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The Angle Orthodontist Mar 2021To compare the effects of Forsus appliances with and without temporary anchorage devices (TADs) for patients with skeletal Class II malocclusion. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To compare the effects of Forsus appliances with and without temporary anchorage devices (TADs) for patients with skeletal Class II malocclusion.
MATERIALS AND METHODS
Through a predefined search strategy, electronic searching was conducted in PubMed, Embase, Web of Science, CENTRAL, ProQuest Dissertations & Theses, and SIGLE with no language restrictions. Eligible study selection, data extraction, and evaluation of risk of bias (Cochrane Collaboration tool) were conducted by two authors independently and in duplicate. Any disagreement was solved by discussion or judged by a third reviewer. Statistical pooling, sensitivity analysis, subgroup analysis, and assessment of small-study effects were conducted by using Comprehensive Meta-Analysis and Stata 12.0. Heterogeneity was analyzed for different types of study designs, TADs, and radiographic examinations.
RESULTS
Electronic search yielded a total of 256 studies after removing duplicates. Among them, six studies were finally included. All articles were of high quality. The pooled mean differences were -0.27 (95% confidence interval [CI]: -0.59, 0.05) for SNA, 0.58 (95% CI: -0.07, 1.23) for SNB, -0.86 (95% CI: -1.74, -0.03) for ANB, 1.63 (95% CI: 0.46, 2.80) for Co-Po, 0.75 (95% CI: 0.28, 1.23) for SN-MP, -7.56 (95% CI: -11.37, -3.76) for L1-MP, 0.47 (95% CI: -0.98, 1.91) for overjet, 0.39 (95% CI: -0.57, 1.35) for overbite, -1.84 (95% CI: -5.15, 1.47) for SN-OP, and 4.97 (95% CI: -1.22, 11.17) for nasolabial angle.
CONCLUSIONS
TADs (especially miniplates) were able to eliminate dental adverse effects of Forsus appliances for correction of skeletal Class II malocclusion.
Topics: Humans; Malocclusion, Angle Class II; Mandible; Orthodontic Appliances, Functional; Orthodontics, Corrective; Overbite
PubMed: 33378419
DOI: 10.2319/051120-421.1 -
Orthodontics & Craniofacial Research Aug 2021This review aims to compare the stability of sagittal skeletal and overjet anteroposterior correction of skeletal class III malocclusion in single-jaw and two-jaw... (Meta-Analysis)
Meta-Analysis Review
This review aims to compare the stability of sagittal skeletal and overjet anteroposterior correction of skeletal class III malocclusion in single-jaw and two-jaw orthognathic procedures. An unrestricted comprehensive electronic search was undertaken on Embase, Cochrane's CENTRAL, Web of Science, Medline, Scopus and LILACs databases up to October 2020. The bibliographies of relevant studies, ongoing, unpublished and grey literature were screened. Two independent reviewers performed study selection, bias assessment and data extraction; a third reviewer mediated inconsistencies. Randomized clinical trials, prospective cohort, retrospective cohort and series with a minimum of 1 year follow-up were eligible for inclusion. Additional subgroup analyses were undertaken. The generated effects were scored using the GRADE approach. Nine articles met the inclusion criteria and eight studies were subsequently analysed quantitatively. No significant difference in sagittal stability at the ANB angle, A-point or B-point on a short-term was detected. However, a statistically significant difference, indicating a greater short-term relapse in overjet with mandibular setbacks alone, was found (MD: -0.40 mm; 95% CI -0.77 to -0.04; I : 0%; P = .03). Long-term follow-up (≥5 years) revealed a statistically non-significant difference in stability of sagittal skeletal and overjet corrections. Within the limitations of this review, both procedures seem to offer comparable skeletal and overjet stability outcomes; however, further high-quality research is required to confirm these findings.
