The adenomatoid odontogenic tumour: an update of selected issues.

The aim of this update was to present the recent notable progress within remaining questions relating to the adenomatoid odontogenic tumour (AOT). Selected issues that were studied included the following: (i) AOT history and terminology, (ii) the so-called peripheral AOT, (iii) AOT and the gubernaculum dentis and (iv) the so-called adenomatoid odontogenic cyst (AOC). The earliest irrefutable European case of AOT was described in 1915 by Harbitz as 'cystic adamantoma'. Recently, Ide et al. have traced two Japanese cases with irrefutable proof described by Nakayama in 1903. The so-called peripheral (gingival) variant of AOT seems to cover a dual pathogenesis, both an 'erupted intraosseous' and an 'extraosseous' (gingival) one. In 1992, we theorized that the generally unnoticed gubernaculum dentis (cord and canal) seems to be involved in the development of AOT. Ide et al. have concluded that the dental lamina in the gubernacular cord seems to be an embryonic source of the vast majority of AOTs. The suggestion by Marx and Stern to change the nomenclature of AOT to adenomatoid odontogenic cyst (AOC) is critically discussed. The present authors agree on the background of the work of several groups of researchers and WHO/IARC classifications that the biology of the follicular variant of AOT is already fully explained and does not make room for any change in diagnostic terms. Further, there is no reason to change terminology in this case where improvements or conditions to better clinical management are not an issue.

Radiographic volume analysis as a novel tool to determine nasopalatine duct cyst dimensions and its association with presenting symptoms and postoperative complications.

OBJECTIVES: The aims of the study were to use cone beam computed tomography (CBCT) images of nasopalatine duct cysts (NPDC) and to calculate the diameter, surface area, and 3D-volume using a custom-made software program. Furthermore, any associations of dimensions of NPDC with age, gender, presence/absence of maxillary incisors/canines (MI/MC), endodontic treatment of MI/MC, presenting symptoms, and postoperative complications were evaluated. MATERIAL AND METHODS: The study comprised 40 patients with a histopathologically confirmed NPDC. On preoperative CBCT scans, curves delineating the cystic borders were drawn in all planes and the widest diameter (in millimeter), surface area (in square millimeter), and volume (in cubic millimeter) were calculated. RESULTS: The overall mean cyst diameter was 15 mm (range 7-47 mm), the mean cyst surface area 566 mm(2) (84-4,516 mm(2)), and the mean cyst volume 1,735 mm(3) (65-25,350 mm(3)). For 22 randomly allocated cases, a second measurement resulted in a mean absolute aberration of ±4.2 % for the volume, ±2.8 % for the surface, and ±4.9 % for the diameter. A statistically significant association was found for the CBCT determined cyst measurements and the need for preoperative endodontic treatment to MI/MC and for postoperative complications. CONCLUSION: In the hands of a single experienced operator, the novel software exhibited high repeatability for measurements of cyst dimensions. Further studies are needed to assess the application of this tool for dimensional analysis of different jaw cysts and lesions including treatment planning. CLINICAL RELEVANCE: Accurate radiographic information of the bone volume lost (osteolysis) due to expansion of a cystic lesion in three dimensions could help in personalized treatment planning.

Assessment of smoking behaviour in a dental setting: a 1-year follow-up study using self-reported questionnaire data and exhaled carbon monoxide levels.

OBJECTIVES: This study analyses the changes in smoking habits over the course of 1 year in a group of patients referred to an oral medicine unit. MATERIALS AND METHODS: Smoking history and behaviour were analysed at baseline and after 1 year based on a self-reported questionnaire and on exhaled carbon monoxide levels [in parts per million (ppm)]. During the initial examination, all smokers underwent tobacco use prevention and cessation counselling. RESULTS: Of the initial group of 121 patients, 98 were examined at the follow-up visit. At the baseline examination, 33 patients (33.67 %) indicated that they were current smokers. One year later, 14 patients (42.24 % out of the 33 smokers of the initial examination) indicated that they had attempted to stop smoking at least once over the follow-up period and 15.15 % (5 patients) had quit smoking. The mean number of cigarettes smoked per day by current smokers decreased from 13.10 to 12.18 (p = 0.04). The exhaled CO level measurements showed very good correlation with a Spearman's coefficient 0.9880 for the initial visit, and 0.9909 for the follow-up examination. For current smokers, the consumption of one additional cigarette per day elevated the CO measurements by 0.77 ppm (p < 0.0001) at the baseline examination and by 0.84 ppm (p < 0.0001) at the 1-year follow-up. CONCLUSIONS: In oral health care, where smoking cessation is an important aspect of the treatment strategy, the measurement of exhaled carbon monoxide shows a very good correlation with a self-reported smoking habit. CLINICAL RELEVANCE: Measurement of exhaled carbon monoxide is a non-invasive, simple and objective measurement technique for documenting and monitoring smoking cessation and reduction.

