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The Angle Orthodontist Jul 2018To evaluate the quantitative effects of miniscrew supported appliances for maxillary molar distalization in Class II malocclusion.
OBJECTIVES
To evaluate the quantitative effects of miniscrew supported appliances for maxillary molar distalization in Class II malocclusion.
MATERIALS AND METHODS
The systematic search included MEDLINE, EMBASE, CINAHL, PsychINFO, Scopus, and key journals and review articles. The date of the last search was January 30, 2017. Methodological quality of the retrospective studies was graded by means of the Quality Assessment Tool for Quantitative Studies, developed for the Effective Public Health Practice Project (EPHPP) and prospective studies by means of Newcastle-Ottawa Scale.
RESULTS
In total, 298 studies were identified for screening, and 14 studies were eligible. The Quality Assessment Tool for Quantitative Studies rated all of the four included retrospective studies as moderate. The Newcastle-Ottawa Scale rated seven studies as high quality and three studies as low quality. The mean molar distalization values varied from 1.8 mm to 6.4 mm. Mean distal tipping of molars varied from 1.65° to 11.3°. The mean distal movement of premolars and incisors varied from 1.75 mm to 5.4 mm and 0.1 mm to 2.7 mm, respectively.
CONCLUSIONS
Miniscrew-supported appliances are effective in molar distalization with distal movement of premolars with minimal anchorage loss and distal tipping of the molar teeth.
Topics: Bone Screws; Humans; Malocclusion, Angle Class II; Maxilla; Molar; Orthodontic Anchorage Procedures; Tooth Movement Techniques
PubMed: 29664335
DOI: 10.2319/091717-624.1 -
The Cochrane Database of Systematic... Dec 2015Crowns for primary molars are preformed and come in a variety of sizes and materials to be placed over decayed or developmentally defective teeth. They can be made... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Crowns for primary molars are preformed and come in a variety of sizes and materials to be placed over decayed or developmentally defective teeth. They can be made completely of stainless steel (know as 'preformed metal crowns' or PMCs), or to give better aesthetics, may be made of stainless steel with a white veneer cover or made wholly of a white ceramic material. In most cases, teeth are trimmed for the crowns to be fitted conventionally using a local anaesthetic. However, in the case of the Hall Technique, PMCs are pushed over the tooth with no local anaesthetic, carious tissue removal or tooth preparation. Crowns are recommended for restoring primary molar teeth that have had a pulp treatment, are very decayed or are badly broken down. However, few dental practitioners use them in clinical practice. This review updates the original review published in 2007.
OBJECTIVES
Primary objectiveTo evaluate the clinical effectiveness and safety of all types of preformed crowns for restoring primary teeth compared with conventional filling materials (such as amalgam, composite, glass ionomer, resin modified glass ionomer and compomers), other types of crowns or methods of crown placement, non-restorative caries treatment or no treatment. Secondary objectiveTo explore whether the extent of decay has an effect on the clinical outcome of primary teeth restored with all types of preformed crowns compared with those restored with conventional filling materials.
SEARCH METHODS
We searched the following electronic databases: Cochrane Oral Health Group Trials Register (to 21 January 2015), Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library, 2014, Issue 12), MEDLINE via Ovid (1946 to 21 January 2015) and EMBASE via Ovid (1980 to 21 January 2015). We searched the US National Institutes of Health Trials Register (http://clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform for ongoing trials and Open Grey for grey literature (to 21 January 2015). No restrictions were placed on the language or date of publication when searching the databases.
SELECTION CRITERIA
Randomised controlled trials (RCTs) that assessed the effectiveness of crowns compared with fillings, other types of crowns, non-restorative approaches or no treatment in children with untreated tooth decay in one or more primary molar teeth. We would also have included trials comparing different methods of fitting crowns.For trials to be considered for this review, the success or failure of the interventions and other clinical outcomes had to be reported at least six months after intervention (with the exception of 'pain/discomfort during treatment and immediately postoperatively').
