Associação entre hábitos orais e má oclusão com problemas respiratórios em escolares de 5 anos / Association between oral habits and malocclusion with respiratory problems in 5-year-old schoolchildren

Introdução Toda má oclusão apresenta origem multifatorial, e dentre os fatores que a desencadeiam estão os hábitos. O surgimento de um hábito pode estar relacionado com o emocional, o fisiológico ou com o aprendizado condicionado do indivíduo. Objetivo Analisar as relações entre hábitos e más oclusões associado a problemas respiratórios em escolares de 5 anos. Material e método Foi realizado um estudo transversal com uma amostra de 753 crianças pertencentes à rede municipal de ensino da cidade de Araraquara, SP. Foram realizados exames clínicos para avaliação da má oclusão (Foster & Hamilton), além de aplicado questionários aos pais para avaliação de condição socioeconômica e demográfica, qualidade de vida relacionada à saúde bucal (ECOHIS) e hábitos. A análise dos dados foi feita pela análise bivariada por teste qui-quadrado seguida de modelo de regressão logística múltipla considerando nível de significância de 5%. Resultado A prevalência de crianças com problemas respiratórios e/ou alergias foi de 46,9%, com má oclusão foi de 58,7% e com algum tipo de hábito oral deletério foi de 12,0%. Apresentaram mais chance de ter problemas respiratórios e/ou alergias crianças do sexo masculino (1,40 vezes mais) e crianças com algum hábito oral deletério (1,95 vezes mais). Conclusão Observou-se que apresentaram maior chance de problemas respiratórios e/ou alergias as crianças do sexo masculino, crianças com algum hábito oral deletério e que apresentavam bruxismo.

Introduction All malocclusion has a multifactorial origin, and among the factors that trigger it are the habits. The appearance of a habit can be related to the emotional, physiological or conditioned learning of the individual. Objective Evaluate the relationship between habits and malocclusions associated with respiratory problems in 5-year-old students. Material and method A cross-sectional study were carried out with a sample of 753 children belonging to the municipal education network of the city of Araraquara-SP. Clinical exams were performed for malocclusion evaluation (Foster & Hamilton), applying questionnaires to the parents for evaluation of socioeconomic and demographic condition, oral health related quality of life (ECOHIS) and habits. Data analysis was performed by bivariate analysis using chi-square test followed by multiple logistic regression model considering 5% significance level. Result The prevalence of children with respiratory problems and/or allergies was 46.9%, with malocclusion was 58.7% and with some type of deleterious oral habit was 12.0%. Male children were 1.40 times more likely to present respiratory problems or allergies and children with some deleterious oral habits were 1.95 times more likely to present respiratory problems or allergies. Conclusion It was observed that male children, children that presented deleterious oral habits, and children with bruxism are more likely to have respiratory problems and/or allergies.

Diagnóstico precoz de la estrechez del maxilar superior en la dentición mixta / Early diagnosis of the maxillary´s narrowness in the mixed dentition

Las compresiones del maxilar superior son alteraciones transversales por discrepancia óseo-dentaria. .En la dentición mixta temprana puede establecerse la estrechez mediante índices que relacionan el tamaño dental con el ancho transversal del arco dentario. Se analizaron 33 modelos superiores de niños en el tercer período de desarrollo clínico según Barnett. Se estableció la estrechez realizando el análisis métrico del arco dental mediante el índice de Pont. Se describió la anomalía de posición anterior según las siguientes variables: A) Apiñamiento dentario: 1-Escalón de los dientes anterosuperiores; 2-Rotación mesial de los cuatro incisivos; 3-Rotación mesial de los incisivos centrales y rotación distal de los incisivos laterales y 4-Rotación distal de los incisivos centrales. B) Ausencia de apiñamiento: 1-Reabsorción atípica y 2- Ausencia de reabsorción atípica. Las anomalías de posición y/o reabsorciones atípicas anteriores en este período de desarrollo clínico se asocian a estrechez transversal del maxilar superior Siendo la malposición más frecuente la rotación mesial de los cuatro incisivos, siguiendo las reabsorciones atípicas y el escalón de los dientes anterosuperiores, luego la rotación mesial de los incisivos centrales y distal de los laterales y por último la rotación distal de los incisivos centrales (AU)

