Designing an artificial intelligence system for dental occlusion classification using intraoral photographs: A comparative analysis between artificial intelligence-based and clinical diagnoses.

INTRODUCTION: This study aimed to design an artificial intelligence (AI) system for dental occlusion classification using intraoral photographs. Moreover, the performance of this system was compared with that of an expert clinician. METHODS: This study included 948 adult patients with permanent dentition who presented to the Department of Orthodontics, School of Dentistry, Mashhad University of Medical Sciences, during 2022-2023. The intraoral photographs taken from the patients in left, right, and frontal views (3 photographs for each patient) were collected and underwent augmentation, and about 7500 final photographs were obtained. Moreover, the patients were clinically examined by an expert orthodontist for malocclusion, overjet, and overbite and were classified into 6 groups: Class I, Class II, half-cusp Class II, Super Class I, Class III, and unclassifiable. In addition, a multistage neural network system was created and trained using the photographs of 700 patients. Then, it was used to classify the remaining 248 patients using their intraoral photographs. Finally, its performance was compared with that of the expert clinician. All statistical analyses were performed using the Stata software (version 17; Stata Corp, College Station, Tex). RESULTS: The accuracy, precision, recall, and F1 score of the AI system in the malocclusion classification of molars were calculated to be 93.1%, 88.6%, 91.2%, and 89.7%, respectively, whereas the AI system had an accuracy, precision, recall, and F1 score of 89.1%, 88.8%, 91.42%, and 89.8% for malocclusion classification of canines, respectively. Moreover, the mean absolute error of the AI system accuracy was 1.98 ± 2.11 for overjet and 1.28 ± 1.60 for overbite classifications. CONCLUSIONS: AI exhibited remarkable performance in detecting all classes of malocclusion, which was higher than that of orthodontists, especially in predicting angle classification. However, its performance was not acceptable in overjet and overbite measurement compared with expert orthodontists.

Low-level laser therapy and laser acupuncture therapy for pain relief after initial archwire placement : A randomized clinical trial.

OBJECTIVE: Pain is among the most unpleasant experience during fixed orthodontic therapy. This study compared the effectiveness of low-level laser therapy (LLLT) and laser acupuncture therapy (LAT) in pain reduction after initial archwire placement. METHODS: This randomized, parallel-group, single-blind clinical trial included 60 female patients who required four premolar extractions to relieve crowding. The subjects were randomly designated into four groups of 15. After placement of the initial orthodontic archwire, patients in group 1 took ibuprofen (400 mg), whereas those in group 2 received LLLT (808 nm, 200 mW, 2 J/cm2) on both buccal and lingual sides of the teeth. In group 3 (LAT), the laser (808 nm, 200 mW, 24 J/cm2) was applied bilaterally to acupuncture points (SI 18, ST 6, LI 4, SJ 2, and SJ 5). Subjects in group 4 received placebo laser treatment. Patients were requested to record the intensity of spontaneous pain, pain while biting with anterior teeth, and pain while biting with posterior teeth at different times using a visual analogue scale (VAS). RESULTS: The intensity of spontaneous and biting pain increased up to the first or second days following initial archwire placement and diminished to a negligible value by the seventh day. No significant difference was found between the study groups concerning spontaneous and biting pain at any timepoint of investigation (P > 0.05). CONCLUSIONS: With the protocols used in the study, low-level laser therapy and laser acupuncture therapy were as effective as ibuprofen and placebo laser treatment for pain reduction in orthodontic patients. TRIAL REGISTRATION: IRCT, IRCT20200622047886N1. Registered 2020-06-29; https://www.irct.ir/trial/49121.

Electromyographic Evaluation of Masticatory Muscle Activity in Individuals with and without Cleft Lip/Palate: A Systematic Review and Meta-analysis.

OBJECTIVE: This study aims to systematically review and meta-analyze the electromyographic activity of masticatory muscles in cleft palate and non-cleft patients, and identify influencing factors. DESIGN: Systematic Review and Meta-analysis. PATIENTS AND EXPOSURES: Patients with cleft lip/ palate. COMPARISON: Patients without CL/P. MAIN OUTCOME MEASURES: Electrical activity of masseter and temporalis muscles at rest and during peak activation. RESULTS: After a comprehensive search in MEDLINE, Web of Science, EMBASE, Scopus, and Cochrane's CENTRAL up to December 2022, without language or date restrictions. Eligible trials were selected based on the PECO question and assessed for bias using Cochrane's ROBINS-E tool. Eight clinical trials with 474 participants were included in the review. Then relevant data was extracted from included studies using customized forms. A random-effects meta-analysis was performed to combine the results of the studies, meta-analyses showed that CL/P patients have elevated electrical activity in the masseter (P = .01) and temporalis (P = <.01) muscles at rest compared to non-cleft control patients. During maximum bite force, cleft patients exhibited a statistically significant decrease in electrical activity in both the masseter (P = .03) and temporalis (P = <.01) muscles. CONCLUSIONS: According to our meta-analysis, cleft patients exhibited increased resting muscle activity but decreased activity during maximum bite force, indicating reduced efficiency of masticatory muscles compared to non-cleft patients. These differences can be attributed to anatomical variations, compensatory mechanisms, and previous treatments.

