Occlusal Abnormalities Research Articles

A rare case of schwannoma of the mandibular nerve extending to parapharyngeal space managed with a preauricular trans mandibular approach

Schwannoma also referred to as neurilemmoma or neurinomas arise from the Schwann cells of the autonomic nerves, peripheral nerves and cranial nerves except optic and olfactory nerves. Head and neck schwannomas account for 25 to 45% of schwannomas and the most common being vagal schwannomas and cervical sympathetic chain schwannomas. Schwannomas arising from the trigeminal nerve are rare and this case report consists of a schwannoma presenting as a left preauricular swelling involving the region of parotid extending from foramen ovale through the infratemporal fossa up to the parapharyngeal space. A combined preauricular trans mandibular approach enabled a complete excision of the tumor. Histopathological confirmation of a benign schwannoma was obtained and the patient is feeling well with minimal postoperative facial palsy with no trismus, occlusion abnormalities and no signs of recurrence on follow up.

Congenital lingual cyst: an unusually large presentation without obstruction

Congenital lingual cysts are rare tumours that present in variable sizes and locations within the tongue. We report the case of an infant whom we received at two weeks for a mass protruding from the oral cavity. On physical examination, the neonate had a good general condition. There was no respiratory or feeding difficulty. There was a large mucosa-covered, pink, soft tissue oral mass, occupying and expanding the oral fissure. The mass extended about 5 cm anterior to the fissure, and the lingual dorsum was identifiable intra-orally at its superior left surface. Head and neck computerized tomography scan showed an intra-lingual cystic mass, with mass effect on surrounding structures and no bone erosion. The diagnosis of a congenital cyst of the tongue was made. Surgical excision was planned at six months, with very close monitoring for feeding or breathing abnormalities. The procedure consisted of a lateral right mucosal incision along the edge of the tongue, followed by meticulous blunt dissection and separation of the cyst from the surrounding tissues. The cyst was excised completely. It had an approximate volume of 180 ml. The mucosa was closed by interrupted stitches. The procedure was well tolerated and post-operative outcome was good. The patient was addressed to the odontostomatologist for management and eventual correction of occlusal abnormalities. Diligent assessment and management of the airway shared by the surgeon and anaesthetist was capital.

Effect of abnormal occlusal contact on temporomandibular joint

Occlusion, temporomandibular joint and masticatory muscle are in a functional system, which cooperate and influence each other. When any one of these elements is abnormal, it will affect the function of other elements. The normal occlusal relationship is the convex-concave relationship of apical fossa contact, and the masticatory movement trajectory is teardrop-like, which is helpful to promote the normal mandibular functional movement. The abnormal occlusal contact relationship changes the convex-concave relationship of apical fossa contact into convex relationship, which will form abnormal masticatory movement trajectory, and may even cause abnormal movement and stress of temporomandibular joint and abnormal contractile activity of masticatory muscle. The longer the duration of this abnormal occlusal relationship, the greater the damage to bone and soft tissue. scissors bite, openbite and crossbite are common occlusal abnormalities in clinic, so this article will focus on the effects of these three abnormal occlusal contacts on the temporomandibular joint.

Prevalence of malocclusions in patients attended at the orthodontic service of the high specialty center

Introduction: The stomatognathic system is constituted by interconnected anatomical elements, its functions are chewing, swallowing, breathing and speaking. During these the mandibular closure occurs, contacting the arcades, (occlusal relationship). Occlusal abnormalities begin at an early age, causing dentofacial deformities that interfere with overall well-being, affect aesthetics, chewing, respiratory, speech or physical and psychological balance functions. Dental malocclusion is any deviation from the ideal occlusion, alters the intercuspidation of the teeth. In Mexico, 60% of the population presents some malocclusion, placing as a health problem, associated with oral habits. In Veracruz there is no documented evidence of this problem.Objective: To evaluate the prevalence of malocclusion in children in Veracruz.Material and Methods: Epidemiological, observational, cross-sectional, comparative and retrospective clinical study in 85 patients aged 6 to 11 years, served in CAE during 2011-2015.Results: Obtaining that 53.95% presented Class I, 37.8% Class II and 8.2% Class III, 38 of the cases (43.7%) presented oral habits with a higher prevalence in the male sex, being the lingual projection the most frequent, 21.1% in ages of 6 to 7 years.

