Maxillary Central Incisor Root Resorption due to Canine Impaction after Trauma. Is the Canine Substitution for Maxillary Incisors a suitable Treatment Option? Two Case Reports.

OBJECTIVE: Canine impaction is a dental anomaly involving intraosseous displacement of the unerupted tooth. This situation is of significant importance causing orthodontic, surgical and interceptive problems. Trauma in the incisor area is a possible cause of the displacement of the tooth bud of the permanent canine resulting in the deviated eruption path. The aim of this article is to present two clinical cases with diagnosis of maxillary canine displacement and impaction in the incisor region after a traumatic injury during childhood, discussing treatment possibilities and outcomes achieved after orthodontic treatment. MATERIALS AND METHODS: In this article ectopic maxillary canines migration in the central incisor area after a traumatic injury to the anterior upper teeth are described. The path of eruption of the canine can cause severe central incisor root resorption. Treatment strategy established for the case reports described involves orthodontic space opening, extraction of the central incisor, uncovering the impacted canine and orthodontic traction of the tooth in place of central incisor. Modification of crown morphology and color were essential to obtain an aesthetic and function outcome. RESULTS: The patients finished treatment with normal and stable occlusion, an adequate width of attached gingiva and good aesthetic results. CONCLUSION: Authors suggest that might have been a possible connection between the trauma of primary dentition causing the displacement of the tooth bud of permanent canine and the deviated path of eruption. For the growing patients with a combination of dental trauma and ectopic eruption, maxillary canine to replace a central incisor was a viable option, offering excellent aesthetic results without recourse to prosthetic replacement.

Orthodontic-surgical treatment: electromyographic and kinesiographic evaluation in follow up period. Experimental study.

INTRODUCTION: The aim of this study was to investigate muscular function and mandibular kinesiology of patients undergoing orthodontic-surgical treatment by electromyography and kinesiography. Electromyographic evaluation is essential to estimate masticatory forces in patients undergoing combined surgical-orthodontic treatment. MATERIALS AND METHODS: 60 patients referred for orthodontic surgical treatment were included in the study, 43 patients presented a class III while 17 presented a class II. The patients underwent electromyographic and kinesiographic examinations during all the therapeutic orthodontic-surgical phases. RESULTS: The relationship between fundamental electromyographic values and age, weight, asymmetry and activation was weak. A strong and positive relationship was observed between the relaxation percentage after TENS (transcutaneous electrical neuromuscular stimulation), the steepness of the post-surgery rehabilitation curve, the initial POC (percentage overlapping coefficient), and for the values in microvolts of the right and left temporal and masseters at the beginning of treatment. CONCLUSIONS: Patients with dentofacial deformities corrected by surgical treatment, have a significant positive treatment outcome in respect of masticatory activity and performance electromyographic evaluation on, before, during and follow up period of the analized patients permit to underline that this examination can predict long term stability.

Neuromuscular evaluation in young patients with unilateral posterior crossbite before and after rapid maxillary expansion.

OBJECTIVES: The aim of this study is to analyze the electromyographic and electrognatographic exams of 55 patients before and after rapid palatal expansion, and to find out a relationship between the results. MATERIALS AND METHODS: The sample consisted of 55 children (28 females and 27 males; age ranging between 6 and10 years) with unilateral posterior crossbite, and subjected to an electromyographic and electrognatographic examination before and after a rapid palatal expansion. RESULTS: By analyzing the results, it is possible to observe an increased electrical activity of the masticatory muscles (right and left masseters and anterior temporalis) both in rest position and during activities after rapid palatal expansion. CONCLUSIONS: Rapid palatal expansion produces important changes in the muscular tone and it increases the muscular activity of the masticatory muscles.

Upper airway obstuction in class II patients. Effects of Andresen activator on the anatomy of pharingeal airway passage. Cone beam evalution.

