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Alforaidi S, Zreaqat M, Hassan R. Dental Arch Relationships of Saudi Children with Unilateral Cleft Lip and Palate. J Contemp Dent Pract 2023; 24:987-990. [PMID: 38317397 DOI: 10.5005/jp-journals-10024-3606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
AIM To determine dental arch relationships of Saudi children born with nonsyndromic complete unilateral cleft lip and palate (UCLP). MATERIAL AND METHODS This is a retrospective cohort study that comprised dental study models of 74 UCLP Saudi children aged 8-10 years who were recruited from 14 referral cleft centers. All participants had their cleft lip and palate repaired with no history of alveolar bone graft or any orthodontic treatment. Dental arch relationships of UCLP patients were assessed using the Great Ormond Street, London, and Oslo (GOSLON) Yardstick-a clinical tool that categorizes dental relationships of UCLP children into five discrete grades from I to V. The reliability of the rating was assessed with weighted kappa (κ) statistics. RESULTS Three children (4.1%) had excellent surgical outcomes (grade I), 18 children (24.3%) filled into grade II (good outcome), 22 subjects (29.7%) had grade III (fair outcome), 27 children (36.5%) had grade IV (poor outcome), and 4 subjects (5.4%) were ranked as having very poor outcomes (grade V). The mean GOSLON score was 3.39. Intrarater and interrater agreements were high indicating good reproducibility. CONCLUSION Based on the dental arch relationships, the treatment outcome of UCLP Saudi children was unsatisfactory, with a mean GOSLON score of 3.39. Delayed palate repair and the use of presurgical orthopedics may be considered in the future for cleft deformity management. CLINICAL SIGNIFICANCE To address the effect of particular cleft surgical protocol on dental arch relationships of UCLP patients. How to cite this article: Alforaidi S, Zreaqat M, Hassan R. Dental Arch Relationships of Saudi Children with Unilateral Cleft Lip and Palate. J Contemp Dent Pract 2023;24(12):987-990.
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Affiliation(s)
- Sahal Alforaidi
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, Taibah University, Saudi Arabia
| | - Maen Zreaqat
- Department of Orthodontics, School of Dental Sciences, Universiti Sains Malaysia, Malaysia, Phone: +60 97673719, e-mail:
| | - Rozita Hassan
- Department of Orthodontics, School of Dental Sciences, Universiti Sains Malaysia, Malaysia
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Srivastav S, Tewari N, Antonarakis GS, Duggal R, Saji S, Lokade AK, Yadav R. Evidence Mapping and Quality Analysis of Systematic Reviews on Various Aspects Related to Cleft Lip and Palate. J Clin Med 2023; 12:6002. [PMID: 37762942 PMCID: PMC10532364 DOI: 10.3390/jcm12186002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/30/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Management of cleft lip and palate is interdisciplinary. An evidence-mapping approach was envisaged to highlight the existing gaps in this field, using only the highest level of evidence. OBJECTIVES To conduct evidence mapping and quality analysis of systematic reviews and meta-analyses related to any aspect of cleft lip and palate. SEARCH METHODS The cleft lip and palate field was divided into 9 domains and 50 subdomains and a method of categorization of systematic reviews was established. A comprehensive search strategy was carried out in seven databases along with the search of gray literature and references of included articles. SELECTION CRITERIA Systematic reviews related to any aspect of cleft lip and palate, conducted by a minimum of two reviewers, with a comprehensive search strategy and adequate quality analysis were included. DATA COLLECTION AND ANALYSIS A self-designed, pre-piloted data-extraction sheet was used to collect information that was analyzed through an expert group discussion. Quality analysis was performed using ROBIS-I, AMSTAR 2, and the PRISMA checklist. RESULTS A total of 144 systematic reviews published between 2008 and 2022 were included. The largest number of these could be categorized in the therapeutic domain (n = 58). A total of 27% of the studies were categorized as inconclusive, 40% as partially conclusive, and 33% as conclusive. As per ROBIS-I, 77% of reviews had high risk of bias while 58% were graded as critically low in quality as per AMSTAR 2. The majority of systematic reviews showed low reporting errors. CONCLUSIONS The majority of systematic reviews related to cleft lip and palate relate to therapeutic and prognostic domains and show high risk of bias and critically low quality regardless of the source journal. The results of this paper might serve as a starting point encouraging authors to carry out high-quality research where evidence is lacking. REGISTRATION A multidisciplinary expert-group formulated an a priori protocol, registered in Open Science Framework (DOI 10.17605/OSF.IO/NQDV2).
