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This work aimed to assess the pulp/tooth area ratio's utility in the upper central incisors using orthopantomograms. A convenience sample of 801 adult patient orthopantomograms was studied. Image J® software was used to measure the pulp/tooth area ratio, and a regression model was developed. Our results conclude that the methodology assessing upper incisors' pulp/tooth area ratio using orthopantomograms can lead to age overestimation and statistically significant differences between chronological and estimated age. For those over 50, no correlation between pulp/tooth area ratio and chronological age was found, suggesting that this may be the upper limit of this technique in this population. This methodology may not be suitable for age estimation, particularly in older adults.
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Objective@#Exploring the position and bone wall thickness characteristics of the maxillary central incisors in Southern Chinese adults to provide a clinical reference for the design of immediate maxillary central incisor implantation surgery.@*Methods@#The hospital ethics committee approved the study, and the patients provided informed consent. CBCT images of 990 adult patients (aged 20-79 years) from the Stomatology Hospital (January 2018 to December 2021) were categorized based on the dental arch form and age-sex groups. Sagittal CBCT images of the maxillary central incisors were used to measure the labial and palatal bone thickness wall at 4 mm the CEJ to apical, the middle of the root, and the angle between the tooth long axis and the long axis of the alveolar process, to compare the thickness of the labial and palatal bone walls in samples of male and female patients, and to explore the relationship between the angle between the tooth long axis and the alveolar process long axis in samples of male and female patients in different age groups (20-39 years; 40-59 years; 60-79 years).@*Results@#Significant differences were found in the labiopalatine side of the alveolar bone of the maxillary incisor root position. A total of 95.8% (948/990) of the maxillary incisors were positioned more buccally, 4.1% (41/990) were positioned more midway, and 0.1% (1/990) were positioned more palatally. The thicknesses of the bone wall at the CEJ of 4 mm below the palatal side, the middle of the root, and at the apex were greater (1.82 ± 0.56 mm, 3.20 ± 1.10 mm, and 7.70 ± 2.00 mm, respectively) than those at the labial side (1.21 ± 0.32 mm, 0.89 ± 0.35 mm, and 1.86 ± 0.82 mm, respectively), with statistical significance (P<0.05). Male bone wall thickness was generally greater than female bone wall thickness (P<0.05). The angle between the long axis of male teeth and the alveolar bone was 14.77° ± 5.66°, while that of female teeth was 12.80° ± 5.70°, with a statistically significant difference (P<0.05). The angle between the long axis of teeth and the alveolar bone in the 40-59-year-old group and the 60-79-year-old group was greater than that in the 20-39-year-old group, and the difference was statistically significant (P<0.05).@*Conclusion@#A total of 95.8% of adults in South China have maxillary central incisors with root deviation toward the labial bone cortex. The thickness of the labial bone wall is much thinner than that of the labial bone wall, which is the middle of the thickness of the root. In Southern Chinese adults, the angle between the upper central incisor and the long axis of the alveolar bone in males is greater than that in females, and the degree of the angle increases with age. It is recommended to pay attention to the thickness of the bone wall around the root and the angle between the teeth before immediate implantation surgery to choose a reasonable implantation plan.
