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Nelson-Filho P, Perdiza M, Ribeiro YJS, Saraiva MDCP, Neuppmann Feres MF, Feres M, Delgado RZR, Silva RAB, Silva LAB. Assessment of microbial contamination in removable orthodontic appliances with and without the use of antimicrobial agents by checkerboard DNA-DNA hybridization analysis. Am J Orthod Dentofacial Orthop 2023; 164:593-601. [PMID: 37306639 DOI: 10.1016/j.ajodo.2023.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/01/2023] [Accepted: 03/01/2023] [Indexed: 06/13/2023]
Abstract
INTRODUCTION This clinical, crossover, double-blind trial evaluated the microbial contamination of removable orthodontic appliances used by children and the efficacy of 0.12% chlorhexidine gluconate spray use for disinfection. METHODS Twenty children aged 7-11 years were instructed to wear removable orthodontic appliances for 1 week. They were instructed to use a placebo solution (control) or 0.12% chlorhexidine gluconate (experimental) to clean the appliances on days 4 and 7 after installation. After this period, the microbial contamination on the surfaces of the appliance was analyzed using checkerboard DNA-DNA hybridization for 40 bacterial species. Data were analyzed by Fisher exact, t, and Wilcoxon tests (α = 0.05). RESULTS Removable orthodontic appliances were heavily contaminated by the target microorganisms. Streptococcus sanguinis, Streptococcus oralis, Streptococcus gordonii, and Eikenella corrodens were found in 100% of the appliances. Among cariogenic microorganisms, Streptococcus mutans and Streptococcus sobrinus were more abundant than Lactobacillus acidophilus and Lactobacillus casei. Red complex pathogens were more abundant than orange complex species. Purple complex bacteria were the most prevalent among bacterial complexes not associated with specific pathologies, detected in 34% of the samples. After the use of chlorhexidine, the number of cariogenic microorganisms (S. mutans, S. sobrinus, and L. casei) decreased significantly (P <0.05), and the numbers of periodontal pathogenic species from the orange and red complex also decreased significantly (P <0.05). There was no reduction for Treponema socranskii. CONCLUSIONS Removable orthodontic appliances were densely contaminated by several bacterial species. Twice-a-week application of chlorhexidine spray effectively reduced cariogenic and orange and red complex periodontal pathogens.
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Affiliation(s)
- Paulo Nelson-Filho
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
| | - Marcela Perdiza
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Yuri Jivago Silva Ribeiro
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Murilo Fernando Neuppmann Feres
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Magda Feres
- Department of Periodontology, Division of Dentistry Research, University of Guarulhos, Guarulhos, São Paulo, Brazil
| | - Renata Zoraida Rizental Delgado
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Raquel Assed Bezerra Silva
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Lea Assed Bezerra Silva
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Molena KF, Prado VDO, Paulo AC, Dantas RVF, Curi Júnior A, Pedroso GL, Furtado TCS, Flores-Mir C, Sanglard LF, Feres MFN. Knowledge changes after applying evidence-based dentistry educational interventions to dental students: A systematic review. J Dent Educ 2023; 87:1321-1369. [PMID: 37414522 DOI: 10.1002/jdd.13290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 05/09/2023] [Accepted: 05/24/2023] [Indexed: 07/08/2023]
Abstract
PURPOSE To critically evaluate the evidence on knowledge changes observed after the application of evidence-based dentistry (EBD) educational interventions to dental students. METHODS We included studies that assessed EBD knowledge after applying educational interventions to undergraduates. Studies that evaluated post-graduate students or professionals, that exclusively described educational interventions, programs, or the application of curriculum revisions were excluded. Electronic databases (PubMed, Embase, Scopus, and Web of Science), unpublished gray literature, and manual searches were performed. Data concerning "perceived" and "actual knowledge" was extracted. The quality of the studies was appraised according to the Mixed Methods Appraisal Tool. RESULTS The 21 selected studies enrolled students at different stages, and the intervention formats were diverse. The educational interventions could be categorized into three modalities, that is, regular, EBD-focused disciplines or courses, and other educational interventions including one or more of the EBD principles, methods, and/or practices. Despite the format, knowledge was generally improved after the implementation of educational interventions. Overall, perceived and actual levels of knowledge increased considering EBD general concepts, principles, and/or practices, and concerning the "acquire" and "appraise" skills. Among the selected studies, two were randomized controlled trials, while most were non-randomized or descriptive studies. CONCLUSIONS EBD-related educational interventions seem to improve dental students' perceived and actual knowledge, according to literature with a high risk of bias. Therefore, more complete, methodologically rigorous, and longer-term studies are still recommended to confirm and expand the current knowledge.
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Affiliation(s)
- Kelly Fernanda Molena
- Department of Pediatric Dentistry, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Viviane de Oliveira Prado
- Department of Pediatric Dentistry, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Alana Cândido Paulo
- Department of Pediatric Dentistry, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
| | | | - Airton Curi Júnior
- Department of Pediatric Dentistry, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Gabriela Leite Pedroso
- Department of Pediatric Dentistry, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Taissa Cassia Souza Furtado
- Department of Pediatric Dentistry, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Carlos Flores-Mir
- Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Luciana Faria Sanglard
- Department of Clinical Dentistry, School of Dentistry, Federal University of Espirito Santo, Vitoria, Brazil
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Figueiredo MAD, Romano FL, Feres MFN, Stuani MBS, Ferreira JTL, Nahás ACR, Matsumoto MAN. Maxillary alveolar bone evaluation following dentoalveolar expansion with clear aligners in adults: A cone-beam computed tomography study. Korean J Orthod 2023; 53:263-275. [PMID: 37497583 PMCID: PMC10387425 DOI: 10.4041/kjod22.243] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 06/04/2023] [Accepted: 06/21/2023] [Indexed: 07/28/2023] Open
Abstract
Objective To investigate the effects of maxillary orthodontic expansion on the alveolar bone tissue in adult patients treated with aligners by using cone-beam computed tomography. Methods Thirty patients (22 females and 8 males; mean age: 36.3 years) were treated with Invisalign® aligners. Cone-beam computed tomography and digital models were obtained before (T0) and after (T1) upper arch expansion. The bone thicknesses in the cervical, middle, and apical areas of the incisors, canines, premolar, and first molars were buccally and palatally measured, totaling 96 areas and 2,880 measurements. The buccolingual inclinations and transverse measurements of the teeth were obtained from digital models to correlate them with the bone changes. The statistical tests used were Student's t-test, analysis of variance, and Pearson's correlation tests (p < 0.05). Results From the 96 areas evaluated, 84 revealed an increase or stability in the alveolar bone thickness and twelve displayed significant bone loss. Bone changes did not correlate with the tooth inclination and transverse measurements. Conclusions Within the limitation of the present study, mild levels of upper arch expansion obtained with Invisalign® aligners in adult patients did not result in any clinically significant loss of alveolar bone thickness.
