Browsing by Author "Kaklamanos, Eleftherios G"

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Antimicrobial Activity of Phytic Acid: An Emerging Agent in Endodontics
(2021) Nassar, Rania; Naidoo, Nerissa; Kaklamanos, Eleftherios G; Senok, Abiola
Background: Phytic acid (IP6) is a promising and emerging agent, and because of its unique structure and distinctive properties, it lends itself to several applications in dentistry. Recently, IP6 was proposed as a potential chelating agent in endodontics. However, there is limited knowledge regarding its antimicrobial and antibiofilm effectiveness. The aims of this study, were therefore to evaluate the antimicrobial and antibiofilm activities of IP6 against a range of microbial species and compare these with ethylenediaminetetraacetic acid (EDTA) and sodium hypochlorite (NaOCl). The contact time required for IP6 to exert its bactericidal effect on Enterococcus faecalis was also determined. Methods: The inhibitory and biocidal activities of IP6, EDTA and NaOCl were assessed using a broth microdilution assay against 11 clinical and reference strains of bacteria and a reference strain of Candida albicans. The contact time required for various IP6 concentrations to eliminate planktonic cultures of E. faecalis was determined using a membrane filtration method according to BS-EN-1040:2005. IP6 bactericidal activity was also evaluated using fluorescent microscopy, and the antibiofilm activity of the test agents was also determined. Results: IP6 was biocidal against all tested microorganisms. At concentrations of 0.5%, 1% and 2%, IP6 required 5 min to exert a bactericidal effect on E. faecalis, while 5% IP6 was bactericidal after 30 s. IP6 also eradicated biofilms of the tested microorganisms. In conclusion, IP6 had notable antimicrobial effects on planktonic and biofilm cultures and exhibited rapid bactericidal effects on E. faecalis. This research highlighted, for the first time the antimicrobial and antibiofilm properties of IP6, which could be exploited, not only in dental applications, but also other fields where novel strategies to counter antimicrobial resistance are required.
Are asthma and allergy associated with increased root resorption following orthodontic treatment? A meta-analysis
(2023) Al-Saqi, Reem Kais; Athanasiou, Athanasios E; Kaklamanos, Eleftherios G
Objective: The aim of this study is to systematically investigate the available evidence from human studies regarding the association of asthma and/or allergy with EARR. Materials and methods: Unrestricted searches in 6 databases and manual searching were performed up to May 2022. We looked for data on EARR after orthodontic treatment in patients with/without asthma or allergy. Relevant data were extracted, and the risk of bias was assessed. An exploratory synthesis was carried out using the random effects model, and the overall quality of the evidence was assessed with the Grades of Recommendation, Assessment, Development, and Evaluation. Results: From the initially retrieved records, nine studies met the inclusion criteria (three cohort and six case-control). Overall, increased EARR was observed in the individuals with allergies in their medical history (Standardised Mean Difference [SMD]: 0.42, 95% Confidence Interval [CI]: 0.19 to 0.64). No difference in EARR development was observed among individuals with or without a medical history of asthma (SMD: 0.20, 95% CI: -0.06 to 0.46). The quality of available evidence, excluding studies at high risk, was rated as moderate for the exposure to allergy, and low for the exposure to asthma. Conclusion: Increased EARR was noted in individuals with allergies compared to the control group, while no difference was observed for individuals with asthma. Until more data become available, good practice would suggest that it is important to identify patients with asthma or allergy and consider the possible implications.
