Efficacy and Accuracy of Maxillary Arch Expansion with Clear Aligner Treatment.

The aim of this work was to evaluate the efficacy and accuracy of maxillary arch transverse expansion using the Invisalign® clear aligner system without auxiliaries other than Invisalign attachments. Knowing the accuracy of a movement through a clear aligner system allows the clinician to plan the treatment with greater precision and to achieve the expected result faster. The study group included 28 patients with a mean age of 17 ± 3.2 years. The treatment protocol for all the selected patients included the application of the Invisalign® clear aligner system without auxiliaries, except for the Invisalign® attachments; in no case were tooth extraction or interproximal enamel reduction (IPR) performed. Linear measurements of the expansion were assessed before treatment (T0), at the end of treatment (T1), and on final virtual models by ClinCheck® (TC). A paired t-test was used to compare T0-T1 and T1-TC differences. A paired t-test was applied, and one normality was validated with the Shapiro-Wilks test. If normality was not met, the nonparametric test (Mann-Whitney U test) was applied. The level of significance was set at 5%. Statistically significant differences were found for all measurements at T0-T1. The results showed an average accuracy of efficacy of 70.88%. The differences in predictability between the various vestibular measurements (intercanine, inter-premolar, and intermolar) were not statistically significant, while they were for gingival measurements. The overall accuracy of the expansion treatment was 70%, regardless of tooth type.

Is There a Correlation between Gingival Display and Incisal Inclination in a Gummy Smile? Study on Cephalometric Parameters.

BACKGROUND: Excessive gingival display or "gummy smile" is a clinical condition where a maxillary gum shows between the inferior line of the superior lip and the gingival line of the incisive superior during a spontaneous smile. The aim of this research was to understand the various skeletal and dentoalveolar components contributing to a gummy smile in a sample of 120 patients. MATERIAL AND METHODS: This retrospective case-control study had the primary objectives of analyzing the existence of a correlation between the presence of gingival exposure and the alteration of the inclination of the upper incisors with respect to the Frankfurt plane, the Palatine plane (bi-spinal) and to the NA line in a sample of orthodontic patients, and also evaluating the association with skeletal, dental, and aesthetic cephalometric parameters. RESULT AND CONCLUSIONS: In our study, it's emerged a correlation between the gingival exposure and the presence of alterations to incisal torque in the vestibular direction and the quantity of maxillary gingiva evident during the smile, which is correlated in particular to the Is-Sts distance, overjet and overbite. The major indicative data, therefore, are related to the vertical position of the upper incisors, in particular with respect to the upper lip and to the sagittal position.

Cranio-cervical posture and rapid palatal expansion therapy.

Objective: Connections between craniocervical posture (CCP) and changes in teeth position have already been demonstrated; however, the defined pathway of relationship is still not clear. The aim of this study was to evaluate CCP modifications after rapid maxillary expansion therapy using rapid palatal expansion therapy (REP)/McNamara appliances. Materials and Methods: A consecutive series of 35 subjects, aged between 6 and 14 years, with no prior history of orthodontic treatment, and requiring skeletal expansion of the upper arch, were selected and analyzed. All patients were treated with REP or Mcnamara appliance: the active phase of 15 days and retaining phase of 6 months. Cephalometric analysis was carried out before (T0) and after (T1) orthodontic therapy evaluating changes in the craniofacial area and those related to CCP. The obtained data were statistically analyzed for the pre-post changes. Results: No statistically significant difference emerged indicating a modification in the CCP measured at T0 and T1 (P > 0.05). Patients treated with the McNamara appliance, compared to those treated with REP, showed a higher value of the angle OPT ^ Ver (P = 0.021), and a lower measure of the angles CVT^EVT (P = 0.035) and EVT^Ver (P = 0.023). Furthermore, patients treated with REP showed a higher hyoid angle value than those treated with McNamara (P = 0.047). Conclusion: This study did not reveal any relationship between the application of palatal expansion therapy and changes in CCP.