Treatment Options of Maxillofacial Fractures in Iran: A Comprehensive Systematic Review.

Background: The aim of this study was to systematically review the literature on the treatment options of maxillofacial fractures in Iran, complementing a previous article regarding causes and the overall prevalence. Methods: A systematic search of PubMed, Cochrane Library, Web of Science (WS) and Google Scholar (GS) electronic databases was conducted to identify the relevant articles published up to January 2023. Studies reporting the treatment option of maxillofacial fractures in Iran were included in the analysis. MOOSE guidelines were adopted for the current systematic review. No data or language restriction were applied. Risk of bias across the articles was assessed. Results: This systematic review included 13 articles with a total of 19,147 treated patients for maxillofacial fractures. ORIF was the most common type of treatment, but complications occurred in approximately 5% of cases. Mandible fractures were not statistically more treated by ORIF than closed reduction or conservative treatment, and no type of treatment was considered statistically preferable depending on the anatomical region affected by Iranian maxillofacial surgeons. The included studies were considered to have a low risk of bias, but many were not clear in reporting cross-referenced data regarding the type of treatment, which could be considered a major flaw. Conclusion: Overall, this study provides valuable insights into the types of treatment used for maxillofacial fractures by Iranian surgeons and highlights the importance of clear reporting of data in research articles.

Shear Bond Strength and Microleakage of Fissure Sealant to Contaminated and Non-Contaminated Enamel: A Systematic Review and Meta-Analysis of In Vitro Studies.

Purpose: The purpose of this study was to review the in vitro literature on shear bond strength (SBS) and microleakage of pit and fissure sealant materials in contaminated (water, human, or artificial saliva) and non-contaminated conditions. Methods: PubMed®, Web of Science™, Scopus®, Embase™, and Cochrane Library databases were used as data sources. Of the 974 studies identified, 56 were considered eligible for full-text screening and 32 were selected for data extraction. Results: The meta-analysis demonstrated that contaminated conditions decreased the SBS of the sealants by 4.33 MPa. In the contaminated subgroup analysis, both unfilled (Clinpro™, 3M™) and filled (FluroShield®, Dentsply) resin-based sealants achieved a similar SBS (P=0.82). Regarding the outcome measurements, extensive methodological heterogeneity was found among the studies for SBS measurements (I 2 equals greater than or equal to 84 percent; P<0.001), whereas homogeneity was found for microleakage (I 2 equals 84 percent; P=0.85). When evaluating resin-based sealants, the level of microleakage in the contaminated and non- contaminated groups was not significantly different (P=0.1). Conclusion: Surface contamination decreases the bond strength between contaminated enamel and both unfilled and filled resin-based sealants, which affects the clinical effectiveness of sealants.

The effects of low-level laser therapy and photodynamic therapy on oral health of fixed orthodontics patients. A systematic review and meta-analysis.

Objective To investigate the effect of low-level laser and photodynamic therapy on the oral health, and periodontal tissue of fixed orthodontic patients and the effect of using photobiomodulation methods compared to routine plaque removal methods and the amount of plaque in fixed orthodontic patients. Method and materials First, the title and summary of related articles were collected by using the search strategy electronic databases PUBMED, EMBASE, Cochrane's CENTRAL, Scopus, ISI and all the articles that were published from the beginning to February 2023 were evaluated. The title, abstracts and full texts of all the relevant studies were reviewed respectively, and those meeting the criteria were entered into our study. Finally, the quality of the studies was examined and the results of the studies were pooled by means of random effects inverse variance meta-analysis. Results Eighteen randomized studies, conducted between 2015 and December 2022, were selected for meta-analysis. Five studies were conducted as split-mouth, twelve as parallel-group, and one as a cross-over design. Among the studies, five examined the effects of low-level laser therapy and twelve assessed the effects of photodynamic therapy. The meta-analysis revealed that photodynamic therapy significantly reduced probing depth compared to scaling (MD=-0.2 mm, P<0.001), though the difference does not seem to be clinically significant. But no significant differences between photodynamic therapy and scaling or low-level laser therapy and control groups in terms of plaque index, or bleeding on probing, gingival crevicular fluid volume, gingival recession, clinical attachment loss, bacterial load and concentrations of inflammatory substances across multiple follow-up periods. Conclusion Moderate evidence indicates that photodynamic therapy (PDT) is comparable to conventional methods in improving oral health, as measured by periodontal indices, inflammatory proteins, bacterial colonies, and white spot lesions, making it a suitable alternative. Limited evidence suggests low-level laser therapy (LLLT) may improve oral health, particularly addressing caries, but further research is needed.

