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Orthodontics & Craniofacial Research May 2023The aim of this systematic review was to compare the shear bond strength (SBS) of orthodontic brackets bonded to human teeth with and without enamel fluorosis (EF) using... (Meta-Analysis)
Meta-Analysis Review
Comparison of shear bond strength of orthodontic brackets bonded to human teeth with and without fluorotic enamel: A systematic review and meta-analysis of experimental in vitro studies.
The aim of this systematic review was to compare the shear bond strength (SBS) of orthodontic brackets bonded to human teeth with and without enamel fluorosis (EF) using conventional bonding interventions/techniques. An unrestricted search of indexed databases was performed with the following eligibility criteria: (a) human fluorotic teeth (experimental-group); (b) human teeth without fluorosis (control-group); (c) studies using phosphoric acid (PA) etching without air abrasion (AA), PA etching combined with AA, and application of self-etching primer (SEP) alone as bonding interventions/techniques and (d) measuring SBS in megapascals (MPa). Data screening, selection and extraction were performed by two reviewers. The risk of bias (rob) was assessed using the JBI Critical appraisal tool for Quasi-Experimental Studies. Meta-analyses were performed using a random effects model. The quality of available evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. Ten in vitro studies were included. Subgroup analyses were performed for each intervention type. The SBS was significantly lower in fluorotic teeth when PA was used without AA (mean difference = 3.26 MPa, confidence interval: [1.00, 5.52]); and there were no significant differences for the PA combined with AA and SEP interventions. All studies had a low rob. The overall level of evidence was at best low. The SBS is lower in teeth with EF when traditional PA is used. No significant differences were found in SBS between teeth with and without EF when PA is used with AA or when SEP is used alone.
Topics: Humans; Orthodontic Brackets; Air Abrasion, Dental; Dental Bonding; Resin Cements; Surface Properties; Acid Etching, Dental; Dental Enamel; Fluorosis, Dental; Shear Strength; Materials Testing; Dental Stress Analysis
PubMed: 35960660
DOI: 10.1111/ocr.12602 -
Orthodontics & Craniofacial Research Feb 2024To evaluate the efficacy of microchips and 3D microsensors in the measurement of orthodontic forces. (Review)
Review
OBJECTIVE
To evaluate the efficacy of microchips and 3D microsensors in the measurement of orthodontic forces.
METHODS
Through September 2023, comprehensive searches were conducted on PubMed/MEDLINE, SCOPUS and SCIELO without restrictions.
RESULTS
After removing duplicate entries and applying the eligibility criteria, 23 studies were included for analysis. All the studies were conducted in vitro, and slightly more than half of them were centred on evaluating orthodontic forces exerted by aligners. Eight utilized microchips as measurement tools, while the remaining studies made use of 3D microsensors for their assessments. In the context of fixed appliances, key findings included a high level of agreement in 3-dimensional orthodontic force detection between simulation results and actual applied forces. Incorporating critical force-moment combinations during smart bracket calibration reduced measurement errors for most components. Translational tooth movement revealed a moment-to-force ratio, aligning with the bracket's centre of resistance. The primary findings in relation to aligners revealed several significant factors affecting the forces exerted by them. Notably, the foil thickness and staging were found to have a considerable impact on these forces, with optimal force transmission occurring at a layer height of 150 μm. Furthermore, the type of material used in 3D-printing aligners influenced the force levels, with attachments proving effective in generating extrusive forces. Deliberate adjustments in aligner thickness were observed to alter the forces and moments generated.
CONCLUSIONS
Microchips and 3D sensors provide precise and quantitative measurements of orthodontic forces in in vitro studies, enabling accurate monitoring and control of tooth movement.
PubMed: 38372469
DOI: 10.1111/ocr.12768 -
Journal of Clinical and Experimental... Mar 2024To compare the effect of conventional brackets and self-ligating brackets on periodontal health. (Review)
Review
BACKGROUND
To compare the effect of conventional brackets and self-ligating brackets on periodontal health.
