High-Density Dermal Matrix for Soft Tissue Augmentation Using a Matrix Tissue Graph Technique-A Comprehensive Multicenter Analysis of 20 Implants: A 1-Year Follow-Up Retrospective Study.

Background: In this multicenter case series analysis, the authors present successful instances of 20 single-screw-retained and implant-supported prosthetic rehabilitation samples. Methods: A high-density heterologous dermal matrix (Derma® Osteobiol by Tecnoss, Torino, Italy) was employed with a specific technique named the matrix tissue graft (MTG) in all these cases characterized by an inadequate initial supra-crestal tissue height (thin if 1 mm or medium if 2 mm) to enhance the peri-implant soft tissues both vertically and horizontally. Results: The implants were deemed successful in all cases, yielding a success proportion of 100% (one-sided 97.5% confidence interval = 83.2-100%). The buccal and lingual gains were, respectively, 2.2 ± 0.38 mm (range 1.7-3.22 mm) and 0.83 ± 0.33 mm (range 0.1-1.5 mm). These measurements were calculated as the maximum distance between two superimposed .stl file models (derived from two different IOS devices) scanned before implant placement and 1 year after dermal matrix healing. Conclusions: An outstanding vertical and horizontal gain was obtained using this heterologous derma matrix placed above the bone crest and surrounding the dental implants.

Combining antibiotic-loaded bone cement-based free vastus lateralis muscle-sparing flap with split-thickness skin grafts: A reliable strategy for reconstructing diabetic foot ulcers at non-weight-bearing areas.

Diabetic foot ulcers (DFUs) present significant challenges due to their associated amputation rates, mortality, treatment complexity and excessive costs. Our earlier work introduced a wound surgical integrated treatment (WSIT) for DFUs, yielding promising outcomes. This study focuses on a specific WSIT protocol employing antibiotic-loaded bone cement (ALBC) in the first Stage, and free vastus lateralis muscle-sparing (VLMS) flaps and split-thickness skin grafts (STSGs) in the second stage to repair non-weight-bearing DFUs. From July 2021 to July 2023, seven DFU patients (aged 47-71 years) underwent this treatment. Demographic data, hospital stay and repair surgery times were collected. Histological and immunohistochemical analyses assessed angiogenesis, collagen deposition and inflammation. SF-36 questionnaire measured pre- and postoperative quality of life. Preoperative ultrasound Doppler showed that the peak blood flow velocity of the recipient area artery was significantly >30 cm/s (38.6 ± 6.8 cm/s) in all patients. Muscle flap sizes varied from 8 × 3.5 × 1 to 18 × 6 × 2 cm. The operation time of the repair surgery was 156.9 ± 15.08 minutes, and the hospital stay was 18.9 ± 3.3 days. Histological analysis proved that covering DFUs with ALBC induced membrane formation and increased collagen, neovascularization and M2 macrophages fraction while reducing M1 macrophages one. All grafts survived without amputation during a 7- to 24-month follow-up, during which SF-36 scores significantly improved. A combination of ALBC with free VLMS flaps and STSGs proved to be safe and effective for reconstructing non-weight-bearing DFUs. It rapidly controlled infection, enhanced life quality and foot function, and reduced hospitalization time. We advocate integrating this strategy into DFU treatment plans.

Exploring the potential of calcium-based biomaterials for bone regeneration in dentistry: a systematic review.

