Early Mixed Dentition Stage Research Articles

Early treatment of skeletal class III malocclusion with facemask therapy in Vietnam.

To evaluate the effects of facemask therapy on skeletal class III malocclusion in the Vietnamese population. This interventional trial enrolled a total of 31 children, dividing them into two age groups: Children aged 7 to 9 (54.8%), who were in the pre-pubescent or early mixed dentition stages, comprised one group. The other group consisted of 14 children, representing 45.2%, who were in the mid-pubescent or late mixed dentition stage, aged 7 to 9. All of them had skeletal class III maxillary deficiency (Angle formed by the A-nasion line and B-nasion line ≤0°, Wits appraisal ≤2). The study aimed to investigate how age affects changes in lateral cephalometric measurements before and after treatment. The research involved clinical records, lateral cephalograms, and dental casts. Both qualitative and quantitative variables were evaluated using specific statistical tests. Fisher's exact test was used for qualitative variables, while paired samples t-tests and independent samples t-tests were used for quantitative variables. In cases where the data did not follow a normal distribution, the Wilcoxon test and Mann-Whitney U-test were used (p ≤ 0.05). The study found that using a facemask improved the skeletal, dental and soft tissues. It led to a forward movement of the maxilla and a rotation of the mandible, resulting in a better relationship between the maxilla and mandible. The upper incisors shifted from a crossbite to a positive overbite, and the upper lip protruded forward. The concave face became more prominent and aesthetically pleasing. Most individuals (80.6%) had positive outcomes, with the highest proportion among children aged 7-9 years. Based on the study's findings, the facemask was highly effective for both age groups in skeletal class III malocclusion. The group of children aged 7-9 years with maxillary deficiency was more efficacious than the group of children aged 10-12 years.

Can malocclusion among children impact their oral health-related quality of life? parents' perspective.

Malocclusion can negatively impact the quality of life of children. Therefore, this study assesses the impact of proxy-reported malocclusion and oral health-related quality of life among children in Riyadh, Saudi Arabia, from the parents or guardians' perspectives. A self-administered electronic questionnaire was used to assess the correlation between proxy-reported malocclusion conditions during the early mixed dentition stage (children age 6-12 years) and oral health-related quality of life using the OHIP-14 measure. All collected data were analyzed using SPSS. Among the 353 participants in the study, anterior open-bite was the most common proxy-reported malocclusion with a prevalence of 19%, followed by unilateral posterior cross bite (13.3%). Furthermore, 31% reported that their children sometimes experienced negative impacts on quality of life from malocclusions. The results also show that OHIP-14 scores were significantly associated with all proxy-reported malocclusion (p < 0.05). The highest OHIP-14 score was found to be significantly associated with the presence of deep-bite from parents' or guardians' perspective. The presence of some proxy-assessed malocclusion was associated with negative impacts on children's oral health-related quality of life. This is very important to consider when assessing the need for orthodontic intervention, especially at this stage as this age is critical in building a child's confidence and self-esteem.

Prevalence of malocclusion and orthodontic treatment needs among Saudi primary school male children aged 6–12 years: A cross-sectional study

Aim: To evaluate the prevalence of malocclusion and the need for early orthodontic treatment (EOT) using dental health component (DHC) of the index of orthodontic treatment need (IOTN). Materials and Methods: In this cross-sectional study, clinical examination was performed on 357 male children, aged 6–12 years who were randomly selected from five public schools and one public pediatric dental clinic, in Al-Kharj province, Saudi Arabia. The examination assessed various occlusal parameters using IOTN, across the total sample and further between two subgroups (early and late mixed dentitions). Results: For the total sample 58.8% had Angle’s Class I malocclusion, 26.7% had Angle’s Class II, 9.8% had Angle’s Class III, while crowding was present in 44.5%. Over 1/4 of the younger group and 42.8% of the older group exhibited at least one feature indicating EOT: anterior crossbite, posterior crossbite, open bite, impinging overbite, ≥7 mm overjet, and Class III malocclusion. However, no statistical differences were found between the two groups (P > 0.05). According to DHC score, 77 participants (21.6%) were in definite OTN. The DHC score demonstrates its validity in identifying evidence-based malocclusion features as significant indicators for EOT. Compared to DHC, the esthetic component significantly overestimated lack of OTN and significantly underestimated definite OTN (P < 0.05). Conclusion: The prevalence of malocclusion and EOT need is generally similar among younger and older children, but the distribution is higher among older children. Orthodontic screening at early mixed dentition stage is essential.

