Relationship of ankyloglossia and obstructive sleep apnea: systematic review and meta-analysis.

PURPOSE: Recent studies have highlighted the potential role of a short lingual frenulum as a risk factor for pediatric obstructive sleep apnea syndrome. A shortened frenulum may contribute to abnormal orofacial development, leading to increased upper airway resistance and susceptibility to upper airway collapsibility during sleep. Recognizing early indicators, such as a short lingual frenulum, is crucial for prompt intervention. This systematic review aims to evaluate the association between a short lingual frenulum and the risk of obstructive sleep apnea syndrome in children. METHODS: This systematic review adheres to PRISMA criteria for a quantitative analysis. A comprehensive search was conducted on five databases until January 2024 to identify relevant studies. The selected articles underwent rigorous analysis, considering study design, sample characteristics, lingual frenulum characterization, sleep assessment methods, and key findings. RESULTS: A total of 239 references were initially identified. Finally, six studies were included in the qualitative synthesis, with four studies eligible for the quantitative synthesis. The Newcastle-Ottawa scale was employed to assess study quality. Meta-analysis, supported by a moderate evidence profile according to the GRADE scale, revealed statistically significant differences, with odds ratios of 3.051 (confidence interval: 1.939 to 4.801) for a short frenulum and 12.304 (confidence interval: 6.141 to 24.653) for a high-arched palate. CONCLUSION: This systematic review and meta-analysis provide evidence supporting the association between ankyloglossia and obstructive sleep apnea in children. Nevertheless, it is crucial to consider additional factors such as tongue mobility and the presence of a high-arched palate in further evaluations.

Cyclic Fatigue Resistance of Rotary versus Reciprocating Endodontic Files: A Systematic Review and Meta-Analysis.

(1) Background: The failure of nickel-titanium (NiTi) rotary files is a complication related to endodontic instruments. The aim of this study was to compare the resistance to cyclic fatigue between rotary and reciprocating file systems. (2) Methods: Specific PICO: Population (P): artificial root canals; Interventions (I): instrumentation with NiTi rotary and reciprocating files; Comparison (C): rotary versus reciprocating files; Outcome (O): cyclic fatigue resistance. Studies were identified through bibliographic research using electronic databases (Medline, Embase, Scopus, SciELO, and WOS). The studies were combined using a random effects model by the inverse variance method. The effect size was the mean of the time to fracture (TTF) and number of cycles to fracture (NCF). Heterogeneity was assessed using the p value of the Q test for heterogeneity and the I2. (3) Results: TTF for rotary files was determined in 474.5 s and 839.1 for reciprocating without statistically significant differences. NCF for rotary systems was determined in 1444.2 and for reciprocating file systems in 4155.9 with statistically significant differences (p = 0.035), making reciprocating files more resistant. (4) Conclusions: Reciprocating files have better resistance to cyclic fatigue than rotary files. When tested in double curvature canals, reciprocating files also showed higher resistance.

Mandibular advancement devices decrease systolic pressure during the day and night in patients with obstructive sleep apnea: A systematic review and meta-analysis.

The aim of this systematic review and meta-analysis was to analyze whether or not mandibular advancement devices (MADs) produce changes in blood pressure in patients with obstructive sleep apnea (OSA) in relation to use time and if the device is used at night or day. MATERIALS AND METHOD: A systematic review of the literature and meta-analysis was carried out in accordance with PRISMA guidelines. In the bibliographic search, a total of four databases were consulted: PubMed-Medline, Scopus, Web of Science, and Cochrane. Of the 622 articles initially revealed, 160 duplicates were eliminated. After applying the selection criteria, 17 articles were included for the qualitative analysis and 4 for the meta-analysis. The studies were combined using a random effects model with the inverse method of variance, determining the mean differences in systolic and diastolic pressure before and after treatment using the MAD splint as the effect size. Day/night circadian effect and treatment time were analyzed using meta-regression with a mixed-effects model. RESULTS: MAD treatment was not found to affect diastolic pressure. By combining the four studies with the control group in a meta-analysis (I2 = 75%; z = - 0.15; p-value = 0.882), the mean difference in diastolic pressure between the MAD group and the control group was estimated at - 0.06 (- 0.86; 0.74). The meta-regression also showed no significant effect of day/night (p = 0.560) or treatment time (p = 0.854) on diastolic pressure. When combining the four studies with the control group (I2 = 84%%; z = - 1.47; p-value = 0.142), a non-significant mean difference in systolic pressure between the MAD group and the control group of - 0.99 (- 2.31; 0.33) was estimated in the meta-analysis. However, when assessing the effect of day/night or treatment time on systolic blood pressure using a meta-regression, the latter showed significant covariates that reduce systolic blood pressure values in the model at night (p < 0.001) and in relation to treatment time (p < 0.001). CONCLUSIONS: Only systolic pressure appears to be affected by the use of the MAD in patients with OSA, and this decrease in systolic pressure is greater at night and when treatment time is longer.

