CATARINA NUNES , BEATRIZ ORNELAS , CARLOS MIGUEL MARTO , ANABELA PAULA , MAFALDA LARANJO , CATARINA MESTRE , RAQUEL TRAVASSOS , INÊS FRANCISCO , FRANCISCO VALE
{"title":"正畸矫正器的细胞毒性:综述","authors":"CATARINA NUNES , BEATRIZ ORNELAS , CARLOS MIGUEL MARTO , ANABELA PAULA , MAFALDA LARANJO , CATARINA MESTRE , RAQUEL TRAVASSOS , INÊS FRANCISCO , FRANCISCO VALE","doi":"10.1016/j.jebdp.2025.102168","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>This umbrella review aims to determine if clear aligners promote cytotoxic and estrogenic effects.</div></div><div><h3>Methodology</h3><div>The review was conducted in conformity with the PRISMA statement. A systematic search was carried out in March of 2025 in 5 databases (Medline through PubMed, Web of Science (all databases), Cochrane Library, Embase, and Epistemonikos). All systematic reviews (SRs) that reported the cytotoxicity and/or estrogenicity of orthodontic aligners were included. The quality of the included studies was evaluated using AMSTAR-2 and the degree of overlap was analysed using Corrected Covered Area (CCA).</div></div><div><h3>Results</h3><div>The literature search resulted in 394 articles. Screening by title and abstract, resulted in 13 articles for full reading, and 4 articles were included in the umbrella review. According to the AMSTAR-2, all reviews were of low quality. The degree of overlap among SRs is high.</div></div><div><h3>Discussion</h3><div>The included SRs indicate that aligners do not have significant estrogenic/cytotoxic capacity and, even in cases of bisphenol A (BPA) leaching, this occurs at levels well below what is considered toxic. The low quality, high risk of bias, considerable overlap, and significant heterogeneity among the included studies impacts the obtained results.</div></div><div><h3>Conclusion</h3><div>It is not possible to affirm or refute the presence of estrogenic or cytotoxic effects or the leaching of monomers such as BPA. In the future, it is recommended that studies adopt a more detailed and prolonged analysis of BPA leaching and it is necessary to carry out clinical studies that evaluate the safety and biocompatibility of orthodontic aligners.</div></div>","PeriodicalId":48736,"journal":{"name":"Journal of Evidence-Based Dental Practice","volume":"25 3","pages":"Article 102168"},"PeriodicalIF":4.1000,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"CYTOTOXICITY OF ORTHODONTICS ALIGNERS: AN UMBRELLA REVIEW\",\"authors\":\"CATARINA NUNES , BEATRIZ ORNELAS , CARLOS MIGUEL MARTO , ANABELA PAULA , MAFALDA LARANJO , CATARINA MESTRE , RAQUEL TRAVASSOS , INÊS FRANCISCO , FRANCISCO VALE\",\"doi\":\"10.1016/j.jebdp.2025.102168\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>This umbrella review aims to determine if clear aligners promote cytotoxic and estrogenic effects.</div></div><div><h3>Methodology</h3><div>The review was conducted in conformity with the PRISMA statement. 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The low quality, high risk of bias, considerable overlap, and significant heterogeneity among the included studies impacts the obtained results.</div></div><div><h3>Conclusion</h3><div>It is not possible to affirm or refute the presence of estrogenic or cytotoxic effects or the leaching of monomers such as BPA. 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引用次数: 0
摘要
目的:本综述旨在确定清除对齐剂是否促进细胞毒性和雌激素作用。方法:按照PRISMA声明进行审查。系统检索于2025年3月在5个数据库(Medline通过PubMed、Web of Science(所有数据库)、Cochrane Library、Embase和Epistemonikos)中进行。所有报道正畸矫正器的细胞毒性和/或雌激素性的系统评价(SRs)都被纳入。使用AMSTAR-2评估纳入研究的质量,使用校正覆盖面积(CCA)分析重叠程度。结果检索到文献394篇。通过标题和摘要筛选,有13篇文章可供全文阅读,4篇文章被纳入总括性综述。根据AMSTAR-2,所有的评论都是低质量的。sr之间的重叠程度很高。所包括的SRs表明,校准剂没有显著的雌激素/细胞毒性能力,即使在双酚A (BPA)浸出的情况下,其水平也远低于被认为有毒的水平。纳入研究的低质量、高偏倚风险、大量重叠和显著异质性影响了获得的结果。结论不可能肯定或反驳雌激素或细胞毒性作用的存在或单体如双酚a的浸出。在未来的研究中,建议对BPA浸出进行更详细和更长期的分析,并有必要开展临床研究,评估正畸矫正器的安全性和生物相容性。
CYTOTOXICITY OF ORTHODONTICS ALIGNERS: AN UMBRELLA REVIEW
Objective
This umbrella review aims to determine if clear aligners promote cytotoxic and estrogenic effects.
Methodology
The review was conducted in conformity with the PRISMA statement. A systematic search was carried out in March of 2025 in 5 databases (Medline through PubMed, Web of Science (all databases), Cochrane Library, Embase, and Epistemonikos). All systematic reviews (SRs) that reported the cytotoxicity and/or estrogenicity of orthodontic aligners were included. The quality of the included studies was evaluated using AMSTAR-2 and the degree of overlap was analysed using Corrected Covered Area (CCA).
Results
The literature search resulted in 394 articles. Screening by title and abstract, resulted in 13 articles for full reading, and 4 articles were included in the umbrella review. According to the AMSTAR-2, all reviews were of low quality. The degree of overlap among SRs is high.
Discussion
The included SRs indicate that aligners do not have significant estrogenic/cytotoxic capacity and, even in cases of bisphenol A (BPA) leaching, this occurs at levels well below what is considered toxic. The low quality, high risk of bias, considerable overlap, and significant heterogeneity among the included studies impacts the obtained results.
Conclusion
It is not possible to affirm or refute the presence of estrogenic or cytotoxic effects or the leaching of monomers such as BPA. In the future, it is recommended that studies adopt a more detailed and prolonged analysis of BPA leaching and it is necessary to carry out clinical studies that evaluate the safety and biocompatibility of orthodontic aligners.
期刊介绍:
The Journal of Evidence-Based Dental Practice presents timely original articles, as well as reviews of articles on the results and outcomes of clinical procedures and treatment. The Journal advocates the use or rejection of a procedure based on solid, clinical evidence found in literature. The Journal''s dynamic operating principles are explicitness in process and objectives, publication of the highest-quality reviews and original articles, and an emphasis on objectivity.