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1.
Oral Health Prev Dent ; 19(1): 67, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33491380

RESUMO

PURPOSE: Orthodontic treatment may introduce a risk to the integrity of enamel due to plaque accumulation and colonisation by oral microbes. This prospective cohort study observed the effect of fixed, self-ligating orthodontic appliances on saliva properties and oral microbial flora. Materials and Methods: Thirty adolescent patients were recruited (13 female, 17 male, mean age 13.97 ±â€¯2.07 years). Saliva samples were collected before placement of fixed orthodontic appliances (T0), and 4 (T1) and 12 (T2) weeks later. Salivary pH, flow rate and buffering capacity were recorded. All saliva samples were cultured on agar plates for 2 days. Salivary prevalence of Neisseria spp., streptococci, Staphylococcus aureus, coagulase-negative staphylococci and Candida albicans were assessed. Results: High buffering capacity was reported in 21 patients at T0, 22 patients at T1 and in 28 patients at T2. Saliva flow rate also increased over time (7.08 ml/5 min at T0, 7.93 ml/5 min at T1 and 8.35 ml/5min at T2). Mean pH was 7.63 at T0, 7.67 at T1 and 7.78 at T2. There was no evidence that either pH or the number of colonies of any of the microbial species changed over time. Conclusion: The increased buffering capacity of saliva as well as the salivary flow rate after initial bonding might be protective against the development of dental caries. Current microbial findings indicate that initiation of orthodontic treatment may not be associated with significant changes in oral microbial flora.


Assuntos
Cárie Dentária , Saliva , Adolescente , Criança , Índice de Placa Dentária , Feminino , Humanos , Masculino , Aparelhos Ortodônticos , Aparelhos Ortodônticos Fixos/efeitos adversos , Estudos Prospectivos
2.
Medicine (Baltimore) ; 99(50): e23165, 2020 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-33327234

RESUMO

BACKGROUND: Although several researchers have analyzed the dental identity of patients experience with corrective methods using fixed and removable appliances, the consequences stay debatable. This meta-analysis intended to verify whether the periodontal status of removable appliances is similar to that of the conventional fixed appliances. METHODS: Relevant literature was retrieved from the database of Cochrane library, PubMed, EMBASE, and CNKI until December 2019, without time or language restrictions. Comparative clinical studies assessing periodontal conditions between removable appliances and fixed appliances were included for analysis. The data was analyzed using the Stata 12.0 software. RESULTS: A total of 13 articles involving 598 subjects were selected for this meta-analysis. We found that the plaque index (PLI) identity of the removable appliances group was significantly lower compared to the fixed appliances group at 3 months (OR = -0.57, 95% CI: -0.98 to -0.16, P = .006) and 6 months (OR = -1.10, 95% CI: -1.60 to -0.61, P = .000). The gingival index (GI) of the removable appliances group was lower at 6 months (OR = -1.14, 95% CI: -1.95 to -0.34, P = .005), but the difference was not statistically significant at 3 months (OR = -0.20, 95% CI: -0.50 to 0.10, P = .185) when compared with that of the fixed appliances group. The sulcus probing depth (SPD) of the removable appliances group was lower compared to the fixed appliances group at 3 months (OR = -0.26, 95% CI: -0.52 to -0.01, P = .047) and 6 months (OR = -0.42, 95% CI: -0.83 to -0.01, P = .045). The shape of the funnel plot was symmetrical, indicating no obvious publication bias in the Begg test (P = .174); the Egger test also indicated no obvious publication bias (P = .1). CONCLUSION: Our meta-analysis demonstrated that malocclusion patients treated with the removable appliances demonstrated a better periodontal status as compared with those treated with fixed orthodontic appliances. However, the analyses of more numbers of clinical trials are warranted to confirm this conclusion.


Assuntos
Má Oclusão/terapia , Aparelhos Ortodônticos Fixos/efeitos adversos , Aparelhos Ortodônticos Removíveis/efeitos adversos , Doenças Periodontais/etiologia , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Má Oclusão/classificação , Má Oclusão/diagnóstico , Pessoa de Meia-Idade , Desenho de Aparelho Ortodôntico/tendências , Aparelhos Ortodônticos/provisão & distribuição , Avaliação de Resultados em Cuidados de Saúde , Doenças Periodontais/epidemiologia , Índice Periodontal , Ensaios Clínicos Controlados Aleatórios como Assunto
3.
Artigo em Inglês | MEDLINE | ID: mdl-33348756

RESUMO

The present study aimed to evaluate the effect of the oral-hygiene regime on the incidence of enamel demineralization in young patients treated with fixed appliances. Research was conducted in a group of 144 patients aged 12-18 years, divided into 2 groups: orthodontically treated and control. The study was divided into three stages: before treatment (I), at 1 month (II), and at 6 months (III) for their follow-up. The International Caries Detection and Assessment System (ICDAS) was used for the visual assessment of white spot lesions (WSL). After 1 month, no new white spot lesions were observed. After 6 months of the treatment, new lesions were observed in 5% of the orthodontically treated patients and in 6% of the patients in the control group. New decalcifications were located on the proximal surfaces of the central incisors, first premolars, and first molars in the orthodontically treated group; and on the lateral incisors, first premolars, and first molars in the control group. We also observed new enamel demineralization on the vestibular surfaces of the canine and first premolar in the study group. The placement of a fixed appliance did not significantly affect teeth with the presence of new white spot lesions compared to the control group during 6 months of observation.


