Validation of the Quality Analysis of Medical Artificial Intelligence (QAMAI) tool: a new tool to assess the quality of health information provided by AI platforms.

BACKGROUND: The widespread diffusion of Artificial Intelligence (AI) platforms is revolutionizing how health-related information is disseminated, thereby highlighting the need for tools to evaluate the quality of such information. This study aimed to propose and validate the Quality Assessment of Medical Artificial Intelligence (QAMAI), a tool specifically designed to assess the quality of health information provided by AI platforms. METHODS: The QAMAI tool has been developed by a panel of experts following guidelines for the development of new questionnaires. A total of 30 responses from ChatGPT4, addressing patient queries, theoretical questions, and clinical head and neck surgery scenarios were assessed by 27 reviewers from 25 academic centers worldwide. Construct validity, internal consistency, inter-rater and test-retest reliability were assessed to validate the tool. RESULTS: The validation was conducted on the basis of 792 assessments for the 30 responses given by ChatGPT4. The results of the exploratory factor analysis revealed a unidimensional structure of the QAMAI with a single factor comprising all the items that explained 51.1% of the variance with factor loadings ranging from 0.449 to 0.856. Overall internal consistency was high (Cronbach's alpha = 0.837). The Interclass Correlation Coefficient was 0.983 (95% CI 0.973-0.991; F (29,542) = 68.3; p < 0.001), indicating excellent reliability. Test-retest reliability analysis revealed a moderate-to-strong correlation with a Pearson's coefficient of 0.876 (95% CI 0.859-0.891; p < 0.001). CONCLUSIONS: The QAMAI tool demonstrated significant reliability and validity in assessing the quality of health information provided by AI platforms. Such a tool might become particularly important/useful for physicians as patients increasingly seek medical information on AI platforms.

Use of Submental Intubation in the Full-Face Makeover (Orthognathic Surgery, Facial Prosthesis Combined With Rhinoplasty).

BACKGROUND: Submental intubation is an intubation technique used for the management of airways in patients who suffered from complex maxillofacial trauma. Few studies focused on the role of submental intubation during Full-Face Makeover, like orthognathic surgery, facial prothesis, and rhinoplasty. METHODS: Authors describe a case series of 5 patients who underwent to Full-Face Makeover with submental intubation to manage the airways. The authors started with the Le Fort I subspinal osteotomy. The maxillary repositioning was guided through a 3D printed intermediate splint in all cases (previously simulated with Dolphin software).Subsequentially, the bilateral sagittal split osteotomy was performed. The mandibular repositioning was guided through a 3D printed final splint. The genioplasty was performed with a horizontal osteotomy after a labial mucosa incision. After the genioplasty, the authors used the incision previously used for the Le Fort I osteotomy to bluntly dissect the tissues in order to insert a custom-made polyether ether ketone zygomatic prosthesis. Lastly, an open rhinoplasty was performed. RESULTS: All the surgery lasted a mean less 6 hours. The submental intubation was removed in the operating room, at the end of the surgery. The patients were then discharged from the hospital 2 days after the surgery in all cases. CONCLUSIONS: Submental intubation is a valid method for the airway management in maxillofacial trauma and can be extended in case of Full-Face Makeover like orthognathic surgery combined with rhinoplasty. The absence of nasal traumatism during surgery leads to a more accurate rhinoplasty, with a greater satisfaction for the patient.

Maxillofacial Fractures in the Province of Terni (Umbria, Italy) in the Last 11 Years: Impact of COVID-19 Pandemic.

The main purpose of this retrospective study is to analyze the main causes and the main anatomical structures involved in maxillofacial traumas in the province of Terni, Umbria. From January 2009 to July 2021, 603 patients were admitted with a maxillofacial trauma diagnosis and underwent surgery at "Santa Maria Hospital" in Terni, Italy. The collected data included sex, age, nationality, cause of trauma, type of fractures, comorbidities, clinical signs, symptoms, date of admission, and date of discharge from the hospital. Causes were divided into 5 categories: road traffic accidents, accidental falls, physical assault, sport accidents, and occupational injuries. Men were more involved than women, with a male:female ratio of 325:1. The mean age of the population was 41.7 years. The main cause of trauma were road traffic accidents (36%), followed by accidental falls (27%), an increasing phenomenon during the current SARS-CoV-2 global pandemic. The orbital floor was the most fractured anatomical site, followed by zygoma and nasal bones.

