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Schmid T, Dritsas K, Gebistorf M, Halazonetis D, Katsaros C, Gkantidis N. Long-term occlusal tooth wear at the onset of permanent dentition. Clin Oral Investig 2024; 28:155. [PMID: 38366215 PMCID: PMC10873235 DOI: 10.1007/s00784-024-05550-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 02/07/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVES This study quantified the long-term occlusal wear in the natural posterior teeth and the associations per tooth type within the dentition. METHODS The sample included 70 orthodontically treated subjects (52 females and 18 males; median age, 14.3 years), followed for a 12.7-year period. They were consecutively selected with no tooth wear-related criteria. Post-treatment (T1) and follow-up dental casts (T2) were scanned and superimposed through three-dimensional methods. Occlusal wear volume of posterior teeth and tooth wear patterns were investigated through non-parametric statistics and analysis of covariance. RESULTS There were no significant differences between contralateral teeth. The average occlusal wear per posterior tooth was 2.3 mm3, with 65.2% of teeth showing values greater than 1 mm3. Males, mandibular teeth, and first molars exhibited slightly greater wear levels than females (median, 2.57 and 2.21 mm3, respectively; p = 0.005), maxillary teeth, and first or second premolars, respectively. In all first premolars and in the mandibular second premolars, the buccal cusps were primarily affected with no other distinct patterns. There were weak to moderate correlations between tooth types, apart from certain strong correlations detected in males. CONCLUSIONS Posterior tooth wear was highly prevalent after a 13-year period starting at the onset of permanent dentition. The detected patterns are in accordance with the concept of canine guidance occlusion that is transforming into group synergy through function. CLINICAL RELEVANCE The widespread tooth wear occurrence and the high intra- and inter-individual variability underline the need for individual patient monitoring to identify high-risk patients at early stages.
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Affiliation(s)
- Thomas Schmid
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Konstantinos Dritsas
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Meret Gebistorf
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Demetrios Halazonetis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, 11527, Athens, Greece
| | - Christos Katsaros
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Nikolaos Gkantidis
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland.
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Ghamri M, Dritsas K, Probst J, Jäggi M, Psomiadis S, Schulze R, Verna C, Katsaros C, Halazonetis D, Gkantidis N. Accuracy of facial skeletal surfaces segmented from CT and CBCT radiographs. Sci Rep 2023; 13:21002. [PMID: 38017262 PMCID: PMC10684569 DOI: 10.1038/s41598-023-48320-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/24/2023] [Indexed: 11/30/2023] Open
Abstract
The accuracy of three-dimensional (3D) facial skeletal surface models derived from radiographic volumes has not been extensively investigated yet. For this, ten human dry skulls were scanned with two Cone Beam Computed Tomography (CBCT) units, a CT unit, and a highly accurate optical surface scanner that provided the true reference models. Water-filled head shells were used for soft tissue simulation during radiographic imaging. The 3D surface models that were repeatedly segmented from the radiographic volumes through a single-threshold approach were used for reproducibility testing. Additionally, they were compared to the true reference model for trueness measurement. Comparisons were performed through 3D surface approximation techniques, using an iterative closest point algorithm. Differences between surface models were assessed through the calculation of mean absolute distances (MAD) between corresponding surfaces and through visual inspection of facial surface colour-coded distance maps. There was very high reproducibility (approximately 0.07 mm) and trueness (0.12 mm on average, with deviations extending locally to 0.5 mm), and no difference between radiographic scanners or settings. The present findings establish the validity of lower radiation CBCT imaging protocols at a similar level to the conventional CT images, when 3D surface models are required for the assessment of facial morphology.
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Affiliation(s)
- Mohammed Ghamri
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland
- Jeddah Second Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
| | - Konstantinos Dritsas
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland
| | - Jannis Probst
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland
| | - Maurus Jäggi
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland
| | - Symeon Psomiadis
- Department of Oral and Maxillofacial Surgery, School of Dentistry, National and Kapodistrian University of Athens, 11527, Athens, Greece
| | - Ralf Schulze
- Division of Oral Diagnostic Sciences, Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland
| | - Carlalberta Verna
- Department of Pediatric Oral Health and Orthodontics, UZB-University Center for Dental Medicine, University of Basel, 4058, Basel, Switzerland
| | - Christos Katsaros
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland
| | - Demetrios Halazonetis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, 11527, Athens, Greece
| | - Nikolaos Gkantidis
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland.
