Applied Sciences

Research

10 pages, 983 KiB

Open AccessArticle

Orthodontics Surgical Assistance (Piezosurgery^®): Experimental Evidence According to Clinical Results

by Dario Bertossi, Dario Donadello, Giamaica Conti, Luca Calogero Carletta, Andrea Sbarbati, Claudia Corega, Alessandra Luise Marie Magistretti, Alessandra Lucchese, Giovanni Salzano, Giulia Ricciardi and Pier Francesco Nocini

Appl. Sci. 2022, 12(3), 1048; https://doi.org/10.3390/app12031048 - 20 Jan 2022

Viewed by 1883

Abstract

Orthodontic tooth movement (OTM) is based on intermitted or continuous forces applied to teeth, changing the mechanical loading of the system and arousing a cellular response that leads to bone adaptation. The traditional orthodontic movement causes a remodeling of the alveolar bone and [...] Read more.

Orthodontic tooth movement (OTM) is based on intermitted or continuous forces applied to teeth, changing the mechanical loading of the system and arousing a cellular response that leads to bone adaptation. The traditional orthodontic movement causes a remodeling of the alveolar bone and changes in the periodontal structures that lead to tooth movement. The use of a piezoelectric instrument in orthodontic surgery has already shown great advantages. The purpose of this study is to rank the behavior of inflammatory mediators in accelerating orthodontic tooth movement. Ten patients with malocclusion underwent orthodontic surgical treatment, which included a first stage of surgically guided orthodontic movement (monocortical tooth dislocation and ligament distraction, MTDLD) to accelerate orthodontic movements. In all cases, corticotomy was performed by Piezosurgery. Bone and dental biopsy was executed to evaluate changes in the cytokines IL-1beta, TNF-alpha and IL-2 in different time intervals (1, 2, 7, 14 and 28 days). The molecular mediators are IL-1 beta, TNF-alpha and IL-2. Immediately after the surgical procedure there was a mild expression of the three molecular markers, while the assertion of IL-1 beta and TNF-alpha reached the maximum value after 24 h and 48 h, indicating a strong activation of the treated tissues. The Piezosurgery^® surgical technique induces an evident stress in short times, within 24–48 h from the treatment, but it decreases significantly during the follow-up. Full article

(This article belongs to the Special Issue From Childhood to Adulthood: New Trends in Multidisciplinary Orthodontics)

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13 pages, 3188 KiB

Open AccessArticle

Mechanical Behaviour and Primary Stability of a Self-Condensing Implant: A Laboratory Critical Simulation of a Severe Maxillary Atrophy on Polyurethane Lamina

by Luca Comuzzi, Giovanna Iezzi, Alessandra Lucchese, Natalia Di Pietro, Pierluigi Balice, Camillo D’Arcangelo, Adriano Piattelli and Margherita Tumedei

Appl. Sci. 2022, 12(3), 966; https://doi.org/10.3390/app12030966 - 18 Jan 2022

Cited by 2 | Viewed by 1598

Abstract

Background: Posterior maxillary atrophies could emerge after the loss of teeth, trauma, infections, or lesions that often require regenerative approaches. In these critical conditions, the achievement of implant primary stability represents a clinical challenge in the operative practice. Therefore, a two-stage approach is [...] Read more.

Background: Posterior maxillary atrophies could emerge after the loss of teeth, trauma, infections, or lesions that often require regenerative approaches. In these critical conditions, the achievement of implant primary stability represents a clinical challenge in the operative practice. Therefore, a two-stage approach is often preferred with a delay of the rehabilitation time and a consistent increasing of the biological and the operative costs. The aim of this study was to evaluate the mechanical behaviour of a self-condenser implant compared to a standard implant in a critical simulation on different thicknesses and densities of polyurethane lamina. Materials and methods: A total of two implant models were tested: a self-condensing device (test) and a standard implant (control). The study evaluated the insertion torque and the pull-out strength values of the test and control implants inserted in different sizes (1, 2, and 3 mm) and density polyurethane lamina (10, 20, and 30 pcf) for a total of 320 experimental sites. Results: In total, 320 experimental sites were produced in the polyurethane samples. A statistically significant difference of insertion and pull-out torque values between the test and control Implants was found in the different bone densities (p < 0.05). The insertion and pull-out torque values were always higher for the test implants in all experimental conditions. In all bone densities, the insertion torque values were higher than the pull-out torque values. The self-condenser dental implant design evaluated in this in vitro study showed a high level of stability in all experimental conditions. Conclusions: The test implant could represent a useful tool for a one-stage surgical approach in the presence of limited residual native bone as an alternative to a delayed technique. Full article