Inside the traverse alteration of the maxillary the compressions are described as uni or bilateral where an imbalance is settled down between the dental size and the size of the maxillary causing alterations in the position of the teeth. In the early mixed teething the narrowness of the maxillary can be settled by means of indexes that relate the dental size with the traverse width of the dental arch. Thirty models of the maxillary of children according to Barnett's third development period were analyzed. The metrical analysis of the dental arch form was carried out through Pont's index. The theoretic values were compared with the real ones establishing the deviations of the norm that is to say the narrow nest. Out of the 30 cases analyzed, 40% presented mesial rotation of the 4 incisors; 27% showed a stop of the front teeth; 27% atypical reabsorption; 20% mesial rotation of the central incisors and distal rotation of the lateral incisors and the 10% presented a distal rotation of the central incisors. With regard to the front atypical discrepancy 36.66% of the cases had a discrepancy above 6 mm and the 23.33% below 3 mm (AU)

Deviating dental arch morphology in mild coronal craniosynostosis syndromes.

OBJECTIVES: To determine whether the intramaxillary relationship of patients with Muenke syndrome and Saethre-Chotzen syndrome or TCF12-related craniosynostosis are systematically different than those of a control group. MATERIAL AND METHODS: Forty-eight patients (34 patients with Muenke syndrome, 8 patients with Saethre-Chotzen syndrome, and 6 patients with TCF12-related craniosynostosis) born between 1982 and 2010 (age range 4.84 to 16.83 years) that were treated at the Department of Oral Maxillofacial Surgery, Special Dental Care and Orthodontics, Children's Hospital Erasmus University Medical Center, Sophia, Rotterdam, the Netherlands, were included. Forty-seven syndromic patients had undergone one craniofacial surgery according to the craniofacial team protocol. The dental arch measurements intercanine width (ICW), intermolar width (IMW), arch depth (AD), and arch length (AL) were calculated. The control group existed of 329 nonsyndromic children. RESULTS: All dental arch dimensions in Muenke (ICW, IMW, AL, p < 0.001, ADmax, p = 0.008; ADman, p = 0.002), Saethre-Chotzen syndrome, or TCF12-related craniosynostosis patients (ICWmax, p = 0.005; ICWman, IMWmax, AL, p < 0.001) were statistically significantly smaller than those of the control group. CONCLUSIONS: In this study, we showed that the dental arches of the maxilla and the mandible of patients with Muenke syndrome and Saethre-Chotzen syndrome or TCF12-related craniosynostosis are smaller compared to those of a control group. CLINICAL RELEVANCE: To gain better understanding of the sutural involvement in the midface and support treatment capabilities of medical and dental specialists in these patients, we suggest the concentration of patients with Muenke and Saethre-Chotzen syndromes or TCF12-related craniosynostosis in specialized teams for a multi-disciplinary approach and treatment.

Dentoalveolar Cleft Treatment Outcome Using Modified Huddart-Bodenham Index and Regression Analysis of Associated Factors.

OBJECTIVES: The aim of this study is to assess the treatment outcome of complete unilateral cleft lip and palate (CUCLP) patients using modified Huddart/Bodenham scoring system (MHB). To determine whether there is an association of congenital and postnatal factors with the treatment outcome. DESIGN: Retrospective observational study. SETTING: Two regional cleft-referral centers. MAIN OUTCOME MEASURES: In the current study, 101 pairs of dental models of non-syndromic CUCLP patients were retrieved from hospital archives. Each occlusal relationship from central incisor till the first permanent molars were scored except the lateral incisor. Sum of 10 occlusal relationships in each study sample gave a total occlusion score. The primary outcome was the mean total occlusion score. RESULTS: According to MHB, a mean (standard deviation) total occlusion score of -8.92 (6.89) was determined. Based on treatment outcome, 66 cases were favorable (grades 1, 2, and 3) and 35 cases were unfavorable (grades 4 and 5). Chi-square tests indicated, difference of cheiloplasty ( P = .001) and palatoplasty ( P < .001) statistically significant. Five variables-gender, family history of cleft, cleft side, cheiloplasty, and palatoplasty-were analyzed with a logistic regression model. CONCLUSIONS: Final model indicated that cases treated with modified Millard technique (cheiloplasty) and Veau-Wardill-Kilner method (palatoplasty) had higher odds of unfavorable treatment outcome.

