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Adverse effects of orthodontic forces on dental pulp. Appearance and character. A systematic review.Acta Odontologica Scandinavica May 2023To comprehensively assess recent data on the effects of orthodontic forces on the dental pulp and to critically evaluate, whether any of the changes are permanent.
OBJECTIVE
To comprehensively assess recent data on the effects of orthodontic forces on the dental pulp and to critically evaluate, whether any of the changes are permanent.
MATERIALS AND METHODS
Articles published between 2/2009 and 2/2022 were searched electronically on the PubMed, EMBASE and SCOPUS databases. The initial search retrieved 780 publications and, applying the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 33 relevant articles were identified. Twenty articles fulfilled the requirements for high ( = 1) or moderate ( = 19) methodological quality and were included. All assessments were made independently by three researchers.
RESULTS
Orthodontic forces appeared to cause a reduction in pulpal blood flow and a reduction in tooth sensibility, as indicated by increased response thresholds and increased amounts of negative responses to tooth sensibility tests. In addition, there were increases in the expression or activity levels of enzymes and neuropeptides associated with hypoxia and inflammation. Fibrotic tissue formation in the pulp was also reported.
CONCLUSIONS
Except for some histological and morphological alterations, the observed pulpal changes were in most cases only temporary, appearing within days of initiating the treatment and usually lasting for weeks. There were no clear signs of permanent damage.
Topics: Humans; Dental Pulp; Bite Force
PubMed: 36436210
DOI: 10.1080/00016357.2022.2137232 -
Dental and Medical Problems 2023This systematic review and meta-analysis aimed to summarize the effectiveness of bonded and removable retainers (the Hawley and Essix retainers) in terms of improving... (Meta-Analysis)
Meta-Analysis Review
This systematic review and meta-analysis aimed to summarize the effectiveness of bonded and removable retainers (the Hawley and Essix retainers) in terms of improving occlusal settling (occlusal contact points/areas) after orthodontic treatment. We searched the Cochrane Library, PubMed, CINAHL Plus, and Dental & Oral Sciences Source (DOSS), as well as SIGLE, Google Scholar and ClinicalTrials.gov for eligible studies. We included randomized and non-randomized controlled trials along with cohort studies. Studies that reported occlusal contacts/areas during retention with fixed bonded and removable retainers were included. To assess the quality of the randomized controlled trials (RCTs), the Cochrane Collaboration risk-of-bias (RoB) tool was utilized, whereas the Newcastle-Ottawa Scale (NOS) was used to assess the quality of cohort studies.We included 6 articles in our systematic review after scrutinizing 219 articles and eliminating the illegible ones based on duplication, titles, abstracts, and objectives. Bonded retainers (BRs) allowed faster and better posterior occlusal settling as compared to the Hawley retainer (HR). However, HR showed good occlusal settling in the anterior dental arch. The Essix retainer (ER) showed a decrease in occlusal contact during the retention phase. Meta-analysis showed no statistically significant difference between BRs and removable retainers. In conclusion, HR allowed better overall occlusal settling as compared to other retainers. However, BRs allowed faster settling in the posterior tooth region. The Essix retainer showed poor settling of occlusion. Overall, there is an insufficient number of high-quality RCTs to provide additional evidence, and further high-quality RCTs are needed.
Topics: Humans; Orthodontic Retainers; Tooth; Malocclusion
PubMed: 37458399
DOI: 10.17219/dmp/146194 -
The Journal of Prosthetic Dentistry May 2017The presence of temporomandibular disorders (TMDs) and/or bruxism signs and symptoms may present multifaceted concerns for the prosthodontist. (Review)
Review
STATEMENT OF PROBLEM
The presence of temporomandibular disorders (TMDs) and/or bruxism signs and symptoms may present multifaceted concerns for the prosthodontist.
PURPOSE
The purpose of this systematic review was to evaluate the relationship between prosthetic rehabilitation and TMDs and bruxism.
MATERIAL AND METHODS
Three research questions were identified based on different clinical scenarios. Should prosthodontics be used to treat TMD and/or bruxism? Can prosthodontics cause TMDs and/or bruxism? How can prosthodontics be performed (for prosthetic reasons) in patients with TMDs and/or bruxism? A systematic search in the PubMed database was performed to identify all randomized clinical trials (RCTs) comparing the effectiveness of prosthodontics with that of other treatments in the management of TMDs and/or bruxism (question 1); clinical trials reporting the onset of TMDs and/or bruxism after the execution of prosthetic treatments in healthy individuals (question 2); and RCTs comparing the effectiveness of different prosthodontics strategies in the management of the prosthetic needs in patients with TMDs and/or bruxism (question 3).
