Microbiological Analysis of Plaque and Its Composition in Three Patient Groups under Different Orthodontic Treatments.

BACKGROUND: This article analyzes differences in microbiological parameters and periodontal health conditions among three patient groups: those undergoing conventional orthodontic treatment with fixed appliances, patients undergoing orthodontic treatment with clear aligners, and a control group receiving no treatment. MATERIALS AND METHODS: In this study, 60 patients were enrolled. The microbiological analysis employed a qualitative and semi-quantitative methodology of bacterial morphotype analysis. RESULTS: The analyses revealed a significant difference in favor of clear oral and periodontal health aligners. This could be attributed to better bacterial biofilm removal and reduced mechanical stress on the periodontal ligament, factors facilitated by the ease of clear aligner removal. Significant differences (p-value < 0.05) were observed for the Full-Mouth Plaque Score, Full-Mouth Bleeding Score, Plaque Index, and periodontal health assessment measurements. CONCLUSIONS: Although overall hygiene appears to be improved in patients in the aligners group compared to those treated with conventional orthodontic appliances, there are no statistically significant results regarding plaque composition. Microbiological aspects will be further addressed using more specific techniques in the follow-up of this research.

Divergence between CBCT and Optical Scans for Soft Tissue Analysis and Cephalometry in Facial Imaging: A cross-sectional study on healthy adults.

BACKGROUND: Facial soft tissue analysis is becoming increasingly emphasized in orthodontic diagnosis and treatment planning. While traditional cephalometry primarily focuses on hard tissues, recent non-invasive imaging techniques offer the potential to comprehensively evaluate three-dimensional (3D) facial soft tissues. The aim of the study was to establish the geometrical 3D and cephalometric divergence between Cone Beam Computed Tomography (CBCT) derived images and scanned soft tissues. Crucial for enhancing orthodontic diagnosis, minimizing patient exposure to ionizing radiation and providing facial cephalometric parameters. MATERIAL AND METHODS: A cross-sectional study was conducted from January 2020 to May 2023. CBCT and 3D facial scans were obtained simultaneously using a specialized imaging system. Reproducible landmark points were selected for both cephalometric and soft tissue analysis. Angular and linear measurements were recorded, and correlations between CT and facial scans were statistically assessed. RESULTS: Comparisons between 10 CBCT-derived and 10 facial scan-based soft tissue representations resulted into 1.8mm mean root median square (RMS). Angular measurements, such as ANB, right gonial angle, and left gonial angle, exhibited a 0.9° of difference with their respective soft tissue variables. In contrast, linear measurements of total anterior facial height showed a lower correlation coefficient, equal to 0.51. The correlation between soft tissues and underlying hard tissues was more pronounced for gonial angles. CONCLUSION: Facial soft tissue analysis using either 3D facial scans or CBCT-derived offers similar results for orthodontic diagnosis and treatment planning. These findings support the use of non-invasive diagnostic tools in orthodontics, although further investigations are needed to comprehensively understand the complexity of hard and soft tissue relationships.

Salivary biomarkers for early detection of oral squamous cell carcinoma (OSCC) and head/neck squamous cell carcinoma (HNSCC): A systematic review and network meta-analysis.

