Alveolar Bone and Gingival Changes in Mandibular Anterior Region Following Herbst Appliance Therapy: A Systematic Review and Meta-analysis.

Objective: To assess the alveolar bone changes and gingival recession following Herbst appliance therapy. Materials and methods: Electronic databases such as PubMed, Ovid, Cochrane Library, Lilacs, Scopus, Web of Science, and Embase were searched until August 2022. Hand-searching of major orthodontic journals was performed to identify all peer-reviewed articles potentially relevant to the review. The quality of the selected studies was ranked using the revised Cochrane risk of bias tool for nonrandomized trials-Risk of Bias In Nonrandomized Studies (ROBINS) 1. Results: Five relevant articles (all nonrandomized studies) were considered for qualitative analysis. The risk of bias was low for four studies and moderate for one. The reduction in the vertical alveolar bone height was 0.13 ± 0.07 mm, with the Herbst appliance. The mean difference in the loss of buccal cortical thickness between the Herbst appliance and untreated control group was 0.22 mm [95% confidence interval (CI) of -0.62-0.18]. Subsequent to Herbst appliance therapy, in the mandibular anterior region 0.1 ± 0.5 mm of gingival recession was observed. Conclusion: Herbst appliance treatment produces a negligible reduction in the buccal cortical thickness, vertical alveolar bone height, and gingival recession. Clinical significance: Though the changes produced by the Herbst appliance were minimal, they are clinically important considering the young age of the patients warranting periodic periodontal assessment. How to cite this article: Kumar MV, Kannan A, Kailasam V. Alveolar Bone and Gingival Changes in Mandibular Anterior Region Following Herbst Appliance Therapy: A Systematic Review and Meta-analysis. Int J Clin Pediatr Dent 2024;17(1):114-120.

Evaluation of pain intensity with prostaglandin E2 biomarker and visual analog scale during initiation of orthodontic treatment: A prospective study.

OBJECTIVES: The aim of this study was to assess subjectively and objectively, at which timepoint the patient undergoing fixed orthodontic treatment will have maximum pain during the initiation of orthodontic treatment. MATERIALS AND METHOD: A total of 22 patients (21 ± 2.7 years, [15 female and 7 male]) requiring extraction of maxillary first premolar participated in the study. Following bonding, an initial archwire of 0.016" NiTi was placed with a distal force of 100 g applied to the canines. The concentration of prostaglandin E2 (PGE2) in the gingival crevicular fluid was assessed at four time points: 1 hour before (T0); 24 hours (T1); 48 hours (T2); 72 hours (T3) after initial archwire placement. The pain intensity was recorded with visual analog scale. RESULTS: The concentration of PGE2 increased from T0 to T1. The highest concentration was observed at T2 following which there was a mild decline at T3. Statistically significant difference in the PGE2 concentration was observed between T0 to T1 and T1 to T2. The visual analogue scale (VAS) scores increased from T0 to T1. The highest score was observed at T2 followed by a decline at T3. A statistically significant difference in the VAS score was noted between T0 to T1 and T2 to T3. On correlating PGE2 and VAS score, a weak negative correlation was noted between T0 to T1 and no correlation was noted between T1 to T2 and T2 to T3. CONCLUSION: The patients experience maximum pain between 24 hours (T1) and 48 hours (T2) following initial archwire placement. The highest concentration of PGE2 and VAS score was observed at 48 hours (T2).

The Evaluation of Maxillary Sinus Dimensions in Different Craniofacial Patterns: A Systematic Review and Meta-Analysis.

This systematic review was intended to evaluate the maxillary sinus dimensions in vertical and sagittal craniofacial patterns and to assess if there was a difference among the craniofacial patterns. A systematic search was performed in seven databases till February 2021. The risk of bias was performed with modified Newcastle Ottawa scale. Meta-analysis was performed using random effects model. Twelve studies were included in the review and 8 in the meta-analysis. Compared to Class I malocclusion, the maxillary sinus area is greater in Class II and lesser in Class III malocclusion. On comparing normo-divergent growth pattern, the maxillary sinus area is lesser in hypo-divergent and greater in hyper-divergent individuals. Most of the studies were graded as satisfactory. The measurements are greater in hyper-divergent Class II malocclusion and in males.

Antimicrobial efficacy of zinc oxide nanoparticle-coated aligners on Streptococcus mutans and Candidaalbicans.

