-
Orthodontics & Craniofacial Research Mar 2024To explore the mandibular retromolar space length (MRSL), initial root-inner cortex contact percentage (IRCCP), and the various factors that influence mandibular molar... (Review)
Review
To explore the mandibular retromolar space length (MRSL), initial root-inner cortex contact percentage (IRCCP), and the various factors that influence mandibular molar distalization. Searches were undertaken in PubMed, EMBASE, Web of Science, Cochrane Library, Scopus, and grey literature (Google Scholar and OpenGrey) for eligible cross-sectional observational studies measuring the MRSL and IRCCP in healthy adult patients. The risk of bias and evidence quality were evaluated using the Joanna Briggs Institute's checklist and GRADE framework. Thirteen studies involving 1169 patients were included for qualitative synthesis. Seven of these studies were eligible for quantitative analysis. Meta-analysis showed that the mean MRSL at the subfurcation-6 mm plane in Asian normodivergent cases was 3.78 mm (95% confidence interval [CI]: 2.81-4.35; I = 79.7%) for skeletal Class-I malocclusions, 3.02 mm (95% CI: 2.10-3.94; I = 62.5%) for Class-II, and 4.43 mm (95% CI: 3.14-5.73; I = 75.1%) for Class-III. The mean MRSL at the sub-cementoenamel junction (CEJ)-10 mm plane for Asian, Class-I, normodivergent cases was 3.28 mm (95% CI: 2.44-4.12; I = 68.9%). The mean IRCCP for Asian, Class-I, normodivergent cases was 27.2% (95% CI: 0.22-0.32; I = 0%). In Asian normodivergent cases, MRSL ranges from 3.28 to 4.43 mm with a 27.2% IRCCP for Class-I. Cone-beam computed tomography imaging is recommended for measuring the MRSL in the apex region particularly before molar distalization. Factors influencing MRSL and IRCCP include different races, skeletal patterns, facial types, and third-molar status.
PubMed: 38462853
DOI: 10.1111/ocr.12778 -
Cureus Feb 2024This systematic review aims to determine the role of the growth hormone receptor (GHR) gene in skeletal malocclusion and its significant influence on the growth of the... (Review)
Review
Role of the Growth Hormone Receptor (GHR) Gene in Skeletal Class II Malocclusion and Its Significant Influence on the Skeletal Facial Profile in Both the Sagittal and Vertical Dimensions: A Systematic Review.
This systematic review aims to determine the role of the growth hormone receptor (GHR) gene in skeletal malocclusion and its significant influence on the growth of the maxilla and the mandible in both sagittal and vertical dimensions. A search of the electronic databases of PubMed, Google Scholar, and Cochrane up to and including the year 2023 was made. In addition to this, a hand search of orthodontic and dentofacial orthopaedic journals was carried out. This search included randomized control trials. The Mesh terms used were "skeletal class II malocclusion", "mandibular retrognathism", "sagittal malocclusion", "genetic expression", "genetic factors", "genetic study", "genetic polymorphism", and "single nucleotide polymorphism". The inclusion criteria included studies such as clinical trials and orthopaedic appliances in the presurgical phase. The exclusion criteria for the study were studies not in the English language, case reports, case series, and studies with irrelevant data. It has been cited in various literature that polymorphic variations of the GHR gene could cause variations in mandibular morphogenesis affecting both the mandibular body length and ramal height. However, its effects are quite variable and are based on different population groups. Polymorphism of the GHR gene can be considered a reliable indicator predicting variations in affecting the growth of the mandible with greater significance in affecting the vertical ramal height compared to the body length of the mandible. Its effects on the maxillary skeletal base are rather limited comparatively.
PubMed: 38449954
DOI: 10.7759/cureus.53596 -
The Saudi Dental Journal Feb 2024The objective of this systematic review is to assess the effectiveness of digital orthodontics in utilizing implants for maxillary protraction as a treatment for... (Review)
Review
OBJECTIVE
The objective of this systematic review is to assess the effectiveness of digital orthodontics in utilizing implants for maxillary protraction as a treatment for skeletal class III malocclusion in children.
MATERIALS AND METHODS
The study was registered with PROSPERO with the number CRD42023407406 on 23/03/2023. We conducted an extensive comprehensive literature search in nine electronic databases, including PubMed, PubMed Central, Scopus, Cochrane databases, Google Scholar, MEDLINE, EMBASE, LILACS, and the Web of Sciences databases. The studies were evaluated for their methodology, the intervention technology used, the outcomes, and their quality. Publication bias assessment was conducted using the Jadad scale and the ROBINS-I assessment tool.
