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Journal of Clinical Medicine Jun 2023Individuals with amelogenesis imperfecta (AI) often present with malocclusions, especially a dental or skeletal anterior open bite (AOB). (Review)
Review
BACKGROUND
Individuals with amelogenesis imperfecta (AI) often present with malocclusions, especially a dental or skeletal anterior open bite (AOB).
OBJECTIVES
To evaluate the craniofacial characteristics in individuals with AI.
MATERIAL AND METHODS
A systematic literature search was conducted with the PubMed, Web of Science, Embase and Google Scholar databases to identify studies relating to the cephalometric characteristics of individuals with AI, without any language or publication date restrictions. The grey literature was searched using Google Scholar, Opengrey and Worldcat. Only studies with a suitable control group for comparison were included. Data extraction and a risk of bias assessment were carried out. A meta-analysis was performed using the random effects model for cephalometric variables that were evaluated in at least three studies.
RESULTS
The initial literature search yielded 1857 articles. Following the removal of duplicates and a screening of the records, seven articles were included in the qualitative synthesis, representing a total of 242 individuals with AI. Four studies were included in the quantitative synthesis. The meta-analysis results showed that individuals with AI present a smaller SNB angle and larger ANB angle than those of control groups in the sagittal plane. In the vertical plane, those with AI present a smaller overbite and larger intermaxillary angle than those without AI. No statistically significant differences were found for the SNA angle when comparing the two groups.
CONCLUSIONS
Individuals with AI seem to present with more vertical craniofacial growth, leading to an increased intermaxillary angle and decreased overbite. This possibly leads to a more retrognathic mandible with a larger ANB angle due to an anticipated posterior mandibular rotation.
PubMed: 37298021
DOI: 10.3390/jcm12113826 -
Dental Traumatology : Official... Oct 2016The aim of this systematic review and meta-analysis was to search for scientific evidence regarding the factors associated with traumatic dental injury (TDI) in the... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The aim of this systematic review and meta-analysis was to search for scientific evidence regarding the factors associated with traumatic dental injury (TDI) in the primary dentition.
METHODOLOGY
An electronic search addressing factors associated with TDI was conducted in the PubMed, ISI, LILACS, Cochrane Library, and Embase databases. Data were extracted and analyzed regarding risk factors, statistical test, effect measures, and study design.
RESULTS
The online search strategy led to the initial retrieval of 2566 articles. After evaluating the titles and abstracts, 24 papers were selected for complete review and data collection. TDI was associated with males (OR: 1.24; 95%CI: 1.09-1.41), inadequate lip coverage (OR: 1.81; 95%CI: 1.50-2.17), overbite (OR: 1.438; 95%CI: 0.94-2.19), and age (1 vs 2 years - OR: 0.47; 95%CI: 0.38-0.58; 2 vs 3 years - OR: 0.78; 95%CI: 0.67-0.91; 3 vs 4 years - OR: 0.82; 95%CI: 0.71-0.95). Overjet and anterior open bite were associated with TDI in the majority of studies.
CONCLUSIONS
Males, older children, and those with inadequate lip coverage, overbite, or overjet are more likely to have TDI in the primary dentition.
Topics: Child; Family Characteristics; Female; Humans; Male; Overbite; Prevalence; Risk Factors; Tooth Injuries; Tooth, Deciduous
PubMed: 26990348
DOI: 10.1111/edt.12268 -
European Journal of Orthodontics Sep 2023To systematically review the available evidence concerning the risk factors for gingival recessions (GR) after orthodontic treatment (OT).
BACKGROUND/OBJECTIVES
To systematically review the available evidence concerning the risk factors for gingival recessions (GR) after orthodontic treatment (OT).
DATA COLLECTION AND ANALYSIS
Data was obtained and collected by systematically searching 3 data bases: Pubmed, EMBASE, and Web of Science until 20 April 2023. Controlled trials, cohort, case-control or cross-sectional studies describing GR or clinical crown height (CCH) after OT were included. The risk of bias in the selected studies was evaluated with the methodological index for non-randomized studies.
