Optimization of the clinical diagnostic examination algorithm of patients with a cross bite complicated by cranio-mandibular dysfunction and postural disorder.

OBJECTIVE: Aim: Optimization of the clinical and diagnostic examination algorithm of patients with cross bite, aggravated by cranio-mandibular dysfunction and postural disorders. PATIENTS AND METHODS: Materials and Methods: 22 patients aged 13-16 years with cross bite with displacement of the lower jaw were examined. The first group consisted of 15 people with a right-sided displacement of the lower jaw, the second - 7 patients with a left-sided one. The condition of the musculoskeletal system was assessed by the position of the head, shoulders, shoulder blades, back (curvature of the spine), legs, chest shape, and abdomen. To determine the state of stability of the body in space, posturological and kinesiological tests were performed. The location of TMJ elements was evaluated on orthopantomograms. Statistical processing of the material was carried out with the help of the "Excel" license package. RESULTS: Results: 63.64% of patients with a cross bite have disorders of the musculoskeletal system: scoliotic posture - 40.91% and scoliosis - 22.73%. TMJ dysfunction was detected in all examined patients. It was established that the anatomical and topographic features of the joint elements depend on the side of the lower jaw displacement. CONCLUSION: Conclusions: The functional imbalance of all structural elements of the musculoskeletal system and the cranio-mandibular complex determined during the research proved the need to optimize the clinical-diagnostic algorithm: consultation of a traumatologist-orthopedic doctor, X-ray examination of TMJ, conducting posturological tests.

Analysis of maxillary asymmetry before and after treatment of functional posterior cross-bite: a retrospective study using 3D imaging system and deviation analysis.

BACKGROUND: Previous evidence would suggest that subjects affected by functional posterior cross-bite (FPXB) present an asymmetric morphology of the maxilla. However, no evidence is available concerning the morphology (symmetry/asymmetry) of the maxilla after treatment of FPXB. This study aimed to investigate the volumetric and morphological changes of the palate in FPXB subjects treated with maxillary expansion and to compare these data with an untreated control group. The study sample included 20 FPXB subjects (mean age 8.1 ± 0.9 years) who underwent maxillary expansion (MEG group) and 21 FPXB subjects (mean age 7.7 ± 1.2 years) as controls (CG group). Digital models were recorded at T0 (first observation) and T1 (12-18 months after first observation) and analyzed to assess palatal volume and symmetry. Deviation analysis and percentage matching calculation were also performed between original and mirrored palatal models for each patient. All data were statistically analyzed for intra-timing, inter-timing and inter-groups assessments. RESULTS: At T0, the cross-bite side (CBS) was significantly smaller than non-cross-bite side (non-CBS) in both groups (p < 0.05). At T1, the CBS/non-CBS difference reduced significantly in the MEG group (p < 0.05) while slightly worsened in the CG, however without statistical significance (p > 0.05). The matching percentage of the palatal models improved significantly at T1 in the MEG group (T0 = 74.02% ± 9.8; T1 = 89.95% ± 7.12) (p < 0.05) while no significant differences were recorded in the CG (T0 = 76.36 ± 8.64; 72.18% ± 9.65) (p > 0.05). LIMITATIONS: The small sample size and the retrospective design of the study represent two limitations that should be overcome with further clinical trials. CONCLUSIONS: Subjects with FPXB present an asymmetric development of the maxillary vault that improves after reestablishment of normal occlusion following maxillary expansion.

Cross-Bite and Oral-Health-Related Quality of Life (OHRQoL) in Preadolescents Aged 11 to 14 Years Old: A Pilot Case-Control Study.