Dental Arch Relationships and Reverse Headgear Effects in Southern Chinese Patients with Unilateral Cleft Lip and Palate: A Retrospective Study.

OBJECTIVE: To evaluate the severity of the dental arch relationships and the treatment outcomes of reverse headgear (RHG) in southern Chinese patients with unilateral cleft lip and palate (UCLP). DESIGN: A retrospective study. SETTING: Faculty of Dentistry, The University of Hong Kong. PATIENTS: Thirty-eight UCLP patients with complete records. Among them, 14 were later treated with RHG (RHG group) and 24 were under review (non-RHG group) before definitive orthodontic or in conjunction with orthognathic surgery. INTERVENTIONS: Study models at T1 (aged 9.4 ± 0.4 years old), prebone grafting and before any orthodontic treatment started; T2 (aged 11.3 ± 0.6 years old), after bone grafting, and RHG treatment (RHG group) or under review (non-RHG group); and T3 (aged 15.3 ± 3.2 years old), pretreatment of definitive orthodontic or in conjunction with orthognathic surgery. MAIN OUTCOME MEASURES: With satisfactory intra- and interexaminer agreement proven by the kappa value, the dental arch relationships of the study models at T1, T2, and T3 were assessed by a solo calibrated examiner using the GOSLON Yardstick. RESULTS: The median GOSLON score for southern Chinese patients with UCLP at T1 was 4.0. Sixty percent of the patients were categorized as "poor" at T1. RHG significantly improved dental arch relationships from T1 to T2, and the improvement was maintained until T3 assessed by the GOSLON Yardstick. CONCLUSIONS: The dental arch relationships in southern Chinese UCLP patients at 8 to 10 years old are unfavorable. RHG treatment shows positive effects in improving the dental arch relationships in UCLP patients, as assessed by the GOSLON Yardstick.

Alignment Strategy for Constricted Maxillary Dental Arch in Patients With Unilateral Cleft Lip and Palate Using Fixed Orthodontic Appliance.

The purpose of this study was to compare the alignment pattern of the constricted maxillary dental arch by fixed orthodontic treatment (FOT) in the well-aligned and constricted arches of unilateral cleft lip and palate (UCLP) patients. 19 UCLP patients were divided into Group 1 (well-aligned arch, n = 9) and Group 2 (constricted arch, n = 10). After the cephalometric and maxillary dental arch variables before (T1) and after FOT (T2) were measured, statistical analysis was performed. There were no significant differences in the surgical timing of cheiloplasty, palatoplasty, and secondary alveolar bone grafting and in the surgical method of cheiloplasty between the 2 groups. However, Group 2 had a higher percentage of palatoplasty method, which could leave the denuded bone for secondary healing than Group 1 (P < 0.05). Although Group 2 showed more constriction and asymmetry in the maxillary dental arch compared to Group 1 at the T1 stage (inter-second premolar width, greater segment angle [GSA], and lesser segment angle [LSA], all P < 0.05), these problems could be effectively resolved by FOT. As a result, at the stage T2, there was no significant difference in all the variables between the 2 groups. During T1-T2, there was a different pattern in change of variables between Groups 1 and 2 (anterior segment angle in the greater segment [P < 0.05] in Group 1 and U1-SN [P < 0.01], inter-molar width [P < 0.05], GSA [P < 0.05[, and LSA [P < 0.01] in Group 2). Therefore, according to the maxillary dental arch shape, different strategy is necessary to obtain proper alignment by FOT.

Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 6. Dental arch relationships in 5 year-olds.

