Craniofacial growth patterns in patients with congenitally missing permanent teeth.

OBJECTIVE: Aim of this study was to investigate any correlations between the congenital absence of certain permanent teeth and individual craniofacial growth patterns. MATERIAL AND METHODS: The lateral cephalograms of n = 101 patients (65 female und 36 male) with various congenitally missing teeth were analyzed according to Hasund [11] prior to orthodontic treatment. Cephalometric data to determine the craniofacial growth pattern comprised GntgoAr, NSBa, ML-NSL, NL-NSL, MLNL angles and the index between upper and lower facial heights. Correlations between the type of missing teeth and growth pattern were examined. Group distribution was A = all patients with missing teeth (n = 101), P = missing second premolars (n = 49), S = missing upper lateral incisors (n = 30), X = various missing teeth (n = 22). We included a control group for each of these groups using data from Riolo et al.'s [22] growth study. RESULTS: Group A revealed an even distribution with n = 32 patients (31.7%) having a vertical growth pattern, n = 37 patients (36.6%) a neutral growth pattern, and n = 32 patients (31.7%) a horizontal growth pattern. The majority of patients (n = 20, 40.8%) in group P exhibited a horizontal growth pattern, whereas there were no significant correlations between the kind of congenitally missing teeth and growth patterns in groups S and X. Comparison of the mean values of groups P, S and X, revealed no significant differences. When comparing the control group to groups A, P and S, we noted significantly or highly significantly smaller gonial and basal plane angles. No significant differences were apparent concerning group X. CONCLUSIONS: This examination demonstrates no statistically-relevant correlation between craniofacial growth pattern and the congenital absence of certain permanent teeth, although horizontal growth is more frequent (but not significant) in patients with congenitally missing second premolars.

Molar inclination in panoramic x-rays as an indicator for extraction decisions.

OBJECTIVE: Recommendations concerning the necessity of extraction therapy are often based upon clinical findings and panoramic x-rays. Since the success of this approach greatly depends on the individual examiner's clinical expertise, we believed it to be of interest to evaluate whether panoramic x-ray findings alone suffice for making the decision to extract. The aim of this study was to evaluate whether the need for extraction therapy can be verified by measuring the angulations between the first and second lower molars. MATERIAL AND METHODS: Orthopantomograms of 30 patients who underwent extraction of four premolars were examined prior to and after treatment. Initial study casts were also evaluated for any correlations between molar inclination and other examination parameters. Orthopantomograms of 30 patients who had experienced comprehensive orthodontic treatment without extraction served as age- and gender-matched controls. RESULTS: Contrary to expectation, the lower second molars showed a stronger mesial inclination before rather than after treatment, and the changes were highly significant. The controls also showed highly significant changes on the left side. The extraction and non-extraction groups did not differ significantly in terms of molar inclination at the beginning of treatment. Gender differences occurred in both groups, but only on one side. No other findings indicated gender differences in terms of molar inclination. CONCLUSION: Our data failed to prove a correlation between distally- inclined lower second molars in the panoramic x-ray and the indication of extraction therapy.

Health-related quality of life in hereditary hemorrhagic telangiectasia.

OBJECTIVE: To assess and differentiate the health-related quality of life (HR-QoL) in patients with hereditary hemorrhagic telangiectasia (HHT). STUDY DESIGN AND SETTING: A prospective, open, cross-sectional questionnaire-based study (including the Short Form-36 Health Survey [SF-36]) performed by a tertiary care center. RESULTS: A total of 77 patients (36 females) were included. Except for one domain (bodily pain), the scores for all scales of the SF-36 were significantly reduced in comparison with normative data. The duration of epistaxis, the presence of hepatic involvement and gastrointestinal bleeding, and the number of visible telangiectases correlated with lower scores on several scales of the SF-36. Unexpectedly, the frequency of epistaxis did not correlate with any scale. CONCLUSIONS: The duration of epistaxis, liver involvement, gastrointestinal bleeding, and the number of visible telangiectases have a major influence on the HR-QoL in HHT whereby the frequency of epistaxis seems to play a minor role. SIGNIFICANCE: The data presented have an impact on therapeutic decisions, medical expert opinions, and research funding.