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1.
Oral Maxillofac Surg Clin North Am ; 35(1): 127-137, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36336595

RESUMO

While primary cleft lip nasal deformity has been well described, secondary cleft lip nasal deformity reflects the combination of residual deformity that follows primary operative maneuvers and growth-related nasal distortions. Secondary cleft lip nasal deformities are further associated with underlying skeletal and dentofacial abnormalities along with soft tissue constriction adding to the complexity of the deformity and posing major aesthetic and functional challenges to the multidisciplinary care team. Definitive rhinoplasties are performed to address these deformities and improve the quality of life in cleft patients following skeletal maturity and ideally after all underlying skeletal discrepancies have been corrected by orthognathic surgery. Maxillary advancement with or without mandibular setback is often required after careful planning and orthodontic preparation. Patients with cleft lip benefit tremendously from definitive rhinoplasty irrespective of inevitable residual discrepancies that remain and adjuvant therapies could enhance the overall outcome.


Assuntos
Fenda Labial , Fissura Palatina , Cirurgia Ortognática , Rinoplastia , Humanos , Fenda Labial/cirurgia , Qualidade de Vida , Estética Dentária , Nariz/cirurgia , Nariz/anormalidades , Palato/cirurgia , Fissura Palatina/cirurgia
3.
Braz. j. oral sci ; 21: e225924, jan.-dez. 2022. ilus
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1355003

RESUMO

Aim: To assess the reliability and validity of morphometric features on 3D digital models produced by scanning maxillary dental casts of Malaysian Malay subjects. Methods: Dental casts of 20 subjects were scanned using a 3D laser scanner (Next Engine Inc., Santa Monica, California, USA). The palatal rugae morphometric features were assessed on the resulting 3D models using 3-Matic Research 9.0 software (Materialise NV, Heverlee, Belgium). The assessments were repeated by the first and second authors to assess the intra- and interexaminer reliability, respectively. Rugae morphometric features were also evaluated on the conventional plaster models to assess the validity of the 3D method. Results: Kappa values of the validity ranged from 0.807 to 0.922 for rugae shape, size category and direction. The intraclass correlation coefficient (ICC) for rugae number validity was 0.979. For intra-examiner reliability, kappa values ranged from 0.716-1.000 for rugae shape, size category and direction. The ICC for rugae number intra-examiner reliability was 0.949. Kappa values of interexaminer reliability for rugae shape, size category and direction were 0.723-885, while the ICC of rugae number was 0.896. Conclusion: Palatal rugae analyses on 3D digital models scanned by the 3D Next Engine laser scanner using 3-Matic Research 9.0 software are valid and reliable


Assuntos
Palato , Antropologia Forense , Imageamento Tridimensional , Odontologia Legal
4.
J. Health Biol. Sci. (Online) ; 10(1): 1-4, 01/jan./2022. ilus
Artigo em Inglês | LILACS | ID: biblio-1370925

RESUMO

Introduction: orofacial clefts are common congenital malformations with an important social, psychological, and economic impact. The treatment of this condition may include different surgical procedures that previously require an adequate oral condition. Case report: we report a case of dental treatment before palatoplasty in a male patient of 17 years-old with bilateral cleft lip and palate and lesion in the jugal mucosa. Final considerations: the adequacy of the oral environment is a fundamental step in the treatment of patients with orofacial clefts and aims to restore oral health regardless of the degree of complexity of the dental treatment through the reduction of the pathogenic microbiota, elimination of retentive niches, instructions on diet and adequate oral hygiene and constant patient motivation.


Objetivos: as fissuras orofaciais são malformações congênitas comuns, com importante impacto social, psicológico e econômico. O tratamento dessa condição pode incluir vários procedimentos cirúrgicos que requerem previamente uma adequada condição bucal. Relato de caso: Relatamos o caso de tratamento odontológico prévio a palatoplastia em um paciente do gênero masculino de 17 anos de idade, com fissura transforame incisivo bilateral e lesão em mucosa jugal. Considerações finais: A adequação do meio bucal é uma etapa fundamental no tratamento de pacientes com fissuras orofaciais e visa restabelecer a saúde bucal independente do grau de complexidade do tratamento odontológico por meio da redução da microbiota patogênica, eliminação de nichos retentivos, orientações sobre dieta e higiene bucal adequada e motivação constante do paciente.


