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Dens Invaginatus (DI) is a developmental anomaly which eventually leads to pulp necrosis and has several clinical implications in sufficient instrumentation and obturation of the root canal system. The present clinical report presents a rare case of a maxillary canine affected with DI leading to pulp necrosis combined with a previous dental trauma, which also led to irreversible pulp damage of the adjacent lateral incisor. A 14-year-old male patient with a history of dental trauma at the right maxillary region, one year earlier, was referred with pain and swelling at the apical area of the right maxillary canine. After CBCT evaluation, complete removal of the invagination was decided. All the procedures were performed under operating microscope and canal obturation was done with apical plug technique using MTA. Two-year follow-up radiographic assessment confirmed complete healing of the periapical tissues for both teeth. The present case describes a rare case of dens invaginatus in a maxillary canine pointing out the importance of obtaining a thorough dental history upon diagnosis, performing also a careful clinical and radiographic evaluation and subsequent treatment planning, especially when addressing complex pathologies and unusual dental malformations. In such cases with high degree of complexity, preoperative CBCT examination is required for decision making and subsequent appropriate management. Key words:Dens Invaginatus, maxillary canine, endodontic treatment.
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OBJECTIVE: The systematic review aimed to review the existing evidence, to identify and appraise the effectiveness of periodontal prevention and treatment modalities in individuals diagnosed with Down syndrome (DS) and to determine the estimates of the effects of implemented periodontal prevention and treatment strategies compared to chromosomally normal (CN) individuals. METHODOLOGY: The systematic review was conducted and reported in conformity with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. The study protocol was registered in the Open Science Framework. Electronic and manual searches, in accordance with PICO framework and delineated inclusion/exclusion criteria, were conducted in multiple databases. RESULTS: The initial search identified 11,704 studies. After removing duplicates, 9,048 remained. Title and abstract screening narrowed these to 281 for full-text review. Ultimately, 16 studies met the inclusion criteria, with 4 eligible for quantitative data synthesis. Results of the meta-analysis indicated that professional tooth cleaning in combination with oral hygiene reinforcement was less effective in the reduction of PPD in patients with DS compared to those without DS (Mean difference (MD): 0.23; 95% Confidence Interval (CI): 0.14 to 0.32; p < 0.001). DISCUSSION: These findings suggest that conventional periodontal treatment is less effective in managing periodontitis in patients with DS. Thus, tailored periodontal care strategies that address the specific needs of individuals with DS should be implemented to improve treatment outcomes for this population The presence of moderate to high risk of bias in the included studies underscores the need for rigorously designed research that minimizes bias through effective blinding, randomization, control of confounding factors, and inclusion of diverse treatment outcomes to further investigate these associations. CONCLUSION: Based on the best available evidence, professional tooth cleaning combined with oral hygiene instructions appears to be less effective in reducing pocket depths in individuals with DS compared to those without DS. https://doi.org/10.17605/OSF.IO/UXTCG.
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OBJECTIVES: To record the proportion of data sharing reporting in terms of primary data and/or statistical code of Randomized Controlled Trials (RCTs), published across 12 high impact journals in Dentistry, covering 6 specialty domains. Associations with certain journal, publication and outcome characteristics were examined. Transparency indicators such as registration or funding statements were assessed. METHODS: We identified and included all RCTs published from January 1st, 2017 to December 31st, 2023 in journals of high impact of the following domains: Periodontology, Endodontics, Restorative Dentistry/Prosthodontics, Orthodontics, Pediatric Dentistry, Oral/Maxillofacial Surgery. The primary outcome was the proportion of RCTs reporting their intent to share or openly shared primary data and we tested for associations with potential predictors. Funding, registration, and statistical code/script sharing practices were also examined. RESULTS: A total of 752 RCTs were included, of which only 119 (15.8%) either openly provided their data or included a statement of intention to share upon request. Only one study openly provided the statistical code underlying the analysis used. RCTs in periodontology more frequently included statements about positive intent to share (57/210;27.1%), followed by Orthodontics (35/157;22.3%). Significant effects of year, dentistry domain and continent of authorship on data sharing practices were identified (p < 0.001 in all cases). There was evidence that registered RCTs had 2.04 times higher odds for intention to share data (95%confidence interval: 1.06, 3.92;p = 0.03). CONCLUSIONS: Overall, in oral health RCTs, empirical evidence suggested very low prevalence of positive data sharing practices. Enhancing transparency is pivotal in promoting reproducibility and credibility of research findings. CLINICAL SIGNIFICANCE: The findings of this empirical report bring attention to key transparency indicators in randomized controlled trials. These largely impact on the credibility and reproducibility of the evidence base for clinical decision making.
