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Johansson K, Matilainen LB, Wiaderny M, Berlin H, Klingberg G, Ghiasi H, Brechter A, Paulsson L. Self-reported pain during different phases of orthodontic treatment with fixed appliance: A multi-centre randomized controlled trial in adolescents with crowding. Orthod Craniofac Res 2024; 27:560-571. [PMID: 38389292 DOI: 10.1111/ocr.12771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2024] [Indexed: 02/24/2024]
Abstract
OBJECTIVES To compare self-reported pain levels across various treatment phases using passive self-ligating (Damon) and conventional (Victory) standardized fixed appliance systems. MATERIALS AND METHODS Adolescents (12-17 years old) with crowding and displaced teeth, planned for non-extraction treatment, were recruited from four orthodontic clinics. They were randomized into stratified blocks (1:1 ratio) using concealed allocation to receive Damon Q™ (34 boys, 28 girls) or Victory™ (39 boys, 31 girls). Pain and analgesic intake were assessed on seven different occasions with validated self-report questionnaires using a 10-grade scale. RESULTS Of the 132 patients included, six were lost to follow up. Clinically relevant mean pain scores (≥4) were registered in both groups after bonding upper and lower arches and after insertion of 0.019 × 0.025 stainless steel archwire. The highest mean scores were reported on day two after bonding the upper arch (Damon 5.96, Victory 7.18, P = .011). In both groups, at least 40% reported taking analgesics during various treatment phases. The Damon group reported a lower intake of analgesics on days one and two (P = .042 and .037) after treatment initiation. In the entire sample, boys reported significantly higher mean pain scores than girls on the second and third days after bonding (P = .008 and .026, respectively). CONCLUSIONS Lower pain levels were reported from the Damon group after bonding. In general, boys reported higher pain than girls did. Clinicians and adolescents need to be aware that clinically relevant pain levels can be expected not only after bonding but also in later phases.
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Affiliation(s)
- Kristina Johansson
- Faculty of Odontology, Malmö University, Malmö, Sweden
- Department of Orthodontics, Östersund Hospital, Östersund, Sweden
| | | | - Michal Wiaderny
- Department of Orthodontics, Folktandvården Dalarna, Falun, Sweden
| | - Henrik Berlin
- Faculty of Odontology, Malmö University, Malmö, Sweden
| | | | - Houda Ghiasi
- Private Orthodontic Practice, Bernhold Ortodonti, Helsingborg, Sweden
| | - Anna Brechter
- Private Orthodontic Practice, Bernhold Ortodonti, Helsingborg, Sweden
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Balisany BH, Chawshli OF, Omer ZQ. A Hypothesis Testing of Archwire Rounding for the Efficacy of Torque Springs in Orthodontics: A Finite Element Study. Cureus 2024; 16:e57292. [PMID: 38559510 PMCID: PMC10981576 DOI: 10.7759/cureus.57292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Achieving the proper buccolingual inclination of teeth is a cornerstone in orthodontic treatment, directly impacting the attainment of ideal occlusal relationships and long-term stability. A practical torque expression that moves the tooth in its proper position across all three planes is imperative to finish orthodontic cases optimally. The primary focus of this research is to investigate Burstone's hypothesis about Warren torque springs when applied to the rectangular wire. Additionally, it examines the hypothesis of rounding these wires in between the bracket wings of the target tooth to be moved. This study aims to determine whether the rounding of wires, in conjunction with the use of torque springs, influences orthodontic outcomes, addressing a notable gap in current literature and resolving controversies in orthodontic practice. METHODS A three-dimensional set of maxillary teeth was modeled. A 0.022" MiniSprint™ brackets and Stainless steel archwires of 0.019" × 0.025" and 0.017" × 0.025" (Forestadent, Pforzheim, Germany) were generated. Warren torque spring was modeled and used in the simulation on the upper right central incisor. Four case scenarios were simulated. In two scenarios, the archwires were untouched for both archwire sizes. In comparison, in the other two scenarios, each archwire size was rounded for the upper right maxillary incisor bracket area. Stresses in the Warren torque springs were calculated, the root tip displacement in the four scenarios was measured in millimeters, and both were analyzed. RESULTS The root tip displacement was highly affected by rounding the archwire. The increase in root tip displacement was 1538% for the Warren torque spring on 0.019" × 0.025" and 783% for 0.017" × 0.025". The amount of root tip displacement was about 18.8 mm for 0.017" × 0.025" with rounding and 12.2 mm for 0.019" × 0.025". The concentration of the stresses in the Warren torque spring was in the neck of the spring next to the coils. CONCLUSION Rounding the archwires while using the Warren torque spring on a rectangular archwire will increase the efficiency of the spring and, in turn, will exhibit more torque on the tooth. Smaller dimensions of rectangular archwires will give more torque in conjunction with Warren torque springs compared to larger sizes of archwires.
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Affiliation(s)
- Blend H Balisany
- Pedodontics, Orthodontics and Preventive Dentistry, College of Dentistry, Hawler Medical University, Erbil, IRQ
| | - Omar F Chawshli
- Pedodontics, Orthodontics and Preventive Dentistry, College of Dentistry, Hawler Medical University, Erbil, IRQ
| | - Zana Q Omer
- Pedodontics, Orthodontics and Preventive Dentistry, College of Dentistry, Hawler Medical University, Erbil, IRQ
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El-Angbawi A, McIntyre G, Fleming PS, Bearn D. Non-surgical adjunctive interventions for accelerating tooth movement in patients undergoing orthodontic treatment. Cochrane Database Syst Rev 2023; 6:CD010887. [PMID: 37339352 PMCID: PMC10281004 DOI: 10.1002/14651858.cd010887.pub3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
BACKGROUND Deviation from a normal bite can be defined as malocclusion. Orthodontic treatment takes 20 months on average to correct malocclusion. Accelerating the rate of tooth movement may help to reduce the duration of orthodontic treatment and associated unwanted effects including orthodontically induced inflammatory root resorption (OIIRR), demineralisation and reduced patient motivation and compliance. Several non-surgical adjuncts have been advocated with the aim of accelerating the rate of orthodontic tooth movement (OTM). OBJECTIVES: To assess the effect of non-surgical adjunctive interventions on the rate of orthodontic tooth movement and the overall duration of treatment. SEARCH METHODS An information specialist searched five bibliographic databases up to 6 September 2022 and used additional search methods to identify published, unpublished and ongoing studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) of people receiving orthodontic treatment using fixed or removable appliances along with non-surgical adjunctive interventions to accelerate tooth movement. We excluded split-mouth studies and studies that involved people who were treated with orthognathic surgery, or who had cleft lip or palate, or other craniofacial syndromes or deformities. DATA COLLECTION AND ANALYSIS Two review authors were responsible for study selection, risk of bias assessment and data extraction; they carried out these tasks independently. Disagreements were resolved by discussion amongst the review team to reach consensus. MAIN RESULTS: We included 23 studies, none of which were rated as low risk of bias overall. We categorised the included studies as testing light vibrational forces or photobiomodulation, the latter including low level laser therapy and light emitting diode. The studies assessed non-surgical interventions added to fixed or removable orthodontic appliances compared to treatment without the adjunct. A total of 1027 participants (children and adults) were recruited with loss to follow-up ranging from 0% to 27% of the original samples. Certainty of the evidence For all comparisons and outcomes presented below, the certainty of the evidence is low to very low. Light vibrational forces Eleven studies assessed how applying light vibrational forces (LVF) affected orthodontic tooth movement (OTM). There was no evidence of a difference between the intervention and control groups for duration of orthodontic treatment (MD -0.61 months, 95% confidence interval (CI) -2.44 to 1.22; 2 studies, 77 participants); total number of orthodontic appliance adjustment visits (MD -0.32 visits, 95% CI -1.69 to 1.05; 2 studies, 77 participants); orthodontic tooth movement during the early alignment stage (reduction of lower incisor irregularity (LII)) at 4-6 weeks (MD 0.12 mm, 95% CI -1.77 to 2.01; 3 studies, 144 participants), or 10-16 weeks (MD -0.18 mm, 95% CI -1.20 to 0.83; 4 studies, 175 participants); rate of canine distalisation (MD -0.01 mm/month, 95% CI -0.20 to 0.18; 2 studies, 40 participants); or rate of OTM during en masse space closure (MD 0.10 mm per month, 95% CI -0.08 to 0.29; 2 studies, 81 participants). No evidence of a difference was found between LVF and control groups in rate of OTM when using removable orthodontic aligners. Nor did the studies show evidence of a difference between groups for our secondary outcomes, including patient perception of pain, patient-reported need for analgesics at different stages of treatment and harms or side effects. Photobiomodulation Ten studies assessed the effect of applying low level laser therapy (LLLT) on rate of OTM. We found that participants in the LLLT group had a statistically significantly shorter length of time for the teeth to align in the early stages of treatment (MD -50 days, 95% CI -58 to -42; 2 studies, 62 participants) and required fewer appointments (-2.3, 95% CI -2.5 to -2.0; 2 studies, 125 participants). There was no evidence of a difference between the LLLT and control groups in OTM when assessed as percentage reduction in LII in the first month of alignment (1.63%, 95% CI -2.60 to 5.86; 2 studies, 56 participants) or in the second month (percentage reduction MD 3.75%, 95% CI -1.74 to 9.24; 2 studies, 56 participants). However, LLLT resulted in an increase in OTM during the space closure stage in the maxillary arch (MD 0.18 mm/month, 95% CI 0.05 to 0.33; 1 study; 65 participants; very low level of certainty) and the mandibular arch (right side MD 0.16 mm/month, 95% CI 0.12 to 0.19; 1 study; 65 participants). In addition, LLLT resulted in an increased rate of OTM during maxillary canine retraction (MD 0.01 mm/month, 95% CI 0 to 0.02; 1 study, 37 participants). These findings were not clinically significant. The studies showed no evidence of a difference between groups for our secondary outcomes, including OIIRR, periodontal health and patient perception of pain at early stages of treatment. Two studies assessed the influence of applying light-emitting diode (LED) on OTM. Participants in the LED group required a significantly shorter time to align the mandibular arch compared to the control group (MD -24.50 days, 95% CI -42.45 to -6.55, 1 study, 34 participants). There is no evidence that LED application increased the rate of OTM during maxillary canine retraction (MD 0.01 mm/month, 95% CI 0 to 0.02; P = 0.28; 1 study, 39 participants ). In terms of secondary outcomes, one study assessed patient perception of pain and found no evidence of a difference between groups. AUTHORS' CONCLUSIONS: The evidence from randomised controlled trials concerning the effectiveness of non-surgical interventions to accelerate orthodontic treatment is of low to very low certainty. It suggests that there is no additional benefit of light vibrational forces or photobiomodulation for reducing the duration of orthodontic treatment. Although there may be a limited benefit from photobiomodulation application for accelerating discrete treatment phases, these results have to be interpreted with caution due to their questionable clinical significance. Further well-designed, rigorous RCTs with longer follow-up periods spanning from start to completion of orthodontic treatment are required to determine whether non-surgical interventions may reduce the duration of orthodontic treatment by a clinically significant amount, with minimal adverse effects.