Assuntos
Fissura Palatina , Higiene Bucal , Palato , Fenda Labial , Cissus , Cárie Dentária , Fissura , Reabilitação Bucal
5.
Anat Histol Embryol ; 51(6): 718-727, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36370057

RESUMO

This study aims to determine the differences in skull between Asian and golden palm civets by geometric morphometric method. The landmarks were marked on these photographs, and principal component, classical cluster and canonical variance analyses were performed. The method of geometric morphometry of the skull is a powerful tool used to differentiate the species. Fourteen and 20 homologous landmarks were marked using tpsutil and tpsdig2 programs on the frontal and palatinal directional photographs, respectively. As a result of the study, the first principal component (PC1) accounted for 33.586% on the frontal view, 41.602% on the palatinal view of the total shape differences, respectively. Distinctive differences on the frontal and palatinal view were observed in the caudal, rostrolateral and the last molars and the caudal palatine, respectively.


Assuntos
Crânio , Viverridae , Animais , Cabeça , Palato
6.
Int J Oral Implantol (Berl) ; 15(4): 353-365, 2022 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-36377626

RESUMO

PURPOSE: To compare the outcomes of soft tissue augmentation during one-stage implant placement using grafts harvested from the hard palate or the maxillary tuberosity. MATERIALS AND METHODS: In this pilot controlled clinical study, non-smoking adults with a single missing tooth in the anterior or premolar region and adequate ridge dimensions for implant placement were enrolled. Each received a single implant and connective tissue graft harvested either from the hard palate (n = 10) or the maxillary tuberosity (n = 10). Digital impressions were taken prior to treatment (T0) and then 2 and 12 months postoperatively (T1 and T2, respectively). The primary study outcome was changes in horizontal ridge dimension. Secondary outcomes included marginal bone level changes over time, pain levels in the first 2 postoperative weeks (W1 and W2) and pink aesthetic score and patient-reported outcome measures at T2. Data analysis included repeated measures analysis of variance for intergroup comparisons. RESULTS: The horizontal ridge dimension increased significantly in both groups (P ≤ 0.002) at all apico-coronal levels examined, with no significant intergroup differences. There was also no significant intergroup difference in marginal bone level changes (P = 0.376). The hard palate group experienced higher pain levels in the donor site compared to the tuberosity group at W1 (P = 0.023). The pink aesthetic score and patient-reported outcome measures were similar between groups at T2. CONCLUSIONS: Soft tissue augmentation during one-stage implant placement results in significant increases in the horizontal ridge dimension.


Assuntos
Implantes Dentários , Maxila , Palato , Adulto , Humanos , Estética Dentária , Maxila/cirurgia , Dor , Palato/cirurgia , Projetos Piloto
8.
J Orofac Orthop ; 83(6): 412-431, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36205766