Periodontal health status, oral microbiome, white-spot lesions and oral health related to quality of life-clear aligners versus fixed appliances: A systematic review, meta-analysis and meta-regression.

Objective: : Assess and evaluate the different indicators of oral health-related quality of life (OHRQoL) among patients treated with clear aligners (CAs) versus those treated with conventional fixed orthodontics (FAs). Methods: : An electronic search was performed on the database is Web of Science, Scopus, and Embase databases. Randomized and non-randomized control trials, cross-sectional, prospective cohort and retrospective trials were included. Quality was assessed with risk of bias tool and risk of bias in non-randomised studies. Meta-analyses were performed with random effects models, estimating the standardized and non-standardized mean differences, odds ratio and risk ratio as the measure of effect. The effect on time was determined using a meta-regression model. Results: : Thirty one articles were included in the qualitative synthesis and 17 in the meta-analysis. CAs had a significantly lower negative impact on QoL, with an "important" effect size, while the influence of time was not significant. Periodontal indicators plaque index (PI), gingival index (GI), probing depth (PD), and bleeding on probing show significantly better values in patients treated with CAs, with moderate to large effect sizes. PI and GI have a significant tendency to improve over time. In microbiological indicators, CAs present a lower biofilm mass without differences in the percentage of patients with high counts of Streptococcus mutans and Lactobacilli bacteria. The risk of white spot lesion onset is ten times lower in carriers of CAs. Conclusions: : Patients wearing CAs show better periodontal indicators, less risk of white spot development, less biofilm mass and a better QoL than patients with FAs.

Relationship between Prostate Inflammation and Periodontal Disease-A Systematic Review and Meta-Analysis.

The aim of this systematic review and meta-analysis was to analyze the association between periodontal disease and prostate inflammation with a null hypothesis stating that periodontal disease does not increase the incidence of prostate inflammation. MATERIALS AND METHODS: A systematic literature review and meta-analysis of longitudinal observational cohort and case-control studies that evaluated the odds ratio or hazard ratio and confidence interval was undertaken based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations (2020). A total of four databases were consulted in the literature search: PubMed-Medline, Scopus, Embase, and Web of Science. After eliminating duplicated articles and applying the inclusion criteria, seven articles were selected for the qualitative and quantitative analyses. RESULTS: Four observational cohort studies and three observational cohort case-control studies were included in the meta-analysis. The four observational cohort studies were combined using the random effects model to estimate a hazard ratio of 1.32 with a confidence interval of 95% between 0.87 and 1.77. The meta-analysis presented high heterogeneity (Q test = 56.1; p value < 0.001; I2 = 94.9%). Moreover, the three observational case-control studies were combined using the random effects model to estimate an odds ratio of 1.62 with a confidence interval of 95% between 1.41 and 1.84. The meta-analysis presented high heterogeneity (Q test = 1.07; p value = 0.782; I2 = 0%). CONCLUSIONS: The incidence of periodontal disease does not increase the risk of the incidence of prostate inflammation.

Salivary metabolomic profile associated with cariogenic risk in children.