MATERIAL AND METHODS
A search of information up to October 2022 was carried out in the following electronic databases: PubMed/MEDLINE, Cochrane Library, Scopus, Web of Science (WoS), EMBASE, SciELO and Google Scholar. We included studies that were randomised clinical trials, dealing with conventional brackets and self-ligating brackets and their effect on periodontal health, with no language restriction and no time limit. The Risk of Bias 2 (Rob 2.0) tool was used to determine the risk of bias of the included studies. The information selected from the studies was entered and analysed with RevMan 5.3, using the mean and standard deviation with a 95% confidence interval as a measure. Finally, an analysis was performed using the GRADE system to classify the quality of the evidence and grade the strength of the recommendation.
RESULTS
The preliminary search yielded a total of 399 articles, discarding those that did not meet the selection criteria, leaving only 13 articles. The effect of conventional and self-ligating brackets on periodontal health was determined using periodontal probing depth (PPD), plaque index (PI), gingival index (GI) and bleeding index (BI), showing advantages of self-ligating brackets in PI and BI, and no differences compared to self-ligating brackets in PPD and GI.
CONCLUSIONS
Self-ligating brackets probably better preserve periodontal health compared to conventional brackets regarding plaque accumulation and bleeding on probing. Conventional brackets, self-ligating brackets, periodontal health, orthodontic treatment, systematic review, meta-analysis.
PubMed: 38600930
DOI: 10.4317/jced.61378 -
International Journal of Environmental... Jul 2022One of the risks that we find after orthodontic treatment is the secondary appearance of white spot lesions (WLS) after the removal of fixed multi-bracket appliances.... (Meta-Analysis)
Meta-Analysis Review
Changes in the Color and Brightness of White Spots Associated with Orthodontic Treatment 6 Months after the Application of Infiltrative Resins: Systematic Review and Meta-Analysis.
One of the risks that we find after orthodontic treatment is the secondary appearance of white spot lesions (WLS) after the removal of fixed multi-bracket appliances. Today, there are several treatment methods, resin infiltration being the most used in the most serious cases. The objective of this study is to carry out a systematic review and meta-analysis to determine the efficacy and stability in the variables of color and gloss, six months after resin infiltration. A comprehensive search was performed in the following databases: PubMed, Embase, Google Scholar, Scopus, Medline, and Web of Science. Articles published in the last 10 years were selected, including in vivo studies with a six-month follow-up. PRISMA guidelines were followed to carry out this systematic review. All studies where the application of resin was performed on carious lesions were discarded. Once the inclusion and exclusion criteria were applied, a final sample of four articles was obtained, on which the review and meta-analysis were carried out. Once examined, all authors considered that there was an immediate improvement in both variables. However, statistically significant differences were obtained in the color change outcome, but not in the brightness outcome in the subgroup analysis after six months of icon resin infiltration.
Topics: Color; Dental Caries; Diagnosis, Oral; Humans; MEDLINE; Orthodontic Appliances, Fixed; PubMed
PubMed: 35954634
DOI: 10.3390/ijerph19159277 -
International Orthodontics Dec 2021This study aimed to evaluate the failure incidence of brackets with at least six months follow-up between self-etch primer and conventional etch/primer, as well as to... (Meta-Analysis)
Meta-Analysis
Comparison of the failure rate, bonding time and ARI score of two orthodontic bonding systems: Self-Etch Primer and Conventional Etching Primer: A systematic review and meta-analysis.
OBJECTIVE
This study aimed to evaluate the failure incidence of brackets with at least six months follow-up between self-etch primer and conventional etch/primer, as well as to investigate the clinical duration of the bonding process and the amount of adhesive remnant index (ARI).
METHODS
Electronic search was conducted in databases including PubMed, Scopus, Web of Science, ProQuest, ClinicalTrials.gov, and ICTRP (International Clinical Trials Registry Platform). The electronic search targeted only randomized clinical trials and was limited from January 2000 to June 2021. Delphi list is used to evaluate the risk of bias and Stata Version14.2 software was used. This systematic review was conducted according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and recorded on the Ethics Committee of Research Institute of Dental Sciences, SBMU (IR.SBMU.DRC.REC.1398.240).
