Treatment of labio-palatal cleft: Presentation of a clinical case.

INTRODUCTION: Management of adult patients with a cleft lip and palate is often multidisciplinary. The aim of orthodontic treatment is to correct the malocclusion. When the skeletal dysmorphosis is significant, the solution has to be orthognathic surgery. OBSERVATION: The authors report the case of a 16-year-old patient with a cleft lip and palate and a skeletal Class III. The aim of the orthodontic treatment was to correct dento-alveolar compensations. The skeletal discrepancy was corrected by maxillary advancement and mandibular setback. DISCUSSION: Collaboration between the orthodontist, the maxillo-facial surgeon and/or the plastic surgeon, both as regards timing and the choice of surgical procedures, is essential for successful secondary correction of the esthetic and functional sequellae of a labio-palatal cleft.

Effect of orthodontic treatment on lip position.

UNLABELLED: Does an advanced or retracted position of the upper and lower incisors lead to modifications in lip position? The aim of our study was to evaluate modifications in lip position following orthodontic treatments. MATERIAL AND METHODS: This study concerned 100 patients who underwent treatment in the dento-facial orthopedic unit in Casablanca. Profile headfilms at the start and at the end of orthodontic treatment were compared using Frapier's analysis. The Student test was applied to evaluate the variations in the cephalometric measurements. RESULTS: We noted a non-significant increase in the nasolabial angle (P = 0.274), a significant decrease in the sagittal position of the lower vermillion border (PsVei) (P < 0.001) and the sagittal position of the soft-tissue supramentale (PsSmc) (P < 0.001), and a significant increase in the vertical position of the soft-tissue menton (PvMec) (P = 0.035). CONCLUSION: The results of this study demonstrate marked improvements in the situation of soft tissues. We suggest further investigation to throw light on the relationship between tooth movement and soft tissue, increasing the size of the sample and taking growth into account.

Prevalence of malocclusions and orthodontic treatment need in 8- to 12-year-old schoolchildren in Casablanca, Morocco.

OBJECTIVES: The purpose of this work was to evaluate the prevalence of malocclusions and orthodontic treatment need among schoolchildren in Casablanca, Morocco. MATERIALS AND METHODS: A sample of 1000 children aged between 8 and 12 years, with no history of orthodontic treatment, was chosen at random in state schools in different administrative areas of the city of Casablanca. Data was registered using the method of Bjork et al. (1964). Orthodontic treatment need was assessed with the index used by the Swedish National Board of Health (SweNBH). RESULTS: We found Angle Class I malocclusions in 61.4%, Class II in 24%, Class III in 10% and an indeterminate molar class with one or more missing molars in 4.6% of the children. Overjet was 1-4mm in 63.8%, 4-6 mm in 17.2% and >6 mm in 10%. Bite was normal in 65.4%, 23.6% presented an overbite greater than 4 mm, 1.7% an anterior open bite ≤3 mm, 1.2% an anterior open bite >3 mm and 0.2% a bilateral open bite. Half of the sample presented anterior crowding, while only 2.5% presented posterior crowding. In all, 84.2% of the subjects needed some orthodontic treatment, and 15.8% needed no treatment. No statistically significant difference was found between sex or age and orthodontic treatment need (P>0.05). CONCLUSIONS: This study found a strong need for orthodontic treatment, confirming the utility of implementing a programme of bucco-dental prevention and screening for malocclusion.

Tooth transposition: a descriptive study in a 547-patient sample.

INTRODUCTION: The aim of this investigation was to study the prevalence of tooth transposition in a population of orthodontic patients. MATERIALS AND METHODS: A total of 547 patient records from our dentofacial orthopedics department were consulted. Each file included clinical observations, panoramic radiography, lateral cephalograms and dental casts. Patients with incomplete or poorly kept orthodontic records were excluded from the sample, as were those with unreadable panoramic radiographs. The classification of tooth transpositions used in the study was that first proposed by S. Peck and L. Peck in 1995. Computerized statistical analysis was performed using Epi-Info 6.0. RESULTS: The prevalence of tooth transposition was 2%, with the female population more heavily affected (64%). Tooth transposition occurred only in the maxillary arch. Of all the teeth, the canines were the most involved in this anomaly (100%). Transposition was associated with tooth agenesis in 18% of cases, peg lateral incisors in 27%, and persistent deciduous teeth in 18%. CONCLUSION: The prevalence of tooth transposition in this study population remained low, but was nonetheless higher than that found in most published investigations.