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Affiliation(s)
- Marcio Antonio de Figueiredo
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Fábio Lourenço Romano
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | | | - Maria Bernadete Sasso Stuani
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - José Tarcísio Lima Ferreira
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | | | - Mírian Aiko Nakane Matsumoto
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
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Muro MP, Caracciolo ACA, Patel MP, Feres MFN, Roscoe MG. Effectiveness and predictability of treatment with clear orthodontic aligners: A scoping review. Int Orthod 2023; 21:100755. [PMID: 37086643 DOI: 10.1016/j.ortho.2023.100755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 04/24/2023]
Abstract
INTRODUCTION In an ideal clinical setting, orthodontic therapy with clear aligners (CA) should improve the patients' initial malocclusion and must guarantee equivalence between the results predicted and those obtained clinically to be considered an effective treatment. Therefore, this scoping review aimed to identify the orthodontic literature concerning the effectiveness and predictability of CA treatments. METHODS A systematic computerized search was performed in 3 databases: PubMed, Scopus, and Embase. Inclusion criteria selected observational and clinical studies performed in at least 10 adult orthodontic patients, whose results of CA treatment's effectiveness and/or predictability were assessed. RESULTS The 3 database computerized searches resulted in 1,553 articles, and 169 full texts were considered potentially relevant. After applying the eligibility criteria, 33 studies were included. Most studies (76%) were designed as cohort studies and have been published in the last 5 years (79%). The majority included only non-extraction treatments (73%), and 79% reported results achieved with the Invisalign® system. The most predictable movement was the buccolingual tipping, while the least predictable movements were rotation, intrusion, and extrusion. Aligner treatment was effective for mild to moderate crowding resolution, and the success of overbite correction still seems to be limited. CONCLUSIONS The studies have demonstrated improvement of initial malocclusion through CA treatments. Still, predictability degree is overestimated and does not accurately reflect the occlusion immediately at the end of treatment. In future studies, there should be an effort to broaden the utilization of alternative aligner systems beyond Invisalign® and broadly disseminate their outcomes to strengthen clear aligners evidence base.
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Affiliation(s)
| | | | - Mayara Paim Patel
- Dental Research Division, School of Dentistry, Guarulhos University, Guarulhos, São Paulo, Brazil
| | | | - Marina Guimarães Roscoe
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Paschoini VL, Nunes DC, Matias M, Nahás-Scocate ACR, Feres MFN. Accuracy of dental calcification stages for the identification of craniofacial pubertal growth spurt: proposal of referral parameters. Eur Arch Paediatr Dent 2023; 24:75-83. [PMID: 36242760 DOI: 10.1007/s40368-022-00759-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 09/30/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE This study primarily aimed to assess the accuracy of radiographic dental calcification parameters for the identification of specific craniofacial growth stages. METHODS Permanent mandibular canines, premolars, and second molars of 288 patients, from 6 to 15 years old, were analysed on randomly selected panoramic radiographs, and categorised according to two calcification methods. Reproducibility analyses and data derived from panoramic records were correlated with the gold-standard method, as evaluated from lateral cephalometric teleradiographs. Accuracy tests were finally calculated, considering several cutoff points. RESULTS Dental calcification methods showed "strong" to "almost perfect" intra- and inter-examiner reproducibility. Significant, although weak correlations were observed for all parameters. Canine and first premolar calcification stage 8 and second premolar and second molar stage 7 showed higher sensitivity rates for identifying the pubertal growth spurt period, as well as the stage F for these teeth. Canine and first premolar stages 10 and H obtained higher specificity rates for identifying the absence of post-pubertal period. CONCLUSIONS The dental calcification parameters showed adequate reproducibility, in addition to significant correlations with cervical vertebrae stages. Radiographic dental calcification parameters used for the mandibular first premolar obtained high accuracy rates and were recommended for identifying specific craniofacial growth periods.
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Affiliation(s)
- V L Paschoini
- School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, University de São Paulo, Av. Café s/n, Monte Alegre, Ribeirão Preto, SP, 14040-904, Brazil.
| | - D C Nunes
- School of Dentistry of Guarulhos, Department of Orthodontics, Guarulhos University, Guarulhos, SP, Brazil
| | - M Matias
- School of Dentistry of Guarulhos, Department of Orthodontics, Guarulhos University, Guarulhos, SP, Brazil
| | - A C R Nahás-Scocate
- School of Dentistry of Guarulhos, Department of Orthodontics, Guarulhos University, Guarulhos, SP, Brazil
| | - M F N Feres
- School of Dentistry of Ribeirão Preto, Department of Pediatric Dentistry, University de São Paulo, Ribeirão Preto, SP, Brazil
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Feres MFN, Albuini ML, de Araújo Castro Santos RP, de Almeida-Junior LA, Flores-Mir C, Roscoe MG. Dentists' awareness and knowledge of evidence- based dentistry principles, methods and practices: a systematic review. Evid Based Dent 2022:10.1038/s41432-022-0821-2. [PMID: 36138157 DOI: 10.1038/s41432-022-0821-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/19/2021] [Indexed: 11/09/2022]
Abstract
Introduction As an attempt to provide supporting evidence for the formulation of future educational strategies on knowledge translation, this systematic review assessed and synthesised the available evidence related to the dentists' awareness, perceived and actual knowledge of evidence-based dentistry (EBD) principles, methods and practices.Methods Primary studies that considered dentists' reports collected from interviews, questionnaires, or conversation sessions were selected. Studies enrolling students, dental hygienists, or other health professionals were not included. Reviews, editorials, letters, study protocols, articles presenting knowledge translation strategies and initiatives, examples of EBD approaches to specific clinical questions, and guidelines focused on EBD implementation were also excluded. Cochrane, Embase, PubMed, Scopus and Web of Science databases were searched. Grey literature was partially covered by the Google Scholar search and the reference lists of the pre-selected studies. The study search was concluded in February 2021. Descriptive data of the selected studies were synthesised, and the risk of bias was assessed according to the National Institutes of Health Quality Assessment Tool for observational cohort and cross-sectional studies.Results Twenty-one articles were included. High percentages of dentists were aware of EBD. Variable proportions of professionals declared to have some understanding of EBD, although few presented actual knowledge of principles, methods and practices.Discussion Methodologically, most studies presented limitations regarding sample representativity, participation rates, detailing of the outcome measures, and validation of the assessment tools. Additionally, extensive overall ranges of responses were often observed across the studies, possibly as a result of heterogeneity across samples and assessment tools. The authors thus suggest developing valid questionnaires including all dimensions (awareness, perceived knowledge and actual knowledge) within an assessment tool. This would contribute to establishing knowledge translation strategies to overcome specific gaps in EBD knowledge.