A comparison of CAD/CAM-based fixed retainers versus conventional fixed retainers in orthodontic patients: a systematic review and network meta-analysis.

OBJECTIVE: Comparing computer-aided design and computer-aided manufacturing (CAD/CAM) fixed retainers and conventional fixed retainers for their effectiveness in orthodontic patients using systematic review and meta-analysis of literature. SEARCH METHODS: A comprehensive search was conducted in MEDLINE, Web of Science, EMBASE, Scopus, Cochrane's CENTRAL, Google Scholar, Ovid, and LILACS up to May 2023, with no language or date restrictions. SELECTION CRITERIA: Only randomized clinical trials (RCTs) that complied with PICO questions were included, and the Cochrane Risk of Bias 2.0 (RoB 2) tool was used to assess the risk of bias in the included studies. DATA COLLECTION AND ANALYSIS: Using custom-piloted forms, relevant data were retrieved from the included studies. Then a random-effects inverse variance meta-analysis was used to pool the results. Primary outcomes were stability of treatment results measured through dental cast measurements and periodontal status, while secondary outcomes were failure rates and patient-reported outcomes. RESULTS: Seven RCTs with 601 participants were included in the review. In the short term (≤6 months), the meta-analysis showed no significant differences in inter-canine distance or arch length between CAD/CAM and conventional fixed retainers in mandibular retainers. However, for Little's irregularity index, single-stranded stainless-steel retainers were notably worse than Ni-Ti CAD/CAM retainers at 3 and 6 months, while multi-stranded stainless-steel retainers only diverged from CAD/CAM at the 6-month milestone, despite the overall clinical inconsequence of these changes. CAD/CAM retainers were associated with a lower plaque index than traditional retainers but no significant difference in gingival index. Failure rates did not differ significantly between CAD/CAM and other types of retainers in mandibular retainers. Nonetheless, one study had a high amount of CAD/CAM retainer failures leading to the study being stopped. CONCLUSIONS: In the short term, CAD/CAM fixed retainers show promise as an alternative to traditional retainers. They may enhance periodontal health, as indicated by lower plaque index scores than conventional retainers. However, extensive research is needed to determine the long-term durability and effectiveness of CAD/CAM retainers in orthodontic treatment, particularly regarding their failure rate. Until comprehensive evidence is available, the use of CAD/CAM retainers should be tailored for each case. REGISTRATION: The protocol for this systematic review was registered at PROSPERO with the ID CRD42023412741.

The Causes and Prevalence of Maxillofacial Fractures in Iran: A Systematic Review.

Background: Maxillofacial fractures are a common type of injury that can result in significant morbidity and mortality. We aimed to systematically review the literature on the prevalence and causes of maxillofacial fractures in Iran to estimate the overall prevalence of maxillofacial fractures and the most common causes. Methods: A systematic search of PubMed, Cochrane Library, Web of Science (WS) and Google Scholar (GS) electronic databases was conducted to identify relevant articles published up to January 2023. Studies reporting the prevalence and causes of maxillofacial fractures in Iran were included in the analysis. MOOSE guidelines were adopted for the current systematic review. No data or language restriction were applied. Risk of bias across the articles was assessed. Results: A total of 32 studies comprising 35,720 patients were included in the analysis. The most common cause of maxillofacial fractures was road traffic accidents (RTAs), accounting for 68.97% of all cases, followed by falls (12.62%) and interpersonal violence (9.03%). The prevalence of maxillofacial fractures was higher in males (81.04%) and in the age group of 21-30 years (43.23%). Risk of bias across studies was considered low. Conclusion: Maxillofacial fractures are a significant public health problem in Iran, with a high prevalence and RTAs being the leading cause. These results highlight the need for increased efforts to prevent maxillofacial fractures in Iran, especially through measures to reduce the incidence of RTAs.

