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Diagnosis and Treatment of Craniofacial and Oral Disease

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A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 25498

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Dr. Chider Chen

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Guest Editor

Department of Oral and Maxillofacial Surgery/Pharmacology, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA
Interests: craniofacial; oral; dental; tissue engineering
Special Issues, Collections and Topics in MDPI journals

Dr. Chenshuang Li

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Guest Editor

Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
Interests: craniofacial; tissue regeneration; arthritis; orthodontics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Craniofacial structures are indispensable for speech and eating, and an impairment disrupts whole-body health through malnutrition and a poor quality of life. Craniofacial structures, such as the teeth, tongue, taste buds, salivary glands, gingiva, and oral mucosa are unique clinical targets due to their highly specialized tissues and compact architecture. In addition, due to the tightly packed and complex anatomy, orofacial soft tissue injuries commonly implicate multiple tissue types; thus, functional unit reconstruction in the orofacial region is more important than single tissue regeneration. Nevertheless, the intraoral nonsterile environment exposes the unique microbiome–host interaction niche, which increases the complexity of craniofacial and oral disease diagnosis and treatment. With the development of 3D imaging, bioprinting, omics analysis, and artificial intelligence, advances have been achieved at both preclinical and translational levels in the area of craniofacial and oral disease. Thus, this Special Issue intends to include both basic and translational advances in the diagnosis and treatment of craniofacial and oral disease. Case reports illustrating rare diseases and unique clinical care and review articles evaluating advanced techniques are also welcomed.

Dr. Chider Chen
Dr. Chenshuang Li
Guest Editors

Manuscript Submission Information

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Keywords

craniofacial
oral
dental
growth and development
CBCT
microbiome
tissue engineering

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Published Papers (9 papers)

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Research

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11 pages, 1826 KiB

Open AccessArticle

Reliability of Cone Beam Computed Tomography in Predicting Implant Treatment Outcomes in Edentulous Patients

by Abdulaziz Alhossan, Yu-Cheng Chang, Tun-Jan Wang, Yu-Bo Wang and Joseph P. Fiorellini

Diagnostics 2023, 13(17), 2843; https://doi.org/10.3390/diagnostics13172843 - 2 Sep 2023

Viewed by 1243

Abstract

Since the development of CBCT has been utilized in dentistry, the images of the CBCT can assist the surgeon to evaluate the anatomy carefully. Despite the value of radiology evaluation, implant procedures may require additional consideration rather than only evaluating the anatomical factors. The purpose of this study is to evaluate the predictability of using CBCT alone to plan for implant placement in edentulous patients digitally. CBCT images were analyzed by clinicians, measuring the maxillary and mandibular ridge heights and widths digitally of four predetermined implant sites in the maxillary and two selected implant sites in the mandibular arches of 91 patients planning for implant-supported overdenture. A total of 47 patients out of the 91 had completed implant placement on the edentulous ridge, contributing to 55 upper and/or lower arches (136 dental implants). Both predictabilities are low, implying that CBCT planning for implant placement on the edentulous ridge is not a good index and is insufficient to predict the surgical procedures as a solo method. The findings of this study indicate that digital planning by CBCT is insufficient to serve as an individual tool to predict implant procedures. Further information and evaluation must be considered for implant placement in the edentulous ridge. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Craniofacial and Oral Disease)

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13 pages, 1552 KiB

Open AccessArticle

A Modified Approach in Lip Repositioning Surgery for Excessive Gingival Display to Minimize Post-Surgical Relapse: A Randomized Controlled Clinical Trial

by Reham N. AlJasser

Diagnostics 2023, 13(4), 716; https://doi.org/10.3390/diagnostics13040716 - 14 Feb 2023

Cited by 6 | Viewed by 5092

Abstract

Lip repositioning surgeries are performed to treat patients with excessive GD (EGD). This study aimed to explore and compare the long-term clinical results and stability following the modified lip repositioning surgical technique (MLRS) with the addition of periosteal sutures compared to the conventional lip repositioning surgery (LipStaT^®) in order to address EGD. A controlled clinical trial with female participants (n = 200) intended to improve their gummy smile were divided into control (n = 100) and test (n = 100) groups. The gingival display (GD), maxillary lip length at rest (MLLR), and maxillary lip length at maximum smile (MLLS) were measured at four time intervals (Baseline; 1 Month; 6 Months, and 1 Year) in millimeters (mm). Data were analyzed by t-tests, Bonferroni-test, and regression analysis using SPSS software. At the one-year follow-up, GD for the control and test groups were 3.77 + 1.76 mm and 2.48 + 0.86 mm, respectively, and their comparisons showed that GD was considerably lower (p = 0.000) in the test group compared to the control group. The MLLS measurements taken at baseline, one-month, six-month, and one-year follow-up showed no significant differences (p > 0.05) between the control and test groups. At baseline, one-month, and six-month follow-up, the mean and standard deviation for the MLLR were almost similar, with no statistically significant difference (p = 0.675). The MLRS is a successful and viable treatment option for the treatment of patients with EGD. The current study showed stable results and no recurrence with MLRS until the one-year follow-up compared to LipStaT^®. With the MLRS, a 2 to 3 mm decline in EGD is usually to be expected. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Craniofacial and Oral Disease)