Assuntos
Cárie Dentária , Higiene Bucal , Aparelhos Ortodônticos Fixos , Adolescente , Estudos de Casos e Controles , Criança , Cárie Dentária/epidemiologia , Cárie Dentária/prevenção & controle , Humanos , Incidência , Higiene Bucal/normas , Aparelhos Ortodônticos Fixos/efeitos adversos
4.
J Int Acad Periodontol ; 22(3): 174-181, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32980830

RESUMO

AIMS: The purpose of this study was to evaluate the impact of fullfixed orthodontic appliances on the periodontium in adult patients. METHODS: Seventeen periodontally and systemically healthy subjects were selected from the Periodontal Clinic of Guarulhos University, 7 males and 10 females (mean age: 38.3 ± 6.3 years). The patients undergoing orthodontic treatment were submitted a clinical examination, a cone beam computed tomography at baseline and after 12 months of treatment. Subgingival biofilm samples were analyzed by Checkerboard DNA-DNA hybridization. Statistical analysis was performed by a Wilcoxon test. RESULTS: The percentage of sites with visible plaque increased (p =0.003), but no significant reduction in marginal bone was observed. The mean periodontal pocket depth was reduced (p=0.001) and the clinical attachment level significantly improved (p =0.001). There was a significant reduction in the mean proportions of the Actinomyces sp and an increase in the orange complex species. The proportions of the red complex species remained unchanged. CONCLUSIONS: In spite of increase in plaque accumulation no significant clinical or tomographic iatrogenic changes in periodontally healthy adults undergoing orthodontic full-fixed appliance treatment could be detected. The microbiological changes did not affect the periodontal parameters in monitored adult patients that received short period of orthodontic treatment.


Assuntos
Placa Dentária , Microbiota , Adulto , Feminino , Humanos , Masculino , Aparelhos Ortodônticos Fixos/efeitos adversos , Bolsa Periodontal , Periodonto
5.
Pediatr. aten. prim ; 22(86): 161-163, abr.-jun. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-198530

RESUMO

El enfisema subcutáneo es el proceso por el cual el aire penetra en el espacio subcutáneo, produciendo distensión de las partes blandas. Puede ser de origen traumático, iatrogénico o producirse de forma espontánea. Es infrecuente su aparición tras procedimientos dentales y no ha sido descrito asociado a la ortopedia dentofacial. Presentamos el caso de una paciente con enfisema subcutáneo tras un traumatismo por un aparato de avance mandibular tipo Herbst


Subcutaneous emphysema is the condition in which air penetrate the subcutaneous space causing soft-tissue distention. It may be traumatic, iatrogenic or may occur spontaneously. Its appearance is rare after dental procedures and has not been reported associated to dentofacial orthopedics. We report the case of a patient who developed subcutaneous emphysema after a trauma from a Herbst-type mandibular advancement appliance


Assuntos
Humanos , Feminino , Criança , Enfisema Subcutâneo/diagnóstico , Aparelhos Ortodônticos Fixos/efeitos adversos , Retrognatismo/terapia , Enfisema Subcutâneo/etiologia , Má Oclusão/terapia , Antibacterianos/uso terapêutico , Anti-Inflamatórios/uso terapêutico
6.
BMC Oral Health ; 20(1): 126, 2020 04 25.
Artigo em Inglês | MEDLINE | ID: mdl-32334590

RESUMO

BACKGROUND: Treatment with fixed orthodontic appliances has been associated with significant biofilm accumulation, thus putting patients at a higher risk of oral health deterioration. The use of probiotics has been proposed to be useful in the prevention or treatment of oral pathologies such as caries and diseases of periodontal tissues. Our aim was to investigate the effects of probiotic use on inflammation of the gingival tissues and the decalcification of the enamel in patients being treated with fixed orthodontic appliances. METHODS: We searched without restrictions 8 databases and performed hand searching until September 2019. We searched for randomized controlled trials (RCTs) evaluating whether individuals with fixed orthodontic appliances benefit from probiotic treatment in terms of the inflammation of the gingivae and decalcification of the enamel. Following the selection of studies and the extraction of pertinent data, we appraised the risk of bias and the confidence in the observed effects based on established methodologies. RESULTS: From the final qualifying studies, three did not show any statistically significant effect on gingival inflammation after probiotic administration of up to 1 month. Similarly, non-significant differences were noted in another study regarding white spot lesions development (mean administration for 17 months). No adverse effects were reported and the level of evidence was considered moderate. CONCLUSIONS: Supplementation of orthodontic patients with probiotics did not affect the development of inflammation in the gingivae and decalcification in the enamel. Additional RCTs, with longer intervention and follow-up periods, and involving different combinations of probiotic strains are required. TRIAL REGISTRATION: PROSPERO (CRD42018118008).


