Dentoalveolar Growth Research Articles

Preterm birth and its effects on craniofacial and dentoalveolar growth

Premature or preterm birth is a condition that takes place either before the 37th week of gestation or when the weight of the neonate is lower than 2500 grams (Paulsson et al., 2004; Cortines and Costa, 2016). Several factors that are related to the mother or the fetus have been considered as potential causes for this condition, whereas there is a consensus that there are potential parameters that could lead to premature birth which still remain to be identified (Hohoff et al., 2005; Seow, 1997). Despite the fact that the incidence of neonatal mortality owing to premature birth has been significantly decreased in the recent years, there are yet some side-effects that could affect specific organ systems of the fetus (Paulsson et al., 2004; Hohoff et al., 2005). Moreover, there are reports of possible influence of preterm birth on the development of the cognitive and psychological background of the affected children (Anderson and Doyle, 2008).

Retrospective evaluation of the orthodontic treatment needs in primary school children with Robin sequence following Tübingen palatal plate therapy in infancy

IntroductionThe aim of this study was to investigate the orthodontic treatment needs (OTN) of children with RS treated with the TPP in infancy compared to age- and sex-matched controls. MethodsThe aim of this study was to investigate the orthodontic treatment needs (OTN) of children with RS treated with the TPP in infancy compared to age- and sex-matched controls. ResultsIn 21 children with RS (n = 23; 19 non-syndromic, 4 syndromic; average age 9.9 years) showed high OTN, which was significantly higher than in controls (n = 21). The latter of 9 controls had minor OTN, followed by 8 participants with borderline OTN. Regarding the intraoral picture, patients with RS had an increased open bite tendency. Without considering the presence of a cleft palate, 16 children with RS had high or very high OTN, compared to 4 of controls. ConclusionsPatients with RS have significantly higher OTN than healthy controls, independent of cleft occurrence. RS is associated with dental anomalies and special skeletal growth patterns, both increasing malocclusion and negatively affecting dentoalveolar growth. This should raise awareness for identifying these needs and provide a comprehensive orthodontic treatment, where functional rehabilitation should be favored over aesthetic results.

Implant placement in the aesthetic zone: Long-term results.

SUMMARY: Implant placement is considered to be a routine procedure for oral rehabilitation, in cases of tooth agenesia or tooth loss (due to factors such as periodontitis, trauma,caries). Dental implants’ position does not change over time due to the process of “osseointegration”. On the contrary, teeth follow craniofacial growth (in particular, orofacial and dentoalveolar growth) and move. The stomatognathic system undergoes changes in its vertical and horizontal dimensions after adulthood. Implant placement on the anterior maxilla is challenging for clinicians, because of continuous eruption of adjacent teeth, as well as, due to occurrence of occlusal changes. Long-term aesthetic complications, such as differences in incisal edges’ length, position of gingival margins and open contact points between implant restorations and adjacent teeth, should be taken into consideration. The aim of this study is to review literature concerning long-term complications after implant placement in the anterior maxilla. Furthermore, 2 case reports concerning aesthetic problems of implant restorations in the esthetic zone will be presented, together with their treatment procedure. Consequently, with time, implant restorations in the anterior maxilla present aesthetic complications of various degrees, which are in need of personalized treatment plan. In order to avoid such complications, implant placement is recommended to be performed after completion of skeletal growth and maturation.

A Comparative Analysis of Dental Measurements in Physical and Digital Orthodontic Case Study Models.