(This article belongs to the Special Issue From Childhood to Adulthood: New Trends in Multidisciplinary Orthodontics)

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13 pages, 612 KiB

Open AccessArticle

Speech Disorders in Dysgnathic Adult Patients in the Field of Severity of Primary Dysfunction

by Anna Lichnowska and Marcin Kozakiewicz

Appl. Sci. 2021, 11(24), 12084; https://doi.org/10.3390/app112412084 - 18 Dec 2021

Cited by 2 | Viewed by 2906

Abstract

The normative functioning of the stomatognathic system and masticatory apparatus requires specific coordination between several structures such as teeth with good occlusion, tongue without ankyloglossia or thrusting, and well-balanced facial muscles. This study aimed to evaluate the influence of non-normative primary functions such [...] Read more.

The normative functioning of the stomatognathic system and masticatory apparatus requires specific coordination between several structures such as teeth with good occlusion, tongue without ankyloglossia or thrusting, and well-balanced facial muscles. This study aimed to evaluate the influence of non-normative primary functions such as breathing, swallowing, biting and chewing on the consonant pronunciation outcome in adults affected with facial skeletal deformities. Moreover, the authors would like to promote a new kind of speech therapy-orthognathic speech therapy. A total of 181 adults affected by skeletal class II and III malocclusion were included, along with the relationship between the malocclusion, speech deficiency (20 phonemes tested) and primary function disorders, in the subjects before and after surgical correction. The impact of surgery on pronunciation and primary function improvement and types of Polish phonemes most often misarticulated by Polish adults were also examined. Patients underwent combined treatment and received a full speech pathology examination. The treatment improved speech (p < 0.05), and primary functions (p < 0.05). Palatal, alveolar (p < 0.05), fricatives (p < 0.05), and labiodental consonant pronunciation (p < 0.05) improved. The surgical correction of malocclusion leads to better oral motor control and articulation of Polish consonants in adults. Full article

(This article belongs to the Special Issue From Childhood to Adulthood: New Trends in Multidisciplinary Orthodontics)

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8 pages, 807 KiB

Open AccessArticle

Computer Assisted Surgery and 3D Printing in Orthopaedic Oncology: A Lesson Learned by Cranio-Maxillo-Facial Surgery

by Giuseppe Bianchi, Tommaso Frisoni, Benedetta Spazzoli, Alessandra Lucchese and Davide Donati

Appl. Sci. 2021, 11(18), 8584; https://doi.org/10.3390/app11188584 - 15 Sep 2021

Cited by 8 | Viewed by 2482

Abstract

Primary bone sarcomas are rare tumors and surgical resection in combination with chemo and radiation therapy is the mainstay of treatment. Some specific anatomical sites still represent a reconstructive challenge due to their complex three-dimensional anatomy. In recent years, patient specific instruments along [...] Read more.

Primary bone sarcomas are rare tumors and surgical resection in combination with chemo and radiation therapy is the mainstay of treatment. Some specific anatomical sites still represent a reconstructive challenge due to their complex three-dimensional anatomy. In recent years, patient specific instruments along with 3D printing technology has come to represent innovative techniques in orthopaedic oncology. We retrospectively reviewed 23 patients affected by primary bone sarcoma treated with patient-specific instruments and 3D printing custom made prostheses. At follow up after approximately two years, the infection rate was 26%, mechanical complication rate 13%, and local recurrence rate 13% (with a five-years implant survival rate of 74%). Based on our experience, patient-specific instruments and 3D custom-made prostheses represents a reliable and safe technique for improving the accuracy of resection of primary bone tumour, with a particular use in pelvic surgery ameliorating functional results. Full article

(This article belongs to the Special Issue From Childhood to Adulthood: New Trends in Multidisciplinary Orthodontics)

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10 pages, 8361 KiB

Open AccessArticle

Pain Assessment during Gnathological Treatment of Temporomandibular Myofascial Pain through Mandibular Repositioning Splints Designed after a Posture-Stabilometric Evaluation

by Michele D’Attilio, Federica Migliore, Francesco Moscagiuri and Francesco Caroccia

Appl. Sci. 2021, 11(18), 8303; https://doi.org/10.3390/app11188303 - 7 Sep 2021

Cited by 2 | Viewed by 2043

Abstract

The aim of the study is to evaluate the effectiveness of two complementary mandibular repositioning splints (SVED and MORA) designed after a preliminary patients’ posture-stabilometric evaluation in treatment for temporomandibular myofascial pain (TMP) using the Pain-Intensity Numeric Rating Scale (PI-NRS) assessment. Eighty-six consecutive [...] Read more.