OBJECTIVES: To identify the metabolomic differences in the saliva of healthy children versus children with active carious lesions and to estimate the predictive capacity of a model based on the salivary metabolomic profile. METHODS: A study of cases (n = 31) and controls (n = 37) was designed for children aged between 6 and 12 (mean age of the cases: 8.9; controls: 8.7). The said children attended public health centers in Valencia, Spain. Intraoral examinations were performed by a single examiner using ICDAS II diagnostic criteria. Unstimulated total saliva samples were analyzed by nuclear magnetic resonance (NMR) spectroscopy. RESULTS: The dft index for cases was 2.84 while it was 0.19 for the control group, the DMFT index was 1.13 and 0.11, respectively. The predictive model generated by the multivariate PLS-DA analysis projects a separation between the cases and the controls on the score chart with a predictive capacity and generating an area under the curve of 0.71. The metabolites: 3-methyl-2-oxovalerate, 3-hydroxybutyrate, lactate, acetone, citrate, ornithine, ethanolamine, taurine, proline, glycine, mannose, glucose, 1-6-Anhydro-ß-d-glucose and citraconate, are those that show greater significance in the model. In the controls, glycine (Cohen's d = 0.430) and glucose (Cohen's d = 0.560) present higher means compared to the cases. On the contrary, taurine (Cohen's d= -0.474) and mannose (Cohen's d= -0.456) show higher means in cases compared to controls. CONCLUSIONS: Our findings show a difference in the salivary metabolomic profiles, specifically in the groups of saccharides and amino acids, suggesting an association of these with the level of caries risk. CLINICAL SIGNIFICANCE: The results reported in the present study reinforce the use of salivary metabolomics as a research method for the search for salivary biomarkers that allow the evaluation of caries risk in patients. Furthermore, it brings us closer to a personalized medicine that will help in dental caries prevention strategies.

Systematic review and network meta-analysis of the accuracy of the orthodontic mini-implants placed in the inter-radicular space by image-guided-based techniques.

OBJECTIVE: The aim of the present systematic review and network meta-analysis (NMA) is to analyze the accuracy of image-guided-based orthodontic mini-implants placement techniques in the inter-radicular space. METHODS: The study was conducted under the PRISMA recommendations. Three databases were searched up to July 2022. In vitro randomized experimental trials (RETs) including static computer-aided implant surgery (s-CAIS), mixed reality (MR), soft tissue static computer-aided implant surgery (ST s-CAIS) and conventional free-hand technique (FHT) for the orthodontic mini-implants placement in the inter-radicular space were selected. The risk of bias was assessed using the Current Research Information System scale. A random effects model was used in the NMA. Direct comparisons were combined with a random effects model in a frequentist NMA to estimate indirect comparisons, and the estimated effect size of the comparisons between techniques were analyzed by difference of means. Inconsistency was assessed with the Q test, with a significance level of p < 0.05, and a net heat plot. RESULTS: A total of 92 articles was identified, and 8 RETs (8 direct comparisons of 4 techniques) were included in the NMA, which examined 4 orthodontic mini-implants placement techniques: s-CAIS, MR, ST s-CAIS, and FHT. Taking FHT as reference, s-CAIS and ST s-CAIS showed statistically significant coronal and apical deviation. In addition, s-CAIS showed statistically significant angular deviation. However, MR did not show statistically significant differences with respect to FHT, which presented the highest p-score. At the coronal deviation, ST s-CAIS presented the highest P-score (0.862), followed by s-CAIS (0.721). At the apical deviation, s-CAIS presented the highest P-score (0.844), followed by ST s-CAIS (0.791). Finally, at the angular deviation s-CAIS presented again the highest P-score (0.851). CONCLUSIONS: Within the limitations of this study, it was found that the image-guided-based orthodontic mini-implants placement techniques showed more accuracy than the free-hand conventional placement technique; specially the computer-aided static navigation techniques for the orthodontic mini-implants placed in the inter-radicular space.

Is Revascularization the Treatment of Choice for Traumatized Necrotic Immature Teeth? A Systematic Review and Meta-Analysis.