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed the title and abstracts for each article from the search results. and independently assessed the full text for each potentially relevant study. At least two authors assessed risk of bias and extracted data using a piloted data extraction form.
MAIN RESULTS
We included five studies that evaluated three comparisons. Four studies compared crowns with fillings; two of them compared conventional PMCs with open sandwich restorations, and two compared PMCs fitted using the Hall Technique with fillings. One of these studies included a third arm, which allowed the comparison of PMCs (fitted using the Hall Technique) versus non-restorative caries treatment. In the two studies using crowns fitted using the conventional method, all teeth had undergone pulpotomy prior to the crown being placed. The final study compared two different types of crowns: PMCs versus aesthetic stainless steel crowns with white veneers. No RCT evidence was found that compared different methods of fitting preformed metal crowns (i.e. Hall Technique versus conventional technique).We considered outcomes reported at the dental appointment or within 24 hours of it, and in the short term (less than 12 months) or long term (12 months or more). Some of our outcomes of interest were not measured in the studies: time to restoration failure or retreatment, patient satisfaction and costs. Crowns versus fillingsAll studies in this comparison used PMCs. One study reported outcomes in the short term and found no reports of major failure or pain in either group. There was moderate quality evidence that the risk of major failure was lower in the crowns group in the long term (risk ratio (RR) 0.18, 95% confidence interval (CI) 0.06 to 0.56; 346 teeth in three studies, one conventional and two using Hall Technique). Similarly, there was moderate quality evidence that the risk of pain was lower in the long term for the crown group (RR 0.15, 95% CI 0.04 to 0.67; 312 teeth in two studies).Discomfort associated with the procedure was lower for crowns fitted using the Hall Technique than for fillings (RR 0.56, 95% CI 0.36 to 0.87; 381 teeth) (moderate quality evidence).It is uncertain whether there is a clinically important difference in the risk of gingival bleeding when using crowns rather than fillings, either in the short term (RR 1.69, 95% CI 0.61 to 4.66; 226 teeth) or long term (RR 1.74, 95% CI 0.99 to 3.06; 195 teeth, two studies using PMCs with conventional technique at 12 months) (low quality evidence). Crowns versus non-restorative caries treatmentOnly one study compared PMCs (fitted with the Hall Technique) with non-restorative caries treatment; the evidence quality was very low and we are therefore we are uncertain about the estimates. Metal crowns versus aesthetic crownsOne split-mouth study (11 participants) compared PMCs versus aesthetic crowns (stainless steel with white veneers). It provided very low quality evidence so no conclusions could be drawn.
AUTHORS' CONCLUSIONS
Crowns placed on primary molar teeth with carious lesions, or following pulp treatment, are likely to reduce the risk of major failure or pain in the long term compared to fillings. Crowns fitted using the Hall Technique may reduce discomfort at the time of treatment compared to fillings. The amount and quality of evidence for crowns compared to non-restorative caries, and for metal compared with aesthetic crowns, is very low. There are no RCTs comparing crowns fitted conventionally versus using the Hall Technique.
