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Children (Basel, Switzerland) Jul 2022In the literature, many studies and articles are investigating new devices and approaches to achieve rapid palate expansion through the opening of the palatal suture,... (Review)
Review
In the literature, many studies and articles are investigating new devices and approaches to achieve rapid palate expansion through the opening of the palatal suture, and evaluating the skeletal, dental, and soft tissue effects. The purpose of this review was to assess how palatal expansion is performed in adolescent patients with permanent dentition. Furthermore, it was reported as an example of successful orthodontic treatment of an 11-year-old female patient affected by maxillary skeletal transverse deficiency, in permanent dentition. A search of the literature was conducted on PubMed, Cochrane, Scopus, Embase, and Web of Science databases. Inclusion criteria were the year of publication between 2017 and 2022, patients aged 10 to 16 years in permanent dentition, with transversal discrepancy, treated with tooth-borne, bone-borne, hybrid palatal expanders. A total of 619 articles were identified by the electronic search, and finally, a total of 16 papers were included in the qualitative analysis. From this study, it was assessed that MARPE is more predictable, and it determines a more significant expansion of the suture than the Hyrax expander, with fewer side effects.
PubMed: 35884030
DOI: 10.3390/children9071046 -
European Journal of Orthodontics Jun 2021Miniscrew-Assisted Rapid Palatal Expansion (MARPE) is a non-surgical treatment for transverse maxillary deficiency. However, there is limited evidence concerning its... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Miniscrew-Assisted Rapid Palatal Expansion (MARPE) is a non-surgical treatment for transverse maxillary deficiency. However, there is limited evidence concerning its efficacy.
OBJECTIVES
This systematic review aims to evaluate the efficacy of MARPE in late adolescents and adults by assessing success rate and skeletal and dental transverse maxillary expansion, as well as treatment duration, dental and periodontal side effects and soft tissue effects.
SEARCH METHODS
Seven electronic databases were searched (MEDLINE, Embase, Cochrane Library, Web of Science, Scopus, ProQuest and ClinicalTrials.gov) without limitations in November 2020.
SELECTION CRITERIA
Randomized and non-randomized clinical trials and observational studies on patients from the age of 16 onwards with transverse maxillary deficiency who were treated with MARPE and which included any of the predefined outcomes.
DATA COLLECTION AND ANALYSIS
Inclusion eligibility screening, data extraction and risk of bias assessment were performed independently in duplicate. When possible, exploratory meta-analyses of mean differences (MDs) with their 95% confidence intervals (CIs) were conducted, followed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis of the evidence quality.
RESULTS
Eight articles were included: two prospective and six retrospective observational studies. One study had a moderate risk of bias, whereas seven studies had a serious risk of bias. GRADE quality of evidence was very low. MARPE showed a high success rate (mean: 92.5%; 95%CI: 88.7%-96.3%), resulting in a significant skeletal width increase (MD: 2.33 mm; 95%CI: 1.63 mm-3.03 mm) and dental intermolar width increase (MD: 6.55 mm; 95%CI: 5.50 mm-7.59 mm). A significant increase in dental tipping, a decrease in mean buccal bone thickness and buccal alveolar height, as well as nasal soft tissue change was present (P < 0.05). The mean duration of expansion ranged from 20 to 126 days.
LIMITATIONS
One of the main drawbacks was the lack of high-quality prospective studies in the literature.
CONCLUSIONS AND IMPLICATIONS
MARPE is a treatment modality that is associated with a high success rate in skeletal and dental maxillary expansion. MARPE can induce dental and periodontal side effects and affect peri-oral soft tissues. Given the serious risk of bias of the included studies, careful data interpretation is necessary and future research of higher quality is strongly recommended.
REGISTRATION
PROSPERO (CRD42020176618).
FUNDING
No grants or any other support funding were received.
Topics: Adolescent; Adult; Humans; Palatal Expansion Technique; Palate; Prospective Studies; Retrospective Studies; Tooth
PubMed: 33882127
DOI: 10.1093/ejo/cjab005 -
PloS One 2017Non-syndromic clefts lip and/or palate (CL/P) defects may have manifold significant and detrimental consequences for the affected individuals and their family... (Meta-Analysis)
Meta-Analysis Review
Treatment outcomes of pre-surgical infant orthopedics in patients with non-syndromic cleft lip and/or palate: A systematic review and meta-analysis of randomized controlled trials.
BACKGROUND
Non-syndromic clefts lip and/or palate (CL/P) defects may have manifold significant and detrimental consequences for the affected individuals and their family environment. Although the use of pre-surgical infant orthopedics (PSIO) was introduced as a means to improve management and treatment outcomes, there still remains a controversy.
OBJECTIVE
To investigate the effectiveness of PSIO in patients with non-syndromic CL/P and evaluate the quality of the available evidence.
