Is Orthodontic Treatment with Microperforations Worth It? A Scoping Review

Malformations of teeth and dental arches can produce functional modifications intermingled with esthetic alterations. Children’s rehabilitation may be long, requiring multiple interventions. One of the main challenges of contemporary orthodontics is to reduce treatment time by accelerating orthodontic tooth movements. Among the currently used methods, micro-osteoperforations (MOPs) are flapless, minimally invasive perforations that induce a local trauma to the bone, increase healing capacity, and accelerate dental movements. The use of MOPs in orthodontics is spreading but there are no definite and recognized protocols for their application. This scoping review collected the available evidence in the effect of MOPs during orthodontic therapy as compared to current treatments, to summarize the evidence. The guidelines proposed by PRISMA-ScR were followed: original clinical studies carried out from 2010 to 2021 were retrieved by medical databases combining the terms “micro-osteoperforations” and “accelerated orthodontic tooth movement”. From a total of 965 articles, nine were finally selected. The studies' aims, designs, methods, measurements, outcomes, and main findings were very heterogenous, with a duration ranging from 4 weeks to 7 months. This included only Class I malocclusion to any malocclusion. It assessed the effects of MOPs coupled with a variety of orthodontic mechanics on either the retraction of maxillary canines, the distalization of maxillary molars, or the modifications on premolar roots. Mostly, variations in the number, location, and timing of MOPs impeded a global assessment. Overall, most of the studies (six out of nine) reported moderately useful effects of MOPs, one was negative, and only two found significant advantages of MOPs over conventional treatment. The review synthesized the available evidence about MOP applications in orthodontics and identified some important gaps in knowledge that could be starting points for a systematic review of the literature. In conclusion, even if MOPs can accelerate tooth movements, the variety of aims and methods of the published research prevents suggestion of their widespread use

Incidental Finding in Pre-Orthodontic Treatment Radiographs of an Aural Foreign Body: A Case Report

The presence of foreign bodies in the external auditory canal of young patients may cause, if left untreated, severe permanent damage to the adjacent anatomical structures, and infections. A 10‐year‐old patient with an intellectual disability underwent orthodontic evaluation. An aural radiopaque finding was visible in the lateral cephalogram and in the orthopantomography. The patient’s mother reported that her son never showed any ear discomfort, except for a mild hearing impairment that was never investigated. The patient was referred to an ear, nose and throat (ENT) specialist that removed the foreign body located in the left external auditory meatus. The careful evaluation of dental radiographs, including pre‐orthodontic and interim orthodontic radiographs, may help to identify silent incidental findings that may otherwise lead to severe complications if left untreated

Gender- and age-related changes in three dimensional facial profiles of healthy Northern Sudanese persons

The study aimed to provide quantitative information about gender-related normative data and growth changes between childhood and young adulthood in the soft tissue facial profiles of Northern Sudanese individuals. The three dimensional coordinates of 50 landmarks on the facial soft tissues were obtained using a hand-held laser scanner in 654 healthy Northern Sudanese subjects (327 males and 327 females) aged 4-30 years. The subjects were divided into 8 nonoverlapping age groups [1]. From selected landmarks, 15 facial angles were calculated and averaged for gender and age: upper, middle, and lower facial, and mandibular corpus convexities in the horizontal plane; relative position of the exocanthia and nasion; facial convexity in the sagittal plane; midfacial to mandibular plane, nasal convexity, nasolabial, mentolabial, interlabial, maxillary prominence, and left and right gonial angles. Comparisons were performed by factorial analysis of variance. On average men had larger facial and mandibular corpus convexities in the horizontal plane than women (ANOVA, p<0.01); on the contrary, no gender differences were found for facial convexities in the sagittal plane. Gender significantly influenced also the relative position of exocanthia and nasion, the maxillary prominence angle and the gonial angles (p<0.01). All analysed measurements were influenced by age (p<0.001): nasal convexity and interlabial angle increased from childhood to young adulthood, while mentolabial and gonial angles, horizontal facial convexity and sagittal facial convexity including the nose decreased as a function of age. No consistent age-related patterns were found for the other evaluated angles. Data collected in the current study can be used as a database for the quantitative description of facial profiles in Northern Sudanese subjects during normal growth and development