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AIM: The aim of the present study was to assess the alterations in morphology, roughness, and composition of the surfaces of a conventional and a flowable composite attachment engaged with aligners, and to evaluate the release of resin monomers and their derivatives in an aqueous environment. METHODS: Zirconia tooth-arch frames (nâ =â 20) and corresponding thermoformed PET-G aligners with bonded attachments comprising two composite materials (universal-C and flowable-F) were fabricated. The morphological features (stereomicroscopy), roughness (optical profilometry), and surface composition (ATR-FTIR) of the attachments were examined before and after immersion in water. To simulate intraoral use, the aligners were removed and re-seated to the frames four times per day for a 7-day immersion period. After testing, the eluents were analyzed by LC-MS/MS targeting the compounds Bis-GMA, UDMA, 2-HEMA, TEGDMA and BPA and by LC-HRMS for suspect screening of the leached dental material compounds and their degradation products. RESULTS: After testing, abrasion-induced defects were found on attachment surfaces such as scratches, marginal cracks, loss of surface texturing, and fractures. The morphological changes and debonding rate were greater in F. Comparisons (before-after testing) revealed a significantly lower Sc roughness parameter in F. The surface composition of the aligners after testing showed minor changes from the control, with insignificant differences in the degree of Câ =â C conversion, except for few cases with strong evidence of hydrolytic degradation. Targeted analysis results revealed a significant difference in the compounds released between Days 1 and 7 in both materials. Insignificant differences were found when C was compared with F in both timeframes. Several degradation products were detected on Day 7, with a strong reduction in the concentration of the targeted compounds. CONCLUSIONS: The use of aligners affects the surface characteristics and degradation rate of composite attachments in an aqueous environment, releasing monomers, and monomer hydrolysates within 1-week simulated use.
Subject(s)
Composite Resins , Materials Testing , Methacrylates , Surface Properties , Zirconium , Zirconium/chemistry , Composite Resins/chemistry , Methacrylates/chemistry , Polyethylene Glycols/chemistry , Polymethacrylic Acids/chemistry , Polyurethanes/chemistry , Bisphenol A-Glycidyl Methacrylate/chemistry , Dental Materials/chemistry , In Vitro Techniques , Humans , Tooth Movement Techniques/instrumentation , Tooth Movement Techniques/methods , Spectroscopy, Fourier Transform Infrared/methodsABSTRACT
Consensus statements can be very influential in medicine and public health. Some of these statements use systematic evidence synthesis but others fail on this front. Many consensus statements use panels of experts to deduce perceived consensus through Delphi processes. We argue that stacking of panel members toward one particular position or narrative is a major threat, especially in absence of systematic evidence review. Stacking may involve financial conflicts of interest, but nonfinancial conflicts of strong advocacy can also cause major bias. Given their emerging importance, we describe here how such consensus statements may be misleading, by analyzing in depth a recent high-impact Delphi consensus statement on COVID-19 recommendations as a case example. We demonstrate that many of the selected panel members and at least 35% of the core panel members had advocated toward COVID-19 elimination (Zero-COVID) during the pandemic and were leading members of aggressive advocacy groups. These advocacy conflicts were not declared in the Delphi consensus publication, with rare exceptions. Therefore, we propose that consensus statements should always require rigorous evidence synthesis and maximal transparency on potential biases toward advocacy or lobbyist groups to be valid. While advocacy can have many important functions, its biased impact on consensus panels should be carefully avoided.
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BACKGROUND: The minimal important difference (MID) is defined as the smallest difference that the patient perceives as important. Furthermore, the smallest worthwhile effect (SWE) is the important change measured with the benefit-harm trade-off method. The aim of this study was to evaluate the MID in orthodontic treatment duration to inform the decision regarding seeking procedures to accelerate orthodontic tooth movement and reduce treatment duration. METHODS: We constructed a survey eliciting views of the MID from adult participants from four countries undergoing orthodontic treatment. Ten questions addressed reduction in the treatment duration for both durations 12 and 24 months, and four questions were related to the reduction in treatment duration that the patients would require to undergo surgical or non-surgical adjunctive procedures. We applied a univariable random effects logistic regression model to examine the association between the participants' characteristics and the MID. Then, we fitted a multivariable logistic random effects regression including significant predictors. RESULTS: Four hundred and fifty adults, with a median age of 21 (interquartile range: 19-24), undergoing orthodontic treatment participated in the survey. Of the respondents, 60% considered 15 days as a trivial reduction from 12 months duration of therapy and 70% considered 15 days a trivial reduction from 24 months. Of the respondents, 48% considered the period of 2 months a moderate reduction from 12 months, and 60% considered 2 months a moderate reduction from 24 months. From these results, we inferred that patients considered reductions of approximately 1 month as the MID in the treatment duration for both 12 and 24 months. However, SWE was considerably more than the MID for most of the participants to decide undergoing surgical adjunctive procedures to reduce the time of therapy. The participants required smaller SWE to undergo non-surgical procedures compared to surgical procedures. CONCLUSION: The MID in the treatment duration is one month for both treatment durations 12 and 24 months. Patients require a greater SWE than the MID to undergo adjunctive procedures to shorten the duration, particularly for surgical procedures.