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Affiliation(s)
- Ahmed El-Angbawi
- Division of Dentistry, The University of Manchester, Manchester, UK
| | | | | | - David Bearn
- School of Dentistry, University of Dundee, Dundee, UK
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Inauen DS, Papadopoulou AK, Eliades T, Papageorgiou SN. Pain profile during orthodontic levelling and alignment with fixed appliances reported in randomized trials: a systematic review with meta-analyses. Clin Oral Investig 2023; 27:1851-1868. [PMID: 36879148 PMCID: PMC10159949 DOI: 10.1007/s00784-023-04931-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 02/22/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVE To assess the pain profile of patients in the levelling/alignment phase of orthodontic treatment, as reported from randomized clinical trials. MATERIALS AND METHODS Five databases were searched in September 2022 for randomized clinical trials assessing pain during levelling/alignment with a visual analogue scale (VAS). After duplicate study selection, data extraction, and risk-of-bias assessment, random effects meta-analyses of mean differences (MDs) and their 95% confidence intervals (CIs) were performed, followed by subgroup/meta-regression, and certainty analyses. RESULTS A total of 37 randomized trials including 2277 patients (40.3% male; mean age 17.5 years) were identified. Data indicated quick pain initiation after insertion of orthodontic appliances (n = 6; average = 12.4 mm VAS), a quick increase to a peak at day 1 (n = 29; average = 42.4 mm), and gradually daily decrease the first week until its end (n = 23; average = 9.0 mm). Every second patient reported analgesic use at least once this week (n = 8; 54.5%), with peak analgesic use at 6 h post-insertion (n = 2; 62.3%). Patients reported reduced pain in the evening compared to morning (n = 3; MD = - 3.0 mm; 95%CI = - 5.3, - 0.6; P = 0.01) and increased pain during chewing (n = 2; MD = 19.2 mm; 95% CI = 7.9, 30.4; P < 0.001) or occlusion of the back teeth (n = 2; MD = 12.4 mm; 95% CI = 1.4, 23.4; P = 0.3), while non-consistent effects were seen for patient age, sex, irregularity, or analgesic use. Subgroup analyses indicated increased pain among extraction cases and during treatment of the lower (rather than the upper) arch, while certainty around estimates was moderate to high. CONCLUSIONS Evidence indicated a specific pain profile during orthodontic levelling/alignment, without signs of consistent patient-related influencing factors.
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Affiliation(s)
- Deborah Susanne Inauen
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstr. 11, 8032, Zurich, Switzerland
| | - Alexandra K Papadopoulou
- Division of Orthodontics, Faculty of Medicine, University Clinics of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1206, Geneva, Switzerland
- Discipline of Orthodontics and Paediatric Dentistry, Sydney Dental School, The University of Sydney, Sydney, Australia
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstr. 11, 8032, Zurich, Switzerland
| | - Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstr. 11, 8032, Zurich, Switzerland.
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Almagrami I, Almashraqi AA, Almaqrami BS, Mohamed AS, Wafaie K, Al-Balaa M, Qiao Y. A quantitative three-dimensional comparative study of alveolar bone changes and apical root resorption between clear aligners and fixed orthodontic appliances. Prog Orthod 2023; 24:6. [PMID: 36843193 PMCID: PMC9968667 DOI: 10.1186/s40510-023-00458-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 01/30/2023] [Indexed: 02/28/2023] Open
Abstract
BACKGROUND This study aimed to evaluate and compare the alveolar bone changes and to investigate the prevalence and severity of orthodontically induced inflammatory root resorption (OIIRR) of maxillary incisors in patients who received treatment with clear aligners (CA) versus conventional fixed appliances (FA), using cone-beam computed tomography (CBCT). METHODS One hundred sixty maxillary incisors from 40 patients with similar baseline characteristics based on the American Board of Orthodontics discrepancy index scores were divided into the CA and FA groups. The dentoalveolar quantitative changes were analyzed using pre- (T0) and post-treatment (T1) CBCT. The measured parameters included alveolar bone thickness (ABT), alveolar bone height (ABH), root length (OIIRR), and maxillary incisor inclinations. RESULTS Post-treatment, the average palatal and total ABT significantly decreased in central and lateral incisors in the FA group. In contrast, the CA group's average labial ABT of the lateral incisors decreased considerably. Regarding the ABH, both groups showed significant labial and palatal marginal bone resorption. In both groups, root lengths significantly decreased after treatment (p < 0.005). The inter-group comparison revealed that ABT and root length had significantly decreased in the FA group compared to the CA group, while the ABH showed no significant difference between the two groups. The mean absolute reductions of ABT and OIIRR in the CA group were significantly less (- 0.01 ± 0.89 and 0.31 ± 0.42) than those in the FA group (0.20 ± 0.82 and 0.68 ± 0.97), respectively. CONCLUSIONS CA and FA treatments appear to cause a significant ABT reduction and a statistically significant increased OIIRR in the maxillary incisor region, with a greater extent expected with FA treatment. However, the increased OIIRR values in the majority of both groups' cases were not clinically significant. Both treatment modalities resulted in a significant ABH reduction, with the highest found in the labial side of lateral incisors in the CA group.
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Affiliation(s)
- Ibtehal Almagrami
- grid.412633.10000 0004 1799 0733Department of Orthodontics, Faculty of Dentistry, First Affiliated Hospital of Zhengzhou University, No.1 Jianshe East Road Erqi District, Zhengzhou, Henan China ,grid.412413.10000 0001 2299 4112Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Sana’a University, Sanaa, Republic of Yemen
| | - Abeer A. Almashraqi
- grid.412603.20000 0004 0634 1084Department of Pre-Clinical Oral Health Sciences, College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - Bushra Sufyan Almaqrami
- grid.49470.3e0000 0001 2331 6153Department of Orthodontics, Hubei-MOST KLOS and KLOBM, School and Hospital of Stomatology, Wuhan University, Wuhan, China ,Ningbo Dental Hospital, Ningbo, Zhejiang China
| | - Amin S. Mohamed
- grid.43169.390000 0001 0599 1243Department of Orthodontics, Xi’an Jiaotong Universit, Xi’an, China
| | - Khaled Wafaie
- grid.412633.10000 0004 1799 0733Department of Orthodontics, Faculty of Dentistry, First Affiliated Hospital of Zhengzhou University, No.1 Jianshe East Road Erqi District, Zhengzhou, Henan China
| | - Maher Al-Balaa
- grid.49470.3e0000 0001 2331 6153Department of Orthodontics, Hubei-MOST KLOS and KLOBM, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yiqiang Qiao
- Department of Orthodontics, Faculty of Dentistry, First Affiliated Hospital of Zhengzhou University, No.1 Jianshe East Road Erqi District, Zhengzhou, Henan, China.
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Wazwaz F, Seehra J, Carpenter GH, Papageorgiou SN, Cobourne MT. Duration of canine retraction with fixed appliances: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop 2023; 163:154-172. [PMID: 36464569 DOI: 10.1016/j.ajodo.2022.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/28/2022] [Accepted: 08/03/2022] [Indexed: 12/02/2022]
Abstract
INTRODUCTION Space closure is a challenging and time-consuming phase of orthodontic treatment with fixed appliances. This systematic review evaluated canine retraction duration using fixed appliances after maxillary first premolar extraction. METHODS Unrestricted systematic literature searches were conducted in 8 databases for randomized clinical trials, assessing the duration and rate of maxillary canine retraction using fixed appliances with or without treatment adjuncts published up to July 2021. Study selection, data extraction, and risk of bias evaluation were conducted independently and in duplicate. Random-effects meta-analyses of average rates or mean differences (MD) and 95% confidence intervals (CI) were conducted at α = 5%, followed by sensitivity and Grading of Recommendations Assessment, Development, and Evaluation analysis. RESULTS Fifty randomized clinical trials (6 parallel and 44 split-mouth designs) covering 811 participants (mean age 19.9 years; 34% male) were included. The estimated average pooled duration to achieve complete canine retraction was 4.98 months (2 trials; 95% CI, -2.9 to 12.88 months). Pooled average canine retraction was 0.97 mm at months 0-1 (23 trials; 95% CI, 0.79-1.16), 1.83 mm at months 0-2 (20 trials; 95% CI, 1.52-2.14), 2.44 mm at months 0-3 (23 trials; 95% CI, 2.10-2.79), 3.49 mm at months 0-4 (6 trials; 95% CI, 1.81-5.17) and 4.25 mm at months 0-5 (2 trials; 95% CI, 0.36-8.14). Surgically-assisted orthodontics was associated with greater canine retraction at all time points: months 0-1 (10 trials; MD, 0.52 mm; P = 0.004), months 0-2 (8 trials; MD, 0.53 mm; P = 0.04), months 0-3 (8 trials; MD, 0.67 mm; P = 0.01), and months 0-4 (3 trials; MD, 1.13 mm; P = 0.01), whereas subgroup analyses indicated significant effects of anchorage reinforcement method and bracket slot size on canine retraction. CONCLUSIONS The average time to achieve complete retraction of the maxillary canine using fixed appliances was around 5.0 months. Most studies used split-mouth randomization to investigate canine retraction for around 1-3 months, with substantial heterogeneity across studies. At 3 months of treatment, high-quality evidence supported greater canine retraction with surgically-assisted orthodontics.
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Affiliation(s)
- Fidaa Wazwaz
- Department of Orthodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, Centre for Craniofacial Development & Regeneration, King's College London, London, United Kingdom
| | - Jadbinder Seehra
- Department of Orthodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, Centre for Craniofacial Development & Regeneration, King's College London, London, United Kingdom
| | - Guy H Carpenter
- Department of Mucosal Biology, Faculty of Dentistry, Oral & Craniofacial Sciences, Centre for Host Disease, King's College London, London, United Kingdom
| | - Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Martyn T Cobourne
- Department of Orthodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, Centre for Craniofacial Development & Regeneration, King's College London, London, United Kingdom.
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Mukhopadhyay M, Verma S, Chitra P. An Umbrella Review of Systematic Reviews With or Without Meta-Analysis Assessing Treatment Outcomes and Efficiency of Self-Ligating Brackets. JOURNAL OF INDIAN ORTHODONTIC SOCIETY 2022. [DOI: 10.1177/03015742221095296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction Self-ligating bracket systems are popular and seem to demonstrate lesser friction, allowing tooth movement without exerting unwanted forces on surrounding structures. This umbrella review aimed to compare self-ligating and conventional bracket systems for treatment efficiency. Methods An electronic search in 8 databases was performed for literature published between January 1, 1990, and October 1, 2021, with manual hand-searching of references of retrieved articles. Quality assessment was performed using the risk of bias in a systematic tool by 2 independent reviewers. Data were extracted using a prepiloted form (Joanna Briggs Institute) for evidence synthesis. Corrected covered area was calculated to quantify study overlaps across systematic reviews with or without meta-analysis. Results 605 articles were retrieved, of which 16 were selected. Most included studies had a low risk of bias, except for 6 that showed an unclear risk of bias. Data analysis revealed a reduction in lower incisor proclination, bacterial accumulation, and oral malodor using self-ligating appliances. Conclusions Self-ligating systems reduce mandibular incisor proclination, bacterial accumulation, external apical root resorption, chairside time, and oral malodor. No other differences could be demonstrated in comparison with conventional appliance systems.
