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1.
PLoS One ; 16(3): e0249119, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33765042

RESUMO

Dental wear analysis through the use of an intraoral scanner is a reality of modern dentistry. This study aimed to investigate the reliability of qualitative tooth wear evaluation through three-dimensional images captured with an intraoral scanner and compared to clinical and photographic examinations. Eighteen adult volunteers of both genders (18 to 55 years old) were submitted to clinical exams, intraoral photographs and intraoral scanning protocol using an optical scanner (TRIOS® Pod, 3Shape, Copenhagen, Denmark). Occlusal tooth wear, from second to second premolars, was measured by two evaluators and reevaluated after 30 days, according to a slight modification of the method described by Mockers et al. Weighted Kappa was used to measure intra and inter-examiner agreement. The Friedman test was used to verify the differences among methods. Random and systematic errors were assessed using Bland-Altman plots. All statistical analysis was performed with p<0.05. There was a substantive agreement for clinical (K = 0.75) and photographic exams (K = 0.79) and a moderate agreement for intraoral scanner analysis (K = 0.60) for inter-examiner evaluation. A substantial intra-examiner agreement was obtained for both evaluators. No significant difference between the methods was observed (p = 0.7343 for examiner 1 and 0.8007 for examiner 2). The Bland-Altman plot confirmed no systematic errors between the methods and a random error of 0.25 with the scanner method when compared to clinical assessment. All three methods showed reliability in qualitative occlusal tooth wear evaluation. Intraoral scanning seems to be a sound and reliable tool to evaluate tooth wear when compared to traditional methods, considering the lower inter-examiner agreement and the inherent limitations of this pilot study. Further research will be necessary in order to achieve more robust evidence.

2.
Dental Press J Orthod ; 26(1): e21spe1, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33729294

RESUMO

INTRODUCTION: The efficiency of clinical procedures is based on practical and theoretical knowledge. Countless daily information is available to the orthodontist, but it is up to this professional to know how to select what really has an impact on clinical practice. Evidence-based orthodontics ends up requiring the clinician to know the basics of biostatistics to understand the results of scientific publications. Such concepts are also important for researchers, for correct data planning and analysis. OBJECTIVE: This article aims to present, in a clear way, some essential concepts of biostatistics that assist the clinical orthodontist in understanding scientific research, for an evidence-based clinical practice. In addition, an updated version of the tutorial to assist in choosing the appropriate statistical test will be presented. This PowerPoint® tool can be used to assist the user in finding answers to common questions about biostatistics, such as the most appropriate statistical test for comparing groups, choosing graphs, performing correlations and regressions, analyzing casual, random or systematic errors. CONCLUSION: Researchers and clinicians must acquire or recall essential concepts to understand and apply an appropriate statistical analysis. It is important that journal readers and reviewers can identify when statistical analyzes are being inappropriately used.


Assuntos
Bioestatística , Projetos de Pesquisa , Humanos , Pesquisadores
3.
Prog Orthod ; 22(1): 8, 2021 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-33718992

RESUMO

BACKGROUND: This review synthesizes the available evidence about the predisposition of individuals with asthma or allergies to orthodontically induced inflammatory root resorption (OIIRR) and possible factors related to root resorption that were investigated in the included studies, such as the type of malocclusion, duration of orthodontic treatment, and tooth units. MATERIAL AND METHODS: Six electronic databases and partial gray literature were searched without date or language restrictions until September 2020. Prospective and retrospective observational cohort and case-control studies were included. The risk of bias (RoB) was assessed using the checklists from the Joanna Briggs Institute and the certainty of the evidence using the GRADE tool. To complement the case-control studies, the odds ratio (OR) of the individuals with allergies/asthma to develop root resorption was calculated. RESULTS: Six studies were included. One study with low RoB, one with moderate, and one with high RoB stated that allergic patients did not report a greater chance of developing OIIRR (OR = 1.17 to 2.10, p = 0.1 to 1), while only one study with low RoB reported that individuals with allergies tend to develop root resorption (OR = 2.4, 95% CI = 1.08-5.37). Three studies with low RoB and one with moderate showed no significant association between asthma and OIIRR (OR = 1.05 to 3.42, p = 0.12 to 0.94). No association was identified between the type of malocclusion and the degree of OIIRR. Uniradicular dental units and a prolonged treatment time seem to be associated with an increased risk of resorption. The certainty of the evidence was considered low for both exposure factors. CONCLUSION: Evidence with a low level of certainty indicates that individuals with allergies or asthma are not more predisposed to OIIRR. Uniradicular teeth and long-term orthodontic treatments are associated with a higher risk of OIIRR. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020188463.