SEARCH METHODS
Search without restrictions, together with hand searching, until May 2016.
SELECTION CRITERIA
Randomized clinical trials investigating the effects of pre-surgical infant orthopedic appliances.
DATA COLLECTION AND ANALYSIS
Following study retrieval and selection, data extraction and individual study risk of bias assessment using the Cochrane Risk of Bias Tool took place. The overall quality of the available evidence was assessed with the Grades of Recommendation, Assessment, Development and Evaluation approach.
RESULTS
Finally 20 papers (3 unique trials) were identified, involving a total of 118 patients with unilateral complete CL/P and 16 with cleft of the soft and at least two thirds of the hard palate. Eight publications were considered as being of low, four of unclear and eight of high risk of bias. In general, the investigated appliances did not present significant effects when compared to each other or to no treatment in terms of feeding and general body growth, facial esthetics, cephalometric variables, maxillary dentoalveolar variables and dental arch relationships, speech and language evaluation, caregiver-reported outcomes, economic evaluation, as well as, adverse effects and problems. Overall, the quality of the available evidence was considered low.
CONCLUSIONS
The aforementioned findings could provide initial guidance in the clinical setting. However, given the multitude of parameters, which may have affected the results, good practice would suggest further research, in order to reach more robust relevant recommendations for management decisions in individual cases.
Topics: Cleft Lip; Cleft Palate; Humans; Infant; Orthopedic Procedures; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 28742129
DOI: 10.1371/journal.pone.0181768 -
JIMD Reports Nov 2022Mucopolysaccharidoses (MPSs) and mucolipidosis II and III (ML II and III) often manifest with orofacial (progressive) abnormalities, which may have a major impact on...
Mucopolysaccharidoses (MPSs) and mucolipidosis II and III (ML II and III) often manifest with orofacial (progressive) abnormalities, which may have a major impact on quality of life. However, because these patients have multiple somatic health issues, orofacial problems are easily overlooked in clinical practice and available literature on this topic solely consists of case reports, small case series, and small cohort studies. The aim of this systematic review was to gain more insight in the nature and extent of orofacial abnormalities in MPS, ML II, and III. A systematic review of all previously published articles addressing orofacial abnormalities in MPS, ML II, and III was performed. Both clinical studies and case reports were included. Outcome was the described orofacial abnormalities, subdivided into abnormalities of the face, maxilla, mandible, soft tissues, teeth, and occlusion. The search resulted in 57 articles, describing orofacial features in 340 patients. Orofacial abnormalities were present in all subtypes of MPS, ML II, and III, and consisted of thickened lips, a hypoplastic midface, a high-arched palate, hypoplastic condyles, coronoid hyperplasia, macroglossia, gingival hyperplasia, thick dental follicles, dentigerous cysts, misshapen teeth, enamel defects, and open bite. Orofacial abnormalities are present in all subtypes of MPS, ML II, and III. As orofacial abnormalities may cause complaints, evaluation of orofacial health should be part of routine clinical care.
PubMed: 36341168
DOI: 10.1002/jmd2.12331 -
Bioengineering (Basel, Switzerland) Aug 2023Biomechanical studies play an important role in understanding the pathophysiology of sleep disorders and providing insights to maintain sleep health. Computational... (Review)
Review
Biomechanical studies play an important role in understanding the pathophysiology of sleep disorders and providing insights to maintain sleep health. Computational methods facilitate a versatile platform to analyze various biomechanical factors in silico, which would otherwise be difficult through in vivo experiments. The objective of this review is to examine and map the applications of computational biomechanics to sleep-related research topics, including sleep medicine and sleep ergonomics. A systematic search was conducted on PubMed, Scopus, and Web of Science. Research gaps were identified through data synthesis on variants, outcomes, and highlighted features, as well as evidence maps on basic modeling considerations and modeling components of the eligible studies. Twenty-seven studies ( = 27) were categorized into sleep ergonomics ( = 2 on pillow; = 3 on mattress), sleep-related breathing disorders ( = 19 on obstructive sleep apnea), and sleep-related movement disorders ( = 3 on sleep bruxism). The effects of pillow height and mattress stiffness on spinal curvature were explored. Stress on the temporomandibular joint, and therefore its disorder, was the primary focus of investigations on sleep bruxism. Using finite element morphometry and fluid-structure interaction, studies on obstructive sleep apnea investigated the effects of anatomical variations, muscle activation of the tongue and soft palate, and gravitational direction on the collapse and blockade of the upper airway, in addition to the airflow pressure distribution. Model validation has been one of the greatest hurdles, while single-subject design and surrogate techniques have led to concerns about external validity. Future research might endeavor to reconstruct patient-specific models with patient-specific loading profiles in a larger cohort. Studies on sleep ergonomics research may pave the way for determining ideal spine curvature, in addition to simulating side-lying sleep postures. Sleep bruxism studies may analyze the accumulated dental damage and wear. Research on OSA treatments using computational approaches warrants further investigation.
