Dentofacial Abnormalities Research Articles

Intra-Operative Nerve Encounters and Incidence of Inferior Alveolar Nerve Sensory Deficit after Bilateral Sagittal Split Osteotomy—A Pilot Study

ABSTRACT Introduction: Bilateral sagittal split osteotomy (BSSO) is the most performed orthognathic surgery for mandibular dentofacial abnormalities. The most common complication is the neurosensory deficit. The current study was aimed at determining the incidence of inferior alveolar nerve neurosensory deficit (NSD) following BSSO surgery, and in assessing intra-operative nerve encounter status and possible relation to NSD. Materials and Methods: The pilot study was conducted in the Oral and maxillofacial surgery department, KIMS Dental college and hospital, Amalapuram, Andhra Pradesh. The sample of thirty subjects were selected from the patients undergoing BSSO surgeries from April 2022- July 2023, as according to the inclusion and exclusion criteria. Patients were followed up for six months postoperatively. The evaluation was done preoperatively and postoperatively (1week, 1 month, 3 months, 6months) using subjective and objective methods. NSD was assessed by both subjective (Five-point scale) and objective (2-point discrimination, pin pressure, and thermal discrimination) tests. Statistical Analysis: Descriptive statistics were used. Results: Post-osteotomy, the inferior alveolar nerve was in the distal fragment in 36 (60%) of the sites, 14 (22%) on the proximal fragment and needed dissection, 10 (18%) not seen post osteotomy, and nil (0%) got transected. The incidence of prolonged NSD was highest seen in the proximal fragment needing dissection. The neurosensory deficit after BSSO was 21.5% in post-six-month follow-up. Conclusion: The incidence of transient neurosensory deficit of the inferior alveolar nerve after BSSO surgeries is inevitable. Prolonged NSD is due to nerve manipulation depending on the nerve status intra-operatively.

Does the modified inferior border osteotomy improve the surgical outcomes in bilateral sagittal split osteotomy?

BackgroundTo investigate the effect of lower border osteotomy on the lingual split pattern and IAN in BSSO procedures. Materials and MethodsThe study comprised 32 patients (64 operated sides) who underwent bilateral sagittal split osteotomy (BSSO) due to dentofacial abnormalities between the periods of April 2021 and April 2022. In the mandible, 32 sides (the conventional group) received standard BSSO surgery, while 32 sides (the modified group) additionally received lower border osteotomy. Data regarding the split difficulty of the mandibular in BSSO surgery and the recovery status of the inferior alveolar nerve (IAN) one year after surgery were obtained and evaluated from patient records. The fracture line was radiographically evaluated for the lingual split pattern following surgery. ResultsA statistically significant difference was observed in favor of the modified group when the mandibular split difficulty of the groups was compared (p = 0.032). The split time of the modified group was found to be statistically shorter than the conventional group (p ≤ 0.001). The mean numbness level of the modified group one year after surgery was statistically significantly lower than that of the conventional group (p = 0.019). Although there was no statistically significant difference between the two groups in terms of lingual fracture pattern, the rate of type 1 (87.5 %) fracture was higher in the modified group compared to the other group (68.8 %) (p = 0.089). ConclusionThe lower border osteotomy performed in addition to the conventional BSSO surgery allows the split procedure easier and in a shorter time. The modification resulted in an increased incidence of type 1 lingual fracture pattern in the mandible. The neurosensory recovery capacity of the IAN in the postoperative period is higher in areas where lower-border osteotomies are performed.

Integrating Orthodontic and Maxillofacial Surgical Approaches for the Correction of Complex Dentofacial Deformities: A Comprehensive Literature Review

This literature review provides a thorough examination of the combination of orthodontic and maxillofacial surgical techniques for treating complex dentofacial abnormalities. The review specifically highlights the achievements made in this field over the previous ten years. The text explores the impact of digital planning, surgical advancements, and interdisciplinary teamwork on improving treatment results. The main subjects covered include pre-surgical orthodontics, the application of 3D technology, customized implants for patients, and the maintenance of stability after surgery. In addition, the study discusses difficulties such as patient expectations and relapse prevention, while also emphasizing upcoming developments like as artificial intelligence and regenerative medicine that offer potential for enhancing treatment methods and enhancing patient care.

