Influence of increased body mass index on orthodontic tooth movement and related parameters in children and adolescents: A systematic review of longitudinal controlled clinical studies

2019 ◽  
Vol 46 (4) ◽  
pp. 323-334 ◽  
Author(s):  
Dimitrios Michelogiannakis ◽  
P Emile Rossouw ◽  
Junad Khan ◽  
Zohaib Akram ◽  
Evangelos Menenakos ◽  
...  

Objectives: To assess the impact of increased body mass index (BMI) on orthodontic tooth movement (OTM) and related parameters in children and adolescents. Search sources: A search of six electronic databases and manual searching were performed up to June 2019 without language and time restrictions. Data selection: Eligibility criteria were as follows: (1) longitudinal controlled clinical studies; (2) children and adolescents undergoing orthodontic therapy (OT); (3) no systemic diseases; (4) experimental group: patients with increased BMI; and (5) control group: patients with normal BMI. Data extraction: Screening, study selection and data extraction were performed; bias within studies was assessed using the Risk of Bias In Non-randomised Studies (ROBINS-I) tool. Results: Seven studies were included. One study showed that an increased BMI is associated with less wear-time of removable orthodontic appliances and one study found no significant association. One study showed that an increased BMI is associated with less cooperation during OT; however, not with the treatment results. One study reported higher pain experience during OT in adolescents with than without increased BMI. Two studies showed that increased BMI in adolescents is related to OTM, one with increased and one with decreased rates of OTM, respectively. One study reported an association between increased BMI and incidence of white spot lesions and gingivitis during OT. The ROBINS-I tool showed low to moderate risk of bias within studies. Conclusions: The influence of BMI on OTM and related parameters in children and adolescents remains debatable.

2019 ◽  
Vol 42 (4) ◽  
pp. 407-414 ◽  
Author(s):  
Eleftherios G Kaklamanos ◽  
Miltiadis A Makrygiannakis ◽  
Athanasios E Athanasiou

Summary Background Recently, the potential impact of different medications on the rate of orthodontic tooth movement and the associated root resorption has been systematically reviewed in animal studies and various effects have been shown. However, animal data cannot be extrapolated to human clinical situations directly. Objectives To systematically investigate the most up to date available evidence from controlled human studies regarding the effect of medication administration on the rate of orthodontic tooth movement and associated root resorption development. Search methods We searched eight databases (covering also grey literature) without restrictions and we performed hand searching up until October 2018. Selection criteria Controlled studies in humans assessing the effect of various medications on the rate of orthodontic tooth movement and root resorption development. Data collection and analysis Study selection was followed by data extraction and risk of bias assessment using the ROBINS-I tool for non-randomized and the Cochrane Risk of Bias Tool for randomized studies. Results Eight studies, at various risk of bias, were finally identified. With regard to the rate of orthodontic tooth movement, local injections of prostaglandin E1 were found to exert an increasing effect, whereas systemic intake of nabumetone decreased it. Following tenoxicam administration, drinking water with fluoride or local injections of calcitriol (vitamin D metabolite), no significant effects were demonstrated. Concerning root resorption development, nabumetone administration was shown to reduce it, whereas fluoride, overall, was not observed to exert any effect. Only in individuals subjected to heavy orthodontic forces, did fluoride show a protective effect for the period of force application, but not in the longer term during retention. Conclusions The aforementioned substances may show varying effects on the rate of orthodontic tooth movement and root resorption development in human subjects. Despite the observed limitations, the orthodontist should be able to identify patients taking pharmaceuticals and consider any implications related to orthodontic treatment. Registration PROSPERO (CRD42017078208).


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sarah Abu Arqub ◽  
Vaibhav Gandhi ◽  
Marissa G. Iverson ◽  
Maram Ahmed ◽  
Chia-Ling Kuo ◽  
...  

