Maxillary alveolar bone evaluation following dentoalveolar expansion with clear aligners in adults: A cone-beam computed tomography study.

Objective: To investigate the effects of maxillary orthodontic expansion on the alveolar bone tissue in adult patients treated with aligners by using cone-beam computed tomography. Methods: Thirty patients (22 females and 8 males; mean age: 36.3 years) were treated with Invisalign® aligners. Cone-beam computed tomography and digital models were obtained before (T0) and after (T1) upper arch expansion. The bone thicknesses in the cervical, middle, and apical areas of the incisors, canines, premolar, and first molars were buccally and palatally measured, totaling 96 areas and 2,880 measurements. The buccolingual inclinations and transverse measurements of the teeth were obtained from digital models to correlate them with the bone changes. The statistical tests used were Student's t-test, analysis of variance, and Pearson's correlation tests (p < 0.05). Results: From the 96 areas evaluated, 84 revealed an increase or stability in the alveolar bone thickness and twelve displayed significant bone loss. Bone changes did not correlate with the tooth inclination and transverse measurements. Conclusions: Within the limitation of the present study, mild levels of upper arch expansion obtained with Invisalign® aligners in adult patients did not result in any clinically significant loss of alveolar bone thickness.

Knowledge changes after applying evidence-based dentistry educational interventions to dental students: A systematic review.

PURPOSE: To critically evaluate the evidence on knowledge changes observed after the application of evidence-based dentistry (EBD) educational interventions to dental students. METHODS: We included studies that assessed EBD knowledge after applying educational interventions to undergraduates. Studies that evaluated post-graduate students or professionals, that exclusively described educational interventions, programs, or the application of curriculum revisions were excluded. Electronic databases (PubMed, Embase, Scopus, and Web of Science), unpublished gray literature, and manual searches were performed. Data concerning "perceived" and "actual knowledge" was extracted. The quality of the studies was appraised according to the Mixed Methods Appraisal Tool. RESULTS: The 21 selected studies enrolled students at different stages, and the intervention formats were diverse. The educational interventions could be categorized into three modalities, that is, regular, EBD-focused disciplines or courses, and other educational interventions including one or more of the EBD principles, methods, and/or practices. Despite the format, knowledge was generally improved after the implementation of educational interventions. Overall, perceived and actual levels of knowledge increased considering EBD general concepts, principles, and/or practices, and concerning the "acquire" and "appraise" skills. Among the selected studies, two were randomized controlled trials, while most were non-randomized or descriptive studies. CONCLUSIONS: EBD-related educational interventions seem to improve dental students' perceived and actual knowledge, according to literature with a high risk of bias. Therefore, more complete, methodologically rigorous, and longer-term studies are still recommended to confirm and expand the current knowledge.

Effectiveness and predictability of treatment with clear orthodontic aligners: A scoping review.

INTRODUCTION: In an ideal clinical setting, orthodontic therapy with clear aligners (CA) should improve the patients' initial malocclusion and must guarantee equivalence between the results predicted and those obtained clinically to be considered an effective treatment. Therefore, this scoping review aimed to identify the orthodontic literature concerning the effectiveness and predictability of CA treatments. METHODS: A systematic computerized search was performed in 3 databases: PubMed, Scopus, and Embase. Inclusion criteria selected observational and clinical studies performed in at least 10 adult orthodontic patients, whose results of CA treatment's effectiveness and/or predictability were assessed. RESULTS: The 3 database computerized searches resulted in 1,553 articles, and 169 full texts were considered potentially relevant. After applying the eligibility criteria, 33 studies were included. Most studies (76%) were designed as cohort studies and have been published in the last 5 years (79%). The majority included only non-extraction treatments (73%), and 79% reported results achieved with the Invisalign® system. The most predictable movement was the buccolingual tipping, while the least predictable movements were rotation, intrusion, and extrusion. Aligner treatment was effective for mild to moderate crowding resolution, and the success of overbite correction still seems to be limited. CONCLUSIONS: The studies have demonstrated improvement of initial malocclusion through CA treatments. Still, predictability degree is overestimated and does not accurately reflect the occlusion immediately at the end of treatment. In future studies, there should be an effort to broaden the utilization of alternative aligner systems beyond Invisalign® and broadly disseminate their outcomes to strengthen clear aligners evidence base.