Assuntos
Asma , Má Oclusão , Reabsorção da Raiz , Asma/complicações , Humanos , Estudos Prospectivos , Estudos Retrospectivos , Reabsorção da Raiz/etiologia , Técnicas de Movimentação Dentária
4.
Artigo em Inglês | LILACS-Express | LILACS, BBO - Odontologia | ID: biblio-1180858

RESUMO

ABSTRACT Objective: To evaluate the effects of unilateral loss of the lower first permanent molar (L6) on the position and development of the lower third molar (L8). Material and Methods: Fifty-four panoramic radiographs of subjects with unilateral loss of L6 were examined. The L8 on the side of the L6 loss was compared with the L8 in the hemiarch without L6 loss (contralateral). The effect of L6 loss on the positioning of L8 was examined in all the samples (n=54), whereas the effect on the development of the third molar was examined in 38 patients with L8 with incomplete root formation. The Signs statistical test was used to evaluate the comparison between loss and contralateral hemiarches. Results: In 20 (37%) of 54 subjects, the L8 was better positioned in the hemiarch with loss of the lower first molar (p<0.001) compared with the control side. In the remaining 34 subjects, no difference was found. When only the L8 considered as impacted on the control side was examined (n=30), the cases with better positioning on the side with L6 loss increased to 66.6% (p<0.001). Conclusion: The loss of lower first molars improves the position of the lower third molar during its active eruption, mainly when the lower third molar is impacted. However, L6 loss does not affect the root development of lower third molars.

5.
Dental press j. orthod. (Impr.) ; 26(1): e21spe1, 2021. tab, graf
Artigo em Inglês | LILACS-Express | LILACS, BBO - Odontologia | ID: biblio-1154062

RESUMO

ABSTRACT Introduction: The efficiency of clinical procedures is based on practical and theoretical knowledge. Countless daily information is available to the orthodontist, but it is up to this professional to know how to select what really has an impact on clinical practice. Evidence-based orthodontics ends up requiring the clinician to know the basics of biostatistics to understand the results of scientific publications. Such concepts are also important for researchers, for correct data planning and analysis. Objective: This article aims to present, in a clear way, some essential concepts of biostatistics that assist the clinical orthodontist in understanding scientific research, for an evidence-based clinical practice. In addition, an updated version of the tutorial to assist in choosing the appropriate statistical test will be presented. This PowerPoint® tool can be used to assist the user in finding answers to common questions about biostatistics, such as the most appropriate statistical test for comparing groups, choosing graphs, performing correlations and regressions, analyzing casual, random or systematic errors. Conclusion: Researchers and clinicians must acquire or recall essential concepts to understand and apply an appropriate statistical analysis. It is important that journal readers and reviewers can identify when statistical analyzes are being inappropriately used.


RESUMO Introdução: A eficiência dos procedimentos clínicos é baseada em conhecimentos práticos e teóricos. Inúmeras informações diárias estão ao alcance do ortodontista; porém cabe a esse profissional saber selecionar o que realmente tem impacto na prática clínica. A Ortodontia baseada em evidências acaba exigindo que o clínico conheça os fundamentos da bioestatística para compreender os resultados das publicações científicas. Tais conceitos também são importantes aos pesquisadores para um correto planejamento e análise dos dados. Objetivo: O presente artigo tem como objetivo apresentar, de forma clara, alguns conceitos essenciais da bioestatística que auxiliem o ortodontista clínico na compreensão da pesquisa científica para uma prática clínica baseada em evidências. Além disso, será apresentada uma versão atualizada do tutorial para auxílio na escolha do teste estatístico adequado. Essa ferramenta em PowerPoint® pode ser empregada para auxiliar o usuário a encontrar respostas para dúvidas comuns sobre bioestatística, como o teste estatístico mais adequado para comparar grupos, escolha de gráficos, realizar correlações e regressões, análises de sobrevivência e dos erros aleatório e sistemático. Conclusão: Pesquisadores e clínicos devem adquirir ou relembrar conceitos essenciais para compreender e aplicar uma análise estatística apropriada. É importante que os leitores e revisores de periódicos possam identificar quando análises estatísticas estão sendo utilizadas de forma inadequada.

