Residents’ journal review

Class I extraction vs nonextraction predictors

Konstantonis D, Anthopoulou C, Makou M. Extraction decision and identification of treatment predictors in Class I malocclusions. Prog Orthod 2013;14:47

The decision to extract teeth remains a controversial topic in orthodontics, with extraction rates fluctuating throughout the past several decades. Although extraction is a viable option in clear-cut cases, identification of predictors for this approach is necessary in borderline situations. The purposes of this retrospective study were to identify the percentages of Class I patients treated with 4 first premolar extractions vs nonextraction in a large patient sample and to determine important predictors for the treatment chosen. The records of 542 Class I (skeletal and dental) white Europeans (331 female, 211 male) were randomly selected from the University of Athens in Greece and 5 private offices; all subjects had full permanent dentitions excluding third molars and no prior history of diseases or treatment. Of this group, 397 (73.2%) were treated without extractions (mean age, 14.55 ± 5.36 years) and 145 (26.8%) with extractions (mean age, 14.52 ± 4.86). Cephalometric and model measurements along with age and sex were analyzed statistically. Discriminant function determined 4 significant predictors ( P <0.000) in descending order of importance (based on standardized canonical coefficients): mandibular crowding, lower lip to E-plane, maxillary crowding, and overjet. This statistical model was successful with a hit ratio of 83.9%, and a mathematical equation was derived for assigning any patient. The model predicted that among 397 nonextraction patients, 377 (95%) were assigned correctly; of 145 extraction patients, 78 (53.8%) were assigned correctly. Misclassifications were often borderline and due to the orthodontist’s preference. Interestingly, mandibular incisor angulation (IMPA) was not a discriminating variable. Although this mathematic model might not apply to all populations, the 4 key orthodontic measurements are useful in directing treatment decisions for patients with Class I malocclusion.

Reviewed by Amir Assefnia

Orthodontically induced external apical root resorption in root-filled and vital teeth

Walker SL, Tieu LD, Flores-Mir C. Radiographic comparison of the extent of orthodontically induced external apical root resorption in vital and root-filled teeth: a systematic review. Eur J Orthod 2013;35:796-802

External apical root resorption (EARR) is a common and multifactorial side effect of orthodontic treatment. The current literature remains controversial regarding the susceptibility of root-filled teeth to orthodontically induced EARR. This systematic review aimed to determine whether root-filled teeth are more susceptible to orthodontically induced EARR than are vital teeth. Reviews of electronic databases and gray literature with no limits were combined with hand-searched references of selected articles. Articles were selected by using the population, intervention, comparison, outcome, and study design (PICOS) format, and reviewed by 2 independent reviewers via the PRISMA checklist. Articles radiograpically comparing orthodontically induced EARR in root-filled (asymptomatic before treatment) and vital teeth were included. Four retrospective cohort studies were finally selected: 3 studies used periapical radiographs, and 1 used panoramic radiographs. The heterogeneity of these studies made it impossible to perform a meta-analysis and highlighted the need for a more standardized method to evaluate orthodontically induced EARR. There were no significant differences in the amounts of orthodontically induced EARR in root-filled and vital teeth during orthodontic movement. However, 2 studies showed that root-filled teeth resorbed less than vital teeth. These results should be interpreted with caution because of the moderate-to-high risk of bias of the studies. The authors emphasized the need for more clinical trials with standardized methodologies to better analyze and compare orthodontically induced EARR in vital and root-filled teeth.

Reviewed by Sharifah Al-Rushaid

Orthodontically induced external apical root resorption in root-filled and vital teeth

Walker SL, Tieu LD, Flores-Mir C. Radiographic comparison of the extent of orthodontically induced external apical root resorption in vital and root-filled teeth: a systematic review. Eur J Orthod 2013;35:796-802

External apical root resorption (EARR) is a common and multifactorial side effect of orthodontic treatment. The current literature remains controversial regarding the susceptibility of root-filled teeth to orthodontically induced EARR. This systematic review aimed to determine whether root-filled teeth are more susceptible to orthodontically induced EARR than are vital teeth. Reviews of electronic databases and gray literature with no limits were combined with hand-searched references of selected articles. Articles were selected by using the population, intervention, comparison, outcome, and study design (PICOS) format, and reviewed by 2 independent reviewers via the PRISMA checklist. Articles radiograpically comparing orthodontically induced EARR in root-filled (asymptomatic before treatment) and vital teeth were included. Four retrospective cohort studies were finally selected: 3 studies used periapical radiographs, and 1 used panoramic radiographs. The heterogeneity of these studies made it impossible to perform a meta-analysis and highlighted the need for a more standardized method to evaluate orthodontically induced EARR. There were no significant differences in the amounts of orthodontically induced EARR in root-filled and vital teeth during orthodontic movement. However, 2 studies showed that root-filled teeth resorbed less than vital teeth. These results should be interpreted with caution because of the moderate-to-high risk of bias of the studies. The authors emphasized the need for more clinical trials with standardized methodologies to better analyze and compare orthodontically induced EARR in vital and root-filled teeth.

Reviewed by Sharifah Al-Rushaid

Only gold members can continue reading. Log In or Register to continue

Apr 6, 2017 | Posted by in Orthodontics | Comments Off on Residents’ journal review
Premium Wordpress Themes by UFO Themes