OF Ortodontijos klinika (05.05)

Background/Objectives: Helicobacter pylori (H. pylori) infection remains common globally, yet data on its prevalence and correlates among dental students in Eastern Europe are limited. Dental students may face potential occupational exposure through contact with saliva and aerosols during their clinical training. This study aimed to measure the seroprevalence of H. pylori among Lithuanian dental students and evaluate its associations with academic year, self-perceived oral health and hygiene factors, and gastrointestinal symptoms. Methods: An observational–analytical cross-sectional study was conducted in 2025 among 202 dental students from lower (I–II) and higher (IV–V) academic years at the Lithuanian University of Health Sciences. Participants underwent serological testing for H. pylori IgG antibodies using capillary blood and completed a structured questionnaire on sociodemographic factors, oral health behaviors, clinical exposure, and gastrointestinal symptoms assessed by the Gastrointestinal Symptoms Rating Scale (GSRS). Descriptive and bivariate statistical analyses were performed to assess associations. Results: Overall H. pylori seroprevalence was 12.4% and did not differ significantly in different academic years. Seropositivity was significantly associated with longer toothbrushing duration and a family history of stomach ulcer. No significant associations were found with the number of patients treated, the use of personal protective equipment, or most oral hygiene indicators. Higher-year students reported greater overall gastrointestinal symptom scores than lower-year students; however, GSRS scores did not differ between H. pylori-seropositive and -seronegative participants. Conclusions: H. pylori seroprevalence in this student population was relatively low, and no association was found with clinical exposure or gastrointestinal symptom severity. Household-related factors may be more relevant to transmission than occupational exposure in dental training. Further longitudinal studies are needed to clarify risk factors and transmission pathways.

Fluoride is used to prevent both primary and secondary dental caries. Using fluoride-containing products is strongly correlated with the corrosion of orthodontic archwires. The aim of this study was to examine the physical, chemical, and mechanical properties of nickel-titanium (NiTi) orthodontic archwires affected by exposure to fluoride-containing toothpaste.

Background: The bond strength of orthodontic tubes to the enamel surface is essential for maintaining appliance stability, especially due to high masticatory forces on molars. Strong adhesion reduces the need for rebonding, shortening treatment time. This study aimed to evaluate the impact of tube base size and enamel sandblasting on bond strength in vitro. Methods: Eighty extracted permanent molar teeth were used for this study, divided into four groups of 20 samples each: M—small base tubes (non-sandblasted enamel), SM—small base tubes (sandblasted enamel), T—large base tubes (non-sandblasted enamel), and ST—large base tubes (sandblasted enamel). Shear bond strength was measured using the Mecmesim Multitesters 2.5-I device. Statistical analysis was conducted using IBM SPSS 27.0 software, applying ANOVA and Tukey’s post hoc test. Results: The highest bond strength (N) was recorded in the ST group, 85.51 ± 25.04 N, and the lowest in the M group, 50.23 ± 19.76 N. In terms of MPa, the SM group had the highest average value, 11.31 ± 3.57 MPa, while the T group had the lowest, 4.89 ± 1.33 MPa. ANOVA showed a statistically significant effect of tube base size on bond strength (p < 0.001), while sandblasting had no significant effect (p > 0.05). Conclusions: Larger base orthodontic tubes demonstrate stronger adhesion to enamel and are recommended for molars. Sandblasting the enamel does not significantly impact bond strength.

