1.
Algharbi, Muteb, et al.
(author)
Do Different Maxillary Expansion Appliances Influence the Outcomes of the Treatment?
2018
In: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 40:1, s. 97-106
Research review (peer-reviewed) abstract
Background and objectives: There is no consensus in the literature regarding which rapid maxillary expansion (RME) design or activation rate benefits the patients the most. Therefore, the primary aim of this systematic review was to see whether there is a difference in the skeletal and dentoalveolar effects of different RME appliances in children and growing adolescents. The secondary aim was to see whether these effects are different when using different activation protocols for these appliances. Data collection and analysis: The search was done in three databases (PubMed, Cochrane Library, and Web of Science). The following inclusion criteria were used: randomized controlled trial, prospective controlled studies, 15 or more patients in each study, human subjects up to 18 years of age, and RME effects had to be assessed by computed tomography/cone beam computed tomography. Study appraisal and synthesis methods: Quality of the methodology was classified according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines as high, moderate, or low. Results: The search resulted in 145 titles and abstracts; 109 of them were excluded based on pre-established criteria. Thirty-six full-text articles were assessed for eligibility and 18 of which satisfied the inclusion criteria. Finally, seven articles were deemed eligible for full inclusion and revealed that all appliances and protocols showed significant expansion in the mid-palatal suture. No evidence was found for the cause of dental tipping. Limitations: In this systematic review, having different age groups in each study and using different anatomical landmarks and outcome measures for assessing the skeletal and dental effects made it difficult to conduct a meta-analysis. Conclusions: There is moderate evidence that all designs produce significant expansion at the mid-palatal suture. However, lack of studies comparing appliances and protocols has been found. Finally, no evidence-based conclusions could be drawn about the appliance effect on teeth tipping.
2.
Bazargani, Farhan, 1969
(author)
Acute inflammation in peritoneal dialysis. Experimental studies in rats. Characterization of regulatory mechanisms.
2005
In: Swedish Dental Journal. Supplement. - Göteborg : Göteborg University. - 0348-6672. ; 171, s. 1-57
Doctoral thesis (other academic/artistic) abstract
The predominant problems associated with peritoneal dialysis (PD) are ultrafiltration failure and peritonitis. PD maintains a state of intraperitoneal inflammation that affects the structure and function of the peritoneal membrane, potentially impairing ultrafiltration efficiency. Paradoxically, some PD fluids also have anti-inflammatory properties that may compromise the immune defense against peritonitis. This anti-inflammatory feature is mostly due to the glucose degradation products (GDPs), formed during heat-sterilization and storage of PD fluids. The main purpose of the present thesis was to study regulatory mechanisms behind the acute intraperitoneal inflammatory response in PD in the presence and absence of experimental peritonitis. Rats were exposed to a single dose of heat- or filter sterilized PD fluids either as an i.p. injection or as an infusion through an indwelling catheter, with or without supplementations, or pretreatment of the animals. The dwell fluid was analyzed zero, two and four hours later concerning activation of the complement and coagulation cascades, neutrophil recruitment and respiratory burst, ultrafiltration volumes, cytokine-induced neutrophil chemoattractant (CINC-1), rat mast cell protease 2 (RMCP-2), glucose, urea and histamine concentrations and ex vivo/in vitro intraperitoneal chemotactic activity.Exposure to filter sterilized PD fluid alone induced intraperitoneal complement activation and coagulation, neutrophil recruitment and increased the levels of CINC-1 during the dwell. Intraperitoneal concentrations of the mast cell markers histamine and RMCP-2 changed little during the dwells and did not indicate mast cell activation. Low molecular weight heparin (LMWH) and C5 blockade improved ultrafiltration. Pretreatment with cobra venom factor, known decomplementing agent, blocked the CINC-1 release and the neutrophil recruitment and improved ultrafiltration. In combination with experimental peritonitis, heat sterilized PD fluid compared to filter sterilized, inhibited the CINC-1 release and the recruitment of neutrophils to the peritoneal cavity without affecting the intraperitoneal complement activation.The results of the present thesis indicate that addition of LMWH to the PD fluid improves ultrafiltration, probably by blocking C5a activity. C5 blockade seems to improve ultrafiltration by a mechanism that involves a reduction in glucose transport, possibly by reducing C5 induced vasodilation. Complement activation is an early step in the acute reaction to PD and probably mediates the downstream events that lead to the recruitment of inflammatory cells to the peritoneal cavity. The cells involved in the release of CINC-1 later in this sequence are probably the mesothelial cells. During experimental peritonitis, heat sterilized PD fluids inhibited the neutrophil respiratory burst response of intraperitoneal neutrophils. Heat sterilized PD fluids also inhibit the recruitment of neutrophils to the peritoneal cavity by a mechanism independent of complement activation but probably depending on cytokine CINC-1 release during peritonitis.
