The Effect of Charcoal-Based Dentifrice and Conventional Whitening Toothpaste on the Color Stability and Surface Roughness of Composite Resin: A Systematic Review of In Vitro Studies.

The objective was to systematically review studies that evaluated the effect of charcoal-based dentifrices (CbDs) and conventional whitening toothpastes (CWTs) on the color stability (CS) and/or surface roughness (SR) of composite resin (CR). The question we focused on was "Do CbD and CWT affect the CS and/or SR of CR?" Indexed databases were searched without language and time restrictions up to and including May 2023 using different keywords. Original experimental studies were included. The risk of bias (RoB) was assessed using the Quality Assessment Tool for In Vitro Studies. Ten in vitro studies performed on CR were included. The number of CR samples assessed ranged between 18 and 200. In one study, CbDs altered the CS and SR of CR, whereas another study showed no difference in changes in the SR and CS of CR when CbDs were compared with CWTs. One study showed that compared with CWTs, CbDs caused changes in the CS of CR but changes in SR were similar between the two dentifrices. One study showed that CbDs and CWTs improved the overall color and enhanced the SR of CR. Three studies had a high RoB, five had a medium RoB, and two had a low RoB. Compared to CWTs, CbDs appeared to affect the CS of CR, but the SR of CR induced by both dentifrices remained consistent. Further well-designed and power-adjusted studies are needed.

Editorial bullying: an exploration of acts impacting publication ethics and related environment.

Bullying and misconduct in the realm of scientific and scholarly publishing have the potential to jeopardize the transparency and integrity of academic discourse. While misconduct issues among authors have been extensively discussed, the role of editors in perpetuating or mitigating such problems has garnered less attention. Scientific publishing serves as the gateway for disseminating innovative research findings globally, and the role of editors, especially Editor/s-in-chief, is pivotal in safeguarding the rigor and credibility of published research. Editor bullying and misconduct involve behaviors that undermine the scientific process, compromise research integrity, and harm the careers and wellbeing of individuals. These actions may manifest as biased decision-making, suppression of dissenting voices, or the exploitation of power dynamics in the peer review process. To address these issues, preventive and therapeutic approaches are suggested, including enhancing awareness, recognizing and mitigating exacerbating factors, and upholding professionalism. Moreover, the importance of a conflict-of-interest declaration for editors is highlighted to ensure transparency and integrity in the editorial process. The present mini-review aims to shed light on editor bullying, illuminating its gravity and the urgency to address these issues within the academic publishing domain/s. This review underscores the more subtle, yet equally significant, issue of professional misconduct in the editorial realm of scientific journals.

Probing the antinociceptive and therapeutic potential of probiotics in managing temporomandibular joint arthritis.

This literature review explored the antinociceptive and therapeutic effects of probiotic therapy (PT) in the treatment of arthritic conditions affecting the temporomandibular joint (TMJ). Indexed databases were searched without time and language restrictions up to and including February 2023, to identify studies addressing the question: "Is PT effective for the management of TMJ arthritis?" The following keywords were used in different combinations with Boolean operators: arthritis, osteoarthritis, pain, probiotic, rheumatoid, temporomandibular disorders, and temporomandibular joint. Original clinical and experimental studies assessing the therapeutic efficacy of PT in the management of osteoarthritis were eligible for inclusion. Letters to the editor, reviews, commentaries, perspectives, and expert opinions were not sought. The structure of the current review was tailored to encapsulate relevant information. A total of 297 relevant studies were identified during the initial literature search, and the full text and reference lists of these studies were scrutinized. To date, the potential role of PT in managing osteoarthritis of the TMJ region remains uninvestigated. No clinical trials in the indexed literature have assessed the efficacy of PT in managing TMJ arthritis; however, this finding does not preclude a potential role of probiotics as antinociceptive and therapeutic agents in susceptible populations.

The second molar dilemma in orthodontics: to bond or not to bond?

