Malocclusion Research Articles

Orthodontics in the Era of Digital Innovation – A Review

The field of orthodontics in its new era is venturing ahead to more up-to-date technological point of view. Digital technology has a significant effect on our lives ever since the modernization of mobile phones. The advances in technology have remodelled the diagnosis and treatment plan in the field of medicine. Digital workflows are currently increasing in the orthodontic practice and has touched every aspect of orthodontics – with transformations in the documentation, study casts, analysis of a dental malocclusion, smile designing, treatment planning and for fabrication of orthodontic appliances. Three - dimensional imaging of the dentition, skeletal components and the face allows for treatment planning in three dimension and use of computer aided design (CAD) and computer aided manufacturing (CAM) for customization of orthodontic appliances. Software integration of digital models, 3D facial imaging and cone-beam computed tomography (CBCT) makes it possible to simulate the treatment plan and to attain a good communication with the patients. Recent advancement in digital videography has allowed the clinicians to capture patient’s speech, oral and pharyngeal function, and smile at the same time. Effective and optimal tooth movement required for the patient can also be monitored with the digitalization. Moreover, this digital platform has created the advantage of accessing the patient’s information from any location with the help of cloud based computing storage systems. These advancements have improved the efficiency, accuracy, consistency, and predictability of the treatment outcomes and have also led to progress in educational component and communication. The digitalization is bringing about a revolutionary change in the field of diagnosis and treatment planning, posing a challenge to clinical efficiency and knowledge. KEY WORDS Digital Orthodontics, Digital Workflow, Digital Dental Models, Digital Radiography, CAD CAM, Orthodontics, Review

Morphometric evaluation of the slot of aesthetic orthodontic brackets.

Introduction: : Dental malocclusion is a public health problem and orthodontics is the specialty in charge of diagnosing and treating it, aesthetic brackets are an alternative, the costs are varied, which makes its precision doubtful. Objective: Evaluate the measurement and geometry of the slot of three brands of aesthetic brackets and verify their precision. Material and Methods: Twenty-four aesthetic Roth prescription 0.022” slot polycrystalline ceramic brackets were evaluated in three brands: American Orthodontics (United States), Morelli (Brazil) and Class One (China). Eight samples were measured per group in a specialized laboratory certified in measurement and calibration, the measurements of internal and external height were verified, per mesial and distal; and the parallelism of the slot of each bracket. The results were processed with SPSS 22 and tests of variance (ANOVA), Tukey and Student's t were used. Results: The measurements of the brackets' grooves do not correspond to the measurements announced by the manufacturers, these are greater, however, American Orthodontics is within the tolerance range (p<0.01); the slots in the mesio-distal direction and the lingual vestibule are not parallel in Morelli and Class One. Conclusion: The results of this study indicate that the slots of the supports are oversized, their geometry is not precise and varies greatly between brands and prices. The three-dimensional control of the tooth could be compromised.

The impact of orthognathic surgery on quality of life in individuals with oral clefts

To evaluate the relationships between individual, environmental, clinical factors and oral health-related quality of life (OHRQoL) in patients with cleft lip and palate (CLP) following orthognathic surgery. A follow-up study was conducted involving 69 adults with unilateral and bilateral CLP under orthodontic treatment. Interviews and oral examinations were conducted prior to orthognathic surgery (T0) to evaluate age, gender, psychological well-being, dental caries, malocclusion, social support, social networks, family income and education and OHRQoL. All participants were reviewed after 6 months (T1) to re-assess psychological well-being, malocclusion and OHRQoL. Structural equation modeling estimated the associations between the variables. OHRQoL total scores reduced following orthognathic surgery, from 11.7 to 6.9 (P < 0.01). Occlusal characteristics and psychological well-being improved between T0 and T1. In the structural equation modeling, reduction of malocclusion (β = 0.02) between T0 and T1 directly predicted poor OHRQoL at T1. Improvement of psychological well-being between T0 and T1 was associated with better OHRQoL at T1 (β = -0.07). Dental caries and malocclusion at T0 were indirectly linked to poor OHRQoL at T1 (β = 0.02). The short follow-up period of 6 months after orthognathic surgery. This represents the first prospective study examining the interrelationships of predictors of OHRQoL in patients with CLP after orthognathic surgery. OHRQoL and psychological well-being improved after orthognathic surgery. Clinical and psychological characteristics were important determinants of OHRQoL. These findings suggest the importance of the biopsychosocial model of health and the patient-centered approach in oral health care in individuals with CLP.

