Malocclusion Complexity in Patients with Disc Displacement Disorders: A Case-Control Study.

This study aimed to determine the possible association between disc displacement (DD) disorders and malocclusion complexity. This cross-sectional study was carried out using a case-control design. The Research Diagnosis Criteria for Temporomandibular Disorders were used to identify cases and controls. The Index of Complexity, Outcome, and Need (ICON) was used to quantify malocclusion complexity as easy, mild, moderate, difficult, or very difficult. A total of 310 subjects were included: 130 cases and 180 controls. A binary logistic regression (p < 0.05) was used to identify associations. The odds ratio (OR) was also calculated. DD was associated with sex, age, and malocclusion complexity (p < 0.05). The malocclusion complexity comparison showed that 89.3% of the controls fell within the easy-moderate levels of the ICON, whereas 85.4% of the cases were in the moderate-very difficult levels (p ≤ 0.001). Difficult and very difficult malocclusions had high ORs (9.801 and 9.689, respectively) compared to the easy cases. In conclusion, patients with malocclusion complexity levels classified as difficult or very difficult have greater odds of presenting DD.

Malocclusion complexity as an associated factor for temporomandibular disorders. A case-control study.

OBJECTIVE: To evaluate the association between temporomandibular disorders (TMD) and malocclusion complexity using the Index of Complexity Outcome and Need (ICON) levels. METHODS: A prospective, cross-sectional, case and control study was done. Cases and controls were matched in a one-to-one relationship (179 subjects each). The Research Diagnostic Criteria was used to evaluate the presence of TMD, and the ICON was used to quantify malocclusion complexity. A binary logistic regression (p < 0.05) was used to identify associations between variables. RESULTS: TMD presence was associated with gender and malocclusion complexity (p < 0.05). The largest proportion of controls were in the lowest three levels of ICON complexity, while most cases were in the three highest levels (p < 0.001). Higher malocclusion complexity indicated a greater TMD risk. CONCLUSION: The results indicate that TMD is associated with malocclusion complexity. As malocclusion complexity increases, so do the odds of presenting with TMD.

Use of Ionized Monocalcium phosphate and enameline derivatives to reduce dentin hypersensitivity after periondontal therapy / Uso de Fostato Monocálcio y derivados en Enamelina para reducir la hipersensibilidad dentaria después de terapia periodontal

Abstract This study aimed to evaluate the effectiveness of using an ionized monocalcium phosphate and enamelin derivatives (IMP+ED) based mouthwash for the treatment of dentin hypersensitivity (DH) after scaling and root planing (SRP). 47 patients who reported DH after SRP treatment were included in this prospective cohort study. The Schiff Cold Air Sensitivity Scale (SCASS) was applied to classify their degree of pain in mild, moderate or intense at two times: after SRP (T0), and after one month of using a IMP+ED-based mouthwash (T1). The McNemar-Bowker test was used to compare the correlated proportions between both times (p<0.05). After the SRP therapy (T0), all the sample members reported pain distributed in the following manner: 12.8% were mild, 27.6% moderate, and 59.6% intense. At one month since treatment and with the use of the IMP+ED-based mouthwash (T1), the distribution of pain levels changed to 83% mild, 12.8% moderate, and 4.3% intense, this change was statistically significant (p<0.001). IMP+ED-based mouthwash produces a positive effect in reducing painful responses caused by exposure of the dentin tubules to the oral environment after SRP therapy.

Resumen El objetivo de este estudio fue evaluar la efectividad de un enjuague bucal a base de fosfato monocálcico ionizado y derivados de enamelina (FCI+DE) para el tratamiento de hipersensibilidad dentinaria (HD) posterior al tratamiento de raspado y alisado radicular (RAR). 47 pacientes que reportaron tener HD posterior al tratamiento de RAR fueron incluidos en este estudio prospectivo de cohorte. Con el fin de clasificar la HD de los pacientes en leve, moderada o intensa se utilizó la Escala de Sensiblidad al Aire Frío de Schiff (ESAFS). Los pacientes fueron evaluados después del tratamiento de RAR (T0) y posterior al uso de un enjuague bucal basado en FCI+DE (T1). Para comparar las proporciones correlacionadas se utilizó la prueba de McNemar-Bowker (p<0.05). La distribución del dolor de los pacientes posterior al tratamiento de RAR (T0) fue la siguiente: 12.8% fueron leves, 27.6% moderado, and 59.6% intenso. Un mes después del uso del enjuague buccal basado en FCI+DE (T1) la distribución en los niveles de dolor cambio a 83% leve, 12.8% moderado, and 4.3% intenso, este cambio fue estadísticamente significativo (p<0.001). El uso del enjuague bucal basado en FCI+DE produce una reducción significativa a la respuesta de dolor causada por la exposición de la dentina al ambiente oral como consecuencia del tratamiento de RAR.

