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This study aimed to evaluate photobiomodulation (PBM) adjunct effect on pain, swelling, and face temperature in individuals with oral cleft submitted to alveolar ridge bone grafting (ABG). The sample consisted of 46 patients with either incomplete or complete unilateral cleft lip and palate aged from 9 to 18 years, both sexes, who underwent ABG with chin donor area. Subjects were randomly divided into 3 groups: (1) Control (C): ABG (n=17); (2) PBM: ABG with PBM (n=14); (3) Simulated photobiomodulation (SPBM): ABG with SPBM (n=15). Aluminum Gallium Arsenide (GaAlAs) infrared laser was used at 808±10 nm and power of 100 mW±20%. GaAlAs infrared laser was applied on 14 points in the subject's face at 4J per point, at 2 times: Immediate postoperative period and 24 hours postoperative. The authors evaluated pain, swelling, and face temperature at 24 hours postoperative; at 7-day postoperative, the authors evaluated pain, medication use, and swelling decreasing perception. No statistically significant difference occurred between groups C, PBM, and SPBM. At 24 hours postoperative, pain values showed statistically significant difference (P=0.04) between group C and SPBM. PBM at the tested parameters did not reduce pain and swelling and did not significantly change face temperature of individuals submitted to ARBG.
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OBJECTIVE: Several materials have been developed to preserve pulp vitality. They should have ideal cytocompatibility characteristics to promote the activity of stem cells of human exfoliated deciduous teeth (SHED) and thus heal pulp tissue. OBJECTIVE: To evaluate the cytotoxicity of different dilutions of bioceramic material extracts in SHED. METHODOLOGY: SHED were immersed in αMEM + the material extract according to the following experimental groups: Group 1 (G1) -BBio membrane, Group 2 (G2) - Bio-C Repair, Group 3 (G3) - MTA Repair HP, Group 4 (G4) - TheraCal LC, and Group 5 (G5) - Biodentine. Positive and negative control groups were maintained respectively in αMEM + 10% FBS and Milli-Q Water. The methods to analyze cell viability and proliferation involved MTT and Alamar Blue assays at 24, 48, and 72H after the contact of the SHED with bioceramic extracts at 1:1 and 1:2 dilutions. Data were analyzed by the three-way ANOVA, followed by Tukey's test (p<0.05). RESULTS: At 1:1 dilution, SHED in contact with the MTA HP Repair extract showed statistically higher cell viability than the other experimental groups and the negative control (p<0.05), except for TheraCal LC (p> 0.05). At 1:2 dilution, BBio Membrane and Bio-C showed statistically higher values in intra- and intergroup comparisons (p<0.05). BBio Membrane, Bio-C Repair, and Biodentine extracts at 1:1 dilution showed greater cytotoxicity than 1:2 dilution in all periods (p<0.05). CONCLUSION: MTA HP Repair showed the lowest cytotoxicity even at a 1:1 dilution. At a 1:2 dilution, the SHED in contact with the BBio membrane extract showed high cell viability. Thus, the BBio membrane would be a new non-cytotoxic biomaterial for SHED. Results offer possibilities of biomaterials that can be indicated for use in clinical regenerative procedures of the dentin-pulp complex.