Background and Objectives: Study models are essential tools used in the dental teaching process. The aim of the present study was to compare the values obtained by manual and digital orthodontic measurements on physical and digital case study models. Materials and Methods: The physical experimental models were obtained by traditional pouring (improved stone-type IV gypsum products) and by additive manufacturing (resins). The digital experimental models were created by scanning the physical ones, using a white light-emitting diode (LED) source and an L-shaped dental scanner—Swing DOF (DOF, Seoul, Korea). The physical study models were first measured using a digital caliper, and then, they were scanned and evaluated using the DentalCad 3.0 Galway software (exocad GmbH, Darmstadt, Germany). The Pont, Linder–Harth, and Bolton indices, which are used in orthodontics for training students, were derived using the available data. Results: When comparing the linear measurement mean ranks taken on physical study models to those of digital models, no statistically significant differences (p > 0.05) were found. A similar result was also shown when the dentoalveolar growth indicators were analyzed. Conclusions: It can be concluded that dental study models made by direct light processing (DLP) and pouring type IV class gypsum are both acceptable for orthodontic teaching purposes.

The dental effects of head and neck rhabdomyosarcoma treatment: a case series

Rhabdomyosarcoma (RMS) is a malignant soft tissue neoplasm of skeletal muscle origin. Approximately 40% of cases of RMS are sited in the head and neck region and nearly 65% of cases are diagnosed in children less than six years of age. Treatment for RMS involves a multimodality approach including surgery, chemotherapy and radiotherapy. When children are exposed to such treatments there are often associated long-term adverse effect which may affect the patients' dento-alveolar growth and development. Three cases are described highlighting these adverse effects and the treatments used for oral rehabilitation. CPD/Clinical Relevance: To inform readers of the long-term effects of rhabdomyosarcoma treatment on the dento-alveolar development.

Long-term follow-up implant site development in the submerged mandibular primary second molars: a case report

Treatment of ankylosed and submerged primary molars without permanent successors is challenging, as normal vertical dentoalveolar growth is compromised. Thus, grafting techniques and distraction osteogenesis are performed for ridge augmentation before implant restoration. However, these techniques are invasive with limited success. Another treatment for implant site development is noninvasive forced eruption. This case report describes long-term follow-up of alveolar ridge augmentation in the submerged mandibular primary second molars using subluxation and orthodontic forced eruption for implant site development. A 19-year old female had Class II molar relationships, upper anterior crowding with large overjet, missing four second premolars and submerged mandibular primary second molars with inadequate vertical development of alveolar bone. For the vertical alveolar bone alterations in the mandible, forced eruption with subluxation of ankylosed lower primary second molars was applied. Treatment outcome was evaluated over 5 years with stable occlusion, healthy periodontal tissues, and successful radiographic results.

Ten-Year Cephalometric Comparison of Patients With Cleft Palate who Received Treatment With Active or Passive Pre-surgical Orthopedic Devices.

Pre-surgical orthopedic (PSO) devices can be used in the management of patient with cleft lip/palate (CL/P) to narrow the alveolar gap (AG) prior to lip surgery. There are few studies comparing these 2 devices. The objective of this work was to compare the effects of active and passive PSO devices on facial growth in a single surgeon's cohort of patients with CL/P over a 10-year period. A retrospective review of all patients with CL/P in a single surgeon's practice from 2002 to 2018 was performed. Preoperative measurements of AG size were done using electronic calipers on patient molds. Patient radiographs were taken at 5 and 10 years of age and cephalometric landmarks were plotted using specialized software. Independent sample t-tests were used to compare means for maxillary, mandibular, vertical, and dento-alveolar growth parameters. Twenty patients with an active device and 23 patients with a passive device were included. No differences were observed in the basic demographic information between the two groups. At the time of lip repair, patients with a passive device had significantly larger horizontal AGs (P < .01), but by the time of palate repair, there was no difference between the two groups (P = .94). There was no significant difference in any growth measurements between the active and passive device groups at 5 and 10 years. Despite closing the AG more quickly, patients treated with an active device have no significant difference in facial growth at 10 years compared to patients treated with a passive device.