PubMed: 37627802
DOI: 10.3390/bioengineering10080917 -
Dento Maxillo Facial Radiology Feb 2019To assess the use of three-dimensional (3D) imaging methods to quantify the changes in soft- and hard-tissues in cleft patients after cleft-related treatment during...
Three-dimensional imaging methods to quantify soft and hard tissues change after cleft-related treatment during growth in patients with cleft lip and/or cleft palate: a systematic review.
OBJECTIVES:
To assess the use of three-dimensional (3D) imaging methods to quantify the changes in soft- and hard-tissues in cleft patients after cleft-related treatment during growth.
METHODS:
PubMed, EMBASE, Web of Science and the Cochrane Library were searched up to 1 June 2018. Included publications were those using 3D imaging to quantify soft- and hard-tissue changes after cleft-related treatments in patients with any type of cleft, during growth. Data extraction and qualitative analysis were performed by two reviewers. The methodological quality of each study was reviewed using the QUADAS-2 tool.
RESULTS:
From 4 databases, 2315 articles were found. Full texts of 422 articles were analyzed and finally 12 articles were included for qualitative analysis. CT was performed in the majority of studies for hard-tissue quantification. Stereophotogrammetry, Laser scanner and 3D digitizer were identified as viable methods to quantify both soft- and hard-tissue changes, depending on whether the scan was made of the facial surface or the cast surface. Most studies conducted imaging analysis without registration between multitemporal images, which is the reason why they did not fulfil the inclusion criteria.
CONCLUSIONS:
Although several imaging modalities have the potential to quantify cleft-related treatment follow-up, there is an urgent need to assess the imaging methods and related analyses allowing to standardise a 3D imaging protocol to quantify hard- and soft-tissue treatment follow-up.
Topics: Cleft Lip; Cleft Palate; Female; Humans; Imaging, Three-Dimensional; Longitudinal Studies; Male; Prospective Studies; Reproducibility of Results; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 30160533
DOI: 10.1259/dmfr.20180084 -
Cureus Nov 2023Obstructive sleep apnea (OSA) is a recurrent partial or complete obstruction of the upper airway during sleep caused by narrowing or collapse of the pharyngeal wall. It... (Review)
Review
Obstructive sleep apnea (OSA) is a recurrent partial or complete obstruction of the upper airway during sleep caused by narrowing or collapse of the pharyngeal wall. It leads to microstimulation and oxyhemoglobin desaturation, resulting in sleepiness and loud snoring. OSA negatively affects the cardiovascular system and may contribute to neurocognitive impairment. The aim of this systematic review is to evaluate the effectiveness and efficacy of appliance therapy in obstructive sleep apnea. The effectiveness was assessed by using the Apnea Hypopnea Index (AHI). An electronic search of the Cochrane Library, PubMed, and Google Scholar was conducted between 1998 and 2021. Articles were independently assessed by three reviewers. The quality of a randomised control trial (RCT) is assessed using the Cochrane risk of bias method. The tool GRADE was used to achieve the desired level of confidence for each outcome reported. Several studies used continuous positive airway pressure (CPAP), mandibular advancement devices (MAD), and tongue retention devices (TRD). The meta-analysis included a total of six papers that met the inclusion criteria. Results showed that CPAP significantly improved AHI compared with an oral appliance (random effects: difference in means = 8.40, 95% CI = 7.21 to 9.60). It was also found that oral appliance (OA) therapy significantly improved AHI compared with baseline before appliance therapy (random effects: mean difference = 13.40, 95% CI = 10.87 to 15.93; p.00001). For mild to moderate OSA, CPAP is considered the gold standard. Our meta-analysis of six RCTs found favorable evidence for OSA patients receiving oral devices; however, they were less effective than CPAP. A subgroup analysis found that MAD may be a beneficial treatment for mild to moderate OSA patients who do not respond to CPAP. The findings suggest that oral appliances may be an effective treatment for OSA, especially in patients with mild to moderate OSA.
