RESUMO
BACKGROUND/OBJECTIVES: Recently, lateral cephalograms have been proposed for guided miniscrew insertion planning. Therefore, the aim was to assess the reliability and safety of such planning on corresponding cone-beam computer tomography (CBCT) images. MATERIALS/METHODS: Intraoral scans, lateral cephalograms, and CBCT images of 52 subjects (even sexes distribution), aged 15.1â ±â 2.5 years, were included. Miniscrew (nâ =â 104) insertion planning was performed using lateral cephalograms superimposed on the maxillary intraoral scans, while the assessment of their bicortical placement, length in bone, contact with adjacent teeth, incisive canal, and nasal floor perforation was done on corresponding superimposed CBCT images. Moreover, maxillary incisor inclination, crowding, and the maxillary intercanine width were measured. RESULTS: The overall miniscrew length in bone was 7.2â ±â 1.3mm. Bicortical placement was seen in 58.7% of the sample (38.5% of subjects). Incisive canal and nasal floor perforation was seen in 25% and 21.2% of subjects, respectively. No contact of the miniscrew with adjacent teeth was recorded. A negative significant interaction was seen between the miniscrew length in bone, the percentage of total miniscrew length and maxillary anterior teeth crowding (ß, -0.10, Pâ =â .047 and ß, -0.90, Pâ =â .006, respectively). Moreover, a positive significant interaction was seen between the incisive canal perforation and maxillary anterior teeth crowding (ORâ =â 1.32, Pâ =â .021). LIMITATIONS: Exclusion of subjects with impacted teeth. CONCLUSIONS: Miniscrew insertion planning using lateral cephalograms, despite being safe in preventing contact with adjacent teeth, is limited in achieving bicortical placement and insufficient in completely avoiding incisive canal and nasal floor perforation.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Palato Duro , Humanos , Reprodutibilidade dos Testes , Tomografia Computadorizada de Feixe Cônico/métodos , Maxila/diagnóstico por imagem , Incisivo/diagnóstico por imagemRESUMO
INTRODUCTION: Despite the substantial prevalence of skeletal Class II Division 1 malocclusion, only a few studies analyzed the maxillomandibular growth changes in these subjects with contrasting results. This study compared the longitudinal maxillomandibular growth changes in growing subjects with Class I and II skeletal relationships, specifically during the circumpubertal growth phase assessed by the modified third finger middle phalanx maturation (MPM) method. An attempt to uncover any maxillomandibular growth peak in subjects with Class II relationship has been followed. METHODS: From the files of the Burlington Growth Study, a total of 32 subjects (13 males, 19 females) with at least 7 annual lateral cephalograms taken at 9 and 16 years old were included and equally distributed between Class II and Class I groups matched for sex. Overall changes in 12 cephalometric parameters were calculated, and maxillomandibular growth peak was also identified individually and used to register subjects according to the year of growth peak ± 2 years. According to this procedure, annualized changes (trends) were analyzed along with the corresponding prepubertal, pubertal, and postpubertal MPM stages. RESULTS: No significant differences were seen between subjects with Class I and II skeletal relationships at 9 and 16 years, except for the parameters of the sagittal maxillomandibular relationship, such as ANB angle. Overall, changes for all the cephalometric parameters were similar between the groups, except for the CoGn distance increment that was significantly lower in the subjects with a Class II relationship. In both groups, the annual changes in CoA, CoGn, and CoGo distances showed a clear peak at the time point corresponding to a median MPM stage 3. CONCLUSIONS: In subjects with a skeletal Class II relationship, mandibular deficiency appears to be mostly established during the prepubertal growth stage and further aggravated during puberty. However, the maxillomandibular growth trend in subjects with Class II relationship is generally similar to that of subjects with a Class I relationship, including the existence of a pubertal peak.
