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European Journal of Medical Research Nov 2023The objective of this systematic review and meta-analysis was to evaluate the effect of chewing gum on orthodontic pain and to determine the rate of bracket breakage... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The objective of this systematic review and meta-analysis was to evaluate the effect of chewing gum on orthodontic pain and to determine the rate of bracket breakage associated with fixed orthodontic appliances.
METHODS
This review and its reporting were performed according to the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA guidelines. Six electronic databases were searched up to March 16, 2023, to identify relevant studies that met the inclusion and exclusion criteria. Furthermore, grey literature resources were searched. The Cochrane Collaboration Risk of Bias tool 2 was used to assess the quality of the included studies. Meta-analysis was conducted using RevMan, and sensitivity analysis and publication bias analysis were performed using STATA software. GRADE tool was used to evaluate the certainty of evidence.
RESULTS
Fifteen studies with 2116 participants were ultimately included in this review, and 14 studies were included in the meta-analysis. Compared with the blank group, chewing gum had a significant pain relieving effect at all times after fixation of the initial archwire (P ≤ 0.05). No significant difference was found between the chewing gum group and the analgesics group at any timepoints (P > 0.05). Only four studies evaluated the rate of bracket breakage and revealed that chewing gum did not increase the rate of bracket breakage. The sensitivity analysis showed that there was no significant difference in the pooled outcomes after the included studies were removed one at times, and Egger analysis revealed no significant publication bias in included studies (P > 0.05).
CONCLUSIONS
Chewing gum is a non-invasive, low-cost and convenient method that has a significant effect on relieving orthodontic pain and has no effect on the rate of bracket breakage. Therefore, chewing gum can be recommended as a suitable substitute for analgesics to reduce orthodontic pain.
Topics: Humans; Chewing Gum; Pain; Analgesics; Orthodontic Brackets; Pain Measurement
PubMed: 37936237
DOI: 10.1186/s40001-023-01467-y -
Journal of Functional Biomaterials Oct 2023Graphene-based materials have great prospects for application in dentistry and medicine due to their unique properties and biocompatibility with tissues. The literature... (Review)
Review
BACKGROUND
Graphene-based materials have great prospects for application in dentistry and medicine due to their unique properties and biocompatibility with tissues. The literature on the use of graphene oxide in orthodontic treatment was reviewed.
METHODS
This systematic review followed the PRISMA protocol and was conducted by searching the following databases: PubMed, Scopus, Web of Science, and Cochrane. The following search criteria were used to review the data on the topic under study: (Graphene oxide) AND (orthodontic) ALL FIELDS. For the Scopus database, results were narrowed to titles, authors, and keywords. A basic search structure was adopted for each database. Initially, a total of 74 articles were found in the considered databases. Twelve articles met the inclusion criteria and were included in the review.
RESULTS
Nine studies demonstrated the antibacterial properties of graphene oxide, which can reduce the demineralization of enamel during orthodontic treatment. Seven studies showed that it is biocompatible with oral tissues. Three studies presented that graphene oxide can reduce friction in the arch-bracket system. Two studies showed that it can improve the mechanical properties of orthodontic adhesives by reducing ARI (Adhesive Remnant Index). Three studies demonstrated that the use of graphene oxide in the appropriate concentration can also increase the SBS (shear bond strength) parameter. One research study showed that it can increase corrosion resistance. One research study suggested that it can be used to accelerate orthodontic tooth movement.
CONCLUSION
The studies included in the systematic review showed that graphene oxide has numerous applications in orthodontic treatment due to its properties.
PubMed: 37888164
DOI: 10.3390/jfb14100500 -
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 -
BMC Oral Health Oct 2023Nowadays bleaching procedures have gained popularity in orthodontic patients. Peroxide and Carbamide acids are the common agents which are used in in-office and at home...
BACKGROUND
Nowadays bleaching procedures have gained popularity in orthodontic patients. Peroxide and Carbamide acids are the common agents which are used in in-office and at home bleaching techniques. Consequently, the Bonding adhesion to the enamel can be influenced by the orthodontic phase and the residual peroxide might interfere with the polymerization and the adhesion of the brackets. Frequent debonding of the brackets from teeth after the bleaching procedure could cause the lengthening of the therapy and promote irregularities on enamel surface derived from an additional bonding phase of the brackets. The aim of this systematic review is to appraise the influence regarding the effect of the bleaching procedure on the bond strength of orthodontic brackets.
