-
Journal of Oral Rehabilitation Dec 2023Patients undergoing mandibular advancement device (MAD) therapy for obstructive sleep apnea (OSA) may experience changes in jaw position and altered occlusion. This... (Review)
Review
Occurrence of Temporomandibular Disorders among patients undergoing treatment for Obstructive Sleep Apnoea Syndrome (OSAS) using Mandibular Advancement Device (MAD): A Systematic Review conducted according to PRISMA guidelines and the Cochrane handbook for systematic reviews of interventions.
BACKGROUND
Patients undergoing mandibular advancement device (MAD) therapy for obstructive sleep apnea (OSA) may experience changes in jaw position and altered occlusion. This could potentially contribute to the development or exacerbation of TMD symptoms. The literature on the long-term impact of MAD treated for OSA on TMD is scarce. Hence, this review was undertaken to ascertain the occurrence of TMD in MAD users.
METHODS
A comprehensive search protocol was implemented across several online databases using MeSH keywords and Boolean operators. A standardised data extraction form was developed specifically for this review. Two reviewers independently extracted the data. RoB-2 was used to evaluate the methodological quality of the included studies.
RESULTS
A total of 13 clinical studies were selected for this review. Some studies reported a significant reduction in the severity and frequency of TMD symptoms following MAD treatment. However, other studies did not observe significant changes in TMD symptoms or TMJ-related parameters from baseline to follow-up intervals. Temporary increases in TMJ-related pain or symptoms at the beginning of the follow-up period, which later subsided, were reported in some studies. Overall, MAD was not discontinued in any OSA patient due to TMDs.
CONCLUSION
The findings reveal that different outcomes associated with TMD are affected differently by MAD treatment for OSAS. According to a few studies, MAD therapy significantly reduced the severity and frequency of TMD symptoms. Other research, however, found no appreciable modifications in TMD symptoms or TMJ-related indicators. Although the overall results point to no significant effect of MAD treatment on TMD symptoms, the disparity in results between studies highlights the need for additional studies using standardised approaches.
Topics: Humans; Occlusal Splints; Sleep Apnea, Obstructive; Temporomandibular Joint Disorders; Pain; Mandibular Advancement; Treatment Outcome
PubMed: 37644889
DOI: 10.1111/joor.13574 -
International Orthodontics Dec 2023Orthognathic surgery is considered nowadays as a revolutionary treatment option for treating skeletal discrepancies and severe malocclusions in the sagittal, vertical...
INTRODUCTION
Orthognathic surgery is considered nowadays as a revolutionary treatment option for treating skeletal discrepancies and severe malocclusions in the sagittal, vertical and transverse dimensions. This surgery allows both the restoration of facial harmony and the achievement of satisfactory dental occlusion. The technology of computer-assisted surgeries including virtual surgical simulation programs and planning software greatly contributes to providing a three-dimensional simulation and precise mobilization of the maxilla and/or mandible, thus allowing the prediction of the final outcome in soft tissues. This study aims to systematically review the available scientific literature about the accuracy of the hard and soft tissue predictions delivered by the many promoted three-dimensional simulation software.
MATERIAL AND METHODS
An electronic search was conducted on various databases: Medline via PubMed, The Cochrane Library, EBSCO-host, and Web of Science. The search was established on a well-defined research question following PICO principle: population, intervention, comparator and outcome. Search evaluation and the assessment of risk of bias were undertaken in each study following its type and design.
RESULTS
Fifteen studies were included for qualitative analysis. Seven studies evaluated the accuracy of soft tissue prediction, seven focused more on the accuracy of hard tissue and one study assessed both hard and soft tissue prediction accuracy delivered by the simulation software. Moreover, three studies were judged to be low risk and four were classified as high risk. Included studies revealed that hard tissue prediction is highly accurate and reliable, leading to clinically acceptable results. Yet, soft tissue prediction is unclear due to various factors that bias its results. Caution should therefore be taken when providing information about the soft tissue planning to patients.
