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The Angle Orthodontist Jul 2023The stomatognathic structures act as a complex and integrated system, thereby accomplishing several essential functions of the body. Aside from participating in food...
The stomatognathic structures act as a complex and integrated system, thereby accomplishing several essential functions of the body. Aside from participating in food digestion, they are key for respiration and swallowing and play a central role in social interaction and stress management. The lifeworks of Robert M. Ricketts (1920-2003), an American orthodontist, and Rudolf Slavicek (1928-2022), an Austrian prosthodontist, were centered on this understanding. Both were educated in the time of gnathology, functional dentistry, and cephalometry and were ready to challenge conventional knowledge and traditions, leading toward innovation. As untiring clinicians, researchers, and mentors, they were fully invested in the study of the stomatognathic system, considering its morphology, dynamics, growth patterns, evolution, and interactions with the body and mind. Based on their extensive knowledge of the masticatory system, they advanced dentistry both with theoretical notions and by implementing new diagnostic and therapeutic concepts, thus reinforcing the idea of dentistry as a medical discipline requiring interdisciplinary effort. Their heritage is represented by numerous publications, discoveries, and inventions that inspire the dental community to follow their exemplary approach to the individualized care of patients. Their knowledge and passion are further passed on through their students. As part of their legacy, they prepared the ground for new research aimed at fostering advancements in occlusion medicine, hence supporting education in oral health.
PubMed: 37503706
DOI: 10.2319/050423-323.1 -
Scientific Reports Sep 2023Dentin hypersensitivity is an oral health concern affecting a large percentage of the world's adult population. Occlusion of the exposed dentinal tubules is among the...
Dentin hypersensitivity is an oral health concern affecting a large percentage of the world's adult population. Occlusion of the exposed dentinal tubules is among the treatment options available, and silver diammine fluoride (SDF) is an occluding agent used for interrupting or dampening the stimulus of the dental pulp nerves that produce pain. In addition to dentin permeability testing, the evaluation of desensitizing agents occluding dentinal tubules strongly relies on microscopic techniques, such as scanning electron microscopy (SEM). Limitations of SEM are that it provides only surface images that lack detailed information on the depth of penetration and amount of material present within the treated specimen, and it is prone to sample preparation artifacts. Here, we present high-resolution X-ray computed tomography (nano-CT) as a potential method for investigating dentin specimens with occluded tubules. We studied human dentin treated with SDF as an exemplary dentinal occlusion treatment option. We evaluated the silver deposits formed on the dentin surface region near the dentinal tubules and in the tubular regions using cross-section SEM, Energy Dispersive X-ray (EDX) analysis, and nano-CT. The resulting images obtained by SEM and nano-CT had comparable resolutions, and both techniques produced images of the tubules' occlusion. Nano-CT provided three-dimensional images adequate to quantitate tubule size and orientation in space. Moreover, it enabled clear visualization of dentinal tubules in any virtual plane and estimation of the amount and depth of occluding material. Thus, nano-CT has the potential to be a valuable technique for evaluating the occluding effects of virtually any material applied to dentinal tubules, supporting deciding between the best occluding treatment options.
Topics: Adult; Humans; Tomography, X-Ray Computed; Artifacts; Microscopy, Electron, Scanning; Dentin
PubMed: 37741849
DOI: 10.1038/s41598-023-42805-8 -
Progress in Orthodontics Dec 2023Foetal alcohol spectrum disorders (FASD) include somatic and neurological developmental disturbances after prenatal alcohol exposure, including facial anomalies....
BACKGROUND
Foetal alcohol spectrum disorders (FASD) include somatic and neurological developmental disturbances after prenatal alcohol exposure, including facial anomalies. However, the knowledge of the orthodontic skeletal and dental cephalometric relations in this group is limited. The aim of the study was to assess the dentofacial characteristics of children and adolescents with FASD and to compare them with a matched control group.
METHODS
The study group comprised all available children and adolescents diagnosed with FASD (> 7 years of age) in whom good quality cephalograms were available. The control group comprised non-syndromic, orthodontically untreated children with normal occlusion and skeletal relations matched with age and gender. Cephalometric analysis included eighteen linear and angular measurements. The general linear model for repeated measures regarding age, gender and the type of FASD was applied.
