A comparative assessment of failures and periodontal health between 2 mandibular lingual retainers in orthodontic patients. A 2-year follow-up, single practice-based randomized trial.

INTRODUCTION The objective of this study was to compare the survival rates and periodontal health in patients with 3-strand round twisted (RT) vs 8-strand rectangular braided (RB) fixed retainers bonded to all 6 anterior teeth in the mandible. METHODS A total of 133 patients completing orthodontic treatment (median age, 24.6 years; 25th percentile, 17.2 years; 75th percentile, 32.4 years; minimum, 15.1 years; maximum, 49.8 years) were randomly allocated in a 1:1 ratio to receive either an RT or RB wire retainer. Inclusion criteria were all mandibular permanent incisors and canines present, no active caries, no restorations, no fractures on the mandibular incisors and canines, no periodontal disease. Patients with poor oral hygiene before debonding were excluded from the trial. The primary outcome was any first-time retainer failure. Secondary outcomes were periodontal index, bleeding on probing, plaque index, gingival index, and probing depth. Randomization was accomplished with random permuted blocks of size 4, 6, or 8 with allocation concealed in sequentially numbered, opaque, sealed envelopes. Blinding was not possible in this trial. Patients were evaluated at baseline, 3, 6, 12, 18, and 24 months after placement of the retainer. Retainer survival was assessed using Cox regression. Periodontal parameters were reported at each time point and generalised estimating equations were used to assess the effect of treatment, time, tooth and treatment X time interaction on the indices. RESULTS Baseline characteristics were similar between groups; in 1 patient, the intervention was discontinued. During 2-year follow-up 37 of 66 (56.1%, RT group) and 32 of 66 (48.5%, RB group) retainers failed at least once (log-rank test, P = 0.55). The adjusted hazard ratio was 0.69 (95% confidence interval, 0.42-1.12; P = 0.13). Neither age nor gender was a predictor of failure. All periodontal parameters (periodontal index, bleeding on probing, plaque index, gingival index, and pocket depth) were comparable between groups and remained relatively stable during follow-up. CONCLUSIONS The overall risk for first-time failure was high and amounted to 52.3% (56.1% in the RT group and 48.5% in the RB group). There was no difference in terms of survival or periodontal health between the examined retainers

Speech and Burden of Secondary Surgical Interventions Following One-Stage Repair of Unilateral Cleft Lip and Palate and Alveolar Bone Grafting Performed at Different Timings.

A comprehensive assessment of the treatment outcome in cleft lip and palate involves evaluating speech and the impact of speech-correcting surgical interventions. This retrospective case-control study compared the speech outcomes of 37 boys and 19 girls with unilateral cleft lip and palate (UCLP) who underwent one-stage cleft repair at an average age of 8.1 months and alveolar bone grafting either before or after 6 years of age, with a non-cleft control group at an average age of 10 years. Two experienced speech and language pathologists conducted perceptual speech assessments using a specialized test of 27 sentences designed for Polish-speaking cleft patients. The results revealed that 5.3% had severe hypernasality, 1.8% had severely impaired speech intelligibility, 10.7% exhibited retracted compensatory articulations, and 7.1% displayed facial grimacing. Mild hyponasality was observed in 12.3% of patients, while 16.1% exhibited voice abnormalities. Additionally, 12.5% of patients required orofacial fistula repairs, 3.6% underwent pharyngoplasties, and 28.6% received ear ventilation tube insertions. The study indicates that speech abnormalities in UCLP patients were relatively infrequent and not highly severe, suggesting that the primary UCLP repair method presented effectively reduced the need for further surgical interventions, leading to positive speech outcomes

Tear Film – Physiology and Disturbances in Various Diseases and Disorders

The tear film is a thin fluid layer covering the ocular surface. It is responsible for ocular surface comfort, mechanical, environmental and immune protection, epithelial health and it forms smooth refractive surface for vision. The traditional description of the tear film divides it into three layers: lipid, aqueous and mucin. The role of each layer depends on the composition of it. Tear production, evaporation, absorption and drainage concur to dynamic balance of the tear film and leads to its integrity and stability. Nonetheless, this stability can be disturb in tear film layers deficiencies, defective spreading of the tear film, in some general diseases and during application of some general and/or topical medications. Dry eye disease is the result of it. In this review not only physiology of the tear film is presented. Moreover, we would like to discuss the influence of various diseases and conditions on the tear film and contrarily, spotlight tear film disorders as a manifestation of those diseases

Self-esteem, coping styles, and quality of life in polish adolescents and young adults with unilateral cleft lip and palate.

Objectives : To evaluate self-esteem, coping styles, and health-related quality of life and their relationships in Polish adolescents and young adults with unilateral complete cleft lip and palate and related sex differences. Design and Participants : Self-report questionnaires measuring self-esteem (Multidimensional Self-Esteem Inventory), coping styles (Coping Inventory for Stressful Situations), and health-related quality of life (WHOQOL-BREF) were completed by 48 participants with cleft lip and palate (age, 16 to 23 years; 31 males, 17 females) and 48 controls without cleft lip and palate (age, 16 to 23 years; 28 males, 20 females) matched for age, place of residence, and socioeconomic status. Results : Regarding self-esteem, individuals with cleft lip and palate scored higher on body functioning (P < .01) and defensive self-enhancement (P < .05). Self-control showed an interaction effect: Females with cleft lip and palate scored higher than controls, but males did not differ between groups (P < .05). Males with cleft lip and palate scored lower than controls in personal power but higher in body functioning (P < .05); females showed no differences between groups. The groups did not differ with regard to coping styles or quality of life, but several correlations were found between self-esteem and coping styles, and quality of life (P < .01). Conclusions : Late adolescents and young adults with and without cleft lip and palate differed little in terms of psychological adjustment measures. The higher scores in defensive self-enhancement of individuals with cleft lip and palate suggest the need for instruments measuring social approval in psychosocial adjustment research involving this group

Alveolar Volume Following Different Timings of Secondary Bone Grafting in Patients with Unilateral Cleft Lip and Palate. A Pilot Study.

