As already known, orthodontic treatment presents a factor of plaque retention, promoting an increase of bacterial growth in the oral cavity. Nevertheless, after orthodontic debonding an alteration of the previous microbiological status may occur. The present study was designed to assess variations among six bacterial species in the oral cavity and the status of oral health after orthodontic debonding. At the end of the fixed orthodontic treatment, 30 patients were divided into three groups based on the type of retention: I - 10 patients were treated with upper and lower fixed retention devices, II - 10 with upper and lower removable retention devices, and III - 10 with lower fixed and upper removable retention devices. To assess the alterations of oral microbiota after orthodontic debonding, two salivary swabs were collected for each individual: the first immediately after debonding (T0) and the other one 6 weeks later (T1). Six species, the ones most correlated with the development of caries and periodontal disease, were selected for microbiological analysis with Real-time PCR: Streptococcus mutans, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Fusobacterium nucleatum. Furthermore, in order to correlate the microbiological outcomes with the clinical condition, oral health indexes at T0 and T1 were assessed for all patients. Six weeks after debonding, the salivary levels of the bacteria investigated tend to decrease and the values of the oral health indexes tend to improve with all types of treatment considered (p<.05). Salivary bacteria levels and oral health are similarly influenced by fixed and/or removable orthodontic retentions.
Idiopathic facial palsy is the most common cause of unilateral neurologic disorders of the cranial nerves. It can result from congenital, due to delivery traumas, and genetic or malformative diseases, or acquired due to infective, inflammatory, neoplastic, traumatic or iatrogenic causes. In the great majority of cases its causes are unknown. A careful differential diagnosis is recommended in paediatric patients, in order to establish the most appropriate treatment as the therapeutic approach differs in relation to the aetiology. Controversy exists regarding treatment options. The primary concern in the treatment is to restore the aesthetics, function and comfort. Facial palsy may result in a multitude of conditions such as: affected salivation, taste and lachrymation, depending on the topography of the facial nerve affection, and patients may also refer auditory hipersesitivity which may result in noise intolerance. In this paper a case of a child with unilateral facial palsy is described. The patient was treated by orthopaedic appliances and surgical facial reanimation. At the end of therapy good aesthetic and functional results were obtained. Oral functions as well as facial expression were partially recovered and symmetry was almost completely restored. Children with idiopathic facial palsy have a better prognosis if the diagnosis is early and treatment is multidisciplinary.
The aim is to evaluate the effects of slow maxillary expansion on maxillary and mandibular arch, using a slow maxillary expander (SME-Leaf Expander) banded on primary second molar. Ninety patients with transverse maxillary deficiency and posterior crossbite were selected. Sixty-nine patients (33 males/36 females; 7.6 ± 1.7 years old) who underwent SME and 21 patients (10 males/11 females; 7.4 ± 1.2 years old) who were treated with rapid maxillary expander (RME). Digital models obtained pre- and post-treatment at appliance removal (9 to 11 months) were processed by means of a 3D scanner (Trios 3, 3Shape D250 laser, Copenhagen, Denmark). Interdental width in both maxilla and mandible were measured with 3 SHAPE Ortho Analyzer. Four Maxillary and four mandibular interdental width were traced and evaluated. The adequate Student’s t-test (dependent or independent) was used to compare intra and intergroups interdental width differences (p < 0.05). The efficacy of the SME was confirmed both on maxillary and mandibular arch. All the maxillary and mandibular interdental widths increased significantly (p < 0.001). The comparison with the RME group showed significant statistical differences between the two treatments with a greater increase in primary first and second intermolar and canine width for the test group (p < 0.001). SME with Leaf Expander produced statistically significant effects for the correction of transverse maxillary deficiencies with a significant indirect effect on the mandibular arch.
Clinical use of portable optical tracking system in dentistry could improve the analysis of mandibular movements for diagnostic and therapeutic purposes. A new workflow for the acquisition of mandibular kinematics was developed. Reproducibility of measurements was tested in vitro and intra- and inter-rater repeatability were assessed in vivo in healthy volunteers. Prescribed repeated movements (n = 10) in three perpendicular directions of the tracking-device coordinate system were performed. Measurement error and coefficient of variation (CV) among repetitions were determined. Mandibular kinematics of maximum opening, left and right laterality, protrusion and retrusion of five healthy subjects were recorded in separate sessions by three different operators. Obtained records were blindly examined by three observers. Intraclass correlation coefficient (ICC) was calculated to estimate inter-rater and intra-rater reliability. Maximum in vitro measurement error was 0.54 mm and CV = 0.02. Overall, excellent intra-rater reliability (ICC > 0.90) for each variable, general excellent intra-rater reliability (ICC = 1.00) for all variables, and good reliability (ICC > 0.75) for inter-rater tests were obtained. A lower score was obtained for retrusion with “moderate reliability” (ICC = 0.557) in the inter-rater tests. Excellent repeatability and reliability in optical tracking of primary movements were observed using the tested portable tracking device and the developed workflow.
