Reliability and validity of cross­culturally adapted oral health­related quality­of­Life instruments for Brazilian children and adolescents: a systematic review.

OBJECTIVE: This systematic review aimed to review the reliability and validity of oral health-related quality of life (OHRQoL) questionnaires for Brazilian children and adolescents. Also, the cross-cultural adaptation was evaluated. METHODS: This systematic review is registered in PROSPERO (CRD42022300018) and was performed based on the COSMIN guideline. Electronic searches were performed in the PubMed/MEDLINE, Web of Science, Lilacs, BVS (BIREME), Scielo, and Embase databases until March 2023 by two independent reviewers. There was no restriction on time or language. The following studies were included: validation studies and cross-cultural adaptation of OHRQoL instruments into Brazilian Portuguese; studies that evaluated the measurement properties of OHRQoL questionnaires in children and adolescents and that reported at least one of the measurement properties: reliability, internal consistency, error measurement, content validity, construct validity, criterion validity, discriminant validity, and/or convergent validity. The following were excluded: studies of systematic reviews of OHRQoL measures; studies reporting OHRQoL assessment through instruments; construction (development) and validation of a new instrument; questionnaires that had a single item; and validation for Portuguese from Portugal. The cross-cultural adaptation process and psychometrics of the included studies were verified. RESULTS: 6556 articles were identified, and 19 manuscripts were included. All studies were conducted in Brazil, and the age of the participants ranged from 2 to 15.42 years old. Sixteen articles presented the cross-cultural validation steps. Cronbach's alpha of the revised instruments ranged from 0.59 to 0.86. CONCLUSIONS: It can be concluded that most studies provided information and evidence regarding validity, reliability, translation, and cultural adaptation.

Patient-reported measures outcomes: modern evaluation of oral health.

Patient reported outcomes have become important, with instruments (patient reported outcomes measures - PROMs) being used to assess treatment success and patient satisfaction. In this editorial, the dental PROM context is presented, and submissions are invited for a special collection from BMC Oral Health entitled 'Patient-reported outcomes in dentistry'.

Counselling treatment versus counselling associated with jaw exercises in patients with disc displacement with reduction-a single-blinded, randomized, controlled clinical trial.

OBJECTIVE: To compare effectiveness of counselling program versus counselling program plus jaw exercises to reduce pain and click in patients with temporomandibular joint disc displacement with reduction (DDWR). MATERIALS AND METHODS: Patients were divided into two groups: instructions for temporomandibular disorders (TMD) plus jaw exercises (test, n = 34), only TMD instructions (control, n = 34). Pain was analyzed by palpation (RDC/TMD). It was investigated if the click caused discomfort. Both groups were evaluated at baseline, 24 h, 7 days, and 30 days' post treatment. RESULTS: The click was present in 85.7% (n = 60). In 30-day evaluation, there was a statistically significant difference between groups in the right median temporal muscle (p = 0.041); and there was a statistically significant difference in treatment self-perception (p = 0.002) and click's discomfort (p < 0.001). CONCLUSION: The exercise with recommendations showed better results, resolution of the click, and self-perception of the treatment effectiveness. CLINICAL RELEVANCE: This study presents therapeutic approaches that are easy to perform and that can be monitored remotely. In view of the current stage of the global pandemic, these treatment options become even more valid and useful. CLINICAL TRIAL REGISTER: This clinical trial was registered at Brazilian Clinical Trials Registry (ReBec) under protocol RBR-7t6ycp ( http://www.ensaiosclinicos.gov.br/rg/RBR-7t6ycp/ ), Date of registration: 26/06/2020.

Oral health-related quality of life in patients with disc displacement with reduction after counselling treatment versus counselling associated with jaw exercises.

OBJECTIVE: The aim of this study was to compare the effectiveness of two types of treatment (counselling programme versus counselling programme plus jaw exercises) to improve the quality of life of patients with disc displacement with reduction (DDWR). MATERIALS AND METHODS: Patients were divided into two groups. The test group received guidelines for temporomandibular disorders (TMD) plus jaw exercises for DDWR, and the control group received only guidelines for TMD. The total number of investigated patients was 70, thus 35 per group. The oral health-related quality of life was assessed by the OHIP-14 questionnaire. Both groups were evaluated at the baseline and 30 days post-treatment. RESULTS: In the counselling group, there was statistically significant decrease in pain (P = .015) and social disability (P = .046) subscales. In the counselling plus jaw exercise group, there was statistically significant decrease in all subscales (P < .05). At 30 days follow-up, there was a statically significant difference between the two groups in pain (P = .004), psychological discomfort (P < .001), psychological disability (P < .001) and social disability (P = .029) subscales. CONCLUSION: The counselling programme plus jaw exercise protocol showed greater improvement in oral health-related quality of life than the group performing only the counselling programme in patients with DDWR.

