Treatment options for impacted maxillary canines and occurrence of ankylotic and resorptive processes: a 20-year retrospective study.

BACKGROUND: This 20-year retrospective study aimed to evaluate the treatment methods used in patients with impacted maxillary permanent canines and to determine the occurrence of ankylotic and resorptive processes and their association with potential risk factors. METHODS: The cohort consisted of 351 consecutive Caucasian patients (120 males and 231 females, mean age 18.4 and 19.9 years, respectively) with 420 impacted maxillary permanent canines. CT and CBCT findings were subsequently confirmed during surgery. Statistical analyses were performed by the generalized linear models, Pearson x2 and Fisher exact tests using the statistical programs R and Statistica v. 14. RESULTS: A total of 273 (65.0%) impacted canines were aligned in the dental arch by orthodontic traction after surgical exposure, this treatment was predominant in patients under 20 years of age. Surgical extraction was performed in 115 (27.2%) impacted canines and was more common in older patients. Ankylotic changes were recorded in 61 (14.5%) impacted canines. The probability of ankylosis increased with age, particularly after the patient's 20th year of life (p < 0.001). Patients were 1.2% likely to develop ankylosis at age 15 years, 4.3% at age 20 years, 14.1% at age 25 years, and 96.8% at age 45 years. Invasive cervical root resorption (ICRR) was found in 8 (1.9%) canines. In 4 canines (1.0%), root ankylosis in addition to ICRR was observed. In contrast to ankylosis, whose frequency of occurrence increased with age, the occurrence of ICRR resulting from PDL damage during surgery was more typical in younger patients. Canines in a high position above the root apices of the adjacent teeth, with a horizontal inclination of the longitudinal axis, with the crown located deep in the center of the alveolar bone and with labiopalatal position, should be considered critically impacted canines with a high risk to failure of orthodontic traction. CONCLUSION: In conclusion, the treatment of impacted canines depends mainly on the age of the patient, and the position and inclination of the longitudinal axis of the impacted tooth. To select an adequate treatment method, we recommend CBCT examination, which allows a precise analysis of the position of impacted canines.

Comparison of microleakage under orthodontic brackets bonded with five different adhesive systems: in vitro study.

BACKGROUND: Orthodontic treatment is associated with numerous adverse side effects, such as enamel discoloration, demineralization or even caries. The presence of microleakage between the enamel and the adhesive and between the adhesive and the base of the orthodontic bracket allows penetration of the bacteria, molecules, and liquids into the enamel and can lead to unpleasant "white spot lesions" or secondary caries beneath and around the brackets. The aim of this in vitro study was to evaluate microleakage in five adhesive systems commonly used in orthodontic practice for bonding brackets. METHODS: One hundred extracted premolars were divided into five groups of twenty teeth. Stainless steel Legend medium metal brackets were bonded to teeth using five adhesive systems: resin-reinforced glass ionomer cement GC Fuji Ortho LC (GCF) and composite materials Light Bond (LB), Transbond XT (TB), Trulock™ Light Activated Adhesive (TL), and GC Ortho Connect (GCO). The specimens were subjected to thermal cycling, stained with 2% methylene blue, sectioned with low-speed diamond saw Isomet and evaluated under a digital microscope. Microleakage was detected at the enamel-adhesive and adhesive-bracket interfaces from occlusal and gingival margins. Statistical analysis was performed using generalized linear mixed models with beta error distribution. RESULTS: Microleakage was observed in all materials, with GCF showing the highest amount of microleakage. Composite materials GCO, TB, and LB exhibited the lowest amount of microleakage with no statistical difference between them, while TL showed a statistically significantly higher amount of microleakage (p < 0.001). The enamel-adhesive interface had more microleakage in all composite materials (GCO, LB, TB, and TL) than the adhesive bracket-interface (p < 0.001). The highest amount of microleakage occurred in the gingival region in all materials. CONCLUSION: Composite materials showed better adhesive properties than a resin-reinforced glass ionomer cement. The presence of microleakage at the enamel-adhesive interface facilitates the penetration of various substances into enamel surfaces, causing enamel demineralization and the development of dental caries.

Morphological types of sella turcica bridging and sella turcica dimensions in relation to palatal canine impaction: a retrospective study.

