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Perillo L, d’Apuzzo F, Grassia V. New Approaches and Technologies in Orthodontics. J Clin Med 2024; 13:2470. [PMID: 38730999 PMCID: PMC11084780 DOI: 10.3390/jcm13092470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
In recent years, new diagnostic and treatment approaches in orthodontics have arisen, and there is thus a need for researchers and practitioners to stay up to date with these innovations [...].
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Affiliation(s)
| | | | - Vincenzo Grassia
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (L.P.); (F.d.)
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2
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Meriç P, Karadede MI. Three-dimensional evaluation of the effects of Bionator and Forsus appliances on oropharyngeal airway volume in patients with mandibular retrognathia. Cranio 2023; 41:529-541. [PMID: 36394427 DOI: 10.1080/08869634.2022.2147283] [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: 11/19/2022]
Abstract
OBJECTIVE To evaluate whether there is a difference between the effects of Bionator and Forsus appliances on airway volume. METHODS Forty patients with mandibular retrognathia were divided into two groups. The Bionator appliance was applied to Group 1, while the Forsus FRD EZ2 appliance was applied to Group 2. Three-dimensional images were captured before and after functional appliance use in both groups. Dolphin 3D software was used for airway measurements. RESULTS No statistically significant difference was found between the groups in terms of volumetric and area measurements. There was a statistically significant difference between the minimum axial T and O-N border T measurements of the groups. CONCLUSION The use of functional appliances may contribute to an increase in oropharyngeal airway dimensions, but there was no difference between the Bionator and Forsus groups in terms of volumetric measurements.
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Affiliation(s)
- Pamir Meriç
- Department of Orthodontics, Faculty of Dentistry, Trakya University, Edirne, Turkey
| | - Mehmet Irfan Karadede
- Department of Orthodontics, Faculty of Dentistry, Izmir Katip Çelebi University, Izmir, Turkey
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3
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Wen X, Wang Y, Gu Y. Transferrin promotes chondrogenic differentiation in condylar growth through inducing autophagy via ULK1-ATG16L1 axis. Clin Sci (Lond) 2023; 137:1431-1449. [PMID: 37694282 DOI: 10.1042/cs20230544] [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] [Received: 05/22/2023] [Revised: 09/08/2023] [Accepted: 09/08/2023] [Indexed: 09/12/2023]
Abstract
Skeletal mandibular hypoplasia (SMH) is one of the most common skeletal craniofacial deformities in orthodontics, which was often accompanied by impaired chondrogenesis and increasing apoptosis of condylar chondrocytes. Therefore, protecting chondrocytes from apoptosis and promoting chondrogenesis in condylar growth is vital for treatment of SMH patients. Transferrin (TF) was highly expressed in condylar cartilage of newborn mice and was gradually declined as the condyle ceased growing. Interestingly, serum level of TF in SMH patients was significantly lower than normal subjects. Hence, the aim of our study was to investigate the effect of TF on survival and differentiation of chondrocytes and condylar growth. First, we found that TF protected chondrogenic cell line ATDC5 cells from hypoxia-induced apoptosis and promoted proliferation and chondrogenic differentiation in vitro. Second, TF promoted chondrogenic differentiation and survival through activating autophagic flux. Inhibiting autophagic flux markedly blocked the effects of TF. Third, TF significantly activated ULK1-ATG16L1 axis. Silencing either transferrin receptor (TFRC), ULK1/2 or ATG16 significantly blocked the autophagic flux induced by TF, as well as its effect on anti-apoptosis and chondrogenic differentiation. Furthermore, we established an organoid culture model of mandible ex vivo and found that TF significantly promoted condylar growth. Taken together, our study unraveled a novel function of TF in condylar growth that TF protected chondrocytes from hypoxia-induced apoptosis and promoted chondrogenic differentiation through inducing autophagy via ULK1-ATG16L1 axis, which demonstrated that TF could be a novel growth factor of condylar growth and shed new light on developing treatment strategy of SMH patients.
