Reinforcement of anchorage during orthodontic brace treatment with implants or other surgical methods.
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ABSTRACT:
SUBMITTER: Jambi S
PROVIDER: S-EPMC6464832 | biostudies-literature | 2014 Aug
REPOSITORIES: biostudies-literature
Publications
Reinforcement of anchorage during orthodontic brace treatment with implants or other surgical methods.
Jambi Safa S Walsh Tanya T Sandler Jonathan J Benson Philip E PE Skeggs Richard M RM O'Brien Kevin D KD
The Cochrane database of systematic reviews 20140819 8
<h4>Background</h4>The term anchorage in orthodontic treatment refers to methods of controlling unwanted tooth movement. This is provided either by anchor sites within the mouth, such as the teeth and the palate, or from outside the mouth (headgear). Recently, new methods of providing anchorage have been developed using orthodontic implants which are surgically inserted into the bone in the mouth. This is termed surgical anchorage. This is an update of a Cochrane review first published in 2007.< ...[more]
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Project description:BackgroundA range of surgical and non-surgical techniques have received increasing attention in recent years in an effort to reduce the duration of a course of orthodontic treatment. Various surgical techniques have been used; however, uncertainty exists in relation to the effectiveness of these procedures and the possible adverse effects related to them.ObjectivesTo assess the effects of surgically assisted orthodontics on the duration and outcome of orthodontic treatment.Search methodsWe searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 10 September 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 8), MEDLINE via OVID (1946 to 10 September 2014), EMBASE via OVID (1980 to 10 September 2014), LILACS via BIREME (1980 to 10 September 2014), metaRegister of Controlled Trials (to 10 September 2014), ClinicalTrials.gov (to 10 September 2014), and the World Health Organization (WHO) International Clinical Trials Registry Platform (to 10 September 2014). We checked the reference lists of all trials identified for further studies. There were no restrictions regarding language or date of publication in the electronic searches.Selection criteriaRandomised controlled trials (RCTs) evaluating the effect of surgical adjunctive procedures for accelerating tooth movement compared with conventional treatment (no surgical adjunctive procedure).Data collection and analysisAt least two review authors independently assessed the risk of bias in the trials and extracted data. We used the fixed-effect model and expressed results as mean differences (MD) with 95% confidence intervals (CI). We investigated heterogeneity with reference to both clinical and methodological factors.Main resultsWe included four RCTs involving a total of 57 participants ranging in age from 11 to 33 years. The interventions evaluated were corticotomies to facilitate orthodontic space closure or alignment of an ectopic maxillary canine, with the effect of repeated surgical procedures assessed in one of these studies. The studies did not report directly on the primary outcome as prespecified in our protocol: duration of orthodontic treatment, number of visits during active treatment (scheduled and unscheduled) and duration of visits. The main outcome assessed within the trials was the rate of tooth movement, with periodontal effects assessed in one trial and pain assessed in one trial. A maximum of just three trials with small sample sizes were available for each comparison and outcome. We assessed all of the studies as being at unclear risk of bias.Tooth movement was found to be slightly quicker with surgically assisted orthodontics in comparison with conventional treatment over periods of one month (MD 0.61 mm; 95% CI 0.49 to 0.72; P value < 0.001) and three months (MD 2.03 mm, 95% CI 1.52 to 2.54; P value < 0.001). Our results and conclusions should be interpreted with caution given the small number of included studies. Information on adverse events was sought; however, no data were reported in the included studies.Authors' conclusionsThis review found that there is limited research concerning the effectiveness of surgical interventions to accelerate orthodontic treatment, with no studies directly assessing our prespecified primary outcome. The available evidence is of low quality, which indicates that further research is likely to change the estimate of the effect. Based on measured outcomes in the short-term, these procedures do appear to show promise as a means of accelerating tooth movement. It is therefore possible that these procedures may prove useful; however, further prospective research comprising assessment of the entirety of treatment with longer follow-up is required to confirm any possible benefit.
