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Orthodontics & Craniofacial Research Feb 2024When treating posterior crossbite, the primary goal is to achieve long-term crossbite correction. The majority of studies however focus on relapse of the increase in the... (Meta-Analysis)
Meta-Analysis Review
When treating posterior crossbite, the primary goal is to achieve long-term crossbite correction. The majority of studies however focus on relapse of the increase in the transverse dimension, but not relapse of the crossbite itself, which is an essential outcome. The aim of the present study was to determine long-term stability (2 years minimum post-treatment) of posterior crossbite correction, treated in mixed or early permanent dentitions of growing children. Following registration in PROSPERO (CRD42022348858), an electronic literature search including PubMed, Embase, Web of Science, the Cochrane Library, and a manual search were conducted up to January 2023, to identify longitudinal studies looking into the long-term stability of crossbite correction in growing children. Data extraction and risk of bias assessment were carried out, and subsequently, a random-effects meta-analyses models were used to calculate estimates for relapse of the crossbite and relapse at the transverse level. Twenty-two studies were included, of varying designs and quality, representing 1076 treated patients, with different expansion appliances and protocols. Meta-analysis results showed that 19.5% (95% CI: 15%; 25%) of patients present with relapse of posterior crossbite at long-term follow-up. At the transverse level, 19.3% of the total expansion (including overexpansion) relapsed (95% CI: 13%; 27%) regardless of whether there a was relapse of the crossbite itself. Data from existing studies, with a moderate level of evidence, indicate that the long-term stability of posterior crossbite correction in growing children is unfavourable in roughly 1 in 5 growing children, with crossbite relapse long-term. On average, 19% of the maxillary expansion performed (including overexpansion) relapses long-term, which may occur in cases with or without relapse of the crossbite.
Topics: Child; Humans; Dentition, Permanent; Malocclusion; Palatal Expansion Technique; Recurrence; Dentition, Mixed
PubMed: 38169092
DOI: 10.1111/ocr.12690 -
Turkish Journal of Orthodontics Dec 2023We aimed to evaluate the effectiveness of functional mandibular advancer (FMA) in treating growing patients with Class II malocclusion.
OBJECTIVE
We aimed to evaluate the effectiveness of functional mandibular advancer (FMA) in treating growing patients with Class II malocclusion.
METHODS
Electronic searches were conducted in MEDLINE (via PubMed), Cochrane Library, Web of Science, Scopus, Embase, and Lilacs from 1945 to 30 November 2021. Studies were selected based on the following inclusion criteria: human studies, Class II growing patient treated with FMA, untreated control group or a comparable group treated with another fixed functional appliance, pre- and post-treatment lateral cephalograms/magnetic resonance imaging/cone-beam computed tomography, randomized clinical trials, prospective studies, and retrospective studies. Data extraction of the included articles was independently performed independently by two authors. The risk of bias was assessed using the ROBINS-I tool. Meta-analysis was performed using the inverse generic model.
RESULTS
Seven articles met the criteria and were included in the systematic review and three articles were included in the meta-analysis. Three studies had at low risk of bias and four studies had a moderate risk of bias. All articles reported anterior positioning of the mandible along with an increase in mandibular length. The meta-analysis results indicated a negligible difference between FMA and other functional appliances for the parameters SNA [0.11, 95% confidence interval (CI) of -1.07 and 1.29] and ANB (-1.00, 95% CI of -1.34 and -0.65). The evidence was limited for soft tissue changes.
CONCLUSION
Class II correction with FMA involved a combination of skeletal and dentoalveolar changes and was similar to other fixed functional appliances.
PubMed: 38164015
DOI: 10.4274/TurkJOrthod.2022.2022.110 -
Bioengineering (Basel, Switzerland) Dec 2023The current review aims to evaluate the scientific evidence relating to the effectiveness of treatment with clear aligners (CAs) in controlling distalization orthodontic... (Review)
Review
The current review aims to evaluate the scientific evidence relating to the effectiveness of treatment with clear aligners (CAs) in controlling distalization orthodontic tooth movement. "Orthodontics, aligners" and "distalization" were the search terms used on the Scopus, Web of Science and Pubmed databases with the Boolean operator "AND". The results of the last ten years of research were 146 studies; of these, 19 publications were included for this review. The distalization movement is possible with invisible masks alone, but the risk of losing anchorage in the anterior sectors is very probable. The stability of the results and the reduction of unwanted effects can be guaranteed by the use of skeletal anchoring devices and interproximal enamel reduction (IPR), with which compensations are obtained to reduce the initial overjet. Temporary anchorage devices (TADs) can be used to manage posterior anchorage after distalization of maxillary molars with aligners. This hybrid approach has demonstrated the greatest orthodontic success. TADs are useful aids to provide direct and indirect skeletal anchorage. The opposite effect must be considered when planning dental distalization, especially of the molars, in patients with large overjet, and corrective measures or the use of auxiliaries may be necessary to prevent midcourse corrections. This systematic review provides a critical evidence-based assessment of the predictability of dental distalization with CAs, an ever-evolving orthodontic technique.
