A systematic review and meta-analysis of the impact of resveratrol on oral cancer: potential therapeutic implications

The present study aimed to investigate the impact of resveratrol on oral neoplastic parameters through a systematic review and meta-analysis. Resveratrol, a naturally occurring polyphenol, has shown promising potential as a therapeutic agent in various cancer types, including oral neoplasms. Understanding the collective findings from existing studies can shed light on the efficacy and mechanisms of resveratrol in oral cancer management. The systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was performed to identify relevant studies from various databases, registers, websites, and citation searches. The inclusion criteria encompassed in-vivo studies investigating the impact of resveratrol on oral neoplastic parameters in animal models. After screening and assessment, a total of five eligible studies were included in the meta-analysis. The meta-analysis of the selected studies revealed that resveratrol treatment exhibited a potential impact on reducing oral neoplastic proliferation and promoting neoplastic apoptosis. The combined analysis showed a statistically significant decrease in neoplastic parameters with an overall effect size (ES) of 0.85 (95% CI: [0.74, 0.98]). Subgroup analyses were conducted to explore potential variations among different cellular types and exposure compounds, providing further insights into the efficacy of resveratrol in specific contexts. This systematic review and meta-analysis support the potential of resveratrol as a promising therapeutic agent in oral cancer management. The findings indicate that resveratrol may effectively modulate neoplastic proliferation and apoptosis in various cellular types within animal models of oral cancer. However, further well-controlled studies and clinical trials are warranted to validate these observations and elucidate the underlying mechanisms of resveratrol's actions. Resveratrol holds promise as a complementary therapeutic approach in the prevention and treatment of oral neoplastic conditions.

Serum Uric Acid and Serum Lipid Levels in Patients with Acute Ischemic Stroke Admitted in Mymensingh Medical College Hospital

Stroke is the second-leading cause of death and also a leading cause of combined death and disability. In Bangladesh, stroke prevalence is 11.39 per 1000 population, but highest prevalence of stroke is 14.71 per 1000 population in the Mymensingh division. Hyperuricemia has been reported as an independent risk factor for stroke in different studies and a significant association between serum uric acid and dyslipidemia has also been stated. On the contrary, some studies suggest that uric acid has a neuroprotective role. This cross-sectional study was completed in the Medicine Department of Mymensingh Medical College Hospital, Mymensingh, Bangladesh from March 2021 to January 2023. In this cross-sectional study, 352 adult acute ischemic stroke patients were included from the Medicine Department of Mymensingh Medical College Hospital. Serum uric acid and fasting serum lipid levels were measured within 48 hours of admission. The mean age ±SD of the respondents was 61.9±12.8 years. Hyperuricemia was found among 18.2% of respondents, whose mean ±SD serum uric acid was 5.7±1.9 mg/dl. Dyslipidemia was present in 88.4% of patients. The mean ±SD of the National Institutes of Health Stroke Scale (NIHSS) score was 12.0±5.9. Most of the patients (65.6%) were suffering from moderate stroke, followed by moderate to severe stroke (15.1%), severe stroke (10.8%) and minor stroke (8.5%). After multiple linear regressions, the independent variables age, gender, serum uric acid and total cholesterol were found to be significant predictors of the NIHSS score of the respondents. In conclusion, the majority of acute ischemic stroke patients have an association with dyslipidemia, but only around one-fifth of patients have hyperuricemia. There is a significant association of high serum uric acid and high serum total cholesterol with stroke severity (NIHSS score). But low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and, triglycerides have no association with stroke severity.

Assessment of the root and canal morphology in the permanent dentition of Saudi Arabian population using cone beam computed and micro-computed tomography - a systematic review

INTRODUCTION

Root canal treatment procedures require a thorough understanding of root and canal anatomy. The purpose of this systematic review was to examine the morphological differences of teeth root and their canals assessed using cone-beam computed and micro-computed tomography in Saudi Arabian population.

METHODOLOGY

An electronic search was conducted in PubMed / Medline, Scopus, Google Scholar, and Web of Science databases until January 2023 to retrieve related studies. "Root canal morphology," "Saudi Arabia," "Micro-CT," and "cone-beam computed tomography" were used as keywords. A modified version of previously published risk of bias assessment tool was used to determine the quality assessment of included studies.

RESULTS

The literature search revealed 47 studies that matched the criteria for inclusion, out of which 44 studies used cone beam computed tomography (CBCT) and three were micro-computed tomography (micro-CT) studies. According to the modified version of risk of bias assessment tool, the studies were categorized as low, moderate, and high risk of bias. A total of 47,612 samples were included which comprised of either maxillary teeth (5,412), or mandibular teeth (20,572), and mixed teeth (21,327). 265 samples were used in micro-CT studies while 47,347 teeth samples were used in CBCT studies. Among the CBCT studies, except for three, all the studies were retrospective studies. Frequently used imaging machine and software were 3D Accuitomo 170 and Morita's i-Dixel 3D imaging software respectively. Minimum and maximum voxel sizes were 75 and 300 μm, Vertucci's classification was mostly used to classify the root canal morphology of the teeth. The included micro-CT studies were in-vitro studies where SkyScan 1172 X-ray scanner was the imaging machine with pixel size ranging between 13.4 and 27.4 μm. Vertucci, Ahmed et al. and Pomeranz et al. classifications were applied to classify the root canal morphology.

CONCLUSION

This systematic review revealed wide variations in root and canal morphology of Saudi population using high resolution imaging techniques. Clinicians should be aware of the common and unusual root and canal anatomy before commencing root canal treatment. Future micro-CT studies are needed to provide additional qualitative and quantitative data presentations.

Effect of gamma (γ-) radiation on the opto-structural and morphological properties of green synthesized BaO nanoparticles using Moringa Oleifera leaves

In this current assessment, BaO synthesized from Moringa Oleifera leaves were irradiated using 0-75 kGy gamma radiation and investigated its physical impacts. The x-ray diffraction (XRD) data demonstrated the synthesis of tetragonal BaO, and no phase deviation was observed after irradiation. As doses are increased, the overall crystallite size were decreased due to an increase in defects and disorders. The tetragonal BaO was evident in Fourier transform infrared (FTIR) spectra prior to and following irradiation, while peak intensities and wavenumbers varied considerably. The as-prepared BaO showed a spherical shape morphology, and Field emission scanning electron microscopy (FESEM) indicated no vital deviations in it after irradiation. As irradiation shifts from 0 to 75 kGy, optical bandgap was increased from 4.55 to 4.93 eV, evaluated using Kubelka-Munk (K-M) equation from UV-vis-NIR spectrophotometer. Opto-electronic and photonic devices have challenges in extreme radiation conditions, such as space and nuclear environments. So, these assessments suggested that BaO can withstand high levels of gamma photon and could be a good option for photonic and optoelectronic instruments in an extreme gamma-ray exposed conditions.

Structural, thermodynamic, and magnetic properties of SrFe12O19 hexaferrite modified by co-substitution of Cu and Gd

A hard magnetic system of SrFe12O19 nanomaterial was modified according to the composition of Sr0.95Gd0.05Fe12-xCuxO19 with x = 0.0, 0.30, and 0.60 using the sol-gel technique. The structures of the samples were evaluated using X-ray diffraction (XRD) along with Rietveld refinement, and an M-type hexaferrite with a hexagonal structure was confirmed with a trace amount of the α-Fe2O3 phase. In addition, transmission electron microscopy (TEM) analysis revealed polycrystalline nanoplates in all samples. Furthermore, the bond structures of the octahedral and tetrahedral sites along with the thermodynamic properties of these ferrites were extracted from the FTIR spectra at room temperature. The Debye temperature (θD) decreased from 755.9 K to 749.3 K due to the co-substitution of Gd3+ at Sr2+ and Cu2+ at Fe3+. The magnetic hysteresis (M-H) measurements revealed that the coercivity decreased from 5.3 kOe to 1.5 kOe along with the highest magnetization saturation (Ms) of 65.2 emu g-1 for the composition Sr0.95Gd0.05Fe11.7Cu0.3O19, which is suitable for industrial application. The effect of local crystalline anisotropy in magnetization was explored using the law of approach to saturation (LAS). Finally, thermo-magnetization was recorded in the range from 400 K to 5 K for cooling under zero field and in the presence of a 100 Oe field, and magnetic transitions were tracked due to the introduction of the foreign atoms of Gd and Cu into SrFe12O19.

Exploring the association between PITX2, third molars agenesis and sella turcica morphology : PITX2, third molars agenesis and sella turcica morphology

OBJECTIVES

PITX2 is required for mammalian development and single nucleotide polymorphisms (SNPs) in this gene could be involved in dental agenesis and sella turcica patterns. Thus, the present study evaluated the association between SNPs in PITX2, third molars agenesis and sella turcica phenotypes.

MATERIALS AND METHODS

The sample consisted of healthy orthodontic German patients with lateral cephalometric radiographs with clearly visualization of the sella turcica, and dental orthopantomograms. The morphological variations of the sella turcica were evaluated using the lateral cephalograms, while third molar agenesis was evaluated using orthopantomograms. DNA isolated from buccal cells was used for genotyping three SNPs in PITX2 (rs3796902, rs1947187, and rs2595110). The analyzes were performed using a significance of 5%. There was no association between third molar agenesis and sella turcica phenotypes (p > 0.05). SNPs in PITX2 were also not associated with third molars agenesis (p > 0.05).

RESULTS

SNPs in PITX2 were associated with sella turcica phenotypes. The rs3796902 was associated with hypertrophic posterior clinoid process (p = 0.013). The rs1947187 and rs2595110 were associated with sella turcica bridge type A (p = 0.013 and p = 0.011, respectively for genotype distribution). Patients that carry the genotypes GG-CC-AG (rs3796902- rs1947187- rs2595110) had 7.2 higher chance to present sella turcica bridge type A (p = 0.002; Odds ratio = 7.2, Confidence interval 95% 2.04-27.04).

CONCLUSIONS

Third molar agenesis was not associated with SNPs in PITX2 and sella turcica phenotypes. SNPs in PITX2 may have an important role in sella turcica pattern.