RESULTS
Forty-eight articles were included, investigating the following six risk factors for GR: 1. OT (n = 21), 2. Type of orthodontic intervention (n = 32), 3. Patient's baseline occlusal and skeletal characteristics (n = 14), 4. Mucogingival characteristics (n = 10), 5. Oral hygiene (n = 9), and 6. Others (n = 12). Significantly higher prevalence, severity and extent of GR were found in orthodontic patients by 10/15, 4/10, and 2/2 articles respectively. 10/16 articles reported significantly more GR and increased CCH in patients where orthodontic incisor proclination was performed. The evidence surrounding maxillary expansion and orthodontic retention was too heterogeneous to allow for? definitive conclusions. Pre-treatment angle classification, ANB, overjet, overbite, arch width and mandibular divergence were found not to be associated with GR (9/14), while pre-treatment crossbite, symphysis height and width were (5/7 studies). A thin gingival biotype, presence of previous GR, baseline width of keratinized gingiva and facial gingival margin thickness were correlated with increased risk of GR after OT by nine articles, while pocket depth was not. Oral hygiene, sex, treatment duration, and oral piercings were found not to be linked with GR in orthodontic patients, while GR was reported to increase with age in orthodontic patients by 50 per cent of the articles investigating this factor. The mean risk of bias for comparative and not comparative studies was 14.17/24 and 9.12/16.
LIMITATIONS
The selected studies were quite heterogeneous regarding study settings, variables reported and included very limited sample sizes.
CONCLUSION
Although studies regarding the risk factors for GR are relatively abundant, they are very heterogeneous concerning design, studied factors, methodology and reporting, which often leads to contradictory results. Uniform reporting guidelines are urgently needed for future research.
PROSPERO REGISTRATION
CRD42020181661.
FUNDING
This research received no funding.
Topics: Humans; Gingival Recession; Cross-Sectional Studies; Overbite; Malocclusion; Gingiva
PubMed: 37432131
DOI: 10.1093/ejo/cjad026 -
American Journal of Orthodontics and... Mar 2023Bonded spurs, fixed or removable palatal cribs have been used to treat anterior open bite (AOB) in growing children. Different conclusions have been brought out by... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Bonded spurs, fixed or removable palatal cribs have been used to treat anterior open bite (AOB) in growing children. Different conclusions have been brought out by different authors. This meta-analysis aimed to evaluate the effect of bonded spurs, fixed and removable palatal cribs in the early treatment of AOB.
METHODS
A comprehensive electronic search was carried out through PubMed, Embase (via Ovid), MEDLINE (via Ovid), Cochrane Central Register of Controlled Trials, and Web of Science up to May 1, 2022. This meta-analysis was performed in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. The work was carried out by 2 reviewers in duplicate and independently, including electronic searching, data extracting, risk of bias assessment, quality of evidence grading, heterogeneity and statistical power analysis, and eligibility evaluation of the retrieved articles.
RESULTS
Four studies out of 181 articles were recruited in the meta-analysis after applying the inclusion and exclusion criteria. The results showed that bonded lingual spurs and fixed palatal crib or spurs produced similar overbite changes (mean difference, -0.32; 95% confidence interval, -1.06 to 0.43; P = 0.41; I = 27%; meta power = 0.099). Fixed palatal crib and removable palatal crib also exhibited comparable effects in correcting AOB (mean difference, -0.02; 95% confidence interval, -0.90 to 0.86; P = 0.96; I = 0%; meta power = 0.2182). The quality of evidence about these 2 outcomes assessed with GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) was low.
CONCLUSIONS
Bonded lingual spurs, fixed palatal crib or spurs, and removable palatal crib had similar effects in the early treatment of AOB. Because the number of included studies was limited and only the overbite changes before and after treatment were assessed, more clinical randomized controlled studies with longer follow-ups are needed to get more clinically significant advice.
