Overview of systematic reviews on periodontal-orthodontic interactions: A comprehensive literature analysis.

The aims of this research were to investigate the methodological quality of systematic reviews on periodontal-orthodontic interactions (i.e. reviews of primary research broadly defined as any including both periodontic and orthodontic components) and to provide a mapping of the researched topics. We searched four major databases (PubMed, Lilacs, Web of Science, and Embase) for systematic reviews of periodontal-orthodontic interactions. We used the AMSTAR-2 tool (the acronym is derived from 'a measurement tool to assess systematic reviews') to assess the methodological quality of the included systematic reviews. Individual AMSTAR-2 ratings were tabulated, and the percentage per item was calculated. To assess the association between the AMSTAR-2 percentage score and the overall confidence in the systematic review results, an ordinal regression model was used. We initially retrieved 973 documents, and 43 systematic reviews were included. Systematic reviews of interventions were the most prevalent (n = 26, 60.5%). Most of the systematic reviews did not report a meta-analysis (n = 25, 58.1%). In addition, most of the studies included in the systematic reviews had an unclear or high risk of bias. Most of the systematic reviews were rated as having critically low or low overall confidence (n = 34, 79.1%). A significant correlation was found between the AMSTAR-2 percentage score and overall confidence in the results. The methodological quality of systematic reviews on periodontal-orthodontic interactions can be improved. The limitations of our study include potential language bias and an arbitrary classification of the topics researched.

Smile Aesthetics Assessment in Patients Undergoing the Finishing Phase of Orthodontic Treatment: An Observational Cross-Sectional Study.

Objective To describe the smile characteristics of patients entering the finishing phase of orthodontic treatment. Methods This observational study involved a non-probabilistic sample of 48 patients. Clinical records served as the basis for determining the type of treatment (with or without extractions). Photographs were analyzed to obtain smile variables. Dental casts and panoramic radiographs were evaluated to ascertain the cast-radiograph evaluation (CRE) index. Univariate and bivariate analyses were conducted at a significance level of 0.05. Results The study evaluated 24 men and 24 women, with an average age of 20.10 ± 6.78 years. Fifty percent of the patients did not undergo extractions, and the average CRE index for the sample was 34.83 ± 9.01. Regarding the smile, a medium smile line was prevalent in 66.7% of cases, and a non-consonant smile arc was observed in 58.3%. Significant differences in the smile arc were found between patients with and without extractions (p=0.019). Right and left buccal corridors measured 2.52 mm ± 1.52 and 2.43 mm ± 1.37, respectively. The upper dental midline deviated by 0.80 ± 0.91 mm and had an angulation of 1.65 ± 2.05º. Both variables showed significant differences between Class I and Class II patients (p=0.020; p=0.027). Symmetrical smiles were also observed (1.05 ± 0.17). Conclusions Based on our findings, clinicians should focus on the smile arc in patients who have not undergone extractions and on the midline inclination in Class II patients. These appear to be the most common areas for improvement in patients who are in the finishing phase of treatment. Additionally, considerable variability exists in the smile characteristics of patients still undergoing orthodontic treatment, leaving room for further enhancement of results.

Impact of COVID-19 on the future career plans of dentists.

BACKGROUND: It is important to complement the scientific literature with the data regarding the impact of the coronavirus disease 2019 (COVID-19) pandemic on the social, work and health practices as well as on the daily life of dentists, and to promote adequate public policies. OBJECTIVES: The aim of the study was to explore the impact of the COVID-19 pandemic on the career plans of dentists in Colombia. MATERIAL AND METHODS: As part of global research on the impact of COVID-19 on dentistry, a crosssectional survey was administered via digital media to dentists in Colombia. The validated questionnaire included inquiries regarding sociodemographic variables, the perception of the risk of contagion with COVID-19 and the impact of COVID-19 on the dentists' career plans. The variables were summarized in absolute and relative frequencies, and a binomial logistic regression analysis was carried out to evaluate the impact of COVID-19 on career plans according to the independent variables. RESULTS: A total of 5,370 dentists answered the survey (women: 3,878; median age: 45 years; response rate: 16.85%). Most of the dentists (96%) believed that COVID-19 infection was a risk for them and 81.96% reported that the COVID-19 pandemic had some impact on their career plans, including reducing working hours (77.96%), retiring early (26.54%) and changing their career away from dentistry (18.15%). The regression model showed that older adults (OR = 1.62; 95% CI: 1.16, 2.26), general practitioners (OR = 1.21; 95% CI: 1.02, 1.44), private practice owners (OR = 2.33; 95% CI: 1.94, 2.79), private practice associates (OR = 2.20; 95% CI: 1.84, 2.63), and those with 'very probable' risk perception (OR = 4.29; 95% CI: 1.35, 13.60) had a significantly greater chance of the pandemic having an impact on their future career plans. CONCLUSIONS: The pandemic has had a great impact on dentists' career plans. Dentists who are most fearful of the risk of contagion, those who are older and those who have their private practice are thinking about reducing working hours, retiring early or changing their career.