Background and Objectives: Current evidence remains insufficient to determine whether the impact of autism spectrum disorder (ASD) on dental health is primarily mediated through oral hygiene and dietary habits or through direct effects of the disorder itself. This study examined the theoretical pathways through which ASD severity and toothbrushing-related and dietary-choice-related factors influence dental health in autistic children and adolescents. Materials and Methods: A cross-sectional study was conducted with 399 mothers reporting on their autistic children (aged 2–18 years, mean = 7.8). The exclusion criterion was being older than 18 years. Data included parent-reported data about ASD severity, dental health status, willingness to brush teeth, and dietary quality (assessed using the Diet Quality Inventory). Structural Equation Modeling (SEM) was used to analyze the direct and indirect effects of ASD severity on dental health, with probit regression coefficients estimated using the WLSMV method. Results: Parent-reported variables of ASD severity, diet quality, and toothbrushing willingness together explained 37% of the variance in dental health. The direct effect of ASD severity on dental health was 0.199 (p = 0.039). The indirect effect via toothbrushing was 0.137 (p = 0.006), and via diet quality, it was 0.070 (p = 0.020). The total indirect effect of ASD on dental health was 0.207 (p = 0.026), which was approximately as strong as the direct effect. The associations among the studied variables were statistically equivalent across sex and age groups. Conclusions: Parent-reported ASD severity shows significant association with dental health outcomes, both directly and indirectly, with toothbrushing behavior emerging as the primary mediator. Interventions that promote regular brushing (and, to a lesser extent, healthier eating) may help to reduce the dental health disparities associated with autism.

Purpose. The aim of the present study was to evaluate the difference between bone atrophy, pink esthetic score, and long-term results in socket shield technique compared to traditional immediate implantation.

Materials and methods. The literature review was carried out according to PRISMA principles and the database search was performed using the following keywords: „Socket shield technique “, „Root membrane “, „Pink esthetic score “, and „Immediate dental implant loading “. This review involved studies with humans that were published in English. The studies were published between 2018 and 2025, and the socket shield technique was compared with traditional immediate implantation.

Results. Out of 517 records, 5 randomized controlled trials were selected, reporting 169 patients who received 184 implants (92 socket-shield technique, 92 immediate implant). Meta-analysis of the Pink Esthetic Score outcomes showed that implants placed using the socket-shield technique (intervention group) achieved significantly higher pink esthetic scores than those implants placed immediately (pooled mean difference = 1.29; 95% CI: 0.32–2.26; p=0.0095), demonstrating a statistically significant effect in favor of the intervention group. Our systematic review demonstrates that socket-shield technique provides superior preservation of marginal bone compared with traditional immediate implantation protocols.

Conclusions. The socket shield technique allows implant rehabilitation characterized by better aesthetic outcomes and minimal bone loss compared to traditional immediate implantation.

Objectives: This systematic review study aims to evaluate the effectiveness of flapless laser corticotomy in accelerating canine distalization during extraction-based orthodontic treatment.

Material and Methods: Present systematic review followed PRISMA guidelines and was registered at the PROSPERO database (CRD420251055675). Literature searches were conducted across PubMed, The Cochrane Library, ScienceDirect, Web of Science databases. The search included human studies, which measured canine distalization rate, published in English up to August 31, 2025, with no time restriction. The quality of the studies was assessed using the Cochrane risk of bias tool (RoB 2.0) and the statistical examination was done using the Review Manager (RevMan).

Results: Seven split-mouth randomized controlled trial studies with 103 patients were included, of which four studies with 55 patients were suitable for quantitative analysis. Flapless laser corticotomy significantly accelerated canine distalization in the first month (MD = 0.83; 95% CI = 0.3 to 1.35, where MD indicates mean difference and CI - 95% confidence interval, P = 0.002) and second month (MD = 0.44; 95% CI = 0.09 to 0.79; P = 0.01), despite high heterogeneity. No significant differences were found in the third (MD = 0.03; 95% CI = -0.18 to 0.24; P = 0.79) or fourth month (MD = -0.04; 95% CI = -0.13 to 0.05; P = 0.37).

Conclusions: The results proved flapless laser corticotomy as an effective method to increase canine distalization speed during the first two months of the treatment. However, more trials with bigger sample sizes should be performed to validate its clinical effectiveness.

