Morphometric aspects and proposal of a new classification of genial tubercles in cone-beam computed tomography in a Brazilian population.

Objective: This study evaluated epidemiological and morphological aspects of genial tubercles (GTs) using cone-beam computed tomography (CBCT). Methods: This retrospective, observational and cross-sectional study evaluated 276 tomographs of adult dentate individuals (18-69 years). The presence and absence of GTs were evaluated, and in cases in which this structure was observed, linear measurements (length, height, and width), and anatomical distances. In addition, a GT classification was proposed based on the presence, number, and location of the tubercles. Results: Of the 276 CT scans, 28 (10.14%) had absence of GTs and in 248 CT scans GTs were present, of which 42 (57.5%) were from females and 106 (42.5%) from males. Regarding the number of GTS, the most prevalent variant was the two-tubercle-variant (143, 57.7%), followed by the presence of a single tubercle (n = 62, 25.0%), 3 tubercles (n = 40, 16.1%) and 4 tubercles (n = 3, 1.2%). The most prevalent classification was IIIA (n = 96, 38.7%), followed by IIIB (n = 60, 36.3%), IIA (n = 53, 21.4%) and IIB (n = 9, 3.6%). Conclusion: A prevalence of GT of approximately 90% was observed, with two GTs per exam as the most frequent finding. Men had a longer mean GT length compared to women. Female individuals exhibited a shorter distance from the base of the GT to the base of the mandible.

Clinical, Imaging, and Therapeutic Aspects of Genial Tubercle Fractures: A Systematic Review.

PURPOSE: The present study reviewed the clinical, imaging, and therapeutic aspects of genial tubercle fracture (GTF). MATERIALS AND METHODS: A 2-phase systematic search of the literature was performed. Search strategies were developed for specific databases (PubMed, Scopus, Web of Science, Cochrane, and LILACS), including the gray literature (Open Grey and Google Scholar). The descriptors "genial tubercle," "fractures, bone," "mentalis," "spinae," and "mandible" were searched without restriction to year of publication. The CARE guideline was applied to evaluate methodologic aspects, and the Meta-Analysis of Assessment and Review Instrument was used to assess the risk of bias. The adopted level of significance was .05. RESULTS: Of 1,970 articles, 1,948 were excluded after applying the eligibility criteria. Furthermore, 2 studies were added through a manual search of the reference lists, totaling 24 articles. Occurrence of GTF was most common in women older than 61 years and men younger than 60 years (difference in age at occurrence was statistically significant; P = .019). The main clinical findings were edentulism, sublingual edema, and pain (P < .001). Previous trauma was commonly absent in women and present in men (P = .018). A cracking sound was mainly reported by women (P = .009). Isolated panoramic and occlusal radiographs were the most commonly performed examinations (P < .001). Diagnosis of sialolithiasis occurred in 37.5% of cases, and conservative treatment was performed in 76.6% of cases. CONCLUSION: GTF was mainly observed in older women, edentulous patients, and those without previous trauma. Conventional radiography and nonsurgical treatment were frequently reported.

Does surgically assisted rapid maxillary expansion associated with pterygomaxillary disjunction result in changes in mandibular position? A PROSPERO-compliant systematic review of the literature.

PURPOSE: This study aimed to assess the effect of surgically assisted rapid maxillary expansion (SARME) associated with pterygomaxillary disjunction (PD) on mandibular positioning. MATERIALS AND METHODS: A two-phase systematic review registered with the PROSPERO database was performed. Search strategies were developed for specific databases (PubMed, Scopus, Web of Science, COCHRANE, LILACS, and DOSS), including the gray literature (Open Gray, Google Scholar, and ProQuest). The methodological and evidential quality of the included studies were assessed. RESULTS: Among 680 studies, four were selected for inclusion. In general, a low risk of bias was observed. The studies included a total of 142 adults, and used imaging to perform linear measurements (preoperatively and postoperatively). The main outcomes were maxillomandibular transverse index (difference between effective mandibular width - distance between the left and right antagonist points - and maxillary width), sagittal (forward and backward) and vertical (impaction and extrusion) changes, dental show, chin projection, and altered mandibular position. CONCLUSION: Although the study demonstrated some mandibular position changes after SARME associated with PD, there is insufficient current evidence to support this result because of the potential study limitations related to the number of investigations chosen for inclusion. Further research is required to validate this finding.