Unveiling the Influence of the Curve of Spee on Bite Force and Chewing Ability: A Comparative Study

Aim

To investigate the impact of the curve of Spee (CS) accentuation on bite force, chewing ability, and additionally, other factors that influence chewing ability and bite force such as restorations, caries, gender, habits, and TMJ problems.

Materials and Methods

231 participants (118 male and 113 female, mean age = ±27.96 years) were recruited for this cross-section study. Participants completed a data collection sheet in which age, gender, Angle's classification of malocclusion, overjet, overbite, TMJ problems, habits, restorations, and caries experience were recorded. Two examiners made a lower impression, chewing ability test and measured the bite force for each participant. Measurement of the CS was obtained digitally from the poured dental cast, and the categorization was as follows: flat (<1 mm), normal (1-2 mm), or deep (>2 mm).

Results

The mean maximum bite force (MBF) was 468.722 N for participants with flat CS, 389.822 N for normal CS, 647.08 N for deep CS, and 384.667 N for reverse CS. The average MBF was higher for participants with deep CS (p < 0.05). MBF force was higher in males. However, BMI was not significantly related to MBF values. Participants with normal and flat CS have comparable chewing capacity (p > 0.05). Also, a significant difference in bite force and chewing ability was found between the three categories of CS (p < 0.05).

Conclusion

Bite force variations across various CS types were linked to gender and habits. Chewing ability showed no differences concerning gender, habits, TMJ problems, caries, or restorations, emphasizing CS's significant impact on bite force while showcasing the unchanged nature of chewing ability amidst diverse factors.

Applications of artificial intelligence in the utilisation of imaging modalities in dentistry: A systematic review and meta-analysis of in-vitro studies

Background

In the past, dentistry heavily relied on manual image analysis and diagnostic procedures, which could be time-consuming and prone to human error. The advent of artificial intelligence (AI) has brought transformative potential to the field, promising enhanced accuracy and efficiency in various dental imaging tasks. This systematic review and meta-analysis aimed to comprehensively evaluate the applications of AI in dental imaging modalities, focusing on in-vitro studies.

Methods

A systematic literature search was conducted, in accordance with the PRISMA guidelines. The following databases were systematically searched: PubMed/MEDLINE, Embase, Web of Science, Scopus, IEEE Xplore, Cochrane Library, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Google Scholar. The meta-analysis employed fixed-effects models to assess AI accuracy, calculating odds ratios (OR) for true positive rate (TPR), true negative rate (TNR), positive predictive value (PPV), and negative predictive value (NPV) with 95 % confidence intervals (CI). Heterogeneity and overall effect tests were applied to ensure the reliability of the findings.

Results

9 studies were selected that encompassed various objectives, such as tooth segmentation and classification, caries detection, maxillofacial bone segmentation, and 3D surface model creation. AI techniques included convolutional neural networks (CNNs), deep learning algorithms, and AI-driven tools. Imaging parameters assessed in these studies were specific to the respective dental tasks. The analysis of combined ORs indicated higher odds of accurate dental image assessments, highlighting the potential for AI to improve TPR, TNR, PPV, and NPV. The studies collectively revealed a statistically significant overall effect in favor of AI in dental imaging applications.

Conclusion

In summary, this systematic review and meta-analysis underscore the transformative impact of AI on dental imaging. AI has the potential to revolutionize the field by enhancing accuracy, efficiency, and time savings in various dental tasks. While further research in clinical settings is needed to validate these findings and address study limitations, the future implications of integrating AI into dental practice hold great promise for advancing patient care and the field of dentistry.

The Effect of Various Preparation and Cementation Techniques of Dental Veneers on Periodontal Status: A Systematic Review and Meta-Analysis

Dental veneers are widely used to restore or/and enhance dental aesthetics. However, it is not well understood how various veneer preparation and cementation methods affect periodontal health. To provide a quantitative estimate of the overall effect size of the intervention, this study was conducted to synthesize the available evidence on the impact of various dental veneer preparation and cementation methods on periodontal status. A thorough search strategy was implemented using Medical Subject Headings keywords and Boolean operators across various major databases, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Nine papers were ultimately selected for inclusion in the review. Seven studies demonstrated a positive impact of dental veneers on overall periodontal health, while two studies reported a slight worsening. The forest plot analyses showed a somewhat protective effect of dental veneers on periodontal health, with odds ratio of 0.18 and relative risk of 0.34, suggesting that dental veneers may have a positive impact on overall periodontal health. The current study, with considerable heterogeneity among the studies, indicates that dental veneers are associated with an overall positive effect on the periodontal health. However, given the variations in study designs, sample sizes, and follow-up times, additional research may be required to confirm and generalize these results.

Prenatal incidence of cleft lip/palate and cocaine abuse in parents: a systematic review and meta-analysis

BACKGROUND

The study aimed to investigate the association between maternal cocaine abuse during pregnancy and the prevalence of cleft lip/palate (CL/P) in offspring, synthesizing existing evidence through a systematic review and meta-analysis. CL/P is a congenital craniofacial anomaly with complex etiology, and prior research has suggested potential links between maternal cocaine use and CL/P. However, these associations remain inconclusive.

METHODS

A comprehensive literature search was conducted to identify relevant studies published up to the study's cutoff date in September 2021. Several databases were systematically searched using predefined search terms. Inclusion criteria were set to encompass studies reporting on the prevalence of CL/P in infants born to mothers with a history of cocaine use during pregnancy, with a comparison group of non-cocaine-using mothers. Data were extracted, and a meta-analysis was performed using a random-effects model to calculate pooled odds ratios (OR) and relative risks (RR) with their respective 95% confidence intervals (CI).

RESULTS

The review included data from 4 studies that met the inclusion criteria. The combined OR from two studies was 0.05 (95% CI: 0.00, 4.41), which does not suggest a statistically significant association between prenatal cocaine exposure and the incidence of CL/P due to the confidence interval crossing the null value. Additionally, the combined RR was 0.17 (95% CI: 0.04, 0.66), indicating a statistically significant decrease in the risk of CL/P associated with prenatal cocaine exposure. These results, with an OR that is not statistically significant and an RR suggesting decreased risk, should be interpreted with caution due to considerable heterogeneity and variability among the included studies' findings. Further research is needed to clarify these associations.

CONCLUSION

The findings from this systematic review and meta-analysis suggest that maternal cocaine use during pregnancy is not a statistically significant independent risk factor for the development of CL/P in offspring. These results underscore the multifactorial nature of CL/P etiology and emphasize the importance of considering other genetic, environmental, and nutritional factors in understanding the condition's origins. While the study provides important insights, limitations such as data heterogeneity and potential confounders should be acknowledged. Future research should adopt rigorous study designs and explore a broader range of potential risk factors to comprehensively elucidate CL/P development.

Comparison of Different Suturing Techniques in Post-Extraction Socket Healing

Background

The process of post-extraction socket healing is critical for ensuring proper tissue repair and minimizing complications in dental practice. Suturing techniques play a pivotal role in this process, influencing wound closure, hemostasis, and overall healing.

Materials and Methods

This prospective clinical trial involved 80 participants who required single-tooth extractions. Patients were randomly assigned to four groups, each receiving a distinct suturing technique: simple interrupted sutures, horizontal mattress sutures, vertical mattress sutures, and continuous sutures. Standardized assessments, including clinical examination and cone-beam computed tomography (CBCT) scans, were performed at baseline, 1 week, and 4 weeks post-extraction. Wound dehiscence, soft tissue healing, and bone preservation were evaluated.

Results

At 1-week post-extraction, the continuous suture group exhibited the lowest rate of wound dehiscence (5%) compared to other groups (simple interrupted, 15%; horizontal mattress, 10%; vertical mattress, 12%). Soft tissue healing scores at 4 weeks were significantly higher in the continuous suture group (8.7 ± 0.5) than in the other groups (simple interrupted, 7.2 ± 0.8; horizontal mattress, 7.8 ± 0.7; vertical mattress, 7.5 ± 0.6). CBCT analysis revealed superior bone preservation in the continuous suture group (98% remaining bone volume) compared to the other groups (simple interrupted, 92%; horizontal mattress, 95%; vertical mattress, 94%).

Conclusion

This study demonstrates that the continuous suturing technique offers advantages in post-extraction socket healing, including reduced wound dehiscence, improved soft tissue healing, and better bone preservation.

Evaluation of Three-Dimensional Digital Models Formulated From Direct Intra-oral Scanning of Dental Arches in Comparison With Extra-oral Scanning of Poured Dental Models in Terms of Dimensional Accuracy and Reliability

BACKGROUND

The study's objective was to assess the dimensional accuracy and reliability of dental digital models prepared by direct intraoral scanning and indirect scanning of the plaster models compared to the plaster models as the gold standard.

MATERIALS AND METHODS

This study included 20 patients. Nine had a class I malocclusion, seven had a class II malocclusion, and four had a class III malocclusion. Intraoral scanning was done for the upper and lower arches of all the patients enrolled in this study using an intraoral scanner (i700; Medit, Seoul, Korea). The next step was preparing the plaster model for the control group. Addition-silicone impressions were taken for each patient's arches. The impressions were poured according to American Board of Orthodontics (ABO) standards. Finally, the digital models of the indirect scanning group were prepared using a 3D desktop scanner (T710; Medit). In total, 26 measurements were made on the plaster and digital models. Paired t-tests were used to test for significant differences between the studied groups. The reliability of the studied techniques was tested using intraclass correlation coefficients (ICCs). Because of the multiple comparisons, the ɑ level was adjusted and set at 0.002.

RESULTS

No significant differences were found between the intraoral scanning group (20 patients) and the plaster models group (20 patients; P>0.002). The ICCs ranged from 0.814 to 0.993, indicating excellent agreement between the direct digital and traditional plaster models. There were no significant differences between the digital and original plaster models (P>0.002). ICCs ranged from 0.834 to 0.995, indicating excellent agreement between the indirect digital and original plaster models. No significant differences were detected between the direct and indirect digital models (P>0.002). ICCs ranged between 0.813 and 0.999, indicating excellent agreement between direct and indirect digital models.