Management of children with autism spectrum disorder in the dental setting: concerns, behavioural approaches and recommendations.

OBJECTIVES: This article reviews the present literature on the issues encountered while coping with children with autistic spectrum disorder from the dental perspective. The autistic patient profile and external factors affecting the oral health status of this patient population are discussed upon the existing body of evidence. MATERIAL AND METHODS: The MEDLINE database was searched using the terms 'Autistic Disorder', 'Behaviour Control/methods', 'Child', 'Dental care for disabled', 'Education', 'Oral Health', and 'Pediatric Dentistry' to locate related articles published up to January 2013. RESULTS: Most of the relevant studies indicate poor oral hygiene whereas they are inconclusive regarding the caries incidence in autistic individuals. Undergraduate dental education appears to determine the competence of dental professionals to treat developmentally disabled children and account partly for compromised access to dental care. Dental management of an autistic child requires in-depth understanding of the background of the autism and available behavioural guidance theories. The dental professional should be flexible to modify the treatment approach according to the individual patient needs.

Does a pulsed mode offer advantages over a continuous wave mode for excisional biopsies performed using a carbon dioxide laser?

PURPOSE: Animal studies of excisional biopsies have shown less thermal damage when a carbon dioxide (CO(2)) laser (10.6 µm) is used in a char-free (CF) mode than in a continuous-wave (CW) mode. The authors' aim was to evaluate and compare clinical and histopathologic findings of excisional biopsies performed with CW and CF CO(2) laser (10.6 µm) modes. MATERIALS AND METHODS: This prospective randomized controlled clinical trial included 60 patients with similar fibrous hyperplasias of the buccal plane willing to undergo excisional CO(2) laser biopsy. Patients were randomly allocated to the CW (5 W) or CF (140 Hz, 400 µs, 33 mJ) group. Duration of surgery, intra- and postoperative complications, and the width (micrometers) of the histopathologic collateral thermal damage zone were registered as primary outcome variables. Secondary outcome variables were pain (patients filled in a visual analog scale [VAS]) and analgesic intake (recorded by patients). RESULTS: The study group consisted of 36 women and 24 men with a median age of 50.5 years. Median durations of surgery were 74.5 seconds in the CW group and 83.5 seconds in the CF group. Intraoperative venous bleeding occurred in 16.7% of patients in the CW group and in 13.3% of patients in the CF group. Median areas of histopathologic collateral damage zones were similar in the CW group (166.5 µm) and the CF group (162.5 µm). There was no statistically significant difference between the VAS values of the 2 groups. Analgesic intake was recorded by 16.7% of patients in the CW group and by 6.7% of patients in the CF group (P = .23, not significant). No statistically significant correlation was found between areas of thermal damage zones and postoperative VAS scores. CONCLUSIONS: In contrast to previous animal studies, no significant difference was found in the widths of thermal damage zones between the CW and CF groups. The VAS values and analgesic intake were low in the 2 groups. The 2 CO(2) laser modes are appropriate for the excision of intraoral mucosal lesions. A safety border of at least 1 mm is recommended regardless of the laser mode used.

Assessment of smoking behaviour in the dental setting. A study comparing self-reported questionnaire data and exhaled carbon monoxide levels.

The present study validated the accuracy of data from a self-reported questionnaire on smoking behaviour with the use of exhaled carbon monoxide (CO) level measurements in two groups of patients. Group 1 included patients referred to an oral medicine unit, whereas group 2 was recruited from the daily outpatient service. All patients filled in a standardized questionnaire regarding their current and former smoking habits. Additionally, exhaled CO levels were measured using a monitor. A total of 121 patients were included in group 1, and 116 patients were included in group 2. The mean value of exhaled CO was 7.6 ppm in the first group and 9.2 ppm in the second group. The mean CO values did not statistically significantly differ between the two groups. The two exhaled CO level measurements taken for each patient exhibited very good correlation (Spearman's coefficient of 0.9857). Smokers had a mean difference of exhaled CO values of 13.95 ppm (p < 0.001) compared to non-smokers adjusted for the first or second group. The consumption of one additional pack year resulted in an increase in CO values of 0.16 ppm (p = 0.003). The consumption of one additional cigarette per day elevated the CO measurements by 0.88 ppm (p < 0.001). Based on these results, the correlations between the self-reported smoking habits and exhaled CO values are robust and highly reproducible. CO monitors may offer a non-invasive method to objectively assess current smoking behaviour and to monitor tobacco use cessation attempts in the dental setting.