INTRODUCTION: This study aimed to assess the antimicrobial effect of zinc oxide (ZnO) nanocoating on aligners. METHODS: Twenty-six samples of aligners were sputter-coated with ZnO nanoparticles and compared with 26 uncoated samples. The antimicrobial effect was assessed on Streptococcus mutans and Candida albicans. The thickness of the ZnO coating was standardized at 100 nm. The antimicrobial effect was evaluated for 7 days at the following time points: 6 hours, 12 hours, first day, second day, fourth day, and seventh day. Colony culture tests were performed for microbial evaluation. RESULTS: ZnO-coated aligners showed significant antimicrobial efficacy against S mutans at all time points tested (P <0.001). The antimicrobial effect was observed up to 2 days after a decline. The activity against C albicans was minimal at all time points, and no statistical significance was observed (P >0.05). CONCLUSIONS: ZnO-nanocoated aligners were effective against S mutans, with the maximum antibacterial effect observed until 2 days and lasting for 7 days. The effect against C albicans was minimal. ZnO-coated aligners appears to be a promising technique to facilitate antimicrobial efficacy against S mutans.

Cranial Base Angle in Patients With Cleft Lip and Palate-A Systematic Review and Meta-Analysis.

Background: Diverse findings have been reported for the cranial base angle (CBA) in patients with CLP (cleft lip and palate) and non-CLP controls. Objective: The aim of this study is to assess and evaluate the CBA in patients with CLP and non-CLP controls. Methods: Data from PubMed, OVID Technologies, Inc., Cochrane, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Scopus, Web of Science, and EMBASE for Excerpta Medica dataBASE (EMBASE) with relevant terms was extracted until December 31, 2020. Inclusion criteria were data of patients with non-syndromic unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP). In the case of UCLP and BCLP, patients with craniofacial syndromes were excluded. The study proposal was registered with PROSPERO (Registration number: CRD42021228632). Results: Fifteen studies with a total of 2032 participants were included for the systematic review and 14 studies with a total of 1972 participants were included for the meta-analysis. The risk of bias was assessed using the Modified Newcastle Ottawa scale under seven domains by two authors. Thirteen studies were graded as "good" and two as "satisfactory." The CBA in patients with CLP were greater than the non CLP Class I controls in six of the 15 studies. CBA was greater in patients with CLP than non-CLP controls by 1.21° (95% CI of 0.19-2.22). Meta-analysis reported considerable heterogeneity (I2 = 86%). Anterior (ACB) and posterior cranial base (PCB) lengths were shorter in patients with CLP than in the non-cleft Class I controls by 2.14 mm (95% CI of 0.99-3.30) and 2.06 mm (95% CI of 1.52-2.60), respectively. Conclusion: Most studies were graded as good. Patients with CLP had greater CBA and shorter ACB and PCB lengths when compared to non-CLP controls.

Effectiveness of Functional Mandibular Advancer in Patients with Class II Malocclusion: A Systematic Review and Meta-analysis.

Objective: We aimed to evaluate the effectiveness of functional mandibular advancer (FMA) in treating growing patients with Class II malocclusion. Methods: Electronic searches were conducted in MEDLINE (via PubMed), Cochrane Library, Web of Science, Scopus, Embase, and Lilacs from 1945 to 30th November 2021. Studies were selected based on the following inclusion criteria: human studies, Class II growing patient treated with FMA, untreated control group or a comparable group treated with another fixed functional appliance, pre- and post-treatment lateral cephalograms/magnetic resonance imaging/cone-beam computed tomography, randomized clinical trials, prospective studies, and retrospective studies. Data extraction of the included articles was independently performed independently by two authors. The risk of bias was assessed using the ROBINS-I tool. Meta-analysis was performed using the inverse generic model. Results: Seven articles met the criteria and were included in the systematic review and three articles were included in the meta-analysis. Three studies had at low risk of bias and four studies had a moderate risk of bias. All articles reported anterior positioning of the mandible along with an increase in mandibular length. The meta-analysis results indicated a negligible difference between FMA and other functional appliances for the parameters SNA [0.11, 95% confidence interval (CI) of -1.07 and 1.29] and ANB (-1.00, 95% CI of -1.34 and -0.65). The evidence was limited for soft tissue changes. Conclusion: Class II correction with FMA involved a combination of skeletal and dentoalveolar changes and was similar to other fixed functional appliances.

