Relationship in development of malocclusions to polymorphisms of selected vitamin D receptors.

BACKGROUND: The development of malocclusion is related to various factor, many of which are still not fully explained. The steroid hormone, 1,25-dihydroxyvitamin D3, has pleiotropic effects. It plays a key role in skeletal metabolism and the control of cell repair by attaching to the nuclear vitamin D steroid receptor (VDR). This vitamin affects bone turnover through the processes of bone tissue formation and resorption via its action on cells of the osteoblastic and osteoclastic lineage, exerts a modulating effect on the immune system, and is involved in the regulation of cell proliferation and differentiation. The role of vitamin D3 (VD3) and its receptor polymorphisms is a rarely studied topic in dentistry. Due to the proven influence on bone turnover processes and immune responses, the main research topic is its relation to periodontal diseases, but so far, its role in the formation and development of malocclusions has not been assessed. OBJECTIVES: This study aimed to assess the association of selected VDR polymorphisms: Cdx2 (rs11658820), TaqI (rs7975232), BsmI (rs1544410), ApaI (rs7975232), and FokI (rs2228570) with the development of malocclusions. MATERIAL AND METHODS: A prospective observational study was performed. The examination consisted of a medical interview, intraand extraoral orthodontic diagnosis, alginate impression, cone beam computed tomography (CBCT), and venous blood sample to obtain genomic DNA and assess VDR polymorphisms. RESULTS: The rs11658820 polymorphism causes an almost 4-fold increase in the probability of the presence of a malocclusion. GT and TT genotypes of rs7975232 are also associated with a similar risk - almost 6 and almost 5 times higher, respectively. In turn, the effect of the rs2228570-AG and GG genotype polymorphisms on the occurrence of transversal anomalies was demonstrated (odds ratio (OR) = 8.46 and OR = 6.92, respectively). CONCLUSIONS: The association of individual polymorphisms with specific malocclusions should be carefully assessed, especially since some trends have been indicated.

CBCT and modern intraoral scanners as tools for developing comprehensive, interdisciplinary treatment plans.

The aim of this narrative literature review is to present the possibilities of using cone beam computed tomography (CBCT) and 3D dental scanners to prepare comprehensive, interdisciplinary treatment plans. Scanners are instruments whose usage seems to be a key element of modern digital dentistry. Their importance in orthodontic treatment with overlay appliances, planning modern prosthetic treatments (CAD/CAM) and implantology cannot be overestimated. These scanners allow for accurate imaging of the tooth structures and their positioning independently in the maxilla and mandible as well as in the occlusion. As a result, dentists can plan treatment, e.g., in the case of the need to implant dental implants, prosthetic crowns or orthodontic braces. Dentistry was revolutionized to a similar extent by the introduction of CBCT to everyday diagnostics, which is the most advanced imaging technology that provides even more detailed images in 3 dimensions. Its use has enabled a wider and more precise range of diagnostics, which in turn has improved the quality of multidisciplinary treatment planning. This paper explains how scanners and CBCT can be used in orthodontics and prosthetics based on the articles found in 3 databases: PubMed, Scopus and Embase. The review included 28 articles on the aforementioned topics and was presented with a brief description of the content of each article.

Application of a three-dimensional scanner to the quantitative assessment of the nail plate condition after a hybrid manicure procedure-Preliminary study.

BACKGROUND: About 90% of women worldwide use nail care products, including manicure ones. A manicure procedure results in nail damage, therefore it is necessary to search for new, objective methods of assessing the impact of the procedures and products applied within the nail plate. In this study, an attempt was made to quantify the impact of manicure procedures on the nail plate condition. MATERIALS AND METHODS: Twenty thumb nail plates were examined. Before the manicure procedures, alginate casts were prepared for each of the subjects. The analysis of the three-dimensional (3D) nail surface structure included the assessment of the nail sections and the assessment of differences in the nail structure after superposition of 3D images of the nail plates before and after the manicure procedures. RESULTS: The obtained results show that the nail plate structure changed to a similar extent in each measured section after the manicure procedure. A change in the height of the nails is not a desirable phenomenon as it suggests damage to the nail caused by the substances included in the preparations applied to the nails, acetone, or filing the nail plate. This proves the great influence of the technique of removing artificial nails on the structure of the natural plate. CONCLUSION: The use of a 3D scanner allows for precise, biometric, quantitative, and repeatable measurements of changes in the nail structure after a manicure procedure. The use of the hybrid and gel manicure procedure causes significant damage to the nail plate, especially in its distal portion.

