Complications associated with orthognathic surgery: A retrospective study of 485 cases.

PURPOSE: To identify the most prevalent types of complications associated with orthognathic surgery and its possible risk factors. METHODS: This study was a retrospective investigation of records of 485 patients who underwent orthognathic surgery between 2008 and 2014 at the Oral and Maxillofacial Surgery Service at the Federal University of Paraná, Curitiba, Brazil. Types of complications were recorded. Independent variables such as sex, age, duration of surgery and hospitalization, number of surgeries, surgical site, and types of osteotomy performed were evaluated. Complications were also evaluated based on the treatment according to the Clavien-Dindo Classification. Data were submitted to statistical analysis with a significance level of 0.05. RESULTS: A total of 93 complications were reported (19.2%), including postoperative malocclusion, hemorrhage, inferior alveolar nerve injury, bad split, and infection. Complications were more common in men (p = 0.029). The number of complications was higher in surgeries that took more time to perform (p < 0.05) when the entire sample was taken into consideration. The prevalence of complications was related to a higher number of procedures per surgery (p = 0.019). Complications were more frequent in mandibular procedures (p = 0.010), particularly in bilateral sagittal split osteotomies (p < 0.001). Related to treatment, Clavien-Dindo grade I complications were the most frequent (72.04%). There was no association between sex, age, surgery duration, length of hospitalization, or surgical site with complication grades according to the Clavien-Dindo classification (p ≥ 0.05). CONCLUSION: Postoperative malocclusion, hemorrhage, inferior alveolar nerve injury, bad split and infection are the most prevalent complication in orthognathic surgery. They seem to be related to sex, duration of surgery, number of surgeries, surgical site, and the type of osteotomy performed. With these in mind, it is possible to explain to the patient the different levels of severity of complications related to the surgery.

Orthognathic Surgery Treatment Need in a Turkish Adult Population: A Retrospective Study.

Objectives: Limited information exists on orthognathic procedures and respective dentofacial deformities in Turkey. This retrospective study assessed the orthognathic surgery procedures in two universities, using the Index of Orthognathic Functional Treatment Need (IOFTN), and compared the IOFTN grades according to gender as well as sagittal and vertical skeletal relationships. Material and Methods: Records of 200 consecutive patients (120 females, 80 males, mean age = 23.4 (SD: 5.4) years) who received orthognathic treatment (2014-2018) were analyzed. Sagittal (ANB angle) and vertical skeletal type (GoGnSN angle), osteotomies, and IOFTN scores were recorded. Results: Class III, II, and I malocclusions formed 69%, 17.5%, and 13.5% of the samples, respectively. Class III skeletal relationships (69%) and high-angle cases (64%) were the most prevalent (p < 0.05). IOFTN scores were unevenly distributed among genders (p < 0.05) and the prevalent scores were 5.3 (40.5%), 4.3 (15.5%), 5.4 (13%), and 5.2 (7.5%), with 94% scoring 4 or 5 (great and very great functional need). Bimaxillary osteotomies were the most prevalent (55%), followed by LeFort I (32%), and 26% had genioplasty. Conclusion: IOFTN is a reliable tool to identify patients in need of orthognathic surgery. Class III malocclusions and Class III sagittal skeletal relationships were more common in this sample. Comparatively, a higher number of patients had genioplasty as a part of their treatment.

C-shaped canals in first and second mandibular molars from Brazilian individuals: A prevalence study using cone-beam computed tomography.