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Compostos de Alumínio , Materiais Biocompatíveis , Compostos de Cálcio , Proliferação de Células , Sobrevivência Celular , Cerâmica , Polpa Dentária , Combinação de Medicamentos , Teste de Materiais , Óxidos , Silicatos , Células-Tronco , Dente Decíduo , Humanos , Dente Decíduo/efeitos dos fármacos , Silicatos/química , Silicatos/toxicidade , Silicatos/farmacologia , Sobrevivência Celular/efeitos dos fármacos , Compostos de Cálcio/química , Compostos de Cálcio/farmacologia , Compostos de Cálcio/toxicidade , Células-Tronco/efeitos dos fármacos , Fatores de Tempo , Óxidos/química , Óxidos/toxicidade , Proliferação de Células/efeitos dos fármacos , Polpa Dentária/efeitos dos fármacos , Polpa Dentária/citologia , Cerâmica/química , Cerâmica/toxicidade , Compostos de Alumínio/química , Compostos de Alumínio/toxicidade , Materiais Biocompatíveis/química , Materiais Biocompatíveis/farmacologia , Análise de Variância , Reprodutibilidade dos Testes , Bismuto/química , Bismuto/toxicidade , Bismuto/farmacologia , Células Cultivadas , Valores de Referência , Sais de Tetrazólio , Xantenos/química , OxazinasRESUMO
OBJECTIVES: This investigation aimed to assess the optimal timing for lip repair in children with cleft lip and palate via 3D anthropometric analysis to evaluate their maxillofacial structures. METHODS: The sample comprised 252 digitized dental models, divided into groups according to the following timing of lip repair: G1 (n = 50): 3 months; G2 (n = 50): 5 and 6 months; G3 (n = 26): 8 and 10 months. Models were evaluated at two-time points: T1: before lip repair; T2: at 5 years of age. Linear measurements, area, and Atack index were analyzed. RESULTS: At T1, the intergroup analysis revealed that G1 had statistically significant lower means of I-C', I-C, C-C', and the sum of the segment areas compared to G2 (p = 0.0140, p = 0.0082, p = 0.0004, p < 0.0001, respectively). In addition, there was a statistically significant difference when comparing the cleft area between G2 and G3 (p = 0.0346). At T2, the intergroup analysis revealed that G1 presented a statistically significant mean I-C' compared to G3 (p = 0.0461). In the I-CC' length analysis, G1 and G3 showed higher means when compared to G2 (p = 0.0039). The I-T' measurement was statistically higher in G1 than in G2 (p = 0.0251). In the intergroup growth rate analysis, G1 and G2 showed statistically significant differences in the I-C' measurement compared to G3 (p = 0.0003). In the analysis of the Atack index, there was a statistically significant difference between G1 and the other sample sets (p < 0.0001). CONCLUSION: Children who underwent surgery later showed better results in terms of the growth and development of the dental arches.
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OBJECTIVES: To evaluate the quantitative values of linear and angular facial anthropometrics in patients with unilateral cleft lip and palate (UCLP) and compare them with those of patients with bilateral cleft lip and palate (BCLP) using three-dimensional (3D) facial imaging. DESIGN: Retrospective, observational, and cross-sectional study. SETTING: Hospital for Rehabilitation of Craniofacial Anomalies/USP (HRAC/USP). PATIENTS/ PARTICIPANTS: In total, 61 non-syndromic patients with CLP who underwent multidisciplinary treatment and rehabilitated with a prosthesis were enrolled and divided into those with UCLP (G1; n = 31) and those with BCLP (G2; n = 30). INTERVENTION: Facial images were captured using a 3D camera after landmarks were marked on each patient's face. The software evaluated linear and angular parameters. Statistical tests were applied. Significance was determined as P < 0.05. MAIN OUTCOME MEASUREMENTS: Overall, 22 linear and 13 angular measurements were evaluated. RESULTS: The nasal length (P = 0.08), middle third of the face (P = 0.06), base nose width (P < 0.001), nasal root width (P < 0.001), nasal tip angle (P = 0.018), philtrum width (P < 0.001), lower face width (P = 0.039) and midfacial depth (P = 0.040) were significantly higher in G2; the upper cutaneous lip height was significantly higher in G1. Sexual dimorphism was observed except for linear measurements (linear distance between the labiale superius and labiale inferius landmarks, nasal root width, and upper cutaneous lip length) and angular measurements. CONCLUSIONS: G2 had a greater length and width of nose and nasal root, nasal tip angle, philtrum width, and lower face width, midfacial depth, and midface third than G1. These findings also revealed the presence of sexual dimorphism.
