Disfunção da articulação temporomandibular em pacientes com anomalias dentomaxilofaciais / Disfunción de la articulación temporomandibular en pacientes con anomalías dentomaxilofaciales / Temporomandibular joint dysfunction in patients with dentomaxillofacial anomalies

Introdução: Pacientes com anomalias dentomaxilofaciais do sistema estomatognático frequentemente experimentam disfunção da articulação temporomandibular, além do exame clínico existem índices que permitem determinar o grau de disfunção. Objetivo: Identificar o grau de disfunção da articulação temporomandibular em pacientes com anomalias dentomaxilofaciais. Métodos: Estudo transversal, descritivo, observacional foi feito com 121 pacientes atendidos na clínica ortodôntica da Clínica Universitária de Especialidades Estomatológicas Manuel Cedeño, no período de maio de 2016 a março de 2018. As variáveis; a serem estudadas foram idade, sexo e grau de disfunção da articulação temporomandibular. Foi aplicado o índice de Maglione et al. Resultados: Pacientes com anomalias dentomaxilofaciais apresentaram um grau leve de disfunção em 71,90 percent da população total; disfunção da articulação temporomandibular esteve presente em 72,58 percent na faixa etária de 18 a 20 anos e no sexo feminino com 61,98 percent. Conclusão: Disfunção temporomandibular leve prevaleceu em pacientes com anomalias dentomaxilofaciais(AU)

Introducción: Los pacientes con anomalías dentomaxilofaciales del sistema estomatognático a menudo experimentan disfunción de la articulación temporomandibular. Además del examen clínico existen índices que permiten determinar el grado de disfunción. Objetivo: Identificar el grado de disfunción de la articulación temporomandibular en pacientes con anomalías dentomaxilofaciales. Métodos: Se realizó un estudio observacional descriptivo de corte transversal con 121 pacientes atendidos en la consulta de Ortodoncia de la Clínica Universitaria de Especialidades Estomatológicas Manuel Cedeño, de mayo de 2016 a marzo de 2018. Las variables a estudiar fueron la edad, sexo y grado de disfunción de la articulación temporomandibular. Se aplicó el índice de Maglione et al. Resultados: Los pacientes con anomalías dentomaxilofaciales tuvieron un grado de disfunción leve en 71,90 por ciento de la población total. La disfunción de la articulación temporomandibular se presentó en 72,58 por ciento del grupo etario de 18 a 20 años y en el sexo femenino, con 61,98 por ciento. Conclusiones: La disfunción de la articulación temporomandibular leve prevaleció en los pacientes con anomalías dentomaxilofaciales(AU)

Introduction: Patients with dentomaxillofacial anomalies of the stomatognathic system often experience temporomandibular joint dysfunction. Besides clinical examination, indices such as Maglione and collaborators' allow to determine the degree of dysfunction. Objective: Identify the degree of temporomandibular joint dysfunction in patients with dentomaxillofacial anomalies. Methods: A cross-sectional observational descriptive study was conducted of 121 patients attending the Orthodontics Service at Manuel Cedeño Dental Specialties University Clinic from May 2016 to March 2018. The variables analyzed were age, sex and degree of temporomandibular joint dysfunction. Use was made of the Maglione and collaborators' index. Results: Patients with dentomaxillofacial anomalies had a mild degree of dysfunction in 71.90 percent of the total population. Temporomandibular joint dysfunction was present in 72.58 percent of the 18-20 years age group and in the female sex, with 61.98 percent. Conclusions: Mild temporomandibular joint dysfunction prevailed in patients with dentomaxillofacial anomalies(AU)

Disfunção da articulação temporomandibular em pacientes com anomalias dentomaxilofaciais / Disfunción de la articulación temporomandibular en pacientes con anomalías dentomaxilofaciales / Temporomandibular joint dysfunction in patients with dentomaxillofacial anomalies

Introdução: Pacientes com anomalias dentomaxilofaciais do sistema estomatognático frequentemente experimentam disfunção da articulação temporomandibular, além do exame clínico existem índices que permitem determinar o grau de disfunção. Objetivo: Identificar o grau de disfunção da articulação temporomandibular em pacientes com anomalias dentomaxilofaciais. Métodos: Estudo transversal, descritivo, observacional foi feito com 121 pacientes atendidos na clínica ortodôntica da Clínica Universitária de Especialidades Estomatológicas Manuel Cedeño, no período de maio de 2016 a março de 2018. As variáveis; a serem estudadas foram idade, sexo e grau de disfunção da articulação temporomandibular. Foi aplicado o índice de Maglione et al. Resultados: Pacientes com anomalias dentomaxilofaciais apresentaram um grau leve de disfunção em 71,90 percent da população total; disfunção da articulação temporomandibular esteve presente em 72,58 percent na faixa etária de 18 a 20 anos e no sexo feminino com 61,98 percent. Conclusão: Disfunção temporomandibular leve prevaleceu em pacientes com anomalias dentomaxilofaciais(AU)