Temporomandibular disorders in Venezuelan and Italian adolescents.

OBJECTIVE: The aim of this research was to compare the prevalence of temporomandibular disorders (TMDs) among Venezuelan and Italian adolescents. METHODS: One hundred-seventeen Venezuelan and 138 Italian adolescents aged 11-18 years were examined according to the Diagnostic Criteria for TMDs (DC/TMD). Signs and symptoms were registered. RESULTS: TMD prevalence among Venezuelan adolescents (17.9%) was lower than that among Italian adolescents (29.7%) and was higher in females and in the 15-18 age group. Intra-articular disorders were the most frequent in Venezuelan (8.5%) and Italian adolescents (13.0%). Pain-associated disorders were more frequent in the 11-14 age group, while intra-articular disorders were more frequent in the 15-18 age group in both samples. Italian adolescents presented greater muscle pain and joint noise than Venezuelan adolescents. CONCLUSION: TMD prevalence in Venezuelan adolescents was lower than that in Italian adolescents. This suggests the involvement of cultural and/or genetic factors in the etiology of these disorders.

Correlation between condylar size on CT and position of the articular disc on MRI of the temporomandibular joint.

Objective: To analyze the relationship between the size of the mandibular condyle and the temporomandibular joint disc position using computed tomography and magnetic resonance imaging.Methods: One hundred joints were retrospectively analyzed. The measures analyzed included the condylar head height, the medio-lateral and antero-posterior dimensions of the condylar head, and the TMJ disc position. ANOVA correlation coefficient and Tukey's post hoc test were employed.Results: The mean age of the subjects was 20.3 years. There were no significant correlations between the disc position in closed-mouth and the condylar head sizes. There was no significant correlation between the position of the disc in open mouth and the height of the condylar head, but there were statistically significant associations between the position of the disc and the horizontal condylar dimensions, the medial-lateral (p < .014), and the anterior-posterior sizes (p < .020).Conclusion: The condylar head size was smaller in subjects with disc displacement without reduction.

Perceived Pain during Rapid Maxillary Expansion (RME): Trends, Anatomical Distinctions, and Age and Gender Correlations.

Objectives: To investigate pain trends and characteristics of different facial districts in patients undergoing rapid maxillary expansion (RME) and its possible correlations with age and gender. Materials and Methods: 85 subjects (45 males and 40 females) undergoing RME were selected and analyzed during first two weeks of treatment. Patients rated daily two types of pain perception: the general perceived pain (GPP), i.e., the pain overall perceived in the face, and the local perceived pain (LPP), i.e., the pain perceived locally in the following anatomical areas: anterior palate (APA), posterior palate (PPA), nasal (NA), joint (JA), and zygomatic (ZA). Patients were provided the Numeric Rating Scale (NRS) and Wong-Baker Faces Pain Rating Scale (FPS) to correctly assess their GPP and LPP. Pearson correlation coefficient and analysis of variance (ANOVA) were, respectively, used to define the linear relationship between all the variables considered and to verify whether the response variables (gender and age) were significantly different (α < 0.05). Results: Sample's mean age was 10.11 years. Average pain values of GPP and LPP progressively rise from day 1 to days 2-3 (pain peak) and tended to decrease until day 14, with a linear decrease for GPP and a not linear decrease for LPP. PPA and APA resulted the most painful areas, followed, respectively, by JA, ZA, and NA. Statistically significant differences resulted in average pain values according to patients' age and gender, both in GPP and LPP. Conclusion: RME causes perception of pain in several maxillofacial areas. Pain reported during RME resulted positively correlated with age and gender of patients.

The VISTA Approach in Canine Disimpaction.

