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Biomedical subjects

Manuel O Lagravere

Publications and source records attributed to Manuel O Lagravere.

3 recordsLinked to original sources

Implant vs screw loading protocols in orthodontics.

OBJECTIVE: This systematic review presents the loading protocols applied when using implants and/or screws in orthodontic treatments. MATERIALS AND METHODS: Clinical trials which assessed the use of implants and/or screws for orthodontic anchorage and studies involving treatment on syndromic patients, surgery, other simultaneous treatments, or appliances (ie mini-plates) were considered. Electronic databases (Medline, Medline In-Process & Other Non-Indexed Citations, Lilacs, Pubmed, Embase, Web of Science, and All Evidence Based Medicine Reviews) were searched with the help of a senior Health Sciences librarian. Abstracts which appeared to fulfill the selection criteria were selected by consensus. The original articles were then retrieved and evaluated with a methodological checklist. References were also hand searched for possible missing articles. RESULTS: Eleven articles fulfilled the selection criteria established. Five studies involved the use of implants while six involved the use of screws for orthodontic purposes. An individual methodological analysis for each article was made. CONCLUSIONS: Loading protocols for implants involve a minimum waiting period of 2 months before applying orthodontic forces while loading protocols for screws involve immediate loading or a waiting period of 2 weeks to apply forces. Success rates for implants were on average higher than for screws.

Bone Screws↗

Long-term dental arch changes after rapid maxillary expansion treatment: a systematic review.

This systematic review evaluates long-term dental arch changes after rapid maxillary expansion treatment on orthodontic patients with constricted arches. Clinical trials that assessed dental arch changes through measurements on dental casts or cephalometric radiographs were selected. No patients with surgical or other simultaneous treatment during the active expansion period were accepted. Electronic databases were searched with the help of a senior Health Sciences librarian. Original articles were retrieved from the selected abstracts, and their references were also scanned for possible missing articles. Forty-one articles met the initial inclusion criteria, but 35 were later rejected because they lacked a control group or only evaluated dental changes or used a semirapid technique. Some of them also lacked a reported measurement error. From the remaining articles, two did not report a long-term evaluation. From the final four articles, two measured changes through dental casts and two assessed changes through radiographs (one through lateral cephalometric radiographs and one through posteroanterior radiographs). Similar maxillary molar and cuspid expansion could be found in adolescents and young adults. Significantly less indirect mandibular molar and cuspid expansion was attained in young adults compared with adolescents. A significant overall gain in the maxillary and mandibular arch perimeter was found in adolescents. More transverse dental arch changes were found after puberty as compared with before, but the difference may not be clinically significant. No anteroposterior dental changes were found on lateral cephalometric radiographs.

Adolescent↗

Long-term skeletal changes with rapid maxillary expansion: a systematic review.

The objective was to evaluate long-term transverse, anteroposterior and vertical skeletal changes after rapid maxillary expansion (RME). The data were clinical trials that assessed skeletal changes through cephalometric analysis. No surgical or other simultaneous treatment during the evaluation period was accepted. Electronic databases (PubMed, Medline, Medline In-Process & Other Non-Indexed Citations, Cochrane Database of Systematic Reviews, ASP Journal Club, DARE, CCTR, Embase, Web of Sciences and Lilacs) were searched with the help of a senior Health Sciences librarian. Abstracts that appeared to fulfill the initial selection criteria were selected by consensus. The original articles were then retrieved. A methodological checklist was used to evaluate the quality of the selected articles. Their references were also hand-searched for possible missing articles. Articles without an adequate control group to factor out growth changes were excluded. Only three articles (one measuring transverse and two anteroposterior and vertical changes) measured RME stability after active expansion, all of them had some methodological flaws, which limit the attainable conclusions. An individual analysis of these articles was made. Long-term transverse skeletal maxillary increase is approximately 25% of the total dental expansion for prepubertal adolescents. Better long-term outcomes are expected in transverse changes because of RME in less skeletally mature patients. RME appears not to produce clinically significant anteroposterior or vertical changes in the position of the maxilla and mandible. The conclusions from this systematic review should be considered with caution because only a secondary level of evidence was found. Long-term randomized clinical trials are needed.

Adolescent↗