MULTIDISCIPLINARY AESTHETIC REHABILITATION IN A PATIENT WITH ENAMEL HYPOPLASIA POST FIXED ORTHODONTIC TREATMENT

Interdisciplinary approach helps the specialists of contributing disciplines immensely in diagnosis, treatment planning, execution of planned treatment and problem solving for any untoward complication. Orthodontic treatment may be adjunctive to periodontal therapy or vice versa. Periodontal problems might lead to occlusal abnormalities which may require orthodontic correction. Of equal importance is that treatment should not induce damage to the periodontal structures. It is imperative that periodontal tissues are healthy before prosthodontic treatment commences, and additional periodontal treatment is commonly indicated to facilitate improved prosthodontic treatment outcomes.

A better way to... manage late presenting complications of temporomandibular joint prostheses

<b>Introduction</b>: Within our centre, Temporomandibular joint (TMJ) prostheses have been provided in varying materials and designs over the years. Various patients have re-presented with various late complications of such surgery including limited mouth opening, facial pain, swelling, malocclusion and malpositioned components. This case series aims to discuss and illustrate the multidisciplinary approach to assessment, planning, and surgery for this cohort of patients. <b>Methods</b>: A Retrospective review of late TMJ protheses complications presenting within our centre has been undertaken. This includes multiple patient cases, with photographs, detailing the MDT planning, surgery and outcomes. <b>Results</b>: The most common presentation was pain and limited mouth opening or ankylosis. A total of twelve cases are included. Five cases were related to full metal prosthesis. Malposition of the condylar element was found in six other cases. Malocclusion was present in three cases. Some cases benefited from the removal of the joint alone, others a simultaneous further joint replacement and some with concurrent orthognathic surgery. Outcomes show reduction in pain and improvement in opening most notably. <b>Conclusions</b>: This case series evidences that complications of TMJ prostheses can present late and that such surgery carries many and significant risks. It highlights the adopted multidisciplinary team approach ensures that prostheses are appropriately designed and positioned correctly, whilst simultaneously addressing any gross occlusal abnormalities.

A Case of Synovial Chondromatosis of Temporomandibular Joint with Numerous Loose Bodies

Here, we report a case of synovial chondromatosis of the temporomandibular joint (TMJ) with numerous loose bodies. A 56-year-old woman was examined in the oral surgery department for trismus and pain in the left TMJ when opening the mouth. Imaging indicated TMJ synovial chondromatosis, and the patient was referred to our department for further examination. Her facial features were symmetrical, and no occlusal abnormalities were found. The maximum mouth opening was 30 mm, and movement of the left mandibular condyle was restricted and accompanied by pain and joint sounds. Panoramic radiography showed deformation of the left mandibular condyle and radiopaque lesions surrounding it. Computed tomography showed numerous small granules around the left mandibular condyle, some of which were calcified. Magnetic resonance imaging showed anterior disc displacement without reduction in the left TMJ and hypointense lesions on T2-weighted images. Bone scintigraphy showed an accumulation in the area of the left TMJ. Based on the diagnosis of the left TMJ synovial chondromatosis, the lesions were removed, and plastic surgery on the mandibular condyle was performed under general anesthesia. We removed 386 white loose bodies. Histopathologically, the loose bodies were consistent with synovial chondromatosis lesions. The postoperative course was uneventful, with no recurrence or TMJ dysfunction approximately 5 years after the surgery, indicating that open surgery is the best course of intervention in such cases.