Dental anomalies in cleft lip and palate: A case-control comparison of total and outside the cleft prevalence.

This study's objective was to compare the total and outside the cleft prevalence of dental anomalies (DA) between patients with cleft lip and palate (CLP) and a control group. This retrospective cross-sectional study was done under a case-control design. The case group consisted of 192 non-syndromic patients with complete CLP, while the control group included 411 patients. All subjects had orthopantomography, intra, and extraoral photographs. The prevalence of dental agenesis, supernumerary teeth, impacted teeth, dental transposition, and microdontia were compared using a chi-squared test (P < .05). Next, a second test was made, but only the anomalies outside the cleft were considered for this study. Total prevalence was 89.1% for cases, and 20.9% for controls (P < .01). The prevalence of each DA was significantly higher for the case group. In the analysis of DAs outside the cleft, the total prevalence was still significantly associated (P < .01); however, only dental agenesis was statistically significant (P < .01). Further analysis found that a high rate of upper premolar absence (P < .01) could explain this event. Patients with CLP have a higher prevalence of DAs compared to controls. After considering only the DAs outside the cleft, the total prevalence remains significantly higher. However, this phenomenon is explained mainly by the elevated prevalence of upper premolars' agenesis. This study's results suggest that environmental factors are behind the high prevalence of DAs in subjects with CLP.

Malocclusion Complexity in Patients with Myofascial Pain with or without Mouth-Opening Limitation: A Case-Control Study.

Background: This study is aimed at determining the association between myofascial pain with or without mouth-opening limitation and malocclusion complexity. Methods: A prospective, cross-sectional, case-control study was conducted. The Research Diagnostic Criteria were used to evaluate the presence of myofascial pain, chronic pain, and depression. The Index of Complexity, Outcome, and Need (ICON) was applied to quantify malocclusion complexity. A total of 96 patients with myofascial pain were grouped into two: subjects without mouth-opening limitation (n = 76, group A) and subjects with mouth-opening limitation (group B, n = 20). Both groups were compared with 231 controls (group C). A Chi-squared test and a multinomial logistic regression (p ≤ 0.05) were used to identify associations between the variables. Results: Statistically significant associations were found between myofascial pain and the variables gender, malocclusion complexity, and depression (p ≤ 0.05). Age was not significantly associated (p = 0.327). Concerning malocclusion complexity, 77.9% of the controls were distributed in the first three ICON levels; however, 76.5% of group A subjects and 90% of group B were in the last three (p < 0.001). The multinomial logistic regression showed a significant association between malocclusion complexity in group A (p < 0.05) and an association between depression and group B (p < 0.05). Group B had the highest grades of chronic pain. Conclusions: Females had greater risk of myofascial pain without mouth-opening limitation. As the complexity of the malocclusion increases, so do the odds of presenting myofascial pain without mouth-opening limitation. Myofascial pain with mouth-opening limitation frequently coexists with depression and chronic pain.

Unexpected malocclusion in a 13,000-Year-old Late Pleistocene young woman from Mexico.

To analyze the etiological factors behind the malocclusion of a Late Pleistocene woman (named Naia), who is the best-preserved of the earliest individuals of the American continent. The examination of Naia's malocclusion was performed through cephalometric and occlusal analyses, and by measuring her mandible. Her data were then compared to published data for modern, medieval, and postmedieval samples and seven Late Pleistocene individuals. Naia presented her permanent dentition fully erupted, except for the impacted mandibular third molars. She presented a class II molar malocclusion with crowding. The dental widths and mandible measurements were similar to or smaller than modern standards. The degree of dental wear was light. The cephalometric analysis confirmed a skeletal class II relationship, with a retrusive mandible and protruded upper incisors. Naia's mild level of dental wear is consistent with a low masticatory force, in a time when the norm was a high amount of grinding. The low masticatory forces help explain Naia's small jaws and crowding. However, it does not clarify Angle's class II relationship. Naia is an example that environmental factors are insufficient to explain the onset of malocclusions and emphasizes the importance of understanding hereditary factors' role.