Evaluation of successful treatment of patients with unilateral functional crossbite

Purpose: Unilateral functional crossbite (UFCB) is one of the most common malocclusions in the deciduous and early mixed dentition stage. It is accompanied by lateral mandibular shift and mandibular midline deviation due to the narrow maxillary dental arch. The aim of this study was to assess the effects of early correction of UFCB with the Fränkel (FR–3) functional regulator.&#x0D; Methods: Ninety Caucasian subjects (32 boys and 58 girls) with UFCB in the early mixed dentition stage (mean age, 6 years and 8 months (SD±1.8)) were treated with the FR–3 functional regulator and monitored. The diagnosis was based on anamnestic data, clinical examinations, radiographs, and analyses of study cast models. Dental casts taken before and after treatment were used in the analysis of effects.&#x0D; Results: Treatment of UFCB involved expansion of the maxillary arch, removal of occlusal interferences, and elimination of the functional shift. The width of the maxilla increased by 2.90 mm (SD±1.63) in the canine region and by 2.78 mm (SD±1.60) in the molar region. Another advantage of early treatment was improvement of maxillary arch length deficiency secondary to maxillary constriction because the permanent incisors were afforded more space before or during eruption than if the crossbite was treated at a later age. At least one abnormal orofacial function was identified in 69 (76,67%) patients with UFCB. Aftertreatment, all crossbites were corrected, functional deviations were eliminated, and no relapses were observed during follow–up at 2 years and 8 months.&#x0D; Conclusion: The Fränkel functional regulator is a functional orthodontic–orthopedic device that is an effective alternative for the treatment of UFCB. Dental occlusion was significantly improved, and the prognosis for normal craniofacial growth and normal function of the stomatognathic system was enhanced.

Detecting the presence of supernumerary teeth during the early mixed dentition stage using deep learning algorithms: A pilot study.

Supernumerary teeth are a common anomaly and are frequently observed in paediatric patients. To prevent or minimize complications, early diagnosis and treatment is ideal in children with supernumerary teeth. This study aimed to apply convolutional neural network (CNN)-based deep learning to detect the presence of supernumerary teeth in children during the early mixed dentition stage. Three CNN models, AlexNet, VGG16-TL, and InceptionV3-TL, were employed in this study. A total of 220 panoramic radiographs (from children aged 6years 0months to 9years 6months) including supernumerary teeth (cases, n=120) or no anomalies (controls, n=100) were retrospectively analyzed. The CNN performances were assessed according to accuracy, sensitivity, specificity, receiver operating characteristic (ROC) curves, and area under the ROC curves for a cross-validation test dataset. The VGG16-TL model had the highest performance according to accuracy, sensitivity, specificity, and area under the ROC curve, but the other models had similar performance. CNN-based deep learning is a promising approach for detecting the presence of supernumerary teeth during the early mixed dentition stage.

Clinical effects of maxillary protraction in different stages of dentition in skeletal class III children: A systematic review and meta-analysis.

