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Cureus Nov 2023Mandibular advancement devices (MADs) remain a popular non-invasive treatment modality for the management of obstructive sleep apnea (OSA). However, the occlusal side... (Review)
Review
Mandibular advancement devices (MADs) remain a popular non-invasive treatment modality for the management of obstructive sleep apnea (OSA). However, the occlusal side effects from long-term therapy may result in poor patient compliance and patient drop-outs. Hence, knowledge of the possible side effects of these devices on occlusion is necessary. This article attempts to systematically review the evidence available in support of the possible long-term effects of mandibular advancement therapy on occlusion in adult sleep apnea patients. A detailed search was conducted for unpublished and published literature and their references in various electronic databases. A grey literature search was also performed. Studies until June 30, 2022, were selected. Randomized controlled trials, non-randomized trials, and cohort studies investigating the occlusal side effects of MADs for the treatment of snoring or OSA with a follow-up of at least four years were included. Study selection, data extraction, and risk of bias assessment were performed individually and in duplicate. The risk of bias was assessed by Cochrane tools for randomized and non-randomized studies. Fourteen studies were selected for the final qualitative analysis. The side effects reported were upper incisor retroclination, lower incisor proclination, decreased overjet and overbite, and change in the total occlusal contact area. The review concludes that long-term MAD therapy has statistically and clinically significant effects on occlusion.
PubMed: 38090465
DOI: 10.7759/cureus.48682 -
Journal of Indian Prosthodontic Society 2023Temporomandibular joint disorders (TMDs) following tooth loss may or may not be prevalent, but the risk of developing these disorders is always there due to changes in...
Temporomandibular joint disorders (TMDs) following tooth loss may or may not be prevalent, but the risk of developing these disorders is always there due to changes in occlusion and vertical dimension, leading to changes in the disc-fossa relationship. The purpose of this systematic review was to evaluate the prevalence and severity of temporomandibular joint (TMJ) disorder in partially versus completely edentulous patients. An elaborated literature search was conducted in PubMed/Medline, Scopus, Web of Science, Lilacs, and Google Scholar databases including all articles about varied effects of partial and complete edentulism on the TMJ published from January 1, 2000, to January 1, 2022. After the meticulous screening, only publications which fulfilled the inclusion parameters were ultimately selected for full-text evaluation and tested for bias using the Joana Briggs Institute Appraisal tools for cross-sectional, case-control, and cohort studies. A total of 547 articles from various electronic databases and manual searches were found. After eliminating the duplicates and thorough screening, 13 studies were included for qualitative synthesis. Most of the studies demonstrated at least one or two signs of the presence of TMDs following tooth loss, the intensity/frequency of which increased in proportion to the number of missing teeth.
Topics: Humans; Tooth Loss; Prevalence; Cross-Sectional Studies; Temporomandibular Joint Disorders; Mouth, Edentulous
PubMed: 37929360
DOI: 10.4103/jips.jips_136_23 -
Stomatologija 2021The aim of this systematic review was to evaluate the results of two treatment methods: space opening for an implant and prosthetic replacement (PR) versus orthodontic...
OBJECTIVE
The aim of this systematic review was to evaluate the results of two treatment methods: space opening for an implant and prosthetic replacement (PR) versus orthodontic space closure (SC) for maxillary lateral incisor agenesis (MLIA).
MATERIAL AND METHODS
The protocol of the systematic review is in line with the PRISMA requirements. An electronic search was carried out on July 11, 2021 in Pubmed, ScienceDirect, Web of Science, and Plos One databases. The review included research articles published less than 10 years ago, written in English, involving both PR and SC methods in permanent dentition, and comparing and evaluating them.
RESULTS
A total of 1,061 initially identified articles were found, full texts of 38 articles were read and assessed for eligibility, and 7 of them were included in this review. All of the articles evaluated the esthetics; in addition, 3 of them assessed periodontal health, 1 evaluated temporomandibular joint (TMJ) dysfunction, and 1 evaluated occlusion morphology disorders. One study of 7 found esthetics after SC to be statistically more pleasant, while the others found the results of both techniques to be equally esthetically satisfying. When comparing periodontal status between the groups, one study found gingival recession to be significantly more common in the SC group, while another article revealed that gingival recession and papillary defects were more common in the PR group. The remaining articles stated that there was no TMJ dysfunction, and differences in occlusion morphology disorders were not significant between the groups.