Resistance to fracture of intraradicular posts made of biological materials.

BACKGROUND: The aim was to analyze the fracture resistance of human teeth treated endodontically and restored with posts made of bovine dentin, human dentin, or glass fiber, and to evaluate the fracture pattern. METHODS: Cylindrical posts of 1.5 mm in diameter cemented to the roots of human maxillary canines presented a length of 15 mm, cervical diameter of 5-5.5 mm in the mesiodistal direction, and 7-7.5 mm in the vestibule-palatal direction. The groups studied were: Group I-10 glass fiber posts; Group II-10 human dentin posts; Group III-10 bovine dentin posts (self-adhesive resin cement); and Group IV-10 bovine dentin posts (resin-modified glass-ionomer cements). The coronal part of tooth was restored with a standardized core build-up using composite. All of the groups were submitted to a compression force test and the resistance to fracture was verified using a universal testing machine. The fracture pattern was likewise evaluated. RESULTS: The values of resistance to fracture were: 723.3N in group I, 561.5N in group II, 556.6N in group III, and, 613.27N in group IV. However, no statistically significant difference was observed among the groups. The fractures in groups I and II were most commonly found in the middle/apical third and were considered irreparable. For restored teeth in group III, half of the fractures appeared in the cervical third and were reparable. In group IV, all of the fractures were reparable, with the majority in the cervical thirds. CONCLUSION: Bovine dentin can be used as intraradicular post to substitute human dentin and glass fiber posts. The greater the malleability of the post, the greater the chances of survival of the teeth when subjected to fracture testing.

Influence of ozonized water on pain, oedema, and trismus during impacted third molar surgery: a randomized, triple blind clinical trial.

BACKGROUND: This study aimed to evaluate the efficacy of ozonized water on pain, oedema and trismus after impacted third molar mandibular surgeries when compared to double distilled water. A randomized triple blind trial was conducted. METHODS: Patients with third molars class II-B of Pell-Gregory were included, and surgical extraction was performed. Irrigation was done with ozonized (group 1) or double distilled water (group 2). The type of irrigation and the side to be operated were randomized. Neither the patients nor the operator or evaluator were aware of the irrigation solution. Pain, oedema and trismus were evaluated at baseline, 24-h, 48-h, 72-h and 7-days after treatment. The data were evaluated by Friedman, Wilcoxon, Mann-Whitney tests, and size effect. RESULTS: It was included 8 men and 12 women, with a mean age of 20.9y.o. The initial pain mean was 7.94 (±12.81) (group 1) and 5.50 (±9.12) (group 2) (p > 0,05). There was a statistically significant reduction of pain, oedema and trismus in intragroup analysis (p < 0.05). There was no statistically significant difference (p > 0.05) when comparing the oedema and trismus between groups. The size effect ranged from small (0.23) to large (1.29). CONCLUSIONS: It was concluded that ozonized water was compatible as irrigation method, not inferior to double distilled water, and had satisfactory effects on management of pain, oedema and trismus after surgical removal of the third molar. TRIAL REGISTRATION: This clinical trial was registered in ClinicalTrials.gov NCT03501225 on April 18, 2018.

Clinical and radiographic evaluation of the Periodontium with biologic width invasion.