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Affiliation(s)
- Xi Wen
- Department of Orthodontics, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China
| | - Yixiang Wang
- Central Laboratory, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China
| | - Yan Gu
- Department of Orthodontics, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China
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Lone IM, Zohud O, Midlej K, Proff P, Watted N, Iraqi FA. Skeletal Class II Malocclusion: From Clinical Treatment Strategies to the Roadmap in Identifying the Genetic Bases of Development in Humans with the Support of the Collaborative Cross Mouse Population. J Clin Med 2023; 12:5148. [PMID: 37568550 PMCID: PMC10420085 DOI: 10.3390/jcm12155148] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 07/30/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023] Open
Abstract
Depending on how severe it is, malocclusion, which may involve misaligned teeth, jaws, or a combination of the two, can hurt a person's overall facial aesthetics. The maxillary molar develops before the mandibular molar in class II malocclusion, which affects 15% of the population in the United States. With a retrusive mandible, patients typically have a convex profile. The goal of this study is to classify the skeletal and dental variability present in class II malocclusion, to reduce heterogeneity, present the current clinical treatment strategies, to summarize the previously published findings of genetic analysis, discuss these findings and their constraints, and finally, propose a comprehensive roadmap to facilitate investigations aimed at determining the genetic bases of malocclusion development using a variety of genomic approaches. To further comprehend the hereditary components involved in the onset and progression of class II malocclusion, a novel animal model for class II malocclusion should be developed while considering the variety of the human population. To overcome the constraints of the previous studies, here, we propose to conduct novel research on humans with the support of mouse models to produce contentious findings. We believe that carrying out a genome-wide association study (GWAS) on a large human cohort to search for significant genes and their modifiers; an epigenetics-wide association study (EWAS); RNA-seq analysis; integrating GWAS and the expression of quantitative trait loci (eQTL); and the testing of microRNAs, small RNAs, and long noncoding RNAs in tissues related to the skeletal class II malocclusion (SCIIMO) phenotype, such as mandibular bone, gum, and jaw in humans and the collaborative cross (CC) mouse model, will identify novel genes and genetic factors affecting this phenotype. We anticipate discovering novel genetic elements to advance our knowledge of how this malocclusion phenotype develops and open the venue for the early identification of patients carrying the susceptible genetic factors so that we can offer early prevention treatment strategies.
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Affiliation(s)
- Iqbal M. Lone
- Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (I.M.L.); (O.Z.); (K.M.)
| | - Osayd Zohud
- Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (I.M.L.); (O.Z.); (K.M.)
| | - Kareem Midlej
- Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (I.M.L.); (O.Z.); (K.M.)
| | - Peter Proff
- Department of Orthodontics, University Hospital of Regensburg, 93053 Regensburg, Germany;
| | - Nezar Watted
- Center for Dentistry Research and Aesthetics, Jatt 4491800, Israel;
- Department of Orthodontics, Faculty of Dentistry, Arab America University, Jenin 34567, Palestine
- Gathering for Prosperity Initiative, Jatt 4491800, Israel
| | - Fuad A. Iraqi
- Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (I.M.L.); (O.Z.); (K.M.)