CONCLUSION
The results of MLIA treatment with SC were more favorable esthetically, but the difference was not statistically significant. There is no statistically significant data related to periodontal health, and neither of the treatment methods caused TMJ or occlusion morphology disorders. If both methods are available, space closure is preferable, although high-quality clinical trials are needed to find more evidence.
Topics: Dental Implants; Esthetics, Dental; Gingival Recession; Humans; Incisor; Maxilla
PubMed: 35635522
DOI: No ID Found -
Bioengineering (Basel, Switzerland) Jun 2024Alveolar preservation techniques for esthetic or functional purposes, or both, are a frequently used alternative for the treatment of post-extraction sockets, the aim of... (Review)
Review
BACKGROUND
Alveolar preservation techniques for esthetic or functional purposes, or both, are a frequently used alternative for the treatment of post-extraction sockets, the aim of which is the regeneration of the lesion and the preservation of the alveolar bone crest.
METHODS
Studies published in PubMed (Medline), Web of Science, Embase, and Cochrane Library databases up to January 2024 were consulted. Inclusion criteria were established as intervention studies, according to the PICOs strategy: adult subjects undergoing dental extractions (participants), with alveoli treated with bone mineral grafts and collagen membranes (intervention), compared to spontaneous healing (comparison), and observing the response to treatment in clinical and radiological measures of the alveolar bone crest (outcomes).
RESULTS
We obtained 561 results and selected 12 studies. Risk of bias was assessed using the Cochrane Risk of Bias Tool, and methodological quality was assessed using the Joanna Briggs Institute. Due to the high heterogeneity of the studies (I > 75%), a random-effects meta-analysis was used. Despite the trend, no statistical significance ( > 0.05) was found in the experimental groups.
CONCLUSIONS
The use of bone mineral grafts in combination with resorbable collagen barriers provides greater preservation of the alveolar ridge, although more clinical studies are needed.
PubMed: 38927801
DOI: 10.3390/bioengineering11060565 -
The Cochrane Database of Systematic... Dec 2015The Cochrane Oral Health Group withdrew this review as of Issue 12, 2015. The review is out of date and does not meet current Cochrane methodological standards. The... (Review)
Review
The Cochrane Oral Health Group withdrew this review as of Issue 12, 2015. The review is out of date and does not meet current Cochrane methodological standards. The editorial group responsible for this previously published document have withdrawn it from publication.
Topics: Adult; Dental Clasps; Dental Occlusion; Denture Retention; Denture, Complete; Humans; Mastication; Mouth, Edentulous; Patient Satisfaction
PubMed: 26623564
DOI: 10.1002/14651858.CD004941.pub3 -
BMC Oral Health Jan 2024Sleep bruxism is a prevalent condition in dentistry practice, characterized by involuntary grinding or clenching of the teeth during sleep. Several therapies, including...
BACKGROUND
Sleep bruxism is a prevalent condition in dentistry practice, characterized by involuntary grinding or clenching of the teeth during sleep. Several therapies, including occlusal splints, have been used to manage sleep bruxism and temporomandibular disorders, including occlusal splints. This study aimed to compare the effectiveness of different occlusal splints in managing sleep bruxism.
METHODS
The PICO framework encompasses the characterization of the population, intervention, comparison, and pertinent outcomes. A comprehensive and systematic literature review was conducted on PubMed, Scopus, and Google Scholar to identify grey literature. The search specifically targeted scientific studies published before September 20, 2023. The Cochrane Collaboration Risk of Bias Tool assessed the accuracy of the included Randomized Control Trials (RCTs). The modified Newcastle-Ottawa Scale assessed non-randomized studies. Data were systematically extracted, synthesized, and reported thematically.
RESULTS
Out of the total of 808 articles that were evaluated, only 15 articles were found to meet the specified inclusion criteria. Adjustable splints, such as full-occlusion biofeedback splints, were more effective in reducing sleep bruxism episodes, improving patient-reported symptoms, and enhancing overall well-being. The impact of different occlusal sprints on electromyographic activity varies, and potential adverse effects should be considered individually.