BACKGROUND: The biologic width is defined as the coronal dimension to the alveolar bone that is occupied by healthy gingival tissue. The objective of the present study was to correlate radiographic findings of biologic width invasion with the periodontium status. METHODS: It were included 14 patients with restored teeth with biological width invasion, on the proximal sites, observed clinically and radiographically. 122 proximal sites were evaluated, 61 in the test group (biological width invasion) and 61 in the control group (adequate biological width). Smokers and patients presenting periodontal disease or restorations with contact in eccentric movements, horizontal over-contour or secondary caries were excluded from the sample. The invasion of the biologic width was diagnosed when the distance from the gingival margin of restoration to the bony crest was less than 3 mm. Intrabony defect and bone crest level, as well as, their vertical and horizontal components were radiographically evaluated when present. Plaque index, bleeding on probing, probing depth, gingival recession height, keratinized gingival height and thickness, and clinical attachment level were clinically evaluated. Data were subjected to Spearman's Correlation and Wilcoxon's test. RESULT: The most prevalent tooth with biological width invasion was the first molar. There was a statistically significant correlation between the bone crest (p < 0.001), vertical (p < 0.001) and horizontal (p = 0.001) components. In the test group, there was a statistically significant correlation between bleeding on probing (p < 0.001; r = 0.618) and width of gingival recession (p = 0.030; r = - 0.602) with the intraosseous component; and between keratinized gingival height and bone level (p = 0.037; r = - 0.267). In the control group, there was a correlation between plaque index (p = 0.027; r = - 0.283) with bone level and correlation between keratinized gingival thickness and bone level (p = 0.034; r = - 0.273) and intrabony component (p = 0.042; r = 0.226). CONCLUSION: A statistically significant relationship was found between bleeding on probing and gingival recession in patients who presented intrabony defects due to the invasion of biological width, which may be also related to the thickness of the keratinized gingiva.

Prevalence of self-reported versus diagnosed dentinal hypersensitivity: a cross-sectional study and ROC curve analysis.

OBJECTIVE: This study aimed to identify and compare the self-reported and diagnosed prevalence of dentinal hypersensitivity (DH) in an University population; and to verify accuracy, sensitivity and specificity of DH stimuli tests. MATERIAL AND METHODS: Three hundred and eighty patients (67.2% women and 32.8% men) were assessed by questionnaire, clinical exam, tactile and cold water tests. The intensity of DH was assessed using a visual analogue scale, and a calibrated examiner measured the scores using a caliper. The ICC for intra-examiner was 0.990. Scores above 5 mm were considered sensitive teeth. The association between variables was assessed by Chi-square test. ROC curve analysis determined accuracy, sensitivity and specificity of the tests (p < .05). RESULTS: The mean age of participants was 24.08 years. 158 (41.7%) volunteers self-reported the presence of DH, while, 88.7% of the participants were clinically diagnosed (p = .023). In total, 8958 teeth were evaluated, of those 3367 (37.6%) were diagnosed sensitive. The most prevalent teeth with DH were incisors and premolars. The accuracy of the tests with cold water and tactile were 99%. The sensitivity and specificity for cold water and tactile tests were 99.9%, 99.7%, 99.1% and 87.6%, respectively. CONCLUSION: The self-reported prevalence of DH was significantly lower than that clinically diagnosed. The cold test proved to be a highly accurate stimulus for the diagnosis of DH.

Associated factors to cervical dentin hypersensitivity in adults: a transversal study.

BACKGROUND: This cross-sectional study aimed to identify the factors associated to the cervical dentin hypersensitivity (DH) in Brazilian adult population. METHODS: Three hundred and eighty patients (67.2% women and 32.8% men) were assessed by questionnaire and thermal test with ice. Participants marked in a visual analogue scale (VAS) the intensity of pain, and a calibrated examiner (ICC 0.990) measured the scores using a caliper. Pain scores above 0.5 mm were considered sensitive teeth. The DH associated factors were investigated by clinical examination. The association between variables was assessed by Spearman correlation and the Chi-square test. Logistic regression was used to determine the variables that predict DH (p < 0.05). RESULTS: The mean age of participants was 24.08 years. In this population, 8958 teeth were evaluated, of those 3037 (33.9%) were diagnosed sensitive. The most prevalent associated factors to DH were abnormal tooth positioning (9.0%), occlusal trauma (6.5%) and gingival recession (5.6%). The erosion predicted significantly the DH on both simple (OR 7.85, p < 0.001) and multiple(OR 4.36, p < 0.001) analysis. CONCLUSION: The exposure of dentinal tubules by erosion is probably the major predictor of dentin hypersensitivity. The healthy tooth is able to protect against DH.

Local Flap Technique After Removing Premaxilla for Closure of Oronasal Fistula.

This letter aimed to describe a surgical technique for oronasal fistula closure that promotes efficient healing and minimizes recurrence. The oronasal fistula was repaired by buccal flap. The technique proved to be simple and efficient.

Dental Implants With Immediate Loading Using Insertion Torque of 30 Ncm: A Systematic Review.