INTRODUCTION: Malocclusions have a negative impact on oral-health-related quality of life (OHRQoL). Posterior cross-bite is one of the most prevalent malocclusions in the preadolescent population. This study investigated the influence of posterior cross-bites (unilateral or bilateral) on OHRQoL in an 11- to 14-year-old population. MATERIALS AND METHODS: A pilot case-control study was carried out at the Dental Clinic of the University of Salamanca between 2021 and 2023. A consecutive sample of 120 preadolescent patients aged 11 to 14 years old was recruited. Three groups were analyzed: a control group (no posterior cross-bite) (n = 40), a group with unilateral posterior cross-bite (n = 40), and a group with bilateral posterior cross-bite (n = 40). To analyze the OHRQoL, the Spanish version of the Child Perception Questionnaire (CPQ-Esp11-14) was used. RESULTS: The mean age of the sample was 12.2 years old (±0.96 years). The group of patients with a bilateral posterior cross-bite was shown to have higher scores in all dimensions of the CPQ-Esp11-14, as well as a higher total score. Sex only influenced the oral symptom dimension of the CPQ-Esp11-14 questionnaire; in this dimension, the girls described a greater impact. Age did not influence OHRQoL. CONCLUSION: The presence of a posterior cross-bite had a negative impact on OHRQoL in the preadolescent population that was studied.

Stability of maxillary expansion osteotomy using patient-specific fixation implants without necessitating removable appliances: a retrospective analysis.

OBJECTIVE: This study aimed to evaluate the long-term stability of surgical maxillary expansion using patient-specific fixation implants (PSFIs) without intraoral retention. MATERIALS AND METHODS: Fifteen patients who had undergone segmented Le Fort I osteotomy and PSFIs with available preoperative (t0) early (t1) and 1-year follow-up computed tomography (CT) scans (t2) were evaluated. The early and 1-year 3D models were superimposed to transfer the bony landmarks; the distances between each pair of landmarks at the different time points were then measured. The distances between the canines and second molars were also measured directly on the CT scans. RESULTS: The achieved maxillary expansions ranged from a median of 4.39 (2.00-6.27) mm at the greater palatine foramina to a median of 2.14 (1.56-2 > 83) mm at the canine level of the palatal bone. One year postoperatively, the changes in skeletal diameters ranged from a median of - 0.53 (- 1.65 to 0.41) mm at the greater palatine foramina (p = 0.12) to 0.17 (- 0.09 to 0.32) mm at the canine level of the palatal bone (p = 0.56). Changes in dental arch diameters ranged from a median of - 0.6 (- 2 to 0.00) mm between the second molars to - 1.3 (- 1.8 to - 0.25) mm between the canines (P < 0.05). CONCLUSION: This study showed the stability of maxillary expansion osteotomy using PSFIs, even without postoperative intraoral retention. CLINICAL RELEVANCE: PSFIs are a reliable method for the surgical treatment of transverse maxillary discrepancy. PFSIs are easy-to-use and improve surgical accuracy.

Comportamiento de la maloclusión funcional e interferencias oclusales en niños con dentición mixta

Introducción: las interferencias oclusales no controladas precozmente pueden producir desviación de la mandíbula en sentido anteroposterior o transversal. El manejo de las mordidas cruzadas se debe iniciar en el momento del diagnóstico, preferiblemente en edades tempranas, con el fin de tratarlas en el nivel primario de prevención. Objetivo: determinar el comportamiento de la maloclusión funcional causada por interferencias oclusales en niños con dentición mixta de la Escuela Primaria Mártires del Corynthia, entre octubre de 2019 y junio de 2021. Materiales y métodos: se realizó un estudio observacional descriptivo de corte transversal en la Escuela Primaria Mártires del Corynthia, del Área de Salud José Jacinto Milanés, del municipio de Matanzas, entre octubre de 2019 y junio de 2021. El universo estuvo conformado por 66 niños. Se utilizó una planilla de recolección de datos y se solicitó el consentimiento informado a los tutores de los niños. Resultados: las edades donde los niños presentaron mayor afectación fueron de 6 a 7 años y de 8 a 9 años, ambos rangos con un 10,6 %. El 27,3 % presentó interferencias oclusales y mordida cruzada posterior unilateral. El 48,5 % fue del sexo femenino y el 30,3 % tenían edades de 6 a 7 años. El 71,2 % eran simétricos y presentaron mordida cruzada posterior unilateral. Los simétricos y con línea media coincidente representaron un 36,4 %. Conclusiones: la maloclusión funcional más frecuente en niños con dentición mixta fue la mordida cruzada posterior unilateral, que se relacionó de manera directa con las interferencias oclusales. Las asimetrías faciales y la línea media desviada estuvieron asociadas a dicha maloclusión.

