Dental Alterations Research Articles

Hypohidrotic Ectodermal Dysplasia and Its Manifestations in the Oral Cavity

The Ectodermal Dysplasias generally present orofacial manifestations, such as skeletal discrepancies and dental alterations. Therefore, the role of a paediatric dentist in the detection and recognition of these repercussions can be crucial in early diagnosis of the disease. The oral rehabilitation of paediatric patients with this condition is extremely important, ideally, at a very early stage, yet contributing for the re-establishment of normal chewing, swallowing and phonetics functions, and, naturally, aesthetics increase. The purpose of this narrative review aims to elucidate dentists about their role in the detection, diagnosis, treatment and monitoring of the Ectodermal Dysplasia’ oral manifestations in paediatric patients, through the presentation of general physical and specific craniofacial characteristics.

Oral health status of children and young adults with maple syrup urine disease in Turkey

BackgroundMaple syrup urine disease (MSUD) is an inherited disorder clinically characterized by ketoacidosis, seizures, coma, psychomotor delay, and intellectual disability. The treatment requires a life-long protein-restricted diet, rich in carbohydrates and fats, supplemented with a medical amino acid formula. Diet, oral health and general health influence each other in a vicious cycle. The aim of this study was to investigate the oral health status of children and young adults with MSUD in Turkey.MethodsA descriptive study was conducted on patients with MSUD who applied for routine follow-up to the pediatric metabolic diseases clinic at Hacettepe University, Children's Hospital in Ankara, Turkey in a 12-month period. Patients with any other concomitant genetic diseases and acute infection were excluded. A total of twenty-five patients were enrolled and underwent oral examination including DMFT/S, dmft/s (decayed/missing/filled teeth/surfaces for deciduous and primary teeth, respectively), plaque and gingival indices. Panoramic radiographs were obtained in 12 cooperative patients.ResultsMean age was 9.88 ± 5.68 s.d years. More than half of the parents had only primary school level education, and low income. Fourteen patients consumed medical formula during or right before sleep. Fourteen patients reported caries-associated pain. Gingival inflammation was present in all 15 patients who cooperated for evaluation. Seven out of twelve patients had at least one dental anomaly or alterations in mandibular morphology. Five patients had previously been treated for caries under general anesthesia. To our knowledge, this is the first study to document oral clinical and radiologic findings in patients with MSUD.ConclusionsImpaired oral health was observed in this rare disease population. Regular dental referral by physicians, preventive measures and dental treatments should be included in multidisciplinary management of maple syrup urine disease to promote oral health.

Dental and maxillomandibular incidental findings in panoramic radiography among individuals with mucopolysaccharidosis: a cross-sectional study.

Mucopolysaccharidosis (MPS) is a group of rare and inherited metabolic disorders caused by the accumulation of macromolecule glycosaminoglycans inside lysosomes. Affected individuals may have dental and craniofacial tissue alterations, facilitating the development of several oral diseases. Objectives To assess, with panoramic radiographic images, the frequency of dental and maxillomandibular incidental findings among MPS individuals and compare them with non-MPS individuals.Methodology A cross-sectional study evaluating a sample of 14 MPS individuals and 28 non-MPS individuals aged from 5 to 26 years was carried out. They were matched for sex and age on a 2:1 proportion. Panoramic radiographs were assessed for the presence/absence of the following dental and maxillomandibular alterations: dental anomalies of number (hypodontia/dental agenesis, supernumerary teeth); anomalies of form (microdontia, macrodontia, conoid teeth, taurodontism, and root dilaceration); anomalies of position (impacted tooth, inverted tooth, tooth migration, partially bony teeth, complete bony teeth); periapical alterations (furcation lesion, circumscribed bone rarefaction); other alterations (radiolucent bone lesions, radiopaque bone lesions, radiopacity in the maxillary sinus, condylar hypoplasia). Differences between groups were tested by the Fisher’s exact test and chi-square test (p<0.05).Results For intrarater agreement, Kappa values were 0.76 to 0.85. The presence of supernumerary teeth (p=0.003); conoid teeth (p=0.009); taurodontism (p<0.001); impacted teeth (p<0.001); partial bony teeth (p=0.040); complete bony teeth (p=0.013); and root dilaceration (p=0.047) were statistically more frequent in MPS individuals compared to non-MPS individuals. Bone rarefaction/furcation lesions (p=0.032), condylar hypoplasia (p<0.001), radiolucent bone lesions (p=0.001), and dentigerous cysts (p=0.002) were also more frequent in MPS individuals.Conclusion The presence of specific oral manifestations is more common in MPS individuals than non-MPS individuals.

