Mandibular Anomalies Research Articles

Perinatal Airway Management Mandibular Anomalies: A National Inpatient Cohort Analysis.

To characterize incidence of mandibular anomalies (MAs) and compare gestational age, airway interventions, and complications among individuals with MA phenotypes (isolated retrognathia, isolated micrognathia, syndromic micrognathia, micrognathia plus cleft palate/cleft lip and palate, agnathia/micrognathia plus cervical auricle/otocephaly, and agnathia/micrognathia plus microstomia) and unaffected individuals. The Healthcare Cost and Utilization Project Kids' Inpatient Database was used to collect data over a 20-year period beginning in 2000. Interventions were classified as perinatal when performed on day of life (DOL) 0 or 1 and subsequent when performed during the birth hospitalization after DOL 1. Hypoxic complications included cardiac arrest, birth asphyxia, hypoxic-ischemic encephalopathy, anoxic brain damage, intraventricular hemorrhage or cerebral infarction. Descriptive statistics are reported, and the Rao-Scott chi-square test compared groups. MAs affected 119 per 100,000 birth visits. Preterm delivery was more frequent for all MA phenotypes. Individuals with MA phenotypes are more likely to require medical attention (airway intervention on DOL 0 or 1 OR no airway intervention received but patient sustained hypoxic complication/mortality): 16.2%-70.7% vs. 3.8%, p < 0.01. Despite receipt of airway interventions at a higher rate, collectively individuals with MAs who received an airway intervention on DOL 0 or 1 have a mildly elevated risk of hypoxic complication or mortality (32.4% vs. 26.4%, p < 0.01). Preterm birth is more common, however, does not account for the elevated rate of airway intervention. Individuals with MAs require higher rates of medical attention, and current airway management paradigms are insufficient to prevent complications and mortality. III Laryngoscope, 2024.

Long-Term Outcomes of Management of Inferior Alveolar Neuropathy Following Orthognatic Surgeries in Patients with Mandibular Anomalies and Deformities

Introduction. Orthognatic surgery is a routine method to manage mandibular anomalies and deformities.&#x0D; Objective: To assess long-term outcomes of rhythmic peripheral magnetic stimulation (rPMS) in patients with neuropathy of the inferior alveolar nerve (IAN) resulting from the surgical treatment of mandibular anomalies and deformities.&#x0D; Materials and methods. The study included 8 males and 16 females aged 32 ± 12 years with IAN neuropathy following the surgical treatment of mandibular anomalies and deformities. Therapeutic rPMS was performed with the Neuro-MS magnetic stimulator (Neurosoft, Ivanovo, Ivanovo Region, Russian Federation). Trigeminal and brainstem acoustic evoked potentials (EPs) were registered with Neuro-MVP (Neurosoft) to assess rPMS both at baseline (in 10 days) and in long term (in 18 ± 2 months).&#x0D; Results. Sensory disorders and pain prevailed in postoperative IAN neuropathy. Sensory disorders improved in 20 patients following 10-day rPMS. The clinical effect persisted in re-assessment. In long term, acoustic brainstem EPs normalized and trigeminal EPs did not change negatively.&#x0D; Conclusion. The use of rPMS in IAN neuropathy following orthognatic surgeries contributes to the functional improvement and stabilization of the peripheral and central brainstem and the trigeminal system.