Introduction: early uncontrolled occlusal interferences can produce anterior-posterior jaw deflection. Management of cross-bites should be initiated at the time of diagnosis, preferably at early ages, in order to treat them at the primary level of prevention. Objective: to determine the behavior of functional malocclusion caused by occlusal interferences in children with mixed dentition from the Martires del Corynthia primary school between October 2019 and June 2021. Materials and methods: a cross-sectional, observational, descriptive study was carried out at the Martires del Corynthia Primary School, of the Jose Jacinto Milanes Health Area, Matanzas municipality, between October 2019 and June 2021. The universe consisted of 66 children. A data collection form was used and informed consent was requested from the children's guardians. Results: the ages where the children presented more affectation were from 6 to 7 years and from 8 to 9 years, both ranges with 10.6%. 27.3% presented occlusal interferences and posterior unilateral cross-bite. 48.5% were female and 30.3% were 6 to 7 years old. 71.2% were symmetrical and presented unilateral posterior cross-bite. Symmetric patients and with a coincident midline represented 36.4%. Conclusions: the most frequent functional malocclusion in children with mixed dentition was the unilateral posterior cross-bite, which was related to occlusal interferences in a direct way. Facial asymmetries and a deviated midline were associated with the before mentioned malocclusion.

Clear aligner treatment for a four-year-old patient with anterior cross-bite and facial asymmetry: A case report.

BACKGROUND: Clear aligners have been widely used to treat malocclusions from crowding, extraction cases to orthodontic-orthognathic cases, and practitioners are exploring the border of it. For the first time, clear aligners were used to early intervene anterior cross-bite and facial asymmetry. CASE SUMMARY: This case report described a four-year-old child presented with anterior cross-bite and facial asymmetry associated with functional mandibular shift, who had undergone a failed treatment with conventional appliances. The total treatment time was 18 weeks, and a stable outcome was obtained. CONCLUSION: The increasing need in early treatment highlights the need for clinicians to thoroughly investigate for the patient regarding clinical manifestation as well as patient compliance. We hope that our case will be contemplated by clinicians when seeking for treatment alternatives.

[Osteoplastic operations in the anterior part of the mandible for correction of malocclusion]. / Kostno-plasticheskie operatsii v perednem otdele nizhnei chelyusti pri korrektsii anomalii prikusa.

Correction of disorders during transformation into one of the most difficult tasks, both in orthodontics and in maxillofacial (orthognathic) surgery. This article presents two clinical cases of median osteotomy/ostectomy. The stages of operations are described. Surgical technique of transversal correction by osteotomy/ ostectomy is presented. Operation is combined with bilateral retromolar osteotomy. Three dimensional fragments moving helps to change lower jaw shape. Indications for this surgical manipulation: one or two side cross-bite, discrepancies between size of teeth and length of alveolar bone (lower macrognathia, microdentia, extra-teeth, huge diastema), asymmetry of mandible.

Relationship between Breastfeeding and Malocclusion: A Systematic Review of the Literature.

