Periodontal health status, oral microbiome, white-spot lesions and oral health related to quality of life-clear aligners versus fixed appliances: A systematic review, meta-analysis and meta-regression.

Objective: : Assess and evaluate the different indicators of oral health-related quality of life (OHRQoL) among patients treated with clear aligners (CAs) versus those treated with conventional fixed orthodontics (FAs). Methods: : An electronic search was performed on the database is Web of Science, Scopus, and Embase databases. Randomized and non-randomized control trials, cross-sectional, prospective cohort and retrospective trials were included. Quality was assessed with risk of bias tool and risk of bias in non-randomised studies. Meta-analyses were performed with random effects models, estimating the standardized and non-standardized mean differences, odds ratio and risk ratio as the measure of effect. The effect on time was determined using a meta-regression model. Results: : Thirty one articles were included in the qualitative synthesis and 17 in the meta-analysis. CAs had a significantly lower negative impact on QoL, with an "important" effect size, while the influence of time was not significant. Periodontal indicators plaque index (PI), gingival index (GI), probing depth (PD), and bleeding on probing show significantly better values in patients treated with CAs, with moderate to large effect sizes. PI and GI have a significant tendency to improve over time. In microbiological indicators, CAs present a lower biofilm mass without differences in the percentage of patients with high counts of Streptococcus mutans and Lactobacilli bacteria. The risk of white spot lesion onset is ten times lower in carriers of CAs. Conclusions: : Patients wearing CAs show better periodontal indicators, less risk of white spot development, less biofilm mass and a better QoL than patients with FAs.

Digital Tools for Translucence Evaluation of Prosthodontic Materials: Application of Kubelka-Munk Theory.

Translucency is one of the most important parameters to be considered by digital systems when predicting the matching appearance and hence the quality of prosthodontic restoration work. Our objective has been to improve the effectiveness of the algorithmic decision systems employed by these devices by (a) determining whether Kubelka-Munk theory can be used as an algorithm for predicting restoration suitability, and (b) evaluating the correlation between the visual evaluation of prosthodontic materials and the predicted translucency based on the use of the ΔE*, OP, CR, and K/S algorithms. In this regard, three zirconia systems and one lithium disilicate have been spectrophotometrically and visually characterized. Based on the results of this study, it has been proven that zirconia systems and lithium disilicate systems exhibit different optical behaviors. The psychophysical experience suggests that none of the existing mathematical methods can adequately estimate translucency, spectrophotometric, and colorimetric techniques, and that which is perceived by an experienced observer. However, translucency evaluation through the K/S algorithmic decision system should not be disregarded. New methods to measure translucency should be developed to improve digital systems for prosthodontic applications.

Reliability of Tooth Width Measurements Delivered by the Clin-Check Pro 6.0 Software on Digital Casts: A Cross-Sectional Study.

The purpose of this study was to assess the accuracy and reliability of tooth width measurements and Bolton Indices delivered by the Clin-Check Pro 6.0 software (Align Technology, San José, CA, USA). Fifty-four plaster casts were selected and measured with a manual calliper by a trained and calibrated observer. The data gathered were compared with those delivered by the software on the corresponding fifty-four virtual casts. The method reliability of the software was assessed by comparing the measurements performed by the software on 201 pairs of clin-checks corresponding to two consecutive treatment phases. Accuracy and reliability were statistically assessed using a mixed model. The software tends to provide larger widths compared with the manual method. Statistically significant differences were found in 23 teeth. At a global level, the mean difference between the methods was -0.19 mm, with a Dahlberg error of 0.24 mm and an intraclass correlation coefficient of 0.98. The Bolton Indices delivered by the two methods had a moderate correlation (ICC = 0.59; 0.69). The within method reliability of the software was extremely high. Tooth width measurements delivered by the software, despite the positive bias, can be considered accurate and clinically acceptable for all teeth except molars. The Bolton Indices made available by the software are not accurate and clinically acceptable, especially in the case of mandibular excess.

Sex estimation through geometric morphometric analysis of the frontal bone: an assessment in pre-pubertal and post-pubertal modern Spanish population.