Awareness of Forensic Odontology among Dental Students and Faculty in Cyprus: A Survey-Based Study
(2023) Kaklamanos, Eleftherios G
Abstract: This study aimed to evaluate the awareness, comprehension, and practices concerning forensic odontology among dental students and faculty at a Dental School in Cyprus. An online, cross-sectional, descriptive survey, employing an adapted, self-administered questionnaire, was disseminated to all dental students and faculty at the School of Dentistry, European University Cyprus, in November 2022. The survey assessed participants’ demographic information and explored their awareness with questions alluding to knowledge, attitudes and practices in forensic dentistry. Of those surveyed, 47 faculty members and 304 students responded, yielding response rates of 66.2% and 80%, respectively. Statistical analysis, including Kendall’s tau test and χ 2 test were employed to examine correlations and associations, with Cramer’s V used to measure the strength of significant associations. The predetermined significance level was α = 0.05. Awareness levels were assessed through participants’ responses to specific questions in the survey. It was revealed that 87% of faculty and 65% of students were familiar with forensic odontology. A noteworthy 94% of faculty and 85% of students recognized teeth as DNA repositories. A high percentage, 98% of faculty and 89% of students, acknowledged the role of forensic odontology in the identification of criminals and deceased individuals. Awareness of age estimation through dental eruption patterns was evident in 85% of faculty and 81.6% of students. A substantial proportion (80% of faculty) maintained dental records, while 78% of students recognized the importance of dental record-keeping in ensuring quality care. Interestingly, 57% of students and 64% of faculty were aware of the possibility of dentists testifying as expert witnesses. The majority, 95.7% of faculty and 85% of students, concurred that physical harm, scars, and behavioral alterations predominantly indicate child abuse. The findings, revealing robust awareness among respondents, underscore the importance of enhancing faculty engagement in relevant seminars to further strengthen their knowledge. Additionally, emphasizing improved record-keeping practices for potential forensic applications emerges as a crucial aspect. These insights have implications for refining dental education in Cyprus and enhancing forensic practices by promoting ongoing professional development and emphasizing meticulous record-keeping within the dental community.
Bisphosphonates as Supplement to Dental Treatment: A Network Meta-Analysis
(2021) Kaklamanos, Eleftherios G
Abstract The objective of this study was to assess clinical measurements related to the effectiveness of bisphosphonate (BP) administration as a supplement to conventional dental treatment in patients free of bone-related diseases using a network meta-analysis. Only randomized controlled trials (RCTs) were included that provided dental clinical measurements on human patients treated with BPs with or without similar untreated controls or treated with placebo. Information sources included a systematic search of 17 electronic databases up to August 2020, complemented by manual searches. Risk of bias assessment was performed with the revised Cochrane risk of bias tool for randomized trials (RoB 2.0). Extracted measurements were pooled according to time of evaluation. The random-effects model by DerSimonian and Laird was used to calculate mean differences (MDs) and the respective 95% confidence intervals (CIs). Seven RCTs were included in the network meta-analysis, assessing 391 subjects reporting on periodontal treatment effects after 2 to 12mo of BP administration. BP treatment was associated with significant improvement of most clinical measurements, compared with BP-naive controls. According to the network ranking, alendronate was more efficient in improvement of probing depth and clinical attachment gain when compared to zoledronate or alendronate/risedronate. Similarly, the local application of alendronate as a gel was more effective than the oral administration. A long-term analysis of the pharmaceutical effects was not possible due to insufficient data. The current review, performed according to existing guidelines, included only RCTs and, through appropriate statistical analyses, provided precise estimates for most assessed outcomes. However, no adverse effects or long-term treatment results were analyzed due to inadequate pertinent data. BP administration seems to be beneficial in the short term for the treatment of periodontal diseases, mainly through controlling periodontal inflammation.