INTRODUCTION: The study aimed to evaluate, through in vivo tomographic analysis, the prevalence of C-shaped canals in mandibular first and second molars of Brazilian individuals, analyzing its frequency by thirds of the roots, and in contralateral teeth. METHODS: Images of 801 mandibular molars (379 first molars and 422 second molars) from 334 Brazilian individuals (142 men and 192 women) were identified through 1544 cone beam computed tomography (CBCT) exams, obtained from a private oral radiologic clinic. The cross-sectional configurations were analyzed to determine the frequency of C-shaped canals at three different axial levels and classified in categories by three experienced endodontists independently. RESULTS: The incidence of C-shaped canals was 181 (23%). Considering the type of tooth, 91 (24.01%) were identified in the first molars, and 90 (21.32%) were found in the second molars. The incidence was significantly higher in female individuals (P < 0.05) for both first and second molars. The most common C-shaped canal configurations were: C1 (89.01% for first molars and 90% second molars), followed by C2 (8.79% for first molars and 6.66% for second molars) and C4 (2.19% for the first molars and 3.33% for the second molars). Bilateral C-shaped canals were significantly higher than unilateral for both first and second molars (P < 0.01). CONCLUSIONS: The prevalence of C-shaped canals in mandibular molars of the Brazilian individuals was higher than previously reported for both mandibular first (24.01%) and second molars (21.32%). The incidence was significantly higher in female individuals and the coronal portion of the roots. The classic C-shaped format "C1" was the most frequent anatomical configuration. Furthermore, the prevalence of bilateral C-shaped canals was higher for the first molar (61.70%) and lower for the second molar (38.29%).

Dental anomalies in pediatric patients with familial adenomatous polyposis.

Familial adenomatous polyposis patients often present with non-malignant extra-intestinal manifestations which include dental anomalies that may be evident prior to the appearance of the colonic adenomas. The aims of this study were to describe the prevalence and type of dental anomalies and the relationships between gene mutations and dental anomalies in these patients. Twenty-two pediatric familial adenomatous polyposis patients and 46 controls, who were age and gender matched participated. Familial adenomatous polyposis patient's had a dental examination with panoramic radiograph and medical record review for age at diagnosis, the presence of the adenomatous polyposis coli gene mutation, and determination of other extra-intestinal manifestations on the body. The control group was identified from a retrospective chart review and selected if there was a current panoramic radiograph. The only significant difference between familial adenomatous polyposis patients and controls were the presence of jaw osteomas and sclerosis (p = .0001). Patients with a mutation in, or upstream of codon 1309 had a higher frequency of osteomas (77.8%) and jaw-bone sclerosis (44.4%), and 77% of these had at least one dental anomaly. This preliminary study showed an association between a genetic variant at, or upstream of codon 1309, and radiographic dental anomalies.

Influencia del tipo y tiempo de lactancia materna en la aparición de los hábitos deformantes / Influences of the type and time of breastfeeding in the onset of deforming oral habits

Introducción: los hábitos bucales deformantes están estrechamente relacionados con el tiempo de lactancia materna; existen hábitos beneficiosos o funcionales y los incorrectos o deformantes. Objetivo: describir la influencia de tipo y tiempo de la lactancia materna en la aparición de hábitos bucales deformantes en niños de 2 a 4 años. Métodos: se realizó un estudio descriptivo transversal y retrospectivo. El universo estuvo formado por 1021 madres con niños de 2 a 4 años de edad y la muestra integrada por 300 madres con sus respectivos hijos, seleccionados por un muestreo aleatorio simple; se obtuvieron las variables edad, sexo, hábitos bucales deformantes, tiempo de lactancia materna y tipo de lactancia. Resultados: el grupo de 3 años (44,7 por ciento) y el sexo femenino (55,7 por ciento), con uso de chupetes y biberones (45,7 por ciento), como hábito bucal deformante en el sexo femenino; la lactancia mixta (65,3 por ciento) en niños con hábitos, lactancia materna por menos de 3 meses (40,8 por ciento). Predominó el hábito de chupetes y biberones (45,7 por ciento) en todos los tiempos de lactancia, observándose que disminuye a medida que aumenta el tiempo de lactancia materna (4,9 por ciento). Conclusiones: la lactancia mixta y el tiempo de lactancia materna exclusiva menor de 3 meses favorecen la práctica de hábitos bucales deformantes(AU)