The aim of the study is to evaluate the effectiveness of two complementary mandibular repositioning splints (SVED and MORA) designed after a preliminary patients’ posture-stabilometric evaluation in treatment for temporomandibular myofascial pain (TMP) using the Pain-Intensity Numeric Rating Scale (PI-NRS) assessment. Eighty-six consecutive sportive non-agonistic subjects with TMP were randomly divided in two groups. Forty-two wear mandibular repositioning splints designed by a posture-stabilometric evaluation, thus constituting the test group. The other 44 subjects were not subjected to any treatment, thus represented the control group. To record pain intensity, subjects in both groups were asked to fill in a PI-NRS which ranged from 0 (no pain) to 10 (worst imaginable pain). In the test group, PI-NRS was assessed three times: before starting therapy (t0), after 4 months (t1) and after 8 months (t2) of treatment. Instead, in the control group PI-NRS was recorded during the first visit (t0) and after 8 months (t2). The Friedman test showed a statistically significant decrease in PI-NRS mean scores after 4 (t1) and 8 (t2) months from the start of the gnathological therapy with mandibular repositioning splints, (p < 0.001) in test group. There is enough evidence to assess that occlusal splint therapy for mandibular repositioning (MORA and SVED) designed through a posture-stabilometric evaluation could be considered in the treatment of temporomandibular myofascial pain. Full article

(This article belongs to the Special Issue From Childhood to Adulthood: New Trends in Multidisciplinary Orthodontics)

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8 pages, 923 KiB

Open AccessArticle

Stimulation of Myofascial Trigger Points in the Sternocleidomastoid Evokes Facial Thermal Response Correlated with the Referred Pain

by Francesco Caroccia, Lucia Raimondi, Francesco Moscagiuri and Michele D’Attilio

Appl. Sci. 2021, 11(14), 6510; https://doi.org/10.3390/app11146510 - 15 Jul 2021

Cited by 2 | Viewed by 3126

Abstract

The purpose of this research is to identify and correlate the referred pain evocated by myofascial trigger points (TrPs) pressure pain threshold (PPT) in the sternocleidomastoid muscle using thermal infrared imaging (IR). Facial IR images of 46 volunteers (21 male and 25 female, [...] Read more.

The purpose of this research is to identify and correlate the referred pain evocated by myofascial trigger points (TrPs) pressure pain threshold (PPT) in the sternocleidomastoid muscle using thermal infrared imaging (IR). Facial IR images of 46 volunteers (21 male and 25 female, average age 32 ± 6.3) undergoing PPT of five TrPs locations on the sternocleidomastoid belly were recorded. Each PPT lasted 10 s, with an interstimulus interval of 2 min. Sixteen thermal IR images were recorded for each subject: at baseline (t0), 2 s before PPT (t1), 2 s (t2) and 60 s (t3) after PPT of each TrPs location. During the interstimulus interval, subjects were asked to draw over a head–neck template displayed on a computer screen the areas of referred pain eventually evoked by the stimulation and the referred pain intensity by means of a Visual Analogue Scale (VAS). The VAS template was then superimposed with the IR records. Two temperature (T) variations were calculated: ΔT₁ = T(t2) − T(t1) and ΔT₂ = T(t3) − T(t1). Differences in ∆T range ≥ 0.2 °C have been considered significant. In 77% of the superimpositions, the referred pain area corresponded to a ΔT₂ ≥ 0.2 °C while only the 59% corresponded to a ΔT₁ ≥ 0.2 °C. In 19% of superimpositions, a ΔT₂ ≥ 0.2 °C did not correspond to a referred pain area indicated by the patient, and this percentage lowers to 4% for ΔT₁ ≥ 0.2 °C. None of the areas that reported a VAS of 0 or 1 showed a ΔT₁ ≥ 0.2 °C or a ΔT₂ ≥ 0.2 °C. Considering the limitations of this pilot study, IR could be used to identify referred pain evocated by TrPs on sternocleidomastoid muscle. Full article

(This article belongs to the Special Issue From Childhood to Adulthood: New Trends in Multidisciplinary Orthodontics)

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7 pages, 530 KiB

Open AccessArticle

Effects of Pacifiers on Peripheral Capillary Oxygen Saturation during Wake Time

by Luca Levrini, Francesca Riccaboni, Vittorio Maurino, Lorenzo Azzi and Luana Nosetti

Appl. Sci. 2021, 11(13), 6042; https://doi.org/10.3390/app11136042 - 29 Jun 2021

Viewed by 2902

Abstract

We studied the variations in peripheral capillary oxygen saturation (SpO2) during wake time in relation to pacifier use and to the following different positions: supine at 0°, supine at 30° (in babies under one year) vs. sitting (in babies between 1 and 3 [...] Read more.

