Search Results (272)

Acromegaly is caused by an excessive secretion of growth hormone and the secondary elevation of IGF-1 levels, leading to progressive changes in multiple body systems, including the craniofacial region and oral cavity. Dental manifestations such as mandibular overgrowth, macroglossia, malocclusion, periodontal disease, and prosthetic difficulties represent not only a clinical component of the disease but also a significant therapeutic and diagnostic challenge. The aim of this review is to present the current state of knowledge on the relationship between acromegaly and oral health and to analyze the role of interdisciplinary collaboration between endocrinologists and dentists in patient care. For this narrative review, a literature search was conducted in the PubMed, Scopus, and Web of Science databases covering the period from 2000 to 2025. Sixty-two peer-reviewed publications meeting the methodological and thematic criteria were included in the analysis, including original studies, meta-analyses, systematic reviews, and case reports. The results indicate significant correlations between disease activity and the severity of periodontal and microbiological changes, while effective endocrine treatment only results in the partial regression of morphological changes. Particular attention was given to the role of the dentist in recognizing the early symptoms of the disease, planning prosthetic and surgical treatment, and monitoring therapy-related complications. Interdisciplinary collaboration models, including integrated clinics and co-managed care, were also described as optimal systemic solutions for improving treatment quality. The conclusion drawn from the analysis are as follows: there is a need for the permanent integration of dentistry into the standard of interdisciplinary care for patients with acromegaly, in both diagnostic and therapeutic dimensions. Increasing awareness among dentists and developing integrated collaboration models may reduce the time to diagnosis, improve patients’ quality of life, and enable the more effective management of craniofacial complications in the course of this rare disease. Full article

Background: Childhood cancer is considered one of the main causes of mortality and morbidity worldwide. There is strong evidence of the oral toxic effects of oncologic treatments, but their incidence is difficult to determine. The novel therapeutic strategies in Pediatric Oncology have led to increased survival in this population, resulting in an increased incidence of long-term effects, which diminish the patient’s quality of life. Methods: The search for articles started on 5 November 2024 and ended on 5 December 2024. Following the PRISMA Statement, a total of 1266 articles were obtained, from which 13 were selected for review. All articles were considered to be of high quality. The antineoplastic treatments used in them were chemotherapy, radiotherapy, surgery and immune therapy. Results: Most articles were cohorts and case controls. Only one case report was obtained. The results revealed that the most prevalent sequelae in the pediatric population after antineoplastic treatment were enamel alterations, microdontia, dental caries, periodontal disease, gingivitis, hyposalivation, alteration of the oral microbiome, alteration of mandibular bone density and malocclusion. The lesions are different depending on the therapy used. Conclusions: Oncologic treatments in children with cancer cause multiple oral sequelae such as microdontia, dental caries, enamel alterations, salivary gland alterations, mucositis and root resorption. It cannot be concluded which therapy has the most detrimental effect as each has a different mechanism of action in the oral cavity. Full article

Orthognathic surgery (OS) is a complex procedure commonly used to treat dentofacial deformities (DFDs). These conditions, related to jaw position or size and often involving malocclusion, affect approximately 15% of the population. Due to the complexity of OS, accurate planning is essential. Digital assessment using computer-aided design (CAD) and computer-aided manufacturing (CAM) tools enhances surgical predictability. However, limitations in soft tissue simulation often require surgeon input to optimize aesthetic results and minimize surgical impact. This study aimed to evaluate the accuracy of virtual surgery planning (VSP) by analyzing the relationship between planning deviations and surgical satisfaction. A single-center, retrospective study was conducted on 16 patients who underwent OS at San Pedro University Hospital of La Rioja. VSP was based on CT scans using Dolphin Imaging software (v12.0, Patterson Dental, St. Paul, MN, USA) and surgeries were guided by VSP-designed occlusal splints. Outcomes were assessed using the Orthognathic Quality of Life (OQOL) questionnaire and deviations were measured through pre- and postoperative imaging. The results showed high satisfaction scores and good overall outcomes, despite moderate deviations from the virtual plan in many cases, particularly among Class II patients. A total of 63% of patients required VSP modifications due to poor soft tissue fitting, with 72% of these being Class II DFDs. Most deviations involved less maxillary advancement than planned, while maintaining optimal occlusion. This suggests that VSP may overestimate advancement needs, especially in Class II cases. No significant differences in satisfaction were observed between patients with low (<2 mm) and high (>2 mm) deviations. These findings support the use of VSP as a valuable planning tool for OS. However, surgeon experience remains essential, especially in managing soft tissue behavior. Improvements in soft tissue prediction are needed to enhance accuracy, particularly for Class II DFDs. Full article