OBJECTIVES: To compare orthodontic treatment (OT) outcome in adolescents undergoing nonextraction fixed OT with or without bonding of second molars using the score of the American Board of Orthodontics Cast Radiograph Evaluation (C-R-Eval). MATERIALS AND METHODS: This study included healthy adolescents with skeletal Class I or mild Class II/Class III malocclusion, normal or deep overbite (OB), and mild-to-moderate dental crowding (<5 mm) who underwent nonextraction fixed OT with ("bonded" group) or without ("not-bonded" group) bonding of second molars. Patient treatment records, pre- and posttreatment digital models, lateral cephalograms, and orthopantomograms were assessed. The evaluated outcomes included leveling of the curve of Spee (COS), OB, control of incisor mandibular plane angle (IMPA), number of emergency visits (related to poking wires and/or bracket failure of the terminal molar tubes), treatment duration, and C-R-Eval. Treatment variables were compared across time points and among groups. RESULTS: The sample included 30 patients (mean age 16.07 ± 1.80 years) in the bonded group and 32 patients (mean age 15.69 ± 1.86 years) in the not-bonded group. The mean overall C-R-Eval score was significantly higher (P < .001) in the not-bonded group (25.25 ± 3.98) than in the bonded group (17.70 ± 2.97). There were no significant differences in mean changes of COS, OB, IMPA, or treatment duration among groups. The mean number of emergency visits was significantly higher in the bonded (3.3 ± 0.6) than the not-bonded group (1.9 ± 0.4) (P < .001). CONCLUSIONS: Bonding of second molars enhances the outcome of nonextraction fixed OT as demonstrated by the C-R-Eval without increasing treatment duration, irrespective of more emergency visits.

Antinociceptive Efficacy of Shamanic Healing for the Management of Temporomandibular Disorders: An Evidence-Based Review.

The aim of this evidence-based review was to assess the antinociceptive efficacy of shamanic healing (SH) for management of temporomandibular disorders (TMD). The addressed focused question was "Is SH effective for the management of TMD?" Indexed databases were searched without time and language restrictions up to and including January 2023 using the following keywords: "disc displacement disorders"; "healing"; "inflammation"; "pain"; "shamanic"; "therapy"; "temporomandibular joint"; "temporomandibular disorders" and "temporomandibular joint disorders". Clinical studies were considered eligible for inclusion. Editorials, case-reports, case-series and commentaries were excluded. Literature search was performed in accordance with the guidelines of the preferred reporting items for systematic review and meta-analysis. Pattern of this evidence-based review was customized to summarize the pertinent information. In the present review, three studies were included and processed for data extraction. All participants were females with a mean age of 38.3 ± 8.3 years (range 25-55 years). Self-rated pain was assessed before application of SH (baseline) and after 9 months of follow-up. In one study, SH significantly reduced self-rated TMD pain scores (P < 0.001) at 9-months' follow-up interview. In all studies patients reported that management of TMD via SH helped improve their quality of life. In one study patients perceived improvements in sleep, energy levels, digestion, and back pain at follow-up. In another study patients reported that they felt "calmer" and "at peace" at follow-up interview. The possible contribution of SH for managing pain among TMD patients warrants additional research. There is a dire need for well-designed and power-adjusted randomized clinical trials with adequate groups and long-term follow-up.

Potential Impact of Long COVID-19 on Orthodontic Treatment.

Pooled estimates indicate about 226 million individuals are currently experiencing or have experienced persistent symptoms from COVID-19. Long COVID-19 (LC) has been associated with a prolonged inflammatory and stress responses in affected individuals. Due to common pathways, LC could impact the biological mechanisms of orthodontic tooth movement, orthodontically-induced inflammatory root resorption and periodontal tissue response of patients undergoing orthodontic treatment. The authors of the present report discussed potential biological mechanisms through which LC may influence orthodontic treatment highlighting the need for further research in this area.