METHODS
An electronic database search was performed. Search terms included: bleaching, brackets, adhesion; data were extracted and summarized. Risk of bias was assessed using the Chocrane risk of bias tool, adapted for in vitro studies.
RESULTS
A total of 8689 articles were screened and 11 studies met the inclusion criteria of this systematic review. 1000 teeth of human and bovine origin were analyzed for the shear bond strength (SBS) of stainless and ceramic brackets after the bleaching treatments. All the authors divided the groups in different subgroups with different bleaching agents and in different concentration. The SBS value allowed to demonstrate the necessity to delay the bonding of the brackets for two weeks after a bleaching treatment and its improvement when tooth mousse or antioxidants agents are used.
CONCLUSIONS
The SBS values and the delay of the bonding procedure must be considered in dental practice and clinical strategies are necessary in order to avoid drawbacks which could cause the debonding of the brackets after bleaching due to the alterations of the dental substrate, thus interfering with the orthodontic treatments.
Topics: Humans; Animals; Cattle; Tooth Bleaching; Orthodontic Brackets; Dental Bonding; Peroxides; Urea; Shear Strength; Dental Stress Analysis; Materials Testing
PubMed: 37833672
DOI: 10.1186/s12903-023-03418-9 -
Turkish Journal of Orthodontics Sep 2023This systematic review aimed to assess salivary flow and pH changes at various stages of orthodontic treatment with fixed appliances. A comprehensive searches in...
This systematic review aimed to assess salivary flow and pH changes at various stages of orthodontic treatment with fixed appliances. A comprehensive searches in electronic databases, including Medline, ResearchGate, Web of Science, SAGE Journals, Cochrane Oral Health Group's Trials Register, and ScienceDirect, without any publication date restrictions until January 2022 was conducted. The Pre-ferred Reporting Items for Reporting Systematic Reviews and Meta Analyses (PRISMA 2020 version) protocol was adopted and the risk of bias assessments were performed using the Cochrane ROBINS-I tool for non-randomized studies. Out of 4902 articles, 25 were fully evaluated, and seven studies that met the inclusion criteria were included in the review. The results showed that orthodontic treatment with fixed orthodontic appliances increased the stimulated salivary flow rate during various stages of treatment. However, the unstimulated salivary flow rate showed different changes. Furthermore, stimulated salivary pH increased, whereas unstimulated salivary pH significantly decreased, depending on the specific period of orthodontic treatment. Overall, fixed orthodontic appliances have an impact on salivary flow rate and pH during different stages of treatment. Nevertheless, the current literature is insufficient to draw definitive conclusions. More well-designedrandomized studies with larger sample sizes are necessary to confirm these findings.
PubMed: 37782023
DOI: 10.4274/TurkJOrthod.2022.2022.66 -
European Review For Medical and... Sep 2023Some of the most significant aspects in orthodontics for achieving favorable treatment outcomes include correct bracket positioning and a shorter period to accomplish...
OBJECTIVE
Some of the most significant aspects in orthodontics for achieving favorable treatment outcomes include correct bracket positioning and a shorter period to accomplish bracket bonding. Two different brackets bonding techniques - direct and indirect bonding - are described in the literature. The aim of this review is to evaluate the differences, advantages, and disadvantages of the two techniques.
MATERIALS AND METHODS
A literature search was conducted on PubMed, Scopus, and Web of Science databases in a period from January 2013 to April 2023 with English language restriction using the following Boolean keywords: "orthodontic bracket* AND (bonding OR placement)".
RESULTS
A total of 3,820 articles were identified by the electronic search, and after duplicate removal, screening, and eligibility, a total of 11 papers were included for the qualitative analysis.
CONCLUSIONS
Indirect bonding is more predictable and precise than direct bonding. Indirect bonding has a greater impact on minimizing bracket placement errors than direct bonding, but it still takes longer to complete than the traditional procedure. However, further studies on the differences between direct and indirect bonding, as well as digital bonding, are needed.
Topics: Humans; Dental Care; Databases, Factual; Object Attachment
PubMed: 37750633
DOI: 10.26355/eurrev_202309_33565 -
Dental Press Journal of Orthodontics 2023With the advent of COVID-19, teledentistry and remote monitoring have become an imminent reality that allows orthodontists to monitor orthodontic treatment through... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
With the advent of COVID-19, teledentistry and remote monitoring have become an imminent reality that allows orthodontists to monitor orthodontic treatment through virtual checkups, which complement in-office appointments.