Posttreatment Stability Following Facemask Therapy in Patients with Skeletal Class III Malocclusion: A Systematic Review.

Background: Skeletal class III malocclusion is a challenging condition that orthodontists frequently come across. The facemask (FM) is a device commonly used to treat this malocclusion. However, the stability of this orthopedic correction remains unclear, and collective documentation of the short-, mid-, and long-term stability after FM therapy is necessary. Aim: The aim of the systematic review was to assess posttreatment stability following FM therapy in patients with skeletal class III malocclusion. Materials and methods: Through a predefined search strategy, electronic searching was conducted in PubMed, Latin American and Caribbean Health Sciences Literature (LILACS), Cochrane, Ovid, Embase, Scopus, and Web of Science until 30th June 2022. Eligible study selection, data extraction, and evaluation of the risk of bias were performed independently by two review authors according to the Cochrane tool for assessing the risk of bias in randomized trials (RoB 2.0 tool) and the Risk of Bias in Nonrandomized Studies-of Interventions (ROBINS-I) tool for nonrandomized trials. A total of 14 studies were finally considered eligible. The systematic review revealed that the maxillo-mandibular differential reverted to class III. The maxillary changes achieved were variable, with SNA angles ranging between -0.7° and 1.9°. Changes in the mandible were greater with an increase in the SNB angle ranging between 0.33° and 3.62°. The lower anterior facial height increased. The maxillary and mandibular incisors were proclined, and the overjet and overbite decreased. The soft tissue changes were insignificant. Conclusion: The effects of FM therapy were found to be stable in the short-term follow-up period. The long-term follow-up revealed that the effects of FM therapy remained stable for the maxilla. However, the mandible continued to grow in a horizontal and unfavorable direction until the adolescent growth spurt. Clinical significance: The major variable that determines the long-term success of FM therapy is the amount and direction of mandibular growth during the adolescent growth spurt. More focus on restricting unfavorable mandibular growth and duration of retention is needed for post-FM therapy. Others: PROSPERO (CRD42021218960). How to cite this article: Raghupathy Y, Ananthanarayanan V, Kailasam V, et al. Posttreatment Stability Following Facemask Therapy in Patients with Skeletal Class III Malocclusion: A Systematic Review. Int J Clin Pediatr Dent 2023;16(6):897-907.

Modified OXIS classification for primary canines.

Background: A new classification called OXIS was proposed for categorising the interproximal contacts of primary molars, and its prevalence was established. The aim of this study was to establish the variations in interproximal contacts of primary canines and thereby modify the OXIS classification of primary molars to primary canines. Additionally, we aimed to estimate the applicability of modifications to primary anterior teeth. Methods: A retrospective study was conducted with sectional die models obtained from a previous study of 1,090 caries-free children. Two calibrated examiners evaluated a total of 4,674 contacts from the occlusal aspect. The contacts were scored according to the former OXIS classification, with two modifications incorporated to encompass the morphological differences and rotations of primary canines and other primary anterior teeth. Results: The most prevalent contact was O (62.1%), followed by X (19.6%), I (12.6%), S type I (4.1%), and S type II (1.6%). Inter-arch comparison by means of the Chi-square test revealed significant differences for all types of contacts ( P < .001). Conclusions: The interproximal contacts of canines were categorised as O, X, I, S I, and S II. The OXIS classification of primary molars was modified to befit the variations in primary canines. This study showed the presence of different types of contacts in primary canines. Identification of these contacts and their complexity has warranted a need for this to be studied as an inherent risk factor for caries risk assessment.

Collum angle of the anterior teeth: A systematic review and meta-analysis.

OBJECTIVES: To assess and evaluate the collum angle (CA) of the anterior teeth of the permanent dentition. METHODS: A search in seven databases for articles that had measured the CA in sagittal malocclusions was conducted until November 30, 2021. The risk of bias was assessed using the Modified Newcastle Ottawa scale. CA measurements using Cone Beam Computed Tomography or lateral cephalograms were included. The CA data were summarized by random-effects inverse generic meta-analyses. RESULTS: Qualitative analysis of the 17 selected articles revealed that four were rated as "very good," 12 as "good" and 1 as "satisfactory." CA was 4.7° (95% CI of 3.1 to 6.4) and 2.0° (95% CI of 0.1 to 3.9) greater in Class II division 2 and Class III malocclusions respectively, than in Class I malocclusion cases. CONCLUSION: Majority of the studies were rated as good or very good. Most studies evaluated the CA of the maxillary central incisors in Class II division 2 malocclusion. Studies assessing other maxillary anterior and mandibular anterior teeth are required. CLINICAL SIGNIFICANCE: Practice of esthetic dentistry for teeth with increased CA is of clinical importance since the angle would determine the longevity and esthetic/cosmetic success of the rehabilitation. Placement of dental implants in areas of missing teeth with increased collum angle leads to excessive stress between the fixture and abutment leading to gingival recession. Thus, knowledge about the collum angle of anterior teeth and its variations in sagittal malocclusions would enable precise treatment planning in the field of esthetic dentistry.