Characteristics and Association of Gender to Dental and Occlusal Anomalies in Malaysian Primary School Children

Aim: To describe the distribution and association of dental and occlusal anomalies to gender in children of mixed and early permanent dentition. Methods: It is a cross-sectional study with stratified random sampling based on the main ethnic composition involving 413 subjects aged between 9 and 11 years old enrolled in 7 national primary schools in Sungai Buloh, Selangor. A calibrated operator carried out clinical examinations, and study models were fabricated. All dental and occlusal anomalies were recorded accordingly and were analysed using SPSS version 21.0. Pearson chi-square test was used to determine the gender-based differences for various parameters. Results: The reported dental anomalies were supernumeraries and clinically missing teeth (impacted or hypodontia) with a prevalence of 1.5% and 6.3%, respectively. The occlusal abnormalities were: crowding (54.0%), sagittal discrepancies (overjet; increased, reduced, and reversed overjet: 55.5%), vertical discrepancies (overbite; increased, reduced, and open bite: 37.5%) and transverse discrepancies (unilateral and bilateral posterior crossbite: 5.1%). Gender-based differences were not statistically significant to all reported dental and occlusal anomalies (p&gt;0.05). Conclusions: Children in the mixed and early permanent dentition showed various dental and occlusal anomalies with crowding being the highest anomaly. Gender was not associated with any type of dental or occlusal characteristics in the studied population.

ОРТОПЕДИЧЕСКОЕ ЛЕЧЕНИЕ ПАЦИЕНТОВ С ДИСТАЛЬНОЙ ОККЛЮЗИЕЙ С ПРИМЕНЕНИЕМ ДЕПРОГРАММАТОРА (КЛИНИЧЕСКИЙ СЛУЧАЙ)

Introduction. An actual problem of modern dentistry is the anomalies of the position of the lower jaw. The share of these diseases in the structure of requests for dental care can reach up to 27%. The most common pathology is distal occlusion, which accounts for 25 to 37% of all occlusion abnormalities. The aim of this work was to describe and demonstrate on a clinical example the method of orthopedic treatment of patients with distal occlusion proposed by the authors. Material and methods of research. The paper presents a new method of orthopedic treatment of patients with distal occlusion using a deprogrammer of the original design. Orthopedic treatment of patients was carried out on the basis of a multidisciplinary clinic of Postnikov in the city of Samara. Using the method proposed by the authors, orthopaedic treatment was performed in 36 patients with distal occlusion. For clarity, the article considers an original clinical case of treatment of a patient with distal occlusion, who was made a deprogrammer of the author's design, with a detailed analysis of each stage of diagnosis and orthopedic treatment. To confirm the effectiveness of the proposed technique, a CT scan of the patient's temporomandibular joint was performed before and after orthopedic treatment. As a result of the treatment, the patient has a decrease in the hypertonicity of the masticatory muscles, which made it possible to position the lower jaw in the position of the central ratio, which is confirmed by CT data. Conclusion. The use of a deprogrammer-mouthguard, the proposed design allows for deprogramming of the masticatory muscles and correctly determining the central ratio of the jaws, and can be used in the treatment of patients with distal occlusion.

Space maintainer ‘Y model’ as a preventive orthodontic treatment for paediatric patients: a case report

Background: Caries is one of the most common oral diseases that occur among children. Caries and dental trauma in children may cause early tooth loss, also known as premature loss, and result in occlusion abnormalities caused by the dental arch narrowing. A space maintainer is a preventive orthodontic appliance designed to maintain a narrow arch to prevent premature loss. Purpose: This study aims to describe the treatment of a case of space management in a patient with premature loss by using the space maintainer ‘Y model’. Case: An eight-year-old boy was accompanied by his mother, complaining that the lower posterior right tooth had been extracted. The mother was worried that the new tooth would have an overlapping growth. Case Management: The diagnosis was mandibular primary molar loss. The study cast was analysed based on Moyers 2.62 cm, Huckaba 2.24 mm, and curve determination 2.40 mm. The mandibular removable space maintainer treatment was performed on the patient and was followed by nine control visits every week. The outcome was a successful treatment from the use of the space maintainer ‘Y model’. Conclusion: The space maintainer treatment with the Y model in the paediatric patient showed a good result, evidenced by the tube opening of 1.2 mm, showing that the appliance followed lateral jaw growth.

Oral Health Status of Down's Syndrome Patients in Aseer, Saudi Arabia.