Giovani e ricerca: il progetto WebValley

WebValley è un'iniziativa di avvicinamento dei giovani alla ricerca scientifica interdisciplinare. Ha come azione principale l’organizzazione di una scuola estiva che permette a studenti delle superiori, di 18 anni, di lavorare in team con ricercatori ed esperti internazionali a un progetto di ricerca per tre settimane, in un'atmosfera vivace e interattiva, caratterizzata dal lavoro in gruppo e dall’uso di tecnologie web per risolvere un problema scientifico a forte connotazione etica, proposto da un esperto esterno. Vengono inizialmente fornite competenze tecniche, con forte attenzione all’open source per il calcolo scientifico e per trattare dati complessi. Si definisce da queste basi un progetto in cui sono gli stessi studenti a organizzarsi in gruppi, selezionare le tecnologie e sviluppare nuove soluzioni. Al termine essi restituiscono al committente e a specialisti del settore i loro risultati in una presentazione pubblica, negli ultimi anni, in lingua inglese e in teleconferenza. WebValley si caratterizza anche per il luogo in cui si svolge: a rotazione, in piccoli paesi di montagna del Trentino, per mostrare come sia possibile sviluppare innovazione in località periferiche disponendo di strumenti tecnici, connessione e conoscenze. Dal 2001, hanno frequentato la scuola circa 220 studenti, molti dei quali si sono poi indirizzati verso una carriera in materie scientifiche e tecnologiche, hanno tenuto i contatti tra loro, collaborando con i ricercatori anche nell’organizzazione dell

The face in Down’s syndrome: indices of overall size and harmony in Sudanese vs Italian subjects

The study aimed to provide quantitative information about the facial soft-tissues of Italian and Northern Sudanese subjects with Down’s syndrome (DS) by using summary anthropometric measurements representative of facial size and harmony. The 3D coordinates of soft-tissue facial landmarks were obtained by a computerized digitizer in 54 Italian subjects with DS (20 females, 34 males, aged 13-52 years), in 64 Northern Sudanese subjects with DS (18 females, 46 males, aged 5-34 years), in 578 healthy Italian, and 653 healthy Northern Sudanese reference subjects, matched for sex and age. From the landmarks, 16 facial dimensions were calculated. Data from subjects with DS were compared to those collected in reference individuals by computing z-scores. Two summary anthropometric measurements for quantifying craniofacial variations were obtained: the mean z-score (an index of overall facial size), and its standard deviation, or the craniofacial variability index (an index of facial harmony) [1]. In subjects with DS, facial size was significantly smaller, and craniofacial variability was significantly larger than in normal individuals; 93% of Italian and 81% of Northern Sudanese subjects with DS had one or both values outside the normal interval. Overall, Italian subjects with DS differed more from the norm than Northern Sudanese ones. In the Northern Sudanese subjects, the mean z-scores and the CVI decreased significantly with age. The facial soft-tissue structures of subjects with DS differed from those of normal controls of the same age, sex and ethnic group: a reduced facial size was coupled with a global anomalous relationship between individual measurements. The alterations in soft-tissue facial dimensions were different in the two ethnic groups and partially influenced by age

Variations of midfacial soft-tissue thickness between 6 and 18 years for the reconstruction of the profile: a help for facial reconstruction of children

Facial approximation techniques used in forensic anthropology are based on soft-tissue thickness databases. A potentially relevant application concerns the facial reconstruction of children in cases where only the skull can be recovered. Although several databases concerning facial soft tissues thicknesses already exist [1-3], no study has so far taken into consideration the Italian population. This study aims at providing data concerning facial thickness on the midline in a population of Italian children. Diagnostic cephalometric X-ray films were obtained from 222 healthy Caucasoid children (91 boys and 131 girls), aged between 6 and 18 years. After setting the Frankfurt plane horizontal, 15 measurements were taken at the mid-facial landmarks: supraglabella, glabella, nasion, nasale, subnasale, nasal tip, superior labial sulcus, labrale superius, stomion, labrale inferius, inferior labial sulcus, suprapogonion, pogonion, gnathion, menton. Mean and standard deviation of soft-tissues thickness at each point were calculated. A two-way analysis of variance (ANOVA) was performed to test the modifications of facial parameters with age and sex (