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Orthodontics, Corrective , Humans , Female , Male , Time Factors , Young Adult , Orthodontics, Corrective/methods , Surveys and Questionnaires , Adult , Tooth Movement Techniques/methodsABSTRACT
OBJECTIVES: To assess to what extent the overall quality of evidence indicates changes to observe intervention effect estimates when new data become available. METHODS: We conducted a meta-epidemiological study. We obtained evidence from meta-analyses of randomized trials of Cochrane reviews addressing the same health-care question that was updated with inclusion of additional data between January 2016 and May 2021. We extracted the reported effect estimates with 95% confidence intervals (CIs) from meta-analyses and corresponding GRADE (Grading of Recommendations Assessment, Development, and Evaluation) assessments of any intervention comparison for the primary outcome in the first and the last updated review version. We considered the reported overall quality (certainty) of evidence (CoE) and specific evidence limitations (no, serious or very serious for risk of bias, imprecision, inconsistency, and/or indirectness). We assessed the change in pooled effect estimates between the original and updated evidence using the ratio of odds ratio (ROR), absolute ratio of odds ratio (aROR), ratio of standard errors (RoSE), direction of effects, and level of statistical significance. RESULTS: High CoE without limitations characterized 19.3% (n = 29) out of 150 included original Cochrane reviews. The update with additional data did not systematically change the effect estimates (mean ROR 1.00; 95% CI 0.99-1.02), which deviated 1.06-fold from the older estimates (median aROR; interquartile range [IQR]: 1.01-1.15), gained precision (median RoSE 0.87; IQR 0.76-1.00), and maintained the same direction with the same level of statistical significance in 93% (27 of 29) of cases. Lower CoE with limitations characterized 121 original reviews and graded as moderate CoE in 30.0% (45 of 150), low CoE in 32.0% (48 of 150), and very low CoE in 18.7% (28 of 150) reviews. Their update had larger absolute deviations (median aROR 1.12 to 1.33) and larger gains in precision (median RoSE 0.78-0.86) without clear and consistent differences between these categories of CoE. Changes in effect direction or statistical significance were also more common in the lower quality evidence, again with a similar extent across categories (without change in 75.6%, 64.6%, and 75.0% for moderate, low, very low CoE). As limitations increased, effect estimates deviated more (aROR 1.05 with zero, 1.11 with one, 1.25 with two, 1.24 with three limitations) and changes in direction or significance became more frequent (93.2% stable with no limitations, 74.5% with one, 68.2% with two, and 61.5% with three limitations). CONCLUSION: High-quality evidence without methodological deficiencies is trustworthy and stable, providing reliable intervention effect estimates when updated with new data. Evidence of moderate and lower quality may be equally prone to being unstable and cannot indicate if available effect estimates are true, exaggerated, or underestimated.
Subject(s)
Randomized Controlled Trials as Topic , Humans , Randomized Controlled Trials as Topic/standards , Evidence-Based Medicine/standards , Evidence-Based Medicine/methods , Meta-Analysis as Topic , Systematic Reviews as Topic/methodsABSTRACT
The aim of this study was to assess the percentage degree of cure (DC%) of 2-mm-thick resin composite attachments used for aligner treatment. Three types of aligner - two thermoformed aligners (Clear Aligner [CLA], polyethylene terephthalate glycol modified; and Invisalign [INV], polyester urethane) and a three-dimensional-printed aligner (Graphy TC-85DAC [GRP], an acrylate-methacrylate copolymer) - were selected, along with two universal resin composites (3M Filtek Universal [FTU] and Charisma Topaz ONE [CTO]). Samples of each composite were placed under each aligner, and the degree of cure of each composite was evaluated on the top (facing the aligner) and the bottom (facing the substrate) attachment surfaces after curing. Five specimens were used per combination of aligner and composite, and an additional group of composites irradiated without aligners served as the control. The DC% measurements were performed using attenuated total reflection Fourier transform infrared (ATR-FTIR) spectroscopy. The DC% across the aligners were (median values) 33.8%-44.8% for CLA, 33.6%-40.8% for INV, 32.8%-40.6% for GRP, and 40.0%-51.7% for the control group. The DC% values of the attachments cured under any aligner were significantly lower than that of the corresponding control, with the values recorded on the top surfaces being 6% higher than those on the bottom surfaces after adjusting for aligner group and composite type.