Impact of Leptin on Periodontal Ligament Fibroblasts during Mechanical Strain.

Orthodontic treatment to correct dental malocclusions leads to the formation of pressure zones in the periodontal ligament resulting in a sterile inflammatory reaction, which is mediated by periodontal ligament fibroblasts (PDLF). Leptin levels are elevated in obesity and chronic inflammatory responses. In view of the increasing number of orthodontic patients with these conditions, insights into effects on orthodontic treatment are of distinct clinical relevance. A possible influence of leptin on the expression profile of PDLF during simulated orthodontic mechanical strain, however, has not yet been investigated. In this study, PDLF were exposed to mechanical strain with or without different leptin concentrations. The gene and protein expression of proinflammatory and bone-remodelling factors were analysed with RT-qPCR, Western-blot and ELISA. The functional analysis of PDLF-induced osteoclastogenesis was analysed by TRAP (tartrate-resistant acid phosphatase) staining in coculture with human macrophages. Pressure-induced increase of proinflammatory factors was additionally elevated with leptin treatment. PDLF significantly increased RANKL (receptor activator of NF-kB ligand) expression after compression, while osteoprotegerin was downregulated. An additional leptin effect was demonstrated for RANKL as well as for subsequent osteoclastogenesis in coculture after TRAP staining. Our results suggest that increased leptin concentrations, as present in obese patients, may influence orthodontic tooth movement. In particular, the increased expression of proinflammatory factors and RANKL as well as increased osteoclastogenesis can be assumed to accelerate bone resorption and thus the velocity of orthodontic tooth movement in the orthodontic treatment of obese patients.

Geometric morphometric analysis of growth patterns among facial types

Introduction:Extreme patterns of vertical facial divergence are of great importance to clinicians because of their association with dental malocclusion and functional problems of the orofacial complex. Understanding the growth patterns associated with vertical facial divergence is critical for clinicians to provide optimal treatment. This study evaluates and compares growth patterns from childhood to adulthood among 3 classifications of vertical facial divergence using longitudinal, lateral cephalograms from the Craniofacial Growth Consortium Study.Methods:Participants (183 females, 188 males) were classified into 1 of 3 facial types on the basis of their adult mandibular plane angle (MPA): hyperdivergent (MPA >39°; n = 40), normodivergent (28° ≤ MPA ≤ 39°; n = 216), and hypodivergent (MPA <28°; n = 115). Each individual had 5 cephalograms between ages 6 and 20 years. A set of 36 cephalometric landmarks were digitized on each cephalogram. Landmark configurations were superimposed to align 5 homologous landmarks of the anterior cranial base and scaled to unit centroid size. Growth trajectories were calculated using multivariate regression for each facial type and sex combination.Results:Divergent growth trajectories were identified among facial types, finding more similarities in normodivergent and hypodivergent growth patterns than either share with the hyperdivergent group. Through the use of geometric morphometric methods, new patterns of facial growth related to vertical facial divergence were identified. Hyperdivergent growth exhibits a downward rotation of the maxillomandibular complex relative to the anterior cranial base, in addition to the increased relative growth of the lower anterior face. Conversely, normodivergent and hypodivergent groups exhibit stable positioning of the maxilla relative to the anterior cranial base, with the forward rotation of the mandible. Furthermore, the hyperdivergent maxilla and mandible become relatively shorter and posteriorly positioned with age compared with the other groups.Conclusions:This study demonstrates how hyperdivergent growth, particularly restricted growth and positioning of the maxilla, results in a higher potential risk for Class II malocclusion. Future work will investigate growth patterns within each classification of facial divergence.