Assessing salivary innate immune responses in adolescents with dentofacial abnormalities and central precocious puberty

Relevance. Central precocious puberty (CPP), characterized by a high incidence of 60% among endocrinopathies during puberty, significantly influences dentofacial development and the local immune defense mechanisms in adolescents. However, the impact on saliva's innate immune function remains underexplored.This study aims to evaluate the innate immune function of saliva in individuals with CPP coexisting with dentofacial abnormalities.Materials and methods. An analysis of saliva biochemical markers was conducted on 59 adolescents diagnosed with CPP and dentofacial abnormalities, alongside a control group of 21 age-matched individuals with dentofacial abnormalities but without systemic conditions, aged 13-18 years. The evaluation focused on lysozyme and urease levels, dysbiosis markers indicating oral microbiota status, malondialdehyde (MDA) levels, and catalase activity to gauge the balance between pro-oxidant and antioxidant systems, alongside proteolytic enzyme elastase activity.Results. Adolescents with combined CPP and dentofacial abnormalities exhibited weakened antioxidant and antibacterial defenses, evidenced by decreased catalase activity (0.105 ± 0.020 mkat/l, p < 0.001) and lysozyme levels (54.7 ± 3.2 U/l, p < 0.02), against a backdrop of increased lipoperoxidation and microbial contamination (MDA levels at 0.48 ± 0.11 μmol/l, p < 0.05, urease levels at 0.713 ± 0.015 μkat/l, p < 0.01), and heightened inflammation (elastase activity up to 2.71 ± 0.12 μkat/l, p < 0.01).Conclusion. The diminished innate immune function in saliva necessitates the development of strategies to enhance it, serving as a preventive measure against gingivitis in patients with CPP.

Awareness about Orthodontists' Role in Treating Osa and Mouth Breathing among Otolaryngologists.

Orthodontic correction of dentofacial abnormalities is a crucial component of oral health because it enhances overall oral health-related quality of life, optimal function, periodontal health, and aesthetics. This study sought to determine whether otolaryngologists recommend patients to orthodontists, whether they are adequately knowledgeable about the fundamentals of orthodontics, and whether they check for orthodontic problems in their patients. We conducted a survey study of otolaryngologists in Gujarat, India. Questionnaires were completed by 47 out of 60 otolaryngologists (response rate 78%). In the assessment of the mouth breathers, a very low frequency of "always" examining the extra-oral features (18%) was found. Reasons otolaryngologists referred patients to orthodontists varied from mouth breathing 48% (23/47) to face or teeth asymmetry 87% (41/47). In the multivariable analyses for the effect of gender, work sector, or years of experience in the decision for orthodontic referral, we could not identify any significant predictors. A low frequency of awareness of orthodontists' role in obstructive sleep apnoea, 48% (23/47) was found. In conclusion, the survey of otolaryngologists in Gujarat, India, revealed areas for improvement in awareness and practices related to orthodontic issues, particularly in cases of mouth breathing. The study highlighted a low frequency of examination of extraoral features and variability in referral patterns, emphasizing potential gaps in knowledge. Additionally, a low awareness of orthodontists' role in treating obstructive sleep apnea was identified. Targeted educational interventions are recommended to enhance interdisciplinary communication and collaboration between otolaryngologists and orthodontists, ultimately fostering a more comprehensive approach to patient care for individuals with dentofacial deformities in Gujarat and potentially influencing practices on a broader scale.

