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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 -
Dental and Medical Problems 2022External apical root resorption (EARR) is a serious complication that should be avoided during orthodontic treatment; this pathology depends on multiple factors. Data... (Meta-Analysis)
Meta-Analysis Review
External apical root resorption (EARR) is a serious complication that should be avoided during orthodontic treatment; this pathology depends on multiple factors. Data from clinical studies should be assessed to determine the influence these factors have on the development of EARR. This systematic review aims to compare EARR produced by different factors (orthodontic systems, dental trauma, and dental vitality). The protocol was registered on the PROSPERO database. The search was performed on 5 databases. Accepted study designs included randomized controlled trials, nonrandomized clinical trials, and observational studies. Full-text articles from clinical studies of EARR associated with orthodontic treatment in English, Spanish, or Portuguese with no publication date restrictions were selected. Data from the studies, such as age, population, study groups, and outcome measures, were recorded. Multiple meta-analyses were performed with data from the included studies. Evidence suggests that EARR induced by orthodontic treatment is similar, regardless of the technique used. Evidence of the effect of previous dental trauma on EARR during orthodontic treatment is limited. There is less EARR associated with orthodontic treatment in endodontically treated teeth than in vital teeth. These conclusions should be considered with caution due to the low certainty of the evidence.
Topics: Humans; Orthodontic Appliances, Fixed; Root Resorption; Tooth, Nonvital; Clinical Trials as Topic
PubMed: 36206494
DOI: 10.17219/dmp/145369 -
Orthodontic bracket bonding techniques and adhesion failures: A systematic review and meta-analysis.Journal of Clinical and Experimental... Sep 2022This systematic review compared the bonding failures of orthodontic brackets bonded by indirect or direct techniques. Data sources: The searched databases were Cochrane... (Review)
Review
BACKGROUND
This systematic review compared the bonding failures of orthodontic brackets bonded by indirect or direct techniques. Data sources: The searched databases were Cochrane Library, LILACS, BBO, PubMed, Scopus, Web of Science.
MATERIAL AND METHODS
A search for randomized clinical trials comparing the two techniques was carried out to answer the research question: When considering orthodontic bracket bonding on permanent teeth, does the indirect technique reduce the number of bonding failures compared to the direct one over time? The quality of the included papers was assessed with Cochrane risk of bias tool and the quality of evidence with GRADE.
RESULTS
From 3096 articles identified, seven were included in the systematic review (five at unclear; two at low risk of bias). Meta-analysis was carried out according to the follow-up periods (0-6 months and 12-15 months).
RESULTS
In the first period, bonding techniques were similar with regard to adhesion failures (RR = 0.59; 95% CI 0.10-3.62; = 0.00001; I2 = 92%); in the 12-to-15-month period, the direct bonding technique proved to be superior (RR = 1.44; 95% CI 1.05 - 1.99; = 0.41; I2 = 0%). The quality of evidence was classified as low for the 0-6 months follow-up and high for the 12 months.
CONCLUSIONS
Based on the absence of heterogeneity and the high quality of evidence, it is concluded that the direct bracket bonding technique has a lower failure rate than the indirect technique in the long term (12-15 months). Orthodontic brackets, fixed orthodontics, systematic review.
PubMed: 36158772
DOI: 10.4317/jced.59768 -
BDJ Open Sep 2022The COVID-19 pandemic has caused major disruptions in dental care globally, in part due to the potential for contaminated aerosol to be generated by dental activities....
INTRODUCTION
The COVID-19 pandemic has caused major disruptions in dental care globally, in part due to the potential for contaminated aerosol to be generated by dental activities. This systematic review assesses the literature for changes in aerosol-contamination levels when rotary instruments are used, (1) as distance increases from patient's mouth; (2) as time passes after the procedure; and (3) when using different types of handpieces.
METHODS
The review methods and reporting are in line with PRISMA statements. A structured search was conducted over five platforms (September 2021). Studies were assessed independently by two reviewers. To be eligible studies had to assess changes in levels of aerosol contamination over different distances, and time points, with rotary hand instruments. Studies' methodologies and the sensitivity of the contamination-measurement approaches were evaluated. Results are presented descriptively.
RESULTS
From 422 papers identified, 23 studies were eligible. All investigated restorative procedures using rotary instruments and one study additionally looked at orthodontic bracket adhesive material removal. The results suggest contamination is significantly reduced over time and distance. However, for almost all studies that investigated these two factors, the sizes of the contaminated particles were not considered, and there were inconclusive findings regarding whether electric-driven handpieces generate lower levels of contaminated particles.
CONCLUSION
Aerosol contamination levels reduce as distances, and post-procedure times increase. However, there was sparce and inconsistent evidence on the clearing time and no conclusions could be drawn. High-speed handpieces produce significantly higher levels of contamination than slow-speed ones, and to a lesser extent, micro-motor handpieces. However, when micro-motor handpieces were used with water, the contamination levels rose and were similar to high-speed handpiece contamination levels.
PubMed: 36068221
DOI: 10.1038/s41405-022-00118-4 -
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 -
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 -
BMC Oral Health Jul 2022Before the magnetic resonance imaging (MRI) examination fixed orthodontic devices, such as brackets and wires, cause challenges not only for the orthodontist but also...
BACKGROUND
Before the magnetic resonance imaging (MRI) examination fixed orthodontic devices, such as brackets and wires, cause challenges not only for the orthodontist but also for the radiologist. Essentially, the MRI-safe scan of the fixed orthodontic tools requires a proper guideline in clinical practice. Therefore, this systematic review aimed to examine all aspects of MRI-safe scan, including artifact, thermal, and debonding effects, to identify any existing gaps in knowledge in this regard and develop an evidence-based protocol.
