Comparative evaluation of the dentoalveolar effects of three Class II correctors: A finite element analysis study.

OBJECTIVE: To compare the stress distribution and total strain applied to the dentition, periodontal ligament (PDL) and cortical and trabecular bones by three Class II correctors using finite element analysis. DESIGN: Three-dimensional analysis of stresses and total strain of the dentition with three Class II correctors. SETTING: Computational study. METHODS: Three-dimensional finite element models of Class II elastics, the Forsus Fatigue Resistant Device (FRD) and the Carriere Motion Appliance (CMA) were constructed from a cone-beam computed tomography (CBTC) image of an orthodontic Class II patient. The distribution of stress (von Mises and principal stress) and the total strain (mm) in maxillo-mandibular dentition, PDL, cortical and trabecular bone were analysed. RESULTS: The highest von Mises yield and the maximum principal stress in the three models were found at the teeth, followed by the cortical bone, trabecular bone and PDL. The maximum stress and total deformation were located at the upper canines and lower molars in the Class II elastics and CMA models, in the upper first molars in the Forsus FRD and CMA, and in the lower first premolars in the Forsus FRD. In addition, stress was distributed in the anterior and posterior regions of the teeth, and the total deformation was found in the distal direction in the upper arch and in the mesial direction in the lower arch. CONCLUSION: The stress concentrations in the three models were located close to the active components of each appliance, producing specific patterns of stress distribution and displacement that should be taken into account when planning the type of appliance to be used for the correction of the Class II malocclusion.

Orthodontic treatment need, the types of brackets and the oral health-related quality of life.

BACKGROUND: Malocclusion can affect the oral health-related quality of life (OHRQoL). The influence of the orthodontic treatment need (OTN) and the type of brackets on OHRQOL is not clear. OBJECTIVES: The aim of the present study was to determine the relationships between OTN and the bracket type and OHRQoL during the first 6 months of orthodontic treatment (OT) in adult patients. MATERIAL AND METHODS: This cohort study was conducted at the Department of Orthodontics of a private university. A total of 216 patients aged ≥18 years participated in the study (106 patients with conventional brackets and 110 with self-ligating brackets). The OHRQoL was evaluated using the 14-item Oral Health Impact Profile (OHIP-14) at 5 time points - before OT (T0), and at 24/48 h (T1), 1 month (T2), 3 months (T3), and 6 months (T4) after the installation of the orthodontic appliance. The OTN was evaluated with the dental aesthetic index (DAI) by 2 previously calibrated operators. For the statistical analysis, the χ2 test and the Mann-Whitney U test were used. Additionally, Poisson regression models were performed. RESULTS: The evidence of an association between OHRQoL and OTN was found only at T3 (p = 0.0095). No association was found between OHRQoL and the bracket type. However, in the regression models, OHRQoL was statistically significantly worse at T3 in the group with a greater OTN (IRR (incidence rate ratio) = 1.34; 95% CI (confidence interval): 1.21;1.48) and at T4 in the self-ligation group (IRR = 1.23; 95% CI: 1.12;1.36). CONCLUSIONS: The OHRQoL was affected in the same way at the beginning of OT, regardless of OTN and the bracket type used. However, a worse OHRQoL was observed at 3 months in subjects with greater OTN and at 6 months in patients with self-ligating brackets.

Relación entre la inclinación de los incisivos con la estabilidad en la alineación del sector anterior según criterios del índice PAR

Introducción : el objetivo de este estudio fue el evaluar la relación entre la inclinación de los incisivos al finalizar tratamiento de ortodoncia con la estabilidad de la alineación de dientes anteriores usando índice PAR. Métodos: estudio analítico de corte transversal, en 47 pacientes que finalizaron ortodoncia, con radiografía lateral inicial y final, se evaluó el ángulo formado entre plano (Silla-Nasion) (U1-NS) e inclinación del incisivo superior y el ángulo entre inclinación axial del incisivo inferior y plano mandibular (Go-Gn). Se aplicó el índice PAR del sector anterior a modelos pretratamiento (T0), postratamiento (T1) y de seguimiento (T2). El análisis estadístico se realizó mediante distribuciones de frecuencias y porcentuales, prueba T, Anova I, Anova II y Manova; significancia P= 0.05. Resultados: no se encontró asociación entre la inclinación del incisivo superior e inferior, la estabilidad en alineación y el puntaje ponderado del PAR entre T2-T1 (P>0.05). El PAR disminuyó 75.29% de T0 a T1 y 58.79% de T0 aT2, con recidiva de 16,5%. No hubo asociación entre tipo de retenedor y puntaje ponderado del PAR. De T0 a T2 hubo asociación entre la interacción de la inclinación del incisivo superior (P=0.03) e inferior (P=0.04), con el puntaje total ponderado del índice PAR. Conclusión: no hubo asociación entre la modificación de la inclinación de los incisivos con la estabilidad del sector anterior. Al terminar ortodoncia se presentó un nivel de corrección alto en el sector antero-superior e inferior, sin embargo, hubo recidiva de 16.5%.