Протокол междисциплинарного взаимодействия остеопата и стоматолога в процессе ортодонтического лечения

Contemporary approaches to orthodontic treatment are complex: in complicated cases, they combine removable/fixed orthodontic appliances and surgical treatment, i.e., extraction of permanent teeth. In order to prevent negative outcomes and complications that can follow correction of dentofacial abnormalities and deformities, children and adults alike need to be thoroughly examined and prepared to the orthodontic stage of treatment. Many studies point to the relationship between orthodontic treatment and development of somatic dysfunctions. The purpose of this work was to develop an osteopathic disorders correction algorithm that can be introduced to an interdisciplinary protocol uniting efforts by an osteopath and an orthodontist with the aim to improve the quality of specialized orthodontic medical care.

Analysis of hardware methods of treatment of patients with temporomandibular joint dysfunction

Objective. To conduct a comparative analysis of effectiveness of treatment of patients with dysfunction of temporomandibular joint (DTMJ) using hardware methods of treatment with occlusive mouthguards of various types. Materials and methods. 99 patients (88 females and 11 males aged 41,2 ± 10,7) with different combinations of revealed and confirmed signs of DTMJ were examined from 2013 to 2023. According to the personal clinical picture, complaints revealed, aetiology and pathogenesis of the disease all the patients of the comparison group and 2 main groups (99 patients) were administered individual complex treatment for DTMJ. The treatment was aimed at the elimination of pain, relief of masticatory muscles spasm, improvement of the extent of opening of mouth, correction of the lower jaw position, occlusive interference elimination and restoration of height of the lower third of the face. While carrying out the hardware treatment, occlusive mouthguards of 3 types were made based on the jaw model of the patients. The models were got from the silicone imprints of the jaw. Results. MR images of temporomandibular joints of the 99 patients showed that ventral dislocation of articular disk occurred most frequently (in 88 patients). Less frequently (4 % of cases) it was combined with dislocation of the disk laterally. Rarely distal dislocation of the articular disk occurred – 1,9 % of cases (2 patients). Study of the results of the appliance of different types of occlusive mouthguards demonstrates the necessity to work out the types of occlusive devices allowing decompression of temporomandibular joint elements, centering lower jaw position and orthodontic elimination of dentofacial abnormalities and deformities which lead to occlusive interference. Conclusions. Analysis of occlusive devices used in the diagnosis and treatment of patients with DTMJ shows that the most effective devices are those that successfully combine elements of splints with a narrower purpose.

Oral Health and Dental Treatment Needs in Thalassemia Major Patients

Abnormalities in haemoglobin is a defining characteristic of hemoglobinopathies, encompassing conditions such as sickle cell anaemia and thalassemia. Thalassemia major, a condition marked by profound anaemia resulting from insufficient haemoglobin production, impacts a significant global population. The objective of this study was to enhance comprehension of the oral health needs specific to individuals with thalassemia major, to improve the provision of healthcare services for this population. A descriptive multicentric cross-sectional study was undertaken including a cohort of 42 individuals diagnosed with severe thalassemia. The assessment of the participants' oral health was conducted with the DMFT/DMFT Index and the OHI-Simplified (OHI-S). The research revealed a significant occurrence of dentofacial abnormalities and dental treatment requirements, thereby emphasizing the importance of complete oral health care for those diagnosed with thalassemia. Individuals diagnosed with thalassemia major may present a distinctive facial attribute referred to as "Chipmunk facie" or "Rodent facie," which arises from the enlargement of the maxilla and zygomatic bone. Malocclusion, along with dental caries and oral ulcers, is a prevalent dental and facial abnormality observed within the study population. The findings of this study underscore the imperative of early detection and intervention of oral health concerns among individuals with thalassemia. Regular dental examinations and prompt intervention for dental and facial abnormalities confer advantages to individuals afflicted with thalassemia. The research highlights the importance of enhancing oral health awareness and providing education to the community as a means to enhance the provision of oral health care for those with thalassemia. The integration of dental care into thalassemia management necessitates the collaborative efforts of medical and dental professionals. Notwithstanding the perceptive conclusions drawn from the study, further research employing larger and more diverse sample sizes is necessary to substantiate and advance the obtained findings. The findings of this study will have significant implications for the development of enhanced management procedures and targeted oral health care programs for those diagnosed with thalassemia major, hence offering substantial benefits to this population. By emphasizing the significance of oral health in the context of thalassemia care, we can augment the overall well-being and quality of life of patients.