Introducción: Los pacientes con anomalías dentomaxilofaciales del sistema estomatognático a menudo experimentan disfunción de la articulación temporomandibular. Además del examen clínico existen índices que permiten determinar el grado de disfunción. Objetivo: Identificar el grado de disfunción de la articulación temporomandibular en pacientes con anomalías dentomaxilofaciales. Métodos: Se realizó un estudio observacional descriptivo de corte transversal con 121 pacientes atendidos en la consulta de Ortodoncia de la Clínica Universitaria de Especialidades Estomatológicas Manuel Cedeño, de mayo de 2016 a marzo de 2018. Las variables a estudiar fueron la edad, sexo y grado de disfunción de la articulación temporomandibular. Se aplicó el índice de Maglione et al. Resultados: Los pacientes con anomalías dentomaxilofaciales tuvieron un grado de disfunción leve en 71,90 por ciento de la población total. La disfunción de la articulación temporomandibular se presentó en 72,58 por ciento del grupo etario de 18 a 20 años y en el sexo femenino, con 61,98 por ciento. Conclusiones: La disfunción de la articulación temporomandibular leve prevaleció en los pacientes con anomalías dentomaxilofaciales(AU)

Introduction: Patients with dentomaxillofacial anomalies of the stomatognathic system often experience temporomandibular joint dysfunction. Besides clinical examination, indices such as Maglione and collaborators' allow to determine the degree of dysfunction. Objective: Identify the degree of temporomandibular joint dysfunction in patients with dentomaxillofacial anomalies. Methods: A cross-sectional observational descriptive study was conducted of 121 patients attending the Orthodontics Service at Manuel Cedeño Dental Specialties University Clinic from May 2016 to March 2018. The variables analyzed were age, sex and degree of temporomandibular joint dysfunction. Use was made of the Maglione and collaborators' index. Results: Patients with dentomaxillofacial anomalies had a mild degree of dysfunction in 71.90 percent of the total population. Temporomandibular joint dysfunction was present in 72.58 percent of the 18-20 years age group and in the female sex, with 61.98 percent. Conclusions: Mild temporomandibular joint dysfunction prevailed in patients with dentomaxillofacial anomalies(AU)

Tratamiento de la clase II división 1 con el activador abierto elástico de Klammt / Treatment of class II division 1 with the elastic open activator of Klammt

Introducción: el activador abierto elástico de Klammt es un aparato funcional que permite la corrección de las anomalías de posición mandibular al aprovechar la fuerza generada por la musculatura. Objetivo: evaluar los resultados del tratamiento de la clase II división 1 con el activador abierto elástico de Klammt. Método: se realizó un estudio cuasi-experimental modalidad antes y después sin grupo control en 15 pacientes que fueron ingresados en la consulta de ortodoncia de la Clínica Universitaria de Especialidades Estomatológicas Manuel Cedeño, y se atendieron en el período de febrero de 2016 a febrero de 2018. Resultados: la población objeto de estudio estuvo representada por 73,33 por ciento de las edades entre siete a nueve años y el sexo femenino el más representativo con el 60,00 por ciento. La clase II división 1 se corrigió en el 80,00 por ciento de los pacientes al igual que la relación molar, y la estética mejoró luego del tratamiento en el 73,33 por ciento de los pacientes. Conclusiones: con el empleo del activador abierto elástico de Klammt se alcanzan resultados favorables en el tratamiento de la clase II división 1 lo cual favorece un equilibrio funcional y estético del sistema estomatognático(AU)

Introduction: the Klammt open elastic activator is a functional device that allows the correction of mandibular position anomalies by taking advantage of the force generated by the musculature. Objective: the objective of the investigation was to evaluate the results of treatment of class II division 1 with the elastic open activator of Klammt. Method: we performed a quasi-experimental modality before and after without a control group in 15 patients who were admitted to the orthodontic clinic of the University Clinic of Stomatological Specialties Manuel Cedeño, and attended in the period from February 2016 to February 2018. Results: the study population was represented by 73.33 percent of the ages between seven to nine years and the female sex was the most representative with 60.00 percent. Class II division 1 was corrected in 80.00 percent of patients as well as the molar ratio, and aesthetics improved after treatment in 73.33 percent of patients. Conclusions: with the use of Klammt elastic open activator favorable results are achieved in the treatment of class II division 1 which favors a functional and aesthetic balance of the stomatognathic system(EU)

Association of sickle cell haemoglobinopathies with dental and jaw bone abnormalities.

