Browsing by Author "Athanasiou, Athanasios E."

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Dental arch spatial changes after premature loss of first primary molars: a systematic review of controlled studies
(2017) Kaklamanos, Eleftherios G; Athanasiou, Athanasios E.
Abstract: Studies investigating dental arch spatial changes following first primary molar premature loss are controversial regarding clinical significance. The purpose of this review was to systematically investigate the relevant literature. Controlled studies investigating changes before and after premature loss of first primary molars were searched in various databases. Split-mouth design studies were considered eligible for inclusion. The risk of bias was judged according to ADA Clinical Practice Guidelines. Only two analyzable split-mouth studies on mandibular first primary molar loss were identified. Space loss in the extraction side was greater at 2, 4, 6 and 8-month follow-ups, reaching a -1.5 mm difference in the final examination (95% Confidence Interval: -2.080 to -0.925; p = 0.000; random effects model). Studies were judged to be at unclear risk of bias. The amount of space decrease after premature loss of first primary molars may have management implications under certain circumstances. Comprehensive assessment of the various characteristics of each patient should precede management decisions in individual cases.
Dental calcification stages as determinants of the peak growth period
(2016-07-25) Athanasiou, Athanasios E.
Objective: The objective of this study was to investigate the diagnostic accuracy of dental maturation stages for identifying individual-specific skeletal maturation phases. Subjects and methods: Prior to initiating this study, 255 orthodontic patients comprising 145 girls and 110 boys from the Department of Orthodontics, Aristotle University of Thessaloniki, Greece were identified. Lateral cephalometric and panoramic radiographs were evaluated. Dental calcification stages were assessed according to the Demirjian method and skeletal maturation according to the cervical vertebral maturation stage (CVMS) method. Statistical assessments included Spearman Brown formula, descriptive statistics, Spearman’s rho correlation coefficient, and positive likelihood ratios (LHRs). Results: The highest (r = 0.725) correlations were found for second molars and the lowest correlation for canines (r = 0.463, p \ 0.001). Positive LHR values exceeding ten were found to identify the pre-peak growth phase in conjunction with the second molar (stage D), second premolar (stage E), and first premolar (stages D and E). Only the second molar (stage F) yielded positive LHR values for identifying the peak growth phase. The positive LHR values for the second molar also facilitated identification of the post-peak growth phase (stage H). Taking the clinical diagnostic efficacy of the second molar into account in identifying these growth phases, we calculated the positive LHRs of the second molar to determine dental maturation stages for diagnosing CVMS II and III. Positive LHR values greater than 10 identified CVMS II (stage D). Conclusion: Evaluating dental maturation is a useful initial diagnostic step when assessing skeletal growth. The calcification stages of the second molar provide reliable diagnostic information with which to determine the pubertal growth spurt.
Digital assessment of direct and virtual indirect bonding of orthodontic brackets: A clinical prospective cross-sectional comparative investigation
(2020) Athanasiou, Athanasios E.
Objective: The objective of this report is to use in orthodontic patients the methods of virtual indirect bonding and direct bonding using eye vision or loupesin order to compare their accuracy in the three dimensions of space. Material and methods: Brackets were directly placed by one clinician to 18 patients with a total number of 298 permanent teeth. Then loupes were used to improve bracket positioning. Intraoral scanning of the dental arches was performed before bonding, after direct bonding and after the use of loupes. Subsequently, an orthodontic software was used to virtually indirectly bond the brackets on the first intraoral scanning taken before bonding. A three-dimensional mesh processing software was used to superimpose the three scans and to perform measurements in the mesio-distal and occlusal-gingival dimensions as well as in the mesio-distal angulation. Results: Virtual indirect bonding was more accurate in bracket positioning compared to direct bonding by eye vision or using loupes in all teeth and most of the teeth groups measured. Specific teeth and locations in the dental arch areas exhibited more bonding inaccuracies in the two direct bonding groups as compared to virtual indirect bonding. The use of loupes did not significantly increase the bonding accuracy compared to direct vision. Conclusion: Indirect virtual bonding facilitated accurate bracket positioning compared to direct vision or with loupes direct bonding in the dimensions and angulation measured.
Do facial morphology, posture and function change following glossectomy? A systematic review
(2019) Kaklamanos, Eleftherios G; Athanasiou, Athanasios E.
