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Medicine Nov 2018The aim of our study was to qualitatively and quantitatively synthesize the evidence regarding ways to improve motivation of oral hygiene among orthodontic patients with... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The aim of our study was to qualitatively and quantitatively synthesize the evidence regarding ways to improve motivation of oral hygiene among orthodontic patients with fixed appliances and identify the effects of motivational methods via comparing the oral hygiene condition before and after the motivations.
METHODS
An electronic search was conducted in PubMed, Ovid, Embase, and the Crochrane Library for relevant random controlled trials (RCT) and clinical controlled trial (CCT) published before May 1, 2017 with manual search in addition. Search and selection of studies, quality assessment, data extraction and synthesis was completed by 2 reviewers independently. Plaque index (PI) and gingival index (GI) at 1, 3, 6-month were pooled with Review Manager 5.3. Bias of included studies was evaluated.
RESULTS
In total, 12 studies fulfilled the inclusion criteria of this systematic review, of which, 5 were included in the meta-analysis. Motivational methods had statistically significant advantage regarding PI in the experimental group over control group at 1, 3, 6-month, while GI was significantly better controlled in the study group at 3, 6-month. The quality of included studies was moderate.
CONCLUSION
It is worthy for orthodontists to put in additional efforts to motivate patients to maintain good oral hygiene throughout the entire treatment process.
Topics: Dental Hygienists; Dental Plaque Index; Humans; Motivation; Oral Hygiene; Orthodontic Brackets; Orthodontists; Patient Education as Topic; Periodontal Index
PubMed: 30461616
DOI: 10.1097/MD.0000000000013182 -
Assessment of bond strength studies of the orthodontic bracket-adhesive system: A systematic review.European Journal of Dentistry 2018The aim of this study was to systematically review the available studies measuring the bond strength of orthodontic bracket-adhesive system under different experimental... (Review)
Review
The aim of this study was to systematically review the available studies measuring the bond strength of orthodontic bracket-adhesive system under different experimental conditions . Literature search was performed in four different databases: PubMed, Web of Science, Cochrane, and Scopus using the keywords - bond strength, orthodontic brackets, bracket-adhesive, and . A total of six full-text articles were selected based on the inclusion and exclusion criteria of our study after a careful assessment by the two independent reviewers. Data selection was performed by following PRISMA 2009 guidelines. Five of the selected studies were clinical trials; one study was a randomized clinical trial. From each of the selected articles, the following data were extracted - number of samples, with the type of tooth involved materials under experiment methods of measurement, the time interval between bonding and debonding orthodontic brackets, mode of force application, and the bond strength results with the overall outcome. The methodological quality assessment of each article was done by the modified Downs and Black checklist method. The qualitative analyses were done by two independent reviewers. Conflicting issues were resolved in a consensus meeting by consulting the third reviewer (MKA). Meta-analysis could not be performed due to the lack of homogenous study results. The review reached no real conclusion apart from the lack of efforts to clinically evaluate the bonding efficiency of a wide range of orthodontic bracket-adhesive systems in terms of debonding force compared to laboratory-based and studies.
PubMed: 30369810
DOI: 10.4103/ejd.ejd_22_18 -
Dental and Medical Problems 2018The objective of this study was to investigate the in vivo effectiveness of laser in the prevention of enamel demineralization during orthodontic treatment. A search of...
The objective of this study was to investigate the in vivo effectiveness of laser in the prevention of enamel demineralization during orthodontic treatment. A search of electronic databases (PubMed, ScienceDirect, Google Scholar, Scopus, the Cochrane Central Register of Controlled Trials - CENTRAL, OpenGrey, and ProQuest Dissertations and Theses - PQDT Open from ProQuest) was carried out. In vivo studies, randomized and/or controlled clinical trials regarding the use of laser treatment to prevent enamel demineralization during orthodontic treatment were included. The risk of bias of the studies included was assessed independently by 2 authors according to Cochrane guidelines. Eight articles were identified, comprising a total of 183 patients. Significant differences were observed in enamel demineralization between laser-irradiated and control groups for all laser types: argon laser, CO2 laser, neodymium-doped yttrium aluminum garnet (Nd:YAG) laser, and Optodan® laser, except for argon laser application for curing bracket adhesives, where no statistically significant differences were noted. Laser irradiation may be effective in inhibiting demineralization during orthodontic treatment, but there is a need for further randomized, controlled clinical trials, utilizing different laser systems to determine real clinical efficacy of the technique.