Assuntos
Má Oclusão Classe II de Angle , Maxila , Masculino , Feminino , Humanos , Criança , Adolescente , Estudos Longitudinais , Maxila/diagnóstico por imagem , Mandíbula/diagnóstico por imagem , Má Oclusão Classe II de Angle/diagnóstico por imagem , Cefalometria/métodosRESUMO
INTRODUCTION: The cervical vertebral maturation (CVM) method comprises 6 stages reported to be prepubertal (1 and 2), pubertal (3 and 4) and postpubertal (5 and 6), and its use has been recommended for planning treatment timing in orthodontics. Reliable use of the method implies that pubertal stages have to mature into postpubertal as soon as the growth peak is terminated. The present study was aimed at determining whether postpubertal CVM stages 5 or 6 are attained in all subjects. METHODS: A total of 450 adult subjects (270 females and 180 males; mean age, 30.4 ± 27.3 years; range, 20-45 years) seeking orthodontic treatment and having a lateral head film were included in the study. Customized cephalometric analysis was used, and each recording was converted into an individual CVM code according to the concavities of the C2 to C4 and shapes of C3 and C4. The retrieved CVM codes, either falling within the reported norms (regular cases) or not (exception cases), were also converted into the CVM stages and a newly introduced CVM score (0-9) capable of defining intermediate stage. RESULTS: The most frequent CVM stage was 5, while the CVM stage 6 was attained in only one third of the sample. Up to about 11% of adult subjects showed the pubertal CVM stage 4. Irrespective of the CVM stage or CVM score, no significant differences were seen between the sexes or across ages. The C4 showed a rectangular vertical shape in only 16.4% of the cases. CONCLUSIONS: The percentage of adult population maintaining a pubertal CVM stage 4 is not high, but still relevant from a clinical standpoint. In light of this finding, planning treatment timing-based only on CVM appears not fully reliable.
Assuntos
Determinação da Idade pelo Esqueleto , Vértebras Cervicais , Ortodontia , Cefalometria , Vértebras Cervicais/crescimento & desenvolvimento , Feminino , Humanos , MasculinoRESUMO
BACKGROUND/OBJECTIVES: Since a high prevalence of back anomalies has been reported among subjects with crossbite, the aim was to assess the degree of back symmetry among subjects with (crossbite) and without (control) unilateral functional crossbite during the pre-pubertal growth phase. METHODS: A group of 70 subjects (36 boys, 34 girls; 6.8 ± 1.2 years) in the primary or mixed dentition phase were included. Clinical assessment of head posture, shoulder, scapula and hip height were performed with the subject standing, and differences between the left and right side greater than 5 mm recorded. Asymmetry of the scapula and trunk prominence greater than 8 mm was recorded along with the prominence of thoracic and lumbar paravertebral musculature during the forward-bending test. Back symmetry was assessed qualitatively and quantitatively on colour deviation maps of superimposed mirrored three-dimensional back scans at a tolerance level of 2 mm. RESULTS: No significant differences were observed between the groups regarding the frequency of clinically assessed back anomalies. The percentage of back symmetry was slightly lower in the crossbite than that in the control group (71.4 ± 13.3% and 79.2 ± 12.1%, respectively). A significant association (P < 0.05) was seen between scapula plane inclination (OR = 3.41) and scapula prominence inequalities (OR = 3.29) and unilateral functional crossbite, while hip height inequalities (OR = 0.94) were more frequent in the control group. No associations were detected between the side of crossbite and side of prominence of back parameters. LIMITATIONS: The use of different thresholds for clinical (5-8 mm) and three-dimensional (2 mm) symmetry assessment. CONCLUSIONS: Although some degree of back asymmetry was detected in the crossbite group during the pre-pubertal growth phase, this asymmetry does not appear to be clinically relevant.