This systematic review and meta-analysis aimed to evaluate the effectiveness of using maxillary protraction during different stages of the dentition by assessing changes in the jaws and inclination of incisors. MEDLINE (PubMed), Embase, Cochrane, Web Of Science, China National Knowledge Infrastructure and Wanfang Databases were searched without time limitations up to 15 January 2022. Google Scholar was used to search grey literature. We included cohort studies that compared the effect of maxillary protraction by analysing primary outcomes and were grouped in age-related conditions. Mean differences and 95% confidence intervals were used for statistical analysis, followed by Grading of Recommendations Assessment, Development and Evaluation analysis. Six studies were finally included. The heterogeneity test showed P≥.1 and I2 ≤50%, and a fixed-effect model was applied. Patients in the early treatment group (ETG) were mainly in the early-mixed dentition stage, while patients in the late treatment group (LTG) were in the late-mixed and early-permanent dentition stage. Meta-analysis showed that there were no statistical differences (P>.05) between the ETG and LTG groups in terms of SNA (the angle composed by point Sella-Nasion-Subspinale), SNB (the angle composed by point Sella-Nasion-Supramentale), ANB (the angle composed by point Subspinale-Nasion-Supramentale), Wits, U1/SN (the angle composed by the axis of upper incisors and Sella-Nasion plane) and L1/MP (the angle composed by the axis of lower incisors and the mandibular plane). Our analysis showed that maxillary protraction applied in the late-mixed or early-permanent dentition stage did not cause different effects on the maxillary growth, the correction of the intermaxillary relationship, the inhibition of mandibular growth and dental tipping of skeletal class III patients when compared to that in the early-mixed dentition stage. Collectively, these data provide a theoretical basis for widening the applicable age period of maxillary protraction and choosing the best treatment opportunity for children patients after a comprehensive assessment.

Clinical Evaluation for Space Maintainer after Unilateral Loss of Primary First Molar in the Early Mixed Dentition Stage

Background and Objectives: Controversy exists regarding the need for a space maintainer after early unilateral loss of a primary first molar. This study aimed to assess the need for a space maintainer after unilateral loss of a primary first molar in the early mixed dentition period. Materials and Methods. In this cross-sectional study, fifty children between 6 and 8 years who had lost a primary first molar unilaterally later than 6 months ago were randomly selected. Midline deviation, molar and canine relationships at both sides, facial growth pattern, and the amount of space loss were all assessed. Data were analyzed using SPSS version 25 via the one-sample t-test, paired t-test, and linear regression (alpha = 0.05). Results. The mean amount of space loss was 1.36 ± 0.78 mm (1.32 mm in the maxilla and 1.40 mm in the mandible). Time since tooth extraction and facial pattern had significant correlations with space loss (P < 0.05). Conclusion. In this particular age group, it is imperative to precisely assess the related factors such as the facial pattern and time since tooth extraction to decide about the placement of a space maintainer for a prematurely lost primary first molar.

Orthodontic treatment for posterior crossbites.

Orthodontic treatment for posterior crossbites.

Anterior crossbite correction in early mixed dentition stage using functional jaw orthopedics principles: a case report with two-years follow-up

A five-year-old and four-month-old male patient presented with Class I malocclusion, anterior crossbite (pseudo-class III) with an overbite, midline deviation to the left (5 mm), left unilateral chewing preference, and incisors in bi-retrusion with diastemas. Initial Bimler cephalometry showed negative anterior face angle (&lt; A), negative bone overjet (A’B’), mesoprosope biotype, negative suborbital facial index, microrhinic dysplasia, and reduced T-TM distance. Pre-treatment gnathostatic models revealed vertical asymmetry and increased left occlusal plane. After the initial assessment, we initiated the treatment with resin-composite planas direct tracks in the deciduous upper molar surface to lift the bite. The patient was oriented to perform right-side mastication movements using hyperboloid exercises. After one month, a new resin-composite lift was carried out in the lower deciduous molar occlusion surface. Planas direct tracks were built directly on the occlusal of the maxillary molars 64 and 65 to start centering the patient’s midline, which was deviated to the left, raising the bite, and increasing the vertical dimension. In the same dental appointment, we completed the right side on the occlusal of the teeth 54 and 55, to adjust the occlusion using 200 microns articulated paper. After a month, the patient returned to the dental office and resins were placed in the occlusal surface of teeth 74, 75, 84, and 85, completing the direct planas tracks and leaving the occlusal plane the most parallel to the Camper’s Plan. Direct planas tracks’ adjustments were made throughout the patient's treatment returns, with 200 microns articulated paper and selective wear. Hyperboloid (silicone-made accessory to stimulate the stomatognathic system) was used to perform chewing exercises on the right side and instructed to be performed before the main meals, for five minutes, encouraging chewing on the right side. The subsequent masticatory evaluation showed protrusive movements. To reduce this movement, planas direct tracks from canine-to-canine were prepared, correcting the anterior bite, and reducing the midline deviation to the left. Posteriorly, functional orthopedic treatment began with the Simões Network 3 (SN3) device, with Bimler’s upper dental arch not touching the incisors and an upper expander. Concomitantly, in the lower dental arch, we initiated the treatment with a Hawley dental appliance against the cervical third of lower incisors and a W-shaped lingual retainer. The SN3 device was built in a laboratory specialized in maxillary functional orthopedics, after molding the patient with alginate and wax bite registration. After 12 months of treatment, the patient presented a centralized midline, had permanent lower incisors, erupting upper central incisors, and adequate bilateral chewing. After 24 months of treatment, the patient presented physiological limits with the contact of the upper central incisors in a determined area with 2 mm overjet, centralized midline, efficient bilateral chewing, and balanced maxillomandibular growth. Post-treatment Bimler cephalometry showed a negative anterior face angle (&lt; A), positive bone overjet (A’B’), mesoprosope biotype, increased T-TM distance. In addition, Planas’ gnathostatic models evidenced a symmetric occlusal plane. In conclusion, functional jaw orthopedics approaches can significantly contribute to the inhibitory and excitatory stimulation of the mandible to the maxilla. Furthermore, functional orthopedics might establish an appropriate development of the stomatognathic system in patients with mixed dentition.