RESULTS
The group with FASD included 35 individuals (21 girls and 14 boys) aged 7-18 years including 21 with foetal alcohol syndrome. The mean age in the study and the control group was 12.8 years (SD, range 3.2, 7.1-18.1) and 13.0 (SD, range 2.9, 9.1-18.1), respectively. Statistically significant differences between the groups were found in 15 out of 18 of the cephalometric measurements (83%). In children with FASD the mandible was more retrusive, the incisors were more proclined and the mandibular incisors and the lips were more protruded when compared with controls. There was no significant evidence of an influence of age, gender or FASD type.
CONCLUSIONS
Dentofacial characteristics of children and adolescents with FASD significantly differ from controls. Early orthodontic diagnosis and prophylaxis should play a part of the interdisciplinary care of patients in this group.
Topics: Male; Child; Humans; Female; Adolescent; Pregnancy; Fetal Alcohol Spectrum Disorders; Prenatal Exposure Delayed Effects
PubMed: 38146015
DOI: 10.1186/s40510-023-00497-w -
Clinical Oral Investigations Sep 2023The aim of this study is to assess the repeatability of a surface electromyographic (EMG) device (Teethan®, Teethan S.p.A., Milan, Italy), designed for the analysis of...
OBJECTIVES
The aim of this study is to assess the repeatability of a surface electromyographic (EMG) device (Teethan®, Teethan S.p.A., Milan, Italy), designed for the analysis of the masseter and anterior temporalis muscles.
MATERIALS AND METHODS
Tests were performed on a sample of 30 healthy fully dentate TMD-free individuals randomly selected. Each test consisted of two distinct recordings performed at 5-min intervals: (i) the patient is asked to clench with maximum voluntary contraction (MVC), with two cotton rolls interposed between the dental arches; (ii) the patient is asked to repeat the same clenching activity without the cotton rolls. The outcomes of the study were the EMG indices conceptualized by the manufacturing company, based on the differences between the two test conditions (i.e., clenching on cotton rolls and on dentition). Pairwise correlation analysis and ANOVA test were performed to assess the strength of correlation and the significance of differences between the results of the three trials.
RESULTS
Thirty TMD-free healthy individuals (20 females and 10 males; mean age 44 years, range 16-60 years) took part in the study. ANOVA test did not show any statistically significant difference between the three trials. The Global Index, which is the mean of the other EMG indices, showed the highest correlation values between the three trials, while some other indices showed a weak-to-medium correlation level. One out of five participants showed a coefficient of variation higher than 10%.
CONCLUSIONS
The statistical analysis showed that the indices provided by the device are quite repeatable. However, this does not necessarily imply a specific clinical application of the device, which was here used in fully controlled experimental conditions.
CLINICAL RELEVANCE
The clinical usefulness of the applied protocol remains questionable. Further studies should test the repeatability of EMG findings gathered with this device under various circumstances, in a more heterogeneous population.
Topics: Male; Female; Humans; Adolescent; Young Adult; Adult; Middle Aged; Pilot Projects; Electromyography; Temporal Muscle; Masseter Muscle; Italy; Muscle Contraction
PubMed: 37507600
DOI: 10.1007/s00784-023-05150-8 -
Journal of Clinical Medicine Sep 2023The aim of this study was to assess the erosive tooth wear (ETW) at early and mature adulthood in subjects with natural normal occlusion. The sample consisted of 23...
The aim of this study was to assess the erosive tooth wear (ETW) at early and mature adulthood in subjects with natural normal occlusion. The sample consisted of 23 untreated subjects with normal occlusion. Dental models were taken longitudinally from the same subjects at 13 (T0), 17 (T1) and 60.9 years of age (T2) at a university. Evaluation of ETW was performed using a modified Basic Erosive Wear Examination (BEWE) index. Interphase changes were evaluated using Friedman and Dunn's test. Ordinal logistic regression was used to assess the influence of sex, dental arch, tooth and dental surfaces on the erosive tooth wear. Linear regression was used to evaluate whether the ETW degree at T1 could discriminate the degree of ETW at T2. The significance level adopted was 5%. ETW showed a significant increase with aging. The median ETW index at T0, T1 and T2 was 2, 4 and 7, respectively. ETW was greater in males in the incisors and canines and on the incisal/occlusal and lingual tooth surfaces. No significant differences were found between the maxillary and mandibular arches. Subjects with severe ETW at mature adulthood had greater tooth wear at age 17. In conclusion, ETW significantly increased during aging in subjects with normal occlusion. The greater the degree of tooth wear at early adulthood, the greater the tooth wear at mature adulthood. Preventive care should be recommended during early adulthood in patients demonstrating erosive tooth wear in order to avoid worsening with aging.
