Could Periodontitis Increase the Risk of Suffering from Pancreatic Cancer?-A Systematic Review.

(1) Background: The relationship between periodontitis and systemic pathologies continues to grow. Recently, the presence of periodontal pathogens has been linked to an increased risk of pancreatic cancer (PC) and its mortality. Thus, a systematic review is needed to identify whether an association between the two diseases can be established. The objective of this review is to elucidate the mechanisms responsible for this association. (2) Methods: A systematic review was carried out using three databases (PubMed, Embase and Scopus) with the following keywords "Periodontitis AND pancreatic cancer". A total of 653 articles were retrieved; before selection and screening, the inclusion and exclusion criteria were defined, resulting in a total of 13 articles being included in the review. (3) Results: The increase in low-grade systemic inflammation, pH changes, and the cytotoxicity of certain periodontopathogenic bacteria were found in the scientific literature reviewed as mechanisms linking periodontitis with the risk of PC. (4) Conclusions: Through this systematic review, we have seen how periodontitis can be related to PC and how it worsens its prognosis. Knowing the behavior of periodontopathogenic bacteria and the influence they have on our immune and inflammatory system may help to achieve an interdisciplinary approach to both pathologies.

Comparison of three fluids for calibration of the new Periotron® 8010

Background: The aim of the present study was to calibrate the Periotron® model 8010 with volumes of three different fluids (distilled water, serum, and saliva) and to identify which of the three is the most reliable, feasible, and reproducible for routine calibration. Material and Methods: A total of 450 samples of Periopaper® were divided into three groups (150 each per group): distilled water, serum matrix and saliva. A calibration curve was run with 0.25, 0.50, 0.75, 1.00 and 1.25 µl of each of the fluids, and the results were determined in Periotron units (PU). Statistical analysis was performed with oneway ANOVA followed by Bonferroni’s post hoc test and a linear equation. Results: Distilled water presented the lowest levels of PU at all volumes, while serum showed the highest levels at high volumes. Linear regression equations rendered similar slopes for saliva and distilled water, while serum was statistically different. Saliva presented a reproduction percentage of 99.7%, which indicated better accuracy and precision than serum and distilled water. Conclusions: Saliva is more reliable and accurate than water or serum for the purpose of calibration of the Periotron® model 8010, though it shares drawbacks with serum. Distilled water is more easily available and does not require any additional procedure, in addition to producing a similar slope to saliva and a smaller deviation from the media than serum. (AU)

Surgical difficulty and postoperative course of the third molar extraction under general anesthesia: An intervention trial.

BACKGROUND: Third molar extractions are one of the most common surgical procedures in the area of ​​stomatology. However, we know that even if they are minor surgeries, they can cause a postoperative period with local and systemic repercussions. Thus, the aim of this intervention trial is to determine the relationship between clinical parameters (pain, inflammation and trismus) and serum parameters (C-reactive protein (CRP), IL-6 and fibrinogen) that are modified in the first postoperative week, and the appearance of complications after extraction with general anesthesia, using the Pederson scale. METHODS: The research question was: Can postoperative discomfort after third molar extraction under general anesthesia be predicted using Pederson scale? An interventional trial was carried out of third molar extractions under general anesthesia in Dr. Peset University Hospital. Patient selection was performed randomized using MS Excel. Then were divided into two groups (n = 126): group A (2 complex extractions) and group B (4 extractions: 2 simple and 2 complex). All parameters were collected at the surgery and 7 days after surgery. RESULTS: The clinical postoperative parameters showed significant differences in relation to surgical difficulty. In summary, the degree of surgical difficulty can be predicted with the Pederson scale before extracting mandibular third molars. CRP and fibrinogen levels increase significantly with the degree of surgical difficulty. CONCLUSION: Significant differences (p < 0.001) were observed in all the intraoperative parameters according to surgical difficulty as assessed by the Pederson scale. Therefore, this scale was a good indicator to estimate the patient's postoperative period.