Observation of factors associated with visceral swallowing pattern in 2–6 year old children: A cross-sectional study

IntroductionThe association between the visceral swallowing pattern (VSP) and dentofacial abnormalities remains controversial. This cross-sectional study aimed to investigate the association between the VSP and various factors including type of birth, gender, tongue posture, lip incompetence, eruption of primary molars, habits and the presence of malocclusions in children with primary and early mixed dentition. Material and methodA total of 219 children (102 boys and 117 girls) were evaluated using a combination of a questionnaire and a structured clinical examination by one pediatric specialist dentist. Kittel’s method of tongue posture evaluation and the Payne technique for assessment of swallowing pattern were included in the clinical examination of myofunctional status. After checking for normality, normal and non-normal distributed data were analyzed using two-sample t-test and Mann-Whitney U test, respectively. Analysis of categorical variables was done using a chi-square test, and Bonferroni correction was used as correction for multiple comparisons. ResultsA total of 56.2 % of the study population had a VSP. The chi-square test indicated a statistically significant higher presence of VSP in male gender. Statistically significant associations were seen between the VSP and lip incompetency, pathologic resting tongue position, habits, anterior open bite and increased overjet. On the other hand, no statistically significant associations were found between VSP and children’s age within the sample population, type of birth, uni- or bilateral crossbites, increased overbite, edge-to-edge anterior bite or completion of eruption of primary molars and/or permanent incisors. ConclusionsThe association between VSP and male gender, pathologic tongue posture, lip incompetency and habits and occlusal traits such as anterior open bite and increased anterior overjet is supported by the results of the present study.

Oral Bad Habit Education in ABA Pasekan Kindergarten Students

A high prevalence of bad oral habits occurs in preschool children aged three to five years in Indonesia. The age under six is the golden age to pay attention to children's health, including oral health. Bad habit oral causes dentofacial abnormalities, dental teeth, psychological disorders, and even affects the growth and development of children. This activity aims to increase the understanding of TK ABA Pasekan students (ABA Kindergarten of Pasekan) about oral health and the consequences of bad oral habits. This activity is an effort to sensitize children to avoid bad habits and have good and correct brushing habits. Educational materials are delivered through counselling using audiovisuals that interest children, followed by questions and answers. Supporting tools used are an in-focus projector, screen, and educational posters. Demonstration sessions by extension workers were followed by students' direct practice of brushing their teeth correctly and adequately. All students of TK ABA Pasekan enthusiastically followed the series of community service activities. Pos-ttest results showed that 100% of TK ABA Pasekan students understood the bad oral habits that children should avoid.

A rare case of severe isolated temporomandibular joint involvement in juvenile idiopathic arthritis

Background: Juvenile idiopathic arthritis is an inflammatory condition of unknown etiology. Early temporomandibular joint involvement may be asymptomatic or with mild symptomatology, despite radiological signs of substantial joint damage. Early diagnosis and management is of substantial importance, because orofacial symptoms due to temporomandibular joint arthritis may be disabling and interfere with impaired quality of life or even dentofacial abnormalities. When temporomandibular joint involvement is the first and only manifestation - a very rare event – it is easy to remain undiagnosed. It is noteworthy that the current body of published material on isolated arthritis of the temporomandibular joint is limited to 2 case reports and a multinational cohort of pediatric rheumatology centers.

Revolutionizing Dental Imaging: A Comprehensive Study on the Integration of Artificial Intelligence in Dental and Maxillofacial Radiology.

