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Hua Xi Kou Qiang Yi Xue Za Zhi = Huaxi... Jun 2018This review aims to assess the relationship between initial archwire materials and pain at the initial stage of orthodontic treatment. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This review aims to assess the relationship between initial archwire materials and pain at the initial stage of orthodontic treatment.
METHODS
On October 1, 2017, seven databases were searched electronically for studies oninitial archwire materials and pain at the initial stage of orthodontic treatment. Quality assessment was performed with bias risk assessment tools suggested by Cochrane's handbook. Data extraction of included studies was also carried out. Network Meta- analysis was conducted using R 3.4.2 (with JAGS 4.3.0), GeMTC 0.14.3, and STATA 11.0.
RESULTS
Five studies with 330 participants were included, comparing four different materials: multi-stranded stainless steel, conventional nickel-titanium, super-elastic nickel-titanium, and thermal heat-activated nickel-titanium. Two studies were at low risk of bias, one was at high risk of bias, and the remaining two were at unclear risk of bias. Network Meta-analysis results showed no statistical differences of pain among the four initial archwire materials at day 1 and day 7. However, the most painless material was most likely to be thermal heat-activated nickel-titanium on rank probability.
CONCLUSIONS
On statistical probability, thermal heat-activated nickel-titanium initial arch wires is most likely to cause the least pain at the initial stage of orthodontic treatment, compared with other materials.
Topics: Dental Alloys; Humans; Materials Testing; Network Meta-Analysis; Nickel; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Pain; Stainless Steel; Surface Properties; Titanium
PubMed: 29984932
DOI: 10.7518/hxkq.2018.03.013 -
Orthodontics & Craniofacial Research Feb 2018The aim of this study is to explore the effectiveness of nickel titanium closing springs (NiTi-CS) and elastomeric power chains (EPC) in orthodontic space closure and to... (Meta-Analysis)
Meta-Analysis Review
UNLABELLED
The aim of this study is to explore the effectiveness of nickel titanium closing springs (NiTi-CS) and elastomeric power chains (EPC) in orthodontic space closure and to assess the adverse periodontal effects, cost efficiency and patient-centred outcomes between both of these methods.
METHODS
An electronic search of online databases (Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Scopus, LILACS and Web of Science), reference lists and grey literature as well as hand search were conducted without language restriction up to November/2017. Two authors blindly and in duplicate were involved in study selection, quality assessment and the extraction of data. Only randomized clinical trials (RCTs) were included. The quality of the studies was assessed using the Cochrane Collaboration's risk of bias tool. 95% confidence intervals and mean difference for continuous data were calculated. A meta-analysis that generated a random-effect model for the comparable outcomes was conducted, and heterogeneity was measured using I statistic.
RESULTS
Of 187 records, 4 RCTs met the criteria and were included in the quantitative synthesis featuring 290 test quadrants. Faster space closure with NiTi-CS was observed with a mean difference of (0.20 mm/month, 95% CI: 0.12 to 0.28). Loss of anchorage appears to be similar within both groups when synthesized qualitatively. With exception to anchorage loss, secondary outcomes could not be investigated in the included trials.
CONCLUSIONS
There is a moderate quality of evidence suggesting a faster orthodontic space closure with the NiTi-CS when compared to EPC. A comparable amount of anchorage loss was observed regardless of the utilized method of space closure. Further high-quality RCTs with parallel-groups, reporting on the adverse effects and patient-centred values, are recommended.
Topics: Elastomers; Humans; Nickel; Orthodontic Space Closure; Orthodontic Wires; Polymers; Stress, Mechanical; Titanium
PubMed: 29265578
DOI: 10.1111/ocr.12210 -
The Cochrane Database of Systematic... Feb 2017Orthodontic treatment involves using fixed or removable appliances (dental braces) to correct the positions of teeth. The success of a fixed appliance depends partly on... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Orthodontic treatment involves using fixed or removable appliances (dental braces) to correct the positions of teeth. The success of a fixed appliance depends partly on the metal attachments (brackets and bands) being glued to the teeth so that they do not become detached during treatment. Brackets (metal squares) are usually attached to teeth other than molars, where bands (metal rings that go round each tooth) are more commonly used. Orthodontic tubes (stainless steel tubes that allow wires to pass through them), are typically welded to bands but they may also be glued directly (bonded) to molars. Failure of brackets, bands and bonded molar tubes slows down the progress of treatment with a fixed appliance. It can also be costly in terms of clinical time, materials and time lost from education/work for the patient. This is an update of the Cochrane review first published in 2011. A new full search was conducted on 15 February 2017 but no new studies were identified. We have only updated the search methods section in this new version. The conclusions of this Cochrane review remain the same.
