Effects of cleft lip and palate on the development of permanent upper central incisors: a cone-beam computed tomography study.

OBJECTIVE: The aim of this study was to evaluate 1. the differences among the cleft sides of unilateral cleft lip and palate (UCLP) patients, non-cleft sides of the same UCLP patients and well matched control patients in the root development and position of permanent upper central incisors and 2. possible gender differences. MATERIALS AND METHODS: The study sample consisted of 40 patient (20 males and 20 females; mean age: 14.84±3.2 years) with non-syndromic UCLP patients, and 40 control patients (20 males and 20 females; mean age: 13.38±1.6 years). Cone-beam computed tomography (CBCT) images were taken off from all patients. All tomographs were obtained in supine position by using CBCT (NewTom 5G, QR, Verona, Italy). RESULTS: Significant smaller root volume of central incisor was observed on the cleft side than on the non-cleft side of UCLP patients (P < 0.05). No significant difference in the root development and position of the central incisors was found between the non-cleft side of the UCLP and the control group (P > 0.05). There were no statistically significant gender differences in any linear, angular, or volumetric measurements (P > 0.05). Only the root volume of the cleft side was smaller in females than in males (P < 0.05). CONCLUSIONS: In general, root volumes of central incisors on the cleft side were 12.15 per cent smaller than non-cleft side. Root development of the central incisor was much more influenced by the cleft in females than in males.

Effects of early bilateral mandibular first molar extraction on condylar and ramal vertical asymmetry.

OBJECTIVES: This study aims to investigate the mandibular vertical asymmetry in a group of adult patients who had early bilateral mandibular first molar extractions. METHODS: Mandibular asymmetry index measurements (condylar, ramal, and condylar plus ramal) were made on the panoramic radiographs of a study group including 30 subjects (mean age, 18.22 ± 1.30 years) and a control group of 25 subjects (mean age, 18.24 ± 1.17 years). Group I comprised the control group patients with no extractions and had excellent class I relationships, no missing teeth, and slight or moderate anterior crowding. Group II included patients with a bilateral mandibular first molar teeth extracted before the age of 12 years. Student's t test was used for the comparison of asymmetry index values between the groups. A paired t test was used to determine possible statistically significant differences between the sides for condylar, ramal, and condylar plus ramal height measurements. RESULTS: No group showed statistically significant side-specific differences for posterior vertical height measurements. Condylar asymmetry index (CAI), ramal asymmetry index, and condylar plus ramal asymmetry index measurements were not statistically different between the groups (p > 0.05). CONCLUSIONS: CAI values were significantly high when compared with the 3 % threshold value in the both groups, but comparisons between the groups were not statistically significant. CLINICAL RELEVANCE: This article investigates the effects of early bilateral mandibular molar teeth extraction that has never been investigated in the literature. The present study showed that the lengths of the condylar, ramal, and condylar plus ramal height were less in the study group than in a well-matched control group of without extraction.

Evaluation of surgical-orthodontic treatments on impacted mandibular canines.

OBJECTIVE: The aim of the study was to evaluate patients treated for impacted mandibular canines through a combined surgical and orthodontic approach. STUDY DESIGN: The cases which were made button operations of impacted mandibular canines were selected from 5100 panoramic radiographs taken from patients who made use of our oral and maxillofacial surgery services between January 1998 to April 2006. All of these selected patients were assessed radiographically. Pertinent information such as sex, age at the time of surgery, site of the unerupted tooth, space availability and any other associated pathoses were also recorded. These patients were called again, and the condition of the mandibular canines was evaluated with panoramic radiographs. If the tooth erupted in the right position and it was functional and asymptomatic, we assumed the treatment to be successful clinically. RESULTS: In the present study, from 5100 patients, 69 patients had impacted mandibular canines and only 21 patients ' teeth (a total of 23 teeth) were treated orthodontically. Sixteen impacted mandibular canine teeth of 14 patients erupted successfully. Two impacted canine were extracted, and only one canine tooth was transplanted to the normal position. Four patients ended the treatment because of failure of eruption. CONCLUSION: If a mandibular canine tooth is impacted, not only is surgical exposure sufficient but also traction force must be applied orthodontically after the surgical exposure. In addition, age influences the success of the treatment on impacted mandibular canine teeth more than the position and impaction level of the teeth.