We studied the variations in peripheral capillary oxygen saturation (SpO2) during wake time in relation to pacifier use and to the following different positions: supine at 0°, supine at 30° (in babies under one year) vs. sitting (in babies between 1 and 3 years of age). We observed 54 patients under the age of three years, weighing over 1.800 g. Peripheral oxygen saturation was recorded for at least 40 min per patient in the following positions: 20 min lying supine at 0° (10 min with a pacifier and 10 min without); 20 min lying supine at 30° inclination or in a sitting position if the baby was older than one year (10 min with a pacifier and 10 min without). Pacifier use improved the peripheral oxygen saturation both in the 0° supine position, and at 30° in a sitting position. No significant differences were observed in the SpO2 levels comparing the different positions. In conclusion a pacifier thus seems to have a positive effect on respiration. Full article

(This article belongs to the Special Issue From Childhood to Adulthood: New Trends in Multidisciplinary Orthodontics)

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11 pages, 2325 KiB

Open AccessArticle

Comparative In Vitro Evaluation of the Primary Stability in D3 Synthetic Bone of Two Different Shapes and Pitches of the Implant Threads

by Stefano Fanali, Margherita Tumedei, Pamela Pignatelli, Alessandra Lucchese, Francesco Inchingolo, Adriano Piattelli and Giovanna Iezzi

Appl. Sci. 2021, 11(12), 5612; https://doi.org/10.3390/app11125612 - 17 Jun 2021

Viewed by 3007

Abstract

Background: Implant primary stability can be affected by several factors related to implant macrogeometry, local anatomy, and surgical techniques. The aim of this research was to study primary stability on polyurethane foam sheets of wide-threaded implant design compared to narrow-threaded implants. Materials and [...] Read more.

Background: Implant primary stability can be affected by several factors related to implant macrogeometry, local anatomy, and surgical techniques. The aim of this research was to study primary stability on polyurethane foam sheets of wide-threaded implant design compared to narrow-threaded implants. Materials and methods: Two different implant designs were positioned on D3 density polyurethane blocks in a standardized environment: the wide-threaded implant and the narrow-threaded implant, for a total of 160 specimens. Moreover, for each group, two different sizes were considered: 3.8 mm × 12 mm and 4.8 mm × 12 mm. The insertion torque (IT) values, the removal strength (RT), and the Periotest analyses were evaluated. Results: A significantly higher IT and RT was reported for wide-threaded implants and two-stage implants (p < 0.01), compared to the narrow-threaded implants. The diameters seemed to provide a significant effect on the primary stability for both implants’ geometry (p < 0.01). A higher mean of the one-stage implant was evident in the Periotest measurements (p < 0.01). Conclusions: Both of the implants showed sufficient stability in polyurethane artificial simulation, while the wide-threaded implant design showed a higher primary stability on alveolar cancellous synthetic bone in vitro. Additionally, the prosthetic joint connection seemed to have a determinant effect on Periotest analysis, and the one-stage implants seemed to provide a high stability of the fixture when positioned in the osteotomy, which could be important for the immediate loading protocol. Full article

(This article belongs to the Special Issue From Childhood to Adulthood: New Trends in Multidisciplinary Orthodontics)

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11 pages, 545 KiB

Open AccessArticle

Clinical and Instrumental TMJ Evaluation in Children and Adolescents with Juvenile Idiopathic Arthritis: A Case—Control Study

by Michele D’Attilio, Beatrice Di Carlo, Francesco Caroccia, Francesco Moscagiuri, Debora Mariarita d’Angelo, Francesco Chiarelli, Felice Festa and Luciana Breda

Appl. Sci. 2021, 11(12), 5380; https://doi.org/10.3390/app11125380 - 10 Jun 2021

Cited by 4 | Viewed by 3113

Abstract

To investigate temporomandibular joint (TMJ) involvement signs such as muscle pain, the ratio of masseter and temporal muscle activity, mouth opening width and jaw deviation during mouth opening in children and adolescents with juvenile idiopathic arthritis (JIA), a group of 32 subjects with [...] Read more.

