Recognition of COVID-19 with occupational origin: a comparison between European countries.

OBJECTIVES: This study aims to present an overview of the formal recognition of COVID-19 as occupational disease (OD) or injury (OI) across Europe. METHODS: A COVID-19 questionnaire was designed by a task group within COST-funded OMEGA-NET and sent to occupational health experts of 37 countries in WHO European region, with a last update in April 2022. RESULTS: The questionnaire was filled out by experts from 35 countries. There are large differences between national systems regarding the recognition of OD and OI: 40% of countries have a list system, 57% a mixed system and one country an open system. In most countries, COVID-19 can be recognised as an OD (57%). In four countries, COVID-19 can be recognised as OI (11%) and in seven countries as either OD or OI (20%). In two countries, there is no recognition possible to date. Thirty-two countries (91%) recognise COVID-19 as OD/OI among healthcare workers. Working in certain jobs is considered proof of occupational exposure in 25 countries, contact with a colleague with confirmed infection in 19 countries, and contact with clients with confirmed infection in 21 countries. In most countries (57%), a positive PCR test is considered proof of disease. The three most common compensation benefits for COVID-19 as OI/OD are disability pension, treatment and rehabilitation. Long COVID is included in 26 countries. CONCLUSIONS: COVID-19 can be recognised as OD or OI in 94% of the European countries completing this survey, across different social security and embedded occupational health systems.

Do the various interceptive treatment modalities improve the position of palatally displaced permanent canines? A meta-analysis.

BACKGROUND: Removal of maxillary primary canines and other interceptive treatment modalities in the mixed dentition have been suggested as methods used to increase the rate of normal eruption of palatally displaced permanent canines (PDCs). However, the information on the overall effect on PDCs' position has been inconclusive. OBJECTIVE: To assess whether this practice improves the position of PDCs and to investigate the quality of the evidence. SEARCH METHODS: Unrestricted searches in 7 databases and manual searching of the reference lists in relevant studies were performed up to June 2022 (Medline via PubMed, CENTRAL, Cochrane Database of Systematic Reviews, Scopus, Web of Science, ClinicalTrials.gov, ProQuest Dissertations, and Theses Global). SELECTION CRITERIA: We looked for data on the positional changes of PDCs (mesial inclination, vertical position, canine crown cusp tip to midline) from randomized controlled trials assessing the various interceptive treatment modalities. DATA COLLECTION AND ANALYSIS: Following study retrieval and selection, relevant data were extracted, and the risk of bias was assessed using the Cochrane Risk of Bias 2 Tool. Exploratory synthesis and meta-regression were conducted using the random effects model and the overall quality of the available evidence was assessed with the Grades of Recommendation, Assessment, Development, and Evaluation approach. RESULTS: Five studies (3 at low risk of bias) were identified, involving 238 individuals, followed for up to 18 months post-intervention with OPG (orthopantomogram) or CBCT (cone-beam computed tomography). Exploratory data synthesis showed that PDCs' position improved more in the extraction sites compared to non-extraction. Analysis of the studies at low risk confirmed the above observations (6- and 12-month). Improvements were observed in patients using headgear after extraction of primary canines compared to extraction alone, but not in patients with double extraction of primary canines and first molars. The quality of available evidence was rated at best as moderate. CONCLUSIONS: Interceptive treatment modalities in the mixed dentition may improve the position of PDCs. However, more studies are necessary in order to determine the clinical significance of the changes. REGISTRATION: PROSPERO (CRD42015029130).

In vivo aging-induced surface roughness alterations of Invisalign® and 3D-printed aligners.

