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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 -
International Orthodontics Sep 2019Patients in active fixed orthodontic treatment or fixed retention phase may require magnetic resonance (MR) scans of the head and neck region. Orthodontists are... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Patients in active fixed orthodontic treatment or fixed retention phase may require magnetic resonance (MR) scans of the head and neck region. Orthodontists are challenged to decide whether to keep or remove orthodontic appliances prior to the scans. The aim of this study was to determine the effect of orthodontic appliances on the diagnostic capability of MR images.
METHODS
Four electronic databases were searched, with no language restrictions, from database inception to October 2016: PubMed, EMBASE, CINAHL, EBMR. A search in Google Scholar and ProQuest, as well as a manual search, were also conducted. Two independent reviewers assessed articles for inclusion. Original studies including any orthodontic appliance on human subjects were considered. Outcomes measured were development of artefacts, diagnostic quality, accuracy, and treatment outcomes. Risk of bias was assessed with the Cochrane Risk of Bias Assessment and QUADAS-2 tools.
RESULTS
Five of 1052 studies identified were included in the final qualitative synthesis. A total of 90 adult human subjects were included. Orthodontic appliances evaluated were brackets, bands, archwires, and fixed retainers. The outcomes assessed were production of artefacts, diagnostic quality and diagnostic accuracy. Detrimental effects on diagnostic quality, and subsequently diagnostic accuracy, rose with increased stainless steel (SS) and proximity to anatomic area of interest. Orthodontic appliances may render images uninterpretable and non-diagnostic.
CONCLUSIONS
There is fair evidence to suggest orthodontic appliances, mainly those with SS, cause MR artefacts. Removal of metal orthodontic appliances prior to MR scans is recommended, especially if the area of interest is near the orthodontic appliance. Additional evidence is needed to provide guidelines to clinicians.
Topics: Artifacts; Databases, Factual; Head; Humans; Magnetic Resonance Imaging; Neck; Orthodontic Appliances; Orthodontic Brackets; Orthodontic Wires; Orthodontics, Corrective; Stainless Steel
PubMed: 31285157
DOI: 10.1016/j.ortho.2019.06.001 -
The Cochrane Database of Systematic... Feb 2024Initial arch wires are the first arch wires inserted into fixed appliance at the beginning of orthodontic treatment. With a number of different types of orthodontic arch... (Review)
Review
BACKGROUND
Initial arch wires are the first arch wires inserted into fixed appliance at the beginning of orthodontic treatment. With a number of different types of orthodontic arch wires available for initial tooth alignment, it is important to understand which are most efficient and which cause the least amount of root resorption and pain during the initial aligning stage of treatment. This is the third update of a Cochrane review first published in 2010.
OBJECTIVES
To assess the effects of initial arch wires for the alignment of teeth with fixed orthodontic braces, in terms of the rate of tooth alignment, amount of root resorption accompanying tooth movement, and intensity of pain experienced by patients during the initial alignment stage of treatment.
SEARCH METHODS
We searched Cochrane Oral Health's Trials Register, CENTRAL, MEDLINE, Embase, and two ongoing trials registries on 4 July 2022.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) of different initial arch wires used to align teeth with fixed orthodontic braces. We included people with full-arch fixed orthodontic appliances on the upper arch, lower arch, or both arches.
DATA COLLECTION AND ANALYSIS
Two independent review authors were responsible for study selection, data extraction, and assessment of risk of bias in included studies. We contacted corresponding authors of included studies to obtain missing information. We resolved disagreements by discussion between the review authors. Our main outcomes were alignment rate (movement of teeth in mm), root resorption, time to alignment, and intensity of pain measured on a 100-mm visual analogue scale (VAS). We pooled data from studies with similar interventions and outcomes using random-effects models. We reported mean differences (MDs) with 95% confidence intervals (CIs) for continuous data, risk ratios (RRs) with 95% CIs for dichotomous data, and alignment rate ratios with 95% CIs for time-to-event data. Two independent review authors assessed the certainty of evidence. We resolved disagreements by discussion between the review authors.
