Palatally displaced canine

  • 文章类型: Observational Study
    背景:一个或多个基因中的突变可导致低体及其特征性特征。大量研究表明,遗传对低体症的发生有很强的影响,并鉴定了几个基因,包括AXIN2,EDA,FGF3,FGFR2,FGFR10,WNT10A,MSX1和PAX9与牙体发育不全和癌变直接相关。这项研究的目的是调查牙齿发育不全的发生和模式,microdontia,诊断为甲状腺乳头状癌(PTC)的女性患者的腭移位犬(PDC),与没有任何恶性肿瘤或甲状腺疾病的对照组女性相比。
    方法:本病例对照研究在口腔正畸科进行。萨格勒布大学牙科医学院,和肿瘤和核医学部门SestreMilosrdnice大学医院中心。该研究涉及临床检查和评估牙齿状况,全景X射线分析,对116例20-40岁女性PTC患者的病史和家族史进行评估,以及对照组中年龄相似的424名女性。
    结果:低酮症的患病率,microdontia,女性PTC患者的PDC在统计学上高于对照组。实验组牙体功能低下的患病率为11.3%,对照组为3.5%。实验组上侧切牙缺失发生率较高,左下中央切牙,与对照组相比,所有第三磨牙(左上除外)。女性PTC患者PDC患病率明显高于对照组(3.5%,0.7%,p=0.002)。作为临床发现的牙髓不足的概率增加了2.6倍,在PTC女性中,microdontia的发生率是其7.7倍。
    结论:我们的研究表明牙本质发育与PTC之间可能存在联系。没有恒牙可能会增加女性患PTC的可能性。在关键的早期检测窗口内,利用7岁正像图识别PTC高危女性,可以通过积极的干预措施显着改善口腔健康结果和PTC预后。
    BACKGROUND: Mutations in one or multiple genes can lead to hypodontia and its characteristic features. Numerous studies have shown a strong genetic influence on the occurrence of hypodontia, and identified several genes, including AXIN2, EDA, FGF3, FGFR2, FGFR10, WNT10A, MSX1, and PAX9, that are directly associated with dental agenesis and carcinogenesis. The objective of this study was to investigate the occurrence and pattern of tooth agenesis, microdontia, and palatally displaced canine (PDC) in women diagnosed with papillary thyroid cancer (PTC), compared to a control group of women without any malignancy or thyroid disease.
    METHODS: This case-control study was carried at the Department of Orthodontics, School of Dental Medicine University of Zagreb, and Department of Oncology and Nuclear Medicine Sestre Milosrdnice University Hospital Centre. The study involved a clinical examination and evaluation of dental status, panoramic X-ray analysis, and assessment of medical and family history of 116 female patients aged 20-40 with PTC, as well as 424 females in the control group who were of similar age.
    RESULTS: The prevalence of hypodontia, microdontia, and PDC was statistically higher in women with PTC than in the control group. The prevalence rate of hypodontia was 11.3% in the experimental group and 3.5% in the control group. The experimental group showed a higher occurrence of missing upper lateral incisors, lower left central incisors, and all the third molars (except the upper left) compared to the control group. Women with PTC showed the prevalence of PDC significantly higher than the control group (3.5%, 0.7%, p = 0.002). The probability of hypodontia as a clinical finding increases 2.6 times, and microdontia occurs 7.7 times more frequently in women with PTC.
    CONCLUSIONS: Our study suggests a possible link between odontogenesis and PTC. The absence of permanent teeth may increase the likelihood of PTC in women. Leveraging the age-7 orthopantomogram to identify women at high risk for PTC within a critical early detection window could significantly improve oral health outcomes and PTC prognosis through proactive interventions.