PubMed: 38135981
DOI: 10.3390/bioengineering10121390 -
Cureus Nov 2023The primary goal of orthodontic therapy in pseudo-class III is to restore the proper dental connection by rectifying the canine and molar relationship to Class I through... (Review)
Review
The primary goal of orthodontic therapy in pseudo-class III is to restore the proper dental connection by rectifying the canine and molar relationship to Class I through lower molar and premolar visualization, as well as providing normal anterior overjet. The purpose of this systematic study was to determine the efficacy of clear aligners in treating class III malocclusion with mandibular molar distalization. A wide range of searches were done on various search engines like Cochrane, Web of Science, Embase, PubMed, Scopus, and Google Scholar to collect relevant articles related to our study. This review's article selection was guided by the PRISMA flowchart. The electronic findings provided numerous articles with nearly 78 articles regarding clear aligners in class III malocclusion with molar distalization. From this, seven full-text papers were evaluated for eligibility criteria, with two articles being rejected with justification and five articles being elaborated in the current systematic review. The current evidence of this review suggested that the clear aligners were effective in correcting class III malocclusion with molar distalization. The amount of molar distalization is about 2 to 3 mm, which helps in achieving molar and canine relationship in class I, with a high compliance level and also improvement of the facial profile.
PubMed: 38046776
DOI: 10.7759/cureus.48134 -
European Journal of Paediatric Dentistry Dec 2023The correlation between malocclusions in deciduous dentition and type of breastfeeding has been described by many authors in numerous articles. The aim of this article...
AIM
The correlation between malocclusions in deciduous dentition and type of breastfeeding has been described by many authors in numerous articles. The aim of this article is to investigate the literature about this important topic.
MATERIALS
The research was conducted by querying the following databases: PubMed, EBMR, Cochrane Library, Web of Sciences, Medline, Web of Sciences, Ovid and Embase. The key words were: "infant" OR "baby", AND "breastfeeding" AND "malocclusion". As with similar literature review papers, the PRISMA-P (Preferred Reporting Items for Systematic Reviews Protocols) was used. The examined articles were of the following types: randomised controlled trials (RCTs), case-control studies and cohort studies. For the qualitative analysis of the selected studies, it was employed the NOS scale (Newcastle-Ottawa Quality Assessment Scale).
CONCLUSION
Two hundred and fifty articles were selected. After filtering out the articles deemed irrelevant or with obvious bias, only 16 articles were left. From our results, it can be concluded that breastfeeding seems to play a decisive role in preventing the onset of posterior cross-bites and Class II malocclusions, and that this protective effect appears to be time-dependent.
Topics: Female; Humans; Breast Feeding; Malocclusion; Protective Factors
PubMed: 38015113
DOI: 10.23804/ejpd.2023.2015 -
Progress in Orthodontics Nov 2023To systematically assess the efficacy of the various interventions used to intrude maxillary molars. Furthermore, to evaluate associated root resorption, stability of... (Review)
Review
AIMS
To systematically assess the efficacy of the various interventions used to intrude maxillary molars. Furthermore, to evaluate associated root resorption, stability of intrusion, subsequent vertical movement of mandibular molars, cost effectiveness, compliance, patient reported outcomes and adverse events.
METHODS
A pre-registered and comprehensive literature search of published and unpublished trials until March 22nd 2023 with no language restriction applied in PubMed/Medline, Embase, Scopus, DOSS, CENTRAL, CINAHL Plus with Full Text, Web of Science, Global Index Medicus, Dissertation and Theses Global, ClinicalTrials.gov, and Trip (PROSPERO: CRD42022310562). Randomized controlled trials involving a comparative assessment of treatment modalities used to intrude maxillary molars were included. Pre-piloted data extraction forms were used. The Cochrane Risk of Bias tool was used for risk of bias assessment, and The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used for certainty of evidence appraisal.
RESULTS
A total of 3986 records were identified through the electronic data search, of which 24 reports were sought for retrieval. Of these, 7 trials were included. One trial was judged at high risk of bias, while the others had some concerns. Based on individual small sample studies, maxillary molar intrusion was achieved using temporary anchorage devices (TADs) and rapid molar intruder appliance (RMI). It was also observed to a lesser extent with the use of open bite bionator (OBB) and posterior bite blocks. The molar intruder appliance and the posterior bite blocks (spring-loaded or magnetic) also intruded the lower molars. Root resorption was reported in two studies involving TADs. None of the identified studies involved a comparison of conventional and TAD-based treatments for intrusion of molars. No studies reported outcomes concerning stability, cost-effectiveness, compliance and patient-reported outcomes. Insufficient homogeneity between the included trials precluded quantitative synthesis. The level of evidence was very low.