Assuntos
Cárie Dentária/prevenção & controle , Placa Dentária/tratamento farmacológico , Gengivite/prevenção & controle , Saúde Bucal , Aparelhos Ortodônticos Fixos/efeitos adversos , Aparelhos Ortodônticos/efeitos adversos , Probióticos/uso terapêutico , Adolescente , Adulto , Criança , Profilaxia Dentária , Feminino , Humanos , Masculino , Higiene Bucal , Descoloração de Dente , Adulto Jovem
7.
Eur J Orthod ; 42(3): 331-343, 2020 06 23.
Artigo em Inglês | MEDLINE | ID: mdl-31758191

RESUMO

BACKGROUND: The use of orthodontic aligners to treat a variety of malocclusions has seen considerable increase in the last years, yet evidence about their efficacy and adverse effects relative to conventional fixed orthodontic appliances remains unclear. OBJECTIVE: This systematic review assesses the efficacy of aligners and fixed appliances for comprehensive orthodontic treatment. SEARCH METHODS: Eight databases were searched without limitations in April 2019. SELECTION CRITERIA: Randomized or matched non-randomized studies. DATA COLLECTION AND ANALYSIS: Study selection, data extraction, and risk of bias assessment was done independently in triplicate. Random-effects meta-analyses of mean differences (MDs) or relative risks (RRs) with their 95% confidence intervals (CIs) were conducted, followed by sensitivity analyses, and the GRADE analysis of the evidence quality. RESULTS: A total of 11 studies (4 randomized/7 non-randomized) were included comparing aligners with braces (887 patients; mean age 28.0 years; 33% male). Moderate quality evidence indicated that treatment with orthodontic aligners is associated with worse occlusal outcome with the American Board of Orthodontics Objective Grading System (3 studies; MD = 9.9; 95% CI = 3.6-16.2) and more patients with unacceptable results (3 studies; RR = 1.6; 95% CI = 1.2-2.0). No significant differences were seen for treatment duration. The main limitations of existing evidence pertained to risk of bias, inconsistency, and imprecision of included studies. CONCLUSIONS: Orthodontic treatment with aligners is associated with worse treatment outcome compared to fixed appliances in adult patients. Current evidence does not support the clinical use of aligners as a treatment modality that is equally effective to the gold standard of braces. REGISTRATION: PROSPERO (CRD42019131589).


Assuntos
Má Oclusão , Aparelhos Ortodônticos Fixos/efeitos adversos , Adulto , Assistência Odontológica , Duração da Terapia , Humanos , Aparelhos Ortodônticos , Resultado do Tratamento
8.
Eur J Orthod ; 42(3): 326-330, 2020 06 23.
Artigo em Inglês | MEDLINE | ID: mdl-31197364

RESUMO

BACKGROUND: Self-applied and professional fluorides are key elements to limit caries-related side-effects during orthodontic treatment with fixed appliances. OBJECTIVE: To evaluate the effectiveness of a new fluoride varnish formula containing 1.5% ammonium fluoride in preventing white spot lesions (WSLs) in adolescents undergoing multi-bracket orthodontic treatment. SUBJECTS AND METHODS: The study employed a randomized controlled triple-blinded design with two parallel arms. One hundred eighty-two healthy adolescents (12-18 years) referred to three orthodontic specialist clinics were eligible and consecutively enrolled. Informed consent was obtained from 166 patients and they were randomly allocated to a test or a placebo group (with aid of a computer program, generating sequence numbers in blocks of 15). In the test group, fluoride varnish was applied in a thin layer around the bracket base every sixth week during the orthodontic treatment, while patients in the placebo group received a varnish without fluoride. The intervention started at onset of the fixed appliances and continued until debonding. The endpoint was prevalence and severity of WSLs on the labial surfaces of the maxillary incisors, canines, and premolars as scored from high-resolution pre- and post-treatment digital photos with aid of a four-level score. RESULTS: One hundred forty-eight patients completed the trial, 75 in the test group and 73 in the placebo group (dropout rate 10.8%). The total prevalence of WSL's on subject level after debonding was 41.8% in the test group and 43.8% in the placebo group. The number of patients exhibiting more severe lesions (score 3 + 4) was higher in the placebo group (P < 0.05); the absolute risk reduction was 14% and the number needed to treat was 7.1. LIMITATIONS: The multicentre design with somewhat diverging routines at the different clinics may have increased risk for performance bias. No health-economic evaluation was carried out. CONCLUSIONS: Regular applications of an ammonium fluoride varnish reduced the prevalence of advanced WSL during treatment with fixed orthodontic appliances. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov (NCT03725020). PROTOCOL: The protocol was not published before trial commencement.