Patients' awareness of the potential benefit of smoking cessation. A study evaluating self-reported and clinical data from patients referred to an oral medicine unit.

The present study analyzed history of smoking and willingness to quit smoking in patients referred for diagnosis and treatment of different oral mucosal lesions. Prior to the initial clinical examination, patients filled in a standardized questionnaire regarding their current and former smoking habits and willingness to quit. Definitive diagnoses were classified into three groups (benign/reactive lesions, premalignant lesions and conditions, and malignant diseases) and correlated with the self-reported data in the questionnaires. Of the 980 patients included, 514 (52%) described themselves as never smokers, 202 (21%) as former smokers, and 264 (27%) as current smokers. In the group of current smokers, 23% thought their premalignant lesions/conditions were related to their smoking habit, but only 15% of the patients with malignant mucosal diseases saw that correlation. Only 14% of the smokers wanted to commence smoking cessation within the next 30 days. Patients with malignant diseases (31%) showed greater willingness to quit than patients diagnosed with benign/reactive lesions (11%). Future clinical studies should attempt (1) to enhance patients' awareness of the negative impact of smoking on the oral mucosa and (2) to increase willingness to quit in smokers referred to a dental/oral medicine setting.

[Prevention of the eruption of an upper later incisor by a compound odontoma. Case report]. / Durchbruchsbehinderung eines lateralen Inzisiven im Oberkiefer aufgrund eines zusammengesetzten Odontoms. Ein Fallbericht.

Odontomas are the most common odontogenic tumours. They are considered as hamartomas - a local tissue malformation without autonomous growth potential - and are non-neoplastic. Clinically and histopathologically, compound and complex odontomas can be differentiated. Compound odontomas consist of a varying number of tooth-like structures and histology show dental tissues in an orderly pattern. Most often compound odontomas are diagnosed in young patients in the anterior maxilla. Patients are rarely complaining of symptoms and they are usually diagnosed during routine radiographic examinations or due to late eruption of permanent or persistence of deciduous teeth. The following case report presents a disturbed eruption of a lateral right incisor of the maxilla in a 8-year old female patient. Clinical, radiological and histopathological characteristics of this lesion will be discussed as well as therapy and follow-up.

The nasopalatine duct cyst: an analysis of the relation between clinical symptoms, cyst dimensions, and involvement of neighboring anatomical structures using cone beam computed tomography.

PURPOSE: This study evaluates the dimensions of nasopalatine duct cysts (NPDCs) and the involvement of neighboring anatomical structures using standardized limited cone beam computed tomography (CBCT) and a possible correlation to the patient's age, gender, preoperative symptoms, and postsurgical complications. MATERIALS AND METHODS: The study included 25 patients with a confirmed histopathologic diagnosis of NPDC. Standardized measurements of NPDC dimensions were performed on sagittal, coronal, and axial CBCT sections. Maximas, minimas, mean, standard error of mean, and confidence intervals (95%) of all measurements were performed. The Kruskal-Wallis test was used to analyze group differences and to assess any association between measurements and preoperative symptoms or postoperative complications. RESULTS: The patients' mean age was 49.5 years, and a male-to-female ratio of 2.1:1 was assessed. Mean cyst dimensions for men and for patients less than 50 years old tended to be higher, without statistical significance. The cyst dimensions had no statistically significant correlation to preoperative symptoms. Initial symptoms were present in all cases with a nasal defect, however. Most of the standardized cyst dimensions exhibited a statistically significant correlation to postoperative complications. CONCLUSIONS: The presence or the absence of symptoms does not correlate with the dimensions of an NPDC. With progressive size of the cyst, the risk for minor postsurgical complications increases.

Pulse or hyaline ring granuloma. Review of the literature on etiopathogenesis of oral and extraoral lesions.