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Affiliation(s)
- Meghna Mukhopadhyay
- Department of Orthodontics and Dentofacial Orthopedics, Army College of Dental Sciences, Secunderabad, India
| | - Shubhnita Verma
- Department of Orthodontics and Dentofacial Orthopedics, Army College of Dental Sciences, Secunderabad, India
| | - Prasad Chitra
- Department of Orthodontics and Dentofacial Orthopedics, Army College of Dental Sciences, Secunderabad, India
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Cobourne MT, Huang GJ. Orthodontic clinical trials: Evaluating outcomes that actually matter. Am J Orthod Dentofacial Orthop 2022; 161:1-2. [PMID: 35012742 DOI: 10.1016/j.ajodo.2021.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 10/06/2021] [Indexed: 11/26/2022]
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Jung MH. Effects of self-ligating brackets and other factors influencing orthodontic treatment outcomes: A prospective cohort study. Korean J Orthod 2021; 51:397-406. [PMID: 34803028 PMCID: PMC8607120 DOI: 10.4041/kjod.2021.51.6.397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 06/22/2021] [Accepted: 07/02/2021] [Indexed: 11/10/2022] Open
Abstract
Objective The purpose of this study was to evaluate the effects of self-ligating brackets (SBs) and other factors that influence orthodontic treatment outcomes. Methods This two-armed cohort study included consecutively treated patients in a private practice. The patients were asked to choose between SBs and conventional brackets (CBs); if any patient did not have a preference, he or she was randomly allocated to the CB or SB group. All patients were treated using an identical archwire sequence. Evaluated parameters were as follows: treatment duration, number of bracket failures, poor oral hygiene, poor elastic wear, extraction, use of orthodontic mini-implants (OMI), OMI failure, American Board of Orthodontics (ABO) Discrepancy Index (DI), arch length discrepancy, and ABO Cast-Radiograph Evaluation (CRE) score. Stepwise regression analysis was performed to generate the equation for prediction of the CRE. Results The final sample comprised 134 patients with an average age of 22.73 years. The average DI, CRE, and treatment duration were 21.81, 14.25, and 28.63 months, respectively. Analysis of covariance showed a significant difference in CRE between the CB and SB groups after adjusting for the effects of confounding variables. Stepwise regression analysis using four variables, namely extraction, SB use, poor elastic wear, and additional appliance use, could explain only 25.2% of the variance in the CRE. Conclusions Although the CRE was significantly better for CBs than for SBs, the clinical significance of this result seems to be limited. Extraction, SB use, poor elastic wear, and additional appliance use may have significant effects on treatment outcomes.
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Affiliation(s)
- Min-Ho Jung
- Department of Orthodontics, Dental Research Institute and School of Dentistry, Seoul National University, Seoul, Korea.,Private Practice, Seoul, Korea
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10
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Wazwaz F, Seehra J, Carpenter GH, Ireland AJ, Papageorgiou SN, Cobourne MT. Duration of tooth alignment with fixed appliances: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop 2021; 161:20-36. [PMID: 34794862 DOI: 10.1016/j.ajodo.2021.06.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 06/01/2021] [Accepted: 06/01/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION A key goal of orthodontic treatment with fixed appliances is alignment of the dentition, and this remains a commonly selected outcome in clinical studies investigating orthodontic tooth movement. This systematic review has evaluated treatment duration to achieve alignment of the mandibular dentition using fixed appliances. METHODS Systematic literature searches without restrictions were undertaken in 9 databases for randomized clinical trials (RCTs) assessing duration and rate of tooth alignment using fixed appliances with or without treatment adjuncts published up to January 2021. After duplicate study selection, data extraction, and risk of bias assessment according to Cochrane, random-effects meta-analyses of aggregate data, and individual patient data were conducted. RESULTS Thirty-five trials were included with 2258 participants (39% male; mean age 17.8 years), giving a pooled duration to achieve whole-arch alignment of the mandibular dentition of 263.0 days (4 trials; 95% confidence interval [CI], 186.7-339.4 days) and incisor alignment in the mandibular arch of 100.7 days (9 trials; 95% CI, 84.1-117.4 days). Surgical-assisted orthodontics was associated with reduced duration of incisor alignment: mean difference of 44.3 days less (4 trials; 95% CI, 20.0-68.9 days; P <0.001; high quality of evidence), whereas subgroup and meta-regression analyses indicated significant effects of baseline crowding and premolar extractions. Individual patient data analysis from 3 RCTs indicated that for each additional participant age year, whole-arch alignment of the mandibular dentition took 13.7 days longer (3 trials; 95% CI, 7.7-17.7 days; P <0.001) and for each additional mm of irregularity, 17.5 days more were needed (2 trials; 95% CI, 9.8-25.2 days; P <0.001). CONCLUSIONS Patient and treatment-related characteristics can significantly affect the duration of tooth alignment and should be taken into account both clinically and when designing trial outcomes. Future research studies investigating rates of orthodontic tooth alignment would benefit from adequate sample sizes and a more consistent methodology in outcome assessment. Data in this systematic review provides a basis for appropriate trial design for future RCTs investigating the rate of orthodontic tooth alignment with fixed appliances.
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Affiliation(s)
- Fidaa Wazwaz
- Department of Orthodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Centre for Craniofacial Development and Regeneration, King's College London, London, United Kingdom
| | - Jadbinder Seehra
- Department of Orthodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Centre for Craniofacial Development and Regeneration, King's College London, London, United Kingdom
| | - Guy H Carpenter
- Department of Mucosal Biology, Faculty of Dentistry, Oral and Craniofacial Sciences, Centre for Host Disease, King's College London, London, United Kingdom
| | - Anthony J Ireland
- Department of Orthodontics, University of Bristol Dental School, London, United Kingdom
| | - Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Martyn T Cobourne
- Department of Orthodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Centre for Craniofacial Development and Regeneration, King's College London, London, United Kingdom.
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11
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Maizeray R, Wagner D, Lefebvre F, Lévy-Bénichou H, Bolender Y. Is there any difference between conventional, passive and active self-ligating brackets? A systematic review and network meta-analysis. Int Orthod 2021; 19:523-538. [PMID: 34629309 DOI: 10.1016/j.ortho.2021.09.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 09/18/2021] [Accepted: 09/21/2021] [Indexed: 01/31/2023]
Abstract
AIM To test the null hypothesis that there was no difference in treatment efficiency between therapies undertaken with conventional (CBs), passive self-ligating (PSLBs) or active self-ligating (ASLBs) brackets. MATERIALS AND METHODS An electronic search was performed in 3 data bases (Pubmed, Web of Science, Cochrane Library) from their origin up to January 2019. Additional references were hand searched. Search was strictly restricted to randomized controlled trials (RCTs) and split-mouth design studies (SMDs). RCTs and SMDs were initially processed separately and subsequently combined in a network meta-analysis. The following variables were evaluated: treatment duration, number of visits, occlusal outcomes, alignment rate, transverse arch dimensional changes, incisor position modification, rate of space closure, anchorage loss, bond failure, root resorption, perception of discomfort during the initial phase of alignment, time to ligate in or to untie an archwire, periodontal variables, quality of life. RESULTS On 229 papers, 30 RCTs and 9 SMDs were finally included in this study. Out of 85 comparisons, 16 only revealed statistically significant differences. It was quicker to untie and ligate an 0.014 NiTi arch from/in 6 ASLBs anterior ceramic brackets compared to 6 ceramic CBs. It was also more painful to insert and remove an 0.019×0.025 SS wire in/from PSLB's brackets compared to CB's attachments. Compared to conventional brackets, there was less maxillary incisor proclination with PSLBs in non-extraction cases. Moreover, there was less bleeding on probing 4-5 weeks after bonding with PSLBs compared to CBs brackets. The only significant difference between ASLBs and PSLBs was that alignment was 10 days faster with active self-ligating braces compared with passive self-ligating braces even if treatment duration between ASLBs and PSLBs was not significantly different. The network meta-analysis revealed that IMPA was greater in extractions cases with CBs compared with both ASLBs (+2,5°) and PSLBs (+1,6°). CONCLUSIONS The vast majority of the studied variables did not show any significant differences between the three types of brackets. The most significant findings were that it was quicker to insert and remove archwires from ASLBs compared to CBs, and it was more painful to insert and remove an 0.019×0.025" stainless steel wire in/from PSLBs compared to CBs. The major difference between ASLBs and PSLBs was that alignment was 10 days faster with active self-ligating braces compared with passive self-ligating braces even if treatment duration between ASLBs and PSLBs was not significantly different. Most of the claims put forward by the suppliers were not substantiated by our network meta-analysis.
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Affiliation(s)
- Raphaëlle Maizeray
- Sous-section d'Orthopédie dento-faciale, Faculté de Chirurgie Dentaire, Université de Strasbourg, 8, rue Ste-Élisabeth, 67000 Strasbourg, France.
| | - Delphine Wagner
- Sous-section d'Orthopédie dento-faciale, Faculté de Chirurgie Dentaire, Université de Strasbourg, 8, rue Ste-Élisabeth, 67000 Strasbourg, France
| | - François Lefebvre
- Santé publique, Méthodologie et Biostatistiques, Hôpitaux Universitaires de Strasbourg, 1, place de l'hôpital, 67091 Strasbourg, France
| | - Hélène Lévy-Bénichou
- Sous-section d'Orthopédie dento-faciale, Faculté de Chirurgie Dentaire, Université de Strasbourg, 8, rue Ste-Élisabeth, 67000 Strasbourg, France
| | - Yves Bolender
- Sous-section d'Orthopédie dento-faciale, Faculté de Chirurgie Dentaire, Université de Strasbourg, 8, rue Ste-Élisabeth, 67000 Strasbourg, France
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Gandhi V, Mehta S, Gauthier M, Mu J, Kuo CL, Nanda R, Yadav S. Comparison of external apical root resorption with clear aligners and pre-adjusted edgewise appliances in non-extraction cases: a systematic review and meta-analysis. Eur J Orthod 2021; 43:15-24. [PMID: 32077935 DOI: 10.1093/ejo/cjaa013] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate and compare the amount of external apical root resorption (EARR) observed during the orthodontic treatment with pre-adjusted edgewise appliance (PEA) or clear aligner therapy (CAT) and with 2D or 3D radiographic methods of measuring the root resorption. SEARCH STRATEGY AND SELECTION CRITERIA A search of PubMed MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, LILACS, Web of Science, Dissertations & Theses Global, ClinicalTrials.gov registry, and the ISRCTN Registry was performed. Studies that have evaluated the amount of root resorption in non-extraction cases using CAT or PEA were selected for the systematic review. A meta-analysis was performed for the amount of root resorption of permanent maxillary incisors using PEA or CAT treatment modalities by either 2D or cone-beam computed tomography radiographic examination. DATA COLLECTION AND ANALYSIS Database research, elimination of duplicate studies, data extraction, and risk of bias were performed by authors independently and in duplication. A random-effect meta-analysis followed by subgroup comparisons were performed to evaluate EARR. RESULTS A total of 16 studies (4 were prospective and 12 were retrospective) were identified for inclusion in the systematic review. The mean root resorption for the permanent maxillary incisors was in the range from 0.25 to 1.13 mm (overall: 0.49 mm; 95% confidence interval [CI] = 0.24 to 0.75 mm). The mean root resorption difference between CAT and PEA was statistically significant (P < 0.05) for 12 but not for 21, 11, or 22. LIMITATIONS One of the drawbacks is a lack of good quality prospective studies, specifically randomized clinical trials in the literature. CONCLUSIONS AND IMPLICATIONS Neither PEA or CAT technique leads to clinically significant root resorption (1 mm) of the maxillary incisors. The amount of EARR of maxillary incisors is not significant in comparing two treatment modalities (PEA and CAT), except for 12, where the PEA group has significantly more EARR when compared to CAT. REGISTRATION The protocol for this systematic review was based on the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0 and was registered at PROSPERO database (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42018113051). This systematic review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.
