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Cureus Oct 2023Due to the clear depiction of facial aesthetics and other craniofacial parameters, portraiture photography (PP) is becoming more and more necessary in modern clinical... (Review)
Review
Due to the clear depiction of facial aesthetics and other craniofacial parameters, portraiture photography (PP) is becoming more and more necessary in modern clinical practice. The studies chosen for this review's inclusion looked at how PP affected the orthodontic treatment and diagnostic procedure on the subjects who were watched in the studies. Studies published within the last decade precisely from 2013 were searched for across major online databases after devising a proper search strategy. Multiple reviewers created a specific data extraction form that was used for the investigation, followed by the evaluation of bias and the variables found in each of the chosen papers. This form was meant for the assessment for various variables encountered in this study. According to the meta-analysis, using PP was related with a statistically significant decrease in the risk of orthodontic treatment and diagnostic modalities, with odds ratios (OR) of 0.52 with a 95% confidence interval (CI) of (0.28, 0.96), and a relative risk (RR) of 0.66 with a CI of (0.45, 0.96). In orthodontics, PP is an important tool that offers useful data for diagnosis, treatment planning, and tracking treatment success. To validate the results of studies like ours, a sizable evidence sample is required due to the limited number of trials that have been performed in this area.
PubMed: 37933372
DOI: 10.7759/cureus.48054 -
European Journal of Medical Research Nov 2023The objective of this systematic review and meta-analysis was to evaluate the effect of chewing gum on orthodontic pain and to determine the rate of bracket breakage... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The objective of this systematic review and meta-analysis was to evaluate the effect of chewing gum on orthodontic pain and to determine the rate of bracket breakage associated with fixed orthodontic appliances.
METHODS
This review and its reporting were performed according to the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA guidelines. Six electronic databases were searched up to March 16, 2023, to identify relevant studies that met the inclusion and exclusion criteria. Furthermore, grey literature resources were searched. The Cochrane Collaboration Risk of Bias tool 2 was used to assess the quality of the included studies. Meta-analysis was conducted using RevMan, and sensitivity analysis and publication bias analysis were performed using STATA software. GRADE tool was used to evaluate the certainty of evidence.
RESULTS
Fifteen studies with 2116 participants were ultimately included in this review, and 14 studies were included in the meta-analysis. Compared with the blank group, chewing gum had a significant pain relieving effect at all times after fixation of the initial archwire (P ≤ 0.05). No significant difference was found between the chewing gum group and the analgesics group at any timepoints (P > 0.05). Only four studies evaluated the rate of bracket breakage and revealed that chewing gum did not increase the rate of bracket breakage. The sensitivity analysis showed that there was no significant difference in the pooled outcomes after the included studies were removed one at times, and Egger analysis revealed no significant publication bias in included studies (P > 0.05).
CONCLUSIONS
Chewing gum is a non-invasive, low-cost and convenient method that has a significant effect on relieving orthodontic pain and has no effect on the rate of bracket breakage. Therefore, chewing gum can be recommended as a suitable substitute for analgesics to reduce orthodontic pain.
Topics: Humans; Chewing Gum; Pain; Analgesics; Orthodontic Brackets; Pain Measurement
PubMed: 37936237
DOI: 10.1186/s40001-023-01467-y -
BMC Oral Health Aug 2023This study aims to assess the scientific evidence regarding the clinical outcomes of Invisalign therapy in controlling orthodontic tooth movement.
OBJECTIVE
This study aims to assess the scientific evidence regarding the clinical outcomes of Invisalign therapy in controlling orthodontic tooth movement.
MATERIALS AND METHODS
An electronic search was conducted on PubMed, Cochrane Library, Web of Science, Embase, and Scopus from November 2015 to November 2022 to identify relevant articles. Methodological shortcomings were highlighted, and an evaluation of the quality of the included studies was completed using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool.
RESULTS
Fifteen non-randomized controlled trials were included in the analysis. Most non-randomized controlled trials (n=11; 73%) were rated with a moderate risk of bias according to the ROBINS-I tool. There were statistically significant differences between the pretreatment and posttreatment arches. The average expansion was significantly different from that predicted for each type of tooth in both the maxilla and mandible. Furthermore, the efficiency decreased from the anterior area to the posterior area in the upper arch.
CONCLUSION
Despite the fact that arch expansion with Invisalign® is not entirely predictable, clear aligner treatment is a viable option for addressing dentition crowding. The efficacy of expansion is greatest in the premolar area. More research focusing on treatment outcomes with different materials of aligners should be conducted in the future. Overcorrection should be considered when planning arch expansion with Invisalign. In the maxilla, the expansion rate decreases from the anterior to the posterior, and presetting sufficient buccal root torque of posterior teeth may result in improved efficiency of expansion.
