Bracket failure increases the treatment time of orthodontic therapy and burdens patients with unnecessary costs, increased chair time, and possible new appointments. To compare the bond failures of different orthodontic materials based on the results of available clinical studies. A systematic search of clinical trials was performed in the Cochrane, Embase, and Pubmed databases with no limitations. The list of investigated techniques contained conventional acid-etch primer (CM-AEP), self-etch primer (SEP), self-cure resin (SCR), and simple or resin-modified glass ionomer (RM-GIC) materials and procedures. Clinical studies reporting the failure rate of bonded brackets after using direct adhesive techniques on buccal sites of healthy teeth were included. Bracket failure rates from eligible studies were extracted by two authors independently. Risk ratios (RRs) were pooled using the random-effects model with DerSimonian–Laird estimation. Thirty-four publications, involving 1221 patients, were included. Our meta-analysis revealed no significant difference in the risk of bracket failures between SEP and CM-AEP. After 6, 12, and 18 months of bonding, the values of RR were 1.04 [95% confidence interval (CI), 0.67–1.61], 1.37 (95% CI, 0.98–1.92), and 0.93 (95% CI, 0.72–1.20), respectively. At 18 months, bracket failure was 4.9 and 5.2% for SEP and CM-AEP, respectively. Heterogeneity was good or moderate (I² < 42.2%). The results of RM-GIC at 12 months indicated a 57% lower risk of bracket failure using SCR as compared with RM-GIC (RR: 0.38; 95% CI, 0.24–0.61). At 18 months, bracket failures for SCR and RM-GIC were 15.8 and 36.6%, respectively (RR: 0.44; 95% CI, 0.37–0.52, I² = 78.9%), demonstrating three to six times higher failure rate than in the case of etching primer applications. A major limitation of the present work is that the included clinical trials, with no exceptions, showed variable levels of risk of bias. Another possible problem affecting the outcome is the difference between the clustering effects of the split mouth and the parallel group bracket allocation methods. The results revealed no significant difference between SEP and CM-AEP up to 18 months after application. RM-GIC had much worse failure rates than acid-etching methods; additionally, the superiority of SCR over RM-GIC was evident, indicating strong clinical relevance. Prospero with CRD42020163362.

The use of maxillary expanders has the effect of distancing the maxillary bones at the level of the median palatal suture. During maxillary expansion, the main resistance forces occur at the zygomatico-maxillary sutures, and not in the median palatal suture, which is the basic principle on which this method is based. In this observational study, we evaluated possible complications at the skeletal and dentoalveolar level after palatal split using miniscrew-assisted rapid palatal expansion (MARPE) associated or not with corticopuncture (CP) therapy. The study included 27 patients with maxillary transverse deficiency and unilateral or bilateral cross-bite. Skeletal and dentoalveolar changes were evaluated using cone beam computed tomography (CBCT) images acquired before and after expansion. The mid-palatal suture was separated in 88.88% of cases, buccal bone height of the alveolar crest had decreased at first molar both at oral and palatal level by approximately 2.07 mm in 40.7% of cases whilst the remaining 59.3% showed insignificant bone loss, with canines exhibiting buccal tipping of 4.10° in 62.5% of cases. Changes of the occlusal planes were observed in 10 cases (37%). Maxillary canines tended to show symmetric buccal inclinations relative to the maxillary basal bone. Six patients; 22.22% showed hypertrophy/hyperplasia of the palatal mucosa associated with ulcerations, erythema, itching, and discomfort in the area. Swelling at the mid-palatal suture after split was observed in all cases and was caused by the resultant force. No cases of necrosis of the palatal mucosa were observed. Although occlusal modifications occur after palatal split, especially in unilateral cross-bite cases, these changes can be treated with the help of fixed orthodontic appliances.

An accurate impression is vital during prosthodontic rehabilitation. Digital scanning has become an alternative to conventional impressions. This study compares conventional preliminary impression techniques with digital scanning, evaluating the efficiency, treatment comfort, and trueness. Impressions of 28 patients were taken using conventional and digital techniques. The efficiency of both impression techniques was evaluated by measuring the mean working time. A visual analog scale questionnaire (1–10) was used to appreciate the participants’ perceptions of discomfort. Morphometric measurements, which were carried out to determine the differences between the casts, were made on the buccolingual cross sections of teeth 11 and 31 and the distolingual and mesiobuccal cusp tips of each first molar. The total treatment time was 75.5 min for conventional and 12 min for digital impressions. The patients scored a mean discomfort assessment of 6.66 for conventional and 9.03 for digital scanning. No significant differences existed between the examined areas (p < 0.05, Wilcoxon and Mann–Whitney tests) of the digital casts obtained by both techniques. The intraoral scan can be considered as an alternative to conventional preliminary impressions for performing study model analysis during orthodontic treatment planning. The digital impression is more comfortable and accepted by the patients than the conventional impression and has a shorter working time.

(1) Background: Hypodontia has a multifactorial aetiology, in which genetic factors are a major component. Associated with this congenital absence, the formed teeth may show differences in size and shape, which may vary with the specific genetic variants and with the location of the missing teeth. The aims of the present study were to investigate a specific variant of MSX1, derive morphometric tooth measurements in a sample of patients with isolated maxillary lateral incisor agenesis and matched controls, and model the findings. (2) Methods: Genotyping of the MSX1 rs8670 genetic variant and morphometric measurements with a 2D image analysis method were performed for 26 hypodontia patients and 26 matched controls. (3) Results: The risk of upper lateral incisor agenesis was 6.9 times higher when the T allele was present. The morphometric parameters showed significant differences between hypodontia patients and controls and between the unilateral and bilateral agenesis cases. The most affected crown dimension in the hypodontia patients was the bucco-lingual dimension. In crown shape there was significant variation the Carabelli trait in upper first molars. (4) Conclusions: The MSX1 rs8670 variant was associated with variations in morphological outcomes. The new findings for compensatory interactions between the maxillary incisors indicate that epigenetic and environmental factors interact with this genetic variant. A single-level directional complex interactive network model incorporates the variations seen in this study.

The anthropometric method is an important tri-dimensional and non-invasive assessment instrument for accurate diagnosis in paedodontics, orthodontics, and other medical fields. Our aim was to propose a technique that is accessible for clinicians and to determine the reference values for Romanian children and adolescents for the facial parameters selected. We proposed three basic instruments: a plastic compass, a ruler, and a digital caliper. Eighty-five children and adolescents (62% girls and 38% boys), aged between 3.5 and 14.5 years, were included in the study. We selected eight transversal, 12 vertical, and three sagittal measurements. Facial indices, according to Farkas L.G., were directly determined. The correlations between facial and general growth parameters, using Pearson correlation coefficient, for the entire sample were significant, direct, and strong for the following: Zy-Zy, Go-Go, N-Gn, N-Sn, Sto-Gn, Tr-Gn, Tr-Sn, Tr-Tr (r = 0.526–0.925, p < 0.001), and insignificant for Sn-Sto (r = 0.099–0.124, p > 0.354). The highest correlation coefficient is exhibited by Tr-Gn (r = 0.893 with height and r = 0.925 with weight). When performing a gender related comparison, we noticed that the vertical and transversal linear parameters and some facial indices are increased in boys (p < 0.05), depending on the age group. The simplified anthropometric technique represents an accessible method to every clinician, bringing important information related to dentofacial growth, diagnosis, and treatment planning in dentistry.