The effect of active oxygen-containing toothpaste on Streptococcus mutans and white spot lesions: An in-vivo randomized controlled trial.

INTRODUCTION: Fixed appliances limit patients' ability to clean their teeth, thus making orthodontic patients highly susceptible to developing white spot lesions (WSLs). Using patient compliance would be one of the simplest methods to prevent WSLs. METHODS: A parallel trial design with 34 patients that met the eligibility criteria were randomized to experimental (received Blue M oxygen for health toothpaste) and control (received Colgate Total fluoridated toothpaste) groups. The eligibility criteria were that the patients should be aged 13-30 years, on fixed mechanotherapy, had undergone therapeutic extraction of all first premolars, had completed leveling and aligning, and had satisfactory oral hygiene (assessed using pretreatment and current Simplified Oral Hygiene Index scores). The objectives were to assess the effects of active oxygen-containing toothpaste on Streptococcus mutans (SM) and WSLs in patients undergoing fixed mechanotherapy. The random allocation sequence was generated using the RAND function in Microsoft Excel. The sequence generated was sealed in opaque white envelopes. The investigators and the participants were blinded until allocation. Blinding of the first author (J.A.G.) who dispensed the toothpaste or the participants was not possible. The outcome assessment was blinded by coding the plaque specimens sent for real-time polymerase chain reaction (RT-PCR) to ensure that the final data assessment was blinded. The study setting was the Department of Orthodontics and Dentofacial Orthopedics, Sri Ramachandra Institute of Higher Education and Research (SRIHER) University. The primary outcome was SM counts, which were analyzed using RT-PCR. The secondary outcome was WSL assessment, performed using DIAGNOdent and International Caries Detection and Assessment System (ICDAS) II criteria at baseline and after 4 weeks. The data were subjected to statistical analysis. RESULTS: Thirty-four patients were randomized to 17 per group and analyzed. RT-PCR showed lower SM in the experimental group (Ct = 32.25 ± 10.6) than in the control group (Ct = 30.9 ± 10.49). However, this was not statistically significant (P = 0.70). ICDAS scores remained the same from baseline and after 4 weeks for both groups. The DIAGNOdent values were in tandem with the ICDAS scores and showed minimal change for the 2 groups (P >0.05). A strong positive correlation was observed for DIAGNOdent and ICDAS scores (τb >0.30). No harms or adverse effects were observed or reported by the patients during the experimental period. CONCLUSIONS: The active oxygen-containing toothpaste showed a greater inhibitory effect on SM than the fluoridated toothpaste. However, this effect was minimal. Both kinds of toothpaste showed negligible effects on WSLs. Thus, active oxygen-containing toothpaste is as effective as fluoridated toothpaste. REGISTRATION: The Trial was registered in the Controlled Trials Registry India (CTRI/2021/10/037458). PROTOCOL: The full protocol can be obtained from any of the authors via e-mail. FUNDING: The project was self-funded.

Impact of oral appliance therapy on quality of life (QoL) in patients with obstructive sleep apnea - a systematic review and meta-analysis.

