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Soft tissue changes with skeletal anchorage in comparison to conventional anchorage protocols in the treatment of bimaxillary proclination patients treated with premolar extraction : A systematic review

Mohan K, Sivarajan S, Lau MN, Othman SA, Fayed MMS

J Orofac Orthop, 2024 Mar;85(2):146-162.
PMID: 35829730 DOI: 10.1007/s00056-022-00411-9

PURPOSE: This review systematically evaluates the evidence related to comparisons between skeletal and conventional anchorage protocols in the treatment of bimaxillary proclination patients who underwent premolars extraction with respect to soft tissue profile changes, treatment duration and three-dimensional (3D) soft tissue changes.
METHODS: Electronic database search and hand search with no language limitations were conducted in the Cochrane Library, PubMed, Ovid, Web of Science, Scopus and ClinicalTrials.gov. The selection criteria were set to include studies with patients aged 13 years and above requiring extractions of upper and lower first premolars to treat bimaxillary proclination with high anchorage demand. Risk of bias assessment was undertaken with Cochrane's Risk Of Bias tool 2.0 (ROB 2.0) for randomised controlled trials (RCTs) and ROBINS‑I tool for nonrandomised prospective studies. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach was used for quality assessment. Results were summarised qualitatively; no meta-analysis was conducted.
RESULTS: Two RCTs and two nonrandomised prospective studies were included. According to the GRADE approach, there is low to very low quality of evidence that treatment using mini-implant anchorage may significantly change nasolabial angle, upper and lower lip procumbence, and facial convexity angle compared to treatment with conventional anchorage. Similarly, very low quality evidence exists showing no differences in treatment duration between treatments with skeletal or conventional anchorage.
CONCLUSIONS: The overall existing evidence regarding the effect of anchorage protocols on soft tissue changes in patients with bimaxillary protrusion and premolar extraction treatment plans is of low quality.
TRIAL REGISTRATION NUMBER: PROSPERO CRD42020216684.

Matched MeSH terms: Bicuspid/surgery
Fulltext Comparison of self- and conventional-ligating brackets in the alignment stage

Wahab RM, Idris H, Yacob H, Ariffin SH

Eur J Orthod, 2012 Apr;34(2):176-81.
PMID: 21478298 DOI: 10.1093/ejo/cjq179

This prospective study investigated the difference in clinical efficiency between Damon™ 3 self-ligating brackets (SLB) compared with Mini Diamond conventional ligating brackets (CLBs) during tooth alignment in straightwire fixed appliance therapy. Twenty-nine patients (10 males and 19 females), aged between 14 and 30 years, were randomly divided into two groups: 14 patients received the SLB and 15 received the CLB. Upper arch impressions were taken for pre-treatment records (T(0)). A transpalatal arch was soldered to both maxillary first molar bands prior to extraction of the maxillary first premolars, followed by straightwire fixed appliances (0.022 × 0.028 inch). A 0.014 inch nickel titanium (NiTi) wire was used as the levelling and aligning archwire. Four monthly reviews were undertaken and impressions of the upper arch were taken at each appointment (T(1), T(2), T(3), and T(4)). Displacements of the teeth were determined using Little's irregularity index (LII). Data were analysed using the Mann-Whitney U-test. In the aligning stage, the CLB group showed significantly faster alignment of the teeth compared with the SLB group at the T(1)-T(2) interval (P < 0.05). However, there were no differences at T(2)-T(3), and T(3)-T(4) for either group (P > 0.05). The CLB group showed 98 per cent crowding alleviation compared with 67 per cent for the SLB after 4 months of alignment and levelling. Mini Diamond brackets aligned the teeth faster than Damon™ 3 but only during the first month. There was no difference in efficacy between the two groups in the later 3 weeks. Alleviation of crowding was faster with CLB than with SLB.

Matched MeSH terms: Bicuspid/surgery
Premolar Cystic Ameloblastoma in a Child

Pathak S, Sonalika WG, Hs V, Tegginammani AS

J Coll Physicians Surg Pak, 2017 Jan;27(1):47-48.
PMID: 28292369 DOI: 2521

Mandibular swellings may occur as a result of many benign lesions of odontogenic or non-odontogenic origin. Ameloblastomas are benign tumours of odontogenic origin, whose importance lies in its potential to grow into enormous size with resulting bone deformity, it is a slow-growing, persistent, and locally aggressive neoplasm. The unicystic ameloblastoma (UA) represents an ameloblastoma variant, presenting as a cyst clinically and radiographically, but showing typical ameloblastomatous epithelium lining histologically. It commonly occurs in second and third decades of life and is rare in children under 12 years of age, and better response to conservative treatment. It shares many clinical and radiographic features with odontogenic cysts/tumours and/or periapical disease of endodontic origin. Reported here is an unusual case of unicystic ameloblastoma involving the crown of an unerupted mandibular first premolar in a 9-year boy in an uncommon location, which was misdiagnosed as periapical lesion of inflammatory origin clinically, and as a dentigerous cyst radiographically. This highlights the importance to routinely submit the removed surgical specimen for histopathological examination.

Matched MeSH terms: Bicuspid/surgery

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