-
Head & Face Medicine Jul 2021Orthodontic retention aims to maintain optimal teeth positions after active treatment. The stability is affected by numerous factors, including patients' individual... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Orthodontic retention aims to maintain optimal teeth positions after active treatment. The stability is affected by numerous factors, including patients' individual features, thus retention should be adjusted in the most optimal way. Bonding a retainer makes retention less dependent on patient's compliance.
QUESTIONS ARISE
What wire or fiber splint type provides the best treatment stability? What materials should be used to bond the wire or fiber splint? Should be the bonding procedure be direct or indirect? The aim of the study is to assess and synthesize available controlled trials investigating failures of fixed retainers.
METHODS
Literature searches of free text and MeSH terms were performed in Scopus, Web of Science, Embase and PubMed Central in order to find studies, referring to failures of fixed retention (12th February 2021). The keywords were: ("orthodontic retainers AND failure AND wire"). The framework of this systematic review according to PICO was: Population: orthodontic patients; Intervention: fixed orthodontic retainer bonding; Comparison: Different protocols of fixed orthodontic retention applied; Outcomes: failure rate, survival rate. Three different specific scales from the Cochrane Collaboration Handbook were used, according to each study type. Additionally, a meta-analysis was conducted to compare the effectiveness of retention using fiber reinforced composite and multistranded steel wire.
RESULTS
The search identified 177 potential articles: 114 from PubMed, 41 from Scopus, 20 from Web of Science and 2 from Embase. After excluding studies inconsistent with selection criteria, 21 studies were included and subjected to qualitative analysis. The main outcome investigated was failure rate. This systematic review has some potential limitations due to the heterogeneity of design between included studies.
CONCLUSIONS
No retainer is proved to guarantee a perfect stability of dental alignment. The retainer should be bonded to all adherent teeth, preferably with additional use of bonding resin. No wire or fiber splint present superior characteristics concerning failure rate. Fiber reinforced composite retention is more sensitive to operator skills, and with imperfect bonding technique, failure rate is much higher. During the first 6 months after bonding retainer the patient should be under frequent control. The study protocol was registered in PROSPERO database with the number CRD42021233406.
Topics: Dental Bonding; Humans; Orthodontic Appliance Design; Orthodontic Retainers; Orthodontic Wires
PubMed: 34301280
DOI: 10.1186/s13005-021-00281-3 -
BMC Oral Health Jul 2022Before the magnetic resonance imaging (MRI) examination fixed orthodontic devices, such as brackets and wires, cause challenges not only for the orthodontist but also...
BACKGROUND
Before the magnetic resonance imaging (MRI) examination fixed orthodontic devices, such as brackets and wires, cause challenges not only for the orthodontist but also for the radiologist. Essentially, the MRI-safe scan of the fixed orthodontic tools requires a proper guideline in clinical practice. Therefore, this systematic review aimed to examine all aspects of MRI-safe scan, including artifact, thermal, and debonding effects, to identify any existing gaps in knowledge in this regard and develop an evidence-based protocol.
METHODS
The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement was used in this study. The clinical question in "PIO" format was: "Does MRI examination influence the temperature of the orthodontic devices, the size of artifacts, and the debonding force in patients who have fixed orthodontic bracket and/or wire?" The search process was carried out in PubMed, PubMed Central, Scopus, and Google Scholar databases. The search resulted in 1310 articles. After selection according to the eligibility criteria, 18 studies were analyzed by two reviewers. The risk of bias was determined using the Quality In Prognosis Studies tool.
RESULTS
Out of the eligible 18 studies, 10 articles examined the heating effect, 6 were about the debonding effect, and 11 measured the size of artifact regarding brackets and wires. Considering the quality assessment, the overall levels of evidence were high and medium. The published studies showed that heating and debonding effects during MRI exposure were not hazardous for patients. As some wires revealed higher temperature changes, it is suggested to remove the wire or insert a spacer between the appliances and the oral mucosa. Based on the material, ceramic and plastic brackets caused no relevant artifact and were MRI-safe. Stainless steel brackets and wires resulted in susceptibility artifacts in the orofacial region and could cause distortion in the frontal lobe, orbits, and pituitary gland. The retainer wires showed no relevant artifact.