Topics: Cephalometry; Humans; Malocclusion, Angle Class III; Mandible; Maxilla; Orthodontics, Corrective; Orthognathic Surgical Procedures; Prospective Studies; Retrospective Studies
PubMed: 33305502
DOI: 10.1111/ocr.12456 -
Indian Journal of Dental Research :... 2020The aim of this systematic review and meta-analysis was to estimate the prevalence of traumatic dental injuries (TDI) in India. The secondary objective was to evaluate... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The aim of this systematic review and meta-analysis was to estimate the prevalence of traumatic dental injuries (TDI) in India. The secondary objective was to evaluate the prevalence rate according to the differences in gender, age, regions, type of TDI and risk factors associated with TDI.
METHODS
The PubMed, LILACS, Web of Science, Cochrane, CINHAL, and Scopus databases, along with the Public Health Electronic Library, TRoPHI and DoPHER were searched from 1 March to 15April 2019 without any restriction of language and year of publication. The qualitative synthesis was done regarding the demographics, study methods, cause of trauma, geographic location, increased overjet and inadequate lip coverage. The meta-analysis was undertaken with STATA-14 software (USA). The pooled prevalence of TDI was calculated using data extracted from 48 studies included in qualitative synthesis and meta-analysis. A sub-group meta-analysis was done by extraction of the data for age groups of 6 years and >6 years.
RESULTS
The pooled prevalence of TDI in Indian population was 13 cases in 100 individuals. The prevalence of TDI for age groups of ≤6 was 15% (males, 15%; females, 16%) and for >6 years was 12% (males, 13%; females, 8%). The most common cause of TDI was falls, and most frequent location was home. The odds ratio for occurrence of TDI and inadequate lip-coverage was 3.35 and overjet greater than 3 mm was 3.53.
CONCLUSIONS
The pooled prevalence of TDI was 13% and slightly higher in children less than 6 years of age. Inadequate lip coverage and increased overjet are the risk factors associated with TDI. Heterogeneity was observed among the studies in terms of design, variables recorded, sampling, study methods and statistical methods. Majority of them also suffered from moderate to high risk of bias.
Topics: Accidental Falls; Child; Female; Humans; India; Male; Overbite; Prevalence; Tooth Injuries
PubMed: 33107464
DOI: 10.4103/ijdr.IJDR_953_19 -
International Journal of Paediatric... Sep 2021The beneficial effect of the extraction of primary canines in the resolution of incisor irregularity and its side effects are controversial. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The beneficial effect of the extraction of primary canines in the resolution of incisor irregularity and its side effects are controversial.
AIM
To systematically review the effects of the extraction of primary canines in incisor irregularity and dental arch morphology.
DESIGN
Controlled non-randomized (non-RCT) and randomized clinical trials (RCT) evaluating children treated with extraction of primary canines compared with those without intervention.
RESULTS
A total of 984 articles were found, of which two RCTs and one non-RCT met the inclusion criteria. Both had a low RoB. A high level of evidence was observed through GRADE. A meta-analysis showed the extraction of primary canines produced a significant decrease in incisor irregularity (95% CI: -3.56, -2.09 mm). This decrease, however, was associated with a reduction of arch length (95% CI: -1.58, -0.94 mm), intermolar width (95% CI: -0.61, -0.22 mm), and overjet (95% CI: -075, -018). A mild overbite increase was found (95% CI: 0.10, 0.76 mm).
CONCLUSION
A high level of evidence showed that the extraction of primary canines improved incisor irregularity in the mixed dentition. Side effects included reduced arch length and intermolar width. A slight reduction in overjet and a mild increase in overbite were also observed. When they are not part of the treatment goal, these occlusal changes can be prevented by installing a lingual arch.
Topics: Dental Arch; Dentition, Mixed; Humans; Incisor; Malocclusion; Tooth Extraction
PubMed: 32946646
DOI: 10.1111/ipd.12726 -
The Journal of Evidence-based Dental... Sep 2020To compare removable and fixed orthodontic devices in the correction of non-skeletal anterior crossbite in children and adolescents in the mixed dentition.
OBJECTIVE
To compare removable and fixed orthodontic devices in the correction of non-skeletal anterior crossbite in children and adolescents in the mixed dentition.