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Affiliation(s)
- Vaibhav Gandhi
- Division of Orthodontics, University of Connecticut Health, Farmington, USA
| | - Shivam Mehta
- Division of Orthodontics, University of Connecticut Health, Farmington, USA
| | - Marissa Gauthier
- L.M. Stowe Library, University of Connecticut Health, Farmington, USA
| | - Jijian Mu
- Department of Community Medicine and Health Care, University of Connecticut Health, Farmington, USA
| | - Chia-Ling Kuo
- Department of Community Medicine and Health Care, University of Connecticut Health, Farmington, USA
| | - Ravindra Nanda
- Division of Orthodontics, University of Connecticut Health, Farmington, USA
| | - Sumit Yadav
- Division of Orthodontics, University of Connecticut Health, Farmington, USA
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Karakasli K, Erdur EA. The effect of platelet-rich fibrin (PRF) on maxillary incisor retraction rate. Angle Orthod 2021; 91:213-219. [PMID: 33347530 DOI: 10.2319/050820-412.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 09/01/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To investigate the efficiency of platelet-rich fibrin (PRF) injection on maxillary incisor retraction rate. MATERIALS AND METHODS The study included 40 patients (23 women and 17 men; mean age; 20.7 ± 1.45) with Class II Division 1 malocclusion. The treatment plan for all patients was extraction of the maxillary first premolars and canine distalization, followed by retraction of the maxillary incisors. Patients were randomly divided into two groups. The study group received injectable platelet-rich fibrin (i-PRF) two times with an interval of 2 weeks; the control group did not receive i-PRF. In both groups, the measurements were bilaterally assessed as the distances between the lateral and canine teeth on the plaster models at five time points. The rate of incisor movement was evaluated by Student's t-test, analysis of variance, and Tukey honestly significant difference tests. Statistical significance was set as P < .05. RESULTS The average movements of incisors were significantly higher in the study group than the control group at all time points (P < .05). According to the within-group comparison, none of the measurements showed any significant differences between the right and left sides in both groups at all time points (P > .05). While the movement of incisors was significantly higher in the study group in the week following the PRF injection compared to the other weeks (P < .05), there were no significant differences in the control group at all-time points (P > .05). CONCLUSIONS Applying i-PRF significantly increased the rate of maxillary incisor retraction at all time intervals. Platelet-rich fibrin injection can be an effective method for shortening treatment duration.
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Jung MH. Factors influencing treatment efficiency. Angle Orthod 2021; 91:1-8. [PMID: 33289803 DOI: 10.2319/050220-379.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 08/01/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES The purpose of this cohort study was to evaluate the effect of self-ligating brackets (SB) and other related factors that influence orthodontic treatment time. MATERIALS AND METHODS This was a two-armed prospective study. Consecutively treated patients who were recruited from a private practice were enrolled and asked to choose between SB and conventional brackets (CB). If the patient did not have a preference, that patient was randomly allocated. An identical archwire sequence was used, and all patients were treated by a single orthodontist. Treatment duration, number of bracket failures, poor oral hygiene, poor elastic wear, whether or not to orthodontic mini-implants (OMI) were used, OMI failure, extraction, American Board of Orthodontics Discrepancy Index, and arch length discrepancy were measured and statistically analyzed using t-tests, correlation analysis, and analysis of covariance (ANCOVA). Stepwise regression analysis was conducted to generate an equation to predict treatment duration. RESULTS A total of 134 patients with an average age of 22.73 years were included. The average treatment duration was 28.63 months. ANCOVA showed no significant difference in treatment duration between CB and SB. Stepwise regression analysis could explain 64.6% of the variance in treatment duration using five variables. CONCLUSIONS SB did not exhibit a significant reduction in treatment time as compared with CB. Patient cooperation, extractions, and malocclusion severity had a significant impact on treatment duration.
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Nakhleh K, Joury E, Dean R, Marcenes W, Johal A. Can socioeconomic and psychosocial factors predict the duration of orthodontic treatment? Eur J Orthod 2020; 42:263-269. [PMID: 31579918 DOI: 10.1093/ejo/cjz074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION AND OBJECTIVES Very little is known about the role of socioeconomic and psychosocial factors in predicting orthodontic treatment duration. Thus, this study aimed to test whether socioeconomic position (SEP) and psychosocial factors, namely, family environment and resiliency can predict orthodontic treatment duration. METHODS Data were analysed from a hospital-based, prospective, longitudinal study that recruited 145 consecutively selected 12- to 16-year-old male and female adolescents. Baseline SEP and psychosocial data were collected by a validated child self-completed questionnaire before the placement of fixed appliances. Linear regression analysis was used. RESULTS The response rate was 98.6 per cent and the dropout was 8.2 per cent. Maternal emotional support was an important predictor of orthodontic treatment duration. Adolescents with high levels of maternal emotional support were more likely to have a shorter orthodontic treatment duration (by nearly four months) than those with low levels of maternal emotional support (P = 0.02). Parental SEP, paternal emotional support, maternal and paternal control, as well as resiliency were not significantly associated with orthodontic treatment duration (P > 0.05). The multivariable regression analysis (including age, gender, and malocclusion severity) confirmed the significance of maternal emotional support as a predictor of orthodontic treatment duration. CONCLUSIONS Maternal emotional support is an important predictor of orthodontic treatment duration. This may be explained by a higher maternal involvement in the orthodontic treatment, which may have facilitated achieving the required orthodontic treatment outcome in a shorter treatment duration.
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Affiliation(s)
| | - Easter Joury
- Centre for Dental Public Health and Primary Care, Institute of Dentistry, Queen Mary University of London, UK.,Health Promotion and Public Health, University of West London, UK
| | - Rabia Dean
- Oral and Maxillofacial Department, Queen Elizabeth Hospital Birmingham, UK
| | - Wagner Marcenes
- Centre for Host Microbiome Interactions, King's College London Faculty of Dentistry, Oral and Craniofacial Sciences, University of London, UK
| | - Ama Johal
- Centre of Oral Bioengineering, Institute of Dentistry, Queen Mary University of London, UK
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Vásquez-Cárdenas J, Zapata-Noreña Ó, Carvajal-Flórez Á, Barbosa-Liz DM, Giannakopoulos NN, Faggion CM. Systematic reviews in orthodontics: Impact of the PRISMA for Abstracts checklist on completeness of reporting. Am J Orthod Dentofacial Orthop 2019; 156:442-452.e12. [PMID: 31582116 DOI: 10.1016/j.ajodo.2019.05.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 05/01/2019] [Accepted: 05/01/2019] [Indexed: 12/13/2022]
Abstract
INTRODUCTION This study evaluated and compared the completeness of reporting of abstracts of orthodontics systematic reviews before and after the publication of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Abstracts Checklist (PRISMA-A). METHODS Abstracts of systematic reviews and meta-analyses in orthodontics published in PubMed, Latin American and Caribbean Health Sciences Literature, and the Cochrane Database of Systematic Reviews databases before March 23, 2018, that met the predefined inclusion and exclusion criteria, were evaluated using the 12 items of PRISMA-A, scoring each item from 0 to 2. Abstracts were classified into 2 groups: before and after publication of the PRISMA-A checklist. Three calibrated evaluators (intraclass correlation coefficient and kappa > 0.8) assessed the scores for compliance with the checklist. The number of authors, country of affiliation of the first author, performance of meta-analysis, and topic of the article were recorded. A regression analysis was performed to assess the associations between abstract characteristics and the PRISMA-A scores. RESULTS Of 1034 abstracts evaluated, 389 were included in the analysis. The mean PRISMA-A score was 53.39 (95% CI, 51.83-54.96). The overall score for studies published after the publication of the checklist was significantly higher than for studies published before (P ≤ 0.0001). The components returning significantly higher scores after publication of PRISMA-A were title (P = 0.024), information from databases (P = 0.026), risk of bias (P ≤ 0.0001), included studies (P ≤ 0.0001), synthesis of results (P ≤ 0.0001), interpretation of results (P = 0.035), financing and conflict of interest (P ≤ 0.0001), and registration (P ≤ 0.0001). These results showed the positive effect of PRISMA-A had on the quality of reporting of orthodontics systematic reviews. Nevertheless, the poor adherence revealed that there is still need for improvement in the quality of abstract reporting. CONCLUSIONS The quality of reporting of abstracts of orthodontic systematic reviews and meta-analyses increased after the introduction of PRISMA-A.
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Affiliation(s)
- Jenny Vásquez-Cárdenas
- Orthodontic Postgraduate Program, Gionorto Research Group, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Óscar Zapata-Noreña
- Orthodontic Postgraduate Program, Gionorto Research Group, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Álvaro Carvajal-Flórez
- Orthodontic Postgraduate Program, Gionorto Research Group, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Diana María Barbosa-Liz
- Orthodontic Postgraduate Program, Gionorto Research Group, Faculty of Dentistry, University of Antioquia, Medellín, Colombia.
| | | | - Clovis Mariano Faggion
- Department of Periodontology and Operative Dentistry, Faculty of Dentistry, University of Münster, Münster, Germany
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Lai TT, Chiou JY, Lai TC, Chen T, Wang HY, Li CH, Chen MH. Perceived pain for orthodontic patients with conventional brackets or self-ligating brackets over 1 month period: A single-center, randomized controlled clinical trial. J Formos Med Assoc 2019; 119:282-289. [PMID: 31208826 DOI: 10.1016/j.jfma.2019.05.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 05/08/2019] [Accepted: 05/14/2019] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND/PURPOSE The objective of this 2-arm parallel trial was to test the superiority of self-ligating brackets (SLB) over conventional brackets (CB) in terms of perceived pain for orthodontic patients. METHODS Patients about to undergo treatment were included to fixed appliance placed with CB or SLB. Eligibility criteria included malocclusion patients whose age between 12 to 40 years and suitable for orthodontic fixed appliance treatment. The main outcome was pain intensity measured by visual analog scale (VAS) with all patients followed at 4 h, 24 h, 3 days, 1 week and 1 month. Randomization was accomplished with a computer-generated list of random numbers. Blinding was applicable for outcome assessment only. Data were analyzed using multi-level nonlinear mixed effect model, Friedman's test and Wilcoxon signed rank test with the Bonferroni correction for multiple tests. RESULTS Eight-eight patients were randomized in a 1:1 ratio to either SLB or CB. All patients completed the study, and none were lost to follow-up. There were no drop-outs after randomization. Baseline characteristics were similar between groups. The is no statistical significant difference in pain intensity between CB and SLB at 4 h, 24 h, 3 days, 1 week and 1 month. Data were analyzed on an intention-to-treat basis. No serious harm was observed. CONCLUSION The results of this study indicated no evidence that the pain intensity differs between CB and SLB at 4 h, 24 h, 3 days, 1 week and 1 month.
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Affiliation(s)
- Tai-Ting Lai
- Division of Orthodontics, Dental Department, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan; Orthodontics and Detofacial Orthopedics Division, Dental Department, Tri-Service General Hospital, Taipei, Taiwan; School of Dentistry, College of Oral Medicine, Taipei Medical University, Taiwan
| | - Jeng-Yuan Chiou
- School of Health Policy and Management, Chung Shan Medical University, Taiwan
| | - Tai-Cheng Lai
- Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ted Chen
- School of Public Health & Tropical Medicine, Tulane University, New Orleans, USA
| | - Huey-Yuan Wang
- Division of Orthodontics, Dental Department, Mackay Memorial Hospital, Taipei, Taiwan
| | - Chung-Hsing Li
- Orthodontics and Detofacial Orthopedics Division, Dental Department, Tri-Service General Hospital, Taipei, Taiwan
| | - Min-Huey Chen
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taiwan; Dental Department, National Taiwan University Hospital, Taiwan.
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Samandara A, Papageorgiou SN, Ioannidou-Marathiotou I, Kavvadia-Tsatala S, Papadopoulos MA. Evaluation of orthodontically induced external root resorption following orthodontic treatment using cone beam computed tomography (CBCT): a systematic review and meta-analysis. Eur J Orthod 2019; 41:67-79. [PMID: 29771300 DOI: 10.1093/ejo/cjy027] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background Orthodontically induced external root resorption (OIRR) is a pathologic consequence of orthodontic tooth movement. However, the limitations of two-dimensional radiography suggest that cone beam computed tomography (CBCT) with its three-dimensional capabilities might be more suitable to assess OIRR. Objective The aim of this study was to assess in an evidence-based manner data on linear or volumetric OIRR measurements of permanent teeth by means of CBCT, during and/or after the end of orthodontic treatment. Search methods Unrestricted electronic and hand searches were performed up to January 2017 in 15 databases. Selection criteria methods Randomized clinical trials, prospective, and retrospective non-randomized studies assessing OIRR during and/or after orthodontic treatment using CBCT in human patients were included. Data collection and analysis After duplicate study selection, data extraction, and risk-of-bias assessment according to the Cochrane guidelines, random-effects meta-analyses, followed by subgroup, meta-regression, and sensitivity analyses were also performed in order to evaluate factors that affect OIRR. Results A total of 33 studies (30 datasets) were included in the qualitative analysis while data from 27 of them were included in the quantitative analysis. Direct comparisons from randomized trials found little to no influence of appliance-related factors on OIRR. Explorative analyses including non-randomized studies found a pooled OIRR of 0.79 mm based on all included studies and 0.86 mm when OIRR was assessed at the end of orthodontic treatment. Statistically significant differences in OIRR were found according to tooth type or jaw, inclusion of extractions, treatment duration, and diagnostic accuracy of the CBCT. Conclusions Based on the results of this study, CBCT seems to be a reliable tool to examine OIRR during or at the end of orthodontic treatment. Although the average OIRR measured with CBCT seems to lack clinical relevance, there are certain factors that may affect OIRR following orthodontic treatment. Nevertheless, due to data heterogeneity and low quality of the included studies, the corresponding results should be interpreted with some caution. Registration PROSPERO (CRD42016030131).