CONCLUSIONS
In conclusion, the thermal and debonding effects of the fixed orthodontic brackets and wires were irrelevant or resoluble; however, the size of the artifacts was clinically relevant and determined most significantly the feasibility of fixed brackets and wires in MRI examination.
Topics: Artifacts; Humans; Magnetic Resonance Imaging; Orthodontic Brackets; Orthodontic Wires; Stainless Steel
PubMed: 35854295
DOI: 10.1186/s12903-022-02317-9 -
Journal of Orthodontic Science 2023A variety of metals and alloys are employed in the field of orthodontics, primary of which happen to be the construction of wires. Through this systematic review, we... (Review)
Review
A variety of metals and alloys are employed in the field of orthodontics, primary of which happen to be the construction of wires. Through this systematic review, we aimed to assess the various metallurgical characteristics of the said metals and alloys. Four hundred and eighty-two documents in total were found after a thorough search of the online journals, and 169 of the papers were initially chosen. Ultimately, 16 documents were selected that satisfied the necessary inclusion and exclusion criteria, primarily studies, literature reviews, and comparative analyses. NiTi alloy was found to be the most commonly used alloy in construction of orthodontic wires across all the studies that we had selected for our review. It also had better performance and consistency in terms of its usage as depicted by the meta-analysis performed, with stainless steel wires being a close second primarily due to its lesser cost compared to the former. Metallurgy and orthodontics are inextricably linked with one another. The various components of orthodontics such as wires, pliers, and other instruments utilize the metallurgical characteristics of metals and alloys that are specially prepared for the challenges of this field. CRD42022378444.
PubMed: 37881657
DOI: 10.4103/jos.jos_52_23 -
Journal of Orthodontic Science 2023Infection control is essential to protect both the doctor and the patient by preventing the spread of infectious diseases. There is no exception in the field of... (Review)
Review
Infection control is essential to protect both the doctor and the patient by preventing the spread of infectious diseases. There is no exception in the field of dentistry, particularly in orthodontics, where numerous appliances are used for a variety of functions and also because the mouth cavity has the highest concentration of bacteria of any body part. Through this systematic review, we aimed to assess the various methods of sterilization employed in an orthodontic setting. Using relevant keywords, reference searches, and citation searches, the databases such as PubMed, MEDLINE, Web of Science, Cochrane, and Scopus were all searched; a total of 206 documents were found, of which 113 were initially selected. The remaining 23 distinct papers were initially made available after 90 publications that were identical to or similar to one another were eliminated. The final selection was made from eight documents that met all inclusion and exclusion requirements. The existing methods of sterilization were found to be competent in dealing with the microorganisms found in a typical orthodontic setting. The chemical method of sterilization was the norm in most of the studies that we assessed, with glutaraldehyde and peracetic acid (PAA) being the most commonly employed compounds for disinfection. CRD42022380831.
PubMed: 37881658
DOI: 10.4103/jos.jos_53_23 -
Journal of Orthodontic Science 2022This systematic review was aimed to test the null hypothesis that coating of orthodontic wires with nanoparticles does not affect the frictional properties at... (Review)
Review
This systematic review was aimed to test the null hypothesis that coating of orthodontic wires with nanoparticles does not affect the frictional properties at bracket--wire interface. Electronic database searches were performed up to September 2020. studies were considered for reviewing process. Study selection, data extraction, risk of bias assessment was performed during reviewing process. Only qualitative analyses of included literature were done due to the presence of heterogeneity among the studies. Out of 1,068 retrieved records, nine studies satisfied the inclusion criteria and included in this review. Studies were assessed at low risk to high risk of bias according to certain parameters. Wide variety of nanoparticles were used for surface coating of orthodontic wires of variable sizes, shapes, and materials like stainless steel, NiTi, and TMA and placed into the slots of different types of orthodontic brackets to evaluate the alteration in frictional and other mechanical properties. Most of the studies clearly indicate that coating with nanoparticles decreases the friction between wire and bracket interface under specified conditions. Furthermore, among the nine included studies, only two considered evaluation of effect of coated brackets on frictional and other mechanical properties and results were heterogeneous. The null hypothesis is rejected and it is concluded that the wires coated with nanoparticles might offer a novel opportunity to substantially reduce frictional resistance at bracket--wire interface during tooth movement. Further studies are necessary to strengthen the evidence regarding effect of coated brackets on frictional properties.
