Preservation of the alveolar bone is a determinant in the outcome of orthodontic treatment. Alveolar bone defects or a decrease of their height and width may occur due to common reasons such as ...inflammation, tooth extraction, or cleft lip and palate. The aim of this systematic review was to investigate and appraise the quality of the most up to date available evidence regarding the applications and effects of platelet-rich fibrin (PRF) in orthodontics. This study was carried out according to preferred reporting items for systematic reviews and meta-analyses guidelines using the following databases: Medline via PubMed, Cochrane Library, Web of Science Core Collection and EMBASE. The qualitative assessment of the included studies was performed using Cochrane Risk of Bias tool and ROBINS-I guidelines. Results: From a total of 489 studies, nine studies were selected. The majority of the included studies demonstrate that autogenous anterior iliac graft with PRF had a higher amount of newly formed bone. Furthermore, this review also suggests that the application of platelet derivatives in the extraction socket can accelerate orthodontic tooth movement. Despite the limitations in the included studies, this systematic review suggested that PRF can improve alveolar cleft reconstruction and orthodontic tooth movement.
(1) Background: It has been recognized that CLP condition may affect oral health-related quality of life (OHRQoL) due to dental anomalies and abnormal craniofacial development. Aim: To assess whether ...orthodontic treatment affected the levels of OHRQoL in CLP patients and their families. (2) Methods: 226 individuals (111 with cleft and 115 control) and their parents were invited to complete the Oral Health Impact Profile-14 (OHIP-14) and Family Impact Scale (FIS), respectively. The Mann-Whitney test was used for quantitative variables and the Fisher's exact test for categorical variables. The Spearman Rank Correlation Coefficient was used to correlate the results of the OHIP and FIS questionnaires. (3) Results: No significant difference was found between groups in OHIP-14 but FIS score revealed a significant difference between the two groups evaluated (
< 0.001). Only the social limitation in OHIP score revealed a significant difference (
= 0.001). Regarding FIS score, the most affected dimensions were family activities (
< 0.001), parental emotions (
= 0.001), and family conflict (
= 0.011). (4) Conclusion: Undergoing orthodontic treatment had a similar impact on the overall quality of life in CLP patients and non-cleft patients. Parents of cleft children had a poorer OHRQoL compared to what was perceived by their children and parents of non-cleft children.
(1) Background: The etiology of orofacial cleft (OC) is not completely known but several genetic and environmental risk factors have been identified. Moreover, a knowledge gap still persists ...regarding neonatal characteristics. This study evaluated the effect of parental age and mothers' body mass index on the risk of having an OC child, in a matched year and sex group (cleft/healthy control). Additionally, birth data were analyzed between groups. (2) Methods: 266 individuals born between 1995 to 2015 were evaluated: 133 OC individuals (85 males/48 females) and 133 control (85 males/48 females). A logistic model was used for the independent variables. ANOVA or Kruskal-Wallis tests were used for comparison between the OC phenotypes. (3) Results: Regarding statistically significant parental related factors, the probability of having a cleft child decreases for each maternal year increase (odds ratio = 0.903) and increases for each body mass index unit (kg/m
) increase (odds ratio = 1.14). On the child data birth, for each mass unit (kg) increase, the probability of having a cleft child decrease (odds ratio = 0.435). (4) Conclusions: In this study, only maternal body mass index and maternal age found statistical differences in the risk of having a cleft child. In the children's initial data, the cleft group found a higher risk of having a lower birth weight but no relation was found regarding length and head circumference.
Objective
To conduct a systematic review with meta‐analysis to assess if cleft lip and palate (CLP) patients undergoing orthodontic treatment have a higher colonization of Streptococcus mutans and ...Lactobacillus than patients without this condition.
Methods
Five electronic databases were searched systematically. The inclusion criteria were as follows: randomized clinical trials, non‐randomized, or quasi‐randomized controlled trials, prospective and retrospective studies published until March, 2021; articles that evaluated S. mutans and Lactobacillus profile in patients with and without cleft lip and palate undergoing orthodontic treatment. The random‐effect model was used to perform the analysis of all the data collected. Statistic heterogeneity was evaluated with I2 test.
Results
In this systematic review, 2 cohort studies were included. The data analysis from 160 patients revealed that patients without cleft lip and palate had 4.5 times more predisposition to oral colonization with S. mutans than CLP patients. No statistical significant difference was found between these patients for colonization with Lactobacillus.
Conclusions
Despite the limitations in the included studies, this systematic review suggested that CLP patients have a lower predisposition to oral colonization with S. mutans when compared to healthy patients.
(1) Background: To evaluate the effects of the direct and indirect contact of leukocyte and platelet-rich fibrin (L-PRF) on bone development, in an ex vivo embryonic chick femur model. (2) Methods: ...Both sections of L-PRF membranes (red and yellow portions) were evaluated with scanning electron microscopy and histochemical staining. The in vivo angiogenic activity was evaluated using a chorioallantoic membrane model. The osteogenic activity was assessed with an organotypic culture of embryonic chick femora through direct and indirect contact, and assessment was conducted by microtomographic and histological analysis. Descriptive statistics, One-Way ANOVA and Tukey's multiple comparisons tests were performed for datasets that presented a normal distribution, and Kruskal-Wallis tests were performed for non-parametric datasets. A significance level of 0.05 was considered. (3) Results: The L-PRF induced angiogenesis reflected by a higher number and a larger and more complex gauge in the vessels that invaded the membrane. The physical presence of the membrane over the bone (direct contact) unleashes the full potential of the L-PRF effects on bone growth enhancement. The greatest increase in mineral content was observed in the diaphysis region. (4) Conclusion: The L-PRF direct contact group presented higher values on mineral content for bone volume, bone surface and bone mineral density than the indirect contact and control groups.