Silver nanoparticles in mouthwashes against infection caused by SARS-CoV-2: a scoping review / Nanopartículas de prata em enxaguatórios bucais para uso em infecções por SARS-CoV-2: uma revisão de escopo

The Silver nanoparticle (AgNPs) have received attention for their antiviral potential against SARS-CoV-2. The objective is to conduct a scope review and map the scientific evidence on the use of AgNPs in mouthwashes as an adjunct in decreasing the viral load in the oral cavity of patients with SARS-CoV-2. A search was performed in the PubMed, Medline, Scielo databases, and a manual search in the reference lists, following the standards of the Joanna Briggs Institute for Scoping Review without restriction of year, language or sample size. Thus, 14 articles were included, where they researched the use of AgNPs with antiviral effect against SARS-CoV-2, mouthwashes for SARS-CoV-2 and AgNPs as mouthwashes. We can suggest that AgNPs are likely antiviral therapies for SARS-CoV-2 and its use in mouthwashes associated with other therapies are promising strands for decreasing viral load and infection by the vírus (AU)

As nanopartículas de prata (AgNPs) têm recebido atenção por seu potencial antiviral no SARS-CoV-2. O objetivo deste trabalho é realizar uma revisão de escopo e mapear as evidências científicas sobre o uso de AgNPs em bochechos como adjuvante na diminuição da carga viral na cavidade oral de pacientes com SARS-CoV-2. Foi realizada busca nas bases de dados PubMed, Medline, Scielo e busca manual nas listas de referências, seguindo os padrões do Joanna Briggs Institute for Scoping Review sem restrição de ano, idioma ou tamanho da amostra. Assim, foram incluídos 14 artigos, onde pesquisaram o uso de AgNPs com efeito antiviral contra SARS-CoV-2, enxaguatórios bucais para SARS-CoV-2 e AgNPs como enxaguatórios bucais, vertentes promissoras para diminuição da carga viral e infecção pelo vírus.(AU)

Dentists' attitudes and practices toward evidence-based dentistry: a systematic review.

INTRODUCTION AND AIMS: Considering that attitudes toward evidence-based dentistry (EBD) may predict implementation behaviors, the objective of this systematic review was to synthesize and evaluate the existing evidence related to dentists' attitudes and practices toward EBD. METHODS: We included primary studies that collected information from interviews, questionnaires, or conversation sessions with dentists. The following sources were searched: Cochrane Central Register of Controlled Trials, Embase, PubMed, Scopus, and Web of Science, in addition to gray literature. The included studies were appraised according to the assessment tools recommended by the Joanna Briggs Institute for qualitative and quantitative observational studies. Descriptive data were collected in standardized tables and descriptively synthesized. RESULTS: The selection process resulted in 36 included studies. Dentists share positive opinions about EBD and predominantly report willingness to learn or adopt these practices. Despite high methodological risks and significant heterogeneity, the results collected in this review indicated that scientific journals, clinical practice guidelines, and trusted colleagues are generally perceived as influential and useful by dentists, who highly consulted these information sources. CONCLUSION: Despite supportive reported attitudes toward EBD, very low certainty exists about actual EBD-related practices.

Dentists' awareness and knowledge of evidence- based dentistry principles, methods and practices: a systematic review.