CONCLUSIONS
Computer assisted 3D simulation protocols allow for more precise repositioning of the maxilla and/or mandible compared to conventional 2D methods. However, 3D soft tissue prediction using simulation software remains less accurate, especially in the labial region.
Topics: Humans; Orthognathic Surgical Procedures; Imaging, Three-Dimensional; Software; Computer Simulation; Maxilla; Surgery, Computer-Assisted; Cephalometry
PubMed: 37499444
DOI: 10.1016/j.ortho.2023.100802 -
International Orthodontics Dec 2023The aim of this systematic review (Prospero CRD42022323188) is to investigate whether an association exists in patients with amelogenesis imperfecta (AI) between...
INTRODUCTION
The aim of this systematic review (Prospero CRD42022323188) is to investigate whether an association exists in patients with amelogenesis imperfecta (AI) between occlusal characteristics and genotype on the one hand and enamel structural phenotype on the other.
MATERIAL AND METHODS
Reports up to May 2023 assessing occlusion of individuals with AI were browsed in a systematic search using Medline, Embase, ISI Web of Science, and the grey literature. Randomised control trials, case control studies, and case series specifying both occlusion, assessed by cephalometric or clinical analysis, and genotype or dental phenotype in patients with AI were included without any age limitation. Two authors independently selected the publications and extracted the data in accordance with the PRISMA statement. The risk of bias was assessed with the Critical Appraisal Checklists from the Johanna Briggs Institute.
RESULTS
Twenty-five articles were chosen from the 261 results. Most of the included publications were case series (n=22) and case control studies (n=3). Thirteen studies reported both a genotype (ENAM, FAM83H, FAM20A, DLX3, CNMM4, WDR72) and occlusal diagnostic. The methodological quality of the studies was moderate. All AI phenotypes showed an open bite (OB) rate around 35%, except mixed form. The other malocclusions were not often mentioned. No correlation between occlusal phenotype and genotype or AI phenotype could be identified in patients with AI, as most studies had short occlusal descriptions and small sample sizes.
CONCLUSION
OB malocclusions were more frequently reported in AI. This review highlighted the need for a more accurate description of orofacial features associated with AI, to better clarify the role of amelogenesis genes in the regulation of craniofacial morphogenesis and identify patients requiring orthognathic surgery at an early stage.
Topics: Humans; Amelogenesis Imperfecta; Genotype; Phenotype; Dental Enamel; Malocclusion; Open Bite; Proteins
PubMed: 37494776
DOI: 10.1016/j.ortho.2023.100789 -
Special Care in Dentistry : Official... 2024Treating anterior restorations is a real challenge for a dentist and conventional protocols are not always applicable. The aim of this study is to determine different... (Review)
Review
INTRODUCTION
Treating anterior restorations is a real challenge for a dentist and conventional protocols are not always applicable. The aim of this study is to determine different therapeutic to conducting anterior restorations in disabled people.
CASE REPORT
We begin by presenting the case of a 23-year-old, handicapped man, who was brought in consultation to compensate for the loss of the left upper central incisor (#21).
MATERIALS AND METHODS
We then performed a systematic literature review in December 2022, in accordance with the PRISMA guidelines. The publications, on three databases, dealing with dental treatments on disabled people were selected whether they were clinical studies or case reports.
RESULTS
In the end, 14 publications were included. Most of the treatments described in the studies (n = 10; 71.43%) concern people aged under 19. The patients present different types of handicaps with various degrees of severity and the oral diseases described are as heterogeneous as the handicaps retrieved.
DISCUSSION
It is therefore difficult to make common treatment recommendations for all these variable profiles and situations. Most of patients in this study are very young, so there is a need for preventive and therapeutic care as earlier as possible, to preserve the vitality of their teeth and dental occlusion.
Topics: Male; Humans; Aged; Young Adult; Adult; Incisor; Disabled Persons; Dental Restoration, Permanent
PubMed: 37470748
DOI: 10.1111/scd.12905 -
European Archives of Paediatric... Aug 2023This study aims to evaluate whether there is a correlation between otitis and dental malocclusions.