OBJECTIVE: To estimate the association between sickle cell anaemia and trait with dental and jaw bone abnormalities. SUBJECTS AND METHODS: Subjects (n = 369) were allocated to three groups: sickle cell anaemia, trait and control. Dental shape, number, size and position and changes in pulp chamber, root and periapex were analysed by intra-oral periapical radiographs. Integrity of lamina dura, quality of cancellous bone and bone trabeculation were also evaluated. Prevalence ratios (PR) were calculated (α = 0.05). RESULTS: Sickle cell anaemia had higher prevalence (PR:8.31) and number of teeth (PR:13.40) with external resorption; higher number of teeth with pulp calcification; partial and total loss of lamina dura; and higher prevalence of changes in trabecular structure of maxilla (PR:6.45) and mandible (PR:5.34). Sickle cell trait showed higher prevalence (PR:1.26) and higher number of teeth (PR:1.98) with partial loss of lamina dura; higher number of teeth with hypercementosis, changes in shape, size, periapex, total loss of lamina dura; and higher prevalence of changes in mandibular trabecular bone (PR:1.43). CONCLUSION: Pulp calcification and external resorption of the root were the most frequent dental alterations in sickle cell anaemia group, while in trait was higher frequency of changes in shape, size, periapex and root. Jaw bone changes were most prevalent in both homozygous and heterozygous subjects.

Percepção estética sobre alterações no terço inferior da face em diferentes regiões do Brasil e a decisão pelo tratamento ortodôntico cirúrgico / Aesthetic perception of changes in the lower third of the face in different regions of Brazil and the decision for surgical orthodontic treatment

Os autores avaliaram em todo o Brasil, o impacto que o posicionamento anteroposterior da mandíbula e alterações verticais na dimensão estômio-mento (St-Me) geram sobre leigos, cirurgiões bucomaxilofaciais e ortodontistas, suas indicações ao tratamento ortodôntico-cirúrgico, bem como, a prevalência do gênero, idade, grupo racial, estruturas ósseas e os tipos de intervenções cirúrgicas realizadas com maior frequência nos seus pacientes com desarmonias dentofaciais. Material e métodos: quatro modelos (duas mulheres e dois homens, leucodermas e melanodermas) foram fotografados em norma frontal e perfil. A dimensão St-Me (vertical) foi aumentada e diminuída em 10 e 20% e o ângulo da convexidade facial (anteroposterior) aumentado e diminuído em 4 e 8º. As imagens foram avaliadas em escala visual analógica por meio de questionários. Resultados: as imagens originais foram significativamente mais atrativas e as grandes alterações menos estéticas. Os cirurgiões bucomaxilofaciais e ortodontistas foram mais exigentes que os leigos e aqueles com menor grau de escolaridade, não conseguiram perceber alterações faciais verticais mais sutis. Os melanodermas foram mais estéticos quando apresentaram suave aumento de 10%, no sentido vertical. O oposto foi observado nos indivíduos leucodermas. Em relação ao gênero, as grandes alterações foram sempre menos atrativas, comparadas às pequenas alterações. Quanto às indicações cirúrgicas, os leigos foram mais tolerantes e os cirurgiões tanto indicariam quanto se submeteriam mais às cirurgias, caso as imagens fossem das próprias faces. Os leucodermas receberam as mesmas indicações às cirurgias, quando o terço inferior da face esteve aumentado (20%) e projetado (8º), e os melanodermas diferiram quanto à discrepância sagital. As mulheres receberam mais indicação à cirurgia nas simulações sagitais para Classe III, e os homens para Classe II. Epidemiologicamente, o gênero feminino foi o mais prevalente (75%) em todas as regiões do Brasil, na faixa etária entre 20 e 30 anos (71%) e leucodermas (75%). A estrutura óssea com mais indicações foi "ambas" (maxila e mandíbula) com 53,76%. Nas regiões Norte, Nordeste e Sul a segunda mais prevalente foi a mandíbula, enquanto no Centro-Oeste e Sudeste foi a maxila. Das intervenções cirúrgicas de um modo geral, o avanço maxilar foi o mais prevalente, seguido do recuo mandibular (23,67% e 23,33%, respectivamente) em todas as regiões. Conclusão: A dimensão St-Me e o ângulo da convexidade facial exerceram forte influência sobre a estética facial e a percepção para a necessidade de cirurgia ortognática, em todas as regiões do Brasil. A maioria dos pacientes atendidos pelos profissionais foi mulheres, jovens, leucodermas que apresentavam alterações esqueléticas em ambos os maxilares, com indicações e submissões às cirurgias combinadas, sobretudo para avanço maxilar e recuo mandibular. (AU)

