Genetic and phenotypic evaluation of the Class III dentofacial deformity: comparisons of three populations

The etiology of skeletal Class III malocclusion is multifactorial, complex and likely results from mutations in numerous genes. In this study, we sought to understand the phenotype/genotype correlation of the Class III trait in 3 specific populations, a Colombian cohort, Amelogenesis Imperfecta (AI) cohort and a Caucasian cohort. The phenotype was evaluated using multiple statistical comparisons of 3 populations followed by genetic analysis of 2 populations. Phenotypic analysis indicated a difference between the z-scores of 10 cephalometric variables among the 3 groups. Pedigree analysis by inspection supported an autosomal dominant mode of inheritance with incomplete penetrance. A Genome-wide scan and linkage analysis of members in 2 cohorts revealed 3 regions suggestive of linkage for the Colombian cohort but was inconclusive for the AI cohort. Our phenotypic and genetic analysis highlights that each group is unique, and that differences between them could be due to specific craniofacial morphologic features

Ortodontska terapija i temporomandibularni poremećaji

Orthodontic treatment has been variously cited both as a protective and harmful factor in temporomandibular disorders (TMD) etiology. Therefore, it is important to understand associations between different malocclusions, orthodontic treatment, and signs and symptoms of temporomandibular disorders (TMD). From the presented literature the suggestion that orthodontic treatment leads to TMD appears to be ill-founded. Clinical studies suggest that orthodontic treatment has little role to play in worsening or precipitating TMD when treated patients are compared with untreated individuals, with or without malocclusion, or when different types of orthodontic treatment are compared. A considerable reduction in signs and symptoms of TMD between the teenage period and young adulthood has been shown in some recent longitudinal studies.Ortodontska terapija često se navodi kao protektivni ili pak otežavajući čimbenik u etiologiji temporomandibularnih poremećaja. Zbog toga je vrlo važno razumjeti vezu između različitih ortodontskih anomalija i ortodontske terapije te znakova i simptoma temporomandibularnih poremećaja. Iz prezentirane literature proizlazi da je pretpostavka po kojoj ortodontska terapija dovodi do TMD-a neutemeljena. Klinička istraživanja pokazuju da ortodontska terapija igra malu ulogu u pogoršanju TMD-a kada se uspoređuju tretirani i netretirani ispitanici, oni s malokluzijama i bez njih ili kada se uspoređuju različite vrste ortodontske terapije. U nedavno objavljenim longitudinalnim istraživanjima navodi se znatno smanjenje simptoma i znakova TMD-a između tinejdžerske i rane odrasle dobi

A multilevel analysis of craniofacial growth in subjects with untreated Class III malocclusion

ObjectiveTo analyse the craniofacial growth of a long‐term semi‐longitudinal sample of Caucasian subjects with untreated Class III malocclusion.Setting and sample populationA total of 144 Caucasian subjects (of North American and Italian origin) with untreated Class III malocclusion. Materials and methodsSubjects aged 2 years and 9 months up to 21 years and 7 months were selected. A multilevel model was used to calculate growth curves for ten variables for both each individual subject and for the whole sample.ResultsThere was a statistically significant increase for total mandibular length (Co‐Gn. T2‐T1 = 8.4 mm), midfacial length (Co‐A. T2‐T1 = 3.4 mm) and lower anterior facial height (ANS‐Me. T2‐T1 = 3.8 mm). The multilevel analysis showed two points of acceleration of growth (about 3‐5 years of age and 11‐15 years of age) for seven out of ten variables. For Co‐Gn and Co‐A variables, males presented points of maximum growth delayed by 1 year in comparison with females, with a greater duration (1 year longer) and a greater total growth of about 5 mm. Active mandibular growth continued for a long time after the pubertal spurt: increases in mandibular length ended at about 17 years of age in females and at 21 years and 7 months in males.ConclusionsUntreated Class III malocclusion showed a specific growth curve, especially for the mandible, whose excesses added up over time. In males, the amounts of mandibular and midfacial growth during the whole observation time were greater and lasted longer than in females.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154906/1/ocr12356.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154906/2/ocr12356_am.pd