Boering’s Arthrosis of the Temporomandibular Joint in a 9-Year-Old Girl; a Case Report
(2020) Chaudhry, Jahanzeb; Omar, Haidi; Kaklamanos, Eleftherios G
Abstract: Boering’s arthrosis is a rare disorder of the temporomandibular joints that usually occurs in the second decade and seldom after age 20. It was first described by G. Boering in 1966. It is more common in females and can be unilateral or bilateral. The disease results in resorption of the condyle with elongation of the articular surface resulting in the characteristics toadstool appearance observed on panoramic images. Condylar changes are often accompanied by anterior displacement of the disc and remodeling of the glenoid fossa. Facial asymmetry is almost always present.We present a case of a 9-year-old female with Boering’s arthrosis. She presented with facial asymmetry and bite abnormality but did not report symptoms typically associated with temporomandibular disorders
Child perceptions questionnaire: translation, cultural adaptation and initial validation in a Greek adolescent population with malocclusion
(2020) Kaklamanos, Eleftherios G
Purpose: Several studies have shown that orthodontic anomalies may afect young people’s Oral Health-Related Quality of Life (OHRQoL). The purpose the present study was to translate in the Greek language, culturally adapt and initially validate the CPQ11-14 ISF-16 for a Greek adolescent population with malocclusion. Methods: Following relevant methodological recommendations, after translation, the comprehensiveness of the Greek version of CPQ11-14 ISF-16 (CPQ11-14 ISF-16-GR) was verifed in a pilot study of 20 Greek adolescents. The main study was undertaken in a sample of 200 adolescents that presented for an initial consultation at the Postgraduate Orthodontic Clinic. Cronbach’s alpha was used to test internal consistency/reliability and Spearman’s rho for criterion validity with the Oral Health Impact Profle (OHIP-14). Forty individuals completed the same questionnaires again after 3 weeks. Test–retest reliability was assessed using Intraclass Correlation Coefcient. Statistical tests were undertaken using SPSS (v. 24, IBM Corp., NY, USA). Results: The CPQ11-14 ISF-16-GR presented high internal consistency (Cronbach’s alpha=0.848>0.70) and very satisfactory Discrimination Index (DI=0.47>0.30). Moreover, the CPQ11–14ISF-16 showed excellent criterion validity with OHIP-14 (rho=0.719, p<0.001). Conclusion: The CPQ11-14 ISF-16-GR exhibits satisfactory psychometric properties to continue the investigation of OHRQoL in Greek adolescents with malocclusion. Further testing of is required in a variety of environments to increase generalizability and investigate the particular characteristics of CPQ application in malocclusion cases.
Could medications and biologic factors affect post orthodontic tooth movement changes? A systematic review of animal studies
(2020) Kaklamanos, Eleftherios G
Background: Immediately after the removal of orthodontic appliances the teeth might start to drift away from their corrected position in an attempt to reach a new equilibrium. Medications and biologic factors could potentially modulate these processes. Objective: To systematically investigate and appraise the quality of the evidence regarding the effect of various medications and biologic factors on the rate of relapse following active tooth movement. Search methods: Search without restrictions in eight databases and hand searching until June 2019. Selection criteria: Studies performed on animal models investigating the effects of medication and biologic factors on the rate of relapse following orthodontic tooth movement. Data collection and analysis: Following study retrieval and selection, relevant data was extracted and the risk of bias was assessed. Results: Seventeen studies were finally identified, mostly at either high or unclear risk of bias. Ketorolac did not show any significant effects on relapse, while the administration of tetracycline, atorvastatin, psoralen and raloxifene decreased it. Overall, the same result was observed with bisphosphonates with the exception of low dosage of risedronate, which did not have an effect. Osteoprotegerin and strontium resulted in reduced relapse, but not in the immediate post-administration period. Inconsistent or conflicting effects were noted after the use of simvastatin and relaxin. The quality of the available evidence was considered at best as low. Conclusions: Specific medications and biologic factors may have an effect on the rate of relapse following tooth movement. The orthodontist should be knowledgeable about the substances potentially affecting retention.
Dental arch spatial changes after premature loss of first primary molars: a systematic review of controlled studies
(2017) Kaklamanos, Eleftherios G; Athanasiou, Athanasios E.