Complications, clinical manifestations of congenital syphilis, and aspects related to its prevention: an integrative review.

to identify the scientific evidence about the clinical complications and manifestations of congenital syphilis and aspects related to its prevention. integrative review after a search in the databases LILACS and MEDLINE, carried out in March 2018, using the descriptors "syphilis, congenital", "complications", and "signs and symptoms", leading to the selection of 27 researches. the publications found were published from 1966 to 2017, and most of them were from Latin America and Africa. Negative outcomes, laboratory changes, and the clinical manifestations in congenital syphilis, whether early or delayed, were, respectively: low weight at birth, anemia, hepatosplenomegaly, and dental alterations. The lack of treatment of the pregnant women in the prenatal was the most common occasion in which the opportunity to prevent the complications of congenital syphilis was lost. the scientific evidences analyzed showed serious complications of congenital syphilis that could be avoided if early opportunities of diagnosing and treating the pregnant women are not lost during the prenatal.

Prótese dentária: influência nas funções estomatognáticas e na qualidade de vida

OBJETIVO: Compreender o impacto da prótese dentária nas funções estomatognáticas e na qualidade de vida dos usuários.MÉTODOS: A amostra foi composta por 50 indivíduos, de ambos os sexos, com idade superior a 18 anos, tendo como critério de inclusão o uso da prótese dentária total ou parcial. Foram excluídos do estudo indivíduos que apresentaram patologias neurológicas, síndromes e/ou dificuldade de compreensão. Na coleta de dados foi realizada avaliação das funções de mastigação, da fala e da deglutição baseada no protocolo MBGR. Para avaliar a qualidade de vida foi aplicado o questionário OHIP-14. Os dados foram analisados de forma descritiva e inferencial, considerando o nível de significância de 5% em todas as análises inferenciais.RESULTADOS: Dos 50 usuários de próteses dentárias, 62% eram do sexo feminino e 38% do sexo masculino, com idade média de 62 anos e 6 meses. Os participantes utilizavam prótese em média há 27 anos e 3 meses, sendo mais frequente o tipo de prótese dentária total (46%). Verificou-se que 78% da amostra apresentou mastigação alterada, 30% fala alterada e 10% deglutição alterada. Quanto ao questionário, 68% da amostra apresentou respostas indicativas de impacto na qualidade de vida.CONCLUSÕES: O uso da prótese dentária ocasiona alterações na função mastigatória principalmente no que se refere à incisão do alimento e ao padrão mastigatório. O tempo de uso pode influenciar na adaptação do indivíduo quanto às funções de fala e de deglutição. A qualidade de vida pode sofrer alterações devido ao uso de prótese.

Jawbone fibrous dysplasia: retrospective evaluation in a cases series surgically treated and short review of the literature.

Background and aim of the work.Fibrous dysplasia is a fibro-osseous osteopathy in which the normal bone architecture is replaced by fibrous tissue and non-functional trabeculae-like osseous structures. In head and neck area monostotic or polyostotic lesions cause a progressively expanding destructive bone swelling producing cosmetic deformities and functional impairments. The aim of this article is to present a retrospective review of a clinical case series with pathologically confirmed jawbone fibrous dysplasia for over an 8-year-period.Material and Methods.Clinical presentation and radiographic features of fibrous dysplasia affecting the jawbone skeletal area, surgical procedures performed including the reconstructive methods employed and clinical outcomes were analysed for each patient.Results.Seven cases were classified as having monostotic fibrous dysplasia while the others four cases were classified as having polyostotic form. The mandible was most commonly involved. The most common presenting features included marked facial deformity, intraoral bulging, malocclusion and dental alterations. Aesthetic and/or functional impairments were the major indications for surgical treatment in all the patients of this series. Six patients underwent bone remodelling while in the remaining cases subtotal or total resection was performed. Bone reconstruction by means of autologous free bone grafts or revascularized free bone flaps was made in three cases.Conclusion.The choice of the tailored therapeutic approach should be evaluated according the patient’s age, rate of growth, anatomic location, type of involvement and the presence or not of functional disturbances and cosmetic alterations. Surgery remains the best therapeutic option.