RESULTS
Out of 2288 extracted studies, 30 of them entered the full-text evaluation process. According to the inclusion criteria, 15 studies entered this systematic review. Containing 607 participants and 10,563 brackets/teeth. All the included studies were of randomized clinical trials (RCT) design with either parallel or split-mouth design. Comparing the two groups, the risk difference effect (RD)=0.007 CI 95% (-0.004,0.018) indicated a neglectable difference in the risk of bracket failure during treatment between the two groups. The index I=53.9% indicated moderate heterogeneity in the results. Furthermore, the P-value=0.007 indicated statistical insignificance between the two interventions in terms of failure rate. The clinical duration of bonding time analysis were equal to SMD _Cohen=-2.67 CI95% (-3.49, -1.85), which indicated a statistically significant reduction in clinical process time, using the self-etch primer. Data synthesis for adhesive remnant index could not be conducted due to heterogeneity among included studies.
CONCLUSIONS
There was no difference between the self-etch primer and conventional etch/primer in bracket debonding at a medium level of evidence, However, there was statistically significant reduction in clinical bonding time using self-etch primer.
Topics: Acid Etching, Dental; Dental Bonding; Dental Cements; Humans; Materials Testing; Orthodontic Brackets; Resin Cements; Shear Strength
PubMed: 34629307
DOI: 10.1016/j.ortho.2021.09.001 -
BioMed Research International 2022Despite the importance of identifying proper novel porcelain preparation techniques to improve bonding of orthodontic brackets to porcelain surfaces, and despite the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Despite the importance of identifying proper novel porcelain preparation techniques to improve bonding of orthodontic brackets to porcelain surfaces, and despite the highly controversial results on this subject, no systematic review or meta-analysis exists in this regard.
OBJECTIVE
To comparatively summarize the effects of all the available porcelain surface treatments on the shear bond strength (SBS) and adhesive remnant index (ARI) of orthodontic brackets (metal, ceramic, polycarbonate) bonded to feldspathic porcelain restorations. . A search was conducted for articles published between January 1990 and February 2021 in PubMed, MeSH, Scopus, Web of Science, Cochrane, Google Scholar, and reference lists. . English-language articles comparing SBS of feldspathic porcelain's surface preparation methods for metal/ceramic/polycarbonate orthodontic brackets were included. Articles comparing silanes/bonding agents/primers without assessing roughening techniques were excluded. . Studies were summarized and risk of bias assessed. Each treatment's SBS was compared with the 6 and 10 MPa recommended thresholds. Studies including comparator (HF [hydrofluoric acid] + silane + bonding) were candidates for meta-analysis. ARI scores were dichotomized. Fixed- and random-effects models were used and forest plots drawn. Egger regressions and/or funnel plots were used to assess publication biases.
RESULTS
Thirty-two studies were included (140 groups of SBS, 82 groups of ARI). Bond strengths of 21 studies were meta-analyzed (64 comparisons in 14 meta-analyses). ARIs of 12 articles were meta-analyzed (28 comparisons in 8 meta-analyses). Certain protocols provided bond strengths poorer than HF + silane + bonding: "abrasion + bonding, diamond bur + bonding, HF + bonding, Nd:YAG laser (1 W) + silane + bonding, CO laser (2 W/2 Hz) + silane + bonding, and phosphoric acid + silane + bonding." Abrasion + HF + silane + bonding might act almost better than HF + silane + bonding. Abrasion + silane + bonding yields controversial results, being slightly (marginally significantly) better than HF + silane + bonding. Some protocols had controversial results with their overall effects being close to HF + silane + bonding: "Cojet + silane + bonding, diamond bur + silane + bonding, Er:YAG laser (1.6 W/20 Hz) + silane + bonding." Few methods provided bond strengths similar to HF + silane + bonding without much controversy: "Nd:YAG laser (2 W) + silane + bonding" and "phosphoric acid + silane + bonding" (in ceramic brackets). ARIs were either similar to HF + silane + bonding or relatively skewed towards the "no resin on porcelain" end. The risk of bias was rather low. . All the found studies were in vitro and thus not easily translatable to clinical conditions. Many metasamples were small.
CONCLUSIONS
The preparation methods HF + silane + bonding, abrasion + HF + silane + bonding, Nd:YAG (2 W) + silane + bonding, and phosphoric acid + silane + bonding (in ceramic brackets) might provide stronger bonds.
