Search Results (22)

Background/Objectives: A previous study evaluating convex facial profiles at rest demonstrated that combined orthodontic and orthognathic surgical treatment is more effective in enhancing facial aesthetics compared to orthodontic camouflage alone. The present follow-up study aimed to reassess these findings by incorporating both profile and frontal facial views in the aesthetic evaluation. Methods: This retrospective cohort study sample included 36 consecutively selected patients with convex facial profiles and Class II Division 1 malocclusion. Two groups of 18 non-growing patients with similar characteristics were compared. Group A was treated with orthodontics and orthognathic surgery, whereas Group B was treated with orthodontics exclusively. Pre- and post-treatment profile and frontal facial photographs were simultaneously presented to orthodontists, oral and maxillofacial surgeons, convex profile patients, and laypeople, asking them to assess changes in facial appearance. Results: Significant positive changes in facial appearance were perceived for Group A, in contrast to no changes for Group B, with a difference of 17/100 visual analogue scale (VAS) units. The rater groups demonstrated a high degree of consistency (ICC > 0.88). Multivariate analysis revealed significant differences in perceived changes between the two treatment groups (F = 14.63, p < 0.001, Pillai’s Trace = 0.36, and partial η² = 0.36), with no significant effects from the rater group (p > 0.05). Similar results are evident when only profile photos were rated (p > 0.05). Conclusions: The combined orthodontic and orthognathic surgery approach effectively enhances facial appearance in convex profile cases, whereas orthodontic treatment alone does not result in significant changes. These findings should be clearly communicated during patient consultations and considered in treatment planning. Full article

The prosthetic emergence profile is a factor potentially affecting marginal bone level around dental implants. The aim of this review is to provide a comprehensive analysis of the influence of the prosthetic emergence profile on peri-implant marginal bone-level stability. The marginal bone level is an important parameter in implant dentistry, reflecting the stability of dental implants, and it is a critical indicator of long-term implant success. Minimizing marginal bone loss around dental implants is a key factor for maintaining implant function, supporting peri-implant soft tissues, and achieving predictable aesthetic outcomes. The scientific literature presents various examples of evidence on the influence of emergence angle and prosthetic designs on marginal bone loss. Several studies suggest that emergence angles exceeding 30° and convex prosthetic designs may increase the risk of peri-implantitis and bone resorption, while others find no significant correlation. Moreover, several studies demonstrated the positive influence of taper joint connections on marginal bone stability. Although the current literature remains diverse, it is essential to prioritize cleanability and minimize plaque accumulation for a successful implant-prosthetic restoration. Proper maintenance and a continuous follow-up to monitor marginal bone loss are beneficial for obtaining stable and optimal long-term results. Full article

Background/Objectives: Contact areas between first and second primary molars, shaped by concave/convex proximal surface morphology, are associated with proximal caries with concave surfaces linked to biofilm stagnation. This study aimed to evaluate the accuracy and clinical feasibility of a scoring system for classifying contact types (concave–concave, concave–convex, convex–convex, convex–concave) for dental practitioners. Methods: Following ethical approval and informed consent, 116 4–5-year-old children were enrolled. A calibrated examiner assessed caries on the distal of first molars and mesial of second molars using ICDAS-merged criteria and scored 464 proximal contacts clinically and radiographically. Stone models from silicone impressions were also scored by 17 trained practitioners, who repeated scoring a week later and assessed contacts clinically in six children. Practitioners completed a feasibility and satisfaction questionnaire. Results: Convex–convex contacts were most prevalent (58.6%), followed by convex–concave (32.6%). Contact type significantly correlated with caries (OR = 13.5; 95% CI: 6.4–28.3). Inter- and intra-examiner reproducibility ranged from 0.71 to 0.82. Most practitioners felt very (64.7%) or moderately (35.3%) capable of applying the system, found it low in difficulty (70.6%), and expressed high satisfaction (82.4%). Conclusions: The study indicated that it is possible for dental practitioners to classify the proximal contact types between primary molars both in an accurate and clinically feasible way. The system exhibited high reproducibility and practitioner satisfaction, indicating its potential as a valuable tool for identifying caries-prone surfaces and supporting evidence-based caries management. Full article