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Project description:BackgroundTemporary anchorage devices (TADs) offer the clinician an immediate temporary source of skeletal anchorage for a range of orthodontic interventions. It is important to understand forces involved in using TADs and the effects on the dentition and surrounding structures, to improve clinical outcomes.ObjectiveTo examine and qualitatively synthesize literature on the forces involved with the use of TADs and the effects on the dentition and surrounding structures in orthodontic tooth movement, to provide better understanding of the complex interactions and the clinical implications.Search methodsElectronic databases searched included: Cochrane Library [including Central Register of Controlled Trials (CENTRAL)], Embase via OVID, Pubmed, and Scopus. Study screening and selection were conducted in duplicate.Selection criteriaStudies selected were clinical studies, simulation studies (computer or laboratory-based), or animal studies with no restriction over gender, age, study type (excluding case reports), or setting. Studies focusing on the forces involved with the use of TADs in orthodontic treatment and their effects on the dentition and surrounding structures were included.Data collection and analysisA data charting form was piloted and refined. Data charting was performed independently and in duplicate. This consisted of key fields with predetermined options and free text. The extracted data were collated, and a narrative synthesis conducted.ResultsThe results from 203 included studies were grouped into seven TAD based interventions combining the clinical, simulation, and animal studies. They were: En masse retraction of anterior teeth, intrusion, movement of a single tooth, orthopaedic interventions, distalisation, maxillary expansion and other types. The forces involved with the use of TADs, and their effects on the dentition and surrounding structures, were presented in descriptive and tabular formats.LimitationsThis review restricted study language to English. Formal appraisal of the quality of evidence is not a required feature of scoping reviews, as per the PRISMA-ScR guidelines, however it was evident that a proportion of clinical studies were of high risk of bias and low quality and therefore any proposed changes the reader may consider to their clinical practice should be contextualized in light of this.ConclusionsAcross the seven types of TAD based interventions the effects on the dentition and surrounding structures are described providing a better understanding of the complex interactions. A guide to the level and direction of forces in each type of intervention is provided to aid clinicians in achieving high quality outcomes.ImplicationsThere is a need to validate future FEA simulation studies by comparing to clinical data. It is also recommended that future scoping reviews incorporate a formal critical appraisal of studies to facilitate the translation of the results into clinical practice. Development of a standard set of terms for TADs is recommended to facilitate future research.RegistrationRegistration of a scoping review is not possible with PROSPERO.FundingNone to declare.
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Project description:BackgroundTemporary anchorage devices have been used for decades in orthodontic practice for many applications. The aim of this systematic review was to assess the effectiveness of orthodontic temporary anchorage devices in canine retraction during the two-step technique.MethodsA search was systematically performed for articles published prior to June 30, 2019 in five electronic databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Scopus). The risk of bias was assessed using the Cochrane risk of bias tool for randomized controlled trials (RCTs) and the risk of bias in nonrandomized studies of interventions (ROBINS-I) tool for controlled clinical trials (CCTs). The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach was used for the quality assessment. Data concerning the mean difference in mesial molar movement and extent of canine retraction were extracted for statistical analysis. The mean differences and 95% confidence intervals were analyzed for continuous data. A meta-analysis with a random-effects model for comparable outcomes was carried out.ResultsThree RCTs and five CCTs were finally included. Meta-analysis showed a significant increase not only in anchorage preservation in the implant anchorage group in both the maxilla (1.56 mm, 95% CI: 1.14 to 1.98, P < 0.00001) and the mandible (1.62 mm, 95% CI: 1.24 to 2.01, P < 0.00001) but also in canine retraction in the implant anchorage group in both the maxilla (0.43 mm, 95% CI: 0.16 to 0.69, P = 0.001) and the mandible (0.26 mm, 95% CI: 0.02 to 0.49, P = 0.03).ConclusionsThere is very low-quality evidence showing that implant anchorage is more efficient than conventional anchorage during canine retraction. Additional high-quality studies are needed.
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Project description:An OTM-related healing model was established where a maxillary second premolar was protracted into the critical-sized defect for 6 weeks (Group DT6). As controls, natural healing models without OTM were set at 2 weeks (Group D2) and at 6 weeks (Group D6) after surgery. Total RNAs were extracted from dissected regenerated tissues and additionally from sound alveolar bone as a baseline (Group C). mRNA profiling was performed using microarray analysis.
