Knowledge of Emergency Management of Avulsed Teeth among Italian Dentists-Questionnaire Study and Next Future Perspectives.

(1) Background: In Italy, about one fourth of all schoolchildren experience a trauma to the permanent dentition. Management of avulsion trauma is challenging and requires adherence to clinical protocols. The aim of this study was to investigate the management knowledge of avulsed teeth among Italian dentists and to promote the guidelines' dissemination through the use of new social media. (2) Methods: The survey was carried out during the COVID-19 lockdown in Italy (March-May 2020). The questionnaire was sent anonymously to a total of 600 dentists. The questionnaire consisted of two parts. Part A-demographic and professional data and Part B-management of traumatic avulsion. (3) Results: The response rate was 50.6% and the mean fraction of correct responses was 0.524. Issues related to the therapeutic management of avulsed teeth were shown to be not well understood by the respondents. Professionals with qualifications in dentistry and those who declared to know the guidelines responded better, while other demographic and professional factors were insignificant. (4) Conclusions: Italian dentists' knowledge of the management of avulsion trauma should be improved. Educational programs and campaigns must be undertaken to improve their awareness and adherence to the Italian and international guidelines.

The Lack of Association between FCN2 Gene Promoter Region Polymorphisms and Dental Caries in Polish Children.

The aim of this study was to examine the association of single-nucleotide polymorphisms (SNPs) in the gene encoding ficolin-2 protein (FCN2 gene) at positions -986 (rs17514136), -602 (rs3124953), and -4 (rs3124952) with dental caries in Polish children. Two hundred and sixty Polish Caucasian children aged 15 years were enrolled in this study: 82 with "higher" caries experience (DMFT >5) and 178 with "lower" caries experience (DMFT ≤5). In addition, subjects with caries experience (DMFT ≥1) and caries-free subjects (DMFT = 0) were compared. FCN2 SNPs were genotyped with PCR-RFLP methods. There were no significant differences in the genotype, allele, or haplotype distributions in 3 analyzed SNPs of the FCN2 gene between children with "higher" and those with "lower" caries experience as well as between children with caries experience and caries-free children. In conclusion, we did not find any association of FCN2 promoter polymorphisms at positions -986, -602, and -4 with dental caries in Polish children.

Sella turcica anomalies on lateral cephalometric radiographs of Polish children.

OBJECTIVES: To assess the prevalence of sella turcica anomalies on lateral cephalograms of children with malocclusion. To describe the craniofacial morphology in patients with sella turcica anomalies. METHODS: Lateral cephalograms obtained at ages 8-16 years (n = 431) were assessed for good visibility of cephalometric structures, including the sella turcica, and the absence of craniofacial congenital deformities; finally, 322 cephalograms were included and analysed. Subsequently, anomalies of sella turcica have been identified. Hypertrophic posterior clinoid process, hypotrophic posterior clinoid process and oblique contour of the floor were the abnormalities found that could not be classified based on literature. The study group consisted of 151 cephalograms with abnormal sella turcica, while the control group consisted of 171 cephalograms without any sellar pathology. Data normality has been tested using Shapiro-Wilk test. Correlations with age were made using Spearman correlation coefficient and those with sex were made using independence test with Yate's correction for continuity. Mann-Whitney test was used to compare between groups and subgroups. The level of significance has been established as p < 0.05. RESULTS: Sellar anomalies were found in 151 individuals (46.9%). Statistically significant differences between patients with normal and abnormal sellar morphology were found concerning: Pg:NB (p = 0.0009), 1+:NA (p = 0.0004) and 1-:NB (p = 0.012), indicating a more distal position of jaw structures in subjects with abnormal sella. CONCLUSIONS: The finding that almost 50% of children with malocclusion have sellar abnormalities confirms a general aetiology of malocclusion. Sella turcica assessment should be carried out during cephalometric analysis.

Facial esthetics in children with unilateral cleft lip and palate 3 years after alveolar bonegrafting combined with rhinoplasty between 2 and 4 years of age.

OBJECTIVES: To evaluate facial esthetics in patients with unilateral cleft lip and palate (UCLP) after alveolar bone grafting combined with rhinoplasty between 2 and 4 years of age. DESIGN: Retrospective case-control study. SETTING: The Department of Pediatric Surgery, Institute of Mother and Child, Warsaw, Poland. MATERIAL AND METHODS: Photographs of full faces and cropped images of five nasolabial components: nasal deviation, nasal form, nasal profile, vermillion border, and inferior view were assessed by 5 professional and 14 layraters in 29 children (23 boys and 6 girls; mean age = 5.3 years, SD 0.5; Early-grafted group) and 30 children (20 boys and 10 girls; mean age = 5.5 years, SD 1.0; Non-grafted group) with complete unilateral cleft lip and palate repaired with a one-stage closure. The groups differed regarding the timing of alveolar bone grafting: in the Early-grafted group, alveolar bone grafting in combination with rhinoplasty (ABG-R) was performed between 2 and 4 years of age (mean age = 2.3 years; SD 0.6); in the Non-grafted group, the alveolar defect was grafted after 9 years of age. No primary nose correction was carried out in any group. To rate esthetics, a modified five-grade esthetic index of Asher-McDade was used, where grade 1 means the most esthetic and grade 5 - the least esthetic outcome. RESULTS: Esthetics of full faces and of all nasolabial elements in the Early-grafted group was significantly better than in Non-grafted group. The scores in the Early-grafted group ranged from 2.30 to 2.66 points, whereas in the Non-grafted group ranged from 2.66 to 3.17 points. All intergroup differences were statistically significant (p < 0.05). CONCLUSIONS: Three years post-operatively, early alveolar bone grafting combined with rhinoplasty is favorable for facial esthetics in children with UCLP, but a longer follow-up is needed to assess whether the improvement was permanent.

