Titanium plate removal in orthognathic surgery: prevalence, causes and risk factors. A systematic literature review and meta-analysis.

The purpose of this review was to analyse the prevalence of titanium plate removal in orthognathic surgery, as well as the causes of plate removal, and to determine the associated risk factors. A thorough search of the PubMed, Scopus, Embase, and Web of Science databases was conducted. The inclusion criteria were studies of adult patients who underwent orthognathic surgery in which monocortical titanium plates and screws were placed. Of the 325 references identified, 19 were included in the qualitative synthesis and meta-analysis. Overall, 13.4% (95% confidence interval (CI) 9.6-18.3%) of the patients required the removal of at least one titanium plate; 9.7% (95% CI 6.3-14.6%) of the plates placed were removed. The main causes of removal were infection (6.6%), exposed plate (2.6%), thermal sensitivity (2.1%), palpable plate or screw (2.0%), and pain/tenderness (1.9%). Female sex, smoking, and plates placed in the lower jaw were the main risk factors, with odds ratios of 1.5 (95% CI 1.1-2.0), 2.5 (95% CI 1.4-4.2), and 1.8 (95% CI 1.0-3.2), respectively. In no case was a publication bias problem detected. Fixation using titanium plates has a relatively low prevalence of removal. Infection is the main reason for removal. Female sex and smoking, are the main risk factors for removal. Plates placed in the lower jaw is a non-significant risk factor.

Oral health in Alzheimer's disease: a multicenter case-control study.

OBJECTIVES: The aim of this case-control study was to carry out an oral health assessment on a group of Alzheimer's patients and to establish a hypothesis regarding the implication of the characteristics of the disease and the treatment of oral health. MATERIALS AND METHODS: A total of 70 Alzheimer's patients, residents at the Alzheimer Center Reina Sofia Foundation (Madrid, Spain) and at the Alzheimer State Reference Center (Salamanca, Spain), and 36 controls (companions/acquaintances), were studied by oral examination and saliva sampling. The oral health indices DMFT/DMFS, CPI, the prosthetic condition, oral hygiene, saliva volume, and pH, as well as the specific microbiological parameters governing the risk of developing caries were assessed. RESULTS: Alzheimer's patients exhibited, as compared to the control group, (1) fewer teeth (10.9 ± 10.5 vs 23.7 ± 6.5), (2) fewer obturations (2.2 ± 3.4 vs 6.6 ± 5.6), (3) fewer periodontally healthy sextants (0.1 ± 0.4 vs 1.4 ± 2.2), (4) worse oral hygiene (43.1 vs 72.2% brushed), (5) greater use of removable prostheses (47.8 vs 8.4%), (6) higher incidence of candida infection (11.8 vs 0.0%) and cheilitis (15.9 vs 0.0%), (7) lower salivary flow (0.6 ± 0.6 vs 1.1 ± 0.6), and (8) lower buffering capacity (46 vs 80%). CONCLUSIONS: After taking into account the influence of age, Alzheimer's patients had worse oral health (caries and periodontal disease), more mucosal lesions (cheilitis and candidiasis), and worse saliva quantity and quality. CLINICAL RELEVANCE: Clinicians should be aware of the implications of Alzheimer's disease in oral health, in order to stablish the effective preventive measures and the optimal treatment plan.

Orthodontic camouflage versus orthognathic surgery for class III deformity: comparative cephalometric analysis.

The objective of this study was to compare different cephalometric variables in adult patients with class III malocclusions before and after treatment, in order to determine which variables are indicative of orthodontic camouflage or orthognathic surgery. The cases of 156 adult patients were assessed: 77 treated with orthodontic camouflage and 79 treated with orthodontics and orthognathic surgery. The following cephalometric variables were measured on pre-treatment (T1) and post-treatment (T2) lateral cephalograms: sella-nasion-A-point (SNA), sella-nasion-B-point (SNB), and A-point-nasion-B-point (ANB) angles, Wits appraisal, facial axis angle, mandibular plane angle, upper and lower incisor inclination, and inter-incisal angle. There were statistically significant differences in cephalometric variables before and after treatment between the two groups. The percentage of normal pre-treatment measurements in the camouflage orthodontics group was 30.7%, which worsened slightly to 28.4% post-treatment. However in the group receiving surgery, this was 24.5% pre-treatment, improving to 33.5% after surgery. SNA, SNB, Wits appraisal, lower incisor inclination, and inter-incisal angle showed differences between the two groups before and after treatment. Wits appraisal, lower incisor inclination, and inter-incisal angle were indicative of one or other treatment. Upper and lower incisor decompensation in both groups did not reach ideal values, which impeded complete skeletal correction in 52% of surgical cases.