Regenerative endodontic treatment (RET) has been considered a reliable procedure to treat immature necrotic teeth; however, the effect of dental trauma on the prognosis of RET is questionable. This systematic review aimed to evaluate the current level of evidence for revascularization techniques (the RET) in the management of traumatized necrotic immature permanent teeth with or without periapical radiolucent areas. Four electronic databases-PubMed, Web of Science, Scopus, and Embase-were searched until November 2022. Only randomized clinical trials, cohort studies, and case-control studies with a minimum of 10 cases and 12 months of follow-ups were included. The search identified 363 preliminary results. After discarding the duplicates and screening the titles, abstracts, and full texts, 13 articles were considered eligible. The results showed that RET techniques seemed to have high survival and success rates, 93.8% and 88.3%, respectively, in the treatment of traumatized necrotic immature permanent teeth. Root maturation with RET techniques seemed to be lower in traumatized teeth. Future studies are needed to evaluate root maturation in traumatized teeth using 3-dimensional radiographic evaluations. In addition, the lack of literature on the studies comparing RET and apexification (calcium hydroxide or an MTA) in the treatment of traumatized necrotic immature teeth highlights the necessity for high-level clinical studies comparing these treatment modalities.

Non-Surgical Management of the Gingival Smile with Botulinum Toxin A-A Systematic Review and Meta-Analysis.

Currently, concern about facial attractiveness is increasing, and this fact has led to orthodontics in adult patients being an increasingly demanded treatment, and with it, multi-disciplinary work. When it is caused by a vertical excess of the maxilla, the ideal solution is orthognathic surgery. However, in borderline cases and when the cause is hyperactivity of the upper lip levator muscle complex, alternative conservative solutions can be considered, such as the application of botulinum toxin A (BTX-A). Botulinum toxin is a protein produced by a bacterium and causes a reduction in the force of muscle contraction. The multi-factorial nature of the smile requires an individualized diagnosis in each patient, since there are multiple ways to treat the gummy smile (orthognathic surgery, gingivoplasty, orthodontic intrusion). In recent years, interest has grown in the simplest techniques that allow the patient to quickly return to their usual routine, such as lip replacement. However, this procedure shows recurrences in the first 6-8 post-operative weeks. The main objective of this systematic review and meta-analysis is to analyze the effectiveness of BTX-A in the treatment of gummy smile in the short term, to study its stability, and to evaluate potential complications. A thorough search of the PubMed, Scopus, Embase, Web of Science, and Cochrane databases and a grey literature search were conducted. The inclusion criteria were studies with a sample size greater than or equal to 10 patients with gingival exposure greater than 2 mm in smile, treated with BTX-A infiltration. Those patients whose exclusive etiology of their gummy smile was related to altered passive eruption, gingival thickening, or overeruption of upper incisors were excluded. In the qualitative analysis, the mean pre-treatment gingival exposure ranged between 3.5 and 7.2 mm, reaching a reduction of up to 6 mm after infiltration with botulinum toxin at 12 weeks. Although multiple muscles are involved in the facial expression, the muscles par excellence selected for blockade with BTX-A were levator labii superioris, levator labii superioris ala nasalis, and zygomaticus minor, infiltrating from 1.25 to 7.5 units per side. In the quantitative analysis, the difference in mean reduction between both groups was -2.51 mm at two weeks and -2.24 mm at three months. The benefit of BTX-A in terms of improvement of gummy smile is demonstrated, as a significant reduction in gummy smile is estimated by BTX-A therapy two weeks after its application. Its results gradually decrease over time, however, they stay satisfactory without returning to their initial values after 12 weeks.

Enamel Wear of Antagonist Tooth Caused by Dental Ceramics: Systematic Review and Meta-Analysis.

BACKGROUND: This systematic review and meta-analysis aimed to evaluate the wear of the antagonist tooth in ceramic restorations. MATERIAL AND METHODS: This study was carried out based on Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) recommendations; it was also registered in PROSPERO (register number: CRD42022316252). Three databases were consulted in the literature search, Embase, Scopus, and Web of Science. The citation searching was conducted by two researchers independently. The clinical studies that evaluated wear in antagonist teeth concerning ceramic restoration were included. Twelve articles were selected after eliminating duplicates ones and applying the inclusion criteria, and two were chosen through citation. Fourteen articles were considered for the qualitative and quantitative analysis (meta-regression and meta-analysis). RESULTS: The mean linear wear of the antagonist tooth in relation to feldspathic was 8.914 µm, for lithium disilicate it was 0.018 µm, and for zirconia it was 0.257 µm. The mean volumetric wear of the antagonist tooth in relation to feldspathic was 0.273 mm3, for hybrid ceramic it was 0.030 mm3, for lithium disilicate it was 0.018 mm3, and for zirconia it was 0.014 mm3. The mean natural tooth wear was 0.7974 µm per month. Tooth wear caused by zirconia at six months was 31.755 µm, at 12 months it was 24.648 µm, and at 24 months it was 20.662 µm. CONCLUSIONS: Feldspathic produces greater wear of the antagonist tooth from ceramic restorations linearly and volumetrically. In addition, zirconia generates the least wear that will decrease over time, and it will be equal to or less than the natural wear in the tooth.