Biological Anchorage and Canine Orthodontic Movement Rate with a New Technique for Micro-Osteoperforations.

INTRODUCTION: The differential management of anchorage and the acceleration of tooth movement are some of the current greatest challenges for orthodontists. Diverse techniques and devices to reinforce anchorage and increase the rate of tooth movement have been proposed. Whether micro-osteoperforations (MOPs) can be used for both purposes is currently investigated. OBJECTIVES: To propose and describe a new technique for biological anchorage, which involves six MOPs performed every four weeks, and to present its results in a clinical case of upper premolar extraction. Intervention. In a dental class II patient who met the selection criteria, three MOPs both on the buccal and palatine sides on the intervention side were performed on the extraction area following the protocol described. No MOPs were performed on the control side. The allocation of the intervention was randomised. The MOPs were performed three times at an interval of four weeks. A 0.019 × 0.025-inch stainless steel wire was activated with calibrated NiTi springs. The three-dimensional movement of the first molars and upper canines was evaluated. In addition, the comfort, periodontal status, and canine root resorption of the patient were evaluated. RESULTS: Clinical and radiographic results suggest that the MOPs had a positive effect in reducing the loss of biological anchorage of the posterior sector and in the rate of canine tooth movement, without damaging changes in the soft and hard tissues. CONCLUSION: The proposed protocol involving six MOPs every four weeks improved the behaviour of biological anchorage and increased distalization on the intervention side in this clinical case.

Ventilation and air-conditioning systems in dental clinics and COVID-19: How much do we know?

BACKGROUND: This study evaluated the association between knowledge and management of ventilation and air-conditioning systems (VAC) to avoid the spread of the SARS-CoV-2 virus in health facilities by dentists and demographic variables. MATERIAL AND METHODS: A cross-sectional digital media survey was administered to dentists as part of global research. The core questionnaire was used including four additional questions on VAC (Q1: knowledge, Q2: work settings, Q3: temperature, and Q4: maintenance). A descriptive analysis was conducted for sociodemographic and VAC variables, and bivariate analysis was carried out using different tests. RESULTS: 5370 dentists answered the survey (median age of 45 years; 72.22% women). About half of the respondents said that they knew about the guidelines issued for the management of air conditioners (AC) during the pandemic, and 16.77% have made modifications to their VAC systems during this period. The most frequent AC temperature range used in the dentists' offices during the pandemic was 18°C to 20°C. As age increased, self-reported knowledge about VAC guidelines expanded. Remote and rural regions were perceived to have less knowledge of the guidelines. CONCLUSIONS: Although perceptions of knowledge about VAC systems during the COVID-19 pandemic was high, the temperature in dental offices was colder than that recommended. Greater disclosure of VAC management practices and adherence to VAC management guidelines are required. Key words:Air conditioning, dentistry, coronavirus.

Dental practice modification, protocol compliance and risk perception of dentists during COVID-19 pandemic in Colombia: a cross-sectional study / Modificación de la práctica odontológica, seguimiento a protocolos y percepción de riesgo de los odontólogos durante la pandemia de COVID-19 en Colombia: estudio de corte transversal

ABSTRACT Introduction: this study aimed to evaluate practice modification, use of personal protective equipment, biosafety measures, impact on career plans, prevalence of contagion, and risk perception of dentists during the COVID-19 pandemic 19 in Colombia. Methods: this is a cross-sectional study. Following ethical approval, an anonymous digital survey was conducted with dentists in Colombia. The questions comprised four domains: 1) sociodemographic, 2) employment and impact on career plans, 3) protocol compliance and biosafety, and 4) knowledge, risk, and contagion risk perception. A descriptive analysis of the data is presented. Results: 5,370 general and specialist dentists participated in the study (women: 3878; average age: 45 years). 41.94% were general dentists. Compliance with safety guidelines and use of personal protective equipment (PPE) was greater than 99%. The majority of dentists (91.29%) canceled their clinical activities during quarantine and have thought about reducing their working hours (77.96%). The perception of COVID-19 risk contagion was high (95.91% reported that contagion is likely/highly likely), although COVID-19 contagion self-report was low (0.61%). Conclusion: COVID-19 pandemic has strongly impacted the practice of dentistry in Colombia, leading to changes in clinical activities and career prospects. Biosafety measures compliance and PPE use was high. Although the contagion risk perception was high, self-reported contagion was very low.

