Adverse effects of lingual and buccal orthodontic techniques: A systematic review and meta-analysis
Por:
Ata-Ali F, Ata-Ali J, Ferrer-Molina M, Cobo T, De Carlos F and Cobo J
Publicada:
1 jun 2016
Categoría:
Orthodontics
Resumen:
Introduction: The aim of this systematic review was to assess the
prevalence of adverse effects associated with lingual and buccal fixed
orthodontic techniques. Methods: Two authors searched the PubMed,
EMBASE, Cochrane Library, and LILACS databases up to October 2014.
Agreement between the authors was quantified by the Cohen kappa
statistic. The following variables were analyzed: pain, caries, eating
and speech difficulties, and oral hygiene. The Newcastle-Ottawa scale
was used to assess risk of bias in nonrandomized studies, and the
Cochrane Collaboration's tool for assessing risk of bias was used for
randomized controlled trials. Results: Eight articles were included in
this systematic review. Meta-analysis showed a statistically greater
risk of pain of the tongue (odds ratio [OR], 28.32; 95% confidence
interval [95% CI], 8.60-93.28; P < 0.001), cheeks (OR, 0.087; 95% CI,
0.036-0.213; P < 0.0010), and lips (OR, 0.13; 95% CI, 0.04-0.39; P <
0.001), as well as for the variables of speech difficulties (OR, 9.39;
95% CI, 3.78-23.33; P < 0.001) and oral hygiene (OR, 3.49; 95% CI,
1.02-11.95; P = 0.047) with lingual orthodontics. However, no
statistical difference was found with respect to eating difficulties
(OR, 3.74; 95% CI, 0.86-16.28; P = 0.079) and caries (OR, 1.15; 95% CI,
0.17-7.69; P = 0.814 [Streptococcus mutans] and OR, 0.67; 95% CI,
0.20-2.23; P = 0.515 [Lactobacillus]). Conclusions: This systematic
review suggests that patients wearing lingual appliances have more pain,
speech difficulties, and problems in maintaining adequate oral hygiene,
although no differences for eating and caries risk were identified.
Further prospective studies involving larger sample sizes and longer
follow-up periods are needed to confirm these results.
Filiaciones:
Ata-Ali F:
Collaborator professor, Area of Orthodontics, Department of Surgery and Medical-Surgical Specialties, Medical and Dental School, University of Oviedo, Instituto Asturiano de Odontologia, Oviedo, Spain.
:
Public Dental Health Service, Arnau de Vilanova Hospital
associate professor, European University of Valencia, Valencia, Spain
Ferrer-Molina M:
Adjunct professor, Stomatology Department, Medical and Dental School, University of Valencia, Valencia, Spain
Cobo T:
Assistant professor, Area of Orthodontics, Department of Surgery and Medical-Surgical Specialties, Medical and Dental School, University of Oviedo, Instituto Asturiano de Odontologia, Oviedo, Spain
De Carlos F:
Associate professor, Area of Orthodontics, Department of Surgery and Medical-Surgical Specialities, Medical and Dental School, University of Oviedo, Instituto Asturiano de Odontologia, Oviedo, Spain
Cobo J:
Chairman, Area of Orthodontics, Department of Surgery and Medical-Surgical Specialities, Medical and Dental School, University of Oviedo, Instituto Asturiano de Odontologia, Oviedo, Spain
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