PREVALENCE OF MAXILOFACIAL ABNORMALITIES AMONG CHILDREN AND ADOLESCENTS IN UZHGOROD

The article presents a comparative analysis of maxillofacial abnormalities in children and adolescents in Uzhhorod. There is a tendency to increase maxillofacial anomalies depending on the age of the patient. It was established that the smallest number of anomalies is observed in children with a temporary bite, and the largest – in children with a permanent bite. In the conditions of a high level of orthodontic morbidity in the population, the purposeful reduction of the level of pathology and solving the problems of improving orthodontic care for children become especially relevant. Data on the prevalence and structure of maxillofacial anomalies and dentition defects determine the indications for treatment and the scope of treatment and prevention measures in the region.&#x0D; Purpose and task. To study the prevalence of maxillofacial anomalies in children of Uzhgorod in order to determine the scope of treatment and prevention measures.&#x0D; Materials and research methods. The total number of examined patients is 946 children aged 6 to 18, including 447 boys and 499 girls. According to the stages of bite formation of temporary and permanent teeth, the examined children were divided into 4 age groups: 6-9 years early variable bite; 10-12 years late variable bite; 13-15 years the beginning of formation of the bite of permanent teeth: 16-18 years permanent bite 6-9 years early mixed eruption of teeth; 10-12 years late mixed teething; 13-15 years the beginning of the formation of the bite of permanent teeth: 16-18 years the permanent dentition. Statistical data processing was performed on a personal computer using licensed software for the Windows operating system and the standard Statsoft software package. Inc STATISTICA 6.0 2300 East 14th Street Tulsa, OK 74104 USA. The Student's t-test value was used to determine the reliability of the difference in results.&#x0D; Results of the research. The study revealed a high prevalence of dento-maxillary anomalies, reaching 47.1%. The highest need for orthodontic treatment was observed in 16-18 year olds. The most common pathologies were diastema (15.1%), crowding of lower jaw teeth (14.9%), dystopia (12.7%), deep bite (11.4%), crowding of teeth on both jaws (5.9%), crowding of upper jaw teeth (5.3%), tortoamalia (4.0%), progeny (3.2%), cross bite (2.2%), open bite (1.9%), abnormalities in tooth size and shape (1.8%), and prognathia (1.2%).&#x0D; Conclusion. The study revealed a high prevalence of dental mandibular anomalies (47.1%) among children aged 6 to 18 years in Uzhhorod. Therefore, there is a need to expand sanitary and educational efforts, including promoting a healthy lifestyle and early detection and treatment of dental mandibular anomalies.

MicroRNAs regulate distal region of mandibular development through Hh signaling.

Mandibular anomalies are often seen in various congenital diseases, indicating that mandibular development is under strict molecular control. Therefore, it is crucial to understand the molecular mechanisms involved in mandibular development. MicroRNAs (miRNAs) are noncoding small single-stranded RNAs that play a critical role in regulating the level of gene expression. We found that the mesenchymal conditional deletion of miRNAs arising from a lack of Dicer (an essential molecule for miRNA processing, Dicerfl/fl ;Wnt1Cre), led to an abnormal groove formation at the distal end of developing mandibles. At E10.5, when the region forms, inhibitors of Hh signaling, Ptch1 and Hhip1 showed increased expression at the region in Dicer mutant mandibles, while Gli1 (a major mediator of Hh signaling) was significantly downregulated in mutant mandibles. These suggest that Hh signaling was downregulated at the distal end of Dicer mutant mandibles by increased inhibitors. To understand whether the abnormal groove formation inDicer mutant mandibles was caused by the downregulation of Hh signaling, mice with a mesenchymal deletion of Hh signaling activity arising from a lack of Smo (an essential molecule for Hh signaling activation, Smofl/fl ;Wnt1Cre) were examined. Smofl/fl ;Wnt1Cre mice showed a similar phenotype in the distal region of their mandibles to those in Dicerfl/fl ;Wnt1Cre mice. We also found that approximately 400 miRNAs were expressed in wild-type mandibular mesenchymes at E10.5, and six microRNAs were identified as miRNAs with binding potential against both Ptch1 and Hhip1. Their expressions at the distal end of the mandible were confirmed by in situ hybridization. This indicates that microRNAs regulate the distal part of mandibular formation at an early stage of development by involving Hh signaling activity through controlling its inhibitor expression level.

Assessing Safety and Clinical Effectiveness of New Approaches to Planning and Integrated Implementation of Full-Mouth Reconstruction.

