Genetic Pattern, Orthodontic and Surgical Management of Multiple Supplementary Impacted Teeth in a Rare, Cleidocranial Dysplasia Patient: A Case Report.

Background: Cleidocranial dysplasia (CCD) is a rare, autosomal dominant skeletal dysplasia with a prevalence of one per million births. The main causes of CCD are mutations in the core-binding factor alpha-1 (CBFA1) or runt-related transcription factor-2 (RUNX2), located at the 6p21 chromosomal region. RUNX2 plays important roles in osteoblast differentiation, chondrocyte proliferation and differentiation, and tooth formation. The disease is characterized by clavicular aplasia or hypoplasia, Wormian bones, delayed closure of cranial suture, brachycephalic head, maxillary deficiency, retention of primary teeth, inclusion of permanent teeth, and multiple supernumerary teeth. Materials and Methods: A 22-year-old girl suffering from cleidocranial dysplasia with short stature, narrow shoulders, craniofacial manifestations (short face, broad forehead, etc.) and dental anomalies (different lower dental elements under eruption, supernumerary and impacted multiple teeth, etc.) was examined at our service (Complex Operative Unit of Odontostomatology of Policlinico of Bari). RX Orthopantomography (OPG) and cone beam computed tomography (CBCT) were requested to better assess the position of the supernumerary teeth and their relationships with others and to evaluate the bone tissue. Results: Under eruption was probably caused by dental interferences with supernumerary teeth; hence, extractions of supernumerary upper canines and lower premolars were performed under general anaesthesia. Surgery outcome was excellent with good tissue healing and improvements in the therapeutic possibilities with future orthodontics. Conclusions: The objective of this article is to give an update about radiological, clinical, and molecular features of CCD and to alert the health team about the importance of establishing an early diagnosis and an appropriate treatment in these patients to prevent impacted teeth complications and to offer them a better quality of life.

Effectiveness of Dental and Maxillary Transverse Changes in Tooth-Borne, Bone-Borne, and Hybrid Palatal Expansion through Cone-Beam Tomography: A Systematic Review of the Literature.

Background and Objectives: Palatal expansion is a common orthodontic technique able to increase the transverse changes for subjects with constricted maxillary arches. The aim of the present investigation was to evaluate through a systematic review the tomography effectiveness of different palatal expander approaches. Materials and Methods: The database used to perform the screening and determine the eligibility of the clinical papers was PubMed (Medline). Results: The database search included a total of 284 results, while 271 articles were excluded. A total of 14 articles were included for the qualitative assessment. Conclusions: The effectiveness of the present studies reported that skeletal expansion was a useful approach to increase the transverse changes for subjects with constricted maxillary arches.

Therapeutic Strategies of Primary Molar Infraocclusion: A Systematic Review.

BACKGROUND: Infraocclusion of deciduous molars is a clinical disturbance that occurs during primary and mixed dentition and has some orthodontic implications. Infraoccluded teeth are believed to be potential sites of malocclusion, with a risk of tipping neighbouring teeth and losing space. This systematic review aims to analyse the management of primary molars infraocclusion and to provide updated guidelines. METHODS: A literature search was performed using PubMed, Scopus, and Web of Science databases from 1 January 2017 to 28 November 2022. The inclusion criteria were: studies only on human subjects, open access studies, case reports, randomised trials, retrospective, observational studies, and English language. RESULTS: A total of 372 publications were identified from the databases and a final number of nine studies were included in the review for qualitative analysis. CONCLUSION: Management of patients suffering from infraocclusion depends on the severity, age at diagnosis, and presence of succeeded premolars. Early diagnosis of infraoccluded primary elements is fundamental and cannot be postponed. Preservation of the primary molars may be a valid option with long-term stability if there is no or moderate primary molar infraocclusion, root resorption of less than half of the root, and no decay or restoration.

Mandibular Crowding: Diagnosis and Management-A Scoping Review.

BACKGROUND: Crowding is the most frequent malocclusion in orthodontics, with a strong hereditary tendency. It already occurs in pediatric age and is mainly hereditary. It is a sign of a lack of space in the arches, and is not self-correcting, but can worsen over time. The main cause of the worsening of this malocclusion is a progressive and physiological decrease in the arch perimeter. METHODS: To identify relevant studies investigating the most common possible treatments for mandibular dental crowding, a comprehensive search of PubMed, Scopus and Web of Science was conducted encompassing the last 5 years (2018-2023) using the following MeSH: "mandibular crowding AND treatment" and "mandibular crowding AND therapy ". RESULTS: A total of 12 studies were finally included. An orthodontic treatment cannot ignore the concept of "guide arch", which concerns the lower arch, because of the objective difficulty in increasing its perimeter; the bone structure of the lower jaw is more compact than that of the upper one. Its expansion, in fact, is limited to a slight vestibularization of the incisors and lateral sectors that may be associated with a limited distalization of the molars. CONCLUSIONS: There are various therapeutic solutions available to the orthodontist, and a correct diagnosis through clinical examination, radiographs and model analysis are essential. The decision of how to deal with crowding cannot be separated from an overall assessment of the malocclusion to be treated.

