Patients' perception of orthodontic retainers: a systematic review.

BACKGROUND: Orthodontic retainers are widely used to prevent relapses after orthodontic treatment; however, evidence about patients' perceptions of retainers is lacking. OBJECTIVE: To assess patients' perception of orthodontic retainers. SEARCH METHODS: PubMed, Web of Science, Scopus, LILACS, LIVIVO, Cochrane Library, and gray literature (Google Scholar) were searched without date or language restrictions. A manual search of the reference lists of the included articles was also performed. SELECTION CRITERIA: Studies comparing patients' perceptions of wearing orthodontic retainers were included. DATA COLLECTION AND ANALYSIS: According to the study design, the risk of bias (RoB) assessment was performed using RoB 2.0 or ROBINS-I. The level of evidence was assessed through the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) tool. RESULTS: Seventeen studies met the eligibility criteria. After the RoB assessment, 12 randomized controlled trials presented a high RoB, and 4 non-randomized controlled trials presented a moderate RoB. The certainty of evidence was classified as very low for the four assessed outcomes. The studies generally reported an initial temporary negative impact of orthodontic retainers. Different esthetic, functional, and ease-of-use advantages are reported using removable and fixed retainers. A quantitative analysis was not performed due to the considerable clinical and methodological heterogeneity among the studies. CONCLUSION: The current evidence, although very limited, suggests that orthodontic retainers have an initial negative impact related to discomfort and functional limitations, but they seem to regress over time. There is a preference for thermoplastic over Hawley-type retainers. However, thermoplastic retainers cause different functional difficulties, and bonded retainers present the advantage of affecting speech function less than orthodontic removable retainers, although they can facilitate oral hygiene problems. REGISTRATION: PROSPERO (CRD42022306665).

Self-correction of the ectopic eruption of the maxillary first permanent molar and its predictive factors: A systematic review.

BACKGROUND: Ectopic eruption of the maxillary first permanent molar is a local disturbance that affects the development of the occlusion. AIM: To evaluate the occurrence of self-correction of maxillary first permanent molar's ectopic eruption and its predictive factors. DESIGN: Five electronic databases and part of the gray literature were investigated. The risk of bias was assessed using the Newcastle-Ottawa scale and the certainty of evidence using the GRADE tool. RESULTS: Four studies were selected: Three had a low risk of bias, and one, moderate. Evidence with a moderate level of certainty was generated, indicating a possibility of 47%-78% of spontaneous correction up to 7 years of age. Supporting the prognosis, whether reversible or irreversible, there was a positive correlation between the severity of the atypical distal resorption of the second primary molar, a higher magnitude of impaction, a larger eruption angle, and a bilateral occurrence with the irreversibility of the cases. CONCLUSION: Spontaneous correction of the ectopic eruption of the maxillary first permanent molar is feasible and dependent on the severity of predictive factors. Early intervention is mandatory in irreversible cases.

Orthodontic Retainers and the Stability of the Maxillary Arch in Unilateral Cleft lip and Palate Patients: A Systematic Review.

OBJECTIVE: The aim of this systematic review was to elucidate the role of orthodontic retainers on the stability of compensatory orthodontic treatment in patients with unilateral cleft lip and palate. METHODS: Five electronic databases (PubMed, Scopus, Web of Science, LILACS, and LIVIVO) and the grey literature (OpenGrey and Google Scholar) were investigated, according to the population, exposure, comparator, outcomes and Study design eligibility criterion. The risk of bias assessment was determined based on the Risk of Bias In Nonrandomized Studies of Exposure (ROBINS-E) and the level of evidence with the GRADE tool. RESULTS: Three studies were included: two presented moderate risk of bias and one high. A moderate level of evidence revealed a mean value of 0.6 mm of intercanine relapse distance, and great variability between the data, regardless of the use or type of retention or rehabilitation. Relapse in the posterior region showed clinical significance, from -1 to -1.7 mm, especially in individuals who did not use retention, except in patients with symmetrical arches with Hawley retainer, where this value varies from -0.2 ± 0.63 mm. CONCLUSIONS: Orthodontic retainers do not seem essential to prevent relapse at anterior maxillary dimensions after compensatory orthodontic treatment in patients with unilateral cleft lip and palate. Relapse in the posterior region can achieve greater clinical significance, which highlights the need for prolonged use of Hawley retainers and periodic evaluation of the stability of treatment results. Prospective studies with a longer follow-up can improve the certainty of the evidence.