Recent advancements in deep learning and artificial intelligence (AI) have profoundly impacted various fields, including diagnostic imaging. Integrating AI technologies such as deep learning and convolutional neural networks has the potential to drastically improve diagnostic methods in the fieldof dentistry and maxillofacial radiography. A systematic study that adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards was carried out to examine the efficacy and uses of AI in dentistry and maxillofacial radiography. Incorporating cohort studies, case-control studies, and randomized clinical trials, the study used an interdisciplinary methodology. A thorough search spanning peer-reviewed research papers from 2009 to 2023 was done in databases including MEDLINE/PubMed and EMBASE. The inclusion criteria were original clinical research in English that employed AI models to recognize anatomical components in oral and maxillofacial pictures, identify anomalies, and diagnose disorders. The study looked at numerous research that used cutting-edge technology to show how accurate and dependable dental imaging is. Among the tasks covered by these investigations were age estimation, periapical lesion detection, segmentation of maxillary structures, assessment of dentofacial abnormalities, and segmentation of the mandibular canal. The study revealed important developments in the precise definition of anatomical structures and the identification of diseases. The use of AI technology in dental imaging marks a revolutionary development that will usher in a time of unmatched accuracy and effectiveness. These technologies have not only improved diagnostic accuracy and enabled early disease detection but have also streamlined intricate procedures, significantly enhancing patient outcomes. The symbiotic collaboration between human expertise and machine intelligence promises a future of more sophisticated and empathetic oral healthcare.

Restorative approaches for managing dental anomalies

Dental anomalies, which stem from a complex interplay of genetic and environmental factors during the phases of tooth development, can have multifaceted effects on the appearance, function, and alignment of teeth within the upper and lower jaw. These anomalies are primarily categorized into four main types based on the variations in the number, size, shape, and eruption timing of teeth. They manifest in diverse forms, such as missing teeth, supernumerary teeth, malformed teeth, and irregular tooth positioning. Restorative dentistry serves as a crucial avenue to rectify these anomalies, aiming to not only enhance the functionality but also the aesthetics of affected teeth, thus bolstering the overall oral health and quality of life of patients. It is of particular significance to consider temporary restorative treatments for children with dento-facial abnormalities, not only to address physical concerns but also to mitigate potential psychological trauma and bullying. Additionally, dental anomalies can heighten the susceptibility to dental caries, periodontal diseases, and occlusal irregularities, potentially necessitating intricate and costly dental interventions over time. The research project, initiated on October 12th, 2023, stems from a comprehensive exploration of existing academic literature, encompassing databases such as PubMed, web of science, and Cochrane. Restorative treatment options in modern dentistry offer a comprehensive approach to addressing structural, functional, and aesthetic irregularities in teeth. Prosthodontic solutions, including crowns, bridges, dental implants, and veneers, restore form and function while enhancing aesthetics. Endodontic and operative procedures, such as root canal therapy and dental fillings, preserve teeth, alleviate discomfort, and prevent complications. Orthodontic treatments like braces and Invisalign correct misalignments, improving both function and aesthetics. Surgical approaches, such as orthognathic surgery and impacted tooth removal, are reserved for severe cases. Treatment choices depend on the specific anomaly, emphasizing early intervention for improved oral health and overall well-being.

Uji validitas dan reliabilitas pediatric Sleep questionnaire terhadap Anak usia 6-18 tahun

Background: Sleep-breathing disorder (SBD) in children is strongly related to the number of dentofacial abnormalities. The manifestation of Children’s sleep problems can be misinterpreted as other pediatric conditions and affect the treatment accuracy. Instrument for screening need to be provided, therefore question about children’s sleep conditions need to be included. One of the instruments is Pediatric Sleep Questionnaire. In pediatric sleep studies, the application of sleep survey instruments has been applied but only a few reported the reliability or validity of the survey instruments. Purpose: The aim of the study is to produce accurate and reliable measuring devices to identify and assess sleep disorders that occur in children. Methods: This research was conducted using analytic observational with cross-sectional design at Tangerang City with 154 respondents who fulfilled inclusion and exclusion criteria. Spearman correlation test is used to measure the validity, Cronbach’s alpha is used to measure the reliability of each item question. Results: Based on the analysis, it showed snoring, sleepiness. and behavior showed a valid result, but two items showed invalid result. This can be caused by several factors; including limited parent’s knowledge and time to accompany children during sleep. Conclusion: This study shows that the PSQ has good validity and reliability which can identify and assess sleep problems in children aged 6-18 years.

