22 02, 2024

Monotherapy with P2Y12-inhibitors after dual antiplatelet therapy: Filling gaps in evidence

2024-02-22T06:49:29+00:00

Int J Cardiol. 2024 Feb 19:131893. doi: 10.1016/j.ijcard.2024.131893. Online ahead of print.

ABSTRACT

BACKGROUND: Whether P2Y12 inhibitor monotherapy (P2Y12-I) is superior to aspirin following DAPT discontinuation post-PCI remains to be established.

METHODS: We updated our prior network meta-analysis where P2Y12-I and aspirin had been compared with DAPT or directly with each other. The focus is specifically on the available direct evidence, now consisting of the three head-to-head comparisons of P2Y12-I and aspirin in event-free PCI patients after DAPT. We include a Trial Sequential Analysis of the direct evidence based on meta-analytical literature.

RESULTS: The main finding reveals a 39% significantly lower risk of myocardial infarction with P2Y12-I (RR 0.61, 95% CI 0.47-0.78, p = 0.0001, I2 = 0%) with no difference in bleeding. Trial Sequential Analysis demonstrates clinically meaningful evidence for a reduction in the incidence of myocardial infarction with P2Y12-I that is also supported by statistical significance.

CONCLUSIONS: Accruing data highlight that P2Y12-I following DAPT discontinuation after PCI is associated with lower risk for MI and a similar risk for bleeding as compared with ASA. In light of potential limitations to the widespread adoption of life-long P2Y12-I treatment, clinicians should consider identifying selected patients who are expected to derive the highest benefit.

PMID:38382856 | DOI:10.1016/j.ijcard.2024.131893

Monotherapy with P2Y12-inhibitors after dual antiplatelet therapy: Filling gaps in evidence2024-02-22T06:49:29+00:00
21 02, 2024

Non-compliance treatment in a young adult full-step class II division 2 malocclusion with preadjusted lingual appliance and upper first molars extractions

2024-02-21T16:53:23+00:00

Int Orthod. 2024 Feb 19;22(2):100848. doi: 10.1016/j.ortho.2024.100848. Online ahead of print.

ABSTRACT

This case report describes a complex full-step class II case in a young adult patient treated with lingual straight-wire appliance and upper first molar extraction. As the patient refused a surgical treatment, she was offered the best possible camouflage with the double aim of obtaining an ideal occlusal relationship and maintaining the profile; appropriate biomechanical strategies, including extraction choice and anchorage control during space closure, were needed to achieve the planned results. This case report demonstrates the possibility of successfully resolving severe sagittal discrepancies in an adult patient without surgical treatment by means of a completely invisible non-compliance technique, with the extraction of the most compromised teeth. This report also underlines the need for careful planning during both diagnostic and treatment phases, in order to obtain the best results.

PMID:38377831 | DOI:10.1016/j.ortho.2024.100848

Non-compliance treatment in a young adult full-step class II division 2 malocclusion with preadjusted lingual appliance and upper first molars extractions2024-02-21T16:53:23+00:00
25 12, 2023

Accuracy of 3D facial scans: a comparison of three different scanning system in an in vivo study

2023-12-25T06:04:45+00:00

Prog Orthod. 2023 Dec 25;24(1):44. doi: 10.1186/s40510-023-00496-x.

ABSTRACT

BACKGROUND: The aim of the study was to compare the accuracy and reproducibility of three different 3D facial scanning systems, relying, respectively, on stereophotogrammetry, structured light and a smartphone app and camera.

METHODS: Thirty subjects have been scanned with three different facial scanning systems, stereophotogrammetry, structured light and a smartphone app and camera. Linear measurements were compared with direct anthropometries measured on the patient’s face, while the study of areas (forehead, tip of the nose, chin, right and left cheek) was evaluated by overlapping scans using the Geomagic Control X program. Statistical analyses were conducted using IBM SPSS v28 software.

RESULTS: The ANOVA test was used to compare linear distances and direct anthropometry measurements, revealing statically significant values for all distances investigated, especially for the Face Hunter scanner, except for the Prn-Pog’ distance (p = 0.092). The three facial scans were superimposed pairwise almost the 100 per cent of the overlapping areas fell within the tolerance limits for all three comparisons analysed. The chin was the most accurately reproduced, with no differences among scanners, while the forehead proved to be the least accurately reproduced by all scanners.