OBJECTIVE: To assess the surface roughness of in-house 3D-printed orthodontic aligners compared with Invisalign® appliances, both retrieved as well as in the 'as-received' control status. DESIGN: An in vitro study following intra-oral material aging. SETTING AND PARTICIPANTS: Twelve clinically used Invisalign® appliances and the same number of 3D-printed aligners, without involvement of attachments, were obtained from a respective number of patients. A similar number of 'as-received' aligners, of each material, were used as control (CON) groups. METHOD: Four groups of materials were examined: A = Invisalign® CON; B = Invisalign® used; C = 3D-printed CON; and D = 3D-printed used. Optical profilometry was employed to examine the following surface roughness parameters: amplitude parameters Sa, Sq and Sz and functional parameters Sc and Sv. Descriptive statistics and quantile regression modeling were conducted, and the level of statistical significance was set at α = 0.05. RESULTS: Intra-oral exposure of 3D-printed aligners was significantly associated with increase in all tested parameters (P < 0.001 at all occasions). Significant differences were detected in the retrieved 3D-printed aligners compared with Invisalign® retrieved, with the exception of Sz. The respective effect sizes (median differences) were as follows: Sa: 169 nm, 95% confidence interval [CI] = 89-248, P < 0.001; Sq: 315 nm, 95% CI = 152-477, P < 0.001; Sc: 233 nm3/nm2, 95% CI = 131-335, P < 0.001; and Sv: 43 nm3/nm2, 95% CI = 17-68, P = 0.002. CONCLUSION: Within the limitations of this study, we concluded that surface roughness differences existed between 3D-printed aligners and Invisalign® in the retrieved status, as well as between the control and retrieved 3D-printed groups.

A 7-Step Guide to High-Definition Liposuction.

BACKGROUND: High-Definition (HD) Liposuction refers to the most advanced body contouring technique, offering an athletic and healthy body appearance. The latest available devices, the criteria of proper selection, and an expert surgeon's tips are highlighted in a 7-step guide approach. METHODS: A retrospective study of prospectively maintained database was conducted from 2015 to 2020. Demographic information, personal history, outcomes, complications were collected and analyzed from 568 patients who underwent the same surgical procedure. RESULTS: 568 patients (247 male and 321 female) were included in the study with a mean BMI of 25.6 (range 21-29 kg/m2) and follow up time ranging from 1 to 48 months. The first 50 procedures represented the initial learning curve, during which most complications had occurred (14 patients/50 patients). Using the 7-step guide, we managed to minimize the overall complications to a rate of 3%. CONCLUSION: The outlined steps have been simplified in a 7-step guide for plastic surgeons to understand, practice and refine HD liposuction in a contemporaneous, efficient, and reproducible manner. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Colour assessment of bleaching effect on orthodontically treated teeth.

AIM: To assess whether the efficacy of external tooth bleaching differs between untreated and orthodontically treated teeth. MATERIALS AND METHOD: Three groups of subjects were formed; group Debonded included 24 consecutive orthodontically treated patients evaluated immediately after removal of fixed appliances. The Retention group included 24 consecutive orthodontically treated patients in the phase of retention. The Untreated group consisted of 24 arbitrarily selected undergraduate dental students without history of fixed-appliances orthodontic therapy. Each of the above three groups was further randomized into two subgroups, Bleaching and Placebo. Each subgroup received either a 38% hydrogen peroxide bleaching treatment or a placebo agent, respectively. Tooth colour changes were assessed at seven timepoints: 1 day before intervention; on the day of intervention before and after treatment; and at 7, 14, 21, and 90 days for parameters L*, a*, b*, and ΔΕ in all upper incisors and canines with the use of a reflectance spectrophotometer. Intra-rater agreement was estimated with the Intra-class Correlation Coefficient and method's error was calculated using the Repeatability Coefficient. Regarding tooth colour changes, an analysis of variance was used to assess differences between groups. RESULTS: Bleaching was associated with an increase of the L* value and decrease of b* and a* values in both orthodontically treated and untreated teeth. Parameters ΔE, L*, and b* exhibited statistically significant differences between the Bleaching-Untreated and Bleaching-Retention subgroups. In the Bleaching subgroups, statistically significant differences were found between different teeth for all parameters. CONCLUSIONS: Previous exposure to fixed orthodontic appliance influenced the efficacy of external tooth bleaching. The effect of bleaching was higher after orthodontic treatment and with longer period in retention. Canines changed in colour more than incisors, and the effect was reduced over time.

