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Orthodontics & Craniofacial Research Nov 2014The aim of the study was to assess treatment effects and potential side effects of different archwires used on patients receiving orthodontic therapy. Electronic and... (Meta-Analysis)
Meta-Analysis Review
The aim of the study was to assess treatment effects and potential side effects of different archwires used on patients receiving orthodontic therapy. Electronic and manual unrestricted searches were conducted in 19 databases including MEDLINE, Cochrane Library, and Google Scholar until April 2012 to identify randomized controlled trials (RCTs) and quasi-RCTs. After duplicate study selection, data extraction, risk of bias assessment with the Cochrane risk of bias tool, and narrative analysis, mean differences (MDs) with confidence intervals (CIs) of similar studies were pooled using a random-effects model and evaluated with GRADE. A total of 16 RCTs were included assessing different archwire characteristics on 1108 patients. Regarding initial archwires, meta-analysis of two trials found slightly greater irregularity correction with an austenitic-active nickel-titanium (NiTi) compared with an martensitic-stabilized NiTi archwire (corresponding to MD: 1.11 mm, 95% CI: -0.38 to 2.61). Regarding archwire sequences, meta-analysis of two trials found it took patient treated with a sequence of martensitic-active copper-nickel-titanium (CuNiTi) slightly longer to reach the working archwire (MD: 0.54 months, 95% CI: -0.87 to 1.95) compared with a martensitic-stabilized NiTi sequence. However, patients treated with a sequence of martensitic-active CuNiTi archwires reported general greater pain intensity on the Likert scale 4 h and 1 day after placement of each archwire, compared with a martensitic-stabilized NiTi sequence. Although confidence in effect estimates ranged from moderate to high, meta-analyses could be performed only for limited comparisons, while inconsistency might pose a threat to some of them. At this point, there is insufficient data to make recommendations about the majority of initial archwires or for a specific archwire sequence.
Topics: Copper; Dental Alloys; Humans; Nickel; Orthodontic Wires; Titanium; Treatment Outcome
PubMed: 24889143
DOI: 10.1111/ocr.12048 -
International Orthodontics Dec 2023Re-mineralizing surface pretreatment is essential for both controlling and preventing white spot lesion (WSL) throughout the time of fixed orthodontic treatment. It is... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Re-mineralizing surface pretreatment is essential for both controlling and preventing white spot lesion (WSL) throughout the time of fixed orthodontic treatment. It is also important that the re-mineralizing have no negative impact on the bonding between the bracket, adhesive, and enamel. Therefore, this review is aimed to investigate the orthodontic brackets' shear bond strength after re-mineralizing surface treatment of enamel.
MATERIAL AND METHODOLOGY
The review was conducted following the PRISMA 2020 guidelines. In-vitro experimental studies measuring shear bond strength (SBS) of orthodontic brackets on both demineralized and intact enamel following re-mineralizing surface treatment were included. Database search was done in PubMed, Scopus, and Science Direct during July 2023. Methodological quality of the studies was assessed according to the guidelines for the reporting of pre-clinical in-vitro studies. Both qualitative and quantitative analyses of the included studies were done.
RESULTS
Matching the inclusion criteria, 46 and 37 studies were selected for qualitative and quantitative analysis respectively. On intact enamel re-mineralizing agents had no negative impact on the brackets' SBS. On the contrary, they seemed to enhance the bond strength remarkably on the demineralized enamel.
DISCUSSION
Re-mineralizing surface pretreatment is crucial prior to fixed orthodontic treatment as it did not reduce the bond strength. Although, it cannot be judged depending solely on the in-vitro results with high heterogeneity. Clinical evidence is required to support the statement.
Topics: Humans; Resin Cements; Orthodontic Brackets; Dental Enamel; Shear Strength; Dental Bonding; Materials Testing; Surface Properties; Dental Stress Analysis
PubMed: 37647675
DOI: 10.1016/j.ortho.2023.100807 -
Clinical Oral Investigations Jan 2022Decalcification during orthodontic treatment is significantly increased. To prevent this negative impact, new treatments with sealants before bonding brackets are... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Decalcification during orthodontic treatment is significantly increased. To prevent this negative impact, new treatments with sealants before bonding brackets are commonly been used. This systematic review discusses current knowledge on shear bond strength when using sealant before bonding.
MATERIALS AND METHODS
A systematic review and meta-analysis were performed to identify studies that address shear bond strength after using a sealant before bonding brackets. The search was carried out using common electronic databases in addition to individual searches. Both screening and study eligibility analysis were performed according to PRISMA and Cochrane Guidelines for systematic reviews. Several terms describing shear bond strength after using a sealant before bonding brackets were searched. Particular attention was paid to bond failure and bracket loss. For the statistical outcome, all results were shown in a forest plot based on standardized mean differences (SMD) with a random-effects model to respect heterogeneity of these studies. To assess the heterogeneity of the different trials, I-value and the Q-Test were performed.