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Aim: This study aimed to investigate the occurrence of enamelin gene (ENAM) single nucleotide polymorphisms (SNP) and ENAM polymorphism association with dental anomalies (DA) in individuals with unilateral or bilateral cleft lip and palate (CLP). Methods: Saliva samples were collected from 147 individuals aged between 6 and 15 years-old, both genders, and divided into 4 groups: Group 1 (G1) - CLP and DA; Group 2 (G2) - CLP without DA; Group 3 (G3) - without CLP with DA; Group 4 (G4) - without CLP and DA. The genomic DNA was extracted from saliva samples and the following ENAM SNPs markers were genotyped: rs3796703, rs3796704, rs3796705, rs7671281, rs2609428, and rs35951442. Fisher exact and Pearson's Chi-square tests statistically analyzed the results (α=5%). Results: Individuals without CLP with DA (Group 3 - 19.2%) showed statistically higher prevalence of SNP rs2609428 heterozygotes (p=0.006) than individuals with CLP and DA (Group 1 - 0%). Individuals without CLP (10%) exhibited statistically higher prevalence of mutated heterozygotes/homozygous (p=0.028) than in individuals with CLP (1.3%). Conclusion: SNP rs2609428 marker of ENAM gene may be associated with dental anomalies in individuals without cleft lip and palate
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Humanos , Masculino , Feminino , Criança , Adolescente , Anormalidades Dentárias , Proteínas da Matriz Extracelular , Fenda Labial , Fissura Palatina , Polimorfismo de Nucleotídeo ÚnicoRESUMO
ABSTRACT Objective: To evaluate the clinical and radiographic response of pulp-dentin complex after selective caries removal with or without pulp lining in primary teeth. Material and Methods: Twenty-four primary molars with deep occlusal caries lesions and without pulpal alterations were selected from children, both genders, aged between 5 and 9 years old. After selective caries removal, the teeth were divided into three groups: without cavity liner (Group I), calcium hydroxide cement - CH (Group II), and Mineral trioxide aggregate - MTA (Group III). The final restoration was performed with resin-modified glass ionomer cement. Clinical and radiographic assessments were conducted at 6-month follow-up. The Kappa test determined intraexaminer reliability. Fisher's exact test evaluated intergroup comparisons (p<0.05). Results: All teeth showed clinical and radiographic success at the 6-month follow-up without statistically significant differences (p>0.05). Conclusion: Selective caries removal without cavity lining was acceptable for deep caries lesions in primary teeth.
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Humanos , Masculino , Feminino , Pré-Escolar , Criança , Dente Decíduo , Radiografia Dentária/instrumentação , Cárie Dentária/prevenção & controle , Capeamento da Polpa Dentária , Hidróxido de Cálcio , Interpretação Estatística de Dados , Cimentos Dentários/química , Polpa DentáriaRESUMO
Objetivo: Avaliar a aceitabilidade e o conhecimento de estudantes de graduação em Odontologia e cirurgiões-dentistas sobre a remoção seletiva de tecido cariado (RSTC). Materiais e Métodos: Participaram do estudo graduandos do terceiro e quarto ano de Odontologia (Grupo 1) e egressos de um Centro Hospitalar de Odontologia (Grupo 2). Os participantes responderam de forma anônima e confidencial um questionário validado contendo onze questões sobre diagnóstico e manejo de lesões cariosas profundas. Teste qui-quadrado de Pearson e regressão logística multivariada foram aplicados (p<0.05). Resultados: A amostra total foi composta por 146 participantes. Destes, 81.5% eram do sexo feminino; 52.05% eram graduados e a faixa etária mais prevalente foi de 18 a 29 anos (85.62%). Sessenta e nove participantes escolheram o tratamento expectante (p=0.027). A análise de regressão logística mostrou diferenças estatisticamente significativas. Os participantes que consideraram a parede pulpar úmida têm aproximadamente oito vezes mais chances de escolha pelo tratamento invasivo (p=0.028). Aqueles que escolheram o tratamento endodôntico como opção de sobrevida em dois anos têm três vezes mais chances de optar pelo tratamento invasivo (p=0.032). Aqueles que afirmaram que a dentina cariada próxima à polpa não deveria ser removida tiveram quase três vezes mais chances de optar por tratamentos minimamente invasivos (p=0.031). Discussão: Estudos com questionários podem ser ferramentas úteis para detectar se estudantes e cirurgiões-dentistas estão seguindo as evidências mais atuais para o tratamento de lesões cariosas profundas. Conclusão: Os participantes tinham certo nível de conhecimento sobre RSTC, mas a aceitabilidade da técnica carecia de consenso.