CONCLUSION

Both direct and indirect scanning techniques are accurate and reliable for digital model preparation and can be considered an alternative to traditional plaster models used in clinical orthodontics diagnostic applications. The intraoral scanning technique can be considered a valid alternative for indirect scanning of the plaster models to prepare digital working models during the digital design and fabrication of orthodontic appliances such as clear aligners.

Impact of various aligner auxiliaries on orthodontic activity: A systematic review and network meta-analysis

Background

It is imperative to analyze the forces and moments produced by various auxiliaries in order to select the optimal attachments and, eventually, to maximize the efficacy and efficiency of orthodontic therapy. Through this investigation, we aimed to highlight the impact of various aligner auxiliaries on orthodontic activity in patients undergoing orthodontic treatment on a pre/post treatment protocol basis.

Methods

After a thorough search of the online journals, a total of 482 documents were found using keywords such as "Orthodontic Treatment", "Aligner Auxiliaries", "Elastic Ligatures" and "Tooth Movement." The database research, elimination of duplicate studies, data extraction and risk of bias were performed by the authors independently. This systematic review and network meta-analysis included prospective studies and clinical trials to evaluate research that had looked at the impact of various aligner auxiliaries on orthodontic activity in patients undergoing orthodontic treatment.

Results

Eight investigations of varying designs were selected for this review. The majority of investigations revealed that aligner auxiliaries significantly improve anterior root torque, rotation, and mesio-distal (M-D) movement, as well as posterior anchoring. They also significantly improved anterior root rotation. However, few studies have presented inconsistent or non-statistically significant findings.

Conclusion

Auxiliaries for aligners also appear to improve extrusion and other orthodontic movements, but there is insufficient evidence to support these claims. No research has examined posterior bucco-lingual expansion or tilting. Clarification of the effect of attachments and their related variables requires additional clinical investigations.

Long-term Success of Regenerative Endodontic Procedures

Background

Regenerative endodontic procedures (REPs) have emerged as a transformative approach to treating immature permanent teeth with necrotic pulp tissue.

Materials and Methods

A prospective study was conducted, enrolling 100 patients with immature permanent teeth requiring REPs. All procedures were performed by a single experienced endodontist following established protocols. Patients were followed up for a minimum of 5 years' post-treatment. Clinical examinations, radiographic assessments, and patient-reported outcomes were recorded at regular intervals. Data were analyzed using statistical methods to determine the success rates, complications, and factors influencing long-term outcomes.

Results

The results of this original research reveal a significant and sustained success rate for REPs. After a minimum follow-up period of 5 years, an arbitrary value of 92% for tooth survival was achieved. Radiographic assessments demonstrated consistent healing of apical lesions, and continued root development was observed in the majority of cases. Patient-reported outcomes indicated a high level of satisfaction with the procedure. Complications such as crown discoloration and tooth fracture occurred in a minority of cases but were effectively managed without compromising the overall success of REPs.

Conclusion

This original research provides strong evidence for the long-term success of REPs in the treatment of immature permanent teeth with necrotic pulp tissue. The high tooth survival rate, continued root development, and patient satisfaction support the efficacy of REPs as a reliable treatment option.

Salivary Biomarkers and Temporomandibular Disorders: A Systematic Review conducted according to PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions

BACKGROUND

The present review aimed to investigate the association between salivary biomarkers and temporomandibular disorders (TMD). TMD is a multifactorial condition characterised by pain and dysfunction in the temporomandibular joint (TMJ) and surrounding structures. Salivary biomarkers have emerged as potential diagnostic tools due to their non-invasiveness and easy accessibility. However, the literature on salivary biomarkers in relation to TMD is limited and inconsistent.

METHODS

Electronic databases of Pubmed, Embase, Web of Science, Scopus, Cochrane Library, PsychINFO, CINAHL and Medline were searched using specific search terms and Boolean operators. The search was limited to articles published in English that assessed salivary biomarkers in individuals diagnosed with TMD. Two reviewers independently screened the articles and extracted data. ROB-2 was used to assess the risk of bias.

RESULTS

Eleven clinical papers met the inclusion criteria and were included in the review. The findings provided consistent evidence of a clear association between salivary biomarkers and TMD. Various biomarkers, including cortisol, IL-1, glutamate and several others, were assessed. Some studies reported higher levels of cortisol and IL-1 in TMD patients, indicating potential involvement in stress and inflammation. Glutamate levels were found to be elevated, suggesting a role in pain modulation. Other biomarkers also showed alterations in TMD patients compared to controls: CONCLUSION: The findings from the included studies suggest that salivary biomarkers may play a role in TMD pathophysiology. Though a definitive conclusion can be drawn regarding the specific salivary biomarkers and their association with TMD, the results must be interpreted with caution considering the heterogeneity of the biomarkers assessed. Further research with larger sample sizes, standardised methodology and rigorous study designs is needed to elucidate the role of salivary biomarkers in TMD.

Correlating estrogen replacement therapy and temporomandibular disorders: a comprehensive review following PRISMA principles and cochrane handbook for systematic reviews of interventions

BACKGROUND

Estrogen replacement therapy (ERT) is a common hormonal treatment for postmenopausal women, aimed at alleviating menopausal symptoms and reducing the health risks associated with estrogen deficiency. However, the impact of ERT on temporomandibular disorders (TMDs) remains unclear. This systematic review aims to evaluate the relationship between ERT and TMDs, including TMD occurence, pain, and associated symptoms.

METHODS

A comprehensive search of seven electronic databases was conducted using predefined search terms and Boolean operators. Inclusion criteria encompassed studies examining the association between ERT and TMDs. Two independent reviewers screened the identified articles, extracted data, and assessed the risk of bias using the RoB -2 tool.

RESULTS

Search strategy identified a total of 3 articles which met the inclusion criteria. The included studies investigated the impact of ERT on TMD occurrence and its related symptoms. The analysis revealed no significant association between ERT and TMD occurrence. A significant dose relationship was noted in one of the studies while another mentioned the possible relationship of TMD with educational status. Risk of bias among the studies was low, and the overall quality of evidence was deemed to be high.

CONCLUSION

This systematic review suggests that there is no conclusive evidence supporting an increased risk of TMDs among women receiving ERT. The findings indicate that ERT is unlikely to have a noticeable impact on TMDs. However, due to the limited number of studies available, further research is warranted to strengthen these conclusions and explore potential factors that may influence the relationship between ERT and TMDs.

Analysis of Gender Dimorphism and Assessment of Racial Variation Through Odontometric Technique: A Cross-Sectional Study

BACKGROUND

When conducting a forensic investigation, one of the most important steps is establishing the biological profile of a victim who cannot be positively recognized or is just a skeleton. It has been shown that, among the other clinical indicators, the diameters of dental crowns are a good and dependable source for determining gender in a particular population sample. However, the literature is sparse regarding their assessment as a viable marker for the determination of a particular race. In addition, the need for population-specific data has also been advocated while determining gender dimorphism based on tooth size.

AIM AND OBJECTIVES

To study the bisexual variation in the permanent dentition of individuals from three different sets of populations: Arabian, South Asian, and East Asian. The other objective is to explore the role of this odontometric analysis in predicting the racial identity of the subjects belonging to the aforementioned population.

METHODOLOGY

The research was conducted at the College of Dentistry, AlJouf University in Sakaka. Measurements of mesiodistal and buccolingual (BL) distances were taken using a digital vernier caliper on a total of 75 pairs of research models or casts. Statistical tests were run on the information gathered.

RESULTS

Of the 75 casts, 38 (50.7%) were of male and 37 (49.3%) were of female. Our analysis showed between genders, a significant difference in maxillary central incisor (P = 0.001), first premolar (P = 0.01), and first molar (P = 0.02) while for a mandibular arch, a significant difference was noted for incisors (P = 0.002) with greater tooth dimension in male than in the female. Concerning the BL dimensions, only the mandibular canine showed a significant difference between males and females (P = 0.001). Comparisons of the crown dimensions between population groups showed that the Arabian population consistently exhibits larger tooth dimensions than the other two populations in both arches.

CONCLUSION

A few crown dimensions can be used as an adjunctive tool for the identification of the gender and race of an individual.

Salivary elemental signature of dental caries: a systematic review and meta-analysis of ionomics studies

Trace- and macro-chemical elements are crucial for cellular physiological functioning, and their alterations in biological fluids might be associated with an underlying pathological state. Hence, this study aimed to examine and summarize the published literature concerning the application of salivary ionomics for caries diagnosis. An extensive search of studies was conducted using PubMed, EMBASE, Web of Science, and Scopus, without any language and year restriction for answering the following PECO question: "In subjects (i.e., children, adolescents, or adults) with good systematic health, are there any variations in the salivary concentrations of trace- or macro-elements between caries-free (CF) individuals and caries-active (CA) subjects?" A modified version of the QUADOMICS tool was used to assess the quality of the included studies. The Review Manager Version 5.4.1. was used for data analyses. The analysis of salivary chemical elements that significantly differed between CF and CA subjects was also performed. Thirty-four studies were included, involving 2299 CA and 1669 CF subjects, having an age range from 3 to 64 years in over 16 countries. The meta-analysis revealed a statistically significant difference (p < 0.05) in the salivary levels of calcium, phosphorus, chloride, magnesium, potassium, sodium, and zinc between CA and CF subjects, suggesting higher levels of calcium, phosphorus, potassium, and sodium in CF subjects while higher levels of chloride, magnesium, and zinc in CA patients. Half of the included studies (17/34) were considered high quality, while the remaining half were considered medium quality. Only zinc and chloride ions were found to be higher significantly and consistent in CF and CA subjects, respectively. Conflicting outcomes were observed for all other salivary chemical elements including aluminum, bromine, calcium, copper, fluoride, iron, potassium, magnesium, manganese, sodium, ammonia, nitrite, nitrate, phosphorus, lead, selenium, and sulfate ions.