Cuestionario sobre salud oral para cuidadores de niños con parálisis cerebral: análisis psicométrico

Objetivo: Analizar las propiedades psicométricas de un cuestionario específicamente diseñado para determinar el grado de conocimiento sobre salud bucal de cuidadores de niños con Parálisis Cerebral. Materiales y métodos: Participaron cien cuidadores de niños con Parálisis Cerebral, usuarios del Instituto Nacional de Rehabilitación Pedro Aguirre Cerda, Santiago. Se evaluó el instrumento mediante el análisis de componentes principales, se calcularon los coeficientes de correlación de Pearson para indagar los patrones de asociación existentes entre sus componentes, se analizó la confiabilidad (alfa de Cronbach) y, considerando los valores percentiles del promedio de las respuestas, se determinaron los puntajes de corte, estableciéndose los niveles de conocimiento reportados por los participantes. Resultados: El análisis indicó que existe un factor latente sobre el único constructo definido -el grado de conocimiento sobre salud bucodental de cuidadores de niños con Parálisis Cerebral. El alfa de Cronbach fue 0.91. Todas las correlaciones fueron positivas y de magnitud no despreciable. Se establecieron cuatro niveles de conocimiento: "muy por debajo de lo esperado", "bajo lo esperado", "sobre lo esperado" y "muy sobre lo esperado". Conclusiones: La confiabilidad de las propiedades psicométricas del instrumento son apropiadas para su uso en atención clínica o proyectos de investigación.

Objective: To assess the psychometric properties of a specifically designed questionnaire to determine the degree of oral health knowledge of caregivers of children with Cerebral Palsy. Material and methods: One hundred caregivers of children with cerebral palsy participated, users of the "Pedro Aguirre Cerda" National Rehabilitation Institute, Santiago. To evaluate the instrument, the principal component analysis was performed, Pearson's correlation coefficients were calculated to investigate the existing association patterns between its components, reliability was analysed (Cronbach's alpha) and, considering the percentile values of the average of the responses, the cut-off scores were determined to establish the levels of knowledge reported by the participants. Results: The analysis indicated the existence of a latent factor on the only construct defined in its design - the degree of knowledge about oral health of caregivers of children with cerebral palsy. A Cronbach's alpha of 0,91 was obtained. All the correlations were positive and of a non-negligible magnitude. Four levels of knowledge were established: "well below expectations", "below expectations", "above expectations" and "very above expectations". Conclusion: The reliability of the instrument´s psychometric properties makes it suitable for its use in clinical practice or research projects.

Pediatric morbidity after oral surgery procedures under general anaesthesia: A systematic review.

The aim of this study is to carry out a systematic review of the existing literature on postoperative morbidity after general anaesthesia (GA) in the dental care of paediatric patients, its frequency, characteristics and association with the intervention performed. MATERIAL AND METHODS: An exhaustive search of the literature published up to 23 February 2022 was carried out in PubMed, Web of Science, Cochrane and EBSCO, with the following strategy: (infant OR child OR adolescent) AND (Oral Surgical Procedures OR Dentistry, Operative) AND Anesthesia, General AND Postoperative Complications. RESULTS: The most frequent reason for the indication of general anaesthesia was dental caries and its complications (up to 91.0% of patients), followed by lack of cooperation/anxiety and/or fear for dental procedures in the office (between 39.8 and 47.9%). There is a higher prevalence for treatments in the special patient group reaching 87.7% compared to 63.3% in healthy patients. The main comorbidities recorded were: physical or mental disability, neurological, haematological, cardiac disorders, asthma, Down's syndrome; it was not possible to establish their association with the intervention performed. Regarding complications, complaints occurred between 43.0 and 98.9% of cases within the first 24 hours, the main reason being pain (between 14.0% and 95.0%). CONCLUSIONS: Pediatric dental procedures under GA carry a very low risk of major complications, but have a virtually universal incidence of minor complications.

Comparison of Malocclusion Prevalence, Type and Severity between Cerebral Palsy and Healthy Subjects: A Prospective Case-Control Study.