PURPOSE
This study aims to evaluate whether there is a correlation between otitis and dental malocclusions.
METHODS
Electronic databases were searched for observational studies published until July 2021 without language or time restrictions.
PROSPERO
CRD42021270760. Observational studies on children with and without OM and/or malocclusion were included. After removing duplicates and excluding not-eligible articles, two reviewers screened relevant articles independently. Two reviewers independently extracted data and assessed data quality and validity through the Newcastle-Ottawa Scale (NOS) quality assessment tool for non-randomized studies.
RESULTS
Five studies met the selection inclusion criteria and were included in the studies for a total of 499 patients. Three studies investigated the relationship between malocclusion and otitis media, while the remaining two studies analyzed the inverse relationship and one of them considered eustachian tube dysfunction as a proxy of OM. An association between malocclusion and otitis media and vice versa emerged, although with relevant limitations.
CONCLUSION
There is some evidence that there is an association between otitis and malocclusion; however, it is not yet possible to establish a definitive correlation.
Topics: Humans; Child; Otitis Media; Malocclusion
PubMed: 37338742
DOI: 10.1007/s40368-023-00807-0 -
Minerva Dental and Oral Science Aug 2023A systematic review of the literature available up to October 2020 has been conducted to determine which cranial plane could represent a stable and reliable parameter to...
INTRODUCTION
A systematic review of the literature available up to October 2020 has been conducted to determine which cranial plane could represent a stable and reliable parameter to evaluate the orientation of the occlusal plane in a frontal view.
EVIDENCE ACQUISITION
An electronic research was performed across the following electronic databases: PUBMED, EBSCO, SCOPUS, WoS, COCHRANE LIBRARY, SciELO, EMBASE and GOOGLE SCHOLAR. Observational studies based on imaging and anthropometry were identified, and all languages have been included. The articles were selected and analyzed by three authors independently. PICO format was adopted to analyze the studies and AXIS guidelines were used to assess the quality of evidence.
EVIDENCE SYNTHESIS
We found eleven articles eligible for full-text analysis. All studies included only young subjects and analyzed the occlusal plane in relation to the frontal plane traced between the right and left tragus (Camper's and Frankfurt planes), to the interpupillary plane, and to other soft and hard tissues references. The outcomes of selected studies were various, with a low quality of evidence, and they did not allow to infer a stable cranial relation between the occlusal plane and other bone structures.
CONCLUSIONS
The evidence does not support that the interpupillary plane represent a reliable parameter to evaluate the occlusal plane orientation in a frontal view; instead, the Frankfurt plane could be a much more stable reference parameter, from a morphological perspective. It is necessary to perform an observational study upon craniums to define which are the most stable cranial reference planes to determine the orientation of the occlusal plane in dentate subjects.
Topics: Humans; Dental Occlusion; Cephalometry; Face; Skull; Ear Auricle; Observational Studies as Topic
PubMed: 37066888
DOI: 10.23736/S2724-6329.22.04659-9 -
The Angle Orthodontist Sep 2023To evaluate the efficacy of chewing gum on the intensity of pain in patients undergoing orthodontic treatment. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To evaluate the efficacy of chewing gum on the intensity of pain in patients undergoing orthodontic treatment.
MATERIALS AND METHODS
A search strategy that included both a manual search and a search of electronic databases was implemented; the electronic databases included PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), ScienceDirect, Scopus, and EBSCO. Only randomized controlled trials were included in this study. All of the studies were assessed independently and in duplicate in accordance with the exclusion and inclusion criteria. The Cochrane risk of bias tool was used to evaluate the risk of bias within the included studies, and the GRADE approach was used to evaluate the certainty of evidence.