Oral cancer became a very common condition. WHO estimates that there are 4 cases of lip and oral cavity cancer for every 100,000 people worldwide. The early diagnosis of cancers is currently a top focus in the health sector. Recent systematic reviews and meta-analyses have identified promising biomarkers for early detection in several original research investigations. However, it is still unclear the quality of these evidence and which biomarker performs the best in terms of early detection. Therefore, the objective was, to map the methodological and reporting quality of available oral squamous cell carcinoma (OSCC) or head/neck squamous cell carcinoma (HNSCC) systematic reviews and meta-analysis. Secondly, to evaluate diagnostic accuracy of salivary biomarkers for common craniofacial cancers and to compare the diagnostic value of different salivary biomarkers. PubMed, Scopus, Web of Science, Embase and Cochrane Library electronic databases were used to map the methodological and reporting quality of the systematic reviews and meta-analysis conducted on the HNSCC, OSCC using the AMSTAR-2 checklist. The inclusion criteria were systematic reviews and meta-analysis published in the topic of HNSCC and OSCC biomarkers. Exclusion criteria were no animal studies; original primary studies, due to limitation of competency in other languages articles with language other than English were excluded. The sensitivity and specificity were calculated for salivary biomarkers and ranked according to network meta-analysis principles. A total of N = 5893 patients were included from four meta-analysis studies. All together, these included n = 37 primary studies. n = 94 biomarkers were pooled from these four meta-analyses and categorised into the stages at which they were detected (I-IV). In OSCC, Chemerin and MMP-9 displayed the highest sensitivity, registering 0.94 (95% CI 0.78, 1.00) and a balanced accuracy of 0.93. Phytosphingosine closely followed, with a sensitivity of 0.91 (95% CI 0.68, 0.99) and a balanced accuracy of 0.87. For HNSCC, the top three biomarkers are Actin, IL-1ß Singleplex, and IL-8 ELISA. Actin leads with a sensitivity of 0.91 (95% CI 0.68-0.99), a specificity of 0.67, and an overall accuracy of 0.79. Subsequently, IL-1ß Singleplex exhibits a sensitivity of 0.62 (95% CI 0.30-0.88), a specificity of 0.89, and an accuracy of 0.75, followed by IL-8 ELISA with a sensitivity of 0.81 (95% CI 0.54-0.97), a specificity of 0.59, and an accuracy of 0.70. In conclusion, there was highest sensitivity for MMP-9 and chemerin salivary biomarkers. There is need of further more studies to identify biomarkers for HNSCC and OSCC.

Skull Biomechanics and Simplified Cephalometric Lines for the Estimation of Muscular Lines of Action.

Our study introduces a novel cephalometric analysis aimed at facilitating biomechanical simulations by elucidating the intricate relationship between craniofacial morphology and the size and inclination of the masseter muscle (MM) while incorporating muscle values. Our study analyzes the line of action of the MM drawn between the Gonion (Go) and Orbital (Or) points concerning dental and skeletal references (occlusal and Frankfort planes). A total of 510 pre-treatment lateral cephalometric tracings (217 males, 293 females, aged 6-50 years) and lateral Bolton standard tracings were examined. The key parameters investigated include (a) skeletal-cutaneous class (linear distance between projections of points A' and B' on the occlusal plane), (b) the angle between the perpendicular line to the occlusal plane and the Go-Or line at the molar occlusal point, and (c) the angle between the Go-Or line and the Frankfort plane. The assessment of anterior-posterior jaw discrepancy, measured as the skeletal-cutaneous class, ranged from -14.5 to 15.5 mm. Abnormal values were identified in two adolescents, showing no gender- or age-related patterns. The angle between the MM's line of action (Go-Or) and the normal to the occlusal plane averaged 39.3°, while the angle between Go-Or and Po-Or (Frankfort plane) averaged 41.99°. Age had an impact on these angles, with an average 3° decrease in adults and a 4° increase between ages 6 and 50. A weak relationship was observed between sagittal jaw discrepancy and the angle between Go-Or and the Frankfort plane, with about 20% of the variance explained by the anteroposterior maxillary-mandibular relationship. In conclusion, the study presents a cephalometric analysis of the relationship between craniofacial morphology and masseter muscle parameters. It finds that age influences the angles between key reference points, while the skeletal-cutaneous class does not exhibit age- or gender-specific trends. These findings can contribute to a better understanding of craniofacial biomechanics and aid in clinical orthodontic assessments and treatment planning.

The Maxilla-Mandibular Discrepancies through Soft-Tissue References: Reliability and Validation of the Anteroposterior Measurement.