Since the late 1950s, reports on an unusual giant-cell granulomatous lesion affecting the jaws, lungs, stomach and intestines have been published. Histopathologically, the lesions showed the presence of structureless hyaline rings with multinucleated giant cells. The aim of this review was to summarize the literature on the etiopathogenesis of the so-called oral and extraoral pulse or hyaline ring granuloma. Literature was searched using PubMed and Medline. In addition, hand search was performed. Search words were oral and extraoral hyaline ring granuloma, giant-cell hyaline angiopathy, pulse granuloma and chronic periostitis. Numerous terms for hyaline ring granuloma have been introduced over time (1971-2008). One hundred seventy-three cases of oral hyaline ring granuloma have been retrieved from the literature. In the mandible, 72.3% occurred . Two theories for etiopathogenesis have been proposed: (1) the origin of the hyaline rings is due to a foreign material (pulse and legumes) having penetrated the oral mucosa or gastrointestinal tract and lungs (exogenous theory) and (2) the rings are due to hyaline degenerative changes in walls of blood vessels (endogenous theory). Experimental production of oral and extraoral hyaline ring granulomas is consistent with the exogenous origin. Particles or remains of leguminous cells having been implanted or aspirated into human tissues whether located to the oral cavity or throughout the entire digestive tract and respiratory system are thought to be causative. Pulse or hyaline ring granulomas are rare but are well-defined oral and extraoral lesions due to implantation of the cellulose moiety of plant foods in contrast to the starch components.

[Focal osteosclerotic lesions of the jaws--a review focusing on diagnostic and therpeutic aspects]. / Fokale Osteosklerosen im Kiefer. Eine Uebersichtsarbeit zur Diagnostik und Therapie.

The diagnosis of osteosclerotic lesions is sometimes quite challenging for the general dental practitioner. When having no clear reason for a sclerotic process in the jaw bone, the dentist is often left without a definite diagnosis and treatment plan. Additionally, the literature often mixes terms for sclerotic bone lesions in the mandible or maxilla, causing further confusion about classification, therapy and prognosis of these entities. Although osteosclerotic jaw lesions can arise in every decade of life, they often are encountered by chance on routine radiographic examinations. For further diagnosis these lesions are even referred for invasive procedures such as bone biopsies. Nevertheless, accurate knowledge about the pathogenesis, radiographic and clinical appearance of these lesions could already lead to a diagnosis without the need for further biopsies. The present review focuses on the focal osteosclerosis of the jaws, discussing diagnosis, treatment and important differential diagnoses.

[Periapical osseous dysplasia of the anterior maxilla--a case presentation]. / Periapikale ossäre Dysplasie der anterioren Maxilla. Ein Fallbericht.

Osseous dysplasias (formerly cemento-osseous dysplasias/ CODs) represent a specific clinico-pathologic spectrum of related, non-neoplastic benign fibro-osseous lesions. The most recent WHO classification (2005) defines them as bone-related lesions (9262/0). The controversial presence of cementum was solved by complete removal of the term "cemento" in the revised classification of tumors. Normal bone architecture is replaced by fibroblasts and collagen fibers containing variable amounts of mineralized material. Osseous dysplasias are often identified as an incidental finding on standard dental radiographs of adults. They usually cause no specific symptoms or obvious clinical findings. Four different types of ODs can be distinguished: the periapical osseous dysplasia (POD), the focal osseous dysplasia (FocOD), the florid osseous dysplasia (FOD) and the familial gigantiform cementoma. This case report presents an unusual localization of a periapical osseous dysplasia (POD) in the anterior maxillary bone in a 33-year old female patient of Caucasian origin. Radiological, clinical and histopathological characteristics of the POD and similar benign lesions are defined and discussed.

[Smokeless tobacco: a new risk factor for oral health? A review]. / Rauchloser Tabak (smokeless tobacco): Ein neues Gesundheitsrisiko in der Zahnmedizin? Eine Ubersichtsarbeit.

Due to migration of different ethnic groups, mainly from Africa and Asia, into Switzerland, many traditional products and habits that have not been seen before were also introduced. Smokeless tobacco (ST)--as one of those habits--is a product of increased use in Switzerland, although no sound epidemiological data are presently available. Numerous studies from North-America, Sweden, Asia and Africa could verify the carcinogenic potency of smokeless tobacco and its effects in the developement of oral cancer and different systemic disorders. For dental professionals and their team it is important to detect ST-associated lesions, and to tell the patients about the potential harmful sequelae of ST products. The present review focusses on the different types of RT products and their effects on oral health.

