Objective: In orthodontic patients submitted to oral hygiene instruction, what is the efficacy of orthodontic toothbrush (O-TB) versus conventional toothbrush (C-TB) on plaque and gingival index reduction in randomized and non-randomized controlled clinical trials? Methods: Electronic database search was performed on PubMed, ClinicalTrials.gov, Cochrane Library and Google Scholar. Database research, study selection, data extraction and ROBINS-I and Risk of Bias Tool 2.0 analysis were conducted by two independently examiners in duplicate. Two different meta-analyses were performedfor plaque index and gingival index, followed by the analysis of overall quality of the evidence using GRADE.Results: A total of 158 studies were identified for screening; six articles were included in qualitative synthesis, and of those, three were subjected to a quantitative synthesis (meta-analysis). Three non-randomized studies presented an overall 'low', 'moderate' and 'high' risk of bias for each one of the articles, and the three randomized clinical trials presented 'low risk' for two articles and 'some concerns' quality for the other one. The overall strength of evidence was ranked 'very low' quality for plaque index and gingival index subgroups.Conclusions: Gingival bleeding is not modified by orthodontic design toothbrush, but there is circumstantial scientific evidence for recommending the use of an O-TB instead a C-TB based on the analysis of plaque index control. Although major plaque removal of the O-TB was validated by meta-analysis, this improvement is not completely clarified which calls for further clinical studies to assess the effects of using an O-TB compared with a C-TB.
Aims
This case report describes an orthodontic and aesthetic rehabilitation in a patient with Turner syndrome.
Methods and results
Careful anamnesis was performed to find the patient's medical history. Based on dental casts, radiographies and photographies it was observed alterations in the craniofacial complex, in the occlusion and in the dental morphology. For the orthodontic treatment, rapid maxillary expansion was performed, followed by the use of fixed orthodontic appliance. At the end, aesthetic rehabilitation, with direct composite resin veneers, was utilized for the correction of existing diastema. Treatment goals were achieved by observing an improvement in facial and smile harmony.
Conclusion
The orthodontic treatment followed by aesthetic rehabilitation of dental morphology showed to be feasible in a patient with Turner syndrome based on an early diagnosis and craniofacial growth follow‐up.
Ortho-surgical treatment in skeletal CLII patients with temporomandibular dysfunction: Case report Tratamento orto-cirurgico em paciente CLII esquelética e com disfunção temporomandibular: Relato de caso
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