The Caudal Septum Pivot Technique for Short Nose Correction.

The short nose represents one of the greatest challenges in rhinoplasty. It is characterized by a reduced distance from the nasal radix to the tip-defining points, often associated with inadequate tip projection. Several techniques have been described for correction of short nose with the common objective of replacing and rebuilding the osteocartilaginous framework. One of the most effective method to correct the short nose is the septal extension graft. The authors describe the caudal septum pivot (CSP) technique, a simple method to elongate short noses by using a graft inserted in the dorsal septum after its division using as pivot the caudal portion, without detaching it from its natural anchorage to the anterior nasal spine. A retrospective analysis was performed reviewing the clinical charts and the operative records of 315 patients who underwent revision rhinoplasty from January 2015 to June 2019; among this group, 34 were considered eligible for the study. The patients (8 men, 26 women; mean age: 25.4 years; age range: 22-53 years) were divided into two groups: in 12 patients (Group 1) the CSP technique was performed, while Group 2 was composed of 22 patients who received a more classic treatment with a septal extension graft. To evaluate the outcomes, nasal length, tip projection, and tip rotation were measured pre- and 1 year postoperatively on digital photographs of each patient. Nasal anthropometric measurements revealed, at 12-month visit follow-up, an improvement in nasal length, tip projection, and nasolabial angle was achieved in all the patients. The comparison of the pre- and postoperative values showed a statistically significant reduction in the nasolabial angle (p < 0.05) and an increase in the tip projection (p < 0.05) and in the nasal lengthening (p < 0.05) in both groups. In authors' experience, the CSP technique could be considered a safe, reliable, and effective alternative technique in selected patients.

A 3-Level Impaction Technique for Dorsal Reshaping and Reduction Without Dorsal Soft Tissue Envelope Dissection.

BACKGROUND: Preservation rhinoplasty (PR) techniques are continuously evolving and many variations of established techniques have been proposed since Daniel coined this term in 2018. OBJECTIVES: The aim of this study was to describe indications for a new "3-level impaction" technique, allowing, in selected cases, a complete profile correction and dorsal reduction without dissection of the dorsal soft tissue envelope (STE). METHODS: Three hundred and fifty primary closed rhinoplasty cases were retrospectively studied from January 2018 and October 2019. Age, sex, race, technical details, surgical time, and complications were registered. Ninety-five dorsa were reduced and shaped without dissecting the dorsal STE by combining: (1) a swinging-door septoplasty with low septal strip resection, (2) endonasal bony cap mosaic osteotomies, and (3) let-down or push-down operation. RESULTS: All patients showed a dramatic change in profile height and shape without either dorsal STE dissection or bony cartilage dorsal tissue resection. Mosaic osteotomies converted the dorsal keystone area from S- to V-shaped dorsum, let-down-operation and low septal strip resection enabled impaction, and profile setting was achieved by quadrangular cartilage flap rotation. The average follow-up time was 14 months (range, 12-16 months). CONCLUSIONS: In selected patients, dorsum can be preserved without STE dissection. By combining multiple endonasal maneuvers it is possible to obtain a dramatic change without dissecting the STE, while simultaneously avoiding any dorsal tissue resection. This method offers a versatile technique in selected patients, which leads to fast recovery and natural results.

Dermal Regeneration Templates in Maxillo-Facial District: A Multipurpose Aid.

ABSTRACT: Since 1980s, the use of dermal regeneration templates (DRT) for reconstructive purposes has been described in Literature.1 The authors present their experience of 13 patients treated with integra dermal regeneration template and a single-stage surgery for different indications like oncologic reconstruction, trauma injuries, and preprosthetic surgery in the maxillo-facial district.The authors retrospectively reviewed a total of 13 patients treated with DRT at Maxillo-Facial Department of S. Maria Hospital in Terni.Inclusion criteria included the presence of a defect nonapproachable primarily or by secondary intention with an easy locoregional flap reconstruction, a complete clinical record, and a minimum 6 months follow-up.A total of 12 patients underwent surgical reconstruction with DRT at the S. Maria Hospital from June 2018 to February 2020.During follow-up, all patients in which intraoral reconstruction was performed showed first signs of re-mucosization and neovascularization after 10 days.Only in 1 patient (8%) a seroma underneath the silicon sheet was observed. Afterward, the patient healed correctly with no other complications.Dermal regeneration template represents an option that should be considered in the head and neck district reconstruction, especially for intraoral defects where, thanks to its long-term functional results and limited alternatives, should represent a relevant choice.

