Basal and dentoalveolar transverse parameters in different sagittal and vertical malocclusions in adults: a comparative study.

OBJECTIVE: This study sought to three-dimensionally (3D) evaluate the maxillomandibular basal bone and dentoalveolar widths using cone-beam computed tomography (CBCT) scans in adult Chinese populations with different vertical and sagittal facial skeletal patterns whilst no apparent posterior dental crossbite. MATERIALS AND METHODS: The retrospective cross-sectional comparative study enrolled CBCT images of 259 adult patients (125 males and 134 females). The subjects were divided into the hyperdivergent(n = 82), hypodivergent(n = 88), and normodivergent(n = 89) groups based on the Jarabak ratio (S-GO/N-Me), which were further divided into three subgroups of skeletal Class I, II and III, based on both the ANB angle and AF-BF parameters. ANOVA was used to analyze the extracted data of the studied groups. The intra- and inter-observer reliability was analyzed using the intra-class correlation coefficient (ICC). RESULTS: In all three vertical facial skeletal patterns, the skeletal Class II had significantly smaller mandibular basal bone width compared to skeletal Class I and Class III, both at the first molar and first premolar levels. The skeletal Class III seemed to have smaller maxillary basal bone width compared to skeletal Class I and Class II malocclusions; however, a significant difference was found only in the normodivergent pattern. As for the dentoalveolar compensation, it was most notable that in the hypodivergent growth pattern, the skeletal Class II had significantly smaller maxillary dentoalveolar width compared to the Class I and Class III groups, both at the first molar and first premolar levels. CONCLUSIONS: Based on the sample in the present study, skeletal Class II has the narrowest mandibular basal bone regardless of the vertical facial skeletal pattern. CLINICAL RELEVANCE: For Chinese adults with no apparent transverse discrepancy, the maxillomandibular basal bone and dentoalveolar widths are revealed in specific categories based on different vertical and sagittal facial skeletal patterns. In diagnosis and treatment planning, particular attention should be paid to skeletal Class II for possibly existing mandibular narrowing.

Quality of web-based Arabic health information on dental implants: an infodemiological study.

BACKGROUND: In the era of the internet, patients seek health information ahead of getting the required treatment. Dental implant, which is among the most sought dental treatments, is not an exception. Incorrect health related information may lead to harmful deeds, so this study sought to assess the quality of web-based Arabic health information on dental implants. METHODS: The following engines were searched: Google ( http://www.google.com ), Yahoo! ( http://www.yahoo.com ), and Bing ( http://www.bing.com ) on 13 January 2022 for specific Arabic terms on "dental implants". The first 100 consecutive websites from each engine were analyzed for eligibility. The eligible websites were assessed using JAMA benchmarks tool, DISCERN tool, and HONcode. An online tool (including FKGL, SMOG and FRE) was used to assess readability of the websites. RESULTS: There were 65 eligible websites, of which only one (1.5%) was HONcode certified. Only 3 (4.5%) websites attained a high score (> 65 out of 80) based on DISCERN tool: The mean DISCERN score was 41.14 ± 12.64. The mean JAMA score was 1.69 ± 1.13; however, only five (7.6%) met all JAMA criteria. The main shortcomings were attributed to not meeting the "Attribution" (54 [83.1%]) and "Authorship" (43 [66.2%]) criteria. The mean grade level of FKGL score was 7.0 ± 4.5. The majority of the websites (60%) scored less than 7, indicating easy content to understand. The mean grade level of SMOG score required to understand a website's text was 3.2 ± 0.6. Around 91% of the websites had reading ease scores ≥ 80, suggesting that the website's content was easy to read. CONCLUSION: Unfortunately, although readable, most of the easily accessible web-based Arabic health information on dental implants does not meet the recognized quality standards.

Successful Management of Peri-Implant Infection from the Endodontic Lesion of Adjacent Natural Tooth.