Influence of psychostimulants on bone mineral density and content among children with attention deficit hyperactivity disorder. A systematic review.

There is a controversy over the influence of psychostimulant medications on bone mineral density (BMD) and bone mineral content (BMC) among children with attention-deficit-hyperactivity-disorder (ADHD). The aim of the present systematic review was to assess the influence of psychostimulant medications on BMD and BMC among children with ADHD. A comprehensive search of electronic databases, including PubMed, Scopus, Embase, and Cochrane Library, was conducted to identify relevant studies published up until July 2023. Clinical studies that addressed the focused question "Do psychostimulant medications affect bone mineral density and content in children with ADHD?" were included. Letters to the Editor, studies on animal-models, ex-vivo and in-vitro studies, commentaries and reviews were excluded. The primary outcome measures were changes in BMD and BMC. Study quality was assessed using the risk of bias for non-randomized studies-exposure tool. Five non-randomized clinical studies were included. The number of participants ranged from 18 to 6489 with mean ages ranging from 7.3 to 13.75 years. The study durations ranged between five and seven years. In all studies osseous evaluation was done using dual-energy X-ray absorptiometry. The bone locations examined included total body, lumbar-spine, femur, femoral-neck, femoral body, and pelvis. Two studies reported that psychostimulant medications reduce BMC and BMD. In one study, bone turnover, serum leptin and fat levels were reduced in children using psychostimulant medications but no unusual reduction recorded among controls. In general, 80 % of the studies concluded that psychostimulant medications compromise BMC and BMD. Power analysis was done in one study. One study had a low RoB and the remaining demonstrated some concerns. Given the methodological concerns observed in the included studies, arriving at a definitive conclusion regarding the effects of psychostimulant medications on BMC, BMD, and bone turnover in children with ADHD is challenging. However, it is important to acknowledge that an association between psychostimulant medications and these bone-related parameters cannot be disregarded.

Artificial intelligence for treatment planning and soft tissue outcome prediction of orthognathic treatment: A systematic review.

BACKGROUND: The accuracy of artificial intelligence (AI) in treatment planning and outcome prediction in orthognathic treatment (OGT) has not been systematically reviewed. OBJECTIVES: To determine the accuracy of AI in treatment planning and soft tissue outcome prediction in OGT. DESIGN: Systematic review. DATA SOURCES: Unrestricted search of indexed databases and reference lists of included studies. DATA SELECTION: Clinical studies that addressed the focused question 'Is AI useful for treatment planning and soft tissue outcome prediction in OGT?' were included. DATA EXTRACTION: Study screening, selection and data extraction were performed independently by two authors. The risk of bias (RoB) was assessed using the Cochrane Collaboration's RoB and ROBINS-I tools for randomised and non-randomised clinical studies, respectively. DATA SYNTHESIS: Eight clinical studies (seven retrospective cohort studies and one randomised controlled study) were included. Four studies assessed the role of AI for treatment decision making; and four studies assessed the accuracy of AI in soft tissue outcome prediction after OGT. In four studies, the level of agreement between AI and non-AI decision making was found to be clinically acceptable (at least 90%). In four studies, it was shown that AI can be used for soft tissue outcome prediction after OGT; however, predictions were not clinically acceptable for the lip and chin areas. All studies had a low to moderate RoB. LIMITATIONS: Due to high methodological inconsistencies among the included studies, it was not possible to conduct a meta-analysis and reporting biases assessment. CONCLUSION: AI can be a useful aid to traditional treatment planning by facilitating clinical treatment decision making and providing a visualisation tool for soft tissue outcome prediction in OGT. REGISTRATION: PROSPERO CRD42022366864.

Correction: Santucci et al. Assessment of Posterior Dentoalveolar Expansion with Invisalign in Adult Patients. Int. J. Environ. Res. Public Health 2023, 20, 4318.

There was an error in the original publication [...].

Assessment of Posterior Dentoalveolar Expansion with Invisalign in Adult Patients.