Relationship between Periodontal Condition of the Pregnant Woman with Preterm Birth and Low Birth Weight.

The aim of this study was to determine the association between the mother's periodontal condition and perinatal complications, such as preterm birth (PTB) and/or low birth weight (LBW), in a cohort of women in Valencia, Spain. Other related factors, such as tobacco, were also analysed. A prospective cohort study was carried out in a sample of 102 women with a single foetus and ages ranging between 18 and 42 years. Sociodemographic and obstetric variables, caries status, percentage of bleeding, clinical attachment loss (CAL), and probing pocket depth (PPD) data have been collected and analysed. The mean age was 32.4 years, and the BMI was normal. The average weight of new-borns (NB) was 3034 g. A total of 9.8% of the women smoked during their pregnancy. Bleeding percentage was 16.43% (SD 14.81%) and PPDs > 3 mm 8.8 (SD 11.08). The mean of CAL > 0 mm was 1.14 (SD 2.83). The frequency of PTB and LBW was 26%. No statistically significant differences were found between probing depth > 3 mm or CAL > 1 mm, with PTB and/or LBW. Periodontal disease in the mother was not statistically significantly related to either PTB or LBW. Tobacco use during pregnancy showed a statistical significance linked to LBW, but not with PTB.

Diagnostic Validity in Occlusal Caries Detection of ICDAS II, DIAGNOdent, Radiography and a Combination of the Three Methods: An In Vitro Study.

In this study, we compare the efficacy and diagnostic concordance of the ICDAS, the radiographic criterion and the instrument known as the DIAGNOdent fluorescence laser pen on occlusal caries lesions using a histological section as the gold standard. Of 100 teeth that did not present cavitated occlusal lesions or occlusal fillings, 80 were chosen through a randomization program and examined by two previously trained and calibrated researchers. Subsequently, the teeth were sectioned with a diamond disk and observed under an optical microscope. The results were studied for caries with a limit established in enamel and caries with extension to dentin. The intra-examiner (0.821-0.933) and inter-examiner (0.817-0.924) reproducibility obtained for both ICDAS and DIAGNOdent for the diagnosis of borderline enamel caries was high. Similarly, intra-examiner (0.686-1.000) and inter-examiner (0.809-0.944) reproducibility for diagnosis of caries with dentin extension was also high for both methods. The sensitivity obtained was 0.76 (ICDAS), 0.87 (DIAGNOdent) and 0.58 (Rx), whereas the specificity obtained was 0.66 (ICDAS), 0.4 (DIAGNOdent) and 0.77 (Rx) for lesions limited to enamel. For lesions with extension to dentin, the sensitivity obtained was 0.73 (ICDAS), 0.82 (DIAGNOdent) and 0.09 (Rx), and the specificity obtained was 0.79 (ICDAS), 0.52 (DIAGNOdent) and 0.97 (Rx). Sensitivity increases in both cases by combining diagnostic methods. In conclusion, ICDAS and DIAGNOdent are better diagnostic methods than Rx for the detection of occlusal caries, and the combination of these methods helps to obtain a better diagnosis.

Comparative Study by Systematic Review and Meta-Analysis of the Peri-Implant Effect of Two Types of Platforms: Platform-Switching versus Conventional Platforms.