Recently, dental implants have had the most important role in oral rehabilitation. Peri-implantitis is considered a common complication of dental implants. Adjacent natural teeth with untreated endodontic pathology may be a potential risk for implant placement. Retrograde/periapical peri-implantitis (RPI), the inverting of the progress direction of peri-implantitis. Radiographically, it is characterized by signs of periapical bone loss and normal coronal osteointegration of the implant; and its prevalence is closely associated with endodontic lesions of adjacent teeth. Another novel separate disease entity is known as the endodontic peri-implant defects (endo-implant defects), manifesting as the peri-implant marginal bone loss due to endodontic pathology of adjacent teeth, to which endodontists and implantologists are supposed to attach great importance. This current study presented two cases of different types of peri-implant infection in which conducting proper intervention to the endodontic lesions of adjacent teeth resulted in full radiographic and clinical resolution of peri-implant defects.

Qualitative and quantitative three-dimensional evaluation of maxillary basal and dentoalveolar dimensions in patients with and without maxillary impacted canines.

BACKGROUND: This study aimed to three-dimensionally evaluate the qualitative and quantitative maxillary basal, dentoalveolar, and dental dimensions in patients with unilateral or bilateral maxillary impacted canines relative to their normal peers. MATERIALS AND METHODS: This is a retrospective comparative study. Cone-beam computed tomography images of one hundred and fifty adult patients were divided into three equal groups: unilateral, bilateral, and control groups. Each had 50 patients that were three-dimensionally analysed. The quantitative measurements involved three basal (molar basal width, premolar basal width, and arch depth), seven dentoalveolar (molar alveolar width, premolar alveolar width, inter-molar width, inter-premolar width, inter-canine width, arch length, and arch perimeter), and two dental (canine length and width) measurements. The qualitative measurements included four bone density areas (buccal, lingual, mesial, and distal) around the maxillary impacted canines. RESULT: Differences between the three groups were statistically different for the quantitative measurements involving the two basal variables (molar basal width and premolar basal width) and all measured dentoalveolar variables; these were smaller in the unilateral and bilateral groups compared with the control group (p < 0.001). Unilateral and bilateral impacted canine groups showed significantly wider and shorter canines than the control group (p < 0.001). The qualitative measurements (the four bone density areas) around unilateral and bilateral impacted canine groups showed significantly greater density than the control group (p < 0.001). There was no significant qualitative or quantitative difference between the unilateral and bilateral impacted canines. The three groups had no significant variations in terms of arch depth. CONCLUSION: Maxillary unilateral and bilateral canine impactions are associated with reduced basal and dentoalveolar dimensions as well as wider and shorter maxillary canines compared to normal peers. The quality of bone around unilateral and bilateral impacted maxillary canines is higher than in non-impacted cases. Unilateral and bilateral canine impactions have quite similar qualitative and quantitative parameters.

Three-dimensional Analysis of Alveolar Bone With and Without Periodontitis.

OBJECTIVE: The aim of this study was to investigate the alveolar bone density and thickness in Chinese participants with and without periodontitis. METHODOLOGY: This study was retrospective and cross-sectional in nature and used cone-beam computed tomography (CBCT) to evaluate alveolar bone loss, bone density, and bone thickness around 668 mandibular molars (344 periodontally healthy teeth and 324 teeth with periodontitis). Comparative statistical tests were done related to the age, sex, tooth type, tooth side, and degree of bone loss. The significance level was set to be P < .05. RESULTS: The alveolar bone density significantly differed between the healthy and periodontitis groups (mean difference = 24.4 Hounsfield units; P = .007). Similarly, the alveolar bone thickness of the healthy group was significantly higher than that of the periodontitis group (4.6 ± 1.8 mm compared to 4.2 ± 1.1 mm). Teeth in females demonstrated a significantly (P ˂ .001) higher bone density compared with males in both healthy and compromised groups. However, males showed a significantly (P ˂ .05) thicker bone of the teeth than females in relation to the healthy group. The alveolar bone density and thickness in both healthy and periodontitis groups significantly differed between the first and the second molars (P < .001). The alveolar bone thickness had a highly significant difference (P < .001) between the different degrees of bone loss. CONCLUSIONS: Alveolar bone thickness and density were reduced at periodontally diseased teeth.