Introduction: deforming oral habits are closely related to the time of breastfeeding; there are beneficial or functional habits and the incorrect or deforming ones. Objective: to describe the influence of type and time of breastfeeding in the onset of deforming oral habits in children aged 2-4 years. Methods: across-sectional and retrospective descriptive study was carried out. The universe consisted of 1021 mothers with children aged 2-4 years and the sample was made up by 300 mothers with their respective children, selected by simple random sampling; age, sex, deforming oral habits, breastfeeding time, and breastfeeding type were obtained. Results: the group of 3 years (44.7 percent) and the female sex (55.7 percent), with the use of pacifiers and baby bottles (45.7 percent), as deforming buccal habit in females, mixed lactation (65.3 percent) in children with habits, breastfeeding for less than 3 months (40.8 percent). Predominantly, the habit of pacifiers and baby bottles (45.7 percent) at all breastfeeding time was observed to decrease as breastfeeding time increases (4.9 percent). Conclusions: mixed breastfeeding and exclusive breastfeeding time of less than 3 months favor the practice of deforming oral habits(AU)

Influencia del tipo y tiempo de lactancia materna en la aparición de los hábitos deformantes / Influences of the type and time of breastfeeding in the onset of deforming oral habits

Introducción: los hábitos bucales deformantes están estrechamente relacionados con el tiempo de lactancia materna; existen hábitos beneficiosos o funcionales y los incorrectos o deformantes. Objetivo: describir la influencia de tipo y tiempo de la lactancia materna en la aparición de hábitos bucales deformantes en niños de 2 a 4 años. Métodos: se realizó un estudio descriptivo transversal y retrospectivo. El universo estuvo formado por 1021 madres con niños de 2 a 4 años de edad y la muestra integrada por 300 madres con sus respectivos hijos, seleccionados por un muestreo aleatorio simple; se obtuvieron las variables edad, sexo, hábitos bucales deformantes, tiempo de lactancia materna y tipo de lactancia. Resultados: el grupo de 3 años (44,7 por ciento) y el sexo femenino (55,7 por ciento), con uso de chupetes y biberones (45,7 por ciento), como hábito bucal deformante en el sexo femenino; la lactancia mixta (65,3 por ciento) en niños con hábitos, lactancia materna por menos de 3 meses (40,8 por ciento). Predominó el hábito de chupetes y biberones (45,7 por ciento) en todos los tiempos de lactancia, observándose que disminuye a medida que aumenta el tiempo de lactancia materna (4,9 por ciento). Conclusiones: la lactancia mixta y el tiempo de lactancia materna exclusiva menor de 3 meses favorecen la práctica de hábitos bucales deformantes(AU)

Introduction: deforming oral habits are closely related to the time of breastfeeding; there are beneficial or functional habits and the incorrect or deforming ones. Objective: to describe the influence of type and time of breastfeeding in the onset of deforming oral habits in children aged 2-4 years. Methods: across-sectional and retrospective descriptive study was carried out. The universe consisted of 1021 mothers with children aged 2-4 years and the sample was made up by 300 mothers with their respective children, selected by simple random sampling; age, sex, deforming oral habits, breastfeeding time, and breastfeeding type were obtained. Results: the group of 3 years (44.7 percent) and the female sex (55.7 percent), with the use of pacifiers and baby bottles (45.7 percent), as deforming buccal habit in females, mixed lactation (65.3 percent) in children with habits, breastfeeding for less than 3 months (40.8 percent). Predominantly, the habit of pacifiers and baby bottles (45.7 percent) at all breastfeeding time was observed to decrease as breastfeeding time increases (4.9 percent). Conclusions: mixed breastfeeding and exclusive breastfeeding time of less than 3 months favor the practice of deforming oral habits(AU)

Exploring the impact of malocclusion and dentofacial anomalies on the occurrence of traumatic dental injuries in adolescents.