Prevalence of Temporomandibular disorders in Orthognathic Surgery patients: A systematic review conducted according to PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions.

Orthognathic surgery is done to treat a variety of dentofacial abnormalities, but a wide gap still remains on how it can result in temporomandibular joint dysfunction (TMD). The primary goal of this review was to assess the effects of various orthognathic surgical techniques on the emergence or exacerbation of TMJ dysfunction. A comprehensive search was conducted across several databases using Boolean operators and MeSH keywords related to temporomandibular joint disorders (TMDs) and orthognathic surgical interventions, with no limitation on the year of publication. Two independent reviewers screened the identified studies based on predetermined inclusion and exclusion criteria, followed by a risk of bias assessment using a standardized tool. Five articles were considered for inclusion in this review. A greater number of females opted for surgical options than their male cohorts. 3 studies were of prospective design, 1 of retrospective and 1 of observational type. Mobility on lateral excursion, tenderness on palpation, arthralgia and popping sounds were the TMD characteristics that showed significant differences. Overall, orthognathic surgical intervention did not show an increase in TMD signs and symptoms as compared to non-surgical counterparts. Though orthognathic surgery reported greater cases of some TMD symptoms and signs as compared to the non-surgical cohorts in four studies, the conclusive evidence is debatable. Further studies are recommended with longer follow up period and greater sample size to determine the impact of orthognathic surgery on TMJ.

РАСПРОСТРАНЕННОСТЬ ЗУБОЧЕЛЮСТНЫХ АНОМАЛИЙ У ДЕТЕЙ СВЕРДЛОВСКОЙ ОБЛАСТИ

The problem of studying the prevalence of dentofacial abnormalities in children in the Sverdlovsk region is relevant, as the data for different regions are differ, which is confirmed by the heterogeneity of indicators and statistics in the research. In 2022, an epidemiological study was conducted among the children's population of 4 cities of the Sverdlovsk region to study the prevalence of dentofacial abnormalities in the age groups 3–5, 6, 12 and 15 years, a total of 455 children were examined. Registration of dentofacial abnormalities was carried out in the author's card of dentofacial system disorders developed, using the classifications of MGMSU and ICD-10. Statistical processing of the data obtained was carried out in STATISTICA 13.3. The study revealed a high prevalence of dentofacial abnormalities in children in the Sverdlovsk region – 71.43% ± 2.12. With age, there is a tendency to increase the frequency of dentofacial abnormalities: in children 3–5 years of dentofacial abnormalities were in 34.85% ± 5.87 cases; in the group of 6-year-olds – in 70.18% ± 4.28; and in groups of 12-year-old and 15-year-old children – 81.38% ± 3.23 and 80.00%. It was revealed that the older the children are, the more likely they have severe malocclusion compared to children aged 3–5 and 6. The groups noted high rates of dentition deformities, the number of which also increases with age (decrease in the length of the upper dentition was detected in 36.26% ± 2.25, the lower dentition – in 47.47% ± 2.34 of cases; narrowing of the upper dentition – in 55.60 ± 2.33%, lower dentition – in 45.49% ± 2.33 of cases). Dentition deformities are associated with the development of teeth abnormalities, such as teeth retention (13.10% ± 2.80 and 9.23% ± 2.54 of cases in 12- and 15-year-old children, respectively), as well as mandibular displacement (displacement to the side was detected in 22.20% ± 1.95 of cases). Performed study is justification for the development and implementation of a regional program for the prevention of dental diseases in children of the Sverdlovsk region.