RESULTS
No clinical trials of the reviewed topics were found, and a comprehensive review relying on the best available evidence was provided. Bruxism is not linearly related to TMDs, and both of these conditions are multifaceted. Based on the diminished causal role of dental occlusion, prosthetic rehabilitation cannot be recommended as a treatment for the 2 conditions. In theory, they may increase the demand for adaptation beyond the stomatognathic system's tolerability. No evidence-based guidelines were available for the best strategy for managing prosthetic needs in patients with TMDs and/or bruxism.
CONCLUSIONS
This systematic review of publications revealed an absence of RCTs on the various topics concerning the relationship between TMD and bruxism and prosthodontics. Based on the best available evidence, prosthetic changes in dental occlusion are not yet acceptable as strategies for solving TMD symptoms or helping an individual stop bruxism. Clinicians should take care when performing irreversible occlusal changes in healthy individuals and in patients with TMD and/or bruxism.
Topics: Bruxism; Humans; Patient Care Planning; Prosthodontics; Temporomandibular Joint Disorders
PubMed: 27836142
DOI: 10.1016/j.prosdent.2016.09.012 -
Cureus Sep 2023Restoration of hemimandibulectomy defects following tumour extirpation to restore oral function is a herculean task for practitioners. Prosthetic treatment alternatives... (Review)
Review
Restoration of hemimandibulectomy defects following tumour extirpation to restore oral function is a herculean task for practitioners. Prosthetic treatment alternatives available for rehabilitation of acquired hemimandibulectomy defects according to mandibular reconstruction type and extent (Cantor-Curtis classification) are unclear. This systematic review aims to assess the spectrum of prosthodontic rehabilitation approaches with regard to reconstruction type and extent of mandibular surgical defects. The databases incorporated for literature search were Google Scholar and Medline (PubMed). Relevant search terms for hemimandibulectomy and reconstruction with prosthetic rehabilitation were used. Two reviewers independently assessed the articles using eligibility criteria; published case reports and case series in the English language and depicting prosthodontic treatment modality of patients greater than 15 years were included. A total of 202 records were identified from the database search of which 19 duplicates were removed. The remaining articles were assessed for eligibility, and 55 articles (comprising 58 cases) were finally included in the study. This review revealed various prosthetic alternatives ranging from guide flange, twin occlusion, palatal ramp, conventional to hybrid partial and complete dentures to implant-supported prosthesis including a few innovative prosthetic approaches. This systematic review provides a plethora of prosthodontic rehabilitation approaches according to the extent of hemimandibular surgical defect and type of reconstruction. This will facilitate practitioners and prosthodontists in sequential treatment planning and management of hemimandibulectomy cases in their routine practice.
PubMed: 37799255
DOI: 10.7759/cureus.44647 -
British Dental Journal Jun 2017Objective The objective of this systematic review is to evaluate the survival rate of resin bonded bridges (RBBs) and understand the relationship between various... (Review)
Review
Objective The objective of this systematic review is to evaluate the survival rate of resin bonded bridges (RBBs) and understand the relationship between various prognostic factors and survival rate.Methods An electronic medline and hand search were carried out to identify prospective studies on RBBs. Critical appraisal of the studies was done and data was extracted from selected studies. Survival rate was estimated with random effect Poissons regression using R software. Influence of location and luting cements was estimated using odds ratio and forest plots using CMA software.Results The predicted survival rate for 5 and 10 years are 83.6% and 64.9%, respectively. Functional survival after rebonding has not been considered in this study. It is expected that functional survival will be higher than event free survival. Debonding of the restoration (78%) is the most common type of failure followed by porcelain fracture (13%). Bridges cemented with Panavia showed the highest survival rate (67%) among the luting cements analysed for 5 years. Retentive tooth preparation, preparation confined to enamel, silicoating, supra gingival margins, Ni-Cr or Co-Cr alloys and no occlusion on pontic in lateral excursions have been reported to be associated with better survival rates. Anterior RBBs were found to be more retentive than posterior RBBs. Pooled odds for retention of RBB in anterior segment when compared to posterior is 1.915 (95%CI - 0.847-4.329). RBBs placed in maxilla were found to be more retentive than bridges placed in mandible. Pooled odds for retention of RBB in maxilla when compared to mandible is 1.774 (95%CI - 0.803-3.917).Conclusion and recommendations Replacement of missing teeth with resin-bonded fixed partial dentures is a conservative alternative to conventional fixed partial dentures and should be included as a treatment option wherever possible. There are numerous factors that influence the longevity of RBBs. To achieve successful long-term survival, careful case selection and consideration of various variables is crucial. There is a clear and urgent need for well controlled studies to better understand the effects of these prognostic factors.