Treatment effects and biomechanical analysis of TMA spring appliance

Background/Aim Among Angle's classification, skeletal class III is the most difficult to treat. Treatment using the TMA spring intraoral appliance was investigated in the late mixed dentition and showed desirable effects. The present work aimed to investigate, biomechanically, the TMA spring appliance in the early mixed-dentition stage with specifically outlined force direction, duration, and magnitude in order to provide solid results that can be relied upon clinically. Patients and methods The sample consisted of 20 patients with an age range 8–10 years and an average of 8.6 years. Lateral cephalograms were taken and analyzed before treatment (T1), posttreatment (T2), and postretention (T3). The patients were instructed to wear the TMA spring appliance 12–16 h/day for 9 months, followed by 6 months of retention. The appliance delivered a force of 400 g/per side as measured with the force gauge. Results Comparing T1–T2 and T1–T3, there was a significant difference between sexes in points U6/S perpendicular; P=0013 and P=0.0159, SNA (P=0.0122, P=0.0371), and ANB (P=0.0491) at T1–T2. There was a significant difference in the whole sample for all the skeletal, dental, and soft-tissue measurements; P value less than 0.05, regarding treatment and retention changes. Conclusions The TMA spring appliance enhanced the cooperation of the patients, resulted in forward movement and clockwise rotation of the maxilla. Mandibular clockwise rotation and dentoalveolar changes also contributed to the overall correction of class III.

Ortodoncia interceptiva durante la pandemia COVID-19: Urgencias y tratamientos prioritarios

A la presente fecha, los diferentes organismos de salud internacionales y locales han publicado recomendaciones, regulaciones y protocolos para atención odontológica durante de la pandemia COVID-19, ajustados a las diferentes etapas de la misma. La Asociación Latinoamericana de Odontopediatría, en su misión apoyar y llevar la mejor información disponible a todos los colegas latinos, ha publicado guías prácticas y documentos de apoyo fáciles de utilizar y compartir con todo el personal odontológico que trabaje en ambiente hospitalario, clínicas gubernamentales, instituciones educativas y clínicas privadas, que presten atención a niños, adolescentes y pacientes en situación de discapacidad.1-3 Diferentes países se encuentran en diferentes etapas de la pandemia por lo que las recomendaciones pueden incluir limitar el tratamiento odontológico a los casos de urgencia o con necesidad de tratamiento prioritario. Esto puede implicar la suspensión temporal de los controles periódicos de ortodoncia interceptiva. El objetivo de esta revisión es proporcionar directrices en el manejo de la atención de pacientes con tratamiento de ortodoncia interceptiva el periodo de Pandemia por COVID-19, utilizando la literatura disponible y la opinión de los expertos. Son muchos los pacientes pediátricos que utilizan aparatos o que necesitan terapia a corto plazo, situaciones que requieren de planificación de tratamiento según la etapa de la pandemia en la cual se encuentre cada localidad. Aunque los procedimientos de ortodoncia generalmente se consideran optativos, hay situaciones en cuales son prioritarios. Siendo así en este documento se busca definir el término de urgencias ortodóncicas durante el confinamiento COVID-19, determinando cuáles situaciones pueden ser manejadas en el hogar a través de la teleodontología y cuáles requieren la asistencia personal a la consulta odontológica. Igualmente, busca describir las maloclusiones que requieren tratamiento prioritario luego del confinamiento COVID-19, realizando algunas recomendaciones terapéuticas basadas en diferentes niveles de evidencia, para la etapa de dentición primaria o mixta temprana. Las recomendaciones que a continuación se proponen están vinculadas a la situación excepcional de pandemia y pueden diferir de las prácticas clínicas habituales. No constituyen un protocolo clínico exhaustivo de todos los tratamientos posibles, sino una guía de orientación, sin sustituir regulaciones locales, protocolos específicos, ni leyes vigentes en cada país y son susceptibles a evolucionar y cambiar en función de la situación sanitaria. Se insta a los profesionales a realizar seguimiento a las actualizaciones que puede haber sobre este documento.

