Comparison of mandibular arch expansion by the schwartz appliance using two activation protocols: A preliminary retrospective clinical study

Background and objectives: Dental crowding is more pronounced in the mandible than in the maxilla. When exceeding a significant amount, the creation of new space is required. The mandibular expansion devices prove to be useful even if the increase in the lower arch perimeter seems to be just ascribed to the vestibular inclination of teeth. The aim of the study was to compare two activation protocols of the Schwartz appliance in terms of effectiveness, particularly with regard to how quickly crowding is solved and how smaller is the increasing of vestibular inclination of the mandibular molars. Materials and methods: We compared two groups of patients treated with different activation's protocols of the lower Schwartz appliance (Group 1 protocol consisted in turning the expansion screw half a turn twice every two weeks and replacing the device every four months; Group 2 was treated by using the classic activation protocol-1/4 turn every week, never replacing the device). The measurements of parameters such as intercanine distance (IC), interpremolar distance (IPM), intermolar distance (IM), arch perimeter(AP), curve of Wilson (COW), and crowding (CR) were made on dental casts at the beginning and at the end of the treatment. Results: A significant difference between protocol groups was observed in the variation of COWL between time 0 and time 1 with protocol 1 with protocol 1 subjects showing a smaller increase in the parameter than protocol 2 subjects. The same trend was observed also for COWR, but the difference between protocol groups was slightly smaller and the interaction protocol-by-time did not reach the statistical significance. Finally, treatment duration in protocol 1 was significantly lower than in protocol 2. Conclusion: The results of our study suggest that the new activation protocol would seem more effective as it allows to achieve the objective of the therapy more quickly, and likely leading to greater bodily expansion

Association between Anatomical Variations and maxillary canine impaction: A retrospective study in orthodontics

This study aims to evaluate whether or not there is a higher prevalence of skeletal abnormalities in subjects with maxillary canine impaction (MCI). This retrospective study was performed on 67 subjects with maxillary canine impaction (test group) and on 67 patients without dental displacement (control group). Sella turcica bridging (SB), ponticulus posticus (PP), atlas posterior arch deficiency (APAD) and the morphology of sella turcica and pterygopalatine fissure were evaluated on lateral cephalometric radiographs. Statistical analysis was performed using chi-square, Mann-Whitney test and multivariate logistic models; the level of significance was p < 0.05. Results showed that in the test and control groups 87% and 62.7% of patients had SB, respectively. PP was observed in 60% of patients in the test group and in 16.4% of patients in the control group. APAD was observed in 9% of test group and in 4.5% of the control group. Skeletal anomalies were significantly increased (p < 0.05) in subjects with MCI. A significant difference between the groups was observed in regards to the shape of the pterygopalatine fissure, found to be less wide and longer in the test group. SB, PP and APAD were higher in subjects with MCI; furthermore, an elongated pterygopalatine fissure was significantly associated with MCI

In-office bacteria test for a microbial monitoring during the conventional and self-ligating orthodontic treatment

This study investigated the microbial level of Streptococcus mutans and Lactobacillus spp. during an orthodontic treatment, and compare the data with untreated control subjects.Sixty young adult subjects were selected (average 20.5, DS 1.62), among which 40 underwent an orthodontic treatment (20 were treated with self-ligating brackets and 20 with conventional brackets) and 20 were controls. Plaque Index, salivary flow and buffering capacity of saliva were assessed before the beginning of the orthodontic treatment. Then the microbial counts were obtained by using an in-office bacteria test.The plaque index (PI) increased over time in each group as well as salivary flow, mostly in subjects treated with self-ligating brackets, suggesting a difference between conventional and self-ligating brackets. S.mutans showed a different trend of colonization in the two treated groups, as for subjects treated with conventional brackets it showed the greater value at the early stage of treatment (T1), followed by a decrease at T2. Lactobacillus spp. showed significant increase over time in the two treated groups, respect to the control group. Linear regression analysis showed no significant predictor for the microbial count at T2.The assortment of the various species of bacteria change over time during the orthodontic treatment, and seems to show different trends, depending on the type of orthodontic device. Consequently a periodical microbial monitoring using in-office bacteria tests, seems indicated

Cone beam computed tomography investigation of the antral artery anastomosis in a population of Central Italy