PubMed: 35754415
DOI: 10.4103/jos.jos_152_21 -
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 -
The Cochrane Database of Systematic... Apr 2010The initial arch wire is the first arch wire to be inserted into the fixed appliance at the beginning of orthodontic treatment and is used mainly for correcting crowding... (Review)
Review
BACKGROUND
The initial arch wire is the first arch wire to be inserted into the fixed appliance at the beginning of orthodontic treatment and is used mainly for correcting crowding and rotations of teeth. With a number of orthodontic arch wires available for initial tooth alignment, it is important to understand which wire is most efficient, as well as which wires cause the least amount of root resorption and pain during the initial aligning stage of treatment.
OBJECTIVES
To identify and assess the evidence for the effects of initial arch wires for alignment of teeth with fixed orthodontic braces in relation to alignment speed, root resorption and pain intensity.
SEARCH STRATEGY
We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (30th November 2009), CENTRAL (The Cochrane Library 2009, Issue 4), MEDLINE (1950 to 30th November 2009) and EMBASE (1980 to 30th November 2009). Reference lists of articles were also searched. There was no restriction with regard to publication status or language of publication. We contacted all authors of included studies to identify additional studies.
SELECTION CRITERIA
Randomised controlled trials (RCTs) of initial arch wires to align crooked teeth with fixed orthodontic braces were selected. Only studies involving patients with upper and/or lower full arch fixed orthodontic appliances were included.
DATA COLLECTION AND ANALYSIS
Two review authors were responsible for study selection, validity assessment and data extraction. All disagreements were resolved by discussion amongst the review team. Corresponding authors of included studies were contacted to obtain missing information.
MAIN RESULTS
Seven RCTs, with 517 participants, provided data for this review. Among them, five trials investigated the speed of initial tooth alignment comparing: 0.016 inch ion-implanted A-NiTi wire versus 0.016 inch A-NiTi versus 0.0175 multistrand stainless steel wire; 0.016x0.022 inch medium force active M-NiTi wire versus 0.016x0.022 inch graded force active M-NiTi wire versus 0.0155 inch multistrand stainless steel wire; 0.016 inch superelastic NiTi wire versus 0.016 inch NiTi wire; 0.014 inch superelastic NiTi wire versus 0.0155 inch multistrand stainless steel wire; 0.016 inch CuNiTi wire versus 0.016 inch NiTi wire. The other two studies investigated pain intensity experienced by patients during the initial stage of treatment comparing: 0.014 inch superelastic NiTi wire versus 0.014 inch NiTi wire; 0.014 inch superelastic NiTi wire versus 0.015 inch multistrand stainless steel wire. Data analyses were often inappropriate within the included studies.
AUTHORS' CONCLUSIONS
There is some evidence to suggest that there is no difference between the speed of tooth alignment or pain experienced by patients when using one initial aligning arch wire over another. However, in view of the general poor quality of the including trials, these results should be viewed with caution. Further RCTs are required.
Topics: Dental Alloys; Humans; Orthodontic Brackets; Orthodontic Wires; Randomized Controlled Trials as Topic; Root Resorption; Tooth Movement Techniques; Toothache
PubMed: 20393961
DOI: 10.1002/14651858.CD007859.pub2 -
Cureus May 2022The objective of the current review was to evaluate the effectiveness of traditional and accelerated methods of palatally impacted canine's (PIC) traction in terms of... (Review)
Review
The Effectiveness of Conventional and Accelerated Methods of Orthodontic Traction and Alignment of Palatally Impacted Canines in Terms of Treatment Time, Velocity of Tooth Movement, Periodontal, and Patient-Reported Outcomes: A Systematic Review.