Assuntos
Cárie Dentária/etiologia , Cárie Dentária/prevenção & controle , Braquetes Ortodônticos/efeitos adversos , Adolescente , Cariostáticos , Fluoretos , Fluoretos Tópicos/uso terapêutico , Humanos , Aparelhos Ortodônticos/efeitos adversos , Aparelhos Ortodônticos Fixos/efeitos adversos
9.
Lasers Med Sci ; 35(2): 487-496, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31691053

RESUMO

The effect of ozone, diode laser irradiation, and presence of teeth crowding/spacing on pain perception in orthodontic patient was tested. Overall, 76 patients [55 women and 21 men; age 35.1(6.4) years] who met the inclusion criteria participated in the study. Immediately after fixed orthodontic appliance placement, the patients were exposed to a pain relief treatment (one single session) using either 635-nm diode laser (SmartM, Lasotronix, Warsaw, Poland) or ozone therapy (OzoneDTA, Apoza, New Taipei City, Taiwan) by placing the handpieces in the area of each teeth apex and interdental papillae, from the maxillary right first molar to the maxillary left first molar. Subjects were divided into three groups: control group (G1, n = 26), ozone (G2, n = 26, exposed to ozone therapy, generator probe type 3, working time per point 5 s, 23 points, application time 1 min and 55 s), and laser group (G3, n = 25, exposed to continuous mode diode laser, 400 mW, handpiece diameter 8 mm, spot area 0.5024 cm2, power density per second 1.59 W/cm2, dose 2 J per point, time: 5 s per point, 23 points, total energy per session 46 J, application time 1 min and 55 s). The level of teeth crowding was assessed using the Lundstrom indicator. The patients received a questionnaire for pain assessment (the Numeric Rating Scale, NRS-11, grade level 0-10) and recorded at 7 time points (1 h, 6 h, and 1, 2, 3, 4, and 5 days ) after the fixed orthodontic appliance placement. The mean pain values for the diode laser, ozone, and control group were 3.6 (1.31) (95% CI, 2.95-4.25), 5.25 (3.37) (95% CI, 3.52-6.98), and 5.75 (2.40) (95% CI, 4.69-6.81), respectively. We observed lower pain values in the diode laser group compared to the control group (p = 0.0237). The use of ozone in this study did not result in significant pain reduction in comparison to control (p = 0.8040) and laser groups (p = 0.1029). There were no differences in pain perception between patients with crowded teeth and non-crowded teeth in each group (G1, p = 0.66, G2, p = 0.86, G3, p = 0.24). The use of 635-nm diode laser led to decreased pain perception; however, ozone and presence of teeth crowding/spacing did not affect the pain perception in orthodontic patients during the first 5 days after the fixed orthodontic appliance placement.


Assuntos
Lasers Semicondutores/uso terapêutico , Maxila/cirurgia , Aparelhos Ortodônticos Fixos/efeitos adversos , Ozônio/uso terapêutico , Dor/cirurgia , Adulto , Feminino , Humanos , Terapia com Luz de Baixa Intensidade , Masculino , Má Oclusão/radioterapia , Manejo da Dor , Medição da Dor , Percepção da Dor , Inquéritos e Questionários
10.
Am J Orthod Dentofacial Orthop ; 156(2): 186-192, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31375228

RESUMO

INTRODUCTION: The purpose of this study was to compare and evaluate salivary microbial levels and periodontal status in patients using a fixed lingual retainer, a removable vacuum-formed retainer, or a Hawley retainer after orthodontic treatment with fixed appliances. METHODS: Forty-five patients who finished their orthodontic treatment with fixed appliances and were about to start the retention phase were randomly divided into the following 3 groups of 15 individuals each: the fixed lingual retainer group, the vacuum-formed retainer group, and the Hawley retainer group. Periodontal measurements, such as the plaque index, gingival index, probing depth, and bleeding on probing, were obtained at the following 4 time points: at debonding (T0) and 1 week (T1), 5 weeks (T2), and 13 weeks (T3) after debonding. Saliva samples were collected 3 times in total: at T0, T2, and T3. A quantitative analysis for Streptococcus mutans and Lactobacillus casei was performed with the use of real-time polymerase chain reaction. The Kruskal-Wallis test and 1-way analysis of variance were used for the statistical comparisons of the groups. RESULTS: No statistically significant difference in salivary S mutans and L casei levels was found among the 3 groups (P >0.05). They showed no statistically significant differences in plaque index, gingival index, bleeding on probing, and probing depth values (P >0.05). All periodontal parameters showed statistically significant decreases from T0 to T3 in all 3 groups (P <0.001). The S mutans and L casei levels were decreased significantly from T2 to T3 in the lingual retainer and Hawley retainer groups, whereas they decreased significantly from T0 to T3 in the vacuum-formed retainer group. CONCLUSIONS: Fixed and removable orthodontic retainers do not differ in salivary S mutans and L casei levels and periodontal status. With all retainers, regardless of whether they are fixed or removable, oral hygiene improved after orthodontic treatment with fixed appliances.


Assuntos
Aparelhos Ortodônticos Fixos/efeitos adversos , Aparelhos Ortodônticos Removíveis/efeitos adversos , Contenções Ortodônticas/efeitos adversos , Índice Periodontal , Saliva/microbiologia , Adolescente , Adulto , Análise de Variância , Criança , DNA Bacteriano , Índice de Placa Dentária , Feminino , Humanos , Lactobacillus casei , Masculino , Higiene Bucal , Desenho de Aparelho Ortodôntico , Ortodontia Corretiva/efeitos adversos , Ortodontia Corretiva/instrumentação , Streptococcus mutans , Vácuo , Adulto Jovem
11.
Int Orthod ; 17(4): 719-725, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31466932