Determination of DUSP6 gene mutation and effect on craniofacial morphology among Malaysian Malay with class III malocclusion patients attending at Hospital Universiti Sains Malaysia

Class III malocclusion is a dominant inherited, slowly progressive dento-skeletal disharmony. It is characterized by over growth of mandible, stunted growth of maxilla, or a combination of both. The etiology of class III malocclusion and the role of genes in this phenotype remain indistinct. Recently, dual specificity protein phosphatases 6 (DUSP6) gene mutations have been reported to cause autosomal dominant form of class III malocclusion. The main objective of this study was to determine the DUSP6 gene mutation in three generations of Malaysian Malay subjects having class III malocclusion and to conduct their cephalometric analyses. Genetic analyses of DUSP6 gene were carried out in 30 subjects by selecting three individuals representing three generations, respectively, from ten Malaysian Malay families having Class III malocclusion and 30 healthy controls. Cephalometric radiographs were obtained only from class III malocclusion subjects and predetermined cephalometric linear and angular measurements were performed using Romexis software. t-test and analysis of variance (ANOVA) were used to analyse the cephalometric measurements from both mutation and non-mutation groups of class III malocclusion subjects. In the current study, a heterozygous missense mutation c.1094C>T (p. Thr 365 Ile) was identified in DUSP6 gene in three members of one family with class III malocclusion, whereas no mutation was found in the control group. t-tests showed significant differences in angular measurements Co-Gn-B andSN-MP variables in mutation group compared to the non-mutation group. Moreover, ANOVA showed no significant differences for all variables except in yen angle of 1st vs 2nd generation. In conclusion, current study successfully identified a missense mutation in DUSP6 gene among one Malaysian Malay family affected by class III malocclusion and cephalometrically found mandible was more prognathic from cranial base in mutation group compared to non-mutation group. The outcome of this study broadened the mutation spectrum of class III malocclusion and the importance of DUSP6 gene in craniofacial morphology

Effectiveness of two retainer types in dental and occlusal stability

ABSTRACT: With the purpose of providing additional details on the selection of retainer type, this study sought to assess the stability of dental and occlusal position during retention phase using two types of retainers in individuals with no remnant growth who completed orthodontic treatment at the Universidad de Antioquia School of Dentistry, Universidad CES, and in private practice in Medellín in 2011. Methods: this was a controlled clinical study with a sample of 47 patients aged 15 to 45 years, randomly selected into two treatment groups: 22 patients with Essix retainer and 25 patients with Hawley plate in both arches. Cephalometric X-rays and study models were taken on all patients at baseline and six months later with monthly clinical evaluations. Results: the clinical and radiographic results showed significant differences in some tooth rotations in terms of upper intercanine distance and molar relationship, but overall there were no statistically significant differences between both retainers in the three space planes. Conclusions: there were no statistically significant differences between the retainers in a six-month evaluation period. Keywords: orthodontic retainers, dental occlusion, dental arch.RESUMEN: En el propósito de ofrecer mayor evidencia sobre la selección del tipo de retenedor, este estudio pretendió evaluar la estabilidad de la posición dentaria y oclusal durante el tratamiento de retención con dos tipos de retenedores en individuos sin crecimiento remanente que finalizaron tratamiento ortodóncico en la Facultad de Odontología de la Universidad de Antioquia, de la Universidad CES y en la práctica privada en Medellín en el año 2011. Métodos: se hizo un ensayo clínico controlado con una muestra de 47 pacientes con edades entre 15 y 45 años, divididos aleatoriamente en dos grupos de tratamiento: 22 pacientes con retenedor tipo Essix y 25 pacientes con placa de Hawley en ambos arcos. A todos los pacientes se les tomó radiografía cefálica lateral y modelos de estudio, al inicio y seis meses después, y se hizo evaluación clínica mensual. Resultados: los resultados clínicos y radiográficos mostraron diferencias significativas en algunas rotaciones dentarias, en la distancia intercanina superior y en la relación molar, pero en general no se encontraron diferencias estadísticamente significativas entre los dos retenedores en los tres planos del espacio. Conclusiones: no se encontraron diferencias estadísticamente significativas entre los retenedores en una evaluación a seis meses. Palabras clave: retenedores ortodóncicos, oclusión dental, arco dental

