Comparison between rapid and mixed maxillary expansion through an assessment of dento-skeletal effects on posteroanterior cephalometry.

BACKGROUND: The aim of this study is to compare the dento-skeletal effects of rapid maxillary expansion (RME) and mixed maxillary expansion (MME), assessed on posteroanterior (PA) cephalograms. METHODS: Treatment groups consisted of 42 patients; mean age in RME group (n = 21,13 female and 8 male subjects) was 8.8 years ± 1.37 at T0 and 9.6 years ± 1.45 at T1 and mean age in MME group (n = 21, 12 female and 9 male patients) was 8.9 years ± 2.34 at T0 and 10.5 years ± 2.08 at T1. Seventeen bilateral anatomic landmarks, 16 linear (12 skeletal and 4 dental) and 4 angular measurements were assessed for each patient at T0 and T1. Data from the two groups were compared using independent sample t test (p < 0.05). RESULTS: At T0, the groups were similar for all examined variables (p > 0.05). Significant and equal increase of lateronasal and maxillary and upper and lower molar widths (p < 0. 01) occurred in both groups at T1. Significant but different increases were observed for maxillary incisal, upper left first molar-lateroorbitale, and maxillary first molar angles (p < 0.001 vs. p < 0.05). Significant increases were reported for upper inter-incisal width apex (p < 0.001) and upper right first molar-lateroorbitale angle (p < 0.05) only in the RME group. At T1, differences in maxillary incisal angle (p < 0.05), upper left first molar-lateroorbitale, and maxillary first molar angles (p < 0.001) were noted. CONCLUSIONS: RME and MME were both effective to increase skeletal transverse dimensions by opening mid-palatal suture in growing patients, while MME was associated with minor dental side effects than RME.

Cytological assessment of healing palatal donor site wounds and grafted gingival wounds after application of ozonated oil: an eighteen-month randomized controlled clinical trial.

OBJECTIVE: The present study was undertaken to assess the therapeutic effects of topical ozonated oil on early healing of free gingival graft surgical sites. STUDY DESIGN: Twenty subjects were entered into this triple-blinded, randomized, placebo-controlled clinical trial, designed to evaluate the efficacy of ozonated oil on free gingival graft surgical wounds. Subjects were assigned to either the ozone group, in which ozonated oil was applied to the surgical wound, or the control group, in which non-ozonated oil was used as a control. Patients were postoperatively evaluated by cytological analysis. Cytological analysis consisted of the keratinisation and superficial cell indices measured at baseline, after 24 h, on the 3rd, 7th, 14th and 21st day and 2, 3, 8 and 18 months postoperatively. RESULTS: Cytological results showed that there was a significant (p < 0.001) improvement in epithelial healing by the 7th, 14th and 21st day and 2, 3 and 8 months postoperatively in the ozone group compared to the control group. CONCLUSION: The present study showed significant improvement in epithelial healing and gingival health after topical application of ozone-treated plant oil to gingival surgical sites.

New osteotomy for transport of a disc of alveolar bone to close an oronasal fistula during distraction osteogenesis for reconstruction of a maxillary defect: in vitro assessment.

We describe a new osteotomy for transport of a disc of alveolar bone, which can simultaneously close an oronasal fistula with two layers of mucoperiosteum during distraction osteogenesis for reconstruction of a maxillary defect.

A novel method for the assessment of three-dimensional tooth movement during orthodontic treatment.

OBJECTIVE: To (1) evaluate the stability of palatal rugae as landmarks for superimposition of dental casts and (2) establish a three-dimensional superimposition method of maxillary dental casts for analyzing orthodontic tooth movement. MATERIALS AND METHODS: The sample consisted of dental casts obtained from 10 patients treated with extraction of bilateral maxillary first premolars and placement of three palatal miniscrews as anchorage for retraction of the anterior teeth. Dental casts were measured by means of laser surface scanning system, and three-dimensional images were reconstructed. Serial dental casts were superimposed on the three miniscrews as registration landmarks (miniscrew-superimposition method), and the displacement of each palatal ruga point during the closure of extraction spaces was measured. Displacement of the central incisors was measured by the miniscrew-superimposition method and the proposed superimposition technique (ruga-palate-superimposition method). Correlation analysis and paired t-tests were performed to determine whether a significant difference existed between the measurements of the two superimposition methods. RESULTS: The medial points of the third palatal rugae and the shape of the palatal vault were stable throughout the treatment. The displacement of the central incisors measured using the ruga-palate-superimposition method showed no significant difference with that measured using the miniscrew-superimposition method. CONCLUSION: The maxillary dental casts can be reliably superimposed on the medial points of the third palatal rugae and the palatal vault as reference landmarks.