RESUMO

PURPOSE: The effects of rapid maxillary expansion (RME) on the transverse palatine and midfacial sutures have been extensively scrutinized. Unlike the dentition stage, age-dependency was not yet regarded when investigating morphological changes of the tooth-bearing palate. Therefore, the first aim of the present study was to analyse age-dependent sutural and morphological changes of the palate in selected patients by cone-beam computed tomography (CBCT) and dental cast analysis. Secondly, age-dependent effects of RME on width, height, and depth of the palate in the region of the maxillary palatine processes were investigated by a comprehensive dental cast study, so that the combination of results could be used to provide a biomechanical explanation of the occurring changes. METHODS: CBCT datasets of 9 patients (between 7.3 and 13.8 years) were measured around the median palatal suture and compared with the results of an individualised dental cast analysis. In addition, possible effects on other maxillary sutures were investigated. In the dental cast study, changes after RME in the tooth-bearing palate were analysed three-dimensionally in 60 children and adolescents. It was possible to divide those into three equally sized, age-dependant groups (PG1: < 10 years, n = 20; PG2: ≥ 10 < 12 years, n = 20; PG3: ≥ 12 years, n = 20). RESULTS: The CBCT analysis reveals age-related differences in sutural responses. The opening width of the median palatine suture decreases cranially (frontal) and dorsally (horizontal). The opening mode thus changes from parallel to triangular in both planes. The transverse palatine suture completely opens in younger patients only (PG1 and PG2). The width increases are always significant in all patients. While in PG1 the width increase is greater posteriorly than anteriorly, this is always reversed in PG2 and PG3. The palatal height always increases significantly anteriorly, but posteriorly only in the youngest patients (PG 1) median and paramedian. In PG 2 and PG 3, the posterior height change is very small. That is the reason why the anteroposterior comparison reveals a much more pronounced height increase anteriorly than posteriorly. CONCLUSION: The comparison of selected CBCT data with a dental cast analysis allows the conclusion that the maxillary expansion after RME in children up to 10 years is rather parallel, whereas it occurs V­shaped (anterior > posterior transversal, inferior > superior vertical) with increasing age, especially in adolescents from the age of 12. In addition to an age-progressive rigidity of the pterygopalatomaxillary junction, morphological changes of the transverse palatine suture during growth seem to be causal. Thus, age-dependent effects of palatal expansion occur due to a positional change of maxillary centres of rotation and resistance. From dental cast measurements, especially at the skeletal-basal level, conclusions can be drawn about the median palatal suture opening mode.


Assuntos
Técnica de Expansão Palatina , Tomografia Computadorizada de Feixe Cônico Espiral , Criança , Adolescente , Humanos , Maxila/diagnóstico por imagem , Palato/diagnóstico por imagem , Palato/cirurgia , Tomografia Computadorizada de Feixe Cônico/métodos , Suturas
10.
Prog Orthod ; 23(1): 35, 2022 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-36244995

RESUMO

BACKGROUND: Midpalatal suture (MPS) repair in growing patients after RPE has been previously reported. However, differences between young and adult patients for timing and pattern of MPS repair after rapid maxillary expansion are expected. The aim of this study was to evaluate the midpalatal suture repair pattern after miniscrew-assisted rapid palatal expansion (MARPE) in adult patients. MATERIALS AND METHODS: The study included 21 patients (six males, 15 females) successfully treated with MARPE with a mean initial age of 29.1 years of age (SD = 8.0; range = 20.1-45.1). MPS repair was evaluated using maxillary axial and coronal sections derived from CBCT exams taken 16 months after the expansion (SD = 5.9). Objective and subjective assessments of MPS repair were performed. Objective assessments were performed measuring MPS bone density at anterior, median and posterior region of hard palate. Pre-expansion and post-retention bone density changes were evaluated using paired t tests (p < 0.05). Midpalatal suture bone repair was scored 0 to 3 considering, respectively, the complete absence of bone repair in the MPS, the repair of less than 50% of the MPS, the repair of more than 50% of the MPS and the complete repair of the MPS. Intra- and interexaminer reliability evaluation were assessed using Kappa coefficient. RESULTS: The objective evaluation showed a significant higher bone density at the pre-expansion stage in all palatal regions. The reliability of the subjective method was adequate with intra- and interexaminer agreements varying from 0.807 to 0.904. Scores 1, 2 and 3 were found in 19.05%, 38.09% and 42.86% of the sample, respectively. The most common region demonstrating absence of bone repair was the middle third. The anterior third of the midpalatal suture was repaired in all patients. CONCLUSIONS: A decreased bone density was observed after the retention period when compared to pre-expansion stage. Most adult patients demonstrated incomplete repair of the midpalatal suture 16 months after MARPE. However, adequate bone repair covering more than half of the hard palate extension was observed in 80.95% of the patients.