BACKGROUND: To analyze the prevalence, type and severity of malocclusions in a group of patients with cerebral palsy (CP) using a facial and occlusal analysis and the Dental Aesthetic Index (DAI). METHODS: A prospective, case-control study was made of two groups, a cerebral palsy and a control group, with the determination of the facial and occlusion analysis in the three spatial planes. The Dental Aesthetic Index (DAI) was used to assess the severity of malocclusion. RESULTS: The patients with CP presented a higher prevalence of increased facial lower third height and a greater tendency towards right-side canine and molar class II malocclusion, narrower transverse relationship and crossbite. The DAI scores were statistically significantly higher in the CP group. Increased physical impairment in the CP group was associated to greater DAI scores. CONCLUSIONS: The prevalence and severity of malocclusion were significantly greater in the CP group. The type of malocclusion predominantly found in these patients was molar class II, with open bite, increased overjet and a narrow arch. The CP group also presented mixed breathing with higher DAI scores and decreased facial lower third height.

Dental caries status in adults with sleep apnea - hypopnea syndrome.

Background: A study is made of dental caries in a group of adults with sleep apnea-hypopnea syndrome (SAHS), establishing comparisons with healthy individuals corresponding to the same population. Material and Methods: A case-control series was analyzed, including patients with recently diagnosed SAHS and individuals without SAHS. Dental examinations were made to record the DMF (decayed, missing, filled) dental score, and demographic, lifestyle and clinical data were collected. Results: A total of 114 participants (60 SAHS cases and 54 controls) were included in the study. Although the mean DMF score in the SAHS group was higher than in the control group (7.03 versus 4.81, respectively), the multivariate regression analysis did not find the difference to be statistically significant (p=0.351). However, a significant correlation was observed between the DMF score and age (r=0.41; p<0.001) and the apnea-hypopnea index (AHI)(r=0.31; p=0.003). Conclusions: Older age and greater severity of SAHS are associated to higher DMF scores. However, the diagnosis of SAHS alone does not influence dental caries status. Key words:Dental caries, sleep apnea syndrome, oral health, DMF index.

Dental treatment under general anesthesia in mentally disabled patients based on an ambulatory surgery model: A Case-control study.

BACKGROUND: Mentally disabled patients commonly offer little or no cooperation in dental treatments, and general anesthesia may become necessary in such cases. The present study was to identify the most relevant factors in dental treatment under general anesthesia in disabled patients based on a Major Ambulatory Surgery (MAS) model. The study analyzes anesthetic variables and type of dental procedures carried out for disabled patients compared with controls. MATERIAL AND METHODS: A case-control study was carried out with 574 patients (263 cases and 311 controls) subjected to dental treatment under general anesthesia in the Day Surgery Unit of Dr. Peset University Hospital (Valencia, Spain). Epidemiological, anthropometric and preoperative data (ASA score, Mallampati classification) were collected. RESULTS: Males and obesity were more prevalent among disabled patients than controls. Significant associations were found between longer surgery time, underwent thoot extraction, tartrectomy, fillings and disabled patients treated under general anesthesia. The preoperative risk scores were likewise higher in disabled patients (ASA III-IV). The duration of surgery increased with the ASA score but didn´t influence postoperative stay. Patient condition in the first 24 hours of late postoperative recovery was good in both groups. CONCLUSIONS: Dental treatment based on the MAS in mentally disabled patients is effective and safe, even in individuals with a certain prior risk (ASA III). Key words:Disabled patients, ambulatory surgery, dental treatment, special needs, Major Ambulatory Surgery by general anesthesia.

Adherence to supportive periodontal treatment in relation to patient awareness.

