Effect of ten different biomarkers in the gingival crevicular fluid of obese and non-obese undergoing fixed orthodontic treatment.

OBJECTIVE: The aim of this study is to evaluate the effect of ten proinflammatory cytokines in GCF of participants with raised body mass index (BMI) compared to non-obese subjects undergoing fixed orthodontic treatment. PATIENTS AND METHODS: In the cross-sectional cohort, subjects were shortlisted through the purposive sampling method with the same age and gender and similar characteristics (cohort). For inclusion and exclusion, predefined criteria were followed. In all included participants obese and non-obese collection of GCF was made from mandibular canine to canine. Identification of inflammatory mediators (MPO and CRP) leptin, adiponectin, and resistin (pg/mL). Bone remodeling biomarkers RANKL (pg/mL) and tissue remodeling biomarkers MMP8, MMP9, TIMP1, and MMP8/TIMP1, MMP9/TIMP1 ratio were collected and blinded by the investigator. Normal distribution of data i.e., age, BMI, the flow rate of GCF, indices plaque and gingival, and uWMS were compared using a t-test. Non-normality biomarker data were evaluated using Mann-Whitney U-test. To assess the relationship between the concentration of GCF biomarkers and plaque and gingival indices Pearson and Spearman correlation coefficients were used. RESULTS: The total number of participants included was 44. In the obese and non-obese groups, the male/female ratio was the same i.e., (n=11 each). The mean age of participants in the obese group was (25.7±1.55 years), whereas the non-obese group was (26.1±1.29 years). In obese the mean BMI was (33.6±2.1 kg/m2) whereas in non-obese (22.9±1.9 kg/m2) (p<0.02). Among the levels of biomarkers adiponectin (p<0.006) and leptin (p<0.028) demonstrated a significant difference between obese and non-obese participants. Also, a significant difference was noted between obese and non-obese in tissue remodeling biomarker MMP9 (p<0.03). CONCLUSIONS: A surge in the level of the biomarkers, i.e., MMP9, leptin, and adiponectin in the gingival crevicular fluid is found in obese undergoing fixed orthodontic treatment.

Differences in hard and soft tissue profile after orthodontic treatment with and without extraction.

Aims and Background: Premolar extraction is often associated with variations in the soft tissue profile that lead to considerable improvements in the facial profile. This study compared the changes in the facial profile of hard and soft tissues and investigated possible differences in the various facial parameters between patients who were treated with and without premolar extraction. Materials and Methods: A total of 98 orthodontically treated patients were divided into two groups with an equal number of participants. Premolar extraction was performed in the test group only. A total of 33 landmarks were identified on each cephalometric radiograph. The intraclass correlation coefficient was calculated. We evaluated changes in measurements between pre- and post-treatment by performing the signed-rank test. We used the Kruskal-Wallis test to compare changes between the groups. Results: No significant differences were observed in the treatment outcomes of skeletal and soft tissue variables in class I and class II participants between the test and control groups (P > 0.01). However, significant differences were noted in the treatment outcomes of dental variables in class II participants between the groups. Dental variables did not show any significant difference in class III patients between the groups. Conclusion: This study showed that skeletal and soft tissue changes were similar in skeletal except for few dental parameters following orthodontic treatment with and without premolar extraction.

Short-term hard and soft tissue changes after mandibular advancement surgery in Class II patients: a retrospective cephalometric study.

AIM: The aim of this study was to describe hard and soft tissue changes after mandibular advancement surgery and to investigate the possible differences between Class II facial patterns. MATERIALS AND METHODS: Lateral cephalograms of 109 patients who underwent combined orthodontic treatment and bilateral sagittal split osteotomy (BSSO) were studied. Radiographs were taken within 6 weeks before surgery (T0) and at least 6 months postoperatively (T1). Patients were classified into 3 groups according to the preoperative mandibular plane angle. Hard- and soft-tissue changes were analysed with an x-y cranial base coordinate system. Measurements were evaluated statistically. RESULTS: Soft and hard tissues of the chin moved forward and downward. The position of the upper lip remained unchanged, while the lower lip moved forward and upward and decreased in thickness. The soft tissue points of the chin follow their corresponding skeletal points almost completely, while the change of the lower lip was only 76 per cent of the movement of the underlying hard tissue. The increase of SNB was more evident in the low-angle group, as well as improvement of the facial convexity. Stomium superius moved more forward in the low- and medium-angle cases. Ratios of hard and soft tissue changes showed no differences for different facial patterns. LIMITATIONS: Limitations derived from the retrospective study design. Only short-term changes could be addressed. The distinction between surgical changes and changes due to skeletal relapse is difficult to assess. Also, the difficulty to reproduce a relaxed lip position during imaging may influence our results. CONCLUSION: Class II characteristics improved after mandibular advancement. Soft tissues of the chin follow their skeletal structures almost in a 1:1 relationship, while movement of the lower lip was less predictable. The facial pattern of Class II patients should be considered in treatment planning.