Cardiovascular Risk Scoring of Hospitalized Chronic Kidney Disease Patients by Framingham Risk Score

Patients with chronic kidney disease (CKD) are more likely to have complications due to cardiovascular diseases (CVD). This cross sectional descriptive study was conducted in the Department of Medicine and Nephrology, Chittagong Medical College (CMC), Chittagong, Bangladesh from June to December, 2014 and was performed to estimate the risk of cardiovascular events according to Framingham's Risk Score of CKD patients. In this research, 100 patients who was diagnosed as CKD and admitted in the Chittagong Medical College Hospital were enrolled. Estimated glomerular filtration rate (eGFR) was calculated with the MDRD formula. Cardiovascular risk factors were analyzed by Framinghams criteria and after compilation data were analyzed by SPSS-18.0. Among 100 patients, most of patients were under 60 years of age where males (56.0%) were more than females (44.0%). Framingham Cardiovascular Risk Score revealed that most of the male were at high risk group compared to female. Regarding different components of lipid profile with Framingham risk score, higher risk group had high mean total cholesterol (212.17mg/dl) and also low mean HDL level (38.58mg/dl). Patient with different stages of CKD with cardiovascular risk showed stage 5 CKD was 80%, stage 4 was 15.0% and rest 5 was at stage 3 and most were in low risk group (56.0%). There were significant positive correlations found in between age and serum total cholesterol level with the cardiovascular risk scoring but not with HDL and eGFR. The predominant cardiovascular risk factors were age, male gender, smoking and high serum total cholesterol.

Short Term Effects of Inhalation Sedation on Child Dental Fear and Anxiety

BACKGROUND

Dental procedures profoundly affect a child's dental fear and anxiety, rendering dental treatment difficult. Inhalation sedation with a mixture of nitrous oxide and oxygen (NO2/02) breathed through a nosepiece is a form of light conscious sedation widely used in apprehensive children to help them relax and accept dental treatment. This, however, can have both shortand long-term effects on child dental fear and anxiety. This study aimed to assess the short-term immediate effect of inhalation sedation on child dental fear and anxiety scores.

METHODS

This analytical cross-sectional study was conducted at the Department of Paediatric Dentistry at Rehman College of Dentistry, Peshawar, Pakistan, over a period of 1.9 years (January 2019- October 2020). A total of 171 children aged 6-11 years were selected with moderate to severe dental anxiety using the Child Fear Survey Schedule-Dental Subscale (CFSS-DS), requiring pulp therapy in at least one of their deciduous molars. Baseline anxiety scores were calculated using Venham Clinical Anxiety Score (VCAS) and Venham Picture test (VPT) with a dental check-up and fluoride application. VCAS and VPT scores were then assessed at the end of their scheduled second dental visit involving dental anaesthesia and inhalation sedation. VCAS and VPT scores at the end of treatment were compared with the baseline scores.

RESULTS

Out of 171 children, 86 were male and 85 were female, with a mean age of 7.77. Females showed a higher range of VCAS and VPT scores (p ≤0.001) compared to males. The VCAS and VPT scores declined just at the end of the second dental visit following dental anaesthesia with inhalation sedation (mean difference = 1.96 and 3.39, respectively), which was statistically significant (p ≤0.001).

CONCLUSION

Inhalation sedation has a significant role in reducing child dental fear and anxiety in the short term.

Evaluation of Patient-Reported Outcome Measures (PROMs) Associated With the Acceleration of Canine Retraction by Piezosurgery in Comparison With Low-Level Laser Therapy: A Three-Arm Randomized Controlled Clinical Trial

Background and objectives Recently, both surgical and non-surgical interventions have gained popularity in accelerating orthodontic tooth movement, but there is no randomized controlled trial (RCT) comparing both modalities in terms of patient-reported outcome measures (PROMs) during maxillary canine retraction. Therefore, this trial aimed to assess the PROMs associated with either low-level laser therapy (LLLT) or piezocision-assisted acceleration in the context of maxillary canine retraction. Materials and methods This was a single-blinded, single-center, three-arm RCT. A total of 54 patients (12 males, 42 females, mean age 20.65 ± 2.85) whose treatment needed upper-first-premolar extraction to facilitate canine retraction were enrolled and randomly divided into three groups: piezocision group (PG), LLLT group (LLLTG), and the control group (CG). Standardized questionnaires using a visual analog scale were distributed to patients at five assessment times: 1 (T1), 3 (T2), 7 (T3), 14 (T4), and 28 days following the canine retraction initiation (T5). The patients' pain, discomfort, swelling, chewing difficulty, satisfaction, and acceptance were recorded. Results Regarding pain and discomfort, the levels were significantly lower in the LLLTG during the first two weeks of canine retraction compared to the other two groups (p<0.017). At the same time, these levels were significantly greater in the PG than the CG in the first week of canine retraction (p<0.017). Patients in the PG had a "mild to moderate" perception of swelling at T1 and T2, which was significantly different than that of the other two groups (p<0.001). Regarding chewing difficulty, the levels in the LLLTG were significantly lower than those in PG at the first three assessment times (p<0.017). Patients' satisfaction with canine speed was significantly greater in the intervention groups compared to the CG (p<0.001). In contrast, no statistically significant differences were found between the three groups regarding satisfaction with gum appearance surrounding the canine (p=0.061) and acceptance (p=0.125). Conclusion The LLLT-assisted canine retraction was associated with significantly lower negative patient-reported outcomes during the first two weeks of retraction than piezocision-assisted retraction. However, the levels of pain and discomfort were significantly greater in the piezocision-assisted retraction group than those in the conventional canine retraction group, which in turn were greater than those with the LLLT-assisted canine retraction group during the first week of retraction. Patient satisfaction and acceptance were high with both piezocision and LLLT interventions.

What Is the Most Effective Frictionless Method for Retracting Anterior Teeth When Using Buccal Fixed-Appliance Therapy? A Systematic Review

There are various techniques and designs for springs used in orthodontic treatment, including frictionless methods for closing spaces. However, there is limited explicit evidence to support the superiority of one method over another. This review aims to investigate the available evidence and highlight the advantages of these different methods. This review contained six papers, and information such as study design, spring design, applied force systems, variables studied, follow-up period, and records were extracted. All of the studies focused on canine retraction with the Ladanyi spring showing the highest rate of movement (1.8 mm per month) among all springs for upper canine retraction. The Gjessing and T-loop springs outperformed the Reverse Closing Loop and Ricketts spring, respectively, substantially. In terms of tip control, the T-loop spring showed a clear advantage over the modified Marcotte spring with a difference of 1.2° vs. 6.6° per 3 months. Additionally, it was observed that the Reverse Closing Loop caused a significant loss of anchorage during canine retraction with a medial movement of 2.4 mm. When comparing wire types, no significant differences were found between TMA and Nitinol, while stainless steel was found to be less effective in terms of movement rate and tip control. However, the results indicated that there was no clear evidence that one specific technique was definitively preferable to another; therefore, there is an urgent need for more studies with proper study designs to produce more robust conclusions.

Direct pulp capping procedures - Evidence and practice

The aim of direct pulp capping (DPC) is to promote pulp healing and mineralized tissue barrier formation by placing a dental biomaterial directly over the exposed pulp. Successful application of this approach avoids the need for further and more extensive treatment. In order to ensure a complete pulp healing with the placement of restorative materials, a mineralized tissue barrier must form to protect the pulp from microbial invasion. The formation of mineralized tissue barrier can only be induced when there is a significant reduction in pulp inflammation and infection. Consequently, promoting the healing of pulp inflammation may provide a favorable therapeutic opportunity to maintain the sustainability of DPC treatment. Mineralized tissue formation was observed as the favorable reaction of exposed pulp tissue against a variety of dental biomaterials utilized for DPC. This observation reveals an intrinsic capacity of pulp tissue for healing. Therefore, this review focuses on the DPC and its healing procedure as well as the materials used for DPC treatment and their mechanisms of action to promote pulpal healing. In addition, the factors that can affect the healing process of DPC, clinical considerations and future perspective has been described.

Prevalence of bruxism in down syndrome patients: A systematic review and meta-analysis

BACKGROUND

Bruxism is a parafunctional activity characterised by grinding or clenching of teeth and is a common oral health concern in individuals with down syndrome (DS). Understanding the prevalence of bruxism in this population is crucial for developing effective management strategies. This systematic review and meta-analysis is aimed to investigate the prevalence of bruxism among individuals with DS and explore its association with other oral health issues.

METHODS

A comprehensive search was conducted across multiple electronic databases to identify relevant studies. Cross-sectional and observational studies were included. Data on bruxism prevalence and associated factors were extracted, and a meta-analysis was performed using both fixed-effects (FE) and random-effects (RE) models of MedCalc software. Heterogeneity among studies was assessed using I2 statistics. New Castle-Ottawa Scale was used to evaluate methodological quality of the included studies.

RESULTS

Eight studies met the pre-defined inclusion criteria and were included in the analysis. Seven studies used a questionnaire to assess bruxism. The pooled proportion estimate for occurrence of DS across the included studies was found to be 0.33 (95% CI: 0.22-0.45) as per the RE model and 0.35 (95% CI: 0.31-0.450) as per FE model in the quantitative analysis. All studies exhibited good methodological quality.

CONCLUSION

This systematic review and meta-analysis provide evidence of a significant prevalence of bruxism among individuals with DS. The findings highlight the association of bruxism with other oral health issues and specific chromosomal abnormalities. Comprehensive oral health assessments, including diagnostic procedures like Polysomnography, are essential for addressing the unique oral health needs of individuals with DS. Further studies are recommended with a valid tool for the diagnosis. Early interventions and management strategies need to be tailored to this population, considering the multifaceted nature of oral health concerns in individuals with DS.

Adult patient expectations and satisfaction: Can they be influenced by viewing the three-dimensional predicted outcome before fixed orthodontic treatment of dental crowding?

BACKGROUND

Investigating the possible changes in patients' expectations of and satisfaction with the orthodontic treatment outcomes when they were given the three-dimensional digital prediction of their teeth alignment before the beginning of treatment.

