Third molar agenesis in individuals with supernumerary teeth.

OBJECTIVES: To explore the association between third molar agenesis and supernumerary tooth formation in a white-European population. MATERIALS AND METHODS: A record review in various orthodontic clinics identified 380 eligible white-European individuals, half of whom had non-syndromic permanent supernumerary teeth (122 males and 68 females, totalling 244 supernumerary teeth; median age: 13.1, iqr: 1.5 years), and the other half were age- and sex-matched controls with full dentition, excluding the third molars. Tooth sequences were identified in panoramic radiographs. RESULTS: In the supernumerary group, approximately 80% of the individuals had a single supernumerary tooth, followed by those having two additional teeth. In both groups, there was no sexual dimorphism in third molar agenesis severity. The prevalence of third molar agenesis in the supernumerary group was similar to that of the control group (28/190 = 14.7% in both groups; p = 1.0). In total, 53 third molars were missing in the supernumerary group (n = 190) compared to 67 in the control group (n = 190; p = .862). The ratio of bilateral to unilateral third molar agenesis was significantly lower in the supernumerary group than in the control group (1.0 vs. 3.7, respectively; p = .026). CONCLUSION: The presence of supernumerary teeth did not significantly alter the likelihood of third molar agenesis or its severity. Bilateral third molar agenesis was considerably less prevalent in individuals with supernumerary teeth compared to controls. The present novel findings have important clinical and developmental implications.

Supernumerary Tooth Patterns in Non-Syndromic White European Subjects.

Supernumerary teeth form at an incidence of about 3% in the population, with differences among races and various clinical consequences. Information on detailed patterns, and especially on white subjects, is scarce in the literature. Therefore, we aimed to investigate the patterns of non-syndromic permanent supernumerary teeth in a white European population. A record review was performed in different orthodontic clinics and identified 207 eligible individuals with 258 supernumerary teeth. Approximately 80% of the subjects had one supernumerary tooth, while 15% had two. Supernumerary tooth formation was more often evident in males (male/female: 1.65). However, there was no sexual dimorphism in its severity. The following pattern sequences, with decreasing prevalence order, were observed in the maxilla: 21 > 11 > 12 > 18 > 28 and in the mandible: 34 > 44 > 35 > 45 > 42. Supernumerary teeth were most often unilaterally present, without sexual dimorphism. In the maxilla, they were more often anteriorly present, whereas in the mandible, an opposite tendency was observed. Supernumerary teeth were consistently more often observed in the maxilla than in the mandible; 74% were impacted, 80% had normal orientation (13% horizontal, 7% inverted), and 53% had normal size. The present thorough supernumerary tooth pattern assessment enables a better understanding of this condition with clinical, developmental, and evolutionary implications.

Long-term effectiveness of non-surgical open-bite treatment: a systematic review and meta-analysis.

BACKGROUND: The etiology of open bite is complex, involving various genetic or environmental factors. Several treatment alternatives have been suggested for the correction of open bite, yet their long-term effectiveness remains controversial. OBJECTIVE: To assess the long-term effectiveness of open-bite treatment in treated with non-surgical approaches versus untreated patients, through lateral cephalometric radiographs. SEARCH METHODS: Unrestricted search of 16 electronic databases and manual searches up to November 2022. SELECTION CRITERIA: Randomized or non-randomized controlled trials reporting on the long-term effects of open-bite treatment through angular lateral cephalometric variables. DATA COLLECTION AND ANALYSIS: Only angular variables on lateral cephalometric radiographs were considered as primary outcomes. For each outcome, the mean differences and 95% confidence intervals were calculated using the random-effects model to consider existing heterogeneity. The revised Cochrane risk-of-bias tool (R.o.B. 2.0) and the risk-of-bias tool for non-randomized studies for interventions (ROBINS-I) were utilized for the randomized and non-randomized trials, respectively. RESULTS: From the initially identified 26,527 hits, only 6 studies (1 randomized and 5 retrospective controlled trials) were finally included in this systematic review reporting on 244 open-bite individuals (134 patients and 110 untreated controls), while five of them were included in the meta-analyses, assessing either the interval ranging from treatment start to post-retention (T3-T1) or from end of treatment to post-retention period (T3-T2). Regarding the vertical plane, for the T3-T2 interval, no significant differences were found for the assessed skeletal measurements, indicating a relative stability of the treatment results. Similarly, with regard to the T3-T1 interval, no significant differences could be identified for the examined skeletal variables, implying that the produced effects are rather minimal and that the correction of the open bite was performed mainly through dentoalveolar rather than skeletal changes. Further, no significant changes could be identified regarding the inclination of the upper and lower incisors. Only the nasolabial angle was significantly reduced in the treated patients in the long term. CONCLUSIONS: According to existing evidence, the influence of non-surgical treatment of open bite on the skeletal tissues and the inclination of the incisors is rather minimal in the long term, while only the nasolabial angle was significantly reduced.

