Malocclusions

咬合不正
  • 文章类型: Journal Article
    背景:本系统综述旨在分析使用不同扩张方案获得的成长患者上颌扩张后下颌弓的自发性牙槽变化:快速上颌扩张(RME),缓慢的上颌扩张(SME),和叶扩张器。
    方法:本研究遵循系统评价和荟萃分析(PRISMA)指南的首选报告项目。资格标准以PICO格式建立,涉及接受缓慢治疗的患者,快速,或在混合或早期恒牙期间的叶片上颌扩张。截至2023年12月,对电子数据库和手动搜索进行了全面搜索。结果测量包括下颌间第一恒磨牙宽度,乳牙间磨牙和犬齿宽度,拱形周长,和足弓长度;考虑了短期和长期结果。符合纳入标准的文章被纳入本系统评价,并使用13分量表的方法学质量评分系统进行定性评估。评估关于文章选择和纳入研究的定性评估的相互审查协议,计算Kappa统计量。
    结果:通过电子和人工检索共识别出1184篇文章。删除副本并对标题和摘要进行初步审查后,对57篇文章进行了全文分析,根据资格和排除标准,最终选择了22项研究,由8项随机对照试验(RCTs)和14项回顾性/病例对照研究组成。对纳入研究的定性评价显示以下得分:6篇论文具有较高的研究质量,5质量适中,11质量低。SME表现出微不足道的下颌变化,在选定的参数中平均变化小于1毫米(范围0.46-2.00毫米),并且长期观察到复发。RME诱导更显著的增加,特别是磨牙间宽度大于1毫米,范围在0.93到3.3毫米之间,和良好的长期稳定性。扩叶器显示出有希望的短期较低的磨牙间宽度增加大于1毫米,范围为0.5至1.69毫米,但长期稳定性未得到彻底评估.
    结论:中小企业的短期和长期影响微不足道,而RME,尤其是哈斯型电器,表现出显著的磨牙间宽度增加,多年来保持稳定。扩叶显示短期较低的磨牙间宽度增加,需要进一步调查长期稳定性。
    BACKGROUND: This systematic review aims to analyze the spontaneous dentoalveolar changes in the mandibular arch after maxillary expansion in growing patients obtained with different expansion protocols: Rapid Maxillary Expansion (RME), Slow Maxillary Expansion (SME), and Leaf Expander.
    METHODS: The study adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Eligibility criteria were established in the PICO format, involving patients who underwent slow, rapid, or leaf maxillary expansion during the mixed or early permanent dentitions. A comprehensive search of electronic databases and manual searches was conducted up to December 2023. The outcome measures included inter-mandibular first permanent molar width, inter-deciduous molar and canine width, arch perimeter, and arch length; both short- and long-term results were considered. The articles that met the inclusion criteria were included in this systematic review and were qualitatively evaluated using a methodological quality scoring system with a 13-point scale. To assess the inter-examiner agreement concerning the article selection and the qualitative assessment of the included studies, Kappa statistics were computed.
    RESULTS: A total of 1184 articles were identified through electronic and manual searches. After the removal of duplicates and the initial examination of the titles and abstracts, 57 articles were considered for the full text analysis, and according to the eligibility and exclusion criteria, 22 studies were finally selected, composed of 8 randomized controlled trials (RCTs) and 14 retrospective/case-control studies. The qualitative assessment of the included studies showed the following scores: 6 papers have high research quality, 5 have moderate quality, and 11 have low quality. SME demonstrated negligible mandibular changes, with less than 1 mm variation on average (range 0.46-2.00 mm) in the selected parameters and relapses observed in the long term. RME induced more significant increases, particularly in intermolar width greater than 1 mm, which ranged between 0.93 and 3.3 mm, and good stability over the long term. Leaf Expander exhibited promising short-term lower intermolar width increases greater than 1 mm and ranged from 0.5 to 1.69 mm, but long-term stability was not thoroughly evaluated.
    CONCLUSIONS: SME results in negligible short- and long-term effects, while RME, especially with Haas-type appliances, exhibits significant intermolar width increases that remain stable over the years. Leaf Expander shows short-term lower intermolar width increases, requiring further investigation into long-term stability.
