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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 -
European Journal of Orthodontics Mar 2023Bracket failure increases the treatment time of orthodontic therapy and burdens patients with unnecessary costs, increased chair time, and possible new appointments. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Bracket failure increases the treatment time of orthodontic therapy and burdens patients with unnecessary costs, increased chair time, and possible new appointments.
OBJECTIVE
To compare the bond failures of different orthodontic materials based on the results of available clinical studies.
SEARCH METHODS
A systematic search of clinical trials was performed in the Cochrane, Embase, and Pubmed databases with no limitations. The list of investigated techniques contained conventional acid-etch primer (CM-AEP), self-etch primer (SEP), self-cure resin (SCR), and simple or resin-modified glass ionomer (RM-GIC) materials and procedures.
SELECTION CRITERIA
Clinical studies reporting the failure rate of bonded brackets after using direct adhesive techniques on buccal sites of healthy teeth were included.
DATA COLLECTION AND ANALYSIS
Bracket failure rates from eligible studies were extracted by two authors independently. Risk ratios (RRs) were pooled using the random-effects model with DerSimonian-Laird estimation.
RESULTS
Thirty-four publications, involving 1221 patients, were included. Our meta-analysis revealed no significant difference in the risk of bracket failures between SEP and CM-AEP. After 6, 12, and 18 months of bonding, the values of RR were 1.04 [95% confidence interval (CI), 0.67-1.61], 1.37 (95% CI, 0.98-1.92), and 0.93 (95% CI, 0.72-1.20), respectively. At 18 months, bracket failure was 4.9 and 5.2% for SEP and CM-AEP, respectively. Heterogeneity was good or moderate (I2 < 42.2%). The results of RM-GIC at 12 months indicated a 57% lower risk of bracket failure using SCR as compared with RM-GIC (RR: 0.38; 95% CI, 0.24-0.61). At 18 months, bracket failures for SCR and RM-GIC were 15.8 and 36.6%, respectively (RR: 0.44; 95% CI, 0.37-0.52, I2 = 78.9%), demonstrating three to six times higher failure rate than in the case of etching primer applications.
LIMITATIONS
A major limitation of the present work is that the included clinical trials, with no exceptions, showed variable levels of risk of bias. Another possible problem affecting the outcome is the difference between the clustering effects of the split mouth and the parallel group bracket allocation methods.
CONCLUSIONS AND IMPLICATIONS
The results revealed no significant difference between SEP and CM-AEP up to 18 months after application. RM-GIC had much worse failure rates than acid-etching methods; additionally, the superiority of SCR over RM-GIC was evident, indicating strong clinical relevance.
REGISTRATION
Prospero with CRD42020163362.
Topics: Humans; Time Factors; Dental Bonding; Orthodontic Brackets; Resin Cements
PubMed: 36222731
DOI: 10.1093/ejo/cjac050 -
Journal of Functional Biomaterials Oct 2023Graphene-based materials have great prospects for application in dentistry and medicine due to their unique properties and biocompatibility with tissues. The literature... (Review)
Review
BACKGROUND
Graphene-based materials have great prospects for application in dentistry and medicine due to their unique properties and biocompatibility with tissues. The literature on the use of graphene oxide in orthodontic treatment was reviewed.
METHODS
This systematic review followed the PRISMA protocol and was conducted by searching the following databases: PubMed, Scopus, Web of Science, and Cochrane. The following search criteria were used to review the data on the topic under study: (Graphene oxide) AND (orthodontic) ALL FIELDS. For the Scopus database, results were narrowed to titles, authors, and keywords. A basic search structure was adopted for each database. Initially, a total of 74 articles were found in the considered databases. Twelve articles met the inclusion criteria and were included in the review.
RESULTS
Nine studies demonstrated the antibacterial properties of graphene oxide, which can reduce the demineralization of enamel during orthodontic treatment. Seven studies showed that it is biocompatible with oral tissues. Three studies presented that graphene oxide can reduce friction in the arch-bracket system. Two studies showed that it can improve the mechanical properties of orthodontic adhesives by reducing ARI (Adhesive Remnant Index). Three studies demonstrated that the use of graphene oxide in the appropriate concentration can also increase the SBS (shear bond strength) parameter. One research study showed that it can increase corrosion resistance. One research study suggested that it can be used to accelerate orthodontic tooth movement.
CONCLUSION
The studies included in the systematic review showed that graphene oxide has numerous applications in orthodontic treatment due to its properties.
PubMed: 37888164
DOI: 10.3390/jfb14100500 -
European Review For Medical and... Sep 2023Some of the most significant aspects in orthodontics for achieving favorable treatment outcomes include correct bracket positioning and a shorter period to accomplish...
OBJECTIVE
Some of the most significant aspects in orthodontics for achieving favorable treatment outcomes include correct bracket positioning and a shorter period to accomplish bracket bonding. Two different brackets bonding techniques - direct and indirect bonding - are described in the literature. The aim of this review is to evaluate the differences, advantages, and disadvantages of the two techniques.
MATERIALS AND METHODS
A literature search was conducted on PubMed, Scopus, and Web of Science databases in a period from January 2013 to April 2023 with English language restriction using the following Boolean keywords: "orthodontic bracket* AND (bonding OR placement)".
