Shilpa Chawla

Introduction: Orthodontic improvements, mainly through the previous decade, have led to a substantial rise in patients’ esthetic needs. Traditional orthodontic procedures have been linked with a compromise in facial appearance, which increases concern among patients pursuing orthodontic treatment. Methods: PubMed, MEDLINE, Google Scholar, and Cochrane Library of Systematic Reviews databases were searched using appropriate entry terms and Boolean operators. Search strategy was conducted till June 2022 for systematic reviews and meta-analyses. Publications were systematically assessed for eligibility, and two observers independently graded the methodologic quality using AMSTAR-2 tool. For each meta-analysis, we estimated the summary effect size by the use of random-effects and fixed-effects models and the 95% confidence interval. We estimated the between-study heterogeneity expressed by I ² (defined as large for I ² ≥50%), evidence of small-study effects (i.e., large studies had significantly more conservative results than smaller studies), and evidence of excess significance bias (i.e., more studies than expected with significant results). Results: Overall, 16 unique systematic reviews and meta-analyses following the eligibility criteria were selected for umbrella review. The results of qualitative analysis of studies revealed that 4 studies had a critically low risk of bias, 11 showed low risk, and 1 study had moderate risk. The results of the meta-analysis favored clear aligners with respect to oral hygiene and root resorption parameters. When tooth movements were considered, the results favored conventional orthodontic treatment. Conclusion: Clear aligner therapy (CAT) has significant advantages with regard to efficiency (treatment time, chair time) in mild-moderate malocclusion cases. The overall accuracy of CAT when compared to fixed orthodontic treatment was found to be 55-82%.

Background: With orthodontic patient demographics expanding to involve more adults, the demand for esthetic appliances is greater and orthodontists are keen on offering their patients more discreet and even invisible options. Clear aligners are a very viable option which offers all this, and it is noteworthy that more and more orthodontists in India are practicing the craft. Keeping this vision in mind, and the fact that aligners are revolutionary and here to stay, this study was conducted to assess the efficiency of various tooth movements carried out with clear aligner therapy as compared to traditional orthodontic treatment. Aim: This questionnaire-based survey aimed to analyze and assess the orthodontists’ perception and experience of various tooth movements carried out with clear aligner in their routine clinical practice in India. Methodology: A cross-sectional study was conducted by sending out a questionnaire on a virtual platform. It was approved by the Ethical Committee of the Dental Institute it was carried out in (Ref no: SDCH/IEC/OUT 2021/13). A sample size of 205 participants within the age group of 27–59 years was taken. The participants comprised of orthodontists practicing in various parts of India. A questionnaire, comprising of 22 closed-ended questions, was created on Google forms and circulated to participants using various social media platforms. The data of responses of participants were analyzed and evaluated with the help of chi-square test and p values were interpreted for the significance of responses. Results: This survey analyzed the experience of orthodontists with respect to the various tooth movements carried out with clear aligners. There were mixed responses, but most of them suggested the aligners to be either same in effectiveness or poorer than the fixed appliances in carrying out various tooth movements. Conclusion: This questionnaire-based survey helped in analyzing the orthodontists’ perception on the use of clear aligners in their routine clinical practice in India. It most importantly helped in assessing various kinds of tooth movements achievable with clear aligners. It also helped in getting an opinion on the movements presently not possible with aligners alone. This study clearly suggests that the general perception amongst the orthodontists is that more advancement is needed as far as aligners are concerned before they become competent enough to deal with various tooth movements easily achievable with fixed appliances.

Finite element analysis (FEA) incorporates the principles of erudite engineering to scrutinize stresses that cause deformation in structural units. This technique uses computer-assisted design software and FEA analysis software for modeling structural units established on their geometry, loading, boundaries, and converts the data into algebraic equations to find solutions for different applications. In dentistry, this computer-based simulation method is deemed revolutionary in forecasting and quantifying stress in investigational biological tissues, dental prostheses, and restorations. This review is designed to explicate the significance of FEA in diverse facets of dentistry with special consideration to orthodontics.

Introduction: The mini CEX (Clinical Evaluation Exercise) is a workplace-based assessment tool intended to assess the clinical performance and a range of other skills such as communication skills, clinical judgment, professionalism, efficiency, and the overall clinical care while directly observing a real patient encounter. The clinical sessions are followed by structured feedback sessions between the assessors and the trainees. Mini CEX focuses on the actual performance and not just knowledge. This leads to better learning as well as helps to develop and strengthen the doctor–patient bond. Materials and Methods: 8 staff members and 9 orthodontic postgraduate students volunteered to participate in this study after the orientation session was taken to sensitize them about the same. An informed consent was taken from all of them. All the students had 2 sessions with all the assessors. As per the protocol of Mini CEX, immediate feedback about their performance was given to the students after each session. Feedback was also obtained from the assessors and the students after the completion of the exercise. This feedback allowed the assessors and the students to give their views on the exercise. Result: Mean scores of all the students significantly improved in the second session as compared to the first encounter. This was attributed to the feedback which they obtained from the assessors immediately after the session, which helped them improvise on various aspects of patient care. The students themselves felt that the exercise helped them learn better. Conclusion: Mini CEX can hence be considered as a valid formative assessment tool which when routinely used could enhance the learning experience, improve the communication skills of the students, as well as improve the doctor–patient bond.