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Krüsi A, Dritsas K, Kalimeri E, Kloukos D, Gkantidis N. Association of Craniofacial Patterns with the Curve of Spee and the Time Required for Orthodontic Levelling. Dent J (Basel) 2022; 10:dj10090175. [PMID: 36135170 PMCID: PMC9498079 DOI: 10.3390/dj10090175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/08/2022] [Accepted: 09/14/2022] [Indexed: 11/24/2022] Open
Abstract
The curve of Spee (CoS) is an important parameter for an individualized treatment plan. The available information regarding a potential association of the depth of the curve of Spee with various skeletal craniofacial characteristics is conflicting and it is also unknown whether certain craniofacial parameters affect the duration of the levelling phase of orthodontic treatment. A prospective sample of 32 patients with mild to moderate crowding that underwent orthodontic treatment with full fixed appliances was used to study these topics. The craniofacial characteristics were captured on pre-treatment lateral cephalometric radiographs and measurements of the CoS were performed on the initial 3D digital dental models using the Viewbox 4 software. Non-parametric statistics and Spearman’s correlations were applied. Weak negative correlations were detected between the CoS depth and the SNA and SNB angles. There was no other association between the CoS and craniofacial parameters, including various anteroposterior measurements. Furthermore, there was no significant association of any craniofacial parameter with the duration of the levelling. Contrary to certain clinical beliefs, it can be argued that the craniofacial characteristics are not associated with the CoS and the time required for its levelling in subjects with moderate pre-treatment CoS depth.
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Affiliation(s)
- Annina Krüsi
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland
| | - Konstantinos Dritsas
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland
| | - Eleni Kalimeri
- Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force and VA General Hospital, GR-115 25 Athens, Greece
| | - Dimitrios Kloukos
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland
- Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force and VA General Hospital, GR-115 25 Athens, Greece
| | - Nikolaos Gkantidis
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland
- Correspondence:
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Bourouni S, Dritsas K, Kloukos D, Wierichs RJ. Efficacy of resin infiltration to mask post-orthodontic or non-post-orthodontic white spot lesions or fluorosis - a systematic review and meta-analysis. Clin Oral Investig 2021; 25:4711-4719. [PMID: 34106348 PMCID: PMC8342329 DOI: 10.1007/s00784-021-03931-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/30/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The present review systematically analyzed clinical studies investigating the efficacy of resin infiltration on post-orthodontic or non-post-orthodontic, white spot lesions (WSL), or fluorosis. MATERIALS Five electronic databases (Central, PubMed, Ovid MEDLINE, Ovid EMBASE, LILACS) were screened. Article selection and data abstraction were done in duplicate. No language or time restrictions were applied. Outcomes were visual-tactile or DIAGNOdent measurements. RESULTS Eleven studies with 1834 teeth being affected in 413 patients were included. Nine studies were randomized control trials, one a prospective cohort study, and one had an unclear study design. Meta-analysis could be performed for "resin infiltration vs. untreated control," "resin infiltration vs. fluoride varnish," and "resin infiltration without bleaching vs. resin infiltration with bleaching." WSL being treated with resin infiltration showed a significantly higher optical improvement than WSL without any treatment (standard mean difference (SMD) [95% CI] = 1.24 [0.59, 1.88], moderate level of evidence [visual-tactile assessment]) and with fluoride varnish application (mean difference (MD) [95% CI] = 4.76 [0.74, 8.78], moderate level of evidence [DIAGNOdent reading]). In patients with fluorosis, bleaching prior to resin infiltration showed no difference in the masking effect compared to infiltration alone (MD [95% CI] = - 0.30 [- 0.98, 0.39], moderate level of evidence). CONCLUSION Resin infiltration has a significantly higher masking effect than natural remineralization or regular application of fluoride varnishes. However, although the evidence was graded as moderate, this conclusion is based on only very few well-conducted RCTs. CLINICAL RELEVANCE Resin infiltration seems to be a viable option to esthetically mask enamel white spot lesions and fluorosis.