BACKGROUND AND AIM: Good dentofacial growth is a major goal in the treatment of unilateral cleft lip and palate (UCLP). The aim was to evaluate dental arch relationships at age 5 years after four different protocols of primary surgery for UCLP. DESIGN: Three parallel randomised clinical trials were undertaken as an international multi-centre study by 10 cleft teams in five countries: Denmark, Finland, Sweden, Norway, and the UK. METHODS: Three different surgical procedures for primary palatal repair (Arms B, C, D) were tested against a common procedure (Arm A) in the total cohort of 448 children born with non-syndromic UCLP. Study models of 418 patients (273 boys) at the mean age of 5.1 years (range = 4.8-7.0) were available. Dental arch relationships were assessed using the 5-year index by a blinded panel of 16 orthodontists. Kappa statistics were calculated to assess reliability. The trials were tested statistically with t- and Chi-square tests. RESULTS: Good-to-very good levels of intra- and interrater reliability were obtained (0.71-0.94 and 0.70-0.87). Comparisons within each trial showed no statistically significant differences in the mean 5-year index scores or their distributions between the common method and the local team protocol. The mean index scores varied from 2.52 (Trial 2, Arm C) to 2.94 (Trial 3, Arm D). CONCLUSION: The results of the three trials do not provide statistical evidence that one technique is better than the others. Further analysis of the possible influence of individual surgical skill and learning curve are being pursued in this dataset. TRIAL REGISTRATION: ISRCTN29932826.

Evaluation of the maxillofacial morphological characteristics of Apert syndrome infants.

Apert syndrome is a rare craniosynostosis syndrome characterized by irregular craniosynostosis, midface hypoplasia, and syndactyly of the hands and feet. Previous studies analyzed individuals with Apert syndrome and reported some facial and intraoral features caused by severe maxillary hypoplasia. However, these studies were performed by analyzing both individuals who had and those had not received a palate repair surgery, which had a high impact on the maxillary growth and occlusion. To highlight the intrinsic facial and intraoral features of Apert syndrome, five Japanese individuals with Apert syndrome from 5 years and 2 months to 9 years and 10 months without cleft palate were analyzed in this study. A concave profile and a skeletal Class III jaw-base relationship caused by severe maxillary hypoplasia were seen in all patients. The patients exhibited anterior and posterior crossbites possibly due to a small dental arch of Maxilla.

GAND classification and volumetric assessment of unilateral cleft lip and palate malformations using cone beam computed tomography.

The aim of this study was to propose a classification for unilateral cleft lip and palate (UCLP) malformations based on cone beam computed tomography (CBCT) images, as well as to estimate the amount of bone necessary for grafting, and to evaluate the relationship of this volume with scores obtained using the classification. CBCT images of 33 subjects with UCLP were evaluated according to gap, arch, nasal, and dental parameters (GAND classification). Additionally, these defects were segmented and the amount of graft needed for alveolar bone grafting was estimated. The reproducibility of GAND classification was analyzed by weighted kappa test. The association of volume assessment with the classification (gap and nasal parameters) was verified using analysis of variance, while the intra-observer agreement was analyzed using the intra-class correlation coefficient. The intra-observer reproducibility of the classification ranged from 0.29 to 0.92 and the inter-observer agreement ranged from 0.29 to 0.91. There were no statistically significant values when evaluating the association of the volume with the classification (P>0.05). The GAND classification is a novel system that allows the quick estimation of the extent and complexity of the cleft. It is not possible to estimate the amount of bone needed for alveolar bone grafting based on the classification; individualized surgical planning should be done for each patient specifically.

Alterações nas dimensões dos arcos dentários em pacientes com classe II, primeira divisão, tratados com AEB / Changes in dental arch dimensions in patients with class II, division 1, malocclusion treated with headgear

O objetivo deste estudo foi avaliar as possíveis alterações nas larguras intercaninos e intermolares, e no comprimento dos arcos dentários, em modelos de gesso, de pacientes submetidos ao tratamento ortodôntico com aparelho extrabucal (AEB). Para isso, foram selecionados 12 pares de modelos em gesso de pacientes com classe II, primeira divisão, antes e após o tratamento com AEB, totalizando 24 pares de modelos. As medidas da distância intermolares e intercaninos foram obtidas por meio de um paquímetro digital com precisão de 0,000 mm. Os resultados demonstraram aumento estatisticamente significante nas distâncias intermolares superiores. Não ocorreram diferenças estatisticamente significantes nas distâncias intercaninos e nos comprimentos dos arcos dentários. Concluiu-se que no tratamento ortodôntico com AEB em pacientes classe II, primeira divisão, na dentição mista, pode-se esperar um aumento significativo nas distâncias intermolares superiores...