Topics: Dental Porcelain; Humans; Materials Testing; Orthodontic Brackets; Shear Strength; Surface Properties
PubMed: 35036438
DOI: 10.1155/2022/8246980 -
International Orthodontics Jun 2020Biofilm accumulation around orthodontic brackets and composite is a common complication of orthodontic treatment. (Meta-Analysis)
Meta-Analysis
An in vitro evaluation of the effects of nanoparticles on shear bond strength and antimicrobial properties of orthodontic adhesives: A systematic review and meta-analysis study.
INTRODUCTION
Biofilm accumulation around orthodontic brackets and composite is a common complication of orthodontic treatment.
OBJECTIVE
A systematic review and meta-analysis were done to find out whether the association of nanoparticles with the orthodontic adhesives compromises its properties and whether there are exceptional nanoparticles exhibiting excellent antimicrobial potential against cariogenic bacteria along with remarkable mechanical properties.
MATERIALS AND METHODS
Electronic databases were searched using the following keywords; orthodontic or orthodontics and antimicrobial or antibacterial and adhesive and nanoparticles and shear bond strength. Thirteen studies were included and meta-analysis was performed.
RESULTS
The results indicated no drastic changes in mechanical properties (0.812, 95% CI [0.750, 0.861], P=0.000). The Ag-HA, Cur, Cur-ZnO, and TiO in concentration≥1% showed a statistically significant difference, where the control groups had higher shear bond strength. Nine studies assessed the antimicrobial properties of nanoparticles. 1 wt% Cu and 5 wt% TiO not only did not affect shear bond strength but also showed more antimicrobial activity against Streptococcus mutans. The analysis demonstrated the absence of heterogeneity (Q value=44.014; df (Q)=12; and I=72.736) in shear bond strength of orthodontic adhesives with nanoparticles, with low risk of bias.
CONCLUSIONS
Adding≤5 wt% antimicrobial nanoparticles to an orthodontic adhesive is less conducive to microbial growth than unmodified adhesive and does not influence bracket-enamel bond strength.
Topics: Anti-Infective Agents; Biofilms; Dental Cements; Dental Stress Analysis; In Vitro Techniques; Nanoparticles; Orthodontic Brackets; Shear Strength; Streptococcus mutans
PubMed: 32088136
DOI: 10.1016/j.ortho.2020.01.011 -
BMC Oral Health Oct 2023Nowadays bleaching procedures have gained popularity in orthodontic patients. Peroxide and Carbamide acids are the common agents which are used in in-office and at home...
BACKGROUND
Nowadays bleaching procedures have gained popularity in orthodontic patients. Peroxide and Carbamide acids are the common agents which are used in in-office and at home bleaching techniques. Consequently, the Bonding adhesion to the enamel can be influenced by the orthodontic phase and the residual peroxide might interfere with the polymerization and the adhesion of the brackets. Frequent debonding of the brackets from teeth after the bleaching procedure could cause the lengthening of the therapy and promote irregularities on enamel surface derived from an additional bonding phase of the brackets. The aim of this systematic review is to appraise the influence regarding the effect of the bleaching procedure on the bond strength of orthodontic brackets.
METHODS
An electronic database search was performed. Search terms included: bleaching, brackets, adhesion; data were extracted and summarized. Risk of bias was assessed using the Chocrane risk of bias tool, adapted for in vitro studies.
RESULTS
A total of 8689 articles were screened and 11 studies met the inclusion criteria of this systematic review. 1000 teeth of human and bovine origin were analyzed for the shear bond strength (SBS) of stainless and ceramic brackets after the bleaching treatments. All the authors divided the groups in different subgroups with different bleaching agents and in different concentration. The SBS value allowed to demonstrate the necessity to delay the bonding of the brackets for two weeks after a bleaching treatment and its improvement when tooth mousse or antioxidants agents are used.
CONCLUSIONS
The SBS values and the delay of the bonding procedure must be considered in dental practice and clinical strategies are necessary in order to avoid drawbacks which could cause the debonding of the brackets after bleaching due to the alterations of the dental substrate, thus interfering with the orthodontic treatments.