Subject(s)
Methacrylates , Polymers , Methacrylates/chemistryABSTRACT
AIM: To identify practices of assessment of gender effects in research articles in orthodontics and detect whether there were significant differences in the treatment effects on outcomes according to gender. MATERIALS AND METHODS: Four major orthodontic journals were sought over a 3-year period to identify publications which included assessment of gender effects on outcomes in their reporting. Data were extracted on the following characteristics: journal, year of publication, region of authorship, and study design. For the studies including reporting of gender effects, whether a significant effect existed was further documented. Additionally, for these studies, data were extracted on population, sample size per gender, treatment, comparison, outcome type, and nature and whether gender analysis was based on subgroup testing or included as a main effect. Descriptive statistics, cross-tabulations, univariable, and multivariable regression models were utilized as appropriate. RESULTS: A total of 718 research articles were eligible for inclusion out of a pool of 1,132 screened articles. Of those, 95 reported on any type of analysis on gender effects (95/718; 13.2%). In the 95 studies that reported assessment of gender effects, it was clear that the majority did not detect significant gender-related differences across the documented outcomes (range of frequency distribution for significant gender differences across all outcomes: 0-50%). Twenty-two articles overall (22/95; 23.2%) described a significant gender effect classified by outcome, 12 favoring female and 10 favoring male participants. Patterns of efficacy and adverse outcomes were schemed either favoring female (root resorption: 4/10; 40.0%, periodontal outcomes: 3/11; 27.3%) or male (cephalometric/growth changes following orthodontic treatment: 4/17; 23.5%) patients across the 22 studies with significant effects. Appropriately designed and adequately powered statistical analyses, with gender effect assessment as a main effect in a multivariable regression model was associated with 6.53 times higher odds for identifying significant gender effects (ORâ =â 6.53; 95% CI: 2.15, 19.8; Pâ =â .001). CONCLUSIONS: A very small proportion of research studies included gender effect assessment in their analyses. Of those, a quarter described significant effects. Nevertheless, careful analysis planning and strategies should be prioritized to allow for any meaningful interpretation.
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Orthodontics , Research Design , Humans , Male , Female , Cross-Sectional Studies , Sample Size , AuthorshipABSTRACT
STATEMENT OF PROBLEM: As the use of traditional posts has been associated with complications and failure outcomes, the introduction of novel materials and minimally invasive dentistry has shifted toward the use of composite resin post-and-core restorations for endodontically treated teeth. As a further process, to improve stress absorption environment in restored teeth, the invention of short fiber-reinforced composite resins (SFRCs) as post-and-core restorations has recently emerged. However, evidence regarding its performance is still scarce, and a synthesis of existing data is lacking. PURPOSE: The purpose of this systematic review and meta-analysis was to assess the performance of SFRC post-and-core restorations, regarding fracture resistance and failure mode and considering both cyclic and static loading. MATERIAL AND METHODS: An electronic search in 5 databases was conducted up to August 2022, and the protocol of the study was registered a priori. The search terms included "fiber reinforced composite," "core build-up," and "post." Studies were considered if they compared SFRC restorations with other types of conventional posts and teeth restored using bulk fill composite resin. The internal validity of the studies was assessed by using a custom-made risk of bias tool. RESULTS: A total of 1271 records were identified, of which 13 were considered for full-text assessment. Eight were ultimately included, all being in vitro studies, and 7 of them were deemed eligible for quantitative syntheses. The results varied considerably across studies with divergent fracture resistance values and percentages of catastrophic failure being reported. Standard depth (6 mm) SFRCs presented fewer repetitions until fracture on average, compared with the individually made FRCs (3 studies: mean difference (MD): -4062; 95% CI: -6148, -1975; P<.001) under cyclic loading. Under static loading, SFRCs (standard depth) presented a nearly 300 N lower fracture force compared with that of intact teeth, (3 studies: MD: -297; 95%CI: -378, -216; P<.001). CONCLUSIONS: Evidence on the laboratory fracture and failure performance of SFRCs is limited, and future studies should incorporate more standardized experimental conditions, as well as SFRCs with limited sacrifice of tooth substrate within the root canal of endodontically treated teeth.
