Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie
Purpose The twin block (TB) is one of the most widely used functional appliances for the correcti... more Purpose The twin block (TB) is one of the most widely used functional appliances for the correction of class II malocclusions. Align Technology (San Jose, CA, USA) developed the Invisalign® mandibular advancement (MA) that replicates the mechanism of action of a functional appliance. The aim of this study was to compare the changes produced by the TB versus those by MA. Methods The records of 56 class II patients treated with the TB (TB group: n = 35) or the MA (MA group: n = 21) were compared to a control sample of 15 untreated class II subjects (UC2). Results The TB and MA groups showed a significant reduction of the ANB angle, compared to the controls (TB group: −1.5°; MA group: −1.5°; UC2 group: +0.2°). For the Co-Gn values, the TB and MA groups showed significant differences when compared with the UC2 group with an increase of 8.4 mm in TB patients and of 8.3 mm in MA patients. The increase of the distance of Pg to the true vertical line (TVL) was the only measurement where sig...
Background: When the incisors do not erupt at the expected time, it is crucial for the clinician ... more Background: When the incisors do not erupt at the expected time, it is crucial for the clinician to determine the etiology and formulate an appropriate treatment plan. Aim: THE AIM OF THIS REPORT IS TO PROVIDE USEFUL INFORMATION FOR IMMEDIATE DIAGNOSIS AND MANAGEMENT OF IMPACTED MAXILLARY INCISORS USING THE INTERCEPTIVE TREATMENT: removal of obstacles and rapid maxillary expansion (RME). Design: An accurate diagnosis may be obtained with clinical and radiographic exam such as panoramic radiograph, computerized tomography (CT) and cone beam computerized tomography (CBCT). It's important to know the predictive measurements of eruption evaluated on panoramic radiograph: distance from the occlusal plane, maturity, angulation and vertical position of the unerupted incisors. Early diagnosis is important and interceptive orthodontic treatment, such as removal of obstacles and orthopedic rapid maxillary expansion (RME), may correct disturbances during the eruption through recovering space for the incisors and improving the intraosseus position of delayed teeth. Results: RME treatment following the surgical removal of the obstacle to the eruption of maxillary incisors leads to an improvement of the intraosseus position of the tooth. Conclusions: The angulation and the vertical position of the delayed tooth appear to be important in trying to predict eruption. The improvement of the intraosseus position of the unerupted incisor, obtained by removal of the odontoma and rapid maxillary expansion, permits a conservative surgery and the achievement of an excellent esthetics and periodontal result.
The aim of this study was to determine the caries prevalence in urban and suburban Albanian schoo... more The aim of this study was to determine the caries prevalence in urban and suburban Albanian schools. A large sample (n= 2617) of subjects, aged 7-15, was examined by a clinical observation without radiograms. The sample comprised 1257 males and 1360 females. For each subject an anamnestic questionnaire about feeding, fluoride, dentist attendance and familiar informations was obtained. Gender and age differences were compared by Chi-square test. The total dmft index (decayed, missing and filled teeth in deciduous dentition) was 2.082; dmft in males was 2.137, in females was 2.032. The total DMFT index (Decayed, Missing and Filled Teeth in permanent dentition) was 2.327; DMFT in males was 2.253, in females was 2.396. Decayed teeth was principal component of both dmft and the DMFT index. Caries prevalence results higher in girls than boys in deciduous and in permanent teeth.
This report describes a rare case of a supplemental tooth with a morphology similar to a lateral ... more This report describes a rare case of a supplemental tooth with a morphology similar to a lateral incisor, found in the canine region of the mandible of a 6-year-old male. The purpose of this paper is to report the importance of early diagnosis and treatment during mixed dentition. The treatment was extraction of the primary mandibular left canine soon after the initial diagnosis of the condition to facilitate the spontaneous eruption of the supplemental tooth and his removal. Twenty-nine months after the removal of the supplemental tooth the mandibular left canine was fully erupted into normal position. No complication arose from the presence of this supernumerary and his early diagnosis has been very important for not disrupting the normal erupting or alignment of other teeth.
