Botulinum toxin type A is effective in reducing excessive gingival display caused by hyperfunctional upper lip elevator muscles; however, this effect is transient. This study aimed to determine the duration of the effectiveness of botulinum toxin type A on a gummy smile. A systematic search was conducted using Medline (PubMed), Scopus, and Web of Science electronic databases, from 1970 to March 2017 with no language restriction; the search included studies evaluating adult patients with excessive gingival display who were treated with botulinum toxin and were followed-up for at least 3 months. OpenGrey and Clinical Trial Registry were also consulted. Quality assessment was applied to determine the level of evidence and bias, and a meta-analysis was performed. Of 2181 full texts, 71 were obtained, with 3 prospective studies meeting the selection criteria. The gingival display was significantly reduced to baseline with 2, 4, and 8 weeks of treatment. The gingival display considerably reduced at the baseline-2-week comparison (-4.44 mm using raw data and-4.05 mm using the standard difference) and increased throughout the weeks of follow-up. There is scant evidence to determine the duration of the effectiveness of toxin type A on a gummy smile. The effect tends to be stable until at least 8 weeks of follow-up, and the gingival exposure may not return to baseline within 12 weeks of follow-up. Well-designed randomized clinical trials with a minimum of 6 months of follow-up are necessary to strengthen the evidence.

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OBJECTIVE: To determine by means of a systematic review the best treatment, whether interproximal wear or incisor extraction, to correct anterior lower crowding in Class I patients in permanent dentition. METHODS: A literature review was conducted using MEDLINE, Scopus and Web of Science to retrieve studies published between January 1950 and October 2013. In selecting the sample, the following inclusion criteria were applied: studies involving interproximal wear and/or extraction of mandibular incisors, as well as Class I cases with anterior lower crowding in permanent dentition. RESULTS: Out of a total of 943 articles found after excluding duplicates, 925 were excluded after abstract analysis. After full articles were read, 13 were excluded by the eligibility criteria and one due to methodological quality; therefore, only fours articles remained: two retrospective and two randomized prospective studies. Data were collected, analyzed and organized in tables. CONCLUSION: Both interproximal wear and mandibular incisor extraction are effective in treating Class I malocclusion in permanent dentition with moderate anterior lower crowding and pleasant facial profile. There is scant evidence to determine the best treatment option for each case. Clinical decision should be made on an individual basis by taking into account dental characteristics, crowding, dental and oral health, patient's expectations and the use of set-up models.

Aim To test the null hypothesis was that there is no difference in the shear strength of indirectly bonded lingual brackets with or without prior application of metal primer on their bases. Materials and methods Forty recently extracted human premolars were obtained and randomly divided into two groups of 20 each: group I (control), phosphoric acid and indirect bonding with Maximum Cure (Reliance Orthodontic Products, Itasca, IL, USA); and group II, application of metal primer (Metal Primer, Reliance Orthodontic Products) on bracket base prior to conditioning and indirect bonding. All products were used according to the manufacturer's instructions. A universal testing machine was used to apply a shear force directly onto the enamel- bracket interface at a speed of 1.0 mm/min. Results Mean (SD) shear bond strength for group I was 12.87 (5.75) MPa and for the group II was 18.47 (8.48) MPa. The Student's t-test showed a significant difference (p = 0.0311) between the groups. The chi-square test for the adhesive remnant index (ARI) indicated that there was a significant difference (p = 0.2750). Conclusion The application of metal primer increased the adhesion of lingual brackets, and may be a promising procedure for clinical orthodontics. How to cite this article e Cal Neto JP, de Albuquerque Calasans-Maia J, de Almeida NV, Rohen H, Freire MAG. Effect of a Metal Primer on the Adhesive Interface Between Composite and Lingual Brackets. J Contemp Dent Pract 2013;14(6):1106- 1108.