3.
Bazargani, Farhan, 1969-, et al.
(author)
Effect of Interceptive Extraction of Deciduous Canine on Palatally Displaced Maxillary Canine : A Prospective Randomized Controlled Study
2014
In: Angle orthodontist. - : The EH Angle Education and Research Foundation Inc. - 0003-3219 .- 1945-7103. ; 84:1, s. 3-10
Journal article (peer-reviewed) abstract
Objective: To evaluate the effect of the extraction of deciduous canines on palatally displaced canines (PDCs), to analyze the impact of the age of the patient on this interceptive treatment, and to assess the outcome of one-sided extraction of a maxillary primary canine on the midline of the maxilla. Materials and Methods: This study included 48 PDCs in 24 consecutive patients with bilateral PDCs. The mean age of the patients at diagnosis was 11.6 years (standard deviation 1.2 years). After randomization, one deciduous canine of each patient was assigned to extraction, and the contralateral side served as control. The patients were then followed at 6-month intervals for 18 months with panoramic and intraoral occlusal radiographs. Results: The rates of successful eruption of the PDCs at extraction and control sites were 67% and 42%, respectively, at 18 months. The difference between the sites was statistically significant, and the effect was significantly more pronounced in the younger participants. A significant decrease in arch perimeter occurred at extraction sites compared to control sites during the observation period. No midline shift toward the extraction side was observed in any patient. Conclusions: The extraction of the deciduous canine is an effective measure in PDC cases, but it must be done in younger patients in combination with early diagnosis, at the age of 10-11 years. Maintenance of the perimeter of the upper arch is an important step during the observation period, and a palatal arch as a space-holding device is recommended.
4.
Bazargani, Farhan, 1969-, et al.
(author)
Orthodontic Bonding With and Without Primer : A Randomized Controlled Trial
2016
In: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 38:5, s. 503-507
Journal article (peer-reviewed) abstract
To evaluate the incidence of failure of brackets bonded with and without primer. A single-operator, cross-mouth, randomized controlled trial (RCT). The Orthodontic Department at the Postgraduate Dental Education Centre, A-rebro, Sweden. Ethical approval was granted by the Regional Ethical Review Board, Uppsala, Sweden. The protocol was not published before trial commencement. Fifty consecutive patients requiring bimaxillary orthodontic treatment with fixed appliances and with an equal number of teeth on each side of the dental arch, were included in this RCT. A cross-mouth methodology was applied. In each patient, two diagonal quadrants (i.e. upper right and lower left, or vice versa) were randomly assigned to the primer group (control group) and the contralateral diagonal quadrants to the non-primer group (experimental group). The randomization process was as follows: A computer-manufactured block-randomization list was acquired and stored with a research secretary at the Postgraduate Dental Education Centre. Each time a patient gave consent, the secretary was contacted by e-mail, and information about which quadrants were to be bonded with and without primer was obtained. All incidents of bracket failure and debonding noted in patient records during the 2012-14 observation period were compiled by the other co-author, whom was blinded to the study and did not perform any orthodontic treatment on the study patients. Number of bracket failures over 18 months. Failure rate without primer was 5.5 per cent and with primer 3.1 per cent; P = 0.063, odds ratio (OR) 1.89 [95% confidence interval (CI) 0.97-3.68] in the adjusted model. Younger ages (10-13 years), boys, and mandible were significantly associated with higher failure rates. Interaction tests indicated that younger patients had significantly higher failure rates without (12.1 per cent) than with primer (4.1 per cent), P < 0.001, OR 3.51 (95% CI 1.93-6.38) in the adjusted model. No failure rate differences between study settings were found for older patients (14-18 years). The difference between two groups was powered at 5 per cent. Some clinicians may consider a difference less than 5 per cent clinically significant. Bonding Victory Series (TM) brackets with Transbond (TM) XT with or without Transbond (TM) MIP primer seems overall to work equally well in a clinical setting, except in younger children where lower failure rate was found in the primer setting.
