Orthodontics Surgical Assistance (Piezosurgery®): Experimental Evidence According to Clinical Results

Orthodontic tooth movement (OTM) is based on intermitted or continuous forces applied to teeth, changing the mechanical loading of the system and arousing a cellular response that leads to bone adaptation. The traditional orthodontic movement causes a remodeling of the alveolar bone and changes in the periodontal structures that lead to tooth movement. The use of a piezoelectric instrument in orthodontic surgery has already shown great advantages. The purpose of this study is to rank the behavior of inflammatory mediators in accelerating orthodontic tooth movement. Ten patients with malocclusion underwent orthodontic surgical treatment, which included a first stage of surgically guided orthodontic movement (monocortical tooth dislocation and ligament distraction, MTDLD) to accelerate orthodontic movements. In all cases, corticotomy was performed by Piezosurgery. Bone and dental biopsy was executed to evaluate changes in the cytokines IL-1beta, TNF-alpha and IL-2 in different time intervals (1, 2, 7, 14 and 28 days). The molecular mediators are IL-1 beta, TNF-alpha and IL-2. Immediately after the surgical procedure there was a mild expression of the three molecular markers, while the assertion of IL-1 beta and TNF-alpha reached the maximum value after 24 h and 48 h, indicating a strong activation of the treated tissues. The Piezosurgery® surgical technique induces an evident stress in short times, within 24–48 h from the treatment, but it decreases significantly during the follow-up. © 2022 by the authors. Licensee MDPI, Basel, Switzerland

The Prevalence Of Hypodontia In Children With Cleft And Nonrelated Controls

The aim of this study was to compare the occurrence of hypodontia, dental age, and asymmetric dental development in children with cleft with a non- sibling control group. The study sample consisted of 30 children with cleft (aged 7.2 to 17.1 years) and 60 controls without cleft (aged between 7 and 18.8 years). Hypodontia, dental age, and asymmetric dental development were assessed on panoramic radiographs of the children with cleft and the control children without cleft. The cleft (p.001) group showed a significantly higher frequency of hypodontia and a significantly higher occurrence (cleft p.01) of asymmetric dental development, compared with the control group. Only a small, but insignificant delay in dental development could be found in the cleft group. The cleft subjects showed a significantly higher occurrence of hypodontia and asymmetric dental development than the non-cleft control group. This may suggest a genetic component for the occurrence of hypodontia and asymmetric dental development

THE PREVALENCE OF HYPODONTIA IN CHILDREN WITH CLEFT AND NONRELATED CONTROLS

The aim of this study was to compare the occurrence of hypodontia, dental age, and asymmetric dental development in children with cleft with a nonsibling control group. The study sample consisted of 30 children with cleft (aged 7.2 to 17.1 years) and 60 controls without cleft (aged between 7 and 18.8 years). Hypodontia, dental age, and asymmetric dental development were assessed on panoramic radiographs of the children with cleft and the control children without cleft. The cleft (p.001) group showed a significantly higher frequency of hypodontia and a significantly higher occurrence (cleft p.01) of asymmetric dental development, compared with the control group. Only a small, but insignificant delay in dental development could be found in the cleft group. The cleft subjects showed a significantly higher occurrence of hypodontia and asymmetric dental development than the non-cleft control group. This may suggest a genetic component for the occurrence of hypodontia and asymmetric dental development