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14 pages, 2389 KiB

Open AccessArticle

Three-Dimensional Analysis of Alveolar Bone Morphological Characteristics in Skeletal Class II Open Bite Malocclusion: A Cone-Beam Computed Tomography Study

by Yingying Tang, Jingfeng Xu, Yun Hu, Yumei Huang, Yang Liu, Baraa Daraqel and Leilei Zheng

Diagnostics 2023, 13(1), 39; https://doi.org/10.3390/diagnostics13010039 - 23 Dec 2022

Cited by 3 | Viewed by 2230

Abstract

This cross-sectional research evaluated the morphological characteristics of alveolar bone in skeletal class II open-bite individuals compared to skeletal class II and class I non-open-bite individuals. A sample of 82 patients (all were in cervical vertebral stage 6) was divided into three groups (class II OB group, n = 29; class II NOB group, n = 29; class I NOB group, n = 24) according to bilateral molar relationship, ANB angle, and anterior overbite measured by cephalometric analysis. The evaluation was performed with specialized software (Mimics 21.0) and initial cone-beam computed tomography (CBCT) data. The alveolar bone height and thickness of the whole dentition area and alveolar crest level and root apex position of the incisors were measured with a series of appropriate CBCT images. One-way analysis of variance followed by the Tukey post hoc test and the Kruskall–Wallis test were performed for statistical comparisons. The class II open-bite group had increased alveolar bone height for the maxillary first molar and decreased alveolar bone height for mandibular molars compared to the class II non-open-bite group (p < 0.05 for both). Furthermore, there were significant negative correlations between the alveolar bone heights of the upper first and second molars (A6-height, A7-height) and overbite (both p < 0.01). The alveolar thicknesses of all measured teeth were generally reduced in the class II OB group. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Craniofacial and Oral Disease)

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13 pages, 909 KiB

Open AccessArticle

Maxillary Sinus Dimensions in Skeletal Class I Chinese Population with Different Vertical Skeletal Patterns: A Cone-Beam Computed Tomography Study

by Jingyi Wang, Min Zou, Abby Syverson, Zhong Zheng and Chenshuang Li

Diagnostics 2022, 12(12), 3144; https://doi.org/10.3390/diagnostics12123144 - 13 Dec 2022

Cited by 3 | Viewed by 1838

Abstract

Due to the close relationship between the maxillary posterior teeth roots and the maxillary sinus floor, the maxillary sinus can significantly impact various dental treatments, including endodontic procedures and surgical apicectomy, periodontal flap surgery, surgical tooth extraction, dental implantation, and orthognathic surgeries. Specifically, in orthodontics, the location of the maxillary sinus floor may affect tooth movement and insertion of temporary anchorage devices (TADs). This study aims to evaluate the dimensions and location of the maxillary sinus in the Chinese orthodontic patient population with skeletal class I. Using cone-beam computed tomography (CBCT), the volumetric size, height, width, and depth of the sinus and the amount of alveolar bone below the sinus floor and buccal/palatal to the sinus wall were compared between patients of different genders and different vertical skeletal patterns. Unlike the previously reported skeletal class II population, the skeletal class I patients with different vertical patterns do not have significantly different size sinuses. On the other hand, males have larger maxillary sinuses in all parameters than females in the testing population. In addition, no significant correlation was noticed between the SN-MP angle and sinus dimensions or between the ANB angle and sinus dimensions. Nevertheless, the distance from the sinus floor to the alveolar bone crest is not correlated with skeletally sagittal or vertical parameters in females but negatively correlated with the skeletal sagittal parameter in males. In summary, different from the skeletal class II population, there is no significant difference in maxillary sinus size and location among different vertical skeletal patterns in the skeletal class I population. Compared to the skeletal class II population, a higher percentage of the skeletal class I population has an alveolar bone with less than 5 mm thickness, representing a narrowed safe zone of TADs placements. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Craniofacial and Oral Disease)