Aim: The aim of this study was to evaluate the acceptability and knowledge of undergraduate dental students and dentists on selective caries tissue removal (SCTR). Materials and Methods: Third- and fourth-year Dentistry undergraduates (Group 1) and graduates working in a Hospital Dentistry Center (Group 2) were included in the study. Participants anonymously and confidentially answered a validated questionnaire containing eleven questions on the diagnosis and management of deep caries lesions. Pearson's Chi-square test and multivariate logistic regression compared the answers (p<0.05). Results: Total sample comprised 146 participants. Of these, 81.5% were female; 52.05% were graduates and the most prevalent age group was 18-29 years old (85.62%). Sixty-nine participants chose stepwise caries removal (p=0.027). The logistic regression analysis showed statistically significant differences. The participants who considered pulp wall moist have approximately eight times more likelihood to choose an invasive treatment (p=0.028). Those who chose endodontic treatment as an option for two-year survival have three times more likelihood to choose an invasive treatment (p=0.032). Those who affirmed that the carious dentin close to the pulp should not be removed had almost three times more likelihood to choose minimally invasive treatments (p=0.031). Discussion: Studies with questionnaires can be useful tools to detect whether the students and dentists are following the most current evidences to treat deep carious lesions. Conclusion: The participants had certain level of knowledge on SCTR, but the technique acceptability lacked consensus.
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Evaluate the shaping ability and preparation time using a pediatric motor-driven rotary instrumentation compared to other systems in resin prototypes of primary molars. METHODS: Thirty specimens were scanned in micro-CT and divided into three groups according to the instrumentation type: pediatric motor-driven Sequence baby File (SBF); conventional motor-driven (Sequence Rotary File - SRF); manual K file. Instrumentation time was timed. After preparation, the specimens were scanned again. The pre- and post-instrumentation images were superimposed to measure the amount of root canal deviation and the resin remnant thickness. ANOVA followed by the Tukey test analyzed the comparisons between groups (p<0.05). RESULTS: No statistically significant differences occurred in root canal deviation among groups (p>0.05). There were statistically significant differences in the comparison among root thirds (p<0.001) but without significant differences in the interaction group vs. root third (p>0.05). Both motor-driven instrumentations showed statistically greater weariness than manual instrumentation (p<0.001), without significant significant differences between SBF and SRF. Motor-driven instrumentation had a shorter working time than manual instrumentation (p<0.001). CONCLUSION: Pediatric motor-driven instrumentation demonstrated good outcomes in relation to root canal deviation and amount of remnant structure, with shorter instrumentation time. SBF can be a suitable alternative for endodontic instrumentation in primary molars.
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Cavidade Pulpar , Preparo de Canal Radicular , Humanos , Criança , Dente Molar , Tratamento do Canal Radicular , Microtomografia por Raio-XRESUMO
Abstract Evaluate the shaping ability and preparation time using a pediatric motor-driven rotary instrumentation compared to other systems in resin prototypes of primary molars. Methods: Thirty specimens were scanned in micro-CT and divided into three groups according to the instrumentation type: pediatric motor-driven Sequence baby File (SBF); conventional motor-driven (Sequence Rotary File - SRF); manual K file. Instrumentation time was timed. After preparation, the specimens were scanned again. The pre- and post-instrumentation images were superimposed to measure the amount of root canal deviation and the resin remnant thickness. ANOVA followed by the Tukey test analyzed the comparisons between groups (p<0.05). Results: No statistically significant differences occurred in root canal deviation among groups (p>0.05). There were statistically significant differences in the comparison among root thirds (p<0.001) but without significant differences in the interaction group vs. root third (p>0.05). Both motor-driven instrumentations showed statistically greater weariness than manual instrumentation (p<0.001), without significant significant differences between SBF and SRF. Motor-driven instrumentation had a shorter working time than manual instrumentation (p<0.001). Conclusion: Pediatric motor-driven instrumentation demonstrated good outcomes in relation to root canal deviation and amount of remnant structure, with shorter instrumentation time. SBF can be a suitable alternative for endodontic instrumentation in primary molars.