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Affiliation(s)
- Sukeshana Srivastav
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, 8000 Aarhus, Denmark
- Division of Paediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi 110029, India
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, 1205 Geneva, Switzerland
| | - Nitesh Tewari
- Division of Paediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Gregory S. Antonarakis
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, 1205 Geneva, Switzerland
| | - Ritu Duggal
- Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Seba Saji
- Division of Paediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Amol Kumar Lokade
- Division of Paediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Rahul Yadav
- Division of Oral and Maxillofacial Surgery, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi 110029, India
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de Castro Ribeiro TT, Castillo RAD, Ozawa TO, Ramalho-Ferreira G, Castillo AAD, Janson G. Late alveolar bone grafting in complete unilateral cleft lip and palate (UCLP): Biomechanical considerations for the success of orthodontic finishing. J Orthod 2022; 49:457-462. [PMID: 35323076 DOI: 10.1177/14653125221087289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Orthodontic treatment in patients with cleft lip and palate (CLP) is challenging. Alignment of the maxillary segments and orthodontic levelling of the teeth adjacent to the cleft area are important before alveolar bone grafting (ABG), in the permanent dentition. In this clinical report, orthodontic procedures, before and after late ABG, are described as an alternative that can optimise the orthodontic and periodontal results. The gingival margins of the teeth adjacent to the cleft area were levelled. Root divergence was corrected. Interdental papilla and improvement of the periodontal condition were obtained.
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Affiliation(s)
- Tiago Turri de Castro Ribeiro
- Department of Orthodontics, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
| | - Rosalinda Aliaga-Del Castillo
- Department of Orthodontics, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
| | - Terumi Okada Ozawa
- Department of Orthodontics, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
| | - Gabriel Ramalho-Ferreira
- Department of Oral and Maxillofacial Surgery, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
| | | | - Guilherme Janson
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
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Heliövaara A, Küseler A, Skaare P, Bellardie H, Mølsted K, Karsten A, Marcusson A, Rizell S, Brinck E, Sæle P, Chalien MN, Mooney J, Eyres P, Shaw W, Semb G. Scandcleft randomized trials of primary surgery for unilateral cleft lip and palate: comparison of dental arch relationships and dental indices at 5, 8, and 10 years. Eur J Orthod 2021; 44:258-267. [PMID: 34476476 PMCID: PMC9127717 DOI: 10.1093/ejo/cjab055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background and trial design The Scandcleft intercentre study evaluates the outcomes of four surgical protocols (common method Arm A, and methods B, C, and D) for treatment of children with unilateral cleft lip and palate (UCLP) in a set of three randomized trials of primary surgery (Trials 1, 2, and 3). Objectives To evaluate and compare dental arch relationships of 5-, 8-, and 10-year-old children with UCLP after four different protocols of primary surgery and to compare three dental indices. The results are secondary outcomes of the overall trial. Methods Study models taken at the ages of 5 (n = 418), 8 (n = 411), and 10 years (n = 410) were analysed by a blinded panel of orthodontists using the Eurocran index, the 5-year-olds’ (5YO) index, and the GOSLON Yardstick. Student’s t-test, Pearson’s correlation, chi-square test, and kappa statistics were used in statistical analyses. Results The reliability of the dental indices varied between moderate and very good, and those of the Eurocran palatal index varied between fair and very good. Significant correlations existed between the dental indices at all ages. No differences were found in the mean 5-, 8-, and 10-year index scores or their distributions within surgical trials. Comparisons between trials detected significantly better mean index scores in Trial 2 Arm C (at all ages) and in Trial 1 Arm B (at 5 and 10 years of age) than in Trial 3 Arm D. The mean Eurocran dental index scores of the total material at 5, 8, and 10 years of age were 2.50, 2.60, and 2.26, and those of the 5YO index and GOSLON Yardstick were 2.77, 2.90, and 2.54, respectively. At age 10 years, 75.8% of the patients had had orthodontic treatment. Conclusions The results of these three trials do not provide evidence that one surgical method is superior to the others. The reliabilities of the dental indices were acceptable, and significant correlations existed between the indices at all ages. The reliability of the Eurocran palatal index was questionable. Trial registration ISRCTN29932826.