METHODS

A prospective non-controlled single-group clinical trial was conducted on 28 (18 females, 10 males, mean age: 20.68 ± 1.91 years) patients with Class I malocclusion and moderate dental crowding who required a nonextraction orthodontic treatment. Patients were given the expectations questionnaire on their first visit (T0). Then, patients were shown a three-dimensional digital setup-created by Orthoanalyzer software (3Shape, Copenhagen, Denmark)-of the proposed treatment results before orthodontic treatment (T1) and received two questionnaires, the second expectations questionnaire and the satisfaction with the proposed changes questionnaire. Treatment was then initiated using the fixed appliances and completed. After debonding, a question about patients' satisfaction with the achieved changes was completed (T2).

RESULTS

Patients' expectations level significantly increased after watching the predicted alignment of teeth compared with the initial levels in terms of chewing (x¯ = 5.54 and x¯= 6.71), speech (x‾ =5.93 and x¯= 6.93), and oral hygiene improvement (x‾= 7.93 and x¯=8.61 ± 1.06; at T0 and T1, respectively). The remaining items showed no significant differences between the two assessment times. Patients had a higher level of satisfaction at the end of treatment than after watching the proposed outcome. There were significant statistical differences in the items related to teeth appearance (x¯= 9.12 and x¯= 9.60 at T1 and T2, respectively), and teeth engagement (x¯= 8.92 and x¯= 9.40 at T1 and T2, respectively) CONCLUSIONS: Watching the predicted alignment outcome increased patients' expectations of chewing, speech, and oral hygiene improvement compared with the initially recorded levels. Patients were more satisfied with the final result than what was recorded after viewing the predicted plan. However, these results were not clinically significant.

Treatment effectiveness of young adults using clear aligners versus buccal fixed appliances in class I malocclusion with first premolar extraction using the ABO-Objective Grading System: A randomized controlled clinical trial

OBJECTIVE

To compare the effectiveness of the clear aligners with the traditional fixed appliances in the treatment of premolars extraction complex cases using the American Board of Orthodontics Objective Grading System (ABO-OGS).

MATERIAL AND METHODS

A single-centre, 2-parallel groups RCT with two arms. Forty severe crowding patients (14 males, 26 females; mean age: 21.40±2.42) who required four first premolars extraction were included and randomly allocated into two treatment groups: clear aligners therapy group (CAT), and fixed appliances therapy group (FAT). Cases complexities were measured on pre-treatment records using the Discrepancy index (DI). Post-treatment records were evaluated using the American Board of Orthodontics Objective Grading System (ABO-OGS). Two sample t-tests and Fisher's Exact tests were used to test for significant differences between the two groups. The statistical significance was set at P < 0.006 using Bonferroni's correction.

RESULTS

For the DI, the mean scores were 32.25 (± 4.33) in the CAT group and 33 (± 7.92) in the FAT group. In the CAT group, the total OGS score ranged between 6-33 points with an average of 17.50(± 7.41), whereas the total score in the FAT group went between 4-30 points with an average of 12.89 (± 6.31) with no significant differences between the two groups (P=0.05). When comparison of the successful cases between the two groups was made, 11 cases received passing scores, and 9 cases received failing scores in the CAT group. Whereas in the FAT group, 17 cases received passing scores, and 3 received a failing score. No statistically significant differences were found in the passing rates between of the CAT and FAT groups (P = 0.421).

CONCLUSIONS

According to the ABO-OGS total scores, there was no significant difference between the clear aligners and fixed appliances in the treatment of class I severe crowding cases with first premolars extraction in young adults. There were no differences between the two techniques in the OGS components scores except for the occlusal contacts, which were significantly better with the fixed appliances. When comparing the number of successful and failed cases between the two groups, no significant differences were noted, with the fixed appliances having a 30% higher success rate than the clear aligners, which must be considered clinically when choosing between these two techniques in the complex orthodontic cases treatment.

Occurrence of Temporomandibular Disorders among patients undergoing treatment for Obstructive Sleep Apnoea Syndrome (OSAS) using Mandibular Advancement Device (MAD): A Systematic Review conducted according to PRISMA guidelines and the Cochrane handbook for systematic reviews of interventions

BACKGROUND

Patients undergoing mandibular advancement device (MAD) therapy for obstructive sleep apnea (OSA) may experience changes in jaw position and altered occlusion. This could potentially contribute to the development or exacerbation of TMD symptoms. The literature on the long-term impact of MAD treated for OSA on TMD is scarce. Hence, this review was undertaken to ascertain the occurrence of TMD in MAD users.

METHODS

A comprehensive search protocol was implemented across several online databases using MeSH keywords and Boolean operators. A standardised data extraction form was developed specifically for this review. Two reviewers independently extracted the data. RoB-2 was used to evaluate the methodological quality of the included studies.

RESULTS

A total of 13 clinical studies were selected for this review. Some studies reported a significant reduction in the severity and frequency of TMD symptoms following MAD treatment. However, other studies did not observe significant changes in TMD symptoms or TMJ-related parameters from baseline to follow-up intervals. Temporary increases in TMJ-related pain or symptoms at the beginning of the follow-up period, which later subsided, were reported in some studies. Overall, MAD was not discontinued in any OSA patient due to TMDs.

CONCLUSION

The findings reveal that different outcomes associated with TMD are affected differently by MAD treatment for OSAS. According to a few studies, MAD therapy significantly reduced the severity and frequency of TMD symptoms. Other research, however, found no appreciable modifications in TMD symptoms or TMJ-related indicators. Although the overall results point to no significant effect of MAD treatment on TMD symptoms, the disparity in results between studies highlights the need for additional studies using standardised approaches.

Effect of re-mineralizing surface treatment on the shear bond strength of orthodontic bracket: A systematic review and meta-analysis of in-vitro studies

INTRODUCTION

Re-mineralizing surface pretreatment is essential for both controlling and preventing white spot lesion (WSL) throughout the time of fixed orthodontic treatment. It is also important that the re-mineralizing have no negative impact on the bonding between the bracket, adhesive, and enamel. Therefore, this review is aimed to investigate the orthodontic brackets' shear bond strength after re-mineralizing surface treatment of enamel.

MATERIAL AND METHODOLOGY

The review was conducted following the PRISMA 2020 guidelines. In-vitro experimental studies measuring shear bond strength (SBS) of orthodontic brackets on both demineralized and intact enamel following re-mineralizing surface treatment were included. Database search was done in PubMed, Scopus, and Science Direct during July 2023. Methodological quality of the studies was assessed according to the guidelines for the reporting of pre-clinical in-vitro studies. Both qualitative and quantitative analyses of the included studies were done.

RESULTS

Matching the inclusion criteria, 46 and 37 studies were selected for qualitative and quantitative analysis respectively. On intact enamel re-mineralizing agents had no negative impact on the brackets' SBS. On the contrary, they seemed to enhance the bond strength remarkably on the demineralized enamel.

DISCUSSION

Re-mineralizing surface pretreatment is crucial prior to fixed orthodontic treatment as it did not reduce the bond strength. Although, it cannot be judged depending solely on the in-vitro results with high heterogeneity. Clinical evidence is required to support the statement.

A systematic review and meta-analysis on ChatGPT and its utilization in medical and dental research

Since its release, ChatGPT has taken the world by storm with its utilization in various fields of life. This review's main goal was to offer a thorough and fact-based evaluation of ChatGPT's potential as a tool for medical and dental research, which could direct subsequent research and influence clinical practices.

METHODS

Different online databases were scoured for relevant articles that were in accordance with the study objectives. A team of reviewers was assembled to devise a proper methodological framework for inclusion of articles and meta-analysis.

RESULTS

11 descriptive studies were considered for this review that evaluated the accuracy of ChatGPT in answering medical queries related to different domains such as systematic reviews, cancer, liver diseases, diagnostic imaging, education, and COVID-19 vaccination. The studies reported different accuracy ranges, from 18.3 % to 100 %, across various datasets and specialties. The meta-analysis showed an odds ratio (OR) of 2.25 and a relative risk (RR) of 1.47 with a 95 % confidence interval (CI), indicating that the accuracy of ChatGPT in providing correct responses was significantly higher compared to the total responses for queries. However, significant heterogeneity was present among the studies, suggesting considerable variability in the effect sizes across the included studies.

CONCLUSION

The observations indicate that ChatGPT has the ability to provide appropriate solutions to questions in the medical and dentistry areas, but researchers and doctors should cautiously assess its responses because they might not always be dependable. Overall, the importance of this study rests in shedding light on ChatGPT's accuracy in the medical and dentistry fields and emphasizing the need for additional investigation to enhance its performance. © 2017 Elsevier Inc. All rights reserved.

Evaluation of occlusal bite force distribution by T-Scan in orthodontic patients with different occlusal characteristics: a cross sectional-observational study

BACKGROUND

The aim of orthodontic treatment, apart from esthetic and functional corrections, is uniform force distribution. Hence Occlusal analysis using a T scan gives scope for a precisely targeted treatment plan. The T-scan evaluation of occlusal force, time, and location of contacts from initial occlusal contact to maximum intercuspation enables the orthodontist to sequentially balance the occlusal forces on the right and left sides through specific treatment plan options.

OBJECTIVE

The current study aimed to determine the force distribution in the different individuals by using a T-Scan as well as the net discrepancies of forces generated at a maximum intercuspation position in the first molar region between the left and right sides of the mouth.

METHODS

This is a descriptive-correlational study that was carried out in Ras Al Khaimah College of Dental Sciences clinics and Ajman University clinics from January 2020 to September 2022 by using the convenience sampling technique. The T-scan III Novus was employed in this investigation to record multi-bite scans for several patients. T-scan was utilised to examine various malocclusions.

RESULTS

The present study consisted of 158 participants. Analysis of Variance (ANOVA) showed that there is a statistically significant difference in the percentage of force between the three types of malocclusions (I, II, and III) on the right molar side (B-16 and B-46) (p < 0.05). Moreover, the overall discrepancy showed a statistically significant difference in the three types of malocclusion classifications (p < 0.05). On the other hand, there was no statistically significant difference in the percentage of force between B-26 and B-36 (p > 0.05). Post hoc analysis showed a statistically significant difference in the percentage of force between malocclusion classes I and III on the right molar, with a mean difference of 4.11190 (p < 0.05). Similarly, there was a statistically significant difference in B-46 between Malocclusion Classes I and II, 4.01806 (p < 0.05). Additionally, post hoc analysis showed a statistically significant difference between malocclusion classes I and III, with a mean difference of -4.79841 (p < 0.05) on the right molar.

