Hair Evaluation in Orthodontic Patients with Oligodontia.

Oligodontia can be isolated or syndromic, associated with other ectodermal abnormalities. The aim of the study was to perform hair examination in orthodontic patients diagnosed with oligodontia with a low clinical expression of symptoms of ectodermal origin. All available orthodontic patients diagnosed with oligodontia in the permanent dentition were enrolled. Hair examination included clinical evaluation of the patients' hair, trichoscopy, trichogram and evaluation of the hair shafts under a polarized light microscope. In total, 25 patients, 18 males and 7 females, aged 6 to 24 years were evaluated for the presence of dental and hair abnormalities. The number of congenitally absent teeth ranged from 6 to 24 teeth and diastemas, microdontia, taurodontism and altered tooth shape were found in 23 patients. Hair disorders were found in 68% of the subjects. Hypotrichosis, the heterogeneity of shaft color and loss of pigment, androgenetic alopecia, telogen effluvium, trichoschisis, pili canaliculi, trichorrhexis nodosa and pseudomoniletrix were observed. Trichoscopy and trichogram are valid non-invasive diagnostic tests which could be used to differentiate between isolated and syndromic oligodontia in patients with a low clinical expression of ectodermal symptoms.

Dentofacial characteristics of children and adolescents with foetal alcohol spectrum disorders: a comparison with matched controls.

BACKGROUND: Foetal alcohol spectrum disorders (FASD) include somatic and neurological developmental disturbances after prenatal alcohol exposure, including facial anomalies. However, the knowledge of the orthodontic skeletal and dental cephalometric relations in this group is limited. The aim of the study was to assess the dentofacial characteristics of children and adolescents with FASD and to compare them with a matched control group. METHODS: The study group comprised all available children and adolescents diagnosed with FASD (> 7 years of age) in whom good quality cephalograms were available. The control group comprised non-syndromic, orthodontically untreated children with normal occlusion and skeletal relations matched with age and gender. Cephalometric analysis included eighteen linear and angular measurements. The general linear model for repeated measures regarding age, gender and the type of FASD was applied. RESULTS: The group with FASD included 35 individuals (21 girls and 14 boys) aged 7-18 years including 21 with foetal alcohol syndrome. The mean age in the study and the control group was 12.8 years (SD, range 3.2, 7.1-18.1) and 13.0 (SD, range 2.9, 9.1-18.1), respectively. Statistically significant differences between the groups were found in 15 out of 18 of the cephalometric measurements (83%). In children with FASD the mandible was more retrusive, the incisors were more proclined and the mandibular incisors and the lips were more protruded when compared with controls. There was no significant evidence of an influence of age, gender or FASD type. CONCLUSIONS: Dentofacial characteristics of children and adolescents with FASD significantly differ from controls. Early orthodontic diagnosis and prophylaxis should play a part of the interdisciplinary care of patients in this group.

Comparisons of Dental Anomalies in Orthodontic Patients with Impacted Maxillary and Mandibular Canines.

To assess the presence and possible associations between the type of dental anomalies and maxillary and mandibular canine impactions in orthodontic patients treated for canine impaction, panoramic radiographs of orthodontic patients treated for canine impaction were assessed for the presence of associated dental anomalies. A random sample of orthodontic patients without canine impaction matched for age and gender served as controls. Descriptive and exact inferential statistics were implemented in order to assess potential associations between canine impaction and dental anomalies. A total of 102 orthodontic patients with 70 maxillary (MaxCI) and 32 mandibular (ManCI) canine impactions were assessed. The control group included 117 orthodontic patients. Dental anomalies were present in more than 50% of patients with impacted canines and in 20% of the controls. Tooth agenesis was significantly more common in the MaxCI group when compared to the ManCI group, while supernumerary teeth and canine transmigration were registered more often in the ManCI group. When compared to the control group, peg-shaped maxillary lateral incisors and tooth agenesis were significantly more prevalent in the MaxCI group, while canine transmigration, supernumerary teeth, the agenesis of mandibular incisors and tooth transpositions were significantly more prevalent in the ManCI group. The impaction of other teeth was significantly more common in both canine impaction groups when compared to the controls. The prevalence of dental anomalies in orthodontic patients with impacted canines was higher than in orthodontic patients without canine impaction. Different types of tooth anomalies were found in the MaxCI and ManCI groups.