The aim of this study was to evaluate possible changes in the intermolar distance, intercanine distance and arch length, through dental casts, of patients undergoing orthodontic treatment with headgear. To that end, we selected 12 pairs of dental casts of patients with class II, division 1 before and after treatment with headgear, totaling 24 pairs of dental casts. The measures of intermolar and intercanine distances were performed on casts with digital calipers accurate to 0.000 mm. The results showed a statistically significant increase in the upper intermolar distances. There were no statistically significant differences in the intercanine distances and dental arches lengths. It was concluded that orthodontic treatment with headgear in class II, division 1 patients, in mixed dentition we can expect a significant increase in the upper intermolar distances...

The Effect of Cleft Size in Infants With Unilateral Cleft Lip and Palate on Mixed Dentition Dental Arch Relationship.

OBJECTIVE: To determine the relationship between infant cleft size and dental arch relationship in the mixed dentition in patients with complete unilateral cleft lip and palate. DESIGN: Retrospective analysis of mixed longitudinal records. PATIENTS: A total of 29 consecutively enrolled patients with unilateral cleft lip and palate participated in a longitudinal study that included dental casts prior to lip surgery (T1: age 1 month), prior to palate surgery (T2: age 10 months), and in mixed dentition (T3: age 9 years). INTERVENTIONS: All infants were managed with lip repair (2.5 months), hard palate repair (12 months), and soft palate repair (16 months) but without any presurgical orthopedic treatment and no orthodontic intervention prior to mixed dentition records. MAIN OUTCOME MEASURES: The outcome measures included determination of an infant cleft severity ratio, defined as the ratio of palatal cleft area to palatal surface area, at both T1 and T2, and the 9-year-old (T3) dental arch relationship as determined using the GOSLON Yardstick. The correlation between the infant cleft severity ratio at T1 and T2 and the later GOSLON Yardstick score at T3 was determined using Pearson r. The intrarater reliability of the infant cleft severity ratio was assessed with Pearson r and the interrater reliability of the GOSLON Yardstick ratings, by weighted kappa. RESULTS: Reliability for the infant cleft severity ratio method was r = .92 to .95, and for GOSLON ratings κ = .81 to .91. There was no significant correlation between 1-month infant cleft severity ratio and GOSLON (r = .3) and 10-month infant cleft severity ratio and GOSLON (r = .1). CONCLUSIONS: Cleft size versus the amount of palatal tissue available for repair and concern over more scarring with a greater infant cleft severity ratio were not factors in affecting the eventual dental arch relationship.

Special distraction osteogenesis before bone grafting for alveolar cleft defects to correct maxillary deformities in patients with bilateral cleft lips and palates: distraction osteogenesis performed separately for each bone segment.

INTRODUCTION: Patients with bilateral cleft lips and palates have premaxillary protrusion and characteristic jaw deformities involving three-dimensional malposition of the premaxilla and bilateral maxillary bone segments. This study examined patients with bilateral cleft lips and palates who had deviation and hypoplasia of the premaxillas and bilateral maxillary segments. Before bone grafting, the patients were treated with special distraction performed separately for each bone segment using a halo-type external device. This report describes this novel treatment method which produced good results. MATERIAL AND METHODS: The subjects were five patients with severe jaw deformities due to bilateral cleft lip and palate. They were treated with maxillary Le Fort I osteotomy and subsequent distraction performed separately for each bone segment using a halo device. In three of five patients, premaxillary osteotomy was not performed, and osteotomy and distraction were performed only for the right and left lateral segments with severe hypoplasia. RESULTS: All patients achieved distraction close to the desired amount. The widths of the alveolar clefts were narrowed, and satisfactory occlusion and maxillary arch form were achieved. After the surgery, three of five patients underwent bone grafting for bilateral alveolar cleft defects and the bone graft survival was satisfactory. CONCLUSIONS: This method had many benefits, including narrowing of alveolar clefts, improvement of maxillary hypoplasia, and achievement of a good maxillary arch form. In addition, subsequent bone grafting for alveolar cleft defects was beneficial, dental prostheses were unnecessary, and frequency of surgery and surgical invasiveness were reduced. This method is a good surgical procedure that should be considered for patients with bilateral cleft lips and palates who have premaxillary protrusion and hypoplasia of the right and left lateral segments.