RESULTS
The initial search identified 416 studies. After a thorough selection process, a total of 15 articles met the inclusion criteria. All 15 articles reported results of in vitro studies. Papers were divided into four subgroups according to their used product: ProSeal, Transbond bonding, the combination of Transbond bonding and ProSeal and Clearfil Protect Bond. The results of this review demonstrate a high heterogeneity of the studies. The SMD of the examined 15 articles show nearly no difference between the control and the intervention groups in shear bond strength (p < 0.0001; OR - 0.12; Cl - 0.47-0.23). Forest plots for comparison of the subgroups depict no difference in shear bond strength as well.
CONCLUSIONS
This meta-analysis concludes that there is no additive benefit for shear bond strength when using sealant before bonding. However, additional randomized controlled studies should be performed to analyze impact of sealants on bonding strength and bracket loss in more detail.
CLINICAL RELEVANCE
Using sealants before orthodontic bonding does not reduce shear bond strength.
Topics: Dental Bonding; Dental Stress Analysis; Materials Testing; Orthodontic Brackets; Resin Cements; Shear Strength
PubMed: 34981251
DOI: 10.1007/s00784-021-04165-3 -
European Journal of Orthodontics Apr 2017The management of post-orthodontic white spot lesions is based on remineralization strategies or a minimal-invasive camouflage of the lesions. (Review)
Review
BACKGROUND/OBJECTIVES
The management of post-orthodontic white spot lesions is based on remineralization strategies or a minimal-invasive camouflage of the lesions.
AIM
The aim of this systematic review was to identify and assess the quality of evidence for the various clinical technologies.
SEARCH METHODS
Four databases were searched for relevant literature published in English between 2011 and 31 October 2015 according to a pre-determined PICO. Only controlled clinical studies were considered. Abstract lists and the selected full-text papers were independently examined by two reviewers and any differences were solved in consensus. The Cochrane handbook and the AMSTAR tool were used for grading the risk of bias. The quality of evidence was rated according to GRADE.
RESULTS
Out of 280 identified publications, seven studies on remineralization, micro-abrasion and resin infiltration met the inclusion criteria. Two of them were assessed with low risk of bias. No pooling of results was possible due to study heterogeneity. The quality of evidence for all technologies was graded as very low.
LIMITATIONS
Only papers published in English with more than 20 adolescents or young adults were considered. Furthermore, a follow-up period of at least 8 weeks was required. The publication bias could not be assessed due to the paucity of included trials.
CONCLUSIONS/CLINICAL IMPLICATIONS
There is a lack of reliable scientific evidence to support re-mineralizing or camouflaging strategies to manage post-orthodontic white spot lesions. Further well-performed controlled clinical trials with long-term follow-up are needed to establish best clinical practice.
Topics: Adolescent; Adult; Dental Caries; Device Removal; Enamel Microabrasion; Evidence-Based Medicine; Female; Humans; Orthodontic Brackets; Publication Bias; Resins, Synthetic; Tooth Remineralization; Young Adult
PubMed: 27030284
DOI: 10.1093/ejo/cjw023 -
Microbial colonisation associated with conventional and self-ligating brackets: a systematic review.Journal of Orthodontics Jun 2022Decalcification and gingivitis caused by plaque accumulation around brackets are common iatrogenic effects of fixed appliances. The influence of conventional versus...
BACKGROUND
Decalcification and gingivitis caused by plaque accumulation around brackets are common iatrogenic effects of fixed appliances. The influence of conventional versus self-ligating bracket design on microbial colonisation is unknown.
OBJECTIVE
To assess the levels of microbial colonisation associated with conventional and self-ligating brackets.
SEARCH SOURCES
Three databases were searched for publications from 2009 to 2021.
DATA SELECTION
Randomised controlled trials comparing levels of microbial colonisation before and during treatment with conventional and self-ligating brackets were assessed independently and in duplicate.
DATA EXTRACTION
Data were extracted independently by two authors from the studies that fulfilled the inclusion criteria. Risk of bias assessments were made using the revised Cochrane risk of bias tool for randomized trials. The quality of the included studies was assessed using the Critical Appraisal Skills Programme Checklist.
RESULTS
A total of 11 randomised controlled trials were included in this systematic review. Six of the studies were found to be at low risk of bias and five presented with some concerns. The studies were considered moderate to high quality. Five trials reported no statistically significant difference in microbial colonisation between bracket types. The remaining studies showed mixed results, with some reporting increased colonisation of conventional brackets and others increased colonisation of self-ligating brackets. The heterogeneity of study methods and outcomes precluded meta-analysis.