RESULTS
A total of 3,820 articles were identified by the electronic search, and after duplicate removal, screening, and eligibility, a total of 11 papers were included for the qualitative analysis.
CONCLUSIONS
Indirect bonding is more predictable and precise than direct bonding. Indirect bonding has a greater impact on minimizing bracket placement errors than direct bonding, but it still takes longer to complete than the traditional procedure. However, further studies on the differences between direct and indirect bonding, as well as digital bonding, are needed.
Topics: Humans; Dental Care; Databases, Factual; Object Attachment
PubMed: 37750633
DOI: 10.26355/eurrev_202309_33565 -
Orthodontics & Craniofacial Research Feb 2023To investigate whether flash-free adhesive ceramic brackets (FFA) have a better clinical performance than conventional adhesive ceramic brackets (CVA) in patients... (Meta-Analysis)
Meta-Analysis Review
To investigate whether flash-free adhesive ceramic brackets (FFA) have a better clinical performance than conventional adhesive ceramic brackets (CVA) in patients undergoing multi-bracket orthodontic treatment. PubMed, CENTRAL, Web of Science, Scopus, Embase, CNKI and Grey-literature were searched without restrictions up to January 2022. Both randomized controlled trials (RCTs) and controlled clinical trials (CCTs) were included. Risk of bias assessment was performed using the RoB 2.0 and ROBINS-I cochrane risk of bias tools. Eight articles, for seven studies, were included in this systematic review, and four split-mouth trials (SMT) were included in the meta-analysis. A random-effects meta-analysis found a statistically significant faster bonding time with FFA (mean difference [MD] = -93.85 seconds/quadrant, P = .002, 2 SMT), and no statistically significant difference regarding bracket failure rate at 6 months (risk ratio [RR] = 1.05; P = .93, 3 SMT), adhesive removal time (MD = -18.26 seconds/quadrant, P = .50, 2 SMT), and amount of remnant adhesive (MD = -0.13/bracket, P = .72, 2 SMT) between FFA and CVA. No difference (P > .05, 3 SMT) was found in enamel demineralization and periodontal measurements. CVA showed a statistically significant higher debonding pain score (P = .004, 1 SMT). Both flash-free and conventional adhesive ceramic brackets had a similar clinical performance, except for the faster bonding with FFA. Further, well-designed clinical trials are still required.
Topics: Humans; Dental Cements; Orthodontic Brackets; Dental Bonding; Dental Debonding; Ceramics; Materials Testing
PubMed: 35506474
DOI: 10.1111/ocr.12585 -
Materials (Basel, Switzerland) Oct 2021Debonding of orthodontic brackets is a common occurrence during orthodontic treatment. Therefore, the best option for treating debonded brackets should be indicated.... (Review)
Review
Debonding of orthodontic brackets is a common occurrence during orthodontic treatment. Therefore, the best option for treating debonded brackets should be indicated. This study aimed to evaluate the bond strength of rebonded brackets after different residual adhesive removal methods. This systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. PubMed, Web of Science, The Cochrane Library, SciELO, Scopus, LILACS, IBECS, and BVS databases were screened up to December 2020. Bond strength comparisons were made considering the method used for removing the residual adhesive on the bracket base. A total of 12 studies were included for the meta-analysis. Four different adhesive removal methods were identified: sandblasting, laser, mechanical grinding, and direct flame. When compared with new orthodontic metallic brackets, bond strength of debonded brackets after air abrasion ( = 0.006), mechanical grinding ( = 0.007), and direct flame ( < 0.001) was significantly lower. The use of an erbium-doped yttrium aluminum garnet (Er:YAG) laser showed similar shear bond strength (SBS) values when compared with those of new orthodontic brackets ( = 0.71). The Er:YAG laser could be considered an optimal method for promoting the bond of debonded orthodontic brackets. Direct flame, mechanical grinding, or sandblasting are also suitable, obtaining clinically acceptable bond strength values.
PubMed: 34683722
DOI: 10.3390/ma14206120 -
International Orthodontics Mar 2021The objectives of this systematic review of the literature are to search for BPA release from biomaterials used in orthodontics and to highlight their possible impact on... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The objectives of this systematic review of the literature are to search for BPA release from biomaterials used in orthodontics and to highlight their possible impact on human health.
MATERIALS AND METHODS
Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) model, digital and manual searches were conducted in February 2020 in the database of CENTRAL, MEDLINE and EMBASE. Thirteen parameters relating to the release and biological effects of BPA were identified and analysed.
RESULTS
Thirty-one non-randomized clinical trials were included. In general, the level of evidence was low, and the risk of bias ranged from moderate to high. Furthermore, although at different concentrations, most of in vitro and in vivo studies found BPA release from orthodontic adhesives. The lack of standardized protocols and the clinical and methodological heterogeneity of the studies prevented a valid interpretation of the actual results. Concerning the possible toxicity of BPA, no conclusive scientific evidence could be drawn, but it seems that orthodontic biomaterials containing BPA have potential adverse biological effects in humans.