Resumen Introducción: este estudio tuvo como objetivo evaluar la modificación de la práctica, uso de elementos de protección personal, protocolos de bioseguridad, afectación en los planes de carrera, prevalencia de contagio y percepción de riesgo de los odontólogos durante la pandemia de COVID-19 en Colombia. Métodos: tras obtener la aprobación ética, se aplicó una encuesta digital anónima a los odontólogos de Colombia. Las preguntas incluyeron cuatro dominios: 1) sociodemográficos, 2) laborales y afectación en los planes de carrera, 3) Seguimiento a protocolos y bioseguridad y 4) Conocimientos, riesgo y percepción de riesgo de contagio. Se presenta un análisis descriptivo de los datos. Resultados: 5370 odontólogos generales y especialistas participaron del estudio (mujeres: 3878; mediana de edad: 45 años). El 41,94% fueron odontólogos generales. La adherencia a protocolos de seguridad y el uso de elementos de protección personal (EPP) fue mayor al 99%. La mayoría de odontólogos (91,29%) suspendió sus actividades clínicas durante la cuarentena y ha pensado en disminuir sus horas de trabajo (77,96%). La percepción de riesgo de contagio de la COVID-19 fue alta (95,91% refirió que es muy probable/probable el contagio), aunque el auto-reporte de contagio por COVID-19 fue bajo (0,61%). Conclusión: la pandemia de la COVID-19 ha impactado fuertemente la práctica de la odontología en Colombia, generando cambios en las actividades clínicas y en las perspectivas de carrera. El seguimiento de protocolos de bioseguridad y de uso de EPP fue alto. Aunque la percepción de riesgo de contagio fue alta, el contagio auto-reportado fue muy bajo.

Relationship between the Dental Aesthetic Index and Discrepancy Index.

OBJECTIVE: To establish the association between malocclusion severity and orthodontic case complexity as assessed by the Dental Aesthetic Index (DAI) and the American Board of Orthodontics Discrepancy Index (ABO-DI), respectively. DESIGN: Cross-sectional study. SETTING: Pre-treatment dental casts and radiographs from 500 individuals (294 women and 206 men; mean age = 26.06 ± 11.58 years) were randomly selected from the orthodontics department of a private university. METHODS: Malocclusion severity was assessed using DAI and case complexity was evaluated with ABO-DI. Three previously calibrated operators performed the measurements. Spearman's correlation analysis, Mann-Whitney U test, Kruskal-Wallis test and a linear generalised model were used for statistical evaluation (P < 0.05 was considered significant). RESULTS: Although the correlation (r = 0.45; P < 0.0001) between malocclusion severity and case complexity was moderate, strong evidence of an association (P < 0.001) between dichotomised DAI and ABO-DI total scores was observed. The linear generalised model showed that for each point of increase in DAI score, the ABO-DI score increased an average of 0.3624 points (P < 0.0001). CONCLUSION: An association between malocclusion severity and case complexity is suggested. A linear generalised model could be used to predict the complexity of the case from the malocclusion severity (DAI score).

Systematic reviews in orthodontics: Impact of the PRISMA for Abstracts checklist on completeness of reporting.

INTRODUCTION: This study evaluated and compared the completeness of reporting of abstracts of orthodontics systematic reviews before and after the publication of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Abstracts Checklist (PRISMA-A). METHODS: Abstracts of systematic reviews and meta-analyses in orthodontics published in PubMed, Latin American and Caribbean Health Sciences Literature, and the Cochrane Database of Systematic Reviews databases before March 23, 2018, that met the predefined inclusion and exclusion criteria, were evaluated using the 12 items of PRISMA-A, scoring each item from 0 to 2. Abstracts were classified into 2 groups: before and after publication of the PRISMA-A checklist. Three calibrated evaluators (intraclass correlation coefficient and kappa > 0.8) assessed the scores for compliance with the checklist. The number of authors, country of affiliation of the first author, performance of meta-analysis, and topic of the article were recorded. A regression analysis was performed to assess the associations between abstract characteristics and the PRISMA-A scores. RESULTS: Of 1034 abstracts evaluated, 389 were included in the analysis. The mean PRISMA-A score was 53.39 (95% CI, 51.83-54.96). The overall score for studies published after the publication of the checklist was significantly higher than for studies published before (P ≤ 0.0001). The components returning significantly higher scores after publication of PRISMA-A were title (P = 0.024), information from databases (P = 0.026), risk of bias (P ≤ 0.0001), included studies (P ≤ 0.0001), synthesis of results (P ≤ 0.0001), interpretation of results (P = 0.035), financing and conflict of interest (P ≤ 0.0001), and registration (P ≤ 0.0001). These results showed the positive effect of PRISMA-A had on the quality of reporting of orthodontics systematic reviews. Nevertheless, the poor adherence revealed that there is still need for improvement in the quality of abstract reporting. CONCLUSIONS: The quality of reporting of abstracts of orthodontic systematic reviews and meta-analyses increased after the introduction of PRISMA-A.