The Effects of Intrusion of Anterior Teeth by Skeletal Anchorage in Deep Bite Patients; A Systematic Review and Meta-Analysis.

BACKGROUND: Deep bite is known as one of the most common malocclusions, and its treatment and retention are often challenging. The use of mini-screws has been suggested as an ideal method for the intrusion of incisors in deep-bite patients. Still, there are conflicting reports regarding the superiority of this method compared to other common treatments. AIM: The aim of this systematic review and meta-analysis was to evaluate the effects of the intrusion of anterior teeth by skeletal anchorage in deep bite patients. METHODS: From the beginning to 15 September 2022, articles on the topic of interest were searched in electronic databases including PubMed, Web of Science, Scopus, EMBASE, and Cochrane's CENTRAL. Additionally, a hand search for pertinent studies and a search of the grey literature were carried out. After the selection of eligible studies, data extraction was performed using piloted forms. Inverse-variance random-effects meta-analyses were used to combine the outcome measures of dental indices, skeletal cephalometric indices, and dental cephalometric indices. RESULTS: A total of 15 studies (6 RCT; 9 CCT) were included in the systematic review and 14 were used in the meta-analyses. The differences in overbite changes (MD = -0.45, p = 0.04), true incisor intrusion [u1-pp] (MD = -0.62, p = 0.003) and molar extrusion [u6-pp] (MD = -0.40, p = 0.01) were statistically significant and TADs showed better treatment results than other intrusion methods (segmented intrusion arch, utility arch, J hook headgear). No significant differences regarding overjet, molar and incisor tipping, and skeletal indices between mini-screw and other intrusion methods could be found. CONCLUSION: The use of mini-screws leads to lower overbite and higher true intrusion (about 0.45 and 0.62 mm, respectively) compared to the use of other methods for intruding upper incisors. Furthermore, the effect of TAD on extrusion of molar teeth is less (by 0.4 mm) than other methods.

Efficacy of Different Methods of Bone-Anchored Maxillary Protraction in Cleft Lip and Palate Children: A Systematic Review and Meta-Analysis.

INTRODUCTION: Bone-anchored maxillary protraction (BAMP) is an effective option for adolescent cleft patients with maxillary hypoplasia. Hence, this study was conducted to access the effectiveness of the many techniques of BAMP in cleft lip and palate patients. METHODS AND MATERIALS: Data was compiled through a global search of random and nonrandom studies that investigated the efficacy of various techniques of BAMP in cleft lip and palate patients. The searches were conducted in ISI Web of Science, EMBASE, Scopus, Medline, and Cochrane Central Register of Controlled Trials from the beginning until October 12, 2021. The pertinent data of the comprised studies were extracted using predetermined extraction forms. Meta-analysis results were obtained by using inverse-variance to calculate the pooled results of the outcome measures. RESULTS: Five studies were submitted for meta-analysis. The BAMP therapeutic methods investigated in the studies were facemask attached to miniplates (FM-MP) and class III elastics attached to maxillary and mandibular miniplates (C3-IE: class III intermaxillary elastic). The mean differences of A-VRP, A-N Prep., ANB, wits, overjet, and SNA landmarks indicated posttreatment was encouraging, showing maxillary protrusion, and correction of class III malocclusion. SNB landmark showed no statistically significant alterations posttreatment. Subgroup analysis of the C3-IE and FM-MP subgroups indicated that the changes in ANB, SNA, and overjet parameters in the FM-MP subgroup were more pronounced than in the C3-IE subgroup. No statistically significant differences were found when the results of these 2-treatment method were compared, except for in the overjet subgroup. CONCLUSION: After undergoing BAMP treatment, the maxilla showed a more horizontal growth, but no changes in the vertical dimension were observed and the mandible did not rotate clockwise. In addition, using facemask-miniplates was more effective in increasing overjet compared with using class III elastics with bone anchors. In conclusion, BAMP treatment is a suitable alternative for adolescents with cleft lip and palate malformation.

Effects of posterior intrusion using skeletal anchorage on treating anterior open bite: A systematic review and meta-analysis.