Introduction As an attempt to provide supporting evidence for the formulation of future educational strategies on knowledge translation, this systematic review assessed and synthesised the available evidence related to the dentists' awareness, perceived and actual knowledge of evidence-based dentistry (EBD) principles, methods and practices.Methods Primary studies that considered dentists' reports collected from interviews, questionnaires, or conversation sessions were selected. Studies enrolling students, dental hygienists, or other health professionals were not included. Reviews, editorials, letters, study protocols, articles presenting knowledge translation strategies and initiatives, examples of EBD approaches to specific clinical questions, and guidelines focused on EBD implementation were also excluded. Cochrane, Embase, PubMed, Scopus and Web of Science databases were searched. Grey literature was partially covered by the Google Scholar search and the reference lists of the pre-selected studies. The study search was concluded in February 2021. Descriptive data of the selected studies were synthesised, and the risk of bias was assessed according to the National Institutes of Health Quality Assessment Tool for observational cohort and cross-sectional studies.Results Twenty-one articles were included. High percentages of dentists were aware of EBD. Variable proportions of professionals declared to have some understanding of EBD, although few presented actual knowledge of principles, methods and practices.Discussion Methodologically, most studies presented limitations regarding sample representativity, participation rates, detailing of the outcome measures, and validation of the assessment tools. Additionally, extensive overall ranges of responses were often observed across the studies, possibly as a result of heterogeneity across samples and assessment tools. The authors thus suggest developing valid questionnaires including all dimensions (awareness, perceived knowledge and actual knowledge) within an assessment tool. This would contribute to establishing knowledge translation strategies to overcome specific gaps in EBD knowledge.

Reproducibility of skeletal and dental maturation parameters / Reprodutibilidade de parâmetros de maturação esqueléticos e dentários

ABSTRACT Objective: Amongst other factors, the effectiveness of orthodontic treatment in children and adolescents depends on the identification of most appropriate intervention timing, which has been traditionally based on the identification of maturational stages. There is a wide variety of radiographic methods to identify these phases, either through skeletal parameters, or dental calcification. Considering that the reliability of any given assessment tool is required to enable its safe clinical use, and aiming an appropriate implementation of these parameters in future researches, this study was performed to assess the reproducibility of radiographic growth evaluation methods. Methods: Lateral teleradiographs, hand-wrist, and panoramic radiographs of sixty-eight orthodontic patients randomly selected from files of the Orthodontics Graduation Course (Guarulhos University, Guarulhos, SP, Brazil) were evaluated by two examiners to access both intra- and inter-examiner reproducibility of the assessment methods conceived by Baccetti et al.; Fishman; Greulich and Pyle; Nolla and Demirjian et al. Results: All methods analyzed showed satisfactory intra- and inter-examiner reliability. Among those that evaluated skeletal maturity, a relatively better performance was observed for Baccetti's method. Fishman's and Greulich's parameters presented similar rates, as did Nolla's and Demirjian's. Conclusion: The assessment tools analyzed presented adequate reproducibility and might potentially be used as assessment tools to evaluate children and adolescent's craniofacial growth. Further researches could evaluate the accuracy of radiographic dental calcification parameters for the identification of craniofacial growth stages.

RESUMO Objetivo: Entre outros fatores, a efetividade do tratamento ortodôntico em crianças e adolescentes depende da identificação do momento de intervenção mais apropriado, que tem sido baseado nos estágios de maturação. Uma variedade de métodos radiográficos identifica essas fases através de parâmetros esqueléticos e da calcificação dentária. Considerando que a confiabilidade de qualquer ferramenta de avaliação é necessária para permitir seu uso clínico e aplicação segura de seus parâmetros em pesquisas futuras, este estudo acessou a reprodutibilidade de métodos radiográficos de avaliação do crescimento. Métodos: Telerradiografias laterais, radiografias carpais e panorâmicas de 68 pacientes ortodônticos randomicamente selecionados dos arquivos do Curso de Graduação em Ortodontia (Universidade de Guarulhos, Guarulhos, SP, Brasil) foram avaliadas por dois examinadores para acessar a reprodutibilidade intra e inter-examinador dos métodos de avaliação concebidos por Baccetti et al.; Fishman; Greulich e Pyle; Nolla e Demirjian et al. Resultados: Todos os métodos analisados mostraram confiabilidade intra e inter-examinador satisfatória. Dentre os que avaliam maturidade esquelética, um desempenho relativamente melhor foi observado para o método de Baccetti e colaboradores. Os parâmetros de Fishman e de Greulich e Pyle apresentaram valores similares, assim como os de Nolla e de Demirjian e colaboradores. Conclusão: As ferramentas de avaliação analisadas apresentaram reprodutibilidade adequada e podem ser utilizadas para avaliação do crescimento craniofacial de crianças e adolescentes. Pesquisas futuras poderiam avaliar a acurácia dos parâmetros radiográficos de calcificação dentária para a identificação dos estágios de crescimento craniofacial.