Captain America's Shield Genioplasty.

ABSTRACT: The chin represents one of the most important determinants of the facial aesthetics. Like many aesthetic parameters, the "ideal" chin has changed in history regarding projection and prominence. From the retrusive profiles of the Renaissance, stronger and more defined mandibular contour are nowadays desired both by masculine and feminine population.This change in the ideal references plays an important role in diagnosis and treatment planning. Various techniques for chin augmentation have been described, using both alloplastic materials and osteotomies.An interesting osteotomy variant, so-called chin shield osteotomy, has been described by Triaca et al to avoid a deep mentolabial fold. The authors describe herein the use of a shield plate, very similar in his form to Captain America's shield, that can at the same time provide bone fixation and soft tissues sustain in the mentolabial fold region, preventing the invasion of the gap between the bone fragments by the connective tissue, as it happens in a guided bone regeneration procedure.

The Pyramid Chin Augmentation: A New Technique.

ABSTRACT: The surgical approach to chin for esthetical purpose can be isolated or in a combination with other treatments like maxillomandibular surgery. Both possibilities include sliding genioplasty or implants of autologous or alloplastic materials. In this article, the authors present their new technique, the Pyramid Chin Augmentation.In January 2020, a 40-year-old male patient came to authors' observation asking for a great augmentation in the sagittal dimension of the chin, a better pronunciation of mandibular angles and of his cheekbones. The surgical treatment consisted in three different procedures at the same time: a chin wing osteotomy, a Pyramid Chin Augmentation and zygomatic PEEK custom-made malar implants. The pyramid was created on the body of the chin wing with a cortical bone graft from the oblique line of the ascending ramus of the mandible. The harvested bone was cut into strips of rectangular shape gradually shorter to be superimposed on the wing forming a pyramid. A fixation with 2 screws was performed and then was necessary to smoothen the edges of the bone layers.The result immediately after the end of the surgery was in line with the set goals. The mandibular angles were more prominent, the chin was more sagittal pronounced, and there was no evidence of depression in the symphysial region.The Pyramid Chin Augmentation Technique can be a valid tool in chin augmentation surgery and can also represent an effective procedure in the finishing touch of other facial surgery techniques.

Customized Surgical Protocols for Guided Bone Regeneration Using 3D Printing Technology: A Retrospective Clinical Trial.

ABSTRACT: 3D printing is one of the most significant technological advancements of the modern era. Among the various surgical disciplines, this new technology has shown significant improvements in the diagnosis and treatment of many diseases. The application of 3D printing has many benefits in training, preoperative planning and education.A retrospective study was conducted at the European University of Madrid (UEM). Patients were selected in this study using the following inclusion criteria: age over 18 years old, a preoperative cone beam computed tomography (CBCT), patients with moderate or severe vertical or horizontal defects, presence or absence of the tooth in the area to regenerate, no bone regeneration surgery before. Bone defects were measured: in the CBCT using White Fox Imaging, on the 3D printed model and then intraoperatively from the area to be regenerated. The average of the bone defects on the 3D measurements was statistically compared with the average of the bone defect measurements in the patient's mouth to evaluate the model reliability.The mean age of the patients was 53,07 years old, with a range from 45 to 63. Females were more affected than males, with a ratio of 12/13 (92%). The most frequent side affected was maxilla 10/13 (77%) and the most type of defect reported was horizontal 10/13 (77%). The means in width (x = 8,2923) and height (x = 6,9615) of the 3D model, were close and clinically acceptable if compared with the means obtained from the measurements in width (x = 7,9230) and height (x = 6,8076) of the patients' bone defects. None of the patients underwent further surgeries or needed intraoperative surgical corrections obtaining reliable results in terms of presurgical planning.It is possible to affirm that the use of 3D printed models can be a crucial complement when planning guided bone regeneration procedures, due to high reliability, and representing a turning point in many aspects of oral surgery.

Slice Functional Condylectomy and Piezosurgery: A Proposal in Unilateral Condylar Hyperplasia Treatment.