INTRODUCTION: Regenerative medicine emerged as a promising strategy for addressing bone defects, with several bone grafts currently being used, including autografts, allografts, xenografts and alloplasts. Calcium-based biomaterials (CaXs), a well-known class of synthetic materials, have demonstrated good biological properties and are being investigated for their potential to facilitate bone regeneration. This systematic review evaluates the current clinical applications of CaXs in dentistry for bone regeneration. EVIDENCE ACQUISITION: A comprehensive search was conducted to collect information about CaXs and their applications in the dental field over the last ten years. The search was limited to relevant articles published in peer-reviewed journals. EVIDENCE SYNTHESIS: A total of 72 articles were included in this scoping review, with eight studies related to periodontology, 63 in implantology and three in maxillofacial surgery respectively. The findings suggest that CaXs hold promise as an alternative intervention for minor bone regeneration in dentistry. CONCLUSIONS: Calcium-based biomaterials have shown potential as a viable option for bone regeneration in dentistry. Further research is warranted to fully understand their efficacy and safety in larger bone defects. CaXs represent an exciting avenue for researchers and clinicians to explore in their ongoing efforts to advance regenerative medicine.

Accuracy of Computer-Guided Implantology with Pilot Drill Surgical Guide: Retrospective 3D Radiologic Investigation in Partially Edentulous Patients.

Background and Objectives: Implant placement with static navigation enables the reaching of a correct position of implants from an anatomical and prosthetic point of view. Different approaches of static navigation are described in the scientific literature, and the pilot-guided approach is one of the least investigated. The aim of the present study is the evaluation of the accuracy of implant insertion using a pilot drill template. Materials and Methods: Fifteen partially edentulous patients, requiring an implant rehabilitation of at least one implant, were enrolled. Pre- and post-operative low-dose CTs were acquired to measure the differences between final positions of implants and virtually planned ones. Three linear discrepancies (coronal, apical, and depth), two angular ones (bucco-lingual and mesio-distal), and the imprecision area were evaluated. Correlations between accuracy and rehabilitated jaws, sectors, and implant length and diameters were also analyzed. Results: Forty implants were inserted in fifteen patients using pilot drill templates. Mean coronal deviation was 1.08 mm, mean apical deviation was 1.77 mm, mean depth deviation was -0.48 mm, mean bucco-lingual angular deviation was 4.75°, and mean mesio-distal one was 5.22°. The accuracy was statistically influenced only by the rehabilitated jaw for coronal discrepancy and sectors and implant diameter for bucco-lingual angular deviations. Conclusions: The pilot drill template could represent a predictable solution to obtain a correct implant placement. Nonetheless, a safety margin of at least 2 mm should be respected during implant planning to prevent damages to anatomical structures. Therefore, the tool is helpful in order to prosthetically drive the implants; still, great attention must be paid in fully relying on this procedure when approaching dangerous structures such as nerves and vessels.

Enigmatic Formations Found in Routine Orthopantomography (OPG) Examinations: A Case Report.

We describe two clinical cases of occasional radiographic findings on orthopantomography (OPG) that were performed routinely, for which the definitive diagnosis may be uncertain. After an accurate remote and recent anamnesis, for reasons of exclusion, we hypothesize a rare case of the retention of a contrast medium in the parenchyma of the major salivary glands (parotid, submandibular, and sublingual) and their excretory ducts as a consequence of sialography examination. In the first case we analyzed, we found it difficult to classify the radiographic signs on the sublingual glands, left parotid, and submandibular, while in the second case, only the right parotid was involved. Using CBCT, the spherical findings were highlighted, with multiple having different dimensions, as well as radiopaque in their peripheral portion and more radiolucent inside them. We could immediately exclude salivary calculi, which usually have a more elongated/ovoid shape and appear homogeneously radiopaque without radiolucency areas. These two cases (of hypothetic medium contrast retention with unusual and atypical clinical-radiographic presentation) have very rarely been comprehensively and correctly documented in the literature. No papers have a follow-up longer than 5 years. We conducted a review of the literature on the PubMed database, finding only six articles reporting similar cases. Most of them were old articles, demonstrating the low frequency of this phenomenon. The research was performed using the following keywords: "sialography", "contrast medium", "retention" (six papers) and "sialography", and "retention" (13 papers). Some articles were present in both searches, and the really significant ones (defined after a careful reading of the entire article and not only of the abstract) resulted only in six occurrences in a time span from 1976 to 2022.