Assuntos
Dorso/patologia , Má Oclusão , Postura , Criança , Dentição Mista , Feminino , Cabeça , Quadril , Humanos , Masculino , Escápula , OmbroRESUMO
OBJECTIVE: The aim of this multicenter prospective study was to analyze clinically and histologically the influence of sinus cavity dimensions on new bone formation after transcrestal sinus floor elevation (tSFE). MATERIAL AND METHODS: Patients needing maxillary sinus augmentation (residual crest height <5 mm) were treated with tSFE using xenogeneic granules. Six months later, bone-core biopsies were retrieved for histological analysis in implant insertion sites. Bucco-palatal sinus width (SW) and contact between graft and bone walls (WGC) were evaluated on cone beam computed tomography, and correlations between histomorphometric and anatomical parameters were quantified by means of forward multiple linear regression analysis. RESULTS: Fifty consecutive patients were enrolled and underwent tSFE procedures, and forty-four were included in the final analysis. Mean percentage of newly formed bone (NFB) at 6 months was 21.2 ± 16.9%. Multivariate analysis showed a strong negative correlation between SW and NFB (R2 = .793) and a strong positive correlation between WGC and NFB (R2 = .781). Furthermore, when SW was stratified into three groups (<12 mm, 12 to 15 mm, and >15 mm), NFB percentages (36%, 13% and 3%, respectively) resulted significantly different. CONCLUSIONS: This study represented the first confirmation based on histomorphometric data that NFB after tSFE was strongly influenced by sinus width and occurred consistently only in narrow sinus cavities (SW <12 mm, measured between buccal and palatal walls at 10-mm level, comprising the residual alveolar crest).
Assuntos
Seio Maxilar/patologia , Osteogênese , Levantamento do Assoalho do Seio Maxilar , Adulto , Idoso , Idoso de 80 Anos ou mais , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Masculino , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Pessoa de Meia-Idade , Estudos Prospectivos , Radiografia Dentária , Levantamento do Assoalho do Seio Maxilar/métodosRESUMO
Background/objectives: The capability of the cervical vertebral maturation (CVM) method in the identification of the mandibular growth peak on an individual basis remains undetermined. The diagnostic reliability of the six-stage CVM method in the identification of the mandibular growth peak was thus investigated. Subjects/Methods: From the files of the Oregon and Burlington Growth Studies (data obtained between early 1950s and middle 1970s), 50 subjects (26 females, 24 males) with at least seven annual lateral cephalograms taken from 9 to 16 years were identified. Cervical vertebral maturation was assessed according to the CVM code staging system, and mandibular growth was defined as annual increments in Co-Gn distance. A diagnostic reliability analysis was carried out to establish the capability of the circumpubertal CVM stages 2, 3, and 4 in the identification of the imminent mandibular growth peak. Results: Variable durations of each of the CVM stages 2, 3, and 4 were seen. The overall diagnostic accuracy values for the CVM stages 2, 3, and 4 were 0.70, 0.76, and 0.77, respectively. These low values appeared to be due to false positive cases. Limitations: Secular trends in conjunction with the use of a discrete staging system. In most of the Burlington Growth Study sample, the lateral head film at age 15 was missing. Conclusions/Implications: None of the CVM stages 2, 3, and 4 reached a satisfactorily diagnostic reliability in the identification of imminent mandibular growth peak.
Assuntos
Vértebras Cervicais/crescimento & desenvolvimento , Mandíbula/crescimento & desenvolvimento , Adolescente , Determinação da Idade pelo Esqueleto/métodos , Envelhecimento/patologia , Cefalometria/métodos , Vértebras Cervicais/diagnóstico por imagem , Criança , Feminino , Humanos , Estudos Longitudinais , Masculino , Mandíbula/diagnóstico por imagem , Radiografia , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
IFT20, a component of the intraflagellar transport (IFT) system that controls ciliogenesis, regulates immune synapse assembly in the non-ciliated T-cell by promoting T-cell receptor (TCR) recycling. Here, we have addressed the role of Rab8 (for which there are two isoforms Rab8a and Rab8b), a small GTPase implicated in ciliogenesis, in TCR traffic to the immune synapse. We show that Rab8, which colocalizes with IFT20 in Rab11(+) endosomes, is required for TCR recycling. Interestingly, as opposed to in IFT20-deficient T-cells, TCR(+) endosomes polarized normally beneath the immune synapse membrane in the presence of dominant-negative Rab8, but were unable to undergo the final docking or fusion step. This could be accounted for by the inability of the vesicular (v)-SNARE VAMP-3 to cluster at the immune synapse in the absence of functional Rab8, which is responsible for its recruitment. Of note, and similar to in T-cells, VAMP-3 interacts with Rab8 at the base of the cilium in NIH-3T3 cells, where it regulates ciliary growth and targeting of the protein smoothened. The results identify Rab8 as a new player in vesicular traffic to the immune synapse and provide insight into the pathways co-opted by different cell types for immune synapse assembly and ciliogenesis.