Effects of Orthodontic Adhesives on Dental Enamel Color Alteration Using Chemically Cured and Light-Cured Composites.

Objectives:The purpose of this investigation was to evaluate the color alteration of dental enamel following the use of light-cured and chemically cured composites for bonding of metal brackets.Materials and Methods:Sixty extracted human premolars divided into five groups (n=12) were included in this study. Metal brackets were bonded using chemically cured (System 1+ and Unite) and light-cured (Transbond XT and Grengloo) composites. The control group remained untreated. After 72 hours of immersion in a staining solution and 24 hours of photoaging, the brackets were debonded, and adhesive remnants were cleaned using a 12-blade tungsten carbide bur and polished with Sof-Lex discs. The color was assessed at the baseline and after cleaning procedures in accordance with the CIE L*a*b (lightness, red/green, blue/yellow) color system. Statistical analyses were performed using paired sample t-test and one-way analysis of variance (ANOVA).Results:The L*, a*, and b* parameters showed a significant increase in all adhesive groups (P<0.001). The experimental groups showed significant color changes (P<0.05), and the mean ΔE ranged from 2.46 to 3.15 units. No significant difference was found between the ΔE of the adhesive groups (P>0.05).Conclusion:The enamel color change is influenced by bonding and debonding procedures. Chemically cured and light-cured composites have similar effects on dental enamel color alterations.

Enamel of Premolars whose Predecessors Presented Rupture of the Follicle Bone Crypt from Periapical Infections.

To observe if dental alterations in premolars are associated with the rupture of the follicle bone crypt caused by a periapical lesion in the predecessor molars. This is a cross-sectional study. Data collection consisted of the analysis of medical records, a socioeconomic questionnaire, and dental clinical examination. Records from patients with a history of a radiographically visible periapical lesion in lower primary molars submitted to pulp therapy or extraction from a university dental clinic were selected. Successor premolars were clinically evaluated for the presence of enamel development defects, shape alterations, and eruption deviations. The descriptive analysis of data was performed, and Fisher's exact tests, linear trend chi-square, and the Student's t-test were applied. Forty-eight permanent teeth were from 36 patients were evaluated in this study, and 20 (41.7%) of the 48 examined premolars showed a radiographic image suggestive of the rupture of the bone crypt. Rupture of the follicle bone crypt was not associated with the occurrence of enamel alterations in premolars (p = 0.418). An association between dental alterations and age over six years at the time of intervention was observed (p = 0.043). The presence of enamel alterations of premolars was not associated with the rupture of the follicle bone crypt caused by a periapical lesion in predecessor molars.

Lower maximum forces on oral structures when using gum-elastic bougie than when using endotracheal tube and stylet during both direct and indirect laryngoscopy by novices: a crossover study using a high-fidelity simulator

BackgroundApplying excessive force during endotracheal intubation (ETI) is associated with several complications, including dental trauma and hemodynamic alterations. A gum-elastic bougie (GEB), a type of tracheal tube introducer, is a useful airway adjunct for patients with poor laryngoscopic views. However, how the use of a GEB affects the force applied during laryngoscopy is unclear. We compared the force applied on the oral structures during ETI performed by novices using the GEB versus an endotracheal tube + stylet.MethodsThis prospective crossover study was conducted from April 2017 to March 2019 in a public medical university in Japan. In total, 209 medical students (4th and 5th grade, mean age of 23.7 ± 2.0 years) without clinical ETI experience were recruited. The participants used either a Macintosh direct laryngoscope (DL) or C-MAC video laryngoscope (VL) in combination with a GEB or stylet to perform ETI on a high-fidelity airway management simulator. The order of the first ETI method was randomized to minimize the learning curve effect. The outcomes of interest were the maximum forces applied on the maxillary incisors and tongue during laryngoscopy. The implanted sensors in the simulator quantified these forces automatically.ResultsThe maximum force applied on the maxillary incisors was significantly lower when using a GEB than when using an endotracheal tube + stylet both with the Macintosh DL (39.0 ± 23.3 vs. 47.4 ± 32.6 N, P < 0.001) and C-MAC VL (38.9 ± 18.6 vs. 42.0 ± 22.1 N, P < 0.001). Similarly, the force applied on the tongue was significantly lower when using a GEB than when using an endotracheal tube + stylet both with the Macintosh DL (31.9 ± 20.8 vs. 37.8 ± 22.2 N, P < 0.001) and C-MAC VL (35.2 ± 17.5 vs. 38.4 ± 17.5 N, P < 0.001).ConclusionsCompared with the use of an endotracheal tube + stylet, the use of a GEB was associated with lower maximum forces on the oral structures during both direct and indirect laryngoscopy performed by novices. Our results suggest the expanded role of a GEB beyond an airway adjunct for difficult airways.