This study aimed to assess skeletal and upper airway modifications induced by the Twin Block appliance in patients with Class II malocclusion due to mandibular retrusion, using two-dimensional imaging techniques. A total of 11 patients (6 males, 5 females) were included and stratified into two groups (Pre-Peak and Peak) based on skeletal maturity evaluated through the cervical vertebral maturation (CVM) method. Lateral cephalometric radiographs were obtained at the beginning (T0) and end (T1) of treatment and analyzed using DeltaDent software. The appliance was worn full-time, except during meals and oral hygiene procedures, with monthly follow-ups. Significant changes were observed between T0 and T1 across the sample. Comparison between groups revealed statistically significant differences only in the H-C3a1 and vertical height (th) parameters (p < 0.05). In conclusion, the Twin Block appliance proved effective in enhancing mandibular and dental positioning, while also exerting a favorable influence on upper airway development. Full article

Background/Objectives: To identify factors associated with the referral by a multiprofessional team to dental services for children and adolescents with rare genetic diseases. Methods: A cross-sectional study was developed with 87 children/adolescents with mucopolysaccharidosis (n = 26) and osteogenesis imperfecta (n = 61) and their caregivers. Recruitment took place at reference centers for rare genetic conditions in five Brazilian states. The caregivers answered a questionnaire on the children. They were examined for malocclusion, dental anomalies, caries experience, and gingivitis. Bivariate and multivariate analyses of the data were performed, considering a 95% confidence level. Results: The average age of children/adolescents was 10.4 years (±5.6) and 17.3% had never gone to a dentist. Among those with past dental experience, the reason for most appointments was oral prophylaxis/preventive maintenance (62.1%). With regard to referrals to a dentist by the multidisciplinary team, 29.9% had never received a referral. The likelihood of having been referred to a dentist by the multiprofessional team was 2.67 times greater for female patients (95% CI: 0.96–7.42) and 7.74 times greater for children/adolescents with a history of toothache (95% CI: 1.61–37.14). Conclusions: Female children/adolescents with mucopolysaccharidosis and osteogenesis imperfecta and those with a history of dental pain were more likely to have been advised by the multiprofessional team to seek dental treatment. Full article

Background/Objectives: Pacifier use is a widespread soothing practice during infancy, but extended use has been linked to adverse dental outcomes, particularly malocclusion. This review aimed to evaluate the association between pacifier use and dental developmental issues in infants and toddlers and to identify key influencing factors. Methods: A scoping review using PubMed, Scopus, Web of Science, and Dentistry and Oral Sciences Source was performed. Peer-reviewed, full-text articles published in English between 2014 and 2024 were screened by two independent reviewers using predefined criteria. Eligible studies were thematically analyzed. Results: From 262 records, 35 studies met the inclusion criteria. Pacifier use was consistently associated with an increased prevalence of malocclusions, including anterior open bite, posterior crossbite, and overjet. The risk and severity of dental issues were strongly influenced by the duration, frequency, and intensity of pacifier use. Prolonged use beyond three years significantly increased the likelihood of structural changes requiring intervention. Conclusion: There is strong evidence linking pacifier use to negative dental developmental outcomes, particularly when use is prolonged or frequent. Early intervention, caregiver education, and timely weaning are critical to minimizing long-term oral health risks. Future research should explore pacifier design, objective measures of use, and how socioeconomic factors may influence pacifier use patterns and oral health outcomes. Understanding these relationships can support the development of more targeted and equitable prevention strategies. Full article