Topics: Child; Child, Preschool; Crowns; Dental Care for Children; Dental Caries; Dental Restoration Failure; Dental Restoration, Permanent; Female; Humans; Male; Molar; Randomized Controlled Trials as Topic; Tooth, Deciduous
PubMed: 26718872
DOI: 10.1002/14651858.CD005512.pub3 -
International Journal of Environmental... Oct 2022A systematic review and meta-analysis were carried out to evaluate the efficacy of silver diamine fluoride (SDF) in controlling caries progression in cavitated primary... (Meta-Analysis)
Meta-Analysis Review
A systematic review and meta-analysis were carried out to evaluate the efficacy of silver diamine fluoride (SDF) in controlling caries progression in cavitated primary molars. A search for randomized and non-randomized trials with follow-up > 6 months was performed using PubMed, Scopus and Embase. The Cochrane risk of bias tools were used for the quality assessment. The success rate and odds ratios were chosen to calculate the effect size for the meta-analysis. A total of 792 papers were identified and 9 were selected. A high variability regarding SDF application protocol was found; otherwise, caries arrest was always recorded using visual/tactile methods. Two studies were judged at low risk of bias, six at moderate risk and one at high risk. Data from five studies were aggregated for meta-analysis. Heterogeneity was found moderate (I = 35.69%, = 0.18). SDF application was found to be overall effective (fixed effect model) in arresting caries progression (ES = 0.35, < 0.01). In a total of 622 arrested lesions, out of 1205 considered, the caries arrest rate was 51.62% ± 27.40% (Confidence = 1.55) using SDF ≥ 38% applied annually or biannually. In conclusion, when applied to active cavitated caries lesions in primary molars, SDF appears to be effective in arresting dental caries progression, especially if applied biannually.
Topics: Cariostatic Agents; Dental Caries; Dental Caries Susceptibility; Fluorides, Topical; Humans; Quaternary Ammonium Compounds; Silver Compounds
PubMed: 36232217
DOI: 10.3390/ijerph191912917 -
Journal of International Society of... 2021The objective was to compare the clinical efficacy of silver diamine fluoride (SDF) and atraumatic restorative treatment (ART) in arresting active caries in primary... (Review)
Review
INTRODUCTION
The objective was to compare the clinical efficacy of silver diamine fluoride (SDF) and atraumatic restorative treatment (ART) in arresting active caries in primary teeth and first permanent molars in children.
MATERIALS AND METHODS
The study protocol was registered in PROSPERO (CRD42020205675). A systematic search was performed in PubMed, Scopus, Embase, Cochrane Library, and gray literature for randomized controlled trials (RCTs) published in English language with a minimum follow-up of 6 months, comparing the caries arrest potential of SDF with ART in primary teeth and first permanent molars in children. The risk of bias and quality assessment of the studies was done using the Cochrane Collaboration Tool and Joanna Briggs Institute Critical Appraisal Tool. Data analysis was performed using RevMan software; the outcomes were summarized in meta-analysis (MA) using the random-effects model, and the odds ratio (OR) at 95% confidence interval (CI) was computed.
RESULTS
A total of 1059 studies were identified, out of which 562 remained after removal of duplicates. Eight studies were considered for full-text eligibility, and four studies were included in the qualitative review. Three out of four studies were conducted on primary dentition, whereas one study was done on erupting first permanent molars in children. MA of the two studies compared 30% SDF with ART in primary molars at 12 months and revealed the OR to be 2.02 (95% CI: 0.86-4.71; = 62%; = 0.10).
CONCLUSION
The current review points to the lack of solid evidence comparing SDF with ART for arresting active caries in primary teeth, especially in the first permanent molars. No statistically significant difference between 30% SDF and ART in primary molars at 12 months was found in the present review. Well-designed RCTs are required to determine a minimum concentration of SDF which is effective and safe for caries arrest in children.
PubMed: 34430496
DOI: 10.4103/jispcd.JISPCD_83_21 -
Journal of Dentistry Oct 2016To evaluate the long-term clinical performance of direct versus indirect composite inlays/onlays in posterior teeth. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To evaluate the long-term clinical performance of direct versus indirect composite inlays/onlays in posterior teeth.
DATA
Screening for inclusion eligibility, quality assessment of studies and data extraction was performed independently by two authors.
SOURCES
The electronic databases MEDLINE, EMBASE, Cochrane Oral Health Group's Trials Register and CENTRAL were searched (14.12.2015), with no restriction to publication date or language. We included only randomised controlled trials (RCTs) and evaluated them according to Cochrane risk of bias tool. The main outcome assessed was the restoration failure, determined by several clinical parameters.