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13 pages, 91880 KiB

Open AccessArticle

Dose Dependence Effect in Biallelic WNT10A Variant-Associated Tooth Agenesis Phenotype

by Haochen Liu, Bichen Lin, Hangbo Liu, Lanxin Su, Hailan Feng, Yang Liu, Miao Yu and Dong Han

Diagnostics 2022, 12(12), 3087; https://doi.org/10.3390/diagnostics12123087 - 7 Dec 2022

Cited by 4 | Viewed by 1692

Abstract

The goal of this study was to identify the pathogenic gene variants in patients with odonto-onycho-dermal dysplasia syndrome (OODD) or nonsyndromic tooth agenesis. Four unrelated individuals with tooth agenesis and their available family members were recruited. Peripheral blood was collected from four probands and five family members. Whole-exome sequencing (WES) and Sanger sequencing were used to identify the pathogenic gene variants. The harmfulness of these variations was predicted by bioinformatics. We identified four biallelic variants of the WNT10A gene in four patients, respectively: the proband#660: c.1176C > A (p.Cys392*) and c.812G > A (p.Cys271Tyr); the proband#681: c.637G > A (p.Gly213Ser) and c.985C > T (p.Arg329*); the proband#829: c.511C > T (p.Arg171Cys) and c.637G > A (p.Gly213Ser); and the proband#338: c.926A> G (p.Gln309Arg) and c.511C > T (p.Arg171Cys). Among them, two variants (c.812G > A; p.Cys271Tyr and c.985C > T; p.Arg329*) were previously unreported. Bioinformatics analysis showed that the pathogenicity of these six variants was different. Tertiary structure analysis showed that these variants were predicted to cause structural damage to the WNT10A protein. Genotype–phenotype analysis showed that the biallelic variants with more harmful effects, such as nonsense variants, caused OODD syndrome (#660 Ⅱ-1) or severe nonsyndromic tooth agenesis (NSTA) (#681 Ⅱ-1); the biallelic variants with less harmful effects, such as missense variants, caused a mild form of NSTA (#829 Ⅱ-2 and #338 Ⅱ-1). Individuals with a heterozygous variant presented a mild form of NSTA or a normal state. Our results further suggest the existence of the dose dependence of WNT10A pathogenicity on the tooth agenesis pattern, which broadens the variation spectrum and phenotype spectrum of WNT10A and could help with clinical diagnosis, treatment, and genetic counseling. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Craniofacial and Oral Disease)

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12 pages, 2127 KiB

Open AccessArticle

Rare X-Linked Hypohidrotic Ectodermal Dysplasia in Females Associated with Ectodysplasin-A Variants and the X-Chromosome Inactivation Pattern

by Haochen Liu, Lanxin Su, Hangbo Liu, Jinglei Zheng, Hailan Feng, Yang Liu, Miao Yu and Dong Han

Diagnostics 2022, 12(10), 2300; https://doi.org/10.3390/diagnostics12102300 - 23 Sep 2022

Cited by 1 | Viewed by 2234

Abstract

The goal of this study was to identify the pathogenic gene variants in female patients with severe X-linked hypohidrotic ectodermal dysplasia (XLHED). Whole-exome sequencing (WES) and Sanger sequencing were used to screen for the pathogenic gene variants. The harmfulness of these variations was predicted by bioinformatics. Then, skewed X-chromosome inactivation (XCI) was measured by PCR analysis of the CAG repeat region in the human androgen receptor (AR) gene in peripheral blood cells. Two novel Ectodysplasin-A (EDA) heterozygous variants (c.588_606del19bp and c.837G>A) and one heterozygous variant (c.1045G>A, rs132630317) were identified in the three female XLHED patients. The bioinformatics analysis showed that these variants might be pathogenic. The tertiary structure analysis showed that these variants could cause structural damage to EDA proteins. Analysis of the skewed X-chromosome inactivation revealed that extreme skewed X-chromosome inactivation was found in patient #35 (98:2), whereas it was comparatively moderate in patients #347 and #204 (21:79 and 30:70). Our results broaden the variation spectrum of EDA and the phenotype spectrum of XLHED, which could help with clinical diagnosis, treatment, and genetic counseling. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Craniofacial and Oral Disease)

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Review

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18 pages, 642 KiB

Open AccessReview

Determinants of Clinical Decision Making under Uncertainty in Dentistry: A Scoping Review

by Alexander Ivon King Murdoch, Jordan Blum, Jie Chen, Dean Baziotis-Kalfas, Angelie Dao, Kevin Bai, Marina Bekheet, Nimret Atwal, Sarah Sung Hee Cho, Mahen Ganhewa and Nicola Cirillo