Canine disimpaction is always a challenging orthodontic treatment overall, even when the impacted permanent canine is in a high position, especially when in tight relation with the upper incisors' roots. Conventional treatment methods are usually not capable of performing the correct force direction, consisting of the contemporary movement in the distal and vestibular directions of the canine crown, often provoking, as side effects, the presence of decubitus on the mucous of the lips and cheeks or a poor final appearance of the periodontal support of the disimpacted canine. Among the different approaches, the vertical incision subperiosteal tunnel access (VISTA) technique shows good performance with regard to the direction of the forces and the canine's periodontal conditions when erupted; it is usually realized through an elastic chain connected to a temporary anchorage device (TAD) in the posterior area. In this paper, a different protocol for the VISTA method is also presented, to be resorted to in cases of difficult miniscrew positioning due to the anatomic conditions or stage of dentitions. The new protocol also considers the use of nickel-titanium coil springs in order to avoid the need of frequent reactivation of the device and consequent patient discomfort, highlighting its advantages and indications with respect to the traditional approach.

Unilateral condylar hyperplasia: a thee-dimensional CBCT morphometric and volumetric evaluation of mandibular condyle by open-source softwares / Hiperplasia condilar unilateral: evaluación morfométrica y volumétrica en TCHC tridimensional del cóndilo mandibular mediante softwares de código abierto

SUMMARY: Unilateral condylar hyperplasia (UCH) is an alteration of the mandibular condyle growth. The aim of this study was to evaluate condyle volume, surface area, and Morphological Index (MI) differences between the affected condyle and an unaffected one in patients with UCH, evaluated through 3D reconstructions cone beam computed tomography (CBCT) images by two open-source softwares. A retrospective cross-sectional study of 16 patients with a certain UCH, 9 females and 7 males with mean age 25.13 ± 6.8 years was made. The image obtained from the CBCT of each condyle were reconstructed using the open-source software 3D SLICER 4.6 ®. The volumetric and area measurements of the 3D reconstruction of the mandibular condyle were made using the open-source soft- ware NETFABB basic 5.0 ®. The mean condylar volume of the hyperplastic condyles was 2.07 ± 1.51 cm3 and the non-hyperplastic condyles was 1.16 ± 0.82 cm3 (p<0.05). The mean area surface of the hyperplastic condyle was 11.77 ± 3.71 cm2 and the non-hyperplasic condyle mean was 8.05 ± 2.17 cm2 (p < 0.05). The mean area surface difference was 3.72 ± 3.57 cm2 (28.0 %). The MI of the hyperplastic condyle was 1.8 ± 0.3 mm and the non-affected condyle was 1.3 ± 0.6 mm (p < 0.05). The use of open-source software for 3D reconstruction with manual segmentation for evaluation of the volume and the condylar surface is a valid tool available to the clinic in the diagnosis and monitoring of patients with condylar hyperplasia.

RESUMEN: La hiperplasia condilar unilateral (HU) es una alteración del crecimiento del cóndilo mandibular. El objetivo de este estudio fue evaluar en pacientes el volumen del cóndilo, el área de superficie y las diferencias del índice morfológico (IM) entre el cóndilo afectado y el no afectado en pacientes, mediante tomografía computarizada de haz cónico (TCHC), por medio de dos softwares. Se realizó un estudio transversal retrospectivo de 16 pacientes con determinada HU, 9 mujeres y 7 hombres con edad media 25,13 ± 6,8 años. La imagen obtenida del TCHC de cada cóndilo se reconstruyó utilizando el software de código abierto 3D SLICER 4.6 ®. Las medidas volumétricas y de área de la reconstrucción 3D del cóndilo mandibular se realizaron utilizando el software de código abierto NETFABB basic 5.0 ®. El volumen condilar medio de los cóndilos hiperplásicos fue de 2,07 ± 1,51 cm3 y el de los cóndilos no hiperplásicos fue de 1,16 ± 0,82 cm3 (p <0,05). La superficie media del cóndilo hiperplásico fue de 11,77 ± 3,71 cm2 y la media del cóndilo no hiperplásico fue 8,05 ± 2,17 cm2 (p <0,05). La diferencia de superficie de área media fue 3,72 ± 3,57 cm2 (28,0 %). El IM del cóndilo hiperplásico fue de 1,8 ± 0,3 mm y el cóndilo no afectado fue de 1,3 ± 0,6 mm (p <0,05). Para el clínico, el uso de software de código abierto en la reconstrucción 3D con segmentación manual, para la evaluación del volumen y la superficie condilar, es una herramienta efectiva en el diagnóstico y tratamiento de pacientes con hiperplasia condilar.