6.
Angle Orthod ; 90(3): 442-456, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33378434

RESUMO

OBJECTIVE: To evaluate the impact of rapid maxillary expansion (RME) on the condylar position, disc joint, joint space, and interarticular relationship in growing patients. MATERIALS AND METHODS: A systematic search was performed in nine databases. The clinical studies selected included those with pre- and post-magnetic resonance, conventional computed tomography or cone beam tomography in growing patients. Risk of bias assessment was performed using the Cochrane Collaboration tool for controlled clinical studies and National Heart, Lung, and Blood Institute (NHLBI) Quality Assessment for Before-After Studies With No Control Group. RESULTS: Initially, 4303 records were identified. Only eight studies fulfilled the criteria and were included in the qualitative analysis. Of those, two were controlled clinical studies with a risk of uncertain to high bias. The remaining papers had a low to moderate risk of bias. Results showed that RME in children and adolescents promoted the following: remodeling in the head and or condylar branch, changes in condylar position and joint space, maintenance of improved symmetry between the condyles, and no ability to modify the position or shape of the articular disc. CONCLUSIONS: RME in growing patients is able, in the short term, to modify the condyle-fossa relationship but does not change the position or shape of the articular disc. The intercondylar symmetric relationship is maintained or improved. Although the NHLBI score shows low to moderate risk of bias, the clinical relevance of these review findings is limited by Cochrane and Grades of Recommendation, Assessment, Development and Evaluation scores.


Assuntos
Técnica de Expansão Palatina , Transtornos da Articulação Temporomandibular , Adolescente , Criança , Tomografia Computadorizada de Feixe Cônico , Cabeça , Humanos , Côndilo Mandibular/diagnóstico por imagem , Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/diagnóstico por imagem
7.
Angle Orthod ; 90(5): 640-647, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-33378487

RESUMO

OBJECTIVES: To investigate the effect of micro-osteoperforation (MOP) on the rate of tooth movement (RTM), space closure duration, and oral health-related quality of life (OHRQoL) during completion of anterior retraction in patients undergoing combined orthodontic-surgical treatment after premolar extraction and decompensation with sliding mechanics. MATERIALS AND METHODS: Twenty-four participants with indications for premolar extractions were randomly allocated to treatment with conventional sliding mechanics (control group; CG) or with to treatment in which three MOPs were performed every activation (experimental group; EG). Dental impressions were taken monthly until space closure was completed and dental casts were converted to three-dimensional models. After the anterior retraction procedure, Oral Health Impact Profile (OHIP-14) questionnaires were filled out at 4 and 72 hours. RESULTS: Eighteen patients (7 men and 11 women) remained in the trial until space closure was completed (mean follow-up period = 247 days). For full space closure RTM, no significant difference (P = .492) was found between groups (0.614 mm/month for the CG; 0.672 mm/month for the EG). The RTM for different time points, groups, time frames and their interaction were statistically different (P < .05). In multiple correlation analysis, the RTM significantly decreased over time for both groups (P < .05). The OHRQoL scores were significantly higher (worse) for the EG. The psychological, physical and social disabilities, and handicap domains displayed significant differences between the two groups. CONCLUSION: Use of MOPs did not change the full space closure RTM, while it had a negative impact on OHRQoL.