Factors for crowding in the early mixed dentition stage

Objective: To find out the factors responsible for crowding in the early mixed dentition. &#x0D; Materials and methods: 60 dental casts of children in their early mixed dentition ( 30 boys and 30 girls) were divided into crowded and noncrowded groups. Comparison were made between the two groups according to following criterion: -(1) space available for permanent lower incisors, (2) total incisor width, (3) deciduous intermolar width, (5) permanent intermolar width, (6) interalveolar width, (7) total arch length. Correlation of the measurements with crowding was also evaluated. &#x0D; Statistical analysis used: Data was analysed using STATA-12.0 (STATA SE, StataCorp., Texas, USA). Means, standard deviation, and medians were calculated for describing the data. Data was tested for normality using Shapiro-Wilks test. Since all variables were found to be non-normally distributed, therefore comparison of all measurements between the crowded and non-crowded groups was done using Wilcoxon ranksum test (Mann-Whitney test). All values were considered statistically significant for a value of p&lt;0.05.&#x0D; Results: Mandibular deciduous intercanine width was significantly larger in Noncrowded Group. The space available for the mandibular permanent incisors and total arch length were significantly larger in Noncrowded Group. The correlation analysis indicated significant correlations between crowding and available space, intercanine width, intermolar width I. No significant correlation was found between crowding and intermolar width II, permanent intermolar width, and interalveolar width. &#x0D; Conclusion: Procedures which preserve the arch length such as timely restoration of proximal caries, prevention of premature loss of deciduous teeth and use of space maintainers such as lingual arch may prove useful in alleviating crowding.

Mesiodense; a common dental problems in pediatric patient. A case report

A mesiodense is a most common supernumerary tooth which is one of the most significant dental anomalies at the primary and early mixed dentition stages. The reported prevalence of mesiodense in general population ranges between 0.15% to 1.9% and more frequently found in the permanent dentition but rarely found in primary dentition. Mesiodense are primarily responsible for eruption disturbances or delay of the maxillary anterior permanent teeth emergence. Therefore the dentists and parents are great concern about malocclusion and esthetic problems which is caused by mesiodense. Early detection, diagnosis and treatment of mesiodense is important to prevent further complications in permanent dentition. A case of mesiodense of 8 years old child in upper anterior region in mixed dentition and their management have been discussed.&#x0D; Update Dent. Coll. j: 2020; 10 (2): 26-28

Perspectives of Indonesian Orthodontists on the Ideal Orthodontic Treatment Time.

