Morphological evaluation of the nasopalatine canal using cone beam computed tomography and its clinical implications for orthodontic miniscrew insertion.

BACKGROUND: The morphology of the nasopalatine canal is crucial in the planning of prosthetic restorations in the anterior region of the maxilla, as well as in the placement of orthodontic mini-implants. OBJECTIVES: The aim of this study was to assess the morphology of the nasopalatine canal using cone beam computed tomography (CBCT) scans of patients from the University Dental Clinic in Krakow, Poland, to define the position of the canal in relation to common sites of palatal median microimplant placement, and to investigate potential correlations between the anatomy of the canal and age and gender of the patients. MATERIAL AND METHODS: A total of 120 CBCT images were used to assess the anatomy of the nasopalatine canal in 3 planes of space. The bone thickness anterior to the nasopalatine canal and the distance between the distal margin of Stenson's foramen and the predicted midpalatal microimplant position were also measured. RESULTS: The most frequently observed canal type in the coronal plane was the Y-shaped canal, which was present in 60.8% of patients. The nasopalatine canal was classified as cone-shaped in 31.7% of the scans, cylindrical in 28.3%, hourglass-shaped in 27.5%, and banana-shaped in 12.5%. The mean length of the nasopalatine canal was 11.58 mm. The mean width of the canal was 2.89 mm at the nasal fossa level, 1.94 mm in the middle, and 5.09 mm at the palatal level. The mean bone thickness anterior to the nasopalatine canal was 9.07 mm at the level of the nasal opening, 6.84 mm at the level of the oral opening, and 7.32 mm in the middle. The mean distance between the distal margin of Stenson's foramen and the predicted midpalatal microimplant position varied from 0 to 11.94 mm, with a mean of 2.49 mm. CONCLUSIONS: Given the variety of nasopalatine canal forms and dimensions, detailed analysis of CBCT scans is essential prior to the placement of implants and microimplants.

Initial assessment of the psycho-emotional state of patients with temporomandibular disorders: A pilot study.

BACKGROUND: Temporomandibular disorders (TMD) are a group of conditions that affect the function of the masticatory muscles, temporomandibular joints and surrounding structures. OBJECTIVES: The objective of the preliminary investigation was to develop an initial questionnaire for emotional assessment, pre-designed for TMD patients, and provide guidance for further management through referral to psychological and/or psychiatric counseling. Additionally, we aimed to compare the results of tests carried out in TMD patients with those of healthy subjects. MATERIAL AND METHODS: The study involved 260 patients who reported for dental treatment. The TMD study group (Group 1, n = 130) consisted of patients diagnosed with TMD, and the control group (Group 2, n = 130) had TMD diagnostically excluded. The questionnaire included 30 questions about the emotional state of the patients in the past 4 weeks. RESULTS: The mean scores were 37.715 points for Group 1 (median (Me) = 35.5, standard deviation (SD) = 12.58 and 24.938 points for Group 2 (Me = 24, SD = 7.95) (p < 0.001). CONCLUSIONS: The research suggests that the developed questionnaire is useful for an initial assessment of the psycho-emotional state of TMD patients. Furthermore, the results emphasize a greater need for psychological counseling in TMD patients compared to their healthy counterparts.

Evaluation of Palatal Bone Thickness at the Implantation Areas of Two Popular Bone-Anchored Distalizers-A Cone Beam Computed Tomography Retrospective Study.

Since class II malocclusion and lack of space within the dental arch due to early loss of deciduous molars is a common orthodontic problem in the Polish population, bone-anchored distalizers are becoming more and more popular. The aim of the present study was to evaluate palatal soft and hard tissue thickness using cone beam computed tomography (CBCT) at the area of micro-implant placement of two appliances for maxillary first molar distalization: Beneslider and TopJet distalizer. The study data were 100 consecutively selected CBCT images (53 of men and 47 of women). Measurements of bone and mucosa thickness were performed at six locations in the palate and tested according to their correlation with sex and age. The biggest bone and mucosa thickness were recorded in the insertion site of the TopJet miniscrew. Bone thickness in all points of paramedian insertion was significantly greater in males and the mean difference was approximately 1-1.8 mm. Age correlates significantly (p < 0.05) and positively (r > 0) with the thickness of the mucosa at all points: the older the patient, the thicker the mucosa at each measurement point. Anatomical diversity of the hard palate in the population involves the need to perform bone and mucosa thickness measurements before palatal micro-implant placement.

What is the safest method of orthodontic debonding - a systematic review of the literature.

The objective of this study was to review the current knowledge based on in vitro and in vivo studies, that evaluated the enamel damage connected with removal of metal and ceramic orthodontic brackets taking into account different debonding methods. Brackets fracture was also assessed. The protocol for this study was constructed according to the PRISMA statement. The literature review was performed in MEDLINE via PubMed, Cochrane and Scopus databases in May 2021. The searching was repeated in Journal of Stomatology, Orthodontic Forum and grey literature was screened using Google Scholar. Out of eligible studies 207 were screened by title and abstract, 85 subjected to full-text analysis and 30 were qualified for the research. The prevalence of enamel fracture ranged from 0 to 94.4%. The results of our review do not allow to identify the manual method of debonding that minimizes the risk of enamel damage. Thermal method and laser irradiation reduce the risk of enamel fracture.

Safe Debonding of Fixed Appliances: A Comparison of Traditional Techniques and LODI Devices on Different Bracket Types in Terms of Enamel Cracks, Site of Bond Failure, and Bracket Reusability.

The objective of this study was to compare the effects of the debonding of three different bracket types by means of three popular debonding methods. A total of 180 human third molars was divided into six groups, consisting of 20 teeth each. Three bracket types were bonded to the enamel (metal brackets with an integral base and a foil mesh base, and ceramic brackets) and three methods of bracket debonding were employed (bracket removal pliers, Weingart pliers, and Lift-Off Debonding Instrument). The samples were examined with scanning electron microscopy to assess the number of enamel cracks, measure the area of adhesive remaining on the enamel, and calculate the adhesive remnant index (ARI). There were no statistically significant differences between the groups in terms of the number of enamel cracks after bracket debonding. The amount of adhesive remaining on the teeth after the brackets were removed was significantly different between the groups. LODI and Weingart pliers are considered to be the safest methods of debonding brackets with an integral base, while LODI is the best tool for brackets with foil mesh. Bracket removal pliers are considered to be the preferred method for ceramic bracket debonding.