EVALUATION OF CEPHALOMETRIC ANALYSIS IN PATIENTS WITH BILATERAL CONDYLAR RETROPOSITION IN TEMPOROMANDIBULAR DYSFUNCTION

Relevance. During the dentoalveolar growth and development, the direction and growth type of facial skull play a very important role. Development of esthetical symmetry, functional relationship, and clinical disharmony depends on skull parameters. Temporomandibular joint dysfunction is one of the most common diseases nowadays. That is why early identification of risk factors is among the priorities. This study aimed at evaluating occlusional and skeletal specific characteristics in patients with temporomandibular joint dysfunction, comparing different cephalometric findings and CT findings relating to condylar position. Materials and methods. The study included 45 individuals. The study group consisted of 26 patients with bilateral condylar retroposition. Control group was made up of 19 patients. The participants underwent clinical examination, functional testing, palpation of masticatory muscles, occlusion diagnosis by applying Baush articulating film 200,100,8 microns, cephalometric analysis: Tweed, Kim, Jarabak, Ricketts, computed tomography of temporomandibular joint. Statistical analysis was carried out by the program IBM SPSS Statistic Base v.22. Results. There were no pathological contacts during evaluation of static and dynamic occlusion, laterotrusion as «canine guidance». The patients of the test group had bilateral posterior joint fissure reduced right-median 1,96, left-median 1,81. In control group the position was right-average 2,75 and left-median 2,67 The patients in the control and test groups the indices Tweed &lt;FMA average were 19,6°/ median 21,7°; &lt;IMPA average 97,9°/ median 97,8°; Kim ODI median was 68,9°/73,74°; Ricketts Overbite median 2.1 mm /1,9 mm, Overjet median was 2,9 mm /2,85 mm, PM-Xi-ANS median was 44,1°/43,75°, &lt;NPog-FH median was 91°/86,85°,&lt;NBa-PtGn median was 91,1°/90,1°, &lt;MeGo-FH median was 18,7°/22,4°; Jarabak &lt;N-S-Ar average was 127,2°/125,6 °. Conclusions. In the patients with bilateral condylar retropositionm the joint fissure is reduced. Cephalometric analysis demonstrated the following: Tweed &lt;FMA, &lt;IMPA; Kim ODI; Ricketts Overbite, Overjet, PM-Xi-ANS, &lt;MeGo-FH; Jarabak &lt;N-S-Ar can not be used as diagnostic criteria of bilateral condylar retroposition. Ricketts &lt;NPog-FH in the test group showed the mandibular retroposition, but with normal type of mandibular growth &lt;NBa-PtGn. It can be used as one of the primary cephalometric diagnostic indicator of bilateral condylar retroposition.

Facilitating CAD/CAM nasoalveolar molding therapy with a novel click-in system for nasal stents ensuring a quick and user-friendly chairside nasal stent exchange

Nasoalveolar molding (NAM) aims to improve nasal symmetry with a nasal stent in cleft lip and palate (CLP) patients. When plates have to be exchanged because of dentoalveolar growth or cleft reduction, the nasal stent has to be mounted onto a new plate. This procedure elongates visiting hours for patients and parents or requires second treatment sessions. This study introduces a quick-lock additive manufacturing solution for chairside nasal stent exchange called RapidNAM. A novel taping retention pin has been designed that enables nasal stent insertion. Patients with unilateral CLP were included in this study. Plaster models were digitalized and measured by two independent observers. Two methods of CAD/CAM-molding therapies were compared: (i) conventional adhesion of a nasal stent (CAD/CAM NAM); (ii) quick-lock system in which the nasal stent was transferred to another plate (RapidNAM). CAD/CAM NAM and its refinement RapidNAM significantly increased the cleft-side nasal height and tilted the nose towards symmetry. The quick-lock system minimizes wire adaptations, since the pre-existing stent can be reused. The new nasal stent development seems a feasible solution to minimize visiting hours but with clinically satisfactory results. This new nasal stent system combines traditional elements of NAM with CAD/CAM-technology.

