Unilateral vicious mastication – The importance and resolution: a case report

Introduction: Patients presenting Temporomandibular Disorders (TMD) are common in our daily clinical practice. One of the possible conditions that lead to TMD is the habitual chewing side syndrome.Methods: In this case report a clinical approach is presented to manage the TMD related to unilateral vicious mastication. A 42 years old woman presented reporting headaches, difficulty to open mouth, presence of sensitivity in the left ear and TMJ region, soreness on the left side temporal region and sensitivity in the anterior inferior teeth. It was noted that the patient habitually clenched and ground teeth. Patient mentioned chew more on the left side.Results: After confirming the unilateral mastication, a modified therapy based on the Neuro occlusal Rehabilitation was applied through the use of a splint. After 60 days the patient described absence of the previous symptoms and pain relief.Conclusion: The evaluation of the masticatory pattern is often neglected; however, it is of great importance since it can lead to several conditions such as condyle wear, pain, alteration of the occlusal plane, deviation of the medial line, deviation of the mandible at mouth opening, bone alterations, Temporomandibular joint(TMJ) hypofunction, headache, among others

Novel methodologies and technologies to assess mid-palatal suture maturation: a systematic review

Abstract Introduction A reliable method to assess midpalatal suture maturation to drive clinical decision-making, towards non-surgical or surgical expansion, in adolescent and young adult patients is needed. The objectives were to systematically review and evaluate what is known regarding contemporary methodologies capable of assessing midpalatal suture maturation in humans. Methods A computerized database search was conducted using Medline, PubMed, Embase and Scopus to search the literature up until October 5, 2016. A supplemental hand search was completed of references from retrieved articles that met the final inclusion criteria. Results Twenty-nine abstracts met the initial inclusion criteria. Following assessment of full articles, only five met the final inclusion criteria. The number of subjects involved and quality of studies varied, ranging from an in-vitro study using autopsy material to prospective studies with in vivo human patients. Three types of evaluations were identified: quantitative, semi-quantitative and qualitative evaluations. Four of the five studies utilized computed tomography (CT), while the remaining study utilized non-invasive ultrasonography (US). No methodology was validated against a histological-based reference standard. Conclusions Weak limited evidence exists to support the newest technologies and proposed methodologies to assess midpalatal suture maturation. Due to the lack of reference standard validation, it is advised that clinicians still use a multitude of diagnostic criteria to subjectively assess palatal suture maturation and drive clinical decision-making

Evaluación de la microdureza superficial de una resina compuesta según fuente de luz, su opacidad y tiempo de exposición Webb-Linares LJ, Reynoso-Zeballos GE, Manuel Lagravere

El objetivo de este estudio fue comparar la microdureza superficial de una resina compuesta según el tipo de lámpara o fuente de luz, opacidad y tiempo de exposición. Se utilizaron la lámpara halógena Astralis® 10 (Ivoclar Vivadent) y la lámpara LED BluePhase® (Ivoclar Vivadent). Se utilizó la resina microhíbrida 4Season® (Ivoclar Vivadent) en los colores Enamel Trans Super Clear (ETSC), Enamel A2 (A2E), Dentin A2 (A2E). El tiempo de exposición empleado fue de 20s, 40s y 60s. Se confeccionaron 5 muestras de 5x5x2 mm por cada grupo de estudio. Las muestras se almacenaron durante 24 horas en un recipiente seco y oscuro despuésde la polimerización. Las muestras se evaluaron utilizando la prueba de microdureza Vickers con un microdurómetro HMV-2 (Shimadzu, Kyoto, Japón), en la superficie superior e inferior. Los datos fueron analizados a través de la prueba ANOVA/Tukey. Para detectar diferencias entre lassuperficies se empleó el análisis t de Student para muestras pareadas. Los mayores valores de microdureza superficial fueron para la resina Enamel Trans Super Clear. La lámpara halógena proporcionó mayores valores de microdureza superficial. Para las lámparas LED o hubo diferencia significativa a los 20s, 40s y 60s. Para la lámpara halógena a los 20s se obtuvo los menores valores de microdureza; entre 40s y 60s no hubo diferencia significativa

Three dimensional evaluation of alveolar bone changes in response to different rapid palatal expansion activation rates

ABSTRACT Introduction: The aim of this multi-center retrospective study was to quantify the changes in alveolar bone height and thickness after using two different rapid palatal expansion (RPE) activation protocols, and to determine whether a more rapid rate of expansion is likely to cause more adverse effects, such as alveolar tipping, dental tipping, fenestration and dehiscence of anchorage teeth. Methods: The sample consisted of pre- and post-expansion records from 40 subjects (age 8-15 years) who underwent RPE using a 4-banded Hyrax appliance as part of their orthodontic treatment to correct posterior buccal crossbites. Subjects were divided into two groups according to their RPE activation rates (0.5 mm/day and 0.8 mm/day; n = 20 each group). Three-dimensional images for all included subjects were evaluated using Dolphin Imaging Software 11.7 Premium. Maxillary base width, buccal and palatal cortical bone thickness, alveolar bone height, and root angulation and length were measured. Significance of the changes in the measurements was evaluated using Wilcoxon signed-rank test and comparisons between groups were done using ANOVA. Significance was defined at p ≤ 0.05. Results: RPE activation rates of 0.5 mm per day (Group 1) and 0.8 mm per day (Group 2) caused significant increase in arch width following treatment; however, Group 2 showed greater increases compared to Group 1 (p < 0.01). Buccal alveolar height and width decreased significantly in both groups. Both treatment protocols resulted in significant increases in buccal-lingual angulation of teeth; however, Group 2 showed greater increases compared to Group 1 (p < 0.01). Conclusion: Both activation rates are associated with significant increase in intra-arch widths. However, 0.8 mm/day resulted in greater increases. The 0.8 mm/day activation rate also resulted in more increased dental tipping and decreased buccal alveolar bone thickness over 0.5 mm/day

