Analysis of the Frequency and Correlated Factors of Midpalatal Suture Maturation Stages in Young Adults, Based on Cone Beam Computed Tomography Imaging.

BACKGROUND: The choice of whether to perform a palatal disjunction in constricted maxilla has traditionally been decided based on the age of the patients, although there are gradually increasing references to the fact that this is not a determining factor. The main goal of this study was to evaluate the frequency of the different stages of midpalatal suture maturation in a sample of young adults between 15 and 30 years of age. Other objectives also included analyzing the possible correlation the maturation stages could maintain with sex and age groups. METHODS: 142 Cone Beam Computed Tomography (CBCT) scans of young adults were performed. The images were divided into four age groups based on age ranges of 15-18, 19-22, 23-26, and 27-30 years. Each group consisted of 26, 41, 39, and 36 patients, respectively, which were classified using Angelieri's method. In addition, sex and age groups were considered as variables, and the possible correlation of the prevalence of each one, according to age and sex, was studied. RESULTS: the sample was classified into 4.9% stage B; 52.1% stage C; 27.5% stage D; and 15.5% stage E. In addition, no statistically significant correlation between sex and the maturation stages was found, but more advanced stages did appear to be related to the chronological age of the subjects. CONCLUSIONS: The frequency of maturational stages where the suture is shown to be consolidated did not appear to be as high as expected; therefore, the idea of rejecting transverse plane treatment in a conventional manner in an out-of-growth patient should be discarded.

Knowledge of First Aid Measures in Dental Trauma: A Survey of Teachers in the Province of Seville, Spain.

The high incidence of childhood dental trauma requires childcare professionals to have basic notions of dental first aid. The aim of this study is to assess the level of knowledge and aptitude (defined as the ability to operate competently in a given activity) of early childhood, primary, and/or secondary education teachers from Seville (Spain) referred to first aid measures in dental trauma. A descriptive study was conducted. The study sample consisted of 442 teachers (334 women and 108 men) coinciding proportionately with the study target population in terms of gender distribution, type of center, and teaching level. A specifically designed questionnaire was used. Most of the participants (88.5%, n = 391) exhibited poor knowledge and aptitude, 11.5% (n = 51) showed a medium level of knowledge and aptitude, and none were categorized as having a high knowledge and aptitude. As a conclusion, teachers in the province of Seville (Spain) showed marked deficiencies in their level of knowledge and aptitude referred to the adoption of first aid measures in dental trauma among their pupils.

Skeletal, Dentoalveolar and Dental Changes after "Mini-Screw Assisted Rapid Palatal Expansion" Evaluated with Cone Beam Computed Tomography.

The purpose of this study was to evaluate skeletal, dentoalveolar and dental changes after Mini-screw Assisted Rapid Palatal Expansion (MARPE) using tooth bone-borne expanders in adolescent patients after analyzing different craniofacial references by Cone beam computed tomography (CBCT) and digital model analysis. This prospective, non-controlled intervention study was conducted on fifteen subjects (mean age 17 ± 4 years) with transversal maxillary deficiency. Pre (T1) and post-expansion (T2) CBCTs and casts were taken to evaluate changes at the premolars and first molar areas. To compare means between two times, paired samples t- or Wilcoxon test were used following criteria. Significant skeletal changes were found after treatment for Nasal width and Maxillary width with means of 2.1 (1.1) mm and 2.5 (1.6) mm (p < 0.00005). Midpalatal suture showed a tendency of parallel suture opening in the axial and coronal view. For dentoalveolar changes, a significant but small buccal bone thickness (BBT) reduction was observed in all teeth with a mean reduction of 0.3 mm for the right and left sides, especially for the distobuccal root of the first molar on the left side (DBBTL1M) [IC95%: (−0.6; −0.2); p = 0.001] with 0.4 (0.4) mm. However, a significant augmentation was observed for the palatal bone thickness (PBT) on the left side. The buccal alveolar crest (BACL) and dental inclination (DI) showed no significant changes after treatment in all the evaluated teeth. MARPE using tooth bone-borne appliances can achieve successful skeletal transverse maxillary expansion in adolescent patients, observing small dentoalveolar changes as buccal bone thickness (BBT) reduction, which was not clinically detectable. Most maxillary expansions derived from skeletal expansion, keeping the alveolar bone almost intact with minor buccal dental tipping.

Efficacy and predictability of maxillary and mandibular expansion with the Invisalign® system.