A novel report on the use of an oncology zygomatic implant-retained maxillary obturator in a paediatric patient

This report details the use of zygomatic oncology osseointegrated implants to support and retain a maxillary obturator in a 13-year-old male patient who underwent a right-sided hemi-maxillectomy (Brown Class 2b) (Brown and Shaw, Lancet Oncol 11:1001–8, 2010) for a myxoid spindle cell carcinoma. At the time of maxillary resection, two zygomatic oncology implants were inserted into the right zygomatic body and subsequently utilised to provide in-defect support and retention for a bar-retained maxillary acrylic obturator prosthesis, which restored the patient’s aesthetics and function to a very high level. Close follow-up over 2 years demonstrated ongoing excellent function and disease control with no deleterious effects on facial or dento-alveolar growth clinically. This is the first clinical report of its kind in the published literature detailing the use of a zygomatic implant-retained obturator in a paediatric patient.

Impact of genioplasty during puberty on the upper airways.

Mouth breathing is a functional disorder that affects craniofacial and dento-alveolar growth and also upper airway (UA) anatomy. This is apparent mainly in dimensional abnormalities of the UA caused by hypertrophy of Waldeyer's ring and excessive vertical development of the lower part, giving rise to labial incompetence that perpetuates the functional disorder. The main aim of this study was to evaluate the development of the oropharyngeal structures in young hyperdivergent patients who had undergone functional genioplasty in the context of orthodontic treatment. This is a comparative retrospective study performed on 47 adolescents who were hyperdivergent, non-obese and exclusive or diurnal mouth breathers, treated at the Centre de soins, d'enseignement et de recherche dentaires (CSERD) in Montpellier, France. All were candidates for early genioplasty for vertical reduction, and were undergoing or at the end of treatment: 23 had been treated surgically (functional genioplasty), and 24 controls had received orthodontic treatment alone. Inter-group comparison of the changes in cephalometric measurements of the oro- and nasopharyngeal zones and maxillomandibular measurements was performed using covariance analysis (ANCOVA) to adjust for confounding factors. Concerning the skeletal structures: in the sagittal dimension, genioplasty led to significantly greater projection of the symphysis in the surgical group than in the control group (P<0.001). However, the sagittal position of the hyoid bone was unchanged. Similarly, in the vertical dimension, the reduction in divergence of the bony base was significantly greater in the surgical group (P<0.001), but with no change in the vertical position of the hyoid bone. Concerning the upper airways: at the level of the nasopharynx, there was a significantly greater increase in the velopharyngeal space in the surgical group (P<0.033). The same observation can be made on the level of the oropharynx, where there was a significant increase in the linguopharyngeal space in the surgical group (P<0.05), which was not the case in the control group. The change in the depth of the pharynx did not differ significantly between the two groups. Early genioplasty performed on adolescents during the growth phase helps to recalibrate the UA by encouraging spontaneous lip closure.

Implant Placement in Growing Adolescents : a Literature Review

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Mandibular growth and dentoalveolar development in the treatment of Class II, division 1, malocclusion using Balters Bionator according to the skeletal maturation

The purpose of the study was to evaluate the influence of the skeletal maturation in the mandibular and dentoalveolar growth and development during the Class II, division 1, malocclusion correction with Balters bionator. Three groups of children with Class II, division 1, malocclusion were evaluated. Two of them were treated for one year with the bionator of Balters appliance in different skeletal ages (Group 1: 6 children, 7 to 8 years old and Group 2: 10 children, 9 to 10 years old) and the other one was followed without treatment ( 7 children, 8 to 9 years old). Lateral 45 degree cephalometric radiographs were used for the evaluation of the mandibular growth and dentoalveolar development. Tantalum metallic implants were used as fixed and stable references for radiograph superimposition and data acquisition. Student's t test was used in the statistical analysis of the displacement of the points in the condyle, ramus, mandibular base and dental points. One-fixed criteria analysis of variance was used to evaluate group differences (95% of level of significance). The intragroup evaluation showed that all groups present significant skeletal growth for all points analyzed (1.2 to 3.7 mm), but in an intergroup comparison, the increments of the mandibular growth in the condyle, ramus and mandibular base were not statically different. For the dentoalveolar modifications, the less mature children showed greater labial inclination of the lower incisors (1.86 mm) and the most mature children showed greater first permanent molar extrusion (4.8 mm).