RESUMO

OBJECTIVE: The objective of this trial was to compare the plaque removal ability of a triple-headed toothbrush to a conventional manual toothbrush in adolescents with fixed orthodontic appliances. MATERIALS AND METHODS: Sixty adolescent patients undergoing orthodontic treatment were randomly assigned to brush one time with either a conventional manual toothbrush or a triple-headed toothbrush. The main outcome was the post-brushing plaque index as measured by the Silness-Löe plaque index. RESULTS: Sixty patients (mean age, 14.2; standard deviation, 1.65) were randomized in a 1:1 ratio to either a manual toothbrush group or a triple-headed toothbrush group. Baseline characteristics were similar between the two groups. There were no dropouts. The mean post-brushing plaque index was 0.84 (95% CI, 0.67-1.02; SD, 0.60) for the conventional manual toothbrush group, and 0.31 (95% CI, 0.13-0.49; SD, 0.48) for the triple-headed toothbrush group. There was a statistically significant difference in the mean plaque index of 0.53 (95% CI, 0.28-0.78; P<0.001) between the two groups after brushing. No harms were observed. CONCLUSION: The results of this study indicate strong evidence that the triple-headed toothbrush leads to a significantly lower plaque index compared to the conventional manual toothbrush post-brushing.


Assuntos
Placa Dentária/terapia , Aparelhos Ortodônticos Fixos/efeitos adversos , Escovação Dentária/métodos , Adolescente , Criança , Índice de Placa Dentária , Desenho de Equipamento , Feminino , Humanos , Masculino , Método Simples-Cego
12.
BMC Oral Health ; 19(1): 72, 2019 05 02.
Artigo em Inglês | MEDLINE | ID: mdl-31046726

RESUMO

OBJECTIVE: To examine: (I) the current evidence of the impact of fixed orthodontic appliances on the development of halitosis in patients undergoing orthodontic treatment, and (II) the influence of different orthodontic bracket systems on halitosis. MATERIAL AND METHODS: Three electronic databases (PubMed, Scopus, and Cochrane Library) were searched prior to March 15, 2018. The review was systematically conducted and reported according to the Cochrane Handbook and the PRISMA statement. Only Randomised Clinical Trials (RCTs) were considered. Selected full-text papers were independently assessed by four investigators and any disagreements were resolved by consensus. The Cochrane Handbook was used to grade the risk of bias and the quality of evidence was rated according to GRADE. RESULTS: Out of 363 identified studies, three RCTs on halitosis and fixed orthodontic appliances met the inclusion criteria. The risk of bias in the three studies was rated as high and the quality of evidence was rated as very low. CONCLUSIONS/CLINICAL IMPLICATIONS: There is a lack of scientific evidence that subjects with fixed orthodontic appliances develop halitosis during treatment. Additional well-conducted RCTs with extended periods of assessment are needed as well as consensus concerning cut-off values for the diagnosis of halitosis.


Assuntos
Halitose , Aparelhos Ortodônticos Fixos/efeitos adversos , Braquetes Ortodônticos/efeitos adversos , Humanos , Aparelhos Ortodônticos , Ensaios Clínicos Controlados Aleatórios como Assunto
13.
Eur J Orthod ; 41(5): 486-494, 2019 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-30934051

RESUMO

BACKGROUND: Pain is an unpleasant side-effect that can be experienced during orthodontic procedures including debonding of fixed appliances. Pain experience can vary depending on the appliance, debonding technique, as well as adjunctive measures used. OBJECTIVES: The primary objective of this systematic review was to assess the effectiveness of different debonding techniques and adjunctive methods on pain/discomfort perception during debonding procedure (PDP) of fixed orthodontic appliances. The secondary objective was to assess the effects of anatomic location and gender on PDP of fixed orthodontic appliances. SEARCH METHODS: Multiple electronic databases were searched from inception to August 2018. Reference lists of the included articles were manually screened. SELECTION CRITERIA: Randomized clinical trials (RCTs) and controlled clinical trials were included. DATA COLLECTION AND ANALYSIS: Study selection, data extraction, and risk of bias assessment were performed independently by two reviewers according to Cochrane guidelines, with disputes resolved by a third reviewer. Clinical heterogeneity in study design and methodology prevented quantitative synthesis of the data. RESULTS: The search yielded 198 articles after the removal of duplicates. Seven studies were included in the final review with a total of 307 participants aged 12-60 years. Of the four studies comparing different debonding instruments of labial fixed appliances, two studies showed that the lift-off debonding instrument (LODI) produced lower PDP levels than ligature cutting pliers. Three studies compared adjunctive measures to reduce PDP of labial fixed appliances. Finger pressure and bite wafers significantly reduced PDP levels. Analgesics administration (ibuprofen + paracetamol tablets) 1 hour prior to debonding also reduced PDP. PDP was significantly higher in anterior segments and in females. LIMITATIONS: The authors acknowledge that there was clinical heterogeneity among the included studies and that the potential effect of diurnal variation on pain during debonding was not considered in any of the included trials. CONCLUSIONS AND IMPLICATIONS: There is weak evidence indicating that using the LODI may reduce PDP of labial fixed appliances. Adjunctive measures such as an intrusive force with finger pressure, bite wafers, and preoperative analgesia may further aid PDP control. Further well-designed parallel-group RCTs taking into consideration the diurnal variation in pain are required. REGISTRATION: PROSPERO (CRD42017084474). FUNDING: None. CONFLICT OF INTEREST: The authors declare that there is no conflict of interest.