Introduction: the objective of this study was to evaluate the relationship between incisor inclination at the end of orthodontic treatment with the anterior teeth alignment stability using PAR index. Methods: analytical cross-sectional study, the angle formed between the plane (Silla-Nasion) (U1-NS) and the inclination of the upper incisor and the angle between axial inclination of the lower incisor and mandibular plane (Go-Gn), were measured in 47 initial and final lateral radiographs of patients who finished orthodontic treatment. The anterior sector PAR index was applied to pretreatment (T0), posttreatment (T1) and follow-up (T2) casts. Statistical analysis was performed using frequency and percentage distributions, T test, Anova I, Anova II and Manova; significance p = 0,05. Results: no association was found between upper and lower incisor inclination, alignment stability and PAR weighted score between T2-T1 (p> 0,05). The PAR decreased 75,29% from T0 to T1 and 58,79% from T0 to T2, with a recurrence of 16,5%. There was no association between retainer type and PAR weighted score. From T0 to T2 there was an association between the interaction of the incisor inclination of upper (p = 0,03) and lower (p = 0,04), with the weighted total score of the PAR index. Conclusion: there was no association between the modification of the incisor inclination with the stability of the anterior sector. At the end of orthodontic treatment there was a high level of correction in the anterior-superior and inferior sector, however, there was a recurrence of 16,5%.

Impact of COVID-19 on the future career plans of dentists.

BACKGROUND: It is important to complement the scientific literature with the data regarding the impact of the coronavirus disease 2019 (COVID-19) pandemic on the social, work and health practices as well as on the daily life of dentists, and to promote adequate public policies. OBJECTIVES: The aim of the study was to explore the impact of the COVID-19 pandemic on the career plans of dentists in Colombia. MATERIAL AND METHODS: As part of global research on the impact of COVID-19 on dentistry, a crosssectional survey was administered via digital media to dentists in Colombia. The validated questionnaire included inquiries regarding sociodemographic variables, the perception of the risk of contagion with COVID-19 and the impact of COVID-19 on the dentists' career plans. The variables were summarized in absolute and relative frequencies, and a binomial logistic regression analysis was carried out to evaluate the impact of COVID-19 on career plans according to the independent variables. RESULTS: A total of 5,370 dentists answered the survey (women: 3,878; median age: 45 years; response rate: 16.85%). Most of the dentists (96%) believed that COVID-19 infection was a risk for them and 81.96% reported that the COVID-19 pandemic had some impact on their career plans, including reducing working hours (77.96%), retiring early (26.54%) and changing their career away from dentistry (18.15%). The regression model showed that older adults (OR = 1.62; 95% CI: 1.16, 2.26), general practitioners (OR = 1.21; 95% CI: 1.02, 1.44), private practice owners (OR = 2.33; 95% CI: 1.94, 2.79), private practice associates (OR = 2.20; 95% CI: 1.84, 2.63), and those with 'very probable' risk perception (OR = 4.29; 95% CI: 1.35, 13.60) had a significantly greater chance of the pandemic having an impact on their future career plans. CONCLUSIONS: The pandemic has had a great impact on dentists' career plans. Dentists who are most fearful of the risk of contagion, those who are older and those who have their private practice are thinking about reducing working hours, retiring early or changing their career.

Biological Anchorage and Canine Orthodontic Movement Rate with a New Technique for Micro-Osteoperforations.