Topics: Composite Resins; Dental Bonding; Dental Restoration Failure; Denture Design; Denture Retention; Denture, Partial, Fixed, Resin-Bonded; Humans; Prognosis
PubMed: 28703151
DOI: 10.1038/sj.bdj.2017.497 -
International Journal of Paediatric... Nov 2020Information about the functional and morphological consequences that occur following the premature loss of anterior teeth is still insufficient. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Information about the functional and morphological consequences that occur following the premature loss of anterior teeth is still insufficient.
AIM
To evaluate the consequences in children's speech and arch integrity following premature loss of primary anterior teeth compared to those without premature losses.
DESIGN
Electronic searches were performed based on the PECO criteria. Observational studies in children (P) who suffered premature loss or extraction of primary anterior teeth (E) compared to children presenting normal occlusion development (C) and the consequences to speech and dental arch perimeter (O) were included. Risk of bias and data extraction were performed. The meta-analysis evaluated the influence of premature loss of primary anterior teeth in articulatory speech disorders (distortion, omission, and substitution) and space loss in the dental arches. Random- and fixed-effect models were used, and heterogeneity was tested. The certainty of evidence was estimated using the GRADE approach.
RESULTS
From a total of 2.234 studies, six studies were included in the qualitative synthesis, and four in speech disorders meta-analysis. Despite it was not possible to perform space loss meta-analysis due to the absence of available data, qualitative analysis showed that there was no space loss after premature loss of mandibular primary incisors; a space loss, however, could be observed in children who lost primary canines at an early stage of dental development. For speech disorders results, children who lost anterior tooth presented higher chance of suffering speech distortion, than children without tooth loss (OR 5.466 [1.689, 17.692] P = .005) with low certainty of evidence. On the other hand, there were no statistically differences between premature loss of primary anterior teeth and omission (OR (a) 1.157 [0.439, 3.049] P = .767 and (OR (b) 1.393 [0.434, 4.70] P = .577) or substitution (OR (a) 1.071 [0.581, 1.974] P = .827 and OR (b) 1.218 [0.686, 2.163] P = .5), both with very low certainty of evidence.
CONCLUSIONS
Premature loss of primary anterior teeth may affect children phonation causing speech distortion. Consequences of space loss to primary dental arch still need to be further studied. Despite the speech distortion results, included articles present low-level evidence-based quality, thus new studies should be performed.
Topics: Child; Dental Arch; Humans; Incisor; Mandible; Speech; Tooth, Deciduous
PubMed: 32243000
DOI: 10.1111/ipd.12644 -
The Journal of Prosthetic Dentistry Sep 2023The complete denture occlusal scheme may influence clinical performance and patient satisfaction. However, a consensus on which occlusal scheme should be used for... (Review)
Review
STATEMENT OF PROBLEM
The complete denture occlusal scheme may influence clinical performance and patient satisfaction. However, a consensus on which occlusal scheme should be used for complete denture users is lacking. As a result, many dentists choose the scheme based on their preferences and clinical experience.
PURPOSE
The purpose of this review was to assess the methodological quality and summarize the scientific evidence from secondary studies about the influence of occlusal schemes on the clinical performance of and patient satisfaction with complete dentures.
MATERIAL AND METHODS
Ten sources were surveyed according to the patient, intervention, comparison, outcome (PICO) strategy. Systematic reviews that evaluated the clinical performance and patient satisfaction (O) of rehabilitated edentulous patients with conventional complete dentures (P) under different occlusal schemes (I/C) were included. Methodological quality was assessed by using A MeaSurement Tool to Assess systematic Reviews (AMSTAR) 2 tool by 2 authors independently. The effect of each occlusal scheme in comparison with others was summarized and classified as positive, neutral, negative, or inconclusive based on the conclusions of the systematic review concerning clinical performance and patient satisfaction outcomes.
RESULTS
The search led to the inclusion of 10 systematic reviews. Seven were classified as of critically low, 2 as low, and 1 as moderate methodological quality. The following occlusal designs were included and analyzed: bilateral balanced occlusion, lingualized occlusion, canine guidance, group function, and monoplane occlusion. Bilateral balanced occlusion and canine guidance obtained satisfactory results for both outcomes. Lingualized occlusion showed a trend toward better results than other occlusal schemes for normal and resorbed ridges. Group function presented mainly inconclusive results, and monoplane occlusion did not deliver satisfactory outcomes.
CONCLUSIONS
The present overview concluded that occlusal schemes might interfere with the clinical performance of and patient satisfaction with complete dentures. Lingualized, bilateral balanced, and canine guidance are preferred compared with monoplane occlusion, but lingualized occlusion tends to show better results in some reviews. However, the results should be carefully considered because of the low quality of the systematic reviews included.
Topics: Humans; Patient Satisfaction; Denture Design; Systematic Reviews as Topic; Denture, Complete; Dental Occlusion; Dental Occlusion, Balanced; Mastication
PubMed: 34991859
DOI: 10.1016/j.prosdent.2021.10.018 -
Journal of Clinical and Experimental... Dec 2020The aim of this systematic review was to analyze the types of human chewing simulator described in scientific literature. (Review)
Review
BACKGROUND
The aim of this systematic review was to analyze the types of human chewing simulator described in scientific literature.
