Objectives/Hypothesis
Mandibular advancement devices are an alternative to continuous positive airway pressure for patients with mild or moderate obstructive sleep apnea/hypopnea syndrome (OSAHS). ...The main aim of this review was to assess the effectiveness of different devices in treating OSAHS, based on polysomnographic measurements such as the apnea/hypopnea index (AHI) and oxygen saturation, and on changes in the upper airway and improvements in the most common symptoms: snoring and somnolence. Their adverse effects were also noted.
Study Design
Systematic review.
Methods
Following an exhaustive search in the Medline, Scopus, and Cochrane Library databases, 22 articles published in the past 10 years met the quality and inclusion criteria.
Results
Using mandibular advancement devices during the hours of sleep helps to prevent snoring and excessive daytime sleepiness, reduce the AHI significantly, and bring about beneficial changes in the upper airway. Adjustable and custom‐made mandibular advancement devices give better results than fixed and prefabricated appliances. Monobloc devices give rise to more adverse events, although these are generally mild and transient.
Conclusions
Mandibular advancement devices increase the area of the airway. They bring the soft palate, tongue, and hyoid bone forward and activate the masseter and submental muscles, preventing closure. All these effects reduce the AHI, increase the oxygen saturation, and improve the main symptoms of OSAHS.
Level of Evidence
NA Laryngoscope, 126:507–514, 2016
Provisional restorations represent an important phase during the rehabilitation process, knowledge of the mechanical properties of the available materials allows us to predict their clinical ...performance. At present, there is no systematic review, which supports the clinicians' criteria, in the selection of a specific material over another for a particular clinical situation. The purpose of this systematic review and meta-analysis was to assess and compare the mechanical properties of dimethacrylates and monomethacrylates used in fabricating direct provisional restorations, in terms of flexural strength, fracture toughness and hardness. This review followed the PRISMA guidelines. The searches were conducted in PubMed, Embase, Web of Science, Scopus, the New York Academy of Medicine Grey Literature Report and were complemented by hand-searching, with no limitation of time or language up to January 10, 2017. Studies that assess and compare the mechanical properties of dimethacrylate- and monomethacrylate-based provisional restoration materials were selected. A quality assessment of full-text articles were performed according to modified ARRIVE and CONSORT criteria and modified Cochrane Collaboration's tool for in vitro studies. Initially, 256 articles were identified. After removing the duplicates and applying the selection criteria, 24 articles were included in the qualitative synthesis and 7 were included in the quantitative synthesis (meta-analysis). It may be concluded that dimethacrylate-based provisional restorations presented better mechanical behavior than monomethacrylate-based ones in terms of flexural strength and hardness. Fracture toughness showed no significant differences. Within the monomethacrylate group, polymethylmethacrylate showed greater flexural strength than polyethylmethacrylate.
In adult patients, treatment of skeletal crossbite requires combined treatment by fixed or removable appliances and orthognathic surgery. In cases of dentoalveolar crossbite, expansion can be ...achieved with fixed multibrackets and removable transparent aligners. Various researchers have already assessed the Invisalign system's predictability for arch expansion. However, most of this research was conducted using older appliances, making it necessary to assess the characteristics of the updated system SmartTrack.
A sample of 114 patients with transverse malocclusion were treated with SmartTrack. The predictability of the system's software (Clincheck) was assessed by comparing planned measurements (width of canines, premolars and molars rotations and inclinations) with the real measurements achieved at the end of the first treatment phase. Measurements were imported to Clincheck software to create three data sets; T1: initial measurements at start of treatment; T2: Clincheck predicted measurements at end of first treatment phase; T3: measurements taken at start of the second treatment phase.
Widths underwent significant advances as a result of treatment. For all widths, virtual planning obtained prognoses of greater expansion than actually achieved: a mean of 0.63 mm more expansion at the canine level (p<0.001), 0.77 mm at first premolar (p<0.001), 0.81 at second premolar (p<0.001), 0.69 mm at first molar (p<0.001), and 0.25 mm at second molar (p = 0.183). All the treatment plan's estimations, with the exception of the second molar, were significantly higher than the actual outcomes.
Aligners are an effective tool for producing arch expansion, being more effective in premolar area and less effective in canine and second molar area. Predictability was reasonable for expansion movement. Overcorrection should be considered at the virtual planning stage in order to obtain the expected outcomes.
The reason of the biological stability loss of mini-implants is still a matter of discussion between dentistry professionals. The main objective of this systematic literature review and meta-analysis ...was to analyze the risk factors that prejudice this loss. A search was made in the electronic databases Pubmed, Scopus, Embase and Cochrane, in addition a manual search was made too in Grey Literature (Opengrey). No limits were set on the year of publication or language. The inclusion criteria were: studies in humans treated with fixed appliances with mini-implants, where the risk factors for secondary stability were evaluated for a minimum of 8 weeks. After eliminating duplicate studies and assessing which ones achieve the inclusion criteria, a total of 26 studies were selected for the qualitative synthesis, 18 of them were included in the quantitative synthesis. Common risk variables were compared in all of them. Analyzing the forest and funnel plots, statistically significant differences were obtained only for location, the upper maxilla having lower risk than the mandible with an odds ratio of 0.56 and confidence interval of 0.39 to 0.80. Prospective studies under controlled conditions should be required in order to obtain a correct assessment of the variables analyzed.