Streptococcus mutans adherence to conventional and self-ligating brackets: an in vitro study.

INTRODUCTION: Although self-ligating brackets presumably provide better hygiene conditions, no consensus has been reached so far. OBJECTIVE: Therefore, the objective of this study was to evaluate, in an in vitro experimental design, the adherence of Streptococcus mutans (SM) in self-ligating and conventional brackets of different manufacturers and ligature types. METHODS: Four commercial brands of maxillary premolar metal brackets were tested (Abzil®; Morelli®; 3M Unitek®; and GAC®). Each one was subdivided into three groups, which varied according to the type of ligature and bracket model (metallic, elastic, and self-ligating), totalizing twelve groups, composed of six brackets each. Previously sterilized brackets were initially immersed in saliva for one hour, and subsequently washed and added in a bacterial suspension, maintained in aerobiosis for 72 hours. The adhered bacteria were then separated and quantified by colony forming units (CFU/mL) counting after 48 hours of growth. The groups were compared by Kruskal-Wallis and Dunn post-hoc tests (p< 0.05). RESULTS: Regardless of the commercial brand, self-ligating brackets had significantly less CFU/mL. However, according to comparisons performed within each commercial brand, only Abzil® self-ligating brackets had significantly lower biofilm adhesion. Among all of the self-ligating models, GAC® brackets presented the highest bacterial adhesion rate. CONCLUSIONS: Self-ligating brackets are likely to present lower rates of biofilm adhesion. Particularly, Abzil® and GAC® self-ligating brackets are less likely to accumulate biofilm. Although such results are derived from an in vitro study, practitioners might acknowledge findings concerning bacterial adhesion as one of the relevant features to be considered during bracket selection.

Effectiveness of Invisalign® aligners in the treatment of severe gingival recession: A case report.

In this report, we demonstrate the effectiveness of the InvisalignⓇ system in the treatment of severe gingival recession and bone dehiscence through torque, translation, and intrusion movements in a young woman. Cone-beam computed tomography was used to assess bone parameters and check the teeth during treatment. The root of the mandibular right central incisor, which was buccally positioned and exhibited bone dehiscence of 9.4 mm, was moved toward the center of the alveolar process by using the InvisalignⓇ system and SmartForceⓇ features. The patient was monitored by a periodontist throughout the orthodontic treatment period. Her gingival recession reduced, while the bone dehiscence reduced from 9.40 mm to 3.14 mm. Thus, movement of the root into the alveolus promoted bone neoformation and treated the gingival recession. The findings from this case suggest that orthodontic treatment using the InvisalignⓇ system, along with periodontal monitoring, can aid in the treatment of gingival recession and alveolar defects.

Qualidade de relatos de revisões sistemáticas sobre traumatismo dentário: overview / Quality of systematic review reports on dental traumatism: an overview