Application of Artificial Intelligence (AI) in a Cephalometric Analysis: A Narrative Review.

In recent years, the application of artificial intelligence (AI) has become more and more widespread in medicine and dentistry. It may contribute to improved quality of health care as diagnostic methods are getting more accurate and diagnostic errors are rarer in daily medical practice. The aim of this paper was to present data from the literature on the effectiveness of AI in orthodontic diagnostics based on the analysis of lateral cephalometric radiographs. A review of the literature from 2009 to 2023 has been performed using PubMed, Medline, Scopus and Dentistry & Oral Sciences Source databases. The accuracy of determining cephalometric landmarks using widely available commercial AI-based software and advanced AI algorithms was presented and discussed. Most AI algorithms used for the automated positioning of landmarks on cephalometric radiographs had relatively high accuracy. At the same time, the effectiveness of using AI in cephalometry varies depending on the algorithm or the application type, which has to be accounted for during the interpretation of the results. In conclusion, artificial intelligence is a promising tool that facilitates the identification of cephalometric landmarks in everyday clinical practice, may support orthodontic treatment planning for less experienced clinicians and shorten radiological examination in orthodontics. In the future, AI algorithms used for the automated localisation of cephalometric landmarks may be more accurate than manual analysis.

Availability of Third Molars as Donor Teeth for Autotransplantation to Replace Congenitally Absent Second Premolars in Children and Young Adults.

The aim of the study was to assess the presence and distribution of third molars (M3) regarding their autotransplantation in patients with congenital absence of second premolars (PM2). Additionally, M3 development in relation to patients' age and gender was investigated. Panoramic radiographs of non-syndromic patients with at least one congenitally absent PM2 were used to assess the localization and number of missing PM2 and the presence or absence of M3 (minimum age 10 years). The alternate logistic regression model was applied to analyze associations between the presence of PM2 and M3. A total of 131 patients with PM2 agenesis were identified (82 females, 49 males). At least one M3 was present in 75.6% and all M3 were present in 42.7% of patients. A statistically significant association between the number of PM2 and M3 agenesis was found; the effects of age and gender were not significant. More than half of M3 in patients between 14-17 years old had completed » of their root development. The congenital absence of maxillary PM2 was associated with the absence of maxillary PM2, M3, and no correlation was found in the mandible. In patients with PM2 agenesis, at least one M3 is often present and can be considered as a donor tooth for autotransplantation.

Bone Remodeling during Orthodontic Movement of Lower Incisors-Narrative Review.

The tooth movement in the alveolus is possible due to bone remodeling. This process could be the risk factor for the formation of gingival recessions-the most common side effects of orthodontic therapy. Gingival recessions are found 5.8-11.5% more frequently among the orthodontically treated patients. What is more, anterior mandibular teeth are the ones most prone to gingival recession dehiscences and fenestrations. The aim of this narrative review was to evaluate, based on CBCT (Cone beam computed tomography) scans, the changes in the alveolar bone of lower incisors in adolescent and adult patients after orthodontic tooth movements. From the pool of 108 publications, a total of 15 fulfilled the criteria of this review. Both retrospective and prospective longitudinal studies-using CBCT or CT (Computed Topography) and evaluating alveolar bone changes in mandibular incisors during orthodontic treatment performed before and after teeth movement-were included. In the group of growing patients, either proclination or retroclination of mandibular incisors led to increase of the distance from CEJ (cementoenamel junction) to marginal bone crest. The difference in bone loss was greater on the lingual side of the incisors in both types of tooth movement. The results were similar for adults patients. The thickness of the alveolar bone was reduced after proclination (total bone thickness) among growing and non-growing patients and retraction (lingual and buccal) of lower anterior teeth in the group of growing patients. The only improvement was measured for buccal thickness of mandibular incisor in bimaxillary protrusion patients treated with extraction therapy. The control of retraction movement (more root than crown movement) enhanced preservation on bone height and thickness. In order to minimize possible deterioration and place teeth in the center of alveolus, CBCT monitoring and scrupulous clinical evaluation are recommended.