Dental Malocclusion and Its Relation to the Podal System.

Background and Objective: This study analyzes the possibility that Stomatognathic and Postural systems are related by muscle chains. Malocclusion may influence the posture, contact between the foot and the ground, center of mass, footprint or vice-versa. This study aimed to verify whether there is a relationship between dental occlusion and podal system.Materials and Methods: A cross-cutting, descriptive study was carried out on 409 children (222 boys and 187 girls) between 8 and 14 years old. Dental occlusion was assessed on the sagittal plane (Angle's classification) the contact between the foot and the ground and the center of mass were evaluated using a stabilometric platform.Results: There was a statistically significant relationship between the plantigrade phase, the contact surface area and center of gravity. There was a prevalence of molar and canine Angle's class II malocclusion. In molar class II, an anterior center of gravity was predominant, in class I it was centered and in class III, it was posterior. There was significant correlation between malocclusions and the FPI (foot posture index) of the left foot and the height of the scaphoid in the right foot (P < 0.001).Conclusions: Some authors agree with our results. There is still much uncertainty in terms of showing a relationship between both systems. In addition, there is scarce scientific evidence on the topic. Some kind of relationship between the two systems has been proven. Studies that evaluate a group of subjects in a longitudinal manner are necessary to enable the changes taking place in both systems to be defined.

The Logopedic Evaluation of Adult Patients after Orthognathic Surgery

Orthodontists correct dental malocclusion, but major facial skeleton deformations (skeletal malocclusion) are often subject to surgical correction. Several speech pathologies are associated with both of the occlusal anomalies mentioned above. The majority of articulation disorders and primary functions cannot be improved without skeletal correction. This study aimed to investigate the outcome of the multimodal and logopaedics treatment of Polish adults affected by skeletal malocclusion and speech-language pathology. A total of 37 adults affected by skeletal Class II and III malocclusion were included, along with the relationship between the malocclusion and speech deficiency (20 phonemes tested) in the subjects before and after surgical correction. The impact of surgery on pronunciation improvement and types of Polish phonemes most often misarticulated by Polish adults were also examined. Patients underwent combined treatment and received a full speech pathology examination. The treatment improved speech (p &lt; 0.05), but the study did not prove that a specific surgery type was associated with pronunciation improvement. Some patients were provided with speech therapy during childhood, yet most had some minor difficulties with lip and tongue movements. Palatal, alveolar (p &lt; 0.05), fricatives (p &lt; 0.05), and labiodental consonant pronunciation (p &lt; 0.05) improved. The surgical correction of malocclusion leads to better articulation of Polish consonants in adults and improves some primary functions.

Randomized trial of a photography-aided behavioural intervention to reduce risk factors for caries and malocclusion in high-risk infants.

To assess the efficacy of a photography-aided behavioural intervention in reducing risk factors for dental caries and malocclusion in high-risk infants. In this randomized trial conducted in a maternity hospital, 55 mothers of recently born infants at high risk of developing oral diseases were allocated to either the intervention (n=28) or usual care (n=27). The intervention arm received the same usual care plus an enhanced, behaviour-oriented, photography-aided, two-stage (0 and +6months) educational programme addressing nutritional, behavioural, lifestyle and familial factors that affect child's oral health. The primary outcome was the proportion of children classified as being at a 'low risk' of developing dental caries at the age of 12months using a modified score based on the Caries-risk Assessment Form of the American Academy of Pediatric Dentistry. Secondary outcomes included risk factors for malocclusion, such as duration of exclusive breastfeeding, pacifier use and bottle-feeding and/or sippy cup usage. At 12months, the proportion of children considered at low risk for dental caries was significantly higher in the intervention group compared to usual care (71% vs 15%, respectively, relative risk=4.82, 95% confidence interval=1.89-12.3, p<0.001). The median duration of exclusive breastfeeding in the intervention group was 1.7 times higher than in the control arm (5months vs 3months, p=0.03). Altogether, our findings provide evidence that a low-cost, two-stage preventive strategy using photographs to deliver a stronger visual impact might significantly reduce the incidence of risk factors for dental caries and malocclusion in 12-month-old children.