Assuntos
Qualidade de Vida , Técnicas de Movimentação Dentária , Dente Pré-Molar , Assistência Odontológica , Feminino , Humanos , Masculino , Saúde Bucal , Inquéritos e Questionários
8.
Angle Orthod ; 90(4): 587-597, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-33378494

RESUMO

OBJECTIVES: To investigate whether there was a difference in success rates when stainless steel (SS) was compared to titanium mini-implants (MIs) in orthodontic patients. MATERIALS AND METHODS: PubMed, Cochrane, Scopus, Web of Science, Lilacs, Google Scholar, Clinical Trials, and OpenGray were searched without restrictions. A manual search was also performed in the references of the included articles. Studies comparing the success rate between SS and titanium MIs were included. Risk of bias (RoB) was assessed using the ROBINS-I (Risk of Bias in Non-randomized Studies-of Interventions) Tool or RoB 2.0 according to the study design. The level of evidence was assessed through GRADE (Grading of Recommendation, Assessment, Development, and Evaluation). RESULTS: Six studies met the eligibility criteria. One study was a randomized clinical trial that evaluated extraalveolar MIs, and nonrandomized trials examined interradicular MIs. The RCT presented a low RoB, two nonrandomized trials presented a moderate risk, and three presented a high risk. The quality of the evidence was high for the randomized clinical trial and moderate for the nonrandomized trials. Most studies found no difference between materials, with good success rates for both (SS, 74.6%-100%; titanium: 80.9%-100%) and only one study, with a high RoB, showed a higher success rate with titanium MIs (90%) when compared with SS (50%). A quantitative analysis was not because of the great heterogeneity among the studies. CONCLUSIONS: Although limited, the current evidence seems to show that the material used is not a major factor in the success rate of MIs. Because it has a lower cost than titanium and presents similar clinical efficiency, SS is a great material for orthodontic MIs.


Assuntos
Aço Inoxidável , Titânio , Humanos
9.
Am J Orthod Dentofacial Orthop ; 158(5): e63-e72, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33131569

RESUMO

INTRODUCTION: This study aimed to assess the stability of compensatory treatment of Class III malocclusion in permanent dentition. METHODS: Thirty-six patients (21 women and 15 men; mean age, 20 years) with Class III malocclusion were subjected to the compensatory treatment of permanent dentition and followed up for at least 3 years after orthodontic treatment (T3). Multivariate Poisson regression was performed to assess the influence of clinical, cephalometric, and dental cast variables at the beginning (T1) and the end of treatment on the stability of Class III malocclusion. RESULTS: Overjet changed from -0.25 mm (-3 to 0.5 mm) at T1 to 1.4 mm (1-2.5 mm) at the end of treatment and 0.8 mm (0-1.5 mm) at T3. Clinical relapse (overjet <1 mm and/or canine Class III relations) was observed in 11 patients (30.6%). Patients treated with extraction of mandibular premolars (risk ratio [RR] = 2.13 × 10-07, P <0.001), with better orthodontic end outcomes (RR = 1.16, P = 0.009) and which had lower maxillary incisor inclination at T1 (RR = 1.08, P = 0.035) showed a lower risk of relapse. Demographic (sex, age), clinical (length of treatment and posttreatment, number of treatment phases, time of Class III elastics), cephalometric (SNA, SNB, ANB, Wits appraisal, SNGoGn, IMPA), and dental cast (peer assessment rating index and arch dimensions) variables were not significantly associated with clinical relapse at T3. CONCLUSIONS: The stability of compensatory treatment of Class III malocclusion in permanent dentition is multifactorial, with few predictive variables. Patients treated with extraction and better orthodontic finishing had a lower risk of relapse, whereas larger maxillary incisor inclination at baseline increased the risk of relapse.


Assuntos
Má Oclusão de Angle Classe III , Sobremordida , Adulto , Cefalometria , Dentição Permanente , Feminino , Humanos , Masculino , Má Oclusão de Angle Classe III/terapia , Mandíbula , Maxila , Resultado do Tratamento , Adulto Jovem
10.
Dental Press J Orthod ; 25(4): 68-74, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32965389