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Background: The surface of resin composite veneers is susceptible to the effect of the oral environment and surface profile characterization of different veneer systems is of importance to the longevity and clinical performance of the materials. The aim of the present study was to evaluate surface profile properties, as defined by gloss and roughness parameters, of prefabricated resin composite veneers (PCV) and compare with a laboratory resin composite (LRC) system, following simulated abrasion. Material and Methods: Twenty eight composite veneers equally divided to a prefabricated composite veneer (PCV) system and a laboratory resin composite (LRC) (control group) were tested following abrasion under a toothbrush simulator. Alterations in gloss (ΔGloss) and roughness (ΔSa, ΔSz, ΔSci, ΔSdr) parameters were examined (after- before abrasion) using a glossmeter and a 3D-optical profilometer, respectively. Correlation matrices between ΔGloss and ΔRoughness parameters were sought across the two resin composite veneer groups. Results: Τhere was weak evidence that the PCV group exhibited less change in surface gloss after experimental abrasion (PCV vs LRC: mean difference ΔGloss in GU, (MD: -1.7; 95% CI: -3.3, -0.1; p=0.04). For the roughness parameters, ΔSci in nm3/nm2 (MD : 0.2; 95% CI: 0.1, 0.3; p=0.002) and ΔSdr in percentage (MD: 10.6; 95% CI: 3.7, 17.5; p=0.004), exhibited the most pronounced differences between the groups with strong evidence demonstrating greater changes for the PCV group compared to the LRC. No strong correlation pattern could be identified between changes in gloss and roughness parameters across the groups. Conclusions: After abrasion, both PCV and LCR showed an increase in surface gloss, while the PCV group demonstrated a rougher core surface profile than LRC. Key words:Prefabricated, resin composite, veneers, gloss, roughness.
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INTRODUCTION: The aim of this prospective case series was to assess the clinical and radiographic outcome of partial pulpotomy in caries-exposed symptomatic, vital, immature, permanent molars. METHODS: Thirty-four immature molars with deep caries and symptoms of irreversible pulpitis were treated by partial pulpotomy and ProRoot MTA as a capping material. After complete caries removal, the inflamed part of the pulp was removed. Complete hemostasis was achieved using a sterile cotton pellet moist initially with sodium hypochlorite 1.5% and then with sterile saline. ProRoot MTA (Dentsply Sirona, Charlotte, NC) was placed as a capping material onto the remaining pulp tissue. The cavity was sealed using a light-curing resin-modified Ca(OH)2 cavity liner, and patients were referred to a pediatric dentist for permanent restoration. Descriptive statistics and cross tabulations were performed including variables examined before, during, and after the procedure. RESULTS: All examined teeth presented a favorable clinical and radiographic outcome with normal periapical tissues, complete apical closure, and formation of a dentinal bridge beneath the capping material. Signs of partial pulp chamber calcification were only detected in 2 cases. Postoperatively, most patients did not report any pain (23/34, 67.7%), whereas the rest reported minor intensity pain (11/34, 32.3) and the use of analgesic or anti-inflammatory drugs only for 1 day (10/34, 29.4%). CONCLUSIONS: Partial pulpotomy seems to provide a universally successful outcome when managing symptomatic vital immature teeth with no signs of complications and completion of apical closure. It could be a viable treatment of choice in cases of caries-exposed vital immature teeth with symptoms of irreversible pulpitis.
