Success of maxillary canine autotransplantation
Patel S, Fanshawe T, Bister D, Cobourne MT. Survival and success of maxillary canine autotransplantation: a retrospective investigation. Eur J Orthod 2010; e-pub, September 2010.
Some treatment options for impacted maxillary canines can lead to unfavorable outcomes. Autotransplantation is an option that involves atraumatic surgical removal of the canine and reimplantation into a previously created socket. The aim of this study was to evaluate survival and success rates after autotransplantation of maxillary permanent canines with closed apices. The sample consisted of 49 patients (mean age at transplantation, 21.8 years), who had autotransplantation of impacted maxillary canines. The sample was divided into 2 categories: 63 autotransplanted maxillary canines with no controls and 27 unilateral transplanted canines with a nontransplanted canine on the contralateral side as a control. Success was determined by using the following criteria: survival, mobility, probing pocket depth, gingival bleeding, vitality, color, internal and external inflammatory resorption, bone level, and signs of pathology. Thirty-eight percent of the sample was considered successful, and the overall survival rate was 83%, with an average duration of 14.5 years (range, 1.4-27.8 years). In the case control sample, the transplanted teeth had unfavorable differences compared with the nontransplanted teeth for probing pocket depth, gingival bleeding, vitality, and color, all of which were statistically significant. The results of this study indicate that autotransplanted canines with closed apices have a low complete success rate but can have a favorable survival rate over the long term. The technique should be considered as an interim measure to maintain bone level before placement of implants in patients who are unwilling to undergo lengthy orthodontic treatment to align ectopic canines.
Reviewed by Brienne Roloff-Chiang
Systematic review of intraoral splints for treating TMD
Fricton J, Look JO, Wright E, Alencar FG Jr, Chen H, Lang M, Ouyang W, Velly AM. Systematic review and meta-analysis of randomized controlled trials evaluating intraoral orthopedic appliances for temporomandibular disorders. J Orofac Pain 2010;24:237-54.
Intraoral orthopedic appliances have historically been used to manage temporomandibular disorders (TMD). Despite their long and widespread use, there is still controversy about their efficacy for treatment of TMD pain. The aim of this systematic review and meta-analysis was to assess the efficacy of intraoral orthopedic appliances to reduce pain in TMD patients compared with a placebo, no treatment, or other treatments as reported in randomized controlled trials (RCTs). The investigators searched the literature and found 44 RCTs of intraoral orthopedic appliances for treating TMD. Ten of these were suitable for meta-analysis. Seven RCTs compared hard stabilization appliances with nonoccluding appliances intended to act as a placebo control. Meta-analysis showed an odds ratio of 2.45, indicating that pain reduction occurred more often in the stabilization appliance group than in the controls. Three RCTs compared hard stabilization appliances with no treatment, and an odds ratio of 2.14 demonstrated a positive net effect with the stabilization appliances, although it was not statistically significant. Studies comparing intraoral appliances with other treatments, including self-care, acupuncture, physical medicine, short-term behavioral therapies, and some pharmacologic treatments found that each has some evidence of equal efficacy to appliances, and these treatments can be considered as initial or concurrent treatment for TMD. The authors concluded that hard stabilization appliances when adjusted properly have good evidence of modest efficacy in the treatment of TMD pain when compared with nonoccluding appliances and no treatment, and are at least equally as effective as alternative treatments. Other types of appliances have some evidence of efficacy in reducing TMD pain, but the potential for adverse events with these appliances is higher.
Reviewed by Jake DaBell
Systematic review of intraoral splints for treating TMD
Fricton J, Look JO, Wright E, Alencar FG Jr, Chen H, Lang M, Ouyang W, Velly AM. Systematic review and meta-analysis of randomized controlled trials evaluating intraoral orthopedic appliances for temporomandibular disorders. J Orofac Pain 2010;24:237-54.
Intraoral orthopedic appliances have historically been used to manage temporomandibular disorders (TMD). Despite their long and widespread use, there is still controversy about their efficacy for treatment of TMD pain. The aim of this systematic review and meta-analysis was to assess the efficacy of intraoral orthopedic appliances to reduce pain in TMD patients compared with a placebo, no treatment, or other treatments as reported in randomized controlled trials (RCTs). The investigators searched the literature and found 44 RCTs of intraoral orthopedic appliances for treating TMD. Ten of these were suitable for meta-analysis. Seven RCTs compared hard stabilization appliances with nonoccluding appliances intended to act as a placebo control. Meta-analysis showed an odds ratio of 2.45, indicating that pain reduction occurred more often in the stabilization appliance group than in the controls. Three RCTs compared hard stabilization appliances with no treatment, and an odds ratio of 2.14 demonstrated a positive net effect with the stabilization appliances, although it was not statistically significant. Studies comparing intraoral appliances with other treatments, including self-care, acupuncture, physical medicine, short-term behavioral therapies, and some pharmacologic treatments found that each has some evidence of equal efficacy to appliances, and these treatments can be considered as initial or concurrent treatment for TMD. The authors concluded that hard stabilization appliances when adjusted properly have good evidence of modest efficacy in the treatment of TMD pain when compared with nonoccluding appliances and no treatment, and are at least equally as effective as alternative treatments. Other types of appliances have some evidence of efficacy in reducing TMD pain, but the potential for adverse events with these appliances is higher.
Reviewed by Jake DaBell
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