Three-dimensional radiographic assessment of bone changes around posterior dental implants at native bone site in Gansu Province, Northwest of China: A retrospective cohort study.

PURPOSE: The aim of this study was to assess bone density and thickness changed following dental implant placement in the maxillary and mandibular jaws. Also, observe the form of bone loss around the implant and the relationship between preoperative bone density and bone thickness with bone loss around dental implants. METHODS: 65 patients, including 102 dental implants, were assessed in this study. CBCT was utilized to determine the bone condition (bone thickness and density at three levels (sub-crestal bone at 3 mm (CB3), 6 mm (CB6), and 9 mm (CB9)) before implant placement, and 2 to 3 years after placement, also determine the bone loss pattern. RESULTS: The difference in bone thickness was 0.32 ± 0.50 mm at CB3, 0.18 ± 0.40 mm at CB6, and 0.14 ± 0.07 mm at CB9. The change buccal bone density at CB3, CB6, and CB9 were 344.5 ± 278.9, 260.5 ± 276, and 138.9 ± 313.9 HU, respectively, and the change in lingual bone density was 252.7 ± 247, 179.9 ± 244.1, and 281 ± 4063 HU, respectively. Only the CB3 level showed a significant decrease in bone thickness (p < 0.001), and a change in bone density was observed at the three levels (p < 0.001). The means of vertical and horizontal bone loss were 0.19 ± 0.23 mm and 0.18 ± 0.22 mm, respectively. Splinted or adjacent dental implants have more horizontal bone loss, with statistically significant (p < 0.001). Age, gender, and implant position were not statistically related to the outcome variables. There was a negative correlation between the preoperative status of the bone condition and pattern bone loss, as indicated by Pearson's correlation coefficient. CONCLUSION: CBCT detected a significant bone thickness decrease was found only at the crestal third. A significant bone density increase was found at three levels around dental implants. Implant areas with higher bone thickness and density had less bone loss.

Three-dimensional assessment of the favorability of maxillary posterior teeth intrusion in different skeletal classes limited by the vertical relationship with the maxillary sinus floor.

BACKGROUND: Understanding the anatomical relationship between the maxillary sinus floor (MSF) and the posterior maxillary teeth (PMT) is important when planning the orthodontic intrusion of the posterior teeth. This study aimed to determine the vertical relationship between posterior maxillary teeth and maxillary sinus floor in different skeletal classes in the Chinese adult population. METHODS: This is a retrospective cross-sectional study involved cone beam computed tomography images of 298 adult patients (145 males and 153 females) between 20 and 45 years old. The sample was categorized according to A point, Nasion, B point (ANB) angle into 102 Class I, 102 Class II, and 94 Class III malocclusion. Non-parametric Wilcoxon Mann-Whitney U and Kruskal-Wallis tests were used to compare the studied groups. The Intra-class Correlation Coefficient (ICC) was used to assess the intra- and inter-observer reliability analysis. RESULTS: Overall, there was a statistically significant difference in the mean distance between both genders (P < 0.001). The measured distance increased with age in all posterior tooth roots (P < 0.001). The root apex in the sagittal view appeared to be closer to the maxillary sinus than in the coronal view; 2.2 ± 4.3 and 3.1 ± 5.5 mm, respectively. The most frequent root scores were Type 1 and Type 2P. In both sagittal and coronal views, Class I demonstrated a higher Type 2P prevalence, whereas Class III showed a lower prevalence. The second molars' mesiobuccal root had the largest number of penetration in the three examined skeletal classes. CONCLUSIONS: Maxillary molars of Class I malocclusion with the majority of Type 2P root-sinus relationship have the highest possible risk of root resorption during molar intrusion due to cortical bone encroachment, while Class III malocclusion showed the least possible risk.