How frequent is ponticulus posticus in italian people? A lateral cephalometric study in an orthodontic population

The term “ponticulus posticus” refers to a partial or complete bony arch over the vertebral artery as it crosses the superolateral surface of the posterior arch of the atlas. This anatomical modification is linked to different symptoms, ranging from neckache to headache and migraine (1). This bony arch may also be incorrectly assessed during orthopedic surgery for fixation of C1-C2, with consequent risk of damaging the vertebral artery (2). Its frequency in the general population has been widely analysed by literature in different geographic contexts (3), but an analysis of the prevalence of such feature in the Italian population is still missing. The present investigation aims at providing data concerning the prevalence of ponticulus posticus in a sample of 221 patients. All the patients underwent lateral cephalometry for odontoiatric purposes and none of them was affected by congenital diseases or skeletal deformities. In the analysed sample ponticulus posticus had a prevalence of 7.7% for the complete form, and 9.0% for the incomplete form. Complete and partial forms were observed respectively in 8.8% and 11.0% of males, and in 6.9% and 7.7% of females, without statistically significant differences (chi-square test, p>0.01). Italian prevalence seems lower than that observed in American populations, and higher than that reported in India and Far East countries. The current investigation provided the first data concerning the frequency of posticulus posticus in Italy: further studies are needed in order to widen the sample and improve the analysis by more advanced radiological examinations such as CT and cone beam CT scans

Facial anthropometry in Northern Sudanese persons from childhood to young adulthood

A deep knowledge of the dimensions and relative positions of facial structures in the different age, gender and ethnic groups, is necessary for a complete anatomical description as well as for a correct reconstruction of the global facial appearance, both for surgical and forensic purposes. No current normative data exist for Northern Sudanese subjects. Sudan is the second largest country in Africa, and it has a multiethnic population, with four major ethnic groups: those of Arab descent in the North, Nilotic tribes in the South, West African tribes in the region of Darfur and Eastern Tribes [1]. In the current study information about normal sex- and age-related linear distances was provided. The three-dimensional coordinates of 14 landmarks on the facial soft tissues were obtained using a hand-held laser scanner in 653 healthy Northern Sudanese subjects (326 males and 327 females) aged 4 to 30 years. From the landmarks, 13 linear distances were calculated, and averaged for age and sex. Comparisons were performed by factorial analysis of variance. All analyzed linear soft-tissue facial dimensions were significantly larger in men than in women (p < 0.05), except mouth width (ch-ch), upper facial height (n-sn) and mandibular corpus length (pg-go). All measurements underwent significant modifications as a function of age (p < 0.01), with significant age x sex interactions (p < 0.01) for all linear dimensions except lower face height (sn-pg). Overall, when compared to literature data for African and Caucasoid subjects, several differences were found, pointing to the necessity of ethnic-specific data [2]. Data collected in the present investigation could serve as a database for the quantitative description of human facial morphology during normal growth and development

Registration of dental arch models in 3D facial volumes: an alternative to CBCT acquisitions

Digital 3D models of dental arches and facial soft tissues may constitute an important support for clinicians and maxillofacial surgeons. They can be obtained using a noninvasive and harmless method1 starting from acquisitions made with a dental scanner and a stereophotogrammetric device. The aim of the study was to compare measures taken on the 3D dental and facial models with the ones obtained through a Cone Beam Computed Tomography (CBCT) device in order to evaluate the reliability of the proposed method and its repeatability. Dental and facial data about a population of seven healthy subjects just undergone CBCT have been acquired and registered twice by three operators following a protocol devised for previous works published by this same laboratory2,3. Five craniofacial and six dental landmarks have been taken into account and their linear distances have been calculated. The errors between the corresponding distances in the alternative method and in the CBCT volume have been normalized on the corresponding distance measured on the CBCT model. Statistically significant differences between repetitions and operators were found in the distances between the orbitalis and dental landmarks. We assume that these differences might have been caused by the difficulty in the positioning of the craniofacial soft-tissue landmarks on the CBCT scans. Also the delicate steps for registering the models of the dental arches could have generated errors as it has been suggested by the significant difference between experienced and inexperienced operators. It is advisable to continue the study on more patients in order to obtain a larger data set. It might also be good to consider soft tissue landmarks that are closer to the respective bone tissue ones