Uncovering and Autonomous Eruption of Palatally Impacted Canines-A Case Report.

The impaction of permanent maxillary canine is a common clinical occurrence, and it is observed in 2% of patients who require orthodontic treatment. This case report describes a new orthodontic-surgical approach through the use of CO2 laser, for the exposure of the palatally impacted canines. A 13-year-old female referred to our observation to make an orthodontic examination because of the maxillary primary canines' persistence in upper arch. Orthopanoramic X-ray showed impaction of both permanent maxillary canines. The family history revealed that the patient's mother had the same orthodontic problem. Cone Beam Computer Tomography (CBCT) was requested to plan the surgical-orthodontic treatment. Surgical exposure of the impacted canines was performed using a CO2 laser and subsequent periodontal pack application. No orthodontic devices were applied for impacted teeth traction on dental arch. Canines' movement was monitored at 1, 8 and 16 weeks post-surgery with photo and intraoral scanner CS3500 (CS3500®, Carestream Health, Atlanta, GA, USA). When canine crowns were completely erupted on palatal side, the alignment in the arch with indirect bonding technique was performed. Complete disimpaction of canine crowns was obtained in only four months. As reported in the literature, this case confirms that impacted canines' exposure to CO2 laser has advantages if compared with traditional surgery: no bleeding during and after the procedure, decontaminant effect on the surgical area, no suture, and a fast spontaneous eruption. Conclusions: The pre-orthodontic uncovering and autonomous eruption of palatally impacted maxillary canines provides simplified, predictable, and more aesthetic outcomes. Furthermore, a significant positive factor is that there is no need to carry out the orthodontic traction of the impacted element, undoubtedly better compliance by the patient during the next alignment phase with the fix orthodontic appliance.

CBCT and Intra-Oral Scanner: The Advantages of 3D Technologies in Orthodontic Treatment.

BACKGROUND: The aim is to demonstrate the validity of the monitoring through intraoral scanner of the dental movements and the real impact, advantages, and convenience, in terms of treatment time and efficiency gain, to frequently monitor a patient with the scanner application. METHODS: A movement control of palatally impacted canines was performed, surgically treated with laser opercolectomy. Three-dimensional models of the patient's dental arch were obtained with intraoral scanner during a monitoring time of 4 months. The STL (Standard Triangle Language) files were superimposed with the 3D models extrapolated from the pre-operative CT (Computerized Tomography). The measurements of eruption, exposed palatal and vestibular areas, and distances between the canines and the incisors were performed, using digital technologies and with a digital caliber. RESULTS: Descriptive and inferential statistical analysis of the data obtained from both conventional and digital monitoring has been realized and performing the T Student Test for paired data. CONCLUSION: The advantages of digital monitoring are numerous, like the possibility to reduce the error of method caused by manual measurement on plaster casts and the possibility to compare the pattern and amount of eruption of the canine in the same patient overtime.

Association between temporomandibular joint disc position evaluated by magnetic resonance imaging and mandibular condyle inclination evaluated by computed tomography.