Topics: Humans; Mandible; Orthodontic Appliances, Removable
PubMed: 37620781
DOI: 10.1186/s12903-023-03302-6 -
Journal of Orthodontics Mar 2024The primary aim of this study was to provide a review of the types and frequency of orthodontic brackets, molar bands and orthodontic auxiliaries used for patients... (Review)
Review
OBJECTIVE
The primary aim of this study was to provide a review of the types and frequency of orthodontic brackets, molar bands and orthodontic auxiliaries used for patients undergoing orthognathic surgery. The secondary aim was to evaluate the risk of failure of these items during orthognathic surgery.
METHODS
From three Dutch hospitals, 124 adult patients were included in this prospective cohort study. Five independent researchers collected the data during surgery using a specifically created data extraction form. The type of surgery, surgeon, orthodontist and type of orthodontic bracket, molar band or auxiliary were noted for each tooth. To evaluate their failure risk, the following variables were noted: failure and site; and type and cause of failure.
RESULTS
Stainless-steel brackets were the most frequently (75.8%) used bracket type seen in patients undergoing orthognathic surgery. Ceramic brackets were seen in 24.2% of the cases and were only applied in the anterior region. Molar bands were present in 58.9% of the patients and mostly with bands on the first molars in combination with bonded tubes on the second molars. In 32.2% of all cases, one or more failures were noted. One-third of all failures were described as detachment of the molar tube on the most posterior molar. Kobayashi ligatures and powerpins showed the highest risk of failure (odds ratio [OR] 3.70, 95% confidence interval [CI] = 1.91-7.15). No significant difference in failure rate was found between stainless-steel brackets, molar bands (OR 0.34, 95% CI = 0.08-1.43) and ceramic brackets (OR 0.44, 95% CI = 0.14-1.45).
CONCLUSION
Stainless-steel brackets, ceramic brackets, molar bands and surgical hooks are suitable for orthognathic cases. Kobayashi ligatures and powerpins had a significantly higher risk of failure so are not recommended for temporary intraoperative maxillomandibular fixation (TIO-MMF).
Topics: Adult; Humans; Orthognathic Surgery; Orthodontic Brackets; Prospective Studies; Molar; Steel; Orthodontic Wires; Stainless Steel; Orthodontic Appliance Design
PubMed: 37462079
DOI: 10.1177/14653125231186825 -
Dental and Medical Problems 2023White spot lesions (WSLs) are one of the most common adverse effects following comprehensive fixed orthodontic treatment. The purpose of this review was to evaluate... (Review)
Review
White spot lesions (WSLs) are one of the most common adverse effects following comprehensive fixed orthodontic treatment. The purpose of this review was to evaluate recent studies addressing the prevention and treatment of these lesions. Electronic databases were searched for English-written studies published between 2015 and October 2020 involving randomized clinical trials aiming at prevention or treatment of orthodontically induced WSLs using the following keywords in their title or abstracts: randomized clinical trial OR randomized controlled trial AND white spot OR caries OR demineralization OR decalcification OR remineralization. From the 23 papers which met the inclusion criteria, 11 were on preventive methods, while 12 addressed treatment protocols. However, most of the reviewed studies had a high risk of bias. The results of this review strongly support the importance of oral hygiene observation in preventing WSLs. Sodium fluoride varnish 5% was confirmed to be effective in the treatment of these lesions, as well as in the prevention of WSLs in patients with suboptimal oral hygiene. In addition, immediate CO2 laser irradiation after bonding can effectively prohibit formation of WSLs during orthodontic treatment. The literature also illustrates a promising masking effect of resin infiltration for the treatment of WSLs. However, little scientific evidence supports the effectiveness of Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) against WSLs, although more clinical trials with long-term follow-up are needed. Oral hygiene maintenance is crucial in the prevention of WSLs, and 5% sodium fluoride varnish and CO2 laser irradiation are recommended in patients with compromised oral hygiene. In the case of WSL formation, fluoride varnish and resin infiltration are effective treatment modalities.
Topics: Humans; Cariostatic Agents; Fluorides, Topical; Tooth Remineralization; Dental Caries; Sodium; Randomized Controlled Trials as Topic
PubMed: 37815515
DOI: 10.17219/dmp/140964 -
European Journal of Orthodontics Sep 2023The effect of probiotics on oral health maintenance in orthodontic patients remains controversial. The aim of the study is to systematically review and assess the... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND OBJECTIVE
The effect of probiotics on oral health maintenance in orthodontic patients remains controversial. The aim of the study is to systematically review and assess the effects of probiotics on the oral health and microbiome of patients undergoing orthodontic treatment.