Topics: Dental Enamel; Humans; Lasers; Orthodontic Appliances; Tooth Demineralization
PubMed: 30328311
DOI: 10.17219/dmp/92636 -
The Cochrane Database of Systematic... Jul 2018Initial arch wires are the first arch wires to be inserted into the fixed appliance at the beginning of orthodontic treatment and are used mainly for the alignment of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Initial arch wires are the first arch wires to be inserted into the fixed appliance at the beginning of orthodontic treatment and are used mainly for the alignment of teeth by correcting crowding and rotations. With a number of different types of orthodontic arch wires available for initial tooth alignment, it is important to understand which wire is most efficient, as well as which wires cause least amount of root resorption and pain during the initial aligning stage of treatment. This is an update of the review entitledInitial arch wires for alignment of crooked teeth with fixed orthodontic braces, which was first published in 2010.
OBJECTIVES
To assess the effects of initial arch wires for the alignment of teeth with fixed orthodontic braces, in terms of the rate of tooth alignment, amount of root resorption accompanying tooth movement, and intensity of pain experienced by patients during the initial alignment stage of treatment.
SEARCH METHODS
Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 5 October 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2017, Issue 9), MEDLINE Ovid (1946 to 5 October 2017), and Embase Ovid (1980 to 5 October 2017. The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) of initial arch wires to align teeth with fixed orthodontic braces. We included only studies involving participants with upper or lower, or both, full arch fixed orthodontic appliances.
DATA COLLECTION AND ANALYSIS
Two review authors were responsible for study selection, 'Risk of bias' assessment and data extraction. We resolved disagreements by discussion between the review authors. We contacted corresponding authors of included studies to obtain missing information. We assessed the quality of the evidence for each comparison and outcome as high, moderate, low or very low, according to GRADE criteria.
MAIN RESULTS
For this update, we found three new RCTs (228 participants), bringing the total to 12 RCTs with 799 participants. We judged three studies to be at high risk of bias, and three to be at low risk of bias; six were unclear. None of the studies reported the adverse outcome of root resorption. The review assessed six comparisons.1. Multistrand stainless steel versus superelastic nickel-titanium (NiTi) arch wires. There were five studies in this group and it was appropriate to undertake a meta-analysis of two of them. There is insufficient evidence from these studies to determine whether there is a difference in rate of alignment between multistrand stainless steel and superelastic NiTi arch wires (mean difference (MD) -7.5 mm per month, 95% confidence interval (CI) -26.27 to 11.27; 1 study, 48 participants; low-quality evidence). The findings for pain at day 1 as measured on a 100 mm visual analogue scale suggested that there was no meaningful difference between the interventions (MD -2.68 mm, 95% CI -6.75 to 1.38; 2 studies, 127 participants; moderate-quality evidence).2. Multistrand stainless steel versus thermoelastic NiTi arch wires. There were two studies in this group, but it was not appropriate to undertake a meta-analysis of the data. There is insufficient evidence from the studies to determine whether there is a difference in rate of alignment between multistrand stainless steel and thermoelastic NiTi arch wires (low-quality evidence). Pain was not measured.3. Conventional NiTi versus superelastic NiTi arch wires. There were three studies in this group, but it was not appropriate to undertake a meta-analysis of the data. There is insufficient evidence from these studies to determine whether there is any difference between conventional and superelastic NiTi arch wires with regard to either alignment or pain (low- to very low-quality evidence).4. Conventional NiTi versus thermoelastic NiTi arch wires. There were two studies in this group, but it was not appropriate to undertake a meta-analysis of the data. There is insufficient evidence from these studies to determine whether there is a difference in alignment between conventional and thermoelastic NiTi arch wires (low-quality evidence). Pain was not measured.5. Single-strand superelastic NiTi versus coaxial superelastic NiTi arch wires. There was only one study (24 participants) in this group. There is moderate-quality evidence that coaxial superelastic NiTi can produce greater tooth movement over 12 weeks (MD -6.76 mm, 95% CI -7.98 to -5.55). Pain was not measured.6. Superelastic NiTi versus thermoelastic NiTi arch wires. There were three studies in this group, but it was not appropriate to undertake a meta-analysis of the data. There is insufficient evidence from these studies to determine whether there is a difference in alignment or pain between superelastic and thermoelastic NiTi arch wires (low-quality evidence).
AUTHORS' CONCLUSIONS
Moderate-quality evidence shows that arch wires of coaxial superelastic nickel-titanium (NiTi) can produce greater tooth movement over 12 weeks than arch wires made of single-strand superelastic NiTi. Moderate-quality evidence also suggests there may be no difference in pain at day 1 between multistrand stainless steel arch wires and superelastic NiTi arch wires. Other than these findings, there is insufficient evidence to determine whether any particular arch wire material is superior to any other in terms of alignment rate, time to alignment, pain and root resorption.