Background: Posterior intrusion with skeletal anchorage is one of the effective methods in the treatment of anterior open bite. Knowing the effects of posterior intrusion, the amount of possible molar intrusion using skeletal anchorage, and its impact on clinical and cephalometric indicators can help the clinician choose the optimal treatment method, especially in borderline surgical cases. Methods: In this systematic review, a series of articles were collected through a systematic search in databases, and the titles and summaries of all these articles were reviewed. After removing the irrelevant articles, the full texts of the related articles were read carefully, and their validity was evaluated. Only RCTs and observational studies that complied with PICO questions were included. The Cochrane Risk of Bias 2.0 (RoB 2), ROBINS-I, and GRADE were used to assess the risk of bias in the included studies. The relevant information on selected articles was extracted, and a meta-analysis was performed with Review Manager 5.4 software. Results: The meta-analysis revealed a significant average molar intrusion of 2.89 mm using temporary anchorage devices (TADs). A subgroup analysis showed that miniplates achieved greater intrusion (3.29 mm) compared to miniscrews (2.25 mm) (P=0.03). The level of applied force did not significantly affect the degree of intrusion. Dental parameters such as overbite and overjet were notably altered, with overbite increasing by 4.81 mm and overjet decreasing by 2.06 mm on average. As for the skeletal cephalometric characteristics, SNB, ANB, and SN-Pog increased while mandibular plane angle and lower anterior facial height (LAFH) decreased, and these changes were significant. Meanwhile, SNA and palatal angle changes were not significant. Conclusion: TADs have proved effective in achieving significant intrusion of maxillary molars, leading to marked improvements in dental and skeletal characteristics in patients with open bite malocclusion. Miniplates proved more effective in achieving greater intrusion.

Long-Term Stability of Alveolar Bone Graft in Cleft Lip and Palate Patients: Systematic Review and Meta-Analysis.

OBJECTIVE: Alveolar bone grafts are the golden standard in treating patients with oral cleft and hence, the long-term success of this treatment is the subject of many studies. The aim of this study was to systematically review literature that examined the long-term stability of alveolar bone grafting in patients with cleft lip and palate. METHODS: In this study, data was collected via a comprehensive search of random and nonrandom studies evaluating the success of bone grafts in patients with cleft lip and palate in ISI Web of Science, EMBASE, Scopus, Medline, and Cochrane Central Register of Controlled Trials from the beginning until July 3, 2020. Also, a search was conducted for ongoing studies in the trial registry and a hand search of related gray literature and references of the relevant studies. The relevant data of the included studies were extracted using predefined extraction forms. Meta-analysis was performed using inverse-variance for calculating the pooled outcome of outcome measures. The pooled mean success rate of alveolar bone graft and mean difference of cleft volume after 1 year was presented as the outcome of the analysis. RESULTS: Eight studies (1 randomized clinical trial study and 7 controlled prospective studies) were included in this meta-analysis. The results of the analyses showed that the total percentage of secondary alveolar success in the follow-up period of at least 1 year according to the Bergland index was 76.52% (pooled success = 76.52%, 44.92-98.10). Also, bone defect in the cleft area reduced significantly after bone grafting (MD = 0.62 cm3, 0.48-0.75, P < 0.00001). The total percentage of bone filling after 1 year and according to CBCT (cone beam computed tomography) was about 63.38%, and the rate of definite natural eruption of canine within the graft was 80.89%. CONCLUSIONS: The total success rate of secondary alveolar bone grafting in the follow-up period of at least 1 year was clinically significant and alveolar bone grafting significantly reduced bone defect volume. Also, there was no difference in the amount of bone remaining after 1 year in patients whose canine had erupted through the grafted bone and in those whose canine had not erupted.

Does Presurgical Nasoalveolar Molding Reduce the Need for Future Bone Grafting in Cleft Lip and Palate Patients? A Systematic Review and Meta-Analysis.

OBJECTIVE: Nasoalveolar molding (NAM) is a technique that is utilized in patients with cleft lip/palate before performing lip surgery. This procedure has been shown to result in a more aesthetic nose with lesser columellar deviation and reduced scaring. The aim of our study was to evaluate the long-term results of NAM and gingivoperiosteoplasty in patients with cleft lip and palate. METHODS AND MATERIALS: An electronic search of databases (ie, PubMed, ISI Web of Science, EMBASE, Scopus, and Google Scholar) from inception to March 2021 was performed and after selecting the eligible studies, relevant data were collected using piloted extraction forms. The success rate of NAM and gingivoperiosteoplasty, and Bergland score were pooled using random-effects inverse variance meta-analysis. RESULTS: Seven studies were included in this meta-analysis and systematic review. The pooled mean success rate of NAM with gingivoperiosteoplasty (GPP) based on the continuity of alveolar bone structure was 71% (95% confidence interval [CI] = 54-85). This means that in 71% of cases NAM + GPP treatment eliminated the need for future bone grafts. Also, no significant difference between the success rate (risk ratio = 1.00, 95% CI = 0.64-1.58) and mean Bergland score (mean difference = 0.64, 95% CI = -1.04 to 2.31) of NAM + GPP and skeletal bone graft was found. CONCLUSIONS: Nasoalveolar molding and gingivoperiosteoplasty was successful in 71% of cases treating patients with cleft lip and palate. This treatment is similar with the secondary alveolar bone graft in both the success rate and the alveolar height that it generates while being less invasive and with lower morbidity.

