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      • Cephalometric predictors of treatment outcome with mandibular advancement devices in adult patients with obstructive sleep apnea : a systematic review

        Giulio Alessandri-Bonetti,Daniela Rita Ippolito,Maria Lavinia Bartolucci,Vincenzo D’Anto,Serena Incerti-Parenti 대한치과교정학회 2015 대한치과교정학회지 Vol.45 No.6

        Objective: The efficacy of mandibular advancement devices (MADs) in the treatment of obstructive sleep apnea (OSA) ranges between 42% and 65%. However, it is still unclear which predictive factors can be used to select suitable patients for MAD treatment. This study aimed to systematically review the literature on the predictive value of cephalometric analysis for MAD treatment outcomes in adult OSA patients. Methods: The MEDLINE, Google Scholar, Scopus, and Cochrane Library databases were searched through December 2014. Reference lists from the retrieved publications were also examined. English language studies published in international peer-reviewed journals concerning the predictive value of cephalometric analysis for MAD treatment outcome were considered for inclusion. Two review authors independently assessed eligibility, extracted data, and ascertained the quality of the studies. Results: Fifteen eligible studies were identified. Most of the skeletal, dental, and soft tissue cephalometric measurements examined were widely recognized as not prognostic for MAD treatment outcome; however, controversial and limited data were found on the predictive role of certain cephalometric measurements including cranial base angle, mandibular plane angle, hyoid to mandibular plane distance, posterior nasal spine to soft-palate tip distance, anterior nasal spine to epiglottis base distance, and tongue/oral cross sectional area ratio thus justifying additional studies on these parameters. Conclusions: Currently available evidence is inadequate for identification of cephalometric parameters capable of reliably discriminating between poor and good responders to MAD treatment. To guide further research, methodological weaknesses of the currently available studies were highlighted and possible reasons for their discordant results were analyzed.

      • Effects of ultrasonic instrumentation with different scaler-tip angulations on the shear bond strength and bond failure mode of metallic orthodontic brackets

        Giulio Alessandri Bonetti,Serena Incerti Parenti,Daniela Rita Ippolito,Maria Rosaria Gatto,Luigi Checchi 대한치과교정학회 2014 대한치과교정학회지 Vol.44 No.1

        Objective: To evaluate the effects of ultrasonic instrumentation with different scaler-tip angulations on the shear bond strength (SBS) and bond failure mode of metallic orthodontic brackets. Methods: Adhesive pre-coated metallic brackets were bonded to 72 extracted human premolars embedded in autopolymerizing acrylic resin. The teeth were randomly divided into 3 groups (n = 24 each) to undergo no treatment (control group) or ultrasonic instrumentation with a scaler-tip angulation of 45˚ (45˚-angulation group) or 0˚ (0˚-angulation group). SBS was tested in a universal testing machine, and adhesive remnant index (ARI) scores were recorded. The Kruskal-Wallis test and Mann-Whitney U-test were used for statistical analysis. Results: The control group had a significantly higher mean SBS value than the treated groups, which showed no significant differences in their mean SBS values. The ARI scores were not significantly different among the groups. Conclusions: Ultrasonic instrumentation around the bracket base reduces the SBS of metallic orthodontic brackets, emphasizing the need for caution during professional oral hygiene procedures in orthodontic patients. The scaler-tip angulation does not influence the SBS reduction and bond failure mode of such brackets.

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