CBCT Evaluation of Alveolar Bone Change and Root Resorption after Orthodontic Treatment: A Retrospective Study.

BACKGROUND: For years, there has been a long debate about the impact of orthodontic treatment on the periodontium of patients. Therefore, it is important to understand the effects of orthodontic forces on the periodontium. The objective of this study was to evaluate the height of the alveolar bone at the four surfaces of specific teeth and the root length of the central incisors before and after orthodontic treatment. MATERIALS AND METHODS: CBCTs from a group of fifty patients were evaluated before (T0) and after orthodontic treatment (T1). Evaluations of the alveolar bone were performed by measuring the distance from the most apical point of the marginal portion to the CEJ at the buccal (B-ABL), lingual (L-ABL), mesial (M-ABL), and distal (D-ABL) surfaces of the central incisor (CI), first premolar (1st PM), and first molar (1st M). Meanwhile, root resorptions were evaluated by measuring the distance from the center of the tooth at the CEJ to the most apical point of the central incisor. RESULTS: The reduction in the alveolar bone level was highest at the buccal segment (75%) and lowest at the distal (42%) segment, although the decrease was not statistically significant. Root resorption, in terms of reduction in the total length, was detected in the upper central incisor. CONCLUSIONS: Fixed orthodontic treatment can produce a significant reduction in root length, but not at the level of the alveolar bone.

Influencing Factors Regarding the Severity of Peri-Implantitis and Peri-Implant Mucositis.

The scientific literature is increasingly focused on peri-implant mucositis and peri-implantitis, which are biological outcomes of dental implant treatment. BACKGROUND/OBJECTIVES: The present study aimed to evaluate the two most critical complications of dental implantation, peri-implant mucositis and peri-implantitis, through the prism of different influencing factors. METHODS: We followed 40 patients, with a total number of 92 dental implants, divided into three age groups: under 35 years, between 35 and 55 years, and older than 55 years. Patients were also divided into groups according to the time since implant placement: 1-3 years, 4-7 years, and more than 7 years. The patients were examined, and periodontal pocket depth, peri-implant pocket depth, Löe-Silness gingival index, mucosal thickness, and keratinized mucosal width were recorded; bone resorption was measured on radiographs using a 2D image analysis method; and a questionnaire was also conducted. RESULTS: Bone resorption was highest in the 35-55 age group (3.09 ± 0.04 mm) and for implants placed 4-7 years ago (3.39 ± 0.12 mm). Females had a mean bone resorption of 3.4 ± 0.15 mm and males of 2.45 ± 0.07 mm. Statistically, there was a significant difference only in the Löe-Silness index: the 35-55 age group had the highest values (p = 0.04). CONCLUSIONS: There were no statistically significant differences between the time since implant placement and the degree of bone resorption, nor between sexes. Peri-implant inflammation may occur at any age, regardless of the lifetime of the implants.

Three-Dimensional Assessment of Upper Airway Volume and Morphology in Patients with Different Sagittal Skeletal Patterns.

BACKGROUND: The relationship between respiratory function and craniofacial morphology has garnered significant attention due to its implications for upper airway and stomatognathic development. Nasal breathing plays a key role in craniofacial growth and dental positioning. This study investigated upper airway morphology and volume differences among individuals with class I, II, and III skeletal anomalies. METHODS: Ninety orthodontic patients' CBCT scans were analyzed to assess the oropharynx and hypopharynx volumes. Skeletal diagnosis was established based on the cephalometric analysis. RESULTS: A significant volume change in the oropharynx and pharynx was demonstrated when comparing class II with class III anomalies (p = 0.0414, p = 0.0313). The total volume of the pharynx was increased in class III anomalies. The area of the narrowest part of the pharynx (MIN-CSA) significantly decreased in classes I and II compared to class III (p = 0.0289, p = 0.0003). Patients with Angle class III anomalies exhibited higher values in the narrowest pharyngeal segment. Gender differences were significant in pharyngeal volumes and morphologies across malocclusion classes. CONCLUSIONS: The narrowest segment of the pharynx had the highest values in patients with Angle class III. The volume of the oropharynx was found to be greater in patients with Angle class III versus patients with Angle class II.

Study Regarding the Monitoring of Nocturnal Bruxism in Children and Adolescents Using Bruxoff Device.