5.
Bazargani, Farhan, 1969-, et al.
(author)
Rapid Maxillary Expansion in Therapy-Resistant Enuretic Children : An Orthodontic Perspective
2016
In: Angle orthodontist. - : The EH Angle Education and Research Foundation Inc. - 0003-3219 .- 1945-7103. ; 86:3, s. 481-486
Journal article (peer-reviewed) abstract
Objective: To evaluate whether rapid maxillary expansion (RME) could reduce the frequency of nocturnal enuresis (NE) in children and whether a placebo effect could be ruled out. Methods: Thirty-four subjects, 29 boys and five girls with mean age of 10.7 +/- 1.8 years suffering from primary NE, were recruited. All subjects were nonresponders to the first-line antienuretic. treatment and therefore were classified as "therapy resistant." To rule out a placebo effect of the RME appliance, all children were first treated with a passive appliance for 4 weeks. Rhinomanometry (RM), acoustic rhinometry (AR), polysomnographic registration, and study casts were made at different time points. Results: One child experienced severe discomfort from the RME appliance and immediately withdrew from the study. Following RME, the long-term cure rate after 1 year was 60%. The RM and AR measurements at baseline and directly after RME showed a significant increase in nasal volume and nasal airflow, and there was a statistically significant correlation between reduction in enuresis and increase in nasal volume. Six months postretention, a 100% relapse of the dental overexpansion could be noted. Conclusions: RME has a curative effect in some children with NE, which could be connected to the positive influence of RME on the sleep architecture. Normal transverse occlusion does not seem to be a contraindication for moderate maxillary expansion in attempts to cure NE in children.
6.
Bazargani, Farhan, 1969-, et al.
(author)
Three-dimensional Analysis of Effects of Rapid Maxillary Expansion on Facial Sutures and Bones : A systematic review
2013
In: Angle orthodontist. - : The EH Angle Education and Research Foundation Inc. - 0003-3219 .- 1945-7103. ; 83:6, s. 1074-1082
Research review (peer-reviewed) abstract
Objective: To evaluate the evidence on three-dimensional immediate effects of rapid maxillary expansion (RME) treatment on growing patients as assessed by computed tomography/cone beam computed tomography (CT/CBCT) imaging. Materials and Methods: The published literature was searched through the PubMed, Embase, and Cochrane Library electronic databases from January 1966 to December 2012. The inclusion criteria consisted of randomized controlled trials, prospective controlled studies, and prospective case-series. Two reviewers extracted the data independently and assessed the quality of the studies. Results: The search strategy resulted in 73 abstracts or full-text articles, of which 10 met the inclusion criteria. When treating posterior crossbites with a RME device, the existing evidence points out that the midpalatal suture opening is around 20%-50% of the total screw expansion. There seems to be no consistent evidence on whether the midpalatal sutural opening is parallel or triangular. The effect on the nasal cavity dimensions after RME seems to be apparent and indicates an enlargement between 17% and 33% of the total screw expansion. Circummaxillary sutures, particularly the zygomaticomaxillary and frontomaxillary sutures and also spheno-occipital synchondrosis, appear to be affected by the maxillary expansion. Overall, however, the changes were small and the evidence not conclusive. Conclusions: CT imaging proved to be a useful tool for assessment of treatment effects in all three dimensions. The majority of the articles were judged to be of low quality, and therefore, no evidence-based conclusions could to be drawn from these studies.