BACKGROUND: The purpose of this study is to evaluate the efficacy and predictability of upper and lower orthodontic expansion with the Invisalign® system. MATERIAL AND METHODS: From a sample of 167 patients; 64 upper and 51 lower arches were randomly selected from patients who had been treated with plastic orthodontics (Invisalign® aligners, SmartTrack® material). Digital models were extracted at the beginning (ModT1) and at the end of treatment (ModT2) as well as the final ClinCheck® (CkT2). The canine, premolar and molar width was measured at the gingival and cuspid level of both arches, as well as the inclination of the upper first molar. Likewise, both arches were divided regarding the planned expansion at the level of the first molar into mild, moderate and severe. RESULTS: The efficacy of expansion in the upper and lower arches showed a statistically significant difference (p<0.00005). During the measurements of predictability, around 98-100% was achieved at the coronal level and between 85-90% at the gingival level. Analyzing predictability regarding to the magnitude of expansion, superior and inferior moderate expansion, both gingival and cuspid, presented higher values. CONCLUSIONS: The Invisalign® system aligners (SmartTrack® material), proved to be a positive alternative for expansion movement offering high degree of predictability, both in the upper and lower arches. As a result, the most predictable level of expansion was moderate, having being the lower arch more foreseeable at the gingival level than the upper arch. Key words:Predictability, Efficacy, Expansion, Aligner, Invisalign®.

Indicación de las distintas técnicas de expansión rápida del paladar quirúrgicamente asistida y comparativa de la estabilidad / Indication of the different surgically assisted rapid palatal expansion techniques and stability comparison

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Clinical and radiographic evaluation of white MTA versus formocresol pulpotomy: A 48-month follow-up study.

PURPOSE: To determine whether there were differences between formocresol (FC) and white mineral trioxide aggregate (MTA) pulpotomy in terms of clinical and radiographic signs or effects upon the permanent successor over a long term. METHODS: A total of 212 molars (74 treated with FC and 138 with white MTA) corresponding to 129 subjects [66 females (51.1%) and 63 males (48.8%)] were evaluated. The coronal pulp was carefully amputated up to the entrance of the root canals using a sharp spoon excavator. Post-amputation bleeding was confirmed to be bright red and was seen to subside after applying 2-3 minutes of gentle pressure with a sterile cotton pellet. One group was treated with a 1:5 dilution of formocresol (20% Buckley's formocresol solution), while a second group was treated using white MTA powder (ProRoot). RESULTS: There were no significant differences in clinical success rate between the two groups (89.9% in the white MTA group versus 82.5% if the FC group). However, the radiographic success rate was significantly greater for white MTA versus FC. The radiographic failure rate in the molars treated with MTA was 7.9% versus 18.9% with FC. Regarding alterations in the timing of eruption, early and delayed eruption were respectively recorded in 7.24% and 8.69% of the cases in the MTA group, versus 9.45% and 4.05% of the cases in the FC group. Thus, neither group showed relevant alterations in the timing of eruption. CLINICAL SIGNIFICANCE: Mineral trioxide aggregate showed a significantly greater radiographic success rate than formocresol in pulpotomy in primary teeth over 6 to 48 months of follow-up. MTA may be indicated as a substitute of formocresol in pulpotomy treatments of temporary molars, with no pathological consequences of any kind to the permanent successor premolar.

Effect of mineral trioxide aggregate (MTA) pulpotomies in primary molars on their permanent tooth successors.

PURPOSE: To determine the long-term success rate of white MTA pulpotomies in primary teeth and its influence upon eruption and calcification of the permanent successor, as well as other key clinical and radiographic parameters. METHODS: A total of 138 molars from participants between 2-10 years of age were included. Clinical and radiographic parameters were monitored in the primary and/or permanent successor at 6, 12, 18, 24, 30, 36, 42, and 48 months or until eruption of the permanent successor, using the contralateral tooth as control. Chi-squared test and the Spearman correlation coefficient (r) were used to evaluate potential associations and distributions between radiographic/clinical parameters (P < 0.05; 95% CI). RESULTS: Clinical alterations were observed in 1.4% of the primary molars. Unfavorable radiographic pulp responses (furcation radiolucency, internal root resorption with perforation, or external root resorption) were observed in 6.5% of the cases. Dentin bridge formation in the roots was observed in a range as low as 71.2% to a maximum of 89.9% of the cases. The presence or absence of dentin bridge formation in any of the roots was not associated or correlated with the age of the patient (P > 0.05). Reparative dentin formation in any of the the root canals was recorded in 37.3 to a 68.1% of the canals (P > 0.05). The 50 permanent successors recorded after exfoliation of the treated molars showed no alterations in color, mineralization, structure or position, and no alterations in the timing of eruption were noted.