Mordida aberta anterior na dentição decídua e mista

Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas MonizA mordida aberta anterior (MAA) é considerada como uma das más oclusões mais difíceis de serem tratadas com sucesso e estabilidade. A mordida aberta anterior desenvolve-se como consequência de inúmeros fatores etiológicos como: hábitos parfuncionais, interposição lingual, dificuldades respiratórias e padrão de crescimento vertical da face. Pode ser classificada como: mordida aberta dentária, dentoalveolar e esquelética. A terapêutica interceptiva da mordida aberta anterior pode abranger a simples remoção do hábito parafuncional, a terapia miofuncional e o uso de aparelhos interceptivos. A conduta escolhida dependerá basicamente da etiologia e da idade do paciente. São diversos os aparelhos que auxiliam na intercepção da mordida aberta anterior sendo o mais indicado por esta revisão de literatura, a grelha lingual que pode ser incluída em vários aparelhos interceptivos. O objetivo deste trabalho consistiu em realizar um levantamento bibliográfico nas bases de dados Pubmed, Scielo e Bireme (BVS) relatando quais as diferentes etiologias da mordida aberta anterior em crianças até 12 anos de idade, relatando também as medidas cefalométricas que podem auxiliar no reconhecimento da mordida aberta anterior e demonstrando o recurso terapêutico interceptivo da mordida aberta anterior e quais os aparelhos mais indicados para esta modalidade clínica.The anterior open bite (AOB) is considered one of the most difficult malocclusions to be treated with success and stability. The anterior open bite develops from various etiological factors as: parafunctional habits, lingual interposition, breathing difficulties and vertical growth pattern of the face. It can be classified as: dental, dentoalveolar and skeletal open bite. The interceptive treatment of anterior open bite may cover the simple removal of parafunctional habit, miofunctional therapy and the use of interceptive appliances. The choice will depend basically of the etiology and the age of the patient. Several are the devices that help in the anterior open bite interception and the most indicated in this literature review was the lingual grid that can be included in various interceptives appliances. The aim of this work was to do a bibliographic survey in Pubmed, Scielo and Bireme (BVS) databases which are the differents etiologies of anterior open bite in children up to 12 years old, also reporting cephalometric variables that can help in the diagnosis of anterior open bite and demonstrating interceptive treatment of anterior open bite and the most suitable appliances for this clinical modality

Influência do nível socioeconômico na autopercepção da necessidade do tratamento ortodôntico: uma revisão sistemática e metanálise

