Efficacy of the combination of myofunctional therapy (lip exercises) and activator high-pull headgear in the closure of interlabial gap in long-face skeletal class II patients with lip incompetence: A 6-8-month longitudinal randomized clinical trial.

Background: Lip incompetence is an important issue in orthodontics. No study has evaluated the effects of the combination of headgear + lip exercises on lip incompetence. Therefore, this study was conducted. Materials and Methods: This was a longitudinal randomized clinical trial on 29 subjects (16 controls and 13 experimental subjects). Both groups were treated with standardized activator high-pull headgear (and followed up monthly) for 6-8 months. In the experimental group, patients were also instructed to practice certain lip exercises 3 sessions a day, 5 times per session. Pre-/post-treatment interlabial gap, upper lip length and vermilion height, lower lip length and vermilion height, nasolabial angle, and profile convexity angle were measured clinically and photographically, immediately before treatment and after it. Data were analyzed using paired/unpaired t-tests (α = 0.025) and partial correlation coefficient controlling for the intervention type (α = 0.05). Results: Lip exercise plus activator headgear significantly changed/improved all parameters (P ≤ 0.006) over the 6-8-month course of treatment. Activator headgear alone changed/improved only 4 parameters: interlabial gap, upper and lower lip lengths, the lower lip vermilion height, and profile convexity (P ≤ 0.008). Compared to the control (activator headgear alone), in the experimental group, the changes observed in the interlabial gap closure (P = 0.011), upper lip lengthening (P = 0.002), and upper lip vermilion lengthening (P = 0.017) were significantly greater. Convexity angle corrections were more successful in cooperative patients (R = 0.469, P = 0.012). Cases with smaller pretreatment nasolabial angles may experience more changes in this angle after treatment (R = 0.581, P = 0.001). Conclusion: The addition of lip exercises to activator high-pull headgear can boost activator headgear's efficacy in treating lip incompetence.

Assessment of orthodontic treatment needs in patients with ß-thalassemia major and sickle cell disease.

Patients suffering from hemoglobinopathies may suffer from pathogic dental and orofacial features. This study aimed to assess the prevalence of malocclusion and the need for orthodontic treatment in patients with ß-thalassemia major (BTM) and sickle cell disease (SCD). The study was conducted on 311 blood transfusion-dependent patients with BTM or SCD and 400 healthy individuals aged 10 to 16. The types of malocclusion were evaluated based on Angle's classification and Dewey's modification, and their oral habits were recorded using a questionnaire. The need for orthodontic treatment was assessed through the Dental Health Component of the Index of Orthodontic Treatment Need (IOTN), and the data were compared with normal participants. The Index of Orthodontic Treatment Need-Dental Health Component (IOTN-DHC) assessment showed that patients had a higher prevalence of objective need for treatment (IOTN grades 4 and 5) compared to healthy children. The prevalence of class II malocclusion was significantly higher in patients. Patients showed significantly less Angle's Class I malocclusion compared to normal participants. Oral habits were presented in 61%, 64.15% and 62.4% of normal participants, BTM and SCD patients, respectively. The higher prevalence of Angle's class II malocclusion and higher percentage of IOTN grade 4 and 5 among BTM and SCD patients reveal the importance of early orthodontic assessment and intervention in children with BMT and SDC.

A Comparison of the Characteristics of Cytokine Storm between Lichen Planus and Oral Squamous Cell Carcinoma.

INTRODUCTION: Lichen planus (LP) is a relatively common chronic mucocutaneous disease that affects the skin and mucous membranes, including oral mucosa. The etiology of the disease is unknown. Some evidence suggests that the immune system and inflammation may play a role in the formation and progression of lichen planus. Some authorities believe that LP is a precancerous condition. The purpose of this study was to investigate the serum levels of the inflammatory cytokines CRP, IL-1, IL-6, and TNF- in patients with oral lichen planus and oral squamous cell carcinoma (OSCC), as well as to assess the relationship between these cytokine levels and clinical symptoms. METHODS: A total of 75 subjects, with 25 in each group of oral lichen planus, healthy control, and oral squamous cell carcinoma, participated in this cross-sectional study. Serum levels of IL-1α, TNF-α, IL-6, and CRP were determined and compared. In comparison to the healthy control group, the lichen planus and oral squamous cell carcinoma groups had higher levels of CRP, IL-1α, IL-6, and TNF-α. RESULTS: We discovered that the mean mRNA and protein levels of CRP, IL-1α, IL-6, and TNF-α were significantly higher in the blood and tissue of lichen planus and OSCC patients than in normal controls. CONCLUSION: Higher levels of CRP, IL-1α, IL-6, and TNF-α may be linked to OLP and oral carcinogenesis. More research with larger groups is required.

Comparative evaluation of oral and dento-maxillofacial manifestation of patients with sickle cell diseases and beta thalassemia major.

BACKGROUND: Regarding the importance of oral and dental health in patients with hemoglobinopathies and also due to the different results of different studies in this background, in patients with beta thalassemia (BTM) and sickle cell disease (SCD), this study aimed to evaluate and compare the oral and dental manifestations of patients with BTM and SCD. MATERIAL AND METHODS: In this cross-sectional study during the years 2014-2017, a total of 175 patients (with documented BTM or SCD attending to Tehran, Mashhad, Isfahan, and Tabriz cities central hospitals) were randomly recruited. Required information was gathered through a thorough physical examination of the oral cavity in a private office and a face-to-face interview by an orthodontist and two dentists. Data were analyzed using SPSS version 22.0. RESULTS: In general, 120 diagnosed patients with BTM (88 males and 32 females) and 55 patients with SCD (25 males and 30 females) attending to Iran largest cities, central hospitals were randomly recruited. We found a significantly higher prevalence (p < .05) of some oral manifestations among the BTM patients (Gingival Index = 2.18 ± 1.300, 1.64 ± 0.963; Decayed teeth = 8.31 ± 3.330, 2.33 ± 1.221; Missing teeth = 3.51 ± 2.016, 1.19 ± 0.820; DMFT = 13.92 ± 7.001, 2.63 ± 1.301) than the apparently healthy people. CONCLUSION: Finally, the study gives an insight into the various oral and dento-maxillofacial manifestations of SCD and BTM and also reveals an association that exists between the oral and dento-maxillofacial manifestations and systemic health in these patients, thus stressing the importance of the concise and periodic examination of these individuals to perform appropriate preventive dental and periodontal care, and the facilitation of the management of the disease.