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  • 文章类型: Journal Article
    背景:目的是提供有关上颌扩张在截获腭移位犬(PDC)中的有效性的现有文献的综合。
    方法:包括评估混合牙列期PDCs受试者上颌扩张效果的研究。在2021年11月30日之前搜索了以下电子数据库:MEDLINE(通过PubMed),Scopus,谷歌学者,WebofScience,科克伦图书馆还进行了灰色文献检索和手动检索。在一项随机对照试验(RCT)中使用Cochrane工具和在非RCT中使用ROBINS-I工具评估偏倚风险。提取数据并使用RevMan5.4进行荟萃分析。建议的分级,评估,使用开发和评估(GRADE)方法来评估证据的确定性。
    结果:从9,586条记录中选择了四项研究,其中包括1个RCT和3个非RCT。前者表现出高风险的偏倚,而非RCT表现出中等风险。三个非RCT的荟萃分析发现,快速上颌扩张后犬齿的α角没有明显改善,差异为-4.26(95%CI-11.41~2.89;P=0.24)。RCT显示,上颌快速扩张的高风险犬的喷发率增加。上颌缓慢扩张没有显示出任何有利的变化。证据水平从低到非常低。
    结论:没有足够的证据推荐使用上颌扩张作为拦截PDC的独立程序。需要进行其他良好的试验。
    BACKGROUND: The objective was to provide a synthesis of the existing literature on the effectiveness of maxillary expansion in intercepting palatally displaced canines (PDCs).
    METHODS: Studies that evaluated the effectiveness of maxillary expansion in subjects with PDCs in the mixed dentition period were included. The following electronic databases were searched until November 30, 2021: MEDLINE (via PubMed), Scopus, Google Scholar, Web of Science, and Cochrane library. Grey literature search and manual search were also performed. The risk of bias was assessed using the Cochrane tool for the one randomized controlled trial (RCT) and the ROBINS-I tool for the non-RCTs. The data were extracted and meta-analysis was performed using RevMan 5.4. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach was used to assess the certainty of evidence.
    RESULTS: Four studies were selected from 9,586 records, which included one RCT and three non-RCTs. The former demonstrated a high risk of bias whereas the non-RCTs showed moderate risk. The meta-analysis of three non-RCTs found no significant improvement in the alpha angle of canines after rapid maxillary expansion, with a difference of -4.26 (95% CI -11.41 to 2.89; P = 0.24). The RCT showed an increase in the eruption rate of high-risk canines with rapid maxillary expansion. Slow maxillary expansion did not demonstrate any favorable change. The level of evidence ranged from low to very low.
    CONCLUSIONS: There is insufficient evidence to recommend the use of maxillary expansion as a stand-alone procedure in intercepting PDCs. Additional well-conducted trials are required.
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  • 文章类型: Journal Article
    这项系统评价旨在找出在全景X射线照片上测量的可能的预测变量,以预测在晚期混合牙列中拦截式拔除后,pat位移位的犬(PDC)的自发爆发。
    在MEDLINE中进行电子数据库搜索,科克伦中心,Scopus,以及截至2020年6月的其他来源。随机和非随机对照试验,并且考虑了没有对照组的前瞻性研究进行回顾。研究选择,数据提取,偏见风险评估(根据RoB2.0,ROBINS-I,和NHLBI得分),在审查过程中进行了证据确定性评估(等级方法)。由于研究之间存在异质性,仅对纳入文献进行定性分析。
    在970条检索记录中,3个对照试验和3个无对照的前瞻性前后研究符合资格标准,并纳入审查。研究被评估为低风险到高风险的偏倚。总体确定性中等到非常低。结果表明,远端扇区的PDC,较低的α角,年轻的科目,根较不发达的PDC从拦截提取中显着受益。然而,垂直距离对喷发预测的影响不大。
    在较年轻的年龄进行拦截提取,近中犬冠位置(扇区),PDC的近倾角(α角)是预测pal位犬科动物自发爆发的最重要变量。这项审查的结果可用于做出基于证据的决策,以管理具有不同部门和中等倾向的PDC。然而,精心设计的临床试验建议加强证据。
    OBJECTIVE: This systematic review was aimed to find out possible predictive variables measured on panoramic radiographs to predict spontaneous eruption of palatally displaced canine (PDC) after interceptive extraction in late mixed dentition.