A Novel Muco-Gingival Approach for Immediate Implant Placement to Obtain Soft- and Hard-Tissue Augmentation.

The aim of this article is to describe a novel approach combining muco-gingival, regenerative and prosthetics concepts for immediate implant insertion that overcomes the limits traditionally considered as contraindications for Type 1 flapless implant positioning, simultaneously obtaining soft- and hard-tissue augmentation. After pre-surgical CBCT evaluation, the surgical technique consisted in the execution of a lateral-approach coronally advanced envelope flap, with oblique submarginal interproximal incisions directed towards the flap's center of rotation (the tooth to be extracted); after buccal-flap elevation, the atraumatic extraction of the tooth was performed. Following guided implant insertion, a mixture of biomaterial and autologous bone was placed, stabilized by a pericardium membrane and a connective-tissue graft sutured in the inner aspect of the buccal flap. The peri-implant soft tissues were conditioned with a provisional crown until the shape and position for the mucosal scallop to resemble the gingival margin of the adjacent corresponding tooth were obtained; then, the definitive screw-retained restoration was placed. Within the limitations of this case report, the proposed immediate implant placement approach combining CTG application and buccal bone regeneration showed the possibility of obtaining 1-year-follow-up implant success, stable bone level, good esthetic results and high patient satisfaction.

A New Matrix for Soft Tissue Management.

Gingival recession is a mucogingival defect defined as the apical shifting of the gingival margin in relation to the CEJ. The use of connective tissue autografts allows for the obtention of very satisfactory results but is associated with undoubted disadvantages. The aim of the present work is to carry out a systematic review of the literature using a meta-analysis to investigate the clinical efficacy of xenogeneic collagen matrix (XCM) in the treatment of gingival recessions. This revision was carried out strictly following the guidelines published in the Cochrane Handbook. Thus, a meta-analysis was performed to calculate relative risks and standardized mean differences for each of the variables considered. The results of the meta-analysis show that CAF + CTG was statistically better than CAF + XCM in almost all the variables analyzed: complete root coverage (RR 0.46), mean root coverage (SMD -0.89), recession reduction (SMD -0.98), clinical attachment level (SMD -0.63) and gingival thickness (SMD -1.68). Meanwhile, CAF + XCM was slightly better than CAF alone in regard to: mean root coverage (SMD 0.51), recession reduction (SMD 0.47) and gingival thickness (SMD 0.56). It is possible to conclude that CAF + CTG still remains the gold standard in radicular coverage.

Custom Bone Regeneration (CBR): An Alternative Method of Bone Augmentation-A Case Series Study.

We performed this clinical study in order to evaluate the reliability of the Guided Bone Regeneration (GBR) surgical technique through the use of customized CAD CAM titanium meshes (Yxoss CBR® Reoss) in order to show an alternative method of bone augmentation. MATERIALS AND METHODS: Nine patients presenting 10 bone defects were referred to solve oral dysfunction due to edentulous atrophic ridges. Guided bone regeneration was performed with titanium meshes combined with autogenous bone grafting and heterologous bovine bone mineral grafting, and exclusively a "poncho technique" soft tissue approach for all the cases. After a mean 9 months of graft healing (range 6-12 months), titanium meshes were removed, and implant surgery was subsequently performed. The results we obtained were positive in terms of volumetric increases in height, length and thickness of the atrophic ridges without biological complications detectable before implant surgery. RESULTS: Out of nine, one site met titanium mesh exposure: however, in all 10 sites a three-dimensional volumetric bone implementation was obtained. The statistical results were estimated by uploading and superimposing cbct scans before and after CBR surgery for each patient, so it was possible evaluate the maximum linear vertical and horizontal bone gain through dedicated Cad Cam software (Exocad GmbH®). The average horizontal gain was 6.37 ± 2.17 mm (range 2.78-9.12 mm) and vertical gain was 5.95 ± 2.06 mm (range 2.68-9.02 mm). A total of 18 implants were placed into the grafted sites with a 100% survival rate (clearly they are relative percentages to be compared to the short time elapsed). CONCLUSIONS: The results we obtained in this study suggest that this CBR procedure (Yxoss® by Reoss) is reliable and safe for bone regeneration to allow implant-prosthetic restoration in horizontal, vertical and combined bone defects. The soft tissue management is diriment: all the cases were managed with a "poncho" flap approach to decrease exposure complication.