The orthodontic treatment need is widely discussed in the literature. Normative criteria used by professionals in this assessment tend to overestimate the treatment need. It is necessary to make the normative criteria compatible with the perceived need by the patient. The orthodontic treatment need doesn’t necessarily reflect on the uptake of orthodontic treatment, especially when the socioeconomic context is taken into consideration. The lower uptake for treatment in individuals with low socioeconomic status may result from lower perceptions of the treatment need or greater satisfaction with your appearance or even unavailability of orthodontic treatment in public services. Against, the aim of this study was to assess, through a systematic review, the influence of the socioeconomic status on self-perception of the orthodontic treatment need. A systematic search was conducted in seven databases: Pubmed, Web of Science, Scopus, Cochrane Library, Brazilian Library of Dentistry (BBO), Lilacs and Google Scholar beyond manual search and grey literature. Two independent researches selected the studies, extracted data and assessed the methodological quality of the included studies through the Joanna Briggs Institute Scale - Checklist for Analytical Cross Sectional Studies. After applying the eligibility criteria, 14 cross sectional studies were included int this review. The extracted data were analyzed through prevalence meta-analysis and qualitative synthesis. For the meta-analysis performed was used STATA software (Stata Corp. 2009. Stata Statistical Software: version 11, College Station, TX, EUA). Certainty of evidence was assessed using GRADE (Grading of Recommendations, Assessment, Development and Evaluation) for narrative synthesis. Methodological problems were found in all studies included. The prevalence of self-perception of the orthodontic treatment need was 35% (95% CI: 0.25-0.46) The socioeconomic status had little or no influence on self-perception of the orthodontic treatment need, but the certainty of the evidence was very low. The high socioeconomic level didn´t influence the self-perception of the orthodontic treatment need.A necessidade do tratamento ortodôntico é amplamente discutida na literatura. Critérios normativos utilizados por profissionais nessa avaliação tendem a superestimar a necessidade de tratamento. É necessário tornar os critérios normativos compatíveis com as necessidades percebidas pelo paciente. A necessidade do tratamento ortodôntico não reflete necessariamente a busca por tratamento, principalmente quando o contexto socioeconômico é levado em consideração. Diante do exposto, o objetivo do presente trabalho foi avaliar, por meio de uma revisão sistemática e metanálise a influência do nível socioeconômico na autopercepção da necessidade do tratamento ortodôntico. Foi realizada uma busca em seis bases de dados: Pubmed, Web of Science, Scopus, Cochrane Library, Biblioteca Brasileira de Odontologia (BBO) e Lilacs além de uma busca manual e na literatura cinzenta. Dois pesquisadores independentes selecionaram os estudos, extraíram os dados e avaliaram a qualidade metodológica dos estudos incluídos através de uma escala específica para estudos transversais do Instituto Joana Briggs. Foram realizadas duas metanálises de prevalência: uma de autopercepção da necessidade do tratamento e outra de maloclusão. A certeza da evidência foi avaliada de forma narrativa através do GRADE (Grading of Recommendations, Assessment, Development and Evaluation). Problemas metodológicos foram destacados em todos os estudos incluídos. A prevalência de autopercepção da necessidade de tratamento ortodôntico foi de 35% (95% IC: 0.25-0.46) e a de maloclusão foi de 36% (95%IC: O nível socioeconômico teve pouca ou nenhuma influência na autopercepção da necessidade do tratamento ortodôntico, porém a certeza da evidência foi muito baixa.CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superio

Suomalaisten lasten kallon, kasvojen ja leukojen kasvun ja kehityksen pitkittäistutkimus