CONCLUSIONS
This review provides valuable insights into the effectiveness of occlusal splints in managing sleep bruxism. The results of this study indicate that occlusal splint therapy is a viable treatment approach for sleep bruxism.
Topics: Humans; Occlusal Splints; Sleep Bruxism; Sleep
PubMed: 38182999
DOI: 10.1186/s12903-023-03782-6 -
Clinical Oral Investigations May 2023To assess the pain profile of patients in the levelling/alignment phase of orthodontic treatment, as reported from randomized clinical trials. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To assess the pain profile of patients in the levelling/alignment phase of orthodontic treatment, as reported from randomized clinical trials.
MATERIALS AND METHODS
Five databases were searched in September 2022 for randomized clinical trials assessing pain during levelling/alignment with a visual analogue scale (VAS). After duplicate study selection, data extraction, and risk-of-bias assessment, random effects meta-analyses of mean differences (MDs) and their 95% confidence intervals (CIs) were performed, followed by subgroup/meta-regression, and certainty analyses.
RESULTS
A total of 37 randomized trials including 2277 patients (40.3% male; mean age 17.5 years) were identified. Data indicated quick pain initiation after insertion of orthodontic appliances (n = 6; average = 12.4 mm VAS), a quick increase to a peak at day 1 (n = 29; average = 42.4 mm), and gradually daily decrease the first week until its end (n = 23; average = 9.0 mm). Every second patient reported analgesic use at least once this week (n = 8; 54.5%), with peak analgesic use at 6 h post-insertion (n = 2; 62.3%). Patients reported reduced pain in the evening compared to morning (n = 3; MD = - 3.0 mm; 95%CI = - 5.3, - 0.6; P = 0.01) and increased pain during chewing (n = 2; MD = 19.2 mm; 95% CI = 7.9, 30.4; P < 0.001) or occlusion of the back teeth (n = 2; MD = 12.4 mm; 95% CI = 1.4, 23.4; P = 0.3), while non-consistent effects were seen for patient age, sex, irregularity, or analgesic use. Subgroup analyses indicated increased pain among extraction cases and during treatment of the lower (rather than the upper) arch, while certainty around estimates was moderate to high.
CONCLUSIONS
Evidence indicated a specific pain profile during orthodontic levelling/alignment, without signs of consistent patient-related influencing factors.
Topics: Humans; Male; Adolescent; Female; Randomized Controlled Trials as Topic; Orthodontic Appliances, Fixed; Pain; Analgesics
PubMed: 36879148
DOI: 10.1007/s00784-023-04931-5 -
Journal of Dentistry Jul 2024This systematic review evaluated the occlusal changes after loading with implant-supported single crowns. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This systematic review evaluated the occlusal changes after loading with implant-supported single crowns.
SOURCES
An electronic literature search was conducted in PubMed, Embase and Cochrane library for randomized (RCTs) or non-randomized controlled clinical trials (CCTs), with a minimum of 10 patients.
STUDY SELECTION
Studies reporting the occlusal force changes on implant-supported single crowns - with natural teeth as antagonist - measured at baseline and after loading periods were included. 4 CCTs including 133 ISCs in posterior sites were included for meta-analysis. All analyzed ISCs had no contact at a light bite and a light contact at a heavy bite in MIP at loading (baseline).
DATA
The relative occlusal forces (ROFs) of each implant-supported single crown (ISC) or control tooth (CT) were extracted. ROFs were defined as percentage of the total occlusal force of the entire dentition at maximum intercuspal position (MIP). A meta-analysis was conducted to compare the ROF changes at different follow-up periods and the weighted mean differences in ROF between ISCs and CTs were pooled and analyzed. The amount of change in ROF was significantly lower in 6 to 12 months after loading comparing the follow-up period between baseline and 6 month (p < 0.05). At baseline and 3-month follow-up, CTs presented significant higher ROF than ISCs (p < 0.05), while no significant difference was found after half year following.
CONCLUSIONS
This study showed that the ROF changes significantly over time after loading of ISCs. It might prove that the occlusal concept defined at the time of prosthetic delivery changes or adapts naturally over time.
CLINICAL SIGNIFICANCE
The function of specific implant occlusal concept (no contact at a light bite and a light contact at a heavy bite in MIP) is limited over time and careful monitoring and occlusal adjustments should be recommendable during the first-year follow-up.
