-
Dental Press Journal of Orthodontics Aug 2018Occlusal side effects or development of pain and/or functional impairment of the temporomandibular complex are potential reasons for poor compliance or abandonment of... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Occlusal side effects or development of pain and/or functional impairment of the temporomandibular complex are potential reasons for poor compliance or abandonment of mandibular advancement splints treatment for snoring and obstructive sleep apnea.
OBJECTIVE
This study aimed at providing a comprehensive review evaluating the craniofacial side effects of oral appliance therapy for snoring and obstructive sleep apnea.
METHODS
An electronic search was systematically conducted in PubMed and Virtual Health Library from their inception until October 2016. Only Randomized Controlled Trials whose primary aim was to measure objectively identified side effects on craniofacial complex of a custom-made oral appliance for treating primary snoring or obstructive sleep apnea were included. Studied patients should be aged 20 or older. The risk of bias in the trials was assessed in accordance with the recommendations of The Cochrane Risk of Bias criteria.
RESULTS
A total of 62 full-text articles were assessed for eligibility. After the review process, only 6 met all the inclusion criteria. All studies were rated as having a high risk of bias. The most uniformly reported mandibular advancement splint side effects were predominantly of dental nature and included a decrease in overjet and overbite. The risk of developing pain and function impairment of the temporomandibular complex appeared limited with long-term mandibular advancement splint use.
CONCLUSION
The limited available evidence suggests that mandibular advancement splint therapy for snoring and obstructive sleep apnea results in changes in craniofacial morphology that are predominantly dental in nature, specially on a long-term basis. Considering the chronic nature of obstructive sleep apnea and that oral appliance use might be a lifelong treatment, a thorough customized follow-up should therefore be undertaken to detect possible side effects on craniofacial complex. It is also important to provide adequate information to the patients regarding these possible changes, especially to those in whom larger occlusal changes are to be expected or in whom they are unfavorable. Long-term assessments of adverse effects of oral appliance therapy, with larger study samples and recruitment of homogenous patient population are still required.
Topics: Adult; Humans; Mandibular Advancement; Periodontal Splints; Sleep Apnea, Obstructive; Snoring
PubMed: 30304153
DOI: 10.1590/2177-6709.23.4.045-054.oar -
Scientific Reports Mar 2018Malocclusion is a common oral disease affecting children with various reported prevalence rates. This meta-analysis aimed to determine the epidemiological... (Meta-Analysis)
Meta-Analysis
Malocclusion is a common oral disease affecting children with various reported prevalence rates. This meta-analysis aimed to determine the epidemiological characteristics of malocclusion among pre-schoolers in mainland China from 1988 to 2017. A total of 31 qualified papers describing 51,100 Chinese children aged 2-7 years were selected. The pooled malocclusion prevalence was 45.50% (95% confidence interval (CI): 38.08-52.81%) with 26.50% Class I (CI: 19.96-33.12%), 7.97% Class II (CI: 6.06-9.87%) and 12.60% Class III (CI: 9.45-15.68%) cases. The most common type of malocclusion was overbite (33.66%, CI: 27.66-39.67%), and the flush terminal type (47.10%, CI: 28.76-65.44%) was the most common in the terminal plane relationship. An increasing trend and wide variations across the country were observed. Additionally, there was no significant difference in malocclusion by gender (relative risk (RR) = 1.01, [0.96-1.06]) or urban/rural area (RR = 0.99, [0.82-1.20]). Although this study represents a narrow view of deciduous-dentition malocclusion in mainland China, the results provide sample evidence that can aid clinicians and policy makers towards early prevention and timely treatment.
Topics: Case-Control Studies; China; Humans; Malocclusion; Prevalence; Tooth, Deciduous
PubMed: 29549346
DOI: 10.1038/s41598-018-22900-x -
Dental and Medical Problems 2019Class III malocclusion is one the most challenging types of orthodontic problems. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Class III malocclusion is one the most challenging types of orthodontic problems.