DISCUSSION AND CONCLUSION
Until we have solid evidence from clinical trials, clinicians should consider that orthodontic adhesives containing BPA have potential short- and long-term adverse biological effects in humans. Careful consideration should therefore be given to bonding, polymerization and debonding protocols in orthodontics.
Topics: Animals; Benzhydryl Compounds; Biocompatible Materials; Databases, Factual; Dental Cements; Endocrine Disruptors; Humans; Orthodontic Brackets; Orthodontics; Phenols; Resin Cements
PubMed: 33308954
DOI: 10.1016/j.ortho.2020.11.002 -
American Journal of Orthodontics and... Feb 2023Space closure is a challenging and time-consuming phase of orthodontic treatment with fixed appliances. This systematic review evaluated canine retraction duration using... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Space closure is a challenging and time-consuming phase of orthodontic treatment with fixed appliances. This systematic review evaluated canine retraction duration using fixed appliances after maxillary first premolar extraction.
METHODS
Unrestricted systematic literature searches were conducted in 8 databases for randomized clinical trials, assessing the duration and rate of maxillary canine retraction using fixed appliances with or without treatment adjuncts published up to July 2021. Study selection, data extraction, and risk of bias evaluation were conducted independently and in duplicate. Random-effects meta-analyses of average rates or mean differences (MD) and 95% confidence intervals (CI) were conducted at α = 5%, followed by sensitivity and Grading of Recommendations Assessment, Development, and Evaluation analysis.
RESULTS
Fifty randomized clinical trials (6 parallel and 44 split-mouth designs) covering 811 participants (mean age 19.9 years; 34% male) were included. The estimated average pooled duration to achieve complete canine retraction was 4.98 months (2 trials; 95% CI, -2.9 to 12.88 months). Pooled average canine retraction was 0.97 mm at months 0-1 (23 trials; 95% CI, 0.79-1.16), 1.83 mm at months 0-2 (20 trials; 95% CI, 1.52-2.14), 2.44 mm at months 0-3 (23 trials; 95% CI, 2.10-2.79), 3.49 mm at months 0-4 (6 trials; 95% CI, 1.81-5.17) and 4.25 mm at months 0-5 (2 trials; 95% CI, 0.36-8.14). Surgically-assisted orthodontics was associated with greater canine retraction at all time points: months 0-1 (10 trials; MD, 0.52 mm; P = 0.004), months 0-2 (8 trials; MD, 0.53 mm; P = 0.04), months 0-3 (8 trials; MD, 0.67 mm; P = 0.01), and months 0-4 (3 trials; MD, 1.13 mm; P = 0.01), whereas subgroup analyses indicated significant effects of anchorage reinforcement method and bracket slot size on canine retraction.
CONCLUSIONS
The average time to achieve complete retraction of the maxillary canine using fixed appliances was around 5.0 months. Most studies used split-mouth randomization to investigate canine retraction for around 1-3 months, with substantial heterogeneity across studies. At 3 months of treatment, high-quality evidence supported greater canine retraction with surgically-assisted orthodontics.
Topics: Humans; Male; Female; Orthodontic Appliances, Fixed; Orthodontics; Mouth; Dental Care; Cuspid; Tooth Movement Techniques
PubMed: 36464569
DOI: 10.1016/j.ajodo.2022.08.009 -
Healthcare (Basel, Switzerland) Jun 2022Coronavirus disease has subjected the whole of humanity to two years of social isolation and a series of restrictions. These circumstances have led to the use of... (Review)
Review
Coronavirus disease has subjected the whole of humanity to two years of social isolation and a series of restrictions. These circumstances have led to the use of information technology in an increasingly widespread manner. Even in the dental field, telematic means have been used to respond to emergencies. The aim of this systematic review of the literature is to evaluate the types of orthodontic emergency that occurred most often and how they were managed by teleorthodontics during the COVID-19 pandemic. The secondary aim is that clinicians will use teleorthodontics not only during pandemics but as an additional tool to manage orthodontics. Out of 1695 articles available on PubMed, Science Direct, Cochrane and SciELO, eight articles were selected for this systematic literature review. Google Scholar was used as a secondary source to confirm that there were no additional articles. The screened papers comprised editorials, clinical studies, cross-sectional studies and retrospective studies in Italian, English or Spanish language. The articles showed that the means by which patients most often communicated with their orthodontists were voice calls and smartphone applications such as WhatsApp Messenger. Through these media, patients communicated their orthodontic emergencies. These mainly involved fixed multibracket appliances and the most common issues were discomfort and pain, fracture or loss of the appliance, protruding distal ends of archwires, brackets, tubes and bands or retainer detachment. Through teleorthodontics, patients could solve these issues by using orthodontic relief wax, cutting the protruding distal ends of the archwire with a nail clipper or a stronger cutter and removing or replacing detached bands, brackets, tubes or metallic ligature with a clean tweezer. In situations where personal contact is limited, teleorthodontics represents a valuable aid for professionals and patients facing orthodontic emergencies. The hope is that it may continue to represent a valuable aid for patients with difficulties in planning an in-office visit.
PubMed: 35742159
DOI: 10.3390/healthcare10061108 -
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