scholarly journals Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
R. Kamber ◽  
H. Meyer-Lueckel ◽  
D. Kloukos ◽  
C. Tennert ◽  
R. J. Wierichs

AbstractTo analyse clinical studies investigating coating agents such as sealants and other bonding materials to prevent the initiation or inhibit the progress of white spot lesions (WSL) during orthodontic treatment with fixed appliances. Electronic databases (Pubmed, CENTRAL, EMBASE) were screened for studies. No language restrictions were applied. Study selection, data extraction and quality assessment were done in duplicate. Primary outcome included assessment of WSL with visual-tactile assessment and/or laser fluorescence measurements. Twenty-four studies with 1117 patients (age: 11–40 years) and 12,809 teeth were included. Overall, 34 different sealants or bonding materials were analysed. Fourteen studies analysed fluoride and 14 studies non-fluoride releasing materials. Meta-analysis for visual tactile assessment revealed that sealants significantly decreased the initiation of WSL compared to untreated control (RR [95%CI] = 0.70 [0.53; 0.93]; very low level of evidence). Materials releasing fluoride did not decrease initiation of WSL compared to those with no fluoride release (RR [95%CI] = 0.84 [0.70; 1.01]; very low level of evidence). For laser fluorescence measurements no meta-analysis could be performed. The use of sealants seems to be effective in preventing the initiation of post-orthodontic WSL. Furthermore, there is no evidence supporting that fluoride-releasing sealants or bonding materials are more effective than those without fluoride release. No gold standard prevention strategy to prevent WSL during treatment with fixed orthodontic appliances has been established yet. However, based on only a limited number of studies the use of sealants seems to be effective in preventing the initiation of post-orthodontic WSL.

2019 ◽  
Vol 7 (1) ◽  
pp. 21 ◽  
Author(s):  
Mohammad Imani ◽  
Hamid Mozaffari ◽  
Mazaher Ramezani ◽  
Masoud Sadeghi

Nickel and chromium ions released from fixed orthodontic appliances may act as allergens. This study aimed to systematically review the effect of fixed orthodontic treatment on salivary levels of these ions by doing a meta-analysis on cross-sectional and cohort studies. The Web of Science, Scopus, Cochrane Library, and PubMed databases were searched for articles on salivary profile of nickel or chromium in patients under fixed orthodontic treatment published from January 1983 to October 2017. A random-effect meta-analysis was done using Review Manager 5.3 to calculate mean difference (MD) and 95% confidence interval (CI), and the quality of questionnaire was evaluated by the Newcastle–Ottawa scale. Fourteen studies were included and analyzed in this meta-analysis. Salivary nickel level was higher in periods of 10 min or less (MD = −11.5 µg/L, 95% CI = −16.92 to −6.07; P < 0.0001) and one day (MD = −1.38 µg/L, 95% CI = −1.97 to −0.80; P < 0.00001) after initiation of treatment compared to baseline (before the insertion of appliance). Salivary chromium level was higher in periods of one day (MD = −6.25 µg/L, 95% CI = −12.00 to −0.49; P = 0.03) and one week (MD = −2.07 µg/L, 95% CI = −3.88 to −0.26; P = 0.03) after the initiation of treatment compared to baseline. Corrosion of fixed orthodontic appliances leads to elevated salivary nickel and chromium concentrations early after initiation of orthodontic treatment. Randomized clinical trials controlling for factors affecting the saliva composition are recommended on a higher number of patients and among different ethnicities.


2020 ◽  
Vol 8 (D) ◽  
pp. 139-145
Author(s):  
Eman Aly ◽  
Hend Salah Hafez ◽  
Amr Hussein Labib ◽  
Tarek Abdel Hamid Harhash ◽  
Mohamed Abou El-Yazeed ◽  
...  

AIM: The aim of this study was to compare the effect of low level laser therapy (LLLT) with non-LLLT as an adjunct to mechanical debridement in patients who develop gingival inflammation during fixed orthodontic treatment. MATERIALS AND METHODS: Thirty subjects undergoing comprehensive fixed orthodontic treatment were randomly allocated. Split mouth design was applied for each patient, where the four quadrants were randomly allocated to receive full mouth debridement. The test group (quadrant) received three laser sessions (days 1, 3, and 5) besides debridement while the control group (quadrant) received debridement only. Both bleeding index (BI) and plaque index (PI) were measured after 1 and 3 months, while the total colony forming units (CFU) were measured after 2 and 6 weeks. RESULTS: Clinical assessments (BI and PI) showed a statistically significant decrease at the first follow-up (after 1 month) and a slight increase in the second (after 3 months) that did not reach the base line. While, the total CFU showed a significant decrease in both follow-ups. CONCLUSION: Laser showed superior results in the treatment of gingival inflammation induced by fixed orthodontic appliances other than debridement only.