ABSTRACT: Condylar hyperplasia is a temporomandibular joint progressive disease characterized by an excessive growth of the mandibular condyle. Condylar overgrowth represents one of the most common causes of facial asymmetry in early adulthood. To date, there is not a clearly established origin of the disease: genetic, traumatic, infective, vascular, and functional factors are involved hypotheses. Clinically, condylar hyperplasia presentation is characterized by an asymmetry of the lower third of the face, deviation of the chin, inclination of the labial line and malocclusion. Several treatments have been proposed over the years in the treatment of mandibular condyle hyperplasia, but to date a gold standard has not been defined. Two are the main approaches: condylectomy and orthognathic surgery, isolated or in a combination. Many condylectomy technique differentiations have been developed: high, low, and proportional, are the most performed. In this technical note, the Slice Functional Condylectomy (SFC), a modification of the proportional condylectomy is presented.

The Deviated Nasal Tip: A Personal Technique for Correction Using Monolateral Crural Overlay and Monolateral Dome Truncation.

This study aimed to present a novel approach to correct nasal tip deviation with monolateral crural overlay or monolateral dome truncation, presenting as an isolated deformity or in complex nose deviations. Nasal tip deviation can be congenital or posttraumatic, due to a dislocated septum or cartilaginous septal or lower lateral cartilage malformations. Although some treatment strategies have been introduced, appropriate treatment remains a challenge because of the complexity and variability of such deformities. It had been assumed that in most nasal tip deviations, a lower lateral cartilage was longer than the contralateral one. The authors analyzed 158 patients from January 2015 to October 2019 with nasal tip deviation and corrected the deviated tip by using a monolateral interruptive technique (lateral crural overlay or monolateral dome truncation) on the lower lateral cartilage. Photographic comparison between preoperative and at least 1-year follow-up for nasal axis deviation variable was analyzed and a self-assessment questionnaire was administrated to the patients at 1-year follow-up. The mean nasal deviation was 6.59° (±3.1°) preoperatively and 1.56° (±0.26°) postoperatively (p < 0.05). The range of differences between pre and postoperative deviations was 2.7° to 15.1°, and the mean difference was 6.1° (±3.21°). Of the 84 patients, 47 (55.95%) were very satisfied, 33 (39.28%) were satisfied, and 4 (4.76%) were unsatisfied with surgical the results and required revision surgery. In authors' hands, monolateral interruptive techniques (lateral crural overlay or monolateral dome truncation) are a viable and feasible option to restore nasal tip symmetry. These techniques achieved high satisfaction rates among patients and resulted in reliable and reproducible symmetry immediately visible after surgery and stable over time (1-year postsurgery controls).

Security Hi-Tech Individual Extra-Light Device Mask 3.0: A Continuous Evolution.

In 2008, the authors presented their Security Hi-tech Individual Extra-Light Device Mask (SHIELD), a customizable protective shield based on the (soccer) player's face cast.In 2017, the authors presented an update in the realization process, based on computer-aided design/computer-aided manufacturing technology, and called it SHIELD 2.0.Now, the authors present a further update in the realization process.

The Role of Three-Dimensional Printing Technology as an Additional Tool in Unilateral Condylar Hyperplasia Surgical Planning.

The purpose of this study is to evaluate whether additive manufactory technology through the use of 3D mandible and skull cast models can provide additional support to the virtual surgical planning for patients affected by unilateral condylar hyperplasia (UCH). This study describes 2 patients affected by active UCH. Cone beam computed tomography (CBCT) scans were converted in STL files and then sent to a 3D printer that provided 3D cast models of patient's mandible and skull. Surgical planning was conducted performing linear measurement both on 3D virtual images and on 3D cast models. Proportional condylectomy was then simulated with the virtual software and on the 3D cast models as well. After 18 months, new CBCT scans of the patients were acquired and new 3D cast models were printed. Measurements performed on the 3D cast models were close and reliable if compared to measurements obtained on 3D virtual images. None of the patients underwent further surgeries obtaining stable results in terms of symmetry. 3D printing technologies have a relevant support for a more accurate planning and surgical treatment in UCH.

Floating Bone Phenomenon in Pierre Robin Sequence.