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INTRODUCTION: The main objective of this study was to evaluate the different factors influencing the perception of female profile facial beauty in Class III patients with protruded mandible that can be treated with orthodontic dental compensation: (1)severity of the protrusion, (2) the upper incisors inclination and (3) the presence of jawlines. The secondary objective was to determine if the rater's gender and profession played a role in the assessment of the preferred profile. METHODS: A normal and smiling photographs of a female subject with normal facial and skeletal profile criteria were digitally manipulated to obtain 3 different mandibular sagittal positions: 0mm, +4mm and +8mm. Each position of the chin was evaluated with the presence or not of jawlines. In the smiling profiles, the same chin modifications were scored, and the maxillary incisor inclination was changed from 0 to +10 degrees with 5 degrees increments. A total of 320 raters (107 dentists, 103 orthodontists and 110 laypeople) scored the attractiveness of the different images using a Visual Analogue Scale. The limit of statistical significance was P<0.05. Generalized estimating equation (GEE) models were conducted to assess the predictors of variations in ratings within each set of photos, as well as the interactions of predictors where adjusted odds ratios (aOR) and their 95% confidence intervals were calculated and reported. RESULTS: In the profiles without a smile, image +4mm chin (Class III treated by compensation) and image +8-mm mandible (Class III not treated) were selected as the most and least attractive images, respectively, by almost all groups with no difference. The presence of jawlines has a positive role in facial attractiveness. In the smiling profiles, all the examiners showed a preference for image +4-mm chin and a slight protrusion of maxillary incisors (+5 degrees). No significant difference was found between genders in this study. CONCLUSIONS: Class III treated by compensation (+4mm) are more attractive than non-treated Class III (+8mm) by almost all groups with no difference. The presence of jawlines has a positive role in facial attractiveness. In the smiling profiles, all the examiners showed a preference for image +4-mm chin and a slight protrusion of maxillary incisors (+5 degrees). Orthodontists older than 50 years old are aware of the difficulty to treat a skeletal Class III and tend to accept it due to their long career experience. No significant difference was found between genders in this study.
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Face , Orthodontists , Humans , Male , Female , Middle Aged , Cross-Sectional Studies , Chin , Smiling , Esthetics, Dental , Perception , Attitude of Health PersonnelABSTRACT
Nasolabial angle is commonly used to assess the soft tissue profile of the subnasal region. The aim of this retrospective study was to evaluate the relationship between the nasolabial angle, the inclination of the lower border of the nose and upper lip, upper incisor inclination and upper lip thickness. A sample of 142 female adolescents aged 13-18 years was chosen. A modified cephalometric analysis was performed with the nasolabial angle, and its components were traced according to Fitzgerald's method. All analysed parameters showed a statistically significant correlation with the nasolabial angle (NLA). The highest correlation was found for the labial (L/FH) and nasal (N/FH) components of the nasolabial angle, respectively. Upper incisor inclinations (1+:SN, U1FA) and upper lip thickness (ULT) had a stronger correlation with L/FH than NLA, but no correlation was found between these parameters and N/FH. Upper lip thickness did not influence the relationship between incisor inclination and NLA or L/FH. The position of the upper incisors and upper lip thickness influence the nasolabial angle indirectly through its labial component (L/FH). Therefore, it seems purposeful to assess the nasolabial angle as a sum of two independent angles, of which only one (L/FH) can be influenced by orthodontic treatment.
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The objective of this review was to critically and systematically appraise the available evidence regarding the effectiveness of high-energy laser therapy (HELT) with flapless corticotomy in accelerating orthodontic tooth movement and the associated untoward effects. We searched eight databases electronically in August 2021: PubMed®, Medline®, Google Scholar, Cochrane Library, Scopus®, Web of Science™, Trip, and PQDT OPEN from ProQuest. Another search was done in the reference lists of the included studies. Randomized controlled trials (RCTs) were included in which patients had received fixed orthodontic treatment combined with HELT-assisted corticotomy in comparison with traditional orthodontic treatment. Cochrane's risk of bias (RoB2) tool was used to assess the risk of bias. Five RCTs and one CCT were included in this review (155 patients). The HELT-based corticotomy around the upper canines led to a greater canine retraction at the first and second months (P < 0.001). In the third month, no statistically significant differences were noticed. In one RCT focusing on incisor intrusion, the irradiated upper incisors showed a greater intrusion speed than that of the control group (4.587 mm in 59 days vs. 3.78 mm in 95.8 days, respectively). No significant side effects associated with the application of HELT were reported. According to the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach, the quality of evidence supporting these findings was low to moderate. Although the acceleration of tooth movement appeared to be significant at least in the first two months, there was low to moderate evidence concerning the efficacy of HELT-based flapless corticotomy in the acceleration of orthodontic tooth movement. There is a need for more well-conducted high-quality RCTs.