OBJECTIVE: This study aimed to perform a review of the literature regarding the survival rate of dental implants with immediate loading using insertion torque of 30 Ncm. MATERIAL AND METHODS: A systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Cochrane Handbook for Systematic Reviews of Interventions (PROSPERO CRD42014015323). The search was performed in the PubMed, Web of Science, Cochrane Library electronic, OVID, and Scielo databases. Manual searches were also performed. The articles identified were assessed independently by 3 researchers. Clinical trials reporting dental implants with immediate loading and 30 Ncm torque in patients ages 18 years or older were included. RESULTS: The searches yielded 589 studies. Six studies were included in the systematic review. The survival rate of dental implants was 96.8%. Three studies showed a low potential risk of bias. CONCLUSION: There is not strong evidence that insertion torque of 30 Ncm is enough for implant survival in cases of immediate loading.

Clinical and Radiographic Evaluation of the Periodontium with Biologic Width Invasion by Overextending Restoration Margins - A Pilot Study.

AIM: The aim of this study was to correlate radiographic examination with the clinical periodontal condition in cases of biologic width invasion by overextending restoration margins in restored premolars and molars. MATERIALS AND METHODS: The present pilot study involved nine people (mean age 32 years) with biologic width invasion by 21 surfaces overextending restoration margins in restored premolars and molars. Radiographs were made in a standardized unit using the interproximal technique and were evaluated by a single calibrated investigator. The clinical periodontal parameters were analyzed with the use of a computerized periodontal probe. Exploratory analysis and Spearman's correlation were used to perform statistical analyses (SPSS, p < 0.05). RESULTS: The most prevalent teeth with biologic width invasion were second premolars and first molars. Mean plaque index was 30.76%, and bleeding on probing was 27.0%. The mesial surface was invaded in 47.6% of cases and the distal surface in 52.4%. The 21 sites with biologic width invasion were found in patients with the following periodontal status: periodontal health (11 sites), gingivitis (2 sites), mild periodontitis (7 sites) and moderate periodontitis (1 site). There was a correlation between plaque index and bleeding on probing with the horizontal component of the bone level. CONCLUSIONS: There was correlation between the radiographic parameters of biologic width invasion and clinical conditions. The measure of the bone crest level correlated with the gingival recession. The horizontal component of bone defect correlated with plaque index and bleeding on probing.

Is the Erich arch bar the best intermaxillary fixation method in maxillofacial fractures? A systematic review.

BACKGROUND: Intermaxillary fixation is used to achieve proper occlusion during and after oral and maxillofacial fracture surgery. The aim of this systematic review was to compare Erich arch bar fixation with other intermaxillary fixation methods in terms of the operating time, safety during installation, oral health maintenance and occlusal stability. MATERIAL AND METHODS: An electronic online search was conducted of the Scirus, PubMed, Ovid, Cochrane Library and VHL databases. A clinical trial dating from the inception of the data bases until August 2013 was selected. Studies that compared Erich arch bars with other intermaxillary fixation methods in patients older than 18 years-old were included. The studies were assessed by two independent reviewers. The methodological quality of each article was analyzed. RESULTS: Nine hundred and twenty-five manuscripts were found. Seven relevant articles were analyzed in this review. The risk of bias was considered moderate for four studies and high for three clinical trials. CONCLUSIONS: There is not enough evidence to conclude that the Erich arch bar is the best intermaxillary fixation method in cases of oral and maxillofacial fractures.

Motion sickness prevalence in school children.

UNLABELLED: This study aimed to determine the prevalence of motion sickness in schoolchildren and related the finding to the postural balance and quality of life. A population-based cross-sectional study was carried out with 831 children aged 7 to 12 years. The frequency of motion sickness was evaluated based on the Motion Sickness Susceptibility Questionnaire-Short (MSSQ-short). Postural balance was assessed using the Romberg test under different sensory conditions. The Dizziness Handicap Inventory was used in order to assess the quality of life. The statistical analyses were performed using the chi-square, Kruskal-Wallis, Mann-Whitney, and Spearman correlation tests. The prevalence of motion sickness was 43.4 % in car, 43.2 % on bus, 11.7 % on park swing, and 11.6 % on Ferris wheel. Mean unadjusted scores on the MSSQ-short ranged from 5.0 (SE = 0.5) for 10-year-olds to 6.8 (SE = 0.5) for 9-year-olds. The most prevalent symptoms following the balance tests were dizziness (89.2 %), vertigo (54.9 %), headache (10.6 %), and nausea (8.2 %). Significant correlations were found between the MSSQ-short score and all postural balance tests. Significant correlations were found between the MSSQ and modified DHI (Dizziness Handicap Inventory) at all ages. CONCLUSION: The prevalence of motion sickness in schoolchildren is greater when in a car or on a bus. An association was found between motion sickness and postural balance tests and motion sickness and quality of life.