MATERIAL AND METHODS
An electronic search was conducted in the databases PubMed, Embase and Scopus. The search strategy included 10 search terms: ""; "dental materials"; "shear strength"; "fatigue fracture"; "bite force"; "prosthetic materials"; "chewing simulator"; "chewing machine"; "simulated mastication"; and "dental wear simulator." Two researchers worked independently to assess the titles and abstracts of the articles. The quality of the trials selected was evaluated by means of the Consolidated Standards of Reporting Trials scale.
RESULTS
The electronic search identified 80 articles related to the topic of interest. After reading the full texts, ten works were selected. The articles focused mainly on the design of chewing simulators. Most of them were considered of moderate quality. Regarding the characteristics that an ideal chewing simulator should encompass, the devices described in articles varied greatly in terms of movement, periodontal ligament simulation, force sensors, and the materials tested.
CONCLUSIONS
No chewing simulator offers all the characteristics necessary to reproduce human masticatory movements and forces under the humidity and pH conditions of the oral cavity. A simulator that encompasses all these characteristics would make it possible to standardize trials involving simulated mastication. In vitro, dental materials, dental wear simulator.
PubMed: 33282141
DOI: 10.4317/jced.57279 -
The British Journal of Oral &... Apr 2022The aim of this systematic review was to find out if manual intraoperative control of occlusion is adequate for the reduction of mandibular fractures in comparison with... (Meta-Analysis)
Meta-Analysis Review
The aim of this systematic review was to find out if manual intraoperative control of occlusion is adequate for the reduction of mandibular fractures in comparison with intermaxillary fixation (IMF). We searched PubMed, Embase, the Cochrane Library and Clinical Trials Registry, and the references of included trials. Our primary outcomes of interest were the reduction of fracture anatomically and radiographically, occlusal disturbances, and the incidence of revision procedures due to poor occlusion or reduction. Our secondary outcomes of interest were operating time and infective complications. Of the 257 studies retrieved (manual reduction = 136, IMF = 121), four were included. The studies had an unclear risk of bias. Nevertheless, the overall effect was statistically significant and in favour of manual reduction, with a lower number of adverse events in the manual reduction group (n = 43) than in the IMF group (n = 78), odds ratio 0.42 (95% CI 0.27 to 0.64). An absolute reduction in adverse events was seen in occlusion disturbances (120 fewer/1000), revision procedures (164 fewer/1000), and infective complications (178 fewer/1000). The evidence to support manual reduction over IMF for the intraoperative control of fracture fragments and occlusion was derived from few studies with an unclear risk of bias, and the quality was low. The results were not different when condylar fractures were present. The overall certainty of evidence was moderate. Clinicians should select the appropriate technique based on the injury pattern, and the treating surgeon's experience and available resources.
Topics: Dental Occlusion; Fracture Fixation, Internal; Humans; Jaw Fixation Techniques; Mandibular Fractures
PubMed: 35248408
DOI: 10.1016/j.bjoms.2021.07.016 -
Clinical Implications of Growth Hormone Deficiency for Oral Health in Children: A Systematic Review.Journal of Clinical Medicine Aug 2021Growth hormone (GH) is involved in the regulation of the postnatal dental and skeletal growth, but its effects on oral health have not been clearly defined. This paper... (Review)
Review
Growth hormone (GH) is involved in the regulation of the postnatal dental and skeletal growth, but its effects on oral health have not been clearly defined. This paper aims to provide a review of current clinical knowledge of dental caries, tooth wear, developmental enamel defects, craniofacial growth and morphology, dental maturation, and tooth eruption in growth hormone deficient (GHD) children. A systematic review was carried out using Scopus, MEDLINE-EbscoHost and Web of Science from 2000 to May 2021. PRISMA guidelines for reporting systematic reviews were followed. All the selected studies involved groups under eighteen years of age, covering a total of 465 GHD patients. The studies that were selected provide reliable evidence for delayed dental maturity and orthodontic disturbances in GHD patients. Data on dental hard tissues pathology are scarce and are limited to occurrences of dental caries. GHD children showed abnormal craniofacial morphology with reduced mandibular dimensions, with a resulting tendency towards Angle's Class II occlusion, which affected up to 31% of patients. Dental age has been shown to be delayed in GHD patients by about 1 to 2 years. Moreover, the risk of dental caries in children with GHD decreases with increasing levels of vitamin D. Hence, further studies would be valuable for evaluating the risk of various oral health problems and to organize targeted dental care for this vulnerable group.
PubMed: 34442031
DOI: 10.3390/jcm10163733