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Resumo Objetivos: Avaliar a prevalência de traumatismo dentário em incisivos superiores de pacientes submetidos a tratamento na Clínica de Ortodontia da UFRJ (Universidade Federal do Rio de Janeiro) e correlacionar oito fatores predisponentes dentofaciais desses indivíduos ao tipo de trauma sofrido. Materiais e Métodos: 765 prontuários de pacientes da Clínica de Ortodontia da UFRJ foram analisados em busca de trauma nos incisivos superiores. 40 prontuários de pacientes traumatizados e com documentação inicial completa foram selecionados. Radiografias cefalométricas laterais foram extraídas dos exames volumétricos, modelos, fotografias e prontuários foram analisados. Resultados: A incompetência labial, o acentuado grau de overjet e a acentuada protrusão e projeção dos incisivos superiores, presentes nos pacientes Classe II esqueléticos, atuam como principais fatores predisponentes para a ocorrência de traumatismo dentário. Conclusões: O tratamento ortodôntico em duas fases, deve ser foco de futuros estudos visando avaliar sua atuação como uma medida preventiva na redução dos índices de trauma dental nesses pacientes.(AU)
Abstract Objective: To evaluate the prevalence of dental trauma in upper incisors of patients submitted to treatment in the orthodontic clinic of UFRJ (Federal University of Rio de Janeiro) and to correlate eight predisposing dentofacial factors of these individuals with the type of trauma suffered. Materials and Methods: 765 medical records of patients of UFRJ Orthodontics Clinic were analyzed for upper incisor trauma. 40 medical records of trauma patients with complete initial documentation were selected. Lateral cephalometric radiographs were extracted from the volumetric exams, models, photographs, and medical records were analyzed. Results: Labial incompetence, marked degree of overjet and protrusion and projection of the upper incisors, present in Class II skeletal patients, act as the main predisposing factors for the occurrence of dental traumatism. Conclusions: two-phase orthodontic treatment should be the focus of future studies aiming to evaluate its performance as a preventive measure in reducing dental trauma rates in these patients.(AU)
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Humans , Radiography, Dental , Tooth Injuries , Incisor , MalocclusionABSTRACT
Objective@# To study the remodeling of alveolar bone after retraction of the maxillary incisors assisting with micro-implant anchorage in adult patients with maxillary protrusion by CBCT.@*Methods@#Forty patients who were treated with extraction of the maxillary first premolars with microimplant anchorage meeting the inclusion criteria were selected. The CBCT data before and after treatment were collected, and the Dolphin Imaging 3D measurement software was used to measure and analyze the height and thickness of the alveolar bone of the 80 upper central incisors and the 80 lateral incisors.@*Results @#After retraction of the incisors assisting with microimplant anchorage, the labial alveolar bone height of the maxillary central incisors decreased (0.11 ± 0.33) mm, and the lingual alveolar bone height of the maxillary central incisors decreased (0.85 ± 1.23) mm. The labial alveolar bone height of the maxillary lateral incisors decreased (0.18 ± 0.42) mm, and the lingual alveolar bone height of the maxillary lateral incisors decreased (1.13 ± 1.14 ) mm. The reduction in the lingual alveolar bone height was greater than that of the labial side, and the difference was statistically significant (P < 0.05). The labial alveolar bone thickness of the maxillary central incisors increased (the root cervix, the root media and the root apex), and the difference was statistically significant (P < 0.001). The labial alveolar bone thickness of the maxillary lateral incisors also increased (P < 0.05), while the lingual alveolar bone thickness and the total alveolar bone thickness of the maxillary central and lateral incisors decreased (P < 0.001). @*Conclusion@#In adults with maxillary protrusion, the microimplant was used to assist the reduction of the anterior teeth. The alveolar bone height of the maxillary incisors was reduced, and the palatal alveolar bone height decreased more than that of the labial side. The alveolar bone of the labrum was thickened, and the palatal alveolar bone thickness and the total alveolar bone thickness of the maxillary incisors were reduced after treatment.