Immunohistochemical expression of β‐Catenin associated to bone strain changes in the subchondral bone of mandibular condyle – study in Wistar rats with dental premature contact

From the biomechanical concepts regarding the masticatory load distribution, the mandible has a load flow pattern from the teeth to the temporomandibular joint (TMJ). Studies have presented morphological changes in the temporomandibular joint after dental occlusal alterations, such as the premature contacts. Thus, it is important to figure out the bone mechanobiology of the mandibular condyle, involving the relation mechanical stimuli x biological response. The aim of this work was to perform an immunohistochemical analysis of β‐catenin expression associated to a computational simulation by finite element analysis (FEA) to evaluate the relation between the osteocyte mechanosensation and the bone strain. This relation was evaluated in rats with occlusal changes by premature contact. Thirty male rats (Rattus norvegicus albinus), Wistar lineage and 2 months old were used in this study. The animals were divided into two groups: control group (N = 10) and experimental group (N = 20). In the experimental group, premature contact was created by a stainless‐steel fragment, with 0.7 mm thickness, cemented on the first upper molar of all animals. Then, these animals were subdivided into two groups, according to the period with premature contact of 7 days (7D) and 14 days (14D). After euthanasia, the immunohistochemical analysis was performed by indirect immunoperoxidase method for β‐catenin expression, using diaminobenzidine for staining and hematoxylin for counter stain. From the head microCT scans of control and experimental groups, finite element models were created and the FEA was performed for both groups, considering the presence of premature contact in experimental group. In all analyses, the subchondral bone of condyle was analyzed in three regions (medial, central and lateral). The immunohistochemical analysis presented higher expression of β‐catenin in the lateral region in all groups as well as the bone strain in FEA. The experimental group presented higher β‐catenin expression 7D compared to control group. At 14D the β‐catenin expression the bone strain was similar to the control group. Thus, in conclusion, the β‐catenin expression can be associated to the strain sensitivity in the subchondral bone of the mandibular condyle. The premature contact increased the bone strain and the expression of β‐catenin in the subchondral bone.Support or Funding InformationBrazilian Coordination for the Improvement of Higher Education Personnel (PNPD/CAPES).

Congenital syphilis or mercury treatment: dental alterations in a twelfth- or thirteenth-century child from Medinaceli, Soria, Spain.

Syphilis, together with its variant congenital syphilis, is a disease caused by Treponema pallidum subsp. pallidum. This paper documents possible new skeletal evidence for congenital syphilis from the Medieval Era (twelfth and thirteenth centuries CE) burial site of Medinaceli in the Province of Soria in North-Central Spain. What is involved is dental alteration due to congenital syphilis, mercury treatment, or a combination of both. This study focuses on the hypoplastic dental changes observed in a child approximately eight years of age. Only a fragmented skull with left maxilla and the left side of the mandible were preserved. Macroscopic analysis, X-rays, computerized tomography (CT) and mercury detection analysis by inductively coupled plasma mass spectrometry (ICP-MS) techniques were used to observe dental abnormalities. In addition to extensive caries in the upper second deciduous molar, pulpo-alveolar lesions and facial alterations were observed. The absence of the rest of the skeleton tends to make a diagnosis of congenital syphilis difficult. However, the dental stigmata observed do permit a reasonable diagnosis.

