Background: The use of digital technology has exponentially increased over recent years. Intraoral scanners, especially, have gained traction within orthodontics. The objective of the present review is to investigate the available evidence to create an up-to-date presentation of various clinical aspects of intraoral scanners in orthodontics. Methods: Search without restrictions in seven databases (Pubmed, CENTRAL, Cochrane Reviews, Scopus, Web of Science, Clinical Trials, Proquest) since inception, and hand searching until October 2020, were conducted. Results: The majority of studies were either cross-over or parallel group studies. The accuracy and reproducibility of intraoral scanners, in comparison to conventional methods, were investigated in several studies, with controversial results. The duration of the procedure did not report any clear outcome in favor of any method. Patients seem to prefer intraoral scanning, even though numerous studies point out the importance of operators’ experience and skills. Conclusions: Despite the innovations that intraoral scanners have brought in orthodontic clinical practice, there are still some challenges and limitations in their use. The majority of existing limitations may be overcome with experience and good clinical skills. More high-quality studies need to be conducted so that clinicians can have a clear image of this new technology.

Summary Background Intraoral scanners have become an increasingly popular alternative to conventional impression methods. Although their accuracy and validity have been examined thoroughly, patient-reported information including experiences, preferences, and satisfaction has not yet been investigated in a systematic way. Objective The objective of this systematic review is to investigate the available data and appraise the evidence on patient-reported experiences and preferences following impression taking with intraoral scanners. Search methods Unrestricted search of seven databases (Pubmed, CENTRAL, Cochrane reviews, Scopus, Web of Science, Clinical Trials, and ProQuest) and grey literature were conducted until October 2020. Detailed search strategies were developed for each database. Selection criteria Studies involving individuals of any gender or age, subjected to full arch impression taking with conventional and intraoral scanning methods were eligible for inclusion. Data collection and analysis Following the retrieval and selection of the studies, data extraction was performed. Risk of bias assessment was performed using the RoB 2 and ROBINS-I tools. Results From the initially identified records, nine studies [eight crossover (two of them randomized) and one parallel group] were eventually included in the present systematic review. Randomized studies were shown, overall, to have some concerns regarding bias, whereas the non-randomized studies were found to be at serious risk, mainly because of bias due to confounding. All studies demonstrated some benefit in favour of intraoral scanning compared with conventional techniques. More positive feelings were generally observed with the intraoral scanners regarding smell, taste, sound, vibration, nausea, and queasiness. Overall, comfort assessment mostly favoured digital methods. No differences were found concerning the level of anxiety between the two methods. Among the included studies, time perception was a parameter leading to contradictory results. Limitations These emerge due to the nature and characteristics of the information retrieved from the included studies. The validation of the instruments to capture patient-reported outcomes needs to be further elaborated. Conclusions Intraoral scanners seem to be a promising new asset in the orthodontic office from the perspective of individuals’ experiences and preferences. Nevertheless, to investigate patient-reported outcomes correctly, further high-quality studies are required in the future. Registration Open Science Framework (https://osf.io/ayug2/)

Summary Background Patients with cleft lip and palate usually present a Class III skeletal pattern. Facemask (FM) is one of the conventional orthodontic treatment modalities used to address the skeletal discrepancy in cleft patients. Objective To investigate the potential effectiveness of FM in unilateral cleft lip and palate (UCLP) patients. Search methods Search without restrictions except language in seven databases since inception and hand searching until January 2019 was conducted. Detailed search strategies were developed for each database which were based on the PubMed strategy and adapted accordingly. Selection criteria Controlled studies assessing the effect of FM in UCLP patients were to be included. Data collection and analysis After retrieval and selection of the studies, data extraction was performed. Both angular and linear cephalometric measurements were collected. Weighted mean differences (WMDs) and 95% confidence intervals (CΙs) between treated and untreated UCLP patients concerning the pre- and post-treatment angular measurements of each group were calculated using a random-effects meta-analysis model. The risk of bias in individual studies was assessed using the ROBINS-I tool. Results From nine eligible studies, five were included in the meta-analysis investigating the use of FM in patients and controls with UCLP (with and without maxillary expansion). Statistically significant differences were evident for SNA/S–N–ss, SNB/S–N–sm, ANB/ss–N–sm, and SN–MP. FM was found to induce an increase of SNA (WMD = 2.12 degrees, 95% CI: 1.58 to 2.66), ANB (WMD = 4.17 degrees, 95% CI: 3.60 to 4.74), and SN–MP angles (WMD = 2.60 degrees, 95% CI: 1.10 to 4.10) and a decrease of SNB angle (WMD = −1.94 degrees, 95% CI: −2.48 to −1.40) in UCLP patients. Low to moderate heterogeneity was observed. Limitations They emerge due to risk of bias, exclusion of non-English papers and methodological characteristics of the included papers. Conclusions According to the available data, FM seems to improve the sagittal skeletal relationships in UCLP patients, increasing the SNA and ANB angles and decreasing the SNB angle. Moreover, in the vertical dimension, FM increases the SN–MP angle. Regarding dental measurements, there are controversial results. More high-quality studies need to be conducted in order to further clarify the impact of FM on UCLP patients. Registration number PROSPERO: CRD42019131619.

Ingestion is the entry of a substance into the human organism, which occurs by taking it through the mouth into the gastrointestinal tract. One of the adverse events that may happen during the course of an orthodontic treatment is the ingestion of orthodontic appliances. The present review aims to investigate the literature regarding the ingestion of orthodontic appliances. An electronic search was carried out in order to identify case reports of ingestion of foreign objects related to orthodontic treatment in PubMed, Scopus, and Web of Science until July 2019.Nineteen articles were retrieved. In these articles, ingestion had occurred inadvertently, due to patients’ or orthodontists’ errors. Some of the most commonly ingested appliances were molar bands, segments of wire, and expansion keys. It is likely that patients with a specific medical background are more prone to ingestion of orthodontic appliances. Special precautions need be taken in order to avoid such incidents. These precautions are analyzed in three categories: general, those related to fixed appliances, and those related to removable appliances.

From this study we concluded that heavy experimental orthodontic forces in rats affect the maxillary cortical bone. The osteogenic reaction to these forces, expressed histologically by subperiosteal callus formation, is similar to that seen in distraction osteogenesis models.