Temporomandibular joint disc displacement is common in the world's population and could be associated with bone and functional characteristics of the temporomandibular joint. The aim of these study was to analyse the association between temporomandibular joint disc position evaluated by magnetic resonance imaging (MRI) and the inclination of the mandibular condyle evaluated by computed tomography (CT). One hundred and seventy temporomandibular joints (TMJ) were retrospectively analysed. The temporomandibular disc position was evaluated by MRI and classified into three types: normal (N), disc displacement with reduction (DDWR) and disc displacement without reduction (DDWoR). The mandibular condyle measurements evaluated by CT included horizontal, sagittal and coronal inclination. ANOVA followed by post hoc Tukey's test was used to evaluate the interaction between condylar inclination and disc position. There was an association between disc position and the horizontal and sagittal condylar inclination (P < .05). There are statistically significant differences in the mean of horizontal and sagittal inclination of the mandibular condyle between the DDWoR and the other disc positions (P = .002 and P = .004). Disc position was not statistical associated with coronal inclination of condyle (P > .05). These results indicate that the inclination of the mandibular condyle may be different in TMJ with various disc position. A more medial horizontal inclination and a more posterior sagittal inclination of the mandibular condyle are associated with DDWoR.

CT Findings of Trifid Mandibular Condyle in a 12Year-Old Patient: A Case Report and Review / Hallazgos en TC de Cóndilo Mandibular Trífido en un Paciente de 12 Años: Reporte de Caso y Revisión

ABSTRACT: Bifid or trifid mandibular condyle is an extremely rare entity, of unknown etiology, although it has been associated with trauma in the condyle growth center. The development of imagining techniques has allowed the exact characterization of these alterations, which were incidentally discovered by routine dental x-rays. The aim of this report is to describe a case of a mandibular condyle with a trifid appearance in a twelve year-old individual with a history of mandibular trauma during childhood and a review of the relevant literature.

RESUMEN: El cóndilo bífido o trífido es una entidad extremamente rara de etología desconocida, sin embargo, ha sido asociada con trauma en el centro de crecimiento condilar. El desarrollo de técnicas imagenológicas ha permitido la exacta caracterización de estas alteraciones, las cuales son incidentalmente descubiertas durante radiografías de rutina. El objetivo de este reporte es describir un caso de un cóndilo mandibular con apariencia trífida en un paciente de 12 años de edad con historia de trauma en la mandíbula durante la primera infancia y una revisión de la literatura relevante.

Pruebas de susceptibilidad a la caries dental y su relación con la clínica del niño / Susceptibility testing of dental caries and its relation ship with the child clinic

El objetivo del presente estudio fue establecer una correlación entre los índices de caries y las pruebas diagnósticas de susceptibilidad a la misma, en 26 niños entre 5 y 10 años de edad, que asistieron a consulta de Clínica Infantil de la Facultad de Odontología de la UCV, a quienes se les determinó los índices de caries CPO-D y ceo-d, el pH de la placa dental y prueba de Snyder. Los resultados demostraron un índice ceo-d promedio muy severo (9,00) y un CPO-D promedio leve (2,15), la prueba de pH mostró que el 84,62% de los pacientes obtuvieron pH iniciales iguales o inferiores a 6, valores muy cercanos al pH crítico 5,5. 50 % de los pacientes mostraron una reducción en el pH final de al menos una unidad con respecto a sus valores iniciales y el 84,62% de los individuos mostraron una actividad cariogénica de moderada a marcada según la prueba de Snyder . A partir de los resultados obtenidos en las pruebas de susceptibilidad y comparándolos con el índice ceo-d registrado, podemos concluir que hay una estrecha correlación entre la severidad del índice y los resultados obtenidos de las pruebas, que indican una alta predisposición de los individuos estudiados a sufrir la enfermedad. Sin embargo, no hay esa correlación entre el índice CPO-D y las pruebas de susceptibilidad a la caries que fueron realizadas.