CONCLUSIONS: All three acquisition systems proved to be effective in capturing 3D images of the face, with the exception of the Face Hunter scanner, that produced statistically significant differences in linear measurements for the distances Tr-Na’ and Zyg-Zyg with respect to direct anthropometric measurements.

PMID:38143253 | DOI:10.1186/s40510-023-00496-x

Accuracy of 3D facial scans: a comparison of three different scanning system in an in vivo study2023-12-25T06:04:45+00:00
1 12, 2023

Invisible treatment with lingual appliance for the correction of an adult class II subdivision with asymmetrical Wilson and Spee curves: A case report

2023-12-01T05:48:17+00:00

Int Orthod. 2023 Nov 29;22(1):100825. doi: 10.1016/j.ortho.2023.100825. Online ahead of print.

ABSTRACT

This article describes a class II subdivision malocclusion successfully treated by an invisible lingual appliance. The combination of en-masse distalization by interradicular palatal mini-screws and inner unilateral class II auxiliaries, first by intermaxillary elastic, later by a class II coil spring, resulted in a dento-alveolar correction, allowing one to maintain the appliance completely invisible. At the same time, the inclination of buccal sectors was normalized by a correct torque expression with set-up overcorrections, resulting in a significant improvement of the buccal corridors. This case report demonstrates the possibility of successfully solving class II division 2 subdivision malocclusion in adult patients without surgery by means of a completely invisible appliance. It also demonstrates that correct levelling and torque expression, for the correction of asymmetrical Spee and Wilson curves, are achievable with an accurate set-up planning. On the other hand, it underlines the necessity of mini-screws, auxiliaries and set-up overcorrections in order to obtain the best results.

PMID:38035872 | DOI:10.1016/j.ortho.2023.100825

Invisible treatment with lingual appliance for the correction of an adult class II subdivision with asymmetrical Wilson and Spee curves: A case report2023-12-01T05:48:17+00:00
18 11, 2023

CAD/CAM-based 3D-printed and PVS indirect bonding jig system accuracy: a systematic review, meta-analysis, and comparative analysis of hard and soft CAD/CAM transfer trays

2023-11-18T16:58:03+00:00

Eur J Orthod. 2023 Nov 18:cjad069. doi: 10.1093/ejo/cjad069. Online ahead of print.

ABSTRACT

BACKGROUND: The widespread use of CAD/CAM transfer trays warrants evaluation of their accuracy as compared to PVS transfer trays.

OBJECTIVES: To quantify the accuracy of CAD/CAM and PVS transfer trays, investigating any differences between soft and hard trays CAD/CAM transfer trays.

SEARCH METHODS: Eight different databases (Scopus, Web of Science, PubMed, Google Scholar, ProQuest, Embase, Cochrane Library, ClinicalTrials.gov) were searched, without restrictions, up to an end date of February 2023.

SELECTION CRITERIA: Clinical trials (randomized and non-randomized) and in vitro studies reporting average imprecision values for bracket positioning obtained by digital superimpositions of digitally planned and real positions.

DATA COLLECTION AND ANALYSIS: Data eligibility, data extraction, and risk of bias (RoB-2 and ROBINS-I) were conducted independently. The data, where possible, were synthesized and quantitatively analysed (meta-analysis of mean differences with 95% confidence intervals). The Grade of Recommendation, Assessment, Development and Evaluation (GRADE) analysis of the quality of evidence was performed. The t-test for independent samples was used to compare the transfer accuracy of hard and soft CAD/CAM transfer trays.