Electromyographic Study of Masticatory Muscle Function in Children with Down Syndrome.

This study assessed the electrical activity of the masticatory muscles in both children with down syndrome (DS) and healthy children. After applying the inclusion and exclusion criteria, 30 patients aged between 7.9 and 11.8 years participated in the study. They were divided into two groups of 15: DS and non-DS. A DAB-Bluetooth device (Zebris Medical GmbH, Germany) was used to record the electromyographical (EMG) activity of the right and left temporal and of the right and left masseter muscles at rest and during maximum voluntary clenching (MVC). The asymmetry index between right and left masticatory muscle EMG activity was calculated for each position. The Mann-Whitney U test was applied to analyze the study results. There were no differences in the electrical activity of the temporal and masseter muscles at rest between the groups. During MVC, the asymmetry index for the masseter muscles was significantly higher in subjects with DS. The electrical potentials of the temporal and masseter muscles in children with DS were significantly lower compared to the corresponding parameters for healthy children when clenching.

Impacted Canine Management Using Aligners Supported by Orthodontic Temporary Anchorage Devices.

INTRODUCTION: Temporary anchorage devices (TADs) represent an essential instrument under difficult anchorage conditions, especially when the procedure is approached with an aligner technique. The objective of this paper is to describe a possible sequence of orthodontic treatment of impacted canines with aligners supported by orthodontic mini-screws. MATERIALS AND METHODS: The resolution of impacted canines requires a specific clinical sequence constituted by different steps: the space creation, the surgical exposure, and the orthodontic traction (on the horizontal, vertical, and buccal direction). Following this sequence, two different clinical scenarios can be identified following the space available and the initial malocclusion. The first scenario is constituted by recreating the space for the impacted canine along with the correction of the malocclusion by means of an aligner system and then approaching the de-impaction with TADs. The second clinical scenario is related to the canine-first approach, an immediate de-impaction stage based solely on the use of TADs and sectional wires, and then a finishing phase with aligners. RESULTS: Both approaches to the treatment of impacted canines can be considered reliable, but of course selecting one or the other depends on the space available in the upper arch and on the initial malocclusion. CONCLUSIONS: The use of aligners in the treatment of impacted canines in combination with TADs and sectional wires represents a viable alternative option to the conventional systems for canine disinclusion. When the treatment is managed with the presented approaches, no further cooperation with the patient is required in order to support the forced eruption, and an ideal biomechanical approach can be easily applied with one or two mini-screws.

The Electrical Activity of the Orbicularis Oris Muscle in Children with Down Syndrome-A Preliminary Study.

The aim of this study was to assess the electrical activity of the superior (SOO) and inferior (IOO) orbicularis oris muscles in children with Down syndrome (DS) and in children without DS. After applying the inclusion and exclusion criteria, 30 subjects were eligible to participate in the later stages of the research-15 subjects with DS (mean age 10.1 ± 1.1) and 15 healthy controls (mean age 9.8 ± 1.0). The electrical potentials of the SOO and IOO muscles were recorded using a DAB-Bluetooth electromyography machine (Zebris Medical GmbH, Germany) during the following tasks: At clinical rest, saliva swallowing, lip protrusion, lip compression, and production of the syllable/pa/. The Mann-Whitney U test was conducted to compare the study results between the groups. An analysis of the electromyographical (EMG) recordings showed that the electrical activity of the orbicularis oris muscle in children with DS and lip incompetence was significantly higher compared to healthy children during saliva swallowing, lip compression, and when producing the syllable/pa/, and this may suggest greater muscular effort due to the need to seal the lips during these functional conditions.

Superior Orbicularis Oris Muscle Activity in Children Surgically Treated for Bilateral Complete Cleft Lip and Palate.