Topics: Alloys; Dental Alloys; Humans; Orthodontic Brackets; Orthodontic Wires; Randomized Controlled Trials as Topic; Root Resorption; Tooth Movement Techniques; Toothache
PubMed: 30064155
DOI: 10.1002/14651858.CD007859.pub4 -
Pakistan Journal of Medical Sciences 2018To evaluate the incidence of orthodontic brackets detachment during orthodontic treatment. (Review)
Review
OBJECTIVES
To evaluate the incidence of orthodontic brackets detachment during orthodontic treatment.
METHODS
Using electronic databases; eligible studies up to January 2018 were retrieved, independently reviewed, and screened. The Coleman Methodology Scoring System (CMS) and Cochrane Collaboration's tool were used to assess quality and risk of bias in the included studies.
RESULTS
Of the seventeen studies included in the final synthesis, thirteen were categorized as randomized clinical trials (RCTs), one prospective cohort and retrospective survey each, whereas two studies could not be categorized. The number of patients in the selected studies ranged between 19 and 153; the mean age was between 10.5 to 38.7 years, and male to female ratio was 353:495. Almost all studies had a high risk of bias, and more than half of the studies had CMS score of 70 or above. The numbers of brackets examined in the studies ranged between 361 and 3336. The incidence of brackets detachment ranged from 0.6 to 28.3%.
CONCLUSIONS
The incidence of brackets detachment during orthodontic treatment is high.
PubMed: 30034451
DOI: 10.12669/pjms.343.15012 -
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 -
The Cochrane Database of Systematic... Apr 2018Bonding of orthodontic brackets to teeth is important to enable effective and efficient treatment with fixed appliances. The problem is bracket failure during treatment... (Review)
Review
BACKGROUND
Bonding of orthodontic brackets to teeth is important to enable effective and efficient treatment with fixed appliances. The problem is bracket failure during treatment which increases operator chairside time and lengthens treatment time. A prolonged treatment is likely to increase the oral health risks of orthodontic treatment with fixed appliances one of which is irreversible enamel decalcification. This is an update of the Cochrane Review first published in 2003. A new full search was conducted on 26 September 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 effects of different orthodontic adhesives for bonding.
SEARCH METHODS
Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 26 September 2017), the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 8) in the Cochrane Library (searched 26 September 2017), MEDLINE Ovid (1946 to 26 September 2017), and Embase Ovid (1980 to 26 September 2017). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA
Trials were selected if they met the following criteria: randomised controlled trials (RCTs) and controlled clinical trials (CCTs) comparing two different adhesive groups. Participants were patients with fixed orthodontic appliances. The interventions were adhesives that bonded stainless steel brackets to all teeth except the molars. The primary outcome was debond or bracket failure.
DATA COLLECTION AND ANALYSIS
Data were recorded on decalcification as a secondary outcome, if present. Information regarding methods, participants, interventions, outcome measures and results were extracted in duplicate by pairs of review authors. Since the data were not presented in a form that was amenable to meta-analysis, the results of the review are presented in narrative form only.
MAIN RESULTS
Three trials satisfied the inclusion criteria. A chemical cured composite was compared with a light cured composite (one trial), a conventional glass ionomer cement (one trial) and a polyacid-modified resin composite (compomer) (one trial). The quality of the trial reports was generally poor.
AUTHORS' CONCLUSIONS
There is no clear evidence on which to make a clinical decision of the type of orthodontic adhesive to use.
Topics: Compomers; Decalcification, Pathologic; Dental Bonding; Dental Cements; Glass Ionomer Cements; Humans; Orthodontic Brackets; Randomized Controlled Trials as Topic
PubMed: 29630138
DOI: 10.1002/14651858.CD002282.pub2 -
Medicine Apr 2018This systematic review and meta-analysis aimed to identify whether there is any relationship between fixed orthodontic appliances and malodor, and if self-ligating... (Meta-Analysis)
Meta-Analysis Review
Effects of fixed orthodontic brackets on oral malodor: A systematic review and meta-analysis according to the preferred reporting items for systematic reviews and meta-analyses guidelines.
BACKGROUND
This systematic review and meta-analysis aimed to identify whether there is any relationship between fixed orthodontic appliances and malodor, and if self-ligating brackets (SLBs) prevent malodor better than conventional brackets (CBs).
METHODS
The electronic databases PubMed, Ovid, EMBASE, and the Cochrane Library were searched from inception to September 2016; a manual search was also performed. Randomized controlled and clinical controlled trials, in which experimental groups received fixed orthodontic therapy and malodor was measured, were included. Patients treated with fixed orthodontic brackets were compared with those without any treatment, and SLB systems were compared with CB systems. Two reviewers independently selected potentially relevant studies, evaluated the risk for bias, extracted essential data, and synthesized findings using Review Manager version 5.3 (Copenhagen: The. Nordic Cochrane Centre, The Cochrane Collaboration, 2014).