PURPOSE: The primary aim was to evaluate dentoalveolar expansion with Invisalign clear aligners comparing linear measurements in ClinCheck vs. cone beam computed tomography (CBCT). This would enable an assessment of to what extent expansion gained from Invisalign clear aligners was due to buccal tipping and/or bodily translation of the posterior teeth. The study also evaluated the predictive value of Invisalign ClinCheck® (Align Technology, San Jose, CA, USA) to final outcomes. METHODS: The orthodontic records of thirty-two (32) subjects comprised the sample to conduct this study. Linear values of the upper arch width were measured for premolars and molars at two different points (occlusal and gingival) utilized for ClinCheck® measurements and three different points for CBCT measurements before (T0 and after treatment (T1). Paired T-tests at a significance level of 0.05 were used for analyses. RESULTS: Expansion was found to be possible with Invisalign clear aligners. However, more expansion was measured at the cusp tips compared to gingival margins (p < 0.0001), indicating more tipping was occurring than bodily translation. ClinCheck® also showed a significant overestimation of the amount of expansion capable, with nearly 70% expression in the first premolar area, and the expression decreased as one moved posteriorly with only 35% expressed at the first molar area (p < 0.0001). CONCLUSIONS: Dentoalveolar expansion with Invisalign is achieved through buccal tipping of posterior teeth and bodily translation; and there is a significant overestimation of the amount of expansion achieved between ClinCheck® and clinical results.

Root coverage surgery for dentin hypersensitivity reduction: a systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: To evaluate the effectiveness of root coverage surgery in reducing dentin hypersensitivity (DH) through a systematic review and meta-analysis. DATA SOURCES: Unrestricted search of four indexed databases up to September 2022 was performed to identify randomized controlled trials (RCTs) evaluating the effect of root coverage surgery on DH frequency and/or intensity presurgically (baseline) and at least 3 months postsurgically. Two authors independently conducted study screening and data extraction. Subgroup meta-analyses were performed separately for stimulated and unstimulated DH frequency and intensity at different timepoints. The risk of bias and quality of the available evidence were assessed. RESULTS: Nineteen RCTs presenting data from 7 days to 30 months after root coverage surgery with various treatment modalities were included from the 662 identified studies. A total of 486 patients contributed 784 recession defects. Results from the subgroup meta-analyses showed that, overall, root coverage surgery reduced the risk for DH by 67% (RR, 0.33; 95% CI, 0.21 to 0.53) and 53% (RR, 0.47; 95% CI, 0.38 to 0.58) upon unstimulated and stimulated DH assessment, respectively. The DH intensity was also significantly reduced (mean visual analog score difference, 2.37; 95% CI, 2.02 to 2.71) upon stimulated DH assessment. No significant changes in DH intensity were observed upon unstimulated DH assessment. The included studies did not have high risk of bias and the quality of evidence was low to high. CONCLUSION: Existing evidence suggests that root coverage surgery may effectively reduce the DH frequency and intensity.

Sugar-free chewing gum versus conventional analgesic drugs for pain relief with fixed orthodontic appliances. A systematic review and meta-analysis.

OBJECTIVE: To compare the effect of chewing sugar-free gum towards alleviating self-reported orthodontic treatment (OT) pain compared with conventional analgesic drugs (CADs). SEARCH SOURCES: An unrestricted search of indexed databases and manual searching was performed up to September 2021. DATA SELECTION: Randomised controlled trials (RCTs) comparing the impact of chewing gum and CADs on relieving self-reported orthodontic pain were included. DATA EXTRACTION: Data screening, extraction and risk of bias (RoB) assessment were performed by two authors. Meta-analyses were performed using a random-effects model. The quality of available evidence was assessed using the Grades of Recommendation, Assessment, Development and Evaluation approach. RESULTS: Nine RCTs were included. Eight RCTs used the Visual Analogue Scale for self-reported pain assessment, while one RCT used the Numeric Rating Scale. Five RCTs had a high RoB and four RCTs had a moderate RoB. Power analysis for sample size estimation was performed in six RCTs. Separate meta-analyses were performed by pooling quantitative data from five RCTs that compared self-reported orthodontic pain between chewing gum and ibuprofen groups for the following timepoints: baseline; immediately; 2 hours; 6 hours; bedtime; 24 hours; 2 days; 3 days; 5 days; and 7 days after the placement of orthodontic appliances. None of the timepoints individually indicated a difference in self-reported pain scores between chewing sugar-free gum and ibuprofen groups. The overall level of evidence was very low. CONCLUSION: Chewing sugar-free gum is a potentially useful alternative to CADs towards pain alleviation during fixed OT.

