The in vitro remineralizing effect of CPP-ACP and CPP-ACPF after 6 and 12 weeks on initial caries lesion

Objective: The aim of this in vitro study was to determine the effects of remineralization promoting agents containing casein phosphopeptidestabilized amorphous calcium phosphate (CPP-ACP), or CPP-ACP in combination with fluoride (CPP-ACPF) on artificial white spot lesions (WSLs) after 6 and 12 weeks. Methodology: White spot lesions were created on 123 sectioned premolars (246 specimens) with a demineralization solution during a 96 hours pH-cycling regime. Two experimental groups were created: a CPP-ACP group (Tooth MousseTM), and a CPP-ACPF group (Mi Paste PlusTM). Additionally, two control groups were created, one using only a conventional toothpaste (1450 ppm fluoride) and another one without any working agents. All teeth were also daily brushed with the conventional toothpaste except the second control group. Tooth MousseTM and Mi Paste PlusTM were applied for 180 seconds every day. The volume of demineralization was measured with transverse microradiography. Six lesion characteristics regarding the lesion depth and mineral content of WSLs were also determined. Results: The application of CPP-ACP and CPP-ACPF had a significant regenerative effect on the WSLs. Compared to Control group 1 and 2 the volume of demineralization after 6 weeks decreased significantly for CPP-ACP (respectively p<0.001 and p<0.001) and CPP-ACPF (respectively p=0.001 and p=0.003). The same trend was observed after 12 weeks. For the CPP-ACPF group, WSL dimensions decreased significantly between 6 and 12 weeks follow-up (p=0.012). The lesion depth reduced significantly after application of CPP-ACP and CPP-ACPF but increased significantly in the Control groups. Mineral content increased for CPP-ACP and CPP-ACPF after an application period of 12 weeks, but this was only significant for CPP-ACP. Conclusions: Long-term use of CPP-ACP and CPP-ACPF in combination with a conventional tooth paste shows beneficial effects in the recovery of in vitro subsurface caries lesions

The evaluation of the transport medium for extracted premolars prior to cryopreservation : a systematic literature review

Prior to cryopreservation, a tooth is transported from a contaminated oral environment to the tooth bank. Our objective was to identify all studies reporting or investigating a transport protocol prior to the cryopreservation of teeth, in terms of decontamination of the subjects. The systematic literature search (1970-2017) was based on MEDLINE via PubMed, Web of Science and the Cochrane Library. The reference lists of the included studies and the Science Citation Index were used for hand searching (snowballing). Only studies reporting the transport conditions of the transplant were included. Language restrictions for English, Dutch or French were applied. The search led to 14 eligible studies. Almost all studies were laboratory studies, so the methodological quality of evidence was low. The majority of the included studies was performed by only five different research groups and the number of subjects varied between 1 and 120 teeth. In general, the teeth were stored in a tissue culture medium supplemented with fetal calf serum and/or different combinations of antibiotics and/or antimycotics. The teeth were transported cooled (4 A degrees C) or at room temperature, for a period of time not exceeding 24 h. Only three studies reported the irrigation of the teeth with phosphate buffered saline prior to the transport. The optimisation of the decontamination during transport was investigated in three studies (from 1971, 1980 and 1982). It was concluded that the literature on this topic is scarce, and the decontamination protocol for teeth, prior to cryopreservation has not been validated recently

Effects of labial adhesion on maxillary arch dimensions and nasolabial esthetics in cleft lip and palate : a systematic review

Labial adhesion is a preliminary surgical lip approximation used in the early management of unilateral and bilateral cleft lip and palate. Our objective was to evaluate its effects on the maxillary arch dimensions and nasolabial esthetics by means of a systematic review. The literature search (1955-2016) was based on MEDLINE via PubMed, Web of Science, EMBASE, and the Cochrane Library. Studies with labial adhesion as a single preliminary step for definitive lip closure, in combination with nasoalveolar molding or in combination with infant orthopedics were considered eligible. Fifteen articles were identified (1978-2015), including 587 patients who underwent labial adhesion. Reduction in alveolar cleft width was between 60.9% and 100% in unilateral cases and between 47.5% and 100% in bilateral cases. Reduction in palatal cleft width was between 28.4% and 59.8% in unilateral cases and between 37.5% and 50.5% in bilateral cases. No conclusive results could be drawn about the effect on nasolabial esthetics. This systematic review comprises the available literature of the last 50 years about labial adhesion. It showed reduction of alveolar and palatal cleft width after a treatment with labial adhesion with or without infant orthopedics. The treatment effect on nasolabial esthetics, especially in the long term, remains unclear

Assessment modalities of non-ionizing three-dimensional images for the quantification of facial morphology, symmetry, and appearance in cleft lip and palate : a systematic review

The use non-ionizing three-dimensional (3D) imaging in cleft lip and palate is an emerging field, but properly designed methods for the assessment of these images are not well established. Therefore, the aim of this study was to review the current literature on the modalities of assessment of non-ionizing 3D images for the quantification of facial morphology, symmetry, and appearance in cleft lip and palate, and to assess the method error of these modalities. A systematic literature search was conducted using MEDLINE (PubMed), Cochrane Central Register of Controlled Trials, Web of Science, and Embase. Cross-sectional studies with prospective or retrospective data collection, using non-ionizing 3D imaging, with a subjective or objective outcome assessment and including at least 10 cleft lip and/or palate patients were considered eligible. Overall, 1767 unique studies were identified and 33 met the inclusion criteria. The images were objectively assessed using elementary measurements and comprehensive statistical methods for superimposition, shape description, and structuring. Subjective assessment was performed using a Likert-type scale or visual analogue scale. It can be concluded that non-ionizing 3D images are widely used in cleft research, but 3D analysis of the images is often methodologically suboptimal. Researchers must fully utilize the content of 3D images to quantify morphology, symmetry, and appearance

