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European Journal of Orthodontics Jan 2024Cervical headgear (cHG) has been shown to be effective in Class II correction both with dental and orthopaedic effects but has traditionally been associated with... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Cervical headgear (cHG) has been shown to be effective in Class II correction both with dental and orthopaedic effects but has traditionally been associated with vertical adverse effects in terms of posterior mandibular rotation.
OBJECTIVE
To assess the treatment effects of cHG treatment in the vertical dimension.
SEARCH METHODS
Unrestricted literature search of five databases up to May 2023.
SELECTION CRITERIA
Randomized/non-randomized clinical studies comparing cHG to untreated controls, high-pull headgear (hp-HG), cHG adjuncts, or other Class II treatment alternatives (functional appliances or distalisers).
DATA COLLECTION AND ANALYSIS
After duplicate study selection, data extraction, and risk-of-bias assessment according to Cochrane, random-effects meta-analyses of mean differences (MD)/standardized mean diffences (SMD) and their 95% confidence intervals (CIs) were performed, followed by meta-regressions, sensitivity analyses, and assessment of certainty on existed evidence.
RESULTS
Two randomized/16 non-randomized studies (12 retrospective/4 prospective) involving 1094 patients (mean age 10.9 years and 46% male) were included. Compared to natural growth, cHG treatment was not associated on average with increases in mandibular (eight studies; SMD 0.22; 95% CI -0.06, 0.49; P = 0.11) or maxillary plane angle (seven studies; SMD 0.81; 95% CI -0.34, 1.95; P=0.14). Observed changes translate to MDs of 0.48° (95% CI -0.13, 1.07°) and 1.22° (95% CI -0.51, 2.94°) in the SN-ML and SN-NL angles, respectively. No significant differences were seen in y-axis, facial axis angle, or posterior face height (P > 0.05). Similarly, no significant differences were found between cHG treatment and (i) addition of a lower utility arch, (ii) hp-HG treatment, and (iii) removable functional appliance treatment (P > 0.05 for all). Meta-regressions of patient age, sex, or duration and sensitivity analyses showed relative robustness, while our confidence in these estimates was low to very low due to the risk of bias, inconsistency, and imprecision.
CONCLUSIONS
cHG on average is not consistently associated with posterior rotation of the jaws or a consistent increase in vertical facial dimensions among Class II patients.
REGISTRATION
PROSPERO registration (CRD42022374603).
Topics: Humans; Male; Child; Female; Retrospective Studies; Prospective Studies; Orthodontics, Corrective; Malocclusion, Angle Class II; Maxilla; Extraoral Traction Appliances; Cephalometry
PubMed: 37866376
DOI: 10.1093/ejo/cjad053 -
The Angle Orthodontist Jan 2024To assess the scientific evidence related to the role of the mandibular third molars on the late crowding of the lower anterior teeth in patients with or without... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To assess the scientific evidence related to the role of the mandibular third molars on the late crowding of the lower anterior teeth in patients with or without previous orthodontic treatment. The secondary outcomes included changes in mandibular arch width and arch length.
MATERIALS AND METHODS
The databases PubMed, Scopus, ProQuest, and Google Scholar were searched from inception until April 2022. The included papers were studies evaluating the role of mandibular third molars on crowding of mandibular anterior teeth in patients of any age and gender, with mandibular third molars impacted or semi-impacted or erupted. Predetermined and prepiloted data collection forms were used to record the necessary information.
RESULTS
Thirteen observational studies were included in the present systematic review. Most of them were assigned an overall risk of bias of moderate risk while the rest of them were at high risk. Four studies found an association between the presence of mandibular third molar and mandibular incisor crowding. Finally, seven studies were included in the quantitative analysis. Three different meta-analyses were conducted: for patients (a) with or (b) without previous orthodontic treatment and (c) in combination for patients with and without previous orthodontic treatment. According to the pooled results of all three meta-analyses, random effects model yielded a significant benefit for those without third molars compared to those with third molars regarding crowding, mean Little's irregularity index and mean arch length.
CONCLUSIONS
Lower third molars may contribute to mandibular crowding and lower arch constriction. Further prospective research of high quality is needed to clarify the impact of third molars on anterior mandibular crowding.