Impact of functional mandibular advancement appliances on the temporomandibular joint - a systematic review.

BACKGROUND: Although many orthodontists have no doubts about the effectiveness of functional appliances for mandibular advancement, the impact on the temporomandibular joint (TMJ) is still in dispute. The objective of this systematic review is to examine the main effects on the TMJ of using functional appliances, both in healthy patients and in patients with a pre-existing disorder. MATERIAL AND METHODS: A systematic review of the literature was conducted in accordance with the PRISMA guidelines. Only systematic reviews, meta-analyses, randomized clinical trials (RCTs), case-control studies and cohort studies were included. A detailed language-independent electronic search was conducted in the Pubmed, Scopus, Cochrane Library and Embase databases. All studies published between 2000 and 2015 were included. RESULTS: A total of 401 articles were identified. Of these, 159 were duplicates and were excluded. On reading the title and abstract, 213 articles were excluded because they did not answer the research question, leaving a total of 29 articles. These articles were read and assessed. Following critical reading of the full text, eight articles were excluded: seven because they were considered of low quality and one because it published redundant data. As a result, 21 articles were included. CONCLUSIONS: After treatment with functional appliances, the condyle was found to be in a more advanced position, with remodelling of the condyle and adaptation of the morphology of the glenoid fossa. No significant adverse effects on the TMJ were observed in healthy patients and the appliances could improve joints that initially presented forward dislocation of the disk.

The use of occlusal indices in high-impact literature.

UNLABELLED: Malocclusion is difficult to define because individuals and cultures vary widely in their perceptions of what constitutes an occlusal problem. A number of occlusal indices have been devised but, probably because of this perceptual problem, none has ever emerged as a standard. OBJECTIVE: The main objective was to review the use of the principal occlusal indices. BASIC RESEARCH DESIGN: The PUBMED database was searched for the main occlusal indices employed, journals with an impact in dentistry and specialist orthodontics journals. RESULTS: The occlusal indices most frequently employed were IOTN (163 studies), PAR (132 studies), DAI (68 studies) and ICON (32 studies). The journals publishing the greatest number of studies using these occlusal indices are those specialising in orthodontics. CONCLUSIONS: In the high-impact scientific literature, the indices in greatest use are IOTN, followed by PAR, DAI and ICON. DAI and IOTN are mainly used in epidemiological or prevalence studies, while PAR is generally used for longitudinal studies. IOTN is used more in Europe. DAI is used worldwide; though least in Europe.

Estudio comparativo de la fiabilidad y reproducibilidad de los tamaños MEDIODISTA LES y las medidas de la arcada dentaria, entre la tomografía Computarizada de haz cónico (CBCT ) y un método digital / No disponible

Introducción: La introducción de herramientas diagnósticas como Tomografía Computarizada de Haz Cónico (CBCT) y su aplicación clínica a la imagen dentofacial en 3D, es una de las materias más interesantes y más novedosas actualmente en Ortodoncia permitiendo obtener imágenes tridimensionales de los dientes y por lo tanto, realizar mediciones sobre las mismas. Objetivos: Valorar la fiabilidad y reproducibilidad de los tamaños mesiodistales y las medidas de la arcada dentaría, entre un Método Tridimensional (CBCT) y un Método Digital. Material y método: La muestra estaba compuesta de 50 pacientes a los que se les realizó un CBCT como parte de su diagnóstico ortodóncico. El CBCT utilizado fue el Dental Picasso (..) (AU)

Introduction: The introduction of diagnostic tools such as Cone Beam Computed Tomography (CBCT) and its clinical application to dentofacial 3D image, is one of the most interesting materials and latest in Orthodontics currently possible to obtain three-dimensional images of the teeth and therefore measurements on them. Objectives: To assess the reliability and reproducibility of tooth size and dental arch measurements between a Three Dimensional Method (CBCT) and a digital one. Material and Methods: The sample consisted of 50 patients who underwent a CBCT as part of orthodontic diagnosis. The CBCT used was Picasso Master 3D ®. The images were sent in DICOM format to secure the company’s Web In Vivo Dental (Anatomage, San Jose, California) to obtain three-dimensional images of the models. To make comparative studies were made of plaster study models these (..) (AU)

[Prevalence of dental caries: comparison between immigrant and autochthonous children]. / Prevalencia de la caries dental en el niño inmigrante: estudio comparativo con el niño autóctono.