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Affiliation(s)
- Arja Heliövaara
- Cleft Palate and Craniofacial Center, Department of Plastic Surgery, Helsinki University Hospital and Helsinki University, Finland
| | - Annelise Küseler
- Cleft Palate Center and University Hospital Aarhus and University of Aarhus, Denmark
| | - Pål Skaare
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital Rikshospitalet, Norway
| | - Haydn Bellardie
- Dental School, University of Manchester, UK.,University of the Western and Cape, Cape Town, South Africa
| | - Kirsten Mølsted
- Copenhagen Cleft Palate Center, University Hospital of Copenhagen, Denmark
| | - Agneta Karsten
- Section for Orthodontics, Division of Orthodontics and Pedodontics, Department of Dental Medicine, Karolinska Institutet and Stockholm Craniofacial Team, Sweden
| | - Agneta Marcusson
- Maxillofacial Unit and Department of Clinical and Experimental Medicine, Linköping University, Sweden
| | - Sara Rizell
- Specialist Clinic for Orthodontics, University Clinics of Odontology, Public Dental Health Service, Västra Götaland Region, Sweden
| | - Eli Brinck
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital Rikshospitalet, Norway
| | - Paul Sæle
- Oral Health Center of Expertise/Western Norway, Bergen, Norway
| | - Midia Najar Chalien
- Specialist Clinic for Orthodontics, University Clinics of Odontology, Public Dental Health Service, Västra Götaland Region, Sweden
| | | | - Phil Eyres
- Dental School, University of Manchester, UK
| | | | - Gunvor Semb
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital Rikshospitalet, Norway.,Dental School, University of Manchester, UK
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Heliövaara A, Leikola J. Prediction of orthognathic surgery need in children with unilateral cleft lip palate: Dental arch relationships and 5-year-olds' index. Orthod Craniofac Res 2021; 24:528-535. [PMID: 33440074 DOI: 10.1111/ocr.12467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/29/2020] [Accepted: 12/29/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate whether dental arch relationships at 6 years of age can categorize treatment outcome and predict later need for orthognathic surgery in children with unilateral cleft lip and palate (UCLP). SETTING AND SAMPLE POPULATION A retrospective longitudinal single-centre study. The study sample comprised 70 consecutive non-syndromic children (47 boys) with complete UCLP operated on by pushback techniques during 1981-1989 and followed until early adulthood in the same cleft centre. MATERIALS AND METHODS Dental casts and maxillomandibular relationships were assessed before orthodontic treatment and secondary alveolar bone grafting at mean age 6.1 years (range 5.6-6.8) using the 5-year-olds' index and lateral cephalograms. The need for orthognathic surgery was retrieved from patient files. Student's t test, Pearson's correlation, and Kappa statistics were used in statistical analyses. RESULTS Orthognathic surgery frequency was 41% (29/70). Those needing orthognathic surgery comprised all 3 patients with an index score of 5 (very poor), 14 of 17 (82%) scoring 4 (poor), 10 of 26 (38%) scoring 3 (fair), and 2 of 19 (11%) scoring 2 (good). Of the five patients with index score 1 (excellent), none needed osteotomies. The mean index score was 2.9. The score was significantly better in those without orthognathic surgery (2.4 versus 3.6). A significant negative correlation existed between the 5-year-olds' index and cephalometric angles ANB and anb. CONCLUSION The use of 5-year-olds' index may help to predict treatment outcome and the clinical need for orthognathic surgery especially in patients with the lowest and highest index scores.