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Affiliation(s)
- Aikaterini Samandara
- Department of Orthodontics, Faculty of Dentistry, Aristotle University of Thessaloniki, Greece
| | - Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Switzerland
| | | | | | - Moschos A Papadopoulos
- Department of Orthodontics, Faculty of Dentistry, Aristotle University of Thessaloniki, Greece
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Currell SD, Liaw A, Blackmore Grant PD, Esterman A, Nimmo A. Orthodontic mechanotherapies and their influence on external root resorption: A systematic review. Am J Orthod Dentofacial Orthop 2019; 155:313-329. [PMID: 30826034 DOI: 10.1016/j.ajodo.2018.10.015] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 10/01/2018] [Accepted: 10/01/2018] [Indexed: 12/31/2022]
Abstract
INTRODUCTION This systematic review assesses the literature regarding the association between orthodontic tooth movement and external root resorption. By determining the evidence level supporting the association, the results could provide clinical evidence for minimizing the deleterious effect of orthodontic tooth movement. METHODS Electronic databases, including MEDLINE, PubMed, Embase, Scopus, CINAHL, Cochrane Library, and LILACS, were searched up to February 2018, with hand searching of selected orthodontic journals undertaken to identify any preelectronic publications. Searches were undertaken with no restrictions on year, publication status, or language. Selection criteria included randomized controlled trials conducted with the use of fixed orthodontic appliances or sequential thermoplastic aligners on human patients. The quality of included studies was assessed with the use of the Cochrane Risk of Bias Tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Inter-rater agreement of the review authors was used for the inclusion of primary articles, risk of bias assessment, and evaluation of the quality of evidence (GRADE), and it was calculated with the use of the Cohen kappa statistic. RESULTS A total of 654 articles were retrieved in the initial search. After the review process, 25 articles describing 24 individual trials met the inclusion criteria. Sample sizes ranged from 6 to 154 patients. Most articles were classified as having unclear risks of bias and very low to low quality of evidence. CONCLUSIONS There is very low to low evidence for supporting positive associations between root resorption and increased force levels, force continuity, intrusive forces, and treatment duration. Moreover, by including a pause in treatment for patients experiencing root resorption, it may be possible for the clinician to reduce the severity of the condition. Of the included studies, the most common methodologic flaws include the absence of a control group, appropriate randomization strategy, and adequate examinations before and after treatment.
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Affiliation(s)
- Scott Derek Currell
- College of Medicine and Dentistry, James Cook University, Queensland, Australia
| | - Andrew Liaw
- Oral Health Services Tasmania, Tasmania, Australia
| | | | - Adrian Esterman
- University of South Australia Cancer Research Institute, University of South Australia, South Australia, Australia; Australian Institute of Tropical Health and Medicine, James Cook University, Queensland, Australia.
| | - Alan Nimmo
- College of Medicine and Dentistry, James Cook University, Queensland, Australia
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Sifakakis I, Papaioannou W, Papadimitriou A, Kloukos D, Papageorgiou SN, Eliades T. Salivary levels of cariogenic bacterial species during orthodontic treatment with thermoplastic aligners or fixed appliances: a prospective cohort study. Prog Orthod 2018; 19:25. [PMID: 30066184 PMCID: PMC6068060 DOI: 10.1186/s40510-018-0230-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 07/01/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fixed orthodontic appliances might be associated with intraoral adverse effects on enamel, due to plaque accumulation and their colonization by oral microbes. At the same time, the demand for esthetic alternatives to orthodontic treatment, like thermoplastic aligners, is growing. However, thermoplastic aligners may behave differently intraorally than fixed appliances in terms of bacterial colonization and biofilm formation. Therefore, the aim of this prospective cohort study was to assess the salivary prevalence of the cariogenic bacteria Streptococcus mutans, Lactobacillus acidophilus, and Streptococcus sanguinis among adolescents treated orthodontically with thermoplastic aligners or fixed appliances. METHODS Thirty adolescent patients (17 girls/13 boys; mean age 13.8 years old) were assigned to treatment with either (i) self-ligating fixed appliances with nickel-titanium archwires or (ii) aligners constructed from clear transparent polyethylenterephthalat-glycol copolyester (PET-G) thermoplastic sheets. Whole stimulated saliva was collected from each patient at three time points: at baseline (before bonding and initiation of orthodontic therapy or before insertion of the thermoplastic aligners), after 2 weeks, and after 1 month. A simplified plaque index, a simplified gingival index, and the decayed, missing, and filled teeth (DMFT) index were assessed from the clinical examination of the patients. Microbiological analysis of salivary bacteria was performed by quantitative polymerase chain reaction, followed by descriptive and inferential statistics at the 5% level. RESULTS Although patients treated with aligners had significantly lower plaque and gingivitis scores throughout treatment compared to patients treated with fixed appliances, no significant difference could be found between the S. mutans counts of the two groups at any time through treatment (P > 0.05). On the other hand, patients treated with aligners had significantly lower salivary S. sanguinis counts at all time points than patients treated with fixed appliances (P < 0.05). Finally, almost no L. acidophilus were identified in the collected saliva samples in either of the treated samples. CONCLUSIONS Within the limitations of this study, there were no differences in the salivary counts of S. mutans or L. acidophilus among adolescent patients treated for 1 month with thermoplastic aligners or self-ligating appliances. On the other hand, patients treated with aligners had lower salivary levels of S. sanguinis compared to those treated with self-ligating appliances.
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Affiliation(s)
- Iosif Sifakakis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - William Papaioannou
- Department of Preventive and Community Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Aikaterini Papadimitriou
- Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force General Hospital, Athens, Greece
| | - Dimitrios Kloukos
- Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force General Hospital, Athens, Greece
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Spyridon N. Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, Faculty of Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, Faculty of Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
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21
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Papageorgiou SN, Xavier GM, Cobourne MT, Eliades T. Effect of orthodontic treatment on the subgingival microbiota: A systematic review and meta-analysis. Orthod Craniofac Res 2018; 21:175-185. [DOI: 10.1111/ocr.12237] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 05/30/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Spyridon N. Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Guilherme M. Xavier
- Department of Orthodontics; King's College London Dental Institute; London United Kingdom
| | - Martyn T. Cobourne
- Department of Orthodontics; King's College London Dental Institute; London United Kingdom
| | - Theodore Eliades
- Department of Orthodontics; King's College London Dental Institute; London United Kingdom
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22
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Martins RP. Early vertical correction of the deep curve of Spee. Dental Press J Orthod 2018; 22:118-125. [PMID: 28658363 PMCID: PMC5484277 DOI: 10.1590/2177-6709.22.2.118-125.sar] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 03/03/2017] [Indexed: 11/22/2022] Open
Abstract
Even though few technological advancements have occurred in Orthodontics recently, the search for more efficient treatments continues. This paper analyses how to accelerate and improve one of the most arduous phases of orthodontic treatment, i.e., correction of the curve of Spee. The leveling of a deep curve of Spee can happen simultaneously with the alignment phase through a method called Early Vertical Correction (EVC). This technique uses two cantilevers affixed to the initial flexible archwire. This paper describes the force system produced by EVC and how to control its side effects. The EVC can reduce treatment time in malocclusions with deep curves of Spee, by combining two phases of the therapy, which clinicians ordinarily pursue sequentially.
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Affiliation(s)
- Renato Parsekian Martins
- Private practice and part-time Faculty, Universidade Estadual Paulista (UNESP), Department of Pediatric Dentistry, School of Dentistry, Araraquara, São Paulo, Brazil. Visiting professor, Jacksonville University School of Orthodontics, Jacksonville, Florida, USA
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23
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Stasinopoulos D, Papageorgiou SN, Kirsch F, Daratsianos N, Jäger A, Bourauel C. Failure patterns of different bracket systems and their influence on treatment duration: A retrospective cohort study. Angle Orthod 2018; 88:338-347. [PMID: 29394090 PMCID: PMC8288329 DOI: 10.2319/081817-559.1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 12/01/2017] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To compare the failure pattern of four different bracket types and to assess its effect on treatment duration. MATERIALS AND METHODS A total of 78 white patients (28 male, 50 female) with a mean age of 12.6 years were included in this retrospective cohort study and treated for a mean period of 30.6 months. The patients were treated in a private practice with stainless steel conventionally ligated brackets, ceramic conventionally ligated brackets, stainless steel self-ligating brackets, or nickel-free self-ligating brackets. The loss of at least one bracket during the course of treatment was analyzed with Cox proportional hazards survival analyses and generalized linear regression. RESULTS The overall bracket failure rate at the tooth level was 14.1% (217 brackets), with significant differences according to tooth type (between 8.0%-23.4%) and bracket type (between 11.2%-20.0%). After taking confounders into account, patients treated with ceramic brackets lost more brackets (hazard ratio = 1.62; 95% confidence interval = 1.14-2.29; P = .007) than patients with stainless steel brackets. On average, treatment time increased by 0.6 months (95% confidence interval = 0.21-1.05; P = .004) for each additional failed bracket. CONCLUSIONS Bracket failure was more often observed with ceramic brackets and was associated with increased treatment duration.
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24
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Papageorgiou SN, Xavier GM, Cobourne MT, Eliades T. Registered trials report less beneficial treatment effects than unregistered ones: a meta-epidemiological study in orthodontics. J Clin Epidemiol 2018; 100:44-52. [PMID: 29705094 DOI: 10.1016/j.jclinepi.2018.04.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 04/06/2018] [Accepted: 04/20/2018] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Clinical trial registration is widely recommended because it allows tracking of trials that helps ensure full and unbiased reporting of their results. The aim of the present overview was to provide empirical evidence on bias associated with trial registration via a meta-epidemiological approach. STUDY DESIGN AND SETTINGS Six databases were searched in September 2017 for randomized clinical trials and systematic reviews thereof assessing the effects of orthodontic clinical interventions. After duplicate study selection and data extraction, statistical analysis included a two-step meta-epidemiological approach within- and across-included meta-analyses with a Paule-Mandel random-effects model to calculate differences in standardized mean differences (ΔSMD) between registered and unregistered trials and their 95% confidence intervals (CI), followed by subgroup and sensitivity analyses. RESULTS A total of 16 meta-analyses with 83 trials and 4,988 patients collectively were finally included, which indicated that registered trials reported less beneficial treatment effects than unregistered trials (ΔSMD = -0.36; 95% CI = -0.60, -0.12). Although some small-study effects were identified, sensitivity analyses according to precision and risk of bias indicated robustness. CONCLUSION Signs of bias from lack of trial protocol registration were found with nonregistered trials reporting more beneficial intervention effects than registered ones. Caution is warranted by the interpretation of nonregistered randomized trials or systematic reviews thereof.
