An unusual presence of primary retention of permanent teeth in subject with hyperthyroidism.

To date neither the eruption mechanism nor the factors controlling eruption have been completely understood. Primary retention of permanent teeth is an isolated condition associated with a localized failure of eruption with no other identifiable local or systemic involvement. Multiple primary retention may be related to lack of eruptive force, rotation of tooth buds, syndromes and metabolic disorders. This article reports an unusual case of primary retention of permanent teeth inclusion in a 21-year-old woman with hyperthyroidism, diagnosed at 14 years of age.

Osteopathic manual therapy versus conventional conservative therapy in the treatment of temporomandibular disorders: a randomized controlled trial.

OBJECTIVE: Temporomandibular disorders (TMD) is a term reflecting chronic, painful, craniofacial conditions usually of unclear etiology with impaired jaw function. The effect of osteopathic manual therapy (OMT) in patients with TMD is largely unknown, and its use in such patients is controversial. Nevertheless, empiric evidence suggests that OMT might be effective in alleviating symptoms. A randomized controlled clinical trial of efficacy was performed to test this hypothesis. METHODS: We performed a randomized, controlled trial that involved adult patients who had TMD. Patients were randomly divided into two groups: an OMT group (25 patients, 12 males and 13 females, age 40.6+/-11.03) and a conventional conservative therapy (CCT) group (25 patients, 10 males and 15 females, age 38.4+/-15.33). At the first visit (T0), at the end of treatment (after six months, T1) and two months after the end of treatment (T2), all patients were subjected to clinical evaluation. Assessments were performed by subjective pain intensity (visual analogue pain scale, VAS), clinical evaluation (Temporomandibular index) and measurements of the range of maximal mouth opening and lateral movement of the head around its axis. RESULTS: Patients in both groups improved during the six months. The OMT group required significantly less medication (non-steroidal medication and muscle relaxants) (P<0.001). CONCLUSIONS: The two therapeutic modalities had similar clinical results in patients with TMD, even if the use of medication was greater in CCT group. Our findings suggest that OMT is a valid option for the treatment of TMD.

The natural head position. Different techniques of head positioning in the study of craniocervical posture.

The aim of this paper was to describe the most important definitions of head posture and the most important methodology to get an natural head posture. After a careful analysis of the literature with no limitations of language or time period, 31 papers were selected. Relevant information was also derived from reference lists of the publications retrieved. The key words used in the search were head posture, cranio-cervical posture, cephalometric analysis, natural head position, lateral cephalometric radiographs, cephalostat, self balance position, mirror position. The definitions of natural head position are various. An accurate head posture registration is time consuming and not particularly feasible on a clinical field. Nevertheless it is possible to apply a craniostat to the patient before the execution of the radiograph without modifying the NHP. The execution of radiographs of the craniocervical zone is connected to the correct position of the head. The NHP is a reproducible positions, and can be useful for making comparisons at any time in the case of the same patient or in comparing different patients cephalometrically.

Correlation of the temporomandibular dysfunction classification index with cephalometric indicators of facial structure: a study on adult female subjects.

AIM: The aim of this study was to determine whether associations exist between temporomandibular dysfunction index (TMI) and craniofacial morphology. METHODS: The sample consisted of 30 symptomatic (mean age 28.3+/-6.7; range 24-39 years, TMI 0.48+/-0.21) and 30 asymptomatic women (mean age 27.4+/-9.2; range 22-42 years, TMI 0.1+/-0.05) seeking orthodontic treatment at Department of Dental Sciences ''G. Messina'', University of Palermo, who had routine lateral cephalograms. Symptoms and signs of temporomandibular joint dysfunction (TMD) were assessed by a standardized clinical examination and the TMI (a clinical measure of dysfunction used to evaluate the severity of TMD). Linear and angular cephalometric measurements were taken to evaluate skeletal and dental characteristics of the two groups. Unpaired t test was used to compare the symptomatic subjects with the control subjects. RESULTS: The sella-nasion-supramentale (SNB) angle (P<0.038, indicating mandibular retrognathism relative to cranial base), the lower facial height and the palatal plane-mandibular plane angle (P<0.025 and P<0.037 respectively, indicating hypodivergent facial profile) were significantly smaller in the symptomatic than in the asymptomatic women. The occlusal plane was steeper (P<0.033) and the cranial flexion was higher (P<0.035) in the symptomatic group than in the asymptomatic group. In addition the overjet (P<0.008) and the overbite (P<0.005) were significantly greater in symptomatic group than in the asymptomatic group. CONCLUSION: This study showed a significant correlation between dentofacial characteristics and TMD.

Mandibular advancement devices: indications and predictors of treatment outcome. A review.

Obstructive sleep apnea syndrome (OSAS) is a chronic sleep and respiratory disorder, which causes a partial or total obstruction of the air passage at the upper airway level. Mandibular advancement devices (MADs) have been used in the treatment of snoring, but may be a valid alternative to the continuous nasal positive airway pressure (CPAP) for certain OSAS cases. Therapy by means of MADs arises the interest of the scientific community and now there are many sleep-centres where dentists work as experts in sleep disorders. MADs are instruments of value because they are simple to use, reversible, portable and they generally have a low complication rate. They mechanically increase the oropharyngeal space by advancing the mandible and/or the tongue and reduce pharyngeal collapsibility. More than 60 different MADs are in use, with considerable variations in design. Several studies show that their systematic use produces an evident improvement in the global quality of life as well as in the symptoms of patients with OSAS, especially sleepiness. Even though significant progress has been made in proving the efficacy of MADs for OSAS, the ability to predict the treatment outcome and hence pre-select suitable candidates for this treatment still remains in its early stage. The first aim of this review is to supply to the clinician informations on the cephalometric and polysomnographic parameters that can be used to predict the efficacy of the outcome of MAD therapy in OSAS. Moreover, we examine the cases for which the use of a MAD is indicated.