Objectives: To systematically investigate and critically appraise the quality of the currently available literature regarding the morphological, postural, and functional changes observed in individuals following glossectomy. Materials and methods: A search without restrictions in eight databases (including grey literature) and hand searching from inception until March 2018 was performed. Data on morphological, postural, and functional changes after glossectomy were reviewed. Methodological quality was evaluated using the risk of bias in nonrandomized studies of intervention tool. Results: Out of 835 initially identified unique records, only three articles following patients for 1 year after glossectomy fulfilled the selection criteria. Overall, no significant morphological, postural, and functional changes were observed. Only the distance between the dorsum and the nasal line increased and the freeway space decreased significantly. Conclusions: Overall, no significant differences were noted in the medium term, in terms of dentofacial structures adaptation and tongue function following glossectomy. Further research is warranted in order to elucidate the consequences of the altered oral environment.
Does common prescription medication affect the rate of orthodontic tooth movement? A systematic review
(2018-03-06) Makrygiannakis, Miltiadis A.; Kaklamanos, Eleftherios G; Athanasiou, Athanasios E.
Background: As the taking of any medication may theoretically affect the complex pathways responsible for periodontal tissue homeostasis and the events leading to orthodontic tooth movement, it is considered important for the orthodontist to be able to identify prospective patients’ history and patterns of pharmaceutical consumption. Objective: To systematically investigate and appraise the quality of the available evidence regarding the effect of commonly prescribed medications on the rate of orthodontic tooth movement. Search methods: Search without restrictions in eight databases and hand searching until June 2017. Selection criteria: Controlled studies investigating the effect of commonly prescribed medications with emphasis on the rate of orthodontic tooth movement. Data collection and analysis: Following study retrieval and selection, relevant data was extracted and the risk of bias was assessed using the SYRCLE’s Risk of Bias Tool. Results: Twenty-seven animal studies, involving various pharmacologic and orthodontic interventions, were finally identified. Most studies were assessed to be at unclear or high risk of bias. The rate of orthodontic tooth movement was shown to increase after the administration of diazepam, Vitamin C and pantoprazole, while simvastatin, atorvastatin, calcium compounds, strontium ranelate, propranolol, losartan, famotidine, cetirizine, and metformin decreased the rate of orthodontic tooth movement. No interference with the rate of orthodontic tooth movement was reported for phenytoin, phenobarbital and zinc compounds, whereas, inconsistent or conflicting effects were noted after the administration of L-thyroxine, lithium compounds, fluoxetine and insulin. The quality of the available evidence was considered at best as low. Conclusions: Commonly prescribed medications may exhibit variable effects on the rate of orthodontic tooth movement. Although the quality of evidence was considered at best as low, raising reservations about the strength of the relevant recommendations, the clinician should be capable of identifying patients taking medications and should take into consideration the possible implications related to the proposed treatment.
Does long-term use of pain relievers have an impact on the rate of orthodontic tooth movement? A systematic review of animal studies.
(2019-09-26) Kaklamanos, Eleftherios G; Athanasiou, Athanasios E.
Background: Pain relief drugs are used and misused widely and may theoretically affect the events leading to orthodontic tooth movement. Objective: To systematically investigate and appraise the quality of the available evidence regarding the effect of pain relief medications on the rate of orthodontic tooth movement. Search methods: Search without restrictions in eight databases (including grey literature) and hand searching until October 2018. Selection criteria: Animal controlled studies investigating the effect of pain relievers on the rate of orthodontic tooth movement. Data collection and analysis: Following study retrieval and selection, relevant data were extracted and the risk of bias was assessed using the SYRCLE’s risk of bias tool. Results: Fourteen studies were finally identified, most of which at unclear risk of bias. Ibuprofen and loxoprofen did not show any significant effects on the rate of orthodontic tooth movement, whereas indomethacin, ketorolac, morphine, and high doses of etoricoxib were found to decrease it. Inconsistent or conflicting effects were noted after the administration of acetaminophen, acetylsalicylic acid, celecoxib, meloxicam, and tramadol. The quality of the available evidence was considered at best as low. Conclusions: Long-term consumption of pain relievers may affect the rate of orthodontic tooth movement. The orthodontist should be capable of identifying patients taking pain relievers independently of orthodontic treatment and consider the possible implications.
Effect of intraoral aging on the setting status of resin composite and glass ionomer orthodontic adhesives
(2014-04) Athanasiou, Athanasios E.