PubMed: 37834962
DOI: 10.3390/jcm12196318 -
Physiological Reports Aug 2023Type 2 diabetes mellitus (T2DM) is a major cause of microvascular dysfunction. However, its effect on blood flow patterns during ischemic demand has not been adequately...
Type 2 diabetes mellitus (T2DM) is a major cause of microvascular dysfunction. However, its effect on blood flow patterns during ischemic demand has not been adequately elucidated. In this study, we investigated the hypothesis that microvascular dysfunction in patients with T2DM manifests as brachial reactive hyperemia (BRH), defined as the ratio of peak blood flow velocities in a brachial artery before and after forearm cuff occlusion. The study enrolled 943 subjects (men, n = 152 [T2DM] and n = 371 [non-T2DM]; women, n = 107 [T2DM] and n = 313 [non-T2DM], respectively) with no history of cardiovascular disease. Semiautomatic measurements were obtained three times at 1.5-year intervals to confirm the reproducibility of factors involved in BRH for each sex. An age-adjusted mixed model demonstrated attenuated BRH in the presence of T2DM in both men (p = 0.022) and women (p = 0.031) throughout the study period. Post hoc analysis showed that the estimated BRH was significantly attenuated in patients with T2DM regardless of sex, except at baseline in women. In multivariate regression analysis, T2DM was a negative predictor of BRH at every measurement in men. For women, BRH was more strongly associated with alcohol consumption. Repeated measurements analysis revealed that T2DM was associated with attenuated postocclusion reactive hyperemia.
Topics: Male; Humans; Female; Brachial Artery; Diabetes Mellitus, Type 2; Hyperemia; Reproducibility of Results; Forearm
PubMed: 37607768
DOI: 10.14814/phy2.15786 -
Biomedical Reports Nov 2023For patients diagnosed with advanced malignant parotid tumour, radical parotidectomy with facial nerve sacrifice is part of the treatment. Multiple surgical techniques... (Review)
Review
For patients diagnosed with advanced malignant parotid tumour, radical parotidectomy with facial nerve sacrifice is part of the treatment. Multiple surgical techniques have been developed to cure facial paralysis in order to restore the function and aesthetics of the face. Despite the large number of publications over time on facial nerve reanimation, a consensus on the timing of the procedure or the donor graft selection has remained to be established. Therefore, the aim of the present study was to conduct a bibliometric analysis to identify and analyse scientific publications on the reconstruction of the facial nerve of patients who underwent radical parotidectomy with facial nerve sacrifice. The analysis on the topic was conducted using the built-in tool of the Scopus database and VOSviewer software. The first 100 most cited articles were separately reviewed to address the aim of the study. No consensus was found regarding the recommended surgical techniques for facial nerve reanimation. The most used donor cranial nerves for transfer included the following: Masseteric branch of the V nerve, contralateral VII nerve with cross-face graft, the XI nerve and the XII nerve. The best timing of surgery is also controversial depending on pre-exiting pathology and degree of nerve degeneration. However, most of the clinical experience suggests facial nerve restoration immediately after the ablative procedure to reduce complications and improve patients' quality of life.
PubMed: 37881603
DOI: 10.3892/br.2023.1663 -
Journal of Pharmacy & Bioallied Sciences Feb 2024Orthognathic surgery is a surgical procedure performed to correct severe jaw misalignments that can affect a patient's facial aesthetics and functional occlusion. While...
BACKGROUND
Orthognathic surgery is a surgical procedure performed to correct severe jaw misalignments that can affect a patient's facial aesthetics and functional occlusion. While the primary goal of orthognathic surgery is to improve functional outcomes and facial appearance, it is essential to assess patient satisfaction as a crucial aspect of overall treatment success.
MATERIALS AND METHODS
Patient selection: We conducted a prospective study involving 50 patients who underwent orthognathic surgery. All patients had a confirmed diagnosis of severe jaw misalignment, as determined by clinical and radiographic assessments. The surgical procedures performed included maxillary advancement, mandibular setback, or a combination of both, depending on the patient's specific diagnosis. Preoperative orthodontic treatment was provided to align the teeth and prepare the patient for surgery. Patients were evaluated preoperatively and at postoperative intervals of 3 months, 6 months, and 1 year.