Three-dimensional assessment of the favorability of maxillary posterior teeth intrusion in different facial patterns limited by the vertical relationship with the maxillary sinus floor.

OBJECTIVE: Posterior teeth intrusion is one of the best treatment options for treatment of skeletal open bite in adults; the surrounding anatomical landmarks are one of the restraining factors. This study aimed to assess the vertical relationship between the maxillary posterior teeth (MPT) and the maxillary sinus floor (MSF) in different facial growth patterns in the Chinese adult population. MATERIALS AND METHODS: Cone beam computed tomography images of 298 patients, 145 males and 153 females aged between 20 and 45 years, were analyzed. Based on Jarabak ratio and the mandibular plane inclination, the sample was categorized into 94 hyperdivergent, 102 hypodivergent, and 102 normodivergent facial patterns subjects. The vertical relationship between the root-apex distances were classified as favorable, indicating no contact (type 1), or unfavorable, indicating roots in contact (type 2) for the posterior teeth intrusion. The relationship in the unfavorable group was subdivided into three subgroups (T2C, T2LC, and T2P). Comparative statistical tests were done related to age, gender, tooth side, and type of multiplanar view (sagittal and coronal). The significant level was set to be P < 0.05. RESULTS: There was a statistically significant difference in the mean distance between both genders in the hyperdivergent group (P < 0.001). The measured distance increased with age in all tooth roots (P < 0.001). In both sagittal and coronal views, the most frequent root scores were type 1 and type 2p (54.2%, 27.5%) and (55.1%, 21.4%), respectively. The hyperdivergent group demonstrated a higher prevalence of type 2P (31.6% and 25.5%), whereas the hypodivergent group showed a lower prevalence (25.1% and 19.2%); furthermore, the second molar's mesiobuccal root in hyperdivergent patients showed the closest distance to the maxillary sinus in sagittal and coronal views, 0.3 ± 3.7 and 0.4 ± 3.1 mm, respectively. CONCLUSIONS: Maxillary molars of hyperdivergent patients have the highest possible risk of root resorption due to the possible risk of cortical bone encroachment, while hypodivergent patients have the least possible risk. CLINICAL RELEVANCE: Analysis of apex-sinus distances can be of great help for safe posterior teeth intrusion and providing correct and adequate treatment.

Treatment of Dental Class-II, Division 2 Malocclusion Associated with a Deep Anterior Overbite: A Case Report Orthodontic Camouflage.

AIM: This study sought to correct the assessment of orthodontic camouflage treatment to provide a harmonized soft-tissue profile, consistent occlusion, and a pleasant smile. BACKGROUND: Class-II, division 2 malocclusions can be treated through dental compensation and growth modification methods instead of surgical-orthodontic treatment, which can be determined by the growth and age of the patient. CASE DESCRIPTION: This case report was of a 14-year-old Chinese female whose chief complaint was crowding of anterior teeth and required treatment for the same. On necessary clinical and radiographical examination, diagnosis of convex facial profile with class-II, division 2 malocclusion was arrived and hence treated with orthodontic camouflage. On treatment completion of 33 months, cephalometric assessment revealed that the anterior maxillary teeth had been successfully intruded and substantially distalized, with a slight counterclockwise rotation of the mandible. The treatment results and profile changes were demonstrated with good patient cooperation. CONCLUSION: Using a utility arch with orthodontic camouflage treatment can help to reinforce molar anchoring and improve a deep bite in the maxillary dentitions. The patient was treated with the devised treatment plan and acceptable results were obtained with patient satisfaction as recorded after 1 year of follow-up. CLINICAL SIGNIFICANCE: To correct a maxillomandibular discrepancy, an orthodontist may conduct a process known as camouflage therapy without necessity of surgery. However, patient selection forms a crucial role, and hence systematic arrival of the diagnosis and treatment protocol is a pivotal factor.