Introduction: The aim of this study was to assess the effect of intraoral aging on the setting status of a resin composite and a glass ionomer adhesive, relative to control specimens stored in water. Methods: Metallic brackets were bonded with resin composite orthodontic adhesive (Transbond XT; 3M Unitek, Monrovia, Calif) or a glass ionomer cement (Fuji I; GC, Tokyo, Japan) to recently extracted premolars and kept in water for 6 months. The same materials were also bonded to the premolars of orthodontic patients. After 6 months, the teeth were carefully extracted, with the brackets intact on their buccal surfaces. All teeth were embedded in epoxy resin and sectioned buccolingually. Fourier transform infrared microscopy and Raman microscopy were used for the estimation of the degree of cure in the composite and the salt yield in the glass ionomer adhesives. Results: The control samples of the composite showed significantly lower degrees of cure than did the retrieved specimens (52.40% ± 3.21% vs 57.62% ± 1.32% by Fourier transform infrared microscopy, and 61.40% ± 2.61% vs 67.40% ± 3.44% by Raman microscopy). Raman microscopy significantly overestimated the degree of cure and failed to provide reliable information for the salt yield in the glass ionomer cement. Fourier transform infrared microscopy showed increased, but no statistically significant difference in, aluminum-carboxylate salts in the retrieved specimens.
The effect of orthodontic adhesive and bracket-base design in adhesive remnant index on enamel
(2015-02-14) Athanasiou, Athanasios E.
Background: The purpose of this study was to identify the effects of bracket-base design and adhesive on adhesive remnant index (ARI) and enamel surface area covered by adhesive. Methods: The sample consisted of 32 recently extracted premolars. The teeth were randomly assigned to one of four groups: conventional mesh base and composite resin; laser-etched base and composite resin; conventional mesh base and resin-modified glass ionomer; and laser-etched base and resin-modified glass ionomer. After a week, all brackets were debonded. The debonded bracket-base surface and the buccal surface of each tooth were studied under the microscope, and the remaining adhesive was scored using the ARI. The extent of coverage of the tooth by adhesive remnants was also calculated, outlining the different areas of adhesive. Results: A Fisher’s exact test indicated significant differences between the groups. The adhesive resin group showed the highest ARI scores independent of the bracket-base design, whereas between the two bracket-base designs, the laser-etched bracket design showed higher ARI. ARI scores reliably depict the extent of enamel covered by adhesive compared with the measurement of the actual area covered. Conclusion: Varying the bracket base and adhesive may result in different ARI scores, which can affect the enamel surface during debonding.
Effectiveness of extraction of primary canines for interceptive management of palatally displaced permanent canines: a systematic review and meta-analysis
(2018) Alyammahi, Ameirah Saeed; Kaklamanos, Eleftherios G; Athanasiou, Athanasios E.
Background: Although extraction of primary canines in the mixed dentition has been suggested as a measure to prevent impaction of palatally displaced permanent canines (PDCs), the relevant evidence has been inconclusive. Objective: To assess the effectiveness of this practice and investigate the quality of the evidence. Search methods: Search without restrictions in 15 databases and hand searching until April 2017. Selection criteria: Randomized clinical trials comparing extraction of primary canines in the mixed dentition to no treatment. Data collection and analysis: Following study retrieval and selection, data extraction, and individual study risk of bias assessment using the Cochrane Risk of Bias Tool, the random effects method of combining treatment effects was used. The overall quality of the available evidence was assessed with the Grades of Recommendation, Assessment, Development, and Evaluation approach. Results: Finally 5 studies were identified involving 214 individuals, followed for up to 48 months post-intervention. Two studies were at low and the rest at high risk of bias. Although at the 12-month evaluation, extraction of the primary canine did not result in a statistically significant difference [risk ratio (RR): 1.537; 95% confidence interval (CI): 0.656–3.601, P = 0.323; 1 study, n = 67 individuals], beyond 12 months a benefit was noted (RR: 1.784; 95% CI: 1.376–2.314, P = 0.000; 5 studies, n = 214 individuals; I2 = 0%). Analysis of the studies at low risk of bias confirmed the above-mentioned result (RR: 1.713; 95% CI: 1.226–2.394, P = 0.002; 2 studies, n = 91 individuals; I2 = 0%; moderate quality evidence). No difference was observed regarding root resorption of adjacent permanent teeth (RR: 0.602; 95% CI: 0.277–1.308, P = 0.200; 1 study; n = 67 individuals; moderate quality evidence). Conclusions: Extraction of primary canines in the mixed dentition may increase the chance of subsequent successful eruption of PDC in the long term. However, better study standardization is necessary.