Objectives Planning, adequate preparation, and further prosthodontic management are the most important steps in the treatment of this population of patients with dental and mandibular anomalies. The purpose of the article is the improvement of safety and clinical effectiveness of prosthodontic rehabilitation of patients after full-mouth reconstruction. Materials and Methods A single-center open prospective nonrandomized study, examination, and treatment of 198 patients with partial or total absence of teeth were performed. Higher safety and clinical effectiveness of the treatment were found in the patients of the main group who showed a significant reduction in the rate of complications relative to the comparison group. In the main group, the number of aesthetic defects and cases of repeated prosthetics decreased in comparison with the corresponding occurrence rate of such cases in patient groups. Results It showed statistically significantly reduction in the rates of occurrence of the complications when using the proposed algorithm: the rate of inflammation of the marginal periodontium and peri-implant tissues in the main group was 2.9 times less frequent and loosening of the supporting implants was 3.9 times less frequent. The rate of polymer chipping or abrasion in the area of the incisal edge or masticatory surface was two times lower in the main group of patients, short crowns were found 1.9 times less often, sores in the area of the dental pontic in the main group were 1.8 times less frequent than in the comparison group, and no fractures of bridgework were found in the main group. The frequency of neuralgic facial pain in the patients of the main group was 5.2 times less than in the comparison group, complaints about pain in the temporomandibular joint area were 8.4 times less frequent, increased abrasion of antagonist teeth was 3.9 times less frequent, and phonetics disorders were 8.4 times less frequent. The effectiveness of the algorithm developed by us is also confirmed by the fact that the number of aesthetic defects and cases of the need for repeated prosthetic treatment was reduced in comparison with the corresponding frequency of such cases in groups of patients where standard approaches to prosthetics were applied. In particular, aesthetic defects found in the main group of patients were 2.5 times less frequent than in the comparison group, and repeated prosthetics was performed 2.7 times less frequently. Conclusion Application of the developed comprehensive approach to planning of prosthodontic rehabilitation provides for significant reduction in the frequency of complications and aesthetic defects, as well as cases of repeated need for prosthetics.

Point Mutations in Muscle Segment Homeobox 1 (MSX1) Gene in an Individual with Mandibular Retrognathia: A Case Report

Malocclusion is an orofacial anomaly that manifests in the form of misaligned dental arches. Mandibular retrognathia is a type of malocclusion, characterised by defective mandibular bone growth. Muscle Segment Homeobox (MSX) gene family, plays an essential role during embryonic development by coordinating processes that decide the patterning and morphogenesis of tissues. Expression of MSX1 and MSX2 genes in the maxilla, mandible and the mesenchymal cells of cephalic neural crest strongly suggest their role in craniofacial development. Here, point mutations (T8I, P11S and A68V) in the coding region of MSX1 gene in a 20-year-old male patient with severe mandibular retrognathia was reported. To date, there has been no report on the association of MSXgenes with mandibular anomalies. Evaluating, the significance of these novel mutations through functional studies in animal models will lead to a better understanding of the role of MSX genes in mandibular morphogenesis.

EP09.01: The fetal zygoma detection: an important landmark in the differential diagnosis of mandibular anomalies

EP09.01: The fetal zygoma detection: an important landmark in the differential diagnosis of mandibular anomalies

Normal mandibular growth and diagnosis of micrognathia at prenatal MRI.

The aim of this article is to present reference data for fetal mandibular growth on magnetic resonance imaging, enabling the diagnosis of micrognathia. Retrospectively, on 355 magnetic resonance scans of apparently facially normal fetuses [gestational age (GA), 20-36 weeks], mandibular anterior-posterior diameter (APD = mandibular size), inferior facial angle (IFA = mandibular position), and jaw index (APD normalized to biparietal diameter) were correlated with GA by Pearson correlation. APD-age relationship was modeled. A receding chin was subjectively determined. Ten fetuses with mandibular anomalies were compared with normal fetuses. For GA, APD showed high correlation (r = 0.850; P < 0.001), IFA (r = 0.086; P = 0.119) no correlation, and jaw index (r = -0.139; P = 0.018) weak correlation. APD-age relationship was expressed by the following: APD = 0.281 + 0.989 * GA (r(2) = 0.723). A receding chin was identified in 7/10 abnormal fetuses. APD, IFA, and jaw index of abnormal and normal fetuses were significantly different (P < 0.001). In 10/10 abnormal fetuses, IFA was <50.0°; in 7/10, jaw index was less than the fifth percentile (micrognathia); in 3/10, jaw index was at low normal range (retrognathia). Subjective identification of micrognathia may be limited. Reference data provide quantitative evaluation of mandibular size and position. An IFA <50° reflects micrognathia or retrognathia; a jaw index less than the fifth percentile suggests micrognathia.