Dental markers of biocultural sex differences in an early modern population from Gothenburg, Sweden: caries and other oral pathologies

BackgroundWith the aim to study dental pathological lesions in an early Swedish modern population, with special reference to sex variances of dental caries, the prevalence and distribution of dental caries and tooth wear were determined in complete and partial human dentitions from an early modern-time city graveyard (1500–1620) excavated in Gamlestaden, Gothenburg, Sweden.MethodsPartial and complete dentitions were examined through visual inspection and using a dental probe. Pathologies were studied, evaluated and presented by teeth and alveoli.ResultsThe study population consisted of 308 individuals. A total of 4,951 teeth in adults and 1,660 teeth in children were examined. Caries prevalence in the studied population was 55% and the highest prevalence of caries was found among the adults, where 68% of the individuals had at least one carious lesion. Caries experience (DMT > 0) in the entire population was 60%, and among adults caries experience was 76%. Women had significantly higher caries experience than men (p < 0.05). Caries was most prevalent in the molar teeth and least prevalent in the incisors and canines. Significant age-related increases in tooth wear were found, and a positive correlation between wear in molars and incisors (p < 0.001). Other clinical findings were signs of apical lesions, crowding of teeth, aplasia, non-erupted canines and calculus.ConclusionsFindings show that dental pathological lesions affected a majority of the studied population, and indicate that women were more predisposed to dental disease than their male counterparts. Results are discussed from a multi-factorial explanation model including dietary, physiological and cultural etiological factors.

Palatal rugoscopy: Individuality and gender differences in subset of population of Karachi.

Objectives: To evaluate the individuality of palatal rugae patten and correlate them in males and females in different age groups by using Trobo’s classification. Study Design: Cross Sectional. Setting: Department of Prosthodontics, Dow Dental College, Dow University of Health Sciences. Period: September 2019 to January 2020. Material &amp; Methods: This study comprised of ninety-four participants with equal number of males and females from 10 years to 70 years, visiting the Prosthodontic department. Study casts included were free of dental abnormality, trauma, malocclusion, orthodontic problems, and deformity in palatal rugae area. Sample size was calculated from software name openepi.com with 95% confidence interval. Data was tabulated and SPSS version 22.0 was used to identify the results. Results: Frequency distribution was performed among age groups in which second group (20 to 39 years) has highest frequency with 52 in number. The cross tab between age group and type of rugae was made which showed group II, having age between 20 to 39 years, had the highest number of palatal rugae configurations amongst all. Conclusion: Sinuous or type E was the predominant type of palatal rugae found in this study. The study did not show significant difference in gender, however number of rugae were found consistently more in young adults with propensity towards individuality. Their use can thus be justified for dental identification in forensic odontology.