MAIN RESULTS
We included 29 RCTs with 1915 participants (2581 arches) in this review. Studies were generally small (sample sizes ranged from 14 to 200 participants). Duration of follow-up varied between three days and six months. Eleven studies received funding, six received no funding, and 12 provided no information about funding sources. We judged eight studies at high risk of bias, nine at low risk, and 12 at unclear risk. We grouped the studies into six main comparisons. Multistrand stainless steel wires versus wires composed of other materials Six studies with 409 participants (545 arches) evaluated multistrand stainless steel (StSt) wires versus wires composed of other materials. We are very uncertain about the effect of multistrand StSt wires versus other wires on alignment rate (4 studies, 281 participants, 417 arches; very low-certainty evidence). There may be little to no difference between multistrand StSt wires and other wires in terms of intensity of pain (MD -2.68 mm, 95% CI -6.75 to 1.38; 2 studies, 127 participants, 127 arches; low-certainty evidence). Conventional nickel-titanium wires versus superelastic nickel-titanium wires Four studies with 266 participants (274 arches) evaluated conventional nickel-titanium (NiTi) wires versus superelastic NiTi wires. There may be little to no difference between the different wire types in terms of alignment rate (124 participants, 124 arches, 2 studies; low-certainty evidence) and intensity of pain (MD -0.29 mm, 95% CI -1.10 to 0.52; 2 studies, 142 participants, 150 arches; low-certainty evidence). Conventional nickel-titanium wires versus thermoelastic copper-nickel-titanium wires Three studies with 210 participants (210 arches) evaluated conventional Ni-Ti versus thermoelastic copper-nickel-titanium (CuNiTi) wires. We are very uncertain about the effects of the different arch wires on alignment rate (1 study, 66 participants, 66 arches; very low-certainty evidence). There may be little to no difference between conventional NiTi wires and thermoelastic CuNiTi wires in terms of time to alignment (alignment rate ratio 1.30, 95% CI 0.68 to 2.50; 1 study, 60 participants, 60 arches; low-certainty evidence). Superelastic nickel-titanium wires versus thermoelastic nickel-titanium wires Twelve studies with 703 participants (936 arches) evaluated superelastic NiTi versus thermoelastic NiTi wires. There may be little to no difference between superelastic NiTi wires and thermoelastic NiTi wires in alignment rate at four weeks (MD -0.28 mm, 95% CI 0.62 to 0.06; 5 studies, 183 participants, 183 arches; low-certainty evidence). We are very uncertain about the effects of the different wires on root resorption (2 studies, 52 participants, 312 teeth; very low-certainty evidence). Superelastic NiTi wires compared with thermoelastic NiTi wires may result in a slight increase in time to alignment (MD 0.5 months, 95% CI 0.21 to 0.79; 1 study, 32 participants, 32 arches; low-certainty evidence) but are probably associated with a slight increase in intensity of pain (MD 6.96 mm, 95% CI 1.82 to 12.10; 3 studies, 94 participants, 138 arches, moderate-certainty evidence). Single-strand superelastic nickel-titanium wires versus coaxial superelastic nickel-titanium wires Three studies with 104 participants (104 arches) evaluated single-strand superelastic NiTi versus coaxial superelastic NiTi wires. Use of single-strand superelastic NiTi wires compared with coaxial superelastic NiTi wires probably results in a slight reduction in alignment rate at four weeks (MD -2.64 mm, 95% CI -4.61 to -0.67; 2 studies, 64 participants, 64 arches, moderate-certainty evidence). Different sizes of nickel-titanium wires Two studies with 149 participants (232 arches) compared different types of NiTi wires. There may be little to no difference between different sizes of NiTi wires in terms of pain (low-certainty evidence).
AUTHORS' CONCLUSIONS
Superelastic NiTi wires probably produce slightly more pain after one day than thermoelastic NiTi wires, and single-strand superelastic NiTi wires probably have a lower alignment rate over four weeks compared with coaxial superelastic NiTi wires. All other evidence on alignment rate, root resorption, time to alignment, and pain is of low or very low certainty in all comparisons. Therefore, there is insufficient evidence to determine whether any particular arch wire material or size is superior to any other. The findings of this review are imprecise and unreliable; well-designed larger studies are needed to give better estimates of the benefits and harms of different arch wires. Orthodontists should exercise caution when interpreting the findings of this review and be prepared to adapt their treatment plans based on individual patient needs.
Topics: Humans; Nickel; Titanium; Root Resorption; Stainless Steel; Copper; Orthodontic Brackets; Pain; Alloys
PubMed: 38319008
DOI: 10.1002/14651858.CD007859.pub5 -
The Journal of Evidence-based Dental... Mar 2023Liu S, Silikas N, Ei-Angbawi A. Analysis of the effectiveness of the fiber-reinforced composite lingual retainer: A systematic review and meta-analysis. Am J Orthod... (Meta-Analysis)
Meta-Analysis
FIBER REINFORCED COMPOSITE RETAINERS MAY BE AS EFFECTIVE AS MULTISTRANDED STAINLESS-STEEL WIRES IN FAILURE RATES AND MINIMAL ADVERSE EFFECT, BUT SUPERIOR IN TERMS OF RELAPSE AND PATIENT SATISFACTION.
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION
Liu S, Silikas N, Ei-Angbawi A. Analysis of the effectiveness of the fiber-reinforced composite lingual retainer: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop. 2022 Aug 26:S0889-5406(22)00,432-2. doi: 10.1016/j.ajodo.2022.07.003. Epub ahead of print. PMID: 36,031,511.
SOURCE OF FUNDING
Not reported.
TYPE OF STUDY/DESIGN
Systematic review with meta-analysis of data.