Aerosol generated by dental procedures: A scoping review.

BACKGROUND: The current pandemic has raised awareness of aerosol dispersion in dental offices. This scoping review was conducted to assess the amount and spread of aerosol generated by dental procedures. METHODS: This scoping review followed the PRISMA-ScR protocol and was conducted by searching multiple databases adopting a core search structure for each database. Detailed eligibility criteria were applied. The authors placed no restrictions on study design, year of publication, and study location. The literature search was updated on September 15, 2021. RESULTS: A total of 51 papers were included in this scoping review. The risk of bias assessment was not conducted as per guidelines. The majority of studies found microorganisms, bloodstains, splatters of aerosol, and particles in the air part of the search strategy. Publication dates ranged from 1969 to 2021. Data came from different dental settings locations. Several factors were identified that have an effect on the amount and spread of the aerosol and spatter. CONCLUSION: Although it is clear that the microbial contamination occurred mainly during aerosol-generating dental procedures, our understanding of the contamination level, spread, and half-life are limited.

Association between tooth agenesis and cancer: a systematic review.

The congenital absence of multiple teeth may share the same genetic background of the development of some types of cancer. OBJECTIVE: This systematic review aimed to investigate the possible association between dental agenesis and cancer, and the perspective of agenesis as an early predictor for cancer risk. METHODOLOGY: The electronic databases PubMed, Scopus, Web of Science, Cochrane Library, LILACS, and OpenGrey were searched and the risk of bias was evaluated using the Newcastle-Ottawa tool. The GRADE tool was used to evaluate the certainty of the evidence. RESULTS: Six studies met the eligibility criteria. A positive co-occurrence between ovarian cancer and hypodontia was found in two articles. Three studies evaluated the association between dental agenesis and colorectal cancer and only one showed common genes for these conditions. One paper found individuals with hypodontia had a higher risk of family history of cancer. Five studies had a fair quality and one a good quality. The certainty of evidence was classified as very low. CONCLUSION: Notwithstanding the limited scientific evidence, there may be a possible association between dental agenesis and cancer due to genes involved in both conditions. Agenesis of multiple teeth could be an early indicator of cancer risk. Nevertheless, studies with a better level of evidence are needed to confirm this possible association.

Como um cirurgião-dentista pode responder a uma dúvida clínica baseado na melhor evidência disponível? / How can a dentist answer a clinical question based on the best available evidence?

Introdução: a prática clínica baseada em evidência científica deve ser pautada, entre outros fatores, na busca prévia de conhecimento embasado pela ciência odontológica. Objetivo: o objetivo deste trabalho é apresentar uma proposta de protocolo de pesquisa, download e tradução de artigos científicos. Materiais e métodos: foi realizado um protocolo de pesquisa científica com o passo-a-passo detalhado em duas das principais bases de dados eletrônicas, ilustrado por meio de exemplos hipotéticos de três dúvidas clínicas. Resultados: o acesso e o desenvolvimento de habilidades de busca pela literatura científica devem chegar ao conhecimento dos profissionais da área odontológica com clareza e objetividade. Assim, a experiência clínica pode ser associada à evidência científica e à preferência do paciente na tomada de decisões. Conclusão: o aprimoramento da prática clínica deve oferecer e entregar qualidade nos resultados de tratamentos por meio da Odontologia baseada em evidências.

Introduction: A clinical practice based on scientific evidence should be performed, among other factors, on the prior search for knowledge supported by dental science. Objective: The objective of this study is to present a research protocol proposal, download and translation of scientific articles. Materials and methods: A step-by-step detailed scientific research protocol was carried out in two of the main electronic databases, illustrated by hypothetical examples of three clinical questions. Results: The access and the development of scientific literature search skills should reach the knowledge of dental professionals with clarity and objectivity. Thus, the clinical experience can be associated with scientific evidence and patient preference in decision-making. Conclusion: The improvement of clinical practice must offer and deliver quality in treatment outcomes through evidence-based dentistry.