BACKGROUND: The purpose of this systematic review was to analyze the available literature about the influence of breastfeeding in primary and mixed dentition on different types of malocclusions. METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines were used to perform the present review. The following electronic databases were searched: Pubmed, Evidence-Based Medicine Reviews (EBMR), Embase, Cochrane Library, Medline, Web of Science and Ovid. RESULTS: A primary research found a total of 279 articles. Two more papers were also considered from the gray literature. Two hundred sixty-three articles were excluded as they were deemed irrelevant on the basis of: duplicates, title, abstract, methods and/or irrelevant contents. Eighteen papers were selected and included in the qualitative analysis. CONCLUSIONS: breastfeeding is a positive factor that seems to reduce the incidence of posterior crossbite, skeletal class II and distoclusion in primary and mixed dentition. A sort of positive relationship between months of breastfeeding and risk reduction seems to exist. More longitudinal research is needed to avoid bias in the results, with data collected prospectively on the months of exclusive breastfeeding, by means of specific questionnaires and successive clinical evaluation of the occlusal condition at the primary dentition, mixed dentition and permanent dentition stages.

Frecuencia de maloclusiones sagitales y transversales en estudiantes de 12 a 18 años de Asunción / Frequency of sagittal and transverse malocclusions in students from 12 to 18 years of age in Asunción

La maloclusión es uno de los trastornos bucodentales más comunes. Reconocer su importancia lleva a la necesidad de realizar estudios epidemiológicos cuyos resultados orienten el desarrollo de programas para su prevención, intercepción y tratamiento. El objetivo de la presente investigación fue determinar la frecuencia de maloclusión en sentido sagital y transversal en estudiantes de nivel secundario de la ciudad de Asunción. Se realizó un estudio descriptivo de corte transversal. La población de estudio estuvo conformada por los alumnos de 12 a 18 años inscriptos en colegios públicos y privados de la ciudad de Asunción durante el 2017. Los datos recabados de la inspección bucodental fueron anotados en fichas clínicas yanalizadas con el programa Epi-Info TM. El número de participantes fue de 1047 estudiantes que cumplieron con los criterios de inclusión. El 52% de los participantes fueron de sexo femenino y el 48% del sexo masculino. La frecuencia de maloclusión en sentido sagital fue del 98%, y en sentido transversal del 27,6%.Entre las maloclusiones en sentido sagital la más frecuente fue la Clase I (53%). La frecuencia de mordida cruzada fue del 23%, de los cuales, el 43% presentó mordida cruzada anterior y el 57% mordida cruzada posterior. De los que presentaron mordida cruzada posterior, el 61% fue unilateral y el 39% bilateral. Se observa una importante frecuencia de maloclusiones en la población de estudio indicativa de la necesidad de establecer acciones para su diagnóstico y tratamiento oportunos

Malocclusion is one of the most common oral disorders. Recognizing its importance leads to the need for epidemiological studies whose results guide the development of programs for its prevention, interception and treatment. The objective of the present investigation was to determine the frequency of malocclusion in the sagittal and transverse direction in secondary school students from the city of Asunción. A descriptive cross-sectional study was carried out. The study population was made up of students from 12 to 18 years old enrolled in public and private schools in the city of Asunción during 2017. The data collected from the oral inspection was recorded in clinical records and analyzed with the Epi-Info program. TM. The number of participants was 1047 students who met the inclusion criteria. Fifty two percent of the participants were female and 48% male. The frequency of malocclusion in the sagittal direction was 98%, and in the transverse direction it was 27.6%.Among sagittal malocclusions, the most frequent was Class I (53%). The frequency of crossbite was 23%, of which 43% presented an anterior crossbite and 57% a posterior crossbite. Of those who presented posterior crossbite, 61% were unilateral and 39% bilateral. An important frequency of malocclusions is observed in the study population indicative of the need of establishing actions for its timely diagnosis and treatment

Gingival Recession in a Case of Anterior Crossbite with Angle Class I Relationship.

Anterior crossbite is one of the most common orthodontic problems encountered during the dental eruption. Usually, the anomaly becomes evident during mixed dentition, as a result of the disharmony between the dental, skeletal and functional components of the orthognathic system. As complications, the presence of the anterior dental cross bite can lead to the thinning of the vestibular alveolar process of the lower incisors and gingival recession. Periodontal changes could recede spontaneously if orthodontic treatment is applied early, in the presence of good oral hygiene. In this case, gingival recession decreased, but not completely receded after orthodontic treatment, although the patient had a good oral hygiene.