OBJECTIVES
The aim of this study was to compare the dentoskeletal effects of facemasks and intraoral appliances in treating class III maxillary deficiency in growing patients through a systematic review of the available literature.
MATERIAL AND METHODS
Electronic and manual searches were performed in the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Database of Systematic Reviews (CDSR), MEDLINE (PubMed), Embase (OVID), and Scopus to find all the relevant studies published by January 2018. All randomized controlled trials (RCTs) recruiting 5-12-year-old patients who received maxillary protraction treatment with any type of facemask and comparing the facemasks with any type of intraoral appliance were included. The primary outcome measure was changes in the A point-nasion-B point angle (ANB), and the secondary outcomes included changes in the overjet, upper-1 (U1) inclination, the mandibular plane angle, and treatment time. The meta-analysis was carried out using the inverse variance-weighted random effects model.
RESULTS
Out of 1,629 articles found in the initial search, 5 studies met the inclusion criteria. The meta-analysis showed no differences in the duration of treatment or in any of the cephalometric variables, with the exception of the overjet.
CONCLUSIONS
It seems that intraoral appliances and facemasks are similar in terms of dentoskeletal effects in the treatment of class III malocclusion as well as treatment duration. However, due to a lack of a sufficient number of high-quality studies, these results should be viewed with caution. Further high-quality, long-term studies are recommended.
Topics: Cephalometry; Child; Child, Preschool; Extraoral Traction Appliances; Humans; Malocclusion, Angle Class III; Orthodontics, Corrective; Overbite
PubMed: 31895504
DOI: 10.17219/dmp/110738 -
The Angle Orthodontist Mar 2021To compare the effects of Forsus appliances with and without temporary anchorage devices (TADs) for patients with skeletal Class II malocclusion. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To compare the effects of Forsus appliances with and without temporary anchorage devices (TADs) for patients with skeletal Class II malocclusion.
MATERIALS AND METHODS
Through a predefined search strategy, electronic searching was conducted in PubMed, Embase, Web of Science, CENTRAL, ProQuest Dissertations & Theses, and SIGLE with no language restrictions. Eligible study selection, data extraction, and evaluation of risk of bias (Cochrane Collaboration tool) were conducted by two authors independently and in duplicate. Any disagreement was solved by discussion or judged by a third reviewer. Statistical pooling, sensitivity analysis, subgroup analysis, and assessment of small-study effects were conducted by using Comprehensive Meta-Analysis and Stata 12.0. Heterogeneity was analyzed for different types of study designs, TADs, and radiographic examinations.
RESULTS
Electronic search yielded a total of 256 studies after removing duplicates. Among them, six studies were finally included. All articles were of high quality. The pooled mean differences were -0.27 (95% confidence interval [CI]: -0.59, 0.05) for SNA, 0.58 (95% CI: -0.07, 1.23) for SNB, -0.86 (95% CI: -1.74, -0.03) for ANB, 1.63 (95% CI: 0.46, 2.80) for Co-Po, 0.75 (95% CI: 0.28, 1.23) for SN-MP, -7.56 (95% CI: -11.37, -3.76) for L1-MP, 0.47 (95% CI: -0.98, 1.91) for overjet, 0.39 (95% CI: -0.57, 1.35) for overbite, -1.84 (95% CI: -5.15, 1.47) for SN-OP, and 4.97 (95% CI: -1.22, 11.17) for nasolabial angle.
CONCLUSIONS
TADs (especially miniplates) were able to eliminate dental adverse effects of Forsus appliances for correction of skeletal Class II malocclusion.
Topics: Humans; Malocclusion, Angle Class II; Mandible; Orthodontic Appliances, Functional; Orthodontics, Corrective; Overbite
PubMed: 33378419
DOI: 10.2319/051120-421.1 -
Journal of Orofacial Orthopedics =... May 2018To systematically search the scientific literature concerning the influence of tooth position on wind instrumentalists' performance and embouchure comfort.