Association between tooth agenesis and cancer: a systematic review

Abstract The congenital absence of multiple teeth may share the same genetic background of the development of some types of cancer. Objective: This systematic review aimed to investigate the possible association between dental agenesis and cancer, and the perspective of agenesis as an early predictor for cancer risk. Methodology: The electronic databases PubMed, Scopus, Web of Science, Cochrane Library, LILACS, and OpenGrey were searched and the risk of bias was evaluated using the Newcastle-Ottawa tool. The GRADE tool was used to evaluate the certainty of the evidence. Results: Six studies met the eligibility criteria. A positive co-occurrence between ovarian cancer and hypodontia was found in two articles. Three studies evaluated the association between dental agenesis and colorectal cancer and only one showed common genes for these conditions. One paper found individuals with hypodontia had a higher risk of family history of cancer. Five studies had a fair quality and one a good quality. The certainty of evidence was classified as very low. Conclusion: Notwithstanding the limited scientific evidence, there may be a possible association between dental agenesis and cancer due to genes involved in both conditions. Agenesis of multiple teeth could be an early indicator of cancer risk. Nevertheless, studies with a better level of evidence are needed to confirm this possible association.

Effects of temperature and humidity on the spread of COVID-19: A systematic review.

BACKGROUND: Faced with the global pandemic of COVID-19, declared by World Health Organization (WHO) on March 11th 2020, and the need to better understand the seasonal behavior of the virus, our team conducted this systematic review to describe current knowledge about the emergence and replicability of the virus and its connection with different weather factors such as temperature and relative humidity. METHODS: The review was registered with the PROSPERO database. The electronic databases PubMed, Scopus, Web of Science, Cochrane Library, LILACS, OpenGrey and Google Scholar were examined with the searches restricted to the years 2019 and 2020. Risk of bias assessment was performed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist tool. The GRADE tool was used to assess the certainty of the evidence. RESULTS: The initial screening identified 517 articles. After examination of the full texts, seventeen studies met the review's eligibility criteria. Great homogeneity was observed in the findings regarding the effect of temperature and humidity on the seasonal viability and transmissibility of COVID-19. Cold and dry conditions were potentiating factors on the spread of the virus. After quality assessment, two studies had a high risk of bias, eleven studies were scored as moderate risk of bias, and four studies were classified as low risk of bias. The certainty of evidence was graded as low for both outcomes evaluated. CONCLUSION: Considering the existing scientific evidence, warm and wet climates seem to reduce the spread of COVID-19. However, these variables alone could not explain most of the variability in disease transmission. Therefore, the countries most affected by the disease should focus on health policies, even with climates less favorable to the virus. Although the certainty of the evidence generated was classified as low, there was homogeneity between the results reported by the included studies.

Dentofacial biometry as a discriminant factor in the identification of remote Amazon indigenous populations.

INTRODUCTION: This study aimed to examine the role of dentofacial morphology in discriminating semi-isolated indigenous groups. These populations present a similar pattern of dietary habits. Studies in human genetics have reported a large intertribal genetic distance and low intratribal variation. METHODS: This study was conducted following the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. Face dimensions were measured through facial photogrammetry, and dental arches and tooth size were evaluated using plaster models. A total of 98 subjects in the permanent dentition and belonging to 4 indigenous groups were analyzed: Arara-Iriri (n = 20), Arara-Laranjal (n = 33), Assurini (n = 25), and Xicrin-Kayapó (n = 20). The random and systematic errors were verified using the Dahlberg formula and the intraclass correlation coefficient (ICC), respectively. In order to evaluate the discrimination of the variables to identify the indigenous groups, a discriminant analysis was performed (P <0.05). RESULTS: A small causal error (Dahlberg, 0.13-1.81) and excellent replicability (ICC, 0.75-0.99) for face dimensions as well as for models (Dahlberg, 0.10-0.68; ICC, 0.94-0.99) were observed. The discriminant analysis allowed the identification of 4 populations by facial and dental arch dimensions and tooth size. Dentofacial biometry revealed an accuracy of 98% for females and 100% for males, which confirms a high intragroup homogeneity and considerable intergroup heterogeneity for dentofacial features. CONCLUSIONS: Biometric measurements of the human face added with tooth size and dental arch dimensions are very useful to identify remote indigenous populations with high accuracy. Supported by previous studies in human genetics, these findings reinforce the role of genetic variation in the determination of dentofacial features.