Assisted reproduction technology outcomes in women with infertility and preexisting diabetes mellitus: a systematic review.

OBJECTIVE: To assess maternal and neonatal outcomes in women with or without preexisting diabetes mellitus (DM) undergoing assisted reproduction technology (ART) treatment. METHODS: Prospective or retrospective controlled trials reporting on women with or without preexisting DM undergoing ART treatment were considered eligible. Twelve electronic databases were systematically searched up to December 2020. The risk of bias was assessed by the Cochrane Risk OF Bias In Non-randomized Studies of Interventions (ROBINS-I) tool. Each primary outcome was extracted and pooled as maternal- or neonatal-related. RESULTS: Two studies were included in the systematic review, reporting on both maternal- and neonatal-related parameters after ART treatment. Due to the limited data, no meta-analysis was conducted. Preterm birth, placenta previa, and excessive bleeding during pregnancy were observed more often in pregnancies complicated by preexisting DM conceived by ART compared with pregnancies without DM. There was no difference in the risk for placental abruption between the groups. Regarding the neonatal outcomes, large-for-gestational-age (LGA) embryos and neonatal intensive care unit (NICU) admission were more commonly reported for women with preexisting DM. In one study, preexisting DM was marginally associated with infant mortality. CONCLUSIONS: Despite the scarce data, preexisting DM in pregnancies conceived by ART is associated with increased risk for maternal and neonatal complications. TRIAL REGISTRATION: Registered in PROSPERO (registration number: 143187).

Effects of systematic bisphosphonate use in patients under orthodontic treatment: a systematic review.

BACKGROUND: Bisphosphonates are a class of drugs prescribed for several osseous related disorders owing to their ability to regulate bone turnover, which could in turn affect orthodontic treatment outcomes. OBJECTIVE: To examine the effect of bisphosphonate (BP) use on orthodontic patients through clinical and radiographic measurements. SEARCH METHODS: Systematic and unrestricted search of 17 databases complemented with additional hand-searches were performed up to March 2019. SELECTION CRITERIA: Articles reporting on human patients with a history of BPs administration that received orthodontic treatment were eligible for inclusion. DATA COLLECTION AND ANALYSIS: Data regarding the medical profile of the patients, the specific type of malocclusion and the performed treatment plan, as well as the clinical and radiographic outcomes were extracted. Quality assessment was performed by the ROBINS-I tool for the cohort studies and by a slightly modified checklist from the original one proposed by Agbabiaka et al. for the case reports. RESULTS: 7 articles (1 retrospective cohort study and 6 case reports) were eventually included in the present review including 122 subjects (29 patients and 93 controls) reporting on the clinical and radiographic changes following orthodontic treatment of patients during or after BPs use. BPs seem to have a controversial effect on the clinical and patient-reported variables, even though the majority of the included patients presented with compromised treatment results and a rather slow rate of tooth movement. Most radiographic findings revealed mild root resorption, widened periodontal ligament spaces and sclerotic changes on the surrounding alveolar bone. However, these results should be interpreted with caution, due to the limited number of the eligible articles and their limitations. LIMITATIONS: The included studies were of rather low quality due to study design and incomplete reporting. CONCLUSIONS AND IMPLICATIONS: BP administration seems to be associated with compromised clinical outcomes, prolonged treatment time, and moderate changes on the roots and surrounding tissues of orthodontic patients. REGISTRATION: Non-registered. FUNDING: None.

