Analysis of Dental Maturation in Relation to Sagittal Jaw Relationships.

BACKGROUND: The degree of mineralization of permanent tooth germs in dental age assessment has been an area of interest among many authors for years. However, only recently have researchers attempted to determine the potential interdependencies between dental age and jaw relationships. The aim of this work was to compare dental maturation in patients with skeletal Class II to patients with skeletal Classes I and III. MATERIAL/METHODS: The study involved 150 patients who sought orthodontic treatment. Dental age was assessed from panoramic radiographs using the Demirjian's method. Skeletal class was evaluated according to the value of the ANPg angle from the Björk's analysis. We used the analysis of variance (ANOVA) and the Student's t-test. RESULTS: The mean dental age in patients with skeletal Class III was significantly higher than the mean dental age in patients with skeletal Class II (p<0.0005). A correlation between the dental age and chronological age was established. The weakest correlation was seen between the dental age and skeletal Class II. Among patients with skeletal Class II, the strongest correlation was found between chronological age and the formation of the germ of the second lower premolar (r=0.67; p<0.001). CONCLUSIONS: Dental age among patients with skeletal Class II was the lowest.

Endometrial cancer and hyperplasia rate in women before menopause with abnormal uterine bleeding undergoing endometrial sampling.

Introduction: Abnormal uterine bleeding (AUB) is the most common symptom of endometrial cancer (EC) and endometrial hyperplasia with (AH) or without (EH) atypia. Risk of malignancy and hyperplasia is significantly lower in premenopausal than in postmenopausal women. Only 10% of EC occurs before menopause. Obesity and age are well-recognized risk factors of endometrial cancer. Endometrial sampling is recommended in women at high risk of endometrial malignancy. The primary objective was to determine the incidence of EC, AH and EH in premenopausal women undergoing dilation and curettage (D&C) because of AUB. Additional objective of the study was to estimate the risk of EC and AH in overweight and obese women with two types of AUB: heavy menstrual bleeding (AUB-HMB) and intermenstrual bleeding (AUB-IMB), according to PALM-COEIN classification. Material and Methods: Retrospective study in the population of women undergoing D&C in tertiary hospital because of AUB between Jan-2016 and Dec-2016. The incidence of EC, AH, EH was established. The influence of the variables: age, BMI, AUBHMB/ AUB-IMB on the occurrence of abnormal histology (EC, AH, EH) was evaluated. Finally, the model built by using backward stepwise regression and mechanism of v-fold cross-validation, showed no statistically significant relationship. Results: EC was detected in 2/213 cases (0.9%; 95% CI 0.0003 to 0.036), AH in 3/213 cases (1.4%), giving a total of 5/213 (2.3%) women with AH or EC. EH was detected in 16/213 (7.5%) women. High BMI raises the chance of AH diagnosis: OR 1.16 (95% CI 1.05- 1.28). The presence of HMB compared to IMB reduces the chance of EH: OR 0.24 (95% CI 0.07-0.9). IMB increases the chance for the diagnosis of EH 4.11 times compared to HMB (OR 4.1, 95% CI 1.1-14.9; p = 0.016). Conclusions: EC in premenopausal women with AUB undergoing D&C is rare. There is a need to search for more effective methods of selection of patients than commonly used. Age and BMI do not seem to be factors that should be used to select patients.

Radiological Indicators of Bone Age Assessment in Cephalometric Images. Review.

The ability to assess bone age accurately is important and allows to diagnose the patient correctly and to plan orthodontic treatment appropriately. The aim of the work is to present views of different authors on the subject of using cephalometric images to determine bone age and its significance for conducting appropriate orthodontic treatment. Publications from the PubMed medical database were analyzed. Search criteria: bone age assessment, CVM method. Ultimately, 36 papers out of 1354 publications were selected. The research of many authors confirms the usefulness of various methods using cephalometric images to assess skeletal age. Currently, the CVM method devised by Baccetti et al. is the most frequently mentioned one in literature. It seems that bone age assessment methods based on evaluating the morphological structure of the cervical vertebrae in cephalometric images can clearly differentiate skeletal maturity in children regardless of their race or sex. Bearing in mind the constant technological progress in medicine and stomatology, bone age assessment methods need to be perfected in order to alleviate their impact on the patient as much as possible.

The role of permanent first molar relationship in assessing class ii malocclusions based on the analysis of diagnostic models from the palatal side.