    METHODS: Electronic database searches were performed in MEDLINE, Cochrane\'s CENTRAL, Scopus, and in other sources up to June 2020. Randomized and nonrandomized controlled trials, and pre-post prospective studies without control groups were considered for review. Study selection, data extraction, risk of bias assessment (by RoB 2.0, ROBINS-I, and NHLBI score), and the certainty of evidence evaluation (GRADE approach) were performed during reviewing process. Only qualitative analyses of included literature were done due to presence of between study heterogeneity.
    RESULTS: Out of 970 retrieved records, 3 controlled trials and 3 prospective before and after studies without control fulfilled the eligibility criteria and were included in the review. Studies were assessed at low risk to high risk of bias. Overall certainty was moderate to very low. Results shows that PDCs in distal sectors, lower alpha angle, younger subjects, PDCs with less advanced developed root were significantly benefited from interceptive extraction. However, Vertical distance had insignificant roll on eruption prediction.
    CONCLUSIONS: Interceptive extraction at younger age, mesial canine crown position (sectors), and mesial inclination of PDC (alpha angulation) are the most important variables predicting the spontaneous eruption of palatally displaced canine. Findings of this review can be utilized to make evidence-based decisions for managing PDCs with diverse sectors and mesial inclinations. However, well designed clinical trials are recommended to strengthen the evidence.
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  • 文章类型: Journal Article
    目的:评估在全景X线照片(PAN)上测量的不同诊断变量对预测晚期混合牙列拦截拔除后pat位移位犬(PDC)自发爆发的有效性。
    方法:数字数据库(MEDLINE,CENTRAL(Cochrane),Scopus,clinicaltrials.gov,ISRCTN注册表)和手工搜索已进行到2020年3月。该综述考虑了随机和非随机对照试验。研究选择,数据提取,偏见风险评估(RoB2.0和ROBINS-I),根据《Cochrane干预措施系统评价手册》进行证据确定性评价(GRADE)。使用随机效应方法定量合成二分和连续数据。
    结果:在767条检索记录中,4项对照试验符合资格标准,并纳入审查。除一项外,研究的偏倚风险较低。总体确定性强至中等。远端部门的PDCs(RR:1.621;95CI:1.259至2.086;P<0.001)和α角<30°(SMD:-1.350;95CI:1.924至-0.776;P<0.001)显著受益于拦截提取。然而,PDC尖尖与咬合平面的垂直距离对喷发预测具有统计学意义(p:0.855)。
    结论:在较年轻的年龄,初始水平定位(扇区位置),和α角(初始近中倾角)是预测pal位犬科动物自发爆发的最重要变量。这项审查的结果可用于做出基于证据的决策,以管理具有不同部门和中等倾向的PDC。然而,建议精心设计的临床试验来加强证据。
    OBJECTIVE: To evaluate the effectiveness of different diagnostic variables measured on panoramic radiographs (PAN) to predict spontaneous eruption of palatally displaced canine (PDC) after interceptive extraction in late mixed dentition.
    METHODS: Digital databases (MEDLINE, CENTRAL (Cochrane), Scopus, clinicaltrials.gov, ISRCTN registry) and hand searches were performed up to March 2020. Both randomized and non-randomized controlled trials were considered for the review. Study selection, data extraction, risk of bias assessment (RoB2.0 and ROBINS-I), and the certainty of evidence evaluation (GRADE) were performed according to Cochrane Handbook for Systematic Reviews of Interventions. The random-effects method for quantitative synthesis of dichotomous as well as continuous data was used.
    RESULTS: Out of 767 retrieved records, 4 controlled trials fulfilled the eligibility criteria and were included in the review. Studies were assessed at low risk of bias except one. Overall certainty was strong to moderate. PDCs in distal sectors (RR: 1.621; 95%CI: 1.259 to 2.086; P<0.001) and alpha-angle <30° (SMD: -1.350; 95%CI: 1.924 to -0.776; P<0.001) were significantly benefited from interceptive extraction. However, Vertical distance of PDC cusp tip from occlusal plane had statistically insignificant (p: 0.855) roll on eruption prediction.