Currently, composite resins have become the material of choice for the restoration of posterior teeth. Although bulk-fill resins represent a tempting alternative due to their lower complexity and ...faster use, some dentists are reluctant to use this material. The objective is to compare the performance of bulk-fill resins and conventional resins in direct restorations of posterior teeth based on the literature. The databases that were used to carry out the research were PubMed/MEDLINE, Embase, the Cochrane Library and the WOS. This umbrella literature review complies with PRISMA standards and assesses the quality of studies using the AMSTAR 2 tool. With the application of the criteria of the AMSTAR 2 tool, the reviews were considered low to moderate. The overall meta-analysis, although without statistical significance, favours mostly the use of conventional resin, as it is about five times more likely to obtain a favourable result than bulk-fill resin. Bulk-fill resins result in a simplification of the clinical process of posterior direct restorations, which is an advantage. The performance in terms of several properties of bulk-fill resins and conventional resins showed that they present similar behaviour.
The role of medical students in the current coronavirus disease 2019 (COVID-19) pandemic is rapidly evolving. The aim of this review is to explore the involvement of medical students in past global ...health emergencies, to help inform current and future scenarios.
A rapid systematic review was undertaken, including articles from online databases discussing the roles, willingness and appropriateness of medical student involvement in global health emergencies. Data were extracted, appraised and written up as a narrative synthesis. This study was registered with PROSPERO (CRD42020177231).
Twenty-eight articles were included. Medical students played a wide variety of clinical and nonclinical roles including education and logistics, although medical assistance was the most commonly reported role. Challenges included a lack of preparedness and negative mental health impacts. A total of 91.7% of included articles about willingness found medical students were more willing to be involved than not.
This review shows medical students are capable and willing to be involved in global health emergencies. However, there should be clear protocols for the roles that they play, taking into account the appropriateness. As a rapid review, there were study limitations and more research is required regarding the impact of these roles on medical students and the system.
The latest Eurocleft study reported several discrepancies in cleft care. Since then, no critical assessment has been performed. This study aimed to better understand the main strengths and ...inefficiencies of cleft care within Europe. The Google documents platform was used to create an online survey to investigate several aspects, i.e., provider characteristics, patient profile, services offered, and treatment protocols and complications. Descriptive statistics were calculated. The association between categorical variables was performed using Fisher's exact test. The significance level chosen was 0.05. A total of 69 individuals from 23 European countries completed the survey. Centralized care was the preferred system, and the majority of the countries have an association for cleft patients and professionals (53.6%). The largest percentage of patients was seen in the university hospital environment (Fisher's exact test
< 0.001). The majority of responders (98.6%) reported that an orthodontist was involved in cleft treatment, and 56.5% of them spend 76-100% of their time treating these patients. Despite cleft care having been reconfigured in Europe, a better consensus among the various centers regarding provider characteristics, services offered, and treatment protocols is still required. There is a need for better coordination between clinicians and national/international regulatory bodies.
Recognition of a hereditary colorectal cancer (CRC) syndrome is crucial and Lynch Syndrome (LS) is the most frequent immunohistochemistry (IHC)—screening for mismatch repair proteins (MMR) deficiency ...in CRC is therefore advocated. An unicentric cohort study was conducted in a central Oncological Hospital to assess its results. All patients under 70 years-old admitted between July 2017–June 2019 and submitted to surgery for CRC were included. Of 275 patients, 56.0% were male, median age 61.0 (IQR:54.5–65.0), with synchronous tumors in six. Histology revealed high grade adenocarcinoma in 8.4%; mucinous and/or signet ring differentiation in 11.3%; and lymphocytic infiltration in 29.8%. Amsterdam (AC) and Bethesda (BC) Criteria were fulfilled in 11 and 74 patients, respectively. IHC revealed loss of expression of MMR proteins in 24 (8.7%), mostly MLH1 and PMS2 (n = 15) and PMS2 (n = 4). Among these, no patients fulfilled AC and 13 fulfilled BC. BRAF mutation or MLH1 promoter hypermethylation was found in four patients with MLH1 loss of expression. Genetic diagnosis was performed in 51 patients, 11 of them with altered IHC. LS was diagnosed in four, and BC was present in three. One patient would not have been diagnosed without routine IHC screening. These results strengthen the important role of IHC screening for MMR proteins loss of expression in CRC.
Three-dimensional technologies are one of the most recent and relevant advancements in the field of Dentistry. These systems, including intraoral scans, 3D imaging exams (CAT scan, CBCT and MRI), ...CAD/CAM 3D printing devices and 3D computer software, have enabled clinicians to greatly improve patient care along with reducing treatment planning time. The present descriptive study aims to explore possible applications of 3D technologies during the diagnosis, treatment plan, case monitoring and result assessment in orthodontics. The overall upgrade provided by these technologies can improve the clinicians' workflow and effectiveness by simplifying conventional techniques considered to be especially arduous.
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