A non-cephalometric two-dimensional appraisal of soft tissue changes by functional therapy in Class II patients : a systematic review and meta-analysis

Background Facial attractiveness has social, psychological, and economic repercussions. Class II malocclusions are associated with a retroposition of the mandible, facial convexity, protruded upper lip, retruded lower lip, and pronounced mentolabial fold. Functional appliances (FA) try to increase mandibular length and normalize lip position, thereby decreasing the facial profile convexity and aesthetics. Objectives The aim of this review and meta-analysis is to investigate the effects of FA on the soft tissues in a non-cephalometric two-dimensional manner. Search methods Medline (via PubMed), Embase (via Ovid), Web of Science, and Cochrane Central were used to identify studies describing the soft tissue results of FA in a non-cephalometric way. The search was conducted up to July 2021. Selection criteria Prospective and retrospective studies investigating the effects of FA appliances on the soft tissues, with non-ionizing, two-dimensional imaging, including an attractiveness assessment based on Visual Analogue Scale or Likert scale, were considered eligible. Data collection and analysis Data extraction was performed separately by two authors. Risk of bias was assessed using the ROBINS-I tool. Results From the eight eligible studies, four were included in the meta-analysis to investigate the influence of assessors on facial attractiveness scores. Age range of the included studies varied from 8 to 21 years old including 313 Caucasian patients whereof 64% females. Six out of eight studies used growing patients as treatment group and only two studies reported follow-up after the end of treatment. Overall facial attractiveness increased after treatment with FA, resulting from a decrease in facial convexity and a normalization of the lip relationship. Orthodontists score higher aesthetic improvements after FA treatment as compared to laypeople. Conclusions Current evidence suggests the positive effects of FA on the facial attractiveness in growing and non-growing patients. FA normalize the lip relationship. Furthermore, they tend to decrease facial convexity and advance the chin point. More pleasing results can be expected in growing patients. Orthodontists are more generous when assessing treatment changes as compared to laypeople. Registration PROSPERO registration (CRD42021254835)

Rapid maxillary expansion vs slow maxillary expansion in patients with cleft lip and/or palate: a systematic review and meta-analysis

ABSTRACT Objectives To compare the dentoalveolar outcomes of slow maxillary expansion (SME) and rapid maxillary expansion (RME) used for maxillary expansion before secondary alveolar bone grafting in patients with cleft lip and/or palate (CL/P). Secondarily, the advantages and disadvantages of SME vs RME were reviewed. Materials and Methods A systematic search was conducted up to November 2021, including Medline (via PubMed), Embase (via Ovid), Web of Science, Cochrane Central, and Google Scholar. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Risk-of-bias assessment was performed using the Risk of Bias (RoB 2.0) and Risk Of Bias In Non-randomized Studies of Interventions (ROBINS I) tool. Overall quality was assessed using the Grading of Recommendations Assessment, Development, and Evaluation tool. Results Of 4007 records, five studies met the inclusion criteria. The randomized control trial (RCT) had a low risk of bias, the non-RCTs presented with a moderate risk of bias. Arch width and perimeter increased significantly with both SME and RME treatments. No difference in the increase in palatal depth was found. The meta-analysis showed a greater anterior-to-posterior expansion ratio for the Quad Helix (QH) appliance. The results for dental tipping were not conclusive. Conclusions SME and RME promote equal posterior expansion in cleft patients. The anterior differential expansion is greater with SME (QH appliance). No clear evidence exists concerning the amount of dental adverse effects of SME and RME in cleft patients. </jats:sec

The evaluation of the transport medium for extracted premolars prior to cryopreservation : an in vitro study

Autotransplantation is a versatile technique for the replacement of a missing tooth and cryopreservation can expand its scope. The aim of this in vitro study is to compare the antimicrobial effect of different transport protocols on procured teeth prior to cryopreservation. Streptococcus oralis biofilms were grown on ten sterile premolars, incubated for 48h and subjected to the following transport procedures: an untreated (contaminated) control group, a group rinsed with phosphate buffered saline (PBS), a group transported in PBS, a group transported in Dulbecco's Modified Eagle's medium (DMEM) supplemented with fetal calf serum (FCS), and a group transported in DMEM supplemented with FCS and antibiotics (AB). The effect of cryopreservation as such, as well as the combination with a transport medium (DMEM+FCS+AB) on the contamination was also tested. The surviving bacteria were harvested, and determined by plate counting. There was no significant reduction in contamination after rinsing the tooth, after transport in PBS or after transport in DMEM with FCS. Significant reductions were observed for transport in DMEM with AB when compared to the control group (p=0.003). Cryopreservation as such reduced the biofilm significantly (p<0.001). No cumulative effect could be found when transport in DMEM+FCS+AB was followed by cryopreservation. Within the limitations of this laboratory set-up, DMEM+FCS+AB was the most effective transport medium in S. oralis biofilm elimination. It could not be concluded that rinsing of the tooth gives an additional reduction. Cryopreservation as such decontaminated the teeth more effectively than any tested transport procedure