ABSTRACT
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.
Subject(s)
Alveoloplasty/methods , Bone Transplantation , Cleft Palate/surgery , Dental Arch/growth & development , Chi-Square Distribution , Child, Preschool , Cleft Lip/surgery , Female , Humans , Male , Malocclusion/etiology , Observer Variation , Regression AnalysisABSTRACT
UNLABELLED: To determine the frequency of incidental maxillary sinus findings using cone-beam computed tomography (CBCT) images made for orthodontic purposes. SETTING AND SAMPLE POPULATION: One hundred thirty-nine consecutive CBCTs from 134 patients treated at the Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland. Indications for CBCT imaging included the localization of impacted teeth and root resorption related to impacted teeth. MATERIAL AND METHODS POPULATION: Two experienced observers reviewed the CBCT scans (fields of view: 4 × 4/6 × 6/8 × 8 cm) and recorded all incidental maxillary sinus findings according to standardized categories. The patient's age and gender, the size of the field of view, the season of CBCT image taking, and the thickness of the Schneiderian membrane were evaluated to identify potential influencing factors. RESULTS: In 65 CBCTs (46.8%), incidental maxillary sinus findings were found (interrater classification agreement of 95.7%/95% CI: 90.9-97.9%). Three types of incidental findings were diagnosed: flat mucosal thickening (23.7%), polypoid mucosal thickening (19.4%), and signs of acute sinusitis (3.6%). There was no correlation between the field of view of the CBCT and the number of incidental findings inside the field. There was no correlation between the season during which the CBCT was made and the number of incidental findings. The mean thickness of the mucosal lining in the maxillary sinus was 1.58 mm (95% CI: 1.17-1.98 mm). CONCLUSIONS: A high percentage of the CBCTs made for orthodontic diagnostic purposes exhibit incidental maxillary sinus findings not associated with the primary indication.