After a failed mandibular osteodistraction, the wrong positioned mandible of a few patients with Pierre Robin sequence returned in the most functional position and regained a proper symmetry, without external intervention. The study aims to explain this self-adjustment and introduce the floating bone phenomenon.The inclusion criteria were severe micrognathia, Fast and Early Mandibular Distraction Osteogenesis protocol, postoperative mandibular wrong positioning, presurgery, immediate postsurgery, and long-term computed tomography scan. Five patients were included. The considered parameters were the distance between mandibular dental centerline and midsagittal facial axis, the rotation of the mandibular body, the magnitude of elongation, and the lowering of the mandibular body.Three patients went from a decentralization >4 mm in the activation phase to a normalization of the said value in the follow-up. In the same period, the interincisal point of 2 patients moved respectively from 0.5 mm on the left and 0.8 mm on the right to 1.2 mm and 1.6 mm on the right, respectively. The rotation of the mandibular body was meanly 25.6° among all patients. The mean value of the distraction was 14.1 mm. A difference of about 4.4 mm between the left and the right side was measured. The lowering of the mandible varied between 2.8 and 12.6 mm.All patients improved their symmetry. Four of them improved in all the measured parameters, while 1 patient presented a worsening in the decentralization of the interincisal point.The floating bone phenomenon could break new grounds in the management of patients with Pierre Robin sequence.

How to Produce Cheap and Easy Custom-Made Sterilizable Filtering Facepiece 2/3 Masks for Healthcare Providers During Pandemic COVID-19 Emergency.

On January 8, 2020, a novel coronavirus was officially announced as the causative pathogen of coronavirus disease (COVID-19) by the Chinese Center for Disease Control and Prevention.On February 26, COVID-19 has been recognized in 34 countries, with a total of 80,239 laboratory-confirmed patients and 2700 deaths.Protecting healthcare workers from infectious hazards is paramount to ensuring their safety in delivering health care.In addition, being able to protect healthcare workers, constituting the front-line response against high-threat respiratory pathogens, such as severe acute respiratory syndrome coronavirus 2, is important for reducing secondary transmission in healthcare-associated outbreaks.Authors present a simple, reliable, and cheap protocol to produce a custom-made sterilizable filtering facepiece 2/3 masks for healthcare providers during pandemic COVID-19 emergency.

Unilateral Condylar Hyperplasia: A Comparison With Two Open-Source Softwares.

Unilateral condylar hyperplasia (UCH) is a condyle disorder that arises due to osteoblastic hyperactivity, resulting in facial asymmetry, malocclusion and dysfunction. Authors, in this retrospective study, compared "gold standard" manual-segmentation with a "semi-manual one" using 2 kinds of open-source software (Horos and ITK-SNAP; Penn Image Computing and Science Laboratory) to calculate volume of 80 UCH condyles (40 patients). Moreover, volumetric differences between affected condyle and unaffected 1, between males and females, ages, and classification type were also analyzed. Fifteen patients (37.5%) were male and 25 (62.5%) were female. The gender ratio was 5:2, not far from the ratio 2:1 shown in literature. The mean age was 24 (SD 8.6) years; 22.9 (SD 6.6) for males and 24.6 (SD 9.6) for females according with the mean age derived from the Raijmakers et al meta-analysis and the Nitzan et al study. Right side (60%, 24 patients) was more often affected than the left side (40%, 16 patients). The 67.5% (27 patients) were classified as trasversal type, 25% (10 patients) as vertical types and 7.5% (3 patients) as combined. Despite Horos and ITK-SNAP values presenting some differences, the data follows the same tendency. The relationship is stronger for healthy condyles than affected condyles.

The discomallear ligament: anatomical, microscopical, and radiologic analysis.

BACKGROUND: Several anatomic relationships between the ear and the temporo-mandibular joint have been proposed to account for the presence of tinnitus during temporo-mandibular disorders. Among the otomandibular structures, the discomallear ligament (DML) is interposed between the malleus and the retrodiscal capsular complex. The aim of present paper was to study through dissection the frequency and morphology of DML, to characterize its type of collagen, and to evaluate the DML on routine computed tomography (CT). METHODS AND RESULTS: The study has been conducted on five un-embalmed adult cadavers, and in all cases, the DML was present (100%). It was constituted mainly by fibers of collagen I, with abundant elastic fibers. On CT exams of 40 patients with no reported pathology of the ear, on axial images, a dense structure, going from the upper end of the petrotympanic fissure to the neck of the malleus, was present in all the cases. In 90%, it showed a triangular shape, in 5% a rectangular shape, and in 5% a curved course. The mean length of the antero-medial side was 2 ± 0.6 mm and that of the antero-lateral side was 1.63 ± 0.5, and the mean area was 1.29 ± 0.83 mm2. CONCLUSION: The DML could represent an anatomical structure that joining the temporo-mandibular joint and the malleus may play a role in the otologic symptoms during temporo-mandibular disorders.

Treatment of Deformational Plagiocephaly With Physiotherapy.

