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Objective@#To evaluate the clinical efficacy of invisible orthodontic appliances without brackets for the distal movement of maxillary molars to improve the ability of orthodontists to predict treatment outcomes.@*Methods@#Web of Science, Cochrane Library, Embase, PubMed, Wanfang Database, CNKI Database, and VIP Database were searched for studies investigating the efficacy of invisible orthodontic appliances for distal movement of maxillary molars in adult patients and published from database inception to August 1, 2023. A total of three researchers screened the studies and evaluated their quality and conducted a meta-analysis of those that met quality standards.@*Results@#This study included 13 pre- and postcontrol trials with a total sample size of 281 patients. The meta-analysis revealed no significant differences in the sagittal or vertical parameters of the jawbone after treatment when compared with those before treatment (P>0.05). The displacement of the first molar was MD=-2.34, 95% CI (-2.83, -1.85); the displacement was MD=-0.95, 95% CI (-1.34, -0.56); and the inclination was MD=-2.51, 95% CI (-3.56, -1.46). There was a statistically significant difference in the change in sagittal, vertical, and axial tilt of the first molar before and after treatment. After treatment, the average adduction distance of the incisors was MD=-0.82, 95% CI (-1.54, -0.09), and the decrease in lip inclination was MD=-1.61, 95% CI (-2.86, -0.36); these values were significantly different from those before treatment (P<0.05).@*Conclusion@#Invisible orthodontic appliances can effectively move the upper molars in a distal direction and control the vertical position of the molars. When the molars move further away, there is some degree of compression and distal tilt movement, which is beneficial for patients with high angles. The sagittal movement of incisors is beneficial for improving the patient's profile.
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Resumen: Objetivo: Evaluar la percepción estética de la sonrisa según variación de la posición vertical y de la angulación del incisivo central superior (ICS) en estudiantes de odontología (EO) y personas comunes (PC) de las tres regiones del Perú. Materiales y Métodos: Diseño descriptivo, transversal. La muestra fueron 462 adultos, divididos en 77 para cada subgrupo de EO y PC de las regiones Lima (Costa), Junín (Sierra) y Loreto (Selva). Mediante el programa Photoshop se modificó una fotografía de sonrisa de mujer variando la posición vertical y angulación del ICS, obteniéndose imágenes que fueron evaluadas mediante la escala visual análoga. Resultados: Las PC calificaron mejor que los EO en la mayoría de las categorías (p<0,001). La sonrisa mejor valorada por EO en posición vertical fue a 1mm y 2mm; y para angulación 0°, mientras que para PC la de 1mm y de 0° respectivamente (p<0,05). Comparando por regiones los EO de Lima dieron la menor calificación para 0° con 52,63 y los de Junín la mayor para 4° con 45,90. Las PC de Loreto registraron el menor puntaje para las categorías de posición vertical (p<0,001), mientras que para angulación en Junín se calificó con un menor puntaje que en Loreto para -6° y 0°; y para 4° Lima brindó la menor calificación (p<0,001). Conclusiones: La percepción estética de la sonrisa es afectada por la variación de posición vertical y angulación del ICS en personas comunes y estudiantes de odontología en las tres regiones del Perú.
Abstract: Objective: To evaluate the esthetic perception of the smile according to the variation of the vertical position and the angulation of the upper central incisor (UPI) by dental students (DS) and common people (CP) of three regions of Peru. Materials and Methods: Descriptive cross-sectional design. The sample was 462 adults, divided into 77 for each subgroup of DS and CP of the Lima (Coast), Junín (Highlands) and Loreto (Rainforest) regions. Using the Photoshop® software, a photograph of a woman's smile was modified by varying the vertical position and angulation of the UPI, obtaining images that were evaluated using the analog visual scale. Results: The CP rated better than DS in most categories (p <0.001). The smile best valued by DS in a vertical position was 1mm and 2mm; and for angulation 0°, while for CP 1mm and 0° respectively (p <0.05). Comparing by regions, the DS of Lima gave the lowest rating for 0 ° with 52.63 and those of Junín the highest for 4° with 45.90. The PC of Loreto registered the lowest score for the vertical position categories (p <0.001), while for angulation in Junín it was rated with a lower score than in Loreto for -6 ° and 0°; and for 4° Lima provided the lowest rating (p <0.001). Conclusions: The esthetic perception of the smile is affected by the variation of vertical position and angulation of the ICS in common people and dental students in the three regions of Peru.