This study evaluated throughout Brazil the impact of the anteroposterior positioning of the mandible and vertical changes in the Stomium-Mentum dimension (St-Me) on laypersons, bucomaxilofacial surgeons and orthodontists, their indications for orthodontic-surgical treatment, and prevalence of gender, age, racial group, bone structures and types of surgical interventions performed more frequently in their patients with dentofacial disharmonies. Material and methods: Four models (two women and two men, leucoderma and melanoderma) had frontal and lateral photographs taken. The St-Me dimension (vertical) was increased and decreased by 10 and 20% and the angle of facial convexity (anteroposterior) increased and decreased by 4 and 8º. The images were assessed with a Visual Analogue Scale questionnaire. Results: the original images were significantly more attractive, and major changes were less aesthetic. Bucomaxilofacial surgeons and orthodontists were more demanding than laypersons and those with lower educational level were unable to notice subtle vertical facial changes. Melanoderma individuals, were more aesthetic when presented a slight increase of 10% in the vertical direction. The opposite was observed in leucoderma subjects. Regarding gender, the major changes were always less attractive, compared to small ones. As far as the surgical indications, the laypersons were more tolerant, and the surgeons would both indicate and undergo surgeries if the images were from their own faces. The leucoderma subjects received the same indications for the surgeries, when the lower-third facial was increased (20%) and projected (8º), and the melanoderma ones differed as to the sagittal discrepancy. Women had more indication for surgery in the sagittal simulations for Class III and men for Class II. Epidemiologically, female gender was the most prevalent (75%) in all regions of Brazil, in the age group between 20 and 30 years (71%) and leucoderma (75%). The bone structure with more indications was "both" (maxilla and mandible) with 53.76%. In the North, Northeast and South regions, the second most prevalent was the mandible, while in the Midwest and Southeast it was the maxilla. Among the general surgical interventions, maxillary advancement was the most prevalent, followed by mandibular retreatment (23.67% and 23.33%, respectively) in all regions. Conclusion: The St-Me dimension and the facial convexity angle wielded a strong influenced facial aesthetics and the perception of the need for orthognathic surgery in all Brazilian regions. Most of the patients with dentofacial disharmonies are women, young, leucoderma, with skeletal alterations in both maxillary bones, submitted or with indication of combined surgery, predominantly maxillary advancement and mandibular setback.

Prevalencia de Anomalías Dentomaxilares y Necesidad de Tratamiento en Adolescentes / Prevalence of Dentomaxillary Anomalies and Treatment Needs in Adolescents

RESUMEN: Las anomalías dentomaxilares (ADM) constituyen un problema de salud pública en Chile, lo que genera la necesidad de un diagnóstico sistemático y la asignación de prioridades de tratamiento. Las ADM que afectan la estética pueden constituir una barrera para la inserción social de los adolescentes. El Dental Aesthetic Index (IED), es un instrumento que permite jerarquizar la necesidad de tratamiento de las ADM. El propósito de esta investigación fue caracterizar las ADM, necesidad de tratamiento a través de IED y auto-percepción estética en escolares de 12 a 15 años. Estudio de Prevalencia en adolescentes de 12 a 15 años, de la ciudad de Viña del Mar. El criterio de exclusión fue tratamiento ortodóncico previo. Se seleccionaron 204 sujetos mediante asignación uniforme con un nivel de confianza de 95 %. Variables recogidas: Edad, tipo de establecimiento educacional, sexo, percepción estética y IED por componentes. La prevalencia según IED fue de 63 % [56 % - 70 %]. La necesidad de tratamiento fue 44,2 % electivo, 31,01 % altamente deseable y 24,81 % obligatorio y prioritario. El IED Comunitario dio 29.5. Se encontró una relación significativa entre IED y percepción estética con un p-valor: 0,006 (Rho: 0,343). La prevalencia de anomalías dentomaxilares medido a través del indicador IED alcanza el 63 % y el IED comunitario de 29,54 % afirmando que el grupo "requiere tratamiento electivo por ADM definida"; en los establecimientos particulares está subestimado pues algunos casos ya han sido tratados con anterioridad a esta investigación.

ABSTRACT: Dentomaxillary anomalies are a public health problem in Chile, resulting in the need for screening and prioritization of treatment. Dentomaxillary anomalies affecting the aesthetics can be a barrier to social integration of adolescents. The Dental Aesthetic Index (DAI) is an instrument to prioritize the need for treatment of malocclusions. The purpose of this research was to characterize the malocclusions, orthodontic treatment needs and esthetic self-perception in schoolchildren from 12 to 15 years through DAI. Prevalence Study in 12 to 15 year-old adolescents from Viña del Mar. The exclusion criteria was previous orthodontic treatment. The sample was 204 subjects selected by uniform allocation with a confidence level of 95 %. Variables included age, type of educational establishment, sex, aesthetic perception and DAI by component. Prevalence of dentomaxillary anomalies by DAI was 63 % [56 % - 70 %], Treatment needs were 44.2 % treatment elective, 31.01 % highly desirable and 24.81 % mandatory. The Community's DAI was 29.5. The relationship between DAI and aesthetic perception was significant (p-value: 0.006; Rho: 0.343). The prevalence of dento-maxillary anomalies measured by DAI reaches 63 % and the communal DAI was 29.54 stating that the group "requires elective treatment for definite malocclusion"; in private schools, it is underestimated because some cases had already been treated prior to this investigation.

Retrospective 25-year follow-up of treatment outcomes in Angle Class III patients : Success versus failure.