Aim This study aims to assess the discoloration of clear orthodontic aligners caused by commonly consumed beverages and to compare the effectiveness of various cleaning agents in stain removal. Materials and methods A total of 100 clear orthodontic aligners were immersed for seven days in four commonly consumed beverages, specifically black coffee, black coffee with milk, kombucha, and a green smoothie, as well as in distilled water, which served as the control solution. Following this immersion period, 20 aligners from each beverage group were cleaned using four different cleansing agents: Bluem Aligner Foam, Curaprox BDC 100 Denture Gel Daily, IsoDent Ortho Cleaner, and 3% hydrogen peroxide. The VITA Easy-Shade compact spectrophotometer used the CIELAB (Commission Internationale de L'Eclairage Lab* colour system) scheme to evaluate the color change of the aligners at four intervals: T0 (before immersion), T1 (after 24 hours), T2 (after 48 hours), T3 (after seven days), and T4 (after cleaning with cleansing agents). The color values were converted into National Bureau of Standards (NBS) units to quantify the degree of color change. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 29 (Released 2022; IBM Corp., Armonk, New York, United States), employing non-parametric methods to assess differences between groups and across time intervals. Results A significant color change in aligners was observed after immersion in the stated solutions (p < 0.001). Among the staining agents, black coffee induced the highest and most consistent colour change at T0-T3 ΔE = 8.867 (8.553-9.22), followed by coffee with milk ΔE = 3.325 (3.259-3.544), kombucha ΔE = 2.45 (2.272-3.094), and green smoothie ΔE = 1.581 (1.463-1.723) (p < 0.001). Intergroup and intragroup comparisons of cleansing agents revealed no significant differences among groups. Conclusion The study demonstrated significant differences in the staining potential of various beverages on clear aligners, with black coffee inducing the most pronounced discoloration. All aligners exhibited progressive color changes over time. The cleansing agents tested showed limited efficacy, with no statistically significant ability to reverse the discoloration.

The aim of this study is to compare maxillary dimensional changes in mixed dentition patients treated with clear aligners (CA) to those treated with rapid palatal expanders (RME). MATERIALS AND METHOD: The systematic review was carried out following the PRISMA guidelines. The PICO question was: do rapid palatal expanders expand the maxilla better than clear aligners in mixed dentition patients? The search with keywords “clear aligner” AND “rapid palatal expander” AND “mixed dentition” was performed in six databases and registers: PubMed, Google Scholar, ScienceDirect, Web of Science, Cochrane Library and ClinicalTrials.gov. Inclusion criteria: full-text research articles published less than five years ago, written only in English, randomized controlled trials, and retrospective and prospective cohort studies. RESULTS: The search resulted in a total of 992 research articles. After applying selection criteria, 8 full-text articles were found, 4 were included in this review for final analysis. A total of 242 patients participated in the conducted studies. Intraoral scans were taken before appliance placement and at the end of treatment, when the appliances were removed. Digital dental casts were then collected and analyzed. The results of Bruni et al showed that expansion was greater in the RME group; however, only the intermolar width at the gingival level was statistically significant (CA:1.58mm(SD1.53) to RME:3.87mm(SD1.67); p<0.001). Lombardo et al found that greater maxillary expansion was achieved with clear aligners in the intercanine width, both at the cusp and gingival levels (p<0.001). The study by Lu et al observed statistically significant differences in the intercanine (CA:1.89mm(SD1.56) to RME:4.18mm(SD2.01), intermolar (CA:2.43mm(SD1.42) to RME:5.32mm(SD1.13), and second interdeciduous molar (CA:1.93mm(SD1.75) to RME:5.52mm(SD1.31) widths (p<0.05), with more efficient expansion in the RME group. The findings of Torbaty et al also showed superior results in the RME group. CONCLUSION: Rapid palatal expansion is the preferred method for achieving maxillary expansion in mixed dentition patients, whereas clear aligners are more suited for targeted expansion of the anterior maxillary arch.