- Department of Orthodontics, University Hospital of Regensburg, 93053 Regensburg, Germany;
- Gathering for Prosperity Initiative, Jatt 4491800, Israel
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Faccioni P, Butera A, Bazzanella S, Albanese M, Gallo S, Pascadopoli M, Scribante A, Pardo A. 3D Evaluation of Upper Airway Morphological Changes in Growing Patients with Class II Malocclusion Using Sander Bite Jumping Appliance. APPLIED SCIENCES 2023; 13:3908. [DOI: 10.3390/app13063908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
Class II malocclusion due to mandibular retrognathia is associated with a posterior positioning of the tongue and the hyoid bone, reducing the oropharyngeal volume. This could be a contributing factor to the development of respiratory and cardiovascular problems. This study evaluates the oropharyngeal volume variation in 13 patients with class II malocclusion undergoing functional orthopedic treatment with Sander Bite Jumping Appliance (SBJ). CBCT scans were performed before treatment (T0) and approximately after 12.5 months (T1): the retropalatal volume and retroglossal volume were quantified in mm3 using a segmentation software. At T1, the retropalatal volume increased in 2523 ± 2088 mm3, and the retroglossal volume increased in 2258 ± 1717 mm3. Both values were statistically significant (p < 0.05). This widening of the airways may allow prevention and treatment of sleep-disordered breathing, including obstructive sleep apnea syndrome.
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Affiliation(s)
- Paolo Faccioni
- Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37124 Verona, Italy
| | - Andrea Butera
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Silvia Bazzanella
- Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37124 Verona, Italy
| | - Massimo Albanese
- Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37124 Verona, Italy
| | - Simone Gallo
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Maurizio Pascadopoli
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Andrea Scribante
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Alessia Pardo
- Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37124 Verona, Italy
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Effectiveness of orthopaedic treatments on the enlargement of the upper airways: Overview of systematic reviews. Int Orthod 2023; 21:100745. [PMID: 36871416 DOI: 10.1016/j.ortho.2023.100745] [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: 12/01/2022] [Revised: 02/05/2023] [Accepted: 02/06/2023] [Indexed: 03/06/2023]
Abstract
OBJECTIVE The aims of this overview are to evaluate the three-dimensional effects of orthopaedic treatment (OT) and myofunctional therapy (MT) on the enlargement of the upper airways (UA). METHODS A search of the MEDLINE/PubMed and EMBASE databases was conducted up to July 2022 and completed by hand search. After selection of the title and abstract, systematic reviews (SR) dealing with the impact of OT and/or MT on UA containing only controlled studies were included. The methodological quality of the SR was assessed by the AMSTAR-2, Glenny and ROBIS tools. A quantitative analysis was done with Review Manager 5.4.1. RESULTS Ten SR were included. The risk of bias was judged low for one SR according to ROBIS. Two SR presented a high level of evidence according to AMSTAR-2. In the quantitative analysis and about the orthopaedic mandibular advancement therapies (OMA), while a significant increase in superior (SPS) [(Mean difference (MD): 1.19; CI 95% [0.59; 1.78]; P<0.0001)] and middle (MPS) pharyngeal space [(MD: 1.10; CI 95% [0.22; 1.98]; P=0.01)] existed in the short-term for both OMA, it was greater for removable. On the other hand, there was no significant change in the inferior pharyngeal space (IPS). Four other SR targeted the short-term efficacy of class III OT. Only treatments with face mask (FM) or face mask+rapid maxillary expansion (FM+RME) allowed a significant increase in SPS [(MD FM: 0.97; CI 95% [0.14; 1.81]; P=0.02/MD FM+RME: 1.54; CI 95% [0.43; 2.66]; P=0.006)]. This was neither the case for chin cup nor in all cases in IPS. The last two SR explored the effectiveness of RME, whether or not associated with bone anchorage, on the dimensions of the UA or on the reduction of the apnoea/hypopnea index (AHI). A significant superiority of the effects of the devices with mixed or only bone anchorages existed concerning the width of the nasal cavity, the nasal airflow and the reduction of the nasal resistance. But, the qualitative analysis showed no significant reduction in AHI after RME. CONCLUSIONS Despite the heterogeneity of the included systematic reviews and their unfortunately not always low risk of bias, this synthesis showed that orthopaedics could provide some short-term improvement in AU dimensions, mainly in the upper and middle areas. Indeed, no devices improved the IPS. Class II orthopaedics improved SPS and MPS; class III orthopaedics, except for the chin cup, improved only SPS. RME, optimised with bone or mixed anchors, mostly improved the nasal floor.