Resumo Objetivo: Avaliar os resultados da instrumentação endodôntica e o tempo de preparo de lima odontopediátrica ativada por motor (Sequence Baby File- SBF) em canais de molares decíduos prototipados. Métodos: Trinta espécimes foram escaneados em micro-CT e divididos em três grupos de acordo com o tipo de instrumentação: mecanizada odontopediátrica (SBF); mecanizada convencional; lima K manual. O tempo de instrumentação foi cronometrado. Após o preparo, os espécimes foram escaneados novamente. As imagens pré e pós-instrumentação foram sobrepostas e a quantidade de desvio do canal radicular e a espessura de resina remanescente foram mensurados. Para as análises de comparações entre os grupos foram realizados teste ANOVA seguido do teste de Tukey (p<0,05). Resultados: Não ocorreram diferenças estatisticamente significativas entre os grupos no desvio do canal radicular (p>0,05). Houve diferenças estatisticamente significativas na comparação entre terços radiculares (p<0,001), mas sem diferenças significativas na interação grupo vs. terço radicular (p>0,05). A instrumentação mecanizada apresentou desgaste estatisticamente maior do que a instrumentação manual (p<0,001), sem diferenças estatísticas entre a SBF e a lima mecanizada convencional. A instrumentação mecanizada teve menor tempo de trabalho quando comparado a instrumentação manual (p<0,001). Conclusão: A instrumentação mecanizada odontopediátrica demonstrou bons resultados em relação ao desvio do canal radicular e quantidade de estrutura remanescente, com menor tempo de instrumentação. A SBF pode ser uma alternativa adequada para a instrumentação endodôntica em molares decíduos.
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Orofacial clefts are the most prevalent craniofacial congenital anomalies, affecting the lip, with or without involvement of the palate, or solely the palate [...].
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This study aimed to evaluate the influence of cleft width on dental arch symmetry of children with unilateral cleft lip and palate. Forty-one children were subjected to impression preoperatively (T1; mean age = 0.31 ± 0.07 years) and postoperatively (T2; mean age = 6 .73 ± 1.02 years). Eighty-two digitized dental casts were analyzed by stereophotogrammetry software. The cleft palate width was measured in the anterior (P-P'), middle (M-M'), and posterior (U-U') regions. Also, the following measurements were obtained: anterior intersegment (I-C') and intrasegment (I-C); total intersegment (I-T') and intrasegment (I-T); cleft-side (C'-T') and non-cleft-side (C-T) canine tuberosity. Paired t test and Pearson correlation coefficient were applied (α = 5%). Cleft width had the following means: 10.16 (± 3.46) mm for P-P', 12.45 (± 3.00) mm for M-M', and 12.57 (± 2.71) mm for U-U'. In the longitudinal analysis, I-C' had a significant reduction, while the other measurements significantly increased (p < 0.001). Asymmetry was verified in the following analyses at T1: I-C' vs. I-C and I-T' vs. I-T (p < 0.001); at T2, only in I-C' vs. I-C (p < 0.001). At T1, P-P' vs. I-C' (r = 0.722 and p < 0.001), P-P' vs. I-T' (r = 0.593 and p < 0.001), M-M' vs. I-C' (r = 0.620 and p < 0.001), and M-M' vs. I-T' (r = 0.327 and p < 0.05) showed a positive and significant correlation. At T2, there was a correlation between M-M' and I-C' (r = 0.377 and p < 0.05). In conclusion, the anterior and middle cleft widths influenced palatal asymmetry in the first months of life, while middle width influenced residual asymmetry.