Rejuvenation of the ageing face and the role of orthodontics: Guidelines for management.

The article reviews the ageing changes of the midfacial and maxillary bones, the mandible, the overlaying soft tissues and the smile, and presents clinical guidelines aiming to rejuvenate older faces by means of orthodontic therapy. With regard to the ageing changes, the maxillary skeleton appears to rotate clockwise inferior to the orbit and becomes retrusive, and as a general pattern the midface contracts and deteriorates with age. Resorption below the mental foramen, reduction in alveolar height, loss of bone at the chin region, and relative increase in size and shape are signs of an aged mandible. Epidermal thinning and decrease in collagen in combination with the effect of gravity and various external factors contribute to the ageing of the skin. Atrophy of the superficial and deep fat, changes in ligamentous tissues and changes in muscle structure, position and tone, all contribute to the stigmata of the aged face. In the article, two late adulthood orthodontic cases are discussed as examples, and general guidelines for orthodontic management of the older face aiming at reversing the 'shrinkage' of the tissues by restoring the facial shape and tightening the soft tissue mask are described. The possible mechanisms explaining the changes observed on the faces of the clinical cases are also discussed. A properly planned and executed orthodontic intervention reversing changes from the inside-out before embarking on cosmetic surgery might have a synergistic effect multiplying the benefits for adult patients.

Could medications and biologic factors affect post-orthodontic tooth movement changes? A systematic review of animal studies.

Immediately after the removal of orthodontic appliances, the teeth might start to drift away from their corrected position in an attempt to reach a new equilibrium. Medications and biologic factors could potentially modulate these processes. The objective of the present systematic review is to systematically investigate and appraise the quality of the evidence regarding the effect of various medications and biologic factors on the rate of relapse following active tooth movement. Search without restrictions in eight databases and hand searching until April 2020 were conducted. Studies performed on animal models investigating the effects of medication and biologic factors on the rate of relapse following orthodontic tooth movement were considered. Following study retrieval and selection, relevant data were extracted and the risk of bias was assessed. Seventeen studies were finally identified, mostly at either high or unclear risk of bias. Ketorolac did not show any significant effects on relapse, while the administration of tetracycline, atorvastatin, psoralen and raloxifene decreased it. Overall, the same result was observed with bisphosphonates with the exception of low dosage of risedronate, which did not have an effect. Osteoprotegerin and strontium resulted in reduced relapse, but not in the immediate post-administration period. Inconsistent or conflicting effects were noted after the use of simvastatin and relaxin. The quality of the available evidence was considered at best as low. It can be concluded that specific medications and biologic factors may have an effect on the rate of relapse following tooth movement. The orthodontist should be knowledgeable about the substances potentially affecting retention.

Does the rate of orthodontic tooth movement change during the estrus cycle? A systematic review based on animal studies.

BACKGROUND: As the fluctuation of sex hormone levels in menstruating women results in periodical effects in bone metabolism, understanding the implications for tooth movement could be of benefit to the orthodontist. This type of research presents practical and ethical problems in humans, but animal models could provide useful information. Our objective was to systematically investigate the available evidence on the question whether the rate of orthodontic tooth movement varies between the different stages of the estrus cycle in animals. METHODS: Unrestricted searches in 7 databases and manual searching of the reference lists in relevant studies were performed up to February 2021 (Medline [PubMed], CENTRAL [Cochrane Library; includes records from Embase, CINAHL, ClinicalTrials.gov, WHO's ICTRP, KoreaMed, Cochrane Review Groups' Specialized Registers, and records identified by handsearching], Cochrane Database of Systematic Reviews [Cochrane Library], Scopus, Web of Knowledge [including Web of Science Core Collection, KCI Korean Journal Database, Russian Science Citation Index, SciELO Citation Index and Zoological Record], Arab World Research Source [EBSCO] and ProQuest Dissertation and Theses [ProQuest]). Our search focused on prospective controlled animal studies, whose samples included female subjects of any species that were quantitatively comparing the amount of tooth movement in the different stages of the estrus cycle. Following study retrieval and selection, relevant data was extracted, and the risk of bias was assessed using the SYRCLE's Risk of Bias Tool. RESULTS: From the finally assessed records, 3 studies met the inclusion criteria. Two of the studies experimented on Wistar rats, whereas the other on cats. Tooth movement was induced by expansion or coil springs. The rate of orthodontic tooth movement was increased during the stages of the estrus cycle when oestrogen and/or progesterone levels were lower. The risk of bias in the retrieved studies was assessed to be unclear. CONCLUSION: Hormonal changes during the estrus cycle may affect the rate of orthodontic tooth movement. Although these animal experiment results should be approached cautiously regarding their translational potential, it could be useful to consider the possible impact of these physiological changes in the clinical setting until more information becomes available. Registration: PROSPERO (CRD42021158069).