Background: The arterial vascular supply of maxillary sinus has to be considered in all the surgical procedures where it is involved. In particular, the intraosseous anastomosis between the posterior superior alveolar artery and the infraorbital artery branches in the bony canal can be tricky to a not well aware clinician. The aim of this study is to investigate the arterial blood supply of the maxillary sinus to give clinicians the basis for a better understanding of vascular complications that can derive from surgical procedures at this level. Materials and methods: One hundred cone beam computed tomography were analysed by the Imaging software for three-dimensional images, i-Dixel 2.0. The parameters considered have been the presence (i), the calibre (ii), the dorso-ventral length (iii) and the cranio-caudal distance (iv). The data have been processed with means, standard deviations and verified by T-Student test. Results: The statistical outputs showed that the 38% of samples presented the intraosseous anastomosis. Those anastomosis resulted long in dorso-ventral way both on left (12.55 ± 4.3 mm) and right side (12.4 ± 4.3 mm). The mean cranio- -caudal distance resulted 15.71 ± 5.08 mm on the left and 14.73 ± 4.74 mm on right side. The calibre measurements resulted quite big as well: 1.68 ± 0.3 mm on the left and 1.54 ± 0.38 mm on the right. The differences between the right and left sides were found not statistically significant. Conclusions: This in vivo investigation shows how a knowledge of the maxillary sinus vascularisation is essential during the programming surgical phase in order to prevent blood complications during the operations involving this region.

Development of a new protocol: a macroscopic study of the tongue dorsal surface

The presence on the dorsal tongue of additional irregularities such as fissures, grooves and the distribution of papillae constitutes a retention area for harbouring bacteria, particularly those that produce sulphur compounds. A protocol to study the morphology of the tongue in a macroscopic way was developed, aimed at better investigating on the relationship between the dorsal surface of the tongue, considered as a microbial ecosystem, and the oral halitosis (1). A patient affected by oral malodour was chosen and included in the study. A picture of his lingual dorsum was taken to show the areas where the coating was visible. Then, an impression with alginate was taken obtaining a replication in plaster and, on the base of this one, a sort of impression tray was modelled utilizing an impression material made of silicone putty. After this, a second impression was taken combining the tray in silicone putty with a silicone material having a very low-light density (using the 2-step double-mix impression technique). The impression obtained was divided and cut with a blade in six parts, according to Winkel Tongue Coated Index (2), and their contour was observed with the stereo-microscope. The images were analysed with the Image J programme, and the parameter considered was the depth among the papillae. The mean measure of this parameter, in the parts where the coating was visible, resulted in a range between 0,25 + 0,019 mm and 0,55 + 0,11 mm. The same measures in the parts where the coating was not visible swung instead in a range between 0,14 + 0,08 mm and 0,23 + 0,07 mm. This new protocol can be considered clinically relevant for the suitable diagnosis and for the personalized treatment of halitosis

Efficacy of essential oil mouthwash with and without alcohol: a 3-Day plaque accumulation model

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to evaluate the antiplaque effect of a new alcohol free essential oil mouthwash with respect to a control of an essential oil with alcohol mouthwash, using an <it>in vivo </it>plaque regrowth model of 3-days.</p> <p>Methods</p> <p>The study was designed as a double-masked, randomized, crossover clinical trial, involving 30 volunteers to compare two different essential oil containing mouthwashes, during a 3-day plaque accumulation model. After receiving a thorough professional prophylaxis at the baseline, over the next 3-days each volunteer refrained from all oral hygiene measures and had two daily rinses with 20 ml of the test mouthwash (alcohol free essential oil) or the control mouthwash (essential oil with alcohol). At the end of the each experimental period, plaque was assessed and the panelists filled out a questionnaire. Each subject underwent a 14 days washout period and there was a second allocation.</p> <p>Results</p> <p>The essential oil mouthwash with ethanol shows a better inhibitory effect of plaque regrowth in 3-days than the mouthwash test with only essential oil in the whole mouth (plaque index = 2.18 against 2.46, respectively, p < 0.05); for the lower jaw (plaque index = 2.28 against 2.57, respectively, p < 0.05); for the upper jaw (plaque index = 2.08 against 2.35, respectively, p < 0.05); for the incisors (plaque index = 1.93 against 2.27, respectively, p < 0.05); and the canines (plaque index = 1.99 against 2.47, respectively, p < 0.05).</p> <p>Conclusion</p> <p>The essential oil containing mouthwash without alcohol seems to have a less inhibiting effect on the plaque regrowth than the traditional alcoholic solution.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov <a href="http://www.clinicaltrials.gov/ct2/show/NCT01411618">NCT01411618</a></p