Rare Disease: Lobar Holoprosencephaly With a Median Cleft Lip-Case Report.

Holoprosencephaly is a complex malformation of the brain associated with the median facial defects. Variability of the clinical picture is the characteristic of this anomaly. In most cases, the degree of severity of the facial anomaly correlates with the degree of damage to the brain. This article aims to present a rare case of child with a milder form of brain anomaly combined with a severe form of facial anomaly. The article also presents the application of a feeding stimulator to improve the child's quality of life. The anomaly was diagnosed by postnatal sonography of the brain, magnetic resonance imaging of the endocranium, and three-dimensional computed tomography of the craniofacial skeleton.

Presurgical orthodontic treatment of patients with complete bilateral cleft lip and palate.

INTRODUCTION: Cleft lips and palates are the most common congenital orofacial anomaly. This type of clefts is the most severe from the orthodontic-surgical therapy aspect. CASE REPORT: A female newborn with a complete cleft of the primary and the secondary palate was admitted to the clinic, where a multiple-role orthodontic device was specially designed and applied to primarily manage the closure of the existing cleft and help to improve the suckling ability of the baby. Besides the fact that it allows breastfeeding, it has a significant orthodontic effect, too. CONCLUSION: Specificity of this device is the lack of extraoral fixation. What can easily be observed is a progressive reduction of the cleft between the separated segments and the premaxilla retrusion. It, thus, allows the creation of much better conditions for further surgical management of the said defect.

[Analysis of soft tissue thickness in persons with malocclusions of Class II division 1 and Class II division 2].

INTRODUCTION: Different malocclusions indicate different thickness of facial soft tissue. OBJECTIVE: The aim of the study was to establish the differences in the thickness of facial soft tissue profile in persons with dentoskeletal Class II/1 and II/2 relationship. METHODS: In the study we used cephalometric rendgenograms profile analysis of 60 patients aged 12-18 years of the Dental Clinic in Nis who had not previously undergone orthodontical treatment. According to the dentoskeletal jaws relations the patients were divided into two groups with Class II division 1 and Class II class division 2. In all of them the standard dentoskeletal profile analysis by Steiner and soft tissue profile analysis by Burston was done. The obtained findings were statistically analyzed and the comparison between the studied groups was performed. RESULTS: The results indicated the following: in the patients with Class II/1 relationship there was a significantly thinner upper lip (t=5.741; p<0.0001), thinner upper lip sulcus (t=3.858; p<0.001) and significantly thinner lower lip (t=2.009; p<0.05) in relation to the patients with Class 11/2. Compensatory effect in the Class II/1 patients was more distinctive in females, as their soft tissue profiles were thicker. In Class 11/2 patients this relationship was in favor of males. CONCLUSION: The facial soft tissue profile indicated significant differences in the thickness dependant on the type of malocclusion and gender. Because of their great variability and a significant participation in the formation of the profile, while planning orthodontic therapy, it is necessary to pay them full attention, with obligatory analysis of the dentoskeletal profile.

[Orthodontic management of facial asymmetry caused by early condilar fracture in a growing patient].

INTRODUCTION: There are numerous possible causes of facial asymmetry. The facial asymmetry can be summarized and divided into three main categories: congenital, developmental, and acquired, resulting from disease or trauma. The most common cause of acquired facial asymmetry is condylar fracture. One of therapy concepts is the functional orthodontic treatment. CASE OUTLINE: The case presented is a 10.4 years old girl whose chief complaint was a progressive facial asymmetry. The patient's medical history established a facial trauma at the age of 2 years. The treatment plan consisted of functional jaw orthopedic appliance therapy (modification of activator) and fixed appliances on the upper and lower jaw. CONCLUSION: Timely diagnosis of condylar fracture, which can lead to facial asymmetry, can be managed by comprehensive orthodontic treatment.

[Soft tissue thickness of face profile conditioning by dento-skeletal anomalies].