OBJECTIVE: To investigate the association between malocclusion/dentofacial anomalies and traumatic dental injuries (TDI) in adolescents. MATERIALS AND METHODS: The sample of this cross-sectional study comprised 509 adolescents aged 11 to 14 years enrolled at public schools in the city of Osório, southern Brazil. Parents answered a structured questionnaire addressing demographic and socioeconomic characteristics. An examiner who had undergone a training and calibration exercise recorded malocclusion/dentofacial anomalies (Dental Aesthetic Index, DAI), TDI (Andreasen), and dental caries (World Health Organisation). Statistical analyses (SPSS software) involved Poisson regression with robust variance. RESULTS: The prevalence of TDI was 11.6%, and the prevalence of defined, severe, and handicapping malocclusion was 24.0%, 21.6%, and 22.0%, respectively. The multivariate analysis demonstrated that the probability of TDI was approximately twofold higher among adolescents with severe malocclusion (prevalence ratio [PR] 2.22; 95% confidence interval [CI] 1.14-4.31) and handicapping malocclusion (PR 1.95; 95% CI 1.01-3.85) in comparison to those with normal occlusion or minor malocclusion. Defined malocclusion was not significantly associated with the outcome. Among the dentofacial anomalies evaluated, the probability of TDI was nearly twofold higher among adolescents with overjet greater than 3 mm (PR 1.96; 95% CI 1.14-3.37) and 2.2-fold higher among those with an abnormal molar relationship (PR 2.24; 95% CI 1.17-4.32), after controlling for confounding variables. CONCLUSIONS: Severe and handicapping malocclusion, accentuated overjet, and abnormal molar relationship were strongly associated with the occurrence of TDI. Future studies should investigate whether the treatment of these conditions can help reduce the occurrence of TDI in adolescents.

[Oral health status in children with intellectual disability living in organized groups].

The aim of the study was to assess oral health status in in children with intellectual disability (ID) living in Moscow Orphanage №15. The study involved 91 children aged 12 (39 children) and 15 (52 children). Caries incidence and DMFT index, periodontal disease incidence, OHI-S and PMA index, malocclusions incidence were assessed at baseline examination. Caries incidence in 12 and 15 y.o. was moderate (53.85% and 56.0%, correspondingly), as well as DMFT (2.77±0.52 и 2.94±0.53 correspondingly). In 2 children with rumination syndrome all teeth were affected by caries and these children received dental treatment under general anesthesia 7 times during last 60 months. Periodontal disease incidence in 12 and 15 y.o. was 89.74% и 86.58%, correspondingly with very high OHI-S indicating unsatisfactory oral hygiene. Malocclusions incidence was 95% and 98%, correspondingly. Thus the main oral problem in children with ID is periodontal disease and poor oral hygiene. Differentiated oral hygiene education approach according to children's physical and intellectual abilities should be considered. Children with rumination syndrome should be addressed by neurologist prior to dental treatment which needs more radical approach.

Adenotonsillar hypertrophy as a risk factor of dentofacial abnormality in Korean children.

No studies for the role of adenotonsillar hypertrophy in development of dentofacial abnormalities have been performed in Asian pediatric population. Thus, we aimed to investigate the relationship between adenotonsillar hypertrophy and dentofacial abnormalities in Korean children. The present study included consecutive children who visited a pediatric clinic for sleep-disordered breathing due to habitual mouth breathing, snoring or sleep apnea. Their palatine tonsils and adenoids were graded by oropharyngeal endoscopy and lateral cephalometry. Anterior open bite, posterior crossbite, and Angle's class malocclusions were evaluated for dentofacial abnormality. The receiver-operating characteristic curve analysis was used to identify age cutoffs to predict dentofacial abnormality. A total of 1,083 children were included. The presence of adenotonsillar hypertrophy was significantly correlated with the prevalence of dentofacial abnormality [adjusted odds ratio = 4.587, 95% CI (2.747-7.658)] after adjusting age, sex, body mass index, allergy, and Korean version of obstructive sleep apnea-18 score. The cutoff age associated with dentofacial abnormality was 5.5 years (sensitivity = 75.5%, specificity = 67%) in the children with adenotonsillar hypertrophy and 6.5 years (sensitivity = 70.6%, specificity = 57%) in those without adenotonsillar hypertrophy. In conclusion, adenotonsillar hypertrophy may be a risk factor for dentofacial abnormalities in Korean children and early surgical intervention could be considered with regards to dentofacial abnormality.

Prevalence and treatment of dentofacial deformities on a multiethnic population: a retrospective study.