The aim of this cross-sectional study was to evaluate the electromyographic activity of the superior orbicularis oris muscle both in children surgically treated for bilateral complete cleft lip and palate (BCCLP) as well as in subjects without BCCLP. The study comprised 77 children aged 6.6 to 12.5 years. All the patients with clefts had previously undergone lip and palate surgery. The upper lip electromyographic (EMG) assessments were made with a DAB-Bluetooth device (Zebris Medical GmbH, Germany) at rest, while swallowing saliva, protruding lips and compressing lips. EMG measurements were also made when the subjects produced phonemes /p/, /b/, and /m/ with the vowel /a/. The Mann-Whitney U test was applied to statistically analyze the EMG values. Significantly higher median upper lip EMG activity under working conditions such as swallowing saliva, lip compression, and production of the phoneme /p/ with the vowel /a/ was observed in patients with BCCLP compared to those without a cleft. The results of the study showed that the upper lip muscle activity increases in children with BCCLP when swallowing saliva, compressing lips and during some speech movement tasks. This may be important in the aspect of the effect of surgical lip repair on the craniofacial growth.

Effective microbiological decontamination of dental healing abutments colonised with Rothia aeria by a diode laser as a helpful step towards successful implantoprosthetic therapy.

The aim of the study was to find variant of diode laser (λ = 810 nm) irradiation, which ensures elimination of unwanted microorganisms, including Rothia aeria, from dental healing abutments, and consequently accelerates process of wound healing in implantologically treated patients. The scope of the study included identification of the most contaminated areas on healing abutments, identification of microorganisms inhabiting various environments of oral cavities, assessment of effectiveness of various laser decontamination parameters against detected microorganisms (preliminary studies) and assessment of wound healing in patients after applying abutments with low roughness and optimal variant of laser irradiation (clinical studies). Imaging of surfaces of the healing abutments was performed using vertical scanning interferometry, scanning electron microscopy and optical microscopy. Microorganisms inhabiting the healing abutments, teeth and saliva from tested patients were identified using matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry. Three programmes of near-infrared diode laser at average powers of 1.00-3.84 W with two variants of exposure time were used for optimisation of laser parameters. Observation of wound healing was performed for 100 patients during 20 days after installation of abutments. On surfaces of the used healing abutments, a large number of microorganisms, with a predominance of R. aeria, were found. Irradiation with periimplantitis surgical programme for 30 s resulted in 99-100% reduction in the number of R. aeria and other microorganisms, depending on type of abutment (in vivo). The use of diode laser in the selected variant accelerates wound healing and provides complete elimination of pathogenic R. aeria and other microorganisms inhabiting surfaces of the healing abutments without marks.

Diagnosis of Temporomandibular Disorders Using Thermovision Imaging.

Temporomandibular joint dysfunction (TMD) is a chronic disease of various etiologies. Correct TMD diagnosis enables to apply effective treatment and significantly improves the quality of patients' lives. One of the diagnostic methods subjected to evaluation in recent years is thermography, which enables safe, noninvasive, and quick imaging of the temperature distribution of temporomandibular joint-associated tissues. This paper, based on Medline, Dentistry & Oral Sciences Source, Academic Search Ultimate, Medline Complete databases, presents basic information related to thermovision imaging and outlines the direction of research conducted in recent years which fight with difficulties in the interpretation of thermograms that require specialized, dedicated analysis and processing of the obtained images. The problem concerns also no standardized protocol for measuring masticatory muscle temperature.

Electromyography as a Means of Assessing Masticatory Muscle Activity in Patients with Pain-Related Temporomandibular Disorders.

Aim: The aim of this study was to evaluate masticatory muscle electrical activity in patients with pain-related and pain-free temporomandibular disorders (TMDs) as well as in subjects with no TMD. Methods: Ninety children with mixed dentition were recruited to the study. Of this total, 30 subjects were diagnosed with pain-related TMD (TMD-P), 30 with pain-free TMD (TMD-PF), and 30 without TMD. We used Axis I of the Research Diagnostic Criteria for TMD (RDC/TMD) to assess the presence of TMD in the examined children. The electromyographical (EMG) potentials of the temporalis and masseter muscles were measured with a DAB-Bluetooth Instrument (Zebris Medical GmbH, Germany) at rest and during maximum voluntary clenching (MVC). Results: An analysis of the EMG recordings showed statistically significant intergroup differences in masticatory muscle electrical activity at rest and during MVC. Significantly higher rest temporalis muscle activity was noted in pain-related TMD subjects compared with that children from the pain-free TMD and non-TMD groups, as well as in TMD-PF children in relation to those without TMD. The EMG potentials of the temporalis muscle during MVC were much lower in patients with TMD-P than in pain-free TMD and non-TMD subjects. Masseter muscle activity at rest in the TMD-pain group was significantly greater, and masseter muscle EMG potentials during clenching were markedly lower than in patients with no TMD diagnosis. Conclusion: The use of electromyography to assess masticatory muscle function revealed alterations in the pattern of temporalis and masseter muscle activity in patients with pain-related TMD compared with the pain-free subjects.