MATERIALS AND METHODS
Electronic searches were conducted in the following databases: PubMed, Web of Science, Scopus, Medline Ovid, Lilacs, US Clinical Trials, and Proquest. A hand search of the reference lists of the included articles and a Google Scholar search were also conducted. References were evaluated by 2 review authors. Articles that met the eligibility criteria were included. Data extraction, methodological quality assessment (Cochrane tool), and strength of the evidence evaluation (GRADE) were also carried out.
RESULTS
Seven articles were included. The results showed that removable and fixed devices were equally efficacious for overjet correction. Removable and fixed devices can also present inconveniences regarding pain and discomfort levels, the accomplishment of everyday activities (leisure and school), and the performance of functions, such as chewing and speech. However, treatment time and costs were significantly lower in orthodontic therapy with fixed appliances. Sequence generation, allocation concealment, and complete outcome data were not a concern. Blinding of participants or personnel was not reported in any article, and blinding of the assessor was a concern in 2 articles. Selective reporting was a concern in 2 articles. The certainty of the evidence for overjet correction was very low.
CONCLUSION
Removable and fixed orthodontic devices are efficacious for overjet correction in non-skeletal anterior crossbite. However, treatment time and costs are lower for cases treated with fixed devices.
Topics: Adolescent; Child; Dentition, Mixed; Humans; Malocclusion; Overbite
PubMed: 32921377
DOI: 10.1016/j.jebdp.2020.101423 -
European Journal of Orthodontics Jan 2021Long-term dental stability is one of the main objectives following combined orthodontic and orthognathic surgical treatment. It is influenced by multiple factors such as...
BACKGROUND
Long-term dental stability is one of the main objectives following combined orthodontic and orthognathic surgical treatment. It is influenced by multiple factors such as surgical, patient-related, and orthodontic aspects. While recent reviews mainly focus on short-term dental changes (0.5-2 years), longer follow-up dental stability remains hardly reviewed.
OBJECTIVES
The aim of this study was to evaluate long-term stability of dental and dentolabial changes following combined orthodontic and orthognathic surgical treatment with a minimum follow-up period of 5 years.
SEARCH METHODS
A systematic search was conducted up to December 2019 using Pubmed, Embase, Web of Science, and Cochrane Central.
SELECTION CRITERIA
Randomized controlled trials (RCTs), prospective and retrospective cohort studies, and case series with a minimum of 10 patients, which reported long-term dental stability following combined orthodontic and orthognathic treatment, were included.
DATA COLLECTION AND ANALYSIS
Long-term changes were assessed for overjet, overbite, maxillary, and mandibular incisors' position and relationship of lip position to maxillary and mandibular incisors. Risk of bias was assessed according to the Cochrane Handbook.
RESULTS
Following the screening of 3178 articles, 11 studies were included (2 RCT, 9 retrospective) with a postoperative follow-up period ranging from 5 to 15 years. A decrease in overjet was observed for patients with skeletal class III malocclusion, whereas overjet increased in class II patients at long-term follow-up. Overbite increased in class II patients, whereas class III showed variable results. The lower incisor position was more stable vertically than horizontally; the latter showing more outcome variability. Dentolabial changes corresponded to the normal ageing process and results were not clinically significant after long-term follow-up.
CONCLUSION
Current evidence suggests variability of dental and dentolabial stability in both skeletal class II and III patients. Further prospective studies are required to develop guidelines for long-term follow-up assessment using computer tomography or cone-beam computed tomography imaging, before final conclusions can be drawn.
REGISTRATION
The protocol for this systematic review (CRD42020133844) was registered in the International Prospective Register of Systematic Reviews (PROSPERO).
Topics: Cephalometry; Humans; Malocclusion, Angle Class II; Malocclusion, Angle Class III; Orthognathic Surgery; Orthognathic Surgical Procedures; Randomized Controlled Trials as Topic
PubMed: 32901268
DOI: 10.1093/ejo/cjaa022 -
Community Dentistry and Oral... Dec 2020We sought to revise, qualify and summarize the body of evidence based on current information on the known associations and risk factors for traumatic dental injury (TDI)... (Review)
Review
OBJECTIVE
We sought to revise, qualify and summarize the body of evidence based on current information on the known associations and risk factors for traumatic dental injury (TDI) occurrence with an overview of systematic reviews.