INTRODUCTION: Immigration to Spain has been high in recent years, especially in some autonomous communities. In both deciduous and permanent teeth, immigrant children have a higher number of dental caries and a lower number of restored teeth than autochthonous schoolchildren. Few studies have compared the prevalence of dental caries between immigrant and autochthonous children. OBJECTIVE: To determine the prevalence of dental caries in two groups of children: an immigrant group and an autochthonous group. MATERIAL AND METHOD: The study sample consisted of 600 children (235 immigrant children and 365 autochthonous children) aged between 6 and 10 years old who were living in the autonomous community of Valencia. The children were examined by two specialists, an odontologist and a pediatrician. RESULTS: The prevalence of dental caries was higher in immigrant children than in autochthonous children. In deciduous dentition, the prevalence of caries was 47.23 % and 32.05 % in immigrants and autochthonous children, respectively. In permanent dentition, the prevalence was 53.19 % and 35.34 %, respectively. CONCLUSIONS: The prevalence of dental caries was higher in immigrant children than in autochthonous children. Pediatricians and/or odontologists should aim to improve knowledge of good dental health care and habits among immigrant children and their parents.

Prevalencia de la caries dental en el niño inmigrante: estudio comparativo con el niño autóctono / Prevalence of dental caries: comparison between immigrant and autochthonous children

Introducción La llegada de inmigrantes a España es una realidad en nuestro país que depende en gran medida de la comunidad autónoma que analicemos. Es evidente por parte de estos niños inmigrantes la existencia de un notorio peor estado de salud dental que los niños autóctonos, con una elevada prevalencia de la caries dental tanto en dientes temporales como permanentes. Son pocos los estudios existentes que comparen la incidencia de la caries dental entre niños inmigrantes y autóctonos. Objetivo Determinar la incidencia de la caries dental en un grupo de niños inmigrantes comparado con un grupo control de niños autóctonos. Material y método Un total de 600 escolares (235 inmigrantes y 365 autóctonos) residentes en la Comunidad Valenciana, con edades comprendidas entre los 6 y los 10 años de edad, fueron explorados por 2 examinadores, un pediatra y un odontólogo. Resultados Hay una mayor incidencia de la caries dental en niños inmigrantes. La incidencia en dentición temporal fue de 47,23 y de 32,05 % en inmigrantes y autóctonos, respectivamente, y de 53,19 % frente a 35,34 % en dentición permanente. Conclusiones Los niños inmigrantes presentan altos niveles de caries dentales en comparación con los niños autóctonos. Es necesario un refuerzo por parte del pediatra y/o odontólogo en las acciones de promoción de la salud dental, con el objetivo de mejorar el estado de salud de este grupo de población

Introduction Immigration to Spain has been high in recent years, especially in some autonomous communities. In both deciduous and permanent teeth, immigrant children have a higher number of dental caries and a lower number of restored teeth than autochthonous schoolchildren. Few studies have compared the prevalence of dental caries between immigrant and autochthonous children. Objective To determine the prevalence of dental caries in two groups of children: an immigrant group and an autochthonous group. Material and method The study sample consisted of 600 children (235 immigrant children and 365 autochthonous children) aged between 6 and 10 years old who were living in the autonomous community of Valencia. The children were examined by two specialists, an odontologist and a pediatrician. Results The prevalence of dental caries was higher in immigrant children than in autochthonous children. In deciduous dentition, the prevalence of caries was 47.23 % and 32.05 % in immigrants and autochthonous children, respectively. In permanent dentition, the prevalence was 53.19 % and 35.34 %, respectively. Conclusions The prevalence of dental caries was higher in immigrant children than in autochthonous children. Pediatricians and/or odontologists should aim to improve knowledge of good dental health care and habits among immigrant children and their parents

[Black stain: a common problem in pediatrics]. / Tinción cromógena: un problema habitual en la clínica pediátrica.