Relationship between the occlusal and sociodemographic characteristics of patients of a latin american postgraduate program in orthodontics / Relación entre las características oclusales y sociodemográficas de los pacientes de un posgrado latinoamericano de ortodoncia

Objective: To describe and compare the occlusal characteristics, and to determine their relationship with the sociodemographic characteristics in subjects who began treatment in the Postgraduate Program in Orthodontics at the University of Antioquia (Medellín-Colombia) between 2012-2016. Materials and Methods: This descriptive study included 106 patients (14-60 years, 52 women and 54 men). A calibrated investigator (Bland Altman: <1, Kappa: ≥0.8) evaluated the discrepancy index (DI), the dental aesthetic index (DAI) and sociodemographic variables in standardized initial records. Correlations and associations between them were established. Results: The DAI mean was 35.62±12.76 and the DI mean was 20.37±13.78. The great majority of patients (92.4%) belonged to low and medium-low socioeconomic strata. Differences were observed regarding oral breathing (p=0.02) and atypical swallowing (p=0.01) indices. Discussion: Despite the severity and high complexity in the index scores, contrary to what was expected, no correlation was found between them. It seems that malocclusions do not have a particular sociodemographic characterization, with aesthetics being the main reason for consultation. Conclusions: The patients evaluated had a high degree of treatment complexity according to the DI and a high severity of malocclusion according to the DAI. No relationships were found between the indices and sociodemographic variables, except for habits of oral breathing and atypical swallowing.

Objetivo: describir y comparar las características oclusales, y determinar su relación con las características sociodemográficas en los sujetos que iniciaron tratamiento en el Posgrado de Ortodoncia de la Universidad de Antioquia (Medellín-Colombia) entre 2012-2016. Materiales y métodos: este estudio descriptivo incluyó 106 pacientes (14-60 años, 52 mujeres y 54 hombres). Un investigador calibrado (Bland Altman: <1, Kappa: ≥0.8) evaluó en las ayudas iniciales estandarizadas el índice de discrepancia (DI), el índice de estética dental (DAI) y las variables sociodemográficas en la historia clínica. Se establecieron las correlaciones y asociaciones entre ellas. Resultados: el promedio DAI fue 35,62±12,76 y el promedio DI fue 20,37±13,78. El 92,4% pertenecía a estratos socioeconómicos bajo y medio bajo. Se observaron diferencias en los índices en los pacientes con respiración oral (p=0,02) y deglución atípica (p=0,01). Discusión: a pesar de la severidad y alta complejidad reflejadas en los puntajes de los índices, contrario a lo esperado, no se encontró correlación entre estos. Parece ser que la maloclusiones no tienen una caracterización sociodemográfica, siendo la estética el motivo de consulta principal. Conclusiones: los pacientes evaluados tuvieron un alto grado de complejidad de tratamiento según el DI y una alta severidad de la maloclusión según el DAI. No se encontraron relaciones entre los índices y las variables sociodemográficas excepto para hábito de respiración oral y deglución atípica

Treatment of Class III malocclusion using Hybrid Hyrax, Face Mask and Alt-RAMEC Protocol: A Case Report in a Latin-American patient.

The management of Class III malocclusion is one of the greatest challenges of orthodontics. Current treatments offer the possibility of using direct skeletal anchorage to improve clinical outcomes. This case shows the results of using a Hyrax hybrid palatal anchorage, Alt-RAMEC (Alternate Rapid Maxillary Expansion and Contraction protocol) and a facemask to treat a maxillary hypoplasia Class III malocclusion in a Latin-American patient. The appliance design and the protocol used are widely described. Clinical and cephalometric results suggest that it is a good treatment option for this Latino patient, with moderate malocclusion and limitations in the dental anchorage. Key words:ALT-RAMEC, Angle Class III, malocclusion, maxillary expansion, mini-screws, orthodontic anchorage, TADs.