Mathematical equations for dental implant stability patterns during the osseointegration period, based on previous resonance frequency analysis studies.

BACKGROUND: Total stability of dental implant can be obtained from resonance frequency analysis (RFA) device, but without primary and secondary stability values. PURPOSE: To formulate mathematical equations for dental implant stability patterns during the osseointegration period. MATERIALS AND METHODS: An online systematically search of the literature between January 1996 and December 2017 was performed for all prospective clinical trials that measured implant stability using RFA device during the osseointegration period. Initial mathematical function with adjustable parameters were created. Then curve-fitting was performed using a computerized program to formulate mathematical equations stability patterns. RESULTS: Nine publications (24 study groups) were included in the mathematical analysis. Curve fitting with low sum of squared errors could be applied in all studies, except one. The stability has been divided into high, medium, and low stability. The curve fitting showed stability dip areas and intersection point which predict the returning of the stability to reach the primary stability. The study groups with low primary stability showed the poorest results, the high and medium stability group showed the stability pattern following the assumed primary stability pattern according to the mathematic equations. CONCLUSIONS: The model of primary and secondary stability could be predicted from the proposed equations.

Dental mutilations and associated alveolar bone pathology in African skulls of the anthropological skull collection, Charité, Berlin.

BACKGROUND: Dental mutilations (DM) were and are still common among people in Africa. The purpose of this study was to examine DM in 33 skulls from Cameroon, which have been collected around the turn of the 20th century (anthropological collection, Berlin Museum of Medical History). MATERIALS AND METHODS: From the files of the museum, locations and/or tribal origin were recorded. DM classification described by De Almeida was used (1957). RESULTS: DM of the inverted V-shaped type was most common (30.3%). Pulp exposure was seen in 10 cases (30.3%). Periapical ostitis/radicular cysts were seen in nine cases (27.3%). General loss of alveolar bone was seen in all cases with a marked loss of the maxillary anterior labial alveolar bone plate in six cases (18.2%). CONCLUSIONS: DM may result in alveolar bone pathology characterised by inflammatory changes such as periapical ostitis or formation of radicular cysts.

Areca chewing in Xiangtan, Hunan province, China: interviews with chewers.

BACKGROUND: To report on Areca chewing (AC) in Xiangtan, Hunan province, China, and to test the knowledge of chewers related to side effects of the habit. METHODS: Interviews with 276 individuals were performed. A questionnaire including general data, chewing habits, educational level and knowledge about side effects were used. Data were analysed using SPSS. Chi-square test was used at a significance level of P < 0.05. RESULTS: Around 257 individuals were chewers (male: 54.1%; female: 45.9%) and 19 were former chewers (male: 31.6%; female: 68.4%). Mean age of chewers was 36.1 years. Around 42.4% of chewers smoked; 58.0% had a drinking habit. Average period of chewing was 11.2 years. Around 88.3% of chewers did not include the nut (seed). Around 79.0% considered AC habits negative for general health and 85.2% for oral health. CONCLUSIONS: Most respondents did not know that AC may induce oral submucous fibrosis and oral cancer. The 'betel quid' chewed in Xiangtan usually does not contain Areca 'nut' (seed, endosperm), but consists of the husk. As no studies on the chemical composition of the Areca husk have been published such investigations are urgently needed.

A review of betel quid chewing, oral cancer and precancer in Mainland China.

On the Chinese mainland, betel quid (BQ) chewing is common in the Hunan and Hainan provinces. The BQ chewing habit in Hunan consists of dried husks and betel nuts, which are sold as industrially packaged, areca nut-based products. In Hainan, the fresh nut is chewed. Tobacco is not added. Reported prevalence of BQ chewing in Hunan province is high (64.5-82.7%). Oral diseases associated with BQ chewing are oral submucous fibrosis (OSF), oral leukoplakia (OL) and oral cancer. Reported prevalence of OSF among BQ chewers ranges from 0.9% to 4.7%. People most commonly affected are between the ages of 30 and 39 years, and 40 and 49 years. The reported prevalence of OL in Hainan ranges from 2.1% to 2.5%. In BQ chewers who also smoke, the reported prevalence is 20.3%. The prevalence of OL in Hunan province ranges from 0.1% to 0.5%. The prevalence of oral cancer among BQ chewers is low, ranging from 0.02% to 0.05%. In cases of OSF, reported prevalence is 2.6% and 1.2%. Presently, data on prevalence of BQ chewing in southern provinces of Mainland China is limited. BQ chewing habits, however, seem to differ between geographic areas. Future case-control studies are necessary to evaluate the risk for oral cancer and other associated oral mucosal diseases resulting from variations in BQ chewing habits.

