Osteoma of the Jaw as First Clinical Sign of Gardner's Syndrome: The Experience of Two Italian Centers and Review.

Gardner's syndrome (GS) is a combination of polyposis, osteomas, fibromas, and sebaceous cysts. The aim of the study is to highlight whether maxillofacial osteoma could represent an early detection symptom of GS. Patients with suspected osteoma of the jaw underwent genetic and radiographical examinations. The database gathered 19 patients with oral osteoma that was histologically diagnosed; the whole sample was positive for APC gene mutation. Other cranial and peripheral locations were reported. Osteoma of the jaw is a crucial predictive factor of GS, and dentists and oral and maxillofacial surgeons must be aware of the importance of a timely diagnosis.

3D Assessment of the Correlation between Neonatal Morphology and Occlusal Outcomes in 5-Year-Old Patients with Complete Unilateral Cleft Lip and Palate

ABSTRACT Objective: To exploit 3D measurement technology to determine any correlation between neonatal palate morphology and occlusal outcomes at five years in patients receiving surgery for unilateral cleft lip and palate (CLP). Material and Methods: Twenty-nine neonatal and 5-year models treated by the same surgeon using the same protocol for CLP correction were scanned using a high-resolution structured-light scanner and stored in stl format. Dedicated software was used to make linear and surface area measurements on the neonatal models, and each digitized 5-year model was assigned a Five-Year-Old (5YO) index score on three separate occasions by the same investigator. Results: Minimum, maximum, mean, standard deviation and standard error were calculated for each variable considered, and the Pearson coefficient was used to identify any correlations between neonatal variables and 5YO scores. Linear regression analysis showed that the only variable to approach significance was the posterior width of the cleft, which showed an R2 equal to 0.111, indicating that it accounts for 11% of the variability of the 5YO index. There was no other appreciable correlation between linear measurements, surface areas, or their inter-relationships. Conclusion: There is no correlation between neonatal morphological characteristics and occlusal outcomes at 5 years in CLP patients treated via the surgical protocol considered.

Early class III treatment with hybrid rapid palatal expander combined with facemask.

BACKGROUND: Class III patients are characterized by a deficiency of the maxilla and/or a prognathism of the mandible and require early treatment. DIAGNOSIS: This case report describes the treatment of a 5-year-old patient with a skeletal class III relationship, a significant mandibular symphysis deviation towards the right side and a different height of the mandibular angles. MANAGEMENT AND OUTCOME: The patient was treated with rapid maxillary expander combined with miniscrew, facemask and aligners. A functional and aesthetic occlusion in an improved facial profile was established at the end of the orthodontic treatment. Pre-treatment, post-treatment and one year retention records for the patient are presented. DISCUSSION: Class III patients require early treatment in order to optimize the traditional expander effects; subsequently hybrid anchorage allowed to maximize skeletal advancement. In addition, loss of space for the erupting teeth and dento-alveolar tipping were avoided. The good results of the phase I treatment and of the active retainer meant that a complex case would become relatively simple at the phase II treatment.

Experimental Study of the Pressures and Points of Application of the Forces Exerted between Aligner and Tooth.

The analysis of forces, moments and pressure points has long been of great interest in orthodontics. Hence, we set out to define a method for measuring the pressure exerted by aligners on the teeth, and specifically to identify the precise points of pressure exertion. Intraoral scans were performed on a patient with optimal alignment and levelling before and after 2º vestibularisation of the upper central incisor. Pressure sensor film was placed in a dedicated housing between the aligner and teeth in order to record the pressure exerted after 15 s of aligner application. The images captured by the film were scanned, digitised, and subsequently analysed. Areas and amounts of pressure generated by the aligners were evaluated, and the net force of each was calculated, adjusted to take into consideration passive values. The method revealed the areas of contact by which the aligner transmits force on the teeth, and the pressures at which it does so. The pressure exerted by an aligner is not evenly distributed across the entire surface of the tooth during lingual tipping of an upper incisor. The areas of force concentration were not identical, as these are influenced by factors resulting from the manufacturing and casting processes.

Comparative SEM analysis of nine F22 aligner cleaning strategies.

BACKGROUND: The orthodontics industry has paid great attention to the aesthetics of orthodontic appliances, seeking to make them as invisible as possible. There are several advantages to clear aligner systems, including aesthetics, comfort, chairside time reduction, and the fact that they can be removed for meals and oral hygiene procedures. METHODS: Five patients were each given a series of F22 aligners, each to be worn for 14 days and nights, with the exception of meal and brushing times. Patients were instructed to clean each aligner using a prescribed strategy, and sections of the used aligners were observed under SEM. One grey-scale SEM image was saved per aligner in JPEG format with an 8-bit colour depth, and a total of 45 measurements on the grey scale ("Value" variable) were made. This dataset was analysed statistically via repeated measures ANOVA to determine the effect of each of the nine cleaning strategies in each of the five patients. RESULTS: A statistically significant difference in the efficacy of the cleaning strategies was detected. Specifically, rinsing with water alone was significantly less efficacious, and a combination of cationic detergent solution and ultrasonication was significantly more efficacious than the other methods (p < 0.05). CONCLUSIONS: Of the nine cleaning strategies examined, only that involving 5 min of ultrasonication at 42 k Hz combined with a 0.3% germicidal cationic detergent was observed to be statistically effective at removing the bacterial biofilm from the surface of F22 aligners.