BACKGROUND: To evaluate the risk profile of noncompliant patients in relation to adherence to supportive periodontal therapy in order to identify factors associated with this profile, and be able to prevent the abandonment of periodontal therapy. MATERIAL AND METHODS: This cross-sectional observational and comparative study was carried out on the patients who attended the Periodontics department of a University in Valencia (by a questionnaire and followed-up the periodontal supportive therapy through the medical history.) 220 patients were interviewed and gave their informed consent and data release permission before taking part in the study, which was approved by the Ethics Committee (UCV/2019-2020/048). RESULTS: 48.84% of self-reported patients were regular compliers, in contrast with 10.62% of referred patients. Those with acute symptoms were greater adherent than those patients who didn´t present symptoms. Regarding patients undergoing surgical procedures, significant results were obtained: 69.70% showed adherence, in contrast with 18.67% patients with basic treatment. Results between men and women were similar. However, the age of the non-compliant patients was slightly older. CONCLUSIONS: Self-reported patients presented a significantly higher degree of adherence to periodontal supportive therapy than the referred patients. Patients with acute symptoms presented higher adherence than those without them. Patients who underwent surgery presented a significantly higher degree of adherence than patients who received basic periodontal treatment. No conclusive data have been found regarding sex and age. Key words:Awareness, periodontal disease, compliance, SPT.

COVID-19, A new challenge in the dental practice.

BACKGROUND: This review was conducted in order to learn the latest information about how to prevent cross-infection of COVID-19 in dentistry. The aim of this study is offer a clinical protocol to reduce the risk of infection of COVID-19 in dental settings. MATERIAL AND METHODS: We carried out a review based on the PRISMA guide (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). We used the following three databases: PubMed, Embase and Scopus. The search strategy was performed in the three databases applying the search terms "COVID-19 AND dental", "COVID-19 AND dentistry", selecting human studies published from November 2019 to May 2020. English publications regarding COVID-19 as the central topic of the research were eligible for inclusion, regardless of study design. There are very few published studies on the association between COVID-19 and dentistry, for that reason we also included the English abstract of two studies written in Chinese. The following exclusion criteria were established: animal studies and in vitro studies. RESULTS: The search identified a total of 212 articles, of which 54 were preselected, and 23 were finally included in the review on the basis of the inclusion and exclusion criteria. We collected all the information about routes of general and oral infection, dental patient evaluation and cross-infection control in Dental Clinic in the selected studies. CONCLUSIONS: Cross infection in the dental clinic involve a very important risk due to the return to dental settings after periods of social isolation of the population after the epidemic outbreak of SARS-CoV-2. Therefore, we must take adequate and sufficient security measures to protect the patients and the dental clinic staff. Key words:COVID-19, COVID-19 cross infection risk, COVID-19 prevention in Dentistry, COVID-19 in Dental Clinic.

General anesthesia for oral and dental care in paediatric patients with special needs: A systematic review.

BACKGROUND: The objective of this study is to conduct a systematic review of the literature on the characteristics, needs and current situation of dental care for pediatric patients with special needs. MATERIAL AND METHODS: An exhaustive search for literature published until June 1, 2020. It was carried out using PubMed, Web of Science, Scopus, Cochrane and EBSCO, with the following keywords: Oral Surgical Procedures and Dentistry, Operational and Anesthesia, General Y (Spanish[lang] or English[lang] ) Y (infant[MeSH] Or child[MeSH] Or adolescent[MeSH]). The research was carried out following the PRISMA research methodology. RESULTS: The most common indication for general anesthesia (GA) was tooth decay in 16 studies (6.5-90.8% of patients), followed by lack of cooperation and/or fear of dental professionals performing dental procedures in 8 studies. There is a higher prevalence of treatment in the group of patients with special needs, reaching 87.7% compared to 69.9% in healthy patients. CONCLUSIONS: In paediatric patients with special needs the use of GA is increasing, monitoring and preventive care are insufficient and withdrawal rates are high. Key words:Oral surgical procedures and dentistry, operational and anesthesia, general.

Influence of anxiety and anesthetic vasoconstrictors upon hemodynamic parameters during dental procedures in controlled hypertensive and non-hypertensive patients.