Geometric morphometric assessment of treatment effects of maxillary protraction combined with chin cup appliance on the maxillofacial complex.

The aim of this study was to investigate the treatment effects on the maxillofacial complex by maxillary protraction combined with chin cup therapy among growing children. An effective geometric morphometric assessment of cephalometric radiographs, using Procrustes analysis and thin-plate spline analysis, was applied to evaluate shape change in the craniofacial and midfacial configurations of a treated sample of 20 children with skeletal Class III malocclusion. This was compared with matched untreated skeletal Class III controls. Marked treatment induced change involved the maxilla and the mandible. Major deformation consisted of forward advancement of the maxillary complex with negligible rotation of the palatal plane and a forward direction of growth of the mandibular condyle associated with a restriction in sagittal advancement of the chin. Considerable dentoalveolar components contributed to the correction of anterior crossbite. Further detailed study of skeletofacial remodelling in response to maxillary protraction in other skeletal components, including the cranial base and the mandibular complex that contribute to Class III skeletal discrepancies, is warranted.

Electrochemical and cytocompatibility assessment of NiTiNOL memory shape alloy for orthodontic use.

Orthodontic arcs and wires are mostly realised from alloys and constitute the motor of dental shifting. Ti-base alloys rapidly replaced the formerly used stainless steel wires due to their excellent corrosion resistance, their high mechanical characteristics and their increased biocompatibility. NiTiNOL shape memory alloys add to these advantages their ability of deforming force. NiTiNOL, highly pure Nickel (hp-Ni) and commercially pure titanium (cp-Ti) were tested by electrochemical assays in artificial saliva and in vitro biological tests with L132 cells and HEPM cells. All tests gave concordant results: the electrochemical assays, the proliferation test, the colony forming method, and the inflammatory test clearly show, that nickel is a corrosive and a cytotoxic material. Ti and NiTiNOL are cytocompatible and in particular corrosion resistant. No significant differences are observed for both materials on the electrochemical and the biological level as well. The NiTiNOL shape memory alloy is a master trump for dental practitioners to repair occlusal defects by shifting teeth under optimal biological conditions. In spite of its high Ni-content, it is biocompatible. It considerably reduces the tune of therapeutic treatment, facilitate the occlusal concept and leads to a result of high clinical quality.

Preoperative histologic assessment of head and neck lesions using cutting needle biopsy.

OBJECTIVE: This study assessed the clinical utility of cutting needle biopsy in which a newly developed Monopty biopsy instrument (MBI) (Monopty, Bard Urologic Division; Covington, Ga) was used in the preoperative assessment of head and neck lesions. STUDY DESIGN: Needle biopsies were performed with the MBI in 16 cases of head and neck lesions that included lesions in lymph nodes, salivary glands, palate, and soft tissue. RESULTS: High-quality histopathologic specimens were obtained without complications in all biopsies performed, and the diagnostic target tissue was obtained in 15 of 16 cases. Diagnoses made from MBI needle biopsy specimens were consistent with the final diagnoses made from subsequent surgical materials in 14 cases, and the accuracy rate was 88%. None of the samples demonstrated significant rush artifacts or obscuring blood, both of which are problems commonly associated with manual biopsy techniques. CONCLUSIONS: This technique offers a safe and effective means of obtaining adequate tissue for the histological assessment of head and neck lesions.

"Prosthetic condition" and patients' judgment of complete dentures.

PURPOSE: This study introduces the concept "prosthetic condition", which combines the quality of complete dentures and residual alveolar ridges. MATERIAL AND METHODS: A pilot study was performed to select quality criteria with an acceptable interobserver agreement. With these criteria, a clinical examination was performed to assess the quality of the existing complete dentures and the residual alveolar ridges of 397 complete denture wearers. During clinical examination, the interobserver agreement of the selected criteria was retested. The "prosthetic condition" was assessed by combining the scores for denture quality and quality of the residual alveolar ridges. Subsequently, participants' satisfaction with and complaints about their dentures were scored according to their answers to specific questions. RESULTS: Logistic regression analysis demonstrated that no variable of the "prosthetic condition" proved to explain the denture satisfaction. Some variables of the "prosthetic condition" had a significant but not relevant correlation with some denture complaints. CONCLUSIONS: More research is necessary to substantiate the concept "prosthetic condition" as an acceptable measure of professionally quality assessment of dentures and denture-bearing surfaces. However, in determining the treatment need of community-dwelling groups, this concept seems a more realistic measure than denture quality only.

