Occlusal Discrepancies Research Articles

Diagnosis of occlusal dysesthesia utilizing prefrontal hemodynamic activity with slight occlusal interference.

Clinical diagnosis of occlusal dysesthesia (OD), also referred to as phantom bite syndrome, is currently based on the absence of objective occlusal discrepancy despite the persistent complaint of uncomfortable bite sensation. We previously demonstrated that the subjective feeling of occlusal discomfort generated by artificial occlusal interference can be objectively evaluated using prefrontal hemodynamic activity in young healthy individuals. The aim of this study was to investigate whether dental patients with and without OD show distinct prefrontal activity during grinding behavior with an occlusal interference. Six dental patients with OD (OD group) and eight patients without OD (control group) grinded piled occlusal strips placed between their first molars and reported their perception and discomfort thresholds during continuous monitoring of prefrontal hemodynamic activity with a portable functional near‐infrared spectroscopy. Although patients without OD showed the typical hemodynamic pattern of increased oxyhemoglobin and reduced deoxyhemoglobin (HHb) concentration, those with OD showed persistent incremental increases of HHb concentration that began at the loading of occlusal strips on their molars before they executed grinding. The intensities of the task‐related HHb activities showed statistically significant differences between OD and control groups, particularly at channel 3, arranged over the left frontal pole cortex. When the discrimination criterion was set using the intensity values of channel 3 from both groups, the overall accuracy of the OD discrimination was 92.9%. Although physiological interpretation has yet to be elucidated, the task‐related response of an increase in HHb may be a useful neuronal signature to characterize dental patients with OD.

In vitro assessment of the marginal and internal fits of interim implant restorations fabricated with different methods

Statement of problemThe fit of an interim implant restoration (IIR) is important for the effective treatment of patients with partial edentulism. However, no clinical trials have evaluated the marginal and internal fittings achieved with various fabrication methods. PurposeThe purpose of this in vitro study was to evaluate and compare the marginal and internal discrepancies in IIRs produced with 3 different methods. Material and methodsPartially edentulous maxillary and mandibular casts from a transfer abutment were used. Prostheses were prepared by applying wax to the implant abutment. Shapes were copied using putty. IIRs were fabricated from poly(methyl methacrylate) for a conventional system with thermoplastic resin (CTR, n=40), a 4-axial milling machine with a crown-designed standard template library for a subtractive manufacturing system with Pekkton milling (SPM, n=40), and a 3-dimensional printer for an additive manufacturing system with digital light processing (ADL, n=40). The marginal and internal discrepancies were evaluated in each group using the silicone replica technique. The space between the abutment and the intaglio surface of the prosthesis was evaluated with a digital microscope (×160 magnification). Results were analyzed with nonparametric 2-way analysis of variance using rank-transformed values and Tukey post hoc test (α=.05). ResultsThe fabricated IIRs were significantly different at all points (P<.001). Moreover, ADL was superior to CTR and SPM. IIRs were significantly different only at the intermarginal discrepancy (the vertical discrepancy between the crown and the point where the margin becomes round and changes to the axial wall), the axiogingival discrepancy (the vertical discrepancy between the internal surface and the axial wall adjacent to the gingival wall of the abutment), and the occlusal discrepancy (the vertical discrepancy between the occlusal wall of the abutment and the internal surface; this discrepancy comprises the internal discrepancy; P<.001). No significant differences were found among the IIRs at the marginal discrepancy (the vertical discrepancy between the abutment margin and the crown; P>.111) and the axio-occlusal discrepancy (the vertical discrepancy between the axial wall adjacent to the occlusal wall of the abutment and the internal surface; this discrepancy comprises the internal discrepancy; P>.257). ConclusionsADL was superior to the other 2 fabrication methods. However, all 3 methods were suitable because they produced a marginal fit which was within the clinically acceptable range.