OBJECTIVES: Despite recommendations for early treatment of hereditary Angle Class III syndrome, late pubertal growth may cause a relapse requiring surgical intervention. This study was performed to identify predictors of successful Class III treatment. MATERIALS AND METHODS: Thirty-eight Class III patients treated with a chincup were retrospectively analyzed. Data were collected from the data archive, cephalograms, and casts, including pretreatment (T0) and posttreatment (T1) data, as well as long-term follow-up data collected approximately 25 years after treatment (T2). Each patient was assigned to a success or a failure group. Data were analyzed based on time (T0, T1, T2), deviations from normal (Class I), and prognathism types (true mandibular prognathism, maxillary retrognathism, combined pro- and retrognathism). RESULTS: Compared to Class I normal values, the data obtained in both groups yielded 11 significant parameters. The success group showed values closer to normal at all times (T0, T1, T2) and vertical parameters decreased from T0 to T2. The failure group showed higher values for vertical and horizontal mandibular growth, as well as dentally more protrusion of the lower anterior teeth and more negative overjet at all times. In adittion, total gonial and upper gonial angle were higher at T0 and T1. A prognostic score-yet to be evaluated in clinical practice-was developed from the results. The failure group showed greater amounts of horizontal development during the years between T1 and T2. Treatment of true mandibular prognathism achieved better outcomes in female patients. Cases of maxillary retrognathism were treated very successfully without gender difference. Failure was clearly more prevalent, again without gender difference, among the patients with combined mandibular prognathism and maxillary retrognathism. Crossbite situations were observed in 44% of cases at T0. Even though this finding had been resolved by T1, it relapsed in 16% of the cases by T2. CONCLUSION: The failure rate increased in cases of combined mandibular prognathism and maxillary retrognathism. Precisely in these combined Class III situations, it should be useful to apply the diagnostic and prognostic parameters identified in the present study and to provide the patients with specific information about the increased risk of failure.

First report of a cystic malformation on the upper jaw of hatchery-reared allis shad Alosa alosa.

The anadromous allis shad Alosa alosa has suffered dramatic population declines throughout Europe and is currently considered as endangered throughout its entire distribution range. In order to reestablish allis shad in the River Rhine, which formerly housed one of the largest and most important populations, an EU-LIFE Project 'The re-introduction of allis shad in the Rhine system' was started in 2007. In course of the LIFE+ Projects, allis shad larvae bred from genitor fish of the Gironde-Garonne-Dordogne population in France were reared in a pilot ex situ stock plant pilot facility in Aßlar, Germany. At an age of 1-2 months, about 100% of these fish developed approximately 0.5- to 0.8-cm large, fluid-filled, transparent cysts in conjunction with the upper jaw. The performed microbiological, virological, parasitological and histological examinations did not detect any infectious agents. Possible causative agents are discussed with regard to environmental factors and the nutrition of larvae. In conclusion, the observed malformations are considered a sign for a severe health problem and therefore a risk for the successful breeding of allis shad in aquaculture.

Retrospective study of the bone morphology in the posterior mandibular region. Evaluation of the prevalence and the degree of lingual concavity and their possible complications

BACKGROUND: In order to choose the appropriate implant size and to prevent complications, an oral surgeon must know the size and shape of the mandible. In the posterior mandibular region, a lingual undercut is often found and could represent a difficulty hard to manage if a lingual or buccal perforation occur. A large series of computed tomography (CT) images of the mandibular first molar was evaluated and the bone morphology, the prevalence and the degree of the lingual concavity in the first molar region were studied. MATERIAL AND METHODS: One hundred and fifty-one computed tomography (CT) examinations of patients were retrospectively evaluated to determine anatomical variations in bone morphology in the submandibular fossa region. RESULTS: A total of 151 subjects were included, consisting of 64 males (M) (42.4%) and 87 females (F) (57.6%). The under-cut type ridge was present in 64.2% of the cases. The concavity angle was 66.6 ± 8.9° (M) and 71.6 ± 8.4° (F) and the linear concavity depth 4.5 ± 2.3 mm (M) and 3.1 ± 1.7 mm (F) (p > 0.05). CONCLUSIONS: Mandibles with any lingual concavity present a potential increased risk of lingual cortical perforation during implant placement surgery. CT imaging allows characterizing the anatomy of the submandibular fossa and provides other important information for the preoperative assessment of the posterior mandible for dental implants placement

Jaw disorders in the pediatric population.