OBJECTIVES
To evaluate the effectiveness of the adhesives used to attach bonded molar tubes, and the relative effectiveness of the adhesives used to attach bonded molar tubes versus adhesives used to attach bands, during fixed appliance treatment, in terms of: (1) how often the tubes (or bands) come off during treatment; and (2) whether they protect the bonded (or banded) teeth against decay.
SEARCH METHODS
The following electronic databases were searched: Cochrane Oral Health's Trials Register (to 15 February 2017), the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 1) in the Cochrane Library (searched 15 February 2017), MEDLINE Ovid (1946 to 15 February 2017), and Embase Ovid (1980 to 15 February 2017). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA
Randomised controlled trials of participants with full arch fixed orthodontic appliance(s) with molar tubes, bonded to first or second permanent molars. Trials which compared any type of adhesive used to bond molar tubes (stainless steel or titanium) with any other adhesive, were included.Trials were also included where:(1) a tube was bonded to a molar tooth on one side of an arch and a band cemented to the same tooth type on the opposite side of the same arch;(2) molar tubes had been allocated to one tooth type in one patient group and molar bands to the same tooth type in another patient group.
DATA COLLECTION AND ANALYSIS
The selection of papers, decision about eligibility and data extraction were carried out independently and in duplicate without blinding to the authors, adhesives used or results obtained. All disagreements were resolved by discussion.
MAIN RESULTS
Two trials (n = 190), at low risk of bias, were included in the review and both presented data on first time failure at the tooth level. Pooling of the data showed a statistically significant difference in favour of molar bands, with a hazard ratio of 2.92 (95% confidence intervals (CI) 1.80 to 4.72). No statistically significant heterogeneity was shown between the two studies. Data on first time failure at the patient level were also available and showed statistically different difference in favour of molar bands (risk ratio 2.30; 95% CI 1.56 to 3.41) (risk of event for molar tubes = 57%; risk of event for molar bands 25%).One trial presented data on decalcification again showing a statistically significant difference in favour of molar bands. No other adverse events identified.
AUTHORS' CONCLUSIONS
From the two well-designed and low risk of bias trials included in this review it was shown that the failure of molar tubes bonded with either a chemically-cured or light-cured adhesive was considerably higher than that of molar bands cemented with glass ionomer cement. One trial indicated that there was less decalcification with molar bands cemented with glass ionomer cement than with bonded molar tubes cemented with a light-cured adhesive. However, given there are limited data for this outcome, further evidence is required to draw more robust conclusions.
Topics: Dental Cements; Dental Restoration Failure; Humans; Light-Curing of Dental Adhesives; Molar; Orthodontic Brackets; Randomized Controlled Trials as Topic; Self-Curing of Dental Resins
PubMed: 28230910
DOI: 10.1002/14651858.CD008236.pub3 -
BMC Oral Health Nov 2016The aim of this study was to compare the external apical root resorption (EARR) in patients receiving fixed orthodontic treatment with self-ligating or conventional... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The aim of this study was to compare the external apical root resorption (EARR) in patients receiving fixed orthodontic treatment with self-ligating or conventional brackets.
METHODS
Studies comparing the EARR between orthodontic patients using self-ligating or conventional brackets were identified through electronic search in databases including CENTRAL, PubMed, EMBASE, China National Knowledge Infrastructure (CNKI) and SIGLE, and manual search in relevant journals and reference lists of the included studies until Apr 2016. The extraction of data and risk of bias evaluation were conducted by two investigators independently. The original outcome underwent statistical pooling by using Review Manager 5.
RESULTS
Seven studies were included in the systematic review, out of which, five studies were statistically pooled in meta-analysis. The value of EARR of maxillary central incisors in the self-ligating bracket group was significantly lower than that in the conventional bracket group (SMD -0.31; 95% CI: -0.60--0.01). No significant differences in other incisors were observed between self-ligating and conventional brackets.
CONCLUSIONS
Current evidences suggest self-ligating brackets do not outperform conventional brackets in reducing the EARR in maxillary lateral incisors, mandible central incisors and mandible lateral incisors. However, self-ligating brackets appear to have an advantage in protecting maxillary central incisor from EARR, which still needs to be confirmed by more high-quality studies.
Topics: Humans; Incisor; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Root Resorption
PubMed: 27871255
DOI: 10.1186/s12903-016-0320-y -
BMC Oral Health Nov 2015The purpose of this systematic review is to identify and review the orthodontic literature with regards to assessing possible differences in canine retraction rate and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The purpose of this systematic review is to identify and review the orthodontic literature with regards to assessing possible differences in canine retraction rate and the amount of antero-posterior anchorage (AP) loss during maxillary canine retraction, using conventional brackets (CBs) and self-ligating brackets (SLBs).
METHODS
An electronic search without time or language restrictions was undertake in September 2014 in the following electronic databases: The Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE via OVID, EMBASE via OVID, Web of science. We also searched the reference lists of relevant articles. Quality assessment of the included articles was performed. Two of the authors were responsible for study selection, validity assessment and data extraction.