Lithuanian dental practitioners’ with less than five years of work experience knowledge about premature loss of deciduous teeth and space maintenance

Gabrielė Jurgelytė1, Austėja Mitalauskienė1, Arūnas Vasiliauskas2 1Lithuanian University of Health Sciences, Medical Academy, Faculty of Odontology 2Lithuanian University of Health Sciences, Medical Academy, faculty of Odontology, Clinic of Orthodontics Abstract Introduction. Premature loss of deciduous teeth is a common complication of dental caries, which can lead to space loss, crowding of teeth. The problem can be prevented by the use of space maintainers. Therefore, dentists must be aware of space maintenance methods. Aim. To analyze Lithuanian dentists’ with less than 5 years of work experience knowledge about premature deciduous teeth loss and space maintenance. Material and methods. An anonymous online survey of 36 closed questions was prepared. The survey was posted on Facebook.com group of Lithuanian dentists. Statistical data analysis was performed using “IBM SPSS” program, version 24.0. In analytical statistics, two-dimensional data analysis of the Chi-square (x2) criterion was applied to compare the distribution of phenomena between groups, when its assumptions are not met, Fisher’s exact criterion (F) was applied. The value of p < 0.05 was considered statistically significant. Results. 166 Lithuanian dentists participated in the study. A correlation between their amount of knowledge about premature deciduous teeth loss and space maintenance, and the frequency of practical work with children was found. Dentists working with children daily, answered correctly to survey’s questions more often compared to those working with children only a few times per year (p<0.05). 50% of dentists estimated their knowledge to be “satisfactorily”, while 38.6% of the participants evaluated their knowledge as “good”. Few participants (6.6%) evaluated their knowledge as “very good”. The rest of the participants (4.8%) evaluated their knowledge as “poor”. Conclusions. Dental practitioners working with children daily have better knowledge about primary teeth loss and space maintenance than those working with children a few times per year. Most of the dentists have satisfactorily knowledge about deciduous teeth loss and space maintenance methods. Therefore, it is essential to renew and expand their awareness. Keywords: preventive orthodontics, dentists, premature teeth loss, space maintainers. https://doi.org/10.53453/ms.2021.06.21

Mini-implantes associados à ancoragem ortodôntica para intrusão de molares: Uma revisão de literatura

A perda dos dentes frequentemente leva à extrusão dos dentes antagonistas, o que resulta em interferência oclusal e espaço inadequado para restaurar o espaço protético. Um pré-requisito para tratar más oclusões dentárias e esqueléticas se faz lançando mão de ancoragens ortodônticas, definida simplesmente como uma resistência ao movimento dentário indesejado e é fundamentalmente a base para tratar vários distúrbios oclusais. A ancoragem é obtida através de aparelhos extra e intrabucais e dos próprios dentes, sendo estes métodos limitados, necessitando de outros dispositivos auxiliares, e um deles são os mini-implantes ou mini-parafusos. Por possuir diâmetro reduzido, os mini-implantes têm sua inserção facilitada o que amplia o leque de sítios de instalação, sendo eficientes no tratamento da extrusão. Portanto, os mini- implantes proporcionam menos efeitos colaterais, mais conforto, técnica simples de ser executada, mas que demanda planejamento prévio, custo baixo e aumenta a efetividade dos tratamentos ortodônticos e consequentemente sua previsibilidade terapêutica, diminua a necessidade de que haja colaboração do paciente, exceto na parte de higienização.

Comparison of Changes in Incisors Inclination and Dental Arch Dimensions in Damon and MBT Systems Using Dolphin Software

Background: There is great controversy regarding the effect of MBT and Damon bracket systems on dental arch dimensions and incisor position. Objectives: We aimed to study the effects of two different brackets (MBT and Damon) on dental arch dimensions and incisors position after orthodontic treatment. Methods: In this retrospective study, the records of 20 patients who underwent orthodontic treatment with MBT or Damon bracket systems were studied. All patients had class I skeletal and dental malocclusion and were treated without extraction. The patients were treated either with Damon or MBT bracket systems (n = 10). Lateral cephalograms were traced using the Dolphin software to determine the position of incisors. In addition, transverse dimensions of dental arches were measured on occlusal photographs. Fishers’ exact test, independent-test, Man-Whitney, paired t-test, and Wilcoxon were used for statistical analysis. P &lt; 0.05 was set as significant. Results: There was no significant difference between the two groups regarding age, sex, and initial values of the variables studied. U1-Apog (mm), upper inter-canine, lower inter-second premolar distance showed a significant difference before and after treatment in the Damon system. However, no significant difference was observed between initial and post-treatment values in the MBT group. L1-Apog (°), IMPA (°), maxillary inter-first and second premolars, inter-canine, and mandibular inter-canine distance was higher in the Damon system after treatment compared to MBT. Changes of the upper and lower transverse dimensions of the dental arches and the incisor positional did not reveal a notable difference in the Damon and MBT systems (P &gt; 0.05). Conclusions: There was no significant difference regarding changes in dental arches and incisor positions between the Damon and MBT systems.