OBJECTIVE
To evaluate the effectiveness of using teledentistry in monitoring the evolution of orthodontic treatment.
MATERIAL AND METHODS
Searches were performed in on-line databases. PECO strategy focused on comparing orthodontic patients exposed and not exposed to teledentistry. Searches and data extraction followed PRISMA guidelines. The assessment of the risk of bias and the certainty of the evidence was performed using the ROBINS-I and GRADE tools, respectively. A meta-analysis was also performed.
RESULTS
Out of 1,178 records found, 4 met the criteria and were included in the qualitative analysis. The risk of bias for follow-up assesment in aligner treatment was low to moderate; while for interceptive treatment, it was high. Studies are favorable to the use of teledentistry. The meta-analysis was performed with aligners studies only, due to heterogeneity. The certainty of the evidence was considered very low.
CONCLUSION
With very low certainty of evidence, teledentistry using Dental Monitoring® software is effective as an aid in monitoring the evolution of interceptive orthodontic treatment (high risk of bias) and, especially, treatment performed with aligners (low to moderate risk of bias). The meta-analysis evidenced a reduction in the number of face-to-face appointments (mean difference = -2.75[-3.95, -1.55]; I2=41%; p<0.00001) and the time for starting refinement (mean difference = -1.21[-2.35, -0.08]; I2=49%; p=0.04). Additional randomized studies evaluating corrective orthodontic treatment with brackets and wires are welcome.
Topics: Humans; COVID-19; Databases, Factual; Orthodontics, Corrective; Orthodontists; Software
PubMed: 37729285
DOI: 10.1590/2177-6709.28.4.e2322195.oar -
Journal of Oral Biology and... 2023The objective of this review is to systematically analyze the available literature on the effects of titanium oxide (TiO₂) coating on the antimicrobial properties,... (Review)
Review
Effects of titanium oxide coating on the antimicrobial properties, surface characteristics, and cytotoxicity of orthodontic brackets - A systematic review and meta analysis of in-vitro studies.
OBJECTIVE
The objective of this review is to systematically analyze the available literature on the effects of titanium oxide (TiO₂) coating on the antimicrobial properties, surface characteristics, and cytotoxicity of orthodontic brackets.
METHODS
In-vitro studies reporting on the effects of Titanium oxide (TiO₂) coatings on antimicrobial properties, surface roughness, cytotoxic activity and bacterial adhesion of orthodontic brackets were included in the review. Electronic databases such as PubMed, SCOPUS, Web of Science and Google Scholar, were searched till September 2022. Risk of Bias was analyzed by using RoBDEMAT tool. Meta-analysis using Random Effects Model was performed for assessing the antimicrobial activity against and
RESULTS
A total of 11 studies were included the RoB analysis revealed sufficient reporting across all the domains and inconsistent reporting in only two of the domains. On qualitative analysis, a significant antimicrobial effect of TiO2 coating on orthodontic brackets against and was reported. The meta analysis revealed a significant overall antimicrobial effect with a high heterogeneity. (SMD: 3.5; p < 0.00001; i2 - 99.2%).
CONCLUSION
An overall significant antimicrobial effect of TiO₂ coated brackets against was noted but with a high heterogeneity. The subgroup analysis revealed a significant antimicrobial effect on with a low heterogeneity but it was limited by a publication bias. The included studies reported reduced surface roughness, minimal bacterial adhesion and less cytotoxic activity with TiO₂ coated brackets than uncoated brackets.
PubMed: 37409325
DOI: 10.1016/j.jobcr.2023.05.014 -
BMC Oral Health Jul 2023Development of white spot lesions (WSLs) is common among orthodontic patients. Several measures have been introduced to prevent and remineralize the lesions. Casein... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Development of white spot lesions (WSLs) is common among orthodontic patients. Several measures have been introduced to prevent and remineralize the lesions. Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) is used for both prevention and remineralization. The effect of its application before bonding is controversial. This systematic review was conducted to investigate the most up to date available literature regarding the effect of CPP-ACP enamel pre-treatment on shear bond strength (SBS) of metallic orthodontic brackets.