Assuntos
Sinapses Imunológicas/metabolismo , Receptores de Antígenos de Linfócitos T/metabolismo , Proteína 3 Associada à Membrana da Vesícula/metabolismo , Proteínas rab de Ligação ao GTP/metabolismo , Animais , Endossomos/genética , Endossomos/metabolismo , Humanos , Sinapses Imunológicas/genética , Células Jurkat , Camundongos , Células NIH 3T3 , Receptores de Antígenos de Linfócitos T/genética , Proteínas SNARE/genética , Proteínas SNARE/metabolismo , Proteína 3 Associada à Membrana da Vesícula/genética , Proteínas rab de Ligação ao GTP/genéticaRESUMO
INTRODUCTION: To date, little information is available regarding individual cervical vertebral maturation (CVM) morphologic changes. Moreover, contrasting results regarding the repeatability of the CVM method call for the use of objective and transparent reporting procedures. In this study, we used a rigorous morphometric objective CVM code staging system, called the "CVM code" that was applied to a 6-year longitudinal circumpubertal analysis of individual CVM morphologic changes to find cases outside the reported norms and analyze individual maturation processes. METHODS: From the files of the Oregon Growth Study, 32 subjects (17 boys, 15 girls) with 6 annual lateral cephalograms taken from 10 to 16 years of age were included, for a total of 221 recordings. A customized cephalometric analysis was used, and each recording was converted into a CVM code according to the concavities of cervical vertebrae (C) C2 through C4 and the shapes of C3 and C4. The retrieved CVM codes, either falling within the reported norms (regular cases) or not (exception cases), were also converted into the CVM stages. RESULTS: Overall, 31 exception cases (14%) were seen. with most of them accounting for pubertal CVM stage 4. The overall durations of the CVM stages 2 to 4 were about 1 year, even though only 4 subjects had regular annual durations of CVM stages 2 to 5. CONCLUSIONS: Whereas the overall CVM changes are consistent with previous reports, intersubject variability must be considered when dealing with individual treatment timing. Future research on CVM may take advantage of the CVM code system.
Assuntos
Vértebras Cervicais/crescimento & desenvolvimento , Adolescente , Cefalometria , Vértebras Cervicais/anatomia & histologia , Vértebras Cervicais/diagnóstico por imagem , Criança , Codificação Clínica , Feminino , Humanos , Estudos Longitudinais , Masculino , Puberdade , RadiografiaRESUMO
Background/objectives: The use of the sole third finger middle phalanx for a maturational method has been proposed but not fully investigated. Herein, the diagnostic reliability of an improved five-stage third finger middle phalanx maturation (MPM) method in the identification of mandibular growth peak has been investigated. Subjects/methods: From the files of the Burlington Growth Study, 35 subjects (20 males, 15 females) with at least 7 annual lateral cephalograms taken from 9 to 16 years were included. Mandibular growth was defined as annual increments in condylion-gnathion (Co-Gn) distance. Subsequently, individual annual increments in Co-Gn were arranged according to annual age intervals, with the first and last intervals defined as 9-10 years and 14/15-16 years, respectively. A full diagnostic reliability analysis (including positive likelihood ratio) was performed to establish the diagnostic reliability of the MPM stage 2 (MPS2) in the identification of the imminent mandibular growth peak. Results: The MPS2 had a satisfactory accuracy in the identification of imminent mandibular growth peak with an overall positive likelihood ratio of 10.3. However, reliability showed noteworthy variability being greater and lower for younger and older age intervals, respectively. Limitations: Secular trend, limited sample size, and annual recording in conjunction with the use of a discrete staging system. At the 15 years recording, 28 of 35 cases were missing. Conclusions/implications: The MPS2 and MPS3 may be considered associated with the onset and maximum mandibular growth peak, respectively, in most of the subjects, indicating their use in planning treatment timing.
