Indicación de las distintas técnicas de expansión rápida del paladar quirúrgicamente asistida y comparativa de la estabilidad / Indication of the different surgically assisted rapid palatal expansion techniques and stability comparison

No disponible

Uso de una checklist para reducir los errores cognitivos en la enseñanza práctica odontológica / Use of checklist to reduce cognitive errors in dental practice teaching

Introducción: Las estrategias de razonamiento heurístico predominan en el ámbito clínico. En odontología, y en particular en la práctica clínica diaria ortodóncica, se hace esencial diagnosticar bajo condiciones de presión, lo que fomenta los errores cognitivos por parte de los alumnos. El objetivo de este estudio fue proponer y validar una checklist como herramienta para disminuir los errores cognitivos diagnósticos por parte de los alumnos. Sujetos y métodos: Treinta y seis estudiantes posgraduados realizaron dos evaluaciones clínicas de pacientes, una de la manera tradicional y otra aplicando la checklist propuesta. Resultados: Se produjo una disminución estadísticamente significativa (p < 0,05) en los errores mediante la prueba de los rangos de Wilcoxon tras el uso de la checklist. Conclusiones: La checklist propuesta ha demostrado su eficacia y ha sido evaluada positivamente por los alumnos; sin embargo, se debe prestar especial atención a los errores cognitivos de comisión porque aumenta de manera considerable su proporción (AU)

Introduction: Heuristic reasoning often dominate clinical judgments. Decision-making process in dentistry, and especially in orthodontics, is carry out under conditions of complexity and uncertainty. Therefore, the student decision processes are flawed by cognitive biases. The aim of our study was suggest and validate a checklist to reduce student diagnostic cognitive biases. Subjects and methods: Thirty-six postgraduate students evaluated clinically patients without checklist and using the proposed checklist. Results: Statistically significant difference (p < 0.05) was found using the Wilcoxon matched signed-rank test between two evaluations. Conclusions: Effectiveness is prove by using the proposed checklist in reduce student cognitive errors and students have been positively evaluated it. Nevertheless, special attention is required to new increment of proportion of commission cognitive errors (AU)

Determination of periodontopathogens in patients with Cri du chat syndrome

OBJECTIVES: Cri du chat syndrome is a genetic alteration associated with some oral pathologies. However, it has not been described previously any clinical relationship between the periodontal disease and the syndrome. The pur-pose of this comparative study was to compare periodontopathogenic flora in a group with Cri du chat syndrome and another without the síndrome, to assess a potential microbiological predisposition to suffer a periodontitis.Study DESIGN: The study compared nineteen subjects with Cri du chat Syndrome with a control group of nineteen patients without it. All patients were clinically evaluated by periodontal probing, valuing the pocket depth, the clinical attachmente level and bleeding on probing. There were no significant differences between both groups. Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia and Treponema denticola were detected by multiplex-PCR using 16S rDNA (microIDENT).RESULTS: When A. actinomycetemcomitans, P. gingivalis, P. intermedia and T. denticola were compared, no statis-tically significant differences were found between the two groups (p > 0.05). The value of T. forsythia was signifi-cantly higher for Cri du chat syndrome (31.6%) than for the control group (5.3%). The odds ratio for T. forsythia was 8.3.CONCLUSIONS: In the present study T. forsythia is associated with Cri du chat syndrome subjects and not with healthy subjects

Lower incisor position in different malocclusions and facial patterns

Introduction: The position of lower incisor has been of considerable concern when planning an orthodontic treatment, having been recognized as one of diagnostic keys, Very important in the development of malocclusion and facial pattern. Objectives: In this study we claim to determine the importance of the position and inclination of lower incisor in the different malocclusions and facial patterns, and to base which of the cephalometric measurement parametersare the mostreliable. Material and Methods: Ninety lateral radiographies were taken, and they were classified by skeletal malocclusion and facial pattern. These teleradiographies have been performed cephalometric analysis, which include lower incisorposition belong the following analysis: Ricketts, Riolo, Tweed, McHorris, Jarabak-MSE and Holdaway. Study Design: Cross-sectional study where we perform statistical analysis Anova test, Pearson correlations and Bonferroni analysis. Results: The analyzed measurements present a statistically significant differentiation in lower incisor inclination respect to the anterior cranial base, McHorris angle, angulation of lower incisor respect to occlusal plane and mandibular plane. Conclusions: There are statistically significant differentiation in lower incisor position and inclination respect the malocclusion and individual facial pattern (AU)