Non-synostotic plagiocephaly consists in an asymmetry of the skull due to mechanical forces applied in utero or postnatally: main differential diagnosis is with true synostotic asymmetry, which is caused by the premature closure of a suture. The correction of positional forms is mostly conservative, with 3 main strategies: counterpositioning, physiotherapy and helmet therapy. There is no synthesized evidence on which is the most effective. The Authors evaluate the modification of antropometric measurments before and after a pediatric physical therapy program in a sample of patients with non-synostotic skull asymmetry, in order to evaluate the improvements in the skull shape. The hypothesis being tested was that physical therapy alone could improve the antropometric measurments. The authors enrolled in this study 24 patients diagnosed of non-synostotic asymmetry, clinically and with ultrasound, referred to the Maxillo-facial Unit of Policlinico Umberto I, Rome, within 2013 and 2016. A standardized pediatric physical therapy intervention program was designed: it consisted in a combination of excercises and manipulative procedures to reduce positional preference, musculoskeletal disorders and cranial deformity. Infants received 16 sessions of physical therapy, of 40 minutes each, once a week, for four months. The Authors evaluate the variation of four anthropometric measurments, performed before and after the physical therapy program: Argenta scale, Oblique Diameter Difference Index (ODDI), Cranial Proportional Index (CPI) or Cephalic Ratio (CR), Cranial Vault Asymmetry Index (CVAI). Craniometric evaluations were extrapolated by standardized 2D digital photographs of frontal, sagittal and transverse planes, by the same physician to minimize bias. The management of positional cranial deformities is still controversially discussed and especially the effects of physiotherapy and osteopathy have been only marginally researched. Statistical analysis revealed the effectiveness of the protocol: all anthropometric measurements improved with a high rate, major in youngest children (P < 0.5) and in more severe first presentations (P < 0.05 or P < 0.01). The results suggest manipulative approach may improve the outcome in the long term follow up of cranial asymmetries.

Synovial Chondromatosis and Calcium Pyrophosphate Deposition of the Temporomandibular Joint: Challenging Diagnosis.

BACKGROUND: The association between the synovial chondromatosis (SC) and the calcium pyrophosphate deposition (pseudogotta) in temporomandibular joint (TMJ) is very rare and has been described just 1 patient in the literature. CLINICAL PRESENTATION: A 64-year-old woman was referred to Dipartimento di Scienze Odontostomatologiche e Maxillo-Facciali, Sapienza Università di Roma after complaining about right temporomandibular pain, limitation in mandibular movements, and tumefaction in the right preauricular region. The patient was hospitalized for the surgery. The microscopic examination of the excised material revealed calcium pyrophosphate dihydrate (CPPD) deposits crystals associated with cartilaginous proliferation. CONCLUSION: The association between the SC and the calcium pyrophosphate deposition (pseudogotta) is a challenging diagnosis among TMJ neoplasms.

Canine Eruption After Secondary Alveolar Bone Graft in Unilateral Cleft Lip and Palate Patients.

PURPOSE: The aim of this article is to analyze dental abnormalities in unilateral cleft lip and palate patients by focusing on the role of the secondary alveolar bone graft (SABG) surgery and its outcomes on canine eruption/inclusion. MATERIALS AND METHODS: A sample of 24 patients with unilateral cleft lip and palate were selected.Dental anomalies, canine eruption based on the existence of supernumeraries, agenesis elements, inclination of the major canine axis before and after surgery, distance from the occlusal plane before and after surgery, and sector classification were analyzed. RESULTS: Out of the 24 patients, 87.5% presented a canine spontaneously erupted in the dental arch while 12.5% needed surgical-orthodontic traction.There is also no proof that inclination of the canine significantly influenced the eruption before (P = 0.5889) and after (P = 0.4029) surgery. Also, there is no any correlation between the 2 sides (P = 0.1257).The SABG surgery showed a significant correlation with canine eruption (P = 0.009242); moreover, SABG shows a positive relationship with the radicular development of the canine (P = 0.005163).Lateral incisive (P = 0.8493) and second premolar agenesis (P = 1) are not statistically correlated with the eruption of the canine. This does not happen with supernumerary elements that are correlated with the surgical-orthodontic traction (P = 0.0004464). CONCLUSIONS: Agenesis does not play any role in the process of canine eruption while supernumeraries do. There is no relationship between the inclination and eruption of the canine.The SABG surgery has a key role because it contributes to create an appropriate support for the erupting canine, the nasal base and the anterior maxilla.