How orthodontic research can be enriched and advanced by the novel and promising evolutions in biomedicine.

Recent advances in developmental, molecular and cellular biology as well as biomedical technologies show a promising future for crossing the gap between biomedical basic sciences and clinical orthodontics. Orthodontic research shall utilise the advances and technologies in biomedical fields including genomics, molecular biology, bioinformatics and developmental biology. This review provides an update on the novel and promising evolutions in biomedicine and highlights their current and likely future implementation to orthodontic practice. Biotechnological opportunities in orthodontics and dentofacial orthopaedics are presented with regards to CRISPR technology, multi-omics sequencing, gene therapy, stem cells and regenerative medicine. Future orthodontic advances in terms of translational research are also discussed. Given the breadth of applications and the great number of questions that the presently available novel biomedical tools and techniques raise, their use may provide orthodontic research in the future with a great potential in understanding the aetiology of dentofacial deformities and malocclusions as well as in improving the practice of this clinical specialty.

Do analgesics used for the pain experienced after orthodontic procedures affect tooth movement rate? A systematic review based on animal studies.

BACKGROUND: Using analgesics for a short period to relieve the pain following specific orthodontic procedures is common. Such medications may influence orthodontic tooth movement biochemical pathways; however, the information originating from human studies is limited. OBJECTIVES: To systematically investigate current evidence from animal experiments on the effect of administering analgesics for a few days, which is consistent with usual clinical practice, on the speed of orthodontic tooth movement. SEARCH METHODS: Eight databases were searched without restrictions, and hand searching was conducted until June 2019. SELECTION CRITERIA: Animal controlled studies assessing the short-term impact of analgesics that can be consumed for orthodontic pain on the speed of orthodontic tooth movement. DATA COLLECTION AND ANALYSIS: Subsequent to retrieving relevant studies and information extraction, the SYRCLE's Risk of Bias Tool was used for risk of bias assessment. RESULTS: Finally, seven studies were selected, and most of them were assessed at unclear risk of bias. Short-term administration of acetaminophen did not affect significantly the speed of tooth movement, while ibuprofen and indomethacin were reported to decrease it. After administering acetylsalicylic acid and celecoxib, the noted effects were inconsistent. The quality of the available evidence for the animal setting was considered as moderate at most. CONCLUSIONS: Consuming specific analgesics for a few days may influence the speed of orthodontic tooth movement in animals. Clinicians should be aware of the relevant implications and be capable to identify those substances that may not interfere with treatment processes.

Does medication administration affect the rate of orthodontic tooth movement and root resorption development in humans? A systematic review.