OBJECTIVE: The aim of the systematic review and meta-analysis carried out was to evaluate the effects of changing the prosthetic platform on peri-implant tissue after 1 year of prosthetic loading. MATERIAL AND METHODS: In November 2020, an electronic search was carried out in PubMed, EMBASE, Web of Science, and Scopus databases with the aim of obtaining all the randomized clinical trials that had been published in the preceding 10 years comparing the effects on the peri-implant tissue of implants with a prosthetic platform change and implants with a conventional platform for at least 1 year after prosthetic loading. Randomized model meta-analyses of the selected studies were performed to compare the results of the two implant groups in terms of vertical maintenance of bone level and increased probing depth. RESULTS: Nine studies were included, summing up a total of 475 implants with prosthetic platform exchange and 462 implants with a conventional platform. Implants with prosthetic platform exchange had less peri-implant bone loss than implants with a conventional platform (mean difference of 0.255 mm, statistically significant) but suffered a greater increase in probing depth (mean difference of 0.082 mm, not statistically significant). However, the probing depth from One Study Remove revealed a statistically significant increase of 0.190 mm in the prosthetic platform exchange group compared to the conventional platform group. CONCLUSION: Implants with platform switching suffer less peri-implant bone loss after 1 year of loading than implants with a conventional platform. Further long-term studies are required to observe how these differences vary over time.

Unplanned molar intrusion after Invisalign treatment.

INTRODUCTION: The objectives of this study were to analyze and quantify molar intrusion after the use of clear aligners and to analyze the relationship with other variables such as age, duration of treatment, and a series of cephalometric osseous and dental measurements at the start of treatment. METHODS: A retrospective descriptive-analytical study was designed with a sample of 58 patients aged 18-60 years who had undergone treatment with Invisalign. The cephalometric measurements were carried out after lateral x-rays were taken of the cranium; these were compared at the start (T0) and conclusion of treatment. Parametric and nonparametric tests were used to compare means, whereas Pearson correlations and multivariate lineal regression analyses were used to establish the variables associated with molar intrusion. RESULTS: Approximately 74.2% of the patients presented some degree of molar intrusion after treatment. Furthermore, 32.8% of patients presented intrusion only at the mandibular molar, whereas 25.9% experienced intrusion at both molars, maxillary and mandibular, simultaneously. However, 15.5% presented intrusion only at the maxillary molar. The average magnitude of intrusion here was 0.98 ± 0.54 mm, whereas the mandibular molar was 0.84 ± 0.29 mm. Statistically significant reductions exist for the distance L6_MP and U6_SN between T0 and at conclusion of treatment. Maxillary molar intrusion correlates negatively with mandibular molar intrusion (r = -0.270). The number of days of treatment did not correlate with either maxillary or mandibular molar intrusion. CONCLUSIONS: Clear aligners give rise to molar intrusion in 74.2% of patients. The cephalometric variables L6_MP T0, mandibular plane angle T0, and facial axis T0 were negatively and significantly associated with maxillary molar intrusion, whereas age and facial axis T0 were negatively associated with mandibular molar intrusion allowing smaller magnitudes of intrusion to be predicted when these variables present high values at T0.

Influence of Guided Tissue Regeneration Techniques on the Success Rate of Healing of Surgical Endodontic Treatment: A Systematic Review and Network Meta-Analysis.

Several regeneration techniques and materials have been proposed for the healing of bone defects after surgical endodontic treatment; however, the existing literature does not provide evidence on the most recommended techniques or materials. The aim of the present systematic review and network meta-analysis (NMA) is to summarize the clinical evidence on the efficacy of guided tissue regeneration techniques (GRTs). The PRISMA recommendations were followed. Four databases were searched up to December 2021. Randomized clinical trials (RCTs) with a minimum follow-up of 6 months were included. The risk of bias was assessed using the Cochrane Collaboration tool. A fixed effects model and frequentist approach were used in the NMA. Direct GRT technique comparisons were combined to estimate indirect comparisons, and the estimated effect size of the comparisons was analyzed using the odds ratio (OR). Inconsistency was assessed with the Q test, with a significance level of p < 0.01, and a net heat plot. A total of 274 articles was identified, and 11 RCTs (6 direct comparisons of 15 techniques) were included in the NMA, which examined 6 GRT techniques: control, Os, PL, MB, MB + Os, and MB + PL. The MB + Os group compared to the control (OR = 3.67, 95% CI: 1.36-9.90) and to the MB group (OR = 3.47, 95% CI: 1.07-11.3) showed statistically significant ORs (p ˂ 0.05). The MB + Os group presented the highest degree of certainly (P-score = 0.93).

Influence of the chemical composition of monolithic zirconia on its optical and mechanical properties. Systematic review and meta-regression.