Topics: Child; Humans; Open Bite; Overbite; Malocclusion, Angle Class II; Palate; Infant Equipment
PubMed: 36564317
DOI: 10.1016/j.ajodo.2022.10.017 -
Progress in Orthodontics Aug 2020The aim of this systematic review was to identify, evaluate, and provide a current literature about the influence of heritability on the determination of occlusal traits. (Review)
Review
BACKGROUND
The aim of this systematic review was to identify, evaluate, and provide a current literature about the influence of heritability on the determination of occlusal traits.
MATERIALS AND METHODS
MEDLINE, SCOPUS, Web of Science, LILACS, and Google Scholar were searched without restrictions up to March 2020. Studies with twin method were considered and the risk of bias assessment was performed using quality of genetic association studies checklist (Q-Genie). The coefficient of heritability (h), model-fitting approaches, and coefficient correlation were used to estimate the genetic/environmental influence on occlusal traits. The GRADE tool was used to assess the quality of the evidence.
RESULTS
Ten studies met the eligibility criteria. Three studies presented good quality, five moderate quality, and two poor quality. Most studies have found that the intra-arch traits, mainly the maxillary arch morphology, such as width (h 16-100%), length (h 42-100%), and shape (h 42-90%), and the crowding, mainly for mandibular arch (h 35-81%), are under potential heritability influence. The traits concerning the inter-arch relationship, as overjet, overbite, posterior crossbite, and sagittal molar relation, seem not to be genetically determined. The certainty of the evidence was graded as low for all outcomes.
CONCLUSIONS
Although weak, the available evidence show that the heritability factors are determinant for the intra-arch traits, namely, arch morphology and crowding. Possibly due they are functionally related, the occlusal traits concerning the maxillary and mandibular relationship seem to have environmental factors as determinants. In this scenario, early preventive approaches can offer a more effective and efficient orthodontic treatment.
Topics: Humans; Malocclusion; Malocclusion, Angle Class II; Mandible; Maxilla; Overbite
PubMed: 32864724
DOI: 10.1186/s40510-020-00330-8 -
Sleep Medicine Reviews Oct 2018An oral appliance (OA) is an effective treatment option for patients with obstructive sleep apnea (OSA), but dental and skeletal changes have been detected by many... (Meta-Analysis)
Meta-Analysis Review
An oral appliance (OA) is an effective treatment option for patients with obstructive sleep apnea (OSA), but dental and skeletal changes have been detected by many studies after long-term OA use. Better understanding of the long-term side effects may decrease discontinuation of OA use and assist clinicians to make informed decisions. Accordingly, a systematic review and meta-analysis were performed to evaluate the dental and skeletal changes associated with OAs designed to advance the mandible. The quality of the studies was determined by using the risk of bias assessment tool for non-randomized studies (RoBANS), and 12 studies were included in the meta-analysis. OA use was associated with a significant decrease of overjet (OJ) and overbite (OB), and it was suggested that both parameters decreased along with the duration of treatment. Meta-analysis also demonstrated a significant increase of L1-MP. However, there were no significant changes of skeletal modifications or mandibular rotation. Changes of incisor inclination were suggested to make a contribution to reduction of OJ and OB. In conclusion, long-term OA use was associated with dental changes. The results of this study provide information for clinicians about the long-term effects of OAs.
Topics: Cephalometry; Mandibular Advancement; Overbite; Sleep Apnea, Obstructive; Snoring
PubMed: 29628335
DOI: 10.1016/j.smrv.2018.02.006 -
Indian Journal of Dental Research :... 2020The aim of this systematic review and meta-analysis was to estimate the prevalence of traumatic dental injuries (TDI) in India. The secondary objective was to evaluate... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The aim of this systematic review and meta-analysis was to estimate the prevalence of traumatic dental injuries (TDI) in India. The secondary objective was to evaluate the prevalence rate according to the differences in gender, age, regions, type of TDI and risk factors associated with TDI.