BACKGROUND: To determine the influence of dental anxiety and the vasoconstrictor used in local anesthesia upon different hemodynamic parameters - systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR) and peripheral oxygen saturation (SatO2) - during dental extraction and oral hygiene. The safety of local anesthesia with vasoconstrictor in patients with medically controlled hypertension was also assessed. MATERIAL AND METHODS: A total of 159 patients were divided into two groups according to the dental treatment received: tooth extraction (n = 106) and oral hygiene (n = 53). The hemodynamic parameters (SBP, DBP, HR and SatO2) were recorded throughout dental treatment. Patient anxiety was assessed using the Beck Anxiety Inventory (BAI), the Modified Corah's Dental Anxiety Scale (MDAS) and the Hamilton test. RESULTS: The HR increased after anesthetic infiltration with vasoconstrictor and decreased after the tooth extraction. However, HR remained stable in the oral hygiene group, in both hypertensive and non-hypertensive patients. The SatO2 values decreased after anesthetic infiltration with vasoconstrictor. These slight changes associated with the vasoconstrictor agent were observed in patients without anxiety, but not in patients with mild or moderate anxiety. Both SBP and DBP remained constant after local anesthetic infiltration with vasoconstrictor, regardless of whether the patients presented hypertension or moderate anxiety. CONCLUSIONS: The vasoconstrictor used in local anesthesia may induce a very subtle increase in HR, with no significant increase in patients who experience anxiety. Key words:Tooth extraction, dental anesthesia, vasoconstrictor agents, dental anxiety, hypertension.

Influence of body mass index and obesity upon the association between periodontitis and sleep apnea-hypopnea syndrome.

OBJECTIVES: We aimed to explore the association between periodontitis and sleep apnea-hypopnea syndrome (SAHS) and the possible influence of body mass index (BMI) and obesity upon this association. MATERIALS AND METHODS: A case-control study was made involving 114 subjects (60 patients with SAHS and 54 controls). A thorough periodontal evaluation was carried out, and demographic and clinical data were collected. RESULTS: Periodontitis was more prevalent in SAHS (80%) than in the controls (48.1%). The recorded statistically significant association (OR = 4.31; p = 0.001) was seen to weaken in the multivariate model (OR = 2.03; p = 0.204), with BMI adopting a more influential role. The apnea-hypopnea index (AHI) was correlated to probing depth (PD) (r = 0.40; p = 0.002) and clinical attachment level (CAL) (r = 0.41; p = 0.001). The periodontal parameters were seen to be higher in obese SAHS patients (BMI ≥ 30 kg/m2) than in non-obese SAHS patients (BMI < 30 kg/m2). CONCLUSIONS: The greater prevalence and severity of periodontitis in patients with SAHS were fundamentally influenced by BMI. On the other hand, periodontitis was more severe in patients with severe SAHS. CLINICAL RELEVANCE: Patients with SAHS have a greater prevalence of periodontitis, fundamentally related to increased obesity. Therefore, obese subjects with SAHS should be screened for periodontal disease.

Xerostomia in patients with sleep apnea-hypopnea syndrome: A prospective case-control study.

BACKGROUND: To describe the characteristics of xerostomia (dry mouth) in the population with sleep apnea-hypopnea syndrome (SAHS) and contrast its prevalence versus that found in healthy subjects, and to compare the frequency of xerostomia in SAHS patients with and without continuous positive airway pressure (CPAP) treatment. MATERIAL AND METHODS: A prospective comparative study was made between adults recently diagnosed with SAHS in a public hospital (n=60) and healthy individuals (n=54). The presence of xerostomia was assessed on waking up and during the day, using a frequency scale from 0 ("never") to 3 ("always"). RESULTS: The prevalence of xerostomia on waking up in the SAHS group was 45%, versus 20.4% among the controls. During the rest of the day the prevalence of the symptom decreased in both the SAHS group (21.7%) and among the controls (9.3%). Multiple binary logistic regression analysis found body mass index (BMI) to be correlated to the association SAHS-xerostomia on waking up (p=0.007). Patients with moderate SAHS had a greater frequency of xerostomia than those with mild SAHS (p=0.022). The frequency of xerostomia on waking up was significantly greater in patients using CPAP than in those without such treatment (57.1% versus 16.7%, respectively) (p=0.008). CONCLUSIONS: The frequency of xerostomia was greater in patients with SAHS, particularly on waking up and in those receiving CPAP. The symptom was more prevalent in individuals with moderate to severe SAHS than in those with mild SAHS, and was significantly influenced by BMI. Key words:Sleep apnea, xerostomia, dry mouth, CPAP, side effects, body mass index, obesity.