Background/Objectives: Supernumerary teeth, or hyperdontia, refer to a developmental anomaly defined by the presence of additional teeth beyond the normal dentition. Hyperdontia may result in clinical complications including delayed eruption, crowding, and malocclusion. Despite its prevalence having been studied in various populations, data from geographically isolated or peripheral groups remain limited. This study aimed to investigate the prevalence and distribution of supernumerary teeth in a sample of children and adolescents from the island of Lesvos, Greece. Methods: A retrospective cross-sectional study was conducted using panoramic radiographs from 621 Caucasian children aged 9–16 years who attended orthodontic or general/pediatric dental clinics in Mytilini, Lesvos island, Greece. Radiographs were examined for the presence, number, type, and location of supernumerary teeth. The analysis included data to explore gender and arch distribution. Results: Supernumerary teeth were identified in 15 individuals, corresponding to a prevalence of 2.4%. A slightly higher occurrence was observed in males (1.4%) than in females (1%). The majority of supernumerary teeth were situated in the maxillary arch (1.9%). Mesiodens represented the most frequently observed type, followed by supernumerary lateral incisors, paramolars, and a single supernumerary central incisor. Conclusions: The prevalence of supernumerary teeth in this population is consistent with reported findings. Mesiodens was the most frequently observed type, with a predominance in the maxillary arch. Early detection of supernumerary teeth is crucial for accurate diagnosis and effective management. Full article

Background: Distalization is a fundamental orthodontic strategy for correcting Class II and Class III malocclusions, particularly in cases where specific dental or skeletal conditions favor its application. Recent technological advances have enabled complex dental movements to be performed using clear aligners, aided by digital planning platforms such as ClinCheck^®. Methods: This retrospective study aimed to evaluate the accuracy of ClinCheck^® in predicting molar and canine distalization outcomes with the Invisalign^® system and to identify clinical factors influencing treatment predictability. Thirty patients with complete permanent dentition and at least 2 mm of programmed distalization were selected. Planned movements were extracted from the Invisalign^® Doctor Site and compared to achieved outcomes using Geomagic^® Control X™ software. Occlusal improvements were assessed using the Peer Assessment Rating (PAR) index. Results: The results revealed significant discrepancies between the programmed and achieved distalization, with mean deviations greater than 1 mm in both arches. Skeletal anchorage with mini-screws significantly improved distalization outcomes in the maxillary arch; however, no significant effect was observed in the mandibular arch. Additionally, no significant associations were found between distalization outcomes and skeletal pattern (ANB angle) or facial biotype. Conclusions: Clear aligners are effective in achieving substantial occlusal improvements, particularly when combined with personalized digital planning and supplementary strategies such as skeletal anchorage. Mandibular cases demonstrated greater reductions in PAR scores, emphasizing the potential of aligners in complex distalization treatments. Full article

Background/Objectives: Temporomandibular disorders (TMDs) are a group of musculoskeletal and neuromuscular conditions involving the temporomandibular joint (TMJ), masticatory muscles, and related anatomical structures. Although magnetic resonance imaging (MRI) is considered a noninvasive and highly informative imaging modality for assessing TMJ soft tissues, few studies have examined how TMJ structural features observed on MRI findings relate to oral function and craniofacial morphology in female patients with malocclusion. To investigate the associations among TMJ structural features, oral function, and craniofacial morphology in female patients with malocclusion, using MRI findings interpreted in conjunction with a preliminary assessment based on selected components of the DC/TMDs Axis I protocol. Methods: A total of 120 female patients (mean age: 27.3 ± 10.9 years) underwent clinical examination based on DC/TMDs Axis I and MRI-based structural characterization of the TMJ. Based on the structural features identified by MRI, patients were classified into four groups for comparison: osteoarthritis (OA), bilateral disk displacement (BDD), unilateral disk displacement (UDD), and a group with Osseous Change/Disk Displacement negative (OC/DD (−)). Occlusal contact area, occlusal force, masticatory efficiency, tongue pressure, and lip pressure were measured. Lateral cephalometric analysis assessed skeletal and dental patterns. Results: OA group exhibited significantly reduced occlusal contact area (p < 0.0083, η² = 0.12) and occlusal force (p < 0.0083, η² = 0.14) compared to the OC/DD (−) group. Cephalometric analysis revealed that both OA and BDD groups had significantly larger ANB angles (OA: 5.7°, BDD: 5.2°, OC/DD (−): 3.7°; p < 0.0083, η² = 0.21) and FMA angles (OA: 32.4°, BDD: 31.8°, OC/DD (−): 29.0°; p < 0.0083, η² = 0.17) compared to the OC/DD (−) group. No significant differences were observed in masticatory efficiency, tongue pressure, or lip pressure. Conclusions: TMJ structural abnormalities detected via MRI, especially osteoarthritis, are associated with diminished oral function and skeletal Class II and high-angle features in female patients with malocclusion. Although orthodontic treatment is not intended to manage TMDs, MRI-based structural characterization—when clinically appropriate—may aid in treatment planning by identifying underlying joint conditions. Full article