RESULTS
We included a total of 17 studies that comprised a total of 376 patients in this analysis. The number of patients and participants fluctuated between 1 and 71, with > 60 % being female. The patients were aged between 1.1 and 19.2 years. We included only nine studies in the -analysis, in which we observed a success rate between 71.4 % and 100 % with a 95 % CI of 17.4 ± 2.988 (±17.2 %) [14.412-20.388]. The failure rates, although minimal, ranged from 5.9 % to 28.6 %, with a 95 % CI of 2.3 ± 1.480 (±64.3 %) [0.820-3.780].
CONCLUSION
The evidence suggests that digital orthodontics is a promising approach for treating children with skeletal class III malocclusion using implants for maxillary protraction. However, further high-quality studies are required for validating our current observations and regulating the stability of treatment outcomes on a long-term basis.
PubMed: 38420003
DOI: 10.1016/j.sdentj.2023.11.013 -
Journal of Cranio-maxillo-facial... Apr 2024This systematic review aimed to investigate the factors that may contribute to the development of OSA after orthognathic surgery in patients with skeletal class III.... (Review)
Review
This systematic review aimed to investigate the factors that may contribute to the development of OSA after orthognathic surgery in patients with skeletal class III. Electronic searches of PubMed, Embase, Web of Science, and Cochrane databases were conducted up to December 10, 2022. In total, 277 studies were retrieved and screened according to the inclusion and exclusion criteria, and 14 were finally selected. All studies were of medium quality (moderate risk of bias). The occurrence of OSA after orthognathic surgery in patients with class III skeletal relationships depends on surgical factors and patient self-factors. Surgical factors include surgery type, amount of maxillary and mandibular movement, and the patient's postoperative swelling. Patient self-factors include weight, age, gender, and hypertrophy of the soft palate, tonsils, and tongue. According to information in the 14 selected articles, the incidences of OSA after Le Fort I impaction and BSSO setback, BSSO setback, and Le Fort I advancement and BSSO setback were 19.2%, 8.57%, and 0.7%, respectively, mostly accompanied with greater amounts of mandibular recession. However, no clear evidence exists to confirm that orthognathic surgery is a causative factor for postoperative sleep breathing disorders in patients with mandibular prognathism. The wider upper airway in patients with class III skeletal might be the reason for the rare occurrence of OSA after surgery. In addition, obesity and advanced age may lead to sleep apnea after orthognathic surgery. Obese patients should be advised to lose weight preoperatively.
Topics: Humans; Orthognathic Surgery; Osteotomy, Le Fort; Sleep Apnea, Obstructive; Malocclusion, Angle Class III; Mandible; Orthognathic Surgical Procedures; Maxilla; Cephalometry
PubMed: 38383249
DOI: 10.1016/j.jcms.2024.02.014 -
International Journal of Clinical... 2023Skeletal class III malocclusion is a challenging condition that orthodontists frequently come across. The facemask (FM) is a device commonly used to treat this...
BACKGROUND
Skeletal class III malocclusion is a challenging condition that orthodontists frequently come across. The facemask (FM) is a device commonly used to treat this malocclusion. However, the stability of this orthopedic correction remains unclear, and collective documentation of the short-, mid-, and long-term stability after FM therapy is necessary.
AIM
The aim of the systematic review was to assess posttreatment stability following FM therapy in patients with skeletal class III malocclusion.
MATERIALS AND METHODS
Through a predefined search strategy, electronic searching was conducted in PubMed, Latin American and Caribbean Health Sciences Literature (LILACS), Cochrane, Ovid, Embase, Scopus, and Web of Science until 30 June 2022. Eligible study selection, data extraction, and evaluation of the risk of bias were performed independently by two review authors according to the Cochrane tool for assessing the risk of bias in randomized trials (RoB 2.0 tool) and the Risk of Bias in Nonrandomized Studies-of Interventions (ROBINS-I) tool for nonrandomized trials. A total of 14 studies were finally considered eligible. The systematic review revealed that the maxillo-mandibular differential reverted to class III. The maxillary changes achieved were variable, with SNA angles ranging between -0.7° and 1.9°. Changes in the mandible were greater with an increase in the SNB angle ranging between 0.33° and 3.62°. The lower anterior facial height increased. The maxillary and mandibular incisors were proclined, and the overjet and overbite decreased. The soft tissue changes were insignificant.
CONCLUSION
The effects of FM therapy were found to be stable in the short-term follow-up period. The long-term follow-up revealed that the effects of FM therapy remained stable for the maxilla. However, the mandible continued to grow in a horizontal and unfavorable direction until the adolescent growth spurt.