The aim of this study was to establish a correlation between caries indices and diagnostic tests of susceptibility to it, in 26 children between 5 and 10 years old, that visited Children's Clinic, Faculty of Dentistry,UCV , who have determined the rates of caries DMFT and dmf-t, the pH of dental plaque and Snyder test. The results showed a dmf-t index very severe (9.00) and a slight average DMFT (2.15), pH test showed that 84.62% of patients achieved initial pH less than or equal to 6, values very close to the critical pH 5.5. 50% of the patients showed a reduction in the final pH of at least one unit with respect to their initial values and 84.62% of individuals showed a caries activity as moderate to strong evidence of Snyder. From the results of susceptibility testing and comparing with the dmf-t index registered, we can conclude that there is a close correlation between the severity of the index and the results of the tests, which indicate a high predisposition of individuals studied to suffer the disease. However, there is no such correlation between the DMFT index and susceptibility tests were made.

Casuística de las micosis de la cavidad bucal(2002-2006): laboratorio de la cátedra de microbiología, Facultad de Odontología, UCV / Casuistry of fungal infections of the oral cavity (2002-2006): Laboratory of the department of Microbiology, Faculty of Dentistry, UCV

En el presente artículo, se hace la segunda revisión de los casos de micosis de la cavidad bucal que se han reportado en el Laboratorio de la Cátedra de Microbiología de la Facultad de Odontología de la Universidad Central de Venezuela, en el lapso de 5 años (Enero 2002-Diciembre 2006), siendo la Estomatitis Subprotésica la micosis que se reportó con mayor frecuencia. Otras micosis reportadas en menor frecuencia fueron: Candidiasis Hiperplásica, Candidiasis Pseudomembranosa, y lesiones asociadas como Queilitis Angular y Glositis Romboidal Media; Histoplasmosis y Paracoccidioidomicosis

In this article, we continue the review of the most frequent oral mycosis that have been reported on a period of five years (January 2002-December 2006) in the laboratory of Microbiology at Dental School of Central University of Venezuela. Pseudomembranous Candidiasis was the most frequent mycosis of the oral cavity reported. Other mycosis reported were: Hyperplasic Candidiasis, Pseudomembranous Candidiasis, and lesions related with oral mycosis like Angular Cheiulitis and Medium Romboidal Glositis, Histoplasmosis and Paracoccidioidomycosis

Casuística de las micosis de la cavidad bucal, reportadas en el Laboratorio de la Cátedra de Microbiología, Facultad de Odontología, U.C.V. (1997-2001)

En el presente artículo, se hace una revisión de los casos de micosis de la cavidad bucal que se han reportado en un período de 5 años (Enero 1997-Diciembre 2001) en el Laboratorio de la Cátedra de Microbiología de la Facultad de Odontología de la Universidad Central de Venezuela, siendo Candidiasis Atrófica la micosis que se reportó con mayor frecuencia en el lapso antes mencionado. Otras micosis reportadas fueron: Candidiasis Hiperplásica, Candidiasis Pseudomembranosa, , y lesiones asociadas como Queilitis Angular y Glositis Romboidal Media.

do artigo o presente, uma revisão transforma-se dos exemplos do micosis da cavidade oral a que la foram relatados em um período de 5 anos (janeiro1997-Diciembre2001) no laboratório da cadeira do microbiologia da faculdade de Odontologia da Universidade Central de Venezuela, sendo candidiasis Atrófica o micosis que foi relatado a maioria freqüentemente no lapso antes do mencionado. O outro micosis relatado era: Candidiasis Hiperplásica, Candidiasis Pseudomembranosa, , e os ferimentos associaram como o rhomboid angular e médio de Queilitis Glositis.

In this article, we make a review of the most frequent oral mycosis that have been reported on a period of five years (January 1997-December 2001) in the laboratory of Microbiology at Dental School of Central University of Venezuela. Atrophic candidiasis was the most frequent mycosis of the oral cavity reported. Other mycosis reported were: Hyperplasic Candidiasis, Pseudomembranous Candidiasis, and lesions related with oral mycosis like Angular Cheiulitis and Medium Romboidal Glositis.