Pre-surgical treatment planning of maxillary canine impactions using panoramic vs cone beam CT imaging.

OBJECTIVES: The aim of this prospective study was to compare the impact of using two-dimensional (2D) panoramic radiographs and three-dimensional (3D) cone beam CT for the surgical treatment planning of impacted maxillary canines. METHODS: This study consisted of 32 subjects (19 females, 13 males) with a mean age of 25 years, referred for surgical intervention of 39 maxillary impacted canines. Initial 2D panoramic radiography was available, and 3D cone beam CT imaging was obtained upon clinical indication. Both 2D and 3D pre-operative radiographic diagnostic sets were subsequently analysed by six observers. Perioperative evaluations were conducted by the treating surgeon. McNemar tests, hierarchical logistic regression and linear mixed models were used to explore the differences in evaluations between imaging modalities. RESULTS: Significantly higher confidence levels were observed for 3D image-based treatment plans than for 2D image-based plans (p < 0.001). The evaluations of canine crown position, contact relationship and lateral incisor root resorption were significantly different between the 2D and 3D images. By contrast, pre- and perioperative evaluations were not significantly different between the two image modalities. CONCLUSIONS: Surgical treatment planning of impacted maxillary canines was not significantly different between panoramic and cone beam CT images.

Human dental age estimation using third molar developmental stages: Accuracy of age predictions not using country specific information.

Unquestionable forensic age investigations are based on statistical models constructed on a sample containing subjects of identical origin as the examined individual. In cases where corresponding models are unavailable, the established report has to describe the possible effects of this unrelated information on the predicted age outcome. The aim of this study is to collect country specific databases of third molar development and to verify how the related dental age estimations are influenced if we were to use dental developmental information only from Belgium or from all collected countries together. Data containing third molar developmental stages scored following Gleiser and Hunt (modified by Köhler) were collected from 9 country specific populations (Belgium, China, Japan, Korea, Poland, Thailand, Turkey, Saudi-Arabia and South-India). Age predictions were obtained from a training dataset and validated on a test dataset. Bayes rule using the repeated third molar scores is applied to get age predictions and prediction intervals. Three age predictions were compared for males and females separately. For the first prediction, the training dataset contains only Belgian subjects. For the second prediction, the training dataset for each country consists only of subjects of the country itself. For the final prediction, subjects from all countries are pooled into one common training dataset. Besides the (absolute) difference between the chronological age and the predicted age, specific interest lies in the juvenile-adult distinction. In the age range from 16 to 22 years 6982 subjects (3189 male and 3793 female) were analyzed. Using information on third molar development from Belgium compared to information from the country specific databases hardly increased the mean absolute differences (MAD) and mean squared errors (MSE): the MAD and MSE increased on average with 0.5 and 2.5 months with maximal increases of, respectively 1.6 and 7.3 months. Using information from all countries pooled compared to country specific information provided even on average negligible increases (0.05 and 0.2 months for MAD and MSE, respectively). For the juvenile-adult discrimination, using information from all countries instead of country specific information yielded comparable performances. Using Belgium instead of country specific information increased the percentage of correctly identified juveniles, but decreased the percentage of correctly identified adults. The adult-juvenile discrimination based on information used from Belgium provides judicially the best applied reference.

Root resorption of the maxillary lateral incisor caused by impacted canine: a literature review.

Root resorption of maxillary lateral incisors caused by erupting canines is well known and a relatively common phenomenon. However, much debate and conflicting evidence exists with regard to the actual resorption trigger and potential etiological factors involved. Consequently, there are no obvious clinical clues concerning prevention and diagnosis as well as subsequent treatment decisions. The introduction of cone beam computer tomography has recently allowed drawing a new and much more documented light on the diagnostic and therapeutic strategies. However, no investigations have determined that this new information may result in another and better diagnostic approach and an improved treatment outcome. Therefore, the present review will attempt to summarize the existing evidence on two- and three-dimensional images and try to link the radiological observations to any further preventive, diagnostic, and/or therapeutic measures. Detection thresholds, accuracy, and reliability of impacted canine localization and neighboring root resorption risks will also be considered. This review demonstrates how adding a third-dimension to the radiographic information may notably alter the prevalence of root resorptions and descriptions of this prevalence. In any case, further investigation is needed to determine resorption detection thresholds in various two-dimensional and three-dimensional imaging techniques, as well as to determine therapeutic thresholds and criteria for strategic tooth extraction based on radiographic manifest and not manageable resorption lesions.