INTRODUCTION: Orthodontic treatment of dento-skeletal anomalies is generally based on the correction of teeth and jaws relationship, while it is expected that soft facial tissue spontaneously adapts to therapeutically achieved relationship and to accompany hard tissue changes. OBJECTIVE: To establish facial soft tissue thickness conditioning by the presence of dento-skeletal anomalies. METHODS: The study was performed at the Dental Clinic of Nis, and involved the analysis of cephalometric rendgenograms in 121 patients, aged 12-18 years, with no previous orthodontical treatment. According to dento-skeletal relationship between teeth and jaws the patients were divided into four groups; class I (control group), class II of division 1, class II of division 2 and class III. The standard analysis of dento-skeletal profile was done according to Steinerand soft tissue profile according to Burstone was done in all. RESULTS: The patients of class II/1 had a significantly thinner upper lip (t = 2.650; p < 0.05) and thinner upper lip sulcus (t = 1.999; p < 0.05). The patients of class II/2 had a significantly thicker upper lip (t = 2.912; p < 0.01), while those of class III had a significantly thinner lower lip (t = 3.900; p < 0.001). CONCLUSION: The thickness of facial soft tissue considerably influences facial profile appearance in persons with a dento-skeletal anomaly. Not only do soft tissues adapt to the existing jaws relationship, but can also camouflage present anomalies.

[Application of palatal RB obturator in babies with isolated palatal cleft].

BACKGROUND: Isolated cleft of secondary palate has a specific clinical picture due to a wide communication between the mouth and nose cavity. As a consequence of that, babies born with this malformation are often subject to infections of the upper bronchial tubes, middle ear, speech disorders, and certainly the most difficult existential problem they face at the very beginning of their lives, the impossibility of suckling (breast feeding). Such babies have to be fed with gastric probe. The difficulties in their nutrition have often been described in literature, yet a singular attitude toward early orthodontic therapy has not been adopted still. The aim of the paper was to describe a design and application of obturator immediately after the birth of a baby with isolated palatal cleft, and the role in feeding. CASE REPORT: We presented a female neonate, born on 27th December 2007, with a wide fissure in the shape of the letter U over the entire secondary palate. The baby was referred to the Stomatology Clinic due to nutrition impossibility. To avoid feeding with gastric probe, the formation of RB obturator was performed (artificial palate). Hereby, the procedure of obturator making with an explanation of its function is presented. CONCLUSION: The application of RB obturator and the necessary education of parents have a major role in shortening the time of breast feeding and increasing the amount of food intake and, thus, for the normal growth and development of newborn infants with isolated palate cleft.

[The influence of size and structure of metal orthodontic bracket base on bond strength on tooth enamel].

INTRODUCTION: The factors which may influence the bond strength of the applied orthodontic brackets on the tooth surface are the size and structure of the bracket base. OBJECTIVE: The aim of the paper was to investigate the influence of size and shape of different types of brackets on bond strength on the enamel and analyze the remaining quality of adhesive material on the tooth surface after debonding of orthodontic brackets (adhesive remnant index - ARI). METHODS: In this study, three types of metal brackets of different sizes and shapes of Dentaurum manufacturer were used (Utratrimm, Equilibrium 2, Discovery, Dentaurum, Inspringen, Germany). The brackets were applied onto the middle part of the anatomic crowns of buccal surfaces of 30 premolars extracted for orthodontic reasons. In addition, the pre-treatment of teeth by 37% orthophosphoric acid and adhesive material System1+ (Dentaurum, Germany) were used. RESULTS: The mean value of the bonded brackets bond strength of Discovery type after debonding was 8.67 +/- 0.32 MPa, while the value of the bonded brackets bond strength of Equilibrium 2 type amounted to 8.62 +/- 0.22 MPa. The value of the bonded brackets bond strength of Ultratrimm type after debonding was 8.22 +/- 0.49 MPa. There were no statistical differences in the values of bond strength regarding all three groups of the investigated orthodontic brackets (F = 4.56; p < 0.05). CONCLUSION: The base size and design of metal orthodontic brackets did not play a significant role in bond strength, while the values of ARI index were identical in all three investigated groups.