Assessing the morphological characteristics of teeth and dental arches as potential predictors of dental crowding.

Background and aims: The early detection of dental crowding and its potential for aggravation is important during the clinical examination of mixed dentition patients, and these desiderates can be addressed by including among the clinically assessed items a series of accessible morphological characteristics of teeth and dental arches. The present study investigates possible correlations between morphological features of permanent teeth, widths of dental arches, and the onset of dental crowding during mixed dentition. Methods: A selected group of 100 class I dental casts on mixed dentition was analyzed. The dental arches were grouped as spaced, normally aligned, and crowded. The dental parameters consisted of mesiodistal dimensions of permanent teeth and specific morphological features of permanent incisors and first molars. The anterior and posterior arch widths according to Pont indices were measured. Results: Statistical analysis of data showed that mesiodistal dimensions of the permanent upper central incisors and lower incisors are significantly larger on severely crowded arches than on normally aligned arches; increased differences between mesiodistal dimensions of central and lateral permanent upper incisors and the presence of semi-shavel incisors and Carabelli cusps are associated with a greater extent of anterior crowding. The severely crowded arches presented significantly narrower anterior and posterior arch widths. Conclusions: Increased mesiodistal dimensions of permanent incisors, the presence of incisors shoveling, the Carabelli cusps on upper first permanent molars, and narrowing of dental arches during the early mixed dentition period were associated with severe dental crowding in class I cases.

Statistical Study on the Motivation of Patients in the Pediatric Dentistry.

Our statistical study included 344 participants selected from the patients of the Pedodontics-Orthodontics Discipline of the Tîrgu-Mures University of Medicine and Pharmacy. The patients' age was between 6 and 18 years, with an average of 13.70 and a standard deviation of 4.62. The study participants were informed and agreed to complete two questionnaires of our conception regarding their health status, oral hygiene, and motivation for pedodontics or orthodontic treatment. The results of the two questionnaires were interpreted according to the gender and age of the patients. Data processing was performed with NCSS/PASS Dawson Edition statistical software, using the CHI2 test, considering a p of less than 0.05 as significant for comparative results. Results showed that girls were more motivated than boys in addressing pedodontic services due to dental, periodontal, and articular problems. Children, aged between 11 and 14 years, were less intrinsically motivated to solve oral health problems due to their low frequency. The intrinsic motivation for a more beautiful dentition was very strong, regardless of age and sex. Girls were more intrinsically motivated for orthodontic treatment than boys. There was a linear increase together in the age of those who wanted to improve their smile and facial appearance. Children between 11 and 14 years had the best self-perception of the appearance of their teeth, mouth, smile, and facial harmony. The strongest extrinsic motivation for orthodontic treatment came from parents or another doctor. The most important reason for orthodontics was dental malpositions, the last one was the improvement of masticatory efficiency. The extrinsic motivation from parents for orthodontics decreases linearly with age, along with the increase in motivation from the person with whom the participants relate emotionally and from the group of friends.

Reducing Friction in Orthodontic Brackets: A Matter of Material or Type of Ligation Selection? In-Vitro Comparative Study.

(1) Background: Orthodontic appliances have changed and improved with the increasing demand for orthodontic treatment of the general population. Patients desire for shorter orthodontic treatments and for the wearing of more aesthetic devices has led to the technological development of orthodontic brackets; these were manufactured from aesthetic materials (ceramics, composite polymers) and presented different designs regarding the way archwires are ligated to the bracket. The aim of this study was to determine whether there were any differences between the static frictional forces generated by stainless steel (metallic) and polycrystalline alumina (ceramics) conventional and self-ligating brackets. (2) Methods: Static friction assessment was carried out in vitro with a universal testing machine, HV-500N-S (Schmidt Control Instruments, Hans Schmidt & Co. GmbH), intended for measuring compression and traction forces. (3) Results: The study revealed significant differences in static frictional forces at the bracket-archwire interface between the tested brackets. Stainless steel brackets produced lower static friction forces than polycrystalline alumina and self-ligating brackets generally produced lower static frictional forces than conventional brackets. The reduction of frictional forces was noticeable in the first stages of treatment, when thin, flexible orthodontic archwires (0.016" NiTi) are used. Engaged with large rectangular stainless steel archwires, (0.019 × 0.025" SS), the frictional forces produced by conventional and self-ligating metal brackets were similar, no significant differences being observed between the two types of metallic design. However, in the case of tested ceramic brackets, the results showed that the self-ligating type allows a reduction in frictional forces even in advanced stages of treatment compared to conventionally ligation. (4) Conclusions: From the perspective of an orthodontic system with low frictional forces, metal brackets are preferable to aesthetic ones, and self-ligating ceramic brackets are preferable to conventional ceramic brackets.