Assuntos
Falanges dos Dedos da Mão/crescimento & desenvolvimento , Mandíbula/crescimento & desenvolvimento , Adolescente , Envelhecimento/patologia , Envelhecimento/fisiologia , Cefalometria/métodos , Criança , Feminino , Falanges dos Dedos da Mão/anatomia & histologia , Falanges dos Dedos da Mão/diagnóstico por imagem , Humanos , Estudos Longitudinais , Masculino , Mandíbula/anatomia & histologia , Mandíbula/diagnóstico por imagem , Radiografia , Reprodutibilidade dos TestesRESUMO
BACKGROUND/OBJECTIVES: Facial soft tissues changes during growth roughly tend to mimic the underlying hard tissues, but not completely. The aim of this mixed longitudinal study was to assess facial growth among pre-pubertal and pubertal subjects without malocclusion using a non-invasive three-dimensional laser scanning system. SUBJECTS/METHODS: Fifty-nine subjects (30 females and 29 males) aged at baseline 5.4-8.9 years with normal occlusion were clustered into the younger, older pre-pubertal, and pubertal groups according to age and the absence/presence of a standing height growth spurt. Three-dimensional facial images were obtained using laser scanners for five consecutive years. Several transversal, sagittal, and vertical parameters were assessed for between and within group comparisons. RESULTS: Significant overall changes of almost all parameters were seen within each group (P < 0.05) without any group differences (P > 0.05). The younger pre-pubertal group showed greater annual growth rates of lip prominence; both pre-pubertal groups showed greater rates in facial middle third height. The pubertal group showed greater annual rates in facial profile angle changes during the growth peak. LIMITATIONS: A high standing height increment (7cm) was used as the threshold for subject allocation in the pubertal group. CONCLUSIONS: Soft tissue facial growth has generally similar amounts and rates irrespective of the pubertal growth spurt. Pre-pubertal subjects show greater annual rates of facial middle third height changes while pubertal subjects show greater annual rates of chin protrusion.
Assuntos
Queixo/crescimento & desenvolvimento , Imageamento Tridimensional/métodos , Mandíbula/crescimento & desenvolvimento , Adolescente , Face , Feminino , Humanos , Lasers , Estudos Longitudinais , Masculino , Má OclusãoRESUMO
Previous studies have demonstrated that membrane tubule-mediated transport events in biosynthetic and endocytic routes require phospholipase A2 (PLA2) activity. Here, we show that cytosolic phospholipase A2ε (cPLA2ε, also known as PLA2G4E) is targeted to the membrane compartments of the clathrin-independent endocytic route through a C-terminal stretch of positively charged amino acids, which allows the enzyme to interact with phosphoinositide lipids [especially PI(4,5)P2] that are enriched in clathrin-independent endosomes. Ablation of cPLA2ε suppressed the formation of tubular elements that carry internalized clathrin-independent cargoes, such as MHC-I, CD147 and CD55, back to the cell surface and, therefore, caused their intracellular retention. The ability of cPLA2ε to support recycling through tubule formation relies on the catalytic activity of the enzyme, because the inactive cPLA2ε(S420A) mutant was not able to recover either tubule growth or transport from clathrin-independent endosomes. Taken together, our findings indicate that cPLA2ε is a new important regulator of trafficking processes within the clathrin-independent endocytic and recycling route. The affinity of cPLA2ε for this pathway supports a new hypothesis that different PLA2 enzymes use selective targeting mechanisms to regulate tubule formation locally during specific trafficking steps in the secretory and/or endocytic systems.
