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Journal of Clinical Medicine Jun 2023Individuals with amelogenesis imperfecta (AI) often present with malocclusions, especially a dental or skeletal anterior open bite (AOB). (Review)
Review
BACKGROUND
Individuals with amelogenesis imperfecta (AI) often present with malocclusions, especially a dental or skeletal anterior open bite (AOB).
OBJECTIVES
To evaluate the craniofacial characteristics in individuals with AI.
MATERIAL AND METHODS
A systematic literature search was conducted with the PubMed, Web of Science, Embase and Google Scholar databases to identify studies relating to the cephalometric characteristics of individuals with AI, without any language or publication date restrictions. The grey literature was searched using Google Scholar, Opengrey and Worldcat. Only studies with a suitable control group for comparison were included. Data extraction and a risk of bias assessment were carried out. A meta-analysis was performed using the random effects model for cephalometric variables that were evaluated in at least three studies.
RESULTS
The initial literature search yielded 1857 articles. Following the removal of duplicates and a screening of the records, seven articles were included in the qualitative synthesis, representing a total of 242 individuals with AI. Four studies were included in the quantitative synthesis. The meta-analysis results showed that individuals with AI present a smaller SNB angle and larger ANB angle than those of control groups in the sagittal plane. In the vertical plane, those with AI present a smaller overbite and larger intermaxillary angle than those without AI. No statistically significant differences were found for the SNA angle when comparing the two groups.
CONCLUSIONS
Individuals with AI seem to present with more vertical craniofacial growth, leading to an increased intermaxillary angle and decreased overbite. This possibly leads to a more retrognathic mandible with a larger ANB angle due to an anticipated posterior mandibular rotation.
PubMed: 37298021
DOI: 10.3390/jcm12113826 -
Biomimetics (Basel, Switzerland) Mar 2023Deep bite is known as one of the most common malocclusions, and its treatment and retention are often challenging. The use of mini-screws has been suggested as an ideal... (Review)
Review
BACKGROUND
Deep bite is known as one of the most common malocclusions, and its treatment and retention are often challenging. The use of mini-screws has been suggested as an ideal method for the intrusion of incisors in deep-bite patients. Still, there are conflicting reports regarding the superiority of this method compared to other common treatments.
AIM
The aim of this systematic review and meta-analysis was to evaluate the effects of the intrusion of anterior teeth by skeletal anchorage in deep bite patients.
METHODS
From the beginning to 15 September 2022, articles on the topic of interest were searched in electronic databases including PubMed, Web of Science, Scopus, EMBASE, and Cochrane's CENTRAL. Additionally, a hand search for pertinent studies and a search of the grey literature were carried out. After the selection of eligible studies, data extraction was performed using piloted forms. Inverse-variance random-effects meta-analyses were used to combine the outcome measures of dental indices, skeletal cephalometric indices, and dental cephalometric indices.
RESULTS
A total of 15 studies (6 RCT; 9 CCT) were included in the systematic review and 14 were used in the meta-analyses. The differences in overbite changes (MD = -0.45, = 0.04), true incisor intrusion [u1-pp] (MD = -0.62, = 0.003) and molar extrusion [u6-pp] (MD = -0.40, = 0.01) were statistically significant and TADs showed better treatment results than other intrusion methods (segmented intrusion arch, utility arch, J hook headgear). No significant differences regarding overjet, molar and incisor tipping, and skeletal indices between mini-screw and other intrusion methods could be found.
CONCLUSION
The use of mini-screws leads to lower overbite and higher true intrusion (about 0.45 and 0.62 mm, respectively) compared to the use of other methods for intruding upper incisors. Furthermore, the effect of TAD on extrusion of molar teeth is less (by 0.4 mm) than other methods.
PubMed: 36975331
DOI: 10.3390/biomimetics8010101 -
European Journal of Orthodontics May 2023Paediatric obstructive sleep apnoea (OSA) is a sleep breathing disorder which may have dramatic effects on childhood behaviour, neurodevelopment, metabolism, and overall... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Paediatric obstructive sleep apnoea (OSA) is a sleep breathing disorder which may have dramatic effects on childhood behaviour, neurodevelopment, metabolism, and overall health in children. Malocclusion and craniofacial morphology may be related to paediatric OSA, and therefore provide information for clinicians to recognize, evaluate and treat patients with this sleeping disorder.