Diagnostics 2023, 13(6), 1076; https://doi.org/10.3390/diagnostics13061076 - 13 Mar 2023

Cited by 7 | Viewed by 3638

Abstract

Clinical decision-making for diagnosing and treating oral and dental diseases consolidates multiple sources of complex information, yet individual clinical judgements are often made intuitively on limited heuristics to simplify decision making, which may lead to errors harmful to patients. This study aimed at systematically evaluating dental practitioners’ clinical decision-making processes during diagnosis and treatment planning under uncertainty. A scoping review was chosen as the optimal study design due to the heterogeneity and complexity of the topic. Key terms and a search strategy were defined, and the articles published in the repository of the National Library of Medicine (MEDLINE/PubMed) were searched, selected, and analysed in accordance with PRISMA-ScR guidelines. Of the 478 studies returned, 64 relevant articles were included in the qualitative synthesis. Studies that were included were based in 27 countries, with the majority from the UK and USA. Articles were dated from 1991 to 2022, with all being observational studies except four, which were experimental studies. Six major recurring themes were identified: clinical factors, clinical experience, patient preferences and perceptions, heuristics and biases, artificial intelligence and informatics, and existing guidelines. These results suggest that inconsistency in treatment recommendations is a real possibility and despite great advancements in dental science, evidence-based practice is but one of a multitude of complex determinants driving clinical decision making in dentistry. In conclusion, clinical decisions, particularly those made individually by a dental practitioner, are potentially prone to sub-optimal treatment and poorer patient outcomes. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Craniofacial and Oral Disease)

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Other

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7 pages, 2783 KiB

Open AccessCase Report

Evaluation of Bilateral Maxillary Sinus Ectopic Teeth Using CT and Cinematic Rendering—A Case Report

by Dario Baldi, Liberatore Tramontano, Bruna Punzo and Carlo Cavaliere

Diagnostics 2023, 13(19), 3084; https://doi.org/10.3390/diagnostics13193084 - 28 Sep 2023

Viewed by 1611

Abstract

Ectopic teeth in the maxillary sinus are a rare finding and pose a diagnostic challenge due to their unusual location and clinical management. A 28-year-old man presented with complaints of discomfort and pressure in the maxillary sinus region. A CT scan and cinematic rendering revealed the presence of ectopic teeth in the maxillary sinus bilaterally. The use of cinematic rendering provided a more detailed and accurate visualization of the ectopic teeth and surrounding anatomical structures. A CT scan is the primary imaging modality used for the diagnosis and visualization of ectopic teeth in the maxillary sinus. In addition, the use of cinematic rendering can improve diagnostic accuracy and reduce the need for further imaging studies. The use of CT and cinematic rendering can help in the diagnosis and visualization of ectopic teeth in the maxillary sinus, aiding in the planning of surgical interventions. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Craniofacial and Oral Disease)

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9 pages, 5233 KiB

Open AccessCase Report

Glandular Odontogenic Cyst in the Anterior Mandible: A Case Report of a Conservative Approach and a Recurrence Detection

by Wladimir Gushiken de Campos, Rita Araújo, Victor Martin, Marília Trierveiler, Pedro Gomes and Celso Augusto Lemos

Diagnostics 2023, 13(8), 1452; https://doi.org/10.3390/diagnostics13081452 - 18 Apr 2023

Cited by 3 | Viewed by 4665

Abstract

Purpose: The glandular odontogenic cyst (GOC) is considered a rare developmental cyst, with an odontogenic origin and both epithelial and glandular characteristics, with less than 200 reported cases in the literature. Methods: In the present case, a 29-year-old man was referred for evaluation of an asymptomatic slow-growing swelling in the anterior region of the mandible, with one-year history. The patient’s medical history did not reveal any systemic alteration. The extraoral examination did not show enlargement of the facial contour and the intraoral examination showed vestibular and lingual swelling. Panoramic radiography and CT scan revealed a well-defined unilocular radiolucent lesion involving the inferior incisors and canines bilaterally. Results: Histopathological analysis revealed multiple cysts lined by stratified epithelium with varying thickness and characteristics, in addition to duct-like structures filled with PAS-positive amorphous material, suggestive of GOC. Conservative treatment was performed through surgical curettage, peripheral ostectomy of the surgical site and apicectomy of the teeth involved in the lesion. There was one recurrence, which was detected in postoperative follow-up, leading to a new surgical approach. Conclusions: Fifteen months after the second procedure, no signs of recurrence were identified, and bone neoformation within the surgical site occurred, supporting that a conservative approach for the treatment of GOC is viable. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Craniofacial and Oral Disease)

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