AIM: To analyze the effects of orthodontic treatment (OT) on periodontal status of maxillary and mandibular anterior teeth (AT) in patients with stage III-IV periodontitis. METHODS: Fifty patients with stage III-IV periodontitis (mean age 45.40, SD 9.95) who underwent periodontal-orthodontic treatment were included in a prospective clinical study. CBCT was performed before (T1) and after (T2) OT. Probing depth (PD), gingival recession (GR), clinical attachment level (CAL) and alveolar bone level (ABL) were measured before (T1) and after (T2) OT on mesial, distal, lingual and buccal surfaces of all AT. Outcomes were compared between maxillary and mandibular AT. RESULTS: All AT showed improvement in mean PD (0.48 mm; SD 0.45; p<0.05). No difference was found on any surface or between maxillary/mandibular AT (p>0.05). All AT showed improvement in mean GR (0.21 mm, SD 0.40; p<0.05). Significantly larger (p<0.05) mean GR improvement on mesial (0.39; SD 0.52) and distal (0.41; SD 0.54) surfaces of maxillary AT compared with mandibular AT (mesial 0.09; SD 0.46; distal 0.15; SD 0.39) was observed. However, maxillary mean buccal (0.17; SD 0.40) and lingual (0.31mm; SD 0.47) surfaces showed improvement compared with mandibular buccal (-0.03; SD 0.39) and lingual (-0.01; SD 0.45) surfaces with tendency to GR worsening (p<0.05). All AT showed improvement in mean CAL (0.62 mm; SD 0.33, p<0.05). Greater (p<0.05) mean CAL improvement on mesial surfaces of maxillary AT (0.94 mm (SD 0.74) compared to mandibular AT (0.64 mm; SD 0.51) was observed. All AT showed no change in mean ABL (0.11 mm; SD 0.52; p>0.05). Mean ABL improvement was greater (p<0.05) on mesial (0.72; SD 0.96) and distal (0.50; SD 0.87) surfaces of mandibular AT compared with mesial (0.25; SD 0.80) and distal (0.17; SD 0.69) surfaces of maxillary AT. On the contrary, mean ABL change on buccal and lingual surfaces of all AT was not significant (p>0.05), however with tendency of ABL loss. CONCLUSIONS: OT resulted in improved mean PD, GR and CAL in all AT. Maxillary AT showed improvement of all parameters, however mandibular AT showed the risk for GR worsening on buccal and lingual surfaces compared with maxillary AT.

AIMS: This in vitro study aims to evaluate the roughness changes of the enamel surface following different techniques of residual orthodontic adhesive removal after molar tubes debonding. MATERIAL AND METHODS: Forty extracted human molars were divided into four groups (n=10) based on residual orthodontic adhesive removal technique: group 1 (G1) – carbide bur (CB); group 2 (G2) – CB and Enhance polishing points; group 3 (G3) – CB and OneGloss polishing points; group 4 (G4) – CB and SuperSnap polishing disks. All samples (n=40) were evaluated using a laser scanning microscope to determine the average enamel surface roughness. A scanning electron microscopy (SEM) analysis was performed on one sample from each group to determine changes in enamel surface integrity. The evaluations were performed before bonding (T1) and after orthodontic adhesive removal (T2). The time required for orthodontic adhesive removal was measured in all groups. The data analysis was performed with SPSS 27.0 using Shapiro-Wilk, Wilcoxon, Spearman’s correlation, Kruskal-Wallis H, and Dunn’s tests. A value of p<0.05 was considered as significant. RESULTS: The mean enamel surface roughness at T1 was 15.94 (SD 2.68) μm. At T2, a significant increase in the mean enamel roughness value to 23.18 (SD 7.59) μm was observed (p=0.000). The G3 group showed the least alteration in enamel roughness. The greatest change in enamel surface roughness was observed in G1 (9.43 μm), followed by G2 (8.55 μm), G4 (7.43 μm), and G3 (3.55 μm). A significant difference was observed in the duration of orthodontic adhesive removal between the G1 and G2 (p=0.034), G1 and G4 (p<0.001), G1 and G3 (p<0.001), G2 and G3 (p=0.007). Spearman’s correlation test showed a significant correlation between the duration of orthodontic adhesive removal and enamel surface roughness assessed at T2 (p<0.05). SEM analysis revealed alterations in enamel surface integrity across all techniques. CONCLUSIONS: The use of a carbide bur to eliminate the thick excess of orthodontic adhesive, followed by OneGloss polishing point to remove the residual orthodontic adhesive, resulted in the lowest enamel surface roughness and minimal changes to enamel integrity; however, this technique was the most timeconsuming among those tested.