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Affiliation(s)
- Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, Zurich 8032, Switzerland.
| | - Guilherme M Xavier
- Department of Orthodontics, King's College London Dental Institute, London SE1 9RT, United Kingdom
| | - Martyn T Cobourne
- Department of Orthodontics, King's College London Dental Institute, London SE1 9RT, United Kingdom
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, Zurich 8032, Switzerland
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25
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DiBiase AT, Woodhouse NR, Papageorgiou SN, Johnson N, Slipper C, Grant J, Alsaleh M, Khaja Y, Cobourne MT. Effects of supplemental vibrational force on space closure, treatment duration, and occlusal outcome: A multicenter randomized clinical trial. Am J Orthod Dentofacial Orthop 2018; 153:469-480.e4. [DOI: 10.1016/j.ajodo.2017.10.021] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 10/01/2017] [Accepted: 10/01/2017] [Indexed: 12/17/2022]
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26
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Savoldi F, Visconti L, Dalessandri D, Bonetti S, Tsoi JKH, Matinlinna JP, Paganelli C. In vitro evaluation of the influence of velocity on sliding resistance of stainless steel arch wires in a self-ligating orthodontic bracket. Orthod Craniofac Res 2018; 20:119-125. [PMID: 28414874 DOI: 10.1111/ocr.12156] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2017] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Of the variables used by in vitro studies of resistance to sliding (RS) in orthodontics, sliding velocity (SV) of the wire is often the one farthest from its clinical counterpart. We investigated whether velocity influences the RS at values approximating the orthodontic movement. METHODS A SS self-ligating bracket with a NiTi clip was fixed onto a custom-made model. Different shaped orthodontic SS wires of four sizes and two types (round, 0.020″ and 0.022″; rectangular, 0.016″×0.022″ and 0.017″×0.025″) were tested using an Instron® testing machine. Wires were pulled at four velocities (1×10-2 mm/s, 1×10-3 mm/s, 1×10-4 mm/s, 1×10-5 mm/s). Shapiro-Wilk test was used to evaluate the normal distribution of the data; two-way ANOVA was performed to compare means in the RS with wire characteristics and SV. Significance level was set at P<.05. RESULTS RS was higher for rectangular wires, and for those with larger diameters. Lower SV was associated with lower RS, with wire type and size having an interaction effect. The RS relatively to SV can be represented as: RS ∝ α[ln(SV)]+β, where α and β are constants. CONCLUSIONS At very low SV and low normal forces, SV influences the RS of SS archwires in orthodontic brackets, and the proportionality is logarithmic. Although respecting these parameters in vitro is challenging, quantitative evaluations of RS should be carried out at clinically relevant velocities if aiming at translational application in the clinical scenario.
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Affiliation(s)
- F Savoldi
- Department of Orthodontics, Dental School, University of Brescia, Brescia, Italy.,Dental Materials Science, Faculty of Dentistry, Prince Philip Dental Hospital, The University of Hong Kong, Hong Kong
| | - L Visconti
- Department of Orthodontics, Dental School, University of Brescia, Brescia, Italy
| | - D Dalessandri
- Department of Orthodontics, Dental School, University of Brescia, Brescia, Italy
| | - S Bonetti
- Department of Orthodontics, Dental School, University of Brescia, Brescia, Italy
| | - J K H Tsoi
- Dental Materials Science, Faculty of Dentistry, Prince Philip Dental Hospital, The University of Hong Kong, Hong Kong
| | - J P Matinlinna
- Dental Materials Science, Faculty of Dentistry, Prince Philip Dental Hospital, The University of Hong Kong, Hong Kong
| | - C Paganelli
- Department of Orthodontics, Dental School, University of Brescia, Brescia, Italy
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27
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Konstantonis D, Vasileiou D, Papageorgiou SN, Eliades T. Soft tissue changes following extraction vs. nonextraction orthodontic fixed appliance treatment: a systematic review and meta-analysis. Eur J Oral Sci 2018; 126:167-179. [PMID: 29480521 DOI: 10.1111/eos.12409] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aim of this systematic review was to assess the effect of systematic extraction protocols during orthodontic fixed appliance treatment on the soft tissue profile of human patients. Nine databases were searched until December 2016 for controlled clinical studies including premolar extraction or nonextraction treatment. After elimination of duplicate studies, data extraction, and risk-of-bias assessment according to the Cochrane guidelines, random-effects meta-analyses of mean differences (MD) or standardized mean differences (SMD) and their 95% CIs were performed, followed by subgroup, meta-regression, and sensitivity analyses. Extraction treatment was associated with increased lower lip retraction (24 studies; 1,456 patients; MD = 1.96 mm), upper lip retraction (21 studies; 1,149 patients; MD = 1.26 mm), nasolabial angle (21 studies; 1,089 patients; MD = 4.21°), soft-tissue profile convexity (six studies; 408 patients; MD = 1.24°), and profile pleasantness (three studies; 249 patients; SMD = 0.41). Patient age, extraction protocol, and amount of upper incisor retraction during treatment were significantly associated with the observed extraction effects, while the quality of evidence was very low in all cases due to risk of bias, baseline confounding, inconsistency, and imprecision. Although tooth extractions seem to affect patient profile, existing studies are heterogenous and no consistent predictions of profile response can be made.
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Affiliation(s)
- Dimitrios Konstantonis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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28
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Abstract
The demand and accessibility of orthodontic care has increased but has also been accompanied by patient requests for shorter treatment times. Longer orthodontic treatment increases the risk of decalcification, gingival recession, and root resorption and so shorter treatment times have multiple advantages as well as appealing to patient's desires. Numerous techniques and materials have been suggested to reduce treatment times but, in most cases, are based upon selected case reports with no prospective clinical trials to validate claims. The present review examines many of the current options purported to accelerate orthodontic tooth movement and the level of evidence presently available. There is some evidence to suggest that low-level laser therapy and a corticotomy involving the raising of a muco-periosteal flap are associated with accelerated orthodontic tooth movement; however, the current level of evidence is low to moderate in quality. For this reason, further research is required before routine application could be recommended.
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Affiliation(s)
- P Miles
- Seton Hill University, Department of Orthodontics, PA, USA
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29
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Saloom HF, Papageorgiou SN, Carpenter GH, Cobourne MT. The effect of obesity on orofacial pain during early orthodontic treatment with fixed appliances: a prospective cohort study. Eur J Orthod 2017; 40:343-349. [DOI: 10.1093/ejo/cjx064] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Hayder F Saloom
- Department of Orthodontics, King’s College London Dental Institute, London, UK
- Department of Mucosal and Salivary Biology, King’s College London Dental Institute, London, UK
- Orthodontic Department, College of Dentistry, University of Baghdad, Iraq
| | - Spyridon N Papageorgiou
- Department of Orthodontics and Department of Oral Technology, University of Bonn, Bonn, Germany
| | - Guy H Carpenter
- Department of Mucosal and Salivary Biology, King’s College London Dental Institute, London, UK
| | - Martyn T Cobourne
- Department of Orthodontics, King’s College London Dental Institute, London, UK
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30
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Papageorgiou SN, Höchli D, Eliades T. Outcomes of comprehensive fixed appliance orthodontic treatment: A systematic review with meta-analysis and methodological overview. Korean J Orthod 2017; 47:401-413. [PMID: 29090128 PMCID: PMC5653689 DOI: 10.4041/kjod.2017.47.6.401] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 02/21/2017] [Accepted: 03/29/2017] [Indexed: 12/13/2022] Open
Abstract
Objective The aim of this systematic review was to assess the occlusal outcome and duration of fixed orthodontic therapy from clinical trials in humans with the Objective Grading System (OGS) proposed by the American Board of Orthodontics. Methods Nine databases were searched up to October 2016 for prospective/retrospective clinical trials assessing the outcomes of orthodontic therapy with fixed appliances. After duplicate study selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, random-effects meta-analyses of the mean OGS score and treatment duration were performed and 95% confidence intervals (CIs) were calculated. Results A total of 34 relevant clinical trials including 6,207 patients (40% male, 60% female; average age, 18.4 years) were identified. The average OGS score after treatment was 27.9 points (95% CI, 25.3–30.6 points), while the average treatment duration was 24.9 months (95% CI, 24.6–25.1 months). There was no significant association between occlusal outcome and treatment duration, while considerable heterogeneity was identified. In addition, orthodontic treatment involving extraction of four premolars appeared to have an important effect on both outcomes and duration of treatment. Finally, only 10 (39%) of the identified studies matched compared groups by initial malocclusion severity, although meta-epidemiological evidence suggested that matching may have significantly influenced their results. Conclusions The findings from this systematic review suggest that the occlusal outcomes of fixed appliance treatment vary considerably, with no significant association between treatment outcomes and duration. Prospective matched clinical studies that use the OGS tool are needed to compare the effectiveness of orthodontic appliances.
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Affiliation(s)
- Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Damian Höchli
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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31
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Papageorgiou SN, Antonoglou GN, Sándor GK, Eliades T. Randomized clinical trials in orthodontics are rarely registered a priori and often published late or not at all. PLoS One 2017; 12:e0182785. [PMID: 28777820 PMCID: PMC5544232 DOI: 10.1371/journal.pone.0182785] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 07/24/2017] [Indexed: 12/31/2022] Open
Abstract
A priori registration of randomized clinical trials is crucial to the transparency and credibility of their findings. Aim of this study was to assess the frequency with which registered and completed randomized trials in orthodontics are published. We searched ClinicalTrials.gov and ISRCTN for registered randomized clinical trials in orthodontics that had been completed up to January 2017 and judged the publication status and date of registered trials using a systematic protocol. Statistical analysis included descriptive statistics, chi-square or Fisher exact tests, and Kaplan-Meier survival estimates. From the 266 orthodontic trials registered up to January 2017, 80 trials had been completed and included in the present study. Among these 80 included trials, the majority (76%) were registered retrospectively, while only 33 (41%) were published at the time. The median time from completion to publication was 20.1 months (interquartile range: 9.1 to 31.6 months), while survival analysis indicated that less than 10% of the trials were published after 5 years from their completion. Finally, 22 (28%) of completed trials remain unpublished even after 5 years from their completion. Publication rates of registered randomized trials in orthodontics remained low, even 5 years after their completion date.
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Affiliation(s)
- Spyridon N. Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- * E-mail:
| | - Georgios N. Antonoglou
- Institute of Dentistry, Department of Oral and Maxillofacial Surgery, University of Oulu, Oulu, Finland
- Department of Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George K. Sándor
- Institute of Dentistry, Department of Oral and Maxillofacial Surgery, University of Oulu, Oulu, Finland
- BioMediTech, Institute of Bioscience and Technology, University of Tampere, Tampere, Finland
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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32
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Papageorgiou SN, Sifakakis I, Keilig L, Patcas R, Affolter S, Eliades T, Bourauel C. Torque differences according to tooth morphology and bracket placement: a finite element study. Eur J Orthod 2017; 39:411-418. [PMID: 27932407 DOI: 10.1093/ejo/cjw074] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Introduction Torque of the maxillary incisors is essential in esthetics and proper occlusion, while torque expression is influenced by many factors. The aim of this finite element study was to assess the relative effect of tooth morphology, bracket prescription, and bracket positioning on tooth displacement and developed stresses/strains after torque application. Methods A three-dimensional upper right central incisor with its periodontal ligament (PDL) and alveolus was modelled. The tooth varied in the crown-root angle (CRA) between 156°, 170°, and 184°. An 0.018-inch slot discovery® (Dentaurum, Ispringen, Germany) bracket with a rectangular 0.018 × 0.025-inch β-titanium wire was modelled. Bracket torque prescription varied between 0°, 12°, and 22°, with bracket placement at the centre of the middle, gingival or incisal third of the crown. A total of 27 models were generated and a buccal root torque of 30° was applied. Afterwards, crown and apex displacement, strains in the PDL, and stresses in the bracket were calculated and analysed statistically. Results The palatal crown displacement was significantly affected by bracket positioning (up to 94 per cent), while the buccal apex displacement was significantly affected by bracket prescription (up to 42 per cent) and bracket positioning (up to 23 per cent). Strains in the PDL were affected mainly by CRA (up to 54 per cent), followed by bracket positioning (up to 45 per cent). Finally, bracket prescription considerably affected the stresses in the bracket (up to 144 per cent). Limitations These in silico results need to be validated in vivo before they can be clinically extrapolated. Conclusion Tooth anatomy and the characteristics of the orthodontic appliance should be considered during torque application.