Objetivo: Realizar uma overview relacionada ao assunto traumatismo em dentes decíduos e permanentes, bem como analisar a qualidade metodológica e o risco de viés dos trabalhos incluídos (PROSPERO CRD42018107840). Métodos: Este trabalho foi conduzido de acordo com o Preferred Reporting Items for Overviews(PRIO). A estratégia de busca foi aplicada nas bases de dados eletrônicas PubMed, WebScience, Embase, Cochrane e Scopus; que incluiu publicações até outubro de 2020, sem restrição de ano e idioma. Foram avaliados os critérios de elegibilidade: trabalhos com enfoque em lesões traumáticas dentárias; apresentar termo "revisão sistemática" (RS) e/ou "meta-análise" no título ou resumo, critérios de elegibilidade, técnicas sistematizadas para coleta e análise de dados, e instrumentos para avaliação da qualidade dos estudos incluídos; identificar as bases de dados utilizadas na pesquisa; abranger o assunto: traumatismo de dentes permanentes e/ou decíduos ou tecidos de suporte. Foi realizada a avaliação da qualidade das RSs utilizando o Assessment of Multiple Systematic Reviews (AMSTAR2) e averiguada a aderência do artigo ao Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Os resultados foram analisados pelo Grading of Recommendations, Assessment, Development and Evaluation (GRADE) a fim de classificar a certeza da evidência científica e avaliado o risco de viés pelo ROBIS. Resultados: Foram identificados 2.561 trabalhos, sendo 2.469 excluídos, totalizando 92 artigos incluídos. Nota-se que a partir do ano de 2018 os trabalhos apresentaram melhor qualidade metodológica. E a maioria dos trabalhos apresentaram certeza da evidência científica alta pelo sistema GRADE modificado, e risco de viés baixo pela ferramenta ROBIS. Conclusão: As revisões sistemáticas e meta-análises incluídas apresentaram dificuldade no processo de estruturação metodológica atribuindo, em média, certeza da evidência científica alta para o GRADE, como também risco de viés baixo pelo ROBIS. Descritores: Traumatismos dentários. Revisão. Dentição permanente. Dente decíduo.

Aim: To carry out an overview related to the subject of trauma to primary and permanent teeth, as well as to analyze the methodological quality and risk of bias in the studied works (PROSPERO CRD42018107840). Methods: this work was carried out according to the Preferred Reporting Items for Overviews (PRIO). The search strategy was applied to the electronic databases PubMed, WebScience, Embase, Cochrane, and Scopus, which included publications until October 2020, with no year or language restrictions. The eligibility criteria were evaluated: studies focusing on traumatic dental injuries; presented the term "systematic review" (RS) and/or "meta-analysis" in the title or abstract, eligibility criteria, systematic techniques for collecting and analyzing data, and instruments to assess the quality of the included studies; identify the databases used in the research; and cover the subject: trauma to permanent and/or deciduous teeth or supporting tissues. An evaluation of the quality of the SRs was performed using Assessment of Multiple Systematic Reviews (AMSTAR2), and adherence of the article to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria was verified. The results were analyzed by Grading of Recommendations, Assessment, Development and Evaluation (GRADE) in order to classify the certainty of scientific evidence, and the risk of bias was assessed by ROBIS. Results: A total of 2,561 papers were identified, of which 2.469 were excluded, totaling a sample of 92 articles. It is noted that from 2018 onwards, the works presented better methodological quality. Moreover, most of the studies showed a certainty of high scientific evidence, determined by using the modified GRADE system and a low risk of bias determined by using the ROBIS tool. Conclusion:The systematic reviews and meta-analyses included in this study presented difficulties in the methodological structuring process, attributing, on average, a certainty of high scientific evidence to GRADE, as well as a low risk of bias determined by ROBIS.

Comparison of the Condyle Sagittal Position of Class I and Class II Division 2 in Orthodontic Patients.

AIM: To compare the condyle sagittal position of class I and class II division 2 in orthodontic patients. MATERIALS AND METHODS: Fifty orthodontic cases (30 females and 20 males; 12-31 years) from the records of an Orthodontic Graduate Program were collected. Such cases presented cone-beam computed tomography (CBCT) as part of their initial diagnostic examinations. The study sample constituted two groups, i.e. class I and class II division 2 groups. A previously calibrated examiner performed the measurements of the images, representing the distance between the condyle and the articular surface of the glenoid fossa, both anteriorly (anterior disk space-ADS) and posteriorly (posterior disk space-PDS). Descriptive statistics were performed. Data were normally distributed, and parametric tests were used. Paired sample test was used to identify differences between the right and the left joints. Differences between class I and class II/2 groups were tested using independent t test. All statistical tests were interpreted at 5% significance level. RESULTS: When the study groups were compared in relation to the dimensions observed for the right and the left ADS and PDS, no significant differences were detected. This study also calculated the differences between right and left disk spaces within the groups, and the differences were not significant for both class I and class II/2 groups. CONCLUSION: The results demonstrated, after the performance of a CBCT comparative analysis, that there is no significant difference between class II/2 and class I orthodontic patients in relation to the condyle sagittal position. CLINICAL SIGNIFICANCE: The results collected here refute the expectation of spontaneous mandibular anterior repositioning after correcting the overbite in class II/2 patients.