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Nguyen PY, Kanukula R, McKenzie JE, Alqaidoom Z, Brennan SE, Haddaway NR, Hamilton DG, Karunananthan S, McDonald S, Moher D, Nakagawa S, Nunan D, Tugwell P, Welch VA, Page MJ. Changing patterns in reporting and sharing of review data in systematic reviews with meta-analysis of the effects of interventions: cross sectional meta-research study. BMJ 2022; 379:e072428. [PMID: 36414269 PMCID: PMC9679891 DOI: 10.1136/bmj-2022-072428] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To examine changes in completeness of reporting and frequency of sharing data, analytical code, and other review materials in systematic reviews over time; and factors associated with these changes. DESIGN Cross sectional meta-research study. POPULATION Random sample of 300 systematic reviews with meta-analysis of aggregate data on the effects of a health, social, behavioural, or educational intervention. Reviews were indexed in PubMed, Science Citation Index, Social Sciences Citation Index, Scopus, and Education Collection in November 2020. MAIN OUTCOME MEASURES The extent of complete reporting and the frequency of sharing review materials in the systematic reviews indexed in 2020 were compared with 110 systematic reviews indexed in February 2014. Associations between completeness of reporting and various factors (eg, self-reported use of reporting guidelines, journal policies on data sharing) were examined by calculating risk ratios and 95% confidence intervals. RESULTS Several items were reported suboptimally among 300 systematic reviews from 2020, such as a registration record for the review (n=113; 38%), a full search strategy for at least one database (n=214; 71%), methods used to assess risk of bias (n=185; 62%), methods used to prepare data for meta-analysis (n=101; 34%), and source of funding for the review (n=215; 72%). Only a few items not already reported at a high frequency in 2014 were reported more frequently in 2020. No evidence indicated that reviews using a reporting guideline were more completely reported than reviews not using a guideline. Reviews published in 2020 in journals that mandated either data sharing or inclusion of data availability statements were more likely to share their review materials (eg, data, code files) than reviews in journals without such mandates (16/87 (18%) v 4/213 (2%)). CONCLUSION Incomplete reporting of several recommended items for systematic reviews persists, even in reviews that claim to have followed a reporting guideline. Journal policies on data sharing might encourage sharing of review materials.
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Affiliation(s)
- Phi-Yen Nguyen
- Methods in Evidence Synthesis Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Raju Kanukula
- Methods in Evidence Synthesis Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Joanne E McKenzie
- Methods in Evidence Synthesis Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Zainab Alqaidoom
- Methods in Evidence Synthesis Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Sue E Brennan
- Methods in Evidence Synthesis Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Neal R Haddaway
- Leibniz-Centre for Agricultural Landscape Research, Müncheberg, Germany
- Stockholm Environment Institute, Stockholm, Sweden
- African Centre for Evidence, University of Johannesburg, Johannesburg, South Africa
| | - Daniel G Hamilton
- School of BioSciences, University of Melbourne, Melbourne, VIC, Australia
| | - Sathya Karunananthan
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Bruyère Research Institute, Ottawa, ON, Canada
| | - Steve McDonald
- Methods in Evidence Synthesis Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Programme, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Shinichi Nakagawa
- Evolution & Ecology Research Centre and School of Biological, Earth and Environmental Sciences, University of New South Wales, Sydney, NSW, Australia
| | - David Nunan
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, Oxford University, Oxford, UK
| | - Peter Tugwell
- Bruyère Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Vivian A Welch
- Bruyère Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Matthew J Page
- Methods in Evidence Synthesis Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Tepedino M, Esposito R, Montaruli G, Monaco A, Chimenti C, Ciavarella D. Changes in hyoid bone and tongue position in Class I subjects after orthodontic treatment with rapid palatal expander. Cranio 2022:1-10. [PMID: 36101967 DOI: 10.1080/08869634.2022.2121015] [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: 10/14/2022]
Abstract
OBJECTIVE To evaluate the effects of the rapid palatal expander (RPE) on the hyoid bone and tongue position in skeletal Class I patients, compared to control groups. METHODS Eighty-four Class I subjects, aged 6-14, were selected. Among these, 28 patients were treated with RPE, 28 with function-generating bite (FGB) appliance, and 28 were untreated. Lateral cephalograms taken before (T0) and after (T1) treatment were retrieved. Changes in the hyoid bone and tongue position were evaluated, and the area above the tongue was measured. RESULTS No significant difference in the hyoid and tongue posture was observed across the groups. However, there were significant differences for HC3 (distance from H-point to the third cervical vertebrae), H2H (distance from H-point to SN plane), and TT-Eb (tongue length) between T0 and T1 in all groups. CONCLUSION The results suggest that hyoid bone and tongue position changes were related to growth rather than treatment.