THE RELATIONSHIP BETWEEN THE SEVERITY OF MALOCCLUSION AND GINGIVAL STATUS IN STUDENTS OF SMPN 5 MARABAHAN

ABSTRACTBackground: South Kalimantan experienced dental and mouth problems with a prevalence of 59,6%, so did Barito Kuala Regency with 68,66%. Malocclusion is a dental and oral health problem related to the disharmony between jaws and teeth. Many cases of malocclusion occur in children aged 12-14 years by 15,6% in the form of crowded teeth in South Kalimantan. Malocclusion is a factor that can cause food debris to stick to the interdental area between the crowded teeth, thus forming plaque accumulation. Plaque is the primary etiological factor that influences gingival status. Objective: This study aimed to determine the relationship between the severity of malocclusion and gingival status in students aged 12-14 years at SMPN 5 Marabahan. Method: This study used analytic survey research with cross sectional research design. The research population was all students of SMPN 5 Marabahan aged 12-14 years who born in March 2005 - January 2008, amounting to 88 people. The minimum sample size which determined by the proportion estimation formula was 47 people. The used sampling technique was simple random sampling technique with inclusion and exclusion criteria. Results: The distribution frequency of the study showed mild malocclusion of 55,3% and mild inflammation of 57,4%. Spearman analysis test results on the severity of malocclusion based on Mal I and gingival status based on GI showed a significance value of p = 0,045 (p &lt; 0,05). Conlclusion: It could be concluded that there was a relationship between the severity of malocclusion and gingival status in students aged 12-14 years at SMPN 5 Marabahan.Keywords:Gingival Index, Gingival Status, Malalignment Index, Malocclusion, Permanent Tooth Occlusion Stage 2.

Association of Morphological Characteristics of Palatal Rugae Pattern with Dental Malocclusion in Himachal Population

Introduction: Palatal rugae used for the evaluation of dental movements and as a landmark in the superimposition of dental cast for orthodontic purpose as it is a stable point. So, the aims and objectives of our study is to investigate the association of morphological characteristics of palatal rugae with dental malocclusion in Himachali population. Materials and methods: 90 subjects divided into three groups (n=30 each) on the basis of Angle’s classification. Palatal rugae were marked on dental casts and evaluated for length, pattern and orientation. Obtained measurements were then statistically analysed. Conclusion: Primary palatal rugae’s length was found more in Class II followed by Class III and Class I malocclusion. Among the pattern of the primary palatal rugae, curved pattern were more evident on both right and left sides of all malocclusion groups. Horizontal directed orientation is more predominant on the right side and posteriorly directed on the left side of the first primary palatine rugae. Keywords: Rugae, Malocclusion, orientation pattern, length, morphology.