Comparison of shear bond strength of orthodontic brackets bonded to human teeth with and without fluorotic enamel: A systematic review and meta-analysis of experimental in vitro studies.

The aim of this systematic review was to compare the shear bond strength (SBS) of orthodontic brackets bonded to human teeth with and without enamel fluorosis (EF) using conventional bonding interventions/techniques. An unrestricted search of indexed databases was performed with the following eligibility criteria: (a) human fluorotic teeth (experimental-group); (b) human teeth without fluorosis (control-group); (c) studies using phosphoric acid (PA) etching without air abrasion (AA), PA etching combined with AA, and application of self-etching primer (SEP) alone as bonding interventions/techniques and (d) measuring SBS in megapascals (MPa). Data screening, selection and extraction were performed by two reviewers. The risk of bias (rob) was assessed using the JBI Critical appraisal tool for Quasi-Experimental Studies. Meta-analyses were performed using a random effects model. The quality of available evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. Ten in vitro studies were included. Subgroup analyses were performed for each intervention type. The SBS was significantly lower in fluorotic teeth when PA was used without AA (mean difference = 3.26 MPa, confidence interval: [1.00, 5.52]); and there were no significant differences for the PA combined with AA and SEP interventions. All studies had a low rob. The overall level of evidence was at best low. The SBS is lower in teeth with EF when traditional PA is used. No significant differences were found in SBS between teeth with and without EF when PA is used with AA or when SEP is used alone.

Association between nonextraction clear aligner therapy and alveolar bone dehiscences and fenestrations in adults with mild-to-moderate crowding.

INTRODUCTION: This study aimed to assess the association between nonextraction clear aligner therapy (CAT) and the presence of alveolar bone dehiscences (ABDs) and fenestrations (ABFs) in adults with mild-to-moderate crowding. METHODS: Cone-beam computed tomography images from 29 adults were obtained before and immediately after nonextraction CAT. Total root lengths were evaluated in axial and cross-sectional slices. Linear measurement for dehiscence (LM-D) was defined as the distance between the alveolar crest to the cementoenamel junction of each root (critical point set at 2 mm). Linear measurement for fenestration (LM-F) was recorded when the defect involved only the apical one-third of a root (critical point set at 2.2 mm). Counts of ABDs/ABFs and magnitudes of LM-Ds/LM-Fs were recorded before and immediately after nonextraction CAT at buccal and lingual root surfaces. Binary logistic regression analyses and repeated measures analyses of variance were performed. RESULTS: Counts of ABDs/ABFs and magnitudes of LM-Ds/LM-Fs increased at most jaw locations and root surfaces. Nonextraction CAT was associated with an increased presence of ABDs and ABFs. Nonextraction CAT was associated with a higher magnitude of LM-Ds but not LM-Fs. CONCLUSIONS: Immediate posttreatment cone-beam computed tomography scans showed that nonextraction CAT is associated with increased ABDs and ABFs in adults with mild-to-moderate crowding.

Effectiveness of Curcumin in Reducing Self-Rated Pain-Levels in the Orofacial Region: A Systematic Review of Randomized-Controlled Trials.