Can occlusal evaluation of children with unilateral cleft lip and palate help determine future maxillofacial morphology?

Objective : To investigate the change in occlusal evaluations from the 5-year-olds' index to the Goslon Yardstick and to compare the relationship between the evaluations and maxillofacial growth in patients with complete unilateral cleft lip and palate (UCLP). Design : A prospective longitudinal study. Subjects : The sample consisted of 85 patients with complete UCLP who underwent surgery from 1969 to 1994 and were treated at the Kyushu University Hospital in Fukuoka, Japan. Subjects had two serial dental casts performed at the ages of 5 and 10 years. Furthermore, each patient had lateral cephalographs taken at the age of 5 years, 76 of 85 subjects had films taken at the age of 10 years, and 54 subjects also had lateral cephalograms taken after the age of 15 years. Methods : Every dental cast was evaluated by the 5-year-olds' index and the Goslon Yardstick, respectively. The lateral cephalographs were traced and digitized, and angular dimensions were calculated. Outcomes were compared using Spearman's rank-order correlation analysis and the Kruskal-Wallis analysis. Results and Conclusion : Dental arch relationships were evaluated and rated as 2.96 in the 5-year-olds' index and 2.85 in the Goslon Yardstick, respectively. Both groupings showed a significant relationship, and they showed no change in 36 out of 85 subjects (42.3%), significant improvement in 30 (35.3%), and deterioration in 19 (22.3%). Two occlusal groupings and maxillofacial morphology on the cephalographs indicated that the grouping reflected the anteroposterior position of the mandible. Moreover, both groupings showed some relation to previous maxillofacial growth, but they did not show any relationship with future growth. The Goslon Yardstick may not predict maxillofacial morphology in adulthood.

Herencia autosómica recesiva en paciente no sindrómico con múltiples dientes supernumerarios / Autosomal recessive inheritance in a non-syndromic patient with multiple supernumerary teeth

La hiperdoncia es una condición caracterizada por la presencia de un número de dientes superior al normal en el arco dentario. Su etiología es incierta, aunque factores genéticos y ambientales así como varias teorías han sido propuestas para explicarlo. Describir las características clínicas y radiográficas presentes en un paciente no sindrómico con múltiples supernumerarios, heredados de manera autosómica recesiva. Se presenta el caso de un hombre de 27 años de edad que acudió a consulta para evaluación odontológica. Al examen físico y extrabucal no reveló deformidades, retardo mental ni presencia de ningún síndrome. Al examen intrabucal se evidenció la presencia de irritantes locales y maloclusión dentaria, ocasionada por el aumento del número dientes en los arcos dentarios. Radiográficamente se observaron múltiples imágenes radiopacas compatibles con 9 unidades dentarias incluidas y 2 erupcionadas. Los exámenes de laboratorio no revelaron alteraciones ni relación con algún síndrome. Se solicitaron radiografías panorámicas a los padres, hermanos e hija del paciente, para descartar la presencia de dientes supernumerarios, encontrándose 9 dientes supernumerarios incluidos en un hermano varón, determinándose la trasmisión del rasgo de manera autosómica recesiva. El hallazgo de la trasmisión de manera autosómica recesiva de múltiples supernumerarios en un paciente no sindrómico encontrado en este caso, no es común, lo cual indica que el examen clínico y estudio de cada paciente debe ser llevado a cabo de manera exhaustiva, para determinar este tipo de trastorno o cualquier otro sin evidencias o manifestaciones clínicas.