Abstract Background The influence of different biological agents on the rate of orthodontic tooth movement (OTM) has been extensively reviewed in animal studies with conflicting results. These findings cannot be extrapolated from animals to humans. Therefore, we aimed to systematically investigate the most up-to-date available evidence of human studies regarding the effect of the administration of different biological substances on the rate of orthodontic tooth movement. Methods A total of 8 databases were searched until the 16th of June 2020 without restrictions. Controlled randomized and non-randomized human clinical studies assessing the effect of biological substances on the rate of OTM were included. ROBINS-I and the Cochrane Risk of Bias tools were used. Reporting of this review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results A total of 11 studies (6 randomized clinical trials and 5 prospective clinical trials) were identified for inclusion. Local injections of prostaglandin E1 and vitamin C exerted a positive influence on the rate of OTM; vitamin D showed variable effects. The use of platelet-rich plasma and its derivatives showed inconsistent results, while the local use of human relaxin hormone showed no significant effects on the rate of OTM. Limitations The limited and variable observation periods after the administration of the biological substances, the high and medium risk of bias assessment for some included studies, the variable concentrations of the assessed biological agents, the different experimental designs and teeth evaluated, and the variety of measurement tools have hampered the quantitative assessment of the results as originally planned. Conclusions and implications Despite the methodological limitations of the included studies, this systematic review provides an important overview of the effects of a variety of biological agents on the rate of tooth movement and elucidates the deficiencies in the clinical studies that have been conducted so far to evaluate the effectiveness of these agents in humans, providing some guidelines for future robust research. Trial registration PROSPERO (CRD42020168481, www.crd.york.ac.uk/prospero)


2019 ◽  
Vol 77 (9) ◽  
pp. 601-613 ◽  
Author(s):  
Johnny G Santos ◽  
Bruna C Alves ◽  
Thais O Hammes ◽  
Valesca Dall’Alba

Abstract Context Obesity has been linked to the intestinal microenvironment. Diet plays an important role in obesity and has been associated with microbiota. Objective This systematic review sought to evaluate the scientific evidence on the effect of dietary modification, including supplementation with prebiotics and probiotics, on microbiota diversity in obesity. Data sources A systematic search was performed in the MEDLINE and EMBASE databases. Studies were considered eligible if they were clinical trials evaluating dietary intervention and microbiota, body weight, or clinical parameters in obesity. Data extraction Data were extracted by 2 independent reviewers. Results From 168 articles identified, 20 were included (n = 931 participants). Increased phyla abundance after food interventions was the main finding in relation to microbiota. Regarding the impact of interventions, increased insulin sensitivity, reduced levels of inflammatory markers, and reduced body mass index were shown in several studies. Conclusions Interventions that modulate microbiota, especially prebiotics, show encouraging results in treating obesity, improving insulin levels, inflammatory markers, and body mass index. Because the studies included in this review were heterogeneous, it is difficult to achieve conclusive and definitive results.


2021 ◽  
Vol 13 (1) ◽  
pp. 28-37
Author(s):  
Zohreh Afshari ◽  
Shabnam Tahamtan ◽  
Farinaz Shirban

Background: Statins are effective therapeutic agents for the treatment of cardiovascular diseases. Their favorable effects on various aspects of oral health including promising effects on bone metabolism and pleiotropic impacts such as anti-inflammatory properties made these drugs a current area of interest in the field of orthodontics. Therefore, the aim of this study was to evaluate the effects of statins on orthodontic tooth movement (OTM) in animals undergoing orthodontic treatments. Methods: Several databases were comprehensively searched for studies measuring the effects of statins on the OTM up to January 2020, including MEDLINE, ISI Web of Science, EMBASE, Scopus, and Cochrane. Animal studies evaluating the effects of statins on tooth movements in animals undergoing orthodontic treatments were selected based on the PICO model .Study selection, data extraction, risk of bias, and study quality assessment were independently performed by two reviewers. Finally, the data were analyzed using random-effects meta-analysis and the mean difference (MD) was used for comparing the outcome measures. Results: Three randomized trials were finally included in this meta-analysis. According to the Systematic Review Centre for Laboratory animal Experimentation Tool, all the included studies had at least one domain at a high risk of bias. The amount of the OTM was insignificantly lower in the statin group (MD = 0.134 mm, %95 confidence interval = -0.020-0.288, P>0.05). Conclusions: Due to the low quality and methodological inconsistencies among the included studies, conclusive confirmation regarding the effect of statins on the OTM remains debatable. Trail Registration: The protocol of this study was registered on PROSPERO (https://www.crd.york.ac.uk/ PROSPERO/) with the ID # CRD42020164155.