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Affiliation(s)
- Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Switzerland.,Department of Oral Technology, School of Dentistry, University of Bonn, Germany
| | - Iosif Sifakakis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens,Greece
| | - Ludger Keilig
- Department of Oral Technology, School of Dentistry, University of Bonn, Germany.,Department of Prosthetic Dentistry, Preclinical Education and Materials Science, School of Dentistry, University of Bonn, Germany
| | - Raphael Patcas
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Switzerland
| | - Stefan Affolter
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Switzerland
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Switzerland
| | - Christoph Bourauel
- Department of Oral Technology, School of Dentistry, University of Bonn, Germany
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33
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Papageorgiou SN, Papadelli AA, Eliades T. Effect of orthodontic treatment on periodontal clinical attachment: a systematic review and meta-analysis. Eur J Orthod 2017; 40:176-194. [DOI: 10.1093/ejo/cjx052] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Anastasia A Papadelli
- Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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34
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Kaklamanos EG, Mavreas D, Tsalikis L, Karagiannis V, Athanasiou AE. Treatment duration and gingival inflammation in Angle’s Class I malocclusion patients treated with the conventional straight-wire method and the Damon technique: a single-centre, randomised clinical trial. J Orthod 2017; 44:75-81. [DOI: 10.1080/14653125.2017.1316902] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Eleftherios G. Kaklamanos
- Department of Orthodontics, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Dimitrios Mavreas
- Practice Limited to Orthodontics, Athens, Greece
- Department of Orthodontics, Faculty of Medicine and Pharmacy, CHIR – Unit Dentistry – ORHE, Vrije University, Brussels, Belgium
| | - Lazaros Tsalikis
- Department of Preventive Dentistry, Periodontology and Implant Biology, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vassilis Karagiannis
- School of Mathematics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Athanasios E. Athanasiou
- Department of Orthodontics, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
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35
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Mousoulea S, Papageorgiou SN, Eliades T. Treatment effects of various prescriptions and techniques for fixed orthodontic appliances. J Orofac Orthop 2017; 78:403-414. [PMID: 28397082 DOI: 10.1007/s00056-017-0094-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 03/02/2017] [Indexed: 01/22/2023]
Affiliation(s)
- Sophia Mousoulea
- Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force General Hospital, Athens, Greece
| | - Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Faculty of Medicine, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Faculty of Medicine, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland.
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Miles P, Fisher L. Authors' response. Am J Orthod Dentofacial Orthop 2017; 151:635-636. [PMID: 28364881 DOI: 10.1016/j.ajodo.2017.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 01/18/2017] [Accepted: 01/19/2017] [Indexed: 10/19/2022]
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Assessment of the changes in arch perimeter and irregularity in the mandibular arch during initial alignment with the AcceleDent Aura appliance vs no appliance in adolescents: A single-blind randomized clinical trial. Am J Orthod Dentofacial Orthop 2017; 150:928-936. [PMID: 27894541 DOI: 10.1016/j.ajodo.2016.07.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2016] [Revised: 07/01/2016] [Accepted: 07/01/2016] [Indexed: 12/30/2022]
Abstract
INTRODUCTION The purpose of this 2-arm parallel trial was to assess the effects of the AcceleDent Aura (OrthoAccel Technologies, Houston, Tex) appliance on the increase in mandibular anterior arch perimeter, the reduction in mandibular arch irregularity, and the amount of discomfort during initial alignment of the mandibular arch with fixed appliances. METHODS Forty Class II adolescent patients with full fixed appliances and treated with maxillary premolar extractions and no extractions in the mandibular arch participated in this randomized clinical trial. They were recruited in a private practice and treated by 1 clinician. Randomization to either a no-appliance group or the AcceleDent Aura appliance group was accomplished with permuted blocks of 10 patients with the allocations concealed in opaque, sealed envelopes. Both the operator and the outcome assessor were blinded, but it was not feasible to blind the patients. Discomfort was recorded during the first week of treatment. Mandibular anterior arch perimeter and anterior irregularity were measured from plaster models taken at the start of treatment and after 5, 8, and 10 weeks. RESULTS No patients were lost to follow-up, and no data were missing. There was no difference in anterior arch perimeter at the start of treatment (P = 0.85; median, 0.6 mm; 95% confidence interval [CI], -1.6, +1.8 mm) or at any other time point (5 weeks: P = 0.84; median, -0.2 mm; 95% CI, -1.6, +1.2 mm; 8 weeks: P = 0.56; median, -0.3 mm; 95% CI, -1.6, +0.7 mm; 10 weeks: P = 0.67; median, -0.1 mm; 95% CI, -1.5, +1.1 mm). There was also no difference between groups for incisor irregularity (P = 0.46; median, -0.5 mm; 95% CI, -2.2, +2.8 mm; P = 0.80; median, 0.0 mm; 95% CI, -1.0, +1.1 mm; P = 0.70; median, 0.1 mm; 95% CI, -0.7, +0.8 mm; P = 0.65; median, 0.2 mm; 95% CI, -0.6, +0.6 mm). No difference was detected at any time during the first week for discomfort (baseline: P = 0.84; median, -1.5 mm; 95% CI, -15.9, +9.8 mm; 6 hours: P = 0.96; median, 0.3 mm; 95% CI, -23.5, +21.8 mm; 1 day: P, 0.75; median, -3.5 mm; 95% CI, -27.1, +26.9 mm; 3 days: P = 0.98; median, -0.6 mm; 95% CI, -20.6, +20.0; 7 days: P = 0.57; median, 0.5 mm; 95% CI, -5.0, +5.3 mm). However, significantly fewer participants in the AcceleDent Aura group used analgesics at day 1 (P = <0.01). CONCLUSIONS The AcceleDent Aura appliance had no effect compared with no appliance on increasing anterior arch perimeter, or reducing irregularity or perceived discomfort during initial alignment with fixed appliances, although more subjects used painkillers at 24 hours in the no-appliance group. REGISTRATION This trial was not registered. PROTOCOL The protocol was not published before trial commencement. FUNDING A special research grant was obtained from the Australian Society of Orthodontists Foundation for Research and Education to purchase the AcceleDent Aura appliances and fund the statistical analysis.
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Papageorgiou SN, Keilig L, Vandevska-Radunovic V, Eliades T, Bourauel C. Torque differences due to the material variation of the orthodontic appliance: a finite element study. Prog Orthod 2017; 18:6. [PMID: 28164256 PMCID: PMC5326743 DOI: 10.1186/s40510-017-0161-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 01/25/2017] [Indexed: 11/17/2022] Open
Abstract
Background Torque of the maxillary incisors is crucial to occlusal relationship and esthetics and can be influenced by many factors. The aim of this study was to assess the relative influence of the material of the orthodontic appliance (adhesive, bracket, ligature, and wire) on tooth displacements and developed stresses/strains after torque application. Methods A three-dimensional upper right central incisor with its periodontal ligament (PDL) and alveolus was modeled. A 0.018-in. slot discovery® (Dentaurum, Ispringen, Germany) bracket with a rectangular 0.018 x 0.025-in. wire was generated. The orthodontic appliance varied in the material of its components: adhesive (composite resin or resin-modified glass ionomer cement), bracket (titanium, steel, or ceramic), wire (beta-titanium or steel), and ligature (elastomeric or steel). A total of 24 models were generated, and a palatal root torque of 5° was applied. Afterwards, crown and apex displacement, strains in the PDL, and stresses in the bracket were calculated and analyzed. Results The labial crown displacement and the palatal root displacement of the tooth were mainly influenced by the material of the wire (up to 150% variation), followed by the material of the bracket (up to 19% variation). The magnitude of strains developed in the PDL was primarily influenced by the material of the wire (up to 127% variation), followed by the material of the bracket (up to 30% variation) and the ligature (up to 13% variation). Finally, stresses developed at the bracket were mainly influenced by the material of the wire (up to 118% variation) and the bracket (up to 59% variation). Conclusions The material properties of the orthodontic appliance and all its components should be considered during torque application. However, these in silico results need to be validated in vivo before they can be clinically extrapolated. Electronic supplementary material The online version of this article (doi:10.1186/s40510-017-0161-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland.
| | - Ludger Keilig
- Department of Oral Technology, School of Dentistry, University of Bonn, Welschnonnenstr. 17, 53111, Bonn, Germany.,Department of Prosthetic Dentistry, Preclinical Education and Materials Science, School of Dentistry, University of Bonn, Bonn, Germany
| | | | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Christoph Bourauel
- Department of Oral Technology, School of Dentistry, University of Bonn, Welschnonnenstr. 17, 53111, Bonn, Germany
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Evaluation of maxillary arch dimensional and inclination changes with self-ligating and conventional brackets using broad archwires. Am J Orthod Dentofacial Orthop 2016; 149:830-7. [DOI: 10.1016/j.ajodo.2015.11.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 11/01/2015] [Accepted: 11/01/2015] [Indexed: 11/23/2022]
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Papageorgiou SN, Gölz L, Jäger A, Eliades T, Bourauel C. Lingual vs. labial fixed orthodontic appliances: systematic review and meta-analysis of treatment effects. Eur J Oral Sci 2016; 124:105-18. [PMID: 26916846 DOI: 10.1111/eos.12250] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2015] [Indexed: 10/22/2022]
Abstract
The aim of this systematic review was to compare the therapeutic and adverse effects of lingual and labial orthodontic fixed appliances from clinical trials on human patients in an evidence-based manner. Randomized and prospective non-randomized clinical trials comparing lingual and labial appliances were included. Risk of bias within and across studies was assessed using the Cochrane tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Random-effects meta-analyses were conducted, followed by subgroup and sensitivity analyses. Six electronic databases were searched from inception to July 2015, without limitations. A total of 13 papers pertaining to 11 clinical trials were included with a total of 407 (34% male/66% female) patients. Compared with labial appliances, lingual appliances were associated with increased overall oral discomfort, increased speech impediment (measured using auditory analysis), worse speech performance assessed by laypersons, increased eating difficulty, and decreased intermolar width. On the other hand, lingual appliances were associated with increased intercanine width and significantly decreased anchorage loss of the maxillary first molar during space closure. Based on existing trials, there is insufficient evidence to make robust recommendations for lingual fixed orthodontic appliances regarding their therapeutic or adverse effects, as the quality of evidence was low.