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Affiliation(s)
- Michele Tepedino
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Rosa Esposito
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Graziano Montaruli
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Annalisa Monaco
- Department of Health, Science and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Claudio Chimenti
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Domenico Ciavarella
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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Alhammadi MS, Qasem AAA, Yamani AMS, Duhduh RDA, Alshahrani RT, Halboub E, Almashraqi AA. Skeletal and dentoalveolar effects of class II malocclusion treatment using bi-maxillary skeletal anchorage: a systematic review. BMC Oral Health 2022; 22:339. [PMID: 35948959 PMCID: PMC9364546 DOI: 10.1186/s12903-022-02363-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 07/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The goal of this systematic review was to assess the available evidence regarding the skeletal and dentoalveolar effects of bi-maxillary skeletal anchorage devices (BMSADs) used in treating growing class II malocclusion patients. METHODS A comprehensive search was conducted on PubMed, Scopus, Science Direct, Web of Science, Cochrane, and LILACS up to November 2021, which was augmented by a manual search. The studies included were clinical trials (RCTs) and/or follow-up observational studies (retrospective and prospective). The outcomes of interest were the skeletal, dentoalveolar, and occlusal treatment-induced changes obtained from pre- and post-cephalometric measurements. The risks of bias of the included studies were assessed using an assessment tool from previous publications. RESULTS Out of 742 screened articles, only 4 were eligible and thus included in the qualitative synthesis. They showed a moderate overall risk of bias. The results are presented as mean changes in both the study and control groups. All studies reported retrusion of the maxillary base and advancement of the mandible (meaning reduced ANB angle). Three of the included studies reported an increase in the vertical jaw relation, which was contrary to what the fourth study reported. Three studies reported an increase in the maxillary incisors' inclination or position, while one study reported their retroclination. Proclination of the mandibular incisors happened in two studies, whereas the other two studies reported retroclination. The overjet was reduced in all included studies. CONCLUSION Apart from the protrusive effects on the mandible, retrusive effects on the maxilla, and the consequent reduction of the overjet, BMSADs results in inconsistent skeletal and dentoalveolar effects. However, the current evidence is limited due to the variability in the biomechanics of the intermaxillary components, type of anchorage, and comparable groups in the included studies. Further RCTs with more standardized methodologies are highly encouraged. CLINICAL RELEVANCE BMSADs (using miniscrews or miniplates on both jaws) induces more skeletal than dentoalveolar effects. However, this must be practiced with caution, based on the benefit to risk (surgical insertion) ratio, and the limited evidence available in hand so far. Registration The protocol for this systematic review was registered at the International Prospective Register of Systematic Reviews (PROSPERO, No.: CRD42020199601).