BACKGROUND: Recently, the potential impact of different medications on the rate of orthodontic tooth movement and the associated root resorption has been systematically reviewed in animal studies and various effects have been shown. However, animal data cannot be extrapolated to human clinical situations directly. OBJECTIVES: To systematically investigate the most up to date available evidence from controlled human studies regarding the effect of medication administration on the rate of orthodontic tooth movement and associated root resorption development. SEARCH METHODS: We searched eight databases (covering also grey literature) without restrictions and we performed hand searching up until October 2018. SELECTION CRITERIA: Controlled studies in humans assessing the effect of various medications on the rate of orthodontic tooth movement and root resorption development. DATA COLLECTION AND ANALYSIS: Study selection was followed by data extraction and risk of bias assessment using the ROBINS-I tool for non-randomized and the Cochrane Risk of Bias Tool for randomized studies. RESULTS: Eight studies, at various risk of bias, were finally identified. With regard to the rate of orthodontic tooth movement, local injections of prostaglandin E1 were found to exert an increasing effect, whereas systemic intake of nabumetone decreased it. Following tenoxicam administration, drinking water with fluoride or local injections of calcitriol (vitamin D metabolite), no significant effects were demonstrated. Concerning root resorption development, nabumetone administration was shown to reduce it, whereas fluoride, overall, was not observed to exert any effect. Only in individuals subjected to heavy orthodontic forces, did fluoride show a protective effect for the period of force application, but not in the longer term during retention. CONCLUSIONS: The aforementioned substances may show varying effects on the rate of orthodontic tooth movement and root resorption development in human subjects. Despite the observed limitations, the orthodontist should be able to identify patients taking pharmaceuticals and consider any implications related to orthodontic treatment. REGISTRATION: PROSPERO (CRD42017078208).

Alveolar ridge alterations in the maxillary anterior region after tooth extraction through orthodontic forced eruption for implant site development: a clinical CBCT study.

OBJECTIVE: To investigate the effects of orthodontic forced eruption (OFE) with the straight-wire appliance in the dimensions of the alveolar process when used for extracting compromised maxillary anterior teeth and implant site development. MATERIAL AND METHODS: Cone-beam computed tomography (CBCT) scans of 7 patients needing extraction of 17 maxillary anterior teeth were obtained before and immediately after OFE. Alveolar plate height and thickness measurements were performed on the buccal and palatal socket walls in CBCT sagittal cross sections. Statistical analysis included sample size calculation, paired t-test, and Wilcoxon test to evaluate alveolar plate dimensional changes and linear regression analysis to assess whether bone changes and the feasibility of implant insertion were associated to tooth type and root length, baseline alveolar plate thickness, and age. RESULTS: OFE caused statistically significant reduction of the buccal alveolar plate height (1.95 ± 1.83 mm) and significant increase of the palatal alveolar plate height (1.31 ± 2.41 mm) in the central tooth socket areas. Buccal reduction was associated positively to the baseline root length and negatively to the thickness of the corresponding plate in the apical level. A non-significant increase was noted in both buccal (0.23 ± 0.93 mm) and palatal (0.63 ± 1.59 mm) proximal bone. Inadequate buccal bone support hindered immediate implant placement in six sockets; however, all inserted implants showed adequate and gradually increasing stability from insertion to final restoration. CONCLUSIONS: OFE resulted in favourable increase in the heights of the palatal and proximal alveolar bone and significant reduction in the buccal plate height, which inhibited implant placement in 35% of the treated sockets.

Do probiotics promote oral health during orthodontic treatment with fixed appliances? A systematic review.

BACKGROUND: Treatment with fixed orthodontic appliances has been associated with significant biofilm accumulation, thus putting patients at a higher risk of oral health deterioration. The use of probiotics has been proposed to be useful in the prevention or treatment of oral pathologies such as caries and diseases of periodontal tissues. Our aim was to investigate the effects of probiotic use on inflammation of the gingival tissues and the decalcification of the enamel in patients being treated with fixed orthodontic appliances. METHODS: We searched without restrictions 8 databases and performed hand searching until September 2019. We searched for randomized controlled trials (RCTs) evaluating whether individuals with fixed orthodontic appliances benefit from probiotic treatment in terms of the inflammation of the gingivae and decalcification of the enamel. Following the selection of studies and the extraction of pertinent data, we appraised the risk of bias and the confidence in the observed effects based on established methodologies. RESULTS: From the final qualifying studies, three did not show any statistically significant effect on gingival inflammation after probiotic administration of up to 1 month. Similarly, non-significant differences were noted in another study regarding white spot lesions development (mean administration for 17 months). No adverse effects were reported and the level of evidence was considered moderate. CONCLUSIONS: Supplementation of orthodontic patients with probiotics did not affect the development of inflammation in the gingivae and decalcification in the enamel. Additional RCTs, with longer intervention and follow-up periods, and involving different combinations of probiotic strains are required. TRIAL REGISTRATION: PROSPERO (CRD42018118008).