OBJECTIVE
The aim of this systematic review was to summarize evidence regarding the association between paediatric OSA and children's dental and craniofacial characteristics.
SEARCH METHODS
PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched from inception to 1 June 2022.
SELECTION CRITERIA
Cross-sectional studies, comparing dental or craniofacial characteristics using clinical dental examinations or radiographic findings between OSA children (less than 18 year, diagnosed with overnight polysomnography) and healthy children, were included.
DATA COLLECTION AND ANALYSIS
The Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies was used to assess the quality of included studies. RevMan software was used for performing the Meta-analyses.
RESULTS
Sixteen studies were included. Meta-analyses showed that the overjet (MD = 0.86, 95% CI: 0.20 to 1.51; P = 0.01), the saggital skeletal jaw discrepancy (ANB; MD = 1.78, 95% CI: 1.04 to 2.52; P < 0.00001) and mandibular plane angle (FH-MP; MD = 3.65, 95% CI: 2.45 to 4.85; P < 0.00001) were greater in OSA-affected children. In contrast, the upper molar arch width (upper first deciduous molar width; MD = -1.86, 95% CI: -3.52 to -0.20; P = 0.03), (Upper second deciduous molar width; MD = -1.06, 95% CI: -1.88 to -0.24; P = 0.01), SNB (MD = -2.10, 95% CI: -3.11 to -1.09; P < 0.0001), and maxillary length (ANS-PNS; MD = -1.62, 95% CI: -2.66 to -0.58; P = 0.002) were smaller in the OSA group.
CONCLUSIONS
This review shows that OSA-affected children tend to present with mandibular retroposition or retrognathia, increased mandibular plane angle and excess anterior overjet. However, these findings need to be viewed with caution as the corresponding differences may not be significant clinically.
REGISTRATION
PROSPERO (CRD42020162274).
Topics: Child; Humans; Cross-Sectional Studies; Sleep Apnea, Obstructive; Overbite; Malocclusion; Polysomnography; Retrognathia
PubMed: 36763565
DOI: 10.1093/ejo/cjac074 -
Contemporary Clinical Dentistry 2022The objective of this study was to compare the effect of miniscrew-supported maxillary incisor intrusion and conventional intrusion mechanics on maxillary incisors and... (Review)
Review
Comparing the Effect of Miniscrew-Supported and Conventional Maxillary Incisor Intrusion on the Inclination of Maxillary Incisors and Molars - A Systematic Review and Meta-Analysis.
OBJECTIVE
The objective of this study was to compare the effect of miniscrew-supported maxillary incisor intrusion and conventional intrusion mechanics on maxillary incisors and molar inclination.
MATERIAL AND METHODS
Search databases (PubMed, Scopus, Web of Science, Embase, EBSCOhost, and the Cochrane Library) were searched for randomized trials on intrusion of maxillary incisors via miniscrew-supported and conventional mechanics. The revised Cochrane risk-of-bias tool for randomized trials (RoB 2.0) was used. Five outcomes ([i] inclination change of upper incisors, [ii] inclination change of upper molars, [iii] intrusion of incisors, [iv] vertical change in upper first molars, and [v] overbite correction achieved) were statistically pooled using Review Manager 5.3. Subgroup analysis was conducted to receive sturdiness in meta-analysis. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation.
RESULTS
Out of 1777 studies, 7 were finally subjected to quality assessment, and 6 were included in the meta-analysis. The incisor inclination following maxillary incisor intrusion increased in miniscrew-supported intrusion in comparison to Connecticut intrusion arch (CTA) subgroup with standard mean difference of 0.66 mm (95% confidence interval = 0.16, 1.03, I = 0%). All the included studies showed an increase in molar inclination (distal tipping) in the CTA subgroup compared to the micro-implant group. Of all the seven included studies, only one study was identified with some concerns for the risk of bias, and the other six were judged to have an overall high risk of bias.