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Fenda Labial , Fissura Palatina , Humanos , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Estudos Longitudinais , Arco Dental , MaxilaRESUMO
INTRODUCTION: The dentist participates in the treatment protocol for craniofacial anomalies in individuals from the first months of life. OBJECTIVE: to compare in a retrospective cohort study the morphometry of the edentulous palate of children microcephaly associated with congenital Zika syndrome (CZS), unilateral complete cleft lip and alveolus (UCL), and without craniofacial anomalies. METHODS: Forty-five digitized dental molds composed the sample divided into three groups: CZS; UCL; and without craniofacial anomalies (control group). The following measurements were evaluated: intercanine and intertuberosity distances; dental arch length, area, volume, and mismatch superimposition. Parametric and non-parametric tests were applied (α = 5%). RESULTS: CZS group showed the smallest means of intercanine distance and area than those of the other groups (p = .001 and p = .010, respectively). The dental arch length was greater in the CZS group than in the control group (p = .020). The evaluation of the mismatch superimposition showed that the CZS group had the lowest means of maximum distance and root mean square than that of the UCL group (p = .025 and p = .005, respectively). CONCLUSION: CZS participants tended to palatal narrowing, while UCL individuals had parameters similar to those of the control group, despite the alveolus defect.
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To evaluate and compare the dental arch symmetry of individuals with and without cleft lip and palate after orthodontic/rehabilitation treatment.Cross-sectional study.Tertiary cleft center in Brazil.Fifty-five participants aged between 18 and 30 years were divided into 3 groups according to treatment. Patients that received either a fixed partial denture (FPD) or implant-supported crown (ISC) in the cleft area or only orthodontic treatment, noncleft patients (NC).An analysis was performed using digitized dental casts scanned by laser and software. The following linear measurements were evaluated: incisor-canine; canine-molar; incisor-molar; surface and volume of the palatal region.Three-way ANOVA was used to compare the study factors: group (FPD/ISC/NC) and side (right/left) followed by the Tukey test to verify their interaction (α = .05).The results showed statistically significant differences among groups for the maxillary linear measurements canine-molar and incisor-molar, but not for incisor-canine. No statistically significant differences were found regarding the side for the maxillary measurements, while the factor interaction showed similarity only for incisor-canine. The mandibular measurements showed no statistical differences among groups, sides, or factor interactions. In surface and volume, all values in patients with cleft presented lesser than in without cleft patients.Regardless of the rehabilitation, arch symmetry can be achieved in the incisor-canine dimension in the cleft area.
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Fenda Labial , Fissura Palatina , Humanos , Adolescente , Adulto Jovem , Adulto , Fenda Labial/terapia , Fissura Palatina/terapia , Estudos Transversais , Arco Dental , Maxila , Incisivo , FotogrametriaRESUMO
OBJECTIVE: This study aimed to self-evaluate the knowledge of different dental professionals' profiles in Brazil on diagnosing and indicating pulpotomy in primary teeth and how these groups updated on this theme. METHODS: Three groups (G1: professors, G2: specialists, and G3: professionals) answered an online questionnaire containing 20 questions and returned 416 questionnaires. Data were subjected to Chi-square associative tests and t tests, with P < .05. RESULTS: G1 and G2 reported to indicate pulpotomy, highlighting the tendency of these groups towards seeking updates on this subject. All 3 groups used academic materials for updating. However, G2 had a high demand for updates through congresses, whilst G3 had a high demand for updates through social media (Google and Google Scholar). The most cited indication by G1 and G2 was "accidental pulp exposure" and by G3 was "teeth with extensive carious lesions that have involved the pulp with radiographic confirmation." All 3 groups opted for pulpotomy to keep the tooth in the arch. Thus, G1 and G2 are the groups who are more updated on the subject, using mainly academic materials, which can be associated with the fact that such groups indicated pulpotomy in primary teeth. The lower interest in searching about pulpotomy in G3 can be understood as a nonclinical application of the topic for this group. CONCLUSIONS: Professionals who work directly with paediatric dentistry (professors or specialists) felt more capable of diagnosing and treating cases of pulpotomy. In addition, most of the professionals used scientifically based sources for getting information and actualisation on the subject of pulp therapies.