Corrigendum to "Enamel Thickness before and after Orthodontic Treatment Analysed in Optical Coherence Tomography".

[This corrects the article DOI: 10.1155/2017/8390575.].

The ways of using machine learning in dentistry.

Innovative computer techniques are starting to be employed not only in academic research, but also in commercial production, finding use in many areas of dentistry. This is conducive to the digitalization of dentistry and its increasing treatment and diagnostic demands. In many areas of dentistry, such as orthodontics and maxillofacial surgery, but also periodontics or prosthetics, only a correct diagnosis ensures the correct treatment plan, which is the only way to restore the patient's health. The diagnosis and treatment plan is based on the specialist's knowledge, but is subject to a large, multi-factorial risk of error. Therefore, the introduction of multiparametric pattern recognition methods (statistics, machine learning and artificial intelligence (AI)) is a great hope for both the physicians and the patients. However, the general use of clinical decision support systems (CDSS) in a dental clinic is not yet realistic and requires work in many aspects - methodical, technological and business. The article presents a review of the latest attempts to apply AI, such as CDSS or genetic algorithms (GAs) in research and clinical dentistry, taking under consideration all of the main dental specialties. Work on the introduction of public CDSS has been continued for years. The article presents the latest achievements in this field, analyzing their real-life application and credibility.

Evaluation of changes in enamel thickness after orthodontic treatment depending on the force applied to remove orthodontic brackets: OCT analysis and universal testing machine.

BACKGROUND: Adhesive materials used in orthodontics have contributed to the broadening of treatment options with fixed braces. The adhesive materials physically and chemically bond to the enamel surface and orthodontic bracket base, which, apart from offering advantages, also entails the risk of enamel damage when removing these materials from the tissue surface after the treatment is complete. OBJECTIVES: The objective of this study was to assess how the bond strength of adhesive materials affects enamel thickness after removing brackets and whether the type of bonding system affects the amount of adhesive strength of the discussed materials. MATERIAL AND METHODS: The tests were carried out on 2 groups of 40 bovine teeth in each group. In the 1st group, the classical orthophosphoric acid and the Transbond Plus self-etching primer (SEP) were used. In the 2nd group, the Transbond XT SEP was applied. In both groups, Transbond XT Light Cure Adhesive was used. The same metal orthodontic brackets were attached to the enamel surface. Optical Coherence Tomography (OCT) scans were made before and after removing brackets, which enabled tissue thickness measurements. The bond strength was evaluated using a universal testing machine. Parametric tests were performed on all obtained variables. Student's t-tests for independent samples and analysis of correlation with Pearson's r were carried out. RESULTS: The bond strength between the orthodontic bracket and enamel is statistically significantly different in the 1st group and the 2nd group, and is higher in the 2nd group. CONCLUSIONS: There are no significant differences in enamel thickness depending on the bonding system type and there is no correlation between the enamel thickness and the bond strength of orthodontic brackets to the enamel.

The Diagnostic Value of Electromyography in Identifying Patients With Pain-Related Temporomandibular Disorders.