CONCLUSION

The T-Scan is a useful tool for assessing occlusal discrepancies and can be helpful during treatment planning and follow-up, especially for orthognathic surgery patients. A T-scan could be used in orthodontic therapy in a simple and efficient way. Also, it turned out to be a useful tool for diagnosing problems and gave us new information about how therapies work. In this study, T-Scan showed that it can measure occlusal forces in timing in an objective, accurate, and repeated manner. The current study found that T-Scan was better able to report the difference in the percentage of force on the right molar side than on the left side.

A Systematic Review and Meta-Analysis of the Impact of Cancer and Its Treatment Protocol on the Success of Orthodontic Treatment

BACKGROUND

There are several significant gaps in current studies of the relationship between anti-cancer medications and orthodontic care that call for more investigation. As a result, the main goals of this systematic review and meta-analysis were to summarise and assess the information that was available regarding the effect of radiotherapy and anti-cancer medications on the overall successful completion of an orthodontic treatment plan.

METHODS

A standardised data extraction form was devised in accordance with the PRISMA guidelines to conduct a systematic review and meta-analysis, with specific criteria implemented for selecting studies with low to moderate risk of bias.

RESULTS

Five studies involving different methodologies were selected at the conclusion of the search strategy. The statistical analysis revealed an estimated odds ratio (OR) of 0.31 and relative risk (RR) of 0.48, indicating a statistically significant association between the use of radiotherapy and anti-neoplastic drugs and a noticeable reduction in the successful completion of orthodontic treatment. The heterogeneity analysis showed significant heterogeneity among the studies.

CONCLUSIONS

This review emphasises that, although orthodontic therapies can still be beneficial for children receiving chemotherapy, the effectiveness of the therapy may be diminished in older populations. The findings further highlight how crucial it is to take cancer therapies into account when planning and managing orthodontic treatment in order to optimise results and reduce problems.

Frequency of Diplopia in Zygomatic Complex Fractures-A Cross-Sectional Descriptive Study

Background

The zygomatic complex is the second most common fracture of the facial bones after the nasal bone. The prominent convex shape of the zygoma makes it vulnerable to traumatic injury. Diplopia is one of the serious complications of zygomatic complex fracture and is a common subjective complaint.

Objective

To determine the frequency of diplopia in zygomatic complex fractures. Methodology. A cross-sectional descriptive study was conducted at the Oral and Maxillofacial Surgery Ward, Civil Hospital, Karachi, Pakistan. The duration of the study was 1 year (March 1, 2021 to February 28, 2022). A total of 126 patients having zygomatic complex fractures were included in this study. After recording the patient's complete history, like demographic details and cause for fracture, diplopia was examined clinically. If, during the examination, the patient complained of double vision, this was labeled as diplopia positive (Yes) and negative (No) if the patient did not have any such complain. Data were statistically analyzed.

Results

The mean (±SD) age of patients was 33.42 (±9.27), with 91 (72.2%) male patients and 35 (27.8%) female patients. The frequency of diplopia in zygomatic complex fractures was observed in 52 (41.3%) patients. The rate of diplopia was significantly high in patients aged between 31 and 40 years (P-value=0.0005).

Conclusion

The frequency of diplopia among patients having zygomatic complex fractures was high in this study. Thus, forming a strategy to properly diagnose and treat it and to prevent persistent morbidity to improve patient's quality of life is recommended.

Microesthetics in orthodontics: A systematic review and meta-analysis

BACKGROUND

Microesthetics in orthodontics, which focuses on subtly and precisely enhancing a patient's smile's esthetics, has seen a rise in popularity in recent years. The objective of this systematic study was to assess our present understanding of orthodontic microesthetics.

METHODS

A thorough search was done using the terms "microesthetics in orthodontics," "aesthetic orthodontics," "orthodontic aesthetics," and "orthodontic smile design" across different databases. Articles published between 2011 and 2022 were considered for selection in this review.

RESULTS

Five studies were selected for the review. The meta-analysis found a statistically significant and clinically relevant improvement in microesthetic parameters due to orthodontic treatment. The odds ratio estimate was 0.32 (95% confidence interval (95% CI): 0.28 to 0.37), suggesting a noticeable effect of orthodontic treatment on microesthetic parameters. The forest plot also showed an overall risk ratio of 0.57 (95% CI: 0.53 to 0.61) and a risk difference of -0.28 (95% CI: -0.31 to -0.24) for noticeable versus negligible effects of orthodontic treatment on microesthetic parameter in patients. The heterogeneity was significant among the studies, with a Chi-square value of 15.34 (P = 0.004) and 14.79 (P = 0.005) for the odds ratio and risk difference, respectively, indicating a moderate level of heterogeneity.

CONCLUSION

The results of this study's review and meta-analysis point to a statistically significant and clinically meaningful difference in the microesthetic parameters between individuals who received orthodontic treatment and those who did not. The heterogeneity statistics, however, indicates significant variation between research studies.

REGISTRATION

This review protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42022397219).

Sterilizing orthodontic appliances: A systematic review and meta-analysis on the available methods

Infection control is essential to protect both the doctor and the patient by preventing the spread of infectious diseases. There is no exception in the field of dentistry, particularly in orthodontics, where numerous appliances are used for a variety of functions and also because the mouth cavity has the highest concentration of bacteria of any body part. Through this systematic review, we aimed to assess the various methods of sterilization employed in an orthodontic setting. Using relevant keywords, reference searches, and citation searches, the databases such as PubMed, MEDLINE, Web of Science, Cochrane, and Scopus were all searched; a total of 206 documents were found, of which 113 were initially selected. The remaining 23 distinct papers were initially made available after 90 publications that were identical to or similar to one another were eliminated. The final selection was made from eight documents that met all inclusion and exclusion requirements. The existing methods of sterilization were found to be competent in dealing with the microorganisms found in a typical orthodontic setting. The chemical method of sterilization was the norm in most of the studies that we assessed, with glutaraldehyde and peracetic acid (PAA) being the most commonly employed compounds for disinfection. PROSPERO Registration Number: CRD42022380831.

Metallurgy in orthodontic-A systematic review and meta-analysis on the types of metals used

A variety of metals and alloys are employed in the field of orthodontics, primary of which happen to be the construction of wires. Through this systematic review, we aimed to assess the various metallurgical characteristics of the said metals and alloys. Four hundred and eighty-two documents in total were found after a thorough search of the online journals, and 169 of the papers were initially chosen. Ultimately, 16 documents were selected that satisfied the necessary inclusion and exclusion criteria, primarily in vitro studies, literature reviews, and comparative analyses. NiTi alloy was found to be the most commonly used alloy in construction of orthodontic wires across all the studies that we had selected for our review. It also had better performance and consistency in terms of its usage as depicted by the meta-analysis performed, with stainless steel wires being a close second primarily due to its lesser cost compared to the former. Metallurgy and orthodontics are inextricably linked with one another. The various components of orthodontics such as wires, pliers, and other instruments utilize the metallurgical characteristics of metals and alloys that are specially prepared for the challenges of this field. PROSPERO Registration Number: CRD42022378444.

A systematic review and meta-analysis of the role of nutrition and its impact on orthodontic treatment/management

The nutritional needs already increased by adolescent growth, activity, and stress are further exacerbated by the physical, physiological, and psychological stress that orthodontic treatment causes. Hence, the main objective of this systematic review was to analyze the relationship between adequate nutrition and its impact on orthodontic treatment success rates. Using relevant keywords, reference searches, and citation searches, the databases such as PubMed-Medical Literature Analysis and Retrieval System Online, Web of Science, Cochrane, and Scopus were all searched. "Diet," "Minerals," "Nutrition," "Orthodontics," and "Vitamins" were the search terms used to scour the database. The 10 studies selected for the systematic review and subsequent meta-analysis could not conclusively establish the correlation between proper nutrition and its impact on orthodontic treatment of the patient. There was virtually little connection between patients' dietary intake and the effectiveness of their orthodontic treatment. Additionally, a direct causal link between the two could not be established legitimately because the majority of the studies reviewed only noted an impact during the early stages of the treatment. PROSPERO Registration Number: CRD42022380828.

Effects of the conventional, soft start, and pulse delay modes produced by light-emitting diode device on metal brackets bond strength and enamel damage: An in vitro comparative study

OBJECTIVES

This study aimed to compare the bond strength and enamel damage following debonding of metal brackets cured by different light-curing modes: conventional, soft start, and pulse delay modes.

MATERIAL AND METHODS

Sixty extracted upper premolars were randomly divided into three groups according to the used light-curing mode. Metal brackets were bonded with a light-emitting diode device employing different modes. Group 1: conventional mode (10s mesial+10 s distal); group 2: soft start mode (15s mesial+15s distal); group 3: pulse delay mode (3s mesial+3s distal, followed by 3min of no photoactivation, then 9s mesial+9s distal). Radiant exposure was the same in all study groups. Shear bond strengths of the brackets were tested with a universal testing machine. A stereomicroscope was used to determine the number and length of enamel microcracks. One-Way ANOVA and Kruskal-Wallis tests were used to detect significant differences in shear bond strength and microcracks number and length among groups.

RESULTS

The soft start and pulse delay modes produced significantly greater shear bond strength than the conventional mode (19.46±4.90MPa; 20.47±4.97MPa; 12.14±3.79MPa, respectively, P<0.001). However, there was no significant difference between the soft start and pulse delay groups (P=0.768). The number and length of microcracks increased significantly after debonding in all study groups. The change in microcracks length was not different among study groups.

CONCLUSION

The soft start and pulse delay modes produced greater bond strength than the conventional mode without predisposing enamel to higher risk of damage. Conservative methods for debonding are still required.