Assuntos
Suturas Cranianas , Técnica de Expansão Palatina , Adulto , Tomografia Computadorizada de Feixe Cônico/métodos , Suturas Cranianas/diagnóstico por imagem , Suturas Cranianas/cirurgia , Feminino , Humanos , Masculino , Maxila/diagnóstico por imagem , Maxila/cirurgia , Palato/diagnóstico por imagem , Palato/cirurgia , Palato Duro/diagnóstico por imagem , Palato Duro/cirurgia , Reprodutibilidade dos Testes , Suturas
11.
Eur J Radiol ; 157: 110566, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36274361

RESUMO

OBJECTIVES: To explore the ability of conventional MRI and histogram analysis of apparent diffusion coefficient (ADC) for differentiating between malignant and benign palatal lesions. MATERIALS AND METHODS: A retrospective analysis was performed on MRI images of 86 patients with palatal lesions confirmed by histopathology between January 2015 and December 2018. Each lesion was evaluated based on the conventional MRI characteristics, including size, location, morphology, inner texture, enhancement, capsule, bone destruction, and nerve invasion. ADC histogram analysis was fitted to a bimodal Gaussian distribution mixture curve. Nine histogram analysis parameters were extracted from ADC maps and were compared between malignant and benign palatal lesions. Statistical analysis was performed to assess the differential performance of each parameter individually and combined. RESULTS: On conventional MRI, the capsule structure and nerve invasion were useful characteristics for the differential diagnosis of palatal lesions. Histogram analysis showed significant differences between the groups in terms of mean ADC values of the lower curve and overall curve of the bimodal histogram, as well as ADC10 and ADC50. The optimal diagnostic threshold of ADC value was ADC50 = 1.17 × 10-3 mm2/s (area under curve [AUC] = 0.934, sensitivity = 93.0 %, specificity = 86.2 %). The combination of conventional MRI and ADC values yielded the best predictive performance, with an AUC of 0.949, and an increase in sensitivity from 80.7 % to 96.5 % and specificity from 58.6 % to 82.8 %, compared to conventional MRI. CONCLUSIONS: Histogram analysis of DWI combined with conventional MRI allows accurate differentiation between benign and malignant palatal lesions.


Assuntos
Imagem de Difusão por Ressonância Magnética , Imageamento por Ressonância Magnética , Humanos , Estudos Retrospectivos , Imagem de Difusão por Ressonância Magnética/métodos , Imageamento por Ressonância Magnética/métodos , Área Sob a Curva , Diagnóstico Diferencial , Palato , Sensibilidade e Especificidade , Curva ROC
12.
J Cancer Res Ther ; 18(4): 1177-1179, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36149182

RESUMO

An epignathus is an extremely rare form of oropharyngeal teratoma that arises from the oral cavity, most commonly from the palate and is associated with a high mortality secondary to airway obstruction in the neonatal period. It predominantly occurs in females. Here, we are presenting a case of giant epignathus in a male baby with associated cleft palate.


Assuntos
Neoplasias Bucais , Síndrome do Desconforto Respiratório , Teratoma , Dispneia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Neoplasias Bucais/complicações , Palato , Teratoma/complicações , Teratoma/diagnóstico
13.
Med Eng Phys ; 107: 103872, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-36068044

RESUMO

This study investigated the effects of miniscrew location on biomechanical performance of bone-borne rapid palatal expander (B-RPE) to midpalatal suture, using finite element (FE). Three cases of B-RPE with different miniscrew locations (3 and 6 mm from midpalatal suture and palatal interdental site) were simulated activations in partly ossified midpalatal suture maturation. This study compared the expansion amount and pattern along the suture line. Equivalent von Mises (EQV) stresses at appliance, miniscrew, midpalatal sutures, and elastic strain at the bone around miniscrew were evaluated. In all cases, they could not break the midpalatal suture of palatine bone. However, midpalatal suture at the maxilla was expanded. The expansion amount and unparallel expanding pattern were increased when miniscrews were positioned away from the suture. The interdental miniscrew position extended the suture more than the other 2 cases, but the pattern was unparallel. When the miniscrews were positioned away from the suture, the EQV stress at the appliance and elastic strain at the bone around the miniscrew were reduced. In the case of the palatal interdental miniscrew, all parameters were of lower magnitude. All cases could expand the partly ossified midpalatal suture maturation. The distance between the midpalatal suture and the miniscrew influenced appliance EQV stress, elastic strain at the bone around the miniscrew, and expansion characteristics.


