Search Results (1,904)

Background/Objectives: Maxillary defects, whether congenital or acquired, can compromise chewing, speech, and aesthetics. This systematic review aimed to evaluate the application and characteristics of definitive palatal obturators in the rehabilitation of such defects, analyzing techniques of fabrication, materials, outcomes of the fabrication, and limitations reported in the literature. Methods: The review was conducted in accordance with PRISMA 2020 guidelines and was registered in PROSPERO (ID: 1011648). A comprehensive search was performed in PubMed, Scopus, Lilacs, and Google Scholar for studies published from 1 January 2014 to 1 January 2025. Inclusion criteria comprised adult patients treated with definitive palatal obturators and with reported follow-up. Exclusion criteria included studies on children, animals, or lacking patient data. Two reviewers independently screened studies and assessed eligibility. Bias was evaluated qualitatively across five domains. No meta-analysis was conducted; data were synthesized descriptively using charts and tables. The study was funded by the Italian Ministry of Health—Current Research IRCCS. Results: A total of 59 studies involving 83 patients (46 males, 37 females; mean age 54.6 ± 13.8 years) were included. Mucormycosis and squamous cell carcinoma were the primary causes of defects. Conventional impressions using alginate and silicone were most common, while digital techniques were reported in only 6.6% of cases. All definitive obturators were fabricated using acrylic resin, with some featuring hollow bulbs, velopharyngeal extensions, or magnetic retention. Multiple sources of bias were observed. Conclusions: Definitive palatal obturators provide effective functional and aesthetic rehabilitation for maxillary defects. However, evidence is limited by methodological weaknesses, lack of standardization, and underutilization of digital technologies. Future studies should focus on improving reporting quality, adopting innovative fabrication protocols, and generating higher-level clinical evidence to support best practices. Full article

Introduction: Cleft lip and/or palate (CLP) is frequently associated with persistent nasal obstruction, often due to structural deformities unaddressed by primary surgical repair. While subjective assessment tools are commonly used to evaluate nasal patency, they underestimate functional impairment, particularly nasal valve collapse. This study aims to objectively evaluate nasal obstruction and identify its anatomical causes in CLP patients after primary rhinoplasty. Methods: We conducted an observational study involving 21 children aged 8–16 with CLP who had undergone primary cheilorhinoplasty but not secondary nasal surgery. Each participant underwent clinical evaluation, nasal endoscopy, acoustic rhinometry, and active anterior rhinomanometry (AAR), both before and after nasal decongestion. The Nasal Obstruction Symptom Evaluation (NOSE) scale was used to assess subjective symptoms. Obstructive sites were diagnosed based on established criteria combining endoscopic and functional findings. Results: Objective nasal obstruction was identified in 80.9% of patients, with nasal valve collapse observed in 66.7%, most commonly among unilateral and bilateral CLP subtypes. External nasal valve collapse was the predominant form (57.1%), followed by internal valve involvement (38.1%). Notably, the NOSE score did not reliably correlate with the AAR results, underlining the limitations of subjective assessment tools. Structural anomalies such as septal deviation (52.5%) and turbinate hypertrophy (23.8%) were also prevalent. Conclusions: This study highlights nasal valve collapse as a major, underrecognized contributor to persistent nasal obstruction in CLP patients after primary repair. Objective assessment methods like AAR and targeted endoscopy should be routinely integrated into secondary rhinoplasty planning. These findings advocate for a personalized approach to secondary nasal reconstruction in CLP patients, integrating objective functional data into surgical planning. Such strategies align with personalized medicine principles by tailoring interventions to individual anatomical and physiological characteristics. Full article