SEARCH METHODS AND SELECTION CRITERIA
Databases including PubMed, Web of Science, Cochrane Library, ClinicalTrials.gov, and ProQuest Dissertations & Theses Global databases were searched from their inception until June 2022. Randomised controlled trials that assessed the effects of probiotics on clinical and microbial outcomes in patients undergoing orthodontic treatment were included.
DATA COLLECTION AND ANALYSIS
Data screening and collection were performed, and the risk of bias (RoB) was assessed using the Cochrane RoB 2 tool. The meta-analysis evaluated the effects of probiotics on Streptococcus mutans (S. mutans) and Lactobacillus counts. The quality of the evidence from the meta-analyses was assessed with Grading of Recommendations Assessment, Development and Evaluation (GRADE).
RESULTS
A total of 405 records were identified, of which 15 studies were included in the qualitative synthesis and 4 in the meta-analysis. The patients in all the included studies were treated with fixed orthodontic appliances. Results regarding clinical outcomes were controversial; four out of five studies reported no significant changes in plaque in the probiotic group (P > .05), and two out of three studies reported no significant changes in the gingival index (P > .05). Regarding microbial outcomes, the meta-analysis results revealed that probiotics significantly increased the likelihood of reducing the abundance of S. mutans to below 105 CFU/ml (risk ratio: 2.05 [1.54, 2.72], P < .001) and reduced the likelihood of increasing the abundance of S. mutans to beyond 106 CFU/ml (risk ratio: 0.48 [0.28, 0.83], P = .009). However, the quality of evidence according to the GRADE was moderate.
CONCLUSIONS AND IMPLICATIONS
There is insufficient evidence to determine the clinical benefits of probiotics as a supplement for the oral health of patients undergoing orthodontic treatment. However, probiotics may have benefits in reducing the salivary S. mutans counts in orthodontic patients.
REGISTRATION
PROSPERO (CRD42022366650).
Topics: Humans; Oral Health; Probiotics; Dietary Supplements; Orthodontic Appliances, Fixed; Streptococcus mutans
PubMed: 37552088
DOI: 10.1093/ejo/cjad046 -
Journal of Functional Biomaterials May 2024The objective of this study was to explore the effects of fixed orthodontic appliances on enamel structure by assessing microfractures, surface roughness, and... (Review)
Review
AIM
The objective of this study was to explore the effects of fixed orthodontic appliances on enamel structure by assessing microfractures, surface roughness, and alterations in color.
METHODS
This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic search of online databases was conducted using the keywords 'enamel' AND 'orthodontic debonding'. Eligibility criteria included both in vivo and ex vivo clinical trials conducted on human teeth.
RESULTS AND DISCUSSION
A total of 14 relevant papers were analyzed. Various instruments and techniques were utilized across different studies to assess surface roughness, color change, and surface fractures.
CONCLUSIONS
The findings of this study suggest that ceramic brackets may lead to an increase in enamel fractures, particularly during bracket removal. The surface roughness of enamel exhibits variability depending on the adhesive substance and polishing methods used post-removal. Fixed orthodontic appliances could induce changes in enamel color, which may be alleviated by the use of nano-hydroxyapatite or specific polishing techniques. Further research is necessary to identify effective strategies for managing these color changes and improving the overall outcomes of fixed orthodontic treatment.
PubMed: 38786634
DOI: 10.3390/jfb15050123 -
Journal of Oral Biology and... 2024Cervical spine posture is related to craniofacial morphology, airway, gait and body posture. This posture may be influenced by the changes in the mandibular position... (Review)
Review
OBJECTIVE
Cervical spine posture is related to craniofacial morphology, airway, gait and body posture. This posture may be influenced by the changes in the mandibular position brought about by functional appliance therapy. Therefore, this systematic review aimed to assess the changes in the cervical spine posture with functional appliance treatment in Skeletal Class II subjects.
METHODS
A search of studies in six electronic databases - Medline (via Pubmed), the Cochrane Library, OVID, LILACS, Scopus and Web of Science were performed until January 18, 2024 without any restriction in date or language of publication. Eligibility screening, study selection, and data extraction were performed by two reviewers independently. The risk of bias assessment of the included studies was performed with the Newcastle Ottawa scale and Cochrane RoB 2.0. Meta-analysis was performed using random effects model for assessment of changes in the cervical spine with removable and fixed functional appliances.
RESULTS
Twelve articles that satisfied the eligibility criteria were included for systematic review and nine articles for meta-analysis. Five studies showed a low risk of bias, one as moderate and six as high risk of bias. GRADE assessment revealed a low quality evidence. Meta-analysis revealed a decrease of the upper cervical inclination by 1.16° (95 % CI of -2.68 to 0.35, I = 6 %), an increase of the middle cervical inclination by 2.20° (95 % CI of 0.46-3.94, I = 49 %), an increase in cervical curvature angle by 1.60° (95 % CI of 0.12-3.09, I = 89 %) and a decrease in cervical lordosis angle by 1.54° (95 % CI of -4.16 to 1.08, I = 0 %).