Abstract: Studies investigating dental arch spatial changes following first primary molar premature loss are controversial regarding clinical significance. The purpose of this review was to systematically investigate the relevant literature. Controlled studies investigating changes before and after premature loss of first primary molars were searched in various databases. Split-mouth design studies were considered eligible for inclusion. The risk of bias was judged according to ADA Clinical Practice Guidelines. Only two analyzable split-mouth studies on mandibular first primary molar loss were identified. Space loss in the extraction side was greater at 2, 4, 6 and 8-month follow-ups, reaching a -1.5 mm difference in the final examination (95% Confidence Interval: -2.080 to -0.925; p = 0.000; random effects model). Studies were judged to be at unclear risk of bias. The amount of space decrease after premature loss of first primary molars may have management implications under certain circumstances. Comprehensive assessment of the various characteristics of each patient should precede management decisions in individual cases.
Dental students' and faculty perception of online exams with e-invigilation in Cyprus
(2023) Kaklamanos, Eleftherios G
Introduction: During the recent pandemic, e-learning and e-assessment methods have been implemented worldwide, providing opportunities for further implementation in the dental curriculum. This study aims to research the dental students' and dental faculty's perceptions of online exams with e-invigilation. Materials and Methods: Online questionnaires were developed and delivered, after three semesters of online exams, to all students and faculty. Descriptive statistics were performed, and answers were grouped into Principal Components (PC) using Principal Component Analysis (PCA). Statistical significance was set at p< .05. Results: Two-hundred and sixty dental students (83.7%) and 24 dental faculty members (63.1%) answered the online questionnaires. PCA of students' responses revealed 4 PC, ‘University support to students’, ‘Comparison between online and face-to-face exams’, ‘Preparation for the online exams’ and ‘Attitudes towards the technology used for the online exams’. PCA of faculty responses revealed 5 PC: ‘Comparison between online and face-to-face exams’, ‘University support to faculty’, ‘Faculty attitudes towards the exam procedures’, ‘Human factors associated with the exam procedures’ and ‘Exam invigilation’. The overall satisfaction was high for both staff and students (higher for students and female staff). Students with previous experience in online exams scored more positively than first-year students. University support, process-related stress and e-invigilation were highlighted. Conclusions: The overall satisfaction with the e-exams was high, despite the technical problems, time-consuming processes and related stress. University support (training, IT support and resources) and mock exams emerged as important elements of online exams, as was the e-invigilation, which students perceived as efficient and non-intrusive.
Do analgesics used for the pain experienced after orthodontic procedures affect tooth movement rate? A systematic review based on animal studies
(2019) Kaklamanos, Eleftherios G
Background: Using analgesics for a short period to relieve the pain following specific orthodontic procedures is common. Such medications may influence orthodontic tooth movement biochemical pathways; however, the information originating from human studies is limited. Objectives: To systematically investigate current evidence from animal experiments on the effect of administering analgesics for a few days, which is consistent with usual clinical practice, on the speed of orthodontic tooth movement. Search methods: Eight databases were searched without restrictions, and hand searching was conducted until June 2019. Selection criteria: Animal controlled studies assessing the short-term impact of analgesics that can be consumed for orthodontic pain on the speed of orthodontic tooth movement. Data collection and analysis: Subsequent to retrieving relevant studies and information extraction, the SYRCLE’s Risk of Bias Tool was used for risk of bias assessment. Results: Finally, seven studies were selected, and most of them were assessed at unclear risk of bias. Short-term administration of acetaminophen did not affect significantly the speed of tooth movement, while ibuprofen and indomethacin were reported to decrease it. After administering acetylsalicylic acid and celecoxib, the noted effects were inconsistent. The quality of the available evidence for the animal setting was considered as moderate at most.
Do facial morphology, posture and function change following glossectomy? A systematic review
(2019) Kaklamanos, Eleftherios G; Athanasiou, Athanasios E.
Objectives: To systematically investigate and critically appraise the quality of the currently available literature regarding the morphological, postural, and functional changes observed in individuals following glossectomy. Materials and methods: A search without restrictions in eight databases (including grey literature) and hand searching from inception until March 2018 was performed. Data on morphological, postural, and functional changes after glossectomy were reviewed. Methodological quality was evaluated using the risk of bias in nonrandomized studies of intervention tool. Results: Out of 835 initially identified unique records, only three articles following patients for 1 year after glossectomy fulfilled the selection criteria. Overall, no significant morphological, postural, and functional changes were observed. Only the distance between the dorsum and the nasal line increased and the freeway space decreased significantly. Conclusions: Overall, no significant differences were noted in the medium term, in terms of dentofacial structures adaptation and tongue function following glossectomy. Further research is warranted in order to elucidate the consequences of the altered oral environment.