Background: The Index of Orthodontic Treatment Need (IOTN) is widely used to assess the need for orthodontic treatment. IOTN consists of the Dental Health Component (DHC) and the Aesthetic Component (AC), evaluating malocclusion morphologically and aesthetically, respectively. However, the discriminatory power of individual DHC items and their relationship with AC grades remain unclear. Objective: This study aimed to evaluate the effectiveness of individual DHC items in school dental examinations and investigate their contribution to AC grades among junior high and high school students. Methods: A total of 726 students (443 males, 283 females; aged 12–18 years) from Tsurumi University Junior and Senior High School, excluding 168 students undergoing or having completed orthodontic treatment, were included. Nine calibrated orthodontists assessed DHC and AC using IOTN during standardized school examinations. The discriminatory power and information precision of DHC items were evaluated by Item Response Theory (IRT) analysis using three-, two-, or one-parameter logistic models depending on convergence. Correspondence analysis visualized the correlation between DHC and AC grades. Simple linear regression analyzed the contribution of each DHC item to AC grades. Results: Orthodontic treatment need was identified in 21.1% of students. Females showed a higher rate of treatment need than males. Correspondence analysis suggested that aesthetic evaluations were more lenient than morphological evaluations. IRT and regression analysis revealed that crowding (4.d), increased overjet (2.a), and increased overbite (2.f) demonstrated high discriminatory power and significant contributions to AC grades. Conclusions: Among the DHC items, crowding, increased overjet, and increased overbite had higher discriminatory power for malocclusion and contributed more significantly to AC evaluations compared to other items. Full article

Background/Objectives: This study evaluates the diagnostic and referral skills of final-year dental students at Al-Iraqia University using a questionnaire based on malocclusion cases ranging from mild to severe. Methods: The questionnaire, featuring photos and radiographs of five selected treated cases from two textbooks, was answered by 165 students who were asked to assess each case and determine whether orthodontic or surgical treatment was necessary, as well as to identify factors contributing to an unesthetic profile, such as irregular teeth. Frequency distribution and the Chi-square test were used for statistical analysis. Results: The results indicated good overall clinical competence. The unesthetic profile and irregular teeth were the main reasons for referring both Class II and III cases for surgery, with mandibular retrusion being the most common factor in aesthetic concerns. Maxillary protrusion was less frequently selected as a key factor in Class II malocclusion cases. Conclusions: The findings suggest that students demonstrated a high level of diagnostic accuracy in identifying treatment needs for various malocclusion cases. Full article

Background: The aim of this study was to evaluate the correlation between skeletal class and dental dimensions analyzed through linear, surface area, and volumetric measurements. Methods: The sample consisted of 90 patients with an average age of 18 years (44 > x > 12). The following tests were used to investigate any correlation between skeletal class and tooth size: Hoeffding’s test, Cramér’s V test, and analysis of variance (ANOVA), followed by Tukey’s post hoc HSD test and the logit model. The significance level was set at 0.050. Results: Cramér’s V test indicated a weak association between skeletal class (I, II, III) and total Bolton index (V = 0.167, p < 0.01). The ANOVA results showed that the total inferior volume and the anterior inferior volume were significantly greater (p = 0.012; p = 0.012) in skeletal class III (p = 0.012) than in the other two skeletal classes. The total upper surface area was significantly greater in patients with skeletal class III compared to those with classes II and I (p = 0.029). The anterior superior surface area was significantly greater in skeletal class III than in class II and I (p = 0.028). From the results of the logit analysis, it is possible to state that the third model is able to explain greater variability (21%) in terms of the distribution of results for the variables considered than the first (20%) and the second (14%). Conclusions: Class III skeletal malocclusions are characterized by increased tooth surface and volumetric dimensions compared to class I and class II. Full article