Effect of dental malocclusion on cerebellar neuron activation via the dorsomedial part of the principal sensory trigeminal nucleus

Occlusion has been proposed to play a role for body posture and balance, both of which are mediated mainly by the cerebellum. The dorsomedial part of the principal sensory trigeminal nucleus (Vpdm) has direct projection to the cerebellum. The experimental unilateral anterior crossbite (UAC) has an impact on the motor nuclei in the brain stem via trigeminal mesencephalic nucleus (Vme). The current aim was to explore whether UAC has an impact on Vpdm‐cerebellum circuit. The inferior alveolar nerve was injected into cholera toxin B subunit (CTb), the cerebellum was injected into fluoro‐gold (FG), and the Vpdm was injected into biotinylated dextran amine (BDA) to identify the activation of Vpdm‐cerebellum circuit by UAC. Data indicated that there were more neuronal nuclei (NeuN)/CTb/FG triple‐labelled neurons and NeuN/CTb/vesicular glutamate transporter 1(VGLUT1) triple‐labelled neurons in the Vpdm, and more NeuN/BDA/ VGLUT1 triple‐labelled neurons in the cerebellum of rats with UAC than in control rats. The VGLUT1 expression in the Vpdm and cerebellum in the UAC group was higher than that in control rats. These findings indicate an excitatory impact of UAC on the Vpdm‐cerebellum pathway and support the role of occlusion for body posture and balance.

Craniofacial Bone Mineral Density During Growth in Mice with Osteogenesis Imperfecta (OI)

Osteogenesis imperfecta (OI or “brittle bone” disease) is a genetic connective tissue defect which results in fragile bones and increased fracture rates. OI type III is the severe form of this disorder, resulting from mutations affecting the formation of type I collagen, the structural protein of bone. Defects in the collagen framework of developing bones lead to improper biomineralization and are thought to underlie the gross structural abnormalities seen in patients with OI, such as midfacial hypoplasia, dental malocclusions, and macrocephaly. Low bone mineral density (BMD) in the post-cranial skeleton and brittle teeth have been reported in human patients with OI as well as murine models of the disorder, yet little is known about craniofacial biomineralization in OI. Typically, skeletal mineralization is responsive to the strain environment throughout growth. The aim of this study is to investigate longitudinal changes in craniofacial BMD in a mouse model of OI type III, and to quantify BMD in regions both proximal and distal to the biomechanical forces generated by feeding behaviors. We hypothesize that mice with OI will have lower BMD at weaning than their unaffected littermates, and will maintain this lower BMD throughout growth. We also hypothesize that both genotypes will demonstrate the absolute highest levels of BMD in regions proximal to the bite point, due to the biomechanical forces generated by feeding. To test these hypotheses, we used the homozygous recessive OI murine (OIM-/-), a mouse strain with a COL1A2 mutation that is a model for OI type III, and their unaffected wild-type (WT) littermates. BMD was measured using in-vivo micro-CT scans at weeks 4 (weaning), 10 (adolescence) and 16 (skeletal maturity) using Bruker CTAnalyzer software. BMD was measured in 8 regions of interest encompassing the neurocranium, facial skeleton, and mandible. BMD values were compared between genotypes via Mann-Whitney U test. In general, this study found there is a trend for OIM mice to have lower BMD values in the craniofacial skeleton as compared to WT mice from weaning through skeletal maturity. OIM mice had significantly (p <0.05) lower BMD than WT mice in all 8 regions during week 4. No significant differences were found in BMD between the genotypes during week 10, possible due to low sample sizes at this time point. At week 16, significant differences (p <0.05) were found in BMD at the parietal bone, mandibular symphysis, and maxillary incisor regions between the genotypes, and weak significant differences (p = 0.07) were found in BMD at the temporomandibular joint region. Additionally, absolute BMD for both genotypes (OIM and WT) tended to be higher within facial and mandibular regions proximal to the bite point compared to the neurocranium at skeletal maturity. Currently, there is no cure for OI, but pharmaceutical interventions (e.g. bisphosphonates) focus on increasing BMD to reduce fracture rates. A better understanding of craniofacial mineralization patterns in OI patients could assist in the timing and implementation of these treatments.