Topics: Humans; Molar, Third; Malocclusion; Tooth, Impacted; Incisor; Mandible
PubMed: 37848193
DOI: 10.2319/032323-205.1 -
Cureus Sep 2023The aim of this study was to evaluate the efficacy and efficiency of orthodontic treatment using clear aligner therapy (CAT). This efficiency was measured using the Peer... (Review)
Review
The aim of this study was to evaluate the efficacy and efficiency of orthodontic treatment using clear aligner therapy (CAT). This efficiency was measured using the Peer Assessment Rating (PAR) index, the American Board of Orthodontics (ABO) index, or the similarity between the final ClinCheck and the final scanned models. A search was done electronically between 1998 and 2021 using the Cochrane Library, PubMed, and Google Scholar databases. Three reviewers individually rated the articles. The ROBINS tool and the Cochrane risk of bias tool were used to evaluate the quality of observational research and randomized controlled trials, respectively. The degree of certainty for each selected outcome was evaluated using the grading of recommendations assessment, development, and evaluation (GRADE) approach.Six studies with a total of 166 participants were considered after the full texts of 61 potential reports were reviewed. This research included in the review covered the period from 1998 to 2021 in retrospect. According to the current systematic review and meta-analysis, transparent aligners had a successful outcome. In mild to moderate cases, aligner treatment appears to have a significant advantage in terms of efficiency (treatment time); nonetheless, insufficient evidence of efficacy was observed based on multiple cross-sectional investigations. When compared to traditional brackets, clear aligners provided a more stable course of treatment.
PubMed: 37842499
DOI: 10.7759/cureus.45072 -
European Journal of Orthodontics Nov 2023The genetic basis of dentoalveolar characteristics has been investigated by several studies, however, the findings are equivocal. The objective of this systematic review... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND OBJECTIVE
The genetic basis of dentoalveolar characteristics has been investigated by several studies, however, the findings are equivocal. The objective of this systematic review and meta-analysis was to evaluate the heritability of dental arches and occlusal parameters in different stages of human dentition.
SEARCH METHODS
Electronic databases PubMed, Embase, Scopus, Web of Science, and Dentistry and Oral Science Source were searched up to August 2023 without the restriction of language or publication date.
SELECTION CRITERIA
Empirical studies investigating the heritability of dentoalveolar parameters among twins and siblings were included in the review.
DATA COLLECTION AND ANALYSIS
Study selection, data extraction, and risk of bias assessment were performed independently and in duplicate by two authors and a third author resolved conflicts if needed. Joanna Briggs Institute's critical appraisal tool was used to evaluate the risk of bias among studies and the certainty of evidence was assessed using the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) criteria.
RESULTS
Twenty-eight studies were included in the systematic review, of which 15 studies reporting heritability coefficients in the permanent dentition stages were deemed suitable for the meta-analysis. Random-effects meta-analyses showed high heritability estimates for maxillary intermolar width (0.52), maxillary intercanine width (0.54), mandibular intermolar width (0.55), mandibular intercanine width (0.55), maxillary arch length (0.76), mandibular arch length (0.57), and palatal depth (0.56). The heritability estimates for the occlusal parameters varied considerably, with relatively moderate values for crossbite (0.46) and overbite (0.44) and low values for buccal segment relationship (0.32), overjet (0.22), and rotation and displacement of teeth (0.16). However, the certainty of evidence for most of the outcomes was low according to the GRADE criteria.
CONCLUSIONS
Based on the available evidence, it can be concluded that the dental arch dimensions have a high heritability while the occlusal parameters demonstrate a moderate to low heritability.
REGISTRATION
PROSPERO (CRD42022358442).