The amount, velocity, timing, and sensation of growth of the craniofacial complex are of interest to clinicians, researchers, and individuals alike, with different populations around the world exhibiting variation. The aims of this study were: to generate population-standard values for craniofacial growth and development in Finns from 4 to 25 years of age as well as to investigate population-specific features regarding growth timing and velocity. This work was based on the prospective Helsinki Longitudinal Growth Study conducted between 1967 and 1994. At the end of the study, when the subjects were examined as a group for the last time, 190 participants, young adults at the time, had remained in the study. Most of them were then aged 24 to 25, the youngest ones being 19 to 20 years of age. After the exclusion of children treated for orthodontics, 105 subjects, 50 boys and 55 girls, formed the final study group of untreated healthy individuals. The present study is based on 551 cephalograms taken from these individuals between the ages 4 to 25 years. This equated to 3 to 8 lateral skull radiographs of each child, with an average 5.2 radiographs per child. These radiographs were analyzed with a computer program specially developed for this study. Tables, growth curves, growth velocity curves, and change curves were created for reference values of Finnish children to describe their size, shape, dimensions, and respective changes. Findings are that Finnish children have a strong closing growth pattern and square facial form when compared to those of other populations, notably British children. Sexual dimorphism appeared in the findings, with males showing more pronounced closing in their pattern of growth and a more distinct mandibular pubertal growth spurt than females. Late or residual growth between ages 20 and 25 years occurred in many variables, especially in males. It is hoped that these data will be useful to clinicians, researchers, and individuals as a reference sample for Finnish normal craniofacial growth.Joukkoa terveitä suomalaislapsia tutkittiin syntymästä saakka noin 25 vuoden ikään asti Helsingin yliopiston hammaslääketieteen laitoksella vuosien 1967 ja 1994 välisenä aikana. Lapsia tutkittiin syntymästä lähtien aluksi puolivuosittain ja vuodesta 1979 lähtien vuosittain. Jo tutkimuskohteina olleiden lasten äideille tehtiin perusteellinen suun alueen tarkastus. Lasten kohdalla tutkimuksen kohteina olivat kallon ja kasvojen kasvu ja kehitys, hampaiston kehitys, karieksen ilmaantuvuus, syljen koostumus, hampaiden mineraalikoostumus, hampaiden kiinnityskudoksien terveys, leukanivelten toiminta, purentavoimat sekä hampaiden kuluminen. Samalla seurattiin somaattista kasvua. Tämä väitöskirjatyö perustuu yllä mainittuun Helsingin pitkittäiseen kasvututkimukseen, ja siinä lasten kallon, kasvojen ja leukojen kasvuun ja kehitykseen. Tutkimuksen päämäärinä oli luoda väestökohtaiset viitearvot suomalaisten lasten kraniofakiaaliselle kasvulle 4-vuotiaista 25-vuotiaiksi sekä tutkia, millaisia väestöspesifisiä piirteitä liittyy kasvun määrään, ajoitukseen ja nopeuteen. Nämä seikat kiinnostavat kliinikoita, tutkijoita sekä yksilöitä eri populaatioissa ympäri maailmaa, koska niissä esiintyy eroja. Säännöllisesti seurantakäynneille osallistuneita lapsia oli tutkimuksen lopussa jäljellä 190. Useimmat heistä olivat tutkimuksen päättyessä 24‒25-vuotiaita ja nuorimmat 19‒20-vuotiaita. Tämän tutkimuksen yksilöt muodostuivat niistä 105 terveestä lapsesta (50 poikaa ja 55 tyttöä), jotka jäivät jäljelle, kun oikomishoitoa saaneet lapset suljettiin pois tästä ryhmästä tietäen, että oikomishoito vaikuttaa kasvuun. Tutkimus on röntgenologinen perustuen sivuttaisessa projektiossa otettuihin kallokuviin, joita otettiin seuranta-aikana kolmesta kahdeksaan kappaletta kustakin yksilöstä. Kallokuvat analysoitiin ja mittaustuloksien perusteella laadittiin taulukoita, kasvukäyriä ja kasvunopeuskäyriä. Nämä muodostavat suomalaislasten viitearvot kuvaamaan kraniofakiaalialueen eri osien kokoa, muotoa ja pituuksia ja näissä havaittavia kasvumuutoksia eri ikävaiheissa. Tärkein havainto on, että suomalaisilla lapsilla on kraniofakiaalisessa kasvussa voimakkaasti sulkeutuva kasvumalli ja kulmikkaampi kasvojen muoto kuin esimerkiksi brittilapsilla. Sukupuoliero näkyi tuloksissa selkeänä siten, että pojilla oli sulkeutuvampi kasvumalli ja selvempi murrosiän kasvupyrähdys alaleuassa kuin tytöillä. Monissa mitoissa oli etenkin pojilla myöhäiskasvua ikävuosien 20 ja 25 välillä. Saatuja viitearvoja voidaan hyödyntää normaalin ja normaalista poikkeavan kasvun tutkimuksessa ja seurannassa, oikomishoidon suunnittelussa tai kraniofakiaalisten oireyhtymien erityishoidoissa