Persistent Idiopathic Facial Pain (PIFP) in Patients Referred to a Multidisciplinary Centre in Italy: A Retrospective Observational Study.

BACKGROUND: Persistent Idiopathic Facial Pain (PIFP), previously named Atypical Facial Pain (AFP) is a poorly understood condition, often diagnosed after several inconclusive investigations. The aim of this retrospective study was to evaluate the demographic and clinical characteristics of patients with PIFP referred to a Facial Pain Center. METHODS: Between May 2011 and September 2014, data on 41 PIFP patients were analyzed regarding temporal, topographical and descriptive pain features, including onset, localization, pain descriptors and intensity. Pharmacological pain treatments were also registered. Finally, the presence and type of previous minor oro-surgery procedures in the painful area were investigated. RESULTS: Demographic and clinical characterization were similar to PIFP patients reported in literature. The presence of previous minor oro-surgery procedures in the painful area was reported in most of these patients, in particular endodontic treatments and tooth extractions. CONCLUSIONS: This retrospective analysis showed a high prevalence of minor oro-surgery procedures in our population, while its role in PIFP pathophysiology remains unknown. A new classification of PIFP built around the main discriminant factor of presence of these procedures in the painful area could be considered while available data were still insufficient to define specific diagnostic criteria.

Microleakage of Direct Restorations-Comparisonbetween Bulk-Fill and Traditional Composite Resins:Systematic Review and Meta-Analysis.

Since the bulk-fill composites were produced, there was a progressive diffusion of their use for direct conservative treatment in posterior teeth. Their chemical structure increases the depth of cure and decreases the polymerization contraction; in this manner, bulk-fill composites can be placed in 4 mm single layers and the treatment times are considerably reduced. However, aesthetic and mechanical properties and impact on microleakage of bulk-fill resins are still unclear.This systematic review and meta-analysis aimed to assess the risk of microleakage of direct posterior restorations made of bulk-fill versus conventional composite resins.Researches were performed on PubMed and Scopus databases. Eligible in vivo studies, published since 2006, were reviewed. Outcomes of marginal discoloration, marginal adaptation, and recurrent caries were considered to conduct the systematic review and meta-analysis. Secondary data were examined to implement additional analysis and assess the risk of bias.Eight randomized clinical trials were analyzed, involving 778 direct restorations. The summary of RCTs led to significant but inconsistent results; the marginal discoloration and recurrent caries were found to be improved respectively by 5.1 and 1.4%, whereas the marginal adaptation was reduced of 6.5%. Secondary analyses revealed that follow-up periods, the adhesive system used and the class of carious lesions evaluated are confounding factors, and they result in a risk of bias across studies.Bulk-fill composites are innovative materials for conservative dentistry and they can be used to reduce treatment steps and duration of operative times. There are insufficient data to explore the relationship between bulk-fill composites and microleakage and further investigations are needed.

Digital Customized Titanium Mesh for Bone Regeneration of Vertical, Horizontal and Combined Defects: A Case Series.