PURPOSE: This article will review the etiology, risk factors, history, and physical assessment of temporomandibular joint disorders (TMDs). In particular, this article discusses the role of the pediatric provider in diagnosing and beginning the initial treatment of TMDs, as well as the appropriate treatment plans. It also reveals some of the controversies regarding etiology and treatment of TMDs, as well as the paucity of research specific to TMDs in pediatrics. DATA SOURCES: A computerized search in PubMed and Ovid Medline, from 2006 to 2012, was conducted. A few seminal articles were included that were published before 2006. Hand searching was also performed, which included a few articles between 2012 and 2015. CONCLUSIONS: Although TMDs are mostly found in adults, it is also a finding in pediatrics, which increases in prevalence during adolescence. More research specific to pediatric patients with TMDs needs to be conducted so that pediatric-specific care can be provided. IMPLICATIONS FOR PRACTICE: TMD is a condition found in the pediatric population, and it is important for providers to take an adequate history and physical examination that incorporates the temporomandibular joint (TMJ) and muscles of mastication. It is also critical that providers begin initial education and management, followed by appropriate referrals.

Adherencia al tratamiento del paciente con fisura labio-palatina (FLAP) 2006 - 2013 / Adherence to treatment of patients with cleft lip palate (FLAP) 2006-2013

Las Fisuras Labio Palatinas son anomalías congénitas que consisten en una hendidura o separación en el labio superior. Se presentan, frecuentemente, acompañadas de paladar hendido. El presente trabajo tiene por objetivo estudiar la complejidad y grado de adherencia, estudiando el grado de abandono en la rehabilitación del paciente FLAP que concurre a instituciones o servicios adheridos a la Red de Servicios / Instituciones de la Argentina. De un total de 749 pacientes fueron contactados aquellos con más de 200 días de inasistencia al servicio en un total de 162 (21,6%), de los cuales 55 (11,4%) manifestó abandono de tratamiento. El 46,8% de los pacientes no cuentan con cobertura por obra social / prepaga o mutual. El 18,2% posee certificado de discapacidad. El 47,8% de los pacientes requieren entre 1 a 2 horas de traslado para su atención, y el 27,3% más de 2 horas, a lo que se debe sumar los tiempos de espera en las instituciones. Del análisis de las variables seleccionadas se podría estimar que la edad, severidad de la lesión, número de convivientes en el domicilio y ausencia de certificado de discapacidad podrían ser utilizados como indicadores de posible abandono en el tratamiento.

Cleft lip palate is a congenital anomaly consisting of a crack or separation in the upper lip. It is often accompanied by cleft palate. The aims of the study it is to analyze the complexity and degree of rehabilitation adhesion, by abandonment analysis, of the FLAP patient who attends institutions or services belonging to the network of services / institutions in Argentina. A total of 749 patients were contacted those with more than 200 days of absenteeism to the service in a total of 162 (21,6%), of which 55 (11,4%) said abandonment of treatment. 46,8% of patients do not have coverage for work social/insurance/mutual. 18,2% possesses a certificate of disability. 47,8% of patients require between 1-2 hours of transfer for your attention, and 27,3% more than 2 hours, what to add the waiting time at the institutions. Analysis of selected variables you could estimate that the age, severity of injury, number of cohabitants in the domicile and absence of disability certificate could be used as indicators of possible abandonment in the treatment.

Incidence of bilateral Marcus Gunn jaw-wink.

This case report describes the unusual finding of bilateral Marcus Gunn jaw-wink. Only a few bilateral jaw-wink patients have been published as case reports. The authors dispute this notion as portrayed in the literature that a bilateral wink is a rare entity. A thorough review of prior case series on congenital ptosis and jaw-wink demonstrates that bilateral involvement is more common than previously thought. A supplemental video shows the classic action of lateral pterygoid contraction causing ipsilateral eyelid retraction.

Assessing anteroposterior basal bone discrepancy with the Dental Aesthetic Index.

OBJECTIVE: To investigate dental appearance and cephalometric features, using a sample of orthognathic and/or orthodontic patients. A special interest was to identify the relationship of the Dental Aesthetic Index (DAI) with anteroposterior basal bone discrepancy (APBBD) and cephalometric indicators. MATERIALS AND METHODS: A full sample of 159 patients in two Japanese hospitals was used. Each patient was assessed with a preorthodontic dental cast and cephalometric radiography. RESULTS: Malocclusion with APBBD was more prevalent among high DAI subjects (P  =  .034, OR  =  1.04, 95% CI: 1.00-1.08), Class III malocclusion patients (P  =  .048, OR  =  2.32, 95% CI: 1.01-5.34) and male patients (P  =  .008, OR  =  2.96, 95% CI: 1.33-6.61). Participants scoring 88 points (the highest score in this sample) of the DAI had 16.84 times the risk of APBBD of those who scored 17 points (the lowest score in this sample). Patients with APBBD presented with a greater adjusted ANB angle (t  =  -8.10, P < .001) and a larger adjusted A-B/NF appraisal (t  =  -9.65, P < .001). The SNA angle (P < .001), the SNB angle (P  =  .002), the adjusted ANB angle (P  =  .001), and the adjusted A-B/NF appraisal (P  =  .035) were associated with DAI scores in cubic regression models. CONCLUSION: This study has demonstrated a relationship between the DAI and APBBD. Feasibility of using the adjusted ANB angle and the adjusted A-B/NF appraisal to assess severity of APBBD has been confirmed. The DAI may provide a supportive method to evaluate orthognathic needs. Future investigations are indicated.