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Affiliation(s)
- Spyridon N Papageorgiou
- Department of Orthodontics, School of Dentistry, University of Bonn, Bonn, Germany.,Department of Oral Technology, School of Dentistry, University of Bonn, Bonn, Germany
| | - Lina Gölz
- Department of Orthodontics, School of Dentistry, University of Bonn, Bonn, Germany
| | - Andreas Jäger
- Department of Orthodontics, School of Dentistry, University of Bonn, Bonn, Germany
| | - Theodore Eliades
- Clinic of Orthodontics and Paediatric Dentistry, Center of Dental Medicine, Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Christoph Bourauel
- Department of Oral Technology, School of Dentistry, University of Bonn, Bonn, Germany
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Gölz L, Knickenberg AC, Keilig L, Reimann S, Papageorgiou SN, Jäger A, Bourauel C. Nickel ion concentrations in the saliva of patients treated with self-ligating fixed appliances: a prospective cohort study. J Orofac Orthop 2016; 77:85-93. [DOI: 10.1007/s00056-016-0012-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 07/28/2015] [Indexed: 01/05/2023]
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Papageorgiou SN, Sifakakis I, Doulis I, Eliades T, Bourauel C. Torque efficiency of square and rectangular archwires into 0.018 and 0.022 in. conventional brackets. Prog Orthod 2016; 17:5. [PMID: 26780465 PMCID: PMC4715034 DOI: 10.1186/s40510-016-0118-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 01/08/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to compare the torque efficacy of square and rectangular wires in 0.018- and 0.022-in. conventionally ligated brackets. METHODS Brackets of the same prescription were evaluated in both slot dimensions. Identical acrylic resin models of the maxilla were bonded with the brackets and mounted on the Orthodontic Measurement and Simulation System. Ten 0.018 × 0.018 in., 0.018 × 0.022 in., and 0.018 × 0.025 in. stainless steel wires were evaluated in the 0.018-in. brackets and ten 0.019 × 0.019 in., 0.019 × 0.025 in., and 0.019 × 0.026 in. stainless steel wires were evaluated in the 0.022-in. brackets. A 15° buccal root torque was gradually applied to the right central incisor bracket, and the moments were recorded at this position. One-way ANOVA was applied for both bracket slot sizes along with post hoc analysis for the various archwire sizes. RESULTS The mean measured moments varied between 10.78 and 30.60 Nmm among the assessed wire-and-bracket combinations. Both square and rectangular archwires in the 0.018-in. bracket system exerted statistically significantly higher moments in comparison with their counterparts in the 0.022-in. bracket system. Rectangular archwires exerted statistically significantly higher moments than square archwires, both for the 0.018- and the 0.022-in. bracket system. CONCLUSIONS Rectangular archwires seem to be more efficient in torque exertion, especially in 0.018-in. brackets.
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Affiliation(s)
- Spyridon N Papageorgiou
- Department of Orthodontics, School of Dentistry, University of Bonn, Bonn, Germany.,Department of Oral Technology, School of Dentistry, University of Bonn, Bonn, Germany
| | - Iosif Sifakakis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Theodore Eliades
- Clinic of Orthodontics and Paediatric Dentistry, Centre of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032, Zurich, Switzerland.
| | - Christoph Bourauel
- Department of Oral Technology, School of Dentistry, University of Bonn, Bonn, Germany
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Shaughnessy T, Kantarci A, Kau CH, Skrenes D, Skrenes S, Ma D. Intraoral photobiomodulation-induced orthodontic tooth alignment: a preliminary study. BMC Oral Health 2016; 16:3. [PMID: 26762247 PMCID: PMC4711021 DOI: 10.1186/s12903-015-0159-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 12/23/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Numerous strategies have been proposed to decrease orthodontic treatment time. Photobiomodulation (PBM) has previously been demonstrated to assist in this objective. The aim of this study was to test if intraoral PBM increases the rate of tooth alignment and reduces the time required to resolve anterior dental crowding. METHODS Nineteen orthodontic subjects with Class I or Class II malocclusion and Little's Irregularity Index (LII) ≥ 3 mm were selected from a pool of applicants, providing 28 total arches. No cases required extraction. The test group (N = 11, 18 arches, 10 upper, 8 lower) received daily PBM treatment with an intraoral LED device (OrthoPulse™, Biolux Research Ltd.) during orthodontic treatment, while the control group (N = 8, 10 arches, 3 upper, 7 lower) received only orthodontic treatment. The PBM device exposed the buccal side of the gums to near-infrared light with a continuous 850-nm wavelength, generating an average daily energy density of 9.5 J/cm(2). LII was measured at the start (T0) of orthodontic treatment until alignment was reached (T1, where LII ≤ 1 mm). The control group was mostly bonded with 0.018-in slot self-ligating SPEED brackets (Hespeler Orthodontics, Cambridge, ON. Canada), while conventionally-ligating Ormco Mini-Diamond twins were used on the PBM group (Ormco, Glendora, Calif. USA). Both groups progressed through alignment with NiTi arch-wires from 0.014-in through to 0.018-in (Ormco), with identical arch-wire changes. The rate of anterior alignment, in LII mm/week, and total treatment time was collected for both groups. Cox proportional hazards models were used to compare groups and while considering age, sex, ethnicity, arch and degree of crowding. RESULTS The mean alignment rate for the PBM group was significantly higher than that of the control group, with an LII change rate of 1.27 mm/week (SD 0.53, 95 % CI ± 0.26) versus 0.44 mm/week (SD 0.20, 95 % CI ± 0.12), respectively (p = 0.0002). The treatment time to alignment was significantly smaller for the PBM group, which achieved alignment in 48 days (SD 39, 95 % CI ± 39), while the control group took 104 days (SD 55, 95 % CI ±19, p = 0.0053) on average. These results demonstrated that intraoral PBM increased the average rate of tooth movement by 2.9-fold, resulting in a 54 % average decrease in alignment duration versus control. The average PBM compliance to daily treatments was 93 % during alignment. CONCLUSIONS Under the limitations of this study, the findings suggest that intraoral PBM could be used to decrease anterior alignment treatment time, which could consequently decrease full orthodontic treatment time. However, due to its limitations, further research in the form of a large, randomized trial is needed. TRIAL REGISTRATION ClinicalTrials.gov NCT02267837 . Registered 10 October 2014.
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Affiliation(s)
- Timothy Shaughnessy
- Shaughnessy Orthodontics, 4330 Johns Creek Parkway, Suite 500, Suwanee, GA, USA.
| | - Alpdogan Kantarci
- Department of Applied Oral Health Sciences, Forsyth Institute, 245 First Street, Cambridge, MA, USA.
| | - Chung How Kau
- Department of Orthodontics, Faculty of Dentistry, University of Alabama, 1919 7th Ave S, SDB 305, Birmingham, AL, USA.
| | - Darya Skrenes
- Biolux Research Ltd, 220-825 Powell St, Vancouver, B.C, Canada.
| | - Sanjar Skrenes
- Biolux Research Ltd, 220-825 Powell St, Vancouver, B.C, Canada.
| | - Dennis Ma
- Biolux Research Ltd, 220-825 Powell St, Vancouver, B.C, Canada.
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An interview with Greg J. Huang. Dental Press J Orthod 2015; 20:32-6. [PMID: 26691967 PMCID: PMC4686742 DOI: 10.1590/2177-6709.20.6.032-036.int] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 08/27/2015] [Indexed: 11/25/2022] Open
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Papageorgiou SN, Keilig L, Hasan I, Jäger A, Bourauel C. Effect of material variation on the biomechanical behaviour of orthodontic fixed appliances: a finite element analysis. Eur J Orthod 2015; 38:300-7. [PMID: 26174769 DOI: 10.1093/ejo/cjv050] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Biomechanical analysis of orthodontic tooth movement is complex, as many different tissues and appliance components are involved. The aim of this finite element study was to assess the relative effect of material alteration of the various components of the orthodontic appliance on the biomechanical behaviour of tooth movement. METHODS A three-dimensional finite element solid model was constructed. The model consisted of a canine, a first, and a second premolar, including the surrounding tooth-supporting structures and fixed appliances. The materials of the orthodontic appliances were alternated between: (1) composite resin or resin-modified glass ionomer cement for the adhesive, (2) steel, titanium, ceramic, or plastic for the bracket, and (3) β-titanium or steel for the wire. After vertical activation of the first premolar by 0.5mm in occlusal direction, stress and strain calculations were performed at the periodontal ligament and the orthodontic appliance. RESULTS The finite element analysis indicated that strains developed at the periodontal ligament were mainly influenced by the orthodontic wire (up to +63 per cent), followed by the bracket (up to +44 per cent) and the adhesive (up to +4 per cent). As far as developed stresses at the orthodontic appliance are concerned, wire material had the greatest influence (up to +155 per cent), followed by bracket material (up to +148 per cent) and adhesive material (up to +8 per cent). LIMITATIONS The results of this in silico study need to be validated by in vivo studies before they can be extrapolated to clinical practice. CONCLUSION According to the results of this finite element study, all components of the orthodontic fixed appliance, including wire, bracket, and adhesive, seem to influence, to some extent, the biomechanics of tooth movement.
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Affiliation(s)
| | - Ludger Keilig
- Oral Technology, and Prosthodontics, Preclinical Education and Dental Materials Science, School of Dentistry, University of Bonn, Germany
| | - Istabrak Hasan
- Oral Technology, and Prosthodontics, Preclinical Education and Dental Materials Science, School of Dentistry, University of Bonn, Germany
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Woodhouse N, DiBiase A, Johnson N, Slipper C, Grant J, Alsaleh M, Donaldson A, Cobourne M. Supplemental Vibrational Force During Orthodontic Alignment. J Dent Res 2015; 94:682-9. [DOI: 10.1177/0022034515576195] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
This prospective 3-arm parallel-group randomized clinical trial investigated the effect of supplemental vibrational force on rate of orthodontic tooth alignment with fixed appliances. Eighty-one subjects (40 males, 41 females; mean age, 14.1 y) undergoing first premolar extraction-based fixed appliance treatment were randomly allocated to treatment supplemented with daily use (20 min) of a removable intraoral vibrational device (AcceleDent; OrthoAccel Technologies Inc.; n = 29), an identical nonfunctional (sham) device ( n = 25), or fixed appliances only ( n = 27). Mandibular study casts were taken at baseline (treatment start: placement of 0.014-in. nickel-titanium arch wire), initial alignment (0.018-in. nickel-titanium arch wire), and final alignment (0.019 x 0.025–in. stainless steel arch wire). Overall mean irregularity index in the mandibular arch at baseline was 8.5 ± 3.8 mm (95% CI, 7.6 to 9.3) with no significant difference between groups ( P = 0.73). For the total sample, mean irregularity index at initial alignment was 2.7 ± 2.8 mm (95% CI, 2.2 to 3.4) with no significant difference between groups ( P = 0.40). Mean time from baseline to initial alignment was 59 ± 25 d (95% CI, 54.5 to 65.6); from initial to final alignment, 150 ± 62.5 d (95% CI, 136 to 165); and baseline to final alignment, 209 ± 65 d (95% CI, 195 to 224). Kaplan-Meier analysis demonstrated that patterns of alignment were not significantly different among the 3 groups ( P = 0.66). Multivariate linear regression for initial and overall alignment rates using initial irregularity index as the covariate showed no significant differences among groups. The most important influence on both initial and overall rates of alignment was initial irregularity ( P = 0.1 × 10−4). This prospective randomized clinical trial found no evidence that supplemental vibrational force can significantly increase the rate of initial tooth movement or reduce the amount of time required to achieve final alignment when used in conjunction with a preadjusted edgewise fixed appliance ( ClinicalTrials.gov NCT02314975).
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Affiliation(s)
- N.R. Woodhouse
- Department of Orthodontics, King’s College London Dental Institute, London, UK
- Department of Orthodontics, Royal Alexandra Children’s Hospital, Brighton and Sussex University Hospitals NHS Foundation Trust, Brighton, UK
| | - A.T. DiBiase
- Department of Orthodontics, William Harvey Hospital, East Kent Hospitals University NHS Foundation Trust, Ashford, UK
| | - N. Johnson
- Department of Orthodontics, Royal Alexandra Children’s Hospital, Brighton and Sussex University Hospitals NHS Foundation Trust, Brighton, UK
| | - C. Slipper
- Department of Orthodontics, Royal Alexandra Children’s Hospital, Brighton and Sussex University Hospitals NHS Foundation Trust, Brighton, UK
| | - J. Grant
- Department of Orthodontics, Royal Alexandra Children’s Hospital, Brighton and Sussex University Hospitals NHS Foundation Trust, Brighton, UK
| | - M. Alsaleh
- Department of Orthodontics, King’s College London Dental Institute, London, UK
| | - A.N.A. Donaldson
- Biostatistics Unit, King’s College London Dental Institute, London, UK
| | - M.T. Cobourne
- Department of Orthodontics, King’s College London Dental Institute, London, UK
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