Novel Candidate Genes for Non-Syndromic Tooth Agenesis Identified Using Targeted Next-Generation Sequencing.

Non-syndromic tooth agenesis (ns-TA) is one of the most common dental anomalies characterized by the congenital absence of at least one permanent tooth (excluding third molars). Regarding the essential role of genetic factors in ns-TA aetiology, the present study aimed to identify novel pathogenic variants underlying hypodontia and oligodontia. In a group of 65 ns-TA patients and 127 healthy individuals from the genetically homogenous Polish population, the coding sequences of 423 candidate genes were screened using targeted next-generation sequencing. Pathogenic and likely pathogenic variants were identified in 37 (56.92%) patients, including eight nucleotide alternations of genes not previously implicated in ns-TA (CHD7, CREBBP, EVC, LEF1, ROR2, TBX22 and TP63). However, since only single variants were detected, future research is required to confirm and fully understand their role in the aetiology of ns-TA. Additionally, our results support the importance of already known ns-TA candidate genes (AXIN2, EDA, EDAR, IRF6, LAMA3, LRP6, MSX1, PAX9 and WNT10A) and provide additional evidence that ns-TA might be an oligogenic condition involving the cumulative effect of rare variants in two or more distinct genes.

Orthodontic evaluation of children and adolescents with different types of Foetal Alcohol Syndrome Disorders.

OBJECTIVE: To assess general and oral health status, including the presence of malocclusion and orthodontic treatment needs, in children and adolescents with FASD in relation to different types of this disorder. SETTING AND SAMPLE POPULATION: A total of 67 participants (29 males and 38 females) aged 2.5-17.8 years with confirmed diagnosis of FASD were included. MATERIALS AND METHODS: The participants were divided into three subgroups: foetal alcohol syndrome (FAS), partial foetal alcohol syndrome (PFAS) and alcohol-related neurodevelopmental disorders (ARND). General health, oral health status, history of dental trauma, presence of dysfunctions or parafunctions, and occlusion were examined. Additionally, the Index of Orthodontic Treatment Need (IOTN) index was calculated. Selected variables were compared to the results obtained from a national monitoring survey on the oral health conditions in Poland. RESULTS: In children and adolescents with FASD, a number of systemic anomalies including alimentary, neurological and musculoskeletal disorders were present. Dysfunctions and parafunctions such as mouth breathing and thumb sucking were frequently recorded. Children with FASD had an increased prevalence of distal occlusion and crossbite compared to the general population. Malocclusions were more often identified in the FAS group. No significant differences in the IOTN between different FASD groups were found. Borderline need for orthodontic treatment was more frequent in children with FASD compared to controls. CONCLUSION: Early screening for the presence of dysfunctions/parafunctions and malocclusions in children with FASD is recommended, so that orthodontic prophylaxis and state-funded orthodontic care programmes for these children are implemented.

Effect of Tooth Agenesis on Mandibular Morphology and Position.

Congenital missing teeth (OMIM #106600) is the most common dental abnormality. The aim of the study was to evaluate the effects of tooth agenesis on the total mandibular length, length of the mandibular body and alveolar process, and the mandibular anteroposterior position. The material was obtained from the Department of Orthodontics, Medical University of Warsaw. The study group included 116 patients aged 9-18 years with a congenital absence of at least two permanent tooth buds in the maxilla and/or mandible (mean: 6.2 teeth missing/patient). All patients were Caucasians: 68 (59%) females and 48 (41%) males. The control group included 115 patients without tooth agenesis matched with the age and gender of the study group. A cephalometric analysis was performed, and it was focused on assessing anteroposterior mandibular measurements. This assessment was based on 17 measurements (12 linear and 5 angular). Statistical analysis of the cephalometric measurements between the study group and the control group showed significant changes regarding selected mandibular measurements. Tooth agenesis does not affect the total length of the mandible and the length of the mandibular body, but it might reduce the length of the mandibular arch length and result in a more retrusive mandibular position.