Interplay of occlusal forces and the periodontium

Occlusal forces are the physiological functional forces that activate the periodontal mechanoreceptors and maintain the health of the periodontium. In the absence of these forces, the periodontium undergoes nonfunctional atrophy, while with occlusal discrepancies or heavy occlusal forces it undergoes destruction. The tolerance capacity of the periodontal ligament to the occlusal forces depends on the magnitude, duration, and frequency of the forces. This article describes the influence of various occlusal forces on the periodontium, their clinical presentation, and the treatment considerations.

Evaluation of Changes in Lip Closing Force After Surgically Assisted Rapid Maxillary Expansion.

Morphological changes in patients subjected to surgical treatment to correct occlusal discrepancies may lead to various functional changes. The aim of the present study was to evaluate changes in lip closing force after surgically assisted rapid maxillary expansion in skeletally mature patients. The study involved 7 female and 7 male patients treated with surgically assisted rapid maxillary expansion. Maximum and minimum lip pressures of patients were measured with Lip De CumLDC-110R. The intercanine distance and incisors angulations were measured preoperatively (T0), at the end of the expansion (T1), at the end of the third month of retention (T2), and at the end of the sixth month of retention (T3). The greatest values of maximum and the minimum lip closing force were observed at the end of the expansion period significantly. The intercanine distance and inclinations of incisors measured at the third and sixth months showed a significant decrease. The present study demonstrated that, following surgically assisted rapid palatal expansion, both the maximum and the minimum lip closing force increases had a tendency to revert to their initial values 6 months after surgery.

In vitro evaluation of marginal, axial, and occlusal discrepancies in metal ceramic restorations produced with new technologies

Statement of problemMarginal and axial discrepancies of metal ceramic restorations are key to their long-term success. Little information is available for metal ceramic restorations fabricated with soft metal milling and laser sintering technologies. PurposeThe purpose of this in vitro study was to compare the marginal, axial, and occlusal discrepancies in single-unit metal ceramic restorations fabricated with new production techniques with those in a single-unit restoration fabricated using a conventional technique. Material and methodsAfter the artificial tooth was prepared, impressions were made, and 40 dies were obtained. Dies were randomly divided into 4 groups (n=10). Cobalt-chromium (Co-Cr) cast (C), hard metal milled (HM), laser sintered (LS), and soft metal milled (SM) copings were fabricated. Marginal, axial, and occlusal discrepancies of these copings were measured using the silicone replica technique before and after the application of veneering ceramic. Data were analyzed with repeated measurements 2-way ANOVAs and Bonferroni post hoc tests (α=.05). ResultsSignificant differences were found in the increase of marginal discrepancy after the application of veneering ceramic in the LS group (P=.016). However, no significant differences in marginal discrepancy were found whether veneering ceramic was applied to copings before or after in the other groups (P>.05). With regard to marginal and occlusal discrepancies, significant differences were found among the production techniques (P<.001 and P<.05, respectively). No significant differences in axial discrepancies were found among the groups (P>.05). ConclusionThis in vitro study showed that metal ceramic restorations produced with HM and newly introduced SM techniques exhibited better marginal adaptations than those produced with the LS or C technique.

Incisor ablation among the late upper paleolithic people of Tam Hang (Northern Laos): Social identity, mortuary practice, and oral health.

A detailed assessment of intentional incisor ablation among the Late Upper Paleolithic people of Tam Hang (northern Laos) was undertaken to understand how this cultural practice, in addition to age and sex, influenced an individual's inclusion in the mortuary context. The covariation of ablation status with occlusal variation and anterior dental pathology was addressed to study the implications of this cultural practice on oral health. Sex, age, caries, antemortem tooth loss, and occlusal variation were assessed through standard osteological methods for 12 individuals. An observational protocol to identify intentional ablation was developed specifically for this sample. Four ablation states were identified that range from no ablation to the removal of two, three, or four lateral (I2) incisors. The timing of ablation was attributed to ritual extractions during early adolescence. Adult age-at-death was the strongest indicator of inclusion in the main burial context and a child burial was isolated from those of adults. Ablation status does not strongly influence inclusion in the mortuary context. Individuals lacking ablation tended to have a higher incidence of anterior caries, pathological tooth loss, incisor crowding, and canine rotation. This study identifies the oldest case of intentional incisor ablation in Late Pleistocene Mainland Southeast Asia. We conclude that ablation does not always "compromise" the dentition; instead, it may have unintentional oral health benefits in some contexts. Am J Phys Anthropol 160:519-528, 2016. © 2016 Wiley Periodicals, Inc.