CLINICAL SIGNIFICANCE
The major variable that determines the long-term success of FM therapy is the amount and direction of mandibular growth during the adolescent growth spurt. More focus on restricting unfavorable mandibular growth and duration of retention is needed for post-FM therapy.
OTHERS
PROSPERO (CRD42021218960).
HOW TO CITE THIS ARTICLE
Raghupathy Y, Ananthanarayanan V, Kailasam V, Posttreatment Stability Following Facemask Therapy in Patients with Skeletal Class III Malocclusion: A Systematic Review. Int J Clin Pediatr Dent 2023;16(6):897-907.
PubMed: 38344378
DOI: 10.5005/jp-journals-10005-2686 -
Diagnostics (Basel, Switzerland) Jan 2024Obstructive sleep apnea syndrome (OSAS) is a respiratory illness that is associated with recurrent episodes of either partial or full obstruction of the upper airways,... (Review)
Review
Obstructive sleep apnea syndrome (OSAS) is a respiratory illness that is associated with recurrent episodes of either partial or full obstruction of the upper airways, or apnea, among other sleep disorders. This study aims to analyze, through a literature review, whether orthodontic treatment can be a good treatment strategy for this type of disorder. We performed a database search on Scopus, Web of Science, and Pubmed with the keywords OSA(S) and orthodontics to select the papers under evaluation. The criteria for inclusion were articles related to OSA(S) children undergoing an orthodontic treatment and clinical studies or case series, excluding systematic reviews, narrative reviews, meta-analyses, adult studies, animal models, and in vitro studies. The screening phase ended with the selection of 16 publications for this work. RME, or rapid maxillary expansion, turned out to be the preferred orthodontic treatment in cases of pediatric OSAS. The goal of this orthodontic procedure is to increase the hard palate's transverse diameter by reopening the mid-palatal suture. Children with maxillary contraction and dental malocclusion typically undergo such a procedure and have excellent results. However, OSAS is a multifactorial disorder; it does not seem related to the morphology of the oral cavity, and therefore, it is not always possible to cope with this problem exclusively through orthodontic treatment.
PubMed: 38337805
DOI: 10.3390/diagnostics14030289 -
Clinical Oral Investigations Feb 2024To compare dental caries, oral hygiene, periodontal status, bruxism, malocclusion, tooth loss, and salivary alterations between autistic and typical developing... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To compare dental caries, oral hygiene, periodontal status, bruxism, malocclusion, tooth loss, and salivary alterations between autistic and typical developing individuals.
MATERIAL AND METHODS
Observational studies presenting clinical measures of oral outcomes between autism spectrum disorder (ASD) individuals and controls. EMBASE, LILACS, PubMed, PsycINFO, Scopus, Web of Science, Google Scholar, and ProQuest were searched up to June 26, 2023. Pairs of reviewers independently conducted study selection, data extraction, and assessments of methodological quality and certainty of evidence. Meta-analyses of standardized mean differences (SMD) and risk ratio (RR) were performed.
RESULTS
A total of 47 studies comprising 6885 autistic individuals were included in the review. Autistic individuals had significantly higher severity of dental-caries experience in primary teeth (SMD 0.29, 95%CI 0.02, 0.56), of dental plaque presence (SMD 0.59, 95%CI 0.24, 0.94), and of gingivitis (SMD 0.45, 95%CI 0.02, 0.88). Autistic individuals showed higher probability of occurrence of gingivitis (RR 1.34, 95%CI 1.08, 1.66,), bruxism (RR 4.23, 95%CI 2.32, 7.74), overjet (RR 2.16, 95%CI 1.28, 3.64), overbite (RR 1.62, 95%CI 1.02, 2.59), crossbite (RR 1.48, 95%CI 1.02, 2.13), and openbite (RR 2.37, 95%CI 1.46, 3.85), when compared to neurotypical individuals. Most estimates showed a small effect size with very low certainty of evidence.
CONCLUSION
Autistic individuals show worse oral health status than controls.
CLINICAL RELEVANCE
The findings reported herein can help to build health policies to better serve autistic individuals including prevention actions and access to specialized dental care.
Topics: Humans; Dental Caries; Autistic Disorder; Autism Spectrum Disorder; Bruxism; Gingivitis; Malocclusion; Overbite
PubMed: 38321186
DOI: 10.1007/s00784-024-05500-0 -
Heliyon Jan 2024The goal of this systematic review and meta-analysis was to assess whether the dimensions of the frontal air sinus correlate with skeletal malocclusion.