Comparisons of different treatment methods and their outcomes for impacted maxillary and mandibular canines: A retrospective study.

BACKGROUND: Impacted canines may pose a functional and an esthetic problem for patients and can affect neighboring incisors. The aim of the study was to compare different treatment methods and their outcomes for impacted maxillary and mandibular canines. METHODS: The authors included 102 patients with 118 impacted canines (82 maxillary and 36 mandibular canines). Impacted canine were confirmed during clinical and radiologic examinations. Eighty-five patients (83%) with 97 impacted canines started the treatment. The authors analyzed treatment types and outcomes. Two maxillary and 4 mandibular canines were scheduled for extraction. RESULTS: Orthodontic extrusion was used most frequently to treat impacted maxillary canines (89%), whereas orthodontic extrusion and transalveolar transplantation were performed most frequently in impacted mandibular canines (33% and 37.5%, respectively). The treatment was successful in 96% of the maxillary and 95% of the impacted mandibular canines. CONCLUSIONS: Different methods were used for impacted maxillary and mandibular canines, but their overall success rate was high. PRACTICAL IMPLICATIONS: Successful outcome is determined via a well-planned and carefully executed orthodontic and surgical treatment. Early diagnosis is pivotal in facilitating spontaneous canine eruption and implementing transalveolar transplantation in a timely way.

Postorthodontic lower incisor and canine inclination and labial gingival recession in adult patients : A prospective study.

PURPOSE: The goal was to determine whether changes in the inclination of lower incisors and canines upon orthodontic treatment with fixed appliances poses a threat for labial gingival recession in adult patients. METHODS: The sample of this prospective clinical trial consisted of 32 adult patients (mean age 25.08 ±6.50 years) treated with fixed appliances. Plaque and bleeding indices, probing pocket depth, clinical attachment level, gingival recession height (GR) and width (GRW), gingival thickness (GT), and keratinized tissue width were clinically recorded, while cone beam computed tomography (CBCT) was used to evaluate teeth inclination before (T1) and after treatment (T2). Oral hygiene, brushing habits, and smoking were controlled. RESULTS: During orthodontic treatment on 15 (8.33%) teeth (10 incisors and 5 canines), spontaneous complete improvement of pre-existing GR was observed. On 2 incisors, GR decreased and on 3 teeth GR did not change. Moreover, 1 incisor presented an increased GR, while 2 teeth developed new defects. Mean GR, GRW, and GT decreased significantly only on the incisors. Proclination of incisors and canines during treatment (compared with retroclination of the teeth) implicated a lower reduction in GR at T2: 0.19 mm (p = 0.034) and 0.18 mm (p = 0.037), respectively. Multiple regression analysis confirmed that more tooth proclination was associated with a higher risk for an increase in GR (p < 0.00). CONCLUSION: Properly planned changes in lower incisor and canine inclination can be carried out in adult patients without posing a high risk to labial gingival recessions if the individual periodontal biotype is respected. The reported outcomes underscore the orthodontic principle to keep tooth roots inside the alveolar bone.

PAX7 nucleotide variants and the risk of non-syndromic orofacial clefts in the Polish population.

