Testing the Accuracy of Pont's Index in Diagnosing Maxillary Transverse Discrepancy as Compared to the University of Pennsylvania CBCT Analysis.

Introduction: Assessment of maxillary transverse discrepancy requires an accurate tool in order to implement the appropriate treatment plan. Aim: To evaluate the accuracy of Pont's Index in confirming a transverse maxillary deficiency by comparing its results with the corresponding results yielded by the University of Pennsylvania CBCT analysis. Material and methods: The study was performed on dental casts and CBCT's of 60 randomly selected patients by adopting a cluster sampling method. The results of Pont's Index and University of Pennsylvania CBCT analysis were analyzed through McNemar's test using Excel Data Analysis, and the accuracy indicators for Pont's Index were computed using MedCalc Ltd. Results: Mc Nemar's test revealed a p-value of 0.85. The accuracy indicators of Pont's Index were: sensitivity: 69%; specificity: 16.6%; positive predictive value: 65%; negative predictive value: 18.75%; positive likelihood ratio: 0.83; negative likelihood ratio: 1.86; and accuracy: 53.28%. Conclusion: Due to the fact that CBCT is not used on a daily basis and Pont's Index has a relatively high sensitivity (69%) making it suitable to detect patients with a narrow maxilla, assessment of the maxillary deficiency on CBCT can be recommended for cases were the midpalatal suture maturation should be evaluated.

Quantitative and qualitative bone analysis in the maxillary lateral region.

PURPOSES: The present study was conducted to assess the amount of bone present between root apices and the maxillary sinus floor in the maxillary lateral region, to compare the evaluations on cone beam computed tomography (CBCT) and orthopantomography (OPG), and to evaluate the bone density of the same region using three-dimensional images on CBCT. METHODS: Fifty-one dental patients were recruited for the study. All subjects were partially edentulous. The distances from the maxillary premolars and molars apices to the maxillary sinus floor were assessed using CBCT and OPG. Color codes were assigned to the bone density of edentulous loci. Parametric and non-parametric tests were used for statistical analyses. A p value <0.05 was considered statistically significant. RESULTS: The maxillary first and second molars recorded the shortest mean distances to the sinus floor, in contrast to the maxillary first premolar. The bone density of the maxillary lateral area increased from the maxillary first premolar to the second molar. No statistical significant differences were found between the evaluated sites. CONCLUSIONS: Our results provide estimates of the minimal and maximal distances between teeth and sinus, as well as the average bone density in the maxillary lateral region. It is important that evaluation of a specific patient be performed during the preoperative planning of implants.

Mandibular second molar impaction treatment using skeletal anchorage.

The mandibular second molar impaction is a rare dental anomaly with a very challenging treatment. Although there are some treatment modalities, often the proper option is surgical exposure and orthodontically assisted eruption with a high rate of success depending on the appropriate appliance design, which assures a good control of the tooth movement with minimum side effects. A case report of a severe bilaterally impaction of the mandibular second molar in an adolescent female patient is presented, successfully treated using a miniplate, as skeletal anchorage.

Assessment of sagittal and vertical skeletal patterns in Romanian patients with obstructive sleep apnea.

OBJECTIVE: To establish the sagittal and vertical skeletal pattern of the Romanian patients with obstructive sleep apnea (OSA). PATIENTS AND METHODS: Lateral cephalograms of forty patients, divided in two groups, group I--twenty patients with OSA (15 males and five females) and aged between 34-76 years and group II (control group)--twenty patients with class II malocclusion (eight males and 12 females), aged between 22-40 years, were analyzed for linear and angular skeletal parameters. RESULTS: For group I--most often, the mandible was in posterior position, the mean value for SNB angle being 76.77 degrees; maxilla tended to be retruded, too. The maxillo-mandibular antero-posterior (AP) relationship was class II in 90% of the cases. A clockwise rotation of the mandible was registered in a vertical plane (mean value SN, ML: 29.82 degrees), the facial height ratio being in a normal range of values. There was a medium positive correlation between ANB angle and apnea/hypopnea index (AHI), while SNA showed a quadratic relationship with AHI. Using t-test, in order to compare the sagittal and vertical skeletal pattern of the two groups, it can be stated that there is a statistical significant difference for antero-posterior (AP) position of the mandible, for the group II mandible retrognathia being more pronounced than in group I. CONCLUSIONS: Romanian patients with OSA had a retrognathic sagittal pattern with a class II antero-posterior relationship. A statistical significant positive correlation between AHI and ANB suggests that the class II antero-posterior maxillomandibular relationship can predispose to OSA.