RESUMO

OBJECTIVE: To evaluate the skill of orthodontists and oral/maxillofacial surgeons (OMFS) in providing a prognosis of mandibular third molars spontaneously erupted, through follow-up panoramic analysis. METHODS: 22 orthodontic patients treated without extraction, presenting spontaneously erupted mandibular third molars (n = 44) were analyzed through panoramic serial radiographs. The first panoramic radiograph was obtained just after orthodontic treatment (PR1), in patients aging from 13 to 19 years. A second panoramic radiograph (PR2), was obtained in average two years later. The radiographs were randomly analyzed by 54 specialists, 27 orthodontists and 27 OMFS, to obtain the opinion about the approach to be adopted to these teeth in PR1. Then, another opinion was collected by adding a serial radiograph (PR1+2). RESULTS: The concordance of the answers was moderate for OMFS (Kappa 0.44; p< 0.0001) and significant for orthodontists (Kappa 0.39; p< 0.0001). In the analysis of the first radiograph (PR1) of the spontaneously erupted molars, OMFS indicated extraction in 44.5% of cases, while orthodontists indicated in 42%, with no difference between groups (p= 0.22). In PR1+2 analysis, orthodontists maintained the same level of extraction indication (45.6%, p= 0.08), while surgeons indicated more extractions (63.2%, p< 0.0001). CONCLUSIONS: Orthodontists and OMFS were not able to predict the eruption of the third molars that have erupted spontaneously. Both indicated extractions around half of the third molars. A follow-up analysis, including one more radiograph, did not improve the accuracy of prognosis among orthodontists and worsened for OMFS.


Assuntos
Dente Serotino/diagnóstico por imagem , Dente Serotino/cirurgia , Dente Impactado/diagnóstico por imagem , Humanos , Mandíbula/diagnóstico por imagem , Dente Molar , Cirurgiões Bucomaxilofaciais , Ortodontistas , Radiografia Panorâmica , Erupção Dentária , Extração Dentária
11.
Artigo em Inglês | MEDLINE | ID: mdl-32981872

RESUMO

OBJECTIVE: The aim of this cross-sectional accuracy study was to compare panoramic reconstruction (PR) and multiplanar reconstruction (MPR) images, which are used to establish the prognosis for impacted mandibular third molars in relation to professional decision making. STUDY DESIGN: Images of 10 patients who had undergone cone beam computed tomography (CBCT) examination were selected, resulting in 2 distinct groups of images, with 10 in each group: PR and MPR. To check prognostic accuracy, 2 images from each group were randomly selected and reinserted into the sample, totaling 24 images. A questionnaire was completed by 54 professionals: 27 orthodontists and 27 oral and maxillofacial surgeons (OMFSs). Data were evaluated by using the χ2 and McNemar's tests and Kappa statistics at P < .05. RESULTS: There were no statistically significant differences when isolated PR images were compared with MPR images by orthodontists (P = .72) or OMFSs (P = .45). However, there were significant differences in the professional decision regarding the prognosis for impacted teeth, where OMFSs indicated the need for more extractions compared with orthodontists (P < .0001). CONCLUSIONS: There are no differences between PR and multiplanar CBCT images with regard to the determination of the prognosis for impacted mandibular third molars. However, there was a difference in the decision making between the different specialties.


Assuntos
Dente Impactado , Tomografia Computadorizada de Feixe Cônico , Estudos Transversais , Humanos , Mandíbula/diagnóstico por imagem , Dente Serotino/diagnóstico por imagem , Dente Serotino/cirurgia , Prognóstico , Radiografia Panorâmica , Dente Impactado/diagnóstico por imagem , Dente Impactado/cirurgia
12.
Prog Orthod ; 21(1): 35, 2020 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-32888097

RESUMO

OBJECTIVES: The aim of this systematic review and meta-analysis is to assess the degree of stability of anterior open bite (AOB) treatment performed through the molar intrusion supported with skeletal anchorage at least 1 year posttreatment. METHODS: This study was registered in PROSPERO (CRD42016037513). A literature search was conducted to identify randomized (RCT) or non-randomized clinical trials based including those considering before and after design. Data sources were electronic databases including PubMed, Cochrane Library, Science Direct, Google Scholar, Scopus, Lilacs, OpenGrey, Web of Science, and ClinicalTrials.gov . The quality of evidence was assessed through the JBI tool and certainty of evidence was evaluated through the GRADE tool. Random effects meta-analysis was conducted when appropriate. RESULTS: Six hundred twenty-four articles met the initial inclusion criteria. From these, only 6 remained. The mean posttreatment follow-up time was 2.5 years (SD = 1.04). The overbite showed a standardized mean relapse of - 1.23 mm (95% CI - 1.64, - 0.81, p < 0.0001). Maxillary and mandibular incisors presented a non-significant mean relapse, U1-PP - 0.04 mm (95% CI - 0.55, 0.48) and L1-MP - 0.10 mm (95% CI - 0.57, 0.37). Molar intrusion showed a relapse rate around 12% for the maxillary molars and a 27.2% for mandibular molars. CONCLUSION: The stability of AOB through molar intrusion using TADs can be considered relatively similar to that reported to surgical approaches, since 10 to 30% of relapse occurs both in maxillary and mandibular molars. The level of certainty ranged between very low and low. RCTs reporting dropout during the follow-up are in dire need.