CONCLUSION
The incisal proclination during deep-bite correction by miniscrew-supported incisal intrusion is more than that in the CTA subgroup; however, the difference may not be clinically very relevant. There is a very low quality of evidence in favor of miniscrew-supported intrusion as compared to conventional intrusion, necessitating the need for good-quality trials.
PubMed: 36686998
DOI: 10.4103/ccd.ccd_385_22 -
American Journal of Orthodontics and... Mar 2023Bonded spurs, fixed or removable palatal cribs have been used to treat anterior open bite (AOB) in growing children. Different conclusions have been brought out by... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Bonded spurs, fixed or removable palatal cribs have been used to treat anterior open bite (AOB) in growing children. Different conclusions have been brought out by different authors. This meta-analysis aimed to evaluate the effect of bonded spurs, fixed and removable palatal cribs in the early treatment of AOB.
METHODS
A comprehensive electronic search was carried out through PubMed, Embase (via Ovid), MEDLINE (via Ovid), Cochrane Central Register of Controlled Trials, and Web of Science up to May 1, 2022. This meta-analysis was performed in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. The work was carried out by 2 reviewers in duplicate and independently, including electronic searching, data extracting, risk of bias assessment, quality of evidence grading, heterogeneity and statistical power analysis, and eligibility evaluation of the retrieved articles.
RESULTS
Four studies out of 181 articles were recruited in the meta-analysis after applying the inclusion and exclusion criteria. The results showed that bonded lingual spurs and fixed palatal crib or spurs produced similar overbite changes (mean difference, -0.32; 95% confidence interval, -1.06 to 0.43; P = 0.41; I = 27%; meta power = 0.099). Fixed palatal crib and removable palatal crib also exhibited comparable effects in correcting AOB (mean difference, -0.02; 95% confidence interval, -0.90 to 0.86; P = 0.96; I = 0%; meta power = 0.2182). The quality of evidence about these 2 outcomes assessed with GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) was low.
CONCLUSIONS
Bonded lingual spurs, fixed palatal crib or spurs, and removable palatal crib had similar effects in the early treatment of AOB. Because the number of included studies was limited and only the overbite changes before and after treatment were assessed, more clinical randomized controlled studies with longer follow-ups are needed to get more clinically significant advice.
Topics: Child; Humans; Open Bite; Overbite; Malocclusion, Angle Class II; Palate; Infant Equipment
PubMed: 36564317
DOI: 10.1016/j.ajodo.2022.10.017 -
Journal of Clinical Medicine Nov 2022Background: Our study aimed to systematically summarize the dentoskeletal effects of Herbst appliance; Forsus fatigue resistance device; and Class II elastics in... (Review)
Review
Background: Our study aimed to systematically summarize the dentoskeletal effects of Herbst appliance; Forsus fatigue resistance device; and Class II elastics in adolescent Class II malocclusion. Methods: Five databases; unpublished literature; and reference lists were last searched in August 2022. Randomized clinical trials and observational studies of at least 10 Class II growing patients that assessed dentoskeletal effects through cephalometric/CBCT superimpositions were eligible. The included studies quality was assessed with the RoB 2 and ROBINS-I tools. A random-effects model meta-analysis was performed. Heterogeneity was explored with subgroup and sensitivity analyses. Results: Among nine studies (298 patients); two-to-three studies were included in each meta-analysis. Less post-treatment upper incisor retroclination (<2) and no overbite; overjet; SNA; SNB; and lower incisor inclination differences were found between Herbst/Forsus and Class II elastics. No differences in maxilla; condyle; glenoid fossa; and most mandibular changes were found between Herbst and Class II elastics; except for a greater 1.5 mm increase in mandibular length and right mandibular ramus height (1.6 mm) with Herbst. Conclusions: Herbst and Class II elastics corrected the molar relationship; but Herbst moved the lower molars more mesially. Apart from an additional mandibular length increase; no other dental and anteroposterior skeletal difference was found. Forsus was more effective in molar correction; overjet reduction; and upper incisor control than Class II elastics. Trial registration number OSF: 10.17605/OSF.IO/8TK3R.