BACKGROUND: Black stain is a common discoloration in pediatric patients. It is caused by microorganisms present in the saliva and is characterized by distinctive dark dots localized at the tooth surface parallel to the gingiva, both in deciduous and permanent dentition. OBJECTIVE: To determine the prevalence of black stain in a group of children in Valencia, Spain and its relationship with dental caries. MATERIAL AND METHODS: A total of 1,100 children aged between 4 and 11 years old were examined by a single observer between January and June 2003. RESULTS: The prevalence of black stain varied in the children studied. CONCLUSIONS: The prevalence of black stain was 7.54 % in our study. No differences were found between sexes or between anterior and posterior teeth. Treatment of black stain consists of professional cleaning every couple of months since the discoloration frequently tends to reappear.

[Prevalence of oral habits and teeth alterations in schoolchildren from Valencia (Spain)]. / Prevalencia de los hábitos bucales y alteraciones dentarias en escolares valencianos.

INTRODUCTION: Oral habits are acquired through the repetition of actions that serve to calm an emotional need of the child. All these oral habits can change the position of the teeth and arches. Pediatricians should identify these habits to instigate successful treatment. OBJECTIVE: The aim of the present study was to determine the prevalence of oral habits in 1,100 Valencian schoolchildren and identify the dental alterations associated with these habits. MATERIAL AND METHODS: Between January and June 2003, 1,100 children aged between 4 and 11 years old were examined by two observers, a dentist and a pediatrician, who were specially trained to detect anomalous habits. RESULTS: The prevalence of each of the distinct habits studied varied. CONCLUSIONS: The conclusions of our study were: a) the prevalence of oral habits was 53 %; b) no differences in oral habits were found between boys and girls, and c) open bite, maxillary cross-bite and overjet can be related to oral habits, although this association was not statistically significant.

Tinción cromógena: un problema habitual en la clínica pediátrica / Black stain: a common problem in pediatrics

Antecedentes: La tinción cromógena es una coloración que se presenta con frecuencia en la práctica clínica pediátrica. La causa es la presencia de las bacterias cromógenas en la saliva del sujeto, y las manifestaciones clínicas consisten en una coloración que se adhiere a la superficie del diente en el tercio más cercano a la encía, tanto en dientes temporales o de leche como en dientes definitivos o permanentes. Objetivo: Conocer la prevalencia de la tinción cromógena en una muestra de escolares valencianos, así como su relación con la caries dental. Material y métodos: Se ha realizado un estudio sobre 1.100 escolares con edades comprendidas entre los 4 y los 11 años de edad. El examen clínico se realizó por un solo observador durante los meses de enero a junio de 2003. Resultados: Los resultados mostraron una distribución desigual en la presencia de la tinción. Conclusiones: La tinción cromógena se presenta con una prevalencia del 7,54 % y se detectó igualmente en ambos sexos. La tinción cromógena aparece de igual manera en dientes anteriores que posteriores. El tratamiento es la realización de limpiezas profesionales periódicas, ya que la coloración tiende a reaparecer con frecuencia

Background: Black stain is a common discoloration in pediatric patients. It is caused by microorganisms present in the saliva and is characterized by distinctive dark dots localized at the tooth surface parallel to the gingiva, both in deciduous and permanent dentition. Objective: To determine the prevalence of black stain in a group of children in Valencia, Spain and its relationship with dental caries. Material and methods: A total of 1,100 children aged between 4 and 11 years old were examined by a single observer between January and June 2003. Results The prevalence of black stain varied in the children studied. Conclusions: The prevalence of black stain was 7.54 % in our study. No differences were found between sexes or between anterior and posterior teeth. Treatment of black stain consists of professional cleaning every couple of months since the discoloration frequently tends to reappear

Prevalencia de los hábitos bucales y alteraciones dentarias en escolares valencianos / Prevalence of oral habits and teeth alterations in schoolchildren from Valencia (Spain)