Background and Objective: Guided bone regeneration allows new bone formation in anatomical sites showing defects preventing implant rehabilitation. Material and Methods: The present case series reported the outcomes of five patients treated with customized titanium meshes manufactured with a digital workflow for achieving bone regeneration at future implant sites. A significant gain in both width and thickness was achieved for all patients. Results: From a radiographic point of view (CBTC), satisfactory results were reached both in horizontal and vertical defects. An average horizontal gain of 3.6 ± 0.8 mm and a vertical gain of 5.2 ± 1.1 mm. Conclusions: The findings from this study suggest that customized titanium meshes represent a valid method to pursue guided bone regeneration in horizontal, vertical or combined defects. Particular attention must be paid by the surgeon in the packaging of the flap according to a correct method called the "poncho" technique in order to reduce the most frequent complication that is the exposure of the mesh even if a partial exposure of one mesh does not compromise the final outcome of both the reconstruction and the healing of the implants.

Clinical and Esthetical Evaluation of 79 Lithium Disilicate Multilayered Anterior Veneers with a Medium Follow-Up of 3 Years.

OBJECTIVES: Primary aim of this study was to evaluate survival rate of lithium disilicate veneers in upper and lower anterior teeth. Secondary aims were to evaluate changing in proportions of teeth before and after restorations and to assess mean thickness of the veneers. MATERIALS AND METHODS: Seventy-nine upper and lower lithium disilicate veneers were made in 13 patients with worn teeth. Mean follow-up was 3 years. To perform anterior definitive rehabilitations, malocclusions and loss of vertical dimension were treated by full mouth rehabilitations to obtain proper occlusal conditions. Veneers were made of lithium disilicate core and fluorapatite-based ceramic stratification. Survival rate was calculated by Kaplan-Meier analysis. Changing in teeth proportion before and after restorations was analyzed by a paired t-test. Descriptive statistics of thickness values were also performed. RESULTS: One case of detachment was observed with a 98.7% survival rate. Teeth's proportions were preserved although the first upper right incisor and canine changed in dimension. CONCLUSIONS: Lithium disilicate veneers in esthetical rehabilitations of worn teeth proved to be an effective way of treatment in a medium follow-up of 3 years. Proportions seemed to be maintained with a minimum dental removal.

Oral mucosal complications in orthodontic treatment.

BACKGROUND: Orthodontic therapy is used to solve numerous oral problems, but the use of fixed oral devices can also impact negatively the oral cavity, if the treatment is not steadily under control. The aim of this study is to evaluate tooth, bone and soft tissues lesions due to the presence of fixed orthodontic appliances. METHODS: One hundred patients with fixed orthodontic appliances were included in the study. In particular, 20 patients with rapid palatal expander (RPE), 20 patients with Forsus appliance, 20 patients with a fixed multibracket appliance treatment, 20 patients with just the lower vestibular multibracket treatment and 20 patients with both upper and lower vestibular multibracket treatment. An accurate oral examination of the oral cavity, comprehending teeth, bone and soft tissues, was carried out thoroughly, in order to find possible lesions caused by the fixed orthodontic treatment. RESULTS: Concerning RPE, 35% patients had reversible palatal lesions, while 45% patients had the impression of the appliance on the tongue. Periodontal damages were observed in 5% of the patients, as well as tooth lesions (i.e. dental caries). 20% of the patients with Forsus appliance experienced the lesion on the cheek mucosa, while 10% individuals reported periodontal problems, and 15% of the subject suffered for WSL (white spot lesion) and dental caries. Upper vestibular multibracket appliance caused superior labial lesions (15%), cheek mucosal lesions (20%), gingivitis (55%), white spot lesions (WSL) of superior teeth (15%), while dental recessions and periodontitis due to the appliance were rarely observed (5%). Lower vestibular multibracket appliance was frequently the cause of inferior labial lesions (15%), cheek mucosal lesions (15%), gingivitis (50%), WSL of inferior teeth (20%) and also in lower arch dental recessions and periodontitis due to the appliance were rarely observed (5%). Patients with both superior and inferior multibracket appliance experienced upper and/or lower lip lesions (25%), lesions of cheek mucosa (25%), gingivitis (65%) and WSL (30%), and just in few cases periodontitis (10%). Data shows a more critical oral situation in patients with both superior and inferior appliances than people with one-arch therapy. CONCLUSIONS: Orthodontic therapy offers a considerable number of advantages, but it is important to underline what may be the adverse consequences also. This allows the orthodontist to inform the patient of all the possible effects of their therapeutic choice. In most cases, RPE can cause an impression of the device on the tongue and reversible lesions of the palate. On the other hand, the orthodontic fixed therapy can cause gingivitis, followed by mucosal lesions, labial lesions and WSL. For these reasons, an accurate assessment of the patients before the application of fixed orthodontic treatment is necessary. Oral hygiene instructions and motivation are very important, as well as periodic controls of the fixed oral device.