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  • 文章类型: Journal Article
    背景:本综述旨在分析正颌手术的复发。
    方法:PubMed,Scopus,和WebofScience数据库用于查找与我们的主题相匹配的论文,日期为2012年1月1日至2022年11月。纳入标准是(1)人体研究,(2)开放获取研究,(3)正颌手术与复发的相关性研究。排除标准为:(1)体外或动物研究,(2)离题研究,(3)审查,(4)英语以外的其他语言。
    结果:获得总共482个结果,在重复去除后产生323个出版物(158)。在筛选和资格阶段之后,排除了247条记录:47条评论,5在动物中,35在体外,180离题作者成功地检索了其余的78篇论文,并评估了他们的资格。共有14项研究最终被纳入审查。
    结论:使用头颅测量检查和数字研究模型,这些研究表明,正颌手术后复发是大多数病例发生的事件。我们研究的局限性在于大多数研究都是回顾性的,并且使用了小样本量。未来的研究目标应该是进行更多样本的长期临床试验。
    BACKGROUND: This review aimed to analyze the relapse in orthognathic surgery.
    METHODS: PubMed, Scopus, and Web of Science databases were used to find papers that matched our topic dating from 1 January 2012 up to November 2022. Inclusion criteria were (1) human studies, (2) open access studies, (3) studies concerning the correlation between orthognathic surgery and relapse. Exclusion criteria were: (1) in vitro or animal studies, (2) off-topic studies, (3) reviews, (4) other languages than English.
    RESULTS: A total of 482 results were obtained resulting in 323 publications after duplicate removal (158). After screening and eligibility phases 247 records were excluded: 47 reviews, 5 in animals, 35 in vitro, 180 off-topic. The authors successfully retrieved the remaining 78 papers and evaluated their eligibility. A total of 14 studies from these were ultimately included in the review.
    CONCLUSIONS: Using cephalometric examinations and digital study models, these studies reveal that the relapse after orthognathic surgery is an event that occurs in most of the cases. The limitation of our research is that most of the studies are retrospective and use small sample sizes. A future research goal should be to conduct long-term clinical trials with larger numbers of samples.
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  • 文章类型: Systematic Review
    背景:本系统综述(ProsperoCRD4202223188)的目的是研究牙釉质不全症(AI)患者的咬合特征和基因型与牙釉质结构表型之间是否存在关联。
    方法:在系统搜索中使用Medline浏览截至2023年5月的报告,以评估AI个体的遮挡,Embase,ISIWebofScience,灰色文学。随机对照试验,病例对照研究,和指定两个遮挡的案例序列,通过头颅测量或临床分析评估,包括AI患者的基因型或牙齿表型,没有任何年龄限制。两位作者根据PRISMA声明独立选择了出版物并提取了数据。使用JohannaBriggs研究所的关键评估清单评估了偏差的风险。
    结果:从261个结果中选择了25篇文章。大多数纳入的出版物是病例系列(n=22)和病例对照研究(n=3)。13项研究报告了两种基因型(ENAM,FAM83H,FAM20A,DLX3,CNMM4,WDR72)和咬合诊断。研究的方法学质量中等。所有AI表型显示开放咬伤(OB)率约为35%,除了混合形式。其他咬合不常被提及。在AI患者中,咬合表型与基因型或AI表型之间没有相关性,因为大多数研究的咬合描述短,样本量小。
    结论:OB咬合不正在AI中更常见。这篇评论强调了需要更准确地描述与人工智能相关的口面特征,为了更好地阐明牙釉质发生基因在颅面形态发生调节中的作用,并在早期阶段识别需要正颌手术的患者。
    BACKGROUND: The aim of this systematic review (Prospero CRD42022323188) is to investigate whether an association exists in patients with amelogenesis imperfecta (AI) between occlusal characteristics and genotype on the one hand and enamel structural phenotype on the other.