Dental arch and skeletal morphology modifications in patients with mixed dentition and mouth breathing

The correlation between the superior airways and the cra­nio­facial development has been the subject of many studies where the mouth breathing is one of the main causes for the underdevelopment of the inferior and middle level of the face. The skeletal and dental alterations are caused by the muscle balance disturbance, where the orbicularis hypotonia makes it impossible to properly close the mouth and the masseters hypertonia applies pressure on the lateral areas of the alveolar arches. This study was conducted in a group of young subjects with mouth breathing, assessing the changes of several skeletal and dental parameters by analyzing the dental casts (anterior perimetry, intermolar distance, inter­canine distance) and the cephalometric ra­­dio­­gra­phy (Tweed and Steiner cephalometric analysis). The analysis was applied before and after functional or­tho­­don­tics treatment, and its aim was to correct the vi­cious habit by encouraging nasal breathing and palatal ex­pan­sion. The functional orthodontics together with mio­gim­nas­ti­cal exercises are an efficient treatment method which sig­­ni­­fi­­can­­tly contributes in breaking the vicious habit and en­­abling treatments for skeletal complications caused by oral breathing.

O propulsor mandibular pode ser usado com incisivos inferiores vestibularizados?

An excellent alternative to Class II treatment are fixed mandibular propulsion appliances. In general, they are devices that do not cause significant changes in the maxilla or mandible because they promote Class II correction primarily by dental alterations through an increase in the lower incisors inclination, decrease of upper incisors inclination, and occlusal plane rotation. The question is if it is possible to use this type of device, even with the lower dental compensation already present, that is, with the lower incisors vestibularized. The objective of this study is to show through a clinical case the use of mandibular propulsion with this type of malocclusion.

REPORT OF DENTAL ALTERATIONS IN AN ARNOLD-CHIARI TYPE 2 SYNDROME PATIENT

Arnold-Chiari syndrome is characterized by enlargement of the cerebellar tonsils going through the foramen magnum, reaching the spinal canal. The syndrome has 4 ratings: type I (asymptomatic in childhood), types II and III (diagnosed in the second week life), and type IV (incompatible with life). Oral alterations are rarely described, tooth agenesis being the most common. This study aims to report the case of a 3-year-old patient who is an Arnold-Chiari syndrome type II carrier with dental alterations. The case was evaluated by the hospital dentistry team because of the dental changes. Based on clinical finds, a skull x-ray (posterior-anterior projection, oblique lateral x-ray) where dental anomaly of number (supranumerary teeth) and enamel hypoplasia was observed. Topic fluor applications and monitoring are being made. The consistent clinical presentation provides further evidence of the dental characteristics of Arnold-Chiari type II syndrome patients. Arnold-Chiari syndrome is characterized by enlargement of the cerebellar tonsils going through the foramen magnum, reaching the spinal canal. The syndrome has 4 ratings: type I (asymptomatic in childhood), types II and III (diagnosed in the second week life), and type IV (incompatible with life). Oral alterations are rarely described, tooth agenesis being the most common. This study aims to report the case of a 3-year-old patient who is an Arnold-Chiari syndrome type II carrier with dental alterations. The case was evaluated by the hospital dentistry team because of the dental changes. Based on clinical finds, a skull x-ray (posterior-anterior projection, oblique lateral x-ray) where dental anomaly of number (supranumerary teeth) and enamel hypoplasia was observed. Topic fluor applications and monitoring are being made. The consistent clinical presentation provides further evidence of the dental characteristics of Arnold-Chiari type II syndrome patients.