Aim: To provide clinicians with useful information for immediate diagnosis and management of impa... more Aim: To provide clinicians with useful information for immediate diagnosis and management of impacted maxillary incisors due to trauma. Methods: We present a case of post-traumatic impaction of a central right maxillary incisor in a young patient. The treatment plan consisted in the interceptive management (surgical and orthodontic), the valuation of the necessary space to move the impacted tooth in the normal position and the biomechanical approach for anchorage, avoiding prosthetic/implants replacement. Results: THE THERAPY OF AN IMPACTED MAXILLARY INCISOR DUE TO TRAUMA REQUIRES A MULTIDISCIPLINARY APPROACH: orthodontic, surgical, endodontic and periodontal considerations are essential for successful treatment. Conclusions: SURGICAL EXPOSURE AND ORTHODONTIC TRACTION IS THE TREATMENT MOST OFTEN USED IN CASE OF POSTTRAUMATIC IMPACTED INCISOR: this technique in fact can lead to suitable results at the periodontal, occlusal and esthetics levels at an early stage and more definitively than with other treatment options.
Background: To evaluate morphologic differences between class III malocclusion success and failur... more Background: To evaluate morphologic differences between class III malocclusion success and failure treatment subjects in order to identify which variables are more predictive for long-term stability in early orthopedic treatment. In this retrospective study, 31 patients were enrolled from the Department of Orthodontics (Rome Tor Vergata). Inclusion criteria were as follows: white ancestry, class III malocclusion, mixed dentition, cervical stage (CS) 1-2, no pseudo-class III. Pre-treatment radiographic and cast records were collected. Each patient underwent rapid maxillary expansion/facial mask/bite block (RME/FM/BB) orthopedic treatment until correction. At T1 (permanent dentition, CS4), records were recollected. According to treatment stability, relapse group (RG, 19) and success group (SG, 12) were identified. Sagittal and vertical cephalometric and digital cast measurements were performed. Student's t tests were used for statistically significant differences inter and intra groups. For discriminant analysis, relapse or success status was added to each patient's T0 data. Results: At T0, RG showed larger upper anterior transversal width (p = 0.0266), while at T1 the upper anterior length was shorter than SG (p = 0.0028). Between T1 and T0, both groups showed larger upper anterior and posterior transversal widths. SG had greater upper anterior (p = 0.0066) and posterior (p = 0.449) sagittal length. RG presented larger lower anterior (p = 0.0012) and posterior (p = 0.0002) transversal widths, while there were no differences in SG lower arch. Discriminant analysis provided two predictive variables with an accuracy of 80.6%: upper anterior length and upper posterior length. A shorter and wider maxilla could be a predisposing factor for relapse and failure of the early orthopedic treatment of class III malocclusion patients. The absence of mandibular changes could be predictable for treatment success.
Aim of this report is to describe a case of a patient in mixed dentition with dento-skeletal clas... more Aim of this report is to describe a case of a patient in mixed dentition with dento-skeletal class II malocclusion, deep bite, increased overjet and gummy smile.IN THIS KIND OF CLINICAL CASE THE OBJECTIVES OF TREATMENT WERE: to correct the dento-skeletal malocclusion, to obtain a correct overbite and overjet, to control the permanent teeth in a good eruption, to improve aesthetical conditions and to maintain clinical results.Treatment plan included just Occlus-o-guide(®), the type that is indicated for mixed dentition (G type). The active phase of therapy was conducted in twelve months and the retention time was two years. Then the patient was controlled every three months and she used the appliance nighttime in alternance for one year more.Occlus-o-guide(®) was the indicated appliance to obtain all the objectives requested to solve the malocclusion. The early therapy with Occlus-o-guide(®) is easy, short and most of treated cases don't need a second phase of orthodontic therapy.