Introduction:It was observed that compared to the general population, mentally challenged subjects have higher rates of poor oral hygiene. Gingivitis is a common finding with moderate or severe variety reported most commonly. Periodontal disease is the most significant oral health problem, which can even lead to mobility of tooth and tooth loss. It is essential to generate oral health precautionary agendas and familiarize it with them.Materials and Methods:Four Centres of rehabilitation in the Aseer region of Saudi Arabia were included and subjects of 3–24 year age group was examined. Written informed consent was obtained from directors of Centres. Caries, oral hygiene status, soft-tissue and hard-tissue lesions were evaluated and statistically analyzed.Results:Higher Decayed, Missing and Filled Teeth score was observed in the present study in contrast to many other studies. Periodontal disease was seen in higher age group with higher percentages. Poor oral hygiene was seen in 27.3% of males and 66.7% of females. Tongue lesions comprised 85.7%, which accounted for the major part of soft-tissue abnormality. Various occlusal abnormalities (75%) and developmental tooth disturbances (53.6%) constitute the higher portion in hard-tissue abnormality.Conclusion:Dentists should be conscious of the range of oral anomalies that can manifest in this group of the patients. The microbial or serological investigation was not done which could have explained the etiology behind these lesions. In spite of these confines, the survey result have provided information regarding the oral health status of Down's syndrome subjects and the necessity of focusing on oral health need.

CHARACTERISTICS OF THE FUNCTIONAL STATE OF THE MAXILLODENTAL SYSTEM ACCORDING TO THE ANALYSIS OF BIOELECTRICAL ACTIVITY OF MUSCLES IN PATIENTS WITH ASSOCIATED OCCLUSAL ABNORMALITIES WHICH REQUIRE COMPREHENSIVE TREATMENT

Malocclusions that have not been eliminated in time can cause complications such as periodontal diseases, TMJ and muscle dysfunctions.An objective indicator of functional disorders is the change of bioelectrical activity of masticatory muscles. The aim of our study was to estimate thefunctional state of maxillodental system in order to develop the individualized treatment and achievement of high functional and aestheticoptimum in patients with associated occlusal abnormalities who need complex treatment. All examined patients had deviations of the averageamplitude of bioelectrical activity of muscles, asymmetry in muscle function, bursts of spontaneous bioelectrical activity at rest, chewing cyclefragmentations, changes in rest and activity ratio during chewing. One of the most important criteria for the transition to the next stage of treatment isnormalization of bioelectrical activity of the muscles. Such approach allows to achieve stable and long-lasting functional results of the treatment.

Multimodal Imaging of Microvascular Abnormalities in Retinal Vein Occlusion.

The technologies of ocular imaging modalities such as optical coherence tomography (OCT) and OCT angiography (OCTA) have progressed remarkably. Of these in vivo imaging modalities, recently advanced OCT technology provides high-resolution images, e.g., histologic imaging, enabling anatomical analysis of each retinal layer, including the photoreceptor layers. Recently developed OCTA also visualizes the vascular networks three-dimensionally, which provides better understanding of the retinal deep capillary layer. In addition, ex vivo analysis using autologous aqueous or vitreous humor shows that inflammatory cytokine levels including vascular endothelial growth factor (VEGF) are elevated and correlated with the severity of macular edema (ME) in eyes with retinal vein occlusion (RVO). Furthermore, a combination of multiple modalities enables deeper understanding of the pathology. Regarding therapy, intravitreal injection of anti-VEGF drugs provides rapid resolution of ME and much better visual improvements than conventional treatments in eyes with RVO. Thus, the technologies of examination and treatment for managing eyes with RVO have progressed rapidly. In this paper, we review the multimodal imaging and therapeutic strategies for eyes with RVO with the hope that it provides better understanding of the pathology and leads to the development of new therapies.