Subject(s)
Dental Caries , Pulpitis , Child , Humans , Pulpotomy/methods , Pulpitis/surgery , Pulpitis/drug therapy , Calcium Compounds/therapeutic use , Silicates/therapeutic use , Dentition, Permanent , Dental Caries/surgery , Treatment Outcome , Oxides/therapeutic use , Drug CombinationsABSTRACT
AIM: To assess the clinical and radiographic outcome of partial pulpotomy by comparing MTA Angelus and Total Fill BC, as pulpotomy agents, in mature teeth with deep caries and symptoms indicative of irreversible pulpitis. METHODOLOGY: The study was designed as a parallel-two arm, double-blind, randomized superiority clinical trial registered at www. CLINICALTRIALS: gov (NCT04870398). Symptomatic mature permanent teeth with deep caries fulfilling the inclusion criteria were randomly treated using either MTA Angelus or Total Fill BC. A partial pulpotomy was performed and following complete haemostasis, the capping material was placed over the remaining pulp tissue and a postoperative periapical radiograph was taken. Clinical and radiographic follow-up evaluation was performed for a median time of 2 years, whereas levels of pain intensity were evaluated preoperatively and for 7 days after intervention using Visual Analogue Scale. For the primary outcome (failure/success of treatment), the Kaplan-Meier survival curves for the capping materials were plotted and a log-rank test for equality of survivor functions was applied. A multivariable random effects Cox Regression model was also applied. For the secondary outcome (postoperatively reported pain), a multivariable mixed effects ordinal logistic regression was structured. RESULTS: One hundred and thirty-seven teeth in 123 patients underwent partial pulpotomy using randomly either MTA Angelus (N = 74) or Total Fill BC (n = 63). The percentage failure for MTA Angelus and Total Fill BC was 10.8% (8/74) and 17.5% (11/63), respectively, but the difference was not statistically significant [adjusted HR: 1.83; 95% confidence interval (CI): 0.68, 4.91; p = .23]. Weak evidence was found that secondary caries involvement may impose a 3.54 times greater hazard for treatment failure (adjusted HR: 3.54; 95% CI: 1.00, 12.51; p = .05). For each passing minute of procedural bleeding control, there was also a 57% higher hazard for treatment failure (adjusted HR: 1.57; 95% CI: 0.99, 2.48; p = .05). The odds for higher postoperative pain were 4.73 times greater for the Total Fill BC compared to MTA Angelus (adjusted OR: 4.73; 95% CI: 2.31, 9.66; p < .001). CONCLUSIONS: Both materials exhibited similar and favourable outcome rates after partial pulpotomy in teeth with deep caries and symptoms of irreversible pulpitis. Total Fill BC was associated with a higher level of postoperative pain intensities.
Subject(s)
Pulpitis , Humans , Pulpitis/surgery , Pulpitis/drug therapy , Pulpotomy , Calcium Compounds/therapeutic use , Silicates/therapeutic use , Oxides/therapeutic use , Treatment Outcome , Drug Combinations , Aluminum Compounds/therapeutic useABSTRACT
AIM: To critically evaluate the reporting quality of a random sample of animal studies within the field of endodontics against the Preferred Reporting Items for Animal Studies in Endodontics (PRIASE) 2021 checklist and to investigate the association between the quality of reporting and several characteristics of the selected studies. METHODOLOGY: Fifty animal studies related to endodontics were randomly selected from the PubMed database with publication dates from January 2017 to December 2021. For each study, a score of '1' was given when the item of the PRIASE 2021 checklist was fully reported, whereas a score of '0' was given when an item was not reported; when the item was inadequately or partially reported, a score of '0.5' was given. Based on the overall scores allocated to each manuscript, they were allocated into three categories of reporting quality: low, moderate and high. Associations between study characteristics and reporting quality scores were also analysed. Descriptive statistics and Fisher's exact tests were used to describe the data and determine associations. The probability value of .05 was selected as the level of statistical significance. RESULTS: Based on the overall scores, four (8%) and 46 (92%) of the animal studies evaluated were categorized as 'High' and 'Moderate' reporting quality, respectively. A number of items were adequately reported in all studies related to background (Item 4a), relevance of methods/results (7a) and interpretation of images (11e), whereas only one item related to changes in protocol (6d) was not reported in any. No associations were confirmed between reporting quality scores and number of authors, origin of the corresponding author, journal of publication (endodontic specialty vs. non- specialty), impact factor or year of publication. CONCLUSIONS: Animal studies published in the specialty of endodontics were mostly of 'moderate' quality in terms of the quality of reporting. Adherence to the PRIASE 2021 guidelines will enhance the reporting of animal studies in the expectation that all future publications will be high quality.