Introduction: Orofacial pain disorders can be divided into several subgroups. One of them is temporomandibular disorders (TMD) with recognizable signs such as joint noises, limitations in the range of motion, or mandibular deviation during function and symptoms-pain in the muscles or joint. Surface electromyography (sEMG) is a diagnostic tool that ensures reliable and valid evaluation of muscle activity. sEMG detects electrical potentials and on this account may conceivably be employed in the TMD recognition. The aim of this study was to assess the sensitivity, specificity, and accuracy of electromyography in diagnosing subjects with temporomandibular disorders, including pain-free TMD and pain-related TMD. Methods: The sample comprised 88 patients with cleft lip and palate and mixed dentition. TMD has been recognized on the grounds of Axis I of the Research Diagnostic Criteria for TMD (RDC/TMD). To evaluate the electrical activity of the temporal and masseter muscles in the rest position and during maximum voluntary contraction, a DAB-Bluetooth Instrument (Zebris Medical GmbH, Germany) was used. The analysis of the receiver operating characteristic (ROC) curve gave information about accuracy, cut-off point value, sensitivity and specificity of the normalized sEMG data. Results: The highest diagnostic efficiency of sEMG in terms of identifying subjects with TMD and pain-related TMD was observed for the mean values of temporal and masseter muscle activity as well as the Asymmetry Index of the masseter muscles in a rest position. A moderate degree of EMG accuracy in differentiating between pain-related TMD and non-TMD children was observed for the mean values of masseter muscle activity and the Asymmetry Index of the masseter muscles at rest. Conclusion: An evaluation of electromyography exhibits its diagnostic usability in recognition of patients with pain-related TMD and it could be used as an adjunctive tool in the identification of this disorder. Clinical Trial Registration: This clinical research was registered in the ClinicalTrials.gov database under the number NCT03308266.

Optical coherence tomography as a non-invasive method of enamel thickness diagnosis after orthodontic treatment by 3 different types of brackets.

BACKGROUND: Medical digital imaging is the basis of effective medical diagnosis and is now in the mainstream of a dynamically developing branch of science. Optical coherence tomography (OCT) enables real-time in situ imaging of tissues without the need for biopsy, histological procedures or X-rays. OBJECTIVES: The aim of the study was to evaluate the application of OCT in orthodontic diagnostics and clinical practice by assessing the thickness of the enamel before and after orthodontic treatment. MATERIAL AND METHODS: A hundred and eighty teeth in this in vitro study were divided into 3 groups of 60 teeth each. In each group (Group 1 - metal brackets, Group 2 - ceramic brackets and Group 3 - composite brackets), the orthodontic brackets were attached to the enamel using the 5th-generation adhesive system. The image of the enamel tissue was captured with a 3D-OCT camera before installing orthodontic brackets and after debonding and mechanical processing. The obtained OCT scans were subjected to expert IT analysis. For the statistical analysis, the Shapiro-Wilk test, the median test, the Mann-Whitney U test, Friedman 2-way analysis of variance (ANOVA), Wilcoxon matched pairs signed ranks test, the χ2 test of independence with Yates's correction, and Fisher's exact test were used. Maxwell's general principle was followed when using this type of test. The level of significance was set at p = 0.05. RESULTS: The thickness of the enamel varied least when metal brackets were used. The changes in enamel thickness in the composite and ceramic bracket groups were not statistically significant. CONCLUSIONS: Optical coherence tomography is an effective diagnostic tool to evaluate the thickness of the enamel tissue before and after orthodontic treatment. Changes in the enamel layer thickness after orthodontic treatment are determined by the type of material which the orthodontic bracket is made of.

Electromyographic Analysis of Masticatory Muscles in Cleft Lip and Palate Children with Pain-Related Temporomandibular Disorders.

Aim: The aim of this study was to assess the electrical activity of temporalis and masseter muscles in children with cleft lip and palate (CLP) and pain-related temporomandibular disorders (TMD-P). Methods: The sample consisted of 31 CLP patients with a TMD-P (mean age 9.5 ± 1.8 years) and 32 CLP subjects with no TMD (mean age 9.2 ± 1.7 years). The children were assessed for the presence of temporomandibular disorders (TMD) using Axis I of the Research Diagnostic Criteria for TMD (RDC/TMD). Electromyographical (EMG) recordings were performed using a DAB-Bluetooth Instrument (Zebris Medical GmbH, Germany) in the mandibular rest position and during maximum voluntary contraction (MVC). Results: The rest activity of the temporalis and masseter muscles was significantly higher in TMD-P group compared with non-TMD children. A significant decrease in temporalis muscle activity during MVC was observed in TMD-P patients. There was a significant increase in the Asymmetry Index for temporalis and masseter muscle rest activity in the TMD-P group. Conclusion: Cleft children diagnosed with TMD-P have altered masticatory muscle activity, and this can affect their muscle function.

The electrical activity of the masticatory muscles in children with cleft lip and palate.