Sex estimates is a key step of biological profile assessment in a forensic or anthropologic context. In this study, the sexual dimorphism of the frontal bone was analyzed to assess the accuracy of sex estimates using a geometric morphometric approach in a pre-pubertal and post-pubertal sample. The shape of the frontal bone was digitized on the lateral cephalograms of 87 pre-pubertal subjects (42 males, mean age 10.14, SD ± 1.48 years; 45 females mean age 10.02, SD ± 1.11 years) and 103 post-pubertal ones (53 males, mean age 29.33 SD ± 11.88 years; 50 females, mean age 26.77 SD ± 11.07 years). A generalized Procrustes analysis (GPA) was performed for shape analyses, filtering the effects of position, rotation, translation, and size. A principal component analysis (PCA) was performed on the GPA transformed variables, and a multiple logistic regression model was used to assess the accuracy of sex estimates. In both age groups, the average size of the centroid was significantly larger in males. The females presented shapes with a shorter distance between P2 (glabella) and P1 (supratoral) and a general narrowing of the structure on the sagittal plane. In the pre-pubertal group, the shape difference was not statistically significant. In the post-pubertal group, the mean shape was significantly different between the sexes. The method displayed a high accuracy for sex estimates (88.7% males, 90.3% females) also when applied in a validation sample (82.6% males and 94.1% females). The described morphometric analysis of the frontal bone is based on a limited number of landmarks, which allows sex estimates with high accuracy in post-pubertal subjects, while it is not applicable in pre-pubertal ones.

Compliance with the ISO 27020:2019 norm of a sample of currently available preadjusted Orthodontic bracket systems. Are the actual dimensions as expected?

BACKGROUND: Determine the exact slot dimension of a sample of a MBT prescription stainless steel conventional brackets from different manufacturers to compare the actual values with the nominal ones declared by the manufacturers and to verify the compliance with tolerance limits given by the ISO 27020:2019. Different batches from each manufacturer were evaluated to determine whether or not they are different in size. In addition, the geometry of the slot walls was assessed. METHODS: 360 stainless steel preadjusted orthodontic brackets of 12 different manufacturers were assessed. All brackets had a nominal slot size of 0.022 by 0.028 inches, belonged to the right upper central incisor, and were fabricated with the metal injection molding technique (MIM). For each manufacturer, three different manufacturing batches were evaluated. Brackets were coded using a single-blind design. RESULTS: All bracket systems in the study group except one displayed a statistically significant difference with the nominal declared value, although only four of the systems did not comply with the tolerance limits established by the ISO 27020:2019. In most of the systems, the slot height was oversized when compared to the nominal one. A significant interbatch variability was found in most of the evaluated systems. Most of the brackets walls were divergent. CONCLUSIONS: The dimensional accuracy of commercially available metal brackets is not guaranteed. The respect for the norm should be enforced as well as the quality controls along the manufacturing process since orthodontic brackets are a precision medical device.

Invisalign treatment from the patient perspective: A Twitter content analyses.

BACKGROUND: Understanding patient perspective is a key factor in improving treatment satisfaction. The aim of the present study is to qualitatively describe the content of Twitter posts related to the treatment with Invisalign in order to get a better understanding of patient experience. MATERIAL AND METHODS: Tweets were prospectively collected during a period of four weeks from public available posts on Twitter using Awario™ a bespoke social media monitoring tool. After applying the pertinent inclusion and exclusion criteria the selected posts were analysed by three investigators using thematic analysis. Specific themes and subthemes were developed. RESULTS: A total of 1564 tweets were analysed; three mayor themes were identified: Pre-treatment related, Treatment related and Patient/clinician relationship. Pre-treatment posts were mainly positive and underlined patients' expectations, while in the treatment phase an almost equal number of positive and negative posts were found. The positive post were about the satisfaction with treatment and the improvement of self-esteem. The negative ones were related to pain, compliance, the impact on diet and pronunciation. CONCLUSIONS: The present study provides a better understanding of patients' experience during clear aligners treatment. Increasing the awareness of the clinicians can improve their ability to face problems related to the orthodontic treatment and to provide to their patients better professional advices and counselling. Key words:Social media, twitter, clear aligners, Invisalign, orthodontics.

There is still room for improvement in the completeness of abstract reporting according to the PRISMA-A checklist: a cross-sectional study on systematic reviews in periodontology.

BACKGROUND: To evaluate the completeness of reporting abstracts of systematic reviews (SRs) before and after the publication of the PRISMA-A checklist in 2013 and to assess if an association exists between abstract characteristics and the completeness of reporting. METHODS: A systematic search of the literature was conducted in the PubMed and Scopus databases in March 2020. The search focused on the SRs of evaluations of interventions published since 2002 in the field of periodontology. The abstracts of the selected SRs were divided into two groups before and after publication of the PRISMA-A checklist in 2013, and compliance with the 12 items reported in the checklist was evaluated by three calibrated evaluators. RESULTS: A set of 265 abstracts was included in the study. The total score before (mean score, 53.78%; 95% CI, 51.56-55.90%) and after (mean score, 56.88%; 95% CI, 55.39-58.44%) the publication of the PRISMA-A statement exhibited a statistically significant improvement (P = 0.012*). Nevertheless, only the checklist items included studies and synthesis of the results displayed a statistically significant change after guideline publication. The total PRISMA-A score was higher in the meta-analysis group and in articles authored by more than four authors. CONCLUSIONS: The impact of the PRISMA-A was statistically significant, but the majority of the items did not improve after its introduction. The editors and referees of periodontal journals should promote adherence to the checklist to improve the quality of the reports and provide readers with better insight into the characteristics of published studies.