METHODS
The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement was used in this study. The clinical question in "PIO" format was: "Does MRI examination influence the temperature of the orthodontic devices, the size of artifacts, and the debonding force in patients who have fixed orthodontic bracket and/or wire?" The search process was carried out in PubMed, PubMed Central, Scopus, and Google Scholar databases. The search resulted in 1310 articles. After selection according to the eligibility criteria, 18 studies were analyzed by two reviewers. The risk of bias was determined using the Quality In Prognosis Studies tool.
RESULTS
Out of the eligible 18 studies, 10 articles examined the heating effect, 6 were about the debonding effect, and 11 measured the size of artifact regarding brackets and wires. Considering the quality assessment, the overall levels of evidence were high and medium. The published studies showed that heating and debonding effects during MRI exposure were not hazardous for patients. As some wires revealed higher temperature changes, it is suggested to remove the wire or insert a spacer between the appliances and the oral mucosa. Based on the material, ceramic and plastic brackets caused no relevant artifact and were MRI-safe. Stainless steel brackets and wires resulted in susceptibility artifacts in the orofacial region and could cause distortion in the frontal lobe, orbits, and pituitary gland. The retainer wires showed no relevant artifact.
CONCLUSIONS
In conclusion, the thermal and debonding effects of the fixed orthodontic brackets and wires were irrelevant or resoluble; however, the size of the artifacts was clinically relevant and determined most significantly the feasibility of fixed brackets and wires in MRI examination.
Topics: Artifacts; Humans; Magnetic Resonance Imaging; Orthodontic Brackets; Orthodontic Wires; Stainless Steel
PubMed: 35854295
DOI: 10.1186/s12903-022-02317-9 -
Journal of Orthodontic Science 2022This systematic review was aimed to test the null hypothesis that coating of orthodontic wires with nanoparticles does not affect the frictional properties at... (Review)
Review
This systematic review was aimed to test the null hypothesis that coating of orthodontic wires with nanoparticles does not affect the frictional properties at bracket--wire interface. Electronic database searches were performed up to September 2020. studies were considered for reviewing process. Study selection, data extraction, risk of bias assessment was performed during reviewing process. Only qualitative analyses of included literature were done due to the presence of heterogeneity among the studies. Out of 1,068 retrieved records, nine studies satisfied the inclusion criteria and included in this review. Studies were assessed at low risk to high risk of bias according to certain parameters. Wide variety of nanoparticles were used for surface coating of orthodontic wires of variable sizes, shapes, and materials like stainless steel, NiTi, and TMA and placed into the slots of different types of orthodontic brackets to evaluate the alteration in frictional and other mechanical properties. Most of the studies clearly indicate that coating with nanoparticles decreases the friction between wire and bracket interface under specified conditions. Furthermore, among the nine included studies, only two considered evaluation of effect of coated brackets on frictional and other mechanical properties and results were heterogeneous. The null hypothesis is rejected and it is concluded that the wires coated with nanoparticles might offer a novel opportunity to substantially reduce frictional resistance at bracket--wire interface during tooth movement. Further studies are necessary to strengthen the evidence regarding effect of coated brackets on frictional properties.
PubMed: 35754415
DOI: 10.4103/jos.jos_152_21 -
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 -
Indian Journal of Dental Research :... 2021The complications of soft drink consumption during orthodontic treatment includes degradation of enamel, reduction in the shear bond strength of orthodontic brackets,...
INTRODUCTION
The complications of soft drink consumption during orthodontic treatment includes degradation of enamel, reduction in the shear bond strength of orthodontic brackets, and also corrosion of orthodontic wires. The main objective of this review is to discuss the adverse effects of carbonated soft drink (CSD) consumption on patients undergoing fixed orthodontic treatment.
METHODS
A search of studies in MEDLINE (via PubMed), the Cochrane library, Web of science, IndMED, EMBASE, Google scholar and limited grey literature on the effects of consumption of CSDs was conducted. All pertinent abstracts were reviewed for inclusion. Full articles were retrieved for abstracts or titles that met the initial inclusion criteria or lacked sufficient detail for immediate exclusion.
RESULTS
Out of the 4484 results obtained from search, 16 articles were selected based on title and 6 articles were eliminated after reading the abstracts. 10 articles were selected for systematic review which included 6 invitro studies, 1 animal study, 1 observational study and 2 invivo studies. Of these, six studies evaluated the effects of carbonated drinks on the shear bond strength of brackets on enamel of which two evaluated the microhardness of enamel, two studies evaluated the mechanical and chemical properties of wires, one evaluated tooth movement and one study focussed on white spot lesions. The results from the selected articles showed that with the consumption of carbonated drinks, there was reduced shear bond strength of orthodontic brackets, altered enamel characteristics, alteration of mechanical and physical properties of orthodontic wires and decrease in rate of orthodontic tooth movement.
CONCLUSION
Based on the available evidence, CSD consumption during orthodontic treatment definitely has an effect on orthodontic appliances, enamel and possibly on tooth movement.
Topics: Animals; Carbonated Beverages; Dental Enamel; Humans; Observational Studies as Topic; Orthodontic Appliances; Orthodontic Brackets; Tooth Movement Techniques
PubMed: 35645080
DOI: 10.4103/ijdr.IJDR_647_20