Assuntos
Mordida Aberta , Procedimentos de Ancoragem Ortodôntica , Cefalometria , Humanos , Maxila , Dente Molar , Técnicas de Movimentação Dentária
13.
PLoS One ; 15(9): e0238339, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32946453

RESUMO

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.


Assuntos
Betacoronavirus/fisiologia , Infecções por Coronavirus/transmissão , Umidade , Pneumonia Viral/transmissão , Temperatura , Viés , Infecções por Coronavirus/epidemiologia , Humanos , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia
14.
Int J Paediatr Dent ; 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32946646

RESUMO

BACKGROUND: The beneficial effect of the extraction of primary canines in the resolution of incisor irregularity and its side effects are controversial. AIM: To systematically review the effects of the extraction of primary canines in incisor irregularity and dental arch morphology. DESIGN: Controlled non-randomized (non-RCT) and randomized clinical trials (RCT) evaluating children treated with extraction of primary canines compared with those without intervention. RESULTS: A total of 984 articles were found, of which two RCTs and one non-RCT met the inclusion criteria. Both had a low RoB. A high level of evidence was observed through GRADE. A meta-analysis showed the extraction of primary canines produced a significant decrease in incisor irregularity (95% CI: -3.56, -2.09 mm). This decrease, however, was associated with a reduction of arch length (95% CI: -1.58, -0.94 mm), intermolar width (95% CI: -0.61, -0.22 mm), and overjet (95% CI: -075, -018). A mild overbite increase was found (95% CI: 0.10, 0.76 mm). CONCLUSION: A high level of evidence showed that the extraction of primary canines improved incisor irregularity in the mixed dentition. Side effects included reduced arch length and intermolar width. A slight reduction in overjet and a mild increase in overbite were also observed. When they are not part of the treatment goal, these occlusal changes can be prevented by installing a lingual arch.

15.
Clin Oral Investig ; 24(10): 3325-3334, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32776170

RESUMO

BACKGROUND: The aim of this study was to evaluate through a systematic review the extraction of third molars as a risk factor for temporomandibular disorders (TMDs). TYPES OF STUDIES REVIEWED: Randomized and nonrandomized controlled clinical trials where patients underwent third molar extraction and with qualitative evaluation of TMDs before and after extraction were included. RESULTS: After applying the inclusion criteria, seven nonrandomized clinical studies were included. QUIPS tool showed that four articles presented a moderate and three a high risk of bias (RoB). Six studies reported that TMDs presented higher level after removal of third molars ranging from OR, 1.81 to 2.15/RR, 2.1. However, one study showed no significant association. GRADE showed heterogeneity in relation to general results, which means that confidence in the estimated effects varied from low to moderate GRADE. The quality of clinical recommendations decreased especially due to the risk of bias in some of the included studies evaluated with the QUIPS tool. CONCLUSIONS AND PRACTICAL IMPLICATIONS: Third molar extraction can be associated with the development of TMD signs and symptoms. Furthermore, TMD can be aggravated according to the third molar location, the degree of impaction and surgical difficulty, age, and gender. This systematic review highlights the need to perform randomized clinical trials with diagnostic criteria and standardized surgical procedures.


