Posteroanterior cephalometric changes in subjects with temporomandibular joint disorders.

OBJECTIVES: The aim of the study was to establish the changes in posteroanterior cephalometric variables in subjects with temporomandibular joint disorders (TMDs). METHODS: Posteroanterior cephalograms of 61 subjects (age range 16-36.6 years, standard deviation 4.88 years) were used to determine cephalometric differences. Subjects were classified according to the Research Diagnostic Criteria for Temporomandibular Joint Disorders into three groups: unilateral TMD, bilateral TMD and no TMD. 14 linear and angular measurements were assessed on the posteroanterior cephalogram. For assessing facial asymmetry, the asymmetry index for bilateral measurements was calculated between the right and the left side. In cases with unilateral TMD, the asymmetry index was calculated using the difference between the unaffected and affected side. The differences among multiple groups were analysed using the one-way analysis of variance test and Scheffé post hoc test. RESULTS: 47 subjects were females (77%) and 14 were males (23%). 19 subjects had unilateral TMDs and 16 subjects had bilateral TMDs. The asymmetry index of the distance from the horizontal plane to the antegonion was higher in subjects with unilateral TMD than in patients with bilateral or no TMD (p < 0.05). Also, the asymmetry index of the distances from the vertical plane to the condyle (p = 0.05), gonion (Go) (p = 0.0004), antegonion (p = 0.002) and chin (Ch) (p = 0.02) was higher in subjects with unilateral TMDs. The asymmetry index of the O point-Go-Go' and O point-Ch-Ch' angles differed significantly in subjects with unilateral TMDs (p < 0.05). CONCLUSIONS: Unilateral TMDs are associated with changes in posteroanterior cephalometric measurements. The assessment of posteroanterior cephalometric variables could be used as a key factor for evaluating the presence of TMDs.

Osteonecrosis of the jaws associated with the use of bisphosphonates. Discussion over 52 cases.

BACKGROUND: Osteonecrosis of the jaws is increasing worldwide in patients treated with bisphosphonates. STUDY DESIGN: A retrospective review of 52 patients who were treated during 2007-2010 for bisphosphonate related maxillofacial symptoms of the jaws was conducted. Patient characteristics and other factors that influenced the disease process were studied. RESULTS: Thirteen patients received bisphosphonates for the prevention or treatment of osteoporosis; 39 for preventing bone metastases from malignant tumors. Thirty-six patients were females (age range 32-87 years, median 64 years); 16 were males (age range 30-81 years, median 73.5 years). Bisphosphonate used was ibandronic acid in four cases, alendronate sodium in 14 cases, and zoledronic acid in 34 cases. Mean bisphosphonate treatment period was 22.44 months (95%CI 19.33-25.55). Thirty patients received intravenous, 22 received oral bisphosphonate. The average period until occurrence of maxillofacial symptoms was 6 months (range 0.5-24 months) in subjects with intravenous bisphosphonate and 12.26 months (range 0.25-36 months) in subjects with oral bisphosphonates (p=0.011). CONCLUSIONS: The risk of bisphosphonate related osteonecrosis of the jaws is very high twelve months after oral administration and six months after intravenous administration in patients who have a trigger point in the jaws area. A proper monitoring of patients receiving bisphosphonates can reduce the risk of osteonecrosis and can prevent complications.

Serum changes induced by intramedullar experimental administration of bisphosphonates.

Bisphosphonates, stable analogues of pyrophosphate, have the ability to bind to bone molecules, possessing anti-resorbtion properties influenced by the radicals linked to the carbon group of their structure. Bisphosphonates link to the hydroxyapatite of the mineral surfaces and are selectively internalized by osteoclasts, whose activity they inhibit, jeopardizing the osteoblastic activity. The purpose of this study is to determine the influence of intramedular administration (at the hip bone) of bisphosphonates on the serum values of alkaline phosphatase, total Ca, Ca2+, proteins and serum osteocalcin in a lot of experience Wistar rats. Fifteen Wistar rats of experience, five in the control group and 10 in the experimental group. All rats underwent surgery to create a bone defect with a 1.5 mm diameter bone-bur at the right femur transcortical through the medullar canal. Rats from experimental group were divided into two groups: group A, who received Zometa 1 mL single dose intramedular, intraoperative and group B, who received Zometa 1 mL in divided doses daily, 0.1 mL for 10 days. 3 mL of blood from the frontal sinus were collected from each subject at 24 hours, 14 days and 21 days postoperatively. From the blood samples were determined: alkaline phosphatase [U/L], seric proteins [g/dL], total Ca [mmol/L, mg/dL], osteocalcin [mmol/L]. The data were statistically analyzed using the ANOVA test. We found an increase in alkaline phosphatase [U/L] in all groups studied. In group B there was a significant decrease in total Ca levels [mg/dL] throughout the experiment compared with controls (11.82→10.36→9.25 mg/dL; 2.95→2.59→2.31 mmol/L; p=0.001). Ca2+ has changed significantly both in group A (1.18→1.25→1.25 mmol/L; p=0.01) and group B (1.21→1.24→1.13 mmol/L; p=0.02). Serum proteins were significantly reduced both in the control group (9.4→8.5→8.1 g/dL; p=0.03) and the experimental groups A (9.3→8.5→8.3 g/dL; p=0.01) and B (9.9→7.6→7.3 g/dL; p=0.0008). At each stage of bone development, multiple factors act in a coordinated manner that leads to increased local metabolic processes, acting both on the process of bone resorption and bone repair. Healing processes are initiated within 24 hours in both studied groups and the control group; at 14 and 21 days the bone healing processes are compromised directly proportional to the administration manner and dose of bisphosphonates.

[Mesialization of upper second molars using skeletal anchorage]. / Mezializarea molarilor doi superiori cu ajutorul miniimplantelor ortodontice.

UNLABELLED: Anchorage represents a great issue that challenged orthodontists all over the years. Nowadays, with the use of microimplants, it has become possible even to induce complex teeth movements. AIM: To present a clinical case in which mesialisation of upper second molars was performed by the means of using miniimplants. RESULTS: The present case shows how a bilateral mesialization of upper second molars using skeletal anchorage was performed by orthodontic treatment using fixed appliances and miniimplants. CONCLUSION: The placing site of the miniimplants plays a huge role in the moments of force produced and delivered to the teeth, thus influencing tooth movement. Miniimplants increase tooth movement control, by the use of skeletal anchorage. The success of their usage depends upon its good primary stabilization and a judicious loading.

[Use of laser-therapy for treatment of oral and maxillofacial hemangioma]. / Utilizarea laserterapiei pentru tratamentul hemangioamelor orale si maxilofaciale.

UNLABELLED: Laser-therapy opened new perspectives for the treatment of vascular lesions of the maxillofacial regions. MATERIAL AND METHOD: The study evaluated the results of diode laser percutaneous coagulation of oral and maxillofacial hemangioma. A group of 12 patients with sonographically certified hemangioma was treated using percutaneous coagulation with a diode laser. RESULTS: The results showed good and rapid healing, without any complications. All patients presented size reduction of the lesions, a favorable esthetic appearance and no morbidity. There were no complications over a follow-up period of 3 years. The study recommends diode laser-therapy as a valuable treatment option for hemangioma in correctly selected indications.