INTRODUCTION: The differential management of anchorage and the acceleration of tooth movement are some of the current greatest challenges for orthodontists. Diverse techniques and devices to reinforce anchorage and increase the rate of tooth movement have been proposed. Whether micro-osteoperforations (MOPs) can be used for both purposes is currently investigated. OBJECTIVES: To propose and describe a new technique for biological anchorage, which involves six MOPs performed every four weeks, and to present its results in a clinical case of upper premolar extraction. Intervention. In a dental class II patient who met the selection criteria, three MOPs both on the buccal and palatine sides on the intervention side were performed on the extraction area following the protocol described. No MOPs were performed on the control side. The allocation of the intervention was randomised. The MOPs were performed three times at an interval of four weeks. A 0.019 × 0.025-inch stainless steel wire was activated with calibrated NiTi springs. The three-dimensional movement of the first molars and upper canines was evaluated. In addition, the comfort, periodontal status, and canine root resorption of the patient were evaluated. RESULTS: Clinical and radiographic results suggest that the MOPs had a positive effect in reducing the loss of biological anchorage of the posterior sector and in the rate of canine tooth movement, without damaging changes in the soft and hard tissues. CONCLUSION: The proposed protocol involving six MOPs every four weeks improved the behaviour of biological anchorage and increased distalization on the intervention side in this clinical case.

Modified short version of the oral health impact profile for patients undergoing orthodontic treatment

Aim: To derive and validate a short version of the Oral Health Impact Profile (OHIP) in Spanish to measure oral health quality of life (OHRQoL) for subjects wearing fixed orthodontic appliances. Methods: Cross-sectional study (data for sensitivity to change analysis were collected longitudinally). The data of 400 subjects (27.34 years, SD 11.66 years, 231 women, and 169 men) were used to develop a short-form instrument, and the data of 126 other subjects (25.95 years, SD 12.39 years, 62 women, and 64 men) were used for its validation. The original OHIPs were translated into Spanish using an iterative forward-backward sequence. After face and content validity were evaluated by an expert committee, an exploratory factorial analysis (EFA) was used to derive the Spanish short-form instrument (OHIP-S14 Ortho). To validate the OHIP-S14 Ortho, validity (content validity assessed by EFA, construct validity assessed by confirmatory factor analysis (CFA), discriminative validity assessed by the Kruskal-Wallis test, and reliability (internal consistency assessed by Cronbach's α test-retest, and inter-observer reliability assessed by correlation coefficients) were evaluated. Sensitivity to change and usefulness of the scale were also evaluated. Results: The OHIP-S14 Ortho included only six of the items in Slade´s original OHIP-14 short-form. A two-factor structure with adequate discriminative validity was found. High internal consistency (α=0.912), excellent inter-observer (Lin's correlation=0.97±0.011; rho= 0.97), test-retest agreement (Lin's correlation=0.80±0.059) and adequate sensitivity to change were also found. Conclusions: The OHIP-S14 Ortho is a valid and reliable instrument to measure OHRQoL in Spanish-speaking patients with fixed orthodontic appliances

Dental practice modification, protocol compliance and risk perception of dentists during COVID-19 pandemic in Colombia: a cross-sectional study / Modificación de la práctica odontológica, seguimiento a protocolos y percepción de riesgo de los odontólogos durante la pandemia de COVID-19 en Colombia: estudio de corte transversal

ABSTRACT Introduction: this study aimed to evaluate practice modification, use of personal protective equipment, biosafety measures, impact on career plans, prevalence of contagion, and risk perception of dentists during the COVID-19 pandemic 19 in Colombia. Methods: this is a cross-sectional study. Following ethical approval, an anonymous digital survey was conducted with dentists in Colombia. The questions comprised four domains: 1) sociodemographic, 2) employment and impact on career plans, 3) protocol compliance and biosafety, and 4) knowledge, risk, and contagion risk perception. A descriptive analysis of the data is presented. Results: 5,370 general and specialist dentists participated in the study (women: 3878; average age: 45 years). 41.94% were general dentists. Compliance with safety guidelines and use of personal protective equipment (PPE) was greater than 99%. The majority of dentists (91.29%) canceled their clinical activities during quarantine and have thought about reducing their working hours (77.96%). The perception of COVID-19 risk contagion was high (95.91% reported that contagion is likely/highly likely), although COVID-19 contagion self-report was low (0.61%). Conclusion: COVID-19 pandemic has strongly impacted the practice of dentistry in Colombia, leading to changes in clinical activities and career prospects. Biosafety measures compliance and PPE use was high. Although the contagion risk perception was high, self-reported contagion was very low.