PURPOSE: Treatment of patients with obstructive sleep apnea (OSA) using mandibular advancement appliances enhances the airway and may be an alternative to continuous positive airway pressure (CPAP) in individuals with reduced adherence to CPAP therapy. The effectiveness as well as improved patient compliance associated with these appliances may improve the quality of life in patients with OSA. The aim of this systematic review of studies was to determine the improvement in quality of life amongst patients with OSA who were treated with an oral appliance. METHODS: The research study was registered on the International Prospective Register of Systematic Reviews (PROSPERO: CRD42021193386). A search was carried out using the search engines Google Scholar, PubMed, Ovid, Cochrane Trial Registry, and LILACS. Patients with OSA treated with oral appliance therapy to advance the mandible were studied. Twenty-five studies were identified through the literature search and all had varying control groups for assessment of quality of life. Seventeen studies were included for the quantitative synthesis. RESULTS: QoL, evaluated by the Functional Outcomes of Sleep Questionnaire (FOSQ), significantly improved in patients treated with oral appliance therapy. There was a mean difference of 1.8 points between the baseline scores and the scores following treatment with an oral appliance. CONCLUSION: Overall, a significant improvement in the QoL was observed with the Functional Outcomes of Sleep Questionnaire, following oral appliance therapy.

Long-term hard and soft tissue response following isolated genioplasty: a systematic review.

PURPOSE: Genioplasty facilitates alteration of the chin position and contour which contributes to aesthetics and function. The response of the hard and soft tissues following genioplasty has not been assessed after a year or more of the surgery being performed. Hence, the aim of this systematic review was to assess the response of the hard and soft tissues occurring at least 1 year after the procedure. MATERIAL AND METHODS: A literature search was conducted in the following electronic databases: PubMed, Ovid, LILACS, and Cochrane Library. Potential articles were identified wherein only studies with genioplasty performed as an isolated procedure and with data at least 12 months after the procedure were included. RESULTS: Five studies were included in this systematic review. Two of the articles included were considered to be of good quality while three were considered to be of moderate quality using a modified Downs and Black tool. The ROBINS-I tool showed a moderate risk of bias for most domains. The study characteristics revealed varying degrees of relapse for the hard and soft tissues. CONCLUSIONS: In the anteroposterior plane, the soft tissue relapsed more than the hard tissues 3 years post genioplasty. However, relapse in the vertical plane showed a wide variation for both the hard and soft tissues. In the anteroposterior plane, the hard tissue to soft tissue response 2 years or more following genioplasty ranged from 1:0.77 to 1:0.91 while in the vertical plane the hard tissue to soft tissue response ranged from 1:0.67 to 1:1.16.

Proximal enamel thickness of the permanent teeth: A systematic review and meta-analysis.

INTRODUCTION: This systematic review aimed to identify, evaluate, and provide a synthesis of the available literature on the proximal enamel thickness (PET) of permanent teeth. METHODS: The eligibility criteria were studies that assessed the PET of the permanent teeth. A search of studies in Medline (via PubMed), the Cochrane Library, Scopus, Web of Science, Embase, and Lilacs databases that measured PET was conducted until August 31, 2020. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias for systematic reviews involving cross-sectional studies. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations approach. PET data generated from the systematic review were summarized by random-effects inverse-generic meta-analysis. RESULTS: From 1388 potentially eligible studies, 11 were considered for systematic review and meta-analysis. The measurement of PET was done with radiographs, microscopes, microtomographs, or profilometers. In total, 4019 mesial and distal surfaces involving 2118 teeth were assessed. All included studies showed low to moderate risk of bias, whereas GRADE revealed that the level of evidence was low. Greater mesial and distal enamel thickness was observed for the premolars and molars, whereas it was least for the mandibular central incisors. The least difference of 0.02 mm (95% confidence interval [CI], -0.07 to 0.11 and -0.06 to 0.09, respectively) between mesial and distal sides was observed for the maxillary and mandibular second molars, whereas the maximum difference of 0.12 mm (95% CI, 0.07-0.17 and 0.07-0.16, respectively) was observed for the maxillary central incisors and maxillary first premolars. The meta-analysis indicated a moderate level of heterogeneity (I2 of 45%). The funnel plot revealed minimal publication bias. CONCLUSIONS: The summary effect of the meta-analysis revealed that the thickness of the enamel on the distal aspect was greater than on the mesial aspect by an average of 0.10 mm (95% CI, 0.09-0.12). This finding would be of relevance to all disciplines of dentistry and especially for the clinician planning interproximal reduction, a procedure that is routinely done for clear aligner therapy.

Radiographic predictors of maxillary canine impaction in mixed and early permanent dentition - A systematic review and meta-analysis.