In vivo evaluation of tooth colour alterations during orthodontic retention: A split-mouth cohort study.

OBJECTIVES: To assess in vivo colour alterations of teeth following removal of fixed orthodontic appliances during retention. SETTING AND SAMPLE POPULATION: The Department of Orthodontics at the Aristotle University of Thessaloniki. Forty-eight patients after orthodontic treatment. MATERIAL AND METHODS: Debonding and cleaning procedures after orthodontic treatment were performed using two different carbide burs attached to a low or high-speed handpiece, respectively, in a non-blinded cohort study with split-mouth design. Spectrophotometric colour data of teeth were recorded: (a) after debonding, (b) three months later, prior to and following finishing with Soflex discs, and (c) after 1 year. The CIE Lab colour parameters were measured for each tooth, and the corresponding ΔΕ differences were calculated. The effect on colour was assessed with 3-way mixed ANOVA and Bonferroni's comparisons test (a < 0.05). RESULTS: Orthodontic debonding and cleaning procedures were found to have statistically significant effects on the CIE colour parameters of treated teeth, since the L* values decreased 0.6 units (P < 0.001), a* values were stable (0.0 units) and b* values increased 1.4 units (P < 0.001), during the first retention year. Finishing temporarily decreased the enamel colour differences. Total ΔΕ differences for all types of teeth measured ranged from 1.4 to 2.1 units. The greatest changes were exhibited during the first 3 months in teeth on which high-speed rotary instruments were used (1.6 units). CONCLUSION: The clinical relevance of this study points out that the colour of natural teeth following removal of fixed orthodontic appliances changes in long-term.

Does long-term use of pain relievers have an impact on the rate of orthodontic tooth movement? A systematic review of animal studies.

BACKGROUND: Pain relief drugs are used and misused widely and may theoretically affect the events leading to orthodontic tooth movement. OBJECTIVE: To systematically investigate and appraise the quality of the available evidence regarding the effect of pain relief medications on the rate of orthodontic tooth movement. SEARCH METHODS: Search without restrictions in eight databases (including grey literature) and hand searching until October 2018. SELECTION CRITERIA: Animal controlled studies investigating the effect of pain relievers on the rate of orthodontic tooth movement. DATA COLLECTION AND ANALYSIS: Following study retrieval and selection, relevant data were extracted and the risk of bias was assessed using the SYRCLE's risk of bias tool. RESULTS: Fourteen studies were finally identified, most of which at unclear risk of bias. Ibuprofen and loxoprofen did not show any significant effects on the rate of orthodontic tooth movement, whereas indomethacin, ketorolac, morphine, and high doses of etoricoxib were found to decrease it. Inconsistent or conflicting effects were noted after the administration of acetaminophen, acetylsalicylic acid, celecoxib, meloxicam, and tramadol. The quality of the available evidence was considered at best as low. CONCLUSIONS: Long-term consumption of pain relievers may affect the rate of orthodontic tooth movement. The orthodontist should be capable of identifying patients taking pain relievers independently of orthodontic treatment and consider the possible implications. TRIAL REGISTRATION: PROSPERO (CRD42017078208).

Effects of systemic medication on root resorption associated with orthodontic tooth movement: a systematic review of animal studies.