Background: Class II Division 1 malocclusion is often characterized by an increased overjet, which has traditionally been considered a negative predictor of aesthetic outcomes, treatment efficacy, and long-term stability. Although early two-phase treatment is generally perceived as less effective than a single-stage pubertal peak intervention, it may be beneficial in cases with concerns such as trauma risk or bullying. This study aimed to assess the relationship between initial overjet and sagittal correction (as measured by the ANB and WITS indices) to identify a threshold beyond which two-phase treatment might be more effective. Methods: A retrospective analysis was conducted on 58 patients (mean age: 9.01 years), all of whom were treated consecutively with the Manni Telescopic Herbst Appliance. Lateral cephalograms taken at the start (T0) and end (T1) of Herbst treatment were analyzed to evaluate changes in skeletal and dental parameters. Results: A significant positive correlation was found between higher initial overjet and increased skeletal sagittal correction. Specifically, for every 1 mm increase in overjet, there was a 0.65 mm reduction in the WITS index and a 0.30° decrease in the ANB angle (p < 0.01). These effects were more pronounced when the initial overjet exceeded 8.0 mm. Conclusions: The Manni Telescopic Herbst Appliance demonstrated enhanced skeletal correction in patients with larger initial overjet values, particularly when the overjet exceeded 8.0 mm. This suggests that early two-phase treatment may be especially beneficial in such cases. Full article

Background/Objectives: Orthodontic camouflage is a treatment strategy designed to address mild to moderate skeletal discrepancies through dental compensation when growth modification or orthognathic surgery (OGS) is unsuitable or declined by the patient. This report highlights the treatment of a child with a skeletal Class II pattern, Class II division 1 malocclusion, a 10.8 mm overjet, traumatic overbite, and unilateral temporomandibular joint (TMJ) ankylosis on the left side. Methods: The treatment plan focused on correcting the proclination of the maxillary incisors and improving the facial profile. A non-extraction camouflage approach using pre-adjusted edgewise appliances was implemented following a gap arthroplasty procedure on the left TMJ. Results: The patient achieved a satisfactory treatment outcome, with an ideal static and functional occlusion and significant improvement in facial esthetics. The approach effectively managed the severe mandibular retrognathia and TMJ ankylosis without OGS, thereby minimizing the risk of progressive condylar resorption. Conclusions: This case underscores the importance of personalized treatment plans tailored to each patient’s dental, skeletal, and individual needs. It demonstrates that non-surgical camouflage treatments can be a viable alternative for addressing severe mandibular retrognathia with TMJ ankylosis, achieving favorable esthetic and functional outcomes. Full article

Osteoporosis is the most common metabolic bone disorder, characterized by reduced bone mass and abnormal bone microarchitecture, resulting in increased bone fragility and a heightened risk of low-energy fractures. Pediatric osteoporosis may be either primary, due to genetic factors, or secondary, arising from chronic diseases and/or their treatment. Oral health and proper occlusion are integral components of overall health, influencing functionality, nutrition, facial aesthetics, and psychosocial development during childhood. Severe malocclusion can adversely affect speech, mastication, appearance, psychological well-being, and social interactions. The aim of this narrative review is to examine the existing literature on orthodontic anomalies and management strategies in pediatric patients with osteoporosis while highlighting clinical challenges, treatment limitations, and areas necessitating further research. A comprehensive literature search was conducted in the PubMed database, focusing on studies involving human subjects aged 3 to 18 years, published in English between 2002 and 2024. The findings indicate that children with osteoporosis present with more severe dental and occlusal complications compared to their healthy peers, often facing increased orthodontic complexity due to skeletal fragility and systemic comorbidities. These challenges necessitate careful, individualized treatment planning and close multidisciplinary collaboration. Although research in this field remains limited due to the rarity of pediatric osteoporosis, recognizing and addressing the specific needs of this population is critical to improving clinical outcomes and guiding future therapeutic approaches. Full article