Subject(s)
Checklist , Endodontics , Animals , Research DesignABSTRACT
AIM: To assess the quality of reporting of Scoping Reviews (ScRs) in Orthodontics according to the PRISMA Extension Checklist for Scoping Reviews (PRISMA-ScR). Our secondary aim was to identify publication characteristics, such as year of publication, journal, inclusion of a reporting guideline, and study registration, associated with ScRs reporting quality. MATERIALS AND METHODS: Pubmed, Scopus, and Web of Science Core Collection were searched as of 1 August 2022 for identification of orthodontic ScRs. This was supplemented by electronic searches within the contents of eleven specialty journals. The item-specific and overall reporting quality score of the examined orthodontic ScRs, based on the PRISMA Extension Checklist for Scoping Reviews were recorded. Association of reporting quality score with publication characteristics was further examined. RESULTS: A total of 40 ScRs were identified and included, with a mean reporting quality score of 73.0 per cent (standard deviation = 14). The majority of studies were published from 2020 onwards (32/40; 80.0%). Of the most adequately reported items were the summary of the evidence description in the Discussion (38/40; 95.0%) and the selection of the sources of evidence in the Results section (34/40; 85.0%). Protocol registration and reporting of limitations were missed in almost half of the ScRs (19/40; 47.5%), while less than half studies were adequately justified (18/40; 45.0%). According to the multivariable linear regression, adherence to appropriate reporting guidelines resulted in improved reporting quality score by 10 per cent (ß-coefficient: 0.10; 95% CI: 0.002, 0.19; P = 0.04), conditional on year and journal of publication. Year, journal of publication, and registration practices did not appear as significant predictors (P > 0.05 in all instances). CONCLUSIONS: The reporting quality of the examined orthodontic ScRs was suboptimal, with questionable justification for their conduct and certain items being mostly affected.
Subject(s)
Checklist , Orthodontics , Humans , Bibliometrics , Systematic Reviews as Topic , Review Literature as TopicABSTRACT
OBJECTIVE: The aim of the present randomized controlled trial (RCT) was to evaluate the efficacy of different alveolar ridge preservation (ARP) techniques on dimensional alterations after tooth extraction, based on clinical measurements. BACKGROUND: Alveolar ridge preservation (ARP) is a common procedure in every day clinical practice, when dental implants are involved in treatment planning. In ARP procedures, a bone grafting material is combined with a socket sealing (SS) material in order to compensate the alveolar ridge dimensional alterations after tooth extraction. Xenograft and allograft are the most frequently used bone grafts in ARP, while free gingival graft (FGG), collagen membrane, and collagen sponge (CS) usually applied as SS materials. The evidence comparing xenograft and allograft directly in ARP procedure is scarce. In addition, FGG is usually combined with xenograft as SS material, while the evidence combing allograft with FGG is absent. Moreover, CS could probably be an alternative choice in ARP as SS material, since it has been used in previous studies but more clinical trials are required to evaluate its effectiveness. MATERIALS AND METHODS: Forty-one patients were randomly assigned in four treatment groups: (A) freeze-dried bone allograft (FDBA) covered with collagen sponge (CS), (B) FDBA covered with free gingival graft (FGG), (C) demineralized bovine bone mineral xenograft (DBBM) covered with FGG, and (D) FGG alone. Clinical measurements were performed immediately after tooth extraction and 4 months later. The related outcomes pertained to both vertical and horizontal assessment of bone loss. RESULTS: Overall, groups A, B, and C presented significantly less vertical and horizontal bone resorption compared to group D. No statistically significant difference was observed between allograft and xenograft, except for the vertical bone resorption at the buccal central site, where xenograft showed marginally statistically significantly reduced bone loss compared to allograft (group C vs group B: adjusted ß coef: 1.07 mm; 95%CI: 0.01, 2.10; p = 0.05). No significant differences were observed in hard tissue dimensions when CS and FGG were applied over FDBA. CONCLUSIONS: No differences between FDBA and DBBM could practically be confirmed. In addition, CS and FGG were equally effective socket sealing materials when combined with FDBA, regarding bone resorption. More RCTs are needed to compare the histological differences between FDBA and DBBM and the effect of CS and FGG on soft tissue dimensional changes. CLINICAL RELEVANCE: Xenograft and allograft were equally efficient in ARP 4 months after tooth extraction in horizontal level. Xenograft maintained the mid-buccal site of the socket marginally better than the allograft, in vertical level. FGG and CS were equally efficient as SS materials regarding the hard tissue dimensional alterations. TRIAL REGISTRATION: Clinical trial registration Number: NCT04934813 (clinicaltrials.gov).