Alterations and pathologies prevalence in panoramic radiographs in patients attending the university dental clinic / Prevalencia de alteraciones y patologías en radiografías panorámicas en pacientes atendidos en una clínica dental universitaria

The aim was to report the prevalence of alterations and pathologies of the analysis of digital panoramic radiographs in the clinic of the Dental School at Escuela Nacional de Estudios Superiores, Unidad León, since October 2011 until April 2012. This was developed as a retrospective study involving 516 digital panoramic radiographs upon which was performed a visual analysis to report the prevalence of abnormalities or pathologies. The findings were related to maxillary sinus abnormality or pathology, nasal cavity, maxillary and mandibular bones and dental abnormalities. The panoramic radiograph because of its versatility is still one of the most important oral and maxillofacial diagnosis methods, it helps us to detect pathologies, which do not always have symptomatology and could cause health problems.

El objetivo fue describir la prevalencia de alteraciones y patologías en radiografías panorámicas digitales de la clínica de la Facultad de Odontología de la Escuela Nacional de Estudios Superiores, Unidad León, desde octubre de 2011 hasta abril de 2012. Se desarrolló un estudio retrospectivo que incluyó a 516 radiografías panorámicas digitales en las que se realizó un análisis visual para informar de la prevalencia de anomalías o patologías. Los hallazgos se relacionaron con anormalidad o patología del seno maxilar, cavidad nasal, hueso maxilar y mandibular, y alteraciones dentales. La radiografía panorámica debido a su versatilidad sigue siendo uno de los métodos de diagnóstico oral y maxilofacial más importantes, que nos ayuda a detectar patologías, que no siempre tienen la sintomatología y podrían causar problemas de salud.

Detection of bifid mandibular condyle using computed tomography

Objective: To determine the frequency and characteristics of bifid mandibular condyle (BMC) using computed tomography (CT) evaluation. Study Design: A retrospective study was carried out using the CT records of 550 patients referred to the Medical School of Erciyes University (Kayseri, Turkey) between 2007 and 2010. T-tests were used to compare frequency of BMC between the left and right sides and between female and male patients. Statistical analysis was performed using SPSS software and a chi-squared test. Results: Of the 550 Patients, 10 patients (1.82%) were found to have BMCs. Five patients were female (50%) and five were male (50%). Of these 10 patients, 7 (70%) had unilateral and 3 (30%) had bilateral BMCs. As a result, a total of 13 BMCs were found in 10 patients. No statistically significant differences were found between either the right- and left-sided BMCs or between female and male patients (p >.05). Conclusions: To our knowledge, this is the first retrospective study investigating the prevalence and characteristics of BMC using computed tomography. Although BMC is an uncommon anomaly, it may be a more frequent condition in the Turkish population. Further studies and research on the orientation of duplicated condylar heads should be carried out (AU)

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Investigation of the maxillary lateral incisor agenesis and associated dental anomalies in an orthodontic patient population

Objectives: The aim of this study was to investigate the prevalence of maxillary lateral incisor (MLI) agenesis and associated dental anomalies as well as skeletal patterns in an orthodontic population, and then to compare it with the prevalence of these anomalies in the general population.Study Design: The material of the present study included the records of the 3872 orthodontic patients. The followings were recorded for each subject with the agenesis of MLI: Age, sex, unilateral or bilateral absence, anteriorposterior skeletal relationship of the maxilla and mandible, and presence of associated dental anomalies. The occurrence of these anomalies was compared with data previously reported for the general populations. Results: Of the 3872 patients examined, 94 were found to have agenesis of the MLI, representing a prevalence of 2.4 per cent, with females being more frequently observed. The most commonly found associated anomalies were ectopic eruption of maxillary canines and reduced or peg- shaped contralateral incisor with the frequencies of 21.3 per cent and 20.2 per cent respectively.Conclusions: Patients with agenesis of MLI showed a significantly higher prevalence of skeletal Class III malocclusion compared with the general population. The prevalence of ectopic eruption, transposition, and transmigration of the maxillary canine and reduced or peg- shaped MLIs were significantly increased (AU)

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Childhood obstructive sleep apnea syndrome: an interdisciplinary approach: a prospective epidemiological study of 4,318 five-and-a-half-year-old children.