Oral implantology is a science in constant evolution, with a considerable number of articles being published every year in scientific journals. Publications can be analyzed through bibliometric ...analysis, thus observing the evolution and trends of the articles published in the journal. To evaluate, through bibliometric analysis, the scientific production of Clinical Implant Dentistry and Related Research (CIDRR) and its evolution and trends in the last 5 years (2016–2020).All articles published in CIDRR in the last 5 years were reviewed and classified according to the year of publication, volume, number, the number of authors, demographic data of the first and last author, the geographical scope of the article, the number of affiliations of the authors, research topic, type of study, and study design. The association between these variables and citation counts was also analyzed. 599 articles were analyzed. 77.4% were authored by 4–6 authors, obtaining 78.4% from 1 to 3 different affiliations. Male researchers predominated in both the first and last authorship. China showed the highest number of publications when comparing the origin of the authors’ affiliations individually; however, most researchers (40.9%) were from the European Union (EU)-Western Europe area. The most studied topic was the implant/abutment design/treatment of the surface (19.1%). Clinical research articles accounted for 92.99% of the publications, of which cross-sectional observational studies prevailed (21.7%). The presence of articles from the United States of America-Canada and EU-Western Europe was positively correlated with the impact factor. This study revealed an increasing trend in Asian research production, particularly Chinese, whereas production of European origin showed a decrease. Clinical studies increased their relative weight to the detriment of translational ones. A growing tendency in the relative weights of female authors was appreciated. Journal citations were associated with certain study variables.
Femtosecond laser has been proposed as a method for conditioning zirconia surfaces to boost bond strength. However, metallic or ceramic bracket bonding to femtosecond laser-treated zirconia surfaces ...has not been tested. This study compared the effects of four conditioning techniques, including femtosecond laser irradiation, on shear bond strength (SBS) of metallic and ceramic brackets to zirconia.Three hundred zirconia plates were divided into five groups: 1) control (C); 2) sandblasting (APA); 3) silica coating and silane (SC); 4) femtosecond laser (FS); 5) sandblasting followed by femtosecond laser (APA+SC). A thermal imaging camera measured temperature changes in the zirconia during irradiation. Each group was divided into 2 subgroups (metallic vs ceramic brackets). SBS was evaluated using a universal testing machine. The adhesive remnant index (ARI) was registered and surfaces were observed under SEM. Surface treatment and bracket type significantly affected the bracket-zirconia bond strength. SBS was significantly higher (p<0.001) for ceramic brackets in all groups (APA+FS > APA > FS > SC > control) than metallic brackets (APA+FS > FS > SC > APA > control). For metallic brackets, groups SC (5.99 ± 1.86 MPa), FS (6.72 ± 2.30 MPa) and APA+FS (7.22 ± 2.73 MPa) reported significantly higher bond strengths than other groups (p < 0.05). For ceramic brackets, the highest bond strength values were obtained in groups APA (25.01 ± 4.45 MPa), FS (23.18 ± 6.51 MPa) and APA+FS (29.22 ± 8.20 MPa).Femtosecond laser enhances bond strength of ceramic and metallic brackets to zirconia. Ceramic brackets provide significantly stronger adhesion than metallic brackets regardless of the surface treatment method.
Lasers have recently been introduced as an alternative means of conditioning dental ceramic surfaces in order to enhance their adhesive strength to cements and other materials. The present systematic ...review and meta-analysis aimed to review and quantitatively analyze the available literature in order to determine which bond protocols and laser types are the most effective. A search was conducted in the Pubmed, Embase and Scopus databases for papers published up to April 2017. PRISMA guidelines for systematic review and meta-analysis were followed. Fifty-two papers were eligible for inclusion in the review. Twenty-five studies were synthesized quantitatively. Lasers were found to increase bond strength of ceramic surfaces to resin cements and composites when compared with control specimens (p-value < 0.01), whereas no significant differences were found in comparison with air-particle abraded surfaces. High variability can be observed in adhesion values between different analyses, pointing to a need to standardize study protocols and to determine the optimal parameters for each laser type.
Class III malocclusion presents some complexity in terms of diagnosis and treatment and affects not only the jaws but the whole craniofacial complex. Besides, functional forward displacement of the ...mandible may be diagnosed in a patient presenting Class III malocclusion, as the 2 entities are not incompatible or mutually exclusive. This case report describes the multidisciplinary, nonsurgical, orthodontic treatment of an adult patient with a skeletal Class III malocclusion, anterior crossbite, and a palatally impacted canine, treated with fixed appliances and skeletal anchorage. To upright the mandibular molars, distalize the whole mandibular arch, and avoid excessive inclination of maxillary incisors to improve dentofacial esthetics, miniscrews were placed in the retromolar area. The treatment results were very satisfactory and remained stable after a reasonable retention period.
•Class III malocclusion presents some complexity in terms of diagnosis and treatment.•Adequate incisor torque is crucial to improve esthetics in Class III malocclusions.•Microscrews were used to distalize the whole mandibular arch.•Spontaneous eruption can be performed in adult patients with superficial canines.
A gummy smile is one of the most problematic characteristics in patients with a Class II Division 2 malocclusion, and the correction of vertical position and incisor torque is often challenging for ...the orthodontist. This case report describes the orthodontic treatment of a 31-year-old woman, assisted by miniscrew mechanics for maxillary arch distalization and correction of a gummy smile with a brachyfacial pattern. Two different mechanics were used. Miniscrews were placed in both maxillary tuberosities, and the maxillary arch was successfully distalized, correcting the Class II relationship. Interradicular miniscrews were placed for maxillary and mandibular incisor intrusion to correct the gummy smile, overbite, and torque. Finally, periodontal surgery was performed to lengthen the maxillary incisor crowns. Satisfactory smile esthetics and good occlusion were achieved. Follow-up after 24 months confirmed that the outcome was stable.
•The diagnosis of gummy smile etiology is crucial for accurate treatment planning.•Adequate vertical position and torque of incisors provide good stability.•Miniscrews facilitate the correction of Class II and incisor overeruption.•Gingivectomy improves smile esthetics when the altered passive eruption is diagnosed.
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