Zinc Oxide and Copper Chitosan Composite Films with Antimicrobial Activity.

The role of the oral microbiome and its effect on dental diseases is gaining interest. Therefore, it has been sought to decrease the bacterial load to fight oral cavity diseases. In this study, composite materials based on chitosan, chitosan crosslinked with glutaraldehyde, chitosan with zinc oxide particles, and chitosan with copper nanoparticles were prepared in the form of thin films, to evaluate a new alternative with a more significant impact on the oral cavity bacteria. The chemical structures and physical properties of the films were characterized using by Fourier transform infrared spectroscopy (FTIR,) Raman spectroscopy, X-ray photoelectron spectroscopy (XPS), elemental analysis (EDX), thermogravimetric analysis (TGA), X-ray diffraction (XRD), scanning electron microscopy (SEM), and contact angle measurements. Subsequently, the antimicrobial activity of each material was evaluated by agar diffusion tests. No differences were found in the hydrophilicity of the films with the incorporation of ZnO or copper particles. Antimicrobial activity was found against S. aureus in the chitosan film crosslinked with glutaraldehyde, but not in the other compositions. In contrast antimicrobial activity against S. typhimurium was found in all films. Based on the data of present investigation, chitosan composite films could be an option for the control of microorganisms with potential applications in various fields, such as medical and food industry.

Evaluation of diagnostic agreement among cephalometric measurements for determining incisor position and inclination / Evaluación de la concordancia diagnóstica entre mediciones cefalométricas para la determinación de la posición e inclinación de los incisivos

SUMMARY: The incisors are a key factor in dental occlusion and dentofacial aesthetics; therefore, the sagittal position and inclination of the incisors is a key parameter in diagnosis and orthodontic treatment planning. In some cases, the orthodontist will use more than one cephalometric analysis, and thus different results can be obtained. The aim of this study was to establish the diagnostic agreement among the different cephalometric measurements used to determine the anteroposterior position and the inclination of the incisors. Lateral cephalometric radiograms of patients between 18 and 59 years old were measured (n=260). Digital cephalometric measurements were made with Dolphin Imaging software, by a single calibrated operator. Here, a specific cephalometric analysis was designed in the software analysis editor. The results for each variable and each measurement were registered and compared. Fleiss's Kappa statistical tests, Cohen's Kappa, and Kendall's coefficient were used to determine the strength of agreement using the Minitab software. The results showed diagnostic strength agreement between slight and moderate among measurements of the same variable. This indicates that same diagnosis might not be obtained when using different approaches to measure the anteroposterior position and inclination of the incisors. It was concluded that there is a difference in the diagnosis between one measurement and another because the results showed slight or moderate strength of agreement. However, in some cases, better agreement was found when the measurements were compared as a function of the diagnostic response.

RESUMEN: Los incisivos son un factor clave en la oclusión dental y la estética dentofacial; por lo tanto, la posición sagital y la inclinación de los incisivos es un parámetro clave en el diagnóstico y la planificación del tratamiento de ortodoncia. En algunos casos, el ortodoncista utilizará más de un análisis cefalométrico y, por lo tanto, se pueden obtener resultados diferentes. El objetivo de este estudio fue establecer el acuerdo de diagnóstico entre las diferentes mediciones cefalométricas utilizadas para determinar la posición anteroposterior y la inclinación de los incisivos. Se midieron radiografías cefalométricas laterales de pacientes entre 18 y 59 años (n = 260). Las mediciones cefalométricas digitales se realizaron con el software Dolphin Imaging, por un solo operador calibrado. Aquí, se diseñó un análisis cefalométrico específico en el editor de análisis de software. Los resultados para cada variable y cada medición se registraron y compararon. Las pruebas estadísticas Kappa de Fleiss, Kappa de Cohen y el coeficiente de Kendall se usaron para determinar la fuerza del acuerdo utilizando el software Minitab. Los resultados mostraron un acuerdo de fuerza diagnóstica entre leve y moderado entre las mediciones de la misma variable. Esto indica que no se puede obtener el mismo diagnóstico cuando se utilizan diferentes enfoques para medir la posición anteroposterior y la inclinación de los incisivos. Se concluyó que existe una diferencia en el diagnóstico entre una medición y otra porque los resultados mostraron una fuerza de acuerdo leve o moderada. Sin embargo, en algunos casos, se encontró un mejor acuerdo cuando se compararon las mediciones en función de la respuesta de diagnóstico.