Assuntos
Acetaminofen , Dor , Adolescente , Adulto , Criança , Assistência Odontológica , Feminino , Humanos , Ibuprofeno , Pessoa de Meia-Idade , Aparelhos Ortodônticos/efeitos adversos , Aparelhos Ortodônticos Fixos/efeitos adversos , Adulto Jovem
14.
J Orofac Orthop ; 80(2): 88-96, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30778609

RESUMO

PURPOSE: To evaluate the impact of a novel computer-fabricated lingual nitinol retainer compared to a conventional lingual flexible spiral wire twistflex retainer on oral health. METHODS: The study was based on a retrospective controlled clinical study with pilot character, an in vitro investigation of material-dependent biofilm formation and an analysis of biofilm formation after intraoral incubation. Sixty-one patients with completed fixed orthodontic treatment and retention phase for at least 6 months with twistflex retainers (group 1, n = 31) or computer-aided design/computer-aided manufacturing (CAD/CAM) nitinol retainers (group 2, n = 30) were included and examined regarding plaque index (PI), gingival index (GI), probing depths, bleeding on probing (BOP) and marginal recessions (MR). Material-dependent biofilm formation of twistflex, untreated nitinol and electropolished nitinol wire samples were assessed (1) in vitro: using optical density (OD) measurement of 10 samples of each and (2) in vivo: using histomorphometric analysis of 18 samples of each. RESULTS: Patients treated with nitinol retainers had significant better oral health indices (PI1 = 1.29 ± 0.06, PI2 = 0.94 ± 0.06; GI1 = 0.71 ± 0.05, GI2 = 0.56 ± 0.04; BOP1 = 0.11 ± 0.01, BOP2 = 0.08 ± 0.01; PD1 = 1.79 ± 0.03 mm, PD2 = 1.59 ± 0.04 mm) except for MR (0.08 ± 0.03 mm versus 0.08 ± 0.02 mm) compared to twistflex retainers. After 24 h intraoral incubation nitinol retainers demonstrated significant less biofilm formation compared to twistflex retainers. In the in vitro investigation the temporary significant differences between the groups were compensated in the end. CONCLUSIONS: Based on the results it can be assumed that nitinol-made CAD/CAM developed lingual retainers have a positive effect on oral health.


Assuntos
Ligas , Desenho Assistido por Computador , Materiais Dentários , Aparelhos Ortodônticos Fixos , Contenções Ortodônticas , Adulto , Biofilmes/crescimento & desenvolvimento , Índice de Placa Dentária , Humanos , Pessoa de Meia-Idade , Saúde Bucal , Aparelhos Ortodônticos Fixos/efeitos adversos , Contenções Ortodônticas/efeitos adversos , Índice Periodontal , Estudos Retrospectivos , Adulto Jovem
15.
Photodiagnosis Photodyn Ther ; 25: 456-459, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30753923

RESUMO

BACKGROUND: The aim of the present study was to comprehensively review indexed literature regarding the potential role of antimicrobial photodynamic therapy (aPDT) in Orthodontics. METHODS: Indexed databases were searched up to and including January 2019 using the following key words: (a) antimicrobial photodynamic therapy; (b) antimicrobial photodynamic chemotherapy; (c) orthodontic; and (d) orthodontics. Original (clinical and experimental) studies, case-reports, and case-series were included. Letters to the Editor, commentaries and review articles were excluded. RESULTS: Out of the 29 studies identified in the initial search, 4 studies were processed for data extraction. Three studies were randomized clinical trials performed in humans and 1 study was experimental. Results from 2 studies showed that aPDT is effective in the treatment of gingival inflammation in patients undergoing orthodontic therapy (OT). One study showed that oral decontamination can be successfully performed using aPDT among patients undergoing OT. Results of the experimental study showed that aPDT helps in surface decontamination of orthodontic instruments. CONCLUSION: There is insufficient evidence in indexed literature to justify the potential role of aPDT in OT. Hence, further studies are required in this regard.


Assuntos
Infecções Bacterianas/tratamento farmacológico , Gengivite/tratamento farmacológico , Aparelhos Ortodônticos Fixos/efeitos adversos , Fotoquimioterapia/métodos , Infecções Bacterianas/etiologia , Gengivite/etiologia , Humanos , Fármacos Fotossensibilizantes/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto
16.
Clin Oral Investig ; 23(7): 2913-2919, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30612244