To investigate temporomandibular joint (TMJ) involvement signs such as muscle pain, the ratio of masseter and temporal muscle activity, mouth opening width and jaw deviation during mouth opening in children and adolescents with juvenile idiopathic arthritis (JIA), a group of 32 subjects with JIA and a control group of 32 healthy subjects were evaluated. Data were collected clinically by muscle palpation (masseters, anterior temporalis and sternocleidomastoids) and instrumental analysis (electromyography and kinesiography). Higher pain was registered in the masseter and sternocleidomastoid muscles on both sides and in the right anterior temporalis in the JIA group compared to the control group (p < 0.05). Electromyography showed no statistically significant difference in the frequency of the pathological ratio of masseter and temporal muscle activity (MM/TA < 1) both in the JIA group and in the control group. Kinesiography showed a statistically significant difference in mouth opening width and jaw deviation during mouth opening between the groups (p < 0.05): JIA subjects showed lower mouth opening values and wider deviation on mouth opening; 29 out of 32 JIA subjects showed jaw deviation towards the right side. JIA affects the TMJ, causing myalgia in the head and neck muscles, a reduction in mouth opening width and an increase in jaw deviation during mouth opening. Full article

(This article belongs to the Special Issue From Childhood to Adulthood: New Trends in Multidisciplinary Orthodontics)

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12 pages, 2959 KiB

Open AccessArticle

Analysis of the Complications in Patients Undergoing Orthognathic Surgery by Piezosurgery^®: A 13 Years Retrospective Study

by Dario Bertossi, Massimo Albanese, Dario Donadello, Luca Calogero Carletta, Riccardo Nocini, Giulia Ricciardi and Alessandra Lucchese

Appl. Sci. 2021, 11(9), 4271; https://doi.org/10.3390/app11094271 - 8 May 2021

Cited by 2 | Viewed by 3007

Abstract

Orthognathic surgery is a branch of maxillo-facial surgery increasingly in demand, which deals with the correction of skeletal deformities. The aim of the present study is to identify the most common post-operative complications following orthognathic bimaxillary surgery performed by means of Piezosurgery^® [...] Read more.

Orthognathic surgery is a branch of maxillo-facial surgery increasingly in demand, which deals with the correction of skeletal deformities. The aim of the present study is to identify the most common post-operative complications following orthognathic bimaxillary surgery performed by means of Piezosurgery^®. Furthermore, through an examination of the available scientific literature, we wanted to establish whether the frequency of postoperative complications were consistent with those already reported. A retrospective study on 58 patients who underwent orthognathic surgery with a bilateral sagittal osteotomy (BSSO) of the mandibular bone branch, maxillary surgery with Le Fort I mono-segmented or multi-segmented approach, and genioplasty technique using Piezosurgery^®. The complications taken into consideration were disorders of the temporomandibular joint (TMJ), paraesthesia and hypoesthesia, asymmetries, nose enlargement, nasal septum deviation, nasal obstruction, dental discolorations, pulpal necrosis, occlusion and masticatory efficiency, gingival recession, periodontal problems, dysgeusia, nausea and vomiting, weeping alterations, hearing problems, delayed healing, superinfection, removal of synthesis means, reoperation, cicatricial outcome, and bilateral pneumothorax. It has been highlighted that a number and type of postoperative complications matched those reported by the most recent literature reviews. Temporomandibular disorders and paraesthesia were the most common ones. The only complication rate that differed from the literature was nerve damage, which was significantly lower. Post-surgical complications depend on the used surgical techniques, clinical work, and treatment methods. The use of piezoelectric devices in orthognathic surgery operations provides an innovative, safe, and effective technique compared to traditional methods. Full article

(This article belongs to the Special Issue From Childhood to Adulthood: New Trends in Multidisciplinary Orthodontics)

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12 pages, 3629 KiB

Open AccessArticle

Intermolar Mandibular Distraction Osteogenesis—A Preliminary Report

by Suen A. N. Lie, Britt H. B. T. Engelen, Veronique C. M. L. Timmer, Nico M. P. Vrijens, Paolo Asperio and Peter A. W. H. Kessler

Appl. Sci. 2021, 11(9), 4118; https://doi.org/10.3390/app11094118 - 30 Apr 2021

Cited by 1 | Viewed by 6191

Abstract

Background: Dental Class II is the most common indication for combined orthodontic-orthognathic treatment. Intermolar mandibular distraction osteogenesis (IMDO) treatment was performed during the growth spurt, to avoid surgery at a later age. The aim of this study is to present our first experience [...] Read more.