Dental alterations on panoramic radiographs of patients with osteogenesis imperfecta in relation to clinical diagnosis, severity, and bisphosphonate regimen aspects: a STROBE-compliant case-control study

This study aimed to assess the prevalence of dental findings on panoramic radiographs (PRs) of patients with osteogenesis imperfecta (OI) and correlate these results with epidemiologic and medical data. A case-control study was conducted with 24 patients with OI and 48 sex- and age-matched controls. Demographic, clinical, and bisphosphonate regimen-related data were recorded. The outcome variables were the presence or absence of dental alterations in PRs. Mann-Whitney U test, Pearson's χ2 test, and multinomial logistic regression analysis (95% confidence interval) were used (significance level of 5%). OI type 4 demonstrated a high prevalence (62.5%), followed by type 1 (37.5%). With regard to prevalence associated with severity, the moderate form was the most prevalent (P = .028). The mean time of intravenous pamidronate regimen was 6.6 ± 4.4 years. Dentinogenesis imperfecta was observed in 75% of patients with OI, and this group showed a high prevalence of dental abnormalities in comparison with controls (P < .05). Bisphosphonate therapy was associated with ectopic teeth (P = .007) and tooth impaction (P = .033). Pulp obliteration was significant with bisphosphonate treatment over a period of 7 years (P = .026). This study found a significant prevalence of dental alterations in patients with OI, and certain alterations were associated with bisphosphonate therapy, indicating its influence on the dentin-related physiopathology.

Craniofacial abnormalities in a murine model of Saethre-Chotzen Syndrome

BackgroundSaethre-Chotzen Syndrome (SCS) is an autosomal dominant syndrome that occurs due to a mutation or deletion of the Twist1 gene at chromosome 7p21. Our aim was to conduct a morphometric analysis of the craniofacial features in the mouse associated with a Twist1+/− mutation. MethodsMicro-computed imaging was conducted for the skulls of forty skeletally mature mice, equally distributed by sex (male and female) and two genotypes (Twist1+/− or murine model of SCS; and Twist1+/+ or wild-type). A morphometric analysis was carried out for eight parameters for the maxillary-zygomatico-temporal region, 10 parameters for the mandible and three parameters for teeth from three-dimensional reconstructions. ResultsCompared with wild-type, the murine model of SCS showed these trends: (1) maxillary-zygomatico-temporal region, significantly shorter length and width posteriorly (p<0.05), (2) mandible, significantly reduced height and width (p<0.05), and (3) teeth, significantly shorter height, shorter mesio-distal width but longer bucco-lingual width (p<0.05). In the murine model of SCS, the key morphological variations included incomplete ossification of the temporal bone and zygomatic arch, twisting and/or incomplete ossification of the palatal process of the maxilla, premaxilla and the ventral nasal concha, as well as bifid coronoid processes. ConclusionsThe skeletal and dental alterations in the height, length and width provide a foundation for large-scale phenomics studies, which will improve existing knowledge of the Twist1 signalling cascade. This is relevant given the predicted shift towards minimally invasive molecular medical treatment for craniosynostosis.

ORAL RADIOGRAPHIC FINDINGS IN SICKLE CELL DISEASE PATIENTS

Sickle cell disease causes vascular microinfarcts that lead to multi-organs alterations including dental involvements. Teeth, oral structures, and maxillofacial bones are affected. Dental alterations of oral and maxillofacial bones are of anatomical, radiographical, and structural significance. Due to compensatory hematopoiesis, hemolysis, and vaso-occlusive events in the maxilla and mandible, bony changes are noticed radiographically in SCD patients. Seven oral radiographic features were reported in the literature among SCD patients: large trabecular spaces, increased medullary spaces, thinning of the inferior mandibular border (osteoporosis), interproximal alveolar bone staircase pattern, thickening of lamina dura, resorption in alveolar bone, and radiopacities/osteosclerosis. Mandibular Hypo-vascularity can induce osteomyelitis and osteonecrosis in SCD patients. Mandibular osteomyelitis can be followed by osteosclerosis (radiopacities) if proper healing is achieved. In this study, we obtained multiple radiographs of 35 SCD patients to 1)determine the common radiographic features seen in SCD patients and 2)assess the seven radiographic features reported in the literature. Results Some SCD patients demonstrated more than one radiographic feature, while other SCD patients manifest no radiographic findings. The most common feature was the staircase pattern and the least common was osteoporosis. A detailed table of the number of SCD patients presented with notable radiographic features is presented in this poster, in addition to a comparison between the common and uncommon features. Conclusion not all SCD patients demonstrate oral radiographic findings, and among the oral radiographic findings reported in the literature, some features are more common than others. Hopefully, 50 or more SCD patients will be included in the study for further evaluation. Furthermore, an equal number of radiographs of competent patients will be examined randomly from Kuwait University's bank of radiographs to serve as a control group. Therefore, we will be able to determine if the reported oral radiographic features are suggestive of SCD or not.