CONCLUSIONS
Maxillary molar intrusion can be attained with different appliances (removable and fixed) and with the use of temporary anchorage devices. Posterior bite blocks (spring-loaded or magnetic) and the RMI offer the additional advantage of intruding the mandibular molars. However, stability of the achieved maxillary molar intrusion long term is unclear. Further high-quality randomized controlled trials are needed.
Topics: Humans; Maxilla; Root Resorption; Tooth Movement Techniques; Orthodontic Anchorage Procedures; Malocclusion; Open Bite; Molar
PubMed: 37953383
DOI: 10.1186/s40510-023-00490-3 -
Cureus Oct 2023Malocclusion may affect interpersonal relationships, self-esteem (SE), and psychological well-being, weakening patients' psychological and social activities. Several... (Review)
Review
Malocclusion may affect interpersonal relationships, self-esteem (SE), and psychological well-being, weakening patients' psychological and social activities. Several studies investigated the effect of orthodontic treatment on these social and psychological aspects, such as SE. However, the direct relationship between SE and orthodontic treatment has not yet been confirmed. This systematic review aimed to evaluate the existing evidence in the literature concerning the influences of orthodontic treatment on patients' SE systematically and critically. An electronic search in the following databases was done in September 2022: PubMed®, Web of Science™, Scopus®, Embase®, GoogleTM Scholar, Cochrane Library databases, Trip, and OpenGrey. Then, the reference list of each candidate study was checked for any potentially linked papers that the electronic search might not have turned up. Inclusion criteria were set according to the population/intervention/comparison/outcome/study design (PICOS) framework. For the data collection and analysis, two reviewers extracted data separately. The risk of bias 2 (RoB-2) and the risk of bias in non-randomized studies (ROBINS-I) tools were used to assess the risk of bias for randomized controlled trials (RCTs) and non-RCTs, respectively. The grading of recommendations assessment, development and evaluation (GRADE) approach was employed to evaluate the quality of the evidence for each finding. Sixteen studies (five RCTs, seven cohorts, and four cross-sectional) were included in this review. Unfortunately, the results could not be pooled into a meta-analysis. Only six studies have reported an increase in SE after orthodontic treatment (P<0.05 in these studies). No agreement between the included studies was observed regarding the influence of fixed orthodontic treatment, gender, or age on SE. The quality of evidence supporting these findings ranged from very low to low. There is low evidence indicating that fixed orthodontic treatment can improve patients' SE. In addition, unclear data are available about the influence of patients' gender and age on SE after orthodontic treatment. Therefore, high-quality RCTs are required to develop stronger evidence about this issue.
PubMed: 37920628
DOI: 10.7759/cureus.48064 -
Journal of Personalized Medicine Oct 2023Intraoral orthodontic elastics (IOE), typically referred to as rubber bands, are important tools for correcting malocclusion, and they are classified into latex and... (Review)
Review
Evaluation of the Loss of Strength, Resistance, and Elasticity in the Different Types of Intraoral Orthodontic Elastics (IOE): A Systematic Review of the Literature of In Vitro Studies.
BACKGROUND
Intraoral orthodontic elastics (IOE), typically referred to as rubber bands, are important tools for correcting malocclusion, and they are classified into latex and synthetic (elastomeric-based) elastics. They have different strengths and sizes, depending on their intended use, that provide clinicians with the ability to correct both anteroposterior and vertical discrepancies. Clinical use, together with saliva, alters the physical characteristics of both latex and synthetic elastics, causing declines in strength over time.
AIM
The aim of the study was to assess, through a systematic review of in vitro studies, the properties of intraoral elastics. The primary goal was to evaluate how IOEs behave in terms of tension strength and duration. The secondary goal was to investigate the force loss during the first hours of wear. The tertiary goal was to assess how these forces decayed.
MATERIALS AND METHODS
The following electronic databases were searched from December 2020 to April 2021: Medline Full Text, PubMed, Cochrane Clinical Trials Register, Science Direct, and Literature Review. Out of 8505 initial articles, 10 were selected for the systematic review.
RESULTS
The force-degradation property was found in all types of IOEs. The loss of strength was directly proportional to time, with the highest value during the first 3 h after extension, regardless of the elastic band size and manufacturer. The forces generated by the latex bands were higher than in those of the elastomeric-based elastics, but they did not consistently correspond to the loads specified by the manufacturers. The retention forces in the latex IOEs were significantly higher than those in the nonlatex bands, suggesting that elastomeric-based bands need to be changed more frequently and at regular intervals throughout a 24 h period.