Aim: The aim of this study was to assess the prevalence of oral habits in an Albanian population ... more Aim: The aim of this study was to assess the prevalence of oral habits in an Albanian population of schoolchildren. Study design: A sample of 2617 subjects, aged 7-15, was examined by clinical observation without radiograms. The sample comprised 1257 males and 1360 females, with no history of orthodontic treatment. Aestethical frontal and profile analysis, intraoral and functional analysis were performed. Statistics: Gender and age differences were compared by chi-square test. The relationship between malocclusions and oral habits was assessed by t-test and the level of significance was assessed at 0.01. Results: The findings indicated that oral habits were present in 2225 subjects (85.0%), 1103 males (87.7%) and 1121 females (82.4%); the most frequent oral habit was pacifier sucking (30%) and it was mostly present in the 7-11 years group. It was observed a significant correlation between oral habits and dental malocclusions, open bite, altered overjet and maxillary contraction. CONCLUSION The high number of oral habits observed in the studied sample suggest that prevention strategies adopted in other countries could be successfully integrated in the development of an effective national programme in Albania aimed at reducing malocclusion risk factors.
The aim of this study was to determine the caries prevalence in urban and suburban Albanian schoo... more The aim of this study was to determine the caries prevalence in urban and suburban Albanian schools. A large sample (n= 2617) of subjects, aged 7-15, was examined by a clinical observation without radiograms. The sample comprised 1257 males and 1360 females. For each subject an anamnestic questionnaire about feeding, fluoride, dentist attendance and familiar informations was obtained. Gender and age differences were compared by Chi-square test. The total dmft index (decayed, missing and filled teeth in deciduous dentition) was 2.082; dmft in males was 2.137, in females was 2.032. The total DMFT index (Decayed, Missing and Filled Teeth in permanent dentition) was 2.327; DMFT in males was 2.253, in females was 2.396. Decayed teeth was principal component of both dmft and the DMFT index. Caries prevalence results higher in girls than boys in deciduous and in permanent teeth.
International Journal of Pediatric Otorhinolaryngology, Sep 1, 2018
To evaluate the relationship between the severity degree of OSA (apnea/hypopnea index AHI > 1) an... more To evaluate the relationship between the severity degree of OSA (apnea/hypopnea index AHI > 1) and palatal area and volume, measured by 3D analysis of digital casts in Marfan children. Methods: Twenty children with a clinical diagnosis of MS were recruited from a tertiary medical center. All the subjects underwent standard nocturnal polygraphy testing. Sixteen Marfan patients (7F,9 M; mean age 8.8yy ± 1.5yy) with AHI > 1 were enrolled. Marfan Group (MG) was compared with a control group (CG) of 17 children without Marfan syndrome (9F,8 M; mean age 8.5yy ± 1.7yy) presenting with nose-breathing pattern. For each subject maxillary digital casts were taken and palatal area and volume were measured. Unpaired t-test was used to test significant differences between MG and CG for area and volume measurements. Pearson correlation coefficient (PCC) was used to measure the linear correlation between the degree of OSA (AHI index) and palatal volume and palatal area. Results: 80% of Marfan children presented an AHI > 1 and a diagnosis of OSA. MG presented statistically significant lower values of palatal surface area (662.68 mm 2 ; P < 0.0001) and palatal volume (2578.1 mm 3 ; P < 0.0001) with respect to CG (923.0 mm 2 and 3756.6 mm 3 , respectively). Correlation analysis showed that AHI index had no linear correlation with palatal area (r = -0,07) and with palatal volume (r = -0,11). Conclusion: OSA is highly prevalent in children with Marfan's syndrome (80%). Marfan children present a reduction of palatal area and volume when compared to healthy subjects. OSA in Marfan children is not linear correlated to the palatal morphology and it shows a multifactorial aetiology.
