Clinical effectiveness of chin cup treatment for the management of Class III malocclusion in pre-pubertal patients: a systematic review and meta-analysis.

BACKGROUND: Chin cup is regarded as the oldest orthodontic appliance for the management of Class III malocclusion. To assess its clinical effectiveness in pre-pubertal patients, a meta-analysis on specific cephalometric values is attempted. METHODS: Detailed electronic and hand searches with no restrictions were performed up to July 2014. Only randomized controlled trials (RCTs) and cohort studies, i.e. prospective controlled trials (pCCTs) and (retrospective) observational studies (OS), were included. Analyses were performed by calculating the standard difference in means and the corresponding 95% confidence intervals, using the random effects model. Data heterogeneity and risk of bias assessment of the included studies were also performed. Study selection, data extraction and risk of bias assessment were performed twice. The level of significance was set at P ≤ 0.05 for all tests, except for heterogeneity (P ≤ 0.1). RESULTS: Seven treated groups from five studies (no RCTs, four pCCTs, one OS) were eligible for inclusion, assessing only the short-term occipital pull chin cup effects. In total, 120 treated patients (mean age: 8.5 to 11 years) compared with 64 untreated individuals (mean age: 7.3 to 9.89 years) were assessed by means of 13 cephalometric variables. The overall quality of these studies was low to medium. In comparison to untreated individuals, the SNB and gonial angles decreased significantly following chin cup use, whereas ANB, Wits appraisal, SN-ML, N-Me and overjet increased. For the rest of the variables, no statistically significant differences were detected. CONCLUSIONS: Although the occipital chin cup affects significantly a number of skeletal and dentoalveolar cephalometric variables, indicating an overall positive effect for the treatment of Class III malocclusion, data heterogeneity and between-studies variance impose precaution in the interpretation of the results.

Prevalence of tooth transposition. A meta-analysis.

OBJECTIVE: To synthesize currently existing data and investigate the prevalence of tooth transposition as well as its relation to gender, dental arch, and quadrant occurrence. MATERIALS AND METHODS: Several electronic databases were searched in order to identify the potentially relevant studies. Initially, 591 papers were retrieved. After applying specific inclusion and exclusion criteria, nine studies were eligible for inclusion in this evaluation. Meta-analysis was performed by determining the event rate and the 95% confidence intervals estimated by the random effect model. RESULTS: Analysis of the data of the primary studies revealed that tooth transposition has a mean prevalence of 0.33%. This prevalence seems to be the same between the two genders. However, tooth transposition appears more frequently in the maxilla than in the mandible and more unilaterally than bilaterally. CONCLUSION: Tooth transposition is a rare phenomenon that affects various populations, including across genders, in a similar manner. Some maxillary predisposition exists, and its unilateral occurrence is higher than that of bilateral.

Handling post-dental extraction patients: how to avoid trans-infection of blood-borne diseases.

PURPOSE: The aim of this study is to assess the risks of cross infection after dental extraction. A systematic approach is proposed to prevent the risks of cross contamination and infection. MATERIALS AND METHODS: A survey was conducted in which patients were asked when and where they disposed of the gauze pad applied to the socket in their mouth postoperatively and whether they had touched it at all before throwing it away. RESULTS: Of the patients, 40% threw the gauze pad in the roads' litter bins and 9.33% threw it away in the practice's bathroom; half of the patients declared that they had touched the gauze pad with their bare hands before its final removal. CONCLUSIONS: The danger of trans-infection of blood-borne diseases is evident, and a series of measures is proposed to control it. Proper patient education, use of alternative methods of stopping postoperative bleeding other than a gauze pad, appropriate scheduling of appointments of already infected patients, and widespread vaccinations are some such measures. Attention and critical evaluation of the case are necessary because the already existing policies and guidelines are always open to improvements.

Assessment of characteristic features and dental anomalies accompanying tooth transposition: a meta-analysis.

INTRODUCTION: The aim of this study was to investigate possible characteristic features and dental anomalies that accompany tooth transposition. METHODS: Several electronic databases were searched. Hand searching was also performed to identify potentially relevant studies. Initially, 409 articles were retrieved (399 by electronic searching, 10 by hand searching). After applying specific exclusion criteria, 5 studies were eligible for this meta-analysis. Meta-analysis was performed by determining the marginal mean proportions and the 95% confidence intervals estimated by the random-effect model. Evaluation of heterogeneity was also done with Q and I(2) statistics. RESULTS: The lack of high-validity studies of the characteristic features and dental anomalies of tooth transposition was noted. The analysis of the data of the studies showed that tooth transposition seems to occur more often unilaterally than bilaterally, with maxillary prevalence and no sex preference, and it is significantly unrelated to dental anomalies, such as congenitally missing teeth, peg-shaped or hypoplastic teeth, or impacted teeth. There might be an association with overretained deciduous teeth. CONCLUSIONS: Tooth transposition is an isolated phenomenon rather than a syndrome. It occasionally can be accompanied by other characteristic features and dental anomalies, but without distinct associations.