STUDY SELECTION
Two studies concerning direct and indirect inlays (82 patients with 248 restorations) and one study for onlays (157 patients with 176 restorations) satisfied the inclusion criteria. Two trials, one of unclear and one of high risk of bias, could be mathematically combined. The meta-analysis indicated no statistically significant difference in the risk failure between direct and indirect inlays, after 5 years (RR: 1.54; 95% Cl: 0.42, 5.58; p=0.52) or 11 years of function (RR: 0.95; 95% Cl: 0.34, 2.63; p=0.92). Only one parameter, the marginal discoloration, slightly favored direct inlays after 11 years (RR: 0.41; 95% Cl: 0.17, 0.96; p=0.04). Only one study dealt with onlays; an overall 5-year survival of 87% (95% CI: 81-93%) was reported.
CONCLUSION
The difference of the two techniques did not reach statistical significance in order to recommend one technique over the other. The scarcity of primary studies support the need for further well-designed long-term studies in order to reach firm conclusions about both techniques.
CLINICAL SIGNIFICANCE
Resin composite materials, placed directly or indirectly, exhibit a promising long-term clinical performance when rehabilitation of posterior teeth is needed. Although many years in clinical practice, the selection of the best treatment protocol still remains subjective. The available studies, and their synthesis, cannot provide reliable evidence in this field.
Topics: Composite Resins; Dental Care; Dental Restoration, Permanent; Humans; Inlays; Molar
PubMed: 27452342
DOI: 10.1016/j.jdent.2016.07.011 -
Head & Face Medicine Mar 2018Primary failure of eruption (PFE) is a rare disease defined as incomplete tooth eruption despite the presence of a clear eruption pathway. Orthodontic extrusion is not...
BACKGROUND
Primary failure of eruption (PFE) is a rare disease defined as incomplete tooth eruption despite the presence of a clear eruption pathway. Orthodontic extrusion is not feasible in this case because it results in ankylosis of teeth. To the best of our knowledge, besides the study of Ahmad et al. (Eur J Orthod 28:535-540, 2006), no study has systematically analysed the clinical features of and factors associated with PFE. Therefore, the aim of this study was to systematically evaluate the current literature (from 2006 to 2017) for new insights and developments on the aetiology, diagnosis, genetics, and treatment options of PFE.
METHODS
Following the PRISMA guidelines, a systematic search was performed using the PubMed/Medline database for studies reporting on PFE. The following terms were used: "primary failure of tooth eruption", "primary failure of eruption", "tooth eruption failure", and "PFE".
RESULTS
Overall, 17 articles reporting clinical data of 314 patients were identified. In all patients, the molars were affected. In 81 reported cases, both the molars and the premolars were affected by PFE. Further, 38 patients' primary teeth were also affected. In 27 patients, no family members were affected. Additional dental anomalies were observed in 39 patients. A total of 51 different variants of the PTH1R gene associated with PFE were recorded.
CONCLUSIONS
Infraocclusion of the posterior teeth, especially if both sides are affected, is the hallmark of PFE. If a patient is affected by PFE, all teeth distal to the most mesial tooth are also affected by PFE. Primary teeth can also be impacted; however, this may not necessarily occur. If a patient is suspected of having PFE, a genetic test for mutation in the PTH1R gene should be recommended prior to any orthodontic treatment to avoid ankylosis. Treatment options depend on the patient's age and the clinical situation, and they must be evaluated individually.
Topics: Age Factors; Bicuspid; Child, Preschool; Female; Follow-Up Studies; Humans; Infant; Male; Molar; Orthodontic Extrusion; Radiography, Panoramic; Sex Factors; Tooth Ankylosis; Tooth Eruption; Tooth, Deciduous; Tooth, Unerupted
PubMed: 29544499
DOI: 10.1186/s13005-018-0163-7 -
Swiss Dental Journal Dec 2021The objective was to systematically analyse clinical studies on restorative procedures for teeth affected by molar-incisor hypomineralisation (MIH). The databases...