Do orthodontic patients develop more gingival recession in anterior teeth compared to untreated individuals? A systematic review of controlled studies
(2020) Bin Bahar, Budoor S.K.; Alkhalidy, Shatha R.; Kaklamanos, Eleftherios G
Objective: To investigate, in an evidence-based manner, the contemporary available information regarding the development of gingival recession in the anterior teeth of orthodontically treated and age-matched untreated individuals. Material and methods: Eight databases were searched without restrictions from the date of coverage initiation to June 30th, 2019 (registration in PROSPERO: CRD42018080948). Studies evaluating gingival recession development following comprehensive orthodontic treatment were reviewed. Following study selection, data extraction and risk of bias assessment, the random effects model was employed for exploratory data synthesis. The confidence in the retrieved estimates was appraised using current guidelines. Results: Finally, three studies, with a follow-up of 6 years maximum, were identified. Overall, the amount of gingival recession did not increase significantly immediately after treatment with normal occlusion. However, for some of the comparisons considered, the risk for orthodontic patients to present with labial gingival recession seemed to increase, especially during retention [mandibular incisors 6 years post-treatment: Odds Ratio: 8.81, 95% Confidence Interval: 1.93–40.07, p = 0.005]. Conclusion: Although the amount of recession does not differ, some increase in the risk for gingival recession development in the anterior teeth may be encountered in orthodonticallytreated individuals compared to untreated subjects with normal occlusion. However, these findings should be viewed cautiously until more studies of high quality become available. Good practice would suggest that it is important to identify patients at potential risk and consider the possible implications for orthodontic treatment.
Do probiotics promote oral health during orthodontic treatment with fixed appliances? A systematic review
(2020) Hadj Hamou, Riham; Senok, Abiola C; Athanasiou, Athanasios E; Kaklamanos, Eleftherios G
Background: Treatment with fixed orthodontic appliances has been associated with significant biofilm accumulation, thus putting patients at a higher risk of oral health deterioration. The use of probiotics has been proposed to be useful in the prevention or treatment of oral pathologies such as caries and diseases of periodontal tissues. Our aim was to investigate the effects of probiotic use on inflammation of the gingival tissues and the decalcification of the enamel in patients being treated with fixed orthodontic appliances. Methods: We searched without restrictions 8 databases and performed hand searching until September 2019. We searched for randomized controlled trials (RCTs) evaluating whether individuals with fixed orthodontic appliances benefit from probiotic treatment in terms of the inflammation of the gingivae and decalcification of the enamel. Following the selection of studies and the extraction of pertinent data, we appraised the risk of bias and the confidence in the observed effects based on established methodologies. Results: From the final qualifying studies, three did not show any statistically significant effect on gingival inflammation after probiotic administration of up to 1 month. Similarly, non-significant differences were noted in another study regarding white spot lesions development (mean administration for 17 months). No adverse effects were reported and the level of evidence was considered moderate. Conclusions: Supplementation of orthodontic patients with probiotics did not affect the development of inflammation in the gingivae and decalcification in the enamel. Additional RCTs, with longer intervention and follow-up periods, and involving different combinations of probiotic strains are required.
Does common prescription medication affect the rate of orthodontic tooth movement? A systematic review
(2018-03-06) Makrygiannakis, Miltiadis A.; Kaklamanos, Eleftherios G; Athanasiou, Athanasios E.