Introduction: The study of facial profiles in the dental field is very important for the diagnosis and the dental and orthodontic treatment plan. The aim of this study is to analyze the three-dimensional morphology of the faces of 269 growing patients with Class I and II occlusions, focusing on children aged between 6 and 9 years old. The analysis was conducted using a non-invasive computerized system, which allowed for the automatic collection of facial landmarks and the subsequent reconstruction of three-dimensional coordinates. Materials and methods: The sample comprised 269 children within the specified age range. Each child’s facial features were captured using the non-invasive computerized system, which utilized two infrared CCD cameras, real-time hardware for label recognition, and software for three-dimensional landmark reconstruction. Sixteen cutaneous facial landmarks were automatically collected for each participant. From these landmarks, 10 angular and 15 linear measurements, as well as five direct distance rates, were derived. The mean values for each age class were calculated separately for children with bilateral Angle Class I occlusion and compared with those for children with bilateral Class II occlusion. In all children, the left and right occlusal classes were measured as suggested by Katz. Results: The analysis revealed notable differences, primarily in the three-dimensional angular measurements between children with Class I and II occlusions. Specifically, Class II children exhibited more convex faces in the sagittal plane and a less prominent lower jaw compared to Class I children. However, no significant differences were observed in linear measurements, except for the lower facial height rate, which varied inconsistently across age groups between the two occlusion types. Discussion and Conclusions: the findings of this research highlight distinct three-dimensional facial morphological differences between children with Class I and II occlusions. While Class II children tended to have more convex facial profiles and less prominent lower jaws, linear measurements showed minimal variation between the two occlusion types. These results underscore the importance of three-dimensional analysis in understanding facial morphology in growing patients with different occlusal patterns. Full article

Background: Intraoral scanning technology has opened new perspectives in dental practice, and combined with CAD/CAM technology, contributes significantly to fabricating high-quality prosthetic restorations. Our in vitro study aims to assess the accuracy of digital models obtained from one laboratory and two less commonly used intraoral scanners by conducting 3D measurements on the digital models obtained. Methods: An articulated simulator cast was used. Forty-eight scans were performed before and after tooth preparation with each scanner. The Zeiss Inspect software (Version: 2023.3.0.969) was used for measurements in sagittal and transversal planes. The obtained values were compared to reference values resulting from manual measurements. Results: Digital impressions provided discrepancies compared to the reference model. The lowest differences at the A2-L2 (the diagonal dimension of the models from the distal fossa of the second right maxillary molar and the maximum oral convexity of the artificial gingiva at the first left premolar) and the A1-B1 (transversal dimension of the model in the posterior area, from the right second molar’s occlusal central fossa to the left second molar central fossa) distances were obtained for the upper models, and at the a1-b1 distance for all the lower models, except the non-prepared models scanned with the intraoral scanners (the discrepancies were not statistically significant). The discrepancies increased with the distance from the starting point of the scan. Conclusion: The number and position of prepared teeth can influence the accuracy of the scans. Distortions can appear in the case of multiple preparations. The scanning protocol and calibration must be optimized for the highest accuracy. Furthermore, in vivo studies are necessary to evaluate the clinical applicability of these findings. Full article

Polishing after the removal of brackets is the final step in orthodontic treatment. It is simple to perform, though some studies have reported that polishing causes damage to the enamel surface. An in vitro study was made of the influence of the buccal surface convexity of the tooth upon possible enamel loss when the remaining resin and adhesive are removed after bracket decementing using two different polishing modes: a tungsten carbide bur at low and high speeds. The convexity of the buccal surface was quantified in 30 incisors and 30 premolars. A stereoscopic microscope was used to obtain photographs of the profile of the crown, and Image J software was used to calculate convexity by dividing the length of a line from the cementoenamel junction to the incisal margin by another line from the mentioned junction to the maximum convexity of the buccal surface. Brackets were cemented on all the teeth and were decemented 24 h later. In both groups, the residual composite was removed with a tungsten carbide bur at a low speed in one-half of the teeth and at a high speed in the other half. The buccal surface of each tooth was then photographed again, and the convexity was calculated and compared against the baseline value. The difference between the two values were taken to represent the enamel loss. The convexity of the premolars was significantly greater than that of the incisors, but this did not result in greater enamel loss when the same polishing mode was used. However, the tungsten carbide bur at a high speed proved more aggressive, causing significantly greater enamel loss than when used at a low speed. Full article