Obstructive Sleep Apnea Syndrome (OSAS). Review of the literature

Obstructive sleep apnea and hypopnea syndrome is characterized by repeated airway collapse during sleep. The literature describes multiple causes of the disease. The main cause is a reduction of the expansion forces of the pharyngeal dilator muscles, as in situations of genioglossal muscle dysfunction, and discoordination between the inspiratory activity of the muscle and respiratory effort, which play an important role in progression of the disease. Other described causes are soft tissue disorders, such as macroglossia or tonsillar hypertrophy, and skeletal structural alterations such as micrognathia and retrognathia. The syndrome is also more frequent in obese people, where the accumulation of fat in the neck region produces narrowing of the pharyngeal airway, thereby diminishing the passage of air. This review focuses on the pathogenesis, epidemiology, main features and diagnosis of the disease, and on its main forms of treatment (AU)

No disponible

Cranial base and maxillary changes in patients treated with Frankel’s functional regulator (1b)

Objectives: The purpose of this study was to assess cranial base and maxillary growth in patients with Class IItype I malocclusions when treated with Frankel’s functional regulator (FR-1b). Study Design: The treatment group was made up of 43 patients that were divided into two groups: prepubescent (n: 28), and pubescent (n: 15). The control group included 40 patients who did not receive any kind of treatment and were likewise divided into a prepubescent group (n: 19), and a pubescent group (n: 21). A computerized cephalometric study was carried out and superimpositions were done in order to assess the antero-posterior, vertical and rotational movement of the maxilla. Results: The results indicate that anterior cranial length is not affected by the regulator but the cranial deflection of the treatment group was diminished. Although a slight counterclockwise rotation effect on the upper jaw was observed due to treatment, no growth restriction of the maxilla in a vertical or antero-posterior direction was observed compared to other non-treated Class II-type I malocclusion patients. Conclusion: The functional regulator does not have any effect on anterior cranial length, but it does affect the angulation of the cranial base. According to our results, the appliance has demonstrated a flattening effect of the cranial base (p<0.05) in the treated sample. The functional regulator induces counterclockwise rotation rather than vertical or sagittal changes in the maxilla (AU)

Effects on the maxilla and cranial base caused by cervical headgear: A longitudinal study

Objectives: The aim of this study is to test the possible orthopedic effects of cervical headgear on the cranial base and maxilla. Study design: a sample consisting of 79 subjects with skeletal class II malocclusion was divided into two groups. The experimental group was made up of 41 patients all treated with cervical headgear. The control group included a total of 38 non-treated patients. Each one of these groups was then subdivided according to age into one of three groups: prepubescent, pubescent or post-pubescent. Cephalometric parameters were compared in both groups in order to measure the cranial base angle and the vertical and sagittal position of the maxilla. Additionally, cephalometric superimpositions taken at the beginning and end of the study were compared. Results: results revealed significant differences in the cranial base angle and in the SNA angle (p<0.05). However, no differences were observed in the variables that measure the maxillomandibular relationship. While no changes were noted in the palatal plane slope, a flattening of the cranial base was found caused by the cervical headgear, in addition to a retrusion of point A that does not mean there was a reduction in the maxillomandibular relationship. Conclusions: cervical headgear treatment induces cephalometric flattening of the cranial base and a decrease of the SNA angle (AU)

Association between condylar asymmetry and temporomandibular disorders using 3D-CT

Objectives: Using reconstructed three-dimensional computed tomography (3D-CT) models, the purpose of this study was to analyze and compare mandibular condyle morphology in patients with and without temporomandibular disorder (TMD). Study Design: Thirty-two patients were divided into two groups: the first comprised those with TMD (n=18), and the second those who did not have TMD (n=14). A CT of each patient was obtained and reconstructed as a 3D model. The 64 resulting 3D condylar models were evaluated for possible TMD-associated length, width and height asymmetries of the condylar process. Descriptive statistics were used to assess the results and student’s t tests applied to compare the two groups. Results: Statistically significant (p<0.05) vertical, mediolateral and sagittal asymmetries of the condylar process were observed between TMD and non-TMD groups. TMD patients showed less condylar height (p<0.05) in comparison with their asymptomatic counterparts. Conclusions: Using 3D-CT, it was shown that condylar width, height and length asymmetries were a common feature of TMD (AU)

Study of mandibular growth in patients treated with Fränkel's functional regulator (1b)

