Histological Characterization of Sacco's Concentrated Growth Factors Membrane

Along with the emerging needs of the dental patients, numerous techniques for oral tissue stimulation and regeneration were developed to be employed in the modern implant rehabilitation therapies. The Concentrated Growth Factors (CGF) are a relatively new therapeutic presidium that can be used for this purpose, enhancing the regenerative potential property of blood cells. Although literature presents numerous studies evaluating the CGF for their clinical uses and efficacy, data regarding their biological characteristics are very few. The present study evaluates and describes the CGF structural morphology by means of classical histological methods, using haematoxilin-eosin and azan mallory stains. A three layers organization with a fibrin complex network was noted, with blood corpuscular elements entrapped, especially in the most external layer. These descriptions enrich the knowledge about this new type of membrane, showing the bio-morphological side of the regenerative techniques. These findings will be useful in clinical practice for the choice of the most suitable technique in each implant rehabilitation. Junto con las nuevas necesidades dentales de los pacientes, se han desarrollado numerosas técnicas para la estimulación y regeneración de los tejidos orales para ser empleadas en las modernas terapias de rehabilitación de implante. Los Factores de Crecimiento Concentrados (FCC) son relativamente una nueva alternativa terapéutica que pueden utilizarse para este propósito, mejorando la propiedad regenerativa potencial de las células de la sangre. A pesar de que la literatura presenta numerosos estudios que evalúan los FCC por sus usos clínicos y su eficacia, los datos relativos a sus características biológicas son muy escasos. El presente estudio evalúa y describe la morfología estructural de los FCC por medio de métodos histológicos tradicionales, utilizando hematoxilina-eosina y tinción de Azan Mallory. Se observó una organización en tres capas con una compleja red de fibrina, con elementos corpusculares de la sangre atrapados, especialmente en la capa más externa. Estas descripciones enriquecen el conocimiento acerca de este nuevo tipo de membrana, que muestra el lado biomorfológico de las técnicas regenerativas. Estos resultados serán de utilidad en la práctica clínica para la elección de la técnica más adecuada en los casos de rehabilitación con implantes

Dentoskeletal effects of the bitejumping appliance and the twin-block appliance in the treatment of skeletal class ii malocclusion: A retrospective controlled clinical trial

The current retrospective controlled trial aimed to compare the dentoskeletal effects of the Bite-Jumping (BJ) and the Twin- Block Appliance (TB) in the treatment of skeletal Class II malocclusion. The sample was screened for eligibility criteria including skeletal and dental Class II malocclusion; Cervical Vertebral Maturation at Stage 3 at treatment start, and Func- tional orthopedic treatment with either a TB or BJ appliances. Twenty-three patients treated with TB, and twenty-three treated with BJ were included. Cephalometric data were compared with a control group of 15 untreated subjects retrieved from the American Association of Orthodontists Foundation Craniofacial Growth Legacy Collection. Baseline character- istics were similar between groups. A significant increase for the AO-BO dimension, and a significant decrease in the over- jet, were registered for both study groups respect to controls. TB was more effective than BJ in increasing the mandibu- lar length (Co-Gn), in reducing the ANB angle and changing the SNB angle. The resulting differences between the two groups could be attributed to the different appliances. In conclusion, both appliances demonstrated a clinical efficacy in treating Class II. TB seems therefore better indicated, respect to BJ, in Class II cases with a predominant component of mandibular hypoplasia

Postural loads during walking after an imbalance of occlusion created with unilateral cotton rolls