PubMed: 38058324
DOI: 10.7759/cureus.48280 -
Dentistry Journal Oct 2023Scanning edentulous arches during complete denture fabrication is a crucial step; however, the quality of the resulting digital scan is still questionable. The purpose... (Review)
Review
Scanning edentulous arches during complete denture fabrication is a crucial step; however, the quality of the resulting digital scan is still questionable. The purpose of this study is to systematically review studies (both clinical and in vitro) and determine whether intraoral scanners have clinically acceptable accuracy when recording completely edentulous arches for the fabrication of removable complete dentures. An electronic search in medical databases like PubMed, Scopus, and Web of Science (WOS), using a combination of relevant keywords, retrieved 334 articles. After full-text evaluation, twelve articles fulfilled the inclusion criteria for this review (eight clinical studies and four in vitro studies). A quality analysis of the included studies was carried out using the QUADAS-2 tool. The accuracy values varied between different intraoral scanners. Different regions of the edentulous arches showed differences in trueness and precision values in both in vitro and clinical studies. Peripheral borders, the inner seal, and poorly traceable structures like the soft palate showed maximum discrepancies. The accuracy of intraoral scanners in recording clear anatomic landmarks like hard tissues with attached mucosa was comparable to conventional edentulous arch impressions. However, higher discrepancies were recorded when digitizing mobile and poorly traceable structures. Intraoral scanners can be used to digitize denture-bearing areas, but the interpretation of the peripheral border and the soft palate should be carefully carried out.
PubMed: 37886926
DOI: 10.3390/dj11100241 -
Oral Surgery, Oral Medicine, Oral... Jun 2022Oral squamous cell carcinoma involving the maxilla (MSCC) is a rare malignancy. The aim was to perform a systematic review and meta-analysis of available literature on... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Oral squamous cell carcinoma involving the maxilla (MSCC) is a rare malignancy. The aim was to perform a systematic review and meta-analysis of available literature on local recurrence (LR), overall survival (OS), and associated risk factors of MSCC.
STUDY DESIGN
The Cochrane, PubMed, and EMBASE databases were searched with related keywords and synonyms. The pooled proportions of both LR and OS were subsequently calculated with 95% confidence intervals.
RESULTS
In total, 2638 articles were screened on title and abstract, 131 articles were screened on full text, and 20 were included. The pooled 5-year LR rate was 19.3%, and the 5-year OS rate was 53.7%. The subgroup analysis between surgery only and surgery with (neo)adjuvant treatment resulted in an odds ratio (OR) of .76 (95% confidence interval [CI]; .41-1.40).
CONCLUSIONS
Postoperative (chemo)radiotherapy or preoperative intra-arterial chemoradiotherapy improves survival when adverse tumor characteristics are present. Posterior tumor extension into the soft palate, pterygoid muscle, pterygoid process, and infratemporal fossa was significantly associated with decreased OS in multiple studies. More research into the risk-reduction of local recurrence is warranted.
Topics: Carcinoma, Squamous Cell; Head and Neck Neoplasms; Humans; Maxilla; Mouth Neoplasms; Neoplasm Recurrence, Local; Squamous Cell Carcinoma of Head and Neck
PubMed: 35165055
DOI: 10.1016/j.oooo.2021.10.003 -
Journal of Clinical and Experimental... Oct 2022Lung cancer metastasis to oral region is very rare. Studies have been published analysing the cases of metastatic tumours to the oral cavity by many researchers. But... (Review)
Review
BACKGROUND
Lung cancer metastasis to oral region is very rare. Studies have been published analysing the cases of metastatic tumours to the oral cavity by many researchers. But very few research work has been conducted till date to analyse only the oral soft tissue metastasis from Lung cancer as the primary source. The goal of this study was to examine published cases of oral soft tissue metastasis from lung cancer as the only primary source from 1st August 1977 to 31st December 2021.
MATERIAL AND METHODS
An electronic search of the published English literature was performed in PubMed/ Medline, Scopus, Google Scholar, and Research gate databases, using keywords like 'Lung cancer', OR/ AND 'Lung carcinoma' OR/ AND 'Oral cavity', OR/AND 'Metastasis', OR/AND 'Primary', OR/AND 'Source', OR/AND 'Initial', OR/AND 'Tongue', OR/AND 'Palate', OR/ AND 'Tonsil', OR/AND 'Lip', OR/AND 'Buccal mucosa', OR/AND 'Floor of mouth', OR/AND 'Salivary glands', OR/ AND 'Parotid', OR/ AND 'Submandibular', OR/ AND 'Sublingual' OR/ AND 'Mandible', OR/AND 'Maxilla. We also searched all related journals manually. Reference list of all articles was also checked.
RESULTS
Our research revealed total 122 patients. The most prevalent diagnosed metastatic lung cancer was adenocarcinoma. Gingiva, tongue and tonsils were the most common site of metastasis. 54% patients died of metastasis with a survival time of 1 week to 2.5 years.
CONCLUSIONS
Oral soft tissue metastasis from lung cancer has a bad prognosis. More cases need to be published in order to raise awareness of these lesions and gain a better understanding of their characteristics. Lung cancer, metastasis, oral, primary, soft tissues.
PubMed: 36320671
DOI: 10.4317/jced.59773