Effects of non-nutritive sucking habits on malocclusions: a systematic review.

The development of the craniomandibular system is guided by genetic interactions and environmental factors, including specific habits such as breastfeeding, bottle feeding, thumb sucking and the use of pacifiers. These habits can have a considerable impact on the growth of the developing jaws and can lead to malocclusion in children. This review aims to investigate potential associations between non-nutritive sucking habits (NNSHs) and malocclusions compared to the presence of nutritive sucking habits (NSHs). To carry out this systematic review, we followed the PRISMA protocol and performed a bibliographic search of the existing literature until April 2023 in the following electronic databases: Medline, PubMed, The Cochrane Library and Embase. Out of a total of 153 records, we included 21 studies. We found that the chances of diagnosing a malocclusion were higher for children with bottle nutrition when compared to breast-fed children. Breastfeeding provides protection against malocclusions. In the same manner, persistent NNSH habits appeared to be associated with increased chances of having malocclusions. The longer the child was breastfed, the shorter the duration of the pacifier habit and the lower the risk of developing moderate/severe malocclusions. The duration of the habits has a positive influence on the appearance of occlusion defects.

Are multi-detector computed tomography and cone-beam computed tomography exams and software accurate to measure the upper airway? A systematic review.

BACKGROUND: Cone-beam computed tomography (CBCT) has several applications in various fields of dental medicine such as diagnosis and treatment planning. When compared to computed tomography (CT), CBCT's radiation exposure dose is decreased by 3%-20%. However, CBCT produces more scattered signals and may present poorer image quality when compared to medical CT. OBJECTIVES: To review the findings regarding the accuracy of multi-detector computed tomography (MDCT) and CBCT and to compare the different software programs that segment the upper airway. SEARCH METHODS: Three databases (PubMed, Medline, and Web of Science) were searched for articles and a manual search was performed. SELECTION CRITERIA: The inclusion criteria were defined following the PICO framework: P-any patient with a CBCT or CT; I-dimensional evaluation of the upper airway using MDCT or CBCT; C-phantoms; O-the primary outcome was MDCT and CBCT accuracy, the secondary outcome was the evaluation and comparison of software programs used to segment the upper airway. DATA COLLECTION AND ANALYSIS: Articles that met eligibility criteria were assessed using the Critical Appraisal Skills Program Checklist. RESULTS: Among the 16 eligible studies, 6 articles referred to the accuracy of MDCTs or CBCTs and 10 to the accuracy of the software. Most articles were qualified as high quality. CONCLUSIONS: MDCT and CBCT scans' accuracy in upper airway dimensional measurements depends on machine brand, parameters, and segmentation technique. Regarding the segmentation technique, 12 programs were studied. Most either underestimated or overestimated upper airway measurements. In particular, OnDemand3D and INVIVO showed poor accuracy. On the contrary, Invesalius, and MIMICS were accurate in assessing nasal cavities when using an interactive threshold. However, results varied due to methodological differences among the studies. Finally, fully automatic segmentation based on artificial intelligence may represent the future of airway segmentation because it is faster and seems to be accurate. However, further studies are necessary. REGISTRATION: This study was registered in Prospero (International Prospective Register of Systematic Reviews) with the ID number CRD42022373998.

Prevalence of Tooth Transposition among Orthodontic Patients in Spain.

Objectives: The aim of this retrospective study was to analyze the prevalence of tooth transposition within an orthodontic population and explore its correlation with facial biotype, skeletal class and sex. Material and methods: This study examined a sample of 2,500 initial orthodontic records from consecutive orthodontic patients who received treatment at the Master Universitario de Orthodontia (Madrid, Spain) between 2014 and 2023. Patients exhibiting incomplete or poor-quality medical records were excluded from the study. The chi-square test was used to assess variations in distribution based on facial biotype, skeletal class and sex. A p-value of < 0.05 was considered statistically significant. Results: The study findings revealed a tooth transposition prevalence rate of 0.28%. No significant differences in prevalence were observed based on sex or facial biotype, but the prevalence of transposition was found to be higher among class I patients (p < 0.05). Conclusion: The prevalence of tooth transposition among orthodontic patients is relatively low (0.28%). However, it is more commonly observed among patients with skeletal class I malocclusion.

Comparison of screening methods for obstructive sleep apnea in the context of dental clinics: A systematic review.

OBJECTIVE: To review the available bibliographic data to identify the best screening methods to detect potential obstructive sleep apnea (OSA) patients during dental clinical practice. METHODS: Relevant studies published up to April 2020 were sourced from PubMed, Embase, MEDLINE, Cochrane, and LILACS databases. RESULTS: Thirty studies were selected. For adults, the screening methods available to the dentist included questionnaires, scales, indexes, pulse oximetry, and anatomical factors. A combination of questionnaires is potentially the most reliable method to detect OSA risk. For children, only information on questionnaires and anatomical factors was found; two questionnaires accurately identified potential OSA risk cases. Anatomical factors also displayed a significant relation with OSA for both populations. CONCLUSION: Dentists have a fundamental role in early detection of potential OSA cases since they can use the methods identified in this review to perform an initial screening of the population. ABBREVIATIONS: OSA: Obstructive sleep apnea; PSG: Polysomnography; HST: Home sleep study; BMI: Body mass index; PPV: Positive predictive value; NPV: Negative predictive value; AHI: Apnea hypopnea index; RDI: Respiratory disturbance index; ODI: Oxygen desaturation index; PSQ: Pediatric Sleep Questionnaire; SRBD: Sleep-related breathing disorder; CSHQ: Children's Sleep Habits Questionnaire; ESS: Epworth Sleepiness Scale; PSQI: Pittsburgh Sleep Quality Index.

Combined Surgical and Orthodontic Treatments in Children with OSA: A Systematic Review.

Obstructive sleep apnea (OSA) is a sleeping breathing disorder. In children, adenotonsillar hypertrophy remains the main anatomical risk factor of OSA. The aim of this study was to assess the current scientific data and to systematically summarize the evidence for the efficiency of adenotonsillectomy (AT) and orthodontic treatment (i.e., rapid maxillary expansion (RME) and mandibular advancement (MA)) in the treatment of pediatric OSA. A literature search was conducted in several databases, including PubMed, Embase, Medline, Cochrane and LILACS up to 5th April 2020. The initial search yielded 509 articles, with 10 articles being identified as eligible after screening. AT and orthodontic treatment were more effective together than separately to cure OSA in pediatric patients. There was a greater decrease in apnea hypoapnea index (AHI) and respiratory disturbance index (RDI), and a major increase in the lowest oxygen saturation and the oxygen desaturation index (ODI) after undergoing both treatments. Nevertheless, the reappearance of OSA could occur several years after reporting adequate treatment. In order to avoid recurrence, myofunctional therapy (MT) could be recommended as a follow-up. However, further studies with good clinical evidence are required to confirm this finding.