A comparison between the band-and-loop space maintainer with a loop-design fibre-reinforced composite space maintainer

The band-and-loop space maintainer (BLSM) is a non-invasive device commonly used to maintain space after the early loss of a single deciduous tooth until the permanent tooth erupts. Unfortunately, however, these devices are difficult to fabricate, require laboratory work and are expensive. Clinically, they tend to fracture, bend or debond under occlusal forces and they are not considered aesthetic. These obvious limitations and challenges warrant the investigation of new materials and device designs for the treatment of premature single tooth loss. The fibre-reinforced composite space maintainer (FRCSM) has many advantages and has been suggested as an alternative to the BLSM. This study considers the clinical failure rates and reasons for failure for a loop-design FRCSMs, as placement techniques have not yet been standardised. The aim of the study was to comparatively investigate the in vivo failure rates (as well as the reasons for failures) of the loop-design FRCSM and the metal BLSM over a 6 month period. The data collected could be useful in the development of more successful FRCSMs. A total of 20 space maintainers were placed – 10 BLSMs and 10 loop-design FRCSMs. For each BLSM placement, an orthodontic band was fitted around the anchor tooth and an alginate impression was taken. This impression, with the band in position, was sent to the dental laboratory for fabrication of the device. At a second appointment, the BLSM was fitted and cemented with glass ionomer cement. For each FRCSM placement, a unidirectional glass fibre bundle was positioned in a continuous loop design extending from the buccal to the lingual surface of the anchor tooth. The fibre bundle was secured in position with a flowable composite, light-cured, and subsequently finished and polished. Monthly follow-up appointments were scheduled over a six-month period and parents/ patients were instructed to report immediately for an emergency appointment if any problem or failure occurred between these arranged appointments. This ensured that the timing of (and reasons for) the failures of both types of device were accurately recorded. With respect to the BLSM, the main reason for device failure was bending of the wire and subsequent impingement on the soft tissue. With respect to the FRCSM, the main reasons for device failure were debonding at the enamel-composite interface and fibre loop fracture. Within the six month follow-up period, both space maintainer types exhibited a 50% failure rate, but 30% of the failed FRCSMs could be repaired chairside whilst the failed BLSMs had to be refabricated in the laboratory. Although the results of this study do not show a significant statistical difference between the failure rates of the two space maintainer types tested (p=0.53), the FRCSM performed well clinically in that it was more easily repairable and remained clinically effective even in cases where the device broke. From the data gathered during this study, it is recommended that further research be done on the effectiveness of the loop-design FRCSM when it is bonded to permanent teeth, and on whether this device would prove more successful if mechanical retention were enhanced when bonding the device to deciduous tooth enamel. Whilst this study has generated valuable new clinical information, the FRCSM cannot yet be confidently recommended as a reliable alternative to the BLSM. Further research on this topic (based on a larger sample size and with a longer follow-up period) is necessary.Dissertation (MSc Dentistry)--University of Pretoria, 2017.Community DentistryMSc DentistryUnrestricte

Methods of space maintenance for premature loss of a primary molar: a review

AIM: This critical appraisal attempts to answer the question: What is the best method of space maintenance (SM) following premature loss of a primary molar in children under 12 years old? METHODS: A search to identify studies relevant to the PICO was conducted. Single case reports and studies prior to 1986 were excluded. The principles of GRADE were followed to appraise the evidence. RESULTS: 20 studies were identified, which evaluated 2265 space maintainers (SMs). Two studies were graded high quality, four moderate, eight low, and six very low. All studies reported on longevity outcomes and most on adverse effects. CONCLUSIONS: There was no strong evidence favouring a particular SM, the following recommendations were made: (a) strong recommendations: In cases where rubber dam cannot be used clinicians should not use Glass Fibre Reinforced Composite Resin (GFRCR) SMs. (b) Weak recommendations: Crown and Loop SMs are recommended for loss of primary first molars; GFRCR SMs (placed under rubber dam) are recommended for loss of primary second molars. Bilateral SMs may have questionable efficacy and their use where there is loss of multiple molars in the same quadrant should be weighed against the risk of unwanted tooth movements, loss of a removable SM or no space maintenance at all

Survival rate of fixed space maintainers used in Dentistry. Systematic review and Meta-analysis