Effects of systemic medication on root resorption associated with orthodontic tooth movement: a systematic review of animal studies
(2018-07-09) Makrygiannakis, Miltiadis A.; Kaklamanos, Eleftherios G; Athanasiou, Athanasios E.
Background: Theoretically, root resorption could be modulated by any medication taken that exhibits possible effects on the implicated molecular pathways. Objectives: To systematically investigate and appraise the quality of the available evidence from animal studies, regarding the effect of commonly prescribed systemic medication on root resorption associated with orthodontic tooth movement. Search methods: Search without restrictions in eight databases (PubMed, Central, Cochrane Database of Systematic Reviews, SCOPUS, Web of Science, Arab World Research Source, ClinicalTrials.gov, ProQuest Dissertations and Theses Global) and hand searching until April 2018 took place. One author developed detailed search strategies for each database that were based on the PubMed strategy and adapted accordingly. Selection criteria: Controlled studies investigating the effect of systemic medications on root resorption associated with orthodontic tooth movement. Data collection and analysis: Following study retrieval and selection, relevant data were extracted and the risk of bias was assessed using the SYRCLE’s Risk of Bias Tool. Results: Twenty-one studies were finally identified, most of which at unclear risk of bias. Rootp;resorption was shown to increase in Vitamin C treated animals in comparison with the control group, whereas a comparative decrease was noted after the administration of the alendronate, ibuprofen, growth hormone, low doses of meloxicam, simvastatin, lithium chloride and strontium ranelate. No difference was noted for acetaminophen, aspirin, fluoxetine, atorvastatin, misoprostol, zoledronic acid and zinc. Finally, inconsistent effects were observed after the administration of celecoxib, prednisolone and L-thyroxine. The quality of the available evidence was considered at best as low. Conclusions: The pharmaceutical substances investigated were shown to exhibit variable effects on root resorption. Although the overall quality of evidence provides the clinician with a cautious perspective on the strength of the relevant recommendations, good practice would suggest that it is important to identify patients consuming medications and consider the possible implications.
English Terms with Greek Origin used in Orthodontics
(2017) Athanasiou, Athanasios E.
Abstract: Greek is an independent branch of the Indo- European family of languages, native and official in Greece and Cyprus. It has the longest documented history of any living Indo-European language, spanning more than 3400 years of written records. English is a language that has roots in many other languages. Many modern English words have Greek roots and knowing some of these roots helps to figure out other English words. According to Webster’s New International Dictionary, Latin and Greek, especially Greek, is an inexhaustible source for the creation of scientific terms. A good deal of English vocabulary derives from Greek, especially in science, medicine, and technology. The literature of the Greeks, together with the Romans, is the starting point of Western thought. It is hard to imagine what our culture would be like without the philosophy of Plato, the dramas of Sophocles, the epics of Homer, the courtroom arguments of Demosthenes, the mathematical discoveries of Euclid and Archimedes, or the medical investigations of Hippocrates. The authors of this dictionary made their best efforts to produce a comprehensive work, based on several orthodontic, dental, medical and language sources, and to include as many English terms used in Orthodontics with Greek origin. Although it is extremely difficult to make an all-inclusive list, the authors feel that the words which may have been missed are negligible in number. It is the sincere hope of the authors that this comprehensive work will help in the better understanding of several not so widely used terms as well as to elucidate and emphasize the value of Greek in the orthodontic specialty. We, as Greeks, are privileged and lucky to speak a language that constitutes a keystone on which science has been based since its very beginning.
In Vitro Assessment of Cytotoxicity and Estrogenicity of Vivera® Retainers
(2018-10) Al Naqbi, Shaima; Athanasiou, Athanasios E.