Comparison of closure occlusal force parameters in post-orthodontic and non-orthodontic subjects using T-Scan® III DMD occlusal analysis

Objective: Balanced occlusal force distribution is a critical factor for restorative, prosthetic or orthodontic treatment. It has been postulated that orthodontic treatment may lead to occlusal discrepancies in the arch due to changing the occlusal relationships. This study was conducted to compare the occlusal force parameters between natural dentition patients and a post-orthodontic treatment group.Method and Materials: Fifty Thai subjects were divided into non-orthodontic and post-orthodontic groups comprised of 25 subjects each (mean age 24.8 years). The T-Scan® III computerized occlusal analysis system was used to record a multi-bite closure for each subject. The initial occlusal contact location, the bilateral percentage force distribution, the percentage force in the anterior and posterior quadrants, and the individual tooth force percentages were calculated for both groups. The Student’s Paired t-Test compared the in-group differences, while a one-way ANOVA analyzed the differences between the two groups.Results: The initial tooth contacts in both groups were found on the second molars and central incisors. Maximum force was most frequently observed on the left second molar tooth (15.9% non-orthodontic; 25.4% post-orthodontic). The bilateral right-to-left side force distribution (51.36% right–48.96% left) was not statistically different for all subjects, nor was it statistically different between the non-orthodontic (48.67% right–51.36% left) and the post-orthodontic groups (48.96% right–51.05% left). Statistically significant differences were found between the quadrants in both the groups (22.46% anterior–77.57% posterior in non-orthodontic subjects; 10.58% anterior–89.42% posterior in post-orthodontic subjects) (p < 0.01).Conclusion: A significant occlusal force discrepancy was found in the post-orthodontic subjects, with higher force percentages observed posteriorly and much less percentage force anteriorly, when compared to the natural dentition subjects. T-Scan® III digital occlusal analysis may be recommended for orthodontic case finishing, to make visible to the clinician the severity of the orthodontically created occlusal force imbalance, such that it can be minimized during orthodontic case finishing.

Relación entre las características periodontales y la sonrisa gingival en niños: un estudio de casos y controles

Introducción: la presencia de sonrisa gingival (SG) es uno de los aspectos más negativamente valorados. Su presencia en la vida adulta es un motivo de consulta constante, pero en la niñez tiende a ser considerado como normal. El objetivo de este estudio fue describir y comparar las características del periodonto de un grupo de niños, con diferentes maloclusiones, con y sin sonrisa gingival y evaluar la influencia de las características gingivales sobre la presencia de sonrisa gingival. Métodos: en este estudio analítico de casos y controles, el tamaño muestral fue probabilístico. Se incluyeron 163 niños en dentición mixta silente que cumplieran los criterios de inclusión y exclusión: 37 fueron casos, con sonrisa gingival (SG) y 126 fueron controles, sin sonrisa gingival (NSG). Se les evaluaron variables oclusales, de sonrisa y periodontales por medio de un examen clínico y de un fotograma. Los evaluadores estaban previamente calibrados (Kappa 0,87 e ICC 0,96). Resultados: la edad promedio de los pacientes en ambos grupos fue de 8,8 años con una desviación estándar de 0,9 para los casos y de 0,8 para los controles. La maloclusión más predominante fue la clase I (63,8% de la muestra). Las características periodontales fueron similares en ambos grupos. El biotipo periodontal grueso tuvo una tendencia a comportarse como factor de riesgo para SG (OR 1,6) pero esta relación no fue estadísticamente significativa. (IC= 95% 0,6 - 4,1). Conclusiones: los factores periodontales no influyen sobre la presencia de sonrisa gingival en niños; su comportamiento en etapas posteriores deberá ser observado.