UNLABELLED: Population-representative data on sleep disorders in children is scarce. BACKGROUND AND OBJECTIVE: The aim of this epidemiological study was to determine the prevalence of various sleep-related breathing disorders (SRBD) and any correlations with occlusion and jaw abnormalities in preschool children. MATERIALS AND METHODS: The study material consisted of 4,318 children (5.5 years old) whose parents completed the Pediatric Sleep Questionnaire (PSQ); 60 out of 140 children (6.3 ± 0.78 years old) with a positive questionnaire score (> 0.33) were examined by an orthodontist and ENT specialist. From this cohort, 15 children who presented a dental occlusion and jaw abnormality but no indication for surgical reduction of adenotonsillar tissue underwent polysomnography in a sleep laboratory. RESULTS: According to the PSQ, 3.3% of the 5.5-year-olds showed evidence of a SRBD. Boys were affected significantly more frequently. Lack of concentration, hyperactivity, morning fatigue, mouth breathing, loud snoring, and breathing interruptions were indicators of SRBD. The SRBD children more frequently presented with jaw abnormalities such as mandibular retrognathia, lateral cross-bite, and increased overjet. The SRBD cohort showed a higher rate of orofacial dysfunctions. Adenotonsillar hyperplasia still played a significant role in the development of SRBD. CONCLUSION: In contrast to previous reports in the literature, the frequency of SRBD in our group of 5- to 6-year-olds was lower (3%). Boys with adenotonsillar hyperplasia and/or mandibular retrognathia, lateral cross bite, and an enlarged overjet require special attention.

Prevalence of bifid mandibular condyle in a Turkish population.

The aim of this study was to determine the frequency of bifid mandibular condyle (BMC) using panoramic radiographs supported by different radiographic techniques. A retrospective study was carried out by evaluating panoramic radiographs of 18,798 patients referred to the Department of Dentomaxillofacial Radiology. T-tests were used to compare the frequency of BMC between left and right sides and between female and male patients. In this study, 98 patients (0.52%) were found to have BMC. Of these patients, 51 (52%) were females and 47 (48%) were males. Of the 98 patients, 71 (72.4%) had unilateral and 27 (27.6%) had bilateral BMC. A total of 125 BMCs were found in 98 patients. No statistically significant differences were found between the right and left BMCs or between female and male patients (P > 0.05). Because symptoms associated with BMC are either absent or minimal, it is usually discovered as an incidental finding during routine radiographic examination. Different appearances of BMC can be seen on panoramic radiographs. The exact orientation of the condyles can only be determined using 3D imaging techniques. BMC may be a more frequent condition in the Turkish population.

[Effect of adverse oral habits on the development of the dentomaxillary system]. / Influenta obiceiurilor vicioase asupra dezvoltarii aparatului dento-maxilar.

UNLABELLED: Main features of the dentomaxillary system (breathing, chewing, swallowing) are provided by the rhythmic movements of the mandible, tongue, lips, mimic muscles, learned during ontogenesis and coordinated neuromusculary and largely automated. AIM: The aim of our study was to prove the role of oral habits in the development of dentomaxillary anomalies. We made experimental investigations--model studies, fotostatic test for face and side face, radiological examinations, clinical general and ENT exam for accurately assess of the factors which contribute to the emergence and development of dentomaxillary anomalies. MATERIAL AND METHODS: The study group consisted of 175 children (94 girls and 81 boys) aged between 7 and 14 years. We made individual sheets for recording neuromuscular and oropharyngeal balance starting from a patient's overall clinical appearance. RESULTS: The diagnosis of most teenagers was first Angle's class of malocclusion with tongue thrusting and mouth breathing. Oral habits disrupt the muscular balance and bone growth producing changes in the dental arch and ocllusal characteristics. The high prevalence of dentomaxillary anomalies (52.57%) and obvious interrelationship with functional imbalances of the dentomaxillary system (62.82% of subjects examined) supports the implication of functional factors in those etiology. CONCLUSIONS: Suppression of vicious habits by methods of awareness, myogymnastic and functional reducing exercises are the first steps of early functional treatment for dentomaxillary anomalies.

Prevalence of Batrachochytrium dendrobatidis in Agalychnis moreletii (Hylidae) of El Salvador and association with larval jaw sheath depigmentation.

Amphibian populations around the world have been declining at an alarming rate due to factors such as habitat destruction, pollution, and infectious diseases. Between May and July 2008, we investigated a fungal pathogen in the critically endangered Morelet's treefrog (Agalychnis moreletii) at sites in El Salvador. Larvae were screened with a hand lens for indications of infection with Batrachochytrium dendrobatidis (Bd), a fungus that can cause lethal chytridiomycosis in amphibians. Subsets of inspected tadpoles were preserved for analysis by polymerase chain reaction to determine the effectiveness of hand lens screening for presence of Bd and to estimate infection prevalence at various sites. Because individuals with signs of infection were preferentially included, we used a novel method to generate unbiased estimates of infection prevalence from these biased samples. External mouthpart deformities, identified with a hand lens, successfully predicted Bd infection across a large spatial scale. Two of 13 sites sampled had high (≥ 89%) estimated prevalence, whereas little or no Bd was detected at the remaining sites. Although it appears that A. moreletii populations in this region are not suffering rapid declines due to Bd, further monitoring is required to determine the extent to which these populations are stably coexisting with the pathogen.