RESULTS: Thirteen studies were synthesized in this systematic review, and then eight studies were included in the quantitative meta-analysis. As regards linear measurements, there was a mean transfer error of 0.0752 mm (95%CI: 0.0428, 0.1076) for mesiodistal measures, 0.0943 mm (95%CI: 0.0402, 0.1484) for vertical, and 0.0815 mm (95%CI: 0.0469, 0.1160) for buccolingual. As for angular measurements, there was an average transfer error of 1.2279° (95% CI: 0.6011, 1.8548) for inclination, 0.9397° (95%CI: 0.4672, 1.4123) for angulation, and 0.8721° (95%CI: 0.4257, 1.3185) for rotation. CAD/CAM transfer trays were less accurate than polyvinylsiloxane (PVS) transfer trays, with those made of soft material being more accurate than the hard ones, except for vertical dimension. The GRADE quality of evidence ranged from very low to moderate.

CONCLUSIONS AND IMPLICATIONS: CAD/CAM transfer trays provide high bracket positioning accuracy, with soft transfer trays offering greater precision than rigid ones. Future randomized prospective trials are required to enhance the strength of the available evidence.

REGISTRATION: Prospero (CRD42023401278 number).

PMID:37977877 | DOI:10.1093/ejo/cjad069

CAD/CAM-based 3D-printed and PVS indirect bonding jig system accuracy: a systematic review, meta-analysis, and comparative analysis of hard and soft CAD/CAM transfer trays2023-11-18T16:58:03+00:00
12 10, 2023

Survival rate of indirectly bonded brackets using single vs. two-component orthodontic adhesive: A 12-month split-mouth clinical trial

2023-10-12T10:50:54+00:00

Saudi Dent J. 2023 Sep;35(6):657-662. doi: 10.1016/j.sdentj.2023.05.017. Epub 2023 May 24.

ABSTRACT

OBJECTIVE: Compare the bonding survival rate of two distinct bonding materials: Ortho Solo + Gradia LoFlo Resin and single component GC Ortho Connect.

MATERIALS AND METHODS: Indirect bonding fixed appliance treatment was required for 26 consecutive patients, 8 males and 18 females, with a mean age of 22.1 +/- 4.2 years. All patients were treated with SWM (Straight-Wire Mirabella) technique (Sweden and Martina, Due Carrare, Padova, Italy). Each patient’s bonding process followed a contralateral pattern. Firstly, a 37 % orthophosphoric acid etching gel was used for 20 s, subsequently the single or two components light-cured adhesives were applied through a split-mouth cross-arch procedure. The patients underwent a 12-month follow-up period and brackets failures were rebounded, but not further included in the study. Statistical analysis was performed to analyse the survival rate of the bonding materials and the influence of the variables, with a significant level of α = 0,05.

RESULTS: The GC Connect group was used on 349 teeth, while the Ortho Solo + Gradia group was used on 351 teeth, and the indirect debonding rate was respectively 17.5% and 12.8%. With respect to the total sample, statistically significant values were found for both sex and dental arch. The bracket’s survival rate for incisors, canines, premolars and molars was not significant. However, a higher debonding rate was clinically appreciable in upper and lower molars.

CONCLUSION: In a 12-months observation period, considering all maxillary and mandibular teeth the indirect survival rate for the group GC Ortho Connect and Ortho Solo + Gradia was respectively 82.5% and 87.2%. Although the difference was not significant, a pronounced tendency to debonding for the single component group was appreciable from a clinically point of view.

PMID:37823083 | PMC:PMC10562160 | DOI:10.1016/j.sdentj.2023.05.017

Survival rate of indirectly bonded brackets using single vs. two-component orthodontic adhesive: A 12-month split-mouth clinical trial2023-10-12T10:50:54+00:00
22 09, 2023

Evaluation of effectiveness and efficiency of fixed orthodontic treatment comparing standard and computer-aided design and manufacturing conventional bracket systems using indirect bonding for both: A retrospective study

2023-09-22T05:02:13+00:00

J World Fed Orthod. 2023 Sep 19:S2212-4438(23)00066-8. doi: 10.1016/j.ejwf.2023.08.001. Online ahead of print.

ABSTRACT

BACKGROUND: To compare the effectiveness and efficiency of orthodontic treatment (OT) with standard versus computer-aided design and computer-aided manufacturing (CAD/CAM) indirect bonding of conventional brackets.