PURPOSE: This systematic review set out to investigate the influence of chemical composition and specimen thickness of monolithic zirconia on its optical and mechanical properties. Meta-analysis and meta-regression analyzed the effects of variations in percentages of yttrium, aluminum, and specimen thickness of monolithic zirconia. STUDY SELECTION: The review followed recommendations put forward in the PRISMA checklist. An electronic search for relevant articles published up to October 2019 was conducted in the Pubmed, Cochrane, Scopus, Scielo, and Web of Science databases, with no language limits and articles published in the last 10 years. From 167 relevant articles; applying inclusion criteria based on the review's PICO question, 26 articles were selected for qualitative synthesis (systematic review) and 24 for quantitative synthesis (meta-analysis). Experimental in vitro studies published were selected and their quality was assessed using the modified Consort scale for in vitro studies of dental materials. RESULTS: The variables yttrium, aluminum and thickness were analyzed in random effects models, observing high heterogeneity (>75%), and finding statistically significant influences on the properties of monolithic zirconia (p<0.05). CONCLUSION: Within the review's limitations, it may be concluded that variations in the percentage of yttrium and aluminum influence the optical and mechanical properties of monolithic zirconia, making it more or less esthetic and resistant in relation to each variable. The clinical implications of these findings can help select the most appropriate type of zirconia to meet the different clinical needs when restoring different regions (posterior or anterior).

Effectiveness of removable appliances with temperature sensors in orthodontic patients: a systematic review and meta-analysis.

BACKGROUND/OBJECTIVE: Patient compliance during orthodontic treatment is one of the factors that most affects success in the final result. The use of removable appliances is frequent at an early age and the monitoring of its use is essential to assess the collaboration of the patient. The aim of this study was to establish the effectiveness of microsensors included in removable appliances during orthodontic treatment or in the retention phase to enable a reliable and individualized follow-up of the patient. SEARCH METHODS: The article search was carried out in various electronic databases and journals without any language restrictions. SELECTION CRITERIA: Studies using microsensors into removable appliances were selected with the key selection criterion of a minimum follow-up of 4 weeks. DATA COLLECTION AND ANALYSIS: The quality of the studies included was evaluated using the Cochrane scale for the randomized controlled trials and the Newcastle Ottawa Scale for control-case, cohort, and transversal studies. The mean of the differences with a 95% confidence interval was expressed for the continuous data. RESULTS: Twenty-nine full-text articles were analysed and included in the qualitative synthesis. In general, the mean daily wear time of removable appliances measured objectively was less than the time that the professional had predetermined. CONCLUSIONS: The use of microsensors as an objective measurement method enhances communication and boosts confidence in the orthodontist-patient relationship. More random clinical studies with temperature sensors are needed to establish to what extent they influence the orthodontic outcome. REGISTRATION: PROSPERO (CRD42019120525).

Need for Orthodontic Treatment in Pupils Aged between 12 and 15 in the Valencian Region (Spain).

The World Health Organization recommends carrying out periodic epidemiological studies in order to provide a basis for the evaluation of the state of health of the population at any given time; in doing so, action strategies can be established for the treatment of different pathologies. The objective of this study is to evaluate the need for orthodontic treatment in adolescents at school aged between 12 and 15 in the Spanish autonomous region known as Comunidad Valenciana (hereafter: Valencian Region). A cross-sectional study was carried out on a sample of 539 12-year-old schoolchildren and 460 15-year-olds, respectively, selected by cluster sampling and representative of the school-aged population of the Valencian Region, using the IOTN-DHC, IOTN-AC, and DAI indices. The need for specific orthodontic treatment according to the IOTN-DHC was 12.6% at 12 years and 7% at 15. For the IOTN-AC and DAI indices, the treatment needs were 4.3% and 0.9% at 12 years and 30.1% and 20.9% at the age of 15. These results were similar to those obtained in the previous study carried out on the same target population. There was no significant association between the need for treatment and gender or social class. We conclude that the need for orthodontic treatment presents values similar to those obtained in 2010.

Failure Rate, Marginal Bone Loss, and Pink Esthetic with Socket-Shield Technique for Immediate Dental Implant Placement in the Esthetic Zone. A Systematic Review and Meta-Analysis.