The aim was to systematically review randomized controlled trials (RCTs) that assessed the effectiveness of curcumin in reducing self-rated pain levels in the orofacial region (OFR). The addressed focused question was "Is curcumin effective in reducing self-rated pain levels in the OFR?". Indexed databases (PubMed (National Library of Medicine), Scopus, EMBASE, MEDLINE (OVID), and Web of Science) were searched up to and including February 2022 using different keywords. The inclusion criteria were (a) original studies (RCTs) in indexed databases; and (b) studies assessing the role of curcumin in the management of pain in the OFR. The risk of bias was assessed using the Cochrane risk of bias tool. The pattern of the present systematic review was customized to primarily summarize the pertinent information. Nineteen RCTs were included. Results from 79% of the studies reported that curcumin exhibits analgesic properties and is effective in reducing self-rated pain associated with the OFR. Three studies had a low risk of bias, while nine and seven studies had a moderate and high risk of bias, respectively. Curcumin can be used as an alternative to conventional therapies in alleviating pain in the OFR. However, due to the limitations and risk of bias in the aforementioned studies, more high-quality RCTs are needed.

Influence of E-Cigarette and Cannabis Vaping on Orthodontically Induced Tooth Movement and Periodontal Health in Patients Undergoing Orthodontic Therapy.

The frequency of e-cigarette vaping of nicotine and marijuana products is increasing among adolescents and young adults; the detrimental effects of vaping on general and oral health have not yet been thoroughly defined [...].

"Testosterone decreases temporomandibular joint nociception"- A systematic review of studies on animal models.

OBJECTIVE: The aim of the present systematic review was to assess the effect of testosterone on temporomandibular joint (TMJ) nociception. DESIGN: A systematic review of pertinent indexed literature was performed. The focused question addressed was "Is there a connection between testosterone and TMJ nociception?" Original studies were included. In-vitro and ex-vivo studies, case-reports/series, letters to the Editor and commentaries were not sought. Indexed databases were searched without time and language restrictions up to and including September 2021 using different free text key words: testosterone OR "male sex hormones" OR "gonadal hormones" AND "temporomandibular joint" OR "temporomandibular dysfunction" AND nociception AND males. The literature search was performed in accordance with the preferred reporting outcomes of systematic reviews and meta-analysis guidelines. The risk of bias (RoB) was assessed using the SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE) tool. RESULTS: Out of the 406 studies identified, seven studies on animal-models were included. All studies were performed in rats with age and weight ranging between 21 and 90 days and 200-300 g, respectively. Testosterone was administered in concentrations ranging between 1 and 10 mg/Kg. Results from all studies showed that testosterone administration in gonadectomized male rats reduces induced TMJ nociception. The RoB was high in 3 and unclear in 4 studies. CONCLUSION: Testosterone offers protection against TMJ nociception in male rats; however, from a clinical perspective, potential contribution of testosterone therapy towards the management of TMD remains indeterminate.

Potential adjunct therapies for the management of temporomandibular disorders: An evidence-based review.

OBJECTIVE: The aim was to review the role of adjuvant therapies that may potentially contribute toward the management of temporomandibular disorders (TMD). METHODS: The addressed focused question was, "Are there any adjuvant therapies that may contribute toward the management of TMD?". Indexed databases were searched up to June 2021. The eligibility criteria were the following: (a) original clinical studies and (b) randomized controlled clinical trials (RCTs). RESULTS: Adjuvant therapies were comprised of acupuncture, manual therapy, jaw exercises, dietary modifications, botulinum toxin therapy, and photobiomodulation. Short-term follow-up results from each of these RCTs showed beneficial effects in terms of pain reduction and improvements in jaw movement among patients with TMD. There are no long-term follow-up results in this regard. CONCLUSION: The most effective adjunct treatment for managing TMD remains unknown, primarily due to a lack of sufficient scientific evidence.

Influence of low-level-laser therapy on the stability of orthodontic mini-screw implants. A systematic review and meta-analysis.