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Affiliation(s)
- S Bourouni
- Department of Restorative, Preventive and Pediatric Dentistry, zmk bern, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.
| | - K Dritsas
- Department of Orthodontics and Dentofacial Orthopedics, zmk bern, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - D Kloukos
- Department of Orthodontics and Dentofacial Orthopedics, zmk bern, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - R J Wierichs
- Department of Restorative, Preventive and Pediatric Dentistry, zmk bern, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
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Dritsas K, Alharbi M, Kouvelis G, Kloukos D, Gkantidis N. Effect of the timing of second molar bonding on the duration of the mandibular arch levelling: a randomized clinical trial. Eur J Orthod 2021; 44:203-209. [PMID: 34226926 DOI: 10.1093/ejo/cjab046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
INTRODUCTION This study investigated the effect of the timing of second molar bonding on the time required for the levelling of the mandibular dental arch. TRIAL DESIGN Single-centre two-arm parallel randomized clinical trial using random permuted blocks. Allocation concealment was achieved through sealed envelopes. There was blinding in outcome assessment, but not of patient or operator. METHODS Thirty-six patients (12-18 years old) with mild to moderate crowding and fully erupted mandibular second molars were assigned randomly (1:1 ratio) in two groups. Group A started fixed orthodontic treatment by bracket bonding in both jaws. Initial wire was 0.014" NiTi. Lower second molar tubes were bonded at the time of 0.016" x 0.022" NiTi wire placement. Group B was same as Group A, but second lower molars were bonded at the first appointment. Placement of the 0.017" x 0.025" stainless steel wire in the mandibular arch was considered the primary endpoint of the trial, indicating the completion of the levelling phase. The days required from bonding to the endpoint comprised the main outcome. Non-parametric statistics were applied. RESULTS There were two dropouts in each group. The compared groups had similar baseline characteristics regarding age, sex, overjet, overbite, space in the dental arch, average Curve of Spee (CoS), and maximum CoS. Group A tended to require more days for levelling (median: 203 days) than Group B (median: 168 days). However, this difference was not statistically significant (P = 0.128). From the tested occlusal factors, only initial overjet was found to be moderately associated with the days required to complete levelling of the mandibular arch (r = 0.45, P = 0.009). CONCLUSIONS In the frame of the current study, the duration of the levelling phase of orthodontic treatment with fixed appliances was not affected by the timing of second molar inclusion in the appliance. Future research could aim in cases with deep CoS to generalize the present findings and in larger sample sizes.
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Affiliation(s)
- Konstantinos Dritsas
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Switzerland
| | - Majed Alharbi
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Switzerland
| | - Georgios Kouvelis
- Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force General Hospital, Athens, Greece.,Department of Orthodontics, Faculty of Dentistry, Aristotle University of Thessaloniki, Greece
| | - Dimitrios Kloukos
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Switzerland.,Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force General Hospital, Athens, Greece
| | - Nikolaos Gkantidis
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Switzerland
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Gkantidis N, Dritsas K, Katsaros C, Halazonetis D, Ren Y. 3D Occlusal Tooth Wear Assessment in Presence of Limited Changes in Non-Occlusal Surfaces. Diagnostics (Basel) 2021; 11:diagnostics11061033. [PMID: 34199782 PMCID: PMC8228780 DOI: 10.3390/diagnostics11061033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/31/2021] [Accepted: 06/01/2021] [Indexed: 12/15/2022] Open
Abstract
The study aimed to develop an accurate and convenient 3D occlusal tooth wear assessment technique, applicable when surfaces other than the occlusal undergo changes during the observation period. Various degrees of occlusal tooth wear were simulated in vitro on 18 molar and 18 premolar plaster teeth. Additionally, their buccal and lingual surfaces were gently grinded to induce superficial changes and digital dental models were generated. The grinded and the original tooth crowns were superimposed using six different 3D techniques (two reference areas with varying settings; gold standard: GS). Superimposition on intact structures provided the GS measurements. Tooth wear volume comprised the primary outcome measure. All techniques differed significantly to each other in their accuracy (p < 0.001). The technique of choice (CCD: complete crown with 30% estimated overlap of meshes) showed excellent agreement with the GS technique (median difference: 0.045, max: 0.219 mm3), no systematic error and sufficient reproducibility (max difference < 0.040 mm3). Tooth type, tooth alignment in the dental arches, and amount of tooth wear did not significantly affect the results of the CCD technique (p > 0.01). The suggested occlusal tooth wear assessment technique is straightforward and offers accurate outcomes when limited morphological changes occur on surfaces other than the occlusal.