Prevention and treatment of recurrence of abnormalities of occlusion and dentition deformities: kinesiologic aspect

Prevention and treatment of recurrence of abnormalities of occlusion and dentition deformities: kinesiologic aspect

Aesthetic components of index of orthodontic treatment need in Serbian adolescents

Background/Aim. The biggest motivating factor for undertaking orthodontic treatment is poor dental aesthetics as a consequence of occlusal abnormalities. The aim of this study was to determine the need for orthodontic treatment, based on the aesthetic components of the Index of Orthodontic Treatment Need (IOTN), to compare the degree of aesthetic component of IOTN and the subjective perception of individuals about their dental aesthetics, but also to compare their evaluation of the aesthetic component of IOTN in comparison with the evaluation of the therapist. Methods. The study was conducted on a sample of 316 students aged 15?19 years who did not have an orthodontic treatment prior to the survey. The research was carried out using the IOTN. The IOTN consists of dental and aesthetic components based on which the need for therapy was determined. The aesthetic component of the index was noted by the therapist (specialist of orthodontics) as well as the subject. Results. According to the grades of subjects, the need for orthodontic treatment was present in 0.38% of male subjects and 2% of female subjects. According to the evaluations of the therapists, the need for orthodontic treatment was present in 7.52% of male subjects and 8% of female subjects. Observing all subjects, the need for orthodontic treatment was present in 0.63% of subjects, and according to the therapist, the need for orthodontic treatment was present in 7.59% of subjects. The mentioned difference was statistically significant. Conclusion. Obtained results show that there is a significant difference in evaluation of dental aesthetics and the need for orthodontic treatment between the subjects and therapists. This can be a cause for concern because patients who are not aware of their orthodontic abnormality can limit the need for further treatment.

Malocclusion in individuals with osteogenesis imperfecta: A systematic review and meta‐analysis

To evaluate whether individuals with osteogenesis imperfecta (OI) are more affected by malocclusion than individuals without OI. Searches in PubMed, Ovid, Web of Science, Scopus, Lilacs and gray literature were performed. Data extraction was conducted by two researchers. Risk of bias assessment employing the Newcastle-Ottawa Scale and meta-analysis were conducted. Results were provided with mean difference (MD), odds ratio (OR) and 95% confidence interval (CI). Strength of evidence was determined. Six cross-sectional studies were included. In comparison with individuals without OI, the group with OI had 19.69-fold greater chance of exhibiting Angle Class III malocclusion (OR=19.69, CI: 9.00-43.09) and presenting anterior crossbite greater (MD=6.08, CI: 2.40-9.77). Individuals without OI had a significantly greater ANB angle (MD=3.88, CI: 1.15-6.61) and SNA angle (MD=2.11, CI: 0.24-3.98) in comparison with those with OI. No difference between groups was found for SNB (MD=-0.50, CI: -2.21 to 1.21) and open bite (MD=0.98, CI: -0.29 to 2.25). Most studies included had moderate methodological quality. Strength of evidence was low or very low. The occurrence of Angle Class III malocclusion and anterior crossbite was greater among individuals with OI compared to those without OI. These findings can assist stakeholders about the occlusal abnormalities affecting OI individuals.

The Impact on Nasal Septal Anatomy and Physiology Following Le Fort I Osteotomy for Orthognathic Surgery.

Orthognathic surgery utilizing a Le Fort I osteotomy is performed by oral and maxillofacial surgeons to correct midface and dental occlusal abnormalities. However, the potential sequelae on sinonasal function have had minimal discussion in the literature. The objective of this study was to assess the impact on nasal septum anatomy and physiology following Le Fort I osteotomy for maxillary repositioning surgery. Thirty patients who previously underwent elective orthognathic surgery with Le Fort I osteotomy were enrolled retrospectively to assess the change in their nasal septal anatomy and nasal breathing. Pre- and postoperative computed tomography (CT) scans were used to determine axial displacement of the septum, in both degrees and millimeters, at 4 different standardized anatomic sites following the surgery. These objective anatomic measurements were then compared to the patient's perception of nasal congestion and difficulty breathing via the validated Chronic Sinusitis Survey-Duration Based (CSS-D). Comparison of the CTs before and after surgery demonstrated a new deviation of the nasal septum in all 30 patients, with maximal axial displacements up to 7.22 mm and a mean of 2.64 mm. Postoperative angular displacement changes ranged from minimal to 24°. The CTs showed persistence of a new septal perforation in 20% (6 of 30 patients) following surgery. The CSS-D results demonstrated a mean worsening of nasal breathing and congestion scores from 1.4 before surgery to 3.0 at least 8 weeks after surgery (P < 0.001). Orthognathic surgery utilizing Le Fort I osteotomy may result in persistent nasal septal perforations, new displacement of the nasal septum, and increased perception of nasal dyspnea not previously reported. Further understanding of anatomic changes and nasal airway obstruction that may be caused following such operations warrants further study in order to improve surgical technique and postoperative outcomes.