Assuntos
Clatrina/metabolismo , Endocitose , Fosfolipases A2 do Grupo IV/fisiologia , Sequência de Aminoácidos , Sinalização do Cálcio , Endossomos/metabolismo , Fosfolipases A2 do Grupo IV/química , Células HeLa , Humanos , Hidrólise , Dados de Sequência Molecular , Fosfatidilinositóis/metabolismo , Sinais Direcionadores de Proteínas , Transporte ProteicoRESUMO
INTRODUCTION: The aim of this study was to monitor the alveolar bone formation at the tension sites of teeth supporting the appliances for rapid maxillary expansion (RME) during the retention phase according to the local gingival crevicular fluid (GCF) alkaline phosphatase (ALP) activity. METHODS: This split-mouth prospective study included 23 prepubertal subjects (15 girls, 8 boys; mean age, 9.0 ± 1.4 years) who had a constricted maxillary arch and were undergoing RME. Periodontal parameters, including probing depth, were recorded at 3 and 6 months after RME. Furthermore, the GCF ALP activity was measured at the tension sites of the supporting test teeth (TT) and at the antagonist control teeth (CT) sites. RESULTS: Periodontal parameters were generally similar between the TT and CT sites during the study, with the exception that probing depth underwent a slight increase at the TT sites. At baseline, the GCF ALP activity was similar between the TT and CT sites; however, at both 3 and 6 months, significantly greater enzymatic activity was seen at the TT sites. The overall probing depth changes were not significantly correlated with the corresponding GCF ALP activity changes for either the TT or the CT sites. CONCLUSIONS: Alveolar bone formation at the tension sites would last up to 6 months of retention after RME. These results warrant more comprehensive studies to assess whether the GCF ALP activity has potential as a diagnostic tool for bone formation during the retention phase of RME.
Assuntos
Fosfatase Alcalina/metabolismo , Líquido do Sulco Gengival/enzimologia , Técnica de Expansão Palatina , Biomarcadores/metabolismo , Desenvolvimento Ósseo , Criança , Feminino , Humanos , Estudos Longitudinais , Masculino , Estudos ProspectivosRESUMO
Oral mucositis (OM) is a serious and acute side effect in patients with cancer who receive chemotherapy or radiotherapy, often leading to the suspension of therapy and a need for opioid analgesic and enteral/parenteral nutrition, with an effect on patient survival. Among the various interventions proposed in OM management, laser therapy is becoming a recommended treatment option but has limitations due to its heterogeneous laser parameters. Here, we report on our successful clinical experience on the use of class IV laser therapy to treat OM induced by different chemotherapy regimens. To shed light on the mechanisms of action of laser therapy in improving OM resolution, we have developed an animal model of chemotherapy-induced OM, in which we compare the efficacy of the standard low-power laser therapy protocol with an innovative protocol, defined as high-power laser therapy. We show that high-power laser therapy is more effective than low-power laser therapy in improving OM lesion healing, reducing the inflammatory burden, and preserving tissue integrity. In addition, high-power laser therapy has been particularly effective in promoting the formation of new arterioles within the granulation tissue. Our results provide important insights into the mechanism of action of biostimulating laser therapy on OM in vivo and pave a way for clinical experimentation with the use of high-power laser therapy.