Assuntos
Transtornos da Articulação Temporomandibular , Dente Impactado , Humanos , Dente Serotino , Fatores de Risco , Extração Dentária
16.
Dental press j. orthod. (Impr.) ; 25(4): 68-74, July-Aug. 2020. tab, graf
Artigo em Inglês | LILACS-Express | LILACS, BBO - Odontologia | ID: biblio-1133672

RESUMO

ABSTRACT Objective: To evaluate the skill of orthodontists and oral/maxillofacial surgeons (OMFS) in providing a prognosis of mandibular third molars spontaneously erupted, through follow-up panoramic analysis. Methods: 22 orthodontic patients treated without extraction, presenting spontaneously erupted mandibular third molars (n = 44) were analyzed through panoramic serial radiographs. The first panoramic radiograph was obtained just after orthodontic treatment (PR1), in patients aging from 13 to 19 years. A second panoramic radiograph (PR2), was obtained in average two years later. The radiographs were randomly analyzed by 54 specialists, 27 orthodontists and 27 OMFS, to obtain the opinion about the approach to be adopted to these teeth in PR1. Then, another opinion was collected by adding a serial radiograph (PR1+2). Results: The concordance of the answers was moderate for OMFS (Kappa 0.44; p< 0.0001) and significant for orthodontists (Kappa 0.39; p< 0.0001). In the analysis of the first radiograph (PR1) of the spontaneously erupted molars, OMFS indicated extraction in 44.5% of cases, while orthodontists indicated in 42%, with no difference between groups (p= 0.22). In PR1+2 analysis, orthodontists maintained the same level of extraction indication (45.6%, p= 0.08), while surgeons indicated more extractions (63.2%, p< 0.0001). Conclusions: Orthodontists and OMFS were not able to predict the eruption of the third molars that have erupted spontaneously. Both indicated extractions around half of the third molars. A follow-up analysis, including one more radiograph, did not improve the accuracy of prognosis among orthodontists and worsened for OMFS.


RESUMO Objetivo: Avaliar a habilidade de ortodontistas e cirurgiões bucomaxilofaciais (CBMF) em propor um prognóstico para terceiros molares inferiores. Métodos: Foram analisados 22 pacientes tratados ortodonticamente sem extração, cujos terceiros molares inferiores irrompidos espontaneamente (n= 44) foram avaliados por meio de radiografias panorâmicas seriadas. A primeira radiografia foi obtida logo após o tratamento ortodôntico (RX1), entre 13 e 19 anos de idade. A segunda radiografia (RX2) foi avaliada dois anos depois, em média. As radiografias foram analisadas aleatoriamente por 54 especialistas, 27 ortodontistas e 27 CBMFs, para obter sua opinião sobre a abordagem a ser adotada na RX1. Em seguida, outra opinião foi coletada adicionando-se a segunda radiografia seriada (RX1+2). Resultados: A concordância das respostas foi moderada para os CBMFs (Kappa = 0,44; p< 0,0001) e significativa para os ortodontistas (Kappa = 0,39; p< 0,0001). Após analisar apenas a primeira radiografia (RX1) dos molares antes deles irromperem espontaneamente, os CBMFs indicaram extração em 44,5% dos casos; enquanto os ortodontistas, em 42%, sem diferença entre os grupos (p= 0,22). Na análise de RX1+2, os ortodontistas mantiveram o mesmo nível de indicação de extração (45,6%, p= 0,08), enquanto os cirurgiões passaram a indicar mais extrações (63,2%, p< 0,0001). Conclusões: Ortodontistas e CBMFs não foram capazes de predizer a erupção de terceiros molares por meio da análise de uma única radiografia panorâmica, indicando extrações em cerca da metade dos terceiros molares examinados. Uma análise de acompanhamento, incluindo mais uma radiografia, não melhorou a precisão do prognóstico entre os ortodontistas, e piorou entre os CBMFs.