Oral and dental health status in patients with eating disorders in Madrid, Spain.

BackgroundThe aim of the present study was to describe and compare the oral and dental health status of two groups, one diagnosed with eating disorders (EDs), and another group without this pathology, assessing the following oral manifestations: dental alterations, periodontal disorders, soft tissue disorders, non-stimulated salivary flow, and oral pH.Material and MethodsThis comparative transversal epidemiological study included 179 participants, of whom 59 were diagnosed with EDs (Eating Disorder Group: EDG) and 120 had no antecedents of EDs (No Eating Disorder Group: NEDG). All patients fulfilled the following inclusion criteria: women aged over 18 years, diagnosed with an ED by a specialist, patients who had undergone at least 1 year monitoring by the Clinical Nutrition Unit, and had not received any periodontal treatment during the previous 6 months. Both groups were homogeneous in terms of sex, age, education, and socioeconomic level. Oral exploration was performed, registering clinical variables, as well as sociodemographic and socioeconomic data, oral hygiene habits, and smoking. Statistical significance was established as p<0.05 (confidence level > 95%).ResultsThe dental erosion (DE) was the most significative feature of dental alterations. The degree of DE was significantly greater in the EDG (p<0.001). A significant association between soft tissue lesions and EDs was found (p<0.001) A notable difference in non-stimulated salivary flow was found between the groups (p<0.001). No significant differences between the groups were found for periodontal status, dental caries, or oral hygiene practices.ConclusionsOn the basis of the results obtained, it is necessary to carry out oral/dental examination as soon as an ED is diagnosed with regular check-ups thereafter. Key words:Eating disorders, anorexia nervosa, bulimia nervosa, oral health, dental erosion.

Update of dental and maxillofacial alterations in patients with pycnodysostosis

ABSTRACT Pycnodysostosis is a rare, autosomal recessive genetic condition, which causes a decrease in bone remodeling, resulting in different clinical and radiographic manifestations. This case series aims to describe two clinical cases diagnosed at the Department of Oral and Maxillofacial Surgery and Traumatology of a University on the Northeast of Brazil. There are two complex cases involving osteomyelitis and dental and bone alterations of the jaws. It is concluded that the knowledge of oral and maxillofacial characteristics of this syndrome are required to plan appropriate treatment for patient in order to avoid complications of dental treatments due to inadequate bone remodeling.

Evaluation of Sagittal Changes in Class II Div 2 Patients with Decelerating Phase of Growth by PowerScope Appliance: A Retrospective Cephalometric Investigation.

Background:Restricted mandibular growth is observed in Class II Div 2 malocclusions. The fixed functional appliances are used to effect the skeletal changes in patients with end stages of skeletal maturity.Aim:This cephalometric study aimed to distinguish the skeletal and dental corrections done in the mandible on skeletal Class II Div 2 subjects when treated with PowerScope appliance (American Orthodontics, Sheboygan, WI).Materials and Methods:This is a cephalometric study based on the retrospective data. The patients selected for this study were with Class II Div 2 malocclusion and assessed to be in decelerating phase of skeletal growth. A total of 12 patients were selected after applying inclusion and exclusion criteria. A PowerScope was placed after incisor correction and followed up till Class I molar relation was achieved. The initial values (T1) at the time of placement of the appliance and the final values at the end of the molar correction (T2) were noted. The cephalometric parameters at T1 and T2 were assessed using sagittal occlusal (SO) analysis by Pancherz. The paired Student’s t-test was used to analyze pre- and posttreatment changes.Results:There was sufficient lengthening of the mandible (4.38 mm). Both the dental and skeletal alterations were observed in the mandible. These changes were marked compared to the maxilla. The pre- and posttreatment changes were statistically significant for the mandibular skeletal changes (P < 0.001) as well as mandibular incisor proclination (P < 0.001).Conclusion:The PowerScope can be used as a propeller for sagittal mandibular correction in Class II Div 2 patients.