Periodontal side effects of rapid and slow maxillary expansion: A systematic review.

OBJECTIVES: To identify the scientific evidence that demonstrates which of the transverse maxillary treatments has the least effect on periodontal tissues. MATERIALS AND METHODS: PubMed (MEDLINE), Cochrane Library, Scopus, Web of Science, Virtual Health Library, Google Scholar, and OpenGrey were searched without restrictions. A hand search was also carried out in the reference lists of the articles selected. The related articles tool in the PubMed database was checked for each article included. Risk of bias assessment was performed using Cochrane Collaboration's Risk of Bias tool for randomized clinical trials and the ROBINS-I tool for nonrandomized studies of interventions. The GRADE tool was used to assess the quality of the evidence. RESULTS: After examination of the full texts, three studies were finally included. Two studies used a Haas expander with different protocols, and one study used a Haas expander compared with a quad-helix appliance. These studies evaluated periodontal parameters and periodontal indices by clinical examination with a millimeter probe, and one study examined computed tomography images. After quality assessment, two studies were considered as having a "low" risk of bias. One study was scored as having a moderate risk of bias. The evidence was graded as moderate quality for alveolar bone level, tooth displacement, and inclination and very low for all other outcomes. CONCLUSIONS: There were no significant differences to enable a sound conclusion about which type of maxillary expansion has the least periodontal side effects.

Tratamento ortodôntico com autotransplante dentário em paciente com fissura palatina / Orthodontic treatment with tooth autotransplantation in patient with cleft palate

O autotransplante dentário é uma técnica que pode ser utilizada para auxiliar o tratamento ortodôntico de alguns tipos de má oclusão, como situações com agenesias dentárias que dificultam a mecânica de fechamento de espaço ou pressupõem a necessidade de uma futura reabilitação com prótese e/ou implante dentário. A técnica de transplante dentário, quando indicada em pacientes com fissura palatina, é realizada de maneira convencional, pois a fissura não envolve o rebordo alveolar, o sítio receptor do dente doador. Esse trabalho objetiva descrever um tratamento ortodôntico compensatório em paciente com fissura palatina que foi submetida a um autotransplante de pré-molar com formação radicular completa como recurso para dissolver o apinhamento, melhorar a intercuspidação, corrigir a linha média inferior e preencher o espaço da agenesia presente. Dessa forma, realizou-se um procedimento viável e em concordância com a má oclusão apresentada pela paciente, que foi reabilitada na área da agenesia com um autotransplante.

Dental autotransplantation is a technique that can be used to aid orthodontic treatment of some types of malocclusion such as tooth agenesis situations, which difficult the mechanics of space closure or require future rehabilitation with prosthesis and/or dental implant. The technique of dental transplantation, when indicated to patients with cleft palate, is performed in a conventional manner, since the cleft does not involve the alveolar ridge (receptor site of the donor tooth). This work aimed to describe a compensatory orthodontic treatment in a patient with cleft palate that has undergone a premolar autotransplantation with complete root formation in order to dissolve crowding, improve intercuspation, correct the lower midline and fill present agenesis space. Thus, it was performed a viable procedure in accordance with the malocclusion presented by the patient, who was rehabilitated with an autotransplantation in the agenesis area.