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Affiliation(s)
- Nikolaos Gkantidis
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, CH-3010 Bern, Switzerland; (K.D.); (C.K.)
- Department of Orthodontics, W.J. Kolff Institute, University Medical Center Groningen, University of Groningen, 9700RB Groningen, The Netherlands;
- Correspondence: or
| | - Konstantinos Dritsas
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, CH-3010 Bern, Switzerland; (K.D.); (C.K.)
| | - Christos Katsaros
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, CH-3010 Bern, Switzerland; (K.D.); (C.K.)
| | - Demetrios Halazonetis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, GR-11527 Athens, Greece;
| | - Yijin Ren
- Department of Orthodontics, W.J. Kolff Institute, University Medical Center Groningen, University of Groningen, 9700RB Groningen, The Netherlands;
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Gkantidis N, Dritsas K, Katsaros C, Halazonetis D, Ren Y. 3D Method for Occlusal Tooth Wear Assessment in Presence of Substantial Changes on Other Tooth Surfaces. J Clin Med 2020; 9:jcm9123937. [PMID: 33291770 PMCID: PMC7761944 DOI: 10.3390/jcm9123937] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 11/28/2020] [Accepted: 12/01/2020] [Indexed: 12/18/2022] Open
Abstract
Early diagnosis and timely management of tooth or dental material wear is imperative to avoid extensive restorations. Previous studies suggested different methods for tooth wear assessment, but no study has developed a three-dimensional (3D) superimposition technique applicable in cases where tooth surfaces, other than the occlusal, undergo extensive morphological changes. Here, we manually grinded plaster incisors and canines to simulate occlusal tooth wear of varying severity in teeth that received a wire retainer bonded on their lingual surfaces, during the assessment period. The corresponding dental casts were scanned using a surface scanner. The modified tooth crowns were best-fit approximated to the original crowns using seven 3D superimposition techniques (two reference areas with varying settings) and the gold standard technique (GS: intact adjacent teeth and alveolar processes as superimposition reference), which provided the true value. Only a specific technique (complete crown with 20% estimated overlap of meshes), which is applicable in actual clinical data, showed perfect agreement with the GS technique in all cases (median difference: −0.002, max absolute difference: 0.178 mm3). The outcomes of the suggested and the GS technique were highly reproducible (max difference < 0.040 mm3). The presented technique offers low cost, convenient, accurate, and risk-free tooth wear assessment.
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Affiliation(s)
- Nikolaos Gkantidis
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland; (K.D.); (C.K.)
- Department of Orthodontics, W.J. Kolff Institute, University Medical Center Groningen, University of Groningen, 9700RB Groningen, The Netherlands;
- Correspondence: ; Tel.: +41-(0)-31-632-25-91
| | - Konstantinos Dritsas
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland; (K.D.); (C.K.)
| | - Christos Katsaros
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland; (K.D.); (C.K.)