AIM: The aim of this study is to assess the response and changes on pharyngeal airway passage (PAP) to class II Andresen appliance in class II growing patients with obstructive sleep apnea syndrome (OSAS). METHODS: The sample consisted of forty patients with a class II malocclusion in the age range of 9 to 14 years with mandibular retrusion and OSAS and ten control group subjects. A CBCT was taken before treatment (T0) and a second one after a follow-up period of approximately 16 months (T1). The dimensions of PAP were determined according to the method described by Jena et al. with Mimics program. The following parameters were considered: DOP, DPH, MP-H, PAS, PNS-U, SNA, SNB, ANB. The statistical analysis was carried out with t test. RESULTS: The change in ANB, SNB, MP-H, PNS-U, PAS was significantly more in the patients undergoing treatment as compared to the control group. The improvement of DOP and DPH among the treatment group subjects was significantly more compared to the control group subjects. CONCLUSIONS: Class II correction by functional appliances during childhood might help to eliminate the adaptive changes in the upper airway and predisposing factors to OSAS, thus decreasing the risk of OSAS development in adulthood.

The complication of oral piercing and the role of dentist in their prevention: a literature review.

OBJECTIVES. The work report about the complications of oral piercing and the role of dentist in their prevention. MATERIALS AND METHODS. The authors conducted a systematic review of the literature through the Medline database by entering "oral piercing", "piercing and complications", "piercing and hygiene" as keywords. Articles published between 1988 and 2012 were considered. RESULTS. Oral piercing is linked to several potential complications. Many of them are due to scarce awareness of the risk, bad habits and inadequate oral care. CONCLUSIONS. The dentist should motivate patients with oral piercing to maintain a good oral care, provide instructions and conduct periodic inspections to secure their understanding and implementation in order to prevent complications.

How various surgical protocols of the unilateral cleft lip and palate influence the facial growth and possible orthodontic problems? Which is the best timing of lip, palate and alveolus repair? literature review.

OBJECTIVES. Cleft lip palate is congenital growth disease with unknown etiology, probably linked to both genetically and external causes. The aim of this work consists in presenting the effects of these diseases on cranio facial growth and the surgical protocols described in literature. MATERIALS AND METHODS. The literature review articles conducted by Medline ranged from 1998 to 2011 have been selected. The key words of the research were "cleft lip palate", "cleft lip palate facial growth", "cleft lip palate surgery". The inclusion criteria were articles that analyzed surgical protocols and the growth of unilateral lip and palate clefts, the timing repair of lip, palate and alveolus. We excluded case reports, studies without control group in the sample and the other types of publication as thesis or conference presentation. 60 articles had the selection criteria of the research. RESULTS. The cleft lip and palate is one of the most common birth defects that needs long rehabilitation between birth and adulthood. Several authors have presented surgical protocols and timing. The effects of these diseases on cranio facial growth and the importance of the early intervention have been described. CONCLUSIONS. The review describes the main surgical protocols and treatment strategies of the unilateral lip and palate clefts. The review discusses how surgery effects the midfacial skeletal growth. Studies agree that the palate repair is the main cause of the maxilla growth disturbances. About the timing of palate repair in the unilateral clefts it can be concluded that most studies found no difference between one or two stages palate repair techniques for the midfacial growth. Also from the research, studies agree that delayed hard palate repair has more positive effects on maxillary growth than that of early hard palate repair. Nevertheless good results, delayed hard palate repair technique is abandoned by many hospital centres because of worse speech outcome. The best technique of palate repair is difficult to conclude, because the research results are part of a big controversy between the centers. From the studies about the alveolar repair it can be concluded that the primary bone grafting had more negative results on the skeletal growth. Gingivoperiosteoplasty and the secondary bone grafting had more positive results for intracranial relationship. The studies agree that the best timing of lip repair is during third-sixth month of life and that lip repair could have negative influence on the maxillary growth.

Non surgical treatment of Crouzon syndrome.

Crouzon syndrome is an autosomal dominant disorder with variable expressivity, characterized by skull and facial malformations. Such alterations vary from case to case. Management requires multidisciplinary approach. Two cases of two sisters affected by Crouzon syndrome are described. Treatment was performed by orthopedic and orthodontic devices without surgery. Good esthetics and functional results were obtained. Five-year follow-up records are presented.