Increased facial profile convexity has a common occurrence in the population and is a primary reason for seeking orthodontic treatment. The present study aimed to compare the perceived changes in facial profile appearance between patients treated with combined orthognathic/orthodontic treatment versus only orthodontic camouflage treatment. For this reason, 18 pairs of before- and after-treatment facial profile photos per treatment group (n = 36 patients) were presented to four types of assessors (surgeons, orthodontists, patients, laypeople). Ratings were recorded on 100 mm visual analogue scales depicted in previously validated questionnaires. All rater groups identified minor positive changes in the facial profile appearance after exclusively orthodontic treatment, in contrast to substantial positive changes (14% to 18%) following combined orthodontic and orthognathic surgery. The differences between the two treatment approaches were slightly larger in the lower face and the chin than in the lips. The combined orthodontic and orthognathic surgery interventions were efficient in improving the facial appearance of patients with convex profile, whereas orthodontic treatment alone was not. Given the significant influence of facial aesthetics on various life aspects and its pivotal role in treatment demand and patient satisfaction, healthcare providers should take these findings into account when consulting adult patients with a convex facial profile. Full article

Skeletal Class II is a common malocclusion affecting the Caucasian population and characterized, in most cases, by a convex profile and mandibular retrusion. Therefore, the treatment plan often requires the use of functional appliances to promote mandibular advancement. In particular, the Herbst appliance is recommended because of its efficiency and minimal need for compliance. However, in addition to skeletal favorable effects, undesired dental compensations could prematurely reduce the overjet needed for a proper orthopedic outcome. The combination of this appliance with skeletal anchorage and elastic ligatures in the lower or both, in the upper and the lower arch, enables effective control of unfavorable tooth movements, improving the therapeutic potential of such a treatment. These improvements have significantly shifted the main focus on facial aesthetics rather than dental occlusion, with the creation of innovative treatment protocols and a new diagnostic approach to Class II malocclusion. Full article

Background and Objectives: A higher prevalence of dental malocclusion has been suggested among individuals with Down Syndrome (DS) compared to controls, although no studies to date have investigated such a difference according to age group. Therefore, the aim of this study was to compare the prevalence of dental malocclusion and other orthodontic measures between DS and non-syndromic (non-DS) individuals across three age groups of children, adolescents, and adults. Materials and Methods: This cross-sectional study was conducted on a total of 147 patients. Of those, 72 were diagnosed with DS and were divided into N = 15 children (<10 years), N = 23 adolescents (10–18 years) and N = 34 adults (>18 years). The remaining 75 patients were sex- and age-matched controls. The two groups were compared according to age group in terms of the prevalence of dental malocclusion, measures of sagittal, vertical, and transverse discrepancy, facial profile, and probable sleep bruxism with chi-square tests for proportion. Results: The DS patients consistently exhibited a higher prevalence of Class 3 malocclusion, concave profile and anterior crossbite compared to the non-DS patients, regardless of age group. The non-DS adolescents presented with a significantly higher prevalence of convex profile than the DS adolescents. The adolescent and adult DS patients most commonly presented with a maxillary transverse discrepancy and posterior crossbite compared to the non-DS controls. The DS adults had a higher prevalence of probable sleep bruxism. Conclusions: Patients with DS showed a higher prevalence of Class 3 malocclusion, concave profile and anterior crossbite compared to non-DS controls, regardless of age group. Other orthodontic measures showed a fluctuation according to the age group considered. Full article