Growth differences in patients with dental agenesis, how its location impacts facial morphology.

BACKGROUND/PURPOSE: Non-formation of a tooth impacts the morphology of the alveolar bone, which may, in turn, generate an imbalance in facial growth. This retrospective case-control study aimed to determine whether observable differences exist in the facial growth of patients with dental agenesis relative to complete dentition controls. MATERIALS AND METHODS: The sample comprised 75 patients with dental agenesis, and each case was paired with two controls of the same age and gender (n = 150). All patients were measured cephalometrically (31 variables), and both groups were compared with student's t- or Z-test (P < 0.05). Subsequently, ANOVA or Kruskal-Wallis tests (P < 0.05) were used to compare facial growth depending on the missing tooth's sagittal location in the dental arch (anterior or posterior agenesis); as well as its location in the affected bone (maxillary, mandibular, or both). RESULTS: Four measurements with significant differences were found, whereas ten were found in the sagittal location in the dental arch analysis. Regarding the affected bone, there were no affected variables. CONCLUSION: it was found that patients with dental agenesis show differences in the sagittal growth of the upper jaw and in the position of the lower incisor. In the studied population, these changes are strongly influenced by the sagittal location of the missing tooth, while its location in the jaws does not affect facial growth.

Orthodontic Treatment of Bilateral Impacted Mandibular Canines and a Mupparapu Type 2 Transmigration.

Dental transmigration is a rare condition that mainly affects the mandibular canines. Since the tooth involved is usually impacted and its crown has crossed the midline towards the opposite side, the treatment options frequently are surgical removal or radiographic follow-up, and, in some cases, orthodontic traction is possible. In 2002, Mupparapu presented a classification for lower canines in transmigration according to their position within the mandible. This paper is aimed at describing the orthodontic treatment of a female patient with two impacted mandibular canines, one of them in a Mupparapu type 2 transmigration position (horizontal impaction position near the lower mandibular border and below the incisors' root apices). Additionally, the paper discusses the biomechanical orthodontic design and the alternative treatment options for these complex cases.

Anatomical variations of maxillary lateral incisors: A comparative analysis of archaeological and modern populations from the Yucatan peninsula.

The aim of this study was to compare the prevalence of anatomical variants of maxillary lateral incisors in archaeological and modern populations from the Maya region. Both populations were derived from the state of Yucatan, Mexico. The archaeological sample consisted of human remains representing 122 individuals from the ancient Maya archaeological site of Xcambo (AD 250-700). The modern sample consisted of 475 dental models from the municipality of Tahdziú, Yucatan. The anatomical variants evaluated included microdontia, barrel-shaped incisors, and talon cusp. The prevalence of each anatomical variant for each population was calculated and compared (Fisher p < 0.05). The prevalence of anatomical variants was 15.57% (n = 19) in the archaeological sample and 14.11% (n = 67) in the modern one; the difference was not significant (p = 0.666). When compared by specific anatomical variants, a significant (p = 0.013) association was observed for microdontia: 2.45% (n = 3) in the archaeological population and 9.05% (n = 43) in the modern population. Barrel-shaped incisors (p = 0.522) and talon cusp (p = 0.466) did not exhibit significant associations. The overall prevalence of anatomical variants in the maxillary lateral incisors in this region has not changed. The prevalence of microdontia has increased over the last 1500 years, and different microevolutionary processes may be called into question for such change.

Impacted Maxillary Canine Prevalence and Its Association with Other Dental Anomalies in a Mexican Population.