2020 ◽  
Vol 32 (4) ◽  
pp. 523-532 ◽  
Author(s):  
Praveen V. Mummaneni ◽  
Mohamad Bydon ◽  
John Knightly ◽  
Mohammed Ali Alvi ◽  
Anshit Goyal ◽  
...  

OBJECTIVEDischarge to an inpatient rehabilitation facility or another acute-care facility not only constitutes a postoperative challenge for patients and their care team but also contributes significantly to healthcare costs. In this era of changing dynamics of healthcare payment models in which cost overruns are being increasingly shifted to surgeons and hospitals, it is important to better understand outcomes such as discharge disposition. In the current article, the authors sought to develop a predictive model for factors associated with nonroutine discharge after surgery for grade I spondylolisthesis.METHODSThe authors queried the Quality Outcomes Database for patients with grade I lumbar degenerative spondylolisthesis who underwent a surgical intervention between July 2014 and June 2016. Only those patients enrolled in a multisite study investigating the impact of fusion on clinical and patient-reported outcomes among patients with grade I spondylolisthesis were evaluated. Nonroutine discharge was defined as those who were discharged to a postacute or nonacute-care setting in the same hospital or transferred to another acute-care facility.RESULTSOf the 608 patients eligible for inclusion, 9.4% (n = 57) had a nonroutine discharge (8.7%, n = 53 discharged to inpatient postacute or nonacute care in the same hospital and 0.7%, n = 4 transferred to another acute-care facility). Compared to patients who were discharged to home, patients who had a nonroutine discharge were more likely to have diabetes (26.3%, n = 15 vs 15.7%, n = 86, p = 0.039); impaired ambulation (26.3%, n = 15 vs 10.2%, n = 56, p < 0.001); higher Oswestry Disability Index at baseline (51 [IQR 42–62.12] vs 46 [IQR 34.4–58], p = 0.014); lower EuroQol-5D scores (0.437 [IQR 0.308–0.708] vs 0.597 [IQR 0.358–0.708], p = 0.010); higher American Society of Anesthesiologists score (3 or 4: 63.2%, n = 36 vs 36.7%, n = 201, p = 0.002); and longer length of stay (4 days [IQR 3–5] vs 2 days [IQR 1–3], p < 0.001); and were more likely to suffer a complication (14%, n = 8 vs 5.6%, n = 31, p = 0.014). On multivariable logistic regression, factors found to be independently associated with higher odds of nonroutine discharge included older age (interquartile OR 9.14, 95% CI 3.79–22.1, p < 0.001), higher body mass index (interquartile OR 2.04, 95% CI 1.31–3.25, p < 0.001), presence of depression (OR 4.28, 95% CI 1.96–9.35, p < 0.001), fusion surgery compared with decompression alone (OR 1.3, 95% CI 1.1–1.6, p < 0.001), and any complication (OR 3.9, 95% CI 1.4–10.9, p < 0.001).CONCLUSIONSIn this multisite study of a defined cohort of patients undergoing surgery for grade I spondylolisthesis, factors associated with higher odds of nonroutine discharge included older age, higher body mass index, presence of depression, and occurrence of any complication.