Assuntos
Antineoplásicos/efeitos adversos , Terapia a Laser , Neoplasias/tratamento farmacológico , Estomatite , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Antineoplásicos/administração & dosagem , Modelos Animais de Doenças , Feminino , Humanos , Masculino , Camundongos , Pessoa de Meia-Idade , Estomatite/induzido quimicamente , Estomatite/patologia , Estomatite/cirurgiaRESUMO
BACKGROUND/OBJECTIVE: Facial asymmetry is very common in adult class III patients; however, the degree of facial asymmetry in growing class III subjects has been poorly investigated. Therefore, the aim was to assess the degree of facial asymmetry of growing class III subjects and to compare it with a sample of growing subjects without malocclusion, recorded using a three-dimensional laser scanning method and classified according to the dentition phase. SUBJECTS/METHODS: A group of 156 Caucasian subjects, 52 with class III malocclusion (28 females and 24 males) and 104 without malocclusion (control, 51 females and 53 males), with an overall mean age 6.7±1.4 years (range 4.3-10.3 years), were included. The subjects were further subdivided according to the presence of either primary or early/intermediate mixed dentitions. Facial asymmetry was assessed on three-dimensional surface facial images obtained using a laser scanning device in terms of mirrored face distances and percentages of asymmetry. Multivariate analyses were used to assess the differences among class III and control groups. RESULTS: Complete facial symmetry was not seen in any subject. No significant differences of facial asymmetry were observed between the class III and control groups, neither in the primary nor in the early/intermediate mixed dentition phases. LIMITATIONS: No conclusions about longitudinal changes in the degree of facial asymmetry among class III subjects could be drawn from the present cross-sectional study. CONCLUSIONS: Based on three-dimensional facial asymmetry analysis, class III subjects do not show clinically relevant facial asymmetry, at least during the pre-pubertal growth period.
Assuntos
Face/anormalidades , Assimetria Facial/congênito , Hiperplasia/patologia , Imageamento Tridimensional/métodos , Má Oclusão Classe III de Angle/patologia , Cefalometria/métodos , Criança , Pré-Escolar , Estudos Transversais , Dentição Mista , Face/patologia , Assimetria Facial/patologia , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Lasers , Masculino , Desenvolvimento Maxilofacial/fisiologia , Puberdade/fisiologia , Dente DecíduoRESUMO
INTRODUCTION: The success of maxillary expansion should not be assessed solely by the elimination of the teeth in crossbite; it should also be defined as the reestablishment of normal maxillary growth. The aim of this research was to quantify longitudinal palatal changes in children treated for maxillary constriction associated with functional crossbite. METHODS: The subjects included 48 white children (mean age, 5.2 ± 0.6 years), divided into a treatment group (n = 23) and a control group (n = 25). Children in the treatment group had maxillary constriction associated with functional crossbite and were treated with a cemented acrylic splint expander. Dental casts were collected at baseline and at 6, 12, 18, 30, 42, and 54 months later. The casts were scanned with a laser scanner, and the palatal surface areas and volumes, and their increments over time were calculated. Nonparametric tests were used for the data analysis. The diagnostic performance in assessing successful treatment of palatal constriction was evaluated by receiver operating characteristic curves. RESULTS: Significantly greater increments in palatal surface area and volume were seen in the treatment group up to 30 months (P <0.05, at least). According to the receiver operating characteristic curves, the best overall diagnostic performance in terms of accuracy was for palatal volume at 18 months, reaching up to a value of 0.85, by using a cutoff value of increments of 13.5%. CONCLUSIONS: An increase in palatal volume of at least 13.5% at 18 months after treatment is a good indicator to assess the reestablishment of normal growth in subjects treated for maxillary constriction in the deciduous dentition.
Assuntos
Imageamento Tridimensional , Maxila/crescimento & desenvolvimento , Doenças Maxilares/diagnóstico , Doenças Maxilares/terapia , Técnica de Expansão Palatina , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Má Oclusão/terapia , Doenças Maxilares/patologia , Modelos Dentários , Avaliação de Resultados em Cuidados de Saúde , Técnica de Expansão Palatina/instrumentação , Sensibilidade e Especificidade , Estatísticas não Paramétricas , Dente DecíduoRESUMO
Conflicting data have been reported in dentistry regarding the diagnostic potential of monitoring body sway while in a static standing bipedalic position. This systematic review reappraises previously reported effects of mandibular position, asymmetric occlusion, and temporomandibular disorders (TMDs) on body sway to determine whether there is sufficient evidence for such correlations and to define the potential diagnostic applications in orthodontics. A literature survey was performed using the Medline, LILACS, and SciELO databases, and the Cochrane Library, covering the period from January 1980 to December 2011. Twelve articles qualified for the final analysis. All of these studies investigated the effects of mandibular position, two focussed also on asymmetrical occlusion, and three on TMDs. Only two studies were judged to be of medium or medium/high quality, with all of the rest classified as low-quality design; no study included follow-up. According to the conclusions of these reports, four studies saw significant correlations between body sway and mandibular position or TMDs. After a reappraisal of the full data set, generally no clinically relevant correlations were uncovered in the comparisons. While more investigations with improved levels of scientific evidence are needed, according to current evidence, the static monitoring of body sway as a diagnostic aid in orthodontics may not be indicated.