INTRODUCTION: The purpose of the present study was to retrospectively analyze patients with dentofacial deformities attending a reference center in a Brazilian educational institution who sought orthosurgical treatment. MATERIAL AND METHODS: The medical records of 251 patients who sought treatment from 2003 to 2011 at Piracicaba Dental School, State University of Campinas (Unicamp) were analyzed. The exclusion criteria were as follows: patients presenting syndromes and labiopalatal clefts; in addition, incomplete records were excluded from the study. RESULTS: The prevalence of dentofacial deformities was greater in women (60.93 %), as well as leukoderma patients (69.22 %). The main motivation for treatment was functional (52 %), followed by esthetics (27 %). As for skeletal pattern, class III was the most incident (55 %), followed by class II (29.5 %) and class I (15.5 %). Regarding the type of deformity, class I patients had predominantly maxillary atresia (53 %). In the case of class II patients, the main deformity was anteroposterior mandibular deficiency (89 %), and in class III, anteroposterior maxillary deficiency (51 %). DISCUSSION: The results of the present study suggest that the profile of patients bearing dentofacial deformities in this population is composed of mostly young women motivated by functional issues, and class III skeletal deformity is the most common.

Correlation between oral health and Child-OIDP index in 12- and 15-year-old children from Modinagar, India.

To investigate the relationship between oral health measures and oral health-related quality of life using the Child-Oral Impact on Daily Performance index among school children of Modinagar. A cross-sectional analytical study was conducted on 900 school children aged 12 and 15 years in Modinagar, India. Children were interviewed about sociodental impacts on quality of life and examined for their normative treatment need for dental caries, traumatic dental injuries, and dentofacial anomalies. Frequency distributions for bivariate analysis and logistic regression for multivariate analysis were used for statistical analysis. Prevalence of oral impacts was high (60%), with a mean score of 2.49 ± 3.92. A significant association (P ≤ .05) was observed in oral impacts on daily performances with age, presence of dental caries, traumatic injuries, and dentofacial anomalies score. A strong association between clinical dental indicators and oral impacts in children showed eating followed by cleaning of teeth and smiling as the most commonly affected daily performances.

Assessment of the epidemiological profile of patients with dentofacial deformities who underwent orthognathic surgery.

The present study aimed to establish the profile of patients who underwent orthognathic surgery in a private clinic by evaluating their demographic characteristics, their facial types, and aspects related to the surgical procedures that were performed. The sample consisted of 419 medical records from male and female patients aged 15 to 62 years who underwent orthognathic surgery between 2001 and 2011. A single examiner collected data by evaluating a database of information extracted from medical records, particularly radiographic and photographic analyses. The following criteria were evaluated: gender, age, skin color, type of orthognathic surgery, type of associated temporomandibular joint (TMJ) surgery, complications, and recurrences. Seventeen patients were rejected because they had incomplete records. The average age of the patients was 28.5 years old; most were females (255 patients) and faioderm (295 patients). The most prevalent facial pattern was Pattern III (n = 166, 41.3%). Orthognathic surgery that affected the maxilla, jaw, and chin was the most prevalent type (n = 199, 49.5% of cases). A genioplasty was performed concurrently with combined surgeries and single-jaw surgery in 76.86% of patients (n = 309). TMJ surgery was performed concomitantly with orthognathic surgery in 4% of cases (n = 16). The most common postoperative complication was infection/inflammation (n = 12). We concluded that there was a higher frequency of orthognathic surgery among women and young people, the brunette skin phenotype was prevalent, and most patients had a combination of maxillary and mandibular problems.

Hospitalizations primarily attributed to dental conditions in the United States in 2008.

OBJECTIVE: The objective of this study was to provide estimates of hospitalizations attributed to oral health related conditions in the United States (US). STUDY DESIGN: The nationwide inpatient sample (NIS) of the Healthcare Cost and Utilization Project (HCUP) for 2008 was used. Hospital admissions with a primary diagnosis of dental/oral health-related conditions were identified using ICD-9-CM diagnosis codes. RESULTS: A total of 50,658 hospital admissions were primarily attributed to oral health-related conditions in 2008. Total US hospitalization charges were $1.218 billion. Total US hospitalization days were 174,496 days. CONCLUSIONS: The current study examines outcomes in patients hospitalized primarily for dental/oral health-related conditions. Of 39,885,120 hospitalizations that occurred in the US, a total of 50,658 (1.27%) were primarily attributed to dental-related conditions. Substantial resources are spent in treating dental-related conditions in hospital settings.