Background: As the taking of any medication may theoretically affect the complex pathways responsible for periodontal tissue homeostasis and the events leading to orthodontic tooth movement, it is considered important for the orthodontist to be able to identify prospective patients’ history and patterns of pharmaceutical consumption. Objective: To systematically investigate and appraise the quality of the available evidence regarding the effect of commonly prescribed medications on the rate of orthodontic tooth movement. Search methods: Search without restrictions in eight databases and hand searching until June 2017. Selection criteria: Controlled studies investigating the effect of commonly prescribed medications with emphasis on the rate of orthodontic tooth movement. Data collection and analysis: Following study retrieval and selection, relevant data was extracted and the risk of bias was assessed using the SYRCLE’s Risk of Bias Tool. Results: Twenty-seven animal studies, involving various pharmacologic and orthodontic interventions, were finally identified. Most studies were assessed to be at unclear or high risk of bias. The rate of orthodontic tooth movement was shown to increase after the administration of diazepam, Vitamin C and pantoprazole, while simvastatin, atorvastatin, calcium compounds, strontium ranelate, propranolol, losartan, famotidine, cetirizine, and metformin decreased the rate of orthodontic tooth movement. No interference with the rate of orthodontic tooth movement was reported for phenytoin, phenobarbital and zinc compounds, whereas, inconsistent or conflicting effects were noted after the administration of L-thyroxine, lithium compounds, fluoxetine and insulin. The quality of the available evidence was considered at best as low. Conclusions: Commonly prescribed medications may exhibit variable effects on the rate of orthodontic tooth movement. Although the quality of evidence was considered at best as low, raising reservations about the strength of the relevant recommendations, the clinician should be capable of identifying patients taking medications and should take into consideration the possible implications related to the proposed treatment.
Does exogenous female sex hormone administration affect the rate of tooth movement and root resorption? A systematic review of animal studies
(2021) Kaklamanos, Eleftherios G
Background: The long-term use of contraceptive methods that contain estrogens, progestogens or combinations of the above among women aged 15 to 49 years is extensive. Both estrogens and progestogens affect bone metabolism. Objective: To systematically investigate and appraise the quality of the available evidence from animal studies regarding the impact of exogenous administration of female sex hormones on the rate of orthodontic tooth movement and root resorption. Search methods: Search without restriction in seven databases (including grey literature) and hand searching were performed until May 2021. Selection criteria: We looked for controlled animal studies investigating the effect from exogenous administration of formulations containing female sex hormones on the rate of orthodontic tooth movement and root resorption. Data collection and analysis: After study retrieval and selection, relevant data was extracted, and the risk of bias was assessed using the SYRCLE’s Risk of Bias Tool. The quality of available evidence was assessed with the Grades of Recommendation, Assessment, Development, and Evaluation. Results: Three studies were identified, all being at unclear risk of bias. Overall, administration of progesterone and the combinations of estradiol with norgestrel and desogestrel were shown to significantly decrease the rate of orthodontic tooth movement when given for longer periods (>3 weeks). Inconsistent information was detected for shorter periods of consumption. Estradiol, with desogestrel use, resulted in less root resorption. The quality of the available evidence was considered to be low. Conclusions: Exogenous administration of female sex hormones may decelerate in the long term the rate of tooth movement and decrease orthodontically induced root resorption in animals. Until more information becomes available, an orthodontist should be able to identify a patient consuming such substances and understand the potential clinical implications and adverse effects that may arise.