OBJECTIVE: The etiology of non-syndromic cleft lip with or without cleft palate (nsCL/P) is multifactorial, heterogeneous, and still not completely understood. The aim of the present study was to examine the associations between common and rare PAX7 nucleotide variants and the risk of this common congenital anomaly in a Polish population. SUBJECTS AND METHODS: Eight top nsCL/P-associated PAX7 variants identified in our cleft genome-wide association study (GWAS) were selected for replication analysis in an independent group of patients and controls (n = 247 and n = 445, respectively). In addition, mutation screening of the PAX7 protein-coding region was conducted. RESULTS: Analysis of the pooled data from the GWAS and replication study confirmed that common PAX7 nucleotide variants are significantly associated with the increased risk of nsCL/P. The strongest individual variant was rs1339062 (c.586 + 15617T > C) with a p-value = 2.47E-05 (OR = 1.4, 95%CI: 1.20-1.64). Sequencing analysis identified a novel synonymous PAX7 substitution (c.87G > A, p.Val29Val) in a single patient with nsCLP. This transition located in the early exonic position was predicted to disrupt potential splice enhancer elements. CONCLUSION: Our study confirmed that PAX7 is a strong candidate gene for nsCL/P. Nucleotide variants of this gene contribute to the etiology of nsCL/P in the homogenous Polish population.

Relationship between periodontal status of mandibular incisors and selected cephalometric parameters : Preliminary results.

PURPOSE: The aim of this cross-sectional study was to evaluate the correlation between the periodontal tissue of mandibular incisors and several dentoalveolar and skeletal cephalometric parameters. MATERIALS AND METHODS: The sample consisted of 35 patients (mean age 26.42 ± 8.02 years). Eligibility criteria included good overall health status with no history of dental trauma, congenital defects, active periodontal diseases, restorative and prosthetic treatment in the area of the mandibular incisors. Gingival recession width and height (GRW, GRH), gingival thickness (GT), width of keratinized gingiva (WKT) and clinical attachment loss (CAL) were evaluated at 140 lower incisors. Incisors inclination (1-:ML), skeletal class (ANB, WITS), intermaxillary angle (NL:ML) and mandibular symphysis dimensions (symph. length and width) were assessed in cephalograms. Spearman's correlation coefficient was used for statistical analysis at the P < 0.05 level. RESULTS: A statistically significant positive moderate correlation was found for GT and WITS and also symph. length. WKT correlated positively with ANB, WITS and symph. length, with moderate strength of the correlation. GRW, GRH and CAL did not correlate with any cephalometric parameters. CONCLUSION: The results of this study indicated evidence for an association between WKT and GT and some cephalometric variables-ANB, WITS, and symphysis length.

Radiological imaging and orthodontic treatment in the case of growing patients after oncological treatment: Case reports.

According to the classification of the World Health Organization (WHO), the most common childhood malignant neoplasms include leukemia, lymphomas, and neoplasms of the central nervous system (CNS) and the sympathetic nervous system. Cancer diseases themselves as well as their treatment carry a high risk of both early and distant effects. The most common dentition disorders resulting from the radiotherapy of the head area and chemotherapy in patients up to the age of 6 years include root agenesis, V-shaped roots, microdontia, hypoplasia of the maxilla and the jawbone, hypodontia, and enamel hypoplasia and hypomineralization. Patients undergoing oncological treatment at the age of <6 years should receive adequate and long-term monitoring due to the possible distant effects of the underlying disease and its treatment. The radiotherapy of the head and neck region performed on a growing patient significantly worsens the patient's prognosis and results in a number of irreversible complications. Planning appropriate orthodontic treatment in such patients contributes to increased comfort later in the patients' lives. Oncology patients do not require special orthodontic procedures; however, the high risk of complications does encourage the planning of orthodontic treatment with the least burden. Dental care for a young patient with a history of oncological disease requires the interdisciplinary cooperation of a pedodontist, orthodontist, prosthetist, and dental surgeon.

The retrospective study of 93 patients with transmigration of mandibular canine and a comparative analysis with a control group.