BACKGROUND: Theoretically, root resorption could be modulated by any medication taken that exhibits possible effects on the implicated molecular pathways. OBJECTIVES: To systematically investigate and appraise the quality of the available evidence from animal studies, regarding the effect of commonly prescribed systemic medication on root resorption associated with orthodontic tooth movement. SEARCH METHODS: Search without restrictions in eight databases (PubMed, Central, Cochrane Database of Systematic Reviews, SCOPUS, Web of Science, Arab World Research Source, ClinicalTrials.gov, ProQuest Dissertations and Theses Global) and hand searching until April 2018 took place. One author developed detailed search strategies for each database that were based on the PubMed strategy and adapted accordingly. SELECTION CRITERIA: Controlled studies investigating the effect of systemic medications on root resorption associated with orthodontic tooth movement. DATA COLLECTION AND ANALYSIS: Following study retrieval and selection, relevant data were extracted and the risk of bias was assessed using the SYRCLE's Risk of Bias Tool. RESULTS: Twenty-one studies were finally identified, most of which at unclear risk of bias. Root resorption was shown to increase in Vitamin C treated animals in comparison with the control group, whereas a comparative decrease was noted after the administration of the alendronate, ibuprofen, growth hormone, low doses of meloxicam, simvastatin, lithium chloride and strontium ranelate. No difference was noted for acetaminophen, aspirin, fluoxetine, atorvastatin, misoprostol, zoledronic acid and zinc. Finally, inconsistent effects were observed after the administration of celecoxib, prednisolone and L-thyroxine. The quality of the available evidence was considered at best as low. CONCLUSIONS: The pharmaceutical substances investigated were shown to exhibit variable effects on root resorption. Although the overall quality of evidence provides the clinician with a cautious perspective on the strength of the relevant recommendations, good practice would suggest that it is important to identify patients consuming medications and consider the possible implications. REGISTRATION: PROSPERO (CRD42017078208).

Medication and orthodontic tooth movement.

As any pharmaceutical substance may influence the events associated with orthodontic tooth movement, it is of importance for the clinician to be able to recognize any prospective patient's history and patterns of medicinal consumption. This review presents the effects of various commonly prescribed medications on the rate of orthodontic tooth movement. The article concludes that it remains, to a degree, unclear which types of medication may have a clinically significant effect in everyday clinical scenarios. However, since both prescription and over-the-counter medication use have recently increased significantly among all age groups, good practice suggests that it is important to identify patients consuming medications and consider the possible implications in orthodontic therapy.

Does common prescription medication affect the rate of orthodontic tooth movement? A systematic review.

Background: As the taking of any medication may theoretically affect the complex pathways responsible for periodontal tissue homeostasis and the events leading to orthodontic tooth movement, it is considered important for the orthodontist to be able to identify prospective patients' history and patterns of pharmaceutical consumption. Objective: To systematically investigate and appraise the quality of the available evidence regarding the effect of commonly prescribed medications on the rate of orthodontic tooth movement. Search methods: Search without restrictions in eight databases and hand searching until June 2017. Selection criteria: Controlled studies investigating the effect of commonly prescribed medications with emphasis on the rate of orthodontic tooth movement. Data collection and analysis: Following study retrieval and selection, relevant data was extracted and the risk of bias was assessed using the SYRCLE's Risk of Bias Tool. Results: Twenty-seven animal studies, involving various pharmacologic and orthodontic interventions, were finally identified. Most studies were assessed to be at unclear or high risk of bias. The rate of orthodontic tooth movement was shown to increase after the administration of diazepam, Vitamin C and pantoprazole, while simvastatin, atorvastatin, calcium compounds, strontium ranelate, propranolol, losartan, famotidine, cetirizine, and metformin decreased the rate of orthodontic tooth movement. No interference with the rate of orthodontic tooth movement was reported for phenytoin, phenobarbital and zinc compounds, whereas, inconsistent or conflicting effects were noted after the administration of L-thyroxine, lithium compounds, fluoxetine and insulin. The quality of the available evidence was considered at best as low. Conclusions: Commonly prescribed medications may exhibit variable effects on the rate of orthodontic tooth movement. Although the quality of evidence was considered at best as low, raising reservations about the strength of the relevant recommendations, the clinician should be capable of identifying patients taking medications and should take into consideration the possible implications related to the proposed treatment. Registration: PROSPERO (CRD42015029130).