Background: This case series study aims to evaluate the spontaneous eruption of impacted canines following diode laser disinclusion surgery without orthodontic traction, and to analyze the correlation with five prognostic factors: age, sex of the patient, angle α, sector, and height of inclusion of the canine. Methods: The sample included 15 patients aged 13–30 years and 20 palatally impacted canines. The patients’ records were collected, and prognostic factors were assessed. All patients underwent disinclusion surgery using a diode laser (K-Laser, Eltech, Blue Derma) and post-surgery, canines were monitored with intraoral scans and photos at 1 week, 8 weeks (T1), and 16 weeks (T2). The STL files were superimposed with the open-source software MeshLab (MeshLab 2023.12, Visual Computing Lab, Pisa, Italy), and the eruption values were measured. Through multiple linear regression analysis, the relationships between the five prognostic factors and the total spontaneous eruption value were analyzed. Results: The canines treated in this study responded with an average eruption of 4.70 mm. For the prognostic factors sex (p = 0.94) and angle α (p = 0.12), no statistically significant relationship with eruption was found. The variables age (p < 0.001), sector II (p = 0.02), sector III (p = 0.03), sector IV (p = 0.06), and inclusion height (p < 0.001) had negative linear coefficients. Consequently, as the values of these three prognostic factors increased, a lower eruption of the included element measured in millimeters was obtained. Conclusions: All canines successfully erupted following the disinclusion procedure, avoiding the use of orthodontic traction. Patient sex and the α angle of impaction were not reliable predictors of eruption outcomes. In contrast, age, sector, and inclusion height measured via CBCT showed high statistical significance and could be used as prognostic factors to predict the eruptive response following disinclusion surgery. Full article

Introduction: The aim of this study was to investigate the spatial relationship between the incisive canal (IC) and apical region of the maxillary central incisors in the Korean population, using cone-beam computed tomography (CBCT) imaging. The findings are intended to inform and improve the planning and execution of immediate implant placement in the maxillary esthetic zone. Materials and methods: CBCT data were collected from 94 patients (48 men, 46 women) aged 20–79 years at Gangnam Dental Clinic, Seoul, South Korea. The sample was divided according to age into three groups: 20–39 years, 40–59 years, and 60–79 years. Exclusion criteria included missing maxillary anterior teeth, severe crowding, periodontitis, pathology, and image artifacts. Measurements of the distance from the root apex to the incisive canal (RIC-11-P, RIC-21-P) and from the root apex to the buccal bone (RBB-11-B, RBB-21-B) were taken from CBCT images. Statistical analyses were conducted using Welch’s t-test, ANOVA, and Pearson correlation, with significance set at p < 0.05. Results: The mean distances from the root apex to the incisive canal were 3.77 mm (RIC-11-P) and 3.62 mm (RIC-21-P), while the mean distances to the buccal bone were 0.86 mm and 0.94 mm, respectively. Males exhibited significantly greater distances compared to females, both in the NPC-to-root apex and buccal bone measurements. Age-related variations were observed, with younger individuals showing shorter distances from the IC to the root apex. However, ANOVA tests and Pearson correlation analysis indicated no statistically significant correlation in these distances across different age groups. The study highlights significant gender differences in maxillary central incisor anatomy, with males having larger distances from the root apex to both the IC and buccal bone, which has implications for implant placement. While age-related changes were observed, they did not significantly affect the mean distances in a statistically meaningful way. Conclusions: These findings underscore the need for personalized treatment planning in immediate implant placement, particularly in relation to gender and age. Comparisons with other population studies suggest that these anatomical differences may be consistent across various ethnic groups, though individual variance factors should still be considered. Full article

This study evaluated the effects of adding a Saccharomyces cerevisiae fermentation product (SCFP) to adult cat diets on palatability, intestinal health, nutrient digestibility, immune parameters, and the fecal microbiome over 42 days. Sixty-three healthy Domestic Short-hair cats were randomized to three diets: a control diet (CD) without SCFP, or the same diet containing 1.0% or 2.0% SCFP, targeting daily intakes of 150 or 300 mg/kg body weight, respectively. Body weight and blood parameters remained within reference ranges across all groups. Stool quality was largely not affected, although compared with controls, SCFP-supplemented cats had slightly firmer stools at day 21, and increased fecal pH. Shotgun metagenomic sequencing revealed that microbiome diversity remained steady in SCFP-fed cats, whereas diversity in the control group declined over time. Fecal immunoglobulin A concentrations were lower in cats supplemented with SCFP at 150 mg/kg BW by the end of the study, and positive shifts in the circulatory leukocyte profile were observed at both inclusion levels. Apparent total tract macronutrient digestibility did not differ among groups. Palatability tests showed diets with SCFP were generally preferred, indicating a potential benefit for commercial feline feeds, particularly at the 150 mg/kg BW level, which was preferred over 300 mg/kg BW. Overall, these findings suggest that SCFP can act as a functional ingredient in feline nutrition to maintain microbial diversity and enhance diet acceptance without compromising digestibility. Full article

