Hemandibular hypoplasia successfully treated with functional appliances: is it truly hemifacial microsomia?

The literature contains a number of case reports on successful orthopedic treatment of hemifacial microsomia (HFM), with surprising changes in the morphology of the condyles. All of these reports regard patients who have substantially no soft tissue involvement but only severe mandibular ramus and condyle deformities. A number of cases with unexpectedly similar phenotypes diagnosed as HFM are described. The authors suggest that it is possible that all of these cases might be misdiagnosed traumatic injuries of the condyle, which present a normal functional matrix and, therefore, with growth and with the help of functional stimulation, tend to grow toward the original symmetry.

Bilateral dental fusion of the upper central incisors: a multidisciplinary approach.

UNLABELLED: The multidisciplinary treatment of a case of bilateral dental fusion of the upper central incisors with maxillary constriction, crowding, and palatal inversion of one of the lateral incisors is reported. The rarity with which this anomaly appears, along with its complex characteristics, often make it extremely difficult to treat. It requires the involvement of different specialists to find the most suitable treatment for each individual patient. CLINICAL SIGNIFICANCE: This particular case of bilateral dental fusion required the involvement of orthodontists, periodontists, endodontists, and restorative specialists. For the individual evaluation of these extremely complex cases, the esthetic and functional results to be reached must be assessed compared to treatment times and biologic and economical costs. The long-term prognoses of these complex therapies also must be borne in mind.

Skeletal and dental modifications produced by the Bionator III appliance.

The therapeutic results of a functional orthopedic treatment with a Balters' Bionator III appliance were evaluated. The sample group included 39 white growing subjects with a dentoskeletal Class III malocclusion. A 2-year study compared results with a control group. The results showed that the Bionator III is effective, especially when the malocclusion is mainly the result of a midfacial deficiency and when there is a hypodivergent growth pattern.

Oral environment temperature changes induced by cold/hot liquid intake.

The use of NiTi shape memory alloys, introduced into orthodontics because of their ability to develop light continuous forces that prove more effective than heavy intermittent forces in the teeth movement, requires the mastering of the functional properties of NiTi wires. More specifically, the recovery force acting on the teeth is a sensitive function of temperature: knowledge of oral temperature modifications is therefore required to understand the stress state modification felt during orthodontic therapy. The temperature modifications induced by cold or hot drink intake in the oral cavity were investigated by using arch wires, fixed to removable Hawley retainers, similar to those currently used in orthodontic practice, by means of six temperature sensors placed in correspondence with specific teeth. Similarly, the temperature changes were detected on a metallic frame, fixed onto the palatal zone to a Hawley retainer, where a palatal expander was placed to correct unilateral or bilateral crossbites in deciduous or in early mixed dentition. The maximum temperature change was observed in the interincisor area: The temperature modification on other teeth depends on the modality of drink intake, with the highest temperature variations being detected in the palatal zone. Hence modifications in the stress state during orthodontic therapy with NiTi wires are to be expected.

[Ultrasonography assessment of ossification foci of the wrist and pubertal growth spurt]. / Valutazione ecografica dei nuclei di ossificazione del polso e del picco di crescita puberale.

High-resolution ultrasound (US) of the hand and wrist was compared with radiography in 26 young patients (mean age: 11.4 years) to be submitted to orthodontic therapy. US scans were targeted on the ossification centers critical for the growth spurt, namely the pisiform and adductor sesamoid bones of the metacarpophalangeal joint of the thumb and the cartilage of the distal phalanx of the third finger. All images were retrospectively reviewed on a double-blind basis by two independent observers who gave a conspicuity score to each structure of interest. All the scores were submitted to statistical analysis with the Wilcoxon test. US images clearly demonstrated the initial appearance of the ossification centers of the pisiform and sesamoid bones. These structures appeared as hyperechoic spots causing marked acoustic shadowing. The persistence of the phalangeal cartilage was depicted as a thin rim interrupting the hyperechoic cortical profile of the bone. US results were statistically equivalent to radiographic findings in the pisiform [p (op1) = .3105; p (op2) = .8886] and sesamoid bones of the thumb [p (op1) = .1386; p (op2) = .354]. A statistically significant difference between the two techniques was found in the third finger cartilage (p (op1) = .0277; p (op2) = .0759) because its profile was poorly depicted on some US images. To conclude, wrist US is proposed as a simple and valuable radiation-free support examination for the follow-up of skeletal maturation in adolescents to be submitted to orthodontic therapy.