Hyperdontia is a condition characterized by the presence of a higher number of teeth than normal in the dental arch. Even though genetic and environmental factors as well as a series of theories have been proposed to explain hyperdontia, its etiology is uncertain. To describe clinical and radiographical characteristics found in a non-syndromic patient with multiple supernumerary teeth by autosomal recessive inheritance. A 27-year-old male referred for dental assessment. Physical and extraoral examinations did not reveal deformities, mental retardation or the presence of syndromes. Intraoral examination evidenced the presence of local irritants and dental malocclusion produced by the increased number of teeth in both dental arches. Radiographs revealed multiple radiopaque images compatible with 9 unerupted and 2 erupted teeth. Laboratory tests did not show alterations or a connection to any syndromes. Panoramic radiographs were requested from parents, siblings and daughter of the patient to rule out the presence of supernumerary teeth. Nine supernumerary unerupted teeth were found in one brother, which determined the transmission of characteristics by autosomal recessive inheritance. The incidental finding of the autosomal recessive transmission of multiple supernumerary teeth in a non-syndromic patient observed in this case is not a common result, indicating that clinical examinations and the study of each patient must be carried out thoroughly in order to determine this or any other type of disorders without evidence or clinical manifestations.

Evaluación de anchos intercaninos e intermolares en escolares con dentición mixta, Comuna de Contulmo, Chile / Evaluation of intercanine and intermolar widths in students with mixed dentition, Contulmo Commune, Chile

Introducción: El éxito del tratamiento ortodóncico temprano se fundamenta en el conocimiento del desarrollo de la dentición, por lo cual la medición de susdimensiones en los diferentes estadios de desarrollo se considera como un factor predictor para el tratamiento y rehabilitación de la población. Objetivo: Conocer y evaluar las características cuantitativas de los anchos intercaninos e intermolares según sexo en la población de niños de 6 a 8 años de la Escuela Artística San Luis de Contulmo.Metodología: Estudio cuantitativo, no experimental, de corte transversal, descriptivo y correlacional. La población de estudio correspondió a 48 alumnos de 6 a 8 años seleccionados por muestreo por conveniencia, a los cuales se les tomó modelos de estudio, midiendo y comparando los anchos intercaninos e intermolares. Resultados: Los promedios resultantes de las mediciones efectuadas fueron: distancia intercanina maxilar 33,2 +/-2,6 mm en hombres y 32,2 +/-2,3 mm en mujeres, respectivamente la distancia intercanina mandibular 27,1 +/-2,3 mm y 26, 6 +/-1,9 mm, la distancia intermolar maxilar 51,9 +/-3,1 y 51,2 +/-3,0 mm y la distancia intermolar mandibular 46 +/-2,6 y 44,8 +/-3,0 mm. Conclusión: Las diferencias entre los anchos intercaninos e intermolares según sexo no son significativas, en cuanto a la edad se observan diferencias significativas entre los 6 y 8 años en el sexo masculino, no así en el femenino. Este estudio representa un interesante punto de partida para el análisis y discusión de futuras investigaciones.

Introduction: The early orthodontic treatment success is based on knowledge the development of the dentition, so measuring their dimensions at different stages of development is considered as a predictor for treatment and rehabilitation of the population. Objective: To explore and evaluate the quantitative characteristics of intercanine and intermolar widths by sex in the population of children of 6-8 years of the Escuela Artistica San Luis de Contulmo. Methodology: quantitative study, non-experimental, cross-sectional, descriptive and correlational. The study population corresponded to 48 students from 6 to 8 years selected by probabilistic sampling, unintentional and opportunistic, to which took study models, measuring and comparing intercanine and intermolar widths. Results: The resulting averages of measurements were: maxillary intercanine 33.2 +/-2.6 mm in men and 32.2 +/-2.3 mm in women, mandibular intercanine distances respectively 27.1 +/- 2.3 mm and 26 6 +/-1.9 mm, the distance intermolar maxillary 51.9 +/-3.1 and 51.2 +/-3.0 mm and the distance mandibular intermolar 46 +/-2.6 and 44.8 +/-3.0 mm. Conclusion: In relation to the difference between intercanine and intermolar widths by sex are not significant, in terms of age significant differences between 6 and 8 males but not in females. This study represents an interesting starting point for the analysis and discussion of future research.