Topics: Humans; Crowns; Bite Force; Dental Prosthesis, Implant-Supported; Dental Implants, Single-Tooth; Follow-Up Studies; Dental Occlusion
PubMed: 38734300
DOI: 10.1016/j.jdent.2024.105000 -
BMC Oral Health Mar 2024Clear aligner therapy has gained popularity as a minimally invasive orthodontic treatment option. However, its impact on the masticatory musculature and the...
Impact of clear aligner therapy on masticatory musculature and stomatognathic system: a systematic review conducted according to PRISMA guidelines and the Cochrane handbook for systematic reviews of interventions.
BACKGROUND
Clear aligner therapy has gained popularity as a minimally invasive orthodontic treatment option. However, its impact on the masticatory musculature and the stomatognathic system is an area of growing interest, as it involves the adjustment of occlusion and tooth movement. This systematic review aims to comprehensively assess and synthesise existing evidence regarding the influence of clear aligner therapy on the masticatory musculature and the stomatognathic system.
METHODS
An exhaustive search was performed on electronic databases that adhered to PRISMA guidelines. Clinical studies that evaluated the impact of patients receiving aligner orthodontic treatment on the muscles of the mastication and stomatognathic systems were included. A standardised data extraction form was devised for relevant variables. Two reviewers extracted the data variables. ROB-2 was used for bias evaluation in the selected studies.
RESULTS
A total of six studies met the inclusion criteria. The wearing of clear aligners significantly impacted the muscles of mastication. Muscle activity and discomfort showed a significant alteration in the initial days of appliance placement. but this observation was temporary, with no significant changes thereafter in subsequent follow-up. Bite force reduction was also noted. All the studies evaluated showed good methodological quality.
CONCLUSION
The review found that aligned orthodontic treatment may have a variable impact on muscles of mastication, with a potential for initial exacerbation of symptoms followed by possible improvement. However, due to the limited number of studies and their heterogeneous nature, further robust research is recommended to fully understand the relationship between aligned orthodontic treatment and masticatory muscles.
Topics: Humans; Masticatory Muscles; Stomatognathic System; Dental Occlusion; Bite Force; Orthodontic Appliances, Removable
PubMed: 38504207
DOI: 10.1186/s12903-024-04029-8 -
Korean Journal of Orthodontics Jan 2022Planning of incisal position is crucial for optimal orthodontic treatment outcomes due to its consequences on facial esthetics and occlusion. A systematic summary of the...
OBJECTIVE
Planning of incisal position is crucial for optimal orthodontic treatment outcomes due to its consequences on facial esthetics and occlusion. A systematic summary of the proposed parameters is presented.
METHODS
Studies on Google Scholar, PubMed, and Cochrane Library, providing quantitative information on optimal central incisor position were included.
RESULTS
Upper incisors supero-inferior position (4-5 mm to upper lip, 67-73 mm to axial plane through pupils), antero-posterior position (3-4 mm to Nasion-A, 3-6 mm to A-Pogonion, 9-12 mm to true vertical line, 5 mm to A-projection, 9-10 mm to coronal plane through pupils), bucco-lingual angulation (4-7° to occlusal plane perpendicular on models, 20-22° to Nasion-A, 57-58° to upper occlusal plane, 16-20° to coronal plane through pupils, 108-110° to anterior-posterior nasal spine), mesio-distal angulation (5° to occlusal plane perpendicular on models). Lower incisors supero-inferior position (41-48 mm to soft-tissue mandibular plane), antero-posterior position (3-4 mm to Nasion-B, 1-3 mm to A-Pogonion, 12-15 mm to true vertical line, 6-8 mm to coronal plane through pupils), bucco-lingual angulation (1-4° to occlusal plane perpendicular on models, 87-94° to mandibular plane, 68° to Frankfurt plane, 22-25° to Nasion-B, 105° to occlusal plane, 64° to lower occlusal plane, 21° to A-Pogonion), mesio-distal angulation (2° to occlusal plane perpendicular on models).
CONCLUSIONS
Although these findings can provide clinical guideline, they derive from heterogeneous studies in terms of subject characteristics and reference methods. Therefore, the optimal incisal position remains debatable.
PubMed: 35046142
DOI: 10.4041/kjod.2022.52.1.53