Is the Quad Helix more efficient to correct mandibular asymmetry before age 7? A retrospective comparative study.

INTRODUCTION: Unilateral posterior crossbite (UPCB), often from dysfunctional and para-functional causes, leads to positional mandibular asymmetries that can develop at a very young age into skeletal mandibular deviation; hence the interest of early maxillary expansion. The purpose of this retrospective study was to compare the impact of maxillary expansion by Quad Helix (QH) on mandibular skeletal asymmetry correction before and after 7 years of age. MATERIALS AND METHODS: All children with UPCB and skeletal mandibular asymmetry, who were treated by QH in the orthodontic department of Montpellier between February 2017 and August 2018 and had a radiography file at baseline (T0) and 12 months later (T1) were retrospectively included. The patients were divided into two groups according to age: under 7 years of age with QH adjusted on second primary molars (early group G1) and over up to 13 years old with QH adjusted on first permanent molars (late group G2). The differences between the right and left sides of the mandible in corpus length ΔL (main eligibility criterion) and ramus height ΔH (secondary criterion) were compared between groups. X2 test, Fisher's exact test and Wilcoxon rank-sum tests were used for baseline comparisons. A multifactorial analysis allowing adjustment on possible confounding factors was used with R software. RESULTS: Out of 67 patients files only 40 were completed and analysed: 13 in G1 and 27 in G2. These groups were comparable at baseline except for the age parameter. Taking into account the initial severity of asymmetry, the analysis of covariance showed a significant intergroup difference with higher correction in the early group of the corpus asymmetry (+1.0; P=0.008). On the contrary, no significant differences were observed between the groups in the ramus asymmetry correction. CONCLUSIONS: Within the limits of this retrospective study, the early unilateral posterior occlusion correction by QH can better reduce both positional and contour mandibular asymmetries in patients under 7 years of age.

Forensic Identification Through Tooth Discoloration And Alignment.

BACKGROUND: Due to poor oral hygiene and use of tobacco, dental discolorations are present in some people and may indicate presence of toxic substances in food or body, while some have anatomical faulty alignment of teeth. The objective of the study was to know the frequency of these discolorations and faulty dental alignment in the target population so that a forensic tool could be developed. METHODS: A cross sectional descriptive study was done in the Dentistry Department of Ayub Teaching Hospital Abbottabad during the month of October 2019, on routine patients visiting the department, using non-probability convenience sampling. A Performa was made to be filled by dentists examining their patients using the standard dentition chart to locate teeth; notation chart was used for recording observations. The preliminaries along with subvariables were recorded in the Performa for each of 101 patients observed; data were analyzed by SPSS 20 for descriptive statistics. RESULTS: A cross sectional descriptive study was done in the Dentistry Department of Ayub Teaching Hospital Abbottabad during the month of October 2019, on routine patients visiting the department, using non-probability convenience sampling. A Performa was made to be filled by dentists examining their patients using the standard dentition chart to locate teeth; notation chart was used for recording observations. The preliminaries along with subvariables were recorded in the Performa for each of 101 patients observed; data were analyzed by SPSS 20 for descriptive statistics. CONCLUSIONS: Dental discolorations and faulty alignment of teeth can be utilized as useful tools in exclusionary method of identification which can be used in living and dead for investigation of identification. It was also observed that there is need to emphasize on community dental hygiene in our hospitals.

Hyrax versus transverse sagittal maxillary expander: An assessment of arch changes on dental casts. A retrospective study.