Common and unusual dental development abnormalities in a patient with bicuspid aortic valve.

Bicuspid aortic valve (BAV) is the most common congenital abnormality of the heart. In this condition, instead of three cusps, the aortic valve has two cusps. Children with congenital heart diseases are at increased risk of developing oral diseases, such as: higher number of decayed teeth, developmental anomalies, periodontal disease, malocclusion, dental crowding, as well as susceptibility to develop infective endocarditis from bacteremia caused by chronic poor oral health. However, little information is available regarding oral manifestations and their management in patients with congenital heart defects, despite the importance of these diseases. This paper presents oral manifestations associated with BAV in a young patient, alongside the general features of the condition. The presented case with BAV brings together features of a complex pathology and multidisciplinary treatment, which was conducted over a long period of time and still continues nowadays.

Upper airway cavities morphologic features in facial asymmetries.

Facial asymmetries have an important impact on the cranio-facial structures morphology, being the result of the genetic, environmental and dysfunctional factors and their impact on the dento-maxillary complex. Asymmetries can be identified in all craniofacial structures, including the upper airway cavities. Craniofacial asymmetries can influence general growth and development by altering the respiratory function. The present study aimed to evaluate morphologic correlations of the upper airway cavities changes in facial asymmetries. Most of the cases included in the study showed on the underdeveloped side that the nostril and nasal fossa were narrowed, while the paranasal sinuses were frequently larger. However, no correlation could be established to answer whether these changes were determined by asymmetry, or if they appeared as compensatory, or if only some structures of the upper airway cavities changed morphologically in a compensatory manner.

Clinical and therapeutic aspects in dento-alveolar disharmony (DAD) with crowding.

UNLABELLED: Dento-alveolar disharmony (DAD) with crowding represents a predispose factor for periodontal pathology installing, especially when septic inflammation is associated. In this context, the identification of integrity or presence of the periodontal structure modifications becomes essential, any discovered element of periodontal pathology transforming into an important factor for a correct and beneficial orthodontic or periodontal-orthodontic therapy setup. The purpose of our study was to reveal the relations between the DAD existence and periodontal modifications within a lot of 528 subjects of 7 to 19 years old wearing different DAD who asked for an orthodontic control, and also the effects of orthodontic therapy upon periodontal structures for the situations in which this therapy was instituted. 74,87% was the percentage for patients with DAD and crowding who accepted the initiation of an orthodontic treatment and 12,75% of them had a friable C type periodontium (with great possibility to evolve towards a periodontal pathology), 25,62% had chronic gingivitis, and in 15,43% there have been noticed gingival recessions more than 2 mm. The orthodontic treatment was finalized for 44,96% of the patients, in 13,43% we noticed the persistence of C type periodontium, in 8,95% of gingival recessions more than 2 mm, in 25,37% chronic gingivitis and in 22,38% hypertrophic gingivitis. CONCLUSION: it is important to initiate an exhaustive control of the patient with DAD before, during and after the orthodontic treatment, especially if the patient is susceptible to develop a periodontal pathology, and also to maintain a good oral hygiene along the treatment.

Prevention perspective in orthodontics and dento-facial orthopedics.

In the present context of the public health directions, considering WHO main objective, that "all people of the world could reach the highest possible health level", in medicine, the accent is put on prevention. In spite of the important progresses achieved in orthodontics field, the treatment still remains a symptomatic one. In this context, we must ask ourselves what are the prevention theoretical and practical coordinates in orthodontics, which measures are available or could be elaborated for preventing the malocclusions development. From the clinical point of view, the most important element of the new perspective is that most of the cases of anomalies which in the present are cured by orthodontics are induced by functional and environmental factors and they can theoretically be prevented. Thus, the identification, control and guidance of the environmental factors which adjust the growing of the maxillaries and of the other cranio-facial structures would be the main target of a prevention program in orthodontics.