METHODS
Electronic searches were performed with no language nor date restrictions.According to the PECO strategy, systematic reviews that investigated participants (P) with (E) and without (O) the presentation of factors relating to TDI and these factors' association with TDI episodes (O) as primary or secondary outcomes were included. Quality assessment and bias control were carried out according to the AMSTAR 2 checklist. In cases of systematic review results of discordance, the Jadad decision algorithm was applied.
RESULTS
After titles, abstracts and full texts were read, 19 systematic reviews were included in this overview. Four were classified with critically low, eleven with low and four with moderate methodological quality, respectively. In all studies, 249 cross-sectional, 34 epidemiological surveys, 22 cohort, 9 case-control, 4 longitudinal, 3 ecological and 30 unspecified studies were included. Male gender, child age, greater overjet, inadequate lip coverage, anterior open bite, caries in the permanent dentition, overweight, a previous history of TDI, tongue piercing, the use of alcoholic beverages and participation in sports were all associated with a greater chance of suffering TDI.
CONCLUSIONS
Sociodemographic, clinical and environmental factors are associated with a greater chance of TDI occurrence. However, most of the systematic reviews included were of a low quality and may not provide an accurate and comprehensive summary of the available research that addresses the question of interest. Well-designed primary studies on different aspects of TDI are encouraged to provide higher quality scientific evidence.
Topics: Child; Cross-Sectional Studies; Dentition, Permanent; Humans; Male; Overbite; Risk Factors; Systematic Reviews as Topic; Tooth Injuries
PubMed: 32893395
DOI: 10.1111/cdoe.12574 -
Progress in Orthodontics Sep 2020The aim of this systematic review and meta-analysis is to assess the degree of stability of anterior open bite (AOB) treatment performed through the molar intrusion... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The aim of this systematic review and meta-analysis is to assess the degree of stability of anterior open bite (AOB) treatment performed through the molar intrusion supported with skeletal anchorage at least 1 year posttreatment.
METHODS
This study was registered in PROSPERO (CRD42016037513). A literature search was conducted to identify randomized (RCT) or non-randomized clinical trials based including those considering before and after design. Data sources were electronic databases including PubMed, Cochrane Library, Science Direct, Google Scholar, Scopus, Lilacs, OpenGrey, Web of Science, and ClinicalTrials.gov . The quality of evidence was assessed through the JBI tool and certainty of evidence was evaluated through the GRADE tool. Random effects meta-analysis was conducted when appropriate.
RESULTS
Six hundred twenty-four articles met the initial inclusion criteria. From these, only 6 remained. The mean posttreatment follow-up time was 2.5 years (SD = 1.04). The overbite showed a standardized mean relapse of - 1.23 mm (95% CI - 1.64, - 0.81, p < 0.0001). Maxillary and mandibular incisors presented a non-significant mean relapse, U1-PP - 0.04 mm (95% CI - 0.55, 0.48) and L1-MP - 0.10 mm (95% CI - 0.57, 0.37). Molar intrusion showed a relapse rate around 12% for the maxillary molars and a 27.2% for mandibular molars.
CONCLUSION
The stability of AOB through molar intrusion using TADs can be considered relatively similar to that reported to surgical approaches, since 10 to 30% of relapse occurs both in maxillary and mandibular molars. The level of certainty ranged between very low and low. RCTs reporting dropout during the follow-up are in dire need.
Topics: Cephalometry; Humans; Maxilla; Molar; Open Bite; Orthodontic Anchorage Procedures; Tooth Movement Techniques
PubMed: 32888097
DOI: 10.1186/s40510-020-00328-2 -
Progress in Orthodontics Sep 2020Malocclusion is a highly prevalent public health problem, and several studies have shown its negative correlation with quality of life, self-esteem, and social... (Review)
Review
BACKGROUND
Malocclusion is a highly prevalent public health problem, and several studies have shown its negative correlation with quality of life, self-esteem, and social perceptions. However, its association with bullying is still controversial.