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Affiliation(s)
| | | | | | | | | | - Marina Guimarães Roscoe
- Department of Biomaterials and Oral Biology, School of Dentistry of Sao Paulo, University of Sao Paulo, Brazil
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Feres MFN, Ruiz-Rodrigues L, Prado VDO, Vicioni-Marques F, Feres M, Nelson-Filho P, Flores-Mir C. Dentists' attitudes and practices toward evidence-based dentistry: a systematic review. JBI Evid Implement 2022; 22:02205615-990000000-00019. [PMID: 36378117 DOI: 10.1097/xeb.0000000000000326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND AIMS Considering that attitudes toward evidence-based dentistry (EBD) may predict implementation behaviors, the objective of this systematic review was to synthesize and evaluate the existing evidence related to dentists' attitudes and practices toward EBD. METHODS We included primary studies that collected information from interviews, questionnaires, or conversation sessions with dentists. The following sources were searched: Cochrane Central Register of Controlled Trials, Embase, PubMed, Scopus, and Web of Science, in addition to gray literature. The included studies were appraised according to the assessment tools recommended by the Joanna Briggs Institute for qualitative and quantitative observational studies. Descriptive data were collected in standardized tables and descriptively synthesized. RESULTS The selection process resulted in 36 included studies. Dentists share positive opinions about EBD and predominantly report willingness to learn or adopt these practices. Despite high methodological risks and significant heterogeneity, the results collected in this review indicated that scientific journals, clinical practice guidelines, and trusted colleagues are generally perceived as influential and useful by dentists, who highly consulted these information sources. CONCLUSION Despite supportive reported attitudes toward EBD, very low certainty exists about actual EBD-related practices.
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Affiliation(s)
| | - Larissa Ruiz-Rodrigues
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Viviane de Oliveira Prado
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Fernanda Vicioni-Marques
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Magda Feres
- Department of Periodontology, Dental Research Division, Guarulhos University, São Paulo, Brazil
- The Forsyth Institute, Cambridge, Massachusetts, USA
| | - Paulo Nelson-Filho
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Carlos Flores-Mir
- Division of Orthodontics, School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
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Prado LH, Previato K, Delgado RZR, Nelson Filho P, Bezerra Segato RA, Nakane Matsumoto MA, Neuppmann Feres MF. Adolescents' perception of malocclusion, their motivations, and expectations concerning the orthodontic treatment. Is it all about attractiveness? A qualitative study. Am J Orthod Dentofacial Orthop 2022; 161:e345-e352. [PMID: 35031194 DOI: 10.1016/j.ajodo.2021.10.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/01/2021] [Accepted: 10/01/2021] [Indexed: 11/01/2022]
Abstract
INTRODUCTION In addition to essential clinical parameters, orthodontic treatment outcomes should also consider patients' opinions and perceptions, which could be comprehensively clarified with a qualitative scientific approach. Considering that the information on younger patients' views is scarce, the objective of this study was to investigate how adolescent orthodontic patients perceive malocclusion, and their motivations and expectations concerning orthodontic corrective treatment. METHODS In this descriptive qualitative study, 12 adolescents aged 12 to 14 years and of both genders, covering a heterogeneous collection of malocclusions, were recruited from the waiting list of an Orthodontics Graduate Course. They were individually interviewed before the appliance insertion by an experienced researcher using an interview guide and photographic records to stimulate patients' self-perception of their oral condition. The interviews proceeded simultaneously with transcription analyses until saturation. After the transcription evaluation, the framework analysis technique was performed. RESULTS Data derived from the transcription analyses were grouped into 3 major themes: perceptions concerning the concepts of normality and abnormality regarding oral health; self-perceptions regarding malocclusion and other discrepancies; and motivations for seeking orthodontic treatment and expectations related to the results. CONCLUSIONS Attractiveness was exceptionally relevant among adolescent patients. Most interviewees seemed to focus their attention on esthetically upsetting dentofacial traits, which they expected to be corrected by orthodontic treatment. In addition to self-oriented appearance-driven motivations, parents, other health professionals, friends, and peers also influenced adolescents' perception of their need for treatment. The achievement of a normal dentofacial status seems to be closely attached to social and individual aspirations.
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Affiliation(s)
- Luara Hernandes Prado
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Kárila Previato
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Renata Zoraida Rizental Delgado
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
| | - Paulo Nelson Filho
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Raquel Assed Bezerra Segato
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Mirian Aiko Nakane Matsumoto
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Murilo Fernando Neuppmann Feres
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Feres MFN, Vicioni-Marques F, Romano FL, Roscoe MG, Souza VMD, Torneri AL, Bueno-Silva B. Streptococcus mutans adherence to conventional and self-ligating brackets: an in vitro study. Dental Press J Orthod 2021; 26:e212019. [PMID: 34932711 PMCID: PMC8690864 DOI: 10.1590/2177-6709.26.6.e212019.oar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 08/31/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Although self-ligating brackets presumably provide better hygiene conditions, no consensus has been reached so far. OBJECTIVE Therefore, the objective of this study was to evaluate, in an in vitro experimental design, the adherence of Streptococcus mutans (SM) in self-ligating and conventional brackets of different manufacturers and ligature types. METHODS Four commercial brands of maxillary premolar metal brackets were tested (Abzil®; Morelli®; 3M Unitek®; and GAC®). Each one was subdivided into three groups, which varied according to the type of ligature and bracket model (metallic, elastic, and self-ligating), totalizing twelve groups, composed of six brackets each. Previously sterilized brackets were initially immersed in saliva for one hour, and subsequently washed and added in a bacterial suspension, maintained in aerobiosis for 72 hours. The adhered bacteria were then separated and quantified by colony forming units (CFU/mL) counting after 48 hours of growth. The groups were compared by Kruskal-Wallis and Dunn post-hoc tests (p< 0.05). RESULTS Regardless of the commercial brand, self-ligating brackets had significantly less CFU/mL. However, according to comparisons performed within each commercial brand, only Abzil® self-ligating brackets had significantly lower biofilm adhesion. Among all of the self-ligating models, GAC® brackets presented the highest bacterial adhesion rate. CONCLUSIONS Self-ligating brackets are likely to present lower rates of biofilm adhesion. Particularly, Abzil® and GAC® self-ligating brackets are less likely to accumulate biofilm. Although such results are derived from an in vitro study, practitioners might acknowledge findings concerning bacterial adhesion as one of the relevant features to be considered during bracket selection.