Imaging Aspects of the Mandibular Incisive Canal: A PROSPERO-Registered Systematic Review and Meta-Analysis of Cone Beam Computed Tomography Studies

PURPOSE: This study aimed to perform a systematic review and meta-analysis of the literature on the mandibular incisive canal (MIC) studies using cone beam computed tomography (CBCT). MATERIALS AND METHODS: A PROSPERO-registered systematic review (#42017056619) was conducted following the PRISMA statements to summarize current knowledge on the CBCT aspects of the MIC. A search was performed in PubMed's Medline and Scopus databases, without date or language restrictions, using the algorithm {[(Interforaminal region) OR (mandibular incisive channel) OR (mandibular incisive nerve) OR (mental mandible) OR (anterior mandible) (cone beam computed tomography). Also, the references were crosschecked. The Meta-Analysis of Statistics Assessment and Review Instrument and meta-analysis was used to evaluate the selected studies. RESULTS: A total of 410 articles were found, and 25 studies were selected after a two-step selection process. The CBCT systems differed regarding field of view (FOV) (large, n = 3; medium, n = 2; small, n = 4; not informed, n = 16) and voxel size (0.15 to 0.4 mm). Geographically, the studies were distributed across four continents (South America, North America, Asia, and Europe), and there was a statistical significance of studies from the American and Asian continents (P < .0001). From 3,421 CBCT exams, the number of female patients was slightly higher than male, and the mean age ranged from 29.8 to 59.1 years. The overall mean prevalence of MIC was 89.6% ± 15.08%, and bilateral occurrence was statistically significant (P < .0001). The studies using a voxel size lower than 0.3 mm showed the highest mean prevalence (93.88%) in comparison with voxel size described as ≥ 0.3 mm (89.33%). Diameter (0.45 to 4.12 mm) and length (6.6 to 40.3 mm) showed great variability among the included studies. CONCLUSION: In summary, the results of this systematic review evidenced a high worldwide prevalence of MIC. There was no prevalence of MIC in relation to sex, and its presence was mainly related to adults between the fourth and sixth decades of life. In addition, great heterogeneity of methodologies was observed.

Preemptive analgesia-related gene and protein expression in third molar surgeries under non steroidal anti-inflammatory drug protocols: A PROSPERO-registered systematic review of clinical studies

BACKGROUND: This study aimed to review translational studies focusing on third molar removal surgeries through a systematic analytical approach. MATERIAL AND METHODS: A PROSPERO-registered systematic review (CRD42017060455) was conducted following the PRISMA statement to summarize current knowledge on gene expression in third molar surgeries. A search was performed in PubMed's Medline and Scopus databases, without date or language restrictions, using the logical expression {[(Third molar) OR (preemptive) OR (cyclooxygenase inhibitors) OR (acute inflammation) AND (gene expression)]}. RESULTS: All studies included in the analysis evaluated gene expression in a third molar extraction model, using the preemptive analgesia methodology in seven investigations. The sample analyzed was obtained from gingival tissue biopsy (n=4), blood (n=1), transudate (n=1) and gingival tissue biopsy/transudate (n=1). There were differences with respect to evaluated genes, drug protocol, sample studied, and method for evaluating gene expression. CONCLUSIONS: Third molar surgeries were found to be associated with different COX-related gene expression patterns. Although inflammatory events following the surgical procedure are associated with COX isoforms, data from preemptive analgesia studies are scarce, especially from studies correlating gene expression and clinical parameters. In the future, from a clinical perspective, identifying the molecular targets of a drug based on individual gene expression may be helpful to delineate specific third molar, surgery-related, preemptive analgesia protocols