RESULTS
Sixteen RCTs were included in the final analysis. The meta-analysis revealed that chewing gum significantly reduced pain intensity in comparison to pharmacologic agents (mean difference [MD] -0.50 [95% confidence interval {CI} -0.90 to -0.10], P = .01). When compared with a placebo, chewing gum significantly reduced pain intensity (MD -0.60 [95% CI -1.06 to -0.13], P = .01), while bite wafer and chewing gum groups had the same levels of reduction in pain intensity (MD -0.15 [95% CI -0.56 to 0.26], P = .48).
CONCLUSIONS
In patients undergoing fixed orthodontic treatment, chewing gum was significantly more effective than both pharmacologic agents and placebo in reducing orthodontic pain 24 hours after the initial placement of the archwire.
Topics: Humans; Chewing Gum; Pain; Dental Occlusion; Pain Measurement; Randomized Controlled Trials as Topic
PubMed: 37043773
DOI: 10.2319/110622-760.1 -
International Journal of Computerized... Mar 2024Occlusion is associated with all disciplines of dentistry and plays a major role in the longevity of both implant- and tooth-borne restorations. Achieving occlusal...
STATEMENT OF THE PROBLEM
Occlusion is associated with all disciplines of dentistry and plays a major role in the longevity of both implant- and tooth-borne restorations. Achieving occlusal harmony ensures balance is established between the dental and myofascial structures, which can be measurably established to high numerical tolerances with the T-Scan digital occlusal analysis system.
PURPOSE
To describe and evaluate the known and proven applications of T-Scan digital occlusal analysis in various dental practice disciplines through a systematic review of the literature.
MATERIALS AND METHODS
An electronic, English-language PubMed/MEDLINE and Cochrane Central Registry of Controlled Trials database search using the keywords "T-Scan," "TMD," "Occlusion," "Implant Protected Occlusion," and "Orthodontics" was conducted without any date restrictions. The related journal findings were hand searched to determine studies that met the eligibility criteria for inclusion in the present systematic review.
RESULTS
The PubMed/MEDLINE search identified 423 articles. After removing duplicates, the titles and abstracts of the remaining 421 studies were screened. 274 ineligible articles were excluded, leaving 147 articles. Of those, 33 articles were not in English, 27 full-text articles were not available, 4 were comments and letters to editors, 1 was a review, and 2 described techniques. A total of 86 articles met the eligibility criteria for inclusion.
CONCLUSION
Much scientific evidence supports the use of T-Scan, as it measures relative occlusal contact forces and the time sequence durations of occlusal contacts objectively, accurately, and repeatedly for improved treatment outcomes. The system's hardware, sensor, and software evolution from T-Scan I to today's T-Scan 10 Novus system has overcome early sensor and system drawbacks to improve the clinical performance of T-Scan in many disciplines of dental medicine.
Topics: Humans; Dental Occlusion; Bite Force; Software; Dental Care; Orthodontics
PubMed: 36928754
DOI: 10.3290/j.ijcd.b3945153 -
The Journal of Prosthetic Dentistry Sep 2023The complete denture occlusal scheme may influence clinical performance and patient satisfaction. However, a consensus on which occlusal scheme should be used for... (Review)
Review
STATEMENT OF PROBLEM
The complete denture occlusal scheme may influence clinical performance and patient satisfaction. However, a consensus on which occlusal scheme should be used for complete denture users is lacking. As a result, many dentists choose the scheme based on their preferences and clinical experience.
PURPOSE
The purpose of this review was to assess the methodological quality and summarize the scientific evidence from secondary studies about the influence of occlusal schemes on the clinical performance of and patient satisfaction with complete dentures.
MATERIAL AND METHODS
Ten sources were surveyed according to the patient, intervention, comparison, outcome (PICO) strategy. Systematic reviews that evaluated the clinical performance and patient satisfaction (O) of rehabilitated edentulous patients with conventional complete dentures (P) under different occlusal schemes (I/C) were included. Methodological quality was assessed by using A MeaSurement Tool to Assess systematic Reviews (AMSTAR) 2 tool by 2 authors independently. The effect of each occlusal scheme in comparison with others was summarized and classified as positive, neutral, negative, or inconclusive based on the conclusions of the systematic review concerning clinical performance and patient satisfaction outcomes.