Morphological findings and energy dispersive X-ray microanalysis of oral amalgam tattoos.

Oral amalgam tattoos (AT) are distinct pigmentations of the oral mucosa resulting from accidental incorporation of dental amalgam in the oral soft tissues. Dental amalgams and in particular mercury, one of the constituents of dental amalgams, have for long been considered toxic. Oral ATs are easily accessible to study soft tissue reaction to amalgam and its degradation products. In this study, 17 oral ATs were examined by transmission electron microscopy and energy dispersive X-ray microanalysis. Ultrastructurally, in the ATs, three kinds of electron-dense particles were observed. The largest particles ranged in size from 0.5 up to several 100 microm. Smaller electron-dense inclusions (0.5-0.1 microm) were seen extracellularly associated with meshworks of elastic fibers and collagen bundles. The third and smallest type of particles (5-30 nm in diameter) was found with basement membranes of small vessels and pericytes and particularly decorating collagen bundles. Element analysis regularly revealed the presence of silver, sulphur, copper and lead in the AT decay products. Mercury was found in only one instance. Tissue reactions due to ATs seem to be minimal. No acute inflammatory changes were seen. Larger inclusions occasionally were surrounded by macrophages and multinucleated cells. TEM and element analysis may in specific cases be helpful in the differential diagnosis of pigmented lesions of the oral mucosa.

Traditional chewing and smoking habits from the point of view of Northern Thai betel quid vendors.

PURPOSE: To evaluate knowledge of betel quid (BQ) vendors in relation to traditional chewing and smoking habits in Northern Thailand. MATERIALS AND METHODS: Interviews of vendors selling BQ and other traditional chewing and smoking items were conducted. Questions related to side effects of BQC were included, as well as questions focusing on why traditional chewing and smoking habits were on the decline. RESULTS: Nineteen stalls in 10 markets were visited and 18 vendors were interviewed (16 women, 2 men, average age 55.0 years, range 28-75 years). Vendors had been present for an average of 21.8 years (range 2-60 years). The number of customers buying BQ regularly was 2-3 per day. More elderly women than men bought BQ. Side effects of BQ on the oral mucosa were largely unknown to vendors. Most respondants thought BQ to be good for teeth. Reasons why young people have given up the BQ habit were black teeth. Miang (fermented tea leaves) and khi yo (traditional cigar) were rarely sold and were considered vanishing habits. CONCLUSIONS: BQ vendors had poor knowledge of the side effects of BQC. BQ vendors unanimously considered traditional habits such as chewing of BQ, miang and smoking of traditional cigars to be on the decline. Nowadays, most of these items are bought to be offered during ceremonies. Generally, traditional habits seem to be replaced by 'modern' lifestyle habits such as cigarette smoking and alcohol consumption. With these changes, general and oral disease patterns will eventually occur.

Facial and dental characteristics of Padaung women (long-neck Karen) wearing brass neck coils in Mae Hong Son Province, Thailand.

INTRODUCTION: Women of the Padaung tribe in Thailand are known to wear brass neck coils (BNC) all their lives. The purpose of this study was to identify the effects of these coils on facial morphology and dental characteristics. METHODS: This study sample included 61 subjects wearing BNC (group I) and 32 subjects not wearing BNC (group II). Each group was subdivided into younger (5-15 years old) and older (more than 15 years old) groups. Facial morphologic variables were assessed by using photographic analysis and direct facial measurements. Dental variables were assessed by model analysis. RESULTS: Total and lower face heights in group I were significantly shorter than in group II (P = .04, P <.001, respectively). Upper and lower lip lengths in group I were significantly shorter than in group II (P = .01, P <.001, respectively). Overjet in group I was significantly larger than in group II (P = .01). Mandibular intercanine width in group I was significantly narrower than in group II (P = .04). Maxillary and mandibular incisor inclinations in the older subset of group I were more proclined than in the older subgroup of group II (P = .04, P = .03, respectively). Palatal height in the older subgroup of group I was less than in the older subgroup of group II (P <.001). Maximum mouth opening in group I was significantly less than in group II (P = .02). CONCLUSIONS: The findings indicated considerable effects on facial morphology and dental characteristics in Padaung women wearing BNC. Deformations could be avoided if they gave up this custom.