Clear aligners (CAs) have emerged as a widely accepted alternative to conventional fixed orthodontic appliances due to their aesthetic appeal, comfort, and removability. Despite their increasing use, the precise biomechanical behavior of CAs—particularly in relation to maxillary arch expansion and torque control—remains incompletely understood. This scoping review aims to synthesize and critically examine the recent body of evidence derived from finite element analysis (FEA) studies investigating the performance of clear aligners in managing transverse discrepancies and controlling tooth movement. It considered studies published up to April 2025. All included FEA studies assumed dental and bone tissues as linearly elastic, homogeneous, and isotropic, unless otherwise specified. Five in silico studies were included, all employing three-dimensional FEA models to assess the influence of various clinical and design parameters, such as aligner thickness, movement sequence, attachment configuration, and torque compensation. The findings consistently show that movement protocols involving alternating activation patterns and specific attachment designs can significantly improve the efficiency of maxillary expansion, while reducing undesired tipping or anchorage loss. Additionally, greater aligner thicknesses were generally associated with increased force delivery and more pronounced tooth displacement. Although FEA provides a powerful tool for visualizing stress distribution and predicting mechanical responses under controlled conditions, the lack of standardized force application and limited clinical validation remain important limitations. These findings underscore the potential of optimized aligner protocols to enhance treatment outcomes, but they also highlight the need for complementary in vivo studies to confirm their clinical relevance and guide evidence-based practice. Full article

The Maxillary Skeletal Expander (MSE) is used for maxillary expansion in adolescents and young adults. Virtual planning using 3D models, CBCT and 3D printers help in case selection, appliance design and fabrication. Using the proposed digital workflow, the accuracy of the patient selection phase and appliance delivery are increased, and the required number of visits to the clinic is decreased. The MSE serves as a guide for the insertion of mini-implants, reducing the number of appointments needed for installation. (1) Introduction: Mini-Implant-Assisted Rapid Palatal Expansion (MARPE) appliances, like the MSE, decrease the side effects that regular tooth-anchored appliances have on dental and periodontal structures, especially for skeletally mature patients, combining palatal anchorage with dental support for guidance. The digital planning of the insertion sites, length and angulation of the mini screws, and the fabrication of the 3D-printed appliance that stands as a mini-implant insertion guide give an undeniable precision. (2) Materials and methods: The laboratory steps used in the digital design and fabrication, and clinical steps needed for the insertion protocol are described. (3) Discussions: The individual assessment of the anatomical structures and the use of virtual integrated dental impressions and CBCT increase the accuracy of diagnosis, appliance fabrication and treatment progress. Implementing a digital workflow for mini-implant-supported expansion is a real advantage for both dental teams and patients. (4) Conclusions: The wide range of advantages and the ease of the process support the introduction of this digital workflow in every orthodontic practice. Full article

Palatal abscesses of endodontic origin are rarer than buccal ones due to maxillary anatomy. Their clinical appearance may resemble that of other palatal illnesses, complicating diagnosis and treatment. Prevention of problems requires early detection and endodontic treatment. A 26-year-old female patient presented with a 2 cm diameter palatal abscess, significant pulsatile discomfort, fever, and enlargement of the anterior hard palate. Clinical examination showed grade 1 mobility of the central and lateral incisors, percussion discomfort, and negative pulp vitality in the case of the lateral incisor. Cone-beam computed tomography (CBCT) showed two radiolucent lesions: a posterior cystic lesion near the first molar and an anterior lesion near the upper left lateral incisor. Palatal cortical bone puncture and soft tissue extension indicated the abscess origin. According to the clinical and imaging evaluation, the upper left lateral incisor had a persistent periapical lesion of endodontic origin that a palatal abscess with cortical bone perforation had exacerbated. Full article