PubMed: 36498570
DOI: 10.3390/jcm11236995 -
Turkish Journal of Orthodontics Jun 2022The aim of this analysis was to evaluate the maxillary incisor intrusion and change in overbite achieved by micro-implants compared to Connecticut intrusion arches among...
The aim of this analysis was to evaluate the maxillary incisor intrusion and change in overbite achieved by micro-implants compared to Connecticut intrusion arches among post-pubertal patients with deep bite. Medline, PubMed, Cochrane, and Google scholar were searched for studies falling under the inclusion criteria. Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) com- paring maxillary incisor intrusion among post-pubertal deep bite cases treated by mini-implants and Connecticut intrusion arches were to be included. Outcome data were extracted using guidelines published by the Cochrane Collaboration. A systematic review was conducted using Cochrane Program Review Manager, version 5. A random effects model was used to assess the mean difference in the amount of incisor intrusion and overbite correction achieved between the 2 methods. Statistical significance was set at P < .05. Assessment of certainty of evidence was conducted using GRADE analysis. Six trials met the inclusion criteria. Mean differences for incisor intrusion -0.67 [95% CI, 0.97, 0.38] I2 = 31%; P < .00001) and overbite correction -0.51 [95% CI, 0.85, 0.16] I2 = 50%; P = .004) achieved with mini-implants were found to be significantly effective when compared to the Connecticut intrusion arch. Low to mod- erate heterogeneity was noted for incisor intrusion and change in overbite analysis respectively. High certainty of evidence was noted for higher association of mini-implants with incisor intrusion and overbite correction. Our meta-analysis suggests that mini-implants are superior to the Connecticut intrusion arch with respect to the amount of incisor intrusion and overbite correction. Further studies are still needed to confirm the superiority.
PubMed: 35788440
DOI: 10.5152/TurkJOrthod.2022.21080 -
International Journal of Environmental... Jun 2022The purpose of this study was to systematically review the literature regarding the prevalence of malocclusion and different orthodontic features in children and... (Review)
Review
UNLABELLED
The purpose of this study was to systematically review the literature regarding the prevalence of malocclusion and different orthodontic features in children and adolescents.
METHODS
The digital databases PubMed, Cochrane, Embase, Open Grey, and Web of Science were searched from inception to November 2021. Epidemiological studies, randomized controlled trials, clinical trials, and comparative studies involving subjects ≤ 18 years old and focusing on the prevalence of malocclusion and different orthodontic features were selected. Articles written in English, Dutch, French, German, Spanish, and Portuguese were included. Three authors independently assessed the eligibility, extracted the data from, and ascertained the quality of the studies. Since all of the included articles were non-randomized, the MINORS tool was used to score the risk of bias.
RESULTS
The initial electronic database search identified a total of 6775 articles. After the removal of duplicates, 4646 articles were screened using the title and abstract. A total of 415 full-text articles were assessed, and 123 articles were finally included for qualitative analysis. The range of prevalence of Angle Class I, Class II, and Class III malocclusion was very large, with a mean prevalence of 51.9% (SD 20.7), 23.8% (SD 14.6), and 6.5% (SD 6.5), respectively. As for the prevalence of overjet, reversed overjet, overbite, and open bite, no means were calculated due to the large variation in the definitions, measurements, methodologies, and cut-off points among the studies. The prevalence of anterior crossbite, posterior crossbite, and crossbite with functional shift were 7.8% (SD 6.5), 9.0% (SD 7.34), and 12.2% (SD 7.8), respectively. The prevalence of hypodontia and hyperdontia were reported to be 6.8% (SD 4.2) and 1.8% (SD 1.3), respectively. For impacted teeth, ectopic eruption, and transposition, means of 4.9% (SD 3.7), 5.4% (SD 3.8), and 0.5% (SD 0.5) were found, respectively.
CONCLUSIONS
There is an urgent need to clearly define orthodontic features and malocclusion traits as well as to reach consensus on the protocols used to quantify them. The large variety in methodological approaches found in the literature makes the data regarding prevalence of malocclusion unreliable.