Effects of early unilateral first molar extraction on skeletal asymmetry.

INTRODUCTION: The purpose of this study was to investigate dental and skeletal asymmetry in patients who had unilateral first molar extractions. METHODS: Two study groups were formed according to the location of the extracted first molars. Group I included 25 subjects who had a maxillary permanent first molar extracted (mean age, 18.25 years). Group II included 26 subjects who had a mandibular permanent first molar extracted (mean age, 17.75 years). The control group included 30 subjects with no missing teeth and normal occlusion (mean age, 18.50 years). Dental and skeletal asymmetry values were computed on posteroanterior radiographs for all subjects. Data were analyzed statistically with paired t tests to determine intragroup differences and with ANOVA and Scheffé tests to determine intergroup differences. RESULTS: Unilateral first molar extractions caused dental midline deviations in both arches, but this was more prominent in the mandibular arch. Unilateral first molar extraction during growth and development can result in remarkable skeletal asymmetry, especially in the lower third of face. CONCLUSIONS: Patients who had early unilateral first molar extraction can have skeletal and dental asymmetries.

Histopathologic investigation of the effects of prostaglandin E2 administered by different methods on tooth movement and bone metabolism.

OBJECTIVE: The aim of this study was to investigate and compare the in vivo effects of prostaglandin E2 (PGE2) administered by different methods on orthodontic tooth movement and bone metabolism macroscopically, histopatologically, and biochemically. METHODS: Forty-five young adult New Zealand rabbits were randomly divided into 3 experimental groups (n = 10/group), 1 positive control group (n = 10), and 1 negative control group (n = 5). The experimental rabbits were fitted with springs exerting 20-g reciprocal force on the maxillary incisors and PGE2 (10 µg/mL) was administered by the intravenous, submucosal, or intraligamentous route after appliance insertion and on days 1, 3, 7, and 14 thereafter. All rabbits were sacrificed on day 21 and their premaxillae were resected for histologic evaluation. RESULTS: Tooth movement was observed in the experimental and positive control groups, but the intraligamentous PGE2 group had the highest values of all analyzed parameters, including serum calcium and phosphorus levels and osteoclastic and osteoblastic populations (p < 0.001). CONCLUSIONS: Submucosal and intraligamentous PGE2 administration significantly increases orthodontic tooth movement and bone metabolism, but the intraligamentous route seems to be more effective.

Extraoral removal of a transmigrant mandibular canine associated with a dentigerous cyst.

Although the maxillary permanent canine is frequently misplaced, misplacement of the mandibular canine is a comparatively rare event. Pre-eruptive migration of a tooth across the midline is called transmigration. This condition has not been reported for teeth other than canines. Dentigerous cysts can involve any tooth, but mandibular canines are rarely affected like premolars and molars. Odontogenic cysts associated with impacted teeth are usually removed through an intraoral approach. However, on rare occasion, an extraoral approach is required to remove these lesions. A case of transmigrant mandibular canine associated with a dentigerous cyst that required an extraoral submental approach for removal is presented.

Transmigrant mandibular canines.

PURPOSE: The aim of the present study was to investigate the patterns of transmigrant mandibular canines, the incidence and classification of transmigrant canines, and the associated pathology of these teeth. PATIENTS AND METHODS: This retrospective cohort study was composed of 4,500 panoramic radiographs of patients who presented to our Oral and Maxillofacial Surgery Services from January 1998 to December 2005. Panoramic radiographs were reviewed. Observations were made on the status of missing permanent mandibular canines, retained deciduous canines, side and number of transmigrant canines, gender and age of patients, and any other associated pathology. RESULTS: In the present study, a total of 15 patients had transmigrated canines-6 females (ages 13-33 years) and 9 males (ages 13-57 years). All transmigrant canines were unilateral. Two canines were impacted in the mandible enveloped in cystic lesions. The rest of the transmigrated canines were in varying stages of intraosseous travel and positioning within the mandible, with no pathological entity. CONCLUSION: The use of a panoramic radiograph is imperative and is recommended for discovering such rare malpositions. If the mandibular canine that has migrated across the mandible is associated with pathology, it may be removed. Otherwise, it should be kept under observation.