METHODS
A search was conducted in electronic databases (MEDLINE (via PubMed), Scopus, Cochrane Library, Web of Science and Google scholar (grey literature)) up to March 29, 2023. The inclusion criteria included in vitro studies comparing the SBS of metal orthodontic brackets following pre-treatment of enamel using CPP-ACP versus control. The exclusion criteria included study types other than in vitro studies, studies conducted on non-human enamel, or studies using CPP-ACP in combination with another intervention. The included studies were analysed by two reviewers, independently. The risk of bias assessment was done using a modified risk of bias tool. A Meta-analysis was performed. I values and Q-test were used for assessment of heterogeneity. Results were displayed in forest plots with a random-effects model. Standardized mean difference, standard error (SE) and 95% confidence intervals were calculated for all studies.
RESULTS
The search resulted in 76 articles. After duplicate removal and assessment for eligibility, 15 studies were included in the review. High statistical heterogeneity was found among the included studies using I values and Q-Test (I = 95.147%; Q = 288.456; df = 14; P < 0.001). The overall effect of CPP-ACP pre-treatment on the SBS of metal orthodontic brackets was not significant (Mean difference = 1.163 MPa, SE = 0.757, 95% CI = -0.321, 2.648, p value = 0.125). The use of CPP-ACP for prevention of WSLs did not significantly affect the SBS of brackets (Standardized mean difference = 1.009, SE = 0.884, 95% CI = -0.723, 2.740, p value = 0.254). No significant change was found when CPP-ACP was used for remineralization of WSLs (Standardized mean difference = 1.501, SE = 1.087, 95% CI = -0.630, 3.632, p value = 0.167).
CONCLUSIONS
Within the limitations of the study, the evidence suggests that the use of CPP-ACP for either prevention or remineralization of WSLs before bonding does not affect the SBS of metal orthodontic brackets.
Topics: Humans; Caseins; Research Design; Databases, Factual; Dental Enamel
PubMed: 37393280
DOI: 10.1186/s12903-023-03103-x -
The Cochrane Database of Systematic... May 2023Without a phase of retention after successful orthodontic treatment, teeth tend to 'relapse', that is, to return to their initial position. Retention is achieved by... (Review)
Review
BACKGROUND
Without a phase of retention after successful orthodontic treatment, teeth tend to 'relapse', that is, to return to their initial position. Retention is achieved by fitting fixed or removable retainers to provide stability to the teeth while avoiding damage to teeth and gums. Removable retainers can be worn full- or part-time. Retainers vary in shape, material, and the way they are made. Adjunctive procedures are sometimes used to try to improve retention, for example, reshaping teeth where they contact ('interproximal reduction'), or cutting fibres around teeth ('percision'). This review is an update of one originally published in 2004 and last updated in 2016.
OBJECTIVES
To evaluate the effects of different retainers and retention strategies used to stabilise tooth position after orthodontic braces.
SEARCH METHODS
An information specialist searched Cochrane Oral Health Trials Register, CENTRAL, MEDLINE, Embase and OpenGrey up to 27 April 2022 and used additional search methods to identify published, unpublished and ongoing studies. SELECTION CRITERIA: Randomised controlled trials (RCTs) involving children and adults who had retainers fitted or adjunctive procedures undertaken to prevent relapse following orthodontic treatment with braces. We excluded studies with aligners.
DATA COLLECTION AND ANALYSIS
Two review authors independently screened eligible studies, assessed risk of bias and extracted data. Outcomes were stability or relapse of tooth position, retainer failure (i.e. broken, detached, worn out, ill-fitting or lost), adverse effects on teeth and gums (i.e. plaque, gingival and bleeding indices), and participant satisfaction. We calculated mean differences (MD) for continuous data, risk ratios (RR) or risk differences (RD) for dichotomous data, and hazard ratios (HR) for survival data, all with 95% confidence intervals (CI). We conducted meta-analyses when similar studies reported outcomes at the same time point; otherwise results were reported as mean ranges. We prioritised reporting of Little's Irregularity Index (crookedness of anterior teeth) to measure relapse, judging the minimum important difference to be 1 mm.