Aim: To investigate the cytotoxicity and estrogenicity of Vivera® retainers by assessing their biological behavioral effects as-received from the manufacturer and after retrieved from patients. Materials and methods: In this, in vitro investigation six sets (maxillary and mandibular) of Vivera® retainers, three as received and three retrieved after four weeks of use by patients of an orthodontic postgraduate clinic, were immersed in the normal saline solution for 14 days following different modes of sterilization. The estrogenicity assays involved two cell lines, namely the estrogen-sensitive MCF-7 and the estrogen-insensitive MDA-MB-231. Following a 6 day incubation with the solutions to be tested, at concentrations varying from 5% to 20% v/v in medium supplemented with 2% fetal calf serum devoid of endogenous estrogens, estrogenicity was assessed by cell counting; β-Estradiol was used as positive control. The statistical analysis of data was performed with two-way analysis of variance (ANOVA) with appliance and concentration as predictors. Differences were further investigated with the Tukey multiple comparison tests at the 0.05 level of significance. Results: No significant MCF-7 proliferation was induced by the three samples compared either to the eluents from as-received retainers or to the negative control. As expected, β-estradiol induced a potent stimulation of MCF-7 cell proliferation, while no effect was observed on MDA-MB-231 cells. Conclusion: Under the conditions of this experiment eluents of as-received and retrieved Vivera® retainers did not seem to exhibit xenoestrogenic activity. Clinical significance: Vivera® retainers can be used as part-time removable oral appliances following the manufacturer’s instructions.
In vitro spectrophotometric evaluation of Vivera® clear thermoplastic retainer discolouration
(2014-11) Athanasiou, Athanasios E.
Aims: To investigate the in vitro effect of different staining solutions on the colour stability of Vivera® retainers. Methods: Thirty flat specimens fabricated using the Vivera® material (Align Technology Inc., CA, USA) were assigned into five Groups (A, B, C, D and E) and immersed at 37°C in solutions of distilled water (control), coffee, tea, red wine, and Coca-Cola®. The CIE colour parameters (L*, a*, b*) of each specimen were measured before immersion (T0) and after 12 hours (T1), three days (T2) and seven days (T3) of solution exposure. Colour differences (ΔΕ) between the interval groups were calculated. Results: Significant differences were observed concerning (i) L* between T3 and T0, T1 and T2 for Group B; (ii) a* between T0 and T1, T2 and T3 for Groups B, C, D and E, as well as between T1 and T2 for Group C; and (iii) b* between T0 and T1, T2 and T3 for Group B and between T0 and T2 and T3 for Group C. The differences between ΔΕ(T1-T0), ΔΕ(T2-T0) and ΔΕ(T3-T0) were statistically significant for Groups B and C, as well as the difference between ΔΕ(T1-T0) and ΔΕ(T2-T0) for Group D. Conclusions: Coffee, tea and red wine caused visible changes in the retainers’ colour.
An in vivo spectrophotometric evaluation of Vivera® and Essix® clear thermoplastic retainer discolouration
(2018-05-01) Athanasiou, Athanasios E.
Aim: To assess the in vivo colour alterations of two different clear thermoplastic retainers. Methods: Thirty patients were randomly allocated into two Groups (N = 15) following the completion of active orthodontic treatment. Group 1 received Vivera® and Group 2 Essix® C+ thermoplastic retainers. Each patient was provided with two fabricated retainers (one for use and the other to serve as a control). The CIELAB parameters of the patients’ upper central incisors were measured with a SpectroShade™ spectrophotometer immediately after retainer placement (T0) and again after 15 days (T1), one month (T2) and three months (T3). The measurements were also performed on teeth without the retainer in place. ΔE differences were calculated. Results: ΔE changes from T0 to T1, T2 or T3 showed no statistically significant differences between Groups 1 and 2 within any combination of measurements or teeth. ΔE(T3-T0) changes for used retainers were 1.55 times higher than control appliances (p = 0.002) and 1.44 times higher than for teeth-only (p = 0.004). For used retainers, changes between T3 and T0 were 1.56 times higher than between T1 and T0 and 1.47 higher than between T2 and T0 (p < 0.001). There were no statistically significant differences in ΔE between teeth 11 and 21. Conclusions: Used retainers exhibited greater colour change than control appliances or teeth-only readings, and increased commensurate with the duration of use. Vivera® and Essix® retainers exhibited similar colour stability. All differences observed were considered clinically acceptable (ΔE < 3.7), although prolonged use could cause clinically significant colour changes.
Medication and orthodontic tooth movement
(2019-06) Kaklamanos, Eleftherios G; Athanasiou, Athanasios E.
Abstract: As any pharmaceutical substance may influence the events associated with orthodontic tooth movement, it is of importance for the clinician to be able to recognize any prospective patient’s history and patterns of medicinal consumption. This review presents the effects of various commonly prescribed medications on the rate of orthodontic tooth movement. The article concludes that it remains, to a degree, unclear which types of medication may have a clinically significant effect in everyday clinical scenarios. However, since both prescription and over-the-counter medication use have recently increased significantly among all age groups, good practice suggests that it is important to identify patients consuming medications and consider the possible implications in orthodontic therapy.