Influence of Occlusal Disorders, Food Intake and Oral Hygiene Habits on Dental Caries in Adolescents: A Cross-Sectional Study

Objective: Dental caries is one of the most common oral diseases affecting children and adolescents. The complex multifactorial etiology of caries involves the host’s characteristics (saliva and tooth enamel), the oral microflora (bacterial plaque), and the substrate (oral hygiene and diet). The aim of the present epidemiologic study was to calculate the DMFT (Decayed, Missed, Filled Teeth) index and to investigate the association between carious lesions with malocclusions, cariogenic food intake and oral care habits in 12-year-old schoolchildren in Southern Italy. Materials and methods: The study sample involved school children attending the 2-year secondary school (corresponding to the eighth grade) of state-funded schools in Naples, in the South of Italy. Children were examined to detect dental caries and occlusal variables; moreover, a questionnaire to find out food and oral hygiene habits was obtained. The association among occlusion variables, oral health, dietary habits, and caries was statistically assessed with the one-way ANOVA, the odds ratio and the χ2 (Chi-Squared test) tests for evaluating the significance. The significance level was set at 0.05. Results: The study showed a lack of association between diet and oral hygiene and caries prevalence in 12-yearold boys and girls, on the contrary, there was a positive association between crossbite and caries. Conclusion: Positive relationship was found between dental caries, parents’ socioeconomic status and crossbite, whereas carious lesions, food intake, oral hygiene and the other type of occlusal disorder did not reveal any significant association.

A Comparative Prospective Study of Two Bone Plating Methods for Fractures of the Mandibular Symphysis or Parasymphysis

Mandibular symphysis and parasymphysis fractures are a common type of injury to facial skeleton. The purpose of this prospective study was to evaluate outcomes for 2 bone plating techniques used in the treatment of mandibular symphysis/parasymphysis fractures. Thirty patients reporting to the department with mandibular symphysis/parasymphysis fractures were divided into 2 groups (group A and group B). A prospective study was carried out in 30 patients with defined inclusion and exclusion criteria. Patients were followed for 3 months postoperatively for occlusion, distraction of lower border radiologically, paraesthesia, infection, failure of bone plate (plate fracture) and screw loosening, postoperative segmental stability and radiological evaluation of fixation. Fifteen patients were treated by open reduction and single miniplate fixation below apices of teeth with arch bar acting as tension band (Group A) and 15 with conventional titanium miniplates following Champy's rule i.e. Two miniplates (Group B). Distraction of lower border was seen in both groups (as in group A-1 patient and group B-2 patients), which was noticed radiographically at all follow ups. There was no occlusal discrepancy present in both groups after 3 months post operatively. The fracture segments were stable in both groups at all times. Paraesthesia was noticed in both groups, which gradually decreased in 1 month and resolved completely by 3rd month follow up. The degree of paraesthesia, distraction of lower border, occlusal discrepancy was not statistically significant between the two groups. Infection was noticed in both groups at the end of 2 weeks, which was treated with antibiotics. The result between both the groups was not significant though. Hardware failure (plate fracture and screw loosening) was not found in both groups. Osteosynthesis by both techniques is effective in providing immediate post operative function but the distinct advantage of less hardware has made the use of a single miniplate quite popular in the recent times.

Tooth Implant an Alternative to Failed Implant Supported Prosthesis in a Smoker

Chronic smoking can lead to failure of Osseo integration due to decrease in local blood flow and failure of cell proliferation by by-products of smoking. This along with immediate failure of a malpositioned implant, devitalization of adjacent tooth necessitating a call for endodontic treatment or the fracture of the adjacent tooth due to malpositioned implant, fracture of the prosthesis due to incomplete seating and occlusal discrepancies have a tremendous impact on the psyche of the patient. Some of them show reluctance to functional rehabilitation with implant supported prosthesis posing a tough challenge to the restorative dentist. A good alternative in such cases would be to save some of the natural teeth and place a precision stud attachment in the canal of selected teeth, which will act like a tooth implant, providing retention and stability similar to implant supported prosthesis.