2018 ◽  
Vol 88 (6) ◽  
pp. 806-811 ◽  
Author(s):  
Ioannis P. Zogakis ◽  
Erez Koren ◽  
Shlomit Gorelik ◽  
Isaac Ginsburg ◽  
Miriam Shalish

ABSTRACT Objectives: To examine possible changes in the levels of salivary antioxidants, C-reactive protein (CRP), cortisol, pH, proteins, and blood in patients treated with fixed orthodontic appliances. Materials and Methods: Salivary samples from 21 orthodontic patients who met specific inclusion criteria were collected before the beginning of orthodontic treatment (T0; baseline), 1 hour after bonding (T1), and 4–6 weeks after bonding (T2). Oxidant-scavenging ability (OSA) was quantified using a luminol-dependent chemiluminescence assay. Cortisol and CRP levels were measured using immunoassay kits. pH levels and presence of proteins and blood in the samples were quantified using strip-based tests. Results: A significant decrease in salivary pH was observed after bonding (P = .013). An increase in oxidant-scavenging abilities during orthodontic treatment was detected, but the change was not statistically significant. Cortisol and CRP levels slightly increased after bonding, but the difference was small without statistical significance. Changes in the presence of proteins and blood were also insignificant. Conclusions: Exposure to fixed orthodontic appliances did not show a significant effect on salivary parameters related to inflammation or stress, with the exception of a significant but transient pH decrease after bonding.


2021 ◽  
Vol 15 (2) ◽  
Author(s):  
Mahsa Esfehani ◽  
Bahareh Mohammad Zahraiee ◽  
Sepideh Arab ◽  
Fatemeh Hajmanoochehri ◽  
Mohammadtaghi Vatandoust

Objectives: This study was aimed to assess salivary sodium and potassium concentrations in patients with fixed orthodontic appliances. Methods: In this case-control study, saliva samples (5 cc) were collected from 13 patients with fixed orthodontic appliances before, and 1 week, 1 month and 3 months after the beginning of the orthodontic treatment using the spitting method. Saliva samples were also collected from 10 healthy individuals as controls. The saliva samples were centrifuged at 3000 rpm for 10 minutes and the salivary sodium and potassium concentrations were measured by spectrophotometry. Data were analyzed using independent and paired t-tests. P-value < 0.05 was considered as significant. Results: The salivary sodium and potassium concentrations were almost the same in both groups at baseline (P > 0.05). A significant reduction in sodium and an increase in potassium levels were noted in the case group at 1 week compared with baseline (P < 0.001). At 1 week, the potassium concentration was significantly higher and the sodium concentration was significantly lower in the case group (P < 0.01). The salivary sodium significantly increased while the salivary potassium significantly decreased at 1 month compared with 1 week (P < 0.001). The differences with the control group were also significant (P < 0.05). No significant differences were noted between the two groups at 3 months (P > 0.05). Conclusions: Time has a significant effect on the release profile of sodium and potassium ions from orthodontic appliances. The salivary sodium and potassium concentrations returned to their normal pretreatment values within 3 months after the start of fixed orthodontic treatment.


2020 ◽  
Vol 8 (1) ◽  
pp. 24 ◽  
Author(s):  
Carmelo Nicotra ◽  
Alessandro Polizzi ◽  
Graziano Zappalà ◽  
Alessandro Leonida ◽  
Francesco Indelicato ◽  
...  

Patients still refuse or discontinue orthodontic treatment due to related pain and discomfort. In this study, we investigate if low-level laser therapy (LLLT) can reduce pain caused by orthodontic bands. Sixty subjects who needed bands placed on the upper permanent first molars were assigned randomly to the LLLT group, placebo, and control groups. Inclusion criteria were: age range 10–14 years, fully erupted upper first molars in healthy condition, presence of tight mesial proximal contact. Exclusion criteria were: systemic or metabolic diseases, chronic pain or neurological or psychiatric disorders, use of pharmacological agents interfering with pain perception, previous orthodontic treatment or the simultaneous presence of other devices in the patient’s mouth. The assessment of pain was performed by using a numeric rating scale (NRS) considering different time intervals, i.e., immediately after bands placement, 6 h, 24 h, and from day 2 to day 5. Differences in the maximum pain and in pain experienced at each time-point, among the three groups, was assessed by using the Kruskal–Wallis H. The final sample included 56 patients, 29 males, and 27 females, with a mean age of 12.03 ± 1.3 years. Patients were randomly allocated into three groups (tested, control, and placebo group) with each group consisting respectively of 19, 20, and 17 individuals. Subjects in the LLLT experienced less pain at each time interval as well as the maximum pain score being lower in the LLLT compared to control and placebo groups. These findings were all statistically significant (p < 0.05). LLLT can alleviate the intensity of pain after the placement of orthodontic bands.


