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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 -
Cureus Mar 2024In this systematic review, we aimed to assess the current evidence regarding the effectiveness of functional treatment with both removable and fixed appliances to... (Review)
Review
Evaluation of the External Soft Tissue Changes Following the Correction of Class II Skeletal Malocclusion in the Adolescence Period Using Removable and Fixed Functional Appliances: A Systematic Review and Meta-Analysis.
In this systematic review, we aimed to assess the current evidence regarding the effectiveness of functional treatment with both removable and fixed appliances to normalize the external soft tissue for skeletal class II adolescent individuals. We performed a broad electronic search to retrieve relevant studies from nine databases to identify randomized controlled trials (RCTs) and controlled clinical trials (CCTs) that investigated soft tissue changes following functional treatment and evaluated the changes using 2D lateral cephalometric radiographs and 3D-optical surface laser scanning. A total of three RCTs and eight CCTs were included. Ages ranged from 11 to 16 years with the fixed functional appliances, and from eight to 12 years with the removable ones, including 689 skeletal class II patients. Version 2 of Cochran's risk-of-bias (RoB2), and the risk of bias in non-randomized studies of interventions (ROBIN-I) were used to assess the risk of bias for the included papers. Of the 11 eligible studies, three studies were included in the meta-analysis to assess the upper and lower lip position in relation to the E-line (Ricketts's aesthetic line) in addition to the nasolabial angle. The meta-analysis showed that the upper lip retracted after functional treatment with Twin-block in relation to E-line (mean difference (MD) = -1.93; 95% CI: -2.37, -1.50; p < 0.00001; χ² = 5.43; p = 0.07; I = 63%), while the lower lip position did not change after functional treatment with Twin-block in relation to E-line (MD = 0.03; 95% CI: -0.56, 0.61; p = 0.92; χ² = 1.74; p = 0.42; I = 0%). The nasolabial angle increased after Twin-block treatment (MD = 5.75; 95% CI: 4.57, 6.93; p < 0.00001; χ² = 6.77; p = 0.03; I = 70%). The mentolabial angle and Z-angle also increased after functional therapy, where the facial convexity angle decreased, regardless of the functional devices used. On the other hand, using the 3D-optical surface laser scanning showed that the upper lip length and the commissural width did not change following therapy, but the lower lip increased in length, as well as the total face height. More high-quality RCTs are required to obtain accurate evidence in this field.
PubMed: 38545423
DOI: 10.7759/cureus.57070 -
Journal of Orthodontic Science 2024Distalization is one of the most useful movements in orthodontic treatments. The aim of this systematic review is to analyze the effectiveness of lower molar... (Review)
Review
Distalization is one of the most useful movements in orthodontic treatments. The aim of this systematic review is to analyze the effectiveness of lower molar distalization using clear aligner therapy (CAT). An electronic search was made from January 2012 to October 2022 using PubMed, Scopus, and LILACS databases without language limitations. This systematic review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses checklist. The search strategy resulted in 151 studies. A screening was performed to remove duplicates, and all the studies that did not respond to our questions for the title or abstract. Three studies underwent full text analysis. From the evaluation of the studies included in this review, it is possible to state that lower molar distalization is a clinical solution, but it is not a full bodily movement. CAT can provide more specifically a distal tipping movement. This is confirmed analyzing the discrepancy between expected movement and obtained movement. CAT can be considered a valid therapeutic option in patients with dental class III malocclusion, but it is obtained as a tipping movement instead of a body movement. Over-correction should be considered during the planning of the therapy.
PubMed: 38516119
DOI: 10.4103/jos.jos_174_23 -
Journal of Orthodontic Science 2023The aim of this systematic review and meta-analysis was to comprehensively analyze the existing information on the prevalence of the need for orthodontic treatment in... (Review)
Review
Prevalence of orthodontic treatment needs in permanent dentition in the population of Gulf Cooperation Council countries: A systematic review and meta-analysis of observational studies.
The aim of this systematic review and meta-analysis was to comprehensively analyze the existing information on the prevalence of the need for orthodontic treatment in the permanent dentition stage among populations in Gulf Cooperation Council (GCC) countries. For observational studies in GCC countries, the key terms were electronically searched in Science Direct, PubMed, Embase, Cochrane Reviews, Google Scholar, and Sage databases (1990-2021). The bias risk for the selected studies was evaluated using the modified Strengthening the Reporting of Observational Studies in Epidemiology statement. Thirteen studies reported on the prevalence of orthodontic treatment needs among 33,134 children in GCC countries in permanent dentition with an age range of 11-19 years satisfied the inclusion criteria. Out of the 13 studies, 9 reported on the prevalence of malocclusion, 11 reported on the prevalence of occlusal traits, and 12 reported on the prevalence of orthodontic treatment needs as per the Dental Health Component (DHC) of Index of Orthodontic Treatment Need (IOTN), 4 reported as per both DHC and Aesthetic Component (AC) of IOTN, and 1 reported as per only AC of IOTN. Meta-analysis of the included studies indicated that the pooled malocclusion prevalence rate was 10.60% (confidence interval [CI] 95%: 0.093-0.076) with 8.58% Class I (CI 95%: 0.074-0.188), 2.09% Class II (CI 95%: 0.014-0.058), and 0.93% Class III (CI 95%: 0.005-0.018) malocclusions. The most prevalent type of occlusal trait was spacing (13.10%, CI 95%: 0.018-0.169), followed by crowding (4.96%, CI 95%: 0.017-0.091). The pooled prevalence of borderline and definite needs for orthodontic treatment based on DHC and AC of IOTN was 0.82% (CI 95%: 0.014-0.035), 1.13% (CI 95%: 0.011-0.091), 4.08% (CI 95%: 0.009-0.114), and 2.06% (CI 95%: 0.002-0.048), respectively. The findings were heterogeneous ( < 0.05). These findings indicated that the prevalence of malocclusion and orthodontic treatment needs was not high in the GCC population.