Oral Health-Related Quality of Life throughout Treatment with Clear Aligners in Comparison to Conventional Metal Fixed Orthodontic Appliances: A Systematic Review
(2023) Kaklamanos, Eleftherios G; Athanasiou, Athanasios E.
Background: Orthodontic clear aligners constitute an alternative and increasingly used orthodontic treatment modality, offering enhanced esthetics with potential consequences regarding patients’ oral health-related quality of life (OHRQoL). Objective: Summarize and systematically evaluate existing evidence on the OHRQoL of patients treated with orthodontic clear aligners compared to treatment with conventional metal, fixed appliances. Search Methods: We searched without limitations six databases and searched manually the reference lists of relevant studies up to the end of October 2022. Selection Criteria: We looked for data from prospective studies that compared OHRQoL, using instruments that had undergone full psychometric validation, between orthodontic patients with clear aligners and labial, fixed, metal orthodontic appliances. Data Collection and Analysis: We extracted the data from the located studies, and we assessed the risk of bias with the Cochrane Collaboration suggested tools. The quality of available evidence was based on the GRADE approach. Results: Three studies were identified. OHRQoL was impacted less by clear aligners compared to treatment with conventional labially placed, fixed, metal appliances. The exploratory meta-regression, with the time point of assessment as predictor, did not reveal any statistically significant effect. The quality of the available evidence ranged from very low to low. Conclusions: According to the exploratory synthesis of the limited available dataset, treatment with clear aligners could be associated with better OHRQoL ratings compared to treatment with conventional labially placed, metal, fixed appliances. However, the quality of the presented evidence renders further high-quality studies warranted to be able to reach safer conclusions.
Orthodontic treatment of a nine-year-old patient with hypophosphatemic rickets diagnosed since the age of two: A case report
(2020) Athanasiou, Athanasios E.
Abstract: Hypophosphatemic rickets (HR) is a genetic disorder with various types of inheritance. It results mainly from defects in factors that control mineral ion homeostasis such as 1,25(OH)2D (Calcitriol) and FGF23 (Fibroblast Growth Factor 23). The existing bibliography regarding orthodontic treatment in patients with hypophosphatemic rickets is extremely limited. The aim of this case report is to describe the orthodontic treatment of a 9-year old Caucasian female patient suffering from HR. The patient presented a healthy late mixed dentition and periodontium. She suffered from a mild Class III maxillary skeletal pattern. There was a bilateral posterior crossbite, short lingual frenulum, a right maxillary mesioposition with a Class II subdivision on this side and a moderate space deficiency in the dental arches. The disorder was controlled by medication. In specific, patient was taking 1.5 mL of phosphate four times per day, 0.3 mL of calcitriol twice per day and 50,000 IU of Vitamin D3 on a weekly basis. Given the Class III skeletal pattern, the medical condition and the absence of relevant bibliography, it was decided to perform maxillary expansion, facemask traction and orthodontic treatment with fixed appliances. By the end of treatment, Class I canine and molar relationships were achieved, overjet and overbite were corrected and space deficiency was addressed in both arches. PAR index was 27 at the beginning of treatment and became 2 by the end of treatment (92.5% correction). The aesthetic component of IOTN was 4 and changed to 1, while the dental component used to be 5i and became 2g. With regards to retention, upper and lower fixed retainers from canine to canine and upper and lower vacuum formed appliances were used. In conclusion, a patient with controlled HR was orthodontically treated in a successful way. Orthodontic therapy was performed in a minimally invasive manner. Thus, HR does not constitute a contraindication for orthodontic treatment, when the disorder is kept under control.
Performance of Hawley-type retainers: a systematic review of randomized clinical trials
(2018) Al Rahma, Wafa Jaber; Kaklamanos, Eleftherios G; Athanasiou, Athanasios E.