Transbuccal versus transoral approach for management of mandibular angle fractures: a prospective, clinical and radiographic study.

ObjectivesWe compared the transbuccal and transoral approaches in the management of mandibular angle fractures.Materials and MethodsSixty patients with mandibular angle fractures were randomly divided into two equal groups (A, transoral approach; group B, transbuccal approach) who received fracture reduction using a single 2.5 mm 4 holed miniplate with a bar using either of the two approaches. Intraoperatively, the surgical time and the ease of surgical assess for fixation were noted. Patients were followed at 1 week, 3 months, and 6 months postoperatively and evaluated clinically for post-surgical complications like scarring, infection, postoperative occlusal discrepancy, malunion, and non-union. Radiographically, the interpretation of fracture reduction was also performed by studying the fracture gap following reduction using orthopantomogram tracing. The data was tabulated and subjected to statistical analysis. A P-value less than 0.05 was considered significant.ResultsNo significant difference was seen between the two groups for variables like surgical time and ease of fixation. Radiographic interpretation of fracture reduction revealed statistical significance for group B from points B to D as compared to group A. No cases of malunion/non-union were noted. A single case of hypertrophic scar formation was noted in group B at 6 months postsurgery. Infection was noted in 2 patients in group B compared to 6 patients in group A. There was significantly more occlusal discrepancy in group A compared to group B at 1 week postoperatively, but no long standing discrepancy was noted in either group at the 6 months follow-up.ConclusionThe transbuccal approach was superior to the transoral approach with regard to radiographic reduction of the fracture gap, inconspicuous external scarring, and fewer postoperative complications. We preferred the transbuccal approach due to ease of use, minimal requirement for plate bending, and facilitation of plate placement in the neutral mid-point area of the mandible.

Influence of Facial and Occlusal Characteristics on Gummy Smile in Children: A Case-Control Study

Objective: To determine the association between occlusal and soft tissue characteristics with the presence of gingival smile (GS) in a pediatric population with inter-transitional mixed dentition. Material and Methods: Case-control study was performed with a probabilistic sample of 163 children in inter-transitional mixed dentition (age:8.8 years ±0.8). Cases were 37 children with GS, and controls were 126 children without GS. Occlusal variables were assessed through clinical examination, and soft tissue variables were assessed through photograms. Kappa test and intraclass correlation coefficient were done (0.87-0.96). The association between malocclusion, gender, and types of smile was assessed using a Chi square test. Comparison of quantitative variables in smile groups was made by Student t test. A multivariate binary logistic regression was performed. Results: Class II malocclusion, short upper lip at smile and short incisor clinical crown, were risk factors for gummy smile (OR= 10.4, 95%CI 3.07- 34.95, OR= 2.1, 95%CI 1.44- 3.13 and OR= 2.5 95%CI 1.34- 4.54 respectively). Lower facial height was a protective factor against GS (OR= 0.76; 95%CI 0.69- 0.85). The logistic regression model explains 48% of GS variability. Conclusion: Class II malocclusion is considered a risk factor for gummy smile. Other variables associated to gummy smile were short upper lip and short incisor clinical crown. Clinicians should considered these aspects in clinical examination of each patient to provide an adequate diagnostic and plan of treatment to control and/or correct a GS.

The prevalence of craniomandibular disorders and occlusal disharmonies in the identical twins