CONCLUSION
Of the 11 studies included in this systematic review, five found no differences in colonisation between conventional and self-ligating brackets. The remaining studies showed mixed results. The evidence is inconclusive regarding the association between bracket design and levels of microbial colonisation.
Topics: Dental Plaque; Humans; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires
PubMed: 34839734
DOI: 10.1177/14653125211056023 -
BMC Oral Health Nov 2016The aim of this study was to compare the external apical root resorption (EARR) in patients receiving fixed orthodontic treatment with self-ligating or conventional... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The aim of this study was to compare the external apical root resorption (EARR) in patients receiving fixed orthodontic treatment with self-ligating or conventional brackets.
METHODS
Studies comparing the EARR between orthodontic patients using self-ligating or conventional brackets were identified through electronic search in databases including CENTRAL, PubMed, EMBASE, China National Knowledge Infrastructure (CNKI) and SIGLE, and manual search in relevant journals and reference lists of the included studies until Apr 2016. The extraction of data and risk of bias evaluation were conducted by two investigators independently. The original outcome underwent statistical pooling by using Review Manager 5.
RESULTS
Seven studies were included in the systematic review, out of which, five studies were statistically pooled in meta-analysis. The value of EARR of maxillary central incisors in the self-ligating bracket group was significantly lower than that in the conventional bracket group (SMD -0.31; 95% CI: -0.60--0.01). No significant differences in other incisors were observed between self-ligating and conventional brackets.
CONCLUSIONS
Current evidences suggest self-ligating brackets do not outperform conventional brackets in reducing the EARR in maxillary lateral incisors, mandible central incisors and mandible lateral incisors. However, self-ligating brackets appear to have an advantage in protecting maxillary central incisor from EARR, which still needs to be confirmed by more high-quality studies.
Topics: Humans; Incisor; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Root Resorption
PubMed: 27871255
DOI: 10.1186/s12903-016-0320-y -
Journal of Oral Biology and... 2023The objective of this review is to systematically analyze the available literature on the effects of titanium oxide (TiO₂) coating on the antimicrobial properties,... (Review)
Review
Effects of titanium oxide coating on the antimicrobial properties, surface characteristics, and cytotoxicity of orthodontic brackets - A systematic review and meta analysis of in-vitro studies.
OBJECTIVE
The objective of this review is to systematically analyze the available literature on the effects of titanium oxide (TiO₂) coating on the antimicrobial properties, surface characteristics, and cytotoxicity of orthodontic brackets.
METHODS
In-vitro studies reporting on the effects of Titanium oxide (TiO₂) coatings on antimicrobial properties, surface roughness, cytotoxic activity and bacterial adhesion of orthodontic brackets were included in the review. Electronic databases such as PubMed, SCOPUS, Web of Science and Google Scholar, were searched till September 2022. Risk of Bias was analyzed by using RoBDEMAT tool. Meta-analysis using Random Effects Model was performed for assessing the antimicrobial activity against and
RESULTS
A total of 11 studies were included the RoB analysis revealed sufficient reporting across all the domains and inconsistent reporting in only two of the domains. On qualitative analysis, a significant antimicrobial effect of TiO2 coating on orthodontic brackets against and was reported. The meta analysis revealed a significant overall antimicrobial effect with a high heterogeneity. (SMD: 3.5; p < 0.00001; i2 - 99.2%).
CONCLUSION
An overall significant antimicrobial effect of TiO₂ coated brackets against was noted but with a high heterogeneity. The subgroup analysis revealed a significant antimicrobial effect on with a low heterogeneity but it was limited by a publication bias. The included studies reported reduced surface roughness, minimal bacterial adhesion and less cytotoxic activity with TiO₂ coated brackets than uncoated brackets.
PubMed: 37409325
DOI: 10.1016/j.jobcr.2023.05.014 -
BDJ Open Sep 2022The COVID-19 pandemic has caused major disruptions in dental care globally, in part due to the potential for contaminated aerosol to be generated by dental activities....
INTRODUCTION
The COVID-19 pandemic has caused major disruptions in dental care globally, in part due to the potential for contaminated aerosol to be generated by dental activities. This systematic review assesses the literature for changes in aerosol-contamination levels when rotary instruments are used, (1) as distance increases from patient's mouth; (2) as time passes after the procedure; and (3) when using different types of handpieces.
METHODS
The review methods and reporting are in line with PRISMA statements. A structured search was conducted over five platforms (September 2021). Studies were assessed independently by two reviewers. To be eligible studies had to assess changes in levels of aerosol contamination over different distances, and time points, with rotary hand instruments. Studies' methodologies and the sensitivity of the contamination-measurement approaches were evaluated. Results are presented descriptively.