MAIN RESULTS
We included 47 studies, with 4377 participants. The studies evaluated: removable versus fixed retainers (8 studies); different types of fixed retainers (22 studies) or bonding materials (3 studies); and different types of removable retainers (16 studies). Four studies evaluated more than one comparison. We judged 28 studies to have high risk of bias, 11 to have low risk, and eight studies as unclear. We focused on 12-month follow-up. The evidence is low or very low certainty. Most comparisons and outcomes were evaluated in only one study at high risk of bias, and most studies measured outcomes after less than a year. Removable versus fixed retainers Removable (part-time) versus fixed One study reported that participants wearing clear plastic retainers part-time in the lower arch had more relapse than participants with multistrand fixed retainers, but the amount was not clinically significant (Little's Irregularity Index (LII) MD 0.92 mm, 95% CI 0.23 to 1.61; 56 participants). Removable retainers were more likely to cause discomfort (RR 12.22; 95% CI 1.69 to 88.52; 57 participants), but were associated with less retainer failure (RR 0.44, 95% CI 0.20 to 0.98; 57 participants) and better periodontal health (Gingival Index (GI) MD -0.34, 95% CI -0.66 to -0.02; 59 participants). Removable (full-time) versus fixed One study reported that removable clear plastic retainers worn full-time in the lower arch did not provide any clinically significant benefit for tooth stability over fixed retainers (LII MD 0.60 mm, 95% CI 0.17 to 1.03; 84 participants). Participants with clear plastic retainers had better periodontal health (gingival bleeding RR 0.53, 95% CI 0.31 to 0.88; 84 participants), but higher risk of retainer failure (RR 3.42, 95% CI 1.38 to 8.47; 77 participants). The study found no difference between retainers for caries. Different types of fixed retainers Computer-aided design/computer-aided manufacturing (CAD/CAM) nitinol versus conventional/analogue multistrand One study reported that CAD/CAM nitinol fixed retainers were better for tooth stability, but the difference was not clinically significant (LII MD -0.46 mm, 95% CI -0.72 to -0.21; 66 participants). There was no evidence of a difference between retainers for periodontal health (GI MD 0.00, 95% CI -0.16 to 0.16; 2 studies, 107 participants), or retainer survival (RR 1.29, 95% CI 0.67 to 2.49; 1 study, 41 participants). Fibre-reinforced composite versus conventional multistrand/spiral wire One study reported that fibre-reinforced composite fixed retainers provided better stability than multistrand retainers, but this was not of a clinically significant amount (LII MD -0.70 mm, 95% CI -1.17 to -0.23; 52 participants). The fibre-reinforced retainers had better patient satisfaction with aesthetics (MD 1.49 cm on a visual analogue scale, 95% CI 0.76 to 2.22; 1 study, 32 participants), and similar retainer survival rates (RR 1.01, 95% CI 0.84 to 1.21; 7 studies; 1337 participants) at 12 months. However, failures occurred earlier (MD -1.48 months, 95% CI -1.88 to -1.08; 2 studies, 103 participants; 24-month follow-up) and more gingival inflammation at six months, though bleeding on probing (BoP) was similar (GI MD 0.59, 95% CI 0.13 to 1.05; BoP MD 0.33, 95% CI -0.13 to 0.79; 1 study, 40 participants). Different types of removable retainers Clear plastic versus Hawley When worn in the lower arch for six months full-time and six months part-time, clear plastic provided similar stability to Hawley retainers (LII MD 0.01 mm, 95% CI -0.65 to 0.67; 1 study, 30 participants). Hawley retainers had lower risk of failure (RR 0.60, 95% CI 0.43 to 0.83; 1 study, 111 participants), but were less comfortable at six months (VAS MD -1.86 cm, 95% CI -2.19 to -1.53; 1 study, 86 participants). Part-time versus full-time wear of Hawley There was no evidence of a difference in stability between part-time and full-time use of Hawley retainers (MD 0.20 mm, 95% CI -0.28 to 0.68; 1 study, 52 participants).
AUTHORS' CONCLUSIONS
The evidence is low to very low certainty, so we cannot draw firm conclusions about any one approach to retention over another. More high-quality studies are needed that measure tooth stability over at least two years, and measure how long retainers last, patient satisfaction and negative side effects from wearing retainers, such as tooth decay and gum disease.
Topics: Adult; Child; Humans; Orthodontic Brackets; Dental Care; Gingivitis; Periodontal Diseases; Drug-Related Side Effects and Adverse Reactions
PubMed: 37219527
DOI: 10.1002/14651858.CD002283.pub5