Early Treatment of Failure of Eruption of a Permanent Molar.

Failure of eruption of a permanent first molar is a relatively infrequent clinical condition that affects the normal development of dentition and may cause malocclusion. There are two conditions that might result in failure of eruption: (1) mechanical failure (ankylosis) and (2) primary failure of eruption, with different clinical features and therapeutic approaches for each. It is often challenging for orthodontists and pediatric dentists to establish differential diagnoses of these conditions to ensure a successful treatment outcome. The purpose of this case report is to discuss the diagnosis and treatment of a failure of eruption of a permanent first molar. (J Dent Child 2019;86(3):150-3).

Comparative tomographic study of the maxillary central incisor collum angle between Class I, Class II, division 1 and 2 patients.

INTRODUCTION: It has been reported that Class II, division 2 maxillary central incisors frequently demonstrate increased collum angles, which indicates an excessive palatal "bend" of the crown. However, evidence supporting such observation is mostly derived from radiographic studies. OBJECTIVE: The objective of this study was to evaluate and compare the collum angle of maxillary central incisors in Class I, Class II, division 1, and Class II, division 2 cases using cone-beam computed tomography. MATERIALS AND METHODS: Forty-eight consecutive orthodontic cases (16 Class I, 16 Class II, division 1, and 16 Class II, division 2 malocclusion) with cone-beam computed tomography as part of their initial diagnostic records were evaluated. Cross-sections including maxillary right and left central incisors were used to calculate the angulation between the crown and root long axes (collum angle). Comparisons between groups were performed using analysis of variance for multiple and post-hoc Tukey for paired analyses. RESULTS: Mean collum angle observed in Class II, division 2 cases was significantly larger (5.2 ± 1.3°) than the ones obtained for Class I (1.1 ± 4.2°) (P = 0.034) or Class II, division 1 cases (0.1 ± 0.7°) (P = 0.014). CONCLUSIONS: Our findings suggest that Class II, division 2 individuals demonstrate accentuated lingual inclination of the maxillary central incisor crown compared to the other types of malocclusion studied here. Such morphological feature indicates the need for better tooth movement planning, especially in regard to root palatal torqueing of the maxillary central incisors.

Effectiveness of open bite correction when managing deleterious oral habits in growing children and adolescents: a systematic review and meta-analysis.

BACKGROUND/OBJECTIVES: Oral habits are common etiological factors for anterior open bites (AOBs) in growing children and adolescents. The objective of this review was to provide a literature synthesis evaluating the effectiveness of open bite correction in growing individuals with the use of habit-interception appliances. SEARCH METHODS: Electronic searches were conducted on PubMed, Embase, Cochrane Library, Web of Sciences, Scopus, Google Scholar, Scielo, and Lilacs databases. Trials registries were consulted for ongoing trials, and a partial grey literature search was also conducted. SELECTION CRITERIA: The selection criteria included controlled clinical trials enrolling growing subjects who underwent habit-interception orthodontic treatment to correct dental and/or skeletal AOB. DATA COLLECTION ANALYSIS: Data was grouped and analysed descriptively. A meta-analysis was only possible regarding crib therapy effectiveness. Qualitative appraisal was performed according to Cochrane Risk of Bias tool for randomized clinical trials (RCTs) and the MINORS tool for non-randomized clinical trials (nRCTs). RESULTS: Two RCTs and nine nRCTs were identified. Most of them presented relevant limitations. Crib therapy demonstrated to be effective (+3.1mm overbite correction). However, most of the dental effects are seemingly lost with time; and the skeletal effects are still controversial. Other habit-interception appliances, such as spurs, were not sufficiently investigated. CONCLUSIONS: Crib therapy appears to be effective on a short time basis. As for other habit-interception appliances, insufficient evidence could not provide reliable conclusions.