Prevalência de dentes supranumerários na região dos pré-molares e sua associação com a presença dos terceiros molares / Prevalence of supranumerary teeth on pre-molars region and their association with third molars

O objetivo do presente estudo foi determinar a prevalência de supranumerários na região dos pré-molares nos estágios de dentadura decídua, mista e permanente, além de verificar sua associação com a presença de terceiros molares. Foram avaliadas radiografias panorâmicas de 1.976 pacientes matriculados no curso de Ortodontia Preventiva e Interceptiva da Profis (Sociedade de Promoção Social do Fissurado Lábio-Palatal), em Bauru-SP. As radiografias foram analisadas em negatoscópio, em ambiente escurecido, por um único examinador que determinou a presença de supranumerários na região dos pré-molares, bem como a presença de terceiros molares. A associação entre o aparecimento de supranumerários e a presença de terceiros molares foi verificada pelo Teste de McNemar. O Teste exato de Fisher foi aplicado para verificar o dimorfismo sexual. Constatou-se uma prevalência de 0,45% de supranumerários na região dos pré-molares na amostra estudada, sendo 11% na maxila e 89% na mandíbula, e não foi observado dimorfismo sexual em relação ao aparecimento dos supranumerários (p=0,32). Nas radiografias avaliadas, foi observado que os quatro terceiros molares estavam presentes sempre que verificada a presença dos supranumerários, detectando uma associação estatisticamente significante (p < 0,01) entre o aparecimento dos pré-molares supranumerários e a presença dos terceiros molares. Concluiu-se que a incidência de pré-molares supranumerários foi baixa na população estudada, e que existe associação entre o aparecimento destes supranumerários com a presença dos terceiros molares.

The purpose of the present study was to determine the prevalence of supranumerary teeth on the pre-molars region during the deciduous, mixed and permanent dentition and also verify their association with the presence of third molars. 1.976 panoramic radiographic from patients of the Preventive and Interceptive Orthodontic Course from Profis (Sociedade de Promoção Social do Fissurado Lábio-Palatal), in Bauru-SP were evaluated. The radiographies were analyzed in viewing box in a dark room by one unique examiner who determined the presence of supranumerary teeth on pre-molars region and also the presence of third molars. The association between the supranumerary and the third molars was verified by the McNemar test. The Fisher’s exact test was used to verify the sexual dimorphism. A prevalence of 0,45% of supranumerary teeth on the pre-molars region was found on the sample, 11% on the maxilla and 89% on the mandible. No sexual dimorphism was found (p=0,32). A statistically significant difference (p < 0,01) association between supranumerary pre-molars and the presence of third molar was found. The conclusion is that the incidence of supranumerary pre-molars is low on the examined sample and there is an association between the supranumerary pre-molars and the presence of third molars.

Odontodisplasia regional: relato de caso em maxila com transpasse de linha média / Regional odontodysplasia: case report in maxilla crossing the midline

Odontodisplasia regional é uma afecção rara, não-hereditária, a qual afeta o desenvolvimento do esmalte e dentina na dentição decídua e/ou permanente. A etiologia ainda é desconhecida. Em geral, esta condição é diagnosticada durante exames radiográficos de rotina e muitos casos são diagnosticados erroneamente como dentes malformados ou odontomas. Esta condição afeta duas vezes mais o sexo feminino do que o masculino e envolve com mais frequência à maxila do que a mandíbula. Esta afecção é também mencionada como "dentes fantasmas", uma vez que os dentes afetados, radiograficamente, não apresentam distinção dos limites entre o esmalte e a dentina; e a câmara pulpar se apresenta alargada. Clinicamente os dentes são vistos com uma coloração castanha ou amarelada. O presente trabalho apresenta um caso clínico de odontodisplasia regional, não usual, que cruza a linha média da maxila, em uma criança do sexo feminino de quatro anos de idade. Todos os dentes decíduos e permanentes superiores do lado esquerdo eram displásicos, assim como também os incisivos centrais, decíduo e permanente do lado direito.

Regional odontodysplasia is a rare, nonhereditary condition that affects the development of the enamel and dentin of the deciduous and/or permanent teeth. The etiology is still unknown. In general, this condition is diagnosed during routine radiographic assessments and many cases are mistaken for malformed teeth or odontomas. This condition affects twice as many females as males and is more common in the maxilla than the jaw. This condition is also called "ghost teeth" because the enamel-dentine border of the affected teeth cannot be distinguished in the radiograph and the pulp chambers are wide. Clinically, the teeth are brownish or yellowish. The present study reports an unusual case of maxillary regional odontodysplasia crossing the midline in a 4-year-old female. All deciduous and permanent teeth in the left side of the maxilla and the central incisors in the right side of the maxilla were dysplastic.