BACKGROUND: Information regarding masticatory muscle function in children with cleft lip and palate (CLP) is limited. As a consequence, research on masticatory muscle activity in cleft subjects is needed. AIM: To assess masticatory muscle activity in children surgically treated for CLP as well as identify the possible factors associated with this activity. DESIGN: The sample comprised 82 children with mixed dentition and Class I occlusions (25 children with unilateral CLP and 57 subjects with no cleft abnormalities). A DAB-Bluetooth Instrument (Zebris Medical GmbH, Germany) was used to take electromyographical (EMG) recordings of the temporal and masseter muscles both in the mandibular rest position and during maximum voluntary contraction (MVC). RESULTS: Patients with clefts showed a significant increase in temporal muscle activity at rest compared with the controls. The presence of clefts and unilateral posterior crossbites are factors strongly associated with increased temporal muscle EMG potentials during rest position. CONCLUSIONS: Children with clefts have altered temporal muscle function. The presence of posterior crossbites affects the temporal muscle activity in cleft subjects. Early diagnosis and orthodontic treatment of malocclusions are necessary to achieve functional improvement in these patients.

The Use of Optical Coherence Tomography in Dental Diagnostics: A State-of-the-Art Review.

Optical coherence tomography provides sections of tissues in a noncontact and noninvasive manner. The device measures the time delay and intensity of the light scattered or reflected from biological tissues, which results in tomographic imaging of their internal structure. This is achieved by scanning tissues at a resolution ranging from 1 to 15 µm. OCT enables real-time in situ imaging of tissues without the need for biopsy, histological procedures, or the use of X-rays, so it can be used in many fields of medicine. Its properties are not only particularly used in ophthalmology, in the diagnosis of all layers of the retina, but also increasingly in cardiology, gastroenterology, pulmonology, oncology, and dermatology. The basic properties of OCT, that is, noninvasiveness and low wattage of the used light, have also been appreciated in analytical technology by conservators, who use it to identify the quality and age of paintings, ceramics, or glass. Recently, the OCT technique of visualization is being tested in different fields of dentistry, which is depicted in the article.

Enamel shear bond strength of different primers combined with an orthodontic adhesive paste.

AIM: The aim of this study was a comparison of shear bond strength (SBS) on tooth enamel of different primers combined with the adhesive paste Transbond XT. MATERIALS AND METHODS: Forty bovine teeth were used in order to create 40 test blocks. The blocks were divided into four groups of 10 blocks each: group A - sample primer (SP); group B - Opal Seal (OS); group C - Transbond Plus SEP (TSEP); group D - Transbond XT Primer (TXT). After surface preparation and application of the primer, respectively, two stainless steel brackets were fixed on each tooth by using Transbond XT. Accordingly, 80 brackets were debonded (n=20). Shear bond strength and adhesive remnant index (ARI) scores were evaluated. Statistical analyses were performed by using the Student's t-test and Mann-Whitney U test. RESULTS: All tested groups revealed high shear bond strength in a similar size range. There were no significant differences between the groups concerning shear bond strength. The ARI scores of group C showed significantly lower ARI scores (0 and 1) than that of group D. Apart from that there was no statistical difference. CONCLUSION: In combination with the adhesive paste Transbond XT, all tested primers were suitable for fixing orthodontic brackets. The primers could be changed according to the clinical situation.

Enamel Thickness before and after Orthodontic Treatment Analysed in Optical Coherence Tomography.

Despite the continuous development of materials and techniques of adhesive bonding, the basic procedure remains relatively constant. The technique is based on three components: etching substance, adhesive system, and composite material. The use of etchants during bonding orthodontic brackets carries the risk of damage to the enamel. Therefore, the article examines the effect of the manner of enamel etching on its thickness before and after orthodontic treatment. The study was carried out in vitro on a group of 80 teeth. It was divided into two subgroups of 40 teeth each. The procedure of enamel etching was performed under laboratory conditions. In the first subgroup, the classic method of enamel etching and the fifth-generation bonding system were used. In the second subgroup, the seventh-generation (self-etching) bonding system was used. In both groups, metal orthodontic brackets were fixed and the enamel was cleaned with a cutter fixed on the micromotor after their removal. Before and after the treatment, two-dimensional optical coherence tomography scans were performed. The enamel thickness was assessed on the two-dimensional scans. The average enamel thickness in both subgroups was not statistically significant.