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Affiliation(s)
- Murilo Fernando Neuppmann Feres
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil (Ribeirão Preto/SP, Brazil)
| | - Fernanda Vicioni-Marques
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil (Ribeirão Preto/SP, Brazil)
| | - Fábio Lourenço Romano
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil (Ribeirão Preto/SP, Brazil)
| | - Marina Guimarães Roscoe
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Biomateriais e Biologia Oral (São Paulo/SP, Brazil)
| | | | - Aline Lira Torneri
- Universidade de Guarulhos, Programa de Pós-Graduação, Mestrado em Ortodontia (Guarulhos/SP, Brazil)
| | - Bruno Bueno-Silva
- Universidade de Guarulhos, Programa de Pós-Graduação, Mestrado em Ortodontia (Guarulhos/SP, Brazil)
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Figueiredo MAD, Romano FL, Feres MFN, Stuani MBS, Nahás-Scocate ACR, Matsumoto MAN. Effectiveness of Invisalign ® aligners in the treatment of severe gingival recession: A case report. Korean J Orthod 2021; 51:293-300. [PMID: 34275885 PMCID: PMC8290087 DOI: 10.4041/kjod.2021.51.4.293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/17/2021] [Accepted: 01/27/2021] [Indexed: 11/25/2022] Open
Abstract
In this report, we demonstrate the effectiveness of the Invisalign® system in the treatment of severe gingival recession and bone dehiscence through torque, translation, and intrusion movements in a young woman. Cone-beam computed tomography was used to assess bone parameters and check the teeth during treatment. The root of the mandibular right central incisor, which was buccally positioned and exhibited bone dehiscence of 9.4 mm, was moved toward the center of the alveolar process by using the Invisalign® system and SmartForce® features. The patient was monitored by a periodontist throughout the orthodontic treatment period. Her gingival recession reduced, while the bone dehiscence reduced from 9.40 mm to 3.14 mm. Thus, movement of the root into the alveolus promoted bone neoformation and treated the gingival recession. The findings from this case suggest that orthodontic treatment using the Invisalign® system, along with periodontal monitoring, can aid in the treatment of gingival recession and alveolar defects.
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Affiliation(s)
- Marcio Antonio de Figueiredo
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Sao Paulo, Brazil
| | - Fábio Lourenço Romano
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Sao Paulo, Brazil
| | | | - Maria Bernadete Sasso Stuani
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Sao Paulo, Brazil
| | | | - Mírian Aiko Nakane Matsumoto
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Sao Paulo, Brazil
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Feres MFN, Eissa O, Roscoe MG, El-Bialy T. Comparison of the Condyle Sagittal Position of Class I and Class II Division 2 in Orthodontic Patients. J Contemp Dent Pract 2020; 21:977-981. [PMID: 33568581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
AIM To compare the condyle sagittal position of class I and class II division 2 in orthodontic patients. MATERIALS AND METHODS Fifty orthodontic cases (30 females and 20 males; 12-31 years) from the records of an Orthodontic Graduate Program were collected. Such cases presented cone-beam computed tomography (CBCT) as part of their initial diagnostic examinations. The study sample constituted two groups, i.e. class I and class II division 2 groups. A previously calibrated examiner performed the measurements of the images, representing the distance between the condyle and the articular surface of the glenoid fossa, both anteriorly (anterior disk space-ADS) and posteriorly (posterior disk space-PDS). Descriptive statistics were performed. Data were normally distributed, and parametric tests were used. Paired sample test was used to identify differences between the right and the left joints. Differences between class I and class II/2 groups were tested using independent t test. All statistical tests were interpreted at 5% significance level. RESULTS When the study groups were compared in relation to the dimensions observed for the right and the left ADS and PDS, no significant differences were detected. This study also calculated the differences between right and left disk spaces within the groups, and the differences were not significant for both class I and class II/2 groups. CONCLUSION The results demonstrated, after the performance of a CBCT comparative analysis, that there is no significant difference between class II/2 and class I orthodontic patients in relation to the condyle sagittal position. CLINICAL SIGNIFICANCE The results collected here refute the expectation of spontaneous mandibular anterior repositioning after correcting the overbite in class II/2 patients.
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Affiliation(s)
- Murilo Fernando Neuppmann Feres
- Department of Pediatric Dentistry, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil, Phone: +5511995026484, e-mail:
| | - Osama Eissa
- Faculty of Dentistry, Tanta University, Egypt
| | | | - Tarek El-Bialy
- Department of Dentistry and Dental Hygiene, University of Alberta, Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada
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Neuppmann Feres MF, Roscoe MG, Job SA, Mamani JB, Canto GDL, Flores-Mir C. Barriers involved in the application of evidence-based dentistry principles: A systematic review. J Am Dent Assoc 2020; 151:16-25.e16. [PMID: 31902396 DOI: 10.1016/j.adaj.2019.08.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 08/06/2019] [Accepted: 08/07/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND The authors' objective in this systematic review was to investigate the barriers involved in the application of evidence-based dentistry principles, as reported by dentists. The authors registered the protocol in the PROSPERO database. TYPES OF STUDIES REVIEWED Eligible studies included qualitative and quantitative approaches, constituting information about barriers, collected through interviews, questionnaires, or conversation sessions. The authors searched databases and reference lists of preselected studies. After the selection process, the authors evaluated the included studies for potential risk of bias and collected either qualitative or quantitative data. RESULTS After the selection process, the authors included 35 studies, of which 16 were reported in this article. The authors synthesized and classified the barriers in 4 categories: self-related, evidence-related, context-related, and patient-related barriers. Shortage of time and financial constraints were the barriers most frequently studied. However, the quantification of these barriers, as well as others, was not possible because of the variability of the results and methodological issues of the included studies. CONCLUSIONS AND PRACTICAL IMPLICATIONS The authors suggest the development of valid questionnaires and their use in representative samples to quantify the effects of specific barriers. The authors encourage practitioners to participate in educational programs focused on training in evidence-based dentistry abilities, in addition to seeking accessible and synthesized formats of reliable scientific knowledge.