Background: Dental Class II is the most common indication for combined orthodontic-orthognathic treatment. Intermolar mandibular distraction osteogenesis (IMDO) treatment was performed during the growth spurt, to avoid surgery at a later age. The aim of this study is to present our first experience with IMDO. Methods: This is a retrospective case series of patients who underwent an IMDO. All patients showed mandibular retrognathism, and orthodontic treatment with functional appliances was not successful. Results: In total, 20 patients (mean age of 14.8 years (SD = 0.9 ys) were included. All patients achieved a Class I occlusion. An average length gain of 9.6 mm (SD = 3.7 mm) was reached. In one patient an abscess occurred. Nine patients presented with root fractures of the second molar; three were lost, one treated endodontically. The average time between insertion and removal of the distractors was 4.6 months (SD = 1.5 mths). In one case a premature consolidation was seen. Conclusion: We achieved satisfactory results with IMDO, although undesirable effects occurred. An advantage is the manageable overall treatment time. Open questions concern the occurrence of root fractures. Furthermore, the question of long-term stability is open. The question of dynamic distraction treatment in relation to temporomandibular joint changes can only be answered in the long term. Full article

(This article belongs to the Special Issue From Childhood to Adulthood: New Trends in Multidisciplinary Orthodontics)

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8 pages, 1458 KiB

Open AccessArticle

Analysis of Tongue Function from the Orthodontist’s Point of View: Not Only a Matter of Deglutition

by Andrea Deregibus, Simone Parrini, Maria Chiara Domini, Jacopo Colombini and Tommaso Castroflorio

Appl. Sci. 2021, 11(6), 2520; https://doi.org/10.3390/app11062520 - 11 Mar 2021

Cited by 1 | Viewed by 3200

Abstract

Many studies report that maxillofacial growth is influenced by genetic and environmental elements and that incorrect breathing, chewing, sucking, and swallowing are promoting factors of malocclusion. This study aims to evaluate the function and the influence of the tongue positions in patients with [...] Read more.

Many studies report that maxillofacial growth is influenced by genetic and environmental elements and that incorrect breathing, chewing, sucking, and swallowing are promoting factors of malocclusion. This study aims to evaluate the function and the influence of the tongue positions in patients with Angle class III malocclusion, maxillary hypoplasia, and posterior crossbite. One hundred patients, aged between 6 and 12 years old, were enrolled for the study. In the first group, patients with a diagnosis of class III malocclusion, affected by maxillary hypoplasia, skeletal class III, and posterior dental crossbite were recruited. In the control group, not treated patients with no malocclusion, skeletal class I, and without posterior dental crossbite were selected. Regarding atypical deglutition, no statistical differences were reported between the two groups, and 14% of patients reported ankyloglossia. Statistical differences were found in tongue rest position and during the execution of “hold and pull” and “chuck” exercises. Results obtained in this observational study showed that the clinician (orthodontist or general dentist) should analyze the presence/absence of atypical swallowing, the anatomical and functional aspects, and the tongue behavior in the rest position. Full article

(This article belongs to the Special Issue From Childhood to Adulthood: New Trends in Multidisciplinary Orthodontics)

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Review

Jump to: Research, Other

17 pages, 282 KiB

Open AccessReview

Current Trends in Skeletal Borderline Patients: Surgical versus Orthodontic Treatment Decisions—What Is the Evidence?

by Cristina Incorvati, Chiara Gulotta, Fiammetta Maria Clara Mirabile, Giovanni Badiali and Claudio Marchetti

Appl. Sci. 2022, 12(9), 4636; https://doi.org/10.3390/app12094636 - 5 May 2022

Cited by 3 | Viewed by 3151

Abstract

Background: The aim is to assess the current evidence-based knowledge about treatment decisions for skeletal malocclusion in adult borderline patients. Methods: A literature search was conducted through three databases. Inclusion criteria were restricted to systematic reviews, prospective, retrospective, and control studies. [...] Read more.