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Rezumat Osteodistracåia bimaxilarã -o metodã eficientã pentru corectarea deficitului transversal. Prezentare de caz Dizarmoniile dento-maxilare apar la pacienåii adulåi datoritã discrepanåei dintre dimensiunea dinåilor aei a osului subjacent fiind mai frecvent întâlnite în cazurile cu hipodezvoltare transversalã maxilarã si mandibularã. Tratamentul ortodontic clasic utilizeazã ca metodã de creare de spaåiu extracåiile dentare sau expansiunea arcadelor, care însã au dezavantaje estetice majore pentru pacienåi. Expansiunea palatinã rapidã asistatã chirurgical împreunã cu osteodistracåia medianã mandibularã reprezintã o metodã de avangardã în tratamentul ortodontic aei chirurgical al pacienåilor cu deficite transversale severe de dezvoltare al ambelor maxilare. Expansiunea obåinutã prin aceastã metodã este mai stabilã aei spaåiul generat este mult mai mare în comparaåie cu metoda convenåionalã ortodonticã. Cazul de faåã ilustreazã avantajele acestei proceduri chirurgicale, care asociatã cu un tratament ortodontic produce modificãri morfologice faciale majore aei ocluzale aei totodatã permite o aliniere dentarã armonioasã. Cuvinte cheie: expansiune palatinã rapidã asistatã chirurgical, osteodistracåie mandibularã medianã, deficit transversal bimaxilar, tratament ortodontic Abstract Severe dental crowding in adult patients is one of the features of disparity between the size of the teeth and the jaws. It is most frequently found in cases with a transverse hypoplasia of the maxilla and the mandible. The traditional orthodontic approach is extraction of teeth or arch expansion, both of them with major esthetic disadvantages for the patients. The surgically assisted maxillary expansion (SARME) and the mandibular midsymphyseal distraction osteogenesis procedures open new horizons for the orthodontists and maxillofacial surgeons in the effort to solve the esthetic demands of the patients with dental crowding and severe transversal discrepancy. The amount of surgical expansion is of higher magnitude and stability then the one achieved in orthodontic cases. The case presented here highlights the importance of the surgical procedure followed by the orthodontic therapy due to the enhancement in occlusion, dental alignment and facial morphology

Correlations between Stress, Anxiety and Coping Mechanisms in Orthodontic Patients

[no abstract available

Eagle Syndrome Surgical Treatment With Piezosurgery

Introduction: Eagle syndrome (ES) is an uncommon complication of styloid process elongation with stylohyoideal complex symptomatic calcification. It is an uncommon condition (4% of the population) that is symptomatic in only 4% of the cases. Eagle syndrome is usually an acquired condition that can be related to tonsillectomy or to a neck trauma. A type of ES is the styloidcarotid syndrome, a consequence of the irritation of pericarotid sympathetic fibers and compression on the carotid artery. Clinical manifestations are found most frequently after head turning and neck compression. Although conservative treat- ment (analgesics, anticonvulsants, antidepressants, local infiltration with steroids, or anesthetic agents) have been used, surgical treatment is often the only effective treatment in symptomatic cases. Materials and Methods: We present the case of a 55-year-old patient, successfully treated under endotracheal anesthesia. The cranial portion of the calcified styloid process was shortened through an external approach, using a piezoelectric cutting device (Piezosurgery Medical II; Mectron Medical Technology, Carasco, Italy) with MT1- 10 insert, pump level 4, vibration level 7. Results: No major postoperative complications such as nerve damage, hematoma, or wound dehiscence occurred. After 6 months, the patient was completely recovered. Two years after the surgery, the patient did not refer any symptoms related to ES. Conclusions: The transcervical surgical approach in patients with ES seems to be safe and effective, despite the remarkable risk for transient marginal mandibular nerve palsy. This risk can be decreased by the use of the piezoelectric device for its distinctive characteristics — such as precision, selective cut action, and bloodless cut

The "Anatomical Balance Correction" for Secondary Cleft Lip Nasal Deformities

Secondary cleft lip nasal deformities corrective procedures are still a major concern for the maxillofacial surgeons.Objective: The aim of this study was twofold, to present a new "anatomical balance" correction for the correction of secondary cleft nose deformities and to evaluate it through a long-term follow-up study.Participants: One hundred twenty patients with cleft lip and palate and secondary nasal tip deformities were recruited for this study. The age ranged from 22 to 39 years (mean: 25.9 years old).Main Outcome Measurements: The stability of the functional aesthetic result has been evaluated by means of an aesthetic protocol completed with a set of 10 photographs.Results: The 3 years follow-up study of 120 patients supports the results of the newly introduced technique that guarantees a better shaping of the nasal tip without further need of another correction procedure.Conclusions: Results indicate that the treatment of secondary cleft nose defects with the "anatomical balance" method gives an improvement of the tip projection by means of various techniques, thus avoiding further surgical procedures

[New morpho-functional rehabilitation methods in cleft lip and palate]

The interdisciplinary, complex therapeutic protocol of the cleft lip and palate patients, applied in the Clinic of Cranio-Maxillo-Facial Surgery of "I. Ha?ieganu" University of Medicine and Pharmacy Cluj-Napoca, involves the morphologic reconstruction as well as the functional rehabilitation. Functional rehabilitation is the aspect, which gives the esthetics, social and familial integration of the patient, offering good quality of life