Assuntos
Técnica de Expansão Palatina , Palato , Análise de Elementos Finitos , Maxila/cirurgia , Palato/cirurgia , Suturas
14.
Surg Radiol Anat ; 44(9): 1261-1267, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36056237

RESUMO

PURPOSE: Saliva distribution over the palatal surface plays an important role in the perception of dry mouth. It is envisaged that non-invasive estimation of the palatal surface area by anthropometric measurements of the head and face can be useful in the assessment of oral dryness. For this purpose, the relationship between the palatal surface area and anthropometric measurements of the head and face was investigated. METHODS: The palatal surface was measured in 51 healthy volunteers using an intra-oral scanner. The distances between anthropometric landmarks of the head and face were determined using an anatomical sliding caliper. Correlations between the palatal surface area and the anthropometric landmarks were investigated. RESULTS: The median palatal surface area for the total study population was found to be 2120.6 mm2. Virtually, all anthropometric measurements showed significant differences between females and males. Various head and face measurements had a significant correlation with the palatal surface area. However, these correlations disappeared when the participants were stratified based on their sex, with the exception of mandibular length and palatal width in females. CONCLUSION: The surface area of the palate correlates with nearly all anthropometric measurements of the head and face included in this study. Yet, the clinical applicability seems limited to females.


Assuntos
Palato , Antropometria/métodos , Feminino , Humanos , Masculino
15.
BMC Oral Health ; 22(1): 423, 2022 09 22.
Artigo em Inglês | MEDLINE | ID: mdl-36138473

RESUMO

BACKGROUND: Miniscrew-Assisted Rapid Palatal Expansion (MARPE) is a non-surgical orthodontic treatment for transverse maxillary deficiency. This study aimed to investigate the Oral Health-related Quality of Life (OHRQoL) and pain perception of patients undergoing MARPE treatment. METHODS: 42 consecutive patients (9 men, 33 women) from the age of 16 onwards (mean: 27.4 ± 9.3 years; range 17.1-55.7 years) who received a MARPE treatment were included. OHRQoL was assessed with the short form of the Oral Health Impact Profile (OHIP-14) questionnaire. Patients filled out the questionnaire at baseline (T0) and weekly during the expansion phase (P1) and in the post-expansion phase (P2). Pain intensity was assessed with a Visual Analogue Scale (VAS) questionnaire and filled out daily during expansion, along with a question on the intake of analgesics. The mean weekly and total OHIP-score and OHIP-score per domain were calculated at T0, P1 and P2, as well as mean weekly and total VAS-scores for average pain, maximum pain and analgesics intake during P1. Kruskal-Wallis tests were used to test for differences in OHIP between T0, P1 and P2. The level of significance was set at 0.05. RESULTS: The mean OHIP-score was 10.86 ± 9.71 at T0 and increased to 17.18 ± 10.43 during P1 (p < 0.001), after which it returned to pre-expansion levels, 9.27 ± 7.92 (p = 0.907) during P2. At the domain level, there was a statistically significant increase in OHIP-score at P1 for functional limitation, physical pain, psychological discomfort and social disability. The mean VAS-score for average pain during expansion was 16.00 ± 19.73 mm. Both OHIP-score (25.00 ± 10.25), average pain (33.72 ± 16.88 mm), maximum pain (44.47 ± 17.99 mm) and analgesics intake (59%) were highest at initiation of the expansion and decreased by the end of expansion. CONCLUSIONS: MARPE is a generally well-tolerated expansion treatment. A temporary decline in OHRQoL and moderate pain are present at the start of expansion, followed by a recovery of OHRQoL and very mild pain during the rest of treatment. Clinicians should be aware of the effects of MARPE on patients' quality of life and manage the expected discomfort and impediments with adequate communication and patient education.