Effectiveness of the transpalatal arch in controlling orthodontic anchorage in maxillary premolar extraction cases: A systematic review and meta-analysis.

OBJECTIVE: To evaluate the effectiveness of the transpalatal arch (TPA) as an anchorage device in preventing maxillary molar mesialization during retraction of the anterior teeth after premolar extraction. MATERIALS AND METHODS: This systematic review intended to include patients indicated for upper premolar bilateral extraction and subsequent retraction of anterior teeth, considering the use of TPA as an anchorage tool in one of the treatment groups. The search was systematically performed, up to April 2015, in the following electronic databases: Medline, Embase, and all evidence-based medicine reviews via OVID, Cochrane Library, Scopus, PubMed, and Web of Science. Risk of bias assessment was performed using Cochrane's Risk of Bias Tool for randomized clinical trials (RCTs) and Methodological Index for Nonrandomized Studies (MINORS) for non-RCTs. RESULTS: Fourteen articles were finally included. Nine RCTs and five non-RCTs presented moderate to high risk of bias. Only one study investigated the use of TPA in comparison with no anchorage, failing to show significant differences regarding molar anchorage loss. A meta-analysis showed a significant increase in anchorage control when temporary anchorage devices were compared with TPA (mean difference [MD] 2.09 [95% confidence interval {CI} 1.80 to 2.38], seven trials), TPA + headgear (MD 1.71 [95% CI 0.81 to 2.6], four trials), and TPA + utility arch (MD 0.63 [95% CI 0.12 to 1.15], 3 trials). CONCLUSION: Based on mostly moderate risk of bias and with some certainty level, TPA alone should not be recommended to provide maximum anchorage during retraction of anterior teeth in extraction cases.

Avaliação da qualidade dos relatos de revisões sistemáticas publicadas em periódicos nacionais ortodônticos / Evaluation of the quality of report of systematic reviews published in Brazilian orthodontic periodicals

As revisões sistemáticas e meta-análises provêm o maior nível de evidência científica e, por este motivo, é necessário que estes estudos sejam reportados com extremo rigor metodológico. Objetivo: Avaliar a qualidade dos relatos de revisões sistemáticas publicadas em periódicos nacionais da área de Ortodontia. Material e métodos: Por meio do uso da palavra-chave “revisão”, e utilização de filtros apropriados, realizaram-se buscas manual e eletrônica por revisões sistemáticas publicadas entre 2000 e 2015 em periódicos ortodônticos brasileiros. Os resultados da busca foram examinados e selecionados, conforme critérios de elegibilidade pré--estabelecidos. A qualidade do relato das revisões selecionadas foi avaliada segundo instrumentos AMSTAR (Assessment of Multiple Systematic Reviews) e PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses). Resultados: A busca deu origem a 267 estudos, dos quais 39 foram incluídos para análise.Foi observado que as falhas mais comuns se relacionaram à ausência de buscas abrangentes, falha no relato da listagem de artigos excluídos e de variáveis de interesse, relato incompleto ou extração inadequada de dados e a não utilização de instrumentos de avaliação de qualidade. A qualidade no relato não esteve associada ao periódico, mas revisões publicadas em inglês parecem demonstrar maior qualidade. Apesar de a qualidade de relato ter melhorado desde 2000, não se nota tendência de evolução ao longo dos últimos anos.Conclusões: A qualidade dos relatos de revisões sistemáticas publicadas em periódicos ortodônticos nacionais pôde ser considerada de baixa a moderada. Por este motivo, estas ainda são passíveis de melhora significativa.