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Cárie Dentária , Pulpotomia , Criança , Humanos , Dente Decíduo , Cárie Dentária/diagnóstico , Cárie Dentária/terapia , Cárie Dentária/patologia , Assistência Odontológica , Odontólogos , Resultado do TratamentoRESUMO
The assessment of rehabilitation outcomes requires a patient documentation protocol, including records obtained at standardized ages, to compare different types of surgeries, their effects, as well as between different rehabilitation centers. The aim of this paper was to present proper trays for babies with different types of cleft lip and palate, which are used in the outpatient routine at Hospital of Rehabilitation of Craniofacial Anomalies/USP (HRAC/USP). The customized trays are made with self-curing acrylic resin. The tray must have suitable depth to copy the buccal sulcus, and wax is usually applied to contour the tray edge, and the adjustment of the tray to the fornix, making the tray specific for each child. The impression precludes the utilization of dental casts for diagnosis, treatment plan, and research measurements. In the clinical practice at HRAC-USP, it was observed that customized trays increased the quality of impression, accurately reproducing anatomical features of dental arches of babies with oral clefts.
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Fenda Labial , Fissura Palatina , Criança , Humanos , Fenda Labial/cirurgia , Fenda Labial/reabilitação , Fissura Palatina/cirurgia , Fissura Palatina/reabilitação , Técnica de Moldagem Odontológica , Resultado do TratamentoRESUMO
Craniofacial development begins during the fourth week of intrauterine life (IUL) [...].
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Abstract This study aimed to evaluate the influence of cleft width on dental arch symmetry of children with unilateral cleft lip and palate. Forty-one children were subjected to impression preoperatively (T1; mean age = 0.31 ± 0.07 years) and postoperatively (T2; mean age = 6 .73 ± 1.02 years). Eighty-two digitized dental casts were analyzed by stereophotogrammetry software. The cleft palate width was measured in the anterior (P-P'), middle (M-M'), and posterior (U-U') regions. Also, the following measurements were obtained: anterior intersegment (I-C') and intrasegment (I-C); total intersegment (I-T') and intrasegment (I-T); cleft-side (C'-T') and non-cleft-side (C-T) canine tuberosity. Paired t test and Pearson correlation coefficient were applied (α = 5%). Cleft width had the following means: 10.16 (± 3.46) mm for P-P', 12.45 (± 3.00) mm for M-M', and 12.57 (± 2.71) mm for U-U'. In the longitudinal analysis, I-C' had a significant reduction, while the other measurements significantly increased (p < 0.001). Asymmetry was verified in the following analyses at T1: I-C' vs. I-C and I-T' vs. I-T (p < 0.001); at T2, only in I-C' vs. I-C (p < 0.001). At T1, P-P' vs. I-C' (r = 0.722 and p < 0.001), P-P' vs. I-T' (r = 0.593 and p < 0.001), M-M' vs. I-C' (r = 0.620 and p < 0.001), and M-M' vs. I-T' (r = 0.327 and p < 0.05) showed a positive and significant correlation. At T2, there was a correlation between M-M' and I-C' (r = 0.377 and p < 0.05). In conclusion, the anterior and middle cleft widths influenced palatal asymmetry in the first months of life, while middle width influenced residual asymmetry.