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O presente estudo propôs avaliar, cefalometricamente, a alteração do ponto A no plano sagital após mudança na inclinação dos incisivos superiores. Métodos: 21 pares de telerradiografias tomadas, no início e no final do tratamento ortodôntico, foram coletados de uma clínica particular na cidade de Aracaju (SE). A amostra foi dividida em dois grupos, de acordo com a movimentação dos incisivos pós-tratamento: Ipro, onde os incisivos proclinaram (n=12); e Iretro, onde os incisivos retroinclinaram (n=9). O ponto A e a inclinação dos incisivos maxilares foram mensurados em relação às linhas ortogonais formadas pelo plano horizontal de Frankfurt e pelo plano pterigoideo vertical. Todos os dados foram medidos duas vezes, com um intervalo de 15 dias, e as médias foram submetidas ao teste t emparelhado e ao teste de correlação de Pearson. Resultados: quando os incisivos maxilares proclinaram 5,26°, o ponto A retraiu 1,54 mm (r=0,75; p < 0,0001), em uma taxa de 1:3,4 mm/graus. Quando os incisivos maxilares retroinclinaram 5,44º, o ponto A avançou 0,71 mm (r=0,81; p < 0,05), em uma taxa de 1:7,7 mm/graus. Conclusão: o ponto A é influenciado diretamente pela alteração na inclinação dos incisivos superiores e tende a acompanhar o movimento do ápice destes dentes.
This study aims to cephalometrically evaluate the changes at point A on the sagittal plane by measuring dental incisor inclinations before and after treatment. Methods: a total of 21 pairs of pre- and post-treatment lateral cephalograms were collected from a private clinic in Aracaju (SE). The sample was divided into 2 groups according to incisors inclination after treatment: Ipro, proclination after treatment (n=12) and Iretro: retroclination after treatment (n=9). The point A and the maxillary incisor inclinations were measured in relation to the orthogonal lines formed between the Frankfurt horizontal and the pterygoid vertical planes. Data were measured twice within a fifteen day interval, and means were subjected to the paired t and Pearson's correlation tests. Results: when maxillary incisors proclined 5.26° degrees, point A retracted 1.54 mm (r=0.75; p < 0.0001), establishing a ratio of 1:3.4 mm/degrees. When the maxillary incisors retroclined 5.44 degrees, the point A advanced 0.71 mm (r=0.81; p < 0.05), establishing a ratio of 1:7.7 mm/degrees. Conclusion: the point A is directly affected by changes in the upper incisor inclinations and tends to follow the apex movement of these teeth.
Subject(s)
Bone Remodeling , Cephalometry , Tooth Movement Techniques , Orthodontics, Corrective/trendsABSTRACT
BACKGROUND: Periapical lesions are often diagnosed on clinical and radiological basis that may be different from the histological finding. The purpose of this study was to compare clinical and radiographic features with histological diagnosis of periapical pathology. METHODOLOGY: A 22 year retrospective analysis of records of teeth diagnosed with periapical lesions that had periradicular surgery and the specimen sent for histopathological examination. Cases with incomplete records were excluded. Age, gender, site of lesion, clinical diagnosis, radiographic report and histopathological diagnosis etc were extracted from the records. The data were analyzed using SPSS version 20.0. Chi square test was used to test association between clinical and histological diagnosis at 95% level of confidence (i.e. p=0.05). RESULTS: Nineteen cases were analyzed in patients within age range of 17 to 57years with a mean age of 32.2±11.7 years and male to female ratio of 1.1:1. All the affected teeth were upper incisors. Majority (n= 13; 68.4%) of the cases were clinically diagnosed to be periapical cyst. While on histological analysis, majority (n=16; 84.2%) of the total cases were diagnosed as periapical granuloma. Ten cases (76.9%) out of 13 diagnosed clinically to be periapical cyst had sclerotic border (p=0.003). CONCLUSION: This study showed sensitivity and specificity of radiographs in detecting periapical lesions were reduced when compared with histology. The insufficiency of conventional radiography in diagnosing periapical lesions could lead to unnecessary surgery for the patient, thus the need for advanced imaging to provide improved quality of diagnosis, treatment planning and prognosis.