Juvenile idiopathic arthritis (JIA) affecting temporomandibular joints (TMJ) in growing patients results in maxillofacial deformities, especially if only one condyle has been affected by the rheumatic disease. Mandibular hypoplasia is the most common issue and it may be associated with maxillary hypoplasia. The aim of this retrospective case-control study is to evaluate the effects of rapid maxillary expansion (RME) in these patients.25 growing patients affected by maxillary hypoplasia, currently in a quiescent phase of JIA for at least one year and monolateral involvement of the TMJs, were treated with RME. Data gathered from posteroanterior and lateral cephalograms before and after 1 year from RME were compared to those of 25 non-JIA controls.Nasal cavity width, maxillary width and upper and lower intermolar width statistically increased. Maxillary and mandibular symmetry indexes presented a statistically significant increase, so did the skeletal class. No signs or symptoms of TMJ activity of JIA occurred according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) criteria. No difference was found when comparing JIA and non-JIA patients apart from the better improvement of several mandibular symmetry indexes in the affected TMJ side of JIA patients. This event is allegedly due to a worse baseline asymmetry in JIA patients that underwent a bigger relative improvement after treatment.Results suggest that solving maxillary hypoplasia and, therefore, premature contacts are likely to have allowed mandibular repositioning and condylar growth. RME is a safe and effective solution that can substantially improve maxillary and mandibular symmetry in growing patients affected by JIA with TMJ involvement.
Mock-up based approach allows the preview of the aesthetic rehabilitation, however, it is crucial that the mock-up does not differ from the expected aesthetic outcomes. With CAD-CAM technologies, it is possible to directly create mock-ups from virtual planned smile project, with greater accuracy and efficiency compared to the conventional moulded mock-ups. In this study, we investigated the trueness of mock-ups obtained with milling and 3D printing technology and a full digital work-flow system.
To compare three-dimensional facial scans obtained by stereophotogrammetry with two different applications for smartphone supporting the TrueDepth system, a structured light technology.Facial scans of 40 different subjects were acquired with three different systems. The 3dMDtrio Stereophotogrammetry System (3dMD, Atlanta, Ga) was compared with a smartphone (iPhone Xs; Apple, Cupertino, Calif) equipped with the Bellus3D Face Application (version 1.6.11; Bellus3D Inc, Campbell, Calif) or Capture (version 1.2.5; Standard Cyborg Inc, San Francisco, Calif). Times of image acquisition and elaboration were recorded. The surface-to-surface deviation and the distance between 18 landmarks from 3dMD reference images to those acquired with Bellus3D or Capture were measured.Capturing and processing times with the smartphone applications were considerably longer than with the 3dMD system. The surface-to-surface deviation analysis between the Bellus3D and 3dMD showed an overlap percentage of 80.01% ± 5.92% and 56.62% ± 7.65% within the ranges of 1 mm and 0.5 mm discrepancy, respectively. Images from Capture showed an overlap percentage of 81.40% ± 9.59% and 56.45% ± 11.62% within the ranges of 1 mm and 0.5 mm, respectively.The face image acquisition with the 3dMD device is fast and accurate, but bulky and expensive. The new smartphone applications combined with the TrueDepth sensors show promising results. They need more accuracy from the operator and more compliance from the patient because of the increased acquisition time. Their greatest advantages are related to cost and portability.
The use of a new fluorescent composite can reduce some of the problems related to procedures of de-bonding orthodontic bracket (enamel damage, dentine lesions, and composite residuals). The aim of the presented study was to compare the effect of fluorescent and conventional non-fluorescent composite on dental surface and composite remnants by in vitro de-bonding tests. De-bonding of florescent composite (DFC) and the de-bonding of standard composite (DSC) were performed by operators on an in vitro sample of 48 teeth under UV light (360–370 nm min 20 mW/cm2). Modified ARI (Adhesive Remnant Index), scored under 5.0×/235 magnification, was used for evaluation of dental surface after the procedure, and the duration required for de-bonding was measured. Significant differences in ARI between the two groups were observed (Pearson two-tailed p = 0.006 1.4 ± 0.1 95% C.I.), and the average duration of de-bonding was 38 s (DFC) and 77 s (DSC) per tooth, respectively (Mann–Whitney test p = 0.015; 57.7 ± 19.9 95% C.I.). The use of fluorescent composite could significantly improve the quality of de-bonding by reducing the quantity of composite residuals and visible enamel damage, while reducing time needed for successful procedure performance.
To evaluate the complication-free and failure-free survival rates of porcelain fused to zirconia (PFZ) and all-resin complete arch fixed implant-supported prostheses over a mean follow-up of 10 years.Subjects with either all-resin or PFZ complete arch fixed implant-supported prostheses on 4 or 6 implants were followed prospectively for 10 years. Cumulative survival rates of prostheses without any catastrophic mechanical complications (resolved without replacing the prosthesis) and free of prosthesis failure (requiring the replacement or removal of the prosthesis) were calculated using life table analysis for up to 10-year period. Additional descriptive variables for various prosthesis events were recorded, such as sex, smoking and drinking status of subjects.A total of 36 subjects with a total of 68 prostheses (53 all-resin and 15 PFZ) were available for evaluation with a mean follow-up of 10 years (SD 1.47; range: 8-13 years). The study registered an overall 90% prostheses survival rate-78% for males and 94% for females; 91% for PFZ and 87% for all-resin; and a 31% complication-free prosthesis survival rate-13% for males and 38% for females; 29% for PFZ and 31% for all-resin at 10 years. A slight decrease in survival rate was identified in the first 3 years since the initial treatment (from 100% to 93%). The number of complications increased with time, especially after the 6th year after the initial treatment.Despite the number of reparable mechanical complications, the results confirmed the long-lasting features of both PFZ and all-resin complete arch fixed implant-supported prostheses over a 10-year period. There was however an increased number of mechanical complications after 6 years which may entail additional treatment cost for patients.