Does interceptive extraction of multiple primary teeth increase the chances of spontaneous eruption of permanent maxillary canines positioned palatally or centrally in the alveolar crest? A Systematic review
(2022-05) Athanasiou, Athanasios E; Kaklamanos, Eleftherios G; AlWadiyah, Mohammed
Introduction: Extraction of primary maxillary canines in the mixed dentition has been suggested to increase the rate of normal eruption of displaced permanent canines (DPCs). In this study we assessed whether extracting multiple primary teeth increases the rate of normal eruption of DPCs positioned palatally or centrally in the alveolar crest. Methods: Unrestricted searches in 8 databases were performed up to March 2021. We looked for data on the prevalence of physiologic eruption of DPCs and the changes in their position from randomized controlled trials. The risk of bias was assessed using the Cochrane Risk of Bias 2 Tool. Exploratory synthesis was carried out using the random effects model. Results: Three studies (at low risk of bias) were identified, involving 128 individuals, followed for up to 48 months. The double extraction did not result in a benefit regarding successful eruption at 24 months follow-up, nor the change in position after 14.8 months. However, after 48 months the double extraction was beneficial (Risk Ratio: 1.17; 95% Confidence Interval: 1.05 to 1.30, P = 0.005). Moreover, after 18 months, the DPCs' position improved more in the double extraction sites. Conclusions: While the extraction of the deciduous canine and first molar does not increase the chance of normal eruption nor improves the position of DPCs in shorter follow-ups, it might confer a benefit after a longer period of observation. Further studies are warranted in order to clarify the magnitude and clinical significance of any potential benefit and provide guidance to clinical decisions.
Does long-term use of pain relievers have an impact on the rate of orthodontic tooth movement? A systematic review of animal studies.
(2019-09-26) Kaklamanos, Eleftherios G; Athanasiou, Athanasios E.
Background: Pain relief drugs are used and misused widely and may theoretically affect the events leading to orthodontic tooth movement. Objective: To systematically investigate and appraise the quality of the available evidence regarding the effect of pain relief medications on the rate of orthodontic tooth movement. Search methods: Search without restrictions in eight databases (including grey literature) and hand searching until October 2018. Selection criteria: Animal controlled studies investigating the effect of pain relievers on the rate of orthodontic tooth movement. Data collection and analysis: Following study retrieval and selection, relevant data were extracted and the risk of bias was assessed using the SYRCLE’s risk of bias tool. Results: Fourteen studies were finally identified, most of which at unclear risk of bias. Ibuprofen and loxoprofen did not show any significant effects on the rate of orthodontic tooth movement, whereas indomethacin, ketorolac, morphine, and high doses of etoricoxib were found to decrease it. Inconsistent or conflicting effects were noted after the administration of acetaminophen, acetylsalicylic acid, celecoxib, meloxicam, and tramadol. The quality of the available evidence was considered at best as low. Conclusions: Long-term consumption of pain relievers may affect the rate of orthodontic tooth movement. The orthodontist should be capable of identifying patients taking pain relievers independently of orthodontic treatment and consider the possible implications.
Does medication administration affect the rate of orthodontic tooth movement and root resorption development in humans? A systematic review
(2019) Kaklamanos, Eleftherios G
Background: Recently, the potential impact of different medications on the rate of orthodontic tooth movement and the associated root resorption has been systematically reviewed in animal studies and various effects have been shown. However, animal data cannot be extrapolated to human clinical situations directly. Objectives: To systematically investigate the most up to date available evidence from controlled human studies regarding the effect of medication administration on the rate of orthodontic tooth movement and associated root resorption development. Search methods: We searched eight databases (covering also grey literature) without restrictions and we performed hand searching up until October 2018. Selection criteria: Controlled studies in humans assessing the effect of various medications on the rate of orthodontic tooth movement and root resorption development. Data collection and analysis: Study selection was followed by data extraction and risk of bias assessment using the ROBINS-I tool for non-randomized and the Cochrane Risk of Bias Tool for randomized studies. Results: Eight studies, at various risk of bias, were finally identified. With regard to the rate of orthodontic tooth movement, local injections of prostaglandin E1 were found to exert an increasing effect, whereas systemic intake of nabumetone decreased it. Following tenoxicam administration, drinking water with fluoride or local injections of calcitriol (vitamin D metabolite), no significant effects were demonstrated. Concerning root resorption development, nabumetone administration was shown to reduce it, whereas fluoride, overall, was not observed to exert any effect. Only in individuals subjected to heavy orthodontic forces, did fluoride show a protective effect for the period of force application, but not in the longer term during retention. Conclusions: The aforementioned substances may show varying effects on the rate of orthodontic tooth movement and root resorption development in human subjects. Despite the observed limitations, the orthodontist should be able to identify patients taking pharmaceuticals and consider any implications related to orthodontic treatment.