Sujets)
Humains , Mâle , Femelle , Adulte , Sourire/physiologie , Dimension verticale , Pérou , EsthétiqueRésumé
Resumen Introducción y Objetivo: La impactación de terceros molares es una situación clínica muy común en la población mundial; Pell & Gregory han sugerido una clasificación para la impactación basados en la posición horizontal y vertical. Identificar la frecuencia de posiciones de terceros molares impactados en pacientes atendidos en la clínica CES-Sabaneta entre los años 2006-2016. Materiales y métodos: De acuerdo a la base de datos del servicio de cirugía oral, dos examinadores durante 3 meses revisaron 626 historias clínicas en pacientes entre 17 a 28 años de edad que tuvieran formula dental completa, con radiografía panorámica y que fueron remitidos por motivos ortodónticos, restaurativos o quirúrgicos. Resultados: Un total de 515 terceros molares fueron evaluados, el tercer molar más impactado fue el 28 (25,6%), seguido del 18 (25,4%), el 48 con 24,6% y el 38 con 24,2%. Prevaleció el género femenino con 58,6%, el diente más impactado fue el 28 (87.8%), a nivel vertical la posición C fue la que más se impactó, mientras que en los hombres el diente más impactado es el 18 con un 79.7%, la posición B fue la más impactada y a nivel horizontal la clase II fue la más común en ambos sexos. Conclusión: A nivel vertical la posición B, fue la más frecuente en los terceros molares del género femenino, sin embargo, en el género masculino hubo una variación, en el maxilar predomino la posición C; a nivel horizontal la clase II fue las posiciones más frecuentes en ambos géneros.
Abstract Introduction and objective: The Impaction of third molars is a very common clinical situation in the world population; Pell & Gregory have suggested a classification for impaction based on horizontal and vertical position. To identify the frequency of impacted third molar positions in patients treated at the CES-Sabaneta clinic between the years 2006-2016. Materials and methods: According to the oral surgery service database, two examiners during 3 months reviewed 626 clinical histories in patients between 17 and 28 years of ages who had complete dental formula, with panoramic radiography and who were remitted for reasons orthodontic, restorative or surgical. Results: A total of 515 third molars were evaluated, the third most impacted molar was 28 (25.6%), followed by 18 (25.4%), 48 with 24.6% and 38 with 24.2%. %. The female gender prevailed with 58.6%. The most impacted tooth was 28 (87.8%). At the vertical level, position C was the most impacted, while in men the most impacted tooth is 18 with a 79.7. %, position B was the most impacted and at the horizontal level class II was the most common in both sex. Conclusions: At the vertical level, position B was the most frequent in the third molars of the female gender, however in the male gender there was a variation, in the maxillary the position C predominated; A horizontal level class II was the most frequent positions in both sex.
Sumário Introdução e Objetivo: O impacto dos terceiros molares é uma situação clínica muito comum na população mundial; Pell & Gregory sugeriram uma classificação para o impacto com base na posição horizontal e vertical. Identifique a frequência de comprometimento das posições dos terceiros molares em pacientes tratados na clínica CES-Sabaneta entre 2006-2016. Materiais e métodos: Segundo o banco de dados do serviço de cirurgia oral, dois examinadores, durante 3 meses, revisaram 626 prontuários em pacientes entre 17 e 28 anos de idade que possuíam fórmula dental completa, com radiografia panorâmica e foram encaminhados por motivos ortodôntico, restaurador ou cirúrgico. Resultados: Foram avaliados 515 terceiros molares, o terceiro molar mais impactado foi 28 (25,6%), seguido por 18 (25,4%), 48 com 24,6% e 38 com 24,2 % O sexo feminino prevaleceu com 58,6%, o dente mais impactado foi 28 (87,8%), no nível vertical a posição C foi a mais impactada, enquanto nos homens o dente mais impactado é 18 com 79,7%. %, posição B foi a mais impactada e horizontalmente a classe II foi a mais comum em ambos os sexos. Conclusão: No nível vertical, a posição B foi a mais frequente nos terceiros molares do sexo feminino, no entanto, no sexo masculino houve variação, na posição maxilar C predominou; horizontalmente, a classe II foi a posição mais frequente em ambos os sexos.