Objectives: The purpose of this study was to assess mandibular growth in patients with Class II division 1 malocclusions when treated with Fränkel's functional regulator 1b. Study Design: The treatment group was made up of 43 patients that were divided into two groups: prepubescent (n:28), and pubescent (n:15). The control group included 40 patients who did not receive any kind of treatment and were likewise divided into a prepubescent group (n:19), and a pubescent group (n:21). A computerized cephalometric study was carried out and superimpositions were done in order to assess the antero-posterior, vertical and rotational movements of the mandible. A two-way ANOVA with interaction was done to compare the changes between the control group and the treatment group, while the Student t for independent samples was used to compare each age group. Results: The Gnathion and Gonion points showed significant differences in the whole sample (p<0.001) as well as in the prepubescent (p<0.001) and pubescent groups (p<0.05). Rotational changes of the mandible measured using the facial axis and mandibular plane showed no statistical differences between both groups (p>0.05). Conclusion: The results show that the FR produces vertical orthopedic growth in the mandible but not horizontal growth compared to non-treated Class II-type I malocclusion patients. No rotational changes were found in the mandible, but we did record mandibular growth along the inclination of the facial axis (AU)

No disponible

Retrospective study of maxilla growth in a Spanish population sample

This study has been designed to evaluate the vertical and sagittal changes in the maxilla due to growth. A samplegroup was chosen of 38 individuals with normal occlusion, composed of 16 females and 22 males between the agesof 8 and 18. The total sample was divided into three groups: prepubescent (8-11 years), pubescent (12-14 years)and post-pubescent (15-18 years). A series of cephalometric angle parameters (SNA, maxillary height, slope of thepalatal plane and maxillary depth) and lineal parameters (effective maxillary length, palatal plane length, middlethird of the face height and convexity) were traced. Superimpositions of the initial and final cephalometries in theBa-N plane and in the Nasion fixed point were carried out to measure growth. An analytic statistical analysis wasapplied using a Student t test for independent samples in order to evaluate the differences found according to sex.An analysis of variance followed by Duncan’s multiple range test was done to study the evolution of each variablethroughout the duration of the experiment. In light of the results obtained, we have come to the following conclusions:sagittal growth of the maxilla is constant from the age of 8 to 18 years with an average increase of 0.2 mm/year. Vertical growth, as well as general maxillary growth, is greater in the prepubescent group (AU)

Diagnostic of craniofacial asymmetry. Literature review

Facial asymmetry is a common feature in many syndromes, and requires surgery as the only valid treatmentoption. Routine diagnostic methods (frontal RX, panoramic RX and submentovertex RX) have serious limitationsmainly due to the transfer from a three dimensional image to a two dimensional plane. The feasibility ofsuch methods is poorly supported due to inherent projection errors (image magnification, cranial rotation) andidentification errors (image quality, precision and reproducibility). The use of computer tomographies representsa substantial improvement in the sense of skeletal and soft tissue structures’ reproduction precision. The interpretationof this new data source makes evident the necessity of new analysis tools for extraction, manipulation andsynthesization of the whole diagnostic and therapeutical potential based on more solid studies in this field (AU)

No disponible

Extracciones en ortodoncia y su influencia en la estética de la sonrisa y el perfil. Concordancia inter e intra observador / No disponible

Introducción: ¿Puede reconocer un ortodoncista a simple vista si un caso fue tratado con o sin extracciones de primeros premolares? Muchos autores han sugerido que las extracciones de primeros premolares afectan a la estética de la sonrisa y el perfil. Objetivo: Determinar la concordancia inter-intra observador para indentificar la realización o no de extracciones, evaluar el incremento o decremento estético del caso y si existe, la relación con las extracciones. Material y métodos: Se mostraron fotografías faciales [iniciales y finales] de sonrisa y perfil de 40 casos: 20 tratados con extracciones de primeros premolares y 20, sin extracciones. Participaron 4 ortodoncistas y 6 estudiantes de la especialidad los cuales debían determinar si el caso había sido tratado con o sin extracciones y determinar su valoración estética personal a través de una escala analógica visual. Conclusiones: Se confirma la idea de que no existe en ortodoncia un criterio unificado basado en la evidencia que determine las pautas para tomar la decisión de extraer o no extraer. Este artículo invita a la reflexión sobre la necesidad de unificar criterios sobre los cuales basar nuestras decisiones de realizar extracciones. Sería necesario determinar parámetros basados en la evidencia científica o elaborar guías de práctica clínica, aún sabiendo las limitaciones en este campo pues somos conscientes de que para la ortodoncia jamás habrá una receta, y que hay tantas maloclusiones como sujetos maloclusivos hay (AU)

No disponible