Primary Stability and Fracture Resistance of Zirconia and Titanium Implants: A Paired Comparative In Vitro Study.

PURPOSE: Compare Neodent Zi® zirconia implants' insertion torque (IT) and removal torque (RT) with Neodent Alvim® titanium. Measure the maximum torque supported by the zirconia implant until its fracture (MT) and the maximum torque sustained by the assembler of this implant (MTA) until its fracture. MATERIAL AND METHODS: In this in-vitro study twenty four implants were used. Two groups of implants with the same macrogeometry and from the same manufacturer were compared, Zirconia (n=12) and Titanium (n=12). Implant bed preparations were completed in bovine ribs following a standardized drilling protocol. Then, the insertion torque (IT), removal torque (RT), maximum torque to fracture (MT) and maximum torque to fracture of the assembler (MTA) were completed using a calibrated torque meter. Data was presented using descriptive statistics including means, standard deviations (SD), medians, and quartiles. The Shapiro-Wilk test was used to verify data normality and the Wilcoxon test was used to evaluate differences between groups. Statistical significance was established as p < 0.05. RESULTS: Zirconia implants showed: IT 89.33 ± 31.18 Ncm and RT 84.89 ± 32.92 Ncm. Titanium implants showed: IT 77.58 ± 28.96 Ncm and RT 76.75 ± 31.29 Ncm without significant differences (p>0.05). In relation to fracture under rotational force, the zirconia implants fractured at 106.17 ± 22.54 Ncm, and the implant assembly fractured at 84.00 ±13.14 Ncm. CONCLUSION: Neodent Zi® implants showed stability but lower fracture torque than Alvim® titanium. As the fracture values of the assembler were significantly lower than the fracture values of the zirconia implants, it can be stated that, as recommended by the manufacturer, they act as a safety measure during installation.

Psychometric assessment of oral health-related quality of life questionnaires cross-culturally adapted for use in Brazilian adults - a systematic review.

OBJECTIVE: This study aimed to review the psychometric properties of oral health-related quality of life (OHRQoL) questionnaires for the Brazilian adult population. METHODS: A systematic review was performed based on the COSMIN guidelines (PROSPERO CRD42022300018). The studies were obtained through electronic searches in the PubMed/MEDLINE, Web of Science, Lilacs, VHL (BIREME), SciELO, and Embase databases. RESULTS: The search was performed in December 2022. Articles on OHRQoL that reported the cross-cultural adaptation of instruments into Portuguese (Brazil) and evaluated the psychometric properties of measuring instruments in adult patients were included. Those about the development of a novel instrument and participants under 18 years of age were excluded. Information was collected on the country, type of instrument validated, psychometric tests, and adaptation process. The certainty of the evidence was assessed using GRADEpro program. The search returned 6,556 articles, and 14 were considered for this review. However, two studies did not report the cross-cultural adaptation process. Content validity, internal consistency, criterion validity, construct validity, reliability, general discriminant validity, Cronbach's alpha value, and general intraclass correlation coefficient value were confirmed in 12 studies. Cronbach's alpha ranged from 0.69 to 0.96. The certainty of the evidence was considered moderate and low. This study has some limitations, such as the lack of information in some reviewed studies, the unavailability of Brazilian instruments, and absence of longitudinal validation of some instruments. CONCLUSIONS: In conclusion, there are 14 OHRQoL instruments adapted for Brazilian adults that can be used with caution by researchers and clinicians, since they presented moderate to low certainty of the evidence.

Prevalence of Mandibular Third Molars According to the Pell & Gregory and Winter Classifications.

Aim: This study aimed to evaluate the prevalence of mandibular third molar positions according to the Pell & Gregory and Winter classifications, and to verify the association between the two classification methods. Material and Methods: This cross-sectional study was conducted at dental imaging clinic, from January to March 2019. The inclusion criteria were third molars with complete rhizogenesis and the presence of the mandibular second molar. Patients under 16 years were excluded. Digital orthopantomography (panoramic radiography) radiographs of the mandibular third molars were analyzed and observed according to both Pell & Gregory and the Winter classifications, in addition to verifying if they were impacted. Data were submitted to chi-square test. Results: and StatisticsIn total, 1087 teeth were analyzed, and 1055 teeth were included in the study. The teeth were most commonly found to be in the mesioangulated position (41.8%). Higher frequency was observed for position IIB (26.4%). The prevalence of impacted teeth was 79.6%. There was a statistically significant association between the Winter classification and Pell & Gregory classification (p < 0.001). Conclusion: It was concluded that 79.6% of the mandibular third molars were impacted. The most frequent classification of teeth was position IIB, and the mesioangulated position.