The objective was to systematically analyse clinical studies on restorative procedures for teeth affected by molar-incisor hypomineralisation (MIH). The databases PubMed, Embase, and Cochrane Library were searched. Only retrospective and prospective clinical studies dealing with sealing or restoration of MIH-affected teeth were included. The language was restricted to English or German. Thirteen of 36 potentially eligible studies were included focusing on the following subjects: extension of enamel preparation, adhesive procedures prior to restoration, application of fissure sealants as well as restoration with conventional glass ionomer cements (GIC), resin modified glass ionomer cements (RMGIC), resin composites, and indirect restorations. Seven clinical studies were controlled trials. However, only two included MIH-unaffected teeth as control. No meta-analysis was performed due to the heterogeneity of study designs (e.g. severity of MIH or the restorative materials investigated). Based on the present analysis, the annual failure rates were in average 21% for fissure sealants, 22% for GIC, 1-6% for RMGIC, 13-32% for resin composites, and 0-7% for indirect restorations. In summary, only few tendencies can be deduced from this review at a low level of evidence (number of studies): 1) preparation margins in sound enamel seem to be superior to preparations in hypomineralised enamel (1 study), 2) RMGIC seems to be superior to GIC (3 studies), 3) resin composites may be used for restoring all severities of MIH (7 studies) with self-etch and etch-and-rinse adhesive systems generally not performing differently (3 studies), and 4) in cases of severe MIH, indirect restorations showed a good clinical success (4 studies).
Topics: Dental Enamel Hypoplasia; Dental Restoration, Permanent; Humans; Incisor; Molar; Prospective Studies; Retrospective Studies
PubMed: 33764037
DOI: 10.61872/sdj-2021-12-764 -
Progress in Orthodontics Sep 2020The aim of this systematic review and meta-analysis is to assess the degree of stability of anterior open bite (AOB) treatment performed through the molar intrusion... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The aim of this systematic review and meta-analysis is to assess the degree of stability of anterior open bite (AOB) treatment performed through the molar intrusion supported with skeletal anchorage at least 1 year posttreatment.
METHODS
This study was registered in PROSPERO (CRD42016037513). A literature search was conducted to identify randomized (RCT) or non-randomized clinical trials based including those considering before and after design. Data sources were electronic databases including PubMed, Cochrane Library, Science Direct, Google Scholar, Scopus, Lilacs, OpenGrey, Web of Science, and ClinicalTrials.gov . The quality of evidence was assessed through the JBI tool and certainty of evidence was evaluated through the GRADE tool. Random effects meta-analysis was conducted when appropriate.
RESULTS
Six hundred twenty-four articles met the initial inclusion criteria. From these, only 6 remained. The mean posttreatment follow-up time was 2.5 years (SD = 1.04). The overbite showed a standardized mean relapse of - 1.23 mm (95% CI - 1.64, - 0.81, p < 0.0001). Maxillary and mandibular incisors presented a non-significant mean relapse, U1-PP - 0.04 mm (95% CI - 0.55, 0.48) and L1-MP - 0.10 mm (95% CI - 0.57, 0.37). Molar intrusion showed a relapse rate around 12% for the maxillary molars and a 27.2% for mandibular molars.
CONCLUSION
The stability of AOB through molar intrusion using TADs can be considered relatively similar to that reported to surgical approaches, since 10 to 30% of relapse occurs both in maxillary and mandibular molars. The level of certainty ranged between very low and low. RCTs reporting dropout during the follow-up are in dire need.