RESULTS
The search led to the inclusion of 10 systematic reviews. Seven were classified as of critically low, 2 as low, and 1 as moderate methodological quality. The following occlusal designs were included and analyzed: bilateral balanced occlusion, lingualized occlusion, canine guidance, group function, and monoplane occlusion. Bilateral balanced occlusion and canine guidance obtained satisfactory results for both outcomes. Lingualized occlusion showed a trend toward better results than other occlusal schemes for normal and resorbed ridges. Group function presented mainly inconclusive results, and monoplane occlusion did not deliver satisfactory outcomes.
CONCLUSIONS
The present overview concluded that occlusal schemes might interfere with the clinical performance of and patient satisfaction with complete dentures. Lingualized, bilateral balanced, and canine guidance are preferred compared with monoplane occlusion, but lingualized occlusion tends to show better results in some reviews. However, the results should be carefully considered because of the low quality of the systematic reviews included.
Topics: Humans; Patient Satisfaction; Denture Design; Systematic Reviews as Topic; Denture, Complete; Dental Occlusion; Dental Occlusion, Balanced; Mastication
PubMed: 34991859
DOI: 10.1016/j.prosdent.2021.10.018 -
The Journal of Prosthetic Dentistry Sep 2023Denture adhesives improve the mastication of complete denture wearers. However, the impact of denture adhesives with different presentations on mastication remains... (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
Denture adhesives improve the mastication of complete denture wearers. However, the impact of denture adhesives with different presentations on mastication remains unclear.
PURPOSE
The purpose of this systematic review was to answer the focused question, "Do different presentations of denture adhesives affect the masticatory function of complete denture wearers?".
MATERIAL AND METHODS
This review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Six databases and the non-peer-reviewed literature were searched up to July 2021. Only clinical studies (randomized clinical trials and nonrandomized clinical trials) comparing the use of different denture adhesive presentations (cream, powder, or strips) were included, without language or follow-up restrictions. The risk of bias was assessed by using the Cochrane tools (RoB 2.0 and ROBINS-I). Masticatory performance, by using single and multiple sieves, masticatory performance with color-changing chewing gum (mixing ability), swallowing threshold (particle size and number of cycles), jaw kinematics, and occlusal force were considered. Meta-analyses were conducted to evaluate masticatory performance (single sieve) and occlusal force outcomes (α=.05), and the certainty of the evidence was determined with the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) evaluations.
RESULTS
Nine studies (6 randomized and 3 nonrandomized clinical trials) were included. The risk of bias was considered moderate. Meta-analyses showed no differences between cream and powder denture adhesives for masticatory performance (standard mean difference=0.02; 95% CI=-0.46 to 0.50, P=.93) or between cream and strip denture adhesives for occlusal force (mean difference=14.35; 95% CI=-11.14 to 39.84, P=.27). Similarly, in qualitative analysis, cream and powder denture adhesives' performances were similar regarding masticatory performance with color-changing chewing gum (mixing ability), occlusal force, swallowing threshold (particle size and number of cycles), and jaw kinematics (P>.05). However, for resorbed ridges, cream denture adhesive resulted in a higher masticatory performance than strip (P<.05). When comparing powder to strip denture adhesives, the occlusal force was higher in the powder group (P<.05). The certainty of evidence was very low for all evaluated outcomes.
CONCLUSIONS
Different presentations of denture adhesives seem to improve the masticatory function of complete denture wearers in a similar way. However, the qualitative analysis showed that, in patients with a resorbed ridge, a cream denture adhesive may be better than strips to improve mastication, although the certainty of evidence was very low.
Topics: Humans; Powders; Chewing Gum; Denture, Complete; Bite Force; Mastication; Adhesives
PubMed: 34772484
DOI: 10.1016/j.prosdent.2021.09.026