The aim of this study was to determine the relationship between the presence of sella turcica bridging and palatal canine impaction (PCI) using several classification methods. In this retrospective study, lateral cephalometric radiographs of 120 subjects with PCI (43 males, 77 females; mean age 18.8 ± 7.8 years) and 120 controls (44 males, 76 females; mean age 18.1 ± 5.6 years) with complete permanent dentition were examined. The extent of sella turcica bridging was assessed using two different methods, and the types of complete sella turcica bridging were evaluated. The sella turcica dimensions were measured and analyzed using the t-test, and comparison of the presence of sella turcica bridging was performed using the two-tailed Fisher's exact test. The frequency of complete sella turcica bridging was significantly higher in subjects with PCI (18.3%) than in controls (8.3%, p = 0.023) but without significant differences in the occurrence of sella turcica bridging of Type A (ribbon-like fusion) and Type B (extension of clinoid processes). No significant differences in partial bridging were found between patients with PCI and controls according to both methods. The length and the anteroposterior diameter were significantly larger in subjects with PCI and no difference was observed between the groups in the sella turcica depth. Complete sella turcica bridging occurred significantly more frequently in subjects with PCI than in controls. However, the association between partial bridging and PCI was not confirmed, therefore, we do not recommend any classification of partial bridging for clinical practice.

Tooth agenesis: What do we know and is there a connection to cancer?

Like all developmental processes, odontogenesis is highly complex and dynamically regulated, with hundreds of genes co-expressed in reciprocal networks. Tooth agenesis (missing one or more/all teeth) is a common human craniofacial anomaly and may be caused by genetic variations and/or environmental factors. Variants in PAX9, MSX1, AXIN2, EDA, EDAR, and WNT10A genes are associated with tooth agenesis. Currently, variants in ATF1, DUSP10, CASC8, IRF6, KDF1, GREM2, LTBP3, and components and regulators of WNT signaling WNT10B, LRP6, DKK, and KREMEN1 are at the forefront of interest. Due to the interconnectedness of the signaling pathways of carcinogenesis and odontogenesis, tooth agenesis could be a suitable marker for early detection of cancer predisposition. Variants in genes associated with tooth agenesis could serve as prognostic or therapeutic targets in cancer. This review aims to summarize existing knowledge of development and clinical genetics of teeth. Concurrently, the review proposes possible approaches for future research in this area, with particular attention to roles in monitoring, early diagnosis and therapy of tumors associated with defective tooth development.

Novel PAX9 gene polymorphisms and mutations and susceptibility to tooth agenesis in the Czech population.

OBJECTIVES: Tooth agenesis is one of the most common developmental anomalies in humans. Genetic and environmental factors may be of etiological importance in this condition. Among genes involved in tooth morphogenesis, mutations in PAX9, MSX1, AXIN2, WNT10a, and EDA genes have been associated with tooth agenesis. The aim of our study was to investigate the relationship between the PAX9 gene variants and tooth agenesis in the Czech population. METHODS: The selected regions of the PAX9 gene were analysed by direct sequencing and compared with the reference sequence from the GenBank online database (NCBI). RESULTS: We found several novel variants in the PAX9 gene, e.g. insertion g.5100_5101insC (rs11373281) with simultaneous substitution g.5272C>G (rs4904155) in exon 1, and mutation g.10934C>T (Gly203Gly, rs61754301) in exon 3. In subjects with full dentition we observed polymorphisms g.10276A>G (rs12882923) and g.10289A>G (rs12883049) in IVS2 (intervening sequence 2) previously related to tooth agenesis in Polish study. CONCLUSIONS: In our study we excluded a direct effect of rs12882923 and rs12883049 polymorphisms on the dental agenesis in the Czech population. All described PAX9 genetic variants were present both in patients with tooth agenesis and controls. We expect that tooth agenesis in our cohort of patients is caused by mutations in regions different from PAX9 exons analyzed in our study.

A screen of a large Czech cohort of oligodontia patients implicates a novel mutation in the PAX9 gene.