Effect of Non-Surgical Periodontal Treatment on Oxidative Stress Markers in Leukocytes and Their Interaction with the Endothelium in Obese Subjects with Periodontitis: A Pilot Study.

AIM: The primary objective of this pilot study was to evaluate the effect of non-surgical periodontal treatment. The secondary aim was to evaluate the effect of dietary therapy on both parameters of oxidative stress in leukocytes and leukocyte-endothelial cell interactions in an obese population. METHODS: This was a pilot study with a before-and-after design. Forty-nine obese subjects with periodontitis were randomized by means of the minimization method and assigned to one of two groups, one of which underwent dietary therapy while the other did not. All the subjects underwent non-surgical periodontal treatment. We determined periodontal, inflammatory and oxidative stress parameters-total reactive oxygen species (ROS), superoxide production, intracellular Ca2+, mitochondrial membrane potential and superoxide dismutase (SOD) activity. We also evaluated interactions between leukocytes and endothelium cells-velocity, rolling flux and adhesion-at baseline and 12 weeks after intervention. RESULTS: Periodontal treatment improved the periodontal health of all the patients, with a reduction in serum retinol-binding protein 4 (RBP4), total superoxide production and cytosolic Ca2+ in leukocytes. In the patients undergoing dietary therapy, there were less leukocyte adhesion to the endothelium, an effect that was accompanied by a decrease in TNFα, P-selectin and total ROS and an increase in SOD activity. CONCLUSIONS: Whereas non-surgical periodontal treatment induces an improvement in leukocyte homeostasis, dietary therapy as an adjuvant reduces systemic inflammation and increases antioxidant status which, in turn, modulates leukocyte-endothelium dynamics.

Association between Periodontal Diseases and Polycystic Ovary Syndrome: A Systematic Review.

BACKGROUND: A convergent association between polycystic ovary syndrome (PCOS) and periodontal disease, in particular chronic periodontitis (CP), has recently been proposed. The underlying molecular mechanisms of this association are not fully understood, though it is thought that chronic inflammation is responsible. Therefore, the aim of this study was to evaluate the association between periodontal disease-gingivitis and CP-and PCOS. MATERIALS AND METHODS: The PICO (Participants, Intervention, Control, and Outcomes) question was as follows: "Is there an association between PCOS and CP?" A systematic review of three databases-PubMed, Embase and Scopus-was performed following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Original studies in human cohorts carried out in the last 10 years and including a control group were eligible for inclusion. Letters to the editor, case reports, and reviews were not considered. RESULTS: Ten articles met all the selection criteria and provided a positive answer to the PICO question. Our review of these articles revealed an association between CP and PCOS, since periodontal parameters were altered more frequently in patients with these conditions than in healthy young women. This altered periodontal response in PCOS was associated with a proinflammatory status that seemed to increase susceptibility to periodontal disease. CONCLUSION: Patients with PCOS appear to be more susceptible to developing periodontal diseases than women without the pathology.

Relationship Between Surgical Difficulty of Third Molar Extraction Under Local Anesthesia and the Postoperative Evolution of Clinical and Blood Parameters.