Objective. The aim of this study was to determine the prevalence of craniomandibular disorders (CMD) and occlusal disharmony in identical twins. Methods. Craniomandibular and occlusal disharmony, in a population of 30 pairs of identical twins, aged 20-40 years, with the same gender, were determined by history and functional analysis. The final evaluation was performed using estimation of dysfunction index (Di) and occlusal index (Oi). Results. In study sample 23 twins (38.3%) had a sign of craniomandibular dysfunction, and 33 (55%) of twins had occlusal abnormalities, such as incompatibility of mid dental arches with intercuspal relation -ICP, lack of contact with the antagonists in the ICP, the presence of occlusal interference or loss of teeth. The analysis of the representation of certain craniomandibular signs in 23 patients in whom the index dysfunction (Di) by Helkimo was greater than zero revailed the prevailing disturbed kinetics of the mandible (44.0%), the sound in the TMJ with movements of the mandible (22.0%) and deviation when opening the mouth (22.0%). Positive occlusal index was in 33 (55%) patients, of whom 24 (40%) had mild occlusal disharmony (Oi I = 1), and 9 (15%) patients had the pronounced occlusal discrepancies (Oi II = 2). Conclusion. The comparative analysis of craniomandibular disorders and occlusal status, in identical twins, has shown that occlusal factors play an important role in the etiology of craniomandibular dysfunction.

Features in subjects with the frontal occlusal plane inclined toward the contralateral side of the mandibular deviation.

The frontal occlusal plane of the maxilla generally inclines toward the ipsilateral side of the mandibular deviation in subjects with facial asymmetry; however, a few patients with facial asymmetry have their frontal occlusal planes inclined toward the contralateral side. We aimed to investigate the morphologic and functional features of such patients. The subjects were 40 patients with facial asymmetry divided into 2 groups based on the inclination of the frontal occlusal plane toward the ipsilateral or the contralateral side. We analyzed lateral and posteroanterior cephalometric radiographs and occlusal variables and evaluated temporomandibular joint symptoms. Statistical comparisons were performed between the 2 groups (P<0.05). The posteroanterior cephalometry significantly differed between the ipsilateral and contralateral groups. Occlusal force and occlusal contact area were significantly larger, and temporomandibular joint symptoms were more frequently found on the side of the upward-inclined frontal occlusal plane than on the opposite side in both groups. The features in the contralateral group in terms of occlusal force and temporomandibular disorders were clinically significant. Clinicians should note that the conditions associated with the contralateral group require less presurgical decompensation.

Malocclusion prevalence and orthodontic treatment need in central Anatolian adolescents compared to European and other nations' adolescents.

Objective: To determine the prevalence of malocclusion and orthodontic treatment need in a large sample of Central Anatolian adolescents and compare them with European-other nations' adolescents. Methods: The sample included 1125 boys and 1204 girls aged between 12 and 16 years with no previous orthodontic treatment history. Occlusal variables examined were molar relationship, overjet, overbite, crowding, midline diastema, posterior crossbite, and scissors bite. The dental health (DHC) and aesthetic components (AC) of the Index of Orthodontic Treatment Need (IOTN) were used as an assessment measure of the need for orthodontic treatment for the total sample. Results: The results indicated a high prevalence of Class I (34.9%) and Class II, Division 1 malocclusions (40.0%). Moreover, increased (18%) and reduced bites (14.%), and increased (25.1%) and reversed overjet (10.%) were present in the sample. Conclusion: Using the DHC of the IOTN, the proportion of subjects estimated to have great and very great treatment need (grades 4 and 5) was 28.%. However, only 16.7% of individuals were in need (grades 8-10) of orthodontic treatment according to the AC.

Evaluation of using ultrasound welding process of biodegradable plates for fixation of pediatric mandibular fractures

PurposeThis study was planned to evaluate, both clinically and radiologically, the efficacy of using ultrasound based welding process by (Sonic weld Rx) for fixation of biodegradableplates in pediatric mandibular fractures. Patients and methods: This study comprised 8 patients, theirages ranged from (2) to (10) years with mandibular fractures treated with open reduction and internal fixation using poly-D and l-lactic acid (PDLLA) plates by SonicWeld Rx through an intra-oral approach.Preopertivelly patients were examined clinically by inspection and palpation both extraorally and intraorally. Radiographic examination via orthopantomograph and computed tomography (CT).Postopertivelly patients were evaluated clinically immediately, at two weeks, and at one, three and six months. Radiographically by Panoramic radiographs immediately and at one, three and six months and Quantitative computed tomography (CT) after one and three months. ResultsThe results revealed primary wound healing in six patients with no signs of infection or dehiscence and two patients exhibited scaring in the repaired wound, proper occlusion, postopertively except one patient had minor occlusal discrepancies corrected by elastics and all cases showed stability of the fractured segments.Radiographic examination for all patients at the different follow up periods statistically revealed significant bone healing. ConclusionWe can conclude that Ultrasound based welding process by (Sonic weld Rx) for fixation of PLDLA plates and pins was effective in pediatric mandibular fractures.