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Listik E, Azevedo Marques Gaschler J, Matias M, Neuppmann Feres MF, Toma L, Raphaelli Nahás-Scocate AC. Proteoglycans and dental biology: the first review. Carbohydr Polym 2019; 225:115199. [DOI: 10.1016/j.carbpol.2019.115199] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 08/11/2019] [Accepted: 08/12/2019] [Indexed: 01/08/2023]
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Marañón-Vásquez GA, Matsumoto MAN, Feres MFN, Ferreira JTL, Consolaro A, Romano FL. Early Treatment of Failure of Eruption of a Permanent Molar. J Dent Child (Chic) 2019; 86:150-153. [PMID: 31645256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Failure of eruption of a permanent first molar is a relatively infrequent clinical condition that affects the normal development of dentition and may cause malocclusion. There are two conditions that might result in failure of eruption: (1) mechanical failure (ankylosis) and (2) primary failure of eruption, with different clinical features and therapeutic approaches for each. It is often challenging for orthodontists and pediatric dentists to establish differential diagnoses of these conditions to ensure a successful treatment outcome. The purpose of this case report is to discuss the diagnosis and treatment of a failure of eruption of a permanent first molar. (J Dent Child 2019;86(3):150-3).
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Affiliation(s)
- Guido Artemio Marañón-Vásquez
- Dr. Marañón-Vásquez is a PhD candidate, Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mírian Aiko Nakane Matsumoto
- Dr. Matsumoto, Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Murilo Fernando Neuppmann Feres
- Dr. Feres is a professor, Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - José Tarcísio Lima Ferreira
- Dr. Ferreira, Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Alberto Consolaro
- Dr. Consolaro is an associate professor, Department of Surgery, Stomatology, Pathology and Radiology, School of Dentistry of Bauru, University of São Paulo, Bauru, São Paulo, Brazil
| | - Fábio Loureço Romano
- Dr. Romano are associate professors, Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil;,
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Feres MFN, Rozolen BS, Alhadlaq A, Alkhadra TA, El-Bialy T. Comparative tomographic study of the maxillary central incisor collum angle between Class I, Class II, division 1 and 2 patients. J Orthod Sci 2018; 7:6. [PMID: 29765918 PMCID: PMC5952234 DOI: 10.4103/jos.jos_84_17] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION: It has been reported that Class II, division 2 maxillary central incisors frequently demonstrate increased collum angles, which indicates an excessive palatal “bend” of the crown. However, evidence supporting such observation is mostly derived from radiographic studies. OBJECTIVE: The objective of this study was to evaluate and compare the collum angle of maxillary central incisors in Class I, Class II, division 1, and Class II, division 2 cases using cone-beam computed tomography. MATERIALS AND METHODS: Forty-eight consecutive orthodontic cases (16 Class I, 16 Class II, division 1, and 16 Class II, division 2 malocclusion) with cone-beam computed tomography as part of their initial diagnostic records were evaluated. Cross-sections including maxillary right and left central incisors were used to calculate the angulation between the crown and root long axes (collum angle). Comparisons between groups were performed using analysis of variance for multiple and post-hoc Tukey for paired analyses. RESULTS: Mean collum angle observed in Class II, division 2 cases was significantly larger (5.2 ± 1.3°) than the ones obtained for Class I (1.1 ± 4.2°) (P = 0.034) or Class II, division 1 cases (0.1 ± 0.7°) (P = 0.014). CONCLUSIONS: Our findings suggest that Class II, division 2 individuals demonstrate accentuated lingual inclination of the maxillary central incisor crown compared to the other types of malocclusion studied here. Such morphological feature indicates the need for better tooth movement planning, especially in regard to root palatal torqueing of the maxillary central incisors.
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Affiliation(s)
- Murilo Fernando Neuppmann Feres
- School of Dentistry, Department of Pediatric Dentistry and Orthodontics, Post-Graduate Program in Orthodontics, Guarulhos University, Guarulhos, Brazil
| | - Bianca Santana Rozolen
- School of Dentistry, Department of Pediatric Dentistry and Orthodontics, Post-Graduate Program in Orthodontics, Guarulhos University, Guarulhos, Brazil
| | - Adel Alhadlaq
- College of Dentistry, Department of Pediatric Dentistry and Orthodontics, King Saud University, Riyadh, Saudi Arabia
| | - Thamer A Alkhadra
- College of Dentistry, Department of Pediatric Dentistry and Orthodontics, King Saud University, Riyadh, Saudi Arabia
| | - Tarek El-Bialy
- School of Dentistry, Division of Orthodontics, University of Alberta, Edmonton, Canada
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Feres MFN, Muniz TS, de Andrade SH, Lemos MDM, Pignatari SSN. Craniofacial skeletal pattern: is it really correlated with the degree of adenoid obstruction? Dental Press J Orthod 2017; 20:68-75. [PMID: 26352848 PMCID: PMC4593533 DOI: 10.1590/2176-9451.20.4.068-075.oar] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The aim of this study was to compare the cephalometric pattern of children with and without adenoid obstruction. METHODS The sample comprised 100 children aged between four and 14 years old, both males and females, subjected to cephalometric examination for sagittal and vertical skeletal analysis. The sample also underwent nasofiberendoscopic examination intended to objectively assess the degree of adenoid obstruction. RESULTS The individuals presented tendencies towards vertical craniofacial growth, convex profile and mandibular retrusion. However, there were no differences between obstructive and non-obstructive patients concerning all cephalometric variables. Correlations between skeletal parameters and the percentage of adenoid obstruction were either low or not significant. CONCLUSIONS Results suggest that specific craniofacial patterns, such as Class II and hyperdivergency, might not be associated with adenoid hypertrophy.
