Rapid Maxillary Expansion Treatment in Patients with Cleft Lip and Palate: A Survey on Clinical Experience in the European Cleft Centers

Cleft lip and palate patients require complex interdisciplinary treatment, including maxillary expansion and secondary alveolar bone grafting. However, the evidence on these treatment procedures and outcomes is lacking. Therefore, this study aimed to survey the subjective observations of European maxillofacial surgeons and orthodontists on the maxillary expansion and bone grafting treatment protocols and the associated complications. An online questionnaire was sent to 131 centers. The questions assessed the participants' demographic data, maxillary expansion and alveolar bone grafting protocols, and the associated complications. Descriptive statistics and a t-test were used to analyze the data. The response rate was 40.5%. The average age for maxillary expansion was 9-10 years. The secondary alveolar bone grafting was planned 5-10 months after the expansion. The most common complications were asymmetric expansion, relapse, and fistula formation. The protocols and materials used vary widely among centers. Anatomical alterations and developmental processes, like tooth eruption adjacent to the cleft, should be seriously considered for treatment planning. This survey showed that there is still a lack of consensus on these treatment procedures. Further clinical trials should focus on long-term outcome evaluation to identify treatment components for optimal alveolar bone substitution and transversal maxillary expansion treatment in patients with clefts

Antibiotics prescribing practices in oral implantology among jordanian dentists. A cross sectional, observational study

<p>Abstract</p> <p>Background</p> <p>In oral implantology, there is no consensus on the most appropriate regimen for antibiotics prescribing, the decision to prescribe antibiotic is usually based on procedure, patient and clinician related factors. The aim of this study was to investigate the rationale of antibiotic prescribing among Jordanian clinicians who practice oral implantology.</p> <p>Findings</p> <p>The target sample for the study was the 250 Jordan Dental Implant Group members. A five page questionnaire contained 41 questions, both closed and open questions were used to collect data. Statistical analysis was performed using SPSS Windows 16.0 (SPSS Inc., Chicago, IL, USA). Descriptive statistics were generated.</p> <p>The response rate was (70.4%) 176/250. Mean age was 37.2 yrs, 49.4% always prescribe antibiotics mainly oral amoxicillin and amoxicillin with clavulinic acid. Antibiotics prescribing increased with flap raising, multiple implants and sinus or bone augmentation. Patient medical condition, periodontitis and oral hygiene were the most important clinical factors in antibiotic prescribing, non-clinical factors were; reading scientific materials, courses and lectures, knowledge gained during training, and the effectiveness and previous experience with the drug.</p> <p>Conclusions</p> <p>Wide variations in antibiotics types, routes, dose and duration of administration were found. Recommendations on antibiotic prescribing are needed to prevent antibiotic overprescribing and misuse.</p

The adaptation of Demirjian’s dental age estimation method on north German children

Ziel: Das Ziel dieser Studie war, die Genauigkeit der Methode von Demirjian et al. zur Einschätzung des Zahnalters an norddeutschen Kindern zu testen, die angewandte Methode im Falle von Ungenauigkeit an diese Stichprobe anzupassen und Perzentilenkurven der Zahnreife für diese Bevölkerungsgruppe zu berechnen. Material und Methoden: Panoramaschichtaufnahmen (PSA) von 1260 norddeutschen Kindern (566 männlich und 694 weiblich) im Alter von 5-17 Jahren aus Patientenakten der Abteilung für Kieferorthopädie, Orthodontie und Kinderzahnmedizin der Charité – Universitätsmedizin Berlin wurden ausgewertet. Demirjians Zahnreifeskala für die sieben Zähne des linken Unterkiefers wurde für die erste Stichprobe verwendet (951 PSA), um das Zahnalter zu schätzen und es mit dem chronologischen Alter jedes Kindes zu vergleichen. Für die Anpassung von Demirjians Methode an diese Stichprobe von Röntgenaufnahmen wurden mittels linearer Regression neue gewichtete Reifegrade errechnet und polynomiale Perzentilenkurven der gesamten Zahnreife im Vergleich zum chronologischen Alter bestimmt. Die zweite Stichprobe (309 PSA) wurde genutzt, um die neu angepasste Methode zu evaluieren und sie mit Demirjians Methode zu vergleichen. Ergebnisse: Demirjians Methode überschätzte das mittlere chronologische Alter der Jungen um 0,46 ± 0,86 Jahre (durchschnittliche Differenz ± Standardabweichung) und der Mädchen um 0,55 ± 0,95 Jahre. Die Formel auf Basis der neu gewichteten Reifgrade schätzte das chronologische Alter der Jungen (0,07 ± 0,82 Jahre) und der Mädchen (-0,04 ± 0,82 Jahre) genauer. Die neu angepasste Methode zeigte keinen signifikanten Unterschied zwischen Zahnalter und chronologischem Alter. Die Methode von Demirjian et al., angewandt bei norddeutschen Kindern, überschätzte die meisten Alterskohorten für beide Geschlechter signifikant. Schlussfolgerung: Die für norddeutsche Kinder neu gewichteten Reifegrade und Perzentilenkurven zeigten eine deutliche Verbesserung der Altersschätzung und waren zuverlässiger im Vergleich zu der Originale Demirjians Methode.Aim: The aim of this study was to test the accuracy of Demirjian’s method for dental age estimation on north German children, to adapt the method used in case of inaccuracy in this sample and to construct dental maturity percentile curves for this population. Materials and Method: Panoramic radiographs of 1260 north German children (566 males and 694 females) aged 5-17 years were collected from patients’ records of the Department of Orthodontics, Dentofacial Orthopedics and Pedodontics, Charité – Universitätsmedizin Berlin, Germany. Demirjian’s dental maturity scale for the seven left mandibular teeth was applied to the first sample (951 panoramic radiographs) to estimate the dental age and compare it to the chronological age of each child. For the adaptation of Demirjian’s method on this sample of radiographs, new weighted maturity scores were created by the use of linear regression. Polynomial percentile curves of the total dental maturity in comparison to the chronological age are presented. The second sample (309 panoramic radiographs) was used to evaluate the adapted method and compare it to Demirjian’s method. Results: Demirjian’s method overestimated the mean chronological age of boys by 0.46 ± 0.86 years (mean difference ± standard deviation) and of girls by 0.55 ± 0.95 years. The new adapted weighted scores estimated the chronological age of boys (0.07 ± 0.82 years) and girls (-0.04 ± 0.82 years) more accurately. The adapted method showed no significant difference between dental age and chronological age. Conclusion: The method by Demirjian et al., when applied to north German children, significantly overestimated most age cohorts for both sexes. The north German weighted scores and percentile curves showed a notable improvement in age estimation and were more reliable for chronological age estimation and dental age assessment