METHODS
The PubMed, LILACS, Web of Science, Cochrane, CINHAL, and Scopus databases, along with the Public Health Electronic Library, TRoPHI and DoPHER were searched from 1 March to 15April 2019 without any restriction of language and year of publication. The qualitative synthesis was done regarding the demographics, study methods, cause of trauma, geographic location, increased overjet and inadequate lip coverage. The meta-analysis was undertaken with STATA-14 software (USA). The pooled prevalence of TDI was calculated using data extracted from 48 studies included in qualitative synthesis and meta-analysis. A sub-group meta-analysis was done by extraction of the data for age groups of 6 years and >6 years.
RESULTS
The pooled prevalence of TDI in Indian population was 13 cases in 100 individuals. The prevalence of TDI for age groups of ≤6 was 15% (males, 15%; females, 16%) and for >6 years was 12% (males, 13%; females, 8%). The most common cause of TDI was falls, and most frequent location was home. The odds ratio for occurrence of TDI and inadequate lip-coverage was 3.35 and overjet greater than 3 mm was 3.53.
CONCLUSIONS
The pooled prevalence of TDI was 13% and slightly higher in children less than 6 years of age. Inadequate lip coverage and increased overjet are the risk factors associated with TDI. Heterogeneity was observed among the studies in terms of design, variables recorded, sampling, study methods and statistical methods. Majority of them also suffered from moderate to high risk of bias.
Topics: Accidental Falls; Child; Female; Humans; India; Male; Overbite; Prevalence; Tooth Injuries
PubMed: 33107464
DOI: 10.4103/ijdr.IJDR_953_19 -
Dental Traumatology : Official... Feb 2022Dental trauma (DT) occurs frequently in children and adolescents. Therefore, understanding the factors associated with its occurrence in these age groups is important to... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND/AIM
Dental trauma (DT) occurs frequently in children and adolescents. Therefore, understanding the factors associated with its occurrence in these age groups is important to establish specific preventive measures. The aim of this study was to investigate the relationships of lip coverage, overjet, and open bite to dental trauma in Brazilian children and adolescents.
MATERIAL AND METHODS
The review protocol was registered in the PROSPERO database (CRD42020156290) and the bibliographic search was performed in nine electronic databases until July 2020. The studies included were observational, performed in Brazil, with healthy children and adolescents (0-19 years old), and without the restriction of date or language. Two reviewers assessed the individual risk of bias of the eligible studies with a standardized checklist. The meta-analyses were stratified by dentition stage and age range using fixed or random effects, odds ratio (OR) as the effect measure, and 95% confidence interval. The heterogeneity across studies was assessed with the I² test and the GRADE approach assessed the certainty of evidence.
RESULTS
The search presented 2493 initial results, from which 55 met the eligibility criteria and were included. Most studies (67%) presented a low risk of bias and were published between 2000 and 2019. Children and adolescents with inadequate lip coverage are 1.86-2.36 times more likely to suffer from DT, while those with increased overjet are 1.94-3.11 times more likely. Children with primary dentitions and anterior open bites are 1.76 (95% CI: 1.20-2.59) times more likely to suffer from DT. The certainty of evidence varied from very low to moderate.
CONCLUSIONS
Inadequate lip coverage, increased overjet, and anterior open bite are associated with the occurrence of dental trauma in Brazilian children and adolescents.
Topics: Adolescent; Adult; Brazil; Child; Child, Preschool; Humans; Infant; Infant, Newborn; Lip; Malocclusion; Malocclusion, Angle Class II; Overbite; Young Adult
PubMed: 34275184
DOI: 10.1111/edt.12707 -
International Journal of Paediatric... Nov 2022To evaluate the clinical effectiveness of the eruption guidance appliances (EGAs) in treating malocclusion in the early mixed dentition. (Meta-Analysis)
Meta-Analysis Review
AIM
To evaluate the clinical effectiveness of the eruption guidance appliances (EGAs) in treating malocclusion in the early mixed dentition.