<p>Abstract</p> <p>Background</p> <p>It was showed that stomatognathic functions correlate with alterations in locomotion, that are detectable through the analysis of loading during walking. For example, subjects with symptoms of Temporomandibular disorders (TMDs) showed a significant higher load pressure on the two feet, respect to health subjects, when cotton rolls were inserted. This previous study appeared to suggest that the alteration of postural loads associated to a particular alteration of stomatognathic condition (in this case, the cotton rolls inserted between the two dental arches) is detectable only in TMD's subjects, while it resulted not detectable in health subjects, because in that study, health subjects did not show any significant alteration of postural loads related to the different stomatognathic tested conditions. In other words, in that previous study, in the group of health subjects, no significant difference in postural loads was observed among the different test conditions; while TMD subjects showed a significant higher load pressure on the two feet when cotton rolls were inserted, respect to all the other tested conditions. Thus, the aim of this study was to better investigate these correlations in health subjects without TMD's symptoms, testing other different intra-oral conditions, and to verifywhether an experimentally induced imbalance of occlusion, obtained putting an unilateral cotton roll, could cause an alteration of postural loading on feet during walking.</p> <p>Findings</p> <p>In a sample of thirty Caucasian adult females (mean age 28.5 ± 4.5), asymptomatic for TMDs, when a cotton roll was positioned on the left or the right sides of dental arches, so causing a lateral shift of the mandible, the percentage of loading and the loading surface of the ipsi-lateral foot, left or right, were found to be significantly lower than in habitual occlusion (p < 0.05). Males were not included because of their different postural attitude respect to females. Further studies in a sample of males will be presented.</p> <p>Conclusions</p> <p>This study showed that in health subjects without TMD's symptoms, an experimentally induced imbalance of the occlusion, obtained through an unilateral cotton roll, is associated to detectable alterations in the distribution of loading on feet surface, during walking.</p

Condylar volume and surface in Caucasian young adult subjects

<p>Abstract</p> <p>Background</p> <p>There have been no quantitative standards for volumetric and surface measurements of the mandibular condyle in Caucasian population. However, the recently developed cone-beam computed tomography (CBCT) system allows measurement of these parameters with high accuracy.</p> <p>Methods</p> <p>CBCT was used to measure the condylar volume, surface and the volume to surface ratio, called the Morphometric Index (MI), of 300 temporo-mandibular joints (TMJ) in 150 Caucasian young adult subjects, with varied malocclusions, without pain or dysfunction of TMJs.</p> <p>Results</p> <p>The condylar volume was 691.26 ± 54.52 mm³in males and 669.65 ± 58.80 mm³in, and was significantly higher (<it>p</it>< 0.001) in the males. The same was observed for the condylar surface, although without statistical significance (406.02 ± 55.22 mm²in males and 394.77 ± 60.73 mm²in females).</p> <p>Furthermore, the condylar volume (693.61 ± 62.82 mm³) in the right TMJ was significantly higher than in the left (666.99 ± 48.67 mm³, <it>p </it>< 0.001) as was the condylar surface (411.24 ± 57.99 mm²in the right TMJ and 389.41 ± 56.63 mm²in the left TMJ; <it>t </it>= 3.29; <it>p </it>< 0.01). The MI is 1.72 ± 0.17 for the whole sample, with no significant difference between males and females or the right and left sides.</p> <p>Conclusion</p> <p>These data from temporomandibular joints of patients without pain or clinical dysfunction might serve as examples of normal TMJ's in the general population not seeking orthodontic care.</p