Topics: Cephalometry; Humans; Maxilla; Molar; Open Bite; Orthodontic Anchorage Procedures; Tooth Movement Techniques
PubMed: 32888097
DOI: 10.1186/s40510-020-00328-2 -
European Archives of Paediatric... Feb 2022To systematically review the aetiological factors associated with molar incisor hypomineralisation (MIH). To this day, the aetiology remains unknown. Determining risk... (Meta-Analysis)
Meta-Analysis
PURPOSE
To systematically review the aetiological factors associated with molar incisor hypomineralisation (MIH). To this day, the aetiology remains unknown. Determining risk factors would allow risk assessment and enhance early diagnosis of MIH in young patients. The aim was to assess, evaluate and summarise the relationship between MIH and reported aetiological hypotheses.
METHODS
Electronic database searches of MEDLINE, EMBASE, EBSCO, LILACS and Cochrane Library were conducted. Authors conformed to PRISMA guidelines. Studies were screened, data extracted, assessment of risk of bias and calibration was completed by two independent reviewers. Meta-analyses with heterogeneity calculations were performed.
RESULTS
Of the potential 8949 studies, 64 studies were included in the qualitative analysis whilst 45 were included in the quantitative analysis. Prenatal factors: results are inconclusive as only unspecified maternal illnesses appear to be linked to MIH. Perinatal factors: prematurity (OR 1.45; 95% CI 1.24-1.70; p = 0.0002) and caesarean delivery (OR 1.45; 95% CI 1.09, 1.93; p < 0.00001) are associated with an increased risk of developing MIH. Birth complications are also highlighted. These three factors can lead to hypoxia, and children with perinatal hypoxia are more likely to develop MIH (OR 2.76; 95% CI 2.09-3.64; p < 0.0001). Postnatal factors: measles, urinary tract infection, otitis media, gastric disorders, bronchitis, kidney diseases, pneumonia and asthma are associated with MIH. Fever and antibiotic use, which may be considered as consequences of childhood illnesses, are also associated with MIH. Genetic factors: an increasing number of studies highlight the genetic and epigenetic influences in the development of MIH.
CONCLUSION
Several systemic and genetic and/or epigenetic factors acting synergistically or additively are associated with MIH, revealing a multifactorial aetiology model. Peri- and postnatal aetiological factors are more likely to increase the odds of causing MIH than prenatal factors.
Topics: Asthma; Child; Dental Enamel Hypoplasia; Female; Fever; Humans; Molar; Pregnancy; Prevalence; Risk Factors
PubMed: 34164793
DOI: 10.1007/s40368-021-00646-x -
International Journal of Oral and... Jan 2024Clinicians frequently prescribe systemic antibiotics after lower third molar extractions to prevent complications such as surgical site infections and dry socket. A... (Meta-Analysis)
Meta-Analysis Review
Clinicians frequently prescribe systemic antibiotics after lower third molar extractions to prevent complications such as surgical site infections and dry socket. A systematic review of randomised clinical trials was conducted to compare the risk of dry socket and surgical site infection after the removal of lower third molars with different prophylactic antibiotics. The occurrence of any antibiotic-related adverse event was also analysed. A pairwise and network meta-analysis was performed to establish direct and indirect comparisons of each outcome variable. Sixteen articles involving 2158 patients (2428 lower third molars) were included, and the following antibiotics were analysed: amoxicillin (with and without clavulanic acid), metronidazole, azithromycin, and clindamycin. Pooled results favoured the use of antibiotics to reduce dry socket and surgical site infection after the removal of a lower third molar, with a number needed to treat of 25 and 18, respectively. Although antibiotic prophylaxis was found to significantly reduce the risk of dry socket and surgical site infection in patients undergoing lower third molar extraction, the number of patients needed to treat was high. Thus, clinicians should evaluate the need to prescribe antibiotics taking into consideration the patient's systemic status and the individual risk of developing a postoperative infection.
Topics: Humans; Dry Socket; Antibiotic Prophylaxis; Surgical Wound Infection; Molar, Third; Network Meta-Analysis; Anti-Bacterial Agents; Tooth Extraction
PubMed: 37612199
DOI: 10.1016/j.ijom.2023.08.001