PURPOSE
To systematically search the scientific literature concerning the influence of tooth position on wind instrumentalists' performance and embouchure comfort.
METHODS
The PubMed, Cochrane, and Embase databases were searched up to November 2017. The main orthodontic journals were searched for papers older than the inception date of PubMed. Grey literature was sought via Google Scholar. Eligible studies were critically appraised and analysed.
RESULTS
The searches retrieved 54 papers. Only two met the inclusion criteria. Searching the orthodontic journals and Google Scholar resulted in two additional eligible studies. All four studies had a cross-sectional design. The sample sizes ranged from 20-100 participants, varying from children to professional musicians. Because of a large heterogeneity in outcome variables, no meta-analysis could be performed. Descriptive analysis shows that there are indications that tooth irregularities have a negative influence on embouchure comfort and performance of a wind instrument player. A large overjet may impede the embouchure of brass musicians and may have a negative influence on trumpet player performance. A wide jaw form seems more beneficial to trumpet player performance than a small jaw form. Furthermore, players of all types of wind instruments can experience embouchure difficulties from extreme spacing or an open bite.
CONCLUSION
Tooth position can influence musical performance and embouchure comfort of wind instrumentalists. A Class I relationship without malocclusion seems appropriate for every type of wind instrument. The more extreme the malocclusion, the greater the interference with wind instrumentalists' performance and embouchure comfort. Evidence however is limited.
Topics: Diastema; Humans; Jaw; Lip; Malocclusion; Mouth; Music; Tongue; Tooth
PubMed: 29532091
DOI: 10.1007/s00056-018-0128-2 -
Journal of Orthodontics Dec 2019To assess the treatment efficacy/efficiency with prefabricated myofunctional appliances (PMA) for children with malocclusion. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To assess the treatment efficacy/efficiency with prefabricated myofunctional appliances (PMA) for children with malocclusion.
DATA SOURCES
Nine databases searched without limitations till July 2019.
DATA SELECTION
Randomised trials comparing PMAs to functional appliance treatment or no treatment.
DATA EXTRACTION
Study selection, data extraction and risk of bias assessment were done in duplicate.
DATA SYNTHESIS
Random-effects meta-analyses of mean differences (MDs) or relative risks (RRs) with their 95% confidence intervals (CIs) were conducted on seven publications (three published and one unpublished trials; 232 patients; 53% male; mean age 10.2 years). Compared to no treatment, one trial indicated that PMAs were somewhat effective in reducing overjet (MD -2.4; 95% CI -3.3 to -1.5), reducing overbite (MD -2.5; 95% CI -3.2 to -1.8), reducing mandibular crowding (RR 0.4; 95% CI 0.2-0.8) and establishing Class I canine relationship (RR = 2.3; 95% CI 1.1-4.9). However, compared to custom-made functional appliances, three trials indicated that PMAs were less effective in reducing the ANB angle (MD 0.9; 95% CI 0.5-1.4), increasing mandibular ramus length (MD -2.2; 95% CI -2.9 to -1.51), reducing overjet (MD 1.5; 95% CI 0.9-2.1), establishing a solid Class I molar relationship (RR 0.3; 95% CI 0.2-0.7), reducing the nasolabial angle (MD 5.8; 95% CI 0.8-10.8) and reducing facial convexity (MD -2.6; 95% CI -4.3 to -0.9). Finally, the quality of evidence was moderate to low due to risk of bias.
CONCLUSIONS
PMAs are more effective in reducing overjet, overbite, mandibular crowding and establishing Class I canine relationship than no treatment. However, compared to custom-made functional appliances, PMAs are less effective in producing dental, skeletal or soft-tissue changes, even though they are less costly.
Topics: Child; Female; Humans; Male; Malocclusion, Angle Class II; Mandible; Myofunctional Therapy; Orthodontic Appliances, Fixed; Orthodontics, Corrective; Overbite; Randomized Controlled Trials as Topic
PubMed: 31597520
DOI: 10.1177/1465312519880558