PubMed: 37881672
DOI: 10.4103/jos.jos_126_22 -
Children (Basel, Switzerland) Mar 2024Mixed dentition represents a critical phase in the oral development of pediatric patients, characterized by the simultaneous presence of primary and permanent teeth.... (Review)
Review
Mixed dentition represents a critical phase in the oral development of pediatric patients, characterized by the simultaneous presence of primary and permanent teeth. This article proposes a comprehensive systematic review of the application of aligners as an innovative methodology in managing mixed dentition. The primary objective is to explore the efficacy, safety, and acceptability of this emerging orthodontic technology in the evolving age group. This systematic review focuses on randomized controlled trials, cohorts, and observational studies investigating the use of aligners in patients with mixed dentition. Clinical, radiographic, and psychosocial parameters will be considered to assess the overall impact of aligner therapy in this critical phase of dental development. An in-depth analysis of such data aims to provide a comprehensive overview of the potential of this technology in pediatric orthodontics. Expected outcomes may contribute to outlining practical guidelines and targeted therapeutic strategies for orthodontists involved in managing mixed dentition. Furthermore, this article aims to identify gaps in the current research and suggest future directions for studies exploring the use of transparent aligners in patients with mixed dentition, thereby contributing to the ongoing evolution of evidence-based orthodontic practices.
PubMed: 38671602
DOI: 10.3390/children11040385 -
Bioengineering (Basel, Switzerland) Dec 2023The current review aims to evaluate the scientific evidence relating to the effectiveness of treatment with clear aligners (CAs) in controlling distalization orthodontic... (Review)
Review
The current review aims to evaluate the scientific evidence relating to the effectiveness of treatment with clear aligners (CAs) in controlling distalization orthodontic tooth movement. "Orthodontics, aligners" and "distalization" were the search terms used on the Scopus, Web of Science and Pubmed databases with the Boolean operator "AND". The results of the last ten years of research were 146 studies; of these, 19 publications were included for this review. The distalization movement is possible with invisible masks alone, but the risk of losing anchorage in the anterior sectors is very probable. The stability of the results and the reduction of unwanted effects can be guaranteed by the use of skeletal anchoring devices and interproximal enamel reduction (IPR), with which compensations are obtained to reduce the initial overjet. Temporary anchorage devices (TADs) can be used to manage posterior anchorage after distalization of maxillary molars with aligners. This hybrid approach has demonstrated the greatest orthodontic success. TADs are useful aids to provide direct and indirect skeletal anchorage. The opposite effect must be considered when planning dental distalization, especially of the molars, in patients with large overjet, and corrective measures or the use of auxiliaries may be necessary to prevent midcourse corrections. This systematic review provides a critical evidence-based assessment of the predictability of dental distalization with CAs, an ever-evolving orthodontic technique.
PubMed: 38135981
DOI: 10.3390/bioengineering10121390 -
The Journal of Clinical Pediatric... Mar 2024The development of the craniomandibular system is guided by genetic interactions and environmental factors, including specific habits such as breastfeeding, bottle...
The development of the craniomandibular system is guided by genetic interactions and environmental factors, including specific habits such as breastfeeding, bottle feeding, thumb sucking and the use of pacifiers. These habits can have a considerable impact on the growth of the developing jaws and can lead to malocclusion in children. This review aims to investigate potential associations between non-nutritive sucking habits (NNSHs) and malocclusions compared to the presence of nutritive sucking habits (NSHs). To carry out this systematic review, we followed the PRISMA protocol and performed a bibliographic search of the existing literature until April 2023 in the following electronic databases: Medline, PubMed, The Cochrane Library and Embase. Out of a total of 153 records, we included 21 studies. We found that the chances of diagnosing a malocclusion were higher for children with bottle nutrition when compared to breast-fed children. Breastfeeding provides protection against malocclusions. In the same manner, persistent NNSH habits appeared to be associated with increased chances of having malocclusions. The longer the child was breastfed, the shorter the duration of the pacifier habit and the lower the risk of developing moderate/severe malocclusions. The duration of the habits has a positive influence on the appearance of occlusion defects.