Assuntos
Má Oclusão/diagnóstico , Mandíbula/anatomia & histologia , Postura , Transtornos da Articulação Temporomandibular/diagnóstico , Oclusão Dentária , HumanosRESUMO
The aim of this study was to evaluate the influence of prolonged sucking habits and mouth breathing on palatal vault morphology in a group of subjects with unilateral functional crossbite [crossbite (CB) group] compared with a group of subjects with normal occlusion [non-crossbite (NCB) group]. A sample of 80 Caucasian subjects (51 CB and 29 NCB; aged 5.3 ± 0.8 years) in the deciduous dentition was selected. A questionnaire regarding the subject's sucking habits was answered by the parents. Any sucking habit that lasted more than 24 months was considered as a prolonged sucking habit. The breathing pattern was assessed by an experienced otorinolarygologist and was classified either mainly nose or mouth breathing. Intercanine and intermolar distances and palatal surface area and volume were recorded three dimensionally on study casts. Univariate and multivariate analyses were employed. Posterior CB was negatively correlated with all the dental and palatal parameters (P < 0.01) with the exception of the palatal surface area that did not reach the statistical significance. Only prolonged sucking habits (but not mouth breathing) was a significant risk indicator for unilateral functional CB (P < 0.001). However, the prolonged sucking habits were not significantly correlated with any of the investigated parameter, and mouth breathing was negatively correlated with the intermolar distance only. Therefore, maxillary constriction in unilateral functional CB might not be influenced by the presence or absence of prolonged sucking habits or mouth breathing.
Assuntos
Sucção de Dedo/efeitos adversos , Má Oclusão/patologia , Respiração Bucal/complicações , Palato/patologia , Criança , Pré-Escolar , Constrição Patológica/etiologia , Feminino , Humanos , Masculino , Maxila/patologia , Dente Decíduo/anatomia & histologiaRESUMO
The aim of the present study was to evaluate the association of tongue posture with the dentoalveolar maxillary and mandibular morphology in a group of Class III subjects in comparison to a group of Class I subjects. Twenty Class III subjects (9 males, 11 females, 19.2 ± 4.6 years) and 20 Class I subjects (6 males, 14 females, 17.4 ± 1.7 years) were included in the present study. Maxillary and mandibular morphology was defined by the intermolar and intercanine distances, at both the cusps and gingival levels, and by measuring surface area and volume of the palatal vault and mouth floor assessed on three-dimensional digital models. Tongue-to-palate distances were measured on lateral cephalograms. The groups were compared using the Mann-Whitney U-test and correlations between each morphological parameter and the tongue-to-palate distances were calculated using the Spearman correlation coefficient. The mandibular intermolar width at the gingival level was significantly greater in the Class III group (P < 0.01), while the maxillary intercanine widths were significantly smaller in the Class III group (P < 0.05). The mouth floor area and volume and the respective ratios between the mouth floor and palate were significantly greater in the Class III group (P = 0.01). The tongue-to-palate distances were generally greater, i.e. lower tongue posture, for the Class III subjects. Significant correlations were seen between tongue-to-palate distances in the posterior region with the area ratio (rho = 0.44, P < 0.05). Tongue posture is significantly lower in Class III subjects and is associated with the dentoalveolar characteristics of the maxilla and mandible.