Treatment effects of fixed functional appliances in patients with Class II malocclusion: a systematic review and meta-analysis.

OBJECTIVE: To assess the treatment effects of fixed functional appliances (FFAs) in treated versus untreated Class II patients by means of lateral cephalometric radiographs. SEARCH METHODS: Unrestricted electronic search of 18 databases and additional manual searches up to October 2014. SELECTION CRITERIA: Prospective randomized and non-randomized controlled trials reporting on cephalometric angular measurements of Class II patients treated with FFAs and their matched untreated controls. DATA COLLECTION AND ANALYSIS: Skeletal, dental, and soft tissue cephalometric data were annualized and stratified according to the time of evaluation in effects. Following risk of bias evaluation, the mean differences (MDs) and 95 % confidence intervals (CIs) were calculated with random-effects models. Patient- and appliance-related subgroup analyses and sensitivity analyses were performed with mixed-effects models. RESULTS: Nine studies were included (244 patients; mean age: 13.5 years and 174 untreated controls; mean age: 12.8 years) reporting on cephalometric effects directly after the removal of FFAs. FFAs were found to induce a small reduction of SNA angle (MD = -0.83 degree/year, 95 % CI: -1.17 to -0.48), a small increase of SNB angle (MD = 0.87 degree/year, 95 % CI: 0.30-1.43), and moderate decrease of ANB angle (MD = -1.74 degree/year, 95 % CI: -2.50 to -0.98) compared to untreated Class II patients. FFA treatment resulted in significant dentoalveolar and soft tissue changes. Several patient- or appliance-related factors seem to affect the treatment outcome. Long-term effectiveness of FFAs could not be assessed due to limited evidence. CONCLUSIONS: According to existing evidence, FFAs seem to be effective in improving Class II malocclusion in the short term, although their effects seem to be mainly dentoalveolar rather than skeletal.

Treatment effects of removable functional appliances in patients with Class II malocclusion: a systematic review and meta-analysis.

OBJECTIVE: To assess the treatment effects of removable functional appliances (RFAs) in treated versus untreated patients with Class II malocclusion by means of lateral cephalometric radiographs. SEARCH METHODS: Unrestricted electronic search of 18 databases and manual searches up to October 2013. SELECTION CRITERIA: Prospective randomized and non-randomized controlled trials reporting on cephalometric angular measurements of Class II patients treated with RFAs and their matched controls. DATA COLLECTION AND ANALYSIS: Skeletal, dental, and soft tissue changes were annualized and stratified to short- and long-term effects. Methodological limitations were evaluated with the Cochrane Risk of Bias tool and the Downs and Black checklist. Mean differences (MDs) with their 95% confidence intervals (CIs) were calculated from random-effects meta-analyses. Patient- or appliance-related subgroup analyses and sensitivity analyses were performed with mixed-effects models. RESULTS: Seventeen studies were included (1031 patients; mean age: 10.6 years), with most of them originating from university clinics and reporting short-term effects (directly after the removal of RFAs). Treatment was associated with minimal reduction of SNA angle (11 studies, MD = -0.28 degree/year, 95% CI: -0.44 to -0.12 degree/year), minimal increase of SNB angle (11 studies, MD = 0.62 degree/year, 95% CI: 0.36-0.88 degree/year), and small decrease of ANB angle (10 studies, MD = -1.14 degree/year, 95% CI: -1.52 to -0.77 degree/year) compared to untreated Class II patients. RFAs caused significant dentoalveolar changes (predominantly retroclination of the upper incisors) and significant soft tissue changes. Skeletal changes were more pronounced with the Twin Block appliance. Various patient- or appliance-related factors influenced the results of the subgroup analyses, while the sensitivity analyses indicated robustness. Existing evidence was inadequate to assess the long-term effectiveness of RFAs. CONCLUSIONS: The short-term evidence indicates that RFAs are effective in improving Class II malocclusion, although their effects are mainly dentoalveolar, rather than skeletal.