Correlations between dentoskeletal variables and deep bite in Class II Division 1 individuals

This study aimed to evaluate the cephalometric pattern of Class II Division 1 individuals with deep bite, and to determine possible correlations between dentoskeletal variables and deep bite. Comparisons were also made between genders and cases that were to be treated both with and without premolar extraction. A total of 70 lateral cephalograms were used, from both male (n = 35) and female (n = 35) individuals with an average age of 11.6 years, who simultaneously presented with ANB ≥ 5º and overbite ≥ 4 mm. Statistical analysis involved parametric (t-test) and non-parametric (Mann-Whitney) tests for independent samples, as well as the Spearman correlation test (p ≤ 0.05). The values of Go-Me, Ar-Pog, PM-1 and PM-CMI were higher in males (p < 0.05). However, no significant differences were found among the averages of the cephalometric measurements when the sample was divided by treatment with and without extraction. Deep bite was positively correlated to the PM-1 and SNA measurements, and negatively correlated to the Go-Me, Ar-Pog, SNB and SNGoMe measurements. The main factors associated with the determination of deep bite in Angle's Class II Division 1 cases were: greater lower anterior dentoalveolar growth and/or lower incisor extrusion, horizontal growth pattern, maxillary protrusion and mandibular retrusion.

Long-term Effects of Traumatic Injuries to Incisors and Periodontal Tissues during Childhood

The purpose of this study was to investigate the incidence of dentoalveolar growth disturbances, loss of teeth and esthetic impairment after the end of growth following traumatic injuries to incisors and periodontal tissues during childhood. 41 patients having sustained dentoalveolar trauma before age 10 and who were now at least aged 16 years, and a total of 68 traumatized teeth were documented by clinical examination, dental casts and photographs. We determined the three-dimensional position of the traumatized teeth on the casts, as well as the traumatized teeth's pulp sensibility, percussive sound and sensitivity, shape and color. 82% of the traumatized teeth were in the upper dentition. 45% of the traumatized teeth experienced subluxation, nearly 30% luxation, 16% avulsion. At the time of the follow-up examination (mean 17.0 years post-trauma), 57% of the traumatized teeth were still in situ. Immediately after trauma 7.4% of the teeth were lost; up to 16 years post-trauma 35.6% of the teeth were lost because of failed root canal filling, root resorption or ankylosis. We observed no functional deviations. Dentoalveolar growth disturbances were rare. Three teeth were markedly discolored. Following dentoalveolar trauma during childhood, negative effects on growth, function and esthetics can be minimized by timely interdisciplinary treatment and by follow-up controls until the end of growth to achieve an outcome satisfying both the patient and clinician.

Orthopedic effects of splint high-pull headgear—A cephalometric appraisal

Objective The purpose of this study was to investigate the orthopedic effect of maxillary splint high-pull head gear appliance on maxillary complex. Design Retrospective study. Settings Patients under treatment in the Department of Orthodontics, Azad University, during one year period from November 2003 to March 2004. Subjects Lateral cephalometric radiograph of 26 patients (11 boys and 15 girls, with a mean age of 11.3 years) treated with splint high-pull headgear appliance was compared with a similar control group of 26 individuals (11 boys and 15 girls with a mean age of 12.6 years). Main outcome measures The result of the present study showed that the treated group more closely approximated Class I cephalometric values after treatment, whereas the control group with a Class II skeletal pattern did not necessarily become “less Class II” due to growth. Results Point A was held efficiently in the treated group (S–A = 0.4 mm) whereas in the control group it had relocated downward and forward 2.00 mm along sella–point A (S–A) line. Also, the relocation of the point A in the horizontal ( X-axis) and vertical ( Y-axis) planes confirmed these findings. No rotational changes of palatal plane were recorded in the treated group. Mandibular skeletal changes were similar to the control group. Maxillary dentition was relocated more posteriorly. Conclusions It was concluded that the maxillary splint with high-pull headgear in the present study held the maxilla in position without any rotational changes of the palatal plane. Therefore, a normal skeletal relationship was achieved in the treated group through a combination of maxillary basal bone and dentoalveolar growth inhibition and a normal expression of mandibular growth.