PURPOSE: To determine whether the Pederson scale is a good predictor of the surgical difficulty of third molar extraction and establish whether such surgical difficulty is directly related to the postoperative course as assessed from clinical (pain, inflammation, and trismus) and blood (C-reactive protein, interleukin-6 [IL-6], and fibrinogen) parameters. MATERIALS AND METHODS: A prospective observational study was conducted of 2 groups of patients who underwent simple or surgical third molar extraction under local anesthesia. Clinical and blood parameters and possible complications were recorded for 1 week after extraction. RESULTS: A total of 118 patients were studied. Surgical difficulty as predicted by the Pederson scale showed significant differences (P < .001) for osteotomy, sectioning of the crown, root sectioning, duration of intervention, type of closure, and number of sutures. Under conditions of equal surgical difficulty, the evolution of the groups was similar for pain and inflammation, although trismus was greater for patients subjected to surgical extraction. After the operation, marked increments were recorded in serum C-reactive protein, IL-6, and fibrinogen, although without differences among different levels of surgical difficulty. The probability of complications was similar in the routine and surgical extraction groups. The appearance of complications was the principal cause of alterations in clinical and blood parameters. CONCLUSIONS: The Pederson scale is a good predictor of the surgical difficulty of third molar removal as assessed from different clinical and blood parameters. C-reactive protein, IL-6, and fibrinogen concentrations varied considerably after the operation but were not influenced by the degree of surgical difficulty. The presence of postoperative complications was associated with a poorer evolution of clinical and blood parameters.

Changes in oral health-related quality of life after three different strategies of implant therapy: a clinical trial.

This research aims to evaluate changes in Oral Health-related Quality of Life (OHQoL) by means of the Oral Impacts on Daily Performances (OIDP) of patients treated with three distinct implant strategies. This clinical trial consisted of an oral examination and a questionnaire-based interview carried out before and after the definitive prosthetic rehabilitation in a consecutive sample of patients requiring dental implants. According to the clinical diagnosis and patient preference, patients were assigned to the one of the following groups: the conventional group (CGCL; n = 40), where implants were inserted without guiding and conventionally loaded; to the guided surgery but conventional loading group (GSCL; n = 35); or to the guided surgery and immediate loading group (GSIL; n = 29). At baseline, the OHQoL was significantly greater among those assigned to CGCL (2.4 ± 1.3) than those assigned to GSCL (3.3 ± 1.3), which were both greater than those patients assigned to GSIL (4.6 ± 2.0). After implant therapy, the oral well-being was significantly better than at baseline, and patient satisfaction was greater when the implants were loaded immediately (8.7 ± 1.1) than if the prosthetic rehabilitation was delayed (8.3 ± 1.1). In the GSIL group, the effect size of the OIDP exceeded the threshold value of 0.8 for all of the OIDP domains and for the total OIDP score and patient satisfaction. A global improvement in the OHQoL scores and patient satisfaction was observed after implant therapy, but the change was markedly greater in the GSIL group.

Craniofacial cephalometric morphologies in different cleft types: a retrospective cross-sectional study of 212 patients.

OBJECTIVE: The aim of this study was to evaluate and compare the craniofacial cephalometric morphologies among different cleft types in a Spanish population. METHODS: A retrospective cross-sectional study was carried out on 212 patients. The patients were subdivided into four groups according to their cleft types: unilateral cleft lip and palate; bilateral cleft lip and palate; cleft lip; and cleft palate. Angular and linear cephalometric measurements were taken on lateral radiographs. RESULTS: Unilateral cleft lip and palate was associated with a dolichofacial growth pattern, skeletal Class III with correct maxillary position, and lingual incisor inclination. Bilateral cleft lip and palate was associated with a mesofacial growth pattern, skeletal Class I with protruded maxillary position, and lingual incisor inclination. Cleft palate was associated with a mesofacial growth pattern, skeletal Class III with correct maxillary position, and lingual incisor inclination. Cleft lip was associated with a brachyfacial growth pattern, skeletal Class I with protruded maxillary position, lingual upper incisor inclination, and corrects lower incisor inclination. Significant correlations were observed between cleft types and their craniofacial cephalometric measurements. CONCLUSIONS: The present information can be used for the determination of orthodontic treatment and even future orthognathic surgery planning, a requirement in most cleft patients.