CONCLUSION
This systematic review indicates that intraoral orthodontic elastics have the greatest loss of force during the first 3 h, that latex rubber bands have the highest strength during the first hour, that the forces generated are not always consistent with the manufacturer's specifications, and that nonlatex (elastomeric-based) IOEs need to be changed frequently and regularly during a 24-h cycle.
PubMed: 37888106
DOI: 10.3390/jpm13101495 -
Journal of Orthodontic Science 2023The aim of this systematic review and meta-analysis was to comprehensively analyze the existing information on the prevalence of the need for orthodontic treatment in... (Review)
Review
Prevalence of orthodontic treatment needs in permanent dentition in the population of Gulf Cooperation Council countries: A systematic review and meta-analysis of observational studies.
The aim of this systematic review and meta-analysis was to comprehensively analyze the existing information on the prevalence of the need for orthodontic treatment in the permanent dentition stage among populations in Gulf Cooperation Council (GCC) countries. For observational studies in GCC countries, the key terms were electronically searched in Science Direct, PubMed, Embase, Cochrane Reviews, Google Scholar, and Sage databases (1990-2021). The bias risk for the selected studies was evaluated using the modified Strengthening the Reporting of Observational Studies in Epidemiology statement. Thirteen studies reported on the prevalence of orthodontic treatment needs among 33,134 children in GCC countries in permanent dentition with an age range of 11-19 years satisfied the inclusion criteria. Out of the 13 studies, 9 reported on the prevalence of malocclusion, 11 reported on the prevalence of occlusal traits, and 12 reported on the prevalence of orthodontic treatment needs as per the Dental Health Component (DHC) of Index of Orthodontic Treatment Need (IOTN), 4 reported as per both DHC and Aesthetic Component (AC) of IOTN, and 1 reported as per only AC of IOTN. Meta-analysis of the included studies indicated that the pooled malocclusion prevalence rate was 10.60% (confidence interval [CI] 95%: 0.093-0.076) with 8.58% Class I (CI 95%: 0.074-0.188), 2.09% Class II (CI 95%: 0.014-0.058), and 0.93% Class III (CI 95%: 0.005-0.018) malocclusions. The most prevalent type of occlusal trait was spacing (13.10%, CI 95%: 0.018-0.169), followed by crowding (4.96%, CI 95%: 0.017-0.091). The pooled prevalence of borderline and definite needs for orthodontic treatment based on DHC and AC of IOTN was 0.82% (CI 95%: 0.014-0.035), 1.13% (CI 95%: 0.011-0.091), 4.08% (CI 95%: 0.009-0.114), and 2.06% (CI 95%: 0.002-0.048), respectively. The findings were heterogeneous ( < 0.05). These findings indicated that the prevalence of malocclusion and orthodontic treatment needs was not high in the GCC population.
PubMed: 37881672
DOI: 10.4103/jos.jos_126_22 -
The Angle Orthodontist Jan 2024To evaluate the effectiveness of distalizing maxillary first molars (U6) by temporary anchorage devices (TADs) according to their location (palatal, buccal, and... (Meta-Analysis)
Meta-Analysis
Effectiveness of miniscrew-supported maxillary molar distalization according to temporary anchorage device features and appliance design: systematic review and meta-analysis.
OBJECTIVES
To evaluate the effectiveness of distalizing maxillary first molars (U6) by temporary anchorage devices (TADs) according to their location (palatal, buccal, and zygomatic), their number, and appliance design.
MATERIALS AND METHODS
An electronic search of maxillary molar distalization with TADs was done through April 2023. After study selection, data extraction, and risk-of-bias assessment, meta-analyses were performed for the extent of distalization, distal tipping, and vertical movement of U6 using the generic inverse variance and random-effects model. The significance level was set at 0.05.
RESULTS
Forty studies met the inclusion criteria: 4 randomized controlled trials (RCTs), 13 prospective studies, and 23 retrospective studies (total of 1182 patients). Distalization of the U6 was not significantly greater (P = .64) by palatal (3.74 mm) and zygomatic (3.68 mm) than by buccal (3.23 mm) TADs. Distal tipping was significantly higher (P < .001) in nonrigid (9.84°) than in rigid (1.97°) appliances. Vertical movement was mostly intrusive and higher but not significantly different (P = .28) in zygomatic anchorage (-1.16 mm).
CONCLUSIONS
Distalization of U6 with TADs can be an effective and stable treatment procedure, especially when performed with rigid palatal appliances. However, further RCTs or prospective cohort studies are strongly recommended to provide more clinical evidence.
Topics: Humans; Malocclusion, Angle Class II; Orthodontic Appliances; Maxilla; Tooth Movement Techniques; Orthodontic Anchorage Procedures; Orthodontic Appliance Design; Molar; Cephalometry
PubMed: 37870251
DOI: 10.2319/052223-364.1