Is radius-union an indicator for completed facial growth?

The purpose of this study was to determine if facial or dentoalveolar growth takes place after the occurrence of the radiographic handwrist stage R-J (completed fusion of the proximal epiphysis and diaphysis of the radius), which generally defines the completion of facial growth. Handwrist roentgenograms and lateral head films (LHFs) from 56 subjects (31 male and 25 female) aged 14 to 21 years were examined. Eight cephalometric distances (3 sagittal, 4 vertical, and 1 diagonal) and their changes during 2 different examination periods (from 1 year before to 2 years after the occurrence of R-J) were assessed. The investigation revealed that after the occurrence of R-J vertical dentoalveolar growth changes between 0.5 and 1.75 mm took place in the mandible and in the maxilla in 20% and 10% of the subjects, respectively. Comparing the 2 periods the frequency of the measured growth changes before and after R-J was, on average, almost equal. Because chronological age cannot be used for the assessment of facial growth termination, a reliable indicator for the assessment of facial growth termination is of major importance. After the occurrence of the handwrist stage R-J, most subjects revealed growth changes of less than 1 mm. Especially in the field of tooth implantology, it is important to forecast even small vertical dentoalveolar growth changes. The detected amount of growth after the insertion of an implant can cause esthetic and functional problems.

Dentoalveolar growth of patients with complete unilateral cleft lip and palate by early two-stage furlow and push back method

Dentoalveolar growth of patients with complete unilateral cleft lip and palate by early two-stage furlow and push back method

The contributions of craniofacial growth to clinical orthodontics

Balanced facial form and functions are derived from a harmonious integration of the various components of the craniofacial complex. These components grow and develop throughout life in a sequential, predictable, and orderly fashion, albeit with a wide range of variation in the amount and timing of growth. The knowledge of growth-related changes is essential in planning orthodontic treatment. It is important to understand and anticipate the amount and relative rate of growth in different parts of the face, especially during childhood and adolescence. The orthodontist needs to assess the developmental status of the individual and estimate the remaining growth to plan treatment. Incremental growth curves made on linear measurements from longitudinal cephalometric radiographs have demonstrated that all facial dimensions have varying relative rates of growth and show small prepubertal and postpubertal growth spurts. 1 The pubertal spurt in facial dimensions was found to coincide with the spurt in skeletal growth, as reflected by body height, lasting 3 to 4 years. It is apparently of shorter duration and occurs earlier in females than in males. To determine the time of the peak growth period in facial dimensions for an individual, several maturity indicators have been tested. The closest relationship was found with skeletal maturation, which can be readily assessed from hand and wrist radiographs. In many cases orthodontic treatment should commence before the onset or early during the pubertal spurt in order to take advantage of the accelerated growth period. Individual variability in amount and rate of growth is fairly large, related mainly to heredity (familial potential), gender, and ethnic background. In addition, growth is a life-long process. The face of an adult male continues to become progressively more orthognathic. 2 The nose grows downward and forward, while the commissure of the lips moves down with lengthening

Dentoalveolar Growth Inhibition Induced by Bone Denudation on Palates: A Study of Two Isolated Cleft Palates with Asymmetric Scar Tissue Distribution

Dentoalveolar Growth Inhibition Induced by Bone Denudation on Palates: A Study of Two Isolated Cleft Palates with Asymmetric Scar Tissue Distribution