CONCLUSIONS
Minimal uprighting of the cervical spine was noted with functional appliances. Fixed functional appliances exerted a greater effect than removable functional appliances. Cervical hyperlordosis was reduced with removable functional appliance treatment. Though these changes are minimal, the clinical orthodontist should be aware that functional therapy also influences cervical spine posture. Due to the heterogeneity and low quality of evidence, the results are to be considered critically.
PubMed: 38855038
DOI: 10.1016/j.jobcr.2024.05.015 -
Revista Cientifica Odontologica... 2023The purpose of this literature review is to provide scientific evidence on the characteristics of white spot lesions (WSL) during orthodontic treatment, their incidence,... (Review)
Review
INTRODUCTION
The purpose of this literature review is to provide scientific evidence on the characteristics of white spot lesions (WSL) during orthodontic treatment, their incidence, prevalence, risk factors related to their development, progression, and regression, as well as explain the most used diagnostic methods.
MATERIALS AND METHODS
An exhaustive search was carried out in the databases of Pubmed, Scopus, Science Direct and Embase up to the date of November 30, 2022. Cross-sectional studies that evaluated white spot lesions before and after orthodontic treatments were included. Two researchers carefully selected the articles evaluated and analyzed different key topics on the subject.
RESULTS
It was found that the prevalence and incidence of white spots during orthodontic treatment varies widely depending on the diagnostic method used, the type of orthodontic technique used and the time of orthodontic treatment. The incidence of white spot lesions is highest in patients treated with conventional braces, followed by those who used self-ligating braces, and was lowest in patients who used aligners. The most affected teeth are the upper lateral incisors and upper maxillary canines at the level of the gingival third.
CONCLUSIONS
The incidence of white spots is associated with orthodontic treatment, being closely related to the treatment technique used and the treatment time. There is a regression of the LMB during the first year after removal of the appliance.
PubMed: 38287997
DOI: 10.21142/2523-2754-1103-2023-168 -
Cureus Dec 2023Understanding the real-world implications of periodic changes to orthodontic appliances can provide valuable insights for future treatment strategies and patient...
BACKGROUND
Understanding the real-world implications of periodic changes to orthodontic appliances can provide valuable insights for future treatment strategies and patient outcomes. This study aimed to investigate the impact of the latest updates added to the G7 and G8 Invisalign series on actual versus predicted outcomes and the percentage accuracy of the treatment.
METHOD
This retrospective study was conducted in private orthodontic practices in Riyadh, Saudi Arabia. Orthodontists carried out Invisalign® treatment using the latest updates added to the G7 and G8 Invisalign series. The study group comprised patients with different malocclusion types who received non-extraction Invisalign treatment. The Invisalign treatment plan was provided by the ClinChecks program (Invisalign, San Jose, United States) for patients treated throughout the years (2016-2022). Different dimensions were assessed to record predicted and actual treatment outcomes with the aid of iTero® (Align Technology, San Jose, United States) and ClinCheck® (Invisalign, San Jose, United States). The percentage accuracy was determined using the formula (100%-((Predicted-Actual)/Predicted) *100%).
RESULTS
A total of 108 patients (male = 34 (31.5%) and female = 74 (68.5%)) treated with Invisalign G7 and G8 series were considered in this study. The overall mean and standard deviation values of vertical distance (2.91±1.42), intermolar distance in the lower arch (52.68±3.15), overjet (2.71±1.06), and inter-incisal angle (138.24±12.18) were higher than the predicted model. However, the predicted model showed higher mean and standard deviation values for intercanine distances in the upper (36.94±1.57) and lower arches (28.48±1.40) and upper intermolar distances (57.21±2.91). The G7 versus G8 intercanine distance in lower (61.28±47.67 vs. 80.51±38.32), intermolar distance in upper (61.72±47.67 vs. 69.95±44.11), and intermolar distance in lower (100.68±3.80 vs. 100.89±2.52) were relatively higher in the G8 series than the G7. The accuracy percentage was higher with the G8 series than with the G7 regarding the intercanine distance in the upper arch. In contrast, the G7 series showed a higher mean percentage accuracy of vertical distance (91.11±84.83 vs. 76.76±65.45), overjet (58.44±35.17 vs. 53.71±45.87), and inter-incisal angle (34.47±44.06 vs. 27.53±37.98) than the G8 series.
CONCLUSION
The percentage accuracy of aligner therapy administered using the Invisalign G7 and G8 series demonstrated no significant variation.
PubMed: 38226098
DOI: 10.7759/cureus.50615