2017-08-01 | GSE85459 | GEO
Project description:PurposeWe developed an augmentation technique for PCL reconstruction with independent internal brace reinforcement and evaluated the functional outcome after PCL reconstruction employing autologous hamstrings augmented with an internal brace system for patients with isolated or combined grade 3 posterior instability who were treated with this technique.MethodsFrom January 2016 to January 2018, patients with isolated or combined grade 3 PCL tears who underwent single-bundle PCL reconstruction using autologous hamstrings augmented with independent internal braces were studied. The function of the operated knee was evaluated according to the International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner activity score. The patients were asked the level of returned to their previous sport. Posterior knee laxity was examined with a KT-1000 arthrometer, and data on range of motion (ROM), re-operation, and other complications were collected.ResultsA total of 33 consecutive patients who received single-bundle PCL reconstruction using autologous hamstrings augmented with independent internal braces with a minimum two years follow-up were included in this study. Two patients had undergone this procedure during the study period and were not included in this study (one had combined bone fractures, and one patient had previous meniscus surgery). Thirty-one patients were available for final analysis. The mean follow-up was 45.35 ± 10.88 months (range 29-66 months). The average IKDC subjective knee evaluation scores from 51.65 ± 12.35 to 84.52 ± 6.42, the Lysholm score from 53.90 ± 11.86 to 85.68 ± 4.99, and the Tegner score from 2.81 ± 0.79 to 6.71 ± 1.83 (P < 0.05 for all). The mean total posterior side-to-side difference in knee laxity, assessed using a KT-1000 arthrometer, decreased from 12.13 ± 2.66 mm pre-operatively to 1.87 ± 0.56 mm post-operatively at 70° (P < 0.05). Most patients (29/31) had normal or near normal knee ROM post-operatively; two patients revealed a 6-15° loss of knee flexion compared with the contralateral knee. Twenty-nine patients (93.55%) returned to a normal daily exercise level. Twenty-three patients (74.19%) returned to competitive sports with high-level sports (Tegner score of 6 or above; eleven patients (35.48%) reported to be on the same level as well as the Tegner level); six patients (19.35%) returned to recreational sports (Tegner score of 4 or 5). Two patients had Tegner scores of 2 and 3, indicating poor function level. No patient needed PCL revision surgery during the follow-up period.ConclusionSingle-bundle PCL reconstruction with internal brace augmentation for PCL injury exhibited satisfactory posterior stability and clinical outcomes in patients with isolated or combined grade 3 PCL injuries at a minimum two year follow-up.
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Project description:This study aimed at evaluating the design and dimensions of five different brands of orthodontic mini-implants, as well as their influence on torsional fracture strength.Fifty mini-implants were divided into five groups corresponding to different manufactures (DEN, RMO, CON, NEO, SIN). Twenty-five mini-implants were subjected to fracture test by torsion in the neck and the tip, through arbors attached to a Universal Mechanical Testing Machine. The other 25 mini-implants were subjected to insertion torque test into blocks of pork ribs using a torquimeter and contra-angle handpiece mounted in a surgical motor. The shape of the active tip of the mini-implants was evaluated under microscopy. The non-parametric Friedman test and Snedecor's F in analysis of variance (ANOVA) were used to evaluate the differences between groups.The fracture torque of the neck ranged from 23.45 N.cm (DEN) to 34.82 N.cm (SIN), and of the tip ranged from 9.35 N.cm (CON) to 24.36 N.cm (NEO). Insertion torque values ranged from 6.6 N.cm (RMO) to 10.2 N.cm (NEO). The characteristics that most influenced the results were outer diameter, inner diameter, the ratio between internal and external diameters, and the existence of milling in the apical region of the mini-implant.The fracture torques were different for both the neck and the tip of the five types evaluated. NEO and SIN mini-implants showed the highest resistance to fracture of the neck and tip. The fracture torques of both tip and neck were higher than the torque required to insert mini-implants.
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Project description:BackgroundThe stability of temporary anchorage devices (TADs) is critical in orthodontic clinics. The failure of TADs is multifactorial, and the role of the oral microbiome has not been clearly defined. Herein, we attempted to analyze the contribution of the oral microbiome to the failure of TADs.MethodsNext-generation sequencing was adopted for analyzing the microbiome on the TADs from orthodontic patients. 29 TADs (15 failed TADs and 14 successful TADs) were used for 16S rRNA gene sequencing. A total of 135 TADs (62 failed TADs and 73 successful TADs) were collected to conduct metagenomic sequencing. Additionally, 34 verified samples (18 failed TADs and 16 successful TADs) were collected for quantitative real-time polymerase chain reaction analysis (qRT-PCR).ResultsSuccessful and failed TADs demonstrated discrepancies in microbiome structure, composition, and function. Clear separations were found in β-diversity in 16S rRNA gene sequencing as well as metagenomic sequencing (p < 0.05). Metagenomic sequencing showed that Prevotella intermedia, Eikenella corrodens, Parvimonas spp., Neisseria elongata, and Catonella morbi were enriched in the failed groups. qRT-PCR also demonstrated that the absolute bacteria load of Prevotella intermedia was higher in failed TADs (p < 0.05). Considering functional aspects, the failed group showed enriched genes involved in flagellar assembly, bacterial chemotaxis, and oxidative phosphorylation.ConclusionsThis study illustrated the compositional and functional differences of microorganisms found on successful and failed TADs, indicating that controlling bacterial adhesion on the surface of TADs is essential for their success rate.
| S-EPMC9844000 | biostudies-literature