7.
Feldmann, Ingalill, et al.
(author)
Pain and Discomfort During the First Week of Rapid Maxillary Expansion (RME) Using Two Different RME Appliances : A Randomized Controlled Trial
2017
In: Angle orthodontist. - : E H Angle Orthodontists Research & Education Foundation, Inc.. - 0003-3219 .- 1945-7103. ; 87:3, s. 391-396
Journal article (peer-reviewed) abstract
Objectives: To evaluate and compare perceived pain intensity, discomfort, and jaw function impairment during the first week with tooth-borne or tooth-bone-borne rapid maxillary expansion (RME) appliances. Materials and Methods: Fifty-four patients (28 girls and 26 boys) with a mean age of 9.8 years (SD 1.28 years) were randomized into two groups. Group A received a conventional hyrax appliance and group B a hybrid hyrax appliance anchored on mini-implants in the anterior palate. Questionnaires were used to assess pain intensity, discomfort, analgesic consumption, and jaw function impairment on the first and fourth days after RME appliance insertion. Results: Fifty patients answered both questionnaires. Overall median pain on the first day in treatment was 13.0 (range 0-82) and 3.5 (0-78) for groups A and B, respectively, with no significant differences in pain, discomfort, analgesic consumption, or functional jaw impairment between groups. Overall median pain on the fourth day was 9.0 (0-90) and 2.0 (0-71) for groups A and B, respectively, with no significant differences between groups. There were also no significant differences in pain levels within group A, while group B scored significantly lower concerning pain from molars and incisors and tensions from the jaw on day 4 than on the first day in treatment. There was a significant positive correlation between age and pain and discomfort on the fourth day in treatment. No correlations were found between sex and pain and discomfort, analgesic consumption, and jaw function impairment. Conclusions: Both tooth-borne and tooth-bone-borne RME were generally well tolerated by the patients during the first week of treatment.
8.
Silva, Ingrid, et al.
(author)
Quality of life in patients undergoing orthognathic surgery - A two-centered Swedish study
2016
In: Journal of Cranio-Maxillofacial Surgery. - : Elsevier BV. - 1010-5182 .- 1878-4119. ; 44:8, s. 973-978
Journal article (peer-reviewed) abstract
Aim: Surgical corrections of dentofacial deformities have both physical and psychological impact on quality of life (QoL). The objectives of the present study were to evaluate the impact of oral health related problems on QoL before and after a combination of orthodontic treatment and orthognathic surgery. Additionally, the study aimed to identify correlations between different dentofacial patterns and possible improvements due to treatment. Material and methods: In a prospective study, we evaluated fifty patients before start of treatment, 6 weeks and 6 months postoperatively. The questionnaires used were: OHIP-14 (Short Form Oral Health Impact Profile), a condition-specific QOL approach (Orthognathic Quality of Life Questionnaires; OQLQ) and a social-demographic questionnaire. Results: There was a statistically significant improvement in the OHIP domains from baseline to 6 months follow-up and for the OQLQ the improvement was significant both at 6 weeks and 6 months in relation to the baseline data. Conclusion: Significant improvement of quality of life over time is proved by both OHIP-14 and OQLQ in the present study. Socio-demographic and holistic considerations are important when evaluating treatment outcome after combined orthodontic and orthognatic surgery. However, longer follow-up would be beneficial. (C) 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