RESULTS
Four studies, involving a total of 152 participants, met the inclusion criteria. Fixed orthodontic appliances caused malodor from the initial visit to 2 to 3 months, but was only significant after the first week (mean difference 20.24 [95% confidence interval [CI]11.75-28.74]; P < .00001). Plaque index, gingival index, and periodontal pocket depths demonstrated no statistical differences between the SLB and CB groups after the first week. However, SLBs significantly controlled malodor better than CBs after the first week (mean difference 4.32 [95% CI 6.02 to 2.61]; P < .00001). The quality of the included studies was relatively low and relevant research in this field is quite scarce.
CONCLUSIONS
Although the evidence base was relatively weak, fixed orthodontic treatment appeared to be a risk factor for malodor, independent of periodontal changes, and SLB systems controlled malodor better than CB systems.
Topics: Dental Plaque Index; Halitosis; Humans; Orthodontic Brackets; Periodontal Index; Periodontal Pocket; Risk Factors
PubMed: 29620635
DOI: 10.1097/MD.0000000000010233 -
Progress in Orthodontics Jan 2018The purpose of this systematic review was to identify studies and present the use of miniscrew implants (MIs) as an alternative treatment to mandibular molar uprighting.... (Review)
Review
The purpose of this systematic review was to identify studies and present the use of miniscrew implants (MIs) as an alternative treatment to mandibular molar uprighting. An electronic search and handsearching were conducted by two independent reviewers to identify relevant articles, published up to January 27, 2017. In order to methodologically assess the eligible studies, a pilot checklist consisting of 22 items was also implemented. After exclusion of all the irrelevant papers, only 17 studies were included, presenting 27 cases of mandibular molar uprighting in all planes using both direct and indirect force traction by MIs. Regarding the quality evaluation, the mean score of the included studies was 13.2, indicating a rather poor methodology implemented in the majority of the included cases. Due to many advantages, MIs provide a unique treatment alternative and constitute a reliable solution for treating tipped or impacted molars. Regarding the force application, a direct method is simpler, as it requires one MI and a single bracket or button, minimizing the patient's discomfort and also reducing chair time compared to more complex indirect anchorage. It also eliminates the possibility of unwanted movement of the anchorage unit, which can occur even with indirect anchorage as a result of technical errors. However, direct anchorage has limitations in cases of lingually tipped or rotated molars because a single force may be insufficient to upright the tooth.
Topics: Bone Screws; Dental Implants; Humans; Mandible; Molar; Orthodontic Anchorage Procedures; Tooth Movement Techniques
PubMed: 29308540
DOI: 10.1186/s40510-017-0200-2 -
BMC Oral Health Nov 2017An evaluation is made of possible differences in treatment effects between labial and lingual fixed appliances. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
An evaluation is made of possible differences in treatment effects between labial and lingual fixed appliances.
METHODS
A comprehensive search was made of the PubMed-Medline, Cochrane Library and LILACS databases, with an additional manual search covering the period up until April 2017. There were no restrictions in terms of year of publication or language. Agreement between the authors was quantified by the Cohen kappa statistic. A random-effect model was applied to calculate weighted mean differences with 95% confidence intervals.
RESULTS
A total of 249 patients corresponding to four eligible studies were included in the systematic review. Among the six angles and distances entered in the meta-analysis, a tendency was observed in lingual appliances to increase the interincisal angle (95% CI -0.80-8.99; p = 0.101) and reduce the angle between the major axis of upper central incisor and the sellar-nasion plane - though statistical significance was not reached (95% CI -5.75-0.32; p = 0.079).
CONCLUSION
The results obtained indicate that treatment with lingual appliances favors incisor tipping by exerting lingual crown torque, but there are no differences in cephalometric values between labial and lingual fixed appliances. Because of the small number of included studies, the results of this meta-analysis should be interpreted with caution. Future research should focus on the generation of a consensus document allowing selection of the type of orthodontic approach not only conditioned to the esthetic requirements of the patient but also considering the characteristics of the malocclusion. On the other hand, standardized international guidelines are lacking; the measurements of angles and distances therefore have to be unified with a view to future investigations.
Topics: Cephalometry; Esthetics, Dental; Humans; Orthodontic Appliance Design; Orthodontic Appliances; Orthodontic Brackets; Tooth Movement Techniques
PubMed: 29166941
DOI: 10.1186/s12903-017-0424-z