Dental arch relationship in 5-year-olds with complete unilateral cleft lip and palate after early alveolar bone grafting.

OBJECTIVE: To evaluate dental arch relationship in preschoolers with unilateral cleft lip and palate after early alveolar bone grafting (ABG). MATERIALS AND METHODS: Three raters blindly assessed the dental arch relationship with the GOSLON Yardstick (using a 5-point scale, from 1--very good to 5--very poor outcome) in Early-grafted group (27 boys and 15 girls; mean age = 5.2 years, SD 0.5) and Non-grafted group (17 boys and 12 girls; mean age = 5.8 years, SD 0.8). The groups differed regarding the age when ABG was performed: between 2 and 4 years (mean = 2.4, SD 0.6) in the Early-grafted group and after 9 years in the Non-grafted group. The strength of agreement of rating was evaluated with kappa statistics. RESULTS: The intra- and inter-rater agreement was high (κ > 0.800). The mean GOSLON score in the Early-grafted group was 2.72 and in the Non-grafted group -2.64. The distribution of the GOSLON grades in the Early-grafted group was: 54.8% had a score 1 or 2, 23.8%--3, and 21.4%--4 or 5; in the Non-grafted group, 38.0% subjects scored 1 or 2, 41.4%--3, and 20.6%--4 or 5 (p = 0.023). CONCLUSIONS: Early alveolar bone grafting carried out between the ages of 2 and 4 years was not found to negatively affect dental arch relationship by the age of 5 years. However, it is possible that such a negative effect could be found if a longer observation period (e.g. at age 10 years or age 15 years) was allowed.

MBL2, MASP2, AMELX, and ENAM gene polymorphisms and dental caries in Polish children.

OBJECTIVE: The aim of the study was to examine whether the MBL2 C(-290)G and G161A, MASP2 A359G, AMELX C287T and C522T, and ENAM C2452T polymorphisms are associated with dental caries. SUBJECTS AND METHODS: Genomic DNA of 95 Polish children with 'higher caries experience' (HC) and 84 subjects with 'lower caries experience' (LC) belonging to two age-groups (5 and 13 years old) was extracted from the buccal mucosa. SNPs were genotyped with PCR-RFLP methods. RESULTS: Among 5-year-old children, we found significantly higher percentage of subjects carrying MBL2 (-290)G allele in HC group compared with LC group (43.2%vs 17.6%, P = 0.023). MBL2 C(-290)G-G161A C-G haplotype was overrepresented in LC group in 5-year-olds (P = 0.01), while the opposite association was observed in 13-year-olds, where C-G was overrepresented in HC group (P = 0.028). In 5-year-old children, the frequency of MBL2 G-G haplotype was higher in HC group compared with LC subjects (P = 0.045), while the opposite association (with borderline significance) was observed in 13-year-old children (P = 0.057). SNPs in MASP2, AMELX, and ENAM were not associated with dental caries. CONCLUSION: MBL2 gene polymorphism is associated with caries experience in Polish children, but the direction of this association seems to be opposite in primary and permanent dentition.

Early alveolar bone grafting has a negative effect on maxillary dental arch dimensions of pre-school children with complete unilateral cleft lip and palate.

OBJECTIVE: To evaluate maxillary dental arch dimensions in pre-school children with a complete unilateral cleft lip and palate (CUCLP) after early alveolar bone grafting. MATERIAL AND METHODS: Intercanine and intermolar widths, length of dental arch and mesiopalatal inclination of both maxillary segments were measured directly on the dental casts of 42 children (27 boys and 15 girls; mean age = 5.2 years, SD 0.5; Early-grafted group), 30 children (18 boys and 12 girls; mean age = 5.8 years, SD 0.8; Non-grafted group), and 40 children (25 boys and 15 girls, mean age = 5.8, SD 0.4; non-cleft Control group). Children from Early-grafted and Non-grafted groups had a CUCLP repaired with a one-stage closure of the entire cleft. An alveolar bone grafting was performed in the Early-grafted group between 2 and 4 years (mean = 2.4, SD 0.6). A one-way anova model with post hoc Tukey's multiple comparison procedures were used to identify intergroup differences. RESULTS: The mesiopalatal inclination of the lesser segment in the Early-grafted group was decreased in comparison with the Non-grafted and Control groups. The intercanine width had a tendency to be reduced in the Early-grafted group relative to Non-grafted group. CONCLUSIONS: Early bone grafting results in a larger collapse of the lesser segment than bone grafting carried out between 9 and 12 years of age.

Tessier type 3 oblique facial cleft with a contralateral complete cleft lip and palate.

Oblique facial clefts are extremely rare congenital deformities with a reported incidence of 0.24% of all facial clefts. This report presents a patient with a right-sided oblique cleft extending through the upper lip, the alar groove and the lower palpebra accompanied by a left-sided complete cleft lip and palate. Hypertylorism and bilateral microphthalmia as well as flexion wrist contractures were also present. Primary straight-line closure of the oblique cleft was undertaken followed by primary closure of the contralateral cleft lip. The treatment modality and 2 year follow-up results are presented.