[Lateral teleradiography of the cranium: the effect of head positioning in the interpretation of cephalometric tracings. An experimental study on a phantom]. / Teleradiografia laterale del cranio: influenza del posizionamento del capo nella interpretazione dei tracciati cefalometrici. Studio sperimentale su fantoccio.

PURPOSE: To assess the influence of head mispositioning during lateral teleradiography of the skull for cephalometric purposes. MATERIAL AND METHODS: We used a human dry skull fixed on a professional support at a three level angular scale to quantitate lateral and anteroposterior rotations and inclinations. We took 15 radiographs at different angles (-2 degrees and -4 degrees right rotation; +2 degrees and +4 degrees left rotation; -2 degrees and -4 degrees anterior roll; +2 degrees and +4 degrees posterior roll; -2 degrees and -4 degrees right pitch; +2 degrees and +4 degrees left pitch; + 2 degrees left rotation and -2 degrees anterior roll; +2 degrees left rotation and +2 degrees left pitch). RESULTS: The analysis of the 15 radiographic tracings compared with the one obtained with the head positioned correctly showed no substantial differences in angular and linear values; no difference was such as to invalidate tracing. DISCUSSION: When skull malpositioning limited within 4 degrees, the angular and linear measurements of the cephalometric tracing are reliable and accurate. Nevertheless, cephalometric findings must always be integrated with clinical and history data. CONCLUSIONS: We believe that even less than perfect teleradiographs of the skull should be used for cephalometric purposes because, even though they require more care of the dentist to analyze them, the results are reliable and the patient is spared further X-ray exposure.

[Digital cephalometric teleradiography with storage phosphors. Comparative study]. / La teleradiografia cefalometrica digitale con fosfori a memoria. Studio comparativo.

Digital cephalometric radiography with light-emitting phosphors was performed on 15 patients during an orthodontic survey. Lateral views were performed; digital post-processing was carried out according to 3 different sets of characteristic variables (analogic-like, Xeroradiography-like and custom-made). Comparative cephalometric film radiographs were performed on another group of 15 patients matched for age and clinical problems. All the digital and conventional images were evaluated by 3 independent observers, who scored 0-2 the visibility of 16 cephalometric landmarks. Digital cephalometric radiography always provided good and clear images, which were easy to read by every observer, thanks to contrast optimization in the digital technique and to the possibility of interactive post-processing that could improve the lowest-quality images. The visibility study of 16 cephalometric landmarks resulted in a moderately higher score for film cephalography than for the digital technique (79.6/96 versus 78.1/96). Among digital post-processing variables, the customized curve gave the best results (mean score: 78.8/96). Digital cephalometric radiography allowed marked reduction in radiation dose (approximately 30-40% of conventional radiographs). This is a major factor when considering the widespread use of this technique and the young age of most patients.

[Morphological surface analysis of nickel-titanium wires. Preliminary SEM observations]. / Analisi morfologica superficiale dei fili in nichel-titanio: osservazioni preliminari al SEM.

Authors studied with Scanning Electron Microscopy (SEM) the surface morphology of new manufactured orthodontic arches made of rectangular NiTi wires. All the wires exhibite various patterns of superficial defects such as scratches and pits. Results suggest to further investigate the changes of wire surfaces subsequent to their use in oral environment and sterilization procedures.

[Changes in the yeast oral flora in patients in orthodontic treatment]. / Modificazioni della flora orale di lieviti nei pazienti in trattamento ortodontico.

The Authors analyzed the modifications of some components of salivary microflora (S. mutans, Lactobacillus and yeasts) induced by orthodontic treatment. This one is able to modify the oral microflora, increasing cariogenic microorganisms concentrations in plaque and saliva. Our results demonstrated a high caries risk for the subjects of the experimental group; this data suggest the need for a critical evaluation of preventive protocols applied to the orthodontic patients.

[Etiopathogenesis and early treatment of malocclusions related to persistence of atypical deglutition]. / Eziopatogenesi e trattamento precoce delle malocclusioni correlate al perdurare della deglutizione atipica.