RESULTS
Six studies met the inclusion criteria, including 2 randomized controlled trials and 4 control clinical studies. One was assessed as being at low risk of bias. Five trials were assessed as being at moderate risk of bias. The meta-analysis from 6 eligible studies showed that no statistically significant difference was observed between the 2 groups in the rate of canine retraction and loss of antero-posterior anchorage of the molars.
CONCLUSION
There is some evidence from this review that both brackets showed the same rate of canine retraction and loss of antero-posterior anchorage of the molars. The results of the present systematic review should be viewed with caution due to the presence of uncontrolled interpreted factors in the included studies. Further well-designed and conducted randomized controlled trials are required, to facilitate comparisons of the results.
Topics: Cuspid; Humans; Orthodontic Brackets; Orthodontic Wires; Tooth Movement Techniques
PubMed: 26531223
DOI: 10.1186/s12903-015-0127-2 -
Journal of Dentistry Aug 2015To evaluate the risk of failure of fixed orthodontic retention protocols. (Review)
Review
OBJECTIVE
To evaluate the risk of failure of fixed orthodontic retention protocols.
DATA
Screening for inclusion eligibility, quality assessment of studies and data extraction was performed independently by two authors.
SOURCES
The electronic databases MEDLINE, EMBASE and CENTRAL were searched with no restrictions on publication date or language using detailed strategies. The main outcome assessed was bond failure.
STUDY SELECTION
Twenty-seven studies satisfied the inclusion criteria. Randomised controlled trials and prospective studies were evaluated according to the Cochrane risk of bias tool. Retrospective studies were graded employing the predetermined criteria of Bondemark.
RESULTS
Nine randomised controlled trials, four of which were of low quality, were identified. Six studies had a prospective design and all were of low quality. Twelve studies were retrospective. The quality of trial reporting was poor in general. Four studies assessing glass-fibre retainers, three RCTs and one prospective, reported bond failures from 11 to 71%, whereas twenty studies evaluating multistranded retainers – nine RCTs, two prospective and nine retrospective – reported failures ranging from 12 to 50%. One comparison was performed, multistranded wires vs. polyehtylene woven ribbon (RR: 1.74; 95% CI: 0.45, 6.73; p=0.42).
CONCLUSION
The quality of the available evidence is low. No conclusive evidence was found in order to guide orthodontists in the selection of the best protocol.
CLINICAL SIGNIFICANCE
Although fixed orthodontic retainers have been used for years in clinical practice, the selection of the best treatment protocol still remains a subjective issue. The available studies, and their synthesis, cannot provide reliable evidence in this field.
Topics: Equipment Failure; Humans; Orthodontic Retainers; Orthodontics
PubMed: 25979824
DOI: 10.1016/j.jdent.2015.05.002 -
Orthodontics & Craniofacial Research Nov 2014The aim of the study was to assess treatment effects and potential side effects of different archwires used on patients receiving orthodontic therapy. Electronic and... (Meta-Analysis)
Meta-Analysis Review
The aim of the study was to assess treatment effects and potential side effects of different archwires used on patients receiving orthodontic therapy. Electronic and manual unrestricted searches were conducted in 19 databases including MEDLINE, Cochrane Library, and Google Scholar until April 2012 to identify randomized controlled trials (RCTs) and quasi-RCTs. After duplicate study selection, data extraction, risk of bias assessment with the Cochrane risk of bias tool, and narrative analysis, mean differences (MDs) with confidence intervals (CIs) of similar studies were pooled using a random-effects model and evaluated with GRADE. A total of 16 RCTs were included assessing different archwire characteristics on 1108 patients. Regarding initial archwires, meta-analysis of two trials found slightly greater irregularity correction with an austenitic-active nickel-titanium (NiTi) compared with an martensitic-stabilized NiTi archwire (corresponding to MD: 1.11 mm, 95% CI: -0.38 to 2.61). Regarding archwire sequences, meta-analysis of two trials found it took patient treated with a sequence of martensitic-active copper-nickel-titanium (CuNiTi) slightly longer to reach the working archwire (MD: 0.54 months, 95% CI: -0.87 to 1.95) compared with a martensitic-stabilized NiTi sequence. However, patients treated with a sequence of martensitic-active CuNiTi archwires reported general greater pain intensity on the Likert scale 4 h and 1 day after placement of each archwire, compared with a martensitic-stabilized NiTi sequence. Although confidence in effect estimates ranged from moderate to high, meta-analyses could be performed only for limited comparisons, while inconsistency might pose a threat to some of them. At this point, there is insufficient data to make recommendations about the majority of initial archwires or for a specific archwire sequence.
Topics: Copper; Dental Alloys; Humans; Nickel; Orthodontic Wires; Titanium; Treatment Outcome
PubMed: 24889143
DOI: 10.1111/ocr.12048