Comparison of self-etch primers with conventional acid-etch technique for bonding brackets in orthodontics: a systematic review and meta-analysis.

BACKGROUND: Bonding with self-etch primers (SEPs) is one of the most popular systems for attaching orthodontic brackets to the enamel surface. There are conflicting reports about the efficacy and success of these systems compared with acid-etch (AE) bonding. OBJECTIVE: This systematic review and meta-analysis was performed to compare SEP with conventional AE technique for bonding brackets in fixed orthodontics. SEARCH METHODS: Articles related to the subject of interest were searched in electronic databases, including PubMed, ISI Web of Science, Scopus, EMBASE, and Cochrane's CENTRAL, from inception to 2 June 2021. Search for grey literature, and hand search for relevant studies were also performed. SELECTION CRITERIA: Based on the PICO model, randomized clinical trials using full-arch bonded fixed orthodontic appliances comparing SEP and conventional AE systems were included in the review process. DATA COLLECTION AND ANALYSIS: After assessing the risk of bias, data from the included studies were extracted using custom piloted forms. Inverse-variance random-effects meta-analyses were performed to combine the results of bracket failure, adhesive remnant index (ARI), and bonding time. RESULTS: Nineteen randomized clinical trials were included in the systematic review and 17 randomized clinical trials [5 parallel-group (PG) and 12 split-mouth (SM) studies] were included in the meta-analysis. No significant difference in bracket failure at 6 months [risk ratio (RR) = 1.50, P = 0.26, 12 SM] and (RR = 0.68, P = 0.34, 2 PG), 12 months (RR = 1.6, 8 SM) and (RR = 1.17, P = 0.54, 2 PG), and ≥18 months (RR = 0.84, P = 0.31, 3 SM) and (RR = 1.20, P = 0.3, 3 PG) between SEP and AE groups could be found. Also, ARI score was similar between different bonding systems [mean difference (MD) = -0.44, P = 0.06, 4 SM]. The bonding time per tooth was faster in the SEP group (MD = -26.55, P < 0.001, 2 SM) and (MD = -24.00, P < 0.001, 2 PG). LIMITATIONS: inclusion of three studies with a high risk of bias and high amount of inconsistency between the results of individual studies were the biggest limitations of our review. CONCLUSIONS: The bracket bonding failure and ARI score were not significantly different between self-etch and conventional AE bonding systems. The bonding time was lower for the SEP, but some other requirements for SEPs like pumice prophylaxis could diminish this advantage. REGISTRATION: The protocol for this systematic review was registered at PROSPERO with the ID CRD42021248540.

The effects of photobiomodulation therapy for treatment of alveolar osteitis (Dry Socket): Systematic review and meta-analysis.

INTRODUCTION: Dry socket (alveolar osteitis) is one of the most common complications that occur after the extraction of permanent teeth. The aim of this review was to evaluate and compare the effectiveness of photobiomodulation (PBT) with other treatment methods on alveolar osteitis. METHODS AND MATERIALS: MEDLINE, Web of Science, EMBASE, Scopus and Cochrane's CENTRAL online databases were searched based on the search strategy. Also, the prominent laser journals and the references of relevant studies were hand searched for eligible studies and then the data were extracted from the retrieved studies were extracted using piloted custom forms. The data were combined and analyzed using inverse-variance random-effect meta-analysis. RESULTS: For the treatment of dry socket, pain perception based on the VAS score, PBT on average has a 3.41 higher pain level reduction compared to alveogyl which seems to be both statistically and clinically significant. In addition, based on the GRADE score, the evidence seems to be of moderate quality. Also, in the individual studies which were included in this systematic review, PBT seems to be more effective than other methods (Salicept, zinc-oxide eugenol, ozone, and photodynamic therapy) in pain reduction of patients with alveolar osteitis. CONCLUSIONS: PBT, in general, has a higher ability in decreasing pain levels for patients with alveolar osteitis (dry socket) compared to alveogyl. Therefore, PBT could be used as an appropriate method for treatment and controlling the signs of dry socket.

Effect of micro-osteoperforation on the rate of orthodontic tooth movement-a systematic review and a meta-analysis.