This research aimed to identify a new measurement to diagnose the sagittal maxillary and mandibular difference that considers the patient's profile (soft tissue Wits appraisal: obtained by projecting points A and B on the occlusal plane and subsequently measuring the linear distance between the two points). This new measurement was compared to the conventional Wits appraisal obtained to diagnose sagittal jaw discrepancy. In total, 300 subjects (162 males, 138 females) aged between 6 and 50 years requiring orthodontic treatment were analyzed. The cephalometric tracings on the pre-treatment lateral cephalometric radiographs were obtained and the two measurements taken were the Wits appraisal and a new measurement which were both calculated and compared. The analysis of the linear correlations between the conventional Wits value and the measurement obtained on the soft-tissue were undertaken. The relevance was established at 5% (p < 0.05). The mean values were also calculated within sex and age classes, and comparisons between sexes were obtained employing the t test Student's for independent samples. Subsequently, chi-square analysis was also utilized to verify the sex distributions in the age groups considered. The results obtained suggested that these two measurements were significantly correlated with each other, with no characteristic patterns of sex or age. These data allowed an estimation of the reference values of the new measurement (-1.9 mm and 5.4 mm for patients with Class I molar relationship) showing that the former was more variable than the latter. The new measurement could allow for an accurate evaluation of the jaws sagittal discrepancy from soft tissue analysis.

Residual Bone Height and New Bone Formation after Maxillary Sinus Augmentation Procedure Using Biomaterials: A Network Meta-Analysis of Clinical Trials.

BACKGROUND: Different factors may affect new bone formation following maxillary sinus floor augmentation for the rehabilitation of posterior edentulous maxilla. The purpose of this study was to determine the influence of residual bone height (RBH) on new bone formation after lateral sinus augmentation utilizing different biomaterials, through a network meta-analysis (NMA). METHODS: PUBMED, Scopus, and Web of Science electronic databases were searched until 31 December 2022 to obtain relevant articles. A hand search was also conducted. Randomised controlled studies on maxillary sinus augmentation comparing different grafting materials in patients with atrophic posterior maxilla, in need of prosthetic rehabilitation, were included. The risk of bias was assessed following the guidelines of the Cochrane Collaboration. The primary outcome was new bone formation (NBF), assessed histomorphometrically. The statistical analysis was performed by splitting the data according to RBH (<4 mm and ≥4 mm). RESULTS: A total of 67 studies were eligible for conducting NMA. Overall, in the included studies, 1955 patients were treated and 2405 sinus augmentation procedures were performed. The biomaterials used were grouped into: autogenous bone (Auto), xenografts (XG), allografts (AG), alloplasts (AP), bioactive agents (Bio), hyaluronic acid (HA), and combinations of these. An inconsistency factor (IF) seen in the entire loop of the XG, AP, and Bio+AP was found to be statistically significant. The highest-ranked biomaterials for the <4 mm RBH outcome were XG+AG, XG+AP, and Auto. Similarly, the surface under the cumulative ranking curve (SUCRA) of biomaterials for ≥4 mm RBH was Auto, Bio+XG, and XG+Auto. CONCLUSION: There is no grafting biomaterial that is consistently performing better than others. The performance of the materials in terms of NBF may depend on the RBH. While choosing a biomaterial, practitioners should consider both patient-specific aspects and sinus clinical characteristics.

Prevalence of Dental Malocclusions in Different Geographical Areas: Scoping Review.

The World Health Organization (WHO) considers malocclusion one of the most important oral health problems, after caries and periodontal disease. Its prevalence is highly variable and is estimated to be between 39% and 93% in children and adolescents. Due to the importance of malocclusions in dentistry, the aim of our review is to assess the frequency of malocclusions among different geographical regions. A literature research was performed through the Pubmed, Medline, Scopus, Web of Science, LILACS, Open Grey and Cochrane Library databases. The "PRISMA" guidelines were used for the following review. Fourteen studies were analysed for this review. Class I was found most frequently, followed by class II and finally class III. Considering the other anomalies, crowding was one of the most frequent with a prevalence of up to 84%, followed by spacing, which reached a frequency of 60%. Prevalence of crossbite and openbite was quite variable, while the evaluation of deepbite revealed more uniform values. The prevalence varied widely for most of the types of malocclusion in relation to the different populations, which suggests a role of genetics and environmental influences, typical of each population in determining dental problems.