OBJECTIVES
To evaluate the relationship between malocclusion and bullying in children and adolescents.
SEARCH METHODS
The databases used for the electronic researches were PubMed, Scopus, Lilacs/BBO, Web of Science, and Cochrane Library. Grey literature was reviewed through Open Grey literature with no language or date restrictions. Selection criteria, based on the PECO strategy, were considered eligible observational studies that included schoolchildren or adolescents (P) with malocclusion (E), compared to those with normal occlusion (C), in which the relationship between malocclusion and bullying was determined (O).
DATA COLLECTION AND ANALYSIS
Risk of bias evaluation was made for the qualitative synthesis by the Fowkes and Fulton criteria. Data regarding the age of participants and types of malocclusion and of bullying were extracted among other reported data. The quality of the evidence analyzed was evaluated through the GRADE approach.
RESULTS
From 2744 articles identified in databases, nine met the eligibility criteria and were included in present systematic review, of which two studies were judged with methodological soundness. The quality of the evidence was classified as very low due to very serious problems for "risk of bias" and "other considerations" and serious problems of "indirectness". The age of participants ranged from 9 to 34 years considering a cohort study, with a bullying recalling perspective. Malocclusion was both evaluated by researchers and self-reported by participants addressing dentofacial characteristics mostly related to the incisors relationship. All studies evaluated the verbal type of bullying, while 3 also considered physical type. Both types were reported as related to malocclusion, although the results showed that extreme maxillary overjet (> 4 mm, > 6 mm, > 9 mm), extreme deep overbite, and having space between anterior teeth or missing teeth were the types of malocclusion with the strongest relations to bullying.
CONCLUSIONS
With very low certainty of evidence, the results of this systematic review suggest that conspicuous extreme malocclusion may be related to the occurrence of bullying among children and adolescents.
Topics: Adolescent; Bullying; Child; Cohort Studies; Humans; Malocclusion; Overbite; Quality of Life
PubMed: 32869136
DOI: 10.1186/s40510-020-00323-7 -
Progress in Orthodontics Aug 2020The aim of this systematic review was to identify, evaluate, and provide a current literature about the influence of heritability on the determination of occlusal traits. (Review)
Review
BACKGROUND
The aim of this systematic review was to identify, evaluate, and provide a current literature about the influence of heritability on the determination of occlusal traits.
MATERIALS AND METHODS
MEDLINE, SCOPUS, Web of Science, LILACS, and Google Scholar were searched without restrictions up to March 2020. Studies with twin method were considered and the risk of bias assessment was performed using quality of genetic association studies checklist (Q-Genie). The coefficient of heritability (h), model-fitting approaches, and coefficient correlation were used to estimate the genetic/environmental influence on occlusal traits. The GRADE tool was used to assess the quality of the evidence.
RESULTS
Ten studies met the eligibility criteria. Three studies presented good quality, five moderate quality, and two poor quality. Most studies have found that the intra-arch traits, mainly the maxillary arch morphology, such as width (h 16-100%), length (h 42-100%), and shape (h 42-90%), and the crowding, mainly for mandibular arch (h 35-81%), are under potential heritability influence. The traits concerning the inter-arch relationship, as overjet, overbite, posterior crossbite, and sagittal molar relation, seem not to be genetically determined. The certainty of the evidence was graded as low for all outcomes.
CONCLUSIONS
Although weak, the available evidence show that the heritability factors are determinant for the intra-arch traits, namely, arch morphology and crowding. Possibly due they are functionally related, the occlusal traits concerning the maxillary and mandibular relationship seem to have environmental factors as determinants. In this scenario, early preventive approaches can offer a more effective and efficient orthodontic treatment.
Topics: Humans; Malocclusion; Malocclusion, Angle Class II; Mandible; Maxilla; Overbite
PubMed: 32864724
DOI: 10.1186/s40510-020-00330-8