METHODS: This retrospective study examined two groups: standard indirect bonding group (12 males, 13 females; mean age 12.21 ± 0.52 years), and digital indirect bonding group (11 males, 14 females; mean age 12.76 ± 1.32 years), treated via a CAD/CAM indirect bonding system. Conventional brackets were used in both groups. Pretreatment and post-treatment records were acquired for all subjects. Weighted Peer Assessment Rating (W-PAR) index was used to assess the effectiveness of OT, in conjunction with five angular cephalometric measurements (ANB°, Sn-GoGn°, U1-PP°, IMPA° and FMA°) and comparatively analyzed using generalized mixed-effects models and post hoc test. Treatment efficiency was assessed in terms of the numbers of bracket repositionings, archwire bends, accidental bracket debondings, appointments and treatment months. Comparative analysis of efficiency was performed using the asymptotic Wilcoxon-Mann-Witney test. Statistical significance was set at 5%.

RESULTS: Total W-PAR and W-PAR component scores decreased significantly during treatment for both groups and in a similar way. Cephalometric measures ANB° and IMPA° significantly decreased and increased, respectively. Significantly fewer bracket repositionings, number of appointments and treatment months were recorded in group digital indirect bonding.

CONCLUSIONS: Although both methods investigated were effective to achieve good outcomes, CAD/CAM indirect bonding method increased the efficiency of OT, when conventional brackets are used.

PMID:37735031 | DOI:10.1016/j.ejwf.2023.08.001

Evaluation of effectiveness and efficiency of fixed orthodontic treatment comparing standard and computer-aided design and manufacturing conventional bracket systems using indirect bonding for both: A retrospective study2023-09-22T05:02:13+00:00
18 09, 2023

Accuracy of lingual straight-wire orthodontic treatment with passive self-ligating brackets and square slot: a retrospective study

2023-09-18T05:57:42+00:00

Prog Orthod. 2023 Sep 18;24(1):30. doi: 10.1186/s40510-023-00482-3.

ABSTRACT

OBJECTIVES: To investigate the accuracy of torque, tip and rotation and linear intra-arch movements yielded by passive self-ligating lingual straight-wire appliances with brackets featuring square slots.

MATERIALS AND METHODS: Twenty-five adult Caucasian patients (16 females and 9 males; mean age 26.5 ± 4.3 years) with Class I or mild Class II head-to-head malocclusion were orthodontically treated via passive lingual self-ligating straight-wire appliances (ALIAS, Ormco, Orange, CA) with no extraction. Records were retrospectively analysed, and digital models of pre-treatment (T0), planned (T1) and achieved (T2) phase were acquired for both arches in each patient via an intraoral scanner (Medit I500 (iScan Medit, Seoul, Korea). VAM software (Vectra, Canfield Scientific, Fairfield, NJ, USA) was used to measure both angular values (torque, tip and rotation) and linear intra-arch widths (between canines, first and second premolars and first and second molars). Measurements were obtained for all the movements investigated for each tooth group (incisors, canines, premolars and molars), by arch (maxillary and mandibular) and for both arches at T0, T1 and T2. The accuracy of angular values was compared using Student’s t-test against a hypothetical 100%, and among the various tooth groups by post-hoc tests. Transverse linear measurements were investigated by means of the non-parametric Friedman test. The significance threshold was set at 0.05.

RESULTS: The mean accuracy of angular values was 77.25 ± 7.71% for torque, 78.41 ± 6.17% for tip and 77.99 ± 6.58% for rotation. In all cases, however, there was a significant difference between planned and achieved movements, and accuracy was significantly lower than the hypothetical 100% for all tooth groups, individual arches and dentition (p < 0.001). For intra-arch diameters, the greatest accuracy values were found for the anterior sectors (83.54 ± 5.19% for the maxillary inter-canine distance) and the lowest for the posterior sectors (67.28% for the maxillary inter-second molar distance).

CONCLUSION: Straight-wire lingual treatment with passive self-ligating appliances featuring with square slot displayed excellent clinical accuracy, albeit with statistical accuracy decreasing antero-posteriorly.

PMID:37718375 | DOI:10.1186/s40510-023-00482-3

Accuracy of lingual straight-wire orthodontic treatment with passive self-ligating brackets and square slot: a retrospective study2023-09-18T05:57:42+00:00