BACKGROUND: The influence of low-level-laser therapy (LLLT) on the stability of orthodontic mini-screw implants (MSIs) has not been systematically reviewed. OBJECTIVES: The aim was to assess the influence of LLLT on the stability of orthodontic MSIs. METHODS: An unrestricted search of indexed databases was performed. SELECTION CRITERIA: Randomized controlled clinical trials (RCTs) investigating the influence of LLLT on orthodontic MSI stability. DATA COLLECTION AND ANALYSIS: Two authors independently performed study retrieval and selection, and data extraction. The risk of bias (RoB) of individual studies was assessed using the Cochrane RoB Tool for RCTs. Meta-analyses were performed separately for RCTs using periotest and resonance frequency analysis (RFA) to measure MSI stability; and a random effects model was applied. Subgroup analyses were performed based on the time-points of MSI stability evaluation. The quality of available evidence was evaluated using the Grades of Recommendation, Assessment, Development, and Evaluation approach. RESULTS: Initially, 1332 articles were screened. Six RCTs with a split-mouth design were included. The periotest was used in 4 RCTs and 2 RCTs used RFA to measure MSI stability. All RCTs had a low RoB. Subgroup analyses based on periotest indicated that MSIs treated with LLLT had significantly higher stability than untreated MSIs at 21 and 30 days [weighted mean difference (MD) = -2.76, confidence interval (CI): [-4.17, -1.36], P-value = 0.0001) and at 60 days (weighted MD = -3.47, CI: [-4.58, -2.36], P < 0.00001); and the level of certainty was high. Subgroup analyses based on RFA showed higher stability of MSIs treated with than without LLLT at 56 and 60 days (standardized MD = 0.82, CI: [0.32, 1.32], P = 0.001), and at 70 and 90 days (standardized MD = 0.86, CI: [0.36, 1.36], P = 0.0007); and the level of certainty was moderate. LIMITATIONS: Due to limited number of relevant studies, it was not possible to perform sensitivity analysis, subgroup analyses for patient and intervention-related characteristics, and reporting biases assessment. CONCLUSIONS: The role of LLLT on the secondary stability of MSIs placed in patients undergoing OT remains debatable. CLINICAL TRIAL REGISTRATION: PROSPERO (CRD42021230291).

Effect of periodontal-orthodontic treatment of teeth with pathological tooth flaring, drifting, and elongation in patients with severe periodontitis: A systematic review with meta-analysis.

AIM: To assess the beneficial and adverse effects on the dental and periodontal issues of periodontal-orthodontic treatment of teeth with pathological tooth flaring, drifting, and elongation in patients with severe periodontitis. MATERIALS AND METHODS: Nine databases were searched in April 2020 for randomized/non-randomized clinical studies. After duplicate study selection, data extraction, and risk-of-bias assessment, random-effect meta-analyses of mean differences (MDs) and their 95% confidence intervals (CIs) were performed, followed by subgroup/meta-regression analyses. RESULTS: A total of 30 randomized and non-randomized clinical studies including 914 patients (29.7% male; mean age 43.4 years) were identified. Orthodontic treatment of pathologically migrated teeth was associated with clinical attachment gain (-0.24 mm; seven studies), pocket probing depth reduction (-0.23 mm; seven studies), marginal bone gain (-0.36 mm; seven studies), and papilla height gain (-1.42 mm; two studies) without considerable adverse effects, while patient sex, gingival phenotype, baseline disease severity, interval between periodontal and orthodontic treatment, and orthodontic treatment duration affected the results. Greater marginal bone level gains were seen by additional circumferential fiberotomy (two studies; MD = -0.98 mm; 95% CI = -1.87 to -0.10 mm; p = .03), but the quality of evidence was low. CONCLUSIONS: Limited evidence of poor quality indicates that orthodontic treatment might be associated with small improvements of periodontal parameters, which do not seem to affect prognosis, but more research is needed.