Camila Alessandra Pazzini

Is there justification for prophylactic extraction of third molars? A systematic review

The present systematic review was performed to investigate if there is evidence justifying the prophylactic extraction of third molars, one of the most frequent procedures in oral surgery. A series of searches was carried out for randomized, clinical trials and systematic reviews in seven databases (MEDLINE, BBO, LILACS, Web of Science, EMBASE, BIREME and Cochrane Library), with no restrictions regarding year or language. A supplemental manual search of the references of retrieved articles was also performed. The search strategy resulted in 260 papers. Both the data extracted and the quality of each paper were evaluated independently by two reviewers. After selection based on the preestablished eligibility criteria, four papers qualified for the final analysis. A medium degree of quality and methodological consistency was found in three studies, and low quality was found in one study. No studies showed a high degree of consistency. The most significant flaw was an inadequate sample size. The results of the present review indicate a lack of scientific evidence to justify the indication of the prophylactic extraction of third molars.

Prevalence of Nickel Allergy and Longitudinal Evaluation of Periodontal Abnormalities in Orthodontic Allergic Patients

OBJECTIVE To determine the prevalence of nickel allergy in a sample of orthodontic patients and longitudinally compare the clinical periodontal status of these individuals with that of a group of nonallergic patients. MATERIALS AND METHODS The initial sample consisted of 96 patients selected randomly from a databank of patients who sought orthodontic care at a teaching institution. Following the selection and beginning of treatment, periodontal status was assessed over a 12-month period (one evaluation every 3 months-T(1), T(2,) T(3,) T(4)) using the Loe index. The evaluations were performed blindly by a single, calibrated examiner and were followed by prophylaxis and orientation regarding oral hygiene. The prevalence of nickel allergy was determined by the patch test 9 months after the beginning of treatment and occurred in 16 individuals (17.2%). Two groups were then established: the allergic group (AG, n = 16) and the age-paired nonallergic control group (NAG, n = 16). Data were analyzed using the Mann-Whitney U-test and Friedmans analysis of variance (ANOVA) tests (P < or = .05). RESULTS Significant differences were present between groups at the T(3) and T(4) evaluations for the LOE index (P = .045 and .009), with allergic individuals showing higher mean values than nonallergic individuals (hyperplasia, change in color, and bleeding). No significant differences were found in the intragroup evaluations between the four evaluations (P > .05). CONCLUSIONS The results suggest a cumulative effect from nickel throughout orthodontic treatment associated with clinically significant periodontal abnormalities in allergic individuals over time.

Short-root anomaly in an orthodontic patient

Short-root anomaly is a rare condition, but it can be a problem for orthodontists and their patients. Our aim in this article was to report the treatment of an orthodontic patient with short-root anomaly, highlighting the diagnostic aspects involved and the strategy used.

Probiotic consumption decreases the number of osteoclasts during orthodontic movement in mice

AIMS The aim of the present study was to investigate the effect of probiotic (Bacillus Subtilis) supplementation on bone remodelling induced by mechanical loading. METHODS C57BL/6 mice were divided in two groups: (1) Probiotic and (2) Vehicle (water). The probiotic (1.5×108CFU/mL) was administered orally for 14 days, starting two days before the induction of orthodontic tooth movement (OTM). OTM was determined by histomorphometric analysis by comparing the right to the left side of the maxilla. The number of osteoclasts was determined by counting TRAP-positive cells. Osteoblasts were counted on Massons trichrome-stained slides. RESULTS OTM was similar between groups (with and without probiotic supplementation) (p=0.46). The number of TRAP-positive cells increased (p<0.01) on the experimental side (where the spring coil was installed) in comparison to the control side in both groups. However, the number of osteoclasts decreased (p˂0.01) in the probiotic group, in comparison to the vehicle group. There was an increase in the number of osteoblasts (p˂0.05) in both the Vehicle and Probiotic groups on the side under OTM, independent of probiotic supplementation. CONCLUSION Oral Supplementation with a probiotic influenced the number of osteoclasts adjacent to the tooth root during orthodontic movement in mice.