Resumen Introducción: este estudio tuvo como objetivo evaluar la modificación de la práctica, uso de elementos de protección personal, protocolos de bioseguridad, afectación en los planes de carrera, prevalencia de contagio y percepción de riesgo de los odontólogos durante la pandemia de COVID-19 en Colombia. Métodos: tras obtener la aprobación ética, se aplicó una encuesta digital anónima a los odontólogos de Colombia. Las preguntas incluyeron cuatro dominios: 1) sociodemográficos, 2) laborales y afectación en los planes de carrera, 3) Seguimiento a protocolos y bioseguridad y 4) Conocimientos, riesgo y percepción de riesgo de contagio. Se presenta un análisis descriptivo de los datos. Resultados: 5370 odontólogos generales y especialistas participaron del estudio (mujeres: 3878; mediana de edad: 45 años). El 41,94% fueron odontólogos generales. La adherencia a protocolos de seguridad y el uso de elementos de protección personal (EPP) fue mayor al 99%. La mayoría de odontólogos (91,29%) suspendió sus actividades clínicas durante la cuarentena y ha pensado en disminuir sus horas de trabajo (77,96%). La percepción de riesgo de contagio de la COVID-19 fue alta (95,91% refirió que es muy probable/probable el contagio), aunque el auto-reporte de contagio por COVID-19 fue bajo (0,61%). Conclusión: la pandemia de la COVID-19 ha impactado fuertemente la práctica de la odontología en Colombia, generando cambios en las actividades clínicas y en las perspectivas de carrera. El seguimiento de protocolos de bioseguridad y de uso de EPP fue alto. Aunque la percepción de riesgo de contagio fue alta, el contagio auto-reportado fue muy bajo.

Biological and orthodontic treatment risk factors associated to external root resorption: a case-control study / Factores de riesgo biológicos y relacionados con el tratamiento de ortodoncia asociados a reabsorción radicular externa: estudio de casos y controles

ABSTRACT Introduction: external apical root resorption (EARR) is considered an adverse effect related to orthodontic treatment, but its specific risk factors remain controversial. The aim of this study was to identify the biological and orthodontic treatment risk factors associated with EARR in the incisors of patients who completed orthodontic treatment. Method: case-control study. 126 subjects (27.81 + 11.02 years old; 56 men, 70 women) selected for convenience; 63 cases and 63 controls, matched with cases in age and sex. EARR was measured on panoramic radiographs using the Levander and Malmgren classification. Demographic, biological, and orthodontic treatment-related variables were taken from clinical records. The cephalometric variables before and after treatment were measured with the Dolphin software. Statistical analysis included: Chi2, U Mann Whitney, t-test, and logistic regression models. Statistical significance was established at p<0.05. Results: there was evidence of association between EARR and previous root resorption (p=0.028; OR=24.925; 95% CI 1.427; 435.344); horizontal skeletal pattern (p=0.008, OR=0.914, 95% CI:0.854;0.977); pre-treatment upper incisor position (p=0.023; OR=0.850; 95% CI:0.738;0.978) and pre-treatment lower incisor position (p=0.019; OR=0.838; 95% CI:0.724;0.971). Previous root resorption and vertical skeletal pattern were significantly associated with EARR in the final multiple regression model. Conclusions: radiographic control and adaptation of orthodontic treatment is recommended in subjects who have previous root resorption and a horizontal skeletal pattern, since they are more likely to present EARR.