RESUMO

OBJECTIVE: This study aimed to evaluate the genotoxic effects in the oral epithelial cells of patients undergoing fixed orthodontic treatment and to compare these to a control group without treatment. The null hypothesis to be tested is that corrective orthodontic treatment at different periods does not cause genotoxic effects in patients. MATERIAL AND METHODS: An observational cross-sectional study including 74 patients enrolled in corrective orthodontic treatment and 21 control patients, between 11 and 35 years of age, of both genders, participated in the research. Patients undergoing treatment were divided into four treatment groups differentiated by treatment periods: G1, n = 21 (1 month to 12 months); G2, n = 21 (13 to 24 months); G3, n = 23 (25 to 48 months); and G4, n = 9 (over 48 months). Cells were collected by scraping the internal side of the cheek and subsequently placed in tubes containing 0.9% sodium chloride solution. The sample underwent evaluation for genotoxic effects by means of the micronucleus test (MNT). Bivariate analyses were performed using parametric tests (t test or ANOVA) and nonparametric tests (Chi-square test, Kruskal-Wallis test, Dunn post-test). The adopted level of significance was 5%. RESULTS: Statistically significant differences for any of the genotoxic abnormalities (binucleated, trinucleated, karyolysis, piknosis, nuclear buds) were not found except for karyolysis, which was higher in the control group than in G4 (p < 0.05). CONCLUSIONS: This study did not demonstrate evidence of genotoxic effects even after long periods of corrective orthodontic treatment. CLINICAL RELEVANCE: This study explores genotoxic effects in fixed orthodontic patients.


Assuntos
Dano ao DNA , Aparelhos Ortodônticos Fixos , Ortodontia Corretiva , Adolescente , Adulto , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Testes de Mutagenicidade , Aparelhos Ortodônticos Fixos/efeitos adversos , Adulto Jovem
17.
Curr Microbiol ; 76(2): 213-221, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30542916

RESUMO

Although periodontal diseases during fixed appliance treatment are a common issue, few studies have focused on the clinical and microbial factors associated with orthodontic appliances. Hence, we investigated changes in the subgingival microbial community and their association with periodontal changes at the early stage of fixed appliance treatment. Subgingival plaques from ten female patients with fixed appliances were obtained at three time points: before, 1 month and 3 months after the placement of the brackets (T0, T1 and T2). The 16S rRNA gene sequencing was used to analyze the microbial community of the subgingival plaque. The Plaque Index (PI) and Gingival Bleeding Index (GBI) were also recorded. The GBI significantly increased at T2, and the PI showed a temporary increase without a significant difference. The alpha diversity indices were stable. However, the beta diversity was significantly higher at T2 compared to T0 and T1. The relative abundance of core microbiomes at the genus level was relatively stable. Four periodontal pathogens at the species level, including Prevotella intermedia (Pi), Campylobacer rectus (Cr), Fusobacterium nucleatum (Fn), and Treponema denticola (Td), increased without significant differences. The subgingival microbial community affected by fixed appliance treatment might cause transient mild gingival inflammation.


Assuntos
Bactérias/classificação , Carga Bacteriana , Gengiva/microbiologia , Microbiota , Aparelhos Ortodônticos Fixos/efeitos adversos , Adulto , Bactérias/isolamento & purificação , Bactérias/patogenicidade , Índice de Placa Dentária , Feminino , Hemorragia , Humanos , Inflamação/etiologia , Inflamação/microbiologia , Doenças Periodontais/etiologia , Doenças Periodontais/microbiologia , Porphyromonas gingivalis/isolamento & purificação , Porphyromonas gingivalis/patogenicidade , Prevotella intermedia/isolamento & purificação , Prevotella intermedia/patogenicidade , RNA Ribossômico 16S/genética , Fatores de Tempo , Adulto Jovem
18.
Mycoses ; 62(3): 247-251, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30561858

RESUMO

OBJECTIVES: We investigated the colonisation by Candida spp in patients using orthodontic fixed appliances by characterising the isolated Candida strains and by evaluating the host oral mucosa response through the measure of human ß-defensins 3 (HBD-3) expression and Interleukin-1ß/IL-10. METHODS: Ninety patients were enrolled after signing an informed consent. Prevalence, susceptibility to fluconazole, genotyping and oral fungal burden of Candida sp. isolated were determined. Host responses were evaluated by measuring HBD-3 expression as well as IL-1ß and IL-10 in saliva. RESULTS: The colonisation rate reached 6.7% (6/90), and 5 patients were colonised with C. albicans strains and one with one with C. tropicalis. The fluconazole MIC90/susceptibility of C. albicans strains ranged 1/0.25-1 µg/mL. However, isolated strains did not present different genotype (SAB>0.9), C. albicans colonisation seems to be influenced by the duration of treatment and by level expression of HBD3 that were higher in colonised patients (not statistically different). A negative correlation between the fungal burden and IL-1ß levels was found in colonised patients but not for IL-10. CONCLUSIONS: Our study revealed that patients with orthodontic fixed appliances were mainly colonised by C. albicans, which was related to a decrease in HBD-3 expression and IL-1ß levels.


Assuntos
Candida/isolamento & purificação , Portador Sadio/epidemiologia , Fatores Imunológicos/análise , Mucosa Bucal/imunologia , Micoses/epidemiologia , Aparelhos Ortodônticos Fixos/efeitos adversos , Saliva/microbiologia , Adolescente , Adulto , Candida/classificação , Candida/efeitos dos fármacos , Candida/imunologia , Candida albicans , Portador Sadio/microbiologia , Contagem de Colônia Microbiana , Feminino , Genótipo , Humanos , Interleucina-10/análise , Interleucina-1beta/análise , Masculino , Testes de Sensibilidade Microbiana , Micoses/microbiologia , Prevalência , Adulto Jovem , beta-Defensinas/análise
19.
Eur J Orthod ; 41(1): 59-66, 2019 01 23.
Artigo em Inglês | MEDLINE | ID: mdl-29722800