Objective: To determine, through a systematic review and meta-analysis, the survival rate of fixed space maintainers used in Dentistry. Material and Methods: A literature search was carried out, following the guidelines of the PRISMA standards, until March 2020, in the biomedical databases: Pubmed, Embase, Scielo, Science Direct, Scopus, SIGLE, LILACS, Google Scholar and the Cochrane Central Registry of Clinical Trials. The selection criteria of the studies were defined as: clinical trials, without language restriction, up to 10 years old and that report the survival rate of fixed space maintainers used in dentistry. Study risk of bias was analyzed using the Cochrane Handbook of Systematic Reviews of Interventions. Results: The search strategy resulted in 159 articles, of which 10 were ultimately included for the present study. All included articles reported that the overall survival rate of the fixed space maintainers used in Dentistry was between 20% and 95%; the one with the highest survival rate is the crown and loop with 86.3%. When comparing the fiber-reinforced composite space maintainers with the band and loop it was observed that there is no difference between them; when comparing the crown and loop with the band and loop, a difference was observed, favoring the crown and loop. Conclusion: The reviewed literature suggests that the overall survival rate of fixed space maintainers used in dentistry ranges from 20 to 86.3% with a follow-up time of 6 to 18 months

Mantenedores de espacio de resina compuesta reforzada con fibra en dentición primaria : revisión sistemática exploratoria

Trabajo de titulación (Cirujano Dentista, Licenciado en Odontología)El mantenedor de espacio (ME), es el método más seguro de prevenir futuras maloclusiones en la dentición permanente causadas por una pérdida prematura en la dentición temporal, el cual debe mantenerse en boca durante el tiempo requerido o hasta la erupción del diente sucesor permanente. El objetivo de esta revisión es analizar la efectividad clínica de un ME de resina compuesta reforzado con fibra (RCRF), proponer ventajas y desventajas y comparar la durabilidad versus aparatología convencional para realizar sugerencias clínicas sobre este tipo de ME. Material y método: La presente revisión sistemática exploratoria plantea un abordaje alternativo al uso de ME convencional, por ME de RCRF, mediante una búsqueda bibliográfica en las bases de datos electrónicas PubMed y el multibuscador virtual del Sistema de bibliotecas de la Universidad Andrés Bello. Fueron seleccionados 9 artículos finales para la investigación con un máximo de 10 años de antigüedad. Resultados: Los factores identificados en la búsqueda para la efectividad de un ME de RCRF son la adhesión, el tiempo de tratamiento, la sensibilidad de la técnica y la cooperación del paciente. Conclusión: Los ME de RCRF pueden ser considerados una opción aceptable por periodos cortos de 6 a 12 meses, además de ser una opción más estética, económica y rápida. El éxito depende principalmente de la adhesión entre resina y diente, siendo esta la causa de fracaso más frecuente. Debido a que la información obtenida es insuficiente y no concluyente, los ME convencionales siguen siendo el tratamiento estándar de elección.The space maintainer (SM), is the surest method of preventing future malocclusions in the permanent dentition caused by premature loss of the primary dentition, which must be kept in the mouth for the required time or until the eruption of the permanent successor tooth. The objective of this review is to analyze the clinical effectiveness of a fiber-reinforced composite resin (FRCR) SM, propose advantages and disadvantages, and compare durability versus conventional appliances to make clinical suggestions about this type of SM. Material and method: The present exploratory systematic review proposes an alternative approach to the use of conventional SM by FRCR SM, through a bibliographic search in the PubMed electronic databases and the virtual multisearch Library´s System of Andrés Bello University. 9 final articles were selected for research with a maximum of 10 years old. Results: The factors identified in the search for the effectiveness of a FRCR SM are adherence, treatment time, sensitivity of the technique, and patient cooperation. Conclusion: FRCR SMs can be considered an acceptable option for short periods of 6 to 12 months, also being more aesthetic, economical and quick option. Success depends mainly on the adhesion between resin and tooth, this being the most frequent cause of failure. Because the information obtained is insufficient and inconclusive, conventional SMs remain the standard choice of treatment

Longevity of fiber-reinforced composite fixed partial dentures (FRC FPD)—Systematic review