The objective of the current review was to evaluate the effectiveness of traditional and accelerated methods of palatally impacted canine's (PIC) traction in terms of treatment duration, velocity, periodontal, and patient-reported variables. An electronic search for randomized controlled trials (RCTs) and controlled clinical trials (CCTs) published between January 1990 and October 2021 was conducted in nine databases. Five major orthodontic journals were hand searched for additional studies. The participants were patients with unilateral or bilateral PICs who received conventional or accelerated orthodontic treatment with fixed appliances. Cochrane's risk of bias tool (RoB 2 tool) for RCTs and ROBINS-I tool for CCTs were used to assess the risk of bias. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) guidelines were used to assess the overall quality of the evidence. Nine articles (eight RCTs and one CCT) were included in this review (371 patients). There was no clarity in most studies about the possible effect of the mechanical traction method on treatment outcomes. The treatment duration decreased (about three to six months) when the open surgical method was used with traditional techniques and the traction velocity increased significantly (about 1-1.5 mm/month) when acceleration methods were used. No significant differences were found between the conventional intervention groups, as well as between the traditional and accelerated groups, in terms of most periodontal variables (p > 0.005). No significant differences were found in the pain levels associated with traditional PICs' traction when comparing different exposure methods in the short-term follow-up (1-10 days), while contradictory results were found in the pain incidence between these methods. The relationship between the pain/discomfort levels and the type of mechanical traction method was not evaluated. According to the GRADE, the quality of evidence supporting these findings ranged from low to very low. The combination of the open surgical technique with various designs of either superelastic wires or elastic traction means can lead to a reduction in the orthodontic treatment duration of PICs. The use of direct anchorage by miniscrews to move the PICs away from the adjacent teeth roots can lead to a reduction in root resorption and shorten the treatment duration. The evidence supporting these findings ranged from low to very low. The use of different types of mechanical means for conventional PICs' traction, with the use of open or closed traction techniques, does not lead to significant differences in periodontal outcomes between intervention groups. Contradictory results exist regarding the severity of the perceived pain in relation to the surgical exposure type, and the relationship between this variable and the mechanical traction method is still unclear. The use of accelerated methods for PICs' traction can lead to an increase in the velocity of traction movement with no significant differences in periodontal outcomes between accelerated and conventional methods. The evidence supporting these findings ranged from low to very low. More high-quality randomized CCTs are needed to establish good evidence in this field. The protocol of this systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42021274476) during the first stages of this review.
PubMed: 35572459
DOI: 10.7759/cureus.24888 -
Cureus Apr 2024Robotics has various applications in dentistry, particularly in orthodontics, although the potential use of these technologies is not yet clear. This review aims to... (Review)
Review
Robotics has various applications in dentistry, particularly in orthodontics, although the potential use of these technologies is not yet clear. This review aims to summarize the application of robotics in orthodontics and clarify its function and scope in clinical practice. Original articles addressing the application of robotics in any area of orthodontic practice were included, and review articles were excluded. PubMed, Google Scholar, Scopus, and DOAJ were searched from June to August 2023. The risk of bias was established using the risk of bias in non-randomized studies (ROBINS) and certainty assessment tools following the grading of recommendations, assessment, development, and evaluation (GRADE) guidelines. A narrative synthesis of the data was generated and presented according to its application in surgical and non-surgical orthodontics. The search retrieved 2,106 articles, of which 16 articles were selected for final data synthesis of research conducted between 2011 and 2023 in Asia, Europe, and North America. The application of robotics in surgical orthodontics helps guide orthognathic surgeries by reducing the margin of error, but it does not replace the work of a clinician. In non-surgical orthodontics, robotics assists in performing customized bending of orthodontic wires and simulating orthodontic movements, but its application is expensive. The articles collected for this synthesis exhibited a low risk of bias and high certainty, and the results indicated that the advantages of the application of robotics in orthodontics outweigh the disadvantages. This project was self-financed, and a previous protocol was registered at the PROSPERO site (registration number: CRD42023463531).
PubMed: 38765377
DOI: 10.7759/cureus.58555