BACKGROUND: The micro-osteoperforation can be used to increase the rate of tooth movement, simplify complex orthodontic movements, and also help adjust the anchorage but there are conflicting reports on the effectiveness and adverse effects of this intervention. OBJECTIVES: The aim of our systematic review and meta-analysis was to evaluate the effects of micro-osteoperforation on the rate of tooth movement in patients undergoing orthodontic treatment. SEARCH METHODS: A comprehensive search of MEDLINE, ISI web of science, EMBASE, Scopus, and CENTRAL online databases for studies measuring the effects of micro-osteoperforation on the rate of orthodontic tooth movement from inception to February 2019 was performed. SELECTION CRITERIA: Based on the PICO model, human studies which evaluated the effects of MOP on the rate of tooth movement in patients undergoing orthodontic treatment were selected for this review. DATA COLLECTION AND ANALYSIS: The relevant data from the eligible studies were extracted using piloted custom extraction forms. The data were combined and analysed using inverse-variance random-effect meta-analysis and the mean difference was used for comparing the outcome measures. RESULTS: Six randomized clinical trials were finally included in this meta-analysis. The rate of canine retraction per month was significantly higher in the MOP group [mean difference (MD) = 0.45 mm, 95% CI = 0.17-0.74]. These results were similar with regard to different malocclusions, the jaw on which it was performed, and MOP methods. The patients did not report any significant differences in terms of pain severity levels after MOP. With regard to the adverse effects, one study reported higher amounts of root resorption among patients undergoing MOP. CONCLUSIONS: The rate of tooth movement was increased after performing MOP but in at least one study higher root resorption was observed. Therefore, the use of MOP can be recommended after weighing the benefits and disadvantages this intervention can bring for each patient. REGISTRATION: The protocol for this review was registered via crd.york.ac.uk/prospero with the ID CRD42019115499.

Skeletal Class III malocclusion treatment using mandibular and maxillary skeletal anchorage and intermaxillary elastics: a case report.

INTRODUCTION: Skeletal Class III malocclusion is one of the most challenging malocclusions to treat. In around 40% of Class III patients, maxillary retrognathia is the main cause of the problem and in most patients, orthopedic/surgical treatments includes some type of maxillary protraction. OBJECTIVE: The aim of this case report was to describe a treatment method for a patient with maxillary retrognathia and Class III skeletal discrepancy using mandibular and maxillary skeletal anchorage with intermaxillary elastics. CASE REPORT: A 13-year-old boy with maxillary retrognathia and mandibular prognathism was treated using bilateral miniplates. Two miniplates were inserted in the mandibular canine area and two other miniplates were placed in the infrazygomatic crests of the maxilla. Class III intermaxillary elastics were used between the miniplates. RESULTS: After eight months of orthopedic therapy, ANB angle increased by 4.1 degrees and ideal overjet and overbite were achieved. Mandibular plane angle was increased by 2.1 degrees and the palatal plane was rotated counterclockwise by 4.8 degrees. CONCLUSION: This case showed that the skeletal anchorage treatment method may be a viable option for treating patients with Class III skeletal malocclusion.

Skeletal Class III malocclusion treatment using mandibular and maxillary skeletal anchorage and intermaxillary elastics: a case report

ABSTRACT Introduction: Skeletal Class III malocclusion is one of the most challenging malocclusions to treat. In around 40% of Class III patients, maxillary retrognathia is the main cause of the problem and in most patients, orthopedic/surgical treatments includes some type of maxillary protraction. Objective: The aim of this case report was to describe a treatment method for a patient with maxillary retrognathia and Class III skeletal discrepancy using mandibular and maxillary skeletal anchorage with intermaxillary elastics. Case report: A 13-year-old boy with maxillary retrognathia and mandibular prognathism was treated using bilateral miniplates. Two miniplates were inserted in the mandibular canine area and two other miniplates were placed in the infrazygomatic crests of the maxilla. Class III intermaxillary elastics were used between the miniplates. Results: After eight months of orthopedic therapy, ANB angle increased by 4.1 degrees and ideal overjet and overbite were achieved. Mandibular plane angle was increased by 2.1 degrees and the palatal plane was rotated counterclockwise by 4.8 degrees. Conclusion: This case showed that the skeletal anchorage treatment method may be a viable option for treating patients with Class III skeletal malocclusion.

