorage control in cases that the proclination of upper incisors and extrusion of upper canines are unwanted.
Background Despite the popularity of clear aligner treatment, the effect of the thickness of these aligners has not been fully investigated. The objective of this study was to assess the effects of incisor torque compensation with different thicknesses of clear aligner on the three-dimensional displacement tendency of teeth in cases of extraction. Methods Three-dimensional finite element models of the maxillary dentition with extracted first premolars, maxilla, periodontal ligaments, attachments, and aligners were constructed and subject to Finite Element Analysis (FEA). Two groups of models were created: (1) with 0.75 mm-thick aligners and (2) with 0.5 mm-thick aligners. A loading method was developed to simulate the action of clear aligners for the en masse retraction of the incisors. Power ridges of different heights were applied to both groups to mimic torque control, and the power ridges favoring the translation of the central incisors were selected. Then, we used ANSYS software to analyze the initial displacement of teeth and the principle stress on the PDL. Results Distal tipping, lingual tipping and extrusion of the incisors, distal tipping and extrusion of the canines, and mesial tipping and intrusion of the posterior teeth were all generated by clear aligner therapy. With the 0.5 mm-thick aligner, a power ridge of 0.7 mm could cause bodily retraction of the central incisors. With the 0.75 mm-thick aligner, a power ridge of 0.25 mm could cause translation of the central incisors. Aligner torque compensation created by the power ridges generated palatal root torque and intrusion of the incisors, intrusion of the canines, mesial tipping and the intrusion of the second premolar; these effects were more significant with a 0.75 mm-thick aligner. After torque compensation, the stress placed on the periodontal ligament of the incisors was distributed more evenly with the 0.75 mm-thick aligner. Conclusions The torque compensation caused by power ridges can achieve incisor intrusion and palatal root torque. Appropriate torque compensation with thicker aligners should be designed to ensure bodily retraction of anterior teeth and minimize root resorption, although more attention should be paid to the anchorage control of posterior teeth in cases of extraction.
ObjectiveTo analysis the relationship between periodontitis (PD) and oral squamous cell carcinoma (OSCC) by bioinformatic analysis.Materials and MethodsWe analyzed the gene expression profiles of PD (GSE16134) from the Gene Expression Omnibus (GEO) database and OSCC samples from TCGA‐HNSC (head and neck squamous cell carcinoma) and identified common differentially expressed genes (DEGs) in PD and OSCC. Then, functional annotation and signaling pathway enrichment, protein interaction network construction, and hub gene identification were performed. Subsequently, the function and signaling pathway enrichment of hub genes, miRNA interaction, and transcription factor interaction analyses were carried out. We analyzed GSE10334 and GSE30784 as validation datasets, and performed qRT‐PCR experiments simultaneously for validation, and obtained 4 hub genes. Finally, immune infiltration analysis and clinical correlation analysis of 4 hub genes and related miRNAs were performed.ResultsWe identified 31 DEGs (16 up‐regulated and 15 down‐regulated). Four hub genes were obtained by qRT‐PCR and validation dataset analysis, including IL‐1β, CXCL8, MMP12, and MMP13. The expression levels of them were all significantly upregulated in both diseases. The functions of these genes focus on three areas: neutrophil chemotaxis, migration, and CXCR chemokine receptor binding. Key pathways include IL‐17 signaling pathway, chemokine signaling pathway, and cytokine–cytokine receptor interactions pathway. Immune infiltration analysis showed that the expressions of 4 hub genes were closely related to a variety of immune cells. ROC curve analysis indicated that AUCs of 4 hub genes are all greater than 0.7, among which MMP12 and MMP13 were greater than 0.9. Kaplan–Meier survival analysis indicated that worse OS was strongly correlated with CXCL8 and MMP13 high‐expression groups. MMP12 low‐expression group was strongly associated with worse OS. The results of multivariate Cox regression analysis showed that age, N stage, CXCL8, MMP12, and MMP13 were independent prognostic factors for OS. We also identified 3 miRNAs, including hsa‐miR‐19b‐3p, hsa‐miR‐181b‐2‐3p, and hsa‐miR‐495‐3p, that were closely related to 4 hub genes. Hsa‐miR‐495‐3p is closely related to the diagnosis and prognosis of OSCC.ConclusionsWe identified 4 hub genes between PD and OSCC, including IL‐1β, CXCL8, MMP12, and MMP13. These genes may mediate the co‐morbid process of PD and OSCC through inflammation‐related pathways such as the IL‐17 signaling pathway. It is worth noting that CXCL8, MMP12, and MMP13 have great significance in the diagnosis and prognosis of OSCC.
Introduction: Clear aligner treatment (CAT) has become popular over recent years because it is both comfortable and aesthetically acceptable. However, most of patients undergoing orthodontic treatment request dental bleaching. A safe and controlled bleaching treatment at the same time as the clear aligner treatment can save time and improve patient satisfaction with the outcome of the treatment.Aim: This study was aimed to develop a thermoforming film loaded with hydrogen peroxide as a clear aligner and detect its efficiency on teeth blenching and its influence on shear bonding strength for attachment.Methods: The thermoforming film loaded with sodium alginate-dopamine/Mesoporous silica nanoparticles compound gel was immersed in 6 wt% hydrogen peroxide solution and the hydrogen peroxide was loaded into mesoporous silica nanoparticle channels by capillary action. Then, a thermoforming film loaded with sustained-release hydrogen peroxide gel was made. Six dentition models were prepared with 90 isolated human premolars and divided into the experiment group, the condition control group and the blank control group, respectively. Then, the experiment group wore the clear aligner made by the thermoforming film loaded with hydrogen peroxide for 40 days; the conditional control group wore the clear aligner made by the ordinary thermoforming film for 40 days; and the blank control group wore no clear aligner. The aligners were updated every 10 days and the color of teeth was measured every 10 days. Tooth color should be determined by specific parameters (L, a* and b*). What’s more, in order to determine the influence of the thermoforming film loaded with sustained-release hydrogen peroxide gel on shear bonding strength for attachment. The shear bonding strength of attachment of isolated premolars were measured.Results: Isolated premolars treated by bleaching experiments showed an increase in L value (ΔL = 7.76 ± 0.64) and a decrease in both a* (Δa = −0.82 ± 0.12) and b* (Δb = −3.10 ± 0.21) values. However, the isolated premolars in conditional control group and blank control group exhibited that an decrease in L value (ΔLCCG = −0.91 ± 0.24; ΔLBCG = −0.86 ± 0.15)and a increase in both a* (ΔaCCG = 0.19 ± 0.05; ΔaBCG = 0.18 ± 0.04) and b* (ΔbCCG = 0.43 ± 0.11; ΔbBCG = 0.31 ± 0.10) value. While the shear bonding strength for attachment after bleaching was 22.78 ± 2.28 MPa, which had no significant change compared with the shear bonding strength for attachment without bleaching experiment (22.21 ± 2.77 MPa) (p > 0.05). Conclusion: A thermoforming film featuring the sustained release of hydrogen peroxide had a good bleaching effect on isolated teeth and had no significant influence on the shear bonding strength for attachment.
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