The online attention to orthodontic research: an Altmetric analysis of the orthodontic journals indexed in the journal citation reports from 2014 to 2018.

BACKGROUND: To describe the impact of research, beyond the limits of the academic environment, Altmetric, a new social and traditional media metric was proposed. The aims of this study were to analyze the online activity related to orthodontic research via Altmetric and to assess if a correlation exists among citations, Mendeley reader count, and the AAS (Altmetric Attention Score). METHOD: The Dimensions App was searched for articles published in the orthodontic journals listed in the Journal Citation Reports (JCR) throughout the years 2014 to 2018. The articles with a positive AAS were collected and screened for data related to publication and authorship. The articles with an AAS higher than 5 were screened for research topic and study design. Citation counts were harvested from Web of Science (WOS) and Scopus. RESULTS: The best performing journals were Progress in Orthodontics and the European Journal of Orthodontics with a mean AAS per published item of 1.455 and 1.351, respectively and the most prevalent sources were Tweets and Facebook mentions. The most prevalent topic was Oral Health-Related Quality of Life (OHRQOL) and the study design was systematic reviews. The correlation between the AAS and the citations in both WOS and Scopus was poor (r = 0.1463 and r = 0.1508, p < .05). The correlation between citations count and Mendeley reader (r = 0.6879 and r = 0.697, p < .05) was moderate. CONCLUSIONS: Few journals displayed a high level of web activity. Journals and editors should enhance online dissemination of the scientific outputs. The authors should report the impact of the findings to the general public in a convenient way to facilitate online dissemination but to avoid an opportunistic use of the research outputs. Despite the lack of correlation, a combination of the citation count and the AAS can give a more comprehensive assessment of research impact.

Trending topics in orthodontics research during the last three decades: A longitudinal bibliometric study on the top-cited articles.

OBJECTIVE: To perform a bibliometric analysis on the top-cited articles over the last three decades from 1989 to 2018, using a longitudinal set-up, in order to analyse how articles' features have evolved over time. SETTING AND SAMPLE POPULATION: A sample of 312 articles divided into three subgroups of 104 top-cited articles for each decade were included. The h-index value was used to determine the sample size. MATERIALS AND METHODS: The articles were identified through a search in the category "dentistry oral surgery and medicine" of the Web of Science database. The information relative to the articles was collected. Descriptive statistics was used to describe the articles and the journals; selected parameters were analysed with the Kruskal-Wallis and the Mann-Whitney U test at the 0.05 level of significance. RESULTS: The top-cited articles were published mainly by orthodontic journals. Along the last two decades, the scientific contribution of Asian and South American countries rose significantly. The trending topics varied in each decade. Skeletal anchorage-related articles dominated the production of the decade 1999-2008 while new technologies as CBCT displayed a higher prevalence in the last decade, where new topics such as corticotomy-assisted orthodontics started to appear. The number of multi-authored articles increased while the articles from no university institutions decreased. CONCLUSION: The publications in the three studied decades were significantly different in terms of numbers and characteristics. A longitudinal set-up allows to study the evolution of the scientific production and how the area of interest has developed over time.

Measuring the social impact of research in Paediatric Dentistry: An Altmetric study.

BACKGROUND: Traditional metrics have been extensively used to evaluate the scientific performance. Despite being widespread accepted, citation-based metrics are not able to describe the social impact of research. A diverse metric, Altmetric, was proposed to overcome those limitations. AIM: This study aims to analyse the social impact of research in the field of paediatric dentistry and to assess if a correlation exists between the JCR citations, the AAS score, and the recently released Dimensions citation count. DESIGN: A bibliometric study was conducted on the four journals related to Paediatric Dentistry listed in the JCR from 2014 to 2017. Descriptive statistics was used to describe the articles and the journals. Pearson's correlation analysis was used to explore the relationship among JCR citations, AAS, and Dimensions. RESULTS: The percentage of articles with an AAS presents a huge variability and was significantly higher in the International Journal of Paediatric Dentistry. In our sample, the correlation between the JCR citation count and the AAS was poor in the years 2014, 2015, and 2016 and low in 2017. The correlation between JCR citation and Dimensions citation count was strong. CONCLUSIONS: The social impact of research in paediatric dentistry can be increased. Dimensions could be an alternative to the JCR. Both the editors and the researcher should change their vision and facilitate the access to research information to scholar and non-scholar audiences.