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Aim: to evaluate the surgical effects of two rehabilitation protocols on dental arch occlusion of 5-year-old children with or without cleft lip and palate. Methods: this is a retrospective longitudinal study the sample comprised 45 digitized dental casts divided into followed groups: Group 1 (G1) children who underwent to cheiloplasty (Millard technique) at 3 months and to one-stage palatoplasty (von Langenbeck technique) at 12 months; Group 2 (G2) children who underwent to cheiloplasty (Millard technique) and two-stage palatoplasty (Hans Pichler technique for hard palate closure) at 3 months and at 12 months to soft palate closure (Sommerlad technique); and Group 3 (G3) children without craniofacial anomalies. Linear measurements, area, and occlusion were evaluated by stereophotogrammetry software. Shapiro-Wilk test was used to verify normality. ANOVA followed by posthoc Tukey test and Kruskal-Wallis followed by posthoc Dunn tests were used to compared groups. Results: For the measures intercanine distance (C-C'), anterior length of dental arch (I-CC'), and total length of the dental arch (IMM'), there were statistical differences between G1x G3 and G2xG3, the mean was smaller for G1 and G2. No statistically significant differences occurred in the intermolar distance and in the dental arch area among groups. The occlusion analysis revealed significant difference in the comparison of the three groups (p=0.0004). Conclusion: The surgical effects of two rehabilitation protocols affected the occlusion and the development of the anterior region of the maxilla of children with oral clefts when compared to children without oral clefts.
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Humanos , Masculino , Feminino , Pré-Escolar , Criança , Cirurgia Bucal , Protocolos Clínicos , Fenda Labial , Fissura Palatina , Arco Dental , Oclusão DentáriaRESUMO
BACKGROUND: It is necessary to analyze and monitor the facial growth of orofacial cleft patients. The documentation should therefore begin before and after primary surgeries. Technological evolution has transformed plaster models into 3D images through scanners that allow rational storage, manipulation, and rotation without the possibility of breakage or damage. Based on this fact, this narrative review aims to provide a feature on the three-dimensional tools available for the assessment of dental arches in children with orofacial cleft and mixed dentition. MATERIAL AND METHODS: Three databases were chosen (PubMed, ScienceDirect, and Scopus) and keywords were used to select papers. RESULTS: During the database screening, 292 potentially relevant papers were found. After removing duplicates, titles, and abstracts, 32 papers presented qualifications for analysis. Through evaluating each document by reading it one by one, 24 papers fulfilled the eligibility criteria. CONCLUSIONS: It was concluded that digital tools-i.e., benchtop scanners which evaluate the dental arches of children with cleft lip, palate, and mixed dentition-are reproducible and reliable, without the use of ionizing radiation, allow storage, manipulation with sustainability, and help preserve the environment.
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OBJECTIVE: Oral cleft surgical repairs are performed using different techniques worldwide. To evaluate and compare the development of the dental arches of children with unilateral cleft lip and palate before and after the primary surgeries performed with different techniques at the first months and six years of life. METHODOLOGY: This is a retrospective longitudinal study. The sample comprised 56 dental casts divided int the following groups: Group 1 (G1) - cheiloplasty (Millard technique) at three months and one-step palatoplasty (von Langenbeck technique) at 12 months; and Group 2 (G2) - cheiloplasty (Millard technique) and two-step palatoplasty: anterior hard palate closure (Hans Pichler technique) at three months and posterior soft palate closure (Sommerlad technique) at 12 months. The digitized dental casts were evaluated at three months - pre-surgical (T1) and six years of life- post-surgical (T2). The following linear measurements were analyzed: intercanine (C-C'), intertuberosity (T-T') distances; anterior dental arch (I-CC'), anterior intersegment (I-C'), and total arch (I-TT') lengths. The palate area was also measured. Parametric and non-parametric tests were applied (p<0.05). RESULTS: In G1, the intragroup comparison showed statistically significant smaller I-CC' and I-C' at T2 (p=0.001 and p<0.001, respectively), while T-T', I-TT', and area comparisons were significantly greater (p<0.001, p=0.002, and p<0.001, respectively). In G2, the intragroup comparison exhibited statistically significant smaller C-C' and I-C' at T2 (p=0.004, for both), whereas T-T', I-TT' and area comparisons were significantly greater (p<0.001, p=0.004, and p<0.001, respectively). At T2, the intergroup analysis revealed that G1 had a statistically significant smaller I-CC' (p=0.014). The analysis of the intergroup differences (∆=T2-T1) showed that G1 had a statistically smaller I-CC' (p=0.043). CONCLUSION: The two-step palatoplasty showed a more favorable prognosis for the maxillary growth than one-step palatoplasty in children with oral clefts.