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Objective To explore the clinical effect of free postnatal delivery in the second stage of labor, and to provide evidence for clinical midwifery. Methods From March 2016 to November 2017, 120 maternity patients from the First People′s Hospital of Hefei were selected and divided into research group and control group, using simple random grouping and the method of random number table, with 60 cases in each group. At the second stage of delivery, the research group used free body position at different stages, while the control group took the position of supine bladder lithotomy position. The delivery outcome, duration of the second stage, postpartum vaginal bleeding within two hours, newborn asphyxia rate, degree of perineal laceration, perineum incision rate, delivery comfort and satisfaction and midwives job satisfaction were compared. Results The vaginal delivery rate of the research group was 96.7％(58/60), which was higher than that of the control group 86.7％ (52/60). The difference was statistically significant (χ2=3.93, P<0.05). The duration of the second stage in the research group was (31.97 ± 9.85) minutes, and that of the control group was (39.50 ± 12.19) minutes. There was a statistically significant difference between the two groups (t=-3.357, P<0.05). There was no significant difference in neonatal asphyxia rate and the amount of postpartum vaginal bleeding within 2 hours between the two groups (P>0.05). The perineum integrity rate in the research group was 10.4％(6/58), higher than that in the control group, which was 0. Perineal side cut rate in the research group was 0, lower than that in the control group, which was 21.1％(11/52). The difference was statistically significant (χ2=11.31, 13.63, P<0.05). Deliverycomfort, delivery satisfaction and midwives job satisfaction in the research group were 91.7％ (55/60), 100.0％ (60/60) and 100.0％ (60/60) respectively, while delivery comfort, delivery satisfaction and midwives job satisfaction in the control group were 38.3％(23/60), 83.3％(50/60) and 76.7％(46/60). The differences were statistically significant (χ2=37.51, 10.91, 15.85, P<0.05). Conclusion The second labor stage free position is effective safe childbirth way of delivery, which can improve the natural births, shorten the labor, lighten the perineal injury, improve the puerpera childbirth comfort and satisfaction, it also raised the midwives job satisfaction, and had no adverse effect on maternal and infant outcomes, so the method has clinical application and dissemination value.
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OBJECTIVES: to evaluate the vertical position adopted by nulliparous women during labor in terms of pain and satisfaction with the position. METHODS: the study was based on a secondary efficacy analysis of data from 107 nulliparous women enrolled in a randomized controlled trial in which the vertical position adopted during the dilation phase of labor was evaluated. The analysis involved comparing the median percentages of the duration for which women remained in the vertical position for each of the variables studied . The Kruskal-Wallis and Mann-Whitney tests were used to determine the difference s betwee n th e groups. Statistical significance was set at p<0.05. RESULTS: at 4cm of dilation , the women with a pain score < 5 remained longer in the vertical position during labor compared to those with a score > 7 (p=0.02) . At 4 and 6 cm of dilation , the women who reported greater satisfaction remained more than 50 percent of the time in the vertical position (p=0.0 2 an d p=0.03 , respectively). CONCLUSIONS: the vertical position helped relieve labor pain and increased comfort and patient satisfaction.
OBJETIVOS: avaliar a posição vertical , adotada por mulheres nulíparas durante o trabalho de parto , em relação à dor e satisfação com a posição. MÉTODOS: abordagem analítica distinta, complementar e de eficácia de 107 nulíparas, secundária aos dados de um ensaio controlado randomizado, que avaliou a posição vertical em nulíparas durante a fase de dilatação do trabalho de parto. A análise foi realizada pela comparação das porcentagens medianas do tempo de permanência na posição vertical para cada categoria das variáveis estudadas. Para testar as diferenças entre as variáveis foram utilizados os testes de Kruskal-Wallis e de Mann-Whitney. A significância foi estabelecida em p<0.05. RESULTADOS: aos 4 cm de dilatação , as mulheres que apresentaram escore de dor < 5 permaneceram maior tempo do trabalho de parto na posição vertical quando comparadas às que tiveram escore > 7 (p=0.02). As mulheres mais satisfeitas, aos 4 e 6 cm de dilatação, permaneceram mais de 50 por cento do tempo na posição vertical (p=0.0 2 e p=0.03, respectivamente). CONCLUSÕES: a posição vertical auxiliou no alívio da dor , melhorou o conforto e satisfação das parturientes.