Topics: Humans; Dental Bonding; Patient Satisfaction; Stainless Steel; Orthodontic Retainers; Orthodontic Wires; Orthodontic Appliance Design; Recurrence
PubMed: 36914296
DOI: 10.1016/j.jebdp.2023.101843 -
BMC Oral Health Nov 2015The purpose of this systematic review is to identify and review the orthodontic literature with regards to assessing possible differences in canine retraction rate and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The purpose of this systematic review is to identify and review the orthodontic literature with regards to assessing possible differences in canine retraction rate and the amount of antero-posterior anchorage (AP) loss during maxillary canine retraction, using conventional brackets (CBs) and self-ligating brackets (SLBs).
METHODS
An electronic search without time or language restrictions was undertake in September 2014 in the following electronic databases: The Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE via OVID, EMBASE via OVID, Web of science. We also searched the reference lists of relevant articles. Quality assessment of the included articles was performed. Two of the authors were responsible for study selection, validity assessment and data extraction.
RESULTS
Six studies met the inclusion criteria, including 2 randomized controlled trials and 4 control clinical studies. One was assessed as being at low risk of bias. Five trials were assessed as being at moderate risk of bias. The meta-analysis from 6 eligible studies showed that no statistically significant difference was observed between the 2 groups in the rate of canine retraction and loss of antero-posterior anchorage of the molars.
CONCLUSION
There is some evidence from this review that both brackets showed the same rate of canine retraction and loss of antero-posterior anchorage of the molars. The results of the present systematic review should be viewed with caution due to the presence of uncontrolled interpreted factors in the included studies. Further well-designed and conducted randomized controlled trials are required, to facilitate comparisons of the results.
Topics: Cuspid; Humans; Orthodontic Brackets; Orthodontic Wires; Tooth Movement Techniques
PubMed: 26531223
DOI: 10.1186/s12903-015-0127-2 -
Hua Xi Kou Qiang Yi Xue Za Zhi = Huaxi... Jun 2018This review aims to assess the relationship between initial archwire materials and pain at the initial stage of orthodontic treatment. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This review aims to assess the relationship between initial archwire materials and pain at the initial stage of orthodontic treatment.
METHODS
On October 1, 2017, seven databases were searched electronically for studies oninitial archwire materials and pain at the initial stage of orthodontic treatment. Quality assessment was performed with bias risk assessment tools suggested by Cochrane's handbook. Data extraction of included studies was also carried out. Network Meta- analysis was conducted using R 3.4.2 (with JAGS 4.3.0), GeMTC 0.14.3, and STATA 11.0.
RESULTS
Five studies with 330 participants were included, comparing four different materials: multi-stranded stainless steel, conventional nickel-titanium, super-elastic nickel-titanium, and thermal heat-activated nickel-titanium. Two studies were at low risk of bias, one was at high risk of bias, and the remaining two were at unclear risk of bias. Network Meta-analysis results showed no statistical differences of pain among the four initial archwire materials at day 1 and day 7. However, the most painless material was most likely to be thermal heat-activated nickel-titanium on rank probability.
CONCLUSIONS
On statistical probability, thermal heat-activated nickel-titanium initial arch wires is most likely to cause the least pain at the initial stage of orthodontic treatment, compared with other materials.
Topics: Dental Alloys; Humans; Materials Testing; Network Meta-Analysis; Nickel; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Pain; Stainless Steel; Surface Properties; Titanium
PubMed: 29984932
DOI: 10.7518/hxkq.2018.03.013 -
L' Orthodontie Francaise Dec 2020The aim of this systematic review and meta-analysis was to compare self-ligating brackets (SLBs) considered as a whole to conventional brackets (CBs). An electronic... (Meta-Analysis)
Meta-Analysis
The aim of this systematic review and meta-analysis was to compare self-ligating brackets (SLBs) considered as a whole to conventional brackets (CBs). An electronic search was performed in three databases (PubMed, MEDLINE via Web of Science, Cochrane Library) from their origin up to June 2017. Additional articles were hand searched from January 2006 to June 2017. This meta-analysis was restricted to randomized controlled trials (RCTs) and split mouth design studies (SMDs). No distinction was made between active and passive SLBs. The following variables were investigated : treatment duration, number of visits, alignment rate, rate of space closure, perception of discomfort during the initial phase of treatment, pain experience during wire insertion or removal, bond failure rate, time to ligate in or to untie an archwire, periodontal indices, occlusal outcomes, transverse arch dimensional changes and root resorption. 25 RCTs and 9 SMDs were finally selected. It was more painful to insert or remove a 0.019× 0.025 SS archwire in/from SLBs. It was significantly quicker to insert or remove an archwire from SLBs. There was less bleeding on probing with SLBs 4 or 5 weeks after bonding. All other variables did not exhibit any significant difference between SLBs and CBs. Out of the 31 comparisons between self-ligating and conventional brackets, 9 only revealed statistically significant differences. This meta-analysis contradicts most of the promotional statements put forward by the distributors.
Topics: Face; Humans; Mouth; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Root Resorption
PubMed: 33355535
DOI: 10.1684/orthodfr.2020.29