Topics: Adolescent; Child; Humans; Malocclusion; Malocclusion, Angle Class II; Orthodontics, Corrective; Overbite; Prevalence
PubMed: 35742703
DOI: 10.3390/ijerph19127446 -
Journal of Orofacial Orthopedics =... Nov 2023This systematic review aimed to assess the effects of orthopedic functional appliances for anterior open bite (AOB) in primary or mixed dentition children. (Review)
Review
PURPOSE
This systematic review aimed to assess the effects of orthopedic functional appliances for anterior open bite (AOB) in primary or mixed dentition children.
METHODS
A search for randomized controlled trials (RCT) was conducted in November 2020 in electronic databases with no data or language restrictions. Primary outcomes were skeletal cephalometric variables and adverse events. We used the Cochrane risk-of-bias tool to assess methodological quality and the GRADE approach to assess the certainty of the evidence.
RESULTS
We identified five RCTs (220 participants). Very low certainty evidence showed an improvement in overbite (mean difference [MD] 3.60; 95% confidence interval [CI] 2.63-4.57) and in the angulation of the upper incisors to the palatal plane (MD 3.70; 95% CI 0.85-6.55) with Frankel's functional regulator, compared to no treatment. There was no difference in the measured cephalometric variables when comparing removable palatal crib to fixed palatal crib, bonded spurs, and chin cup. When comparing removable versus magnetic bite blocks, a beneficial effect was observed in overbite, overjet, skeletal anteroposterior angular measurements, and skeletal vertical linear measures in the magnetic group. No adverse events were reported.
CONCLUSION
There was insufficient evidence to infer the effects of these treatments for AOB, and high-quality RCTs are needed to increase the estimated effects.
PROSPERO REGISTER
CRD42020175634, prospectively registered (05 July 2020).
PubMed: 35438306
DOI: 10.1007/s00056-022-00388-5 -
European Journal of Orthodontics Sep 2022In recent years, digital models have become increasingly popular among orthodontists, both for clinical and scientific purposes. It is, therefore, crucial to... (Meta-Analysis)
Meta-Analysis
Assessment of the reliability of measurements taken on digital orthodontic models obtained from scans of plaster models in laboratory scanners. A systematic review and meta-analysis.
BACKGROUND
In recent years, digital models have become increasingly popular among orthodontists, both for clinical and scientific purposes. It is, therefore, crucial to appropriately investigate their reliability. To this date, however, there has been no scientific, statistical investigation of their reliability as compared to the traditional gold standard-plaster models in the form of a meta-analysis.
OBJECTIVES
To evaluate the reliability and reproducibility of measurements taken on digital orthodontic models obtained from scanning plaster models in laboratory scanners compared to measurements taken directly on plaster models.
SEARCH METHODS
Multiple electronic databases (PubMed, Scopus, Web of Science, Google Scholar and Cochrane Central Register of Controlled Trials) were searched for articles with no year or language limitations.
SELECTION CRITERIA
The included original papers should have dealt with the accuracy and repeatability of the measurements conducted on plaster and digital models derived from laboratory scanners. In order to provide an adequate statistical analysis, the studies should have provided sufficient data, that is the difference of means (MDs) with standard deviations (SDs) for analysed measurements.
DATA COLLECTION AND ANALYSIS
In total, 25 types of non-standardised measurements were found in the evaluated studies. The quantitative analysis included papers that compared at least one of the parameters: upper/lower intermolar width, upper/lower intercanine width, overjet and overbite and provided standard deviation of the mean differences between measurements obtained on plaster and digital models from a laboratory scanner.
RESULTS
GRADE and QUADAS tools were used to assess the quality of evidence, and they revealed substantial heterogeneity. Random-effects meta-analysis revealed no statistically significant differences for analysed measurements. Four of the analysed papers reported differences that may be considered clinically significant.
CONCLUSIONS
No statistical significance between the direct measurements on plaster models and the digital ones taken from laboratory scanners could be identified by means of random-effects meta-analysis.
REGISTRATION
The systematic review was registered in the PROSPERO database (ID CRD42020215411).
Topics: Computer Simulation; Humans; Models, Dental; Overbite; Reproducibility of Results
PubMed: 35363303
DOI: 10.1093/ejo/cjac005