Subject(s)
Alveolar Bone Loss , Alveolar Ridge Augmentation , Humans , Animals , Cattle , Tooth Socket/surgery , Tooth Socket/pathology , Alveolar Process/surgery , Alveolar Bone Loss/prevention & control , Alveolar Bone Loss/pathology , Collagen/therapeutic use , Tooth Extraction/methods , Alveolar Ridge Augmentation/methodsABSTRACT
BACKGROUND: High-pull headgear with fixed appliances is a common therapeutic plan in class II growing individuals, especially in those with a tendency to hyperdivergence. The stability of this approach has not been adequately assessed in the long-term. The aim of this retrospective study was to assess that long-term stability by means of lateral cephalograms. Seventy-four consecutive patients were included and examined at three time-points: pre-treatment (T1), end of treatment (T2), and at least five years post-treatment (T3). RESULTS: The average initial age of the sample was 9.3 years (standard deviation, SD: 1.6). At T1, the mean ANB was 5.1 degrees (SD: 1.6), the mean SN-PP 5.6 (SD: 3.0) and the mean MP-PP 28.7 degrees (SD: 4.0). The median follow-up time was 8.6 years with an interquartile range of 2.7. A statistically significant, but of small magnitude increase in the SNA angle was noted at T3 compared to T2 after adjusting for the pre-treatment SNA value (mean difference (MD): 0.75; 95% CI: 0.34, 1.15; P<0.001). The inclination of the palatal plane appeared stable in the post-treatment period, while the MP-PP angle showed scarce evidence of decrease during the post-treatment period after adjusting for sex, pre-treatment SNA and SN-PP angles (MD: -2.29; 95% CI: -2.85, -1.74; P<0.001). CONCLUSIONS: The sagittal position of the maxilla and the inclination of the palatal plane appeared to be stable after treatment with high-pull headgear and fixed appliances in the long-term. Continuous mandibular growth, both sagittaly and vertically, contributed to the stability of class II correction.
Subject(s)
Malocclusion, Angle Class II , Humans , Child , Retrospective Studies , Malocclusion, Angle Class II/diagnostic imaging , Malocclusion, Angle Class II/therapy , Orthodontic Appliances, Fixed , Maxilla , Mandible , Cephalometry , Extraoral Traction Appliances , Treatment OutcomeABSTRACT
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.
Subject(s)
Orthodontic Appliances, Removable , Humans , Aging , Printing, Three-DimensionalABSTRACT
BACKGROUND: Scoping Reviews (ScRs) have emerged in the orthodontic literature as a new methodological perspective to collate and summarize scientific evidence. The aim of the present study was to identify and record the proportion of Scoping Reviews in orthodontics that have been clearly and adequately justified, based on the methodological framework of such types of reviews. Associations with a number of publication characteristics were also sought. Three major databases, namely PubMed, Scopus and Web of Science Core Collection, as well as 11 specialty orthodontic journals were electronically sought from inception until August 1, 2022, for ScRs. The primary outcome pertained to whether the published reports of the ScRs included an appropriate justification and explanation for the selection of this kind of knowledge synthesis methodology. Potential association with year, journal, continent of authorship, number of authors, methodologist involvement, appropriate reporting guidelines and registration practices followed were explored. RESULTS: A total of 40 ScRs were eligible for inclusion, with the majority not being adequately justified (22/40; 55.0%). The majority of studies were published from 2020 onward (32/40; 80.0%). The regression model did not reveal any significant association between justification of ScRs and a number of publication characteristics (p > 0.05 at all levels). CONCLUSIONS: Less than half of the included ScRs were adequately justified in terms of selection of the appropriate synthesis methodology. Awareness should be raised in the scientific community regarding the correctness of the use of this newly emerging type of study in orthodontics, to safeguard against any trace of research waste.
Subject(s)
Orthodontics , Humans , Bibliometrics , AuthorshipABSTRACT
PURPOSE: To identify and assess any changes in the pulp tissue complex following orthodontic force application. MATERIALS AND METHODS: Published and unpublished literature was searched in seven databases until 9 August 2022 for randomised controlled trials (RCTs) and prospective trials (nR-PCT). Representative key words included 'pulp response', 'pulp tissue', 'orthodontic force', and 'tooth movement'. Study selection, data extraction, risk of bias and certainty of evidence assessment were conducted independently by two reviewers. Random effects meta-analyses with respective confidence intervals (95%CIs) were conducted where applicable. RESULTS: A total of 363 records were screened, a final number of 24 articles were eligible for qualitative synthesis, while 8 of those contributed to meta-analyses. There was evidence that pulpal blood flow (PBF) decreased after 3 weeks of tooth movement compared to no force application (4 studies, mean difference: -1.68; 95% CI: -3.21, -0.15; p = 0.03). However, this was not the case after 6 months of treatment (p = 0.68). A rise in the activity of aspartate aminotransferase (AST) was detected after 7 days of treatment, but combining 2 studies, this was not statistically significant (p = 0.25). Other outcomes were assessed through single studies. Risk of bias was within the range of 'some concerns/moderate to high/critical overall', while certainty of evidence was low to very low according to GRADE. CONCLUSIONS: As a short-term effect, PBF decreased upon initiation of orthodontic force application, while enzymatic and peptide activity within the pulp was transiently affected. Further long-term evidence of improved quality and certainty is needed.