Assuntos
Saúde Bucal , Técnica de Expansão Palatina , Palato , Qualidade de Vida , Adolescente , Adulto , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor , Satisfação do Paciente , Estudos Prospectivos , Qualidade de Vida/psicologia , Adulto Jovem
16.
BMJ Case Rep ; 15(9)2022 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-36175042

RESUMO

Methotrexate-associated lymphoproliferative disorder (MTX-LPD) can occur in the oral cavity, and only a few cases with palatal involvement have been reported. Chemotherapy may be needed if there is no remission after the withdrawal of MTX. We report a case of MTX-LPD presenting with a swelling of the palate that required chemotherapy. A woman in her 70s with rheumatoid arthritis reported a swelling on the left side of the palate. Her condition was diagnosed as Epstein-Barr virus-negative diffuse large B-cell lymphoma (MTX-LPD). Since the mass did not remit after MTX withdrawal, she underwent five courses of chemotherapy. Currently, the patient is in complete remission. In patients on MTX who develop a swelling on the palate, MTX-LPD should be included among the differential diagnostic possibilities. Diagnosis and treatment of MTX-LPD call for consultation with a haematologist. If the mass fails to regress following withdrawal of MTX, appropriate chemotherapy is indicated.


Assuntos
Infecções por Vírus Epstein-Barr , Transtornos Linfoproliferativos , Feminino , Herpesvirus Humano 4 , Humanos , Transtornos Linfoproliferativos/induzido quimicamente , Transtornos Linfoproliferativos/diagnóstico , Transtornos Linfoproliferativos/tratamento farmacológico , Metotrexato/efeitos adversos , Palato
17.
Head Face Med ; 18(1): 30, 2022 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-36057719

RESUMO

BACKGROUND: Guided insertion of palatal miniscrews using a lateral cephalogram instead of cone beam computed tomography (CBCT) significantly reduces the radiation level for the patient. Till now no data are available on the risk of hitting the incisors in this regard, which is one of the worst clinical complications when inserting a paramedian miniscrew. Hence, this study aims to investigate the distance between the mini-implant and the roots of the central and lateral incisors. METHODS: Lateral cephalogram, an intraoral scan, and CBCT of 20 patients were superimposed. After a miniscrew (1.7 × 8 mm) placement based on intraoral scan and lateral cephalogram, the CBCT was used as control for the distance between the miniscrews and the roots of the incisors. RESULTS: The mean value of the shortest distance between the miniscrew and roots of the incisors in the lateral cephalogram was 4.74 ± 1.67 mm. The distance between both miniscrews and the central incisors measured in the CBCT was 5.03 ± 2.22 mm and 5.26 ± 2.21 mm and between the two miniscrews and the lateral incisors was 4.93 ± 1.91 mm and 5.21 ± 2.64 mm. No significant differences between the distances in the CBCT and the lateral cephalogram could be observed. In one case, the CBCT control revealed the penetration of two palatally displaced canines after insertion based on intraoral scan and lateral cephalogram. CONCLUSIONS: The use of an intraoral scan and a lateral cephalogram for guided paramedian insertion of palatal miniscrews can prevent incisor root damage. This may reduce the radiation since no CBCT seems necessary. The current investigation focuses on the anterior paramedian area of the palate. Outside that region and in complex cases with displaced teeth in the palatal area, a CBCT might be indicated.


Assuntos
Maxila , Palato , Tomografia Computadorizada de Feixe Cônico/métodos , Incisivo/diagnóstico por imagem , Incisivo/cirurgia , Maxila/diagnóstico por imagem , Maxila/cirurgia , Raiz Dentária/diagnóstico por imagem , Raiz Dentária/cirurgia
18.
J Oral Maxillofac Surg ; 80(12): 1902-1911, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36113583

