Background The micro-osteoperforation can be used to increase the rate of tooth movement, simplify complex orthodontic movements, and also help adjust the anchorage but there are conflicting reports on the effectiveness and adverse effects of this intervention. Objectives The aim of our systematic review and meta-analysis was to evaluate the effects of micro-osteoperforation on the rate of tooth movement in patients undergoing orthodontic treatment. Search methods A comprehensive search of MEDLINE, ISI web of science, EMBASE, Scopus, and CENTRAL online databases for studies measuring the effects of micro-osteoperforation on the rate of orthodontic tooth movement from inception to February 2019 was performed. Selection criteria Based on the PICO model, human studies which evaluated the effects of MOP on the rate of tooth movement in patients undergoing orthodontic treatment were selected for this review. Data collection and analysis The relevant data from the eligible studies were extracted using piloted custom extraction forms. The data were combined and analysed using inverse-variance random-effect meta-analysis and the mean difference was used for comparing the outcome measures. Results Six randomized clinical trials were finally included in this meta-analysis. The rate of canine retraction per month was significantly higher in the MOP group [mean difference (MD) = 0.45 mm, 95% CI = 0.17–0.74]. These results were similar with regard to different malocclusions, the jaw on which it was performed, and MOP methods. The patients did not report any significant differences in terms of pain severity levels after MOP. With regard to the adverse effects, one study reported higher amounts of root resorption among patients undergoing MOP. Conclusions The rate of tooth movement was increased after performing MOP but in at least one study higher root resorption was observed. Therefore, the use of MOP can be recommended after weighing the benefits and disadvantages this intervention can bring for each patient. Registration The protocol for this review was registered via crd.york.ac.uk/prospero with the ID CRD42019115499.
However, only the lower midfacial area can be advanced, and it is impossible to resolve the overall midface deficiency due to the position of the Le Fort I osteotomy line. 5,9 Thus, facial implant placement can be considered because the upper-midface deficiency cannot be resolved through Le Fort I osteotomy.Various types of prosthesis, including silicone (polydimethylsiloxane), GoreTex (expanded polytetrafluorethylene, WL Gore & Associates Inc, Flagstaff, AZ), and MedPor (high-density porous polyethylene, Porex Industries, Fairburn, GA), have been used to alleviate facial depression. Since these prostheses are supplied by sizes, premanufactured prostheses of an appropriate size should be selected during the surgery and need to be carved before placing them. Consequentially, the prostheses are not passively fitted on the bone surface, and the gap is formed, leading to a risk of prothesis migration to an unwanted area. Also, since prostheses are often placed based on the surgeon's tactile sense and experiences, there are possibilities of malpositioning or under-/overcorrection. 10
Context: Maxillary deficiency can lead to the reduction of airway space and increase the chances of development of obstructive airway disorders. Facemask therapy is one of the main treatment protocols in developing maxillary deficient patients. Objectives: The purpose of this systematic review and meta-analysis was to assess the changes in the airway dimensions after face-mask therapy in both cleft lip and palate and non-cleft patients. Data Sources: A systematic search in different electronic databases (EMBASE, Pubmed, Cochrance Central register of controlled trials), IADR proceedings and a hand search by October 2020 were conducted and a meta-analysis and systematic review was performed. Results: In patients without cleft lip and palate, upper pharyngeal width was significantly increased by mean of 2.05mm (CI = 95%, 0.61 - 3.50) following facemask therapy in comparison to patients who did not receive the treatment.Other upper pharyngeal (nasopharyngeal) measurements also showed a statistically significant improvement after therapy: S-PNS by 4.64mm (CI = 95%, 3.34 - 5.94), AD1-PNS by 3.81 mm (CI = 95%, 2.40 - 5.21), AD2-PNS by 2.90 mm (CI = 95%, 0.13 - 5.67) and Pm’-SPL by 2.53 (CI = 95%, 0.54 - 4.51). Lower pharyngeal measurments did not show any significant changes after the treatment (P > 0.05).In the analysis of studies with 3D imaging modalities, upper pharyngeal volume was also significantly increased by 499.29mm3 (CI = 95%, 69.58-929.00) after the treatment. In addition, a review of articles that included cleft lip and palate patients also showed after the treatment, the upper pharyngeal measurements all showed a significant improvement (P < 0.05), whereas the oropharyngeal region was relatively stable. Conclusions: In maxillary deficient patients with or without an orofacial cleft, facemask therapy can improve the nasopharyngeal area dimensions; however, this treatment protocol appears not to have an effect on the oropharyngeal area of the airway tract.
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