RESUMEN Introducción: la reabsorción radicular externa apical (RREA) es considerada un efecto adverso relacionado con el tratamiento de ortodoncia, pero sus factores de riesgo específicos siguen siendo controversiales. El objetivo del presente estudio consistió en identificar los factores de riesgo biológicos y relacionados con el tratamiento de ortodoncia asociados a la RREA en incisivos de pacientes que finalizaron tratamiento de ortodoncia. Método: estudio de casos y controles. 126 sujetos (27,81 + 11,02 años; 56 hombres, 70 mujeres) tomados por conveniencia; 63 casos y 63 controles, emparejados con los casos en edad y sexo. La RREA se midió sobre radiografías panorámicas con la clasificación de Levander y Malmgren. Las variables demográficas, biológicas y relacionadas con el tratamiento de ortodoncia fueron tomadas de los registros clínicos. Las variables cefalométricas antes y después del tratamiento fueron medidas con el software Dolphin. El análisis estadístico incluyó: Chi2, U Mann Whitney, prueba t y modelos de regresión logística. La significancia estadística fue establecida en p<0,05. Resultados: se encontró evidencia de asociación entre RREA y reabsorción radicular previa (p=0,028; OR=24,925; IC 95% 1,427; 435,344); patrón esquelético horizontal (p=0.008, OR=0.914, 95% CI:0.854;0.977); posición de incisivo superior pretratamiento (p=0.023; OR=0.850; 95% CI:0.738;0.978) y posición de incisivo inferior pretratamiento (p=0.019; OR=0.838; 95% CI:0.724;0.971). La reabsorción radicular previa y el patrón esquelético vertical estuvieron asociados significativamente con la RREA en el modelo final de regresión múltiple. Conclusiones: se recomienda control radiográfico y adaptación del tratamiento de ortodoncia en los sujetos que presenten reabsorción radicular previa y patrón esquelético horizanotal, ya que son más propensos a presentar RREA.

Aparatos funcionales preferidos por ortodoncistas en Colombia para tratar maloclusiones clases II y III / Preferred functional appliances among orthodontists in colombia to treat class II and III malocclusions / Aparelhos funcionais preferidos entre ortodontistas na Colômbia para tratar maloclusões de classe II e III

Antecedentes: La preferencia de los ortodoncistas en Colombia en el uso de aparatos funcionales y los factores diagnósticos que pueden influenciar la indicación del clínico de una determinada aparatología no es bien conocidos. Objetivo: Comparar las preferencias en el uso de aparatos funcionales para tratamiento de maloclusiones clases II y III entre un posgrado de ortodoncia y una población de ortodoncistas y evaluar la asociación entre el aparato indicado y las características demográficas y diagnósticas de los pacientes del postgrado de ortodoncia. Métodos: Estudio de corte transversal. Se revisaron 565 historias clínicas, de un programa de posgrado de ortodoncia y 180 encuestas a miembros de la Sociedad Colombiana de Ortodoncia (SCO). Para evaluar asociación se utilizó la prueba Chi2 y prueba t. La significancia estadística fue establecida en P < 0,05. Resultados: En el posgrado de ortodoncia el aparato funcional más utilizado para tratar la maloclusión Clase II fue el Simoes Network (55,42 %) y para Clase III fue el Lázaro (28,95 %). La mayoría de los miembros de la SCO prefiere tratar la maloclusión de Clase II con las Pistas Indirectas Planas (32,78 %) y la Clase III con la Máscara Facial (62,22 %). Se encontraron diferencias estadísticamente significativas (P < 0,05) entre las preferencias de uso de aparatos funcionales por los ortodoncistas de SCO y el postgrado de ortodoncia evaluado. Conclusiones: Los resultados sugieren que la indicación de los aparatos funcionales para el manejo de maloclusiones Clase II y Clase III no solamente está guiada por la maloclusión, sino que también por la formación académica y preferencias individuales de los ortodoncistas.

Background: The preference for the functional appliances to treat Class II and Class III malocclusions by orthodontists in Colombia and their reasons to select them is not well established, yet. Purpose: To compare the preferences in the use of functional appliances to treat Class II and Class III malocclusions between an orthodontic graduate program and the orthodontist members of the Colombian Society of Orthodontists (CSO) and to evaluate the association between the indicated functional appliance and the diagnostic and demographic characteristics of the patients in the orthodontic program. Methods: In this cross-sectional study were reviewed 565 clinical records of the orthodontic graduate program and the survey of 180 members of the CSO. Chi square and t test at a level of significance P < 0.05 were used to compare both groups. Results: the most frequently functional appliance used to treat Class II malocclusion in the orthodontic graduate program was Simoes Network (55, 42 %) and to treat Class III was the Lazaro (28, 95 %). CSO members preferred Planas indirect tracks (32,78 %) to treat Class II and Facial Mask (62,22 %) to treat Class III. Statistically significant differences (P < 0, 05) in the use preference of functional appliances between the orthodontic graduate program and the orthodontist from the CSO were found. Conclusions: The results suggest that the selection of functional appliances to treat Class II and Class III malocclusions is not only guided by the malocclusion but by the orthodontist´s academic background and individual preferences as well.