ObjectiveThe aim of this study was to explore the types of orthodontic treatment provided by Indonesian orthodontists and to analyse their perspectives on the ideal time to initiate orthodontic treatment.Materials and MethodsA cross‑sectional survey was conducted using the Google Drive questionnaire template. This electronic questionnaire was sent to a sample of orthodontists across different regions of Indonesia. The participants were asked to report the stage at which they would start orthodontic treatment, as well as answer questions about occlusal abnormalities and functional problems. Descriptive statistics for all variables were determined, including both practice characteristics and orthodontic treatment timing.ResultsA total of 152 orthodontists agreed to participate in the study, of which 64.5% were female and 35.5% were male. Indonesian orthodontists prefer two-phase orthodontic treatment. Sucking habits and open bite were found to be the most frequent indications for treatment in the primary dentition. Anterior crossbite was found to be the most frequent indication for treatment during the early mixed dentition stage. Severe Class II was found to be the most frequent indication for treatment during the late mixed dentition stage. Indonesian orthodontists are more concerned about impacted canines and midline diastema than other occlusal deviations in the permanent dentition.ConclusionBased on the results of this study, we can conclude that Indonesian orthodontists favor two-phase orthodontic treatment. They also prefer to treat sucking habits and open bite in the primary dentition, anterior crossbite in the early mixed dentition, and severe Class II during the late mixed dentition stage.

Are parents\u2019 education levels associated with either their oral health knowledge or their children\u2019s oral health behaviors? A survey of 8446 families in Wuhan

BackgroundChildren aged 6–7 years are in the early mixed dentition, which is a period of high prevalence of dental caries and other dental diseases and a critical period for the formation of oral health behaviors. Therefore, good oral hygiene habits of children and oral health knowledge of parents are very important. This study sought to explore the relationship between children’s oral health behaviors, parental oral health knowledge, parental choices of pit and fissure sealants, and parents’ education levels based on a large-scale sample size for the first time, and to compare the influences of parental education levels between parents.MethodsFamilies of the first and second graders of primary schools in Wuhan Hongshan District were included in this study. A total of 8446 questionnaires were collected to obtain comprehensive information on children’s oral health behaviors, parents’ oral health knowledge and parents’ pit and fissure sealants-related choices. The relationship between these outcome variables and parents’ education levels were studied using logistic regression analysis and chi-square test.ResultsParents who reported good educational background had more favorable oral health knowledge than those of other parents, and their children had better oral hygiene behaviors. Four indicators of five measures to children’s oral health behaviors were significantly associated with mother’s education level (P < 0.05), and three of them were related to father’s education level (P ≤ 0.01). Moreover, seven indicators of eight measures to parents’ oral health knowledge were significantly related to mother’s education level (P < 0.05) and four of them were affected by the father’s (P < 0.05). In addition, parents with higher educational attainments paid more attention to the completeness of medical facilities, the environment of dental practice, the distance to treatment sites, and took less concern of children’s willingness when choosing the pit and fissure sealants sites.ConclusionsIn families with children at the early mixed dentition stage, parents with higher education levels tend to have better oral health knowledge and more oral health care needs, such as pit and fissure sealants. In addition, children of parents who have better educated parents tend to perform better oral hygiene practices.

Occurrence of ectopic eruption of different classes of teeth in growing children – A prospective Study

Purpose: Most of the disorders related to tooth eruption occur during transitional stage of dentition. Among all the eruption problems, ectopic eruption is said to be the most frequent. This study is undertaken to observe ectopic eruption of different permanent teeth and their relative frequency of occurrence in early mixed dentition stage. Methods and Materials: After thorough clinical and radiographic examination, a sample of 169 subjects with at least one ectopic permanent tooth in age group of 6-13 years were selected. Data of ectopically erupted teeth was collected and subjected to statistical analysis. Results: Females are having higher rate of ectopic eruptions when compared to males at a ratio of 2:1.5 and unilateral ectopic eruptions occurred most commonly (68.2%). Conclusion: Ectopic eruption of more than one class of permanent teeth was observed in 1/5th of the subjects. Mandibular lateral incisors are the most commonly ectopically erupted teeth. Keywords: Eruption problems, Ectopic eruption, Permanent teeth.