Topics: Humans; Animals; Cattle; Tooth Bleaching; Orthodontic Brackets; Dental Bonding; Peroxides; Urea; Shear Strength; Dental Stress Analysis; Materials Testing
PubMed: 37833672
DOI: 10.1186/s12903-023-03418-9 -
International Journal of Clinical... Jan 2024The present review was conducted to test whether the addition of titanium dioxide (TiO) nanoparticles (NPs) within orthodontic bracket adhesives would alter their... (Review)
Review
OBJECTIVE
The present review was conducted to test whether the addition of titanium dioxide (TiO) nanoparticles (NPs) within orthodontic bracket adhesives would alter their properties and assess their antimicrobial activity against cariogenic microorganisms in addition to noteworthy mechanical properties.
MATERIALS AND METHODS
Using predetermined inclusion criteria, an electronic search was conducted using Dissertations and Thesis Global, the Web of Science, Cochrane, Scopus, and Medline/PubMed. Specific terms were utilized while searching the database.
RESULTS
Only seven of the 10 included studies assessed shear bond strength (SBS). The mean SBS among the control group varied from 9.43 ± 3.03 MPa to 34.4 ± 6.7 MPa in the included studies, while in the experimental group, it varied from 6.33 ± 1.51 MPa to 25.05 ± 0.5 MPa. Antibacterial activity was assessed in five of the 10 included studies using TiO NPs, which could easily diffuse through bacterial media to form the growth inhibition zone.
CONCLUSION
Antibacterial NPs added to orthodontic adhesives at a concentration of 1-5 wt% inhibit bacterial growth and have no effect on bond strength.
HOW TO CITE THIS ARTICLE
D Tivanani MVD, Mulakala V, Keerthi VS. Antibacterial Properties and Shear Bond Strength of Titanium Dioxide Nanoparticles Incorporated into an Orthodontic Adhesive: A Systematic Review. Int J Clin Pediatr Dent 2024;17(1):102-108.
PubMed: 38559855
DOI: 10.5005/jp-journals-10005-2729 -
Progress in Orthodontics Jun 2024Metallic and elastomeric ligatures are widely used in orthodontics to secure the archwire within the bracket slots, but elastomeric ligatures have traditionally been... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Metallic and elastomeric ligatures are widely used in orthodontics to secure the archwire within the bracket slots, but elastomeric ligatures have traditionally been associated with increased microbial colonization, which could adversely affect periodontal health.
AIM
This systematic review compares the periodontal effects of elastomeric and steel ligatures used for orthodontic fixed appliances.
METHODS
Unrestricted literature search of 7 databases (MEDLINE, Scopus, Web of Science, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and Virtual Health Library) up to July 2023 were performed for randomized / non-randomized clinical studies on humans comparing the two ligation methods during fixed-appliance therapy. After duplicate study selection, data extraction, and risk-of-bias assessment with the Risk of Bias (RoB) 2 or the Risk Of Bias In Non-randomized Studies - of Interventions (ROBINS-I) tool, random-effects meta-analyses of Mean Differences (MD) or Standardized Mean Differences (SMD) and their 95% confidence intervals (CIs) were carried out, followed by assessment of certainty of existing evidence with the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach.
RESULTS
A total of 11 studies (3 randomized / 8 non-randomized) with 354 patients (mean age 14.7 years and 42% male) were included. No statistically significant differences were seen for plaque index (5 studies; SMD = 0.48; 95% CI = -0.03 to 1.00; P = 0.07), gingival index (2 studies; MD = 0.01; 95% CI = -0.14 to 0.16; P = 0.89), probing pocket depth (2 studies; MD = 0; 95% CI = -0.17 to 0.16; P = 0.97), or Streptococcus mutans counts (4 studies; SMD = 0.40; 95% CI=-0.41 to 1.20; P = 0.21). Elastomeric ligatures were associated with moderately increased total bacterial load (3 studies; SMD = 0.43; 95% CI = 0.10 to 0.76; P = 0.03). Confidence in these estimates was low in all instances due to the inclusion of non-randomized studies with high risk of bias.
CONCLUSIONS
Existing low quality evidence indicates that ligature method does not seem to influence the periodontal health during fixed treatment, even if elastomeric ligatures are associated with a moderate increase of bacterial load.
REGISTRATION
PROSPERO (CRD42023444383).
Topics: Humans; Elastomers; Orthodontic Appliances, Fixed; Steel; Periodontal Index; Orthodontic Brackets; Ligation
PubMed: 38880839
DOI: 10.1186/s40510-024-00520-8