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Abstract
OBJECTIVE To evaluate the effectiveness of rapid maxillary expansion (RME) on the sagittal dental or skeletal parameters of growing children with Class II malocclusion. MATERIALS AND METHODS A systematic review intended to identify relevant literature was conducted. The search was performed on Medline, Embase, Cochrane Library, and Scopus databases. Reference lists of the included articles were also screened for relevant documents. The qualitative assessment was performed according to the Methodological Index for Non-Randomized Studies (MINORS) tool, and the resultant data were grouped and analyzed concerning dental and skeletal sagittal effects of RME. RESULTS Of 25 screened studies, seven articles met eligibility criteria and were included. Study samples were observed during mixed dentition stage and characterized as having either Class II dental malocclusion or skeletal discrepancy. None of the included studies was a randomized clinical trial. Included controlled studies presented several inadequacies related to control group or lacked appropriate comparative statistical analysis. Besides being frequently based on deficient methodology, dental and skeletal sagittal effects of RME were either controversial or lacked clinical relevance. CONCLUSION The effect of RME on the sagittal dimension of Class II malocclusions has not been proved yet. Future randomized controlled clinical trials are still needed to definitely address this question.
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Affiliation(s)
| | - Hasnain Raza
- b Master of Sciences student, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Adel Alhadlaq
- c Associate Professor and Consultant in Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Tarek El-Bialy
- d Associate Professor of Orthodontics and Biomedical Engineering, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
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Izuka EN, Feres MFN, Pignatari SSN. Immediate impact of rapid maxillary expansion on upper airway dimensions and on the quality of life of mouth breathers. Dental Press J Orthod 2016; 20:43-9. [PMID: 26154455 PMCID: PMC4520137 DOI: 10.1590/2176-9451.20.3.043-049.oar] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 10/02/2014] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE: To assess short-term tomographic changes in the upper airway dimensions and
quality of life of mouth breathers after rapid maxillary expansion (RME). METHODS: A total of 25 mouth breathers with maxillary atresia and a mean age of 10.5 years
old were assessed by means of cone-beam computed tomography (CBCT) and a
standardized quality of life questionnaire answered by patients' parents/legal
guardians before and immediately after rapid maxillary expansion. RESULTS: Rapid maxillary expansion resulted in similar and significant expansion in the
width of anterior (2.8 mm, p < 0.001) and posterior nasal floor (2.8 mm, p <
0.001). Although nasopharynx and nasal cavities airway volumes significantly
increased (+1646.1 mm3, p < 0.001),
oropharynx volume increase was not statistically significant (+1450.6 mm3, p = 0.066). The results of the quality of
life questionnaire indicated that soon after rapid maxillary expansion, patients'
respiratory symptoms significantly decreased in relation to their initial
respiratory conditions. CONCLUSIONS: It is suggested that RME produces significant dimensional increase in the nasal
cavity and nasopharynx. Additionally, it also positively impacts the quality of
life of mouth-breathing patients with maxillary atresia.
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Feres MFN, Kucharski C, Diar-Bakirly S, El-Bialy T. Effect of low-intensity pulsed ultrasound on the activity of osteoclasts: An in vitro study. Arch Oral Biol 2016; 70:73-78. [DOI: 10.1016/j.archoralbio.2016.06.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 04/16/2016] [Accepted: 06/07/2016] [Indexed: 01/24/2023]
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Diar-Bakirly S, Feres MFN, Saltaji H, Flores-Mir C, El-Bialy T. Effectiveness of the transpalatal arch in controlling orthodontic anchorage in maxillary premolar extraction cases: A systematic review and meta-analysis. Angle Orthod 2016; 87:147-158. [PMID: 27504820 DOI: 10.2319/021216-120.1] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the effectiveness of the transpalatal arch (TPA) as an anchorage device in preventing maxillary molar mesialization during retraction of the anterior teeth after premolar extraction. MATERIALS AND METHODS This systematic review intended to include patients indicated for upper premolar bilateral extraction and subsequent retraction of anterior teeth, considering the use of TPA as an anchorage tool in one of the treatment groups. The search was systematically performed, up to April 2015, in the following electronic databases: Medline, Embase, and all evidence-based medicine reviews via OVID, Cochrane Library, Scopus, PubMed, and Web of Science. Risk of bias assessment was performed using Cochrane's Risk of Bias Tool for randomized clinical trials (RCTs) and Methodological Index for Nonrandomized Studies (MINORS) for non-RCTs. RESULTS Fourteen articles were finally included. Nine RCTs and five non-RCTs presented moderate to high risk of bias. Only one study investigated the use of TPA in comparison with no anchorage, failing to show significant differences regarding molar anchorage loss. A meta-analysis showed a significant increase in anchorage control when temporary anchorage devices were compared with TPA (mean difference [MD] 2.09 [95% confidence interval {CI} 1.80 to 2.38], seven trials), TPA + headgear (MD 1.71 [95% CI 0.81 to 2.6], four trials), and TPA + utility arch (MD 0.63 [95% CI 0.12 to 1.15], 3 trials). CONCLUSION Based on mostly moderate risk of bias and with some certainty level, TPA alone should not be recommended to provide maximum anchorage during retraction of anterior teeth in extraction cases.
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Feres MFN, Abreu LG, Insabralde NM, de Almeida MR, Flores-Mir C. Effectiveness of open bite correction when managing deleterious oral habits in growing children and adolescents: a systematic review and meta-analysis. Eur J Orthod 2016; 39:31-42. [DOI: 10.1093/ejo/cjw005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Feres MFN, Abreu LG, Insabralde NM, Almeida MRD, Flores-Mir C. Effectiveness of the open bite treatment in growing children and adolescents. A systematic review. Eur J Orthod 2015; 38:237-50. [PMID: 26136439 DOI: 10.1093/ejo/cjv048] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Accepted: 06/09/2015] [Indexed: 11/12/2022]
Abstract
BACKGROUND The extensive literature concerning the early treatment of anterior open bite (AOB) is still controversial and covers a wide variety of therapeutic approaches. OBJECTIVES The objective of this study was to provide a comprehensive review evaluating the effectiveness of the orthodontic correction of AOB in growing individuals. SEARCH METHODS Search was conducted on PubMed, Embase, Cochrane Library, Web of Science, Scopus, Google Scholar, Scielo, and Lilacs databases. Trials registries were consulted for ongoing trials, and grey literature was also contemplated. SELECTION CRITERIA Selection process was performed to include controlled trials enrolling growing subjects who underwent orthodontic treatment to correct AOB and/or hyperdivergent facial pattern. DATA COLLECTION AND ANALYSIS Data were grouped and analysed descriptively. Qualitative appraisal was performed according to the Cochrane risk of bias tool, for randomized clinical trials (RCTs), and MINORS tool for non-RCTs. RESULTS The 22 studies included in this review mostly considered mixed dentition subjects, and there was a considerable variation regarding therapeutic approaches. Because of poor-quality and/or insufficient evidence, consistent results were not found. However, some useful clinical inferences and suggestions for future studies were provided for each therapeutic modality considered here. CONCLUSIONS Additional efforts must still be directed to perform, whenever possible, RCTs; or to conduct prospective controlled trials with adequate sample sizes, consecutively assembled subjects, with the comparison of contemporary and equivalent groups.