The Efficacy of a New AMCOP® Elastodontic Protocol for Orthodontic Interceptive Treatment: A Case Series and Literature Overview.

BACKGROUND: Elastodontics is a specific interceptive orthodontic treatment that uses removable elastomeric appliances. They are functional appliances that produce neuromuscular, orthopedic and dental effects. Thus, these devices are useful in the developmental age, when skeletal structures are characterized by important plasticity and adaptation capacity, allowing to remove factors responsible for malocclusions. Elastomeric devices are generally well tolerated by patients requiring simple collaboration and management. This work can be useful to update all orthodontists already adopting these appliances or for those who want to approach them for the first time. This study aimed to describe four cases treated with new elastomeric devices called AMCOP Bio-Activators and to provide an overview of elastodontics, its evolution, indications and limits. METHODS: A total of four clinical cases were presented after a treatment period of 16-20 months to evaluate the clinical and radiological effects of the elastodontic therapy. RESULTS: The effectiveness of Bio-Activators on clinical cases was evidenced with a significant improvement in skeletal and dentoalveolar relationship, and malocclusion correction in a limited treatment period (16-20 months). CONCLUSIONS: The Bio-Activators showed clinical effectiveness to achieve therapeutic targets according to a low impact on the patient's compliance.

Effects of Resveratrol, Curcumin and Quercetin Supplementation on Bone Metabolism-A Systematic Review.

Phenolic compounds are natural phytochemicals that have recently reported numerous health benefits. Resveratrol, curcumin, and quercetin have recently received the most attention among these molecules due to their documented antioxidant effects. The review aims to investigate the effects of these molecules on bone metabolism and their role in several diseases such as osteopenia and osteoporosis, bone tumours, and periodontitis. The PubMed/Medline, Web of Science, Google Scholar, Scopus, Cochrane Library, and Embase electronic databases were searched for papers in line with the study topic. According to an English language restriction, the screening period was from January 2012 to 3 July 2022, with the following Boolean keywords: ("resveratrol" AND "bone"); ("curcumin" AND "bone"); ("quercetin" AND "bone"). A total of 36 papers were identified as relevant to the purpose of our investigation. The studies reported the positive effects of the investigated phenolic compounds on bone metabolism and their potential application as adjuvant treatments for osteoporosis, bone tumours, and periodontitis. Furthermore, their use on the titanium surfaces of orthopaedic prostheses could represent a possible application to improve the osteogenic processes and osseointegration. According to the study findings, resveratrol, curcumin, and quercetin are reported to have a wide variety of beneficial effects as supplement therapies. The investigated phenolic compounds seem to positively mediate bone metabolism and osteoclast-related pathologies.

Oxidative Stress and Oral Mucosal Diseases: An Overview.

BACKGROUND: Reactive oxygen species (ROS) and free radicals are physiologically produced during cellular metabolism. When their balance is disrupted in favor of ROS, a condition called oxidative stress occurs. Oxidative stress represents a widespread phenomenon involved in several pathological conditions. The aim of the present review was to report current knowledge on oxidative stress related to oral mucosal diseases. MATERIALS AND METHODS: Articles from 2000 to 2018 were selected for relevance, validity and quality, from results obtained in PubMed, MEDLINE and Google Scholar using the following search terms: oxidative stress and oral lichen, oral pemphigus, aphthous stomatitis, oral leukoplakia, oral cancer, oral squamous cell carcinoma and oral carcinoma. All articles were independently screened for eligibility by the authors. RESULTS: This narrative review integrates extensive information from all relevant published studies focusing on oxidative stress in oral mucosal diseases. We outline the pathogenetic function of oxidative stress in the most frequent inflammatory, potentially malignant and malignant diseases of the oral mucosa and provide detailed findings from human research. CONCLUSION: Although variability in findings between individual studies exists, it justifies the conclusion that oxidative stress is a significant process in the oral mucosal diseases pathogenesis.