    CONCLUSIONS: Interceptive extraction at a younger age, initial horizontal localization (sector position), and alpha-angle (initial mesial inclination) are the most important variables predicting the spontaneous eruption of palatally displaced canines. Findings of this review can be utilized to make evidence-based decisions for managing PDCs with diverse sectors and mesial inclinations. However, well-designed clinical trials are recommended to strengthen the evidence.
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  • 文章类型: Journal Article
    The aim of this systematic review was to assess whether interceptive treatment carried out in the mixed dentition period improves the position of Palatally Displaced Canines (PDC).
    A systematic search was performed on various computerized databases. A hand search was also performed by reviewing the references within the examined studies and titles of the papers published over the last 30 years on various orthodontic journals.
    This systematic review analysed eight articles, of which five were Randomized Clinical Trials (RCT) and three were prospective control studies. Qualitative assessment was done for all the eight studies. The effect of interceptive measures such as extraction of primary canine, Rapid Maxillary Expansion (RME), cervical pull headgear and Transpalatal Arch (TPA) on successful eruption of Palatally Displaced Canines was analyzed.
    Interceptive treatment improves the position of PDC and reduces the chances of impaction. Significant changes in success rate depend on diagnosis at early mixed dentition stage. A combination of interceptive measures which includes extraction of primary canine, cervical pull headgear, TPA and RME aided in successful eruption. However, Randomized clinical trials with increased sample size, proper randomization comparing all the interceptive measures along with assessment of other factors such as patient satisfaction, pain experience and cost factor will yield more evidence based conclusions.
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  • 文章类型: Journal Article
    这项研究的目的是使用“表面匹配”技术,在单侧pal骨移位犬(PDC)的患者中,通过锥形束计算机断层扫描(CBCT)扫描在PDC侧和非PDC侧的上颌牙齿形态。
    选择28例单侧PDC患者(平均年龄16.04±1.77岁)的CBCT图像。本研究中的每颗牙齿都被分割,然后使用MimicsResearch软件绘制成3D模型,并测量牙根长度。之后,使用GeomagicControlX软件进行PDC侧和非PDC侧之间的3D偏差分析。
    比较PDC侧切牙的根长和体积时,获得了统计学上的显着差异(p≤0.001),非PDC侧和对照组。根据三维偏差分析的结果,患者和对照组之间的侧切牙和犬齿差异有统计学意义(p≤0.0001),而牙冠和根尖差异更大。
    与PDC相邻的侧切牙的根部比对侧切牙短。此外,单侧PDC受试者的侧切牙和犬之间存在形态学差异。
    The goal of this study was to investigate in patients with unilateral palatally displaced canine (PDC) the morphology of maxillary teeth from cone-beam computed tomography (CBCT) scans both on the PDC side and non-PDC side using a \"surface matching\" technique.
    CBCT images from 28 patients (mean age 16.04 ± 1.77 years) with unilateral PDC were selected. Each tooth in this study was segmented and then rendered into a 3D model using Mimics Research software and the root length was measured. Afterwards, 3D deviation analysis between the PDC and non-PDC side was carried out using Geomagic Control X software.
    Statistically significant differences (p ≤ 0.001) were obtained when comparing the root lengths and volumes of lateral incisors from the PDC side, non-PDC side and control group. In accordance with the findings of 3D deviation analysis, statistically significant differences between the patients and control group were obtained for the lateral incisors and canines (p ≤ 0.0001) and greater differences were found for the tooth crowns and root tips.
    Lateral incisors adjacent to PDCs have shorter roots than contra-lateral lateral incisors. Furthermore, there were morphological differences between lateral incisors and canines in subjects with unilateral PDCs.