OBJECTIVE: The aim of this study was to compare arch changes before and after maxillary expansion with Transverse Maxillary Sagittal Expander (TSME) and Hyrax Palatal Expander (HPE), in growing patients with diagnosis of maxillary hypoplasia. MATERIALS AND METHODS: The sample consisted of 40 patients' records (20 males 20 females mean age 9.2 ±â€¯2.6 years) were selected from the archive of the Orthodontic Department of the University of Milan, Italy. Patients were randomly divided in two groups: patients in group 1 were treated with HPE as they presented only transverse deficiency of the maxilla and in group 2 were treated with TSME. Plaster models have been measured with a Verniere caliper to evaluate the differences in maxillary expansion of the two devices. Measurements were performed on casts poured from impressions taken before appliance bonding (T0), immediately after appliance debonding (T1) and at 6 months follow-up (T2). The variations in the following distances have been considered: inter-molar distance, inter-canine distance, palatal depth, palatal length and arch circumference. Shapiro-Wilk test was performed to assess normality distribution. ANOVA for repeated measures with multiple paired t-test for pairwise comparisons and its non-parametric equivalent Friedman's test with multiple Wilcoxon tests for pairwise comparisons were performed to evaluate changes in time of each variable in each group. Between groups comparisons were performed for each variable at each observing time using independent t-test or Mann-Whitney test. Significance level was set at p < 0,05. RESULTS: Both the Friedman test and the rm-ANOVA test and their respective post-hoc show that within both groups the respective variables have a statistically significant increase between T0 and T1 (p < 0,05) and a slight decrease between T1 and T2 (p < 0,05) that is not clinically relevant remaining always T2 greater than T0 in a statistically and clinically relevant way (p < 0,05). The analysis between the differences of the measurements at different timing measured by the Mann-Whitney test shows that for all the variables there is no statistically significant difference between the 2 devices (p < 0,05), except for the perimeter of the arch and the length of the palate; in this case it appeared that the TSME is better statistically (p < 0,05). CONCLUSIONS: The study has shown that RPE and TSME can achieve similar results in transversal palatal expansion. Differences have been found in the palatal length and in the arch perimeter where TSME seems to be more efficient.

Plagiocephaly after Neonatal Developmental Dysplasia of the Hip at School Age.

Developmental dysplasia of the hip (DDH) may require early abduction treatment with infants sleeping on their back for the first few months of life. As sleeping on back is known to cause deformational plagiocephaly, we assessed school age children treated for dislocation or subluxation of the hip-joint in infancy. Plagiocephaly was analyzed by using cephalic index (CI) and oblique cranial length ratio (OCLR) as anthropometric measurements from 2D digital vertex view photographs. Six of the 58 (10.3%) DDH children and only one of the 62 (1.6%) control children had plagiocephaly (p = 0.041). Furthermore, cross bite was found in 14 (24.1%) of the DDH children and in 7 (10.3%) of the control children. Developmental dysplasia of the hip in infancy was associated with cranial asymmetries and malocclusions at school age. Preventive measures should be implemented.

Malocclusion Generates Anxiety-Like Behavior Through a Putative Lateral Habenula-Mesencephalic Trigeminal Nucleus Pathway.

Malocclusion is an important risk factor for temporomandibular disorder (TMD), a series of disorders characterized by dysfunction in the orofacial region involving the temporomandibular joint (TMJ) and jaw muscles. We recently showed that experimental unilateral anterior crossbite (UAC) produced masseter hyperactivity through a circuit involving the periodontal proprioception, trigeminal mesencephalic nucleus (Vme), and trigeminal motor nucleus (Vmo). Anxiety is a common complication in patients with TMD. The lateral habenula (LHb) is involved in emotional modulation and has direct projections to the Vme. Therefore, the present research examined whether UAC facilitates excitatory input from the LHb to the Vme and, subsequently, anxiety-like behaviors in rats. The LHb activation was evaluated by the electrophysiological recording, assessment of vesicular glutamate transporter-2 (VGLUT2) mRNA expression, and measurement of anxiety-like behaviors. The effects of LHb activity on Vme were evaluated by electrophysiological recording from Vme neurons and local changes in VGLUT2 protein density. UAC produced anxiety in modeled rats and increased neuronal activity in the LHb. VGLUT2 mRNA expression was also increased in the LHb. Further, VGLUT2-positive boutons were observed in close apposite upon parvalbumin (PV)-labeled Vme neurons. VGLUT2 protein expression was also increased in the Vme. Significantly, injection of VGLUT2-targeted shRNA into the LHb reduced the expression of VGLUT2 protein in the Vme, attenuated UAC-associated anxiety-like behaviors, and attenuated electrophysiological changes in the Vme neurons. In conclusion, we show that UAC activates the LHb neurons as well as the periodontal proprioceptive pathway to provide excitatory input to the Vme and produce anxiety in rats. These findings provide a rationale for suppressing activity of the LHb to attenuate both the physical and psychological effects of TMD.