RESULTS
From 422 papers identified, 23 studies were eligible. All investigated restorative procedures using rotary instruments and one study additionally looked at orthodontic bracket adhesive material removal. The results suggest contamination is significantly reduced over time and distance. However, for almost all studies that investigated these two factors, the sizes of the contaminated particles were not considered, and there were inconclusive findings regarding whether electric-driven handpieces generate lower levels of contaminated particles.
CONCLUSION
Aerosol contamination levels reduce as distances, and post-procedure times increase. However, there was sparce and inconsistent evidence on the clearing time and no conclusions could be drawn. High-speed handpieces produce significantly higher levels of contamination than slow-speed ones, and to a lesser extent, micro-motor handpieces. However, when micro-motor handpieces were used with water, the contamination levels rose and were similar to high-speed handpiece contamination levels.
PubMed: 36068221
DOI: 10.1038/s41405-022-00118-4 -
Journal of Orofacial Orthopedics =... Mar 2017In orthodontic treatment, the effects of differences in the design between active and passive self-ligating bracket (ASLB and PSLB, respectively) are usually neglected.... (Comparative Study)
Comparative Study Meta-Analysis Review
PURPOSE
In orthodontic treatment, the effects of differences in the design between active and passive self-ligating bracket (ASLB and PSLB, respectively) are usually neglected. This study investigated differences in effectiveness and efficiency between ASLBs and PSLBs.
METHODS
To identify randomized, controlled clinical trials (RCTs) comparing ASLB with PSLB, the electronic databases Medline, Embase, Cochrane Central Register of Controlled Trials, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, and Chinese Medical Journal Database were searched without language or time limits. Relevant available dental journals and reference lists from included studies were manually searched for applicable reports. Meta-analyses were conducted with the Review Manager program. Two independent reviewers performed all search processes; disagreements were discussed with a third reviewer.
RESULTS
Eight studies were included in the systematic review, of which six were included in the meta-analysis due to the data consistency. Three had a low risk of bias, four had an unclear risk of bias, and one had a high risk of bias. With regard to alignment efficiency, meta-analysis favors ASLB [mean difference (MD) -10.24 days, 95% confidence interval (CI) -17.68 to -2.80]. However, the same analysis does not favor either design in terms of width change due to treatment for intercanine (MD -0.49 mm, 95% CI -1.10 to 0.13 mm) interfirst premolar (MD -0.07 mm, 95% CI -0.69, 0.56 mm) intersecond premolar (MD -0.58 mm, 95% CI -1.25 to 0.08 mm) and intermolar (MD 0.10 mm, 95% CI -0.82 to 1.02 mm) width.
CONCLUSIONS
Based on current clinical evidence from RCTs, ASLB appears to be more efficient for alignment, while neither design shows an advantage for width change. Further research is needed to confirm present results.
Topics: Adolescent; Dental Prosthesis Design; Evidence-Based Medicine; Female; Humans; Male; Malocclusion; Orthodontic Brackets; Prevalence; Randomized Controlled Trials as Topic; Risk Factors; Tooth Movement Techniques; Treatment Outcome
PubMed: 28224175
DOI: 10.1007/s00056-016-0059-8 -
Medicine Nov 2018The aim of our study was to qualitatively and quantitatively synthesize the evidence regarding ways to improve motivation of oral hygiene among orthodontic patients with... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The aim of our study was to qualitatively and quantitatively synthesize the evidence regarding ways to improve motivation of oral hygiene among orthodontic patients with fixed appliances and identify the effects of motivational methods via comparing the oral hygiene condition before and after the motivations.
METHODS
An electronic search was conducted in PubMed, Ovid, Embase, and the Crochrane Library for relevant random controlled trials (RCT) and clinical controlled trial (CCT) published before May 1, 2017 with manual search in addition. Search and selection of studies, quality assessment, data extraction and synthesis was completed by 2 reviewers independently. Plaque index (PI) and gingival index (GI) at 1, 3, 6-month were pooled with Review Manager 5.3. Bias of included studies was evaluated.
RESULTS
In total, 12 studies fulfilled the inclusion criteria of this systematic review, of which, 5 were included in the meta-analysis. Motivational methods had statistically significant advantage regarding PI in the experimental group over control group at 1, 3, 6-month, while GI was significantly better controlled in the study group at 3, 6-month. The quality of included studies was moderate.
CONCLUSION
It is worthy for orthodontists to put in additional efforts to motivate patients to maintain good oral hygiene throughout the entire treatment process.
Topics: Dental Hygienists; Dental Plaque Index; Humans; Motivation; Oral Hygiene; Orthodontic Brackets; Orthodontists; Patient Education as Topic; Periodontal Index
PubMed: 30461616
DOI: 10.1097/MD.0000000000013182