Topics: Humans; Dental Arch; Malocclusion; Overbite; Malocclusion, Angle Class II; Dentition, Permanent
PubMed: 37822010
DOI: 10.1093/ejo/cjad061 -
Brazilian Oral Research 2023The aim of this review was to evaluate the prevalence of dental caries, periodontal disease, malocclusion, and tooth wear in indigenous in Brazil. A systematic review of... (Meta-Analysis)
Meta-Analysis
The aim of this review was to evaluate the prevalence of dental caries, periodontal disease, malocclusion, and tooth wear in indigenous in Brazil. A systematic review of observational studies was performed according to the PRISMA guidelines (CRD42020218704). The search strategy involved the electronic databases of Embase, LILACS, PubMed, Web of Science, Scopus, and the CAPES Theses and Dissertations for gray literature. The eligibility criteria consisted of publications that assessed the prevalence of oral conditions in indigenous populations in Brazil. Studies with indigenous people living in urban area were excluded. The risk of bias was evaluated by using JBI Critical Appraisal for prevalence studies. Thirty studies were included in the review, and the majority showed a low risk of bias. A meta-analysis of 20 studies was conducted using the random-effects model and a 95% confidence interval. Several ethnicities were studied in isolation or in groups (n = 7,627 for dental caries; n = 2,774 for periodontal disease; n = 1,067 for malocclusion; n = 150 for tooth wear). The prevalence of caries ranged from 50% among indigenous people aged 18-36 months to 100% among those aged 65-74 years. The prevalence of periodontal disease ranged from 58% to 83%. The prevalence of malocclusion was 43%. Tooth wear was assessed in only one ethnic group and showed a prevalence of 100% in indigenous people aged >18 years. The certainty of evidence assessed by the GRADE system ranged from very low to moderate. This systematic review showed significant differences in the prevalence of dental caries, periodontal disease and malocclusion between indigenous population groups and territories in which indigenous people live.
Topics: Humans; Dental Caries; Brazil; Prevalence; Periodontal Diseases; Tooth Wear; Malocclusion; Indigenous Peoples
PubMed: 37820252
DOI: 10.1590/1807-3107bor-2023.vol37.0094 -
EFORT Open Reviews Oct 2023The objective of this systematic review was to assess a possible relationship between stomatognathic alterations and idiopathic scoliosis (IS).
PURPOSE
The objective of this systematic review was to assess a possible relationship between stomatognathic alterations and idiopathic scoliosis (IS).
DESIGN
This study is a systematic review with meta-analysis of observational studies.
METHODS
The protocol of this systematic review with meta-analysis was registered in PROSPERO (CRD42022370593). A bibliographic search was carried out in the Pubmed (MEDLINE), Scopus, Web of Science and CINAHL databases using the MeSH terms 'Scoliosis' and 'Stomatognathic Disease'. The odds ratio (OR) of prevalence and standardized mean difference (SMD) were used to synthesize the results.
RESULTS
Of 1592 studies located, 14 studies were selected with 3018 subjects (age: 13.9 years). IS was related to Angle's class II (OR = 2.052, 95% CI = 1.236-3.406) and crossbite (OR = 2.234, 95% CI = 1.639-3.045). Patients with malocclusion showed a higher prevalence of IS than controls (OR = 4.633, 95% CI = 1.467-14.628), and subjects with IS showed high overjet (SMD = 0.405, 95% CI = 0.149-0.661) and greater dysfunction due to temporomandibular disorders (SMD = 1.153, 95% CI = 0.780-1.527).
CONCLUSION
Compared with healthy controls, subjects with IS have twice the risk of suffering from occlusion disorders, present greater temporomandibular dysfunction and have a greater overjet in the incisors. Moreover, subjects with malocclusion have an IS prevalence up to four times higher. The systematic orofacial examination of patients with IS should be recommended.
PubMed: 37787475
DOI: 10.1530/EOR-23-0094 -
Turkish Journal of Orthodontics Sep 2023This systematic review was intended to evaluate the maxillary sinus dimensions in vertical and sagittal craniofacial patterns and to assess if there was a difference...
This systematic review was intended to evaluate the maxillary sinus dimensions in vertical and sagittal craniofacial patterns and to assess if there was a difference among the craniofacial patterns. A systematic search was performed in seven databases till February 2021. The risk of bias was performed with modified Newcastle Ottawa scale. Meta-analysis was performed using random effects model. Twelve studies were included in the review and 8 in the meta-analysis. Compared to Class I malocclusion, the maxillary sinus area is greater in Class II and lesser in Class III malocclusion. On comparing normo-divergent growth pattern, the maxillary sinus area is lesser in hypo-divergent and greater in hyper-divergent individuals. Most of the studies were graded as satisfactory. The measurements are greater in hyper-divergent Class II malocclusion and in males.