Background: Craniofacial clefts represent the most common congenital malformation in the head and neck region. Although most patients undergo primary cleft repair in childhood, many still present midfacial growth deficiencies in adulthood. This study aimed to evaluate and compare the incidence and indications for orthognathic surgery in adult patients with cleft lip (CL), cleft lip and alveolus (CLA), cleft lip and palate (CLP), and isolated cleft palate (CP). Materials and Methods: Sixty adult cleft patients (36 males and 24 females) born with a cleft and with a mean age of 19.51 ± 1.83 years were retrospectively enrolled in this study. All patients had undergone primary lip and palate repair during childhood at the Oral and Maxillofacial Surgery Service of “Mother Teresa” University Hospital Centre in Tirana. Clinical records, orthodontic documentation, and cephalometric data were reviewed to determine the indication for orthognathic surgery. Results: The statistical analysis showed that orthognathic surgery was deemed necessary in 30% patients, including ten males (56%) and eight females (44%). The most prevalent type of cleft was CLP, accounting for 35% of all patients, and it showed the highest surgical indication rate (83.3%). Cleft patients and the need for orthognathic surgery were evaluated according to the skeletal malocclusion in three planes. The need for surgery was more prevalent in patients with skeletal class III malocclusion with maxillary hypoplasia (83.3% of surgical cases), those with anterior and posterior crossbite (21.7% of all patients), and in deep bite patients (16.7% of all patients). Additionally, all patients with facial asymmetry (15%) required orthognathic surgery, highlighting the strong association between asymmetry and surgical indication. Conclusions: Patients with craniofacial cleft, especially those with CLP and combined maxillary deficiencies, demonstrate a significantly higher need for orthognathic surgery. Quantitative assessment supports the necessity of a multidisciplinary treatment approach to address persistent skeletal discrepancies and optimize functional and aesthetic outcomes in adult cleft patients. Full article

Digital dentistry is undergoing rapid evolution, with three-dimensional imaging technologies increasingly integrated into routine clinical workflows. Originally developed for accurate dental arch reconstruction, modern intraoral scanners have demonstrated expanding versatility in capturing intraoral mucosal as well as perioral cutaneous structures. Concurrently, photogrammetry has emerged as a powerful method for full-face digital reconstruction, particularly valuable in orthodontic and prosthodontic treatment planning. These advances offer promising applications in forensic sciences, where high-resolution, three-dimensional documentation of anatomical details such as palatal rugae, lip prints, and bite marks can provide objective and enduring records for legal and investigative purposes. This study explores the forensic potential of two digital acquisition techniques by presenting two cadaveric cases of animal bite injuries. In the first case, an intraoral scanner (Dexis 3600) was used in an unconventional extraoral application to directly scan skin lesions. In the second case, photogrammetry was employed using a digital single-lens reflex (DSLR) camera and Agisoft Metashape, with standardized lighting and metric scale references to generate accurate 3D models. Both methods produced analyzable digital reconstructions suitable for forensic archiving. The intraoral scanner yielded dimensionally accurate models, with strong agreement with manual measurements, though limited by difficulties in capturing complex surface morphology. Photogrammetry, meanwhile, allowed for broader contextual reconstruction with high texture fidelity, albeit requiring more extensive processing and scale calibration. A notable advantage common to both techniques is the avoidance of physical contact and impression materials, which can compress and distort soft tissues, an especially relevant concern when documenting transient evidence like bite marks. These results suggest that both technologies, despite their different origins and operational workflows, can contribute meaningfully to forensic documentation of bite-related injuries. While constrained by the exploratory nature and small sample size of this study, the findings support the viability of digitized, non-destructive evidence preservation. Future perspectives may include the integration of artificial intelligence to assist with morphological matching and the establishment of digital forensic databases for pattern comparison and expert review. Full article