Topics: Child; Female; Humans; Sucking Behavior; Malocclusion; Breast Feeding; Bottle Feeding; Habits; Fingersucking; Pacifiers
PubMed: 38548628
DOI: 10.22514/jocpd.2024.029 -
Cureus Nov 2023The primary goal of orthodontic therapy in pseudo-class III is to restore the proper dental connection by rectifying the canine and molar relationship to Class I through... (Review)
Review
The primary goal of orthodontic therapy in pseudo-class III is to restore the proper dental connection by rectifying the canine and molar relationship to Class I through lower molar and premolar visualization, as well as providing normal anterior overjet. The purpose of this systematic study was to determine the efficacy of clear aligners in treating class III malocclusion with mandibular molar distalization. A wide range of searches were done on various search engines like Cochrane, Web of Science, Embase, PubMed, Scopus, and Google Scholar to collect relevant articles related to our study. This review's article selection was guided by the PRISMA flowchart. The electronic findings provided numerous articles with nearly 78 articles regarding clear aligners in class III malocclusion with molar distalization. From this, seven full-text papers were evaluated for eligibility criteria, with two articles being rejected with justification and five articles being elaborated in the current systematic review. The current evidence of this review suggested that the clear aligners were effective in correcting class III malocclusion with molar distalization. The amount of molar distalization is about 2 to 3 mm, which helps in achieving molar and canine relationship in class I, with a high compliance level and also improvement of the facial profile.
PubMed: 38046776
DOI: 10.7759/cureus.48134 -
Cureus Oct 2023Malocclusion may affect interpersonal relationships, self-esteem (SE), and psychological well-being, weakening patients' psychological and social activities. Several... (Review)
Review
Malocclusion may affect interpersonal relationships, self-esteem (SE), and psychological well-being, weakening patients' psychological and social activities. Several studies investigated the effect of orthodontic treatment on these social and psychological aspects, such as SE. However, the direct relationship between SE and orthodontic treatment has not yet been confirmed. This systematic review aimed to evaluate the existing evidence in the literature concerning the influences of orthodontic treatment on patients' SE systematically and critically. An electronic search in the following databases was done in September 2022: PubMed®, Web of Science™, Scopus®, Embase®, GoogleTM Scholar, Cochrane Library databases, Trip, and OpenGrey. Then, the reference list of each candidate study was checked for any potentially linked papers that the electronic search might not have turned up. Inclusion criteria were set according to the population/intervention/comparison/outcome/study design (PICOS) framework. For the data collection and analysis, two reviewers extracted data separately. The risk of bias 2 (RoB-2) and the risk of bias in non-randomized studies (ROBINS-I) tools were used to assess the risk of bias for randomized controlled trials (RCTs) and non-RCTs, respectively. The grading of recommendations assessment, development and evaluation (GRADE) approach was employed to evaluate the quality of the evidence for each finding. Sixteen studies (five RCTs, seven cohorts, and four cross-sectional) were included in this review. Unfortunately, the results could not be pooled into a meta-analysis. Only six studies have reported an increase in SE after orthodontic treatment (P<0.05 in these studies). No agreement between the included studies was observed regarding the influence of fixed orthodontic treatment, gender, or age on SE. The quality of evidence supporting these findings ranged from very low to low. There is low evidence indicating that fixed orthodontic treatment can improve patients' SE. In addition, unclear data are available about the influence of patients' gender and age on SE after orthodontic treatment. Therefore, high-quality RCTs are required to develop stronger evidence about this issue.
PubMed: 37920628
DOI: 10.7759/cureus.48064 -
Journal of Personalized Medicine May 2024Over the years, various researchers have attempted to compare digital cephalometry with the conventional manual approach. There is a need to comprehensively analyze the... (Review)
Review
Over the years, various researchers have attempted to compare digital cephalometry with the conventional manual approach. There is a need to comprehensively analyze the findings from the earlier studies and determine the potential advantages and limitations of each method. The present systematic review aimed to compare the accuracy of digital and manual tracing in cephalometric analysis for the identification of skeletal and dental landmarks. A systematic search was performed using the keywords "Digital" AND "Manual" AND "Cephalometry" to identify relevant studies published in the English language in the past decade. The electronic data resources consulted for the elaborate search included the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, CINAHL, EMBASE, PsycINFO, Scopus, ERIC, and ScienceDirect with controlled vocabulary and free text terms. A total of = 20 studies were identified that fulfilled the inclusion and exclusion criteria within the timeframe of 2013 to 2023. The data extracted from the included articles and corresponding meta-analyses are presented in the text. The findings of the present systematic review and meta-analysis revealed trends suggesting that digital tracing may offer reliable measurements for specific cephalometric parameters efficiently and accurately. Orthodontists must consider the potential benefits of digital cephalometry, including time-saving and user-friendliness.
PubMed: 38929786
DOI: 10.3390/jpm14060566