Background: Although post-treatment changes are almost inevitable, and retention has long been recognized as one of the most critical and routine problems faced by orthodontists, there remains a lack of certainty regarding the parameters of any definitive retention protocol following orthodontic treatment. Objective: To investigate the performance of the Hawley-type retainers. Search methods: Search without restrictions in 15 databases and hand searching until December 2016. Selection criteria: Randomized clinical trials comparing the performance of Hawley-type retainers to other removable appliances or comparing different Hawley-type retainers’ wearing schedules. Data collection and analysis: Following study retrieval and selection, data extraction and individual study risk of bias assessment using the Cochrane Risk of Bias Tool took place. The overall quality of the available evidence was assessed with the Grades of Recommendation, Assessment, Development, and Evaluation approach. Results: Finally, 10 studies were identified involving 854 individuals, followed for up to 1 year after debonding. Eight studies compared subjects using Hawley and clear thermoplastic retainers; another compared Hawley to positioner and, finally, one trial involved individuals allocated to different Hawley appliance wearing schedules. Three studies were considered as being of low, four of unclear, and three of high risk of bias. In general, few differences were observed between the Hawley and other removable retainers regarding outcomes relevant to maxillary and mandibular dental arch measurements, dental arch relationships and occlusal contacts, speech evaluation, patient reported outcomes, adverse effects, and problems related to the appliances, as well as economic evaluation related outcomes. Moreover, no differences were observed between the compared Hawley wearing schedules. Overall, the quality of the available evidence was considered low. Conclusions: Given the overall quality of the available evidence and the multitude of parameters, which may have affected the results of the included trials, good practice would suggest further research in the respective field in order to increase both the quantity and quality of information available.
Precision of a Reflectance Spectrophotometer in Measuring Anterior Tooth Color
(2018) Athanasiou, Athanasios E.
Background: Intraorally, a common instrumental approach for measuring tooth color is reflectance spectrophotometry. Objective: To evaluate the precision of a reflectance spectrophotometer in accurately measuring anterior tooth color. Methods: The twelve labial surfaces of the anterior teeth of sixteen patients were measured spectrophotometrically (SpectroShadeTM Micro) on three non-consecutive days (1st, 2nd, 8th). Tooth color was converted to L*, a* and b* colorimetric values; intra-examiner repeatability was assessed in ΔΕ-units between two same day repeated measurements. Intra-examiner reproducibility was measured for the effect of tooth type, time and their interaction. The linear effect of the acquisition angle on the colorimetric values of each tooth was also estimated. Results: The highest values of systematic or random error occurred for teeth #33, #43 and #32. There were no statistically significant differences in systematic or random errors for any tooth between the three measurement days. Statistically significant differences were found for tooth type (p=0.039), whereas time and tooth and time interaction were not statistically significant. A statistically significant linear correlation was found between the L* and a* values and the acquisition angle for teeth #12 and #31, (p<0.008). Conclusion: The reflectance spectrophotometer provided a precise measurement of tooth color in-vivo since the systematic and random errors generated were below the threshold for perceivable color mismatches (ΔΕ<1). In rejection of the null hypotheses, the tooth type (maxillary central incisors) and variation of the acquisition angle of image capture (L* and a* parameters in teeth #12 and #31) affected the reproducibility of intraoral spectrophotometric measurements.
Pulpal and Periodontal Tissues Changes Associated with Le Fort I and Sagittal Split Ramus Osteotomies: A review
(2018) Athanasiou, Athanasios E.
Introduction: Le Fort I and sagittal split ramus osteotomies are the most commonly performed orthognathic surgery procedures on the maxilla and mandible, respectively. Techniques: Despite progress in the techniques, these procedures may still be associated with morbidity, expressed as inflammation, inadequate bony union, periodontal damages or in extreme cases even total bone loss. Discussion: Through a comprehensive review of the literature, the influences of maxillary and mandibular surgery on Pulpal Blood Flow (PBF), pulp sensitivity and pulp vitality are examined. Moreover, adverse effects of maxillary surgery on tooth color and periodontal tissues are also reported. The effects had a variety of expression. Concerning maxillary surgery, some studies showed an initial increase in PBF followed by a decrease to the baseline or even lower levels after 1-3 months. Other studies found an initial decrease in PBF followed by an increase soon after. There were also studies that showed no significant PBF changes, in contrast. Conclusion: Concerning mandibular surgery, a recent study showed a decrease in PBF immediately after sagittal split ramus osteotomy. Some authors detected tooth discoloration of maxillary teeth after Le Fort I osteotomy. Root resorption and root injury were also detected, but were of minor significance. Usually, these adverse effects derive from injury of the vessels of the palatal pedicle. This pedicle should be maintained intact for the avoidance of blood flow impairments. In addition, the descending palatine artery should be protected during maxillary surgery procedures in order to maintain the highest possible blood flow on the maxillary teeth.