Background: The aim is to assess the current evidence-based knowledge about treatment decisions for skeletal malocclusion in adult borderline patients. Methods: A literature search was conducted through three databases. Inclusion criteria were restricted to systematic reviews, prospective, retrospective, and control studies. Only articles comparing orthodontic camouflage and orthognathic surgical treatment for Class II and Class III malocclusions in adult patients were selected to be reviewed. Results: Seven articles concerning Class II and nine concerning Class III met the inclusion criteria. Scientific evidence was poor due to low methodological quality. Conclusions: Surgical treatment was found to better improve skeletal and soft-tissue cephalometric values, whereas camouflage treatment mainly involved dentoalveolar movements. Aesthetic changes, as perceived by the patient, were not significantly different in the two groups. Recently improved surgical techniques, differing from those described in the analyzed articles, may provide similar or more stable outcomes compared with orthodontic-only treatment. Although some cephalometric variables can be helpful, the most important parameters for treatment selection are the patient’s presenting complaint and their self-image perception. Further studies with larger sample sizes and similar pretreatment conditions, and considering patient self-evaluation of esthetics and function, should be undertaken. Full article

(This article belongs to the Special Issue From Childhood to Adulthood: New Trends in Multidisciplinary Orthodontics)

11 pages, 442 KiB

Open AccessReview

The Effect of Removable Orthodontic Appliances on Oral Microbiota: A Systematic Review

by Alessandra Lucchese, Chiara Bonini, Maddalena Noviello, Maria Teresa Lupo Stanghellini, Raffaella Greco, Jacopo Peccatori, Antonella Biella, Elena Tassi, Valeria Beretta, Fabio Ciceri, Marta Marcolina, Enrico Gherlone and Maurizio Manuelli

Appl. Sci. 2021, 11(6), 2881; https://doi.org/10.3390/app11062881 - 23 Mar 2021

Cited by 13 | Viewed by 4888

Abstract

Background (1): Removable orthodontic appliances may favor plaque accumulation and oral microbe colonization. This might be associated with intraoral adverse effects on enamel or periodontal tissues. The proposed systematic review was carried out to evaluate qualitatively and quantitatively the microbiological changes occurring during [...] Read more.

Background (1): Removable orthodontic appliances may favor plaque accumulation and oral microbe colonization. This might be associated with intraoral adverse effects on enamel or periodontal tissues. The proposed systematic review was carried out to evaluate qualitatively and quantitatively the microbiological changes occurring during orthodontic therapy with removable orthodontic appliances. Methods (2): PubMed, Cochrane Library, Embase, Web of Science, Scopus, Ovid Medline, and Dentistry and Oral Sciences Source were searched. The research included every article published up to January 2020. The Preferred Reporting Items for Reporting Systematic reviews and Meta Analyses (PRISMA) protocol and the “Swedish Council on Technology Assessment in Health Care Criteria for Grading Assessed Studies” (SBU) method were adopted to conduct this systematic review. Results (3): The current study has a moderate evidence, demonstrating that removable appliances do influence the oral microbiota. Significant alterations occur just 15 days after the beginning of therapy, independently from the type of appliance. Furthermore, the levels of oral pathogens decrease significantly or even returned to pre-treatment levels several months later the therapy end. Conclusions (4): This review suggests that orthodontic treatment with removable appliances induces changes to oral microflora, but these alterations might not be permanent. Full article

(This article belongs to the Special Issue From Childhood to Adulthood: New Trends in Multidisciplinary Orthodontics)

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Other

Jump to: Research, Review

12 pages, 5005 KiB

Open AccessCase Report

Fixed Flexible Spiral Wire Retainers and Unwanted Tooth Movements: A Case Report

by Pauline A. J. Steegmans, Ronald E. G. Jonkman and Jan de Lange

Appl. Sci. 2023, 13(2), 922; https://doi.org/10.3390/app13020922 - 9 Jan 2023

Cited by 3 | Viewed by 4312

Abstract

This case report presents a study of unwanted tooth movements during the retention phase after orthodontic treatment. The early recognition of these unwanted tooth movements is paramount for patients and clinicians to prevent the associated negative consequences. A 21-year-old male presented with aesthetic [...] Read more.