| | - Demetrios Halazonetis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, GR-11527 Athens, Greece;
| | - Yijin Ren
- Department of Orthodontics, W.J. Kolff Institute, University Medical Center Groningen, University of Groningen, 9700RB Groningen, The Netherlands;
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Arn ML, Dritsas K, Pandis N, Kloukos D. The effects of fixed orthodontic retainers on periodontal health: A systematic review. Am J Orthod Dentofacial Orthop 2020; 157:156-164.e17. [PMID: 32005466 DOI: 10.1016/j.ajodo.2019.10.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 10/01/2019] [Accepted: 10/01/2019] [Indexed: 12/27/2022]
Abstract
INTRODUCTION The objective of this systematic review was to assess the available evidence in the literature for the effects of fixed orthodontic retainers on periodontal health. METHODS The following databases were searched up to August 31, 2019: Medline, EMBASE, the Cochrane Oral Health Group's Trials Register, CENTRAL, ClinicalTrials.gov, the National Research Register, and Pro-Quest Dissertation Abstracts and Thesis database. Randomized controlled trials (RCTs), controlled clinical trials, cohort studies of prospective and retrospective design, and cross-sectional studies reporting on periodontal measurements of patients who received fixed retention after orthodontic treatment were eligible for inclusion. The quality of the included RCTs was assessed per the revised Cochrane risk of bias tool for randomized trials (RoB 2.0), whereas the risk of bias of the included cohort studies was assessed using the Risk Of Bias In Nonrandomized Studies of Interventions tool. A modified version of the Newcastle-Ottawa scale was used for cross-sectional studies. RESULTS Eleven RCTs, 4 prospective cohort studies, 1 retrospective cohort study, and 13 cross-sectional studies fulfilled the inclusion criteria. The quality of evidence was low for most of the included studies. In contrast to the general consensus, 2 RCTs, 1 prospective cohort study, and 2 cross-sectional studies reported poorer periodontal conditions in the presence of a fixed retainer. The results of the included studies comparing different types of fixed retainers were heterogeneous. CONCLUSIONS According to the currently available literature, orthodontic fixed retainers seem to be a retention strategy rather compatible with periodontal health, or at least not related to severe detrimental effects on the periodontium.
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Affiliation(s)
- Marie-Laure Arn
- Department of Orthodontics and Dentofacial Orthopedics, School of Dentistry, University of Bern, Bern, Switzerland
| | - Konstantinos Dritsas
- Department of Orthodontics and Dentofacial Orthopedics, School of Dentistry, University of Bern, Bern, Switzerland
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, School of Dentistry, University of Bern, Bern, Switzerland
| | - Dimitrios Kloukos
- Department of Orthodontics and Dentofacial Orthopedics, School of Dentistry, University of Bern, Bern, Switzerland; Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force General Hospital, Athens, Greece.
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Kouvelis G, Dritsas K, Doulis I, Kloukos D, Gkantidis N. Authors' response. Am J Orthod Dentofacial Orthop 2019; 155:305-306. [PMID: 30826029 DOI: 10.1016/j.ajodo.2018.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 12/12/2018] [Accepted: 12/13/2018] [Indexed: 10/27/2022]
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Kouvelis G, Dritsas K, Doulis I, Kloukos D, Gkantidis N. Effect of orthodontic treatment with 4 premolar extractions compared with nonextraction treatment on the vertical dimension of the face: A systematic review. Am J Orthod Dentofacial Orthop 2018; 154:175-187. [DOI: 10.1016/j.ajodo.2018.03.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 03/01/2018] [Accepted: 03/01/2018] [Indexed: 01/28/2023]
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Abstract
Autopsy was performed on 49 male cadavers and the entire course of the left testicular vein (LTV) was studied. The testicular venous pathway was divided into four levels: scrotal, inguinal, pelvic, and lumbar. At the scrotal level, many small testicular veins constituting the pampiniform plexus showed various anastomoses with the cremasteric and vasal veins. At the inguinal and pelvic level, 4-12 and 2-8 LTVs were recognized, respectively. At the pelvic level, absence of valves was seen in 33% of the cases. At the lumbar level, 1-5 LTVs were observed and were mainly anastomosed with the retroperitoneal, ureteral, and kidney capsular veins. Absence of valves at the lumbar level was seen in 37% of the cases. In 11 cases, the valves that were present were incompetent. The presence of more than one LTV at the lumbar level indicates the necessity for attentive identification of all of the testicular veins during surgical treatment of varicocele.
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Affiliation(s)
- N Sofikitis
- Department of Forensic Medicine, Athens University School of Medicine, Greece
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Al-Sibai A, Albites V, Dritsas K, Novin N. Carcinoma arising in a villous adenoma in a 19 year-old male with review of the literature. Md State Med J 1979; 28:45-6. [PMID: 370471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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