DESIGN
Electronic databases were comprehensively searched for the eligibility literature of the EGA treatment for a period spanning from the earliest available date in each database up to July 2021. Randomized controlled trials, controlled clinical trials, and prospective and retrospective cohort studies were included in the present review. The quality of clinical trials was assessed according to the Cochrane Collaboration's tools (RoB2.0 and ROBINS-I), whereas cohort studies were based on the Newcastle-Ottawa Scale (NOS). The data were gathered and synthesized with the Stata software (version 12).
RESULTS
The screen yielded 436 articles, of which 17 papers were potentially eligible, and 7 articles from 3 studies (1 RCT, 1 CCT, and 1 PCS) were qualified for the final review and analysis. The meta-analysis showed both favorable dentoalveolar and skeletal changes in short term. Both overjet and overbite had a significant decrease after treatment (MD = -2.38 mm, 95% CI: -2.82 to -1.94, p < .001, and MD = -2.43 mm, 95% CI: -3.52 to -1.35, p < .001, respectively), and SNB increased significantly by 0.73 degrees (95% CI: 0.17-1.28, p = .01). After the retention period, however, overbite had a significant increase of 0.88mm, which indicated the occurrence of a relapse (95% CI: 0.60-1.16, p < .001).
CONCLUSIONS
According to the existing evidence, the EGA treatment is effectively correcting overjet and overbite in the early mixed dentition in short term; furthermore, high-quality and long-term studies are warranted to determine its long-term effectiveness.
Topics: Dentition, Mixed; Humans; Malocclusion; Malocclusion, Angle Class II; Overbite; Prospective Studies; Retrospective Studies; Treatment Outcome
PubMed: 35191109
DOI: 10.1111/ipd.12961 -
Journal of Dental Research, Dental... 2023Posterior intrusion with skeletal anchorage is one of the effective methods in the treatment of anterior open bite. Knowing the effects of posterior intrusion, the... (Review)
Review
BACKGROUND
Posterior intrusion with skeletal anchorage is one of the effective methods in the treatment of anterior open bite. Knowing the effects of posterior intrusion, the amount of possible molar intrusion using skeletal anchorage, and its impact on clinical and cephalometric indicators can help the clinician choose the optimal treatment method, especially in borderline surgical cases.
METHODS
In this systematic review, a series of articles were collected through a systematic search in databases, and the titles and summaries of all these articles were reviewed. After removing the irrelevant articles, the full texts of the related articles were read carefully, and their validity was evaluated. Only RCTs and observational studies that complied with PICO questions were included. The Cochrane Risk of Bias 2.0 (RoB 2), ROBINS-I, and GRADE were used to assess the risk of bias in the included studies. The relevant information on selected articles was extracted, and a meta-analysis was performed with Review Manager 5.4 software.
RESULTS
The meta-analysis revealed a significant average molar intrusion of 2.89 mm using temporary anchorage devices (TADs). A subgroup analysis showed that miniplates achieved greater intrusion (3.29 mm) compared to miniscrews (2.25 mm) (=0.03). The level of applied force did not significantly affect the degree of intrusion. Dental parameters such as overbite and overjet were notably altered, with overbite increasing by 4.81 mm and overjet decreasing by 2.06 mm on average. As for the skeletal cephalometric characteristics, SNB, ANB, and SN-Pog increased while mandibular plane angle and lower anterior facial height (LAFH) decreased, and these changes were significant. Meanwhile, SNA and palatal angle changes were not significant.
CONCLUSION
TADs have proved effective in achieving significant intrusion of maxillary molars, leading to marked improvements in dental and skeletal characteristics in patients with open bite malocclusion. Miniplates proved more effective in achieving greater intrusion.
PubMed: 38584993
DOI: 10.34172/joddd.2023.40754