2021 ◽  
pp. 030157422110195
Author(s):  
Ashish Agrawal ◽  
TM Chou

Introduction: The objective of this systematic review is to assess the effect of vibrational force on biomarkers for orthodontic tooth movement. Methods: An electronic search was conducted for relevant studies (up to December 31, 2020) on the following databases: Pubmed, Google scholar, Web of Science, Cochrane Library, Wiley Library, and ProQuest Dissertation Abstracts and Thesis database. Hand searching of selected orthodontic journals was also undertaken. The selected studies were assessed for the risk of bias in Cochrane collaboration risk of bias tool. The “traffic plot” and “weighted plot” risk of bias distribution are designed in the RoB 2 tool. The 2 authors extracted the data and analyzed it. Results: Six studies fulfilled the inclusion criteria. The risks of biases were high for 4, low and some concern for other 2 studies. The biomarkers, medium, device, frequency and duration of device, as well as other data were extracted. The outcomes of the studies were found to be heterogenous. Conclusion: One study showed highly statistically significant levels of IL-1 beta with <.001. Rate of tooth movement was correlated with levels of released biomarkers under the influence of vibrational force in 3 studies, but it was found to be significant only in 1 study. It was further observed that vibration does not have any significant reduction in pain and discomfort.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
So-Ryoung Lee ◽  
Kyung-Do Han ◽  
Eue-Keun Choi ◽  
Seil Oh ◽  
Gregory Y. H. Lip

AbstractWe evaluated the association between nonalcoholic fatty liver disease (NAFLD) and incident atrial fibrillation (AF) and analyzed the impact of NAFLD on AF risk in relation to body mass index (BMI). A total of 8,048,055 subjects without significant liver disease who were available fatty liver index (FLI) values were included. Subjects were categorized into 3 groups based on FLI: < 30, 30 to < 60, and ≥ 60. During a median 8-year of follow-up, 534,442 subjects were newly diagnosed as AF (8.27 per 1000 person-years). Higher FLI was associated with an increased risk of AF (hazard ratio [HR] 1.053, 95% confidence interval [CI] 1.046–1.060 in 30 ≤ FLI < 60, and HR 1.115, 95% CI 1.106–1.125 in FLI ≥ 60). In underweight subjects (BMI < 18.5 kg/m2), higher FLI raised the risk of AF (by 1.6-fold in 30 ≤ FLI < 60 and by twofold in FLI ≥ 60). In normal- and overweight subjects, higher FLI was associated with an increased risk of AF, but the HRs were attenuated. In obese subjects, higher FLI was not associated with higher risk of AF. NAFLD as assessed by FLI was independently associated with an increased risk of AF in nonobese subjects with BMI < 25 kg/m2. The impact of NAFLD on AF risk was accentuated in lean subjects with underweight.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Barbara Iyen ◽  
Stephen Weng ◽  
Yana Vinogradova ◽  
Ralph K. Akyea ◽  
Nadeem Qureshi ◽  
...  

Abstract Background Although obesity is a well-recognised risk factor for cardiovascular disease (CVD), the impact of long-term body mass index (BMI) changes in overweight or obese adults, on the risk of heart failure, CVD and mortality has not been quantified. Methods This population-based cohort study used routine UK primary care electronic health data linked to secondary care and death-registry records. We identified adults who were overweight or obese, free from CVD and who had repeated BMI measures. Using group-based trajectory modelling, we examined the BMI trajectories of these individuals and then determined incidence rates of CVD, heart failure and mortality associated with the different trajectories. Cox-proportional hazards regression determined hazards ratios for incident outcomes. Results 264,230 individuals (mean age 49.5 years (SD 12.7) and mean BMI 33.8 kg/m2 (SD 6.1)) were followed-up for a median duration of 10.9 years. Four BMI trajectories were identified, corresponding at baseline, with World Health Organisation BMI classifications for overweight, class-1, class-2 and class-3 obesity respectively. In all four groups, there was a small, stable upwards trajectory in BMI (mean BMI increase of 1.06 kg/m2 (± 3.8)). Compared with overweight individuals, class-3 obese individuals had hazards ratios (HR) of 3.26 (95% CI 2.98–3.57) for heart failure, HR of 2.72 (2.58–2.87) for all-cause mortality and HR of 3.31 (2.84–3.86) for CVD-related mortality, after adjusting for baseline demographic and cardiovascular risk factors. Conclusion The majority of adults who are overweight or obese retain their degree of overweight or obesity over the long term. Individuals with stable severe obesity experience the worst heart failure, CVD and mortality outcomes. These findings highlight the high cardiovascular toll exacted by continuing failure to tackle obesity.


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