RESUMO

Background: Caries is an undesirable side-effect of treatment with fixed orthodontic appliances. Therefore, it is crucial to understand how orthodontic treatment and different fluoride regimens affect caries risk and individual risk factors. Objective: To evaluate the effects of orthodontic treatment and different fluoride regimens on caries risk and caries risk factors, including cariogenic bacteria. Trial design: Three-armed, parallel group, randomized, controlled trial. Methods: Patients referred to the Specialist Clinic of Orthodontics, Mölndal Hospital, Sweden, were distributed randomly into the following groups: group I (Control group), 1450 ppm fluoride (F) toothpaste; group II, 1450 ppm F toothpaste plus 0.2 per cent sodium fluoride (NaF) mouth rinse; and group III, 5000 ppm F toothpaste. The inclusion criteria were: age 12-20 years; and bimaxillary treatment with fixed appliances. The primary outcome variables were: caries risk; and the numbers of cariogenic bacteria. Radiographs were taken before treatment to determine the caries status. Data were collected before treatment and after 1 year with a fixed appliance. The variables were compiled into a Cariogram to assess the caries risk. Comparisons were made over time within and between the groups. The generation of randomization sequence was performed in blocks of 30. Blinding was employed during the data analysis and the caries registration. Recruitment: The clinical study duration was from October 2010 to December 2012. Results: Overall, 270 patients were randomized, of which 15 were excluded from the study. Therefore, 255 patients were included in the analyses. The caries risk increased significantly during orthodontic treatment in group I (P < 0.0001), whereas groups II and III had unchanged caries risks. All the groups showed statistically significant increases in the numbers of cariogenic bacteria. Harms: No harms were reported during the trial. Conclusions: To avoid an increased risk of caries during orthodontic treatment, everyday use of high-fluoride toothpaste (5000 ppm F) or mouth rinse (0.2% NaF) in combination with ordinary toothpaste is recommended. Registration: The trial was not registered.


Assuntos
Bactérias/isolamento & purificação , Cariostáticos/administração & dosagem , Cárie Dentária/prevenção & controle , Fluoretos/administração & dosagem , Aparelhos Ortodônticos Fixos/efeitos adversos , Cremes Dentais/química , Adolescente , Cariostáticos/uso terapêutico , Criança , Assistência Odontológica/métodos , Cárie Dentária/etiologia , Cárie Dentária/microbiologia , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Fluoretos/uso terapêutico , Humanos , Masculino , Antissépticos Bucais/química , Antissépticos Bucais/uso terapêutico , Método Simples-Cego , Fluoreto de Sódio/uso terapêutico , Suécia , Adulto Jovem
20.
J Oral Rehabil ; 46(3): 257-267, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30378703

RESUMO

BACKGROUND: Although inflammation can alter cytokines release and nerve function, it is not yet fully established if orthodontic-induced inflammation can cause significant extraoral trigeminal somatosensory alterations and release of inflammatory chemical mediators. OBJECTIVE: The primary aim of this study was to investigate the impact of orthodontic separator and short-term fixed orthodontic appliance on the extraoral trigeminal somatosensory function and concentrations of cytokines in the gingival crevicular fluid (GCF). METHODS: Twenty-two female patients were evaluated as follow: baseline, 24 hour-after elastomeric separator (-aES), 24 hour- and 1 month-after bonding brackets (-aBB) at both arches. The outcome variables were as follows: self-reported pain (Visual Analog Scale), QSTs (current perception threshold-CPT, cold detection threshold-CDT, warm detection threshold-WDT, mechanical detection threshold-MDT, mechanical suprathreshold-MST and wind-up ratio-WUR. All QSTs were performed at infra-orbital and mental nerve entry zone at patient`s dominant side. In addition, GCF samples in order to assess cytokines profile (IL-1ß,IL-8,IL-6 and TNF-α) were collected. ANOVA and Tukey's post hoc analyses were performed (a = 5%). RESULTS: Patients reported higher pain intensity 24 hour-aBB compared to baseline and 24 hour-aES (P < 0.050). Patients were less sensitive to pin-prick pain (MST) at 24 hour-aBB and 1 month-aBB compared to baseline (P < 0.006). Significant increases in IL-6 levels were observed 24 hour-aBB (P < 0.001). Multiple comparison analysis showed significant increase in IL-1ß levels (P < 0.001) and TNF-α (P < 0.001) 1 month-aBB compared to baseline. CONCLUSION: Elastomeric separators only induced mild pain and were not able to significantly increase proinflammatory cytokines level in the GCF. In addition, orthodontic fixed appliance may induce only minor somatosensory changes at extraoral trigeminal locations.


Assuntos
Citocinas/metabolismo , Dor Facial/fisiopatologia , Líquido do Sulco Gengival/metabolismo , Mediadores da Inflamação/metabolismo , Aparelhos Ortodônticos Fixos/efeitos adversos , Técnicas de Movimentação Dentária/efeitos adversos , Adolescente , Criança , Dor Facial/metabolismo , Feminino , Humanos , Medição da Dor , Limiar Sensorial/fisiologia , Adulto Jovem
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