RESULTS
Patient satisfaction scores and functional outcomes were as follows: aesthetics of facial profile (1-year post-op): mean score = 4.6, chewing function (1-year post-op): mean score = 4.4, speech function (1-year post-op): mean score = 4.3, and overall satisfaction with surgical outcome (1-year post-op): mean score = 4.5. Objective assessments revealed a significant improvement in occlusion and facial aesthetics. The mean reduction in overjet was 4.8 mm, and the mean reduction in overbite was 3.2 mm. Additionally, the mean postoperative ANB angle improved by 3.7°, indicating a better facial balance.
CONCLUSION
Orthognathic surgery in our cohort of 50 patients resulted in high levels of patient satisfaction with both functional outcomes and facial aesthetics. Objective measurements also indicated significant improvements in occlusion and facial balance.
PubMed: 38595408
DOI: 10.4103/jpbs.jpbs_864_23 -
BDJ Open Mar 2024To assess the attitude and practices of dentists and dental assistants in managing dust particles generated during dental prostheses or appliances grinding and polishing.
OBJECTIVES
To assess the attitude and practices of dentists and dental assistants in managing dust particles generated during dental prostheses or appliances grinding and polishing.
MATERIALS AND METHODS
Data were collected from 207 dentists and 125 dental assistants through an online questionnaire. The questionnaire included adjusted prosthesis types, self-protective methods, types and frequency of protective device use, and reasons for non-frequent use.
RESULTS
Protective grinding devices, including dust protective boxes and mounted plastic sheets, were commonly used for substantial acrylic resin adjustments, while air blowing was preferred for minor adjustments. Post-COVID-19, there was a 3-fold increase in the use of protective grinding devices among dentists and a 1.3-fold increase among dental assistants. During try-in procedures, dentists commonly rinsed prostheses with water rather than using disinfectants. Non-frequent users adopted self-protection methods, such as face shields and air filters. Surgical drapes and high-volume evacuators were used for patient's protection.
CONCLUSION
Despite an increased tendency of the use of protective grinding devices following COVID-19, a significant number still report infrequent use. Identified protective devices in this study have drawbacks not fully meeting dentists' expectations. Invention of a more user-friendly device is necessary to ensure regular use, preventing potential toxicity from dust particles.
PubMed: 38503744
DOI: 10.1038/s41405-024-00206-7 -
Medicine Sep 2023To explore the effects of a combined orthodontic and restorative approach on chewing, swallowing, and language function in patients with malocclusion and dental defects. (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
To explore the effects of a combined orthodontic and restorative approach on chewing, swallowing, and language function in patients with malocclusion and dental defects.
METHODS
A total of 112 patients with malocclusion and dentition defects admitted to the Lianyungang Hospital of Traditional Chinese Medicine from June 2019 to June 2022 were prospectively selected. The patients were divided into study and control groups using a simple random number table method, with 56 patients in each group. The control group received routine restoration, whereas the study group received a combination of orthodontic and restorative treatments. The chewing function, swallowing and language function, and gingival periodontal condition before and after treatment in both groups were compared using t-test or Wilcoxon test, while treatment satisfaction were compared using chi-square test or Fisher exact test.
RESULTS
After treatment, maximum area frame bite force/max movie force in both groups increased compared to before treatment, while occlusion time, bite force distrbution balance, and standard deviation hue decreased compared to before treatment. Moreover, maximum area frame bite force/max movie force in the study group was higher than that in the control group, whereas occlusion time, bite force distrbution balance, and standard deviation hue were lower than those in the control group (P < .05). The swallowing and language function scores of the study group were higher than those of the control group (P < .05). After treatment, the bleeding index, plaque index, and probing depth of both groups decreased compared to before treatment, and the study group was lower than the control group (P < .05). The treatment satisfaction of the study group (94.64%) was higher than that of the control group (82.14%) (P < .05).
CONCLUSION
Adopting a combined orthodontic and restorative approach to intervene in patients with malocclusion and dentition defects is beneficial for improving their periodontal condition, effectively restoring chewing, swallowing, and language functions, and achieving high patient satisfaction.
Topics: Humans; Dentition; Malocclusion; Gingival Diseases; Periodontal Diseases; Control Groups
PubMed: 37657034
DOI: 10.1097/MD.0000000000035025