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Affiliation(s)
| | - Lucas Guimarães Abreu
- *School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | | | | | - Carlos Flores-Mir
- *School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
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Feres MFN, Hermann JS, Sallum AC, Pignatari SSN. Radiographic adenoid evaluation: proposal of an objective parameter. Radiol Bras 2015; 47:79-83. [PMID: 25741053 PMCID: PMC4337152 DOI: 10.1590/s0100-39842014000200008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 10/17/2013] [Indexed: 11/21/2022] Open
Abstract
Objective The objective of the present study was to evaluate current radiographic parameters
designed to investigate adenoid hypertrophy and nasopharyngeal obstruction, and to
present an alternative radiographic assessment method. Materials and Methods In order to do so, children (4 to14 years old) who presented with nasal
obstruction or oral breathing complaints were submitted to cavum radiographic
examination. One hundred and twenty records were evaluated according to
quantitative radiographic parameters, and data were correlated with a
gold-standard videonasopharyngoscopic study, in relation to the percentage of
choanal obstruction. Subsequently, a regression analysis was performed in order to
create an original model so the percentage of the choanal obstruction could be
predicted. Results The quantitative parameters demonstrated moderate, if not weak correlation with
the real percentage of choanal obstruction. The regression model (110.119*A/N)
demonstrated a satisfactory ability to "predict" the actual percentage of choanal
obstruction. Conclusion Since current adenoid quantitative radiographic parameters present limitations,
the model presented by the present study might be considered as an alternative
assessment method in cases where videonasopharyngoscopic evaluation is
unavailable.
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Affiliation(s)
| | - Juliana Sato Hermann
- Master, Fellow PhD degree of Pediatric Otorhinolaryngology, Department of Otorhinolaryngology and Head & Nerck Surgery, Escola Paulista de Medicina - Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
| | | | - Shirley Shizue Nagata Pignatari
- PhD, Professor, Division of Pediatric Otorhinolaryngology and Head & Neck Surgery, Escola Paulista de Medicina - Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
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Feres MFN, Hermann JS, Pignatari SSN. Cephalometric evaluation of adenoids: an analysis of current methods and a proposal of a new assessment tool. Am J Orthod Dentofacial Orthop 2012; 142:671-8. [PMID: 23116508 DOI: 10.1016/j.ajodo.2012.07.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2012] [Revised: 07/01/2012] [Accepted: 07/01/2012] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Although the scientific literature recognizes that lateral cephalometric radiographs might be clinically useful, there is no consensus in relation to the best parameter available. Therefore, this research was aimed at evaluating current radiographic assessment methods designed to investigate adenoid hypertrophy and nasopharyngeal obstruction. METHODS Children from 4 to 14 years old with nasal obstruction or oral breathing complaints, suspected to be caused by adenoid hypertrophy, received cephalometric examinations. One hundred twenty radiographic records were evaluated according to several current methods, and data were compared with respective gold-standard videonasopharyngoscopic examinations, in relation to the percentage of choanal obstruction. RESULTS Groups derived from a grading system had significantly different percentages of choanal obstruction. However, this parameter showed low sensitivity. Significant but moderate correlations were observed between most of the quantitative radiographic parameters and the percentage of choanal obstruction. Alternatively, a regression model was introduced; it demonstrated satisfactory ability to predict choanal obstruction percentage. Despite limitations, this model could also distinguish patients who might benefit from referral to otolaryngologic care. CONCLUSIONS Current adenoid assessment methods have significant limitations. A novel assessment method introduced here might be clinically useful.
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Affiliation(s)
- Murilo Fernando Neuppmann Feres
- Division of Pediatric Otolaryngology, Department of Otolaryngology, Head and Neck Surgery, Federal University of São Paulo, São Paulo, Brazil.
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Abstract
The assessment of adenoids by x-ray imaging has been the topic of heated debate, but few studies have looked into the reliability of most existing radiographic parameters. Objective: This study aims to verify the intra-examiner and inter-examiner reproducibility of the adenoid radiographic assessment methods. Materials and Methods: This is a cross-sectional case series study. Forty children of both genders aged between 4 and 14 were enrolled. They were selected based on complaints of nasal obstruction or mouth breathing and suspicion of pharyngeal tonsil hypertrophy. Cavum x-rays and orthodontic teleradiographs were assessed by two examiners in quantitative and categorical terms. Results: All quantitative parameters in both x-ray modes showed excellent intra and inter-examiner reproducibility. Relatively better performance was observed in categorical parameters used in cavum x-ray assessment by C-Kurien, C-Wang, C-Fujioka, and C-Elwany over C-Cohen and C-Ysunza. As for orthodontic teleradiograph grading systems, C-McNamara has been proven to be more reliable than C-Holmberg. Conclusion: Most instruments showed adequate reproducibility levels. However, more research is needed to properly determine the accuracy and viability of each method.
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Feres MFN, Hermann JS, Cappellette M, Pignatari SSN. Lateral X-ray view of the skull for the diagnosis of adenoid hypertrophy: a systematic review. Int J Pediatr Otorhinolaryngol 2011; 75:1-11. [PMID: 21126775 DOI: 10.1016/j.ijporl.2010.11.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2010] [Revised: 10/30/2010] [Accepted: 11/01/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Many studies have been developed aiming to reveal the usefulness of cavum X-rays and telerradiographies as diagnostic tools for the detection of upper airway obstruction due to adenoid hypertrophy. However, the scientific literature is diverse and controversial. Therefore, a systematic review is proposed; with the objective to determine the diagnosis value of lateral X-ray view of the skull regarding adenoid hypertrophy. METHODS Searching was conducted on Pubmed, Lilacs, Cochrane Library, Embase, and Web of Knowledge databases; and was restricted to studies published in English, Portuguese or Spanish languages, carried out on humans under 18 years of age. All the obtained publications were first submitted to a pre-selection, and then, full-texts (n=66) were analyzed and selected by independent examiners. The resultant studies (n=11) were systematically and critically analyzed, and qualified according to QUADAS (Quality Assessment of Diagnostic Accuracy Studies) questionnaire, an assessment tool designed to qualify diagnostic tests accuracy studies. RESULTS Searching and selection procedures generated 11 studies which were considered adequate to be systematically analyzed. Accordingly, large variation was observed concerning the evaluation methods of radiographic and fibronasoendoscopic exams, and the sample characteristics. Additionally, little amount of scientific evidences could be provided, since few radiographic variables were analyzed simultaneously. Moreover, assessment methods were, at most, subjective or poorly described. QUADAS application revealed other significant limitations related to the sampling, such as inadequate spectrum of the investigated "disease" (adenoid hypertrophy), and poor report of the subjects' enrollment and participation process. Further, QUADAS revealed inadequacies regarding methodological features, including poor description of the radiographic exams and assessment methods. In addition, it was also shown that most of the studies did not specify the moment in clinical time when both exams were performed; neither reported a strategy of "blindness" by the examiners. CONCLUSIONS Despite such limitations, the majority of the resultant data indicates that lateral X-rays might be considered somewhat useful, even though it could not be clearly demonstrated. Future research should then adhere to greater methodological rigor, in order to investigate the significance of radiographies as a screening test.
