Apostolos I. Tsolakis

Open versus closed surgical exposure of palatally impacted maxillary canines: comparison of the different treatment outcomes—a systematic review

Objective This study aims to compare the effectiveness of two different canine exposure techniques (open and closed) regarding periodontal outcomes, duration of surgical treatment and canines eruption, patients inconvenience, aesthetics, and orthodontic treatment complications. Search methods Electronic database searches of published and unpublished literature were performed. The reference lists of eligible studies were hand searched for additional studies. Selection criteria Randomized clinical trials (RCTs), quasi-randomized clinical trials (Q-RCTs) and non-randomized trials of prospective and retrospective design with patients of any age that compared group with palatally impacted canines treated by open exposure to a similar group treated by closed exposure technique were selected. There was not any restriction in language or year of publication. Data collection and analysis Study selection, data extraction, and risk of bias assessment were performed individually and in duplicate. Results Search strategy resulted in 159 articles and nine articles were selected for the final analysis. They were three non-randomized trials, one Q-RCT, and two reports of another Q-RCT and three reports of one RCT. The level of reported evidence was high for the RCT and one Q-RCT but poorer for the other trials. Four articles reported periodontal outcomes, three searched the duration of surgical procedure, two the duration of canine eruption, two investigated patients inconvenience, two reported on failure rates and two addressed aesthetic outcomes. The results are inconsistent and there is considerable disagreement for the majority of the outcomes among studies. Conclusion According to existing articles we may conclude that there is no difference between the two techniques regarding the periodontal outcomes and aesthetic appearance. The surgical procedure is shorter in the open exposure group and the amount of postoperative pain during the first day is similar between the open and closed surgical exposure patients. However, these conclusions are based on two single trials with high level of evidence, while the rest of the studies present high risk of bias.

Reliability of different radiographic methods for the localization of displaced maxillary canines

Introduction The purpose of this study was to evaluate the reliability of the radiographic images of the main conventional x‐ray techniques compared with the information from cone‐beam computed tomography (CBCT). Methods Twenty patients with unilateral or bilateral impaction of the maxillary canines had radiographic examinations by means of periapical x‐rays, occlusal x‐rays, panoramic x‐rays, and CBCT scans. Three experienced orthodontists examined all x‐rays from each patient and evaluated the radiographic images of the impacted canines. The examiners were asked to detect resorption in adjacent teeth and the buccal‐palatal position of the impacted canines. Agreement between examiners was statistically tested. Results Different diagnoses were produced by the 3 examiners regarding localization of the impacted canines and the presence or absence of root resorption of the adjacent teeth in conventional radiographic images. It appears that whereas panoramic x‐ray is more sensitive in detecting resorption and tooth position, occlusal and periapical imaging have higher specificity and positive predictive value. The examiners were in good or excellent agreement when occlusal and periapicals were used for the definite diagnosis of resorption and tooth position. There was no disagreement of the examiners in CBCT images, which were used as the gold standard. Conclusions Conventional radiographic methods demonstrated a more subjective diagnostic procedure compared with CBCT images. CBCT is a more accurate and precise examination method compared with conventional radiography for the localization of impacted teeth and root resorption of the adjacent teeth. HighlightsPanoramic x‐rays were more sensitive for detecting resorption and tooth position.Occlusal and periapical images had higher specificity and positive predictive value.Diagnostic procedures were more subjective for conventional radiographs than CBCT.For localizing impacted teeth, CBCT images were more accurate and precise.CBCT images were also more accurate for identifying root resorption of adjacent teeth.

Highly cited orthodontic articles from 2000 to 2015

Introduction: Identification of highly cited articles based on the h‐index and its properties is important for the evaluation of the past, present, and future of any research discipline. In this study, we aimed to identify the h‐classic articles in orthodontics. Methods: One search on the Web of Science identified all articles from 2000 to 2015 in the 89 journals indexed by the 2015 InCites Journal Citation Reports in the scientific area “dentistry, oral surgery, and medicine.” A second search was performed in the Web of Science using all mesh terms related to orthodontics. Then, we applied the h‐classic method to select the recent articles with the greatest scientific impact in orthodontics. Results: Eighty articles were considered as h‐classic articles. They were published in 20 of the 89 dental journals of the 2015 InCites Journal Citation Reports list. Only 36 articles appeared in orthodontic journals: 23 in the American Journal of Orthodontics & Dentofacial Orthopedics (28.8%), 7 in The Angle Orthodontist (8.8%), and 6 in European Journal of Orthodontics (7.5%). Thirty‐eight articles originated from Europe, 28 from the Americas, and 14 from the Middle East and Asia. Conclusions: More than half of fundamental orthodontic research is published in nonorthodontic journals showing that our field is currently limited, and interactions with other research fields should be sought to increase orthodontic research importance and appeal. HighlightsThe h‐index measures an articles or authors productivity and citation impact.The 80 most cited orthodontic articles were identified as h‐classics.More than 25% of the orthodontic h‐classics originated from U.S. universities.Scandinavian countries accounted for a third of the articles from Europe.Fewer than half of the orthodontic h‐classics were published in orthodontic journals.

Distraction-like phenomena in maxillary bone due to application of orthodontic forces in ovariectomized rats.

BACKGROUND Orthodontic forces may not only influence the dentoalveolar system, but also the adjacent and surrounding cortical bone. AIM Since there is very limited information on this issue, we aimed to study the possible changes in maxillary cortical bone following the application of heavy orthodontic forces in mature normal and osteoporotic rats. MATERIALS AND METHODS Twenty-four 6-month-old female rats were selected and divided into an ovariectomized group and a normal group. In both groups, the rats were subjected to a 60 grFNx01 orthodontic force on the upper right first molar for 14 days. RESULTS In both groups, histological sections showed that the application of this force caused hypertrophy and fatigue failure of the cortical maxillary bone. The osteogenic reaction to distraction is expressed by the formation of subperiosteal callus on the outer bony side, resembling that seen in distracted bones. CONCLUSION From this study we concluded that heavy experimental orthodontic forces in rats affect the maxillary cortical bone. The osteogenic reaction to these forces, expressed histologically by subperiosteal callus formation, is similar to that seen in distraction osteogenesis models.

The Effect of Chin-cup Therapy in Class III Malocclusion: A Systematic Review

Background: The treatment of Class III malocclusion has been challenging for orthodontists. Among a plethora of treatment modalities, the chin-cup is considered a traditional appliance for early orthopedic intervention. Objective: The present study aims to investigate the current scientific evidence regarding the effectiveness of chin-cup therapy in Class III malocclusion of prognathic growing patients. Method: A systematic review of the literature was conducted using PubMed/Medline and the Cochrane Central Register of Controlled Trials from January 1954 to October 2015. Articles were selected based on established inclusion/ exclusion criteria. Results: The search strategy resulted in 3285 articles.14 studies were selected for the final analysis. They were all CCTs, 13 of retrospective and 1 of prospective design. Methodological quality was evaluated by a risk of bias assessment, as suggested by the Cochrane Risk of Bias Assessment Tool for Non-Randomized Studies on Interventions. The reported evidence presented favorable short-term outcomes both in hard and soft tissues improving the Class III profile, as well as desirable dento-alveolar changes, positively affecting the Class III malocclusion. Conclusion: There is considerable agreement between studies that chin-cup therapy can be considered for the short-term treatment of growing patients with Class III malocclusion, as indicated by favorable changes both in the hard and soft tissues. The existence of considerable risk of bias in all selected studies and the unclear long-term effectiveness of chin-cup therapy highlight the need for further investigation to draw reliable conclusions.