Background: Children affected by unilateral cleft lip and palate (UCLP) represent a therapeutic challenge requiring the development of novel therapies, such as the implant of a bioengineered tissue—BIOCLEFT—or the use of nasoalveolar molding (NAM). The objective of this work was to evaluate the effects of NAM on the surgical and aesthetic outcomes of children with UCLP. Methods: A total of 36 children with UCLP treated at a craniofacial malformations management unit were evaluated, including 23 patients treated with presurgical NAM followed by palate surgical correction (NAM group) and 13 patients treated surgically without previous NAM (non-NAM group). Measurements were obtained from each patient immediately before palate surgery, including four linear measurements: nasal ala projection length (NAPL), nasal dome height (NDH), superoinferior alar groove position (S-I AGP), and nasal dome position (M-L NDP), and two angular measurements: columellar deviation (CD) and nasal bridge deviation (NBD). Results: When NAM was used, a significant improvement of the basilar view linear measurements of the patient’s nose was found, including the NAPL and NDH, and the frontal view linear measurement M-L NDP, but not S-I AGP. Significant improvements were also observed in the angular measurements of nasal symmetry CD and NBD. All these variables, except the S-I AGP, significantly correlated with the treatment group, and two variables—NAPL and CD—significantly contributed to generate a predictive model developed using binary logistic regression. Conclusions: These findings support the use of NAM to efficiently improve the nasal symmetry and the presurgical outcomes of patients with UCLP. Full article

Background/Objectives: Many women report restrictions on caffeine intake during gestation, but some of these restrictions are withdrawn during the lactation period. Given that both periods have elevated epigenetic plasticity, our aim was to compare the effects of caffeine exposure during each isolated period on offspring metabolism and susceptibility to obesity in response to metabolic overload. Methods: Pregnant Wistar rats received orogastric caffeine (CAF) (25 mg/kg/day) or vehicle during gestation (CAF G) or lactation (CAF L) periods. We evaluated the body mass, adiposity, hormone levels, and food behavior of offspring of both sexes at different ages. Adult animals were subjected to metabolic overload, with fructose solution (10%) offered for ten days. Results/Discussion: CAF G and CAF L dams presented lower T3 levels (−70 and −52%) because of reduced TSH activity in the thyroid gland (−28 and −29%), despite unchanged gland morphology. At weaning, CAF G and CAF L males presented lower T3 levels (−75 and −80%), as did CAF L females (−85%). At puberty, females in the CAF L group showed glucose intolerance. In adulthood, CAF G males exhibited a greater preference for palatable food. In addition, CAF G and CAF L males showed increased feed efficiency, suggesting a greater susceptibility to obesity development. To test this susceptibility, the animals were subjected to fructose overload. Indeed, we observed that despite the absence of a fructose effect in the control group, male CAF G and female CAF L animals showed greater adiposity in response to fructose overload (+43% and +37%, respectively). Conclusions: Caffeine exposure during lactation increases the risk of obesity development among female offspring. However, for male offspring, gestation seems more critical. Full article

Background/Objectives: Impacted teeth are characterized by having more than three-quarters of root development completed, however failing to erupt or demonstrate imminent eruption, as evidenced both by clinical and radiographic evaluation. Canine impaction is an entity of clinical significance considering its potential to affect both oral function and facial aesthetics. If not appropriately managed, this condition may adversely impact functional occlusion and structural smile integrity. The purpose of the study was to investigate the prevalence of impacted and transmigrant canines in a Greek orthodontic cohort and identify potential sex-based differences. Methods: A total of 2594 panoramic radiographs and clinical records of consecutive patients in the mixed and permanent dentition stages, treated at the Department of Orthodontics of the Aristotle University of Thessaloniki, Greece, were retrospectively retrieved and analyzed to detect the presence of impacted and transmigrant canines. Patients lacking complete clinical records or panoramic radiograph, undergoing or had undergone orthodontic treatment, or presenting conditions affecting normal permanent dentition development, including pathological conditions, cleft lip and palate or hereditary disorders, were excluded. Results: At least one impacted canine was detected in 109 patients (67% females, 33% males), with a median age of 15 years (IQR: 13–18), documenting a 4.2% prevalence (6.97% females, 2.32% males). The frequency of maxillary canine impaction was 3.97%, while in the mandible a frequency of 0.46% was reported. The frequency of bilateral canine impaction was 1%, with it being present in 25.7% of patients with canine impaction. The prevalence of transmigrant canines was 0.11%, with detection solely in the mandible. A statistically significant sex difference was detected solely in the prevalence of impaction. Conclusions: Considering the implications of canine impaction, the epidemiological investigation of this entity may facilitate an early diagnosis and treatment. Full article