Allergic reactions and nickel-free braces: a systematic review

Nickel-free braces have gained popularity as a viable alternative for patients who are allergic to nickel. The purpose of this systematic review was to determine whether evidence exists to justify the use of nickel-free brackets in orthodontic patients who are allergic to nickel. An electronic search was performed using 7 databases (MEDLINE, BBO, LILACS, Web of Science, EMBASE, BIREME and Cochrane Library), without restriction regarding year or language, with supplemental manual searching of the references of retrieved articles. The search strategy produced 89 papers. The data extraction and quality score of each paper were evaluated independently by two reviewers, once each. After selection based on the eligibility criteria, four papers, including 2 controlled clinical trials and 2 clinical trials, qualified for the final analysis. Quality assessment of the included articles was also performed. Nickel-free braces (Ni content - 2% max.) seem to represent a viable alternative for orthodontic patients who are allergic to nickel. However, further in vivo studies, considering the immunology characteristics of patients, are needed to determine the clinical implications of the findings of this study.

Longitudinal assessment of periodontal status in patients with nickel allergy treated with conventional and nickel-free braces

OBJECTIVE To perform a longitudinal comparison of periodontal status in allergic individuals treated with conventional and nickel-free braces. MATERIALS AND METHODS Forty-two individuals allergic to nickel were randomly divided into two groups: those receiving conventional braces (n  =  21) and those receiving nickel-free braces (n  =  21). Periodontal status (gingival hyperplasia, change in color and bleeding) was assessed before treatment (T0) and at 3-month intervals for 12 months (T1, T2, T3, and T4), using the Löe Index. Evaluations were performed blindly by a single, calibrated examiner, followed by prophylaxis and orientations regarding oral hygiene. Data were analyzed using the Mann-Whitney U-test for comparisons of the gingival index between groups and Friedmans test for successive comparisons between sessions in the same group (P ≤ .05). RESULTS Periodontal status did not differ between groups in the initial 9 months of treatment, whereas significant differences were found at T3 and T4 (.039 and .047, respectively). Individuals wearing conventional appliances had higher mean gingival index scores than those wearing nickel-free braces. CONCLUSION Individuals with an allergy to nickel exhibit better periodontal health when treated with nickel-free braces than with conventional braces.

Crohn's disease: clinical manifestations of orthodontic interest.

Crohns disease is a chronic inflammation of the small intestine; it can involve other organs, such as the skin, eyes, lungs, and joints. Oral manifestations are common, especially ulcers and stomatitis, which macroscopically and histologically resemble those found in the gastrointestinal tract. However, orthodontic alterations are not yet known. This article reviews aspects related to the diagnosis of Crohns disease and clinical considerations for an orthodontic patient.

Prospective evaluation of the psychosocial impact of the first 6 months of orthodontic treatment with fixed appliance among young adults

OBJECTIVE To evaluate the psychosocial impact of the first 6 months of orthodontic treatment with a fixed appliance among young adults and compare the results with those of a control group of patients awaiting treatment for malocclusion. MATERIALS AND METHODS A study was conducted with a sample of 120 patients on a waiting list for orthodontic treatment at a university. The participants were allocated to an experimental group submitted to treatment and a control group awaiting treatment. The groups were matched for sex and age. All participants were instructed to answer the Brazilian version of the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) at baseline and after 6 months. Statistical analysis involved the Wilcoxon test for the total PIDAQ score and the score of each subscale. All patients participated until the end of the study. RESULTS Significant differences between baseline and the 6-month evaluation were found for the total PIDAQ score as well as the dental self-confidence and social impact subscales in both groups. No differences between baseline and the 6-month evaluation were found regarding the psychological impact or esthetic concern subscales in the control group. The patients in the experimental group reported greater esthetic impact 6 months after beginning treatment (P < .001). The first 6 months of orthodontic treatment seem to improve psychosocial impact. CONCLUSION The first 6 months of orthodontic treatment seem to improve the psychosocial impact of malocclusion. The patients analyzed in the present study reported a greater esthetic impact and less psychological impact after 6 months of using an orthodontic appliance.

Nickel: Humoral and periodontal changes in orthodontic patients

INTRODUCTION: Although several studies have discussed nickel influence on the development of immunological reactions in orthodontic patients, it is noticed that the evidence towards the appliances, as well as towards the possible consequences of this material on the oral and general health of the individual are still inconsistent. OBJECTIVE: The aim of this article is to present the current stage of knowledge on this issue, highlighting the most recent findings considering the periodontal and humoral aspects of allergic subjects.