Tooth agenesis is one of the most common developmental anomalies in humans. To date, many mutations involving paired box 9 (PAX9), msh homeobox 1 (MSX1), and axin 2 (AXIN2) genes have been identified. The aim of the present study was to perform screening for mutations and/or polymorphisms using the capillary sequencing method in the critical regions of PAX9 and MSX1 genes in a group of 270 individuals with tooth agenesis and in 30 healthy subjects of Czech origin. This screening revealed a previously unknown heterozygous g.9527G>T mutation in the PAX9 gene in monozygotic twins with oligodontia and three additional affected family members. The same variant was not found in healthy relatives. This mutation is located in intron 2, in the region recognized as the splice site between exon 2 and intron 2. We hypothesize that the error in pre-mRNA splicing may lead to lower expression of PAX9 protein and could have contributed to the development of tooth agenesis in the affected subjects.

Dentoskeletal characteristics in patients with palatally and buccally displaced maxillary permanent canines.

The aim of this retrospective study was to analyse dentoskeletal characteristics in patients with eruption disturbances of the maxillary permanent canines. Pre-treatment panoramic radiographs and lateral cephalograms of 636 consecutive orthodontic patients were assessed. The control group included 456 patients with physiologically erupted maxillary permanent canines (261 females and 195 males, mean age 12.6 and 12.4 years, respectively). The other groups comprised 144 subjects with palatally displaced canines (PDCs) (92 females and 52 males, mean age 14.2 and 14.7 years, respectively) and 36 patients with buccally displaced canines (BDCs) (16 females and 20 males, mean age 12.4 and 12.8 years, respectively). The selected dentoskeletal parameters were compared with classic cephalometric norms using the method of analysis of variance, chi-square, and Fisher's exact tests. The PDC patients showed a significantly more prognathic maxilla, a significantly more frequent occurrence of skeletal class I, retroinclination of maxillary central incisors, hypodivergent relationship, and mandibular anteriorotation and less frequent posteriorotation. A significantly more frequent retrognathic maxilla and skeletal class III and less frequent retroinclination of the maxillary central incisors were found in the BDC patients. The results of this study indicate the existence of different facial morphology and more likely also etiopathogenesis of eruption disturbances of the canines in the PDC and BDC patients.

Root resorption associated with ectopically erupting maxillary permanent canines: a computed tomography study.

The aims of this retrospective computed tomography (CT) study were to determine the occurrence of severe root resorption involving the pulpal canal of adjacent permanent teeth associated with ectopically erupting canines, and to verify the existence of related factors. The sample consisted of 255 consecutive patients (159 females and 96 males, mean age 18.4 and 16.8 years, respectively). Three hundred and thirty-four ectopic maxillary canines and adjacent teeth were analysed using CT images. Statistical significance was evaluated with chi-square and Fisher's exact tests. The results showed that severe root resorption of adjacent permanent teeth occurred in 17.7 per cent of ectopic canines and was equally common in females and males. Severe root resorption affected 12.6 per cent of the lateral incisors, 4.8 per cent of the first premolars, and 2.1 per cent of the central incisors. No relationship was found between the type or side of ectopic eruption, inclination of the longitudinal axis of the ectopic canine and the occurrence of severe root resorption. A significant relationship was found between a bucco-lingual position of the ectopic canine and root resorption (P < 0.05). Root resorption mainly occurred in the apical third (57.6 per cent) and apical and middle thirds (27.1 per cent). A significant relationship existed between the occurrence of root resorption and complete loss of space for the erupting canine (P < 0.05). No association was found between alignment of the upper permanent incisor and root resorption. A widened dental follicle occurred in 15 per cent of ectopic canines but did not cause root resorption of the adjacent permanent teeth. Since root resorption is asymptomatic, early detection by radiographic examination is essential for correct diagnosis and treatment.

Diffractive-optics-based sensor as a tool for detection of biocompatibility of titanium and titanium-doped hydrocarbon samples.

Adsorption of the elongated human plasma fibrinogen (HPF) and globular human serum albumin molecules on a titanium-based surface is monitored by analyzing permittivity and optical roughness of protein-modified surfaces by using a diffractive optical element (DOE)-based sensor and variable angle spectro-ellipsometry (VASE). Both DOE and VASE confirmed that fibrinogen forms a thicker and more packed surface adlayer compared to a more porous and weakly adsorbed albumin adlayer. A linear relation of the permittivity (ε(')) and dielectric loss (ε('')) was found for some of the dry titanium-doped hydrocarbon (TDHC) surfaces with excellent HPF adsorption ability. We discuss some aspects of TDHC's aging and its possible effects on fibrinogen adsorption.