    METHODS: Reports up to May 2023 assessing occlusion of individuals with AI were browsed in a systematic search using Medline, Embase, ISI Web of Science, and the grey literature. Randomised control trials, case control studies, and case series specifying both occlusion, assessed by cephalometric or clinical analysis, and genotype or dental phenotype in patients with AI were included without any age limitation. Two authors independently selected the publications and extracted the data in accordance with the PRISMA statement. The risk of bias was assessed with the Critical Appraisal Checklists from the Johanna Briggs Institute.
    RESULTS: Twenty-five articles were chosen from the 261 results. Most of the included publications were case series (n=22) and case control studies (n=3). Thirteen studies reported both a genotype (ENAM, FAM83H, FAM20A, DLX3, CNMM4, WDR72) and occlusal diagnostic. The methodological quality of the studies was moderate. All AI phenotypes showed an open bite (OB) rate around 35%, except mixed form. The other malocclusions were not often mentioned. No correlation between occlusal phenotype and genotype or AI phenotype could be identified in patients with AI, as most studies had short occlusal descriptions and small sample sizes.
    CONCLUSIONS: OB malocclusions were more frequently reported in AI. This review highlighted the need for a more accurate description of orofacial features associated with AI, to better clarify the role of amelogenesis genes in the regulation of craniofacial morphogenesis and identify patients requiring orthognathic surgery at an early stage.
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  • 文章类型: Journal Article
    Treacher Collins Syndrome (TCS) is a genetic disorder with predominantly autosomal dominant inheritance, associated with different mutations in specific genes. This review aimed to evaluate the facial, temporomandibular, zygomatic and bucco-dental phenotype in TCS individuals, and describe surgical and non-surgical solutions for each case in order to improve the quality of life of these individuals. A review of the literature on the craniofacial characteristics of the TCS was carried out, using the PICO strategy, and then a systematic search method was performed in Medline, Scopus, LILACS and SCIELO databases, identifying articles of impact and relevance until 10 June 2020, 240 articles were recovered and only 35 fulfilled the selection criteria. We found the main craniofacial and oral morphological characteristics of these individuals, and the possible functional alterations inducing repercussion in the stomatognathic apparatus. Among other characteristics, the most representative include hypoplasia in the zygomatic and mandibular complex, which can cause difficulty in breathing and feeding. In some cases, cleft palate and malocclusions such as anterior open bite may lead to Angle\'s Class II malocclusion, sometimes causing problems in the temporomandibular joint. In conclusion, individuals with TCS have specific craniofacial features including maxillary hypoplasia, altered orbital zones, mandibular retrognathia, and temporomandibular disorders. Oral deformities produce to a higher prevalence of caries and calculus formation because of poor hygiene due to the malformations present in these patients.
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  • 文章类型: Journal Article
    BACKGROUND: A limited amount of systematic literature reviews on the association between malocclusions and oral health-related quality of life (OHRQOL) summarize inconclusive results. Therefore, we conduct a systematic review and meta-analysis on the association of malocclusions with OHRQOL in children.
    METHODS: Relevant studies were identified in Pubmed, Embase, Cochrane, Google Scholar and other databases. All studies with data on malocclusions or orthodontic treatment need and OHRQOL in children were included. Methodological quality of the studies was assessed with the Newcastle-Ottawa Scale (NOS). Random effects models were used to estimate summary effect measures for the association between malocclusion and OHRQOL in a continuous and a categorical data analysis. Tests for heterogeneity, publication bias and sensitivity of results were performed.
    RESULTS: In total, 40 cross-sectional studies were included in the meta-analyses. Summary measures of the continuous data show that OHRQOL was significantly lowered in children with malocclusions (standardized mean difference (95 % CI] = 0.29 (0.19-0.38)). The summary odds ratio for having an impact on OHRQOL was 1.74 times higher in children with malocclusion than in children without malocclusions. Heterogeneity among studies was partly explained by malocclusion assessment, age of the children and country of study conduction.
    CONCLUSIONS: Our results provide evidence for a clear inverse association of malocclusion with OHRQOL. We also showed that the strength of the association differed depending on the age of the children and their cultural environment.
    CONCLUSIONS: Dentists benefit from understanding the patient differences regarding the impact of malocclusions.
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