Nomogram for assessment of restoration of a positive overjet in unilateral cleft lip and palate.

In 92 patients with unilateral cleft lip and palate investigated on a long-term basis correlation-regression analysis of the development of overjet according to the development of interalveolar relations assessed in a defined method from X-ray films at the ages of 5, 10, 15 years and in adult age was implemented. The limits comprising 95% of the assembled data were also defined. Based on this analysis a formerly elaborated nomogram for age 10-15 years was extended for the whole postnatal period. Nomogram makes it possible to estimate from a single X-ray cephalometric parameter the risk of failure of the restoration of a positive overjet according to the age of the patient. The system defines critical boundaries which must be achieved for safe restoration of a positive overjet and makes it possible to check the course of treatment. The simple work with the nomogram and readily obtainable baseline data (age and X-ray cephalometric parameter on the interalveolar relations) make its application in clinical practice possible. It can serve as part of the documentation of the patient's therapy.

Preliminary assessment of the epithelial nuclear-cytoplasmic ratio and nuclear volume density in human palatal lesions.

We have analysed both the nuclear-cytoplasmic (N/C) ratio and nuclear volume densities (VVN) in defined strata from human hard palate lesions with and without malignant potential to determine the prognostic reliability and/or validity of this parameter. Measurements of cellular and nuclear areas of basal and spinous cells from normal (N) and pathological palatal epithelium were made on histological sections using an image analyser. The lesions comprised fibrous hyperplasia (FH), traumatic inflammation (INF), benign hyperkeratosis (HK), squamous cell papilloma (PP), dysplastic epithelium adjacent to invasive carcinoma (CE) and islands of invasive squamous cell carcinoma (CI). In basal cells, no significant differences were detected in comparisons of N/C and VVN between all pathological groups and the N control group. The mean value for CE was lower than that obtained for N. In spinous cells, the only statistically significant comparison was between IF and FH for both N/C and VVN. Both parameters were lower in CE than in N. Of all groups analysed except CI, the CE group is the only one likely to possess an increased malignant potential. The N/C ratio therefore seems to be of no value as a predictor of malignancy in palatal epithelial lesions.

Assessment of the nasopharyngeal area by cephalometry in cases of cleft lip and palate.

The nasopharyngeal area in 149 patients with cleft lip and palate and 157 normal individuals was evaluated by cephalometric radiography. The patients were male and female Caucasians, ranging in age from 12 to 16 years. Linear cephalometric parameters: (Ptm'-Sl; Ptm'-IPPF; IPPF-I, I-Ptm'), ANS angle and nasopharyngeal area were utilized. From comparative analysis of nasopharyngeal area in the cleft and the control groups, the following conclusions were made: 1) The nasopharyngeal area was smaller in the cleft group. 2) There was no correlation between ANS angle and nasopharyngeal area in either group.

Sickle cell gnathopathy: radiologic assessment.

To provide objective evaluation of sickle cell gnathopathy, lateral skull radiographs of fifty patients with sickle cell anemia and twenty-five controls, matched for age and sex, were evaluated with respect to hard palate length and palate--alveolar ridge (PAR) angle. These measurements were compared to the angle formed between sella, nasion, and a point just below the anterior nasal spine of the maxilla (SNA angle), which is widely used in evaluation of the midfacial skeletal profile. The maxillary protrusion was found to be due to an increase in the PAR angle, as there was significant difference in this measurement between the two groups while there was no difference in the hard palate and SNA angle measurements. In keeping with prior explanations, marrow hyperplasia is the cause of maxillary overgrowth. Although often detected clinically, sickle cell gnathopathy can be evaluated radiographically simply and accurately by measurement of the PAR angle.

Mutilation of the uvula among Bedouins of the South Sinai.

Mutilation of the uvula, as practiced by various tribes of Bedouins in the South Sinai, was discovered while carrying out anthropological studies in the area. Partial or total amputation of the uvula is performed on both boys and girls during the first or second year of life, as a ritual custom. Anatomical changes in the soft palate due to the uvulectomy in 115 subjects are described. The remnant of the uvula (scar) was classified according to size as: very large, large, medium, small, trace or none. A notch or kind of cleft of the palate, as a result of the uvulectomy, was considered the most extreme degree of extirpation. The majority (47%) were of small size and a notch was found in 9.6%. Changes in shape and symmetry of the arches of the palate as a result of the uvulectomy are also described. These changes are explained on the basis of the anatomical structure of the palate and uvula. The possible effects of the uvulectomy on health in general and on speech in particular are discussed.