This study was intended to evaluate the relationship between secondary alveolar bone grafting (SABG) timing and the alveolar volume in patients with unilateral cleft lip and palate (UCLP). The material consisted of CTs of 35 patients (17 males, 18 females) with UCLP who underwent a one-stage primary cleft repair at a mean age of 8.4 months and SABG at different timings ranges of 1.8-18.8 years. The mean age at CT was 17.2 years. The relative coefficient (Ꞷ) which was independent from factors such as individual maxillary size, gender or age at the CT was introduced in order to compare volumes of the cleft-side in relation to the non-cleft-side alveolus. Pearson correlation coefficient r between Ꞷ coefficient and SABG timing was weak negative (r = -0.34, p = 0.045). The multiple regression analysis implied that the dependent variable-Ꞷ coefficient was associated with independent variables (cleft repair and SABG timings and age at CT) with r2 = 0.228. Only patient's age at SABG explained the dependent variable (p = 0.003). The study cautiously indicates a tendency to larger alveolar volume following earlier timing of SABG. Nevertheless, the further research on a larger group of patients should be performed before formulating any clinical indications

Maxillofacial morphology in post-pubertal patients with unilateral cleft lip and palate following early vs. late secondary alveolar bone grafting.

The study aimed at comparing maxillofacial morphology and burden of surgical treatment in post-pubertal patients with unilateral cleft lip and palate (UCLP) following early vs. late secondary alveolar bone grafting (SABG). In this retrospective study maxillofacial morphology was assessed on lateral cephalograms of skeletally matured patients with UCLP operated on consecutively in one center by the same method of one-stage primary cleft repair followed by SABG. Cephalometric analysis comprised 8 angular and 7 linear measurements. Maxillary growth restriction was evaluated by measuring SNA angle and Co-A and PNS-A distances. Five linear regression models with SNA, SNB, ANB, Co-A, and MP/SN as dependent variables and age at primary cleft repair, age at SABG, age at taking cephalogram, surgeon, and total number of surgical interventions as independent variables were also created. 135 patients were included in the study - 70 patients (47 males and 23 females) had early SABG (E-SABG group) and 65 patients (40 males and 25 females) had late SABG (L-SABG group). Mean age at bone grafting procedure was 2.7 years (range 1.5-5.9, SD 1.1) and 10.3 years (range 6.1-18.8, SD 3.2) in E-SABG and LSABG group respectively. The variables describing the degree of maxillary growth restriction - SNA, Co-A, and PNS-A - were comparable in both groups (p = 0.707, 0.116, and 0.932, respectively). Regression models demonstrated that independent variables were not associated with the values of SNA angle, SNB angle, ANB angle, MP/SN angle, and Co-A distance (p = 0.761, 0.088, 0.249, 0.380, and 0.363, respectively). The percentages of oronasal fistula repair, VPI repair, repeated SABG, upper lip correction, rhinoplasty, orthognathic surgery were 22.9, 7.1, 15.7, 24.3, 42.9, 2.9 in E-SABG group and 27.7, 7.7, 9.2, 36.9, 47.7, 3.1 in L-SABG group respectively. Mean number of all surgical interventions was 3.2 in E-SABG and 3.4 in L-SABG group, respectively (p = 0.271). Considering the comparable maxillofacial morphology and burden of surgical care in matured patients after early and late SABG, the choice of timing of bone grafting surgery could be left to the discretion of the surgeon

Transplant vs implant in a patient with agenesis of both maxillary lateral incisors: A 9-year follow-up.

INTRODUCTION Agenesis of a maxillary lateral incisor occurs in about 2% of the population. Treatment options should adapt to natural biologic changes in a lifelong perspective. METHODS AND RESULTS A young woman with bilateral agenesis of the maxillary lateral incisors was treated with transplantation of a developing maxillary third molar on one side and a dental implant on the contralateral side, after orthodontic space opening. The periodontal examination, including bacterial testing of the transplant, the implant, and the control central incisor, was performed 9 years after the treatment. A radiologic assessment was also performed. The transplanted tooth did not differ from a natural incisor, except for the pulp obliteration, and the total bacteria count was higher at the implant site. The periodontal tissues around the implant showed progressive signs of recession. CONCLUSIONS Both tooth transplants and dental implants for replacing missing maxillary incisors can be effective in the long term. This report supports natural tooth substitution rather than implant placement for dental agenesis in the anterior maxilla

Metaphor Comprehension and Interpretation in Cleft Palate Children Aged 6–9

The level of metaphor comprehension and interpretation was investigated in a sample of children with cleft palate (CP), aged 6;0-8;11, and healthy controls matched with age, sex, socioeconomic status, and IQ level. The Wechsler Intelligence Scale for Children - Revised (WISC-R) was used to evaluate the children’s cognitive functioning, and the metaphor tests from a modified version of the Right Hemisphere Language Battery - Polish version (RHLB-PL) were used to assess comprehension of figurative language. The CP and control groups differed significantly in Verbal IQ values and in performance in the Vocabulary test, Comprehension test, Picture Metaphor Explanation test, and Written Metaphor Explanation test. In both metaphor explanation tests, children with CP gave fewer responses than controls. The results suggest no differences between children with CP and controls in understanding figurative language, although they point to weaker performance in communicating responses and producing statements in the CP children group