Effectiveness of various interceptive treatments on palatally displaced canine–a systematic review

The aim of this systematic review was to assess whether interceptive treatment carried out in the mixed dentition period improves the position of Palatally Displaced Canines (PDC). A systematic search was performed on various computerized databases. A hand search was also performed by reviewing the references within the examined studies and titles of the papers published over the last 30 years on various orthodontic journals. This systematic review analysed eight articles, of which five were Randomized Clinical Trials (RCT) and three were prospective control studies. Qualitative assessment was done for all the eight studies. The effect of interceptive measures such as extraction of primary canine, Rapid Maxillary Expansion (RME), cervical pull headgear and Transpalatal Arch (TPA) on successful eruption of Palatally Displaced Canines was analyzed. Interceptive treatment improves the position of PDC and reduces the chances of impaction. Significant changes in success rate depend on diagnosis at early mixed dentition stage. A combination of interceptive measures which includes extraction of primary canine, cervical pull headgear, TPA and RME aided in successful eruption. However, Randomized clinical trials with increased sample size, proper randomization comparing all the interceptive measures along with assessment of other factors such as patient satisfaction, pain experience and cost factor will yield more evidence based conclusions.

Concomitant hypo-hyperdontia: A rare entity

Background/purposeConcomitant hypo-hyperdontia (CHH) is a rare numeric dental anomaly characterized by congenital missing teeth and supernumerary teeth occurring in the same individual. Due to its rarity and sporadicity, the causes of CHH have been completely unknown. Detailed characterization and presentation of more CHH cases not only strengthen clinical diagnosis and treatment for the patients but facilitate the search for etiological factors of the disorder. Materials and methodsFrom a pedodontic patient population, 21 CHH subjects, with a mean age of 6 years 10 months, were identified and characterized. Dental records and radiographs were scrutinized and analyzed for the distribution and frequencies of involved teeth and concurrent dental anomalies. Through further literature review, 59 CHH cases with supernumeraries in the premaxillary region were retrieved for comparative analyses. ResultsThe boys were affected twice as often as the girls. While most cases were unrelated and sporadic, two sisters and a pair of identical twins from two unrelated families were presented. Of all cases, only one was of syndromic CHH carrying Duchenne muscular dystrophy. Bimaxillay CHH, with anomalies involving two jaws, occurred more than 4 times as often as maxillary CHH. While all supernumeraries were found in premaxillary region, hypodontia frequently involved lateral incisors and premolars of both jaws. ConclusionAs genetic contribution to CHH is strongly suggested by its familial occurrence and syndromic cases, environmental factors seem to play certain roles in modifying disease phenotypes. Judicious use of radiographs during early mixed dentition stage enhances clinical diagnosis and treatment of CHH.

Influence of Different Palatoplasties on the Facial Morphology of Early Mixed Dentition Stage Children With Unilateral Cleft Lip and Palate.

To compare the maxillofacial morphology in the early mixed dentition phase between two patient groups with unilateral cleft lip, alveolus, and palate who underwent different types of palatoplasty. Cross-sectional study. An institutional study. Seventy-one patients with unilateral cleft lip and palate (UCLP) treated at Osaka University Dental Hospital, Japan, were divided into two groups: 33 patients were treated by early two-stage palatoplasty by the modified Furlow Technique (ETS), and 38 patients were treated by one-stage Wardill-Kilner push-back palatoplasty (PB). Intergroup comparisons were performed. The dental, skeletal, and soft-tissue features were evaluated. For intergroup comparisons, Mann-Whitney U test was used for the statistical analyses. No significant differences existed between the ETS and PB groups regarding the skeletal features except for the mandibular ridge height. Meanwhile, the upper central incisor and upper lip of the ETS group showed a more anterior position than those in the PB group. Early two-stage Furlow palatoplasty leads to more protruded upper lip, providing more anteriorly positioned upper incisors compared with PB, at least at the early mixed dentition stage.

Orthodontic Treatment of a Child with Short Root Anomaly : a Case Report

Short root anomaly (SRA) is very rare, but can be problematic for physicians because patients with SRA are more vulnerable to root resorption with orthodontic forces. During the mixed dentition period, it may be difficult to diagnose generalized SRA. This article reports the treatment of an orthodontic patient with SRA at the early mixed dentition stage. Despite local tooth loss, a relatively favorable outcome was obtained without excessive root resorption. Ultimately, orthodontic therapy is possible for patients with generalized SRA, but precautions should be taken to avoid complications, such as tooth loss or root resorption.