Introducción: Los hábitos orales son costumbres adquiridas por la repetición continuada de una serie de actos que sirven para calmar una necesidad emocional. Todos los hábitos anómalos modifican la posición de los dientes y la relación y la forma que guardan las arcadas dentarias entre sí. El pediatra debe identificar estos hábitos de manera precoz para tener éxito en el tratamiento. Objetivo: El objetivo del presente trabajo es conocer la prevalencia de estos hábitos orales anómalos en una muestra de escolares valencianos, así como las alteraciones dentarias asociadas. Material y métodos: Se ha realizado un estudio sobre 1.100 escolares con edades comprendidas entre los 4 y los 11 años de edad. El examen clínico se realizó por dos observadores, un pediatra y un odontólogo, entrenados para ello, durante los meses de enero a junio de 2003 para la detección de estos hábitos anómalos. Resultados: Los resultados mostraron una distribución desigual para cada uno de los diferentes hábitos. Conclusiones: Las conclusiones de nuestro estudio fueron: a) la prevalencia encontrada de los diferentes hábitos fue del 53%; b) estos hábitos aparecen de igual manera independientemente del sexo, y c) las alteraciones de mordida abierta anterior, compresión maxilar y aumento del resalte están relacionadas con la presencia de hábitos orales, aunque sin ser estadísticamente significativo

Introduction: Oral habits are acquired through the repetition of actions that serve to calm an emotional need of the child. All these oral habits can change the position of the teeth and arches. Pediatricians should identify these habits to instigate successful treatment. Objective: The aim of the present study was to determine the prevalence of oral habits in 1,100 Valencian schoolchildren and identify the dental alterations associated with these habits. Material and methods Between January and June 2003, 1,100 children aged between 4 and 11 years old were examined by two observers, a dentist and a pediatrician, who were specially trained to detect anomalous habits. Results: The prevalence of each of the distinct habits studied varied. Conclusions: The conclusions of our study were: a) the prevalence of oral habits was 53 %; b) no differences in oral habits were found between boys and girls, and c) open bite, maxillary cross-bite and overjet can be related to oral habits, although this association was not statistically significant

Valoración de los métodos de predicción de tamaños dentarios en dentición mixta / Assessment of the mixed dentition methods to predict unerupted teeth

Desde siempre, conocer el tamaño de los dientes no erupcionados, caninos y premolares, en dentición mixta, ha sido un claro reto en ortodoncia. El objetivo del presente trabajo es mostrar todos los métodos existentes en la bibliografía para realizar la predicción del tamaño de estos dientes, así como sus ventajas e inconvenientes. Estos métodos pueden clasificarse en 4 grandes grupos: los basados en ecuaciones de regresión; los basados en mediciones directas en radiografías; los que combinan elementos de los 2 anteriores, y otro método no clasificable en ninguno de los anteriores. Los métodos basados en ecuaciones de regresión son rápidos de realizar pero presentan coeficientes de correlación bajos y de poca fiabilidad; los que usan mediciones directas sobre radiografías periapicales presentan el problema de obtener imágenes distorsionadas en ocasiones, lo cual limita la exactitud de estas técnicas; los métodos combinados son los más fiables, aunque son los que más tiempo consumen y son más complejos de realizar. Por último, se presenta un método digital de gran fiabilidad y sencillo y rápido de realizar, no clasificable en ninguno de los grupos anteriores. Se trata de un método basado en la interpolación de tamaños de los dientes utilizando listas de tamaños dentarios y dientes de referencia ya erupcionados

The estimation of the size of unerupted permanent teeth, canines and premolars, in mixed dentition has always been considered an essential aspect in orthodontics. The aim of the present study is to show all the methods that have been developed to make these predictions and their advantages and disadvantages. Four main methods have been used to estimate the mesiodistal crown widths of unerupted canines and premolars: calculations from prediction equations and tables, direct measurements on radiographs, combination of radiographic measurements and prediction tables and other independent method. Methods with a regression equation that relate the widths of unerupted teeth to the widths of erupted teeth are easy and fast to use but not very reliable, methods of measuring unerupted teeth on radiographs depend on the quality of the x-ray films available for use and methods that combine regression equations and radiographs present great accuracy but are time consuming and difficult to use. Finally, we present a new digital computerized-aid method to predict the size of unerupted teeth in mixed dentition using several reference teeth already erupted and mesiodistal teeth tables

Método de medición del índice de Bolton mediante digitalización de la arcada dentaria / Bolton tooth-size analyses measurement by a digital and computerized new method

El presente trabajo consiste en la puesta a punto de un método de medida que a través de una imagen digitalizada de la arcada dentaria y el correspondiente programa informático desarrollado por nosotros, permite de una forma rápida, sencilla y exacta, la medición de los tamaños mesiodistales de los dientes, así como el posterior cálculo del índice de Bolton.Este procedimiento, al que denominamos método digital, resulta igualmente sensible y más rápido de realizar que el método de medición tradicional. (AU)