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Affiliation(s)
- Maged S. Alhammadi
- Orthodontics and Dentofacial Orthopedics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
- Department of Orthodontics, Pedodontics and Preventive Dentistry, Faculty of Dentistry, Sanaʼa University, Sanaʼa, Republic of Yemen
| | | | | | | | - Rahaf T. Alshahrani
- Internship Program, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Esam Halboub
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Abeer A. Almashraqi
- Department of Pre-Clinical Oral Health Sciences, College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
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Ganesh G, Tripathi T. Effect of fixed functional appliances on pharyngeal airway dimensions in Skeletal Class II individuals - A scoping review. J Oral Biol Craniofac Res 2021; 11:511-523. [PMID: 34377659 PMCID: PMC8327667 DOI: 10.1016/j.jobcr.2021.07.004] [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: 04/06/2021] [Accepted: 07/10/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Skeletal Class II malocclusion due to a retrognathic mandible produces a backwardly positioned tongue and soft palate, emanating compromised upper airway dimensions and breathing difficulties. AIMS The present review aims to explore and concise the findings of the existing studies assessing the effects of fixed functional appliances on pharyngeal airway dimensions by advancing the mandible. DESIGN A literature search was carried out on MEDLINE/PubMed, Cochrane Library, Science direct, Semantic Scholar and Google Scholar databases for studies up to December 2020, resulting in 1037 studies. Specified inclusion/exclusion criteria guided the selection of 18 relevant articles. The sample size, type of the appliance, method of assessment and outcomes of these articles were assessed in detail and tabulated. RESULTS Out of 18 studies included, 12 were retrospective longitudinal and the remaining were clinical trials. Majority of the studies (72%) reported a positive influence of the fixed functional appliances on the dimensions of the oropharyngeal and hypopharyngeal airways with minimal effects on nasopharyngeal airway. CONCLUSION Thus, it can be concluded that fixed functional appliances have a beneficial effect on the middle and lower pharyngeal airway dimensions by advancing the mandible.
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Affiliation(s)
- Gayatri Ganesh
- Department of Orthodontics and Dentofacial Orthopaedics. Maulana Azad Institute of Dental Sciences, Bahadur Shah Zafar Marg, New Delhi, 110002, India
| | - Tulika Tripathi
- Department of Orthodontics and Dentofacial Orthopaedics, Maulana Azad Institute of Dental Sciences, Bahadur Shah Zafar Marg, New Delhi, 110002, India
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Orthopedic Treatment for Class II Malocclusion with Functional Appliances and Its Effect on Upper Airways: A Systematic Review with Meta-Analysis. J Clin Med 2020; 9:jcm9123806. [PMID: 33255537 PMCID: PMC7759817 DOI: 10.3390/jcm9123806] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/18/2020] [Accepted: 11/23/2020] [Indexed: 02/06/2023] Open
Abstract
Aim of this systematic review was to assess the effects of orthopedic treatment for Class II malocclusion with Functional Appliances (FAs) on the dimensions of the upper airways. Eight databases were searched up to October 2020 for randomized or nonrandomized clinical studies on FA treatment of Class II patients with untreated control groups. After duplicate study selection, data extraction, and risk of bias assessment according to Cochrane guidelines, random effects meta-analyses of mean differences (MDs) and their 95% confidence intervals (CIs) were performed, followed by subgroup/meta-regression analyses and assessment of the quality of evidence. A total of 20 nonrandomized clinical studies (4 prospective/16 retrospective) including 969 patients (47.9% male; mean age 10.9 years) were identified. Orthopedic treatment with FAs was associated with increased oropharynx volume (MD = 2356.14 mm3; 95% CI = 1276.36 to 3435.92 mm3; p < 0.001) compared to natural growth. Additionally, significant increases in nasopharynx volume, minimal constricted axial area of pharyngeal airway, and airway were seen, while removable FAs showed considerably greater effects than fixed FAs (p = 0.04). Finally, patient age and treatment duration had a significant influence in the effect of FAs on airways, as had baseline matching and sample size adequacy. Clinical evidence on orthopedic Class II treatment with FAs is associated with increased upper airway dimensions. However, the quality of evidence is very low due to methodological issues of existing studies, while the clinical relevance of increases in airway dimensions remains unclear.
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