Does the rate of orthodontic tooth movement change during pregnancy and lactation? A systematic review of the evidence from animal studies
(2020) Kaklamanos, Eleftherios G
Background: The changes in bone homeostasis observed during pregnancy and lactation could result in alterations in the rate of orthodontic tooth movement, but research in human subjects presents significant ethical and practical limitations. Our aim was to compare the amount of orthodontic tooth movement between pregnant/ lactating or not animals. Methods: We searched without restrictions 8 databases and performed hand searching until July 2019 (PubMed, Central, Cochrane Database of Systematic Reviews, SCOPUS, Web of Science, Arab World Research Source, ClinicalTrials.gov, ProQuest Dissertations and Theses Global). We searched for studies comparing quantitatively the amount of orthodontic tooth movement between pregnant/lactating or not animals. Following retrieval and selection of studies, the collection of related data was performed and the risk of bias was assessed using the SYRC LE’s Risk of Bias Tool. Exploratory synthesis was carried out using the random effects model. Results: Four studies were finally identified raising no specific concerns regarding bias. One study showed that lactation increased the rate of tooth movement by 50 % [p < 0.05]. Although an overall increase was noted in the pregnancy group as well, it did not reach statistical significance [3 studies, Weighted Mean Difference: 0.10; 95% Confidence Interval: − 0.04 - 0.24; p = 0.165]. Conclusions: The metabolic changes occurring during pregnancy and lactation may have an impact on the rate of tooth movement in animals. Although these animal experimental results should be approached cautiously, it could be safe practice to consider the impact of these physiological changes in the clinical setting.
Does the rate of orthodontic tooth movement change during the estrus cycle? A systematic review based on animal studies
(2021) Almidfa, Noura Saeed Sultan; Kaklamanos, Eleftherios G
Background: As the fuctuation of sex hormone levels in menstruating women results in periodical efects in bone metabolism, understanding the implications for tooth movement could be of beneft to the orthodontist. This type of research presents practical and ethical problems in humans, but animal models could provide useful information. Our objective was to systematically investigate the available evidence on the question whether the rate of orthodontic tooth movement varies between the diferent stages of the estrus cycle in animals. Methods: Unrestricted searches in 7 databases and manual searching of the reference lists in relevant studies were performed up to February 2021 (Medline [PubMed], CENTRAL [Cochrane Library; includes records from Embase, CINAHL, ClinicalTrials.gov, WHO’s ICTRP, KoreaMed, Cochrane Review Groups’ Specialized Registers, and records identifed by handsearching], Cochrane Database of Systematic Reviews [Cochrane Library], Scopus, Web of Knowledge [including Web of Science Core Collection, KCI Korean Journal Database, Russian Science Citation Index, SciELO Citation Index and Zoological Record], Arab World Research Source [EBSCO] and ProQuest Dissertation and Theses [ProQuest]). Our search focused on prospective controlled animal studies, whose samples included female subjects of any species that were quantitatively comparing the amount of tooth movement in the diferent stages of the estrus cycle. Following study retrieval and selection, relevant data was extracted, and the risk of bias was assessed using the SYRCLE’s Risk of Bias Tool. Results: From the fnally assessed records, 3 studies met the inclusion criteria. Two of the studies experimented on Wistar rats, whereas the other on cats. Tooth movement was induced by expansion or coil springs. The rate of orthodontic tooth movement was increased during the stages of the estrus cycle when oestrogen and/or progesterone levels were lower. The risk of bias in the retrieved studies was assessed to be unclear. Conclusion: Hormonal changes during the estrus cycle may afect the rate of orthodontic tooth movement. Although these animal experiment results should be approached cautiously regarding their translational potential, it could be useful to consider the possible impact of these physiological changes in the clinical setting until more information becomes available.