2014 ◽  
Vol 08 (03) ◽  
pp. 373-380 ◽  
Author(s):  
Fatma Boke ◽  
Cagri Gazioglu ◽  
Sevil Akkaya ◽  
Murat Akkaya

ABSTRACT Objective: The aim of this retrospective study was to evaluate the relationship between orthodontic treatment and gingival health. Materials and Methods: A total of 251 patients among whom 177 were girls and 74 were boys, recruited from the records pool of the Department of Orthodontics, Faculty of Dentistry, University of Gazi, were included in the study. Patients’ treatments have been completed by postgraduate students during the period between 2006 and 2012. Patients’ folders were analyzed according to their age, treatment time, and the type of orthodontic treatment. Intra-oral photographs were analyzed, and the presence or absence of visible plaque, visible inflammation, and gingival recession were recorded, and incisor inclinations analyzed on lateral cephalometric films, before and after orthodontic treatment. Results: No statistically significant difference was found in patients treated with functional appliances before and after treatment. In patients treated with fixed orthodontic appliances, visible plaque, visible inflammation, and gingival recession showed significant increases after treatment, gingival biotype did not show any significant difference. Positive correlation was found between lower incisor position and gingival recession in patients treated with fixed appliance and extraction. And also cuspids were the teeth with the highest prevalence of gingival recession. Conclusion: Considering the relationship between orthodontic treatment and gingival health, cooperation among patients, orthodontists, and periodontists is important.


2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Anand Marya ◽  
Adith Venugopal ◽  
Nikhilesh Vaid ◽  
Mohammad Khursheed Alam ◽  
Mohmed Isaqali Karobari

Fixed orthodontic treatment has been compromised at many levels during the pandemic period, as clinics underwent a prolonged lockdown and patients could not be treated regularly. With the end of the pandemic nowhere in sight, may be it is time to put newer tools, such as clear aligner therapy, for better use. Fixed orthodontic appliances by nature are not always self-limiting, which, if left unmonitored over a long period may cause undesirable side effects, pain, and discomfort. The undesired tooth movements that may occur with arch wire-guided mechanics in addition to problems with cut wires or removed brackets may be minimized with the use of aligners. While the benefits of using aligners are for all to see, they do require extensive planning and careful evaluation of the progress. This article reviews the advantages of using aligners during the pandemic period and how it can be beneficial in helping orthodontists resume their practice.


2020 ◽  
Vol 10 (9) ◽  
pp. 3107 ◽  
Author(s):  
Antonino Lo Giudice ◽  
Gaetano Isola ◽  
Lorenzo Rustico ◽  
Vincenzo Ronsivalle ◽  
Marco Portelli ◽  
...  

The purpose of this article is to evaluate the amount of the relapse of anterior crowding and the efficacy of retention appliances by reviewing the best available scientific evidence. A survey of articles published up to November 2019 about the stability of dental alignment and retention after fixed orthodontic treatment was performed using seven electronic databases. Study Selection: Only randomized clinical trials investigating patients previously treated with multi-bracket appliances with a follow-up period longer than 6 months were included. Data Extraction: Two authors independently performed the study selection, data extraction, and risk of bias assessment. All pooled data analyses were performed using a random-effects model. Statistical heterogeneity was evaluated. In total, eight randomized clinical trials (RCTs) were included, grouping data from 987 patients. The ages of the patients varied across the studies, ranging between 13 and 17 years. The observation period ranged between 6 and 24 months. The data showed no significant intercanine width modifications during the retention period with both fixed and removable retainers. A significant modification of Little’s Index was found for the mandibular removable retainers with a mean difference of 0.72 mm (95% Cl, 0.47 to 0.98) and for the maxillary removable retainers with a mean difference of 0.48 mm (95% Cl, 0.27 to 0.68). No significant changes were found by evaluating Little’s Index modification for the mandibular fixed retainers. The results of this meta-analysis showed that all the considered retainers were effective in maintaining dental alignment after fixed orthodontic treatment. However, fixed retainers showed greater efficacy compared to removable retainers.


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