Aim: To compare the failure rate, marginal bone loss, and pink esthetic for the socket-shield technique and the conventional technique for immediate dental implant placement in the esthetic zone. Material and methods: A systematic literature review and meta-analysis, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, of clinical studies that evaluated the failure rate, marginal bone loss, and pink esthetic with the socket-shield technique for immediate dental implant placement in the esthetic zone was performed. A total of 4 databases were consulted in the literature search: PubMed-MEDLINE, Scopus, Embase, and Web of Science. After eliminating duplicated articles and applying the inclusion criteria, 16 articles were selected for the qualitative and quantitative analysis. Results: Four randomized controlled trials, five prospective clinical studies, four retrospective studies, and three case series were included in the meta-analysis. The dental implant failure rate for the socket-shield technique for immediate dental implant placement was 1.37% (95% CI, 0.21-2.54%); however, no statistically significant differences between the conventional and socket-shield technique were found. The estimated mean difference in the marginal bone loss for the socket-shield technique was -0.5 mm (95% CI, -0.82 to -0.18) and statistically significant (p < 0.01), with a high heterogeneity (I2 = 99%). The mean pink esthetic score was 12.27 (Q test = 4.47; p-value = 0.61; I2 = 0%). The difference in pink esthetic between the conventional (n = 55) and socket-shield techniques (n = 55) for immediate dental implant placement was 1.15 (95% CI, 0.73-1.58; Q test = 8.88; p value = 0.11; I2 = 44%). The follow-up time was found to be significant (beta coefficient = 0.023; R2 = 85.6%; QM = 3.82; p = 0.049) for the PES for the socket-shield technique. Conclusions: Within the limitations of this systematic review with meta-analysis, the dental implant failure rate did not differ between the socket-shield technique and conventional technique for immediate implant placement in the esthetic zone. However, a lower marginal bone loss and higher pink esthetic scores were found for the socket-shield technique compared to the conventional technique.

Survival Rate and Prosthetic and Sinus Complications of Zygomatic Dental Implants for the Rehabilitation of the Atrophic Edentulous Maxilla: A Systematic Review and Meta-Analysis.

The aim of this systematic review and meta-analysis was to analyze and compare the survival rate and prosthetic and sinus complications of zygomatic dental implants for the rehabilitation of the atrophic edentulous maxilla. MATERIALS AND METHODS: We conducted a systematic literature review and meta-analysis, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, of clinical studies that evaluated the survival rate and prosthetic and sinus complications of zygomatic dental implants for the rehabilitation of the atrophic edentulous maxilla. Four databases were consulted during the literature search: Pubmed-Medline, Scopus, Embase, and Web of Science. After eliminating duplicate articles and applying the inclusion criteria, 46 articles were selected for the qualitative analysis and 32 for the quantitative analysis. RESULTS: Four randomized controlled trials, 19 prospective clinical studies, 20 retrospective studies, and 3 case series were included in the meta-analysis. Conventional dental implants failure (n = 3549) were seen in 2.89% (IC-95% 1.83-3.96%), while zygomatic dental implants failure (n = 1895) were seen in 0.69% (IC-95% 0.21-1.16%). The measure of the effect size used was the Odds Ratio, which was estimated at 2.05 with a confidence interval of 95% between 1.22 and 3.44 (z test = 2.73; p-value = 0.006). The failure risk of conventional dental implants is 2.1 times higher than that of zygomatic dental implants. Slight heterogeneity was determined in the meta-analysis between 23 combined studies (Q test = 32.4; p-value = 0.070; I2 = 32.1%). Prosthetic complications were recorded in 4.9% (IC-95% 2.7-7.3%) and mild heterogeneity was observed in a meta-analysis of 28 combined studies (Q test = 88.2; p-value = 0.001; I2 = 69.4%). Sinus complications were seen in 4.7% (IC-95% 2.8-6.5%) and mild heterogeneity was observed in a meta-analysis of 32 combined studies (Q test = 75.3; p-value = 0.001; I2 = 58.8%). CONCLUSIONS: The high survival rate and low prosthetic and sinus complications related to zygomatic dental implants suggest the use of zygomatic dental implants for the rehabilitation of the atrophic edentulous maxilla.