BACKGROUND/OBJECTIVE: Early diagnosis and the interception of potential impaction is the most desirable approach for management of impacted canines. Several radiographic predictors have been previously proposed to predict canine impaction. Hence the aim of this systematic review was to identify the most effective radiographic predictors of maxillary canine impaction. SEARCH METHOD: The following databases were searched: PubMed via Medline, Science Direct, LILACS, Cochrane library and Ovid MEDLINE. All comparative studies including observational and interventional studies that compare a canine impacted group versus a control group were included. The primary outcome assessed were the radiographic predictors used for diagnosis of maxillary canine impaction. RESULTS: Thirteen articles were included in this systematic review. The most commonly used parameters are sector classification, angle formed by the long axis of the canine and the midline, angle formed by the long axis of the canine and the lateral incisor, angle formed by the long axis of the canine and the occlusal plane, and perpendicular distance between the canine cusp tip to the occlusal plane and to the midline. Meta-analysis indicated that the angle formed by the long axis of the canine and the midline with a value of 19.9° and above (95% CI of 6.68 to 33.15), the angle formed by the long axis of the canine and the lateral incisor with a value of 20.01° and above (95% CI of 7.52 to 32.51) favoured canine impaction. CONCLUSIONS: With eleven of the thirteen articles showing a low risk of bias/good quality, it can be concluded that canine impactions can be predicted using various linear and angular parameters measured on different radiographs (orthopantomograms, lateral cephalograms, postero-anterior cephalograms and cone-beam computed tomography). However, further three-dimensional studies are required to accurately predict and diagnose canine impactions. REGISTRATION: The study protocol was registered on the International Prospective Register of Systematic Reviews (Reg no: CRD42020200518).

Effect of sandblasting on the shear bond strength of recycled metal brackets: A systematic review and meta-analysis of in-vitro studies.

INTRODUCTION AND OBJECTIVE: Sandblasting is an efficient and economic method of rebonding brackets. Literature is divided regarding the Shear Bond Strength (SBS) associated with sandblasted brackets. Hence this systematic review was conducted to obtain conclusive evidence on the same. The aim was to compare the SBS between sandblasted brackets bonded to extracted human teeth and new brackets bonded on extracted teeth that have not been previously bonded. MATERIALS AND METHODS: The following databases were searched up to April 30, 2021: PubMed via Medline, Web of Science, LILACS, Cochrane, EMBASE and Scopus. Articles comparing SBS of a new bracket with that of a rebonded bracket following sandblasting were included. Two reviewers independently selected the studies, extracted the data and assessed the risk of bias which was based on a modification of the Risk Of Bias In Nonrandomized Studies of Interventions Tool (ROBINS-I). SBS data generated from the systematic review was summarized and a meta-analysis using random effects inverse-generic model was done. RESULTS: Sixteen studies generated 521 samples for the new bracket group and 391 samples for the sandblasted group. These sixteen studies showed a low risk of bias. Meta analysis reported the mean difference between the SBS of new and sandblasted brackets to be 0.85. (95 CI of -0.24 to 1.94). This difference can be clinically disregarded. The high degree of heterogeneity indicated by an I2 of 87% led to a subgroup analysis. CONCLUSIONS: With the studies showing a high quality of evidence, it can be concluded that sandblasting is an efficient means of recycling debonded brackets without affecting SBS. The inherent deficiencies of in vitro bond strength studies should be borne in mind when making this conclusion. The study protocol was registered on the International Prospective Register of Systematic Reviews (Reg no: CRD42020193616).

Effects of haemostatic agents on bond strength - An In Vitro study.

AIM: To evaluate and compare the effect of contamination with haemostatic agents like Tranexamic Acid (TA) and Ethamsylate, on the shear bond strength. MATERIALS AND METHODS: There are about 100 extracted human premolars randomly segregated into four groups each consisting of 25 samples. Group I was bonded with Transbond, Group II was bonded with Transbond after blood contamination, while groups III and IV were bonded with Transbond after contamination with Tranexamic acid and the shear bond strength was measured. The data were compared by One- way ANOVA and Tukey (HSD) tests. RESULTS: Group I had the highest shear bond strength (SBS) while Group II, where the teeth were contaminated with blood showed the least SBS values ANOVA indicated significant differences between the four groups (P < .05). Tukey HSD revealed that contamination with TA (Group III) had a statistically higher SBS that contamination with Ethamsylate (Group IV) (P < .05). CONCLUSION: Since tranexamic acid and ethamsylate reduces the bleeding when used during surgery, these haemostatic agents may be considered in bonding situations where blood contamination is anticipated.