Dental anomalies within extant members of the mammalian Order Pilosa

AbstractRecent discovery of a supernumerary dental anomaly in two‐toed sloths led to an extensive review of extant sloth specimens to look for additional anomalies. In total, 881 museum specimens were examined. These revealed two primary types of anomalies, hyperdontia (extra teeth) and anodontia (loss of teeth), occurring at a rate of 2.4% (n = 21). Two‐toed sloths, Choloepus, were more likely to have hyperdontia in the anterior dentition, whereas three‐toed sloths, Bradypus, experienced anodontia more frequently with the upper caniniforms. Both genera experienced both anomalies. The majority affected the upper dentition, with only three specimens exhibiting mandibular anomalies. Beyond the patterns of tooth positioning, all anomalies were random with respect to age, sex and geography. A few specimens not counted in the initial assessment expressed incomplete anodontia, indicating that the loss occurred postnatally and was not an embryological anomaly. For Bradypus, the findings provide new support for the hypothesis that the taxon represents a neotenic lineage and opens new possibilities about its relationship to the extinct ground sloths with a suggested rooting above that of the basal position it typically occupies for Folivora.

Oculoauriculovertebral anomaly: segregation analysis.

Seventy-four families of probands with oculoauriculovertebral anomaly were evaluated, including 116 parents and 195 offspring. Relatives were examined to identify ear malformations, mandibular anomalies, and other craniofacial abnormalities. For segregation analysis using POINTER, selection of the sample was consistent with single ascertainment. Different population liabilities were used for probands and relatives, because affection was narrowly defined for probands and broadly defined for relatives. The hypothesis of no genetic transmission was rejected. The evidence favored autosomal dominant inheritance; recessive and polygenic models were not distinguishable.

Simultaneous correction of maxillary and mandibular dentofacial deformities without the use of postoperative intermaxillary fixation. A clinical and cephalometric study

Simultaneous correction of maxillary and mandibular anomalies was performed in 23 patients. The maxillary segment was stabilized by means of steel wires as horizontal mattress sutures, which, in all cases, gave good stability. A modified sagittal split has been applied in all cases. The method makes a safe split osteotomy possible under controlled conditions. The design of the osteotomy and the screw osteosynthesis counteract relapse. Postoperatively, no rigid intermaxillary fixation (IMF) was used. Masticatory function was started from the 1st postoperative day and in most cases was normalized 2–3 weeks after surgery according to the patients own judgement. Cephalometric analysis was performed on 15 patients by a superimposition technique. There was an overall good postoperative stability of the maxilla and mandible in the horizontal and vertical planes. We conclude that omitting IMF has no negative effect on the postoperative stability of the fragments.

Hemimandibular hyperplasia—Hemimandibular elongation

Clinical and radiographic experience as well as histological findings leave no doubt that the term refers only to hyperplasia of the condyle alone and should therefore not be used to mean the two hemimandibular anomalies as is the case in the literature today. There are two basically different malformations of one side of the mandible which we call hemimandibular hyperplasia and hemimandibular elongation respectively. We are convinced that there exist pure and mixed forms of both growth anomalies because we have observed several such clinical cases. The stimulus for the abnormal growth either lies within the fibrocartilaginous layer or is produced by it. Different histological patterns within the condylar growth zone were seen in the two anomalies. The pathophysiological bases of the abnormal growth are discussed. They seem to contribute to the understanding of the normal and abnormal mandibular growth and consequently also of many of the mandibular anomalies. The explanations are demonstrated by the illustrations of some cases.

Hemimandibular hyperplasia — Hemimandibular elongation

Clinical and radiographic experience as well as histological findings leave no doubt that the term "condylar hyperplasia" refers only to hyperplasia of the condyle alone and should therefore not be used to mean the two hemimandibular anomalies as is the case in the literature today. There are two basically different malformations of one side of the mandible which we call hemimandibular hyperplasia and hemimandibular elongation respectively. We are convinced that there exist pure and mixed forms of both growth anomalies because we have observed several such clinical cases. The stimulus for the abnormal growth either lies within the fibrocartilaginous layer or is produced by it. Different histological patterns within the condylar growth zone were seen in the two anomalies. The pathophysiological bases of the abnormal growth are discussed. They seem to contribute to the understanding of the normal and abnormal mandibular growth and consequently also of many of the mandibular anomalies. The explanations are demonstrated by the illustrations of some cases.