RESUMO

PURPOSE: A commonly reported complication of surgically assisted rapid palatal expansion (SARPE) that has not been explored extensively is uneven expansion between left and right sides, which requires secondary surgery for correction. This systematic review aims to analyze the prevalence and potential causes of asymmetric expansion in the transverse dimension after SARPE to guide the clinical practice. METHODS: Electronic databases and manual search were used to search for original articles published on SARPE on March 11, 2022. Original human studies that recorded the number and percentage of asymmetric expansion after two-piece SARPE were included. The 2020 Preferred Reporting Items for Systemic Reviews and Meta-Analyses guideline was implemented for the quality assessment and data analysis of the included articles. The study was registered at the International Prospective Register of Systematic Reviews under the number CRD42022300782. RESULTS: After applying inclusion and exclusion criteria, 13 articles were included in the final review. The risk of bias was high in 8 studies and medium in the other 5 studies. Overall, the prevalence of asymmetric expansion in the transverse dimension (different amount of expansion between left and right sides) was 7.52%, with 12.90% of patients involved receiving a second surgery for correction. Expander design did not significantly affect the rate of asymmetry expansion. Pterygomaxillary fissure release significantly increased the rate of asymmetry expansion (11.02% vs 5.08%, P < .001). In comparison, lateral nasal wall osteotomy (4.26% vs 14.77%, P < .001) and release of the nasal septum (5.22% vs 17.15%, P < .001) significantly lowered the rate of asymmetry expansion, respectively. CONCLUSIONS: Asymmetric dentoskeletal expansion between left and right sides is a common complication of SARPE procedures, mostly caused by variations in surgical cuts. However, the risk of bias in currently available publications is high. Further studies are warranted to fully understand the causes of asymmetric expansion.


Assuntos
Maxila , Técnica de Expansão Palatina , Humanos , Maxila/cirurgia , Revisões Sistemáticas como Assunto , Palato , Osteotomia
19.
N Z Med J ; 135(1562): 104-107, 2022 09 23.
Artigo em Inglês | MEDLINE | ID: mdl-36137771

RESUMO

Palatal mucosal changes secondary to smoking habit have been recognised since at least the 19th century. Smoker's palate, or nicotinic stomatitis is associated with habitual cigar or pipe smoking, regular consumption of thermally hot beverages and more recently has been identified in those who vape. It is considered of negligible malignant transformation risk, typically resolving on habit cessation. However a variant, palatal keratosis associated with reverse smoking (PKARs), is recognised as an established oral potentially malignant disorder. Reverse smoking involves smoking the lit end of the cigarette intraorally and the condition may result in increased incidence of palatal squamous cell carcinoma development. We highlight a case to create awareness of both this unusual smoking habit, and the palate as an overlooked site in oral cancer screening.


Assuntos
Ceratose Actínica , Doenças da Boca , Humanos , Ceratose Actínica/patologia , Nova Zelândia , Palato/patologia , Fumar/efeitos adversos , Fumar/epidemiologia
20.
BMC Oral Health ; 22(1): 320, 2022 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-35915494

RESUMO

OBJECTIVE: This study aimed to investigate whether the subjects with mouth breathing (MB) or nasal breathing (NB) with different sagittal skeletal patterns showed different maxillary arch and pharyngeal airway characteristics. METHODS: Cone-beam computed tomography scans from 70 children aged 10 to 12 years with sagittal skeletal Classes I and II were used to measure the pharyngeal airway, maxillary width, palatal area, and height. The independent t-test and the Mann-Whitney U test were used for the intragroup analysis of pharyngeal airway and maxillary arch parameters. RESULTS: In the Skeletal Class I group, nasopharyngeal airway volume (P < 0.01), oropharyngeal airway volume (OPV), and total pharyngeal airway volume (TPV) (all P < 0.001) were significantly greater in subjects with NB than in those with MB. Furthermore, intermolar width, maxillary width at the molars, intercanine width, maxillary width at the canines, and palatal area were significantly larger in subjects with NB than in those with MB (all P < 0.001). In the Skeletal Class II group, OPV, TPV (both P < 0.05) were significantly greater in subjects with NB than in those with MB. No significant differences in pharyngeal airway parameters in the MB group between subjects with Skeletal Class I and those with Skeletal Class II. CONCLUSION: Regardless of sagittal Skeletal Class I or II, the pharyngeal airway and maxillary arch in children with MB differ from those with NB. However, the pharyngeal airway was not significantly different between Skeletal Class I and II in children with MB.


Assuntos
Imageamento Tridimensional , Maxila , Respiração Bucal , Faringe , Cefalometria/métodos , Tomografia Computadorizada de Feixe Cônico/métodos , Humanos , Imageamento Tridimensional/métodos , Mandíbula , Maxila/diagnóstico por imagem , Palato , Faringe/diagnóstico por imagem
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