Diagnosis and clinical course of ocular ischemic syndrome with retinal vascular abnormalities due to unilateral ocular artery and internal carotid artery stenosis in a child with neurofibromatosis type 1: a case report

BackgroundNeurofibromatosis type 1 (NF1) is a hereditary disease that causes neurofibromas generally, but it has been reported to sometimes be associated with various forms of blood vessel stenosis, occlusion and vascular abnormalities of unknown mechanism. However, a symptomatic case with simultaneous ophthalmic artery stenosis and internal carotid artery stenosis is an extremely rare pathogenesis in a child with NF1. In this report, we performed the diagnosis and observation using various imaging modalities for this rare pediatric case.Case presentationA 6-year-old girl diagnosed with NF1 presented with gradual visual loss in the right eye. Best corrected visual acuity (BCVA) was 20/40 OD and the intraocular pressure (IOP) was normal in both eyes. Retinal vascular abnormalities with tortuous vessels and optic disc pallor were observed in the right fundus. Widefield fluorescein angiography revealed multiple sites of neovascularization and a large non-perfusion area in the peripheral retina. Optical coherence tomography angiography showed retinal vascular abnormalities in the right eye and revealed differences in inner retinal thickness and blood flow signal between the left and right eyes. Laser speckle flowgraphy showed that chorioretinal blood flow was significantly decreased in the right eye. Cerebral angiography revealed the right ophthalmic artery was significantly narrowed throughout. In addition, Magnetic resonance angiography revealed that the right internal carotid artery was significantly narrowed in the ophthalmic segment. We diagnosed ophthalmic artery and internal carotid artery stenosis with retinal vascular abnormalities and ocular ischemic syndrome in NF1. Because IOP increased to 35 mmHg, due to neovascular glaucoma in addition to mild vitreous hemorrhage occurred, panretinal photocoagulation was performed after intravitreal bevacizumab injection. After treatments, IOP normalized, but BCVA decreased to 20/100 OD. Arterial spin labeling showed normal cerebral blood flow. The patient is currently being carefully monitored.ConclusionsWe have described the diagnosis and treatment of ocular ischemic syndrome due to multiple arteries stenosis in a child with NF 1. Utilization of various imaging modalities was helpful in diagnosing the complicated pathogenesis. However, since direct intervention by neurosurgery is not possible in this case, it is expected that treatment will be extremely difficult in the future.

Semi-Fixed Space Maintainer Treatment In Premature Loss Deciduous Tooth

Introduction: The period of deciduous teeth is an important period in child development. Damage to deciduous teeth that occur and cannot be treated conservatively will cause premature decay of teeth which is often called premature loss. A space maintainer is a passive tool used to maintain dental arches due to premature loss of deciduous teeth. Method: An 11-year-old girl accompanied by her mother came to RSGMP Unjani in 2018 with complaints of lower right back teeth missing because they have removed. The patient's mother is worried that her replacement teeth will not grow properly. Intraoral examination revealed tooth loss 85. The study model was analyzed using the Moyers method. Results: Analysis of the lower jaw model showed excess space. Patients were treated with a semi-fixed band and loop space maintainer on teeth 85. Conclusion: Premature loss results in excess space in the arch, so as to prevent further occlusion abnormalities in the child's growth and development process, we need a special tool used to maintain space due to premature loss of deciduous teeth.

PROGNOSIS OF RETENTION AND ABNORMAL POSITION OF CANINES

PROGNOSIS OF RETENTION AND ABNORMAL POSITION OF CANINES