AIM: The aim of the work is to determine the significance of posterior relationship between the first upper and lower molars from the palatal side in diagnosing Class II malocclusions. MATERIAL AND METHODS: One hundred and fifty diagnostic models and lateral cephalograms of patients from the Zbigniew Zak District Memorial Outpatient Clinic in Cracow were assessed. RESULTS: Out of 150 patients, skeletal Class II was diagnosed in 108 patients based on measuring the ANB angle (>4°), and in 115 patients based on the Wits appraisal (≥2 mm). In 68 patients (45.3%) with a bilateral complete posterior relationship of permanent first molars from the palatal side, skeletal Class II was confirmed on the basis of the ANB angle (>4°). In 3 patients (2%) skeletal Class II did not occur, despite a bilateral complete posterior relationship of permanent first molars from the palatal side. In 69 patients (46%) with a bilateral complete posterior relationship of permanent first molars from the palatal side, skeletal Class II was confirmed by means of the Wits appraisal. Only in 2 patients (1.3%), skeletal Class II did not occur despite a bilateral complete posterior relationship of permanent first molars from the palatal side. CONCLUSIONS: The occurrence of a bilateral complete posterior relationship of permanent first molars from the palatal side constitutes a very reliable predictive parameter of skeletal Class II. Diagnosing a correct first molar relationship from the palatal side leads to a high probability that skeletal Class II does not occur.

[Coronary artery disease as cause of non-odontogenic toothache. A review of literature]. / Choroba wiencowa jako przyczyna niezebopochodnego bólu zebów. Przeglad pismiennictwa.

AIMS: The aim of the work is to present, based on the latest available literature, the clinical picture of non-odontogenic toothache as a symptom of coronary artery disease. MATERIAL AND METHODS: Analysis of full text scientific studies, including research and casuistic works, which present the characteristics of the most frequently reported pain symptoms of the viscerocranium area, including toothache, in patients in the course of coronary artery disease. RESULTS: The pain of the viscerocranium region turned out to be the most frequent symptom of ischaemic heart disease when chest pain is absent. The most frequently reported pain symptoms of the viscerocranium area in the course of ischaemic heart disease involve: pain of the upper part of the thorax, left side of the mandible, right side of the mandible, the region of the left temporomandibular joint and the left ear, toothache. The patients most frequently described the pain as pressing and burning. The pain also intensified during physical exercise. CONCLUSION: The aetiology of toothache may be very diverse. An accurate and quick differential diagnosis of odontogenic and non-odontogenic toothache is not an easy task even for an expert clinician. Nonetheless, it is crucial for patients' life and health. A dentist may play a significant role in an early diagnosis of ischaemic heart disease.

[Multiloculated mesenteric and retroperitoneal tumour - lymphatic malformation - in a 4-year-old girl]. / Wielokomorowy guz krezki I prezestrzeni zaotrzewnowej - malformacja chlonna u czteroletniej dziewczynki.

Mesenteric cysts are rare and mostly benign abdominal tumours in children. Majority of them are lymphangiomas (lymphatic malformations). We diagnosed a broad, multiloculated mesenteric and retroperitoneal cyst, associated with intensive inflammation, in a 4-year-old girl. Surgical therapy was fully successful.

Orthodontic treatment in oncological patients.

The progress in oncological treatment has led to the current increase of childhood cancer survival rate to 80%. That is why orthodontists more and more frequently consult patients who had completed a successful anti-cancer therapy in childhood. Oncological treatments such as chemotherapy, radiotherapy or supportive immunosuppressive therapy cause numerous side effects in growing patients, connected i.a. with growth, the development of teeth or the viscerocranium. This is a special group of patients that needs an optimised plan of orthodontic treatment and often has to accept a compromise result. The purpose of the current work is to discuss the results of orthodontic treatment in patients after an anti-cancer therapy. Time of treatment was 12,5 months. In 6 patients (from 40 undergoing orthodontic therapy) we haven't reached a normocclusion, in 9 patients we should have stopped the therapy because of the recurrence. In 11 patients we found mucosa inflammation and in 1 patient the therapy stopped before the end because of very low oral hygiene level. Bearing in mind the limited number of original works on the above topic in Polish medical literature, the study has been carried out in order to make Polish orthodontists more acquainted with the topic and the standards of dealing with an oncological patient.

Prosthetic rehabilitation of patients with unilateral complete cleft of the primary and secondary palate.

The goal of this paper was to present the orthodontic treatment of a patient with unilateral lip, alveolar and hard palate cleft (UCLP) and the agenesis of permanent teeth and prosthetic rehabilitation of two cases differing from each other in the extent of tissue deficiency. Both patients underwent a long, multi-specialist surgico-orthodontic treatment including derotation of the maxilla's smaller segment and restoration of space for the missing teeth. In the first case presented, cross-bite on the front teeth and the canine was eliminated during a late phase of orthodontic treatment in order to prepare for final prosthetic rehabilitation. Two prosthetic restorations in patients with similar dental anomalies (hypodontia of the right upper incisors) were presented and discussed in detail. Prosthetic rehabilitation with cemented restoration was carried out after the end of growth. Satisfactory function of the orthognathic system and face appearance were accomplished. In both cases cemented prosthetic restorations preserve the treatment outcome and bite stability. The results were excellent and satisfying for the patients. The patient who presented more extensive tissue distortion has retained correct bite and prosthetic restorations for 20 years. The patient whose correction of the malocclusion and the cemented prosthetic restoration was completed is also predicted to maintain long-standing oral health and good functioning of the masticatory system.