Systematic reviews and meta-analyses provide the best scientific evidence. Therefore, it is necessary that these studies be accurately reported. Objective: The aim of this study was to evaluate the quality ofthe report of systematic reviews published in Brazilian periodicals on Orthodontics. Material and methods: With the use of the key word “review”, and appropriate search filters, electronic and manual searches were performed in order to locate systematic reviews that were published between 2000 and 2015 in Brazilian periodicals in Orthodontics. Resultant records were examined and selected, according to pre-defined eligibility criteria. The quality of the reports was evaluated after the application of AMSTAR (Assessment of Multiple Systematic Reviews) and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta--analyses) assessment tools. Results: Initial search resulted in 267 studies, out of which 39 were includedfor the analysis. It was observed that the most frequent flaws were: non-comprehensive searches, failure tocite excluded studies and the outcomes of interest, incomplete report or inappropriate data extraction, andfailure to use quality assessment tools. The overall quality of the report was not associated to the journal ofpublication, but reviews published in English language seemed to present higher quality. Even though the quality of report improved since 2000, such trend appeared to weaken over the last years. Conclusions: The quality of the report of systematic reviews published in Brazilian periodicals on Orthodontics was consideredas sub-optimal. The refore, these studies are still likely to be significantly improved.

Effect of low-intensity pulsed ultrasound on the activity of osteoclasts: An in vitro study.

OBJECTIVE: The objective of this in vitro study was to evaluate the effect of low-intensity pulsed ultrasound on the resorption activity of osteoclast cell cultures. DESIGN: RAW 264.7 cells were cultured and seeded over plates that were pre-coated with a synthetic carbonate apatite, and marked with fluoresceinamine-labeled sodium chondroitin polysulfate. Plates were randomly divided into 4 groups according to the treatment assigned to each one of them: NO RANKL (no RANK-L addition and no ultrasound application), NO LIPUS (addition of RANK-L and no ultrasound application), LIPUS 10 (addition of RANK-L and 10min of ultrasound application per day), and LIPUS 20 (addition of RANK-L and 20min of ultrasound application per day). The ultrasound device produced 1.5MHz pulses with a repetition rate of 1kHz and intensity of 30mW/cm2. The experiment extended for one week and afterwards, resorption activity was evaluated according to the fluorescence intensity analysis and pit resorption measurements (number of pits and mean area). RESULTS: Our experiment consistently demonstrated that low-intensity pulsed ultrasound application enhanced osteoclasts resorptive activity. In addition, it was demonstrated that when daily ultrasound application lasted longer (20min) the resorption was the highest. Results obtained from both evaluation methods were reasonably coherent. CONCLUSIONS: Low-intensity pulsed ultrasound increases osteoclast resorptive activity in the absence of osteoblasts. This effect seems to be influenced by ultrasound treatment time. Future research might be directed to investigate osteoclast response to different ultrasound application protocols (frequencies and intensities) and potential cellular mechanisms.

Effectiveness of the open bite treatment in growing children and adolescents. A systematic review.

BACKGROUND: The extensive literature concerning the early treatment of anterior open bite (AOB) is still controversial and covers a wide variety of therapeutic approaches. OBJECTIVES: The objective of this study was to provide a comprehensive review evaluating the effectiveness of the orthodontic correction of AOB in growing individuals. SEARCH METHODS: Search was conducted on PubMed, Embase, Cochrane Library, Web of Science, Scopus, Google Scholar, Scielo, and Lilacs databases. Trials registries were consulted for ongoing trials, and grey literature was also contemplated. SELECTION CRITERIA: Selection process was performed to include controlled trials enrolling growing subjects who underwent orthodontic treatment to correct AOB and/or hyperdivergent facial pattern. DATA COLLECTION AND ANALYSIS: Data were grouped and analysed descriptively. Qualitative appraisal was performed according to the Cochrane risk of bias tool, for randomized clinical trials (RCTs), and MINORS tool for non-RCTs. RESULTS: The 22 studies included in this review mostly considered mixed dentition subjects, and there was a considerable variation regarding therapeutic approaches. Because of poor-quality and/or insufficient evidence, consistent results were not found. However, some useful clinical inferences and suggestions for future studies were provided for each therapeutic modality considered here. CONCLUSIONS: Additional efforts must still be directed to perform, whenever possible, RCTs; or to conduct prospective controlled trials with adequate sample sizes, consecutively assembled subjects, with the comparison of contemporary and equivalent groups.