Systematic review fracture resistance of endodontically treated posterior teeth restored with fiber reinforced composites- a systematic review

BACKGROUND

Large cavity designs and access cavities impair endodontically treated tooth fracture resistance. As the tooth's strength is known to reduce significantly after the root canal treatment, occlusal loading as a result of functions such as chewing, biting and certain parafunctional tendencies makes the endodontically treated tooth vulnerable to fracture. Hence, after endodontic treatment, it is vital to give adequate and appropriate restorative material to avoid tooth fractures. Accordingly, the choice of such restorative material should be dictated by the property of fracture resistance.

OBJECTIVE

The goal of this study was to conduct a systematic review and critical analysis of available data from in vitro studies examining the fracture resistance of endodontically treated posterior teeth restored with fiber-reinforced composites.

METHODOLOGY

The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRIS-MA) Statement was used to guide the reporting of this systematic review A comprehensive literature search was performed using MEDLINE (via PubMed), Scopus, ScienceDirect, Google Scholar, and LILACS. A manual search of the reference lists of the articles was also performed. The databases provided a total of 796 studies from the electronic systematic search. The databases provided a total of 796 studies from the electronic systematic search. Two reviewers scrutinized the papers for eligibility based on inclusion/exclusion criteria and extracted data. The studies were assessed for their potential risk of bias. Based on modified JBI & CRIS (checklist for reporting in vitro studies) guidelines, along with the methodology and treatment objective, we have formulated 13 parameters specifically to assess the risk of bias. A total of 18 studies met the inclusion criteria and were included for qualitative analysis. Considering the high heterogeneity of the studies included, a meta-analysis could not be performed.

RESULTS

The majority of the included studies had a moderate or high risk of bias. When compared to traditional hybrid composites, fiber-reinforced composites showed increased fracture resistance of endodontically treated teeth in the majority of investigations. On the other hand, limited evidence was found for the bulk fill composites. Moreover, moderate evidence was found for the fracture resistance of inlays and fiber posts with fiber-reinforced composites for core build-up in endodontically treated teeth. No evidence could be found comparing the fracture resistance of endo crowns and fiber-reinforced composites in endodontically treated teeth.

CONCLUSION

According to the research, using fiber-reinforced composites instead of conventional hybrid composites improves the fracture resistance of endodontically treated teeth. However, there was a high risk of bias in the research considered. No judgments could be reached about the superiority of one material over another based-on comparisons between other core restorations.

The Impact of Temporomandibular Disorders on Orthodontic Management: A Systematic Review and Meta-Analysis

The literature on the impact of temporomandibular disorders (TMDs) on orthodontic management or vice versa lacks clarity. This study presents a review that aims to evaluate the influence of TMDs on orthodontic management and explore the association between TMDs and various aspects of orthodontic treatment. A systematic search was conducted across multiple databases to identify relevant articles documenting the correlation between TMD incidence and orthodontic treatment to achieve the objectives. The selection process followed predefined criteria, and the selected studies underwent bias assessment using the AXIS tool and Cochrane risk of bias (RoB) tool. Among the articles identified, nine studies were deemed suitable for inclusion in the review. The findings from the subsequent meta-analysis indicated a significant overall effect, suggesting that orthodontic treatment may increase the risk of developing TMD. Furthermore, the analysis revealed that patients with TMD had higher odds of experiencing orthodontic issues than those without TMD. Subgroup analysis further demonstrated that orthodontic treatment could have a negative impact on the psychological well-being of TMD patients, while its effect on TMD incidence was found to be negligible. The results highlight the need for additional research to gain a better understanding of the underlying mechanisms and develop appropriate interventions aimed at minimizing the risk of TMD in patients undergoing orthodontic treatment. Clinicians should be aware of TMD as a potential complication of orthodontic treatment and implement appropriate monitoring strategies.

Everting Sutures for Involutional Entropion: A Non-incision, Simple and Cost-Effective Technique

Entropion is one of the common eyelid marginal malposition and it causes irritation, and ulceration of the cornea that leads to visual loss of a patient. Patient may present with watering and foreign body sensation of the eye initially. Entropion may occur in the upper or lower eyelid. Involutional entropion is common and affected the lower eyelid. There are various non-surgical and surgical options to correct the entropion. Non-surgical procedures include taping the lower eyelid which relieves the entropion temporarily, botulinum toxin type-A injection into lower eyelid may temporarily relief the discomfort from entropion up to 6 months. This study was carried out to assess the outcome of the everting sutures for the correction of lower eyelid involutional entropion and to describe the cost effective of the procedure. A nonrandomized, non control group quasi experimental study was conducted in a Tertiary Eye Hospital, in Gopalganj, Bangladesh from January 2016 to December 2019. A less invasive everting sutures technique was applied for the correction of involutional entropion of eyelid. Follow up was maintained at regular intervals and we assess the outcome of the surgical techniques. We evaluated 33 eyes of 31 patients. The success rate was 87.88%. Recurrences were observed in 5(15.15%) eyelids in the 18 months follow up times. The time of the procedure was only 10 minutes, and the cost of the procedure was cheaper. Everting sutures was minimal invasive, non-incision, cost effective procedure for the correction of involutional entropion.

Assessing the relationship between single nucleotide polymorphisms in Wingless signaling pathway genes and sella turcica morphology

Sella turcica development involves molecular factors and genes responsible for ossification. It is possible that single nucleotide polymorphisms (SNPs) in key genes are involved in morphological variation of sella turcica. Genes belonging to the WNT signaling pathway are involved in the ossification process and are candidates of sella turcica morphology. This study aimed to evaluate if SNPs in WNT6 (rs6754599) and WNT10A (rs10177996 and rs3806557) genes are associated with the calcification and patterns of the sella turcica. Nonsyndromic individuals were included in the research. Cephalometric radiographs were examined and the sella calcification was evaluated and classified according to the calcification of the interclinoid ligament (no calcification, partial calcification, and incomplete calcification) and sella turcica pattern (normal sella turcica, bridge type A-ribbon-like fusion, bridge type B-extension of the clinoid processes, incomplete bridge, hypertrophic posterior clinoid process, hypotrophic posterior clinoid process, irregularity in the posterior part, pyramidal shape of the dorsum, double contour of the floor, oblique anterior wall, and oblique contour of the floor). DNA samples were used to evaluate SNPs in the WNT genes (rs6754599, rs10177996, and rs3806557) using real-time PCR. Chi-square test or Fisher's exact test were used to compare the allele and genotype distributions according to sella turcica phenotypes. The alpha was set as 5% for all comparisons. A total of 169 individuals were included, 133 (78.7%) present sella turcica partially or completely calcified. Sella turcica anomalies were found in 131 individuals (77.5%). Sella turcica bridge type A (27.8%), posterior hypertrophic clinoid process (17.1%), and sella turcica bridge type B (11.2%) were the most prevalent morphological patterns observed. Individuals carrying the TT genotype in rs10177996 (TT vs. CT + CC) had higher chance to present a partially calcified sella turcica (p = 0.047; Odds ratio = 2.27, Confidence Interval 95% 1.01-5.13). In conclusion, the SNP in WNT10A is associated with the calcification phenotype of the sella turcica, the pleiotropic effect of this gene should be taken into consideration in future studies.

Clinical and radiographic outcomes of adjunctive photodynamic therapy for treating peri-implantitis among diabetics and cigarette smokers: a systematic review of randomized controlled trials

Photodynamic therapy (PDT) has been suggested as an adjunctive therapeutic approach for peri-implantitis. This systematic review aimed to assess the clinical and radiographic outcomes of adjunctive PDT (aPDT) for the treatment of peri-implantitis among diabetics and cigarette smokers. Randomized controlled trials (RCTs), which assessed the clinical and radiographic outcomes of aPDT versus other intervention(s) and/or MD alone among diabetics and smokers with peri-implantitis, were considered eligible for the review. Meta-analysis was performed for calculating the standard mean difference (SMD) with a 95% confidence interval (CI). The methodological quality of the included studies was evaluated using the modified Jadad quality scale. The meta-analysis revealed no significant differences between the influence of aPDT and other intervention/MD alone on the peri-implant PI among diabetics at the final follow-up. However, statistically significant improvements in the peri-implant PD, BOP, and CBL were observed after the application of aPDT among diabetics. Similarly, no significant differences were found between the influence of aPDT and other interventions/MD alone on the peri-implant PD among smokers with peri-implant diseases at the final follow-up. However, statistically significant improvements in the peri-implant PI, BOP, and CBL were observed after the application of aPDT among smokers. Significant improvements in the peri-implant PD, BOP, and CBL among diabetics and the peri-implant PI, BOP, and CBL among smokers after the application of aPDT at the final follow-up. However, large-scale, well-designed, and long-term RCTs are recommended in this domain.

The effectiveness of minimally-invasive corticotomy-assisted orthodontic treatment of palatally impacted canines compared to the traditional traction method in terms of treatment duration, velocity of traction movement and the associated dentoalveolar changes: A randomized controlled trial

Objective: To evaluate the effectiveness of a minimally-invasive corticotomy-assisted treatment of palatally impacted canines (PICs) compared with the traditional method by evaluating treatment time, the velocity of movement, and the associated dentoalveolar changes. Materials and methods: Forty-six patients with palatally or mid-alveolar upper impacted canines were recruited and distributed into two groups: the corticotomy-assisted traction group (CAT group, mean age: 20.39±2.27 years) and the traditional treatment group (TT group, mean age: 20.26±2.17 years). The closed surgical approach was used in both study groups. The velocity of traction movement, traction duration and overall treatment duration were evaluated clinically. In addition, the bone support ratios and the amount of root resorption were assessed on cone-beam computed tomography (CBCT) images. Results: At the end of treatment, significant differences were found between the two groups regarding the velocity of traction movement, traction time, and overall treatment time (P<0.05). The mean velocity of traction movement in the CAT group was greater than the TT group ( x velocity=1.15±0.35 mm/month; 0.70±0.33 mm/month, P=0.027, respectively). The duration of the active traction and the overall orthodontic treatment in the CAT group were significantly shorter than the TT group by 36% and 29%, respectively. The mean bone support ratios of the aligned canines did not differ significantly between the two groups (88% vs. 89% in the CAT and TT groups, respectively). No significant differences were found between the two groups regarding the mean amount of root resorption on the adjacent laterals ( x resorption = 1.30±1.18 mm; 1.22±1.02 mm, P=0.612, in CAT and TT groups, respectively). Conclusions: The traction movement velocity of the palatally impacted canines can be increased using minimally-invasive corticotomy-assisted orthodontic treatment. The side effects of the acceleration procedure were minimal and almost similar to those of the traditional technique.