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Affiliation(s)
- Murilo Fernando Neuppmann Feres
- Division of Pediatric Otolaryngology, Department of Otolaryngology, Head and Neck Surgery, Federal University of São Paulo, Sorocaba, SP, Brazil.
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Abstract
OBJETIVO: o presente estudo destinou-se a comparar a morfologia tegumentar de indivíduos segundo a tipologia facial. MÉTODOS: foram utilizadas 90 telerradiografias de pacientes de ambos os sexos, de 12 a 16 anos de idade, divididas em três grupos distintos, referentes a cada padrão morfológico: mesofacial, dolicofacial e braquifacial. Os grupos foram comparados no que se refere às medidas de espessura e altura do lábio superior e inferior, além da espessura do mento mole. Ainda, foi apurada a presença de correlações entre as variáveis de tecido mole avaliadas e medidas cefalométricas de natureza dentária e esquelética. RESULTADOS E CONCLUSÕES: os lábios superiores e inferiores, assim como o mento mole, não apresentaram diferenças em relação às suas espessuras em todos os grupos morfológicos. Porém, as alturas do lábio superior e inferior foram significativamente maiores para os dolicofaciais quando esses foram comparados aos demais grupos. Braquifaciais apresentaram menor altura do lábio superior quando comparados aos mesofaciais, embora ambos não tenham se diferenciado significativamente no que se refere à altura do lábio inferior. A análise das correlações estabelecidas entre as variáveis dos tecidos moles e duros indicou evidências de um desenvolvimento vertical dos lábios superior e inferior em acompanhamento ao desenvolvimento vertical do esqueleto. O posicionamento vertical do incisivo superior se correlacionou significativamente aos mesmos parâmetros labiais, o que garantiu um nível de exposição semelhante desse elemento dentário em todos os grupos.
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Abstract
OBJETIVO: o presente estudo propõe-se a comparar as dimensões da nasofaringe e as características esqueléticas avaliadas por exame cefalométrico, em indivíduos com padrões morfológicos distintos. MÉTODOS: foram utilizadas 90 telerradiografias de pacientes de ambos os gêneros, de 12 a 16 anos de idade, as quais foram igualmente divididas em três grupos distintos, referentes aos padrões morfológicos - braquifacial, mesofacial e dolicofacial. Foram realizadas medições específicas da região nasofaringeana (ad1-Ptm, ad2-Ptm, ad1-Ba, ad2-S0, (ad1-ad2-S0-Ba-ad1/Ptm-S 0-Ba-Ptm) X 100, e Ptm-Ba) e relativas ao padrão esquelético da face. RESULTADOS: observou-se que os pacientes dolicofaciais apresentaram menor profundidade sagital óssea (Ptm-Ba) e da via aérea da nasofaringe (ad1-Ptm e ad2-Ptm). Sugere-se que essas diferenças estejam relacionadas a um posicionamento relativamente mais posterior da maxila, comum a esses pacientes. Todavia, não foram detectadas diferenças quanto à espessura de tecido mole na parede posterior nasofaringeana (ad1-Ba e ad2-S0), ou à sua proporção em relação a toda a área delimitada para a nasofaringe [(ad1-ad2-S0-Ba-ad1/Ptm-S 0-Ba-Ptm) X 100]. CONCLUSÃO: sugere-se, portanto, que as características faciais de excesso vertical encontradas em pacientes dolicofaciais podem ocorrer, dentre outros fatores, em virtude da obstrução da via aérea nasofaringeana, uma vez que tais dimensões se apresentaram menores para os dolicofaciais.
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Feres MFN, Mazzieiro ÊT, Landre Júnior J. Estudo comparativo de diferentes prescrições de braquetes pré-ajustados em modelos virtuais pelo Método de Elementos Finitos. ACTA ACUST UNITED AC 2009. [DOI: 10.1590/s1415-54192009000400006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVOS: comparar os efeitos de diferentes prescrições de braquetes pré-ajustados na movimentação dentária dos dentes anterossuperiores, por meio da utilização do Método de Elementos Finitos (MEF). MÉTODOS: foi utilizado um modelo tridimensional composto por um incisivo central, um incisivo lateral e um canino, todos do hemiarco superior esquerdo. Esses elementos foram submetidos à atuação de vetores de força que simularam a ação dos pré-ajustes de angulação e torque dos braquetes das prescrições de Alexander, Andrews, Capelozza, MBT, Ricketts e Roth. Após a simulação, os dados referentes ao deslocamento espacial dos pontos incisais e apicais foram registrados de forma que o novo posicionamento admitido pelos longos eixos dentários e seus pontos constituintes fossem determinados. RESULTADOS: a maioria das prescrições se comportou similarmente em relação aos parâmetros avaliados. As diferenças significativas encontradas no estudo se referem ao incisivo lateral superior que continha o braquete com a prescrição de Ricketts, que apresentou uma menor inclinação vestibular de seu longo eixo. Além disso, o canino superior da mesma prescrição apresentou uma maior inclinação de seu longo eixo para mesial e uma maior inclinação vestibular de seu longo eixo em relação às outras. A avaliação qualitativa da movimentação do incisivo central superior indicou um maior deslocamento distal dos ápices radiculares para as prescrições cujos autores estipularam maiores valores de angulação (Andrews, Capelozza, Roth e Alexander), e um maior deslocamento vestibular da coroa para as prescrições que estipularam os maiores valores de torque para os incisivos centrais (Ricketts, MBT, Alexander e Roth).
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