Short-term "in vivo" study on cellular DNA damage induced by acrylic Andresen activator in oral mucosa cells.

OBJECTIVES: To analyse through comet assay and micronucleus test the viability and DNA damage occurred in buccal mucosa epithelial cells after a short-term exposure to Andresen activator resin monomers. SETTING AND SAMPLE POPULATION: Test group consisting of 26 subjects was treated with Andresen activator; 16 subjects who had never undergone orthodontic treatment were enrolled in the control group. MATERIAL & METHODS: Buccal mucosa samples were collected before treatment and after 7, 15, 30, 60 and 90 days. The analyses performed on the cells included the following: cellular viability, comet assay and micronucleus test. Mean ± SD were calculated for cellular viability, tail moment, tail intensity, tail length, micronuclei, binuclear and bud cells. Significance (P < 0.05) was evaluated with Dunnett's test. RESULTS: Cellular viability did not change during observational time, and its trend was similar to the controls. Tail moment and tail intensity significantly increased after 30 and 60 days, respectively, whereas tail length remained unchanged over time in the test group; the same parameters did not change in the control group. In the test group, micronuclei, binuclear and bud cells significantly increased after 30, 60 and 90 days, respectively. CONCLUSION: The resin monomers of the Andresen activator cause genotoxic effects detectable through comet assay and micronucleus test, but they do not produce clear cytotoxic effects after a 90 days exposure.

Clinical Success of Dental Implants Placed in Posterior Mandible Augmented With Interpositional Block Graft: 3-Year Results From a Prospective Cohort Clinical Study.

PURPOSE: The purpose of the present cohort study was to investigate the 3-year efficacy and clinical performance of implant-supported rehabilitations in posterior mandibles augmented with the sandwich osteotomy technique. MATERIALS AND METHODS: Twenty-three partially edentulous patients who developed atrophy of the posterior mandible (residual ridge height, 3 to 7 mm) were treated (32 surgical sites) with vertical bone augmentation using interpositional equine cancellous bone blocks and porcine corticocancellous bone particulate. All implants were placed 4 months after augmentation and were loaded with fixed dental prostheses. One side per patient was selected and followed for 3 years, and the patient was the unit of analysis. Linear radiographic vertical bone gain and peri-implant marginal bone loss were assessed; secondary outcomes-complication rates after surgery, prosthesis and implant failure rates, width of keratinized mucosa, and patient satisfaction-were evaluated. RESULTS: All patients reported postoperative paresthesia that resolved over a period of 2 months after the augmentation procedure. The mean vertical bone gain was 5.6 mm after 4 months. Ninety-one dental implants were positioned into the augmented areas. The global 3-year survival rate was 95.5%. The mean peri-implant marginal bone loss around implants was 1.06 ± 0.37 mm 3 years after loading, whereas the width of keratinized mucosa had an overall increase of 0.39 ± 0.36 mm. CONCLUSION: The results of the present 3-year study suggested high success rates for implants placed in areas augmented with the osteotomy sandwich technique. This surgical approach could be helpful in the presence of a low residual vertical height in the posterior mandible before implant placement.

Syndromes associated with dental agenesis.