Depending on how severe it is, malocclusion, which may involve misaligned teeth, jaws, or a combination of the two, can hurt a person’s overall facial aesthetics. The maxillary molar develops before the mandibular molar in class II malocclusion, which affects 15% of the population in the United States. With a retrusive mandible, patients typically have a convex profile. The goal of this study is to classify the skeletal and dental variability present in class II malocclusion, to reduce heterogeneity, present the current clinical treatment strategies, to summarize the previously published findings of genetic analysis, discuss these findings and their constraints, and finally, propose a comprehensive roadmap to facilitate investigations aimed at determining the genetic bases of malocclusion development using a variety of genomic approaches. To further comprehend the hereditary components involved in the onset and progression of class II malocclusion, a novel animal model for class II malocclusion should be developed while considering the variety of the human population. To overcome the constraints of the previous studies, here, we propose to conduct novel research on humans with the support of mouse models to produce contentious findings. We believe that carrying out a genome-wide association study (GWAS) on a large human cohort to search for significant genes and their modifiers; an epigenetics-wide association study (EWAS); RNA-seq analysis; integrating GWAS and the expression of quantitative trait loci (eQTL); and the testing of microRNAs, small RNAs, and long noncoding RNAs in tissues related to the skeletal class II malocclusion (SCIIMO) phenotype, such as mandibular bone, gum, and jaw in humans and the collaborative cross (CC) mouse model, will identify novel genes and genetic factors affecting this phenotype. We anticipate discovering novel genetic elements to advance our knowledge of how this malocclusion phenotype develops and open the venue for the early identification of patients carrying the susceptible genetic factors so that we can offer early prevention treatment strategies. Full article

Background: With the introduction of high-tech appliances, anchorage devices, and improved patient awareness of the risks associated with maxillofacial surgery, treating complex situations with orthodontic treatment has become more difficult in recent years. This study was conducted to demonstrate that orienting the occlusal plane, all the dental, skeletal, and soft tissue parameters, would be improved and to find which of these parameters could be correlated with the steepness of the occlusal plane. Materials and methods: This was a retrospective study including 40 cephalometric interpretations for patients who were planned for four-unit extractions (20 cephalometric radiographies before treatment and 20 after finishing the treatment). All were treated in the same orthodontic clinic with the same protocol using the McLaughlin–Bennett–Trevisi (MBT) prescription, with 22 slots and one-step retraction following four-unit extraction based on temporary anchorage devices (TADs). Results: There was no significant change in the canting of the occlusal plane, and it remained relatively stable from 6.31° to 7.55°, while all the soft tissue-related cephalometric measurements were reduced significantly, except the nasolabial angle, as the relation of the upper and lower lip to the esthetic line of Ricketts’ (E-Line) was reduced by 2.91 and 2.46°, respectively; furthermore, the angle of convexity was reduced from 10.92° to 9.79°. Besides, the upper incisor display was reduced by 0.38° Conclusions: Both the Frankfort mandibular angle and upper-incisor-to-Frankfort horizontal plane were significant parametric factors associated with profile change after extraction treatment having a positive 0.01-level Pearson association with occlusal plane steepness. Therefore, using the MBT prescription with TAD-based retraction is one of the favorable methods for the management of complex cases. Full article

Studies related to facial soft tissue thickness (FSTT) have been conducted since the late 19th century. Soft tissue is any tissue in the body that is not hardened by ossification or calcification processes, such as bones and teeth; and varies according to sex, age, race, and nutritional status. Forensically, soft tissue thickness plays an important role in cases where a cadaver has no unique characteristics; and the remains cannot be identified through DNA analysis, fingerprints, or examination of dental records. Therefore, the results of the current study suggest that the average thickness of the three skeletal classes (i.e., straight, concave, and convex) should be used for face restoration and forensic art research. It is thought that the current study’s results will be invaluable in the fields of forensic science, forensic art, anthropology, and dentistry. As a result, gender differences were observed in all classes, and the facial tissue thickness in Korean adults differed according to gender and occlusion type. Full article