The online attention to research in periodontology: An Altmetric study on the most discussed articles on the web.

AIM: To assess the online attention to research in the field of Periodontology. To assess the correlation between the Altmetric Attention Score (AAS) and the citations count in Web of Science (WOS), Scopus and Dimensions. MATERIAL AND METHODS: The articles were identified by a search performed through the Dimensions Free App. The search included the six journals related to periodontology listed in the Journal Citation Report (JCR) in the year 2017. The 200 articles with the highest AAS were collected and screened for data related to publication, authorship and research. Citations were harvested from WOS, Scopus and Dimensions. RESULTS: The Journal of Clinical Periodontology was the most prevalent publication accounting for the 51, 5% of the published items followed by the Journal of Periodontology that published the 34, 5% of the 200 articles with the highest AAS. 65% of these articles were published between 2013 and 2018. The mean AAS was 33, 81 being Tweets and news outlets the most frequent Altmetric resources. Systematic reviews were the most prevalent study design. The correlation between the AAS and the citations in WOS, Dimensions and Scopus was poor. A strong correlation exists between the citations in WOS, Dimensions and Scopus. CONCLUSIONS: Online attention to periodontal research is high. Systemic interaction studies had a significantly higher visibility. The classic citations count in combination with the AAS can offer a more comprehensive insight into research by highlighting what is valuable for the researcher and for the lay persons. The online profile of journals should be edited to facilitate spread of research information in non-scholar audiences.

[Systematic review about dental caries in children and adolescents with obesity and/or overweight]. / Revisión sistemática sobre la caries en niños y adolescentes con obesidad y/o sobrepeso.

INTRODUCTION: Obesity and overweight (O/OW) in children have reached epidemic character and both are a risk factor for chronic serious health problems. This study was perfomed in order to research the relationship between O/OW and dental caries. MATERIAL AND METHODS: [corrected] A SR was conducted between 2007-2011 in tertiary information sources (Trip, Cochrane and NGC), secondary (PubMed, IME, MEDES IBECS) and primary (reference checks). INCLUSION CRITERIA: Patients (children 0-18 years), risk factor (O/OW) and outcomes (primary: caries, secondary: other oral pathology). DATA COLLECTED: Author, year, country, type of study, patient age, cases (with O/OW) and controls (body mass index-BMI-normal or low), comorbidities, socioeconomic status, prevalence of caries and other results in oral health. RESULTS: Forty-seven documents were located, 37 of them met the criteria of the RS, temporarily distributed in 2007 (6 articles), 2008 (6), 2009 (5), 2010 (11) and 2011 (9). They presented a very wide degree of heterogeneity (in patients, intervention, primary outcome and type of design), which does not allow to apply quantitative synthesis of data (meta-analysis). Studies are conflicting regarding the relationship between BMI and frequency of dental caries (DMFT, dmft). CONCLUSIONS: Systematic review allows dentists and pediatricians to know the relationship between O/OW and dental caries.

Introducción: Obesidad y el sobrepeso (O/SP) infantil han alcanzado caracteres de epidemia y son un factor de riesgo de enfermedades crónicas graves para la salud. El objetivo es realizar una revisión sistemática (RS) sobre la relación de O/SP con caries en pediatría. Material y métodos: RS de la literatura 2007-2011 en fuentes de información terciaria (Trip, Cochrane y NGC), secundaria (PubMed, IME, IBECS y MEDES) y primarias (revisión de referencias). Criterios de inclusión: Pacientes (niños de 0-18 años), factor de riesgo (O/SP) y variable de interés (primaria: caries; secundarias: resto patología bucodental). Datos recogidos: Autor, año, país, tipo de estudio, edad pacientes, casos (con O/SP) y controles (con índice de masa corporal -IMC- normal o bajo), estado socioeconómico, prevalencia de caries y otros resultados en salud bucodental. Resultados: Se localizaron un total de 48 documentos, de los que 37 cumplieron los criterios de búsqueda de la RS, distribuidos temporalmente: 6 artículos del año 2007, 6 del 2008, 5 del 2009, 11 del 2010 y 9 del 2011. Presentaron un grado de heterogeneidad muy amplio (en pacientes, intervención, variable principal de interés y tipo de diseño), lo que no permite aplicar síntesis cuantitativa (metanálisis) de los datos, pero si cualitativa. Los estudios son discordantes respecto a la relación entre IMC y frecuencia de caries (CAOD, caod). Conclusiones: La RS permite al odontólogo y pediatra conocer la potencial relación entre O/SP y caries dental.