Objective. We quantified the prevalence of impacted maxillary canines (IMC) and their association with other dental anomalies (DAs). Materials and Methods. A retrospective study was done with 860 patients 12 to 39 years of age. The prevalence of IMC was calculated and compared by sex. The sample was divided into a control group and an impaction group, and the prevalence was calculated in both for a series of anomalies: agenesis, supernumerary teeth, shape anomalies of the upper laterals (microdontia, peg and barrel shape, and talon cusp), fusion, gemination, other impacted teeth, transposition, and amelogenesis imperfecta. The prevalence values for both groups were compared (Pearson's χ2 test, p ≤ 0.05). Results. IMC were present in 6.04% of the sample with no difference by sex (p = 0.540). Other DAs occurred in 51.92% of the IMC group and in 20.17% of the controls (p < 0.05). Significant associations (p < 0.05) were identified between IMC and four other DAs: microdontia, barrel shape, other impacted teeth, and transposition. The prevalence of all anomalies was lower in the control group. Conclusion. IMC were seen in 6.04% of patients. Patients with this condition also had a higher prevalence of other DAs. These other anomalies should be used as risk indicators for early diagnosis.

Agenesia de terceros molares, prevalencia, distribución y asociación con otras anomalías dentales / Third molar agenesis, prevalence, distribution and association with other dental anomalies

La agenesia de terceros molares se ha reportado en un 24,3 por ciento en México. La agenesia dental está asociada a otras anomalías dentales debido a su origen genético. El objetivo del presente estudio fue determinar la prevalencia y distribución de agenesia de terceros molares así como establecer su asociación con otras anomalías dentales en una población ortodóntica. La muestra incluyó 670 pacientes ortodónticos de 9 a 20 años de edad. Se excluyeron pacientes con tratamiento ortodóntico previo y condiciones sindrómicas. Se calculó la prevalencia de agenesia de terceros molares y se comparó por sexo. Posteriormente los pacientes fueron divididos en 2 grupos, con agenesia de al menos un tercer molar y un grupo control y en ambos se calculó la prevalencia de 10 anomalías dentarias. Los resultados se compararon por medio de la prueba exacta de Fisher (p<0,05). La prevalencia fue del 25,97 por ciento, no hubo diferencia estadística entre géneros (p=0,139). El 41,95 por ciento de los pacientes del grupo de agenesia presentó anomalías asociadas, mientras que en el control fueron el 23,59 por ciento. Se encontró una diferencia significativa entre ambos grupos (p=0,0001). Al comparar individualmente la prevalencia de cada anomalía por grupo, se encontró que la agenesia (p=0,0001) y los dientes retenidos (p=0,015) estaban disminuidos significativamente en el grupo control. En conclusión se encontró una prevalencia del 25,97 por ciento, sin preferencia de sexo. Los pacientes con agenesia de terceros molares presentan mayor prevalencia de anomalías dentales asociadas, particularmente agenesia de otros dientes y dientes retenidos.

Prevalence of third molar agenesis has been estimated in 24.3 percent in Mexico. Dental agenesis is associated with other dental anomalies due its genetic origin. The aim of this study was to determine the prevalence and distribution of third molar agenesis and to establish its association with other dental anomalies in an orthodontic population. The sample included 670 orthodontic patients from 9 to 20 years old. Exclusion criteria were patients with previous orthodontic treatment and syndromic conditions. Third molar agenesis prevalence was calculated and sex values were compared. Then, patients were divided into 2 groups, with agenesis of at least one third molar and a control group; prevalence of 10 dental anomalies were calculated for both groups. The results were compared using Fisher's exact test (p <0.05). Third molar agenesis prevalence was 25.97 percent, there was no statistical difference between sexes (p= 0.139). The 41.95 percent of patients in the agenesis group had abnormalities associated, whereas in the control group it was 23.59 percent. A significant difference between groups was found (p= 0.0001). When comparing the prevalence of each individual anomaly between groups, it was found that agenesis (p= 0.0001) and impacted teeth (p= 0.015) were significantly decreased in the control group. In conclusion it was found a prevalence of 25.97 percent, with no sex preference. Patients with agenesis of third molars have a higher prevalence of associated dental anomalies, particularly agenesis of other teeth and impacted teeth.