Alternative of timely treatment of unilateral posterior cross-bite in primary and mixed early dentition. Case series / Tratamiento de la mordida cruzada posterior unilateral en dentición primaria y mixta temprana: Serie de casos

Introduction Unilateral posterior cross bites (UPCB) are one of the most frequent types of malocclusions found in both primary and early mixed dentitions. Due to its multifactorial origin, its treatment is focused not only on the correction of malocclusion, but also on long-term functional and occlusal stability that reduces alterations in the growth and development of the stomatognathic system at an early age. The objective of this series of cases is to present two alternatives of timely treatment for this malocclusion. Description of the cases The first case is an 8-year-old patient with left UPCB who receives controlled palatal expansion treatment with a Hyrax screw with acrylic splint, in which favorable results are obtained in a short time and with long-term stability. The second case, a 4-year-old patient with a right UPCB is presented with Planas' direct tracks, achieving a desired mandibular postural change. Discussion The treatment alternatives presented, several authors have reported a series of benefits obtained from the type of intervention that not only achieve the correction of malocclusion, but also achieve the improvement of structures that make up the craniofacial complex, within which highlights the desired long-term stability. These benefits are obtained through the selected treatment alternative, according to the diagnosis and clinical characteristics presented in each patient and justifies the decision to perform an early intervention especially in this type of malocclusion. Conclusion The early treatment of the unilateral posterior crossbite should be selected according to the type of dentition and the patient's need, which favors the proper growth and development of the stomatognathic system.

Introducción: Las mordidas cruzadas posteriores unilaterales (MCPU) constituyen uno de los tipos de maloclusiones más frecuentes encontrados tanto en dentición primaria como en dentición mixta temprana. Debido a su origen multifactorial su tratamiento se encuentra enfocado no solo en la corrección de la maloclusión, sino en obtener una estabilidad oclusal y funcional a largo plazo que disminuya las alteraciones en el crecimiento y desarrollo del sistema estomatognático en edades tempranas. El objetivo de esta serie de casos es presentar dos alternativas de tratamiento oportuno para esta maloclusión. Descripción de los casos: El primer caso es un paciente de 8 años de edad con MCPU izquierda quien recibe tratamiento de expansión palatina controlada con un tornillo tipo Hyrax con férula acrílica, en el cual se obtienen resultados favorables en corto tiempo y con estabilidad a largo plazo. El segundo caso es una paciente de 4 años de edad con MCPU derecha a la cual se le realizan Pistas Directas Planas logrando un cambio postural mandibular deseado. Discusión: En las alternativas de tratamiento presentadas, varios autores han reportado una serie de beneficios obtenidos a partir del tipo de intervención que no solo logran la corrección de la maloclusión, sino que a su vez alcanzan la mejoría de estructuras que componen el complejo craneofacial, dentro de los cuales se destaca la estabilidad a largo plazo deseada. Estos beneficios se obtienen a través de la alternativa de tratamiento seleccionada, según el diagnóstico y las características clínicas presentadas en cada paciente y justifica la decisión de realizar una intervención temprana especialmente en este tipo de maloclusión. Conclusión: El tratamiento temprano de la mordida cruzada posterior unilateral debe ser seleccionado según el tipo de dentición y necesidad del paciente, lo que favorece el adecuado crecimiento y desarrollo del sistema estomatognático.