Sensitivity and Specificity of Cephalometric Measures for the Diagnosis of Sagittal Skeletal Malocclusion

Objective: To evaluate and compare sensitivity and specificity of ANB, Wits, APDI and AF-BF to diagnose sagittal skeletal malocclusions, in children between 6 to 12 years old, using ROC curves, a widely accepted method for the analysis and evaluation of diagnostic tests. Material and Methods: A descriptive-comparative study of diagnostic tests was conducted. From a population of 3,000 children, a non-probabilistic sample of 209 was selected. The clinical classification of the patients as class I, II or III, made by a group of experts based on the visual inspection of models and photographs, was chosen as the gold standard. After calibration (ICC>0.94) the variables were measured in cephalograms. Eight ROC curves were plotted (I vs II, and I vs III for each one of the variables). The area under the curve was measured and compared (Ji-square test). Cut points were established. Results: To discriminate Class I from II, ANB showed the largest area under the curve (AUC) (0.876) and the cut point (best sensitivity and specificity) was at 5.75°. To discriminate class I from III, Wits showed the largest AUC (0.874) with a cut point of -3.25 mm. There were no statistical differences between the AUC for the four variables (p=0.48 y p=0.38 for class I-II and I-III). Conclusion: ANB and Wits performed better for the diagnosis of class II and III, respectively. Cut points in children were different from those reported in adults.

Comparación de los efectos de tres enjuagues en el manejo de la mucositis oral secundaria al tratamiento de leucemia linfoblástica aguda en niños / Comparison of the effects of three mouth rinses in the management of oral mucositis secondary to the treatment of acute lymphoblastic leukemia in children

Introducción: el presente estudio se hizo con el propósito de comparar los efectos de tres enjuagues en el tratamiento de la mucositis oral secundaria al tratamiento de la leucemia linfoblástica aguda en niños en edades entre 3 y 15 años, que estaban hospitalizados en el Pabellón de Hematooncología Infantil del Hospital Universitario San Vicente de Paúl de Medellín. Métodos: se usaron tres enjuagues: triconjugado conformado por: lidocaína en gel al 2%, hidróxido de aluminio e hidróxido de magnesio con simeticona en suspensión (MylantaMR) e hidrocloruro de difenhidramina en jarabe (BenadrylMR); sucralfato constituido por sucralfato de sacarosa de aluminio en suspensión (Dip SucralfatoMR) y lidocaína en gel al 2%, y un tercer enjuague denominado control conformado por lidocaína en gel al 2%; a los tres enjuagues se les adicionó nistatina genérica (100.000 UI) en suspensión para prevenir la sobreinfección fúngica. La asignación de enjuagues fue al azar haciendo a cada paciente tres enjuagues diarios con el asignado; se hizo un registro diario de la severidad de la mucositis y la duración del episodio con el fin de establecer diferencias entre ellos. El tipo de estudio fue cuasi experimental de tipo comparativo y ciego, con una muestra de catorce casos (seis con triconjugado, cuatro con Sucralfato y cuatro de grupo control) recolectados en un periodo de 32 meses, entre abril de 2005 y noviembre de 2007. Resultados y conclusiones: no se encontraron diferencias estadísticamente significativas en la duración ni en la severidad de la mucositis que presentaron los grupos de pacientes con la utilización de los enjuagues estudiados.

Introduction: the present study was conducted to compare the effects of three mouth rinses in the treatment of oralmucositis induced by chemotherapy in children between 3 and 15 years of age, with acute lymphoblastic leukemia and who were hospitalized at the Pediatric Hemato oncology Pavilion of the San Vicente de Paul University Hospital in the city of Medellin. Methods: three mouth rinses were compared: Triconjugate diphenhydramine, milk of magnesia (magnesium hydroxide) and lidocaine in gel; Sucralfate comprising sucralfate suspended and lidocaine in gel; and a third rinse, called Control consisting of lidocaine in gel; nistatin was added to the mouth rinses to avoid fungal infection. Each group had 3 daily rinses with the assigned mouth rinse and a daily log was made with information related to the severity of mucositis and duration of the episode. The type of study was a quasi-experimental comparative blind design, the sample had 14 cases (triconjugate with 6 cases, 4 in the sucralfate group and 4 in the control group) and collection of the sample was made over a period of 32 months between April 2005 and November 2007. Results and conclusion: no statistically significant differences were found in the severity nor on the length of mucositis among the rinses used by the patients.