Background/Objectives: Soft tissues are essential for maintaining the function and long-term success of dental implants. In many cases, implant placement necessitates soft tissue augmentation procedures such as free gingival grafts (FGGs) or connective tissue grafts (CTGs) to restore lost gingival architecture. Nevertheless, a significant challenge associated with FGG and CTG is postoperative pain, largely due to morbidity at the palatal donor site. To address this issue, various approaches have been proposed to reduce patient discomfort and promote improved wound healing at the donor site. This study aimed to compare the effectiveness of four different methods for protecting the palatal donor site following free gingival graft harvesting. Methods: A total of 76 patients undergoing implant therapy with an indication for free gingival grafting were selected and divided into four groups based on the method used to protect the palatal donor site: an absorbable gelatin sponge secured with sutures (GS); an absorbable gelatin sponge with sutures and cyanoacrylate tissue adhesive (GS+CTA); oxidized regenerated cellulose combined with cyanoacrylate tissue adhesive (ORC+CTA); and an absorbable gelatin sponge covered with a flowable resin composite and stabilized with sutures (GS+FRC). The effectiveness of each method was evaluated in terms of postoperative pain, bleeding, and wound healing. Results: Although the differences in pain intensity among the groups were not statistically significant throughout the observation period (p > 0.05), the GS+FRC group consistently exhibited the lowest mean pain scores. No statistically significant differences were observed between the groups regarding the incidence of secondary bleeding. The highest mean wound healing rate was recorded in the GS+FRC group (75.95 ± 18.75%), whereas the ORC+CTA group demonstrated the lowest rate (43.66 ± 25.74%). Conclusions: The use of an absorbable gelatin sponge covered with a flowable resin composite and secured with sutures, despite the presented limitations, appears to be a promising approach for palatal wound protection. While this group consistently demonstrated the lowest mean pain scores, differences in pain intensity among the groups were not statistically significant. Nonetheless, it achieved the most favorable outcomes in terms of wound epithelialization. Full article

Background/Objectives: The components of food and beverages are important elements that determine their palatability. Although the components of sake, a traditional Japanese alcoholic beverage, have been studied for many years, their correlation with sensory characteristics is unclear. Methods: We investigate the correlation with the sake metabolome analysis method developed by our group using ultra-high-performance liquid chromatography quadrupole time-of-flight mass spectrometry. We constructed orthogonal projections to latent structure models to predict sensory evaluation data obtained through the quantitative descriptive analysis method from the sake metabolome data. Results: For two years of study, 8 sensory evaluation models of the 2016 brewing year and 11 sensory evaluation models of the 2017 brewing year, including color, ethyl hexanoate, Hine-ka, Nama hine-ka, ethyl acetate, grainy/sweet aroma, sweetness, sourness, body, astringency, harsh taste/acrid taste, aftertaste, and overall quality, demonstrated a predictive performance with Q² > 0.5. Liquid chromatography-based analytical data indicated that it is possible to predict not only taste but also aroma. Additionally, the generalization performance of the prediction models for sensory evaluation attributes common to both years was verified. Conclusions: These results provide a new option for explaining the sensory characteristics of sake from its components and contribute to a deeper understanding of them. Full article