A longitudinal study of dental arch morphology in children with the syndrome of Crouzon or Apert.

The aim of this study was to compare changes in dental arch morphology between patients with Crouzon syndrome or Apert syndrome and controls. Children between 4 and 14 yr of age with Crouzon syndrome (n = 40) or Apert syndrome (n = 28) were compared with non-syndromic controls (n = 457) in terms of arch widths, depths, and length dimensions. Multilevel statistical modeling techniques were used to evaluate changes over time. Dental arch dimensions were found to be smaller in patients with Crouzon syndrome or Apert syndrome compared with control subjects. Maxillary intercanine width for patients with Apert syndrome were increased, whilst other arch width variables showed no change. Patients with Crouzon syndrome showed increases in maxillary intercanine width, whilst intermolar width showed no change over time. Dental arch dimensions in syndromic patients were thus found to be consistently smaller than in control subjects between 4 and 14 yr of age, implying that patients with Crouzon syndrome and Apert syndrome had a diminished growth potential.

Oral and dental restoration of wide alveolar cleft using distraction osteogenesis and temporary anchorage devices.

Closure of large alveolar clefts and restoration by a fixed bridge supported by implants is a challenge in cleft alveolus treatment. A major aesthetic concern with distraction osteogenesis is obtaining a predictable position of the implant in relation to the newly generated bony alveolar ridge. We describe the treatment of a large cleft alveolus and palate reconstruction by distraction osteogenesis utilizing temporary anchorage devices (TADs) followed by a fixed implant-supported bridge. The method consists of segmental bone transport by distraction osteogenesis using a bone-borne distractor to minimize the alveolar cleft, followed by closure of the residual small defect by bone grafting three months later. During the active transport distraction, TADs were used exerting multidirectional forces to control the distraction vector forward and laterally for better interarch relation. A vertical alveolar distraction of the newly reconstructed bone of 15 mm facilitated optimal implant placement. The endosseous implants were osteointegrated and supported a fixed dental prosthesis. In conclusion, the large cleft alveolus defect was repaired in three dimensions by distraction osteogenesis assisted by TADs, and the soft tissues expanded simultaneously. Endosseous implants were introduced in the newly reconstructed bone for a fixed dental prosthesis enabling, rehabilitation of aesthetics, eating and speaking.

Correction of an asymmetric maxillary dental arch by alveolar bone distraction osteogenesis.

This case report describes a new surgical orthodontic approach involving alveolar bone distraction osteogenesis for correction of an asymmetric maxillary dental arch. The treatment was combined with conventional orthognathic surgery to improve the mandibular lateral deviation. This new treatment strategy produced an ideal dental arch and a symmetric facial appearance efficiently and effectively.

Dento-alveolar characteristics in adolescents born extremely preterm.

It has been shown that children born extremely preterm (EPT) often suffer from medical complications and growth restrictions in early childhood. Catchup growth diminishes these effects but the children are known to have lower weight, height, and head circumference as school children. Effects on enamel development have been shown. How this affects the dento-alveolar outcome during adolescence is not known. Forty EPT children with a gestational age (GA) of less than 29 weeks, at 12-16 years of age, and matched healthy controls born at term, with a GA of 37-43 weeks, were examined. Data from the clinical examination, dental casts, and bitewing radiographs were collected and compared. Malocclusion was noted, and dento-alveolar length, width, palatal height, and mesio-distal tooth width were measured. Medical diagnoses, neurological, and neuropsychiatric disturbances were noted at the time of the survey. The two groups were compared with an epidemiological normal reference material. The results showed no differences between the controls and reference material. Angle Class II was the most frequent malocclusion associated with morbidity, neurological, and neuropsychiatric disturbances, followed by deep bite and overjet. Three or more malocclusions were almost twice as common among the EPT children compared with the controls. Significantly smaller incisors, canines, and first molars were found. In summary, the EPT children, during adolescence, had medical aberrations as well as dento-alveolar effects opposed to the healthy children born at term. Dentists should be aware of this and treatment plans should be made in due time.