17.
Prog Orthod ; 21(1): 27, 2020 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-32715352

RESUMO

BACKGROUND: The aim of this systematic review was to evaluate the effect of micro-osteoperforations (MOPs) performed with Propel and other mini-screws on the rate of tooth movement, pain/discomfort, periodontal health, anchorage loss, and root resorption in patients undergoing orthodontic retraction compared to a control group. MATERIALS AND METHODS: PubMed, Cochrane, Web of Science, LILACS, Google Scholar, Scopus, and OpenGrey were searched without restriction. A manual search was also carried out. Only randomized clinical trials (RCT) were included. The risk of bias (RoB) was assessed using RoB 2.0 and the certainty of evidence through the GRADE tool. RESULTS: Among the twelve RCTs reviewed, five used the Propel system. Overall, the RoB was classified as low (4), moderate (5), and high (3). Two RCTs with moderate and one with a low RoB using the Propel system reported mild increases on rate of tooth movement associated with MOPs. One RCT with a moderate and another with high RoB did not find a significant effect of Propel on orthodontic movement. Regarding tooth movement, a subgroup meta-analysis found no differences between control and Propel movement (95% CI = - 0.01 to 0.75) or other mini-screws (- 0.02 to 0.31) related to rate of tooth movement per month. There was no effect of MOPs on root resorption, periodontal health, anchorage loss, and a mild effect on pain and oral health related to quality of life regardless of mini-screw type. The level of certainty was graded as low for the rate of tooth movement and pain/discomfort, as moderate for anchorage loss, and high for root resorption. CONCLUSION: A low certainty of evidence supports that MOPs performed with Propel seem to have no significant effect on the rate of tooth movement. Moreover, this intervention does not seem to cause an increase in root resorption, periodontal heath, pain/discomfort, or anchorage loss. Thus, the Propel system does not appear to produce different results from those observed for other mini-screws.


Assuntos
Dor , Reabsorção da Raiz , Técnicas de Movimentação Dentária , Parafusos Ósseos , Humanos , Qualidade de Vida
18.
Am J Orthod Dentofacial Orthop ; 157(5): 619-630, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32354435

RESUMO

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.


Assuntos
Biometria , Grupos Populacionais , Arco Dental/anatomia & histologia , Face/anatomia & histologia , Feminino , Humanos , Índios Sul-Americanos , Masculino , Fotogrametria
19.
Artigo em Inglês | MEDLINE | ID: mdl-32454957

RESUMO

Background. This in vitro study aimed to evaluate biofilm accumulation on and deactivation force of orthodontic nickeltitanium (NiTi) archwires before and after exposure to an oral medium. Methods. Four commercial brands of orthodontic NiTi 0.016" archwires were examined before and after exposure to the oral medium for 4 weeks. Six archwire segments, 30 mm in length, from each manufacturer were tested in a device with four selfligating brackets, channel 0.022", adapted to a universal test machine to evaluate the deactivation force between 0.5 and 3 mm of deflection. The presence of biofilm on the archwire surfaces was evaluated by scanning electron microscopy, before and after exposure to the oral medium. The Wilcoxon and kappa tests were applied to the biofilm scores, three-way ANOVA for repeated measures (Bonferroni post-test), and linear regression between biofilm and deactivation force. Results. The exposure to the oral medium promoted moderate to severe presence of debris on the archwire surfaces and caused a reduction in deactivation force for the Ormco and GAC brands, while maintaining them with adequate force levels. The MORELLI and ORTHOMETRIC archwires underwent no significant reduction in deactivation force; moreover, these maintained elevated levels of force after exposure to the oral medium. The Spearman test indicated a low correlation between biofilm accumulation and deflection force for the Morelli (R2=0.132 and P=0.683) and Orthometric (R2=0.308 and P=0.330) brands. On the other hand, the GAC (R=0.767 and P=0.004) and ORMCO (R=0.725 and P=0.008) brands exhibited statistically significant correlation between these variables. Conclusion. Exposure to the oral medium for one month might give rise to significant changes in the dissipation of forces of orthodontic NiTi archwires, resulting from biofilm accumulation.

20.
PLoS One ; 15(4): e0230809, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32315345

RESUMO

Riverine populations are typical of the Amazon region that depend on nature for subsistence. These people are considered an intermediate population between the urban and indigenous, the original Amazon habitants. The aim of this cross-sectional study was to evaluate the relationship between tooth wear and age in a remote riverine population from the Amazon, located by the Tucumanduba River (n = 94), and to compare them to previous findings obtained from semi-isolated indigenous (n = 223) and urban populations (n = 40) from the Amazon region, which were examined using the same methodology. Using linear regression, tooth wear explained 54.5% of the variation in the ages of the riverine subjects (p<0.001). This coefficient is mid-way between those obtained in semi-isolated indigenous populations (65-86%) and urban subjects (12%) living in the Amazon. Our findings suggest that tooth wear, a direct evidence of what an individual ate in the past, may be an indicator of the acculturation process in remote populations.


Assuntos
Desgaste dos Dentes/epidemiologia , Aculturação , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Grupos Populacionais , Rios , População Urbana , Adulto Jovem
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