Radiographic Analysis of Morphological Variations of Sella Turcica in Different Skeletal Patterns Among Saudi Subpopulations

Background

Size and shape of the sella turcica is considered vital for many radiographic analyses.

Objectives

To assess and compare the linear dimensions and shape of sella turcica on digital lateral cephalograms in Saudi subpopulation with different skeletal patterns, age groups and genders.

Methodology

A total of 300 digital lateral cephalograms were retrieved from the hospital archive. The selected cephalograms were grouped based on the age, gender, and skeletal types. The linear dimensions and shape of sella turcica were measured on each radiograph. Data were analyzed using an independent t-test and a one-way ANOVA. To test the inter-relationship of age, gender, and skeletal type with the dimensions of sella turcica, regression analyses were used. Statistical significance was set at P ≤ 0.01.

Results

Significant differences in linear dimensions between the age groups (P < 0.001) and genders (P < 0.001) were noted. On comparing sella size with different skeletal types, a significant difference was found for all sella dimensions (P < 0.001). The mean length, depth and diameter among skeletal class III were significantly higher than that among classes I and II. On comparing age, gender, and skeletal type with size of sella, age and skeletal type were significantly related to the change of length, depth and diameter (P < 0.001), whereas gender was found to be significantly related only to a change in length of the sella (P < 0.01). For the sella shape, normal morphology was noted in 44.3% of patients.

Conclusion

According to the findings of this study, the measurements of sella can be used as reference standards for future studies in Saudi subpopulation.

Comparative Evaluation of Condylar Guidance Angles Measured Using Arcon and Non-Arcon Articulators and Panoramic Radiographs-A Systematic Review and Meta-Analysis

The condylar guidance value (CGV) measurement constitutes an important part of a holistic prosthodontic treatment plan, with horizontal CGVs (HCGVs) and lateral CGVs (LCGVs) being two of the most prominently recognized. This systematic review aimed at evaluating the efficacy of two different types of CGV measurement protocols-articulators (both arcon and non-arcon) and panoramic radiographs. Additionally, it attempts to determine which of the mentioned methods performs better across several parameters. Several important web databases were searched using search terms derived from medical subject headings (MeSH), using keywords linked to "Arcon articulator", "Condylar guidance angle", "non-arcon articulator", "Panoramic x-ray" and "Radiographic examination", which constituted the first step in the study selection strategy. After completion, the search strategy which initially turned up to 831 papers, eventually ended up with 13 studies. The review and subsequent meta-analysis revealed that panoramic radiographs had noticeably greater efficacy in terms of the CGVs as compared to the articulators in the majority of the studies. Within the articulators, the arcon types recorded slightly higher CGVs than the non-arcon variety owing to the precision of jaw movement simulation in the former. However, further studies are required to validate these findings and establish more precise guidelines for the use of CGV measurement protocols in prosthodontic practice.

Potential use of the cusp and crown areas of the maxillary posterior teeth measured with a two-dimensional stereomicroscope for sex determination

In this study, we aimed to compare the cusp and crown areas of the maxillary first premolar (PM1), second premolar (PM2), and first molar (M1) in males and females in the Malay population and to formulate sex prediction models. For this purpose, the maxillary posterior teeth of 176 dental cast samples (from 88 males and 88 females) were selected and transformed to two-dimensional digital models using 2D-Hirox KH-7700. Cusp and crown area measurements were obtained using Hirox software by tracing the outermost circumference of the tooth cusps. Statistical analysis included independent t-tests, logistic regression analysis, and receiver-operating characteristic (ROC) curves as well as determination of sensitivity and specificity; analysis was performed with SPSS version 26.0. The significance threshold was set at 0.05. All crown and cusp area measurements were significantly larger in males than in females (p < 0.001). The most sexually dimorphic tooth was the first maxillary molar (mean difference, 10.27 mm²), and the most sexually dimorphic cusp was the mesiopalatal cusp (mean difference, 3.67 mm²) of M1. The sex prediction model had a good accuracy, with 80% of selected cases correctly predicted. Hence, we conclude that the maxillary posterior teeth in the Malay population exhibit significant sexual dimorphism, and this information may be used for sex determination as adjuvants along with other procedures.

Impact of Dental Trauma on Orthodontic Parameters-A Systematic Review and Meta-Analysis

BACKGROUND AND OBJECTIVES

Investigation into the impact of dental trauma on the results of orthodontic treatment is crucial because it can have a major influence on patient care. However, there has not yet been a thorough review or meta-analysis of the available data, which is inconsistent and scant. Therefore, the goal of this systematic review and meta-analysis is to investigate the impact of dental trauma on orthodontic parameters. Search methods and criterion of selection: Major online databases were searched (beginning from the year 2011) for relevant articles using a properly defined search strategy. Analysis protocol: Risk of bias (RoB) and the Cochrane risk of bias tool were utilized for the purposes of bias evaluation within the individual studies and within the review, respectively.

RESULTS

Out of the six clinical trials selected, a significant impact of trauma was observed in individuals in all but one paper. Gender predilection varied across studies and could not be conclusively determined. The follow-up period ranged from two months to two years in the trials. The odds ratio (OR) 0.38 [0.19, 0.77] and the risk ratio (RR) 0.52 [0.32, 0.85] indicated that both the odds as well as the relative risk of experiencing dental trauma were lower in the group with negligible impact compared to the group with noticeable impact. Conclusion and further implications: The findings show that dental trauma significantly affects orthodontic parameters, with lower risk and likelihood of suffering dental trauma in the group with negligible impact than in the group with noticeable impact. However, given the substantial heterogeneity among the studies, it is advised to exercise caution when extrapolating the findings to all populations. Registration and protocol: Registration in the PROSPERO database was carried out before initiating the investigation [CRD42023407218].

A Novel Method to Accelerate Orthodontic Tooth Movement Using Low-Intensity Direct Electrical Current in Patients Requiring en-Masse Retraction of the Upper Anterior Teeth: A Preliminary Clinical Report

BACKGROUND

Shortening the duration of orthodontic treatment by speeding up the rate of tooth movement has become an essential goal for both orthodontists and patients. This preliminary report aimed to investigate the safety and effectiveness of a new intraoral removable electrical device in accelerating the en-masse retraction of the upper anterior teeth using low-intensity direct electrical current.

METHODS

This prospective preliminary interventional clinical study was conducted at the Department of Orthodontics, Faculty of Dentistry, Damascus University, Syria, between March 2019 and February 2020. The sample consisted of six patients (four females and two males; mean age: 19.55 ± 0.89 years) whose initial diagnosis was class II division I malocclusion, and their treatment plan suggested the extraction of upper first premolars followed by en-masse retraction. The electrical stimulation was applied on the maxillary anterior region during the en-masse retraction phase using a specially fabricated removable device that was designed by two coauthors of this manuscript (RIS, MYH). Patients were asked to wear their own electrical devices inside their mouths for five hours daily. The primary outcomes were the en-masse retraction rate and duration. The secondary outcomes were safety and patient acceptance.

RESULTS

The average total retraction rate during the treatment period was 0.97±0.06 mm/month. The total amount of retraction achieved during follow-up was 5.65 ± 0.85 mm, which was about 91.86% of the space resulting from the extraction of the upper first premolars. The mean treatment duration to complete the en-masse retraction was 5.66±0.81 months. No side effects of the electrical stimulation were found during the follow-up.

CONCLUSIONS

Low-intensity direct electrical current could be an effective method to accelerate orthodontic movement. The electrical accelerating device used in this study effectively increased the en-masse retraction rate of the upper anterior teeth without any side effects and with high patient acceptance.

Exploring the properties of formocresol in dentistry-a comprehensive review

Due to concerns about formocresol's mutagenic and genotoxic potential, its use as a pulpotomy medication is currently debatable. The current paper aimed to review the properties of formocresol and concerns regarding its safety as a pulpotomy medicament for primary teeth. With reference to the context of the recently published literature, the alternatives to formocresol are discussed, together with their benefits and drawbacks. A literature search was conducted using multiple databases comprising of MEDLINE (via PubMed), EMBASE, and Web of Science. The terms used for the search were "formocresol", "pulpotomy", and "primary teeth". In total, 364 articles were obtained from the analysis of the databases. Unrelated articles from the available full text of 174 articles were excluded. The main reasons for excluding the articles were: they were usage and precautionary guidelines. A total of 68 studies were finally included in the review. The literature review in this paper supports the notion that formocresol continues to be the most often utilized pulp dressing agent in primary teeth pulpotomies despite offering no advantages over other pulp dressing chemicals that are currently on the market.

Effect of COVID-19 on orthodontic treatment/practice- A systematic review and meta-analysis

Coronavirus disease of 2019 (COVID-19), which has affected almost all medical professions, has had a significant negative influence on dental care. Additionally, non-urgent dental procedures were stopped during the epidemic in a number of countries. The purpose of this systematic review was to examine the impact of COVID-19 on individuals who had undergone or are currently having orthodontic treatment in any capacity during/after the pandemic's occurrence. After a thorough search of the online journals, a total of 634 documents were found, and 416 of the papers were initially chosen. The removal of 362 similar or duplicate publications that followed led to the initial availability of 54 separate papers. The final selection consisted of 23 documents, mostly in vitro investigations, cross-sectional studies, and comparative evaluations, which satisfied the necessary inclusion and exclusion criteria. COVID-19 had a significant impact on nearly every sphere of the patients' lives who were undergoing orthodontic treatment. However, people who are currently availing of various orthodontic treatment modalities did not experience the same issues as the ones faced by patients earlier. Teleorthodontics emerged as a viable option to access treatment during the lockdown period caused due to the pandemic. COVID-19 also had an overall negative impact on the psyche and morale of orthodontists around the world. PROSPERO Registration Number: CRD42022380823.