Anchorage miniscrews: a histologic study of peri-implant soft tissue.

INTRODUCTION: The aim of our study was to investigate the different histologic reactions of peri-implant soft tissue to miniscrews used in various orthodontic indications in patients during the course of treatment. MATERIAL AND METHODS: Our study focuses on patients receiving orthodontic treatment and in whom we placed anchorage miniscrews for various orthodontic indications. Twenty-eight miniscrews from the same manufacturer (Dual Top Anchor system(®), Korea) were studied. The soft tissue surrounding each miniscrew was sampled for histologic analysis. RESULTS: All the peri-implant soft tissue samples displayed signs of inflammation. Each tissue sample exhibited either a moderately or highly inflamed surface epithelium and underlying connective tissue. DISCUSSION AND CONCLUSION: The variations in tissue response shown by the different human biopsies could be greater than those observed in standardized conditions in animal experiments. Interpretations regarding tissue response on a small number of human biopsies should be made cautiously. Nevertheless, this histological information is invaluable in order to validate and confirm the animal model.

Anchorage miniscrews: a surface characterization study using optical microscopy.

INTRODUCTION: The aim of this study was to assess the surface changes in orthodontic miniscrew implants retrieved after usage and compare them with brand-new, as-received control miniscrews. MATERIAL AND METHODS: The study sample consisted of 28 miniscrews from the same manufacturer: Dual Top Anchor system® (Korea) of different diameters and lengths. One brand-new miniscrew served as a control. Surface characterization was carried out using optical microscopy (Leica DM2500M®) and image magnification (×5, ×10 and ×20). RESULTS: Observations under optical microscopy showed signs of pitting and crevice corrosion mainly at manufacturing defects. Retrieved miniscrew implants displayed larger surface cracks from corrosive attacks (pitting and crevice). Qualitative sample analysis suggested a loss of gloss and texture, giving the surface a dull appearance. Localized pitting was the most frequent form of corrosion observed in our sample. DISCUSSION AND CONCLUSION: Despite a smooth appearance to the naked eye, the miniscrews all had crack-like surface manufacturing defects. Examination of the surface of these miniscrews, after usage, evidenced pitting or crevice corrosion principally in the area of enhance corrosion resistance.

Prevalence of temporomandibular dysfunction in orthodontic treatment.

UNLABELLED: The aim of our study was to investigate the prevalence of temporomandibular dysfunction (TMD) during orthodontic treatment. MATERIAL AND METHOD: the study investigated all the patients receiving orthodontic treatment in the dentofacial orthopedic department in Casablanca in the course of the different stages of treatment over a 4-month period. We looked for a possible association between the presence of at least one sign of TMD, the Helkimo anamnesis index, the clinical Helkimo index and the following factors: age, gender, extractions, or not, of premolars, duration, type and stage of orthodontic treatment, molar and canine class, crowding, overjet, overbite and unilateral crossbite. Data were analysed using Epi-info 6.0.fr software. The analysis of the results was done using the Chi(2) test (P<0.05). RESULTS AND CONCLUSION: no statistically significant association could be established between TMD and the various factors under investigation with the exception of the association between gender and the Helkimo anamnesis index, stage of treatment and the Helkimo anamnesis index and the Angle molar class and the Helkimo clinical index.

[Craniomandibular dysfunction and malocclusions]. / Dysfonctionnement cranio-mandibulaire et malocclusions.

INTRODUCTION: For many years, the literature reported the key role of occlusal factors in the development of craniomandibular dysfunctions (CMD). In our study, we investigated the connections between the functional and morphological features of dental occlusion and CMDs in a population of students at the Casablanca Faculty of Dental Medicine, Morocco. MATERIAL AND METHOD: Our study comprised a sample of 142 students from the Casablanca Faculty of Dental Medicine aged between 18 and 30 years. An information card was filled in providing general details, medical history, the clinical examination and an assessment of the orofacial functions. We looked for possible links between CMDs and the various malocclusions. The statistical test used was the Khi2 test under Epi-info 6.0 under MS Dos. RESULTS AND CONCLUSION: There is no connection between craniomandibular dysfunctions and certain malocclusions in the student population at the Casablanca Faculty of Dental Medicine.