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  • 文章类型: Journal Article
    目的:确定是否可以通过截获性拔除初级上颌犬齿来成功治疗pal位永久性犬齿(PDC)。
    方法:数字数据库(Medline,Scopus,WebofScience,和Cochrane)进行搜索,以检索1952年至2016年4月发表的文章。大学图书馆员为每个数据库制定了搜索策略。两名经过校准的审阅者独立审阅了潜在相关的标题和摘要。完整阅读了符合纳入和排除标准的论文。根据方法学质量标准对所选文章进行评价和评分。
    结果:4项随机临床试验(RCTs)纳入系统评价。与两项较早的研究相比,另外两个最近的RCT被发现有更好的研究设计,进行得更好,并涉及更好地报告结果。纳入的研究比较了干预组(患有PDC的儿童正在进行原发性犬的提取)与对照组(患有PDC但没有原发性犬的受试者)。在四项研究中的三项中,在超过65%的病例中,初级犬的拦截提取促进了PDC的爆发。总的来说,与对照组(36%-42%)相比,干预组成功喷发的发生率(50%-69%)明显较高.
    结论:根据现有证据,可以合理地得出结论,提取初级犬科动物可以促进PDC的爆发。然而,进一步高质量,随机临床试验在其他人群中是必要的.希望这项研究将有助于正畸医生做出关于临床管理PDC的循证决策。
    OBJECTIVE: To determine whether the successful management of palatally displaced permanent canines (PDCs) can be achieved by the interceptive extraction of primary maxillary canines.
    METHODS: Digital databases (Medline, Scopus, Web of Science, and Cochrane) were searched to retrieve articles published from 1952 to April 2016. The university librarian developed search strategies for each database. Two calibrated reviewers independently reviewed potentially related titles and abstracts. Papers meeting the inclusion and exclusion criteria were read in full. The selected articles were evaluated and scored according to methodological quality criteria.
    RESULTS: Four randomized clinical trials (RCTs) were included in the systematic review. Compared with two older studies, two more recent RCTs were found to have better study designs, were better conducted, and involved better reporting of the results. The included studies compared intervention groups (children with PDCs undergoing extraction of primary canines) with controls (subjects with PDCs but no primary canine extractions). In three of the four studies, the interceptive extraction of primary canines facilitated eruption of PDCs in more than 65% of cases. Overall, the intervention groups had a markedly higher incidence of successful eruption of PDCs (50%-69%) compared with the control groups (36%-42%).
    CONCLUSIONS: Based on the available evidence, it is reasonable to conclude that eruption of PDCs can be facilitated by extraction of primary canines. However, further high-quality, randomized clinical trials are warranted in other population groups. It is hoped that this study will help orthodontists make evidence-based decisions about clinically managing PDCs.
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  • 文章类型: Comparative Study
    OBJECTIVE: To examine the relationship between palatally displaced maxillary canines (PDC) and the maxillary transverse dimension using cone-beam computed tomography (CBCT).
    METHODS: Thirty-three patients (11 males and 22 females, mean age 18.2 years) with PDC were matched to 66 patients (22 males and 44 females, mean age 18.1 years) without PDC (control) by gender, age, and posterior occlusion. A CBCT image was taken on all the patients prior to any orthodontic treatment. For each patient the maxillary basal bone widths and interdental widths at the maxillary first molars and first and second premolars were measured on axial and coronal sections of CBCT images. In addition, the presence of permanent tooth agenesis and the widths of maxillary incisors were recorded.
    RESULTS: Similar maxillary transverse dimensions, both skeletally and dentally, were found between the PDC and control groups. In the PDC group, the number of patients with permanent tooth agenesis was six times higher than in the control group. In addition, the maxillary lateral incisors on PDC-affected sides were smaller than those of control group (P < .05).
    CONCLUSIONS: The maxillary transverse dimension, both skeletally and dentally, had no effect on the occurrence of PDC. The higher prevalence of permanent tooth agenesis was found in the PDC group. Moreover, the mean mesiodistal width of maxillary lateral incisors in the PDC group was significantly smaller than in the control group (P < .05).
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