OBJECTIVES: The aim of this study was to evaluate characteristics of patients with unilateral transmigration of a mandibular canine in the largest study group presented until now. MATERIALS AND METHODS: The study group consisted of 93 patients with unilateral transmigration of mandibular canine; the control group included 85 non-affected patients. Type of transmigration, status of deciduous and permanent canines, prevalence of missing teeth, class of occlusion, and space conditions were assessed to draw comparisons between groups. RESULTS: In this study, 64.5 per cent patients presented type 1 of transmigration; types 2, 3, 4, and 5 were present in, respectively, 23.7, 5.4, 4.3, and 2.1 per cent patients. There was a clear, statistically significant difference (P < 0.0001) between the mean crown and apex migration and angulation for the three groups of canines (transmigrated, contralateral, and control), whereas no differences were observed for the total number of permanent teeth present. In the study group, 73.1 per cent patients retained their primary canine on the affected side and 18.3 per cent on the contralateral side; in the control group, 22.3 per cent subjects had at least one primary canine. There was a statistically significant difference in the distribution of types of malocclusion between the study and the control groups. CONCLUSIONS: Transmigration of mandibular canine was associated with the presence of retained primary canine on the affected side, higher mesial tilting of contralateral mandibular canine when compared to the canines in the control group. Additionally, higher prevalence of Angle's Class I occlusion in patients with canine transmigration was recorded.

Assessment of the Dental Age of Children in the Polish Population with Comparison of the Demirjian and the Willems Methods.

BACKGROUND Dental age is less affected than the bone age by nutritional and hormonal factors. The assessment of dental age in children is of value in clinical and forensic practice. The aims of this study were to compare the Demirjian method and the Willems method in the assessment of dental age in children in Poland and to consider the need to standardize dental age assessment. MATERIAL AND METHODS Polish children of Caucasian ethnicity (n=1,002) who were treated at a single orthodontic center between 1994-2016 included girls (n-540) and boys (n=462) aged between 4-17 years, and 1,002 panoramic radiographs were reviewed. Dental age was assessed using the Demirjian method and the Willems method, the findings of the two methods were compared with the chronological age of the study participants. RESULTS Following statistical analysis, both the Demirjian method and the Willems method overestimated the dental age of the younger study participants, and underestimated the dental age of the older study participants. Both the Demirjian method and the Willems method had similar accuracy in estimating the chronological and dental age in the Polish population. CONCLUSIONS In the assessment of dental age in Polish children from panoramic radiographs, both the Demirjian method and the Willems method were accurate and should still be used as a method of choice. However, it seems reasonable to create international standards for the assessment of dentition maturity for this population to obtain a more acceptable range of error values between the dental age and chronological age.

Correlation between functional disorders of the masticatory system and speech sound disorders in children aged 7-10 years.

BACKGROUND: Masticatory system and speech sound disorders concur, have the same causes and similar consequences - both increase the risk of dental and periodontal diseases. OBJECTIVES: The study was conducted to establish the correlation between functional disorders of the masticatory system and speech sound disorders. MATERIAL AND METHODS: Three hundred patients aged 7-10 years were examined to detect functional disorders of the masticatory system and speech sound disorders. Functional disorders were assessed in patients with and without speech sound disorders. RESULTS: According to the study results, functional disorders of the masticatory system concur more often with speech sound disorders than with correct articulation and lead to speech sound disorders. There is a strong correlation between: - any dysfunction and errors in the /p/, /b/, /m/, /s/, /z/, /t͡ s/, /d͡ z/, /ɕ/, /ʑ/, /t͡ ɕ/, and /d͡ ʑ/ sounds, - mouth breathing and errors in the /p/, /b/, /m/, /s/, /z/, /t͡ s/, /d͡ z/, /ɕ/, /ʑ/, /t͡ ɕ/, and /d͡ ʑ/ sounds, - persistent tongue thrust and errors in the /s/, /z/, /t͡ s/, /d͡ z/, /ʂ/, /ʐ/, /t͡ ʂ/, /d͡ ʐ/, /ɕ/, /ʑ/, /t͡ ɕ/, and /d͡ ʑ/ sounds, and - parafunctional sucking and errors in the /s/, /z/, /t͡ s/, /d͡ z/, /ʂ/, /ʐ/, /t͡ ʂ/, /d͡ ʐ/, /ɕ/, /ʑ/, /t͡ ɕ/, and /d͡ ʑ/ sounds. CONCLUSIONS: To implement effective and early prevention and treatment, it is crucial to know the correlation between the masticatory system and speech sound disorders, as it reduces treatment duration and minimizes relapses of not only communication disorders, but also of concurrent masticatory system disorders.