INTRODUCTION: Dental agenesis is the congenital absence of a variable number of teeth due to the lack of formation of the corresponding tooth germ. The aim of this work was to investigate the syndromic conditions characterized by dental agenesis. EVIDENCE ACQUISITION: Based on the research conducted through the OMIM® (Online Mendelian Inheritance in Man) and PubMed online databases, more than ninety syndromes associated with severe or moderate agenesis have been found. EVIDENCE SYNTHESIS: The main clinical features of these syndromes are described, especially those concerning the stomatognathic apparatus, referring to the most recent literature. Among these syndromes there are three clinical conditions associated with dental agenesis that are common for the clinician: Down Syndrome, ectodermal dysplasia and labio-palatal cleft. CONCLUSIONS: It must be kept in mind that the success of the treatment of these patients is based on the compliance of the patient as well as on the collaboration among specialists.

Cyclic fatigue comparison among endodontic instruments with similar cross section and different surface coating.

BACKGROUND: The aim of this study was to analyze the influence of rotary instruments' geometry and surface titanium-nitride (TiN) treatment on the fatigue fracture, through the comparison of cyclic fatigue resistance of two endodontic systems that have similar cross-sectional design and different surface coating. METHODS: In this study 130 Mtwo (10/.04; 15/.05; 20/.06; 25/.06; 30/.05; 35/.04; 40/.04) and Easy Shape (15/.04; 20/.05; 25/.06; 30/.05; 35/.04; 40/.04) were tested for cyclic fatigue resistance. Time to fracture (TtF) was determined by counting the seconds of continuous rotation until final fracture in an artificial canal with 60° angle and a 5 mm radius of curve. The fracture surface of each fragment was examined with a scanning electron microscope (SEM). Data were subjected to one-way analysis of variance (ANOVA) and Tukey post-hoc tests. RESULTS: Mtwo perform a significantly (P<0.001) higher number of cycles to fracture (NCF) compared with Easy Shape of the same size and taper. The comparison between Mtwo and Easy Shape instruments with the same taper showed higher TtF values of Mtwo files than the Easy Shape ones (P<0.001) while there were no differences among Mtwo and Easy Shape instruments with the same tip, (P>0.05). CONCLUSIONS: Mtwo exhibit a higher NCF thanks to the smaller metal volume contained in their core. Titanium-nitride coating does not influence the performance of Easy Shape instruments on static test of cyclic fatigue.

Variations of the profile of the nose of the upper lip.

BACKGROUND: The aim of this study is to analyze the path needed to achieve a good aesthetic and functional result in patients treated with orthognathic surgery. METHODS: Seventy-three patients with only III class malocclusion were treated with sagittal split ramus osteotomy and with Le Fort I in only one piece. Through the analysis of anatomical cephalometric tracings, changes in the skeletal base, upper incisor and nose's shape were evaluated. The statistical analysis measurements were calculated for each length and for each angle at T0 (preoperative value) and at T1 (postoperative value). RESULTS: A significant statistical correlation was found mainly between forward movement of the upper maxilla and the outline of the nose, the nasal projection, and the naso-labial angle (NLA). The upper incisor in movements of verticality and inclination did not show any significant correlations with modifications of the NLA. CONCLUSIONS: A significant correlation can be seen between the forward movements of the upper maxilla with the outline of the nose, the nasal projection and the Naso-Labial Angle.

Cone-beam volumetric imaging in craniofacial medicine.

With the development of X-ray computed tomography (CT) in the 1960s and its first use for clinical studies in 1972 by Sir Godfrey Hounsfield, radiological tomography attained widespread use and today is one of the essential imaging techniques in medical radiology. It is a technically mature and clinically widely accepted method and complements classical X-ray panoramic radiography in many areas. The technology is frequently used in craniofacial radiology, because of its characteristic low radiation dose, high spatial resolution and lower cost compared with CT. The aim of this work was to describe the principles of cone beam computed tomography, to make a brief description of the existing devices, to present briefly the use of 3D diagnosis in craniofacial medicine.