Effectiveness of extraction of primary canines for interceptive management of palatally displaced permanent canines: a systematic review and meta-analysis.

Background: Although extraction of primary canines in the mixed dentition has been suggested as a measure to prevent impaction of palatally displaced permanent canines (PDCs), the relevant evidence has been inconclusive. Objective: To assess the effectiveness of this practice and investigate the quality of the evidence. Search methods: Search without restrictions in 15 databases and hand searching until April 2017. Selection criteria: Randomized clinical trials comparing extraction of primary canines in the mixed dentition to no treatment. Data collection and analysis: Following study retrieval and selection, data extraction, and individual study risk of bias assessment using the Cochrane Risk of Bias Tool, the random effects method of combining treatment effects was used. The overall quality of the available evidence was assessed with the Grades of Recommendation, Assessment, Development, and Evaluation approach. Results: Finally 5 studies were identified involving 214 individuals, followed for up to 48 months post-intervention. Two studies were at low and the rest at high risk of bias. Although at the 12-month evaluation, extraction of the primary canine did not result in a statistically significant difference [risk ratio (RR): 1.537; 95% confidence interval (CI): 0.656-3.601, P = 0.323; 1 study, n = 67 individuals], beyond 12 months a benefit was noted (RR: 1.784; 95% CI: 1.376-2.314, P = 0.000; 5 studies, n = 214 individuals; I2 = 0%). Analysis of the studies at low risk of bias confirmed the above-mentioned result (RR: 1.713; 95% CI: 1.226-2.394, P = 0.002; 2 studies, n = 91 individuals; I2 = 0%; moderate quality evidence). No difference was observed regarding root resorption of adjacent permanent teeth (RR: 0.602; 95% CI: 0.277-1.308, P = 0.200; 1 study; n = 67 individuals; moderate quality evidence). Conclusions: Extraction of primary canines in the mixed dentition may increase the chance of subsequent successful eruption of PDC in the long term. However, better study standardization is necessary.

Performance of Hawley-type retainers: a systematic review of randomized clinical trials.

Background: Although post-treatment changes are almost inevitable, and retention has long been recognized as one of the most critical and routine problems faced by orthodontists, there remains a lack of certainty regarding the parameters of any definitive retention protocol following orthodontic treatment. Objective: To investigate the performance of the Hawley-type retainers. Search methods: Search without restrictions in 15 databases and hand searching until December 2016. Selection criteria: Randomized clinical trials comparing the performance of Hawley-type retainers to other removable appliances or comparing different Hawley-type retainers' wearing schedules. Data collection and analysis: Following study retrieval and selection, data extraction and individual study risk of bias assessment using the Cochrane Risk of Bias Tool took place. The overall quality of the available evidence was assessed with the Grades of Recommendation, Assessment, Development, and Evaluation approach. Results: Finally, 10 studies were identified involving 854 individuals, followed for up to 1 year after debonding. Eight studies compared subjects using Hawley and clear thermoplastic retainers; another compared Hawley to positioner and, finally, one trial involved individuals allocated to different Hawley appliance wearing schedules. Three studies were considered as being of low, four of unclear, and three of high risk of bias. In general, few differences were observed between the Hawley and other removable retainers regarding outcomes relevant to maxillary and mandibular dental arch measurements, dental arch relationships and occlusal contacts, speech evaluation, patient reported outcomes, adverse effects, and problems related to the appliances, as well as economic evaluation related outcomes. Moreover, no differences were observed between the compared Hawley wearing schedules. Overall, the quality of the available evidence was considered low. Conclusions: Given the overall quality of the available evidence and the multitude of parameters, which may have affected the results of the included trials, good practice would suggest further research in the respective field in order to increase both the quantity and quality of information available. Registration: PROSPERO (CRD42015029279). Funding: No funding was received for the present systematic review.