Association of CDKAL1 nucleotide variants with the risk of non-syndromic cleft lip with or without cleft palate.

Although the aetiology of non-syndromic cleft lip with or without cleft palate (nsCL/P) has been studied extensively, knowledge regarding the role of genetic factors in the pathogenesis of this common craniofacial anomaly is still limited. We conducted a follow-up association study to confirm that CDKAL1 nucleotide variants identified in our genome-wide association study (GWAS) for nsCL/P are associated with the risk of this anomaly. In addition, we performed a sequence analysis of the selected CDKAL1 exons. A mega-analysis of the pooled individual data from the GWAS and a replication study revealed that six out of thirteen CDKAL1 variants were positively replicated and reached the threshold of statistical significance (Ptrend < 3.85E-03). They represented a single association signal and were located within the fifth intron of CDKAL1. The strongest individual variant was rs9356746 with a Ptrend value = 5.71E-06 (odds ratio (OR) = 1.60, 95% confidence interval (CI): 1.30-1.97). Sequencing analysis did not reveal any pathogenic mutations of this gene. This study provides the first evidence that chromosomal region 6p22.3 is a novel susceptibility locus for nsCL/P. The location of the risk variants within the CDKAL1 intronic sequence containing enhancer elements predicted to regulate the SOX4 transcription may suggest that SOX4, rather than CDKAL1, is a potential candidate gene for this craniofacial anomaly.

Trichoscopy of Focal Alopecia in Children - New Trichoscopic Findings: Hair Bulbs Arranged Radially along Hair-Bearing Margins in Aplasia Cutis Congenita.

PURPOSE: To establish whether trichoscopy can be useful in the differential diagnosis of patchy alopecia in children. PROCEDURES: The study was a retrospective analysis (2012-2015) and included 68 patients under 6 years of age. The inclusion criteria were age and the presence of 1-3 alopecia patches. A total of 124 alopecia patches were examined with the use of a videodermoscope: 102 alopecia areata, 8 tinea capitis, 6 trichotillomania, 3 temporal triangular alopecia and 5 aplasia cutis congenita. RESULTS: In all aplasia cutis congenita lesions, trichoscopy revealed elongated hair bulbs visible through the semitranslucent epidermis, seen at the hair-bearing margin and radially arranged. Hair regrowth [upright regrowing hairs (44%), circular hairs (23%) and vellus hairs (20%)] was observed in the majority of alopecia areata patches. For triangular alopecia, upright regrowing hairs (100%; 3/3), vellus hairs (100%; 3/3) and circle hairs (33%; 1/3) were seen inside the alopecia patch. CONCLUSION: Trichoscopy is a useful technique for the differential diagnosis of patchy alopecia in children. A novel finding in this study indicates that radially arranged hair bulbs visible through the translucent epidermis are characteristic of nonbullous type aplasia cutis congenita.

Impacted Teeth: An Interdisciplinary Perspective.

A tooth normally erupts when half to three-quarters of its final root length has developed. Tooth impaction is usually diagnosed well after this period and is generally asymptomatic. It is principally for this reason that patients seek treatment later than optimal. Tooth impaction is a common problem in daily orthodontic practice and, in most cases, it is recognized by chance in a routine dental examination. Therefore, it is very important that dental practitioners are aware of this condition, since early detection and intervention may help to prevent many harmful complications. The treatment of impacted teeth requires multidisciplinary cooperation between orthodontists, oral surgeons and sometimes periodontists. Orthodontic treatment and surgical exposure of impacted teeth are performed in order to bring the impacted tooth into the line of the arch. The treatment is long, more complicated and challenging. This article presents an overview of the prevalence, etiology, diagnosis, treatment and complications associated with the management of impacted teeth.