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Affiliation(s)
- Arja Heliövaara
- Department of Plastic Surgery, Cleft Palate and Craniofacial Center, Helsinki University Hospital, Helsinki, Finland
| | - Junnu Leikola
- Department of Plastic Surgery, Cleft Palate and Craniofacial Center, Helsinki University Hospital, Helsinki, Finland
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Haque S, Khamis MF, Alam MK, Wan Ahmad AWM. The Assessment of 3D Digital Models Using GOSLON Yardstick Index: Exploring Confounding Factors Responsible for Unfavourable Treatment Outcome in Multi-Population Children With UCLP. Front Pediatr 2021; 9:646830. [PMID: 34262887 PMCID: PMC8273310 DOI: 10.3389/fped.2021.646830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 05/28/2021] [Indexed: 11/13/2022] Open
Abstract
To evaluate dental arch relationship (DAR) using GOSLON Yardstick and also to explore the association between multiple factors (age, gender, UCLP types, UCLP side, Family history of cleft, family history of Class III malocclusion, techniques of cheiloplasty, techniques of palatoplasty) and DAR in children unilateral cleft lip and palate (UCLP) in different populations. Two hundred fifty-five laser scanned 3D digital models (LS3DM) of UCLP children (5-12 years) from Malaysia, Bangladesh, and Pakistan were included. The intra- and inter-examiner agreements were evaluated by kappa statistics, to compare the GOSLON mean score between the populations and to explore the responsible factors that affect DAR, one way ANOVA, and crude logistic regression analysis was used, respectively. The mean GOSLON score was 2.97; 3.40 and 3.09 in Malaysia, Bangladesh, and Pakistan, respectively. Twenty seven, 40, and 30 subjects were in unfavourable (category rating 4 and 5) groups in Malaysia, Bangladesh, and Pakistan, respectively. A significant association was found between techniques of palatoplasty (p = 0.03; p = 0.04 and p = 0.04 in Malaysia, Bangladesh, and Pakistan, respectively) and unfavourable DAR. Different cheiloplasty techniques (p = 0.04) and gender (p = 0.03) also exhibited noteworthy associations with unfavourable DAR in the Bangladeshi population. Bardach techniques of palatoplasty were significantly associated with unfavourable DAR in all three populations. Moreover, male UCLP and modified Millard techniques of cheiloplasty were also associated with unfavourable DAR in the Bangladeshi population.
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Affiliation(s)
- Sanjida Haque
- Orthodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Mohd Fadhli Khamis
- Oral Biology and Forensic Odontology Unit, School of Dental Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Forensic Odontology Unit, Hospital Universiti Sains Malaysia, Kota Bharu, Malaysia
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Terumi Ozawa O, Daniela Salzedas C, Beatriz Oliveira DL, Sathler R, Baessa G, Garib D. Efficacy of Rapid Maxillary Expansion Associated With Maxillary Protraction in Patients With Unilateral Complete Cleft Lip and Palate. Cleft Palate Craniofac J 2020; 57:872-876. [DOI: 10.1177/1055665619896675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: To evaluate the efficacy of rapid maxillary expansion (RME) and maxillary protraction (MP) in patients with unilateral complete cleft lip and palate (UCLP) using the Goslon yardstick index. Design: Retrospective study. Patients: Dental casts of 34 Goslon 3 (G3) and Goslon 4 (G4) patients treated with RME and MP were evaluated which composed the treated sample (S1). The dental cast were taken before the RME (T1) and immediately after the use of face mask for MP was suspended (T2). In order to verify the stability of the treatment, dental casts of 17 of these patients were evaluated 1 year after the treatment was finished (T3). For the control sample (S2), dental casts of 20 untreated G3 and G4 patients were evaluated. Results: At T2, 85.7% of study sample patients initially G3 and 70% of patients initially G4 obtained improvement in occlusal index. At T3, the majority of patients initially classified as G3 and G4 returned to the same classification as in the beginning of the treatment. The evaluation of the control sample showed that patients initially classified as G3, 55.6% continued at this initial index, and 44.4% had it worsened. Those initially G4, 100%, continued at this initial index. Conclusion: The immediate result of RME and MP was satisfactory, and despite the instability of these results, the outcome of this treatment option was better than the untreated sample.
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Affiliation(s)
- Okada Terumi Ozawa
- Department of Orthodontics, Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Bauru, Brazil
| | - Costa Daniela Salzedas
- Department of Orthodontics, Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Bauru, Brazil
| | - de Lima Beatriz Oliveira
- Department of Orthodontics, Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Bauru, Brazil
| | - Renata Sathler
- Department of Orthodontics, Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Bauru, Brazil
| | - Gleisieli Baessa
- Department of Orthodontics, Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Bauru, Brazil
| | - Daniela Garib
- Department of Orthodontics, Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Bauru, Brazil
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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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