RESUMO Introdução: a Classe III esquelética é considerada uma das más oclusões mais difíceis de se tratar. Em cerca de 40% dos pacientes afligidos por ela, a principal causa do problema é o retrognatismo maxilar e, na maioria desses pacientes, o tratamento ortopédico/cirúrgico inclui algum tipo de protração da maxila. Objetivo: o objetivo do presente relato de caso é descrever o método de tratamento de um paciente Classe III com discrepância esquelética e retrognatismo maxilar, usando elásticos intermaxilares e ancoragem esquelética superior e inferior. Relato de caso: paciente de 13 anos de idade, com retrognatismo maxilar e prognatismo mandibular, tratado com miniplacas inseridas bilateralmente. Duas miniplacas foram instaladas na região dos caninos inferiores, e outras duas miniplacas foram inseridas na região da crista infrazigomática maxilar. Elásticos intermaxilares de Classe III foram conectados às miniplacas. Resultados: após 8 meses de tratamento ortopédico, o ângulo ANB aumentou 4,1o e obteve-se sobressaliência e sobremordida ideais. O ângulo do plano mandibular aumentou 2,1o e o plano palatal girou 4,8o no sentido anti-horário. Conclusão: esse caso clínico demonstrou que o método de tratamento com ancoragem esquelética pode ser uma opção válida para pacientes com má oclusão de Classe III esquelética.

Comparison of the success rate of a bioactive dentin substitute with those of other root restoration materials in pulpotomy of primary teeth: Systematic review and meta-analysis.

BACKGROUND: Several root canal restoration materials can be used after pulpotomy in primary teeth; however, it is unclear which is the most successful. The authors' aim in this systematic review and meta-analysis was to compare the radiographic and clinical failure rates of a calcium silicate-based bioactive material (Biodentine, Septodont) with those of other root restoration materials such as mineral trioxide aggregate (MTA), formocresol, and ferric sulfate. TYPES OF STUDIES REVIEWED: On the basis of the determined study strategy, the authors performed a comprehensive search of the MEDLINE, Web of Science, Embase, and Cochrane Central Register of Controlled Trials online databases. The authors considered only randomized controlled trials. In the included studies, the authors compared the clinical and radiographic failure rates at different follow-up times of the pulpotomy of primary teeth with extensive caries treated by using Biodentine and other root restoration materials. RESULTS: All of the included studies had an unknown or high risk of bias. On the basis of the Grading of Recommendations Assessment, Development and Evaluation scale, the quality of evidence for the comparison of MTA and Biodentine was moderate. Biodentine had a statically significantly higher radiographic failure rate than did MTA at 6 and at 9 through 12 months after pulpotomy. The authors found no substantial differences between the clinical failure rates of Biodentine and MTA and the radiographic or clinical failure rates of Biodentine and formocresol or of Biodentine and ferric sulfate. CONCLUSIONS AND PRACTICAL IMPLICATIONS: MTA has a significantly lower radiographic failure rate than does Biodentine but no difference in clinical failure rates. On the basis of this result, the dentist can weigh the advantages and disadvantages of using Biodentine, MTA, ferric sulfate, and formocresol and can make a more informed decision about using the proper root restoration material.

The effects of photodynamic and low-level laser therapy for treatment of oral lichen planus-A systematic review and meta-analysis.

BACKGROUND: Oral lichen planus (OLP) is a chronic immune-mediated disorder that inflicts oral mucosa in 0.5-2% of the population. Surgery, photodynamic therapy, laser therapy and most commonly pharmacological therapy (like corticosteroids) has been used for treating OLP. New phototherapy approaches have been shown to have positive effects on treating some oral lesions and the aim of our study was to assess the effects of different phototherapy treatments on OLP. METHODS: We conducted a comprehensive electronic search using the determined search strategy in MEDLINE, EMBASE and CENTRAL electronic databases. A hand search of the reference list of the relevant studies and related systematic reviews was also performed. RESULTS: For low-level laser therapy, before and after studies showed a significant difference in pain (MD = -4.39, CI = 95% -4.83, -3.96) and sign score (MD = -1.86, CI = 95% -2.53, -1.19) after treatment. The comparison between corticosteroid therapy and LLLT also showed a significant difference in their effects for severity (MD = 0.57, CI = 95% 0.04, 1.09), but no differences in sign (MD = 0.21, CI = 95% -0.83, 1.24)and pain (MD = -0.10, CI = 95% -0.57,0.38) score was found between these two methods. Before and after studies of photodynamic therapy did not reveal any differences in lesion size. (MD = -1.95, CI = 95% -4.39, 0.490). CONCLUSION: Low-level laser therapy seems to be a reliable alternative to corticosteroids for treating OLP without the adverse effects associated with the pharmacological method. No conclusive evidence for the effectiveness of photodynamic therapy in treating OLP lesion exists.