RESUMEN
This systematic review aimed to investigate if there is a better interceptive treatment for palatally displaced canines (PDC) in the mixed dentition stage. The PubMed/MEDLINE, CENTRAL, Scopus, and EMBASE databases were searched for randomized clinical trials related to the research topic. The gray literature and reference lists were also assessed. Network meta-analysis was conducted to analyze the effects of different approaches on PDC eruption. The surface under the cumulative ranking area was calculated to rank the treatments. The certainty of the evidence was evaluated using the GRADE approach. Of the 892 eligible studies, 18 were selected for full-text analysis and 9 for meta-analysis, involving 506 participants and 730 PDC, to compare 9 approaches. The proportion of erupted PDC was significantly higher for all interceptive treatments compared with control (no intervention). Furthermore, the proportion of erupted PDC was higher in patients subjected to rapid maxillary expansion (RME) than those who underwent double extraction of primary canine and primary molar (relative risk (RR) = 2.68 ICr95%: 1.12-9.35). A higher proportion of erupted PDC was found for RME (RR = 3.07 ICr95%: 1.31-10.67), RME plus use of transpalatal arch (TA) plus extraction of primary canine(s) (EC) (RR = 1.43 ICr95%: 1.09-1.95), EC plus use of cervical pull headgear (RR = 1.38 ICr95%: 1.11-1.79), and EC plus use of TA (RR = 1.36 ICr95%: 1.00-1.9) than for EC. RME was most likely to be considered as the best interceptive treatment. Overall, the certainty of the evidence was considered low due to imprecision and indirectness. In conclusion, no intervention in the mixed dentition stage is the worst choice for PDC.
Asunto(s)
Erupción Ectópica de Dientes , Humanos , Diente Canino , Metaanálisis en Red , Ortodoncia Interceptiva , Erupción Ectópica de Dientes/terapia , Extracción Dental , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
Abstract This systematic review aimed to investigate if there is a better interceptive treatment for palatally displaced canines (PDC) in the mixed dentition stage. The PubMed/MEDLINE, CENTRAL, Scopus, and EMBASE databases were searched for randomized clinical trials related to the research topic. The gray literature and reference lists were also assessed. Network meta-analysis was conducted to analyze the effects of different approaches on PDC eruption. The surface under the cumulative ranking area was calculated to rank the treatments. The certainty of the evidence was evaluated using the GRADE approach. Of the 892 eligible studies, 18 were selected for full-text analysis and 9 for meta-analysis, involving 506 participants and 730 PDC, to compare 9 approaches. The proportion of erupted PDC was significantly higher for all interceptive treatments compared with control (no intervention). Furthermore, the proportion of erupted PDC was higher in patients subjected to rapid maxillary expansion (RME) than those who underwent double extraction of primary canine and primary molar (relative risk (RR) = 2.68 ICr95%: 1.12-9.35). A higher proportion of erupted PDC was found for RME (RR = 3.07 ICr95%: 1.31-10.67), RME plus use of transpalatal arch (TA) plus extraction of primary canine(s) (EC) (RR = 1.43 ICr95%: 1.09-1.95), EC plus use of cervical pull headgear (RR = 1.38 ICr95%: 1.11-1.79), and EC plus use of TA (RR = 1.36 ICr95%: 1.00-1.9) than for EC. RME was most likely to be considered as the best interceptive treatment. Overall, the certainty of the evidence was considered low due to imprecision and indirectness. In conclusion, no intervention in the mixed dentition stage is the worst choice for PDC.
RESUMEN
OBJECTIVE: This study aimed to evaluate and compare the effectiveness of two treatments for dentin hypersensitivity in vivo during 90 days of follow-up. MATERIALS AND METHODS: The sample consisted of 117 teeth (13 patients) that were divided into three groups: control with carbomer 940 gel (n = 32) (placebo treatment), 2% sodium fluoride gel (n = 31) and low-level infrared diode laser (n = 54). Prior to the desensitizing treatment, the dentin hypersensitivity status of each tooth was assessed by an evaporative stimulus; the patient's response was evaluated using the Visual Analogue Scale (VAS) and by counting the Exposure Time to Air Blast (ETAB) with a dental air syringe. Re-evaluations of the treatments occurred after 5 min, 7, 15, 30 and 90 days. The statistical analysis was performed using the Kruskal-Wallis test, Friedman test, one-way ANOVA, Tukey's test and Spearman's rank correlation (α = 5%). RESULTS: No significant differences were observed among the low-level laser, 2% topical fluoride and carbomer 940 gel applications. When the methods of evaluation (VAS and ETAB) were compared, there was no difference among the groups with respect to the values for every period of evaluation (p < 0.001), verifying that the scores obtained with the VAS decreased at the same proportion as the remaining time of ETAB increased. CONCLUSIONS: This study showed that both tested therapies were efficacious in controlling painful symptoms associated with dentin hypersensitivity over the entire 90-day follow-up period. The treatments were able to reduce the painful symptoms caused by dentin hypersensitivity, including placebo.
Asunto(s)
Sensibilidad de la Dentina/terapia , Resinas Acrílicas/administración & dosificación , Adolescente , Adulto , Brasil , Femenino , Estudios de Seguimiento , Geles , Humanos , Masculino , Persona de Mediana Edad , Placebos , Fluoruro de Sodio/administración & dosificación , Escala Visual Analógica , Adulto JovenRESUMEN
This double-blind randomized clinical trial evaluated the efficacy and safety of two carbamide peroxide concentrations used in at-home vital bleaching. Ninety-two volunteers with a shade mean of C1 or darker for the six maxillary anterior teeth were randomized into two balanced groups (n=46) according to bleaching agent concentration: 10% (CP10) or 16% (CP16) carbamide peroxide. The patients were instructed to use the whitening agent in a tray for two hours once a day for three weeks. Shade evaluations were done with a value-oriented shade guide and a spectrophotometer at baseline and one week post-bleaching (four-week evaluation). Tooth sensitivity was measured daily using a scale ranging from 0 (no sensitivity) to 4 (severe sensitivity). At the end of the study, the volunteers filled out a questionnaire with seven questions aimed to give their opinion about the adopted treatment regimen. Both carbamide peroxide concentrations resulted in significantly lighter teeth at the four-week evaluation compared to the baseline for all color parameters (p < 0.0001) and shade median (p < 0.001). There was no significant difference between the two groups in terms of shade change difference with either the spectrophotometer (p = 0.1) or the shade guide (p = 0.7). Also, no statistically significant difference was found in relation to deltaL* (p = 0.7), delta a* and deltaE* (p = 0.5). A significant reduction in yellowness (delta b*) was observed for CP16 compared to CP10 (p = 0.05) in crude analysis, which disappeared after controlling for b* parameter at baseline. The group treated with CP16 experienced more tooth sensitivity during the first (p = 0.02) and third (p = 0.01) weeks of treatment compared to the CP10 group. However, no major difference was observed (p = 0.09) when the degree of tooth sensitivity between groups was compared. Both 10% and 16% carbamide peroxide concentrations were equally effective and safe for a three-week at-home tooth-bleaching treatment.