OBJECTIVE
The goal of this systematic review and meta-analysis was to assess whether the dimensions of the frontal air sinus correlate with skeletal malocclusion.
STUDY SELECTION
PubMed, Scopus, Embase, and Google Scholar were searched for relevant studies published up to May 23, 2023. The review included observational and retrospective studies that compared the dimensions of the frontal air sinus between different skeletal malocclusions. The PECOS method was used in this study ("Population, Exposure, Comparator, Outcome, and Study design"). The search was done using the following English keywords: "frontal sinus" OR "lateral cephalometric" OR "malocclusion" AND "surface area".
RESULTS
Seven studies were included, which involved 1101 participants, of whom 403 were class I, 375 were class II, and 323 were class III. These studies had a moderate risk of bias. The surface area of the frontal sinus in class III was significantly larger than in class I (standardized difference in means (SDM) = -0.971; 95 % CI = -1.147- -0.796; P < 0.001) and in class II (SDM = -1.535; 95 % CI = -1.732- -1.337; P < 0.001).
CONCLUSION
Class III malocclusion is associated with a larger surface area of the frontal sinus compared to classes I and II.
PubMed: 38293353
DOI: 10.1016/j.heliyon.2024.e24200 -
Revista Cientifica Odontologica... 2023The purpose of this systematic review was to identify, evaluate, and provide information about palatal bone thickness in different vertical growth patterns for the... (Review)
Review
INTRODUCTION
The purpose of this systematic review was to identify, evaluate, and provide information about palatal bone thickness in different vertical growth patterns for the placement of orthodontic anchorage devices.
METHODS
We performed a systematic review of the published data in Medline via PubMed, Web of Science, Cochrane Library, and Scopus from January 2000 to August 2022 using eligibility criteria. Data collection analysis and data extraction were performed independently by three reviewers. Sensitivity analyses were performed with the Cochrane risk of bias tool and the ROBINS-I tool was used for non-randomized studies.
RESULTS
A total of 343 articles were identified. The inclusion criteria included palatal bone thickness and vertical facial growth. However, both variables were found in 4 studies and only 2 had a control group. The different studies evaluated palatal bone thickness according to sex (male 14.1 mm; female 9.68 mm) and vertical malocclusion (normal 2.2 -12.6 mm; open bite 1.9 -13.2mm) with heterogeneous results. Likewise, the vertical growth pattern with a low angle (9.39 mm) was greater than the normal (8.55 mm) and high angle (7.53 mm).
CONCLUSIONS
Palatal bone thickness varies according tp different vertical growth patterns, with the greatest thickness being found near the incisive foramen in hypodivergent individuals.
PubMed: 38288456
DOI: 10.21142/2523-2754-1102-2023-152 -
BMC Oral Health Jan 2024The Herbst appliance is an excellent therapy for treating class II malocclusions with increased overjet. Its mechanics involve propelling the mandibular bone using two... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The Herbst appliance is an excellent therapy for treating class II malocclusions with increased overjet. Its mechanics involve propelling the mandibular bone using two pistons the patient cannot remove. The so-called bite-jumping keeps the mandible in a more anterior position for a variable period, usually at least 6 months. This appliance does not inhibit joint functions and movements, although there are scientific papers in the literature investigating whether this appliance can lead to temporomandibular disorders. This systematic review aims to evaluate whether Herbst's device can cause temporomandibular diseases by assessing the presence of TMD in patients before and after treatment.
METHODS
A literature search up to 3 May 2023 was carried out on three online databases: PubMed, Scopus and Web of Science. Only studies that evaluated patients with Helkimo scores and Manual functional analysis were considered, as studies that assessed the difference in TMD before and after Herbst therapy. Review Manager version 5.2.8 (Cochrane Collaboration) was used for the pooled analysis. We measured the odds ratio (OR) between the two groups (pre and post-Herbst).
RESULTS
The included papers in this review were 60. Fifty-seven were excluded. In addition, a manual search was performed. After the search phase, four articles were considered in the study, one of which was found through a manual search. The overall effect showed that there was no difference in TMD prevalence between pre-Herbst and post-Herbst therapy (OR 0.74; 95% CI: 0.33-1.68).
CONCLUSION
Herbst appliance seems not to lead to an increase in the incidence of TMD in treated patients; on the contrary, it appears to decrease it. Further studies are needed to assess the possible influence of Herbst on TMDs.
Topics: Humans; Prevalence; Cephalometry; Orthodontic Appliances, Functional; Malocclusion, Angle Class II; Temporomandibular Joint Disorders
PubMed: 38281907
DOI: 10.1186/s12903-023-03738-w