PubMed: 37782024
DOI: 10.4274/TurkJOrthod.2022.2022.4 -
Bioengineering (Basel, Switzerland) Sep 2023This review aimed to analyze the relapse in orthognathic surgery. (Review)
Review
BACKGROUND
This review aimed to analyze the relapse in orthognathic surgery.
METHODS
PubMed, Scopus, and Web of Science databases were used to find papers that matched our topic dating from 1 January 2012 up to November 2022. Inclusion criteria were (1) human studies, (2) open access studies, (3) studies concerning the correlation between orthognathic surgery and relapse. Exclusion criteria were: (1) in vitro or animal studies, (2) off-topic studies, (3) reviews, (4) other languages than English.
RESULTS
A total of 482 results were obtained resulting in 323 publications after duplicate removal (158). After screening and eligibility phases 247 records were excluded: 47 reviews, 5 in animals, 35 in vitro, 180 off-topic. The authors successfully retrieved the remaining 78 papers and evaluated their eligibility. A total of 14 studies from these were ultimately included in the review.
CONCLUSION
Using cephalometric examinations and digital study models, these studies reveal that the relapse after orthognathic surgery is an event that occurs in most of the cases. The limitation of our research is that most of the studies are retrospective and use small sample sizes. A future research goal should be to conduct long-term clinical trials with larger numbers of samples.
PubMed: 37760172
DOI: 10.3390/bioengineering10091071 -
The Journal of Clinical Pediatric... Sep 2023The aim of this systematic review was to explore the prevalence of temporomandibular disorders (TMD) in patients affected by congenital craniofacial disorders (CCD). Out...
The aim of this systematic review was to explore the prevalence of temporomandibular disorders (TMD) in patients affected by congenital craniofacial disorders (CCD). Out of 292 papers, 9 studies were included with 561 participants. The included studies analyzed at least 15 patients treated for temporomandibular disorders, evaluating at least one clinical outcomes such as orofacial pain and/or muscular diseases, malocclusion, skeletal abnormality and/or deformities concerning temporomandibular joint, upper/lower jaw bone malformations. These findings provide an evidence of an association between temporomandibular disorders and congenital craniofacial disorders. The evidence is supported by the findings of a small number of papers in the literature, some of which were of just fair quality. To be definitive in this regard, additional research with a sizable sample size and control group are required.
Topics: Child; Humans; Temporomandibular Joint Disorders; Temporomandibular Joint; Facial Pain; Malocclusion; Mandible
PubMed: 37732431
DOI: 10.22514/jocpd.2023.049 -
Clinical Oral Investigations Oct 2023To provide a critical overview of the effect of various orthodontic and/or dentofacial orthopedic interventions on three-dimensional volumetric changes in the upper... (Review)
Review
OBJECTIVE
To provide a critical overview of the effect of various orthodontic and/or dentofacial orthopedic interventions on three-dimensional volumetric changes in the upper airway.
MATERIALS AND METHODS
Four databases were searched for clinical studies concerning 3D volumetric assessments based on CBCT before and after orthodontics interventions. The quality of the studies was assessed using the quality assessment tool of the National Heart, Lung and Blood Institute. After the use of inclusion and exclusion criteria, the pre-and post-treatment volumes were used to visualize the effect of various orthodontics interventions.
RESULTS
A total of 48 studies were included in this review and none of which were RCTs. The quality of all included studies was assessed as medium. Overall, there is a tendency for an increase in airway volumes after various orthodontic interventions, except for studies concerning extraction therapy with fixed appliances in adults, in which both increases and decreases in airway volumes have been reported.
CONCLUSION
Orthodontic treatment by growth modification and non-extraction therapy with fixed appliances, regardless of the malocclusion, generally showed positive effects on the airway volume. Orthodontic treatment in combination with extractions does not provide an unambiguous insight. A consensus on the methodology of the airway measurement and nomenclature is urgently needed in order to gain insight into the effect of different interventions on three-dimensional airway changes.
CLINICAL RELEVANCE
Various orthodontic treatments do not negatively influence the upper airway volume. However, extraction therapy in adults should be chosen with caution, especially in subjects belonging to a group susceptible to airway obstruction.
Topics: Adult; Humans; Spiral Cone-Beam Computed Tomography; Malocclusion
PubMed: 37723313
DOI: 10.1007/s00784-023-05207-8