Microtensile resistance of an adhesive system modified with chitosan nanoparticles.

Aim: The aim of this study was to evaluate whether 2.5% chitosan applied after dentin acid etching or incorporated into the adhesive system interferes with the microtensile strength of the interface tooth-resin. Subjects and Methods: Sixty healthy bovine teeth had the incisal thirds and the roots sectioned and were randomly allocated into three groups (n = 60). G1 (control): acid attack + Clearfil SE Bond + Z350 resin; G2: treatment with 2.5% chitosan + Clearfil SE Bond + Z350 resin; G3: treatment with 2.5% chitosan incorporated into dentin adhesive + Z350 resin. The stick-shaped specimens made in each group were randomly divided into two subgroups and subjected to degradation of the adhesive interface (with aging: specimens immersed in 2.5% sodium hypochlorite for 12 h and washed in distilled water for 1 h, and without aging). The groups were submitted to a microtensile strength test with a 0.5 mm/min speed until rupture. Statistical analysis of the data was performed according to normal distribution. Results: Microtensile data were obtained by calculating the area of each toothpick, obtaining values in megapascal. No aging: G1 - 5251.69, G2 - 5.52 ± 1.46, and G3 - 3.91 ± 1.21. With aging: G1 - 3.45 ± 1.29, G2 - 2.75 ± 0.78, and G3 - 3.53 ± 1.33. Statistical analysis showed that the aging factor and adhesive modification decreased the bonding strength of the resin-dentin (P = 0.001). As well, the interaction between the analyzed factors showed statistically significant differences (P = 0.002). Conclusions: Accelerated aging decreases the adhesion strength in G1, even when chitosan is previously applied to the adhesive system. However, when adding chitosan to the adhesive, adhesion remained similar after aging but lower when compared to the other groups.

Sensitivity and specificity of assessment scales of dentin hypersensitivity - an accuracy study.

The aim of the present study was to compare the sensitivity and specificity of pain scales used to assess dentin hypersensitivity (DH). The preferred scale, and toothbrushing habits of participants were also investigated. This cross-sectional study was conducted with students and employees of a Brazilian Federal University who presented DH. The participants answered a questionnaire about their toothbrushing and drinking habits. Hypersensitive and non-sensitive teeth were submitted to tactile and ice stick stimuli. Then, the subjects marked their pain level in the visual analogue (VAS), numeric scale (NS), faces pain scale (FPS) and verbal evaluation scale (VES). DH was also assessed by Schiff scale (SS). The data were analyzed by Wilcoxon and Chi-Square tests, as well as by ROC curve. The mean age of the sample (56 women, 16 men) was 27.8 years. The most prevalent acidic beverage was coffee (36.0%) and the most preferred scale was the NS (47.2%). The pain level was statistically higher in teeth with DH compared to teeth without DH (p < 0.05). The accuracy ranged from 0.729 (SS) to 0.750 (NS). The highest sensitivity value was 81.9% for NS. The SS presented the highest specificity (91%). The visual analog, numerical, verbal evaluation, faces pain, and Schiff scales were accurate for DH diagnosis. The Schiff scale was the preferred scale for DH assessment.

Systematic review of biological therapy to accelerate orthodontic tooth movement in animals: Translational approach.

OBJECTIVES: To systematically review and evaluate what is known regarding contemporary biological therapy capable of accelerating orthodontic tooth movement (OTM) in animal model. MATERIALS AND METHODS: MedLine, Scopus, Web of Science and OpenGrey were searched without restrictions until June 2019. Following study retrieval and selection, relevant data was extracted using a standardized table. Risk of bias (RoB) assessment was performed using the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) tool. RESULTS: Fifty-one animal studies were included. Two biological therapies were identified as capable of accelerating the OTM: chemical methods (49 studies) and gene therapy (2 studies). The main substances that increased the OTM rate were cytokines (13 studies), followed by growth factors (6 studies) and hormones (5 studies). Most studies were assessed to be at unclear or high RoB. The application protocols, measurement and reporting of outcomes varied widely and methodologies were not adequately reported. CONCLUSIONS: Although biological therapies to accelerate OTM have been widely tested and effective in preclinical studies, the validity of the evidence is flawed to support translational of these results. There is a need for well-designed experimental studies to translate these methods for clinical field.