This case report presents a study of unwanted tooth movements during the retention phase after orthodontic treatment. The early recognition of these unwanted tooth movements is paramount for patients and clinicians to prevent the associated negative consequences. A 21-year-old male presented with aesthetic complaints regarding his upper front teeth. He underwent orthodontic treatment at the age of 9 years and 11 months and finished his treatment 2 years and 11 months later. Flexible spiral wires (FSW) were bonded to the anterior segment of the upper and lower jaws to stabilize the end result. The failure of the fixed retainers had never occurred previously. The diagnostic assessment demonstrated a previously orthodontically treated class I malocclusion with excessive angulation and torque differences in the maxillary anterior segment. To correct the position of the maxillary anterior segment and prevent further misalignment, the patient received orthodontic re-treatment. Thereafter, the result was retained with fixed braided-rectangular-wire (BRW) retainers located at 12–22 and 33–43 and a vacuum-formed retainer (VFR) in the maxilla. The end result appeared to be stable after 28 months of retention. Unwanted tooth movements can occur during the orthodontic retention phase and might result from the use of fixed flexible spiral wire retainers. Follow-up appointments are recommended to monitor the stability and recognize these movements. Full article

(This article belongs to the Special Issue From Childhood to Adulthood: New Trends in Multidisciplinary Orthodontics)

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10 pages, 7038 KiB

Open AccessCase Report

Custom-Made Alloplastic Prosthetic Implant to Treat Temporomandibular Joint Ankylosis in Pediatric Patients: A Case Study

by Andrea Lazzarotto, Alessandro Tel, Riccardo Nocini, Luca Raccampo, Salvatore Sembronio, Fabio Costa and Massimo Robiony

Appl. Sci. 2022, 12(1), 142; https://doi.org/10.3390/app12010142 - 24 Dec 2021

Cited by 7 | Viewed by 2887

Abstract

Temporomandibular Joint (TMJ) ankylosis represents a fairly common condition which surgeons need to face. According to Rowe, it can be defined as a restricted functional capacity of the jaw with limited movements owing to bony or fibrous adhesions between the condyle and either [...] Read more.

Temporomandibular Joint (TMJ) ankylosis represents a fairly common condition which surgeons need to face. According to Rowe, it can be defined as a restricted functional capacity of the jaw with limited movements owing to bony or fibrous adhesions between the condyle and either glenoid fossa, disc or eminence (or both). It can become a disease which impacts patients’ daily life, who suffer from limited mandibular excursion with reduced intercisal opening, anterior open bite, inability to swallow, sleep disorders, and speech problems. In children this may also result in abnormal mandibular and facial growth. In this paper, we deal with the case of a child with an important momolateral ankylosis, previously treated surgically with Costochondral Grafting arthroplasty without success and subsequently treated with a custom-made prosthesis. Full article

(This article belongs to the Special Issue From Childhood to Adulthood: New Trends in Multidisciplinary Orthodontics)

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The Usefulness of Modified Mallampati Score and CT Upper Airway Volume Measurements in Diagnosing OSA among Patients with Breathing-Related Sleep Disorders

by Bartosz Dalewski, Agata Kamińska, Aleksandra Syrico, Alicja Kałdunska, Łukasz Pałka and Ewa Sobolewska

Appl. Sci. 2021, 11(9), 3764; https://doi.org/10.3390/app11093764 - 22 Apr 2021

Cited by 15 | Viewed by 3593

Abstract

Background: Obstructive sleep apnea (OSA) is a condition causing restriction of the airflow through the upper airways during sleep, despite preserved inspiratory muscle activity. This may lead to the development of secondary hypertension, ischemic heart disease, myocardial infarction, and arrhythmia. Moreover, the prevalence [...] Read more.

Background: Obstructive sleep apnea (OSA) is a condition causing restriction of the airflow through the upper airways during sleep, despite preserved inspiratory muscle activity. This may lead to the development of secondary hypertension, ischemic heart disease, myocardial infarction, and arrhythmia. Moreover, the prevalence of OSA is on the rise. Methods: Comparison of scores from the Berlin Questionnaire, modified Mallampati scores (MMP), pulse oximetry readings and Upper Airway Volume (UAV) data obtained from CBCT (Cone Beam Computed Tomography). The study group of 129 patients of both sexes reporting sleep-related breathing problems completed the Berlin Questionnaire, had their oxygen saturation (SpO2) measured with a PO40 pulse oximeter, and oropharyngeal tissues assessed according to MMP. CBCT scans were put into 3D Amira TM 3D computer analysisto obtain UAV values. Results: Snoring was associated with significantly higher BMI compared to non-snoring patients. Furthermore, snoring patients had higher heart rate, modified Mallampati score, and lower UAV than the non-snoring group. The multifactorial analysis showed MMP as a useful indicator of the risk of snoring (OR = 7.468 (3863–14, 507, p < 0.001)). Conclusions: The composition of MMP together with UAV and the Berlin questionnaire might be reliable indicators to assess the risk of snoring. Full article

(This article belongs to the Special Issue From Childhood to Adulthood: New Trends in Multidisciplinary Orthodontics)

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