Objectives: Fixed appliance treatment with premolar extraction is often required after functional appliance treatment to relieve crowding and improve facial aesthetics in the Asian population. This study compared the treatment efficacy of two approaches for treating Class II division 1 malocclusion: functional appliance followed by fixed appliance treatment with extraction (two-phase) and fixed appliance treatment with extraction (one-phase). Methods: Growing skeletal Class II patients with an overjet of ≥6 mm treated with two- or one-phase orthodontics were included. The two groups consisted of 29 patients (mean age = 12.55) and 30 patients (mean age = 12.72), respectively. Pre- and post-treatment cephalograms were analysed and skeletal, dental, and soft tissue characteristics were compared using independent t-tests. Treatment changes were compared within and between groups using paired and independent t-tests, respectively. Stepwise discriminant analysis was performed to identify the variables that best predicted pre-treatment group allocations. Results: At baseline, there were no significant between-group differences in age, gender, cervical vertebral maturation, or overjet. The two-phase group had greater Class II skeletal discrepancies (ANB angle and Wits appraisal). During treatment, the two-phase group showed greater improvements in intermaxillary relationship and facial convexity compared with the one-phase group (p < 0.01). Following treatment, the two-phase group had a greater L1/APog distance (p < 0.05). Facial convexity and Wits appraisal were identified as parameters significantly influencing the clinicians’ decision to use a one- or two-phase approach. Conclusions: In patients requiring premolar extraction, two-phase (vs. one-phase) treatment produced greater improvements in the intermaxillary relationship and facial convexity. Full article

Peri-implantitis is a significant problem associated with dental implants. It has been hypothesized that creating a soft-tissue seal around the implant neck prevents peri-implantitis. This study aims to clarify the effects of the surface smoothness of titanium disks on soft tissues. Thus, titanium disks were prepared through electrolytic composite polishing (ECP), sisal buffing (SB), hairline polishing (HP), and laser cutting (LC). The surface roughness values of seven items was measured. For ECP, SB, HP, and LC samples, the Ra values were 0.075, 0.217, 0.671, and 1.024 μm and the Sa values were 0.005, 0.115, 0.500, and 0.676, respectively, indicating that the surface roughness was remarkably lower with ECP. Moreover, the Wsk values for ECP, SB, HP, and LC were 0.521, 1.018, −0.678, and −0.558, respectively. The smooth surfaces produced by ECP and SB were biased toward the concave surface, whereas those produced by HP and LC were biased toward the convex surface. The Rku values for ECP, SB, HP, and LC were 2.984, 11.774, 14.182, and 26.232, respectively. Only the ECP exhibited a moderate bias peak and produced an extremely smooth surface. The contact angles in the cases of ECP, SB, HP, and LC were 60.1°, 66.3°, 68.4°, and 79.3°, respectively, indicating the hydrophobicity of the titanium disks. Human oral fibroblasts were then incubated on each disk for 24 and 48 h to measure cell attachment, and no significant differences were observed. The differences in Ra and Sa did not affect cell attachment. Therefore, by applying ECP to the abutment or implant neck, the cell attachment required for soft-tissue formation while preventing bacterial adhesion can be achieved. Full article

Treatment of third-class malocclusions often presents a challenge for orthodontists. Skeletal disharmony is often associated with dental malposition. There are several therapeutic choices, including the use in combination of transverse expansion of the maxilla with rapid palatal expander (RPE) and posterior-anterior traction with a Delaire face mask (FM). The purpose of the study is to verify whether there are significant differences in the treatment outcome in the case of use of a face mask followed by a palatal expander or with the sequence of these auxiliaries reversed. Subject and Methods: The two groups were both made up of 13 patients, subdivided into group A, i.e., those whose sequence involved the use of extraoral traction first and then the disjunctor, and those with an inverted sequence in group B. Some cephalometric parameters and dento-skeletal characteristics were evaluated pre-treatment (t0) and at the end of therapy (t1). Results: Considering the T1–T0 of group A (Delaire + rapid palatal expander), the evaluation of the results obtained in this work allows us to observe how within group A there is a significant improvement in the Witts and Nanda indices and facial convexity. Group B (treated with the palate disjunctor sequence followed by traction with Delaire’s mask) showed a significant improvement in ANB, in AoBo, and AppBpp values and in convexity. The two groups were comparable, and no statistically significant difference was highlighted. Discussion: The early therapy of the third skeletal classes by means of a rapid palate expander and face mask is effective. There is no statistically significant difference in the two groups who performed the therapy in reverse mode. This suggests that the clinician should choose the treatment sequence based on the skeletal and occlusal conditions of their patients at the start of treatment. Conclusion: Early therapy of third skeletal classes with sagittal expansion using a rapid palate expander can be performed earlier or later than posterior-anterior traction with a Delaire mask. Full article