Bruxism is a parafunctional activity represented by the gnashing and clenching of one's teeth. The aim of this study was to determine the utility of screening and monitoring with a Bruxoff device during nocturnal bruxism in 51 children and adolescents (36 with bruxism and 15 without bruxism) by assessing the variations in the intensity and duration of parafunctional activity in each patient. Bruxoff measurements were recorded for at least 60 min for three consecutive nights for each subject. All the parameters recorded using Bruxoff in the control and the study groups showed a statistically significant difference (p < 0.05). The differences found by comparing the values recorded in the male and female study groups are significant for heart rate, the number of masseter muscle contractions during one night, and mixed contractions. The Bruxoff device proved to be important in diagnosing patients with bruxism in our practice.

Evaluation of Intraoral Full-Arch Scan versus Conventional Preliminary Impression.

An accurate impression is vital during prosthodontic rehabilitation. Digital scanning has become an alternative to conventional impressions. This study compares conventional preliminary impression techniques with digital scanning, evaluating the efficiency, treatment comfort, and trueness. Impressions of 28 patients were taken using conventional and digital techniques. The efficiency of both impression techniques was evaluated by measuring the mean working time. A visual analog scale questionnaire (1-10) was used to appreciate the participants' perceptions of discomfort. Morphometric measurements, which were carried out to determine the differences between the casts, were made on the buccolingual cross sections of teeth 11 and 31 and the distolingual and mesiobuccal cusp tips of each first molar. The total treatment time was 75.5 min for conventional and 12 min for digital impressions. The patients scored a mean discomfort assessment of 6.66 for conventional and 9.03 for digital scanning. No significant differences existed between the examined areas (p < 0.05, Wilcoxon and Mann-Whitney tests) of the digital casts obtained by both techniques. The intraoral scan can be considered as an alternative to conventional preliminary impressions for performing study model analysis during orthodontic treatment planning. The digital impression is more comfortable and accepted by the patients than the conventional impression and has a shorter working time.

Full-Mouth Rehabilitation of a Patient with Gummy Smile-Multidisciplinary Approach: Case Report.

The impairment of aesthetic function leads to a decreased quality of life. An unaesthetic smile due to excessive gingival exposure demands, most of the time, a complex treatment in which the objective is the vertical reduction of the amount of exposed fixed gingiva by obtaining a complete exposure of the anatomical crown of the teeth and restoring the ideal dimensions of the biological width. This paper presents a case of a 48-year-old female patient who was unsatisfied with her aesthetics and had disturbed masticatory function due to the absence of some posterior teeth. The cone beam computed tomography was performed to evaluate the facial and dental morphology. The treatment plan included diode laser and piezo-surgery utilization for the frontal area of the upper arch and implants to restore the distal area of the lower and upper arch. Zirconia ceramic was used for the final restorations. This complex and multidisciplinary full-mouth rehabilitation lasted for two years, and the patient was pleased with the result. This case showed that a well-established treatment plan is necessary to obtain long-lasting results. The use of adequate procedures and equipment ensures a predictable result.

Influence of the Operator`s Experience, Working Time, and Working Position on the Quality of the Margin Width: In Vitro Study.

Background and Objectives: Appropriate tooth preparation is mandatory to obtain a perfect marginal fit of fixed restorations. The heavy chamfer is the most commonly used finish line, especially for minimally invasive tooth preparation. The aim of the study was to compare the width of the finish line obtained during tooth preparation performed by experienced (university lecturers) and inexperienced persons (dental students) in different working times and positions. Materials and Methods: Forty left upper-second molars were prepared on the simulator by each participant, totalizing 160 prepared teeth. A new round-end tapered diamond was used to obtain the 0.5 mm width of the heavy chamfer. The prepared teeth were photographed using a Canon D5300 camera with a macro lens attached to a tripod. The measurements were made with the Image-Pro Insight software selecting the same eight reference points. From these points, perpendicular lines were drawn above the finish line to the axial walls and the distance between the chamfer's outer edge and the axial wall's inner edge was measured. GraphPad Instat and NCSS Dowson Edition software were used. The statistical significance was set at p < 0.05. The mean (M) and standard deviation (SD) were calculated. The used tests: one sample t-test, ANOVA test, and Tukey-Kramer Multiple Comparisons Test. Results: Statistically significant differences were obtained according to the experience of the participant, preparation time, patient's position, and the chamfer width on the prepared tooth different surfaces. Conclusions: Daytime or weeklong tiredness and patient position do not affect the width of the heavy chamfer prepared by experienced and inexperienced persons. The experience and the operator's working position influence the width of the prepared finish line.