With Phenotypic Signs of Connective Tissue Dysplasia: Cross-Sectional Clinical Study

Background. The dental health is an integral part of a person's well-being. Students of higher educational institutions comprise a health risk group, since they experience extensive physiological changes and personal socialization. The impact of connective tissue dysplasia on dental health is a relevant research task.Objective. To analyze the correlation between dental pathology and phenotypic signs of connective tissue dysplasia in first-year students.Methods. A cross-sectional clinical study of the dental health and phenotypic signs of connective tissue dysplasia was conducted as part of routine dental examination of 263 first-year students of KubSMU, aged 18–23. All participants were divided into 2 groups: group 1 – participants with 0-2 signs of connective tissue dysplasia (n = 108); group 2 – participants with 3 or more signs of dysplasia (n = 155). Statistical analysis of the results was carried out using Microsoft Excel 2010 and Statistica 6.0.Results. Unsatisfactory and poor oral hygiene levels in the group of participants with connective tissue dysplasia outnumber these levels in the control group by 30% and 22%, with very poor level in the second group 2.3 times higher (p ≤ 0.05). The incidence of noncarious tooth pathology in individuals with dysplasia is 26% higher than in the control group. The caries intensity index in group 2 is almost 20% bigger than in the control group. As expected, the group of participants with no signs of dysplasia revealed better periodontal health, namely 51.85% versus 45.81% (p ≤ 0.05). In terms of mucosal pathology, a statistical significant difference between groups 1 and 2 was noted for traumatic injuries (16.35% and 19.35%, respectively). Dentofacial abnormalities were observed more often in individuals with 3 or more phenotypic signs of connective tissue dysplasia.Conclusion. Higher morbidity rate of caries and noncarious pathology in the group of first-year students with 3 or more phenotypic signs of connective tissue dysplasia, compared to the group with 0–2 phenotypic manifestations of dysplasia, indicated the need to create a database of the dentofacial profiles of students, develop an algorithm for regular medical check-up of students, as well as provide differentiated preventive and therapeutic measures for students with dysplasia.

Definitive Rhinoplasty and Orthognathic Surgery for Patients with Cleft Lip Palate.

While primary cleft lip nasal deformity has been well described, secondary cleft lip nasal deformity reflects the combination of residual deformity that follows primary operative maneuvers and growth-related nasal distortions. Secondary cleft lip nasal deformities are further associated with underlying skeletal and dentofacial abnormalities along with soft tissue constriction adding to the complexity of the deformity and posing major aesthetic and functional challenges to the multidisciplinary care team. Definitive rhinoplasties are performed to address these deformities and improve the quality of life in cleft patients following skeletal maturity and ideally after all underlying skeletal discrepancies have been corrected by orthognathic surgery. Maxillary advancement with or without mandibular setback is often required after careful planning and orthodontic preparation. Patients with cleft lip benefit tremendously from definitive rhinoplasty irrespective of inevitable residual discrepancies that remain and adjuvant therapies could enhance the overall outcome.

Features of oral hygiene index assessment in children with dentofacial abnormalities and deformities against the background of bronchopulmonary pathology

Features of oral hygiene index assessment in children with dentofacial abnormalities and deformities against the background of bronchopulmonary pathology

Role of paediatricians in oral disease prevention

Oral diseases pose a major health burden, especially in children, causing pain, discomfort, disfigurement and also affecting the quality of life. Most of the oral diseases are preventable by early diagnosis, thereby achieving standard oral and dental healthcare in children. The paediatricians due to the unique position, they occupy in child care, are invaluable in diagnosing the early changes in dental and facial structures. Oral health awareness among paediatricians and implementation of their oral health-related knowledge in their practice can have a significant impact on prevention of oral disease in children. This review discusses the common oral conditions in children such as early childhood caries, childhood oral habits and dentofacial abnormalities in children and the role of the paediatrician.