Management of mandibular angle fractures using a 1.7 mm 3-dimensional strut plate

AimWe report our experience with the use of 1.7mm 3-dimentional (3D) strut plate for the management of mandibular angle fractures. MethodsThis prospective study enrolled 15 patients in whom mandibular angle fractures were treated with 1.7mm 3D plate using trans-buccal trochar. Patients were evaluated at 72h, 2 weeks, 6 weeks and 12 weeks for fracture stability, occlusion, soft-tissue swelling, infection and post-operative inferior alveolar nerve damage. Other complications like wound dehiscence, non-union, mal-union and hardware failure were also assessed. ResultsIn the immediate post-operative period, fracture instability was seen in 1 (6.7%) patient which resolved by 2 weeks. Mild occlusal discrepancy was also noted in 1 (6.7%) patient. Wound dehiscence was seen in 5 (33.3%) patients and all resolved by local measures. 1 (6.7%) patient developed post-operative nerve paraesthesia. Immediate post-operative radiographic evaluation demonstrated optimal reduction in all cases with no inferior border gaping. No case of infection, hardware failure, non-union and mal-union was noted. ConclusionWithin the limitations of the study, 1.7mm 3D strut plate was found to be effective for management of non-communited mandibular angle fractures.

Evaluation of using microplates osteosynthesis for pediatric mandibular fractures

ObjectiveThe purpose of this study was to evaluate both clinically and radiographically using of two microplates in treatment of displaced pediatric mandibular fractures. Materials & methodsThis study included ten children had displaced mandibular fracture with age ranged between (4–11) years were treated using two microplates and microscrews through intraoral approach. All children were examined preoperative clinically and radiographically by panoramic view and computed tomography (CT) or lower occlusal view. All children were evaluated postoperative clinically at one week, one and three months for wound healing, occlusion, infection, nerve affection and stability of fracture and radiographically by panoramic view at second postoperative day, one and three months and by quantitative CT at one and three months to evaluate the accuracy of reduction and bone healing at fracture line. ResultsClinically there were no complications in all cases overall follow up period except for two cases showing occlusal discrepancy treated with guiding elastics. Radiographic results showed that good alignment of fracture segments horizontally and vertically without displacement and significant increase in bone mineral density gain after one and three months. ConclusionTitanium microplates provide adequate stability for fracture segments in treatment of pediatric mandibular fracture. Low profile and malleability of microplates allow adaptation to mandible easily and minimize the possibility of trauma to teeth buds.

Clinical outcomes of three different types of hardware for the treatment of mandibular angle fractures: a comparative retrospective study

A retrospective study was conducted to compare the clinical outcomes of three different types of hardware that are used in mandibular angle fracture fixation. Thirty patients were selected from the hospital database. The patients were categorized into the following groups: group A, in which a single 2.0-mm locking miniplate was used; group B, in which a single rigid 2.3-mm plate was used; and group C, in which a single lag screw was inserted. All patients were followed for 6 months. With regard to intraoperative variables, significant differences were found among the groups in the duration of surgery and cost. Group C had the shortest surgical time, followed by group A and then group B. Two patients, one in group A and one in group B, suffered an occlusal discrepancy after surgery. Of the group A patients, two exhibited wound dehiscence and one had an infection. One patient in group B had an exposed plate. Sensory nerve involvement was noted in three group C patients and one group B patient. The lag screw was associated with the fewest complications and exhibited all of the advantages of plating systems in the treatment of angle fracture. The lag screw involved the least hardware and a short operating time, however the differences were not significant.