Swallowing disorders can cause maxillary deformation. Nosological, diagnostic and therapeutic aspects are considered.

[Toxico-allergic phenomena connected to the use of nickel-containing alloys]. / Fenomeni tossico-allergici correlati all'impiego di leghe contenenti nichel.

The biocompatibility of unprecious metal alloys, particularly those containing nickel, is controversial. Nickel is a known cancerous agent, and the main responsible of metal allergic reactions in human. Dentists must be aware about risks related to this material. It is mandatory carry out careful anamnesis about nickel hypersensitivity avoiding it in subject with known hypersensibility.

[Role of prolonged sucking in the development of dento-skeletal changes in the face. Review of the literature]. / Ruolo del succhiamento protratto nell'insorgenza di alterazioni dento-scheletriche del distretto facciale: revisione della letteratura.

Thumbsucking is the earliest and most common habit in children, affecting almost the 45% of young population in the world, from birth through adolescence. Infantile digital sucking and other non-nutritive sucking habits have been significantly correlated with malocclusion in both primary and permanent dentitions. The severity of malocclusions correlated with such habits depends on the frequency, the duration, the intensity and the position of the thumb in the mouth. Prolonged fingersucking may cause an anterior open bite, diastema, proclination and protrusion of maxillary incisors, increased overjet and overbite, retrusive position of mandible, posterior cross-bite. Self correction of malocclusions may occur if the habit is discontinued before 4 y.o.

[Role of lower third molars in the development of dental malocclusion: review of the literature]. / Ruolo dei terzi molari inferiori nell' insorgenza di malocclusioni dentarie: revisione della letteratura.

The Author's aims was to review the role of the lower third molars in delayed crowding of the jaw. A global agreement exists on the fact that lower molars should be considered only one between several factors able to cause malocclusion. Finally, the germectomy of the third molars has to be performed only in carefully selected patients after a comprehensive diagnostic evaluation of the single case.

[Multidisciplinary approach to repositioning of impacted upper canines]. / Approccio multidisciplinare al riposizionamento dei canini superiori inclusi.

In this paper, the Authors present epidemiology, ethiopatology, diagnosis and treatments elements of the impacted canines. Furthermore they describe the different surgical techniques needed for the exposure of these teeth.

[Infection control in orthodontics: infective agents and modality of transmission. 1]. / Il controllo delle infezionti in ortodonzia: agenti infettani e modalita di tramsissione. Parte I.

Adequate attention to prevention of cross-contamination in dental operatory is largely ignored by orthodontists. This occurs for two principal reasons. The first one is that orthodontic patients, usually children, are erroneously considered a low-risk population. The second one is that orthodontic procedures are usually considered nontissue invasive and not able to produce contamination of staff, patients or instruments. Nevertheless, since 1972, we know that we can find HBsAg in saliva too and moreover we cannot exclude to see blood in the mouth of our patients during orthodontic procedures. Furthermore the high volume of patients that orthodontists see every day and the possibility to treat orthodontically adult patients, take the risk of cross-contamination in orthodontic at the same level of other dental practices. The aim of the Authors is to sensitize orthodontists to the risk of cross-contamination giving the latest data of prevalence of hepatitis, tuberculosis and AIDS in adolescent population.

[Agenesis of the upper lateral incisor: orthodontic therapy and replacement]. / L'agenesia dell'incisivo laterale superiore: terapia ortodontica e di sostituzione.

In this paper the Authors outline an uneven prevalence of superior lateral incisors agenesis. The treatment of this situation can be accomplished by various methods. It is possible to obtain the complete closure of dental spaces or maintain the physiological space. The Authors present four cases of young patients in which they decided to maintain orthodontically the space and to put them adhesive bridges.

[Optimization of the surgical technic for extraction of the lower third molars]. / Ottimizzazione della tecnica chirurgica per l'avulsione dei terzi molari inferiori.

The high incidence of third molar extraction is related to their frequent pathology. The use of an uncomplicated and reliable diagnostic and therapeutic protocol therefore became extremely important. The protocol has to include careful selection and preparation as well as the appropriate choice of instruments and surgical techniques. This is even more important, considering the elective nature of the procedure and the local and more rarely, systemic complications that could develop.