Oral Session: Fiber Reinforced Restorative Resins: Properties and Use ; Oral PresentationObjectives: to assess the longevity of Fiber-Reinforced Composite Fixed Partial Dentures (FRC FPDs) through systematically reviewing contemporary clinical evidence. Population investigated comprised patients requiring replacement of a single missing anterior/posterior tooth. Intervention was FRC FPDs. No control/ comparison selected. Outcome was longevity of FRC FPDs. The focus question was: ‘What is the longevity of FRC FPDs used to replace one anterior or posterior tooth in patients?’Methods: PubMed, MEDLINE, and Web of Science databases were searched between January 2007 and December 2015. Randomised, non-randomised, controlled, prospective and retrospective clinical studies were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses were applied. The Overall Strength of Clinical Recommendation (OSCR) was assessed using the Strength of Recommendation Taxonomy system. Survival of FPDs was assessed using the Kaplan-Meier method. Analysis of FPD-survival according to location and occurrence of different failures was performed using Logrank and Chi-square testing.Results: Nine clinical studies were included, involving placement of 592 FRC FPDs in 463 patients. Follow-up periods ranged between 2 months and 8 years. Kaplan-Meier overall survival probability was 94.5% (95% C.I: 92.5%- 96.5%) at 4.8 years. There was no significant difference in survival probability of anterior versus posterior FRC FPDs (P = 0.278). Veneering material fracture/delamination occurred significantly more than other types of failures (Ps < 0.05). A meta-analysis could not be performed. OSCR was moderate.Conclusions: FRC FPDs demonstrated high overall survival with predictable performance outcomes. Consequently, FRC FPDs can be considered as viable medium-term management alternatives for replacing single anterior or posterior teeth in patients. However, long-term performance remains unclear

Duration of tooth alignment with fixed appliances: A systematic review and meta-analysis

INTRODUCTION A key goal of orthodontic treatment with fixed appliances is alignment of the dentition, and this remains a commonly selected outcome in clinical studies investigating orthodontic tooth movement. This systematic review has evaluated treatment duration to achieve alignment of the mandibular dentition using fixed appliances. METHODS Systematic literature searches without restrictions were undertaken in 9 databases for randomized clinical trials (RCTs) assessing duration and rate of tooth alignment using fixed appliances with or without treatment adjuncts published up to January 2021. After duplicate study selection, data extraction, and risk of bias assessment according to Cochrane, random-effects meta-analyses of aggregate data, and individual patient data were conducted. RESULTS Thirty-five trials were included with 2258 participants (39% male; mean age 17.8 years), giving a pooled duration to achieve whole-arch alignment of the mandibular dentition of 263.0 days (4 trials; 95% confidence interval [CI], 186.7-339.4 days) and incisor alignment in the mandibular arch of 100.7 days (9 trials; 95% CI, 84.1-117.4 days). Surgical-assisted orthodontics was associated with reduced duration of incisor alignment: mean difference of 44.3 days less (4 trials; 95% CI, 20.0-68.9 days; P <0.001; high quality of evidence), whereas subgroup and meta-regression analyses indicated significant effects of baseline crowding and premolar extractions. Individual patient data analysis from 3 RCTs indicated that for each additional participant age year, whole-arch alignment of the mandibular dentition took 13.7 days longer (3 trials; 95% CI, 7.7-17.7 days; P <0.001) and for each additional mm of irregularity, 17.5 days more were needed (2 trials; 95% CI, 9.8-25.2 days; P <0.001). CONCLUSIONS Patient and treatment-related characteristics can significantly affect the duration of tooth alignment and should be taken into account both clinically and when designing trial outcomes. Future research studies investigating rates of orthodontic tooth alignment would benefit from adequate sample sizes and a more consistent methodology in outcome assessment. Data in this systematic review provides a basis for appropriate trial design for future RCTs investigating the rate of orthodontic tooth alignment with fixed appliances

Special oils for halal and safe cosmetics

Three types of non conventional oils were extracted, analyzed and tested for toxicity. Date palm kernel oil (DPKO), mango kernel oil (MKO) and Ramputan seed oil (RSO). Oil content for tow cultivars of dates Deglect Noor and Moshkan was 9.67% and 7.30%, respectively. The three varieties of mango were found to contain about 10% oil in average. The red yellow types of Ramputan were found to have 11 and 14% oil, respectively. The phenolic compounds in DPKO, MKO and RSO were 0.98, 0.88 and 0.78 mg/ml Gallic acid equivalent, respectively. Oils were analyzed for their fatty acid composition and they are rich in oleic acid C18:1 and showed the presence of (dodecanoic acid) lauric acid C12:0, which reported to appear some antimicrobial activities. All extracted oils, DPKO, MKO and RSO showed no toxic effect using prime shrimp bioassay. Since these oils are stable, melt at skin temperature, have good lubricity and are great source of essential fatty acids; they could be used as highly moisturizing, cleansing and nourishing oils because of high oleic acid content. They are ideal for use in such halal cosmetics such as Science, Engineering and Technology 75 skin care and massage, hair-care, soap and shampoo products