Three-dimensional assessment of the spheno-occipital synchondrosis and clivus after tooth-borne and bone-borne rapid maxillary expansion

Objectives: To assess changes in spheno-occipital synchondrosis after rapid maxillary expansion (RME) performed with conventional tooth-borne (TB) and bone-borne (BB) appliances. Materials and methods: This study included 40 subjects with transverse maxillary deficiency who received TB RME or BB RME. Cone-beam computed tomography images (CBCT) were taken before treatment (T0), and after a 6-month retention period (T1). Three-dimensional surface models of the spheno-occipital synchondrosis and basilar part of the occipital bone were generated. The CBCTs taken at T0 and T1 were registered at the anterior cranial fossa via voxel-based superimposition. Quantitative evaluation of Basion displacement was performed with linear measurements and Euclidean distances. The volume of the synchndrosis was also calculated for each time point as well as the Nasion-Sella-Basion angle (N-S-Ba°). All data were statistically analyzed to perform inter-timing and intergroup comparisons. Results: In both groups, there was a small increment of the volume of the synchondrosis and of N-S-Ba° (P &lt; .05). Basion showed a posterosuperior pattern of displacement. However, no significant differences (P &gt; .05) were found between the two groups. Conclusions: Although TB and BB RME seemed to have some effects on the spheno-occipital synchondrosis, differences were very small and clinically negligible

Nasal septum changes in adolescent patients treated with rapid maxillary expansion

Objective: To analyze cone-beam computed tomography (CBCT) scans to measure changes in nasal septal deviation (NSD) after rapid maxillary expansion (RME) treatment in adolescent patients. Methods: This retrospective study involved 33 patients presenting with moderate to severe nasal septum deviation as an incidental finding. Out of these 33 patients, 26 were treated for transverse maxillary constriction with RME and seven, who did not undergo RME treatment, were included in the study as control group. CBCT scans were taken before appliance insertion and after appliance removal. These images were analyzed to measure changes in nasal septum deviation (NSD). Analysis of variance for repeated measures (ANOVA) was used. Results: No significant changes were identified in NSD regardless of the application or not of RME treatment and irrespective of the baseline deviation degree. Conclusion: This study did not provide strong evidence to suggest that RME treatment has any effect on NSD in adolescent patients; however, the results should be interpreted with caution, due to the small sample size and large variation amongst individual patient characteristics

Additional file 1: of Novel methodologies and technologies to assess mid-palatal suture maturation: a systematic review

Articles excluded from final inclusion criteria and reasons. (DOCX 17 kb

Evaluation of mandibular changes after rapid maxillary expansion: a CBCT study in youngsters with unilateral posterior crossbite using a surface-to-surface matching technique

Objectives: The purpose of this study was to evaluate mandibular asymmetry in youngsters with posterior unilateral crossbite (PUXB), through cone-beam computed tomography and reverse engineering technique, before and after rapid maxillary expansion (RME) treatment. Materials and methods: Forty cone-beam computed tomography (CBCT) images were obtained from all patients at two time points, namely T0 acquired before the placement of a Hyrax expander and T1 after appliance removal. The CBCT scans were segmented and volume rendered into a surface there-dimensional (3D) mesh model. Thereafter, mandibular models were digitally registered by using a “best-fit” algorithm. Surface and volumetric changes, between T0 and T1, were compared by using Student’s t tests. Results: A slight increase of 0.45 cm3 of the total mandibular volume was found at T1 when compared with T0 (p < 0.001). The mandibular hemi-volume on the crossbite side (CB) was slightly smaller than the non-crossbite side both at T0 and T1. However, the mean differences of hemi-volume from the CB (crossbite) and non-CB side between T0 and T1 show a decrease of 0.26 cm3 (p < 0.001). Findings for the surface-to-surface deviation analysis demonstrated a fine percentage of matching at T0 which slightly improved at T1 (p < 0.001). Conclusions: Youngsters affected by PUXB showed a very slight and not statistically significant volumetric and morphological asymmetry between CB side and non-CB side at T0. However, the change in mean differences of 0.26 cm cannot be considered clinically relevant. Clinical relevance: Mandibles in young PUXB patients exhibit only a very mild mandibular asymmetry. Although the statistically significant mean change found right after RME removal cannot be considered clinically relevant, a more consistent sample and a longer follow-up could be of interest in explaining the short-term findings