Antecedentes: A preferência pelos aparelhos funcionais para tratar as más oclusões de Classe II e Classe III por ortodontistas na Colômbia e seus motivos para selecioná-los ainda não está bem estabelecida. Objetivo: Comparar as preferências no uso de aparelhos funcionais para tratamento de más oclusões Classe II e Classe III entre um programa de pós-graduação ortodôntica e os membros ortodontistas da Sociedade Colombiana de Ortodontistas (CSO) e avaliar a associação entre o aparelho funcional indicado e o características diagnósticas e demográficas dos pacientes no programa ortodôntico. Métodos: Neste estudo transversal foram revisados 565 prontuários clínicos do programa de pós-graduação ortodôntica e a pesquisa de 180 membros da OSC. Qui-quadrado e teste t ao nível de significância P <0,05 foram usados para comparar ambos os grupos. Resultados: o aparelho funcional mais frequentemente utilizado para tratar a má oclusão de Classe II no programa de pós-graduação ortodôntica foi a Rede Simões (55, 42%) e para tratar a Classe III foi o Lazaro (28, 95%). Os membros da OSC preferiram as pistas indiretas Planas (32,78%) para tratar a Classe II e a Máscara Facial (62,22%) para tratar a Classe III. Diferenças estatisticamente significantes (P <0,05) na preferência de uso de aparelhos funcionais entre o programa de pós-graduação ortodôntica e o ortodontista da OSC foram encontradas. Conclusões: Os resultados sugerem que a seleção de aparelhos funcionais para tratar as más oclusões de Classe II e Classe III não é guiada apenas pela má oclusão, mas também pela formação acadêmica do ortodontista e preferências individuais.

Determinación tomográfica de la prevalencia de forma y tamaño de los rebordes residuales en pacientes edentados / Tomographic determination of residual ridges shape and size prevalence in edentate patients

INTRODUCCIÓN: el objetivo de esta investigación fue determinar tomográficamente la prevalencia de forma y tamaño de los rebordes residuales en pacientes edentados y su asociación con edad, sexo y reborde residual superior e inferior. MÉTODOS: se evaluaron 722 tomografías tomadas del centro de diagnóstico de UniCIEO, entre 2010 y 2012, de las cuales se obtuvieron 102 imágenes de rebordes residuales, 70 superiores y 32 inferiores, de 73 pacientes (46 mujeres, 27 hombres) con rangos de edad entre 24.67 y 90.17 años. La evaluación de forma y tamaño del reborde residual fue definido a través de nueve plantillas, generadas por el software Galaxis 3D, del sistema Cone beam GALILEOS (Sirona Dental Systems Inc., Bensheim, Germany). RESULTADOS: la prevalencia de forma y tamaño del reborde residual superior fue: ovoide grande 48.6%, triangular grande 42.9%, triangular mediano 4.3%, cuadrado grande 2.9%, ovoide mediano 1.4%; en inferior ovoide grande 93.8%, cuadrado grande 6.25%. CONCLUSIONES: la mayor prevalencia de forma y tamaño del reborde residual fue la ovoide grande, tanto en el maxilar superior como en el inferior. No se encontró asociación entre forma y tamaño con ninguna de las variables estudiadas.

INTRODUCTION: the objective of this tomographic study was to determine residual ridges shape and size prevalence in edentate patients and its association with age, sex, and upper and lower residual ridge. METHODS: we evaluated 722 scans taken at the UniCIEO diagnostic center between 2010 and 2012, obtaining 102 residual ridges images, 70 of the maxilla and 32 of the mandible, from 73 patients (46 women and 27 men) aged between 24.67 and 90.17 years. The evaluation of residual ridge size and shape was achieved through nine templates generated by the Galaxis 3D computer program, of the Cone beam GALILEOS system (Sirona Dental Systems Inc., Bensheim, Germany). RESULTS: the prevalent shape and size of upper residual ridge were: large ovoid 48.6%, large triangular 42.9%, medium triangular 4.3%, large square 2.9%, medium ovoid 1.4%; and in the mandible they were: large ovoid 93.8%, and large square 6.25%. CONCLUSIONS: the most prevalent residual ridge size and shape was large ovoid both in the upper and lower maxilla. We found no association between shape/size and any of the variables under study.