Microdebrider: a painless and effective technique for adenoidectomy; comparative study with curette assisted adenoidectomy

&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Adenoid is a nasopharyngeal tissue which forms Waldeyer's ring as said by Meyer, 1968. Adenoids become demonstrable with signs of CSOM with adenoid hyperplasia, recurrent rhino-sinusitis, characteristic ‘adenoid facies’, nasal obstruction, mouth breathing, snoring, drooling of saliva and speech abnormalities and dental malocclusion. Adenoidectomyis the common surgery done using various techniques like curette, microdebrider and many more. In this study we evaluate and compare the efficacy of adenoidectomy by microdebrider verses curette assisted adenoidectomy. Aim of the study was to evaluate and compare the efficacy and benefits of adenoidectomy by microdebrider with curette assisted adenoidectomy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This is a prospective randomized single-blind study done for 1 year. Total 150 patients were included which were diagnosed as adenoid hypertrophy based on clinical and radiological examination and were equally divided in 2 group for both the procedures (curette and microdebrider).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Patients show good response to the treatment with microdebrider assisted adenoidectomy with less complication and early recovery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;We observe that proper examination and early surgical intervention using modern technique i.e., microdebrider reduces the time, residual tissue with less complication and promote early recovery.&lt;/p&gt;

A 13-year follow-up multidisciplinary management of replanted avulsed permanent incisor: Case report

Background: Permanent teeth avulsion represents a high rate among all dental trauma injuries and their rapid management is very important for prognosis. The aim of the present study is to report the multidisciplinary treatment and 13-years follow-up of a case of the replantation of a permanent maxillary central incisor after dental avulsion.Clinical presentation: A 8-year-old male patient presenting avulsion of right maxillary central incisor (11) and subluxation associated with uncomplicated crown fracture of left permanent central incisor (21) was treated with immediate replantation of the #11. Due to anterior open bite, severe crowding of teeth in the trauma region and Angle's Class II profile, an orthodontic approach was performed. Long-term follow-up at 12-years after the trauma, and 7-years after the beginning of orthodontic treatment, appliance was removed, and permanent root canal filling of right maxillary central incisor was performed.Clinical Relevance: The treatment of choice for a dental avulsion is to replant the tooth as soon as the trauma has occurred for a better prognosis, addressing the guidelines of the International Association of Dental Traumatology (IADT) associated with orthodontic management.Conclusion: Clinical results after 13-years follow-up showed that this approach controlled the progressive resorption and allowed orthodontic movement maintained the patient’s health over time.

The relationship of temporomandibular disorders with Class II malocclusion as a risk factor

Objectives: The temporomandibular joints (TMJs) play a fundamental role in mastication, deglutition, speech, and even respiration. Thus, temporomandibular disorders (TMDs) can affect the quality of life, especially if they become chronic. Considering the controversy regarding the etiology of the TMDs, this study aimed to assess the relationship of TMDs with dental malocclusion. Materials and Methods: Totally, 885 dentate patients between 18 years and 60 years with complete dental records and no condylar ankylosis, history of trauma, bruxism, clenching, or congenital TMJ anomalies participated in this study. Tenderness on palpation, clicking, crepitus, pain, deviation on mouth opening, open bite, deep bite, cross bite, and class of malocclusion (I, II or III) were recorded for all patients. Results: Of patients, 60.2% were males and 39.8% were females. Gender had no correlation with TMDs. Patients had a mean age of 34.8 years. Age had no correlation with TMDs. Of TMD symptoms, clicking had the highest frequency (23.3%) followed by deviation on mouth opening (10.6%), pain at the mouth opening (2.9%), tenderness on palpation (1.4%), trismus (1.2%), and crepitus (1.1%). Of patients, 76.7% were Class I, 13.8% were Class II, and 6.2% were Class III. Less than 2% of patients had deep bite, open bite, or cross bite. Conclusion: TMDs had a relatively high prevalence (35%) in our study population. Age, gender, and class of malocclusion had no correlation with TMDs; however, Class II malocclusion was slightly more prevalent among TMD patients, which needs to be taken into account by patients and orthodontists.