X-ray analysis of the mandible in patients with crossbite and mandibular displacement.

OBJECTIVE: Introduction: Significant morphological and aesthetic disabilities of the face, observed during the formation of a cross bite in combination with the displacement of the mandible, prompt the doctors - orthodontists to study carefully the morphogenesis of this anomaly. The aim: Analysis of the mandible structure in patients with a cross bite and lower jaw displac ement based on the analysis of orthopantomograms. PATIENTS AND METHODS: Materials and methods: For this study, the orthodontic examination of 20 patients, 18-22 years old, was made they complained about facial asymmetry, displacement of the lower jaw and a violation of the cosmetic centers. A diagnosis of the buccal cross bite form in combination with the displacement of the lower jaw was put according to the Uzhumeckiene classification. The methods used do not contradict the conclusions of the ethics commission. RESULTS: Results: The analysis of the obtained data indicates that the angle of the mandible has more variable (p ≤ 0,05). Go120,8º and 125,1º. Significant of the angles of the canines according to the basal arch of the lower jaw of 102,8º and 105,4º (p≤0.01) and the angle of inclination of the first permanent molars of 89,6º and 91,4º, respectively (p≤0.01). CONCLUSION: Conclusions: The obtained data indicate that there is no clear correlation between changes in the studied parameters and the localization of anomalies (left-sided, right-sided). Indicators of the angle of the lower jaw are significantly altered from the opposite direction of its displacement. The change in the angles of inclination of the canine and the first permanent molars, as occlusive compensation, is determined reliably. The more the angle of the mandible changes, the more the lower jaw moves in the transversal direction. Perhaps this is due to the asymmetric tone of masticatory muscles.

Forensic Odontology And Dental Status Of Adult Patients Attending The Out Patient Dental Department Of A Tertiary Care Hospital.

BACKGROUND: Pakistan is one of the countries where practice of forensic odontology and its record keeping is poor due to which we face difficulty in identification of individuals in disasters and other medicolegal problems. The objectives of this study were to know the status of forensic odontology and to determine the dental status of adult patients attending dental outpatient department of Ayub Teaching Hospital Abbottabad. METHODS: A cross-sectional Study was carried out from 1st September to 30th September 2018 in the Department of Dentistry, Ayub Teaching Hospital, Abbottabad. A questionnaire was designed including preliminary record, standard dental chart, notation chart and other variables. A sample of 96 patients having all permanent teeth were included and examined. Non-probability convenience sampling was used. Data was collected and analyzed on SPSS. RESULTS: The sample consisted of 59.4% males and 40.6% females. Mean number of present teeth with sound status was 24±5. Faulty development was found in 14.6% of the patients. Faulty alignment, black/brown stains and attrition were observed in 38.5%, 86.5% and 25% of the patients respectively. No statistically significant association was found (p >0.05) between gender and faulty development, faulty alignment, staining or attrition. Forensic odontological practice and its record are not maintained in the hospital.. CONCLUSIONS: High proportion the patients have black/brown stains. Faulty alignment is more as compared to faulty development. In our study we observed that no odonatological record is maintained in our hospital.

Use of digital scan data for evaluation of edentulous ridge relationship: A case report for removable prosthesis with unilateral cross bite / 대한치과보철학회지

After the teeth were extracted, maxillary and mandibular alveolar ridges show the opposite resorption pattern and as a result, the mandibular arch is enlarged than maxillary arch relatively. In this situation, we should evaluate both alveolar ridge relationship and arrange the artificial teeth properly for stability of removable prosthesis. This case is a 77 years old male patient who wishes to make removable prosthesis and has atrophic alveolar ridge. By use of model scanner and CAD software, the angle between interalveolar crest line and occlusal plane was easily measured. Depending on the measurement, the artificial teeth are arranged in unilateral cross bite and after completion, patient was satisfied with the denture which showed proper stability, retention, support.