Scoliosis and dental occlusion: a review of the literature

<p>Abstract</p> <p>Background</p> <p>Idiopathic scoliosis is a deformity without clear etiology. It is unclear wether there is an association between malocclusion and scoliosis. Several types of occlusion were described in subjects with scoliosis, mostly case-reports.</p> <p>Objectives</p> <p>The aim of this review was to evaluate the type of occluslins more prevalent in subjects with scoliosis</p> <p>Search strategy</p> <p>All randomised and controlled clinical trials identified from the Cochrane Oral Health Group Trials Register, a MEDLINE search using the Mesh term scoliosis, malocclusion, and relevant free text words, and the bibliographies of papers and review articles which reported the outcome of orthodontic treatment in subjects with scoliosis that were published as abstracts or papers between 1970 and 2010.</p> <p>Selection criteria</p> <p>All randomised and controlled clinical trials published as full papers or abstracts which reported quantitative data on the outcomes malocclusion in subjects with scoliosis.</p> <p>Data collection and analysis</p> <p>Data were extracted without blinding to the authors, age of patients or type of occlusion.</p> <p>Main results</p> <p>Using the search strategy eleven observational longitudinal studies were identified. No randomized clinical trials were recorded. Twenty-three cross-sectional studies were recorderd, and the others studies were reviews, editorials, case-reports, or opinions. The clinical trials were often not controlled and were about the cephalometric evaluation after treatment with the modified Milwuakee brace, followed by the orthodontic treatment of the class II relationship with a functional appliance. Clinical trials also included the study of the associations between scoliosis and unilateral crossbite, in children with asymmetry of the upper cervical spine. This association was also investigated in rats, pigs and rabbits in clinical trials. The other associations between scoliosis and occlusion seems to be based only on cross-sectional studies, case-reports, opinions.</p> <p>Authors' conclusions</p> <p>Based on selected studies, this review concludes that there is plausible evidence for an increased prevalence of unilateral Angle Class II malocclusions associated with scoliosis, and an increased risk of lateral crossbite, midline deviation in children affected by scoliosis. Also, documentation of associations between reduced range of lateral movements and scoliosis seem convincing. Data are also mentioned about the association between plagiocephaly and scoliosis.</p

AWAKE BRUXISM TREATED WITH PREGABALINE IN A PATIENT WITH GENERALIZED ANXIETY DISORDER

Background: Bruxism is excessive teeth grinding or jaw clenching. Several symptoms are commonly associated with bruxism, including hypersensitive teeth, aching jaw muscles, headaches, tooth wear, and damage to dental restorations. There are two types of bruxism, awake bruxism and sleep bruxism. Awake bruxism is generally treated by dentists and maxilla-facial surgeons through several treatment modalities such as, counselling about triggers, relaxation, occlusal splints and botulinum toxin type A injections. Methods: We will present the case of a 21-year-old woman presenting mood swings with a high level of anxiety and concentration difficulties since childhood. She also complained of awake bruxism. Intelligence was evaluated using The Wechsler Adult Intelligence Scale - Fourth Edition (WAIS-IV). Attention-deficit hyperactivity disorder (ADHD) was investigated through a neuropsychology test. Results: Intelligence evaluation showed normal intellectual function. Neuropsychology test showed a profile corresponding to ADHD. Bupropion XR 300 mg was initiated for ADHD. Pregabalin was prescribed for general anxiety syndrome. The patient reported a complete disappearance of awake bruxism at a daily dose of 375 mg, with no occlusal appliances. Following the improvement of the anxiety symptoms, the attempt to reduce the dose twice leading to the recurrence of bruxism Conclusions: A 21 years old female treated with 375 mg daily doses of pregabalin for generalized anxiety disorder experienced a significant reduction of daytime bruxism. More studies are needed to determine whether pregabalin has a long term effect against awake bruxism

Assessment of the third finger middle phalanx maturation stages: A study of repeatability and diagnostic agreement

Data regarding the repeatability of the third finger middle phalanx maturation (MPM) method is still lacking. This study evaluated both the repeatability and diagnostic accuracy of the visual assessment of the MPM stages. Ten operators were given detailed instructions of the 5-stage MPM method and were asked to stage 80 cases, which included radiographs of equal number of all 5 MPM stages. Radiographs of the third finger were created by cropping hand-wrist radiographs of the Burlington Growth Study, ensuring the inclusion of several borderline cases. Such assessment was repeated in two sessions (T1 and T2) 4 weeks apart. For both the sessions, overall agreement and kappa coefficients were above 80% and 0.86, respectively. Most of the disagreements were seen for stages 1 and 2 with overall mean scores between the sessions being 29.7% and 39.4%, respectively. With only 4 exceptions (out of over 1,600 recordings), 1-stage apart disagreements were seen. Overall diagnostic accuracy ranged from 83.7% for MPM stage 2 (T1) to 99.3% for MPM stage 5 (T1). The MPM method has a satisfactorily level of repeatability and diagnostic agreement. About 1 case out of 5 remains misclassified, disagreement is mostly limited to 1-stage apart, with stage 2 being the most critical