The purpose of this retrospective study was to evaluate the mandibular shape differences between ... more The purpose of this retrospective study was to evaluate the mandibular shape differences between a group of success and a group of failure Anterior Open Bite (AOB) malocclusion early orthodontic treatment in growing subjects, in order to identify mandibular features of relapse. Methods: Twenty three patients (7 males, 16 females, 9.3 years ±1,5 years) were enrolled from the Department of Orthodontics at the University of Rome Tor Vergata. Inclusion criteria were: white ancestry, overbite < 0 mm, mixed dentition phase, end-to-end or Class I molar relationship, first skeletal class assessed on lateral cephalograms (0° < ANB < 4°), cervical skeletal maturation CS1-CS2, no previous orthodontic treatment, no congenital diseases. Pre-treatment (T1) lateral cephalograms were acquired. Each patient underwent early orthodontic treatment with Rapid Maxillary Expander (RME) and Bite Block (BB) or Quad-Helix Crib (QHC) until open bite correction. Radiographic records were recollected at T2 (permanent dentition, skeletal cervical maturation CS3-CS4). Mean interval time T2-T1 was 4.2 years ±6 months. According to treatment stability, a Relapse Group (RG 11 patients, 3 M, 8F; 13.7 years ±8 months, 7 subjects treated with RME/BB, 4 with QH/C) and a Success Group (SG, 12 patients, 4 M, 8F; 13.4 ± 10 months, 7 subjects treated with QH/C, 5 with RME/BB) were identified. On the lateral radiographs the mandibular length (Co-Gn), the inferior gonial angle (NGo^GoMe) and the antegonial notch depth (AND) were analyzed. Then the mandibular Geometric Morphometric analysis (GMM) was applied. Intergroup statistically significant differences were found using student's t-tests. Procrustes analysis and principal component analysis (PCA) were performed for the GMM. Results: At T1 no statistically significant differences were found between RG and SG, however higher values of antegonial notch depth were found in RG. T2-T1 comparison showed in RG statistically significant increases in Co-Gn (p = 0.04), NGo^GoMe angle (p = 0.01) and antegonial notch depth (p = 0,04). PC1 confirmed the increase in the antegonial notch depth in RG when compared to SG at T2. The increased antegonial notch depth associated with the increased mandibular length and the increased gonial angle could be responsible of relapse of early orthodontic treatment in open bite growing subjects.
Background: To study the covariation between palatal and craniofacial skeletal morphology in Clas... more Background: To study the covariation between palatal and craniofacial skeletal morphology in Class III growing patients through geometric morphometric analysis (GMM). Methods: In this retrospective study, 54 Class III subjects (24F,30M;7.6±0.8yy) were enrolled following these inclusion criteria: European ancestry, Class III skeletal and dental relationship, early mixed dentition, prepubertal skeletal maturation, familiarity for Class III malocclusion, no pseudo Class III malocclusion. Each patient provided upper digital cast and cephalogram before starting the therapy. Landmarks and semilandmarks were digitized (239 on the casts;121 on the lateral radiographs) and GMM was used. Procrustes analysis and principal component analysis (PCA) were applied to show the principal components of palatal and craniofacial skeletal shape variation. Two-block partial least squares analysis (PLS) was used to assess pattern of covariation between palatal and craniofacial morphology. Results: Regarding palatal shape variation, PC with largest variance (PC1) described morphological changes in the three space dimensions, while, concerning the craniofacial complex components, PC1 revealed morphological differences along the vertical plane. A significant covariation was found between palatal and craniofacial shape. PLS1 accounted for more than 61,7% of the whole covariation, correlating the craniofacial divergence to palatal height and width. Conclusions: In Class III subjects increments of angle divergence are related to a narrow and high palate.
Background: The purpose of this study was to evaluate the palatal morphological changes in Anteri... more Background: The purpose of this study was to evaluate the palatal morphological changes in Anterior Open Bite (AOB) pre-pubertal subjects treated with Rapid Maxillary Expansion and Bite-Block (RME/BB) or Quad Helix with crib (QH/C) when compared with a Control Group (CG) by using Geometric Morphometric Analysis (GMM). Methods: AOB group (AOBG) included 30 subjects (20 females, 10 males, mean age 8.1 ± 0.8ys) with dentoskeletal AOB. AOBG was divided in two subgroups according to the treatment strategy: RME/BB group (RME/BBg) included 15 subjects (10 females, 5 males, QH/C group (QH/Cg) comprised 15 subjects (10 females, 5 males). The two subgroups were compared with a CG of 15 subjects (10 females, 5 males) matched for sex, age, vertical pattern, and observation period. Digital upper dental casts were collected before treatment (T1) and at the end of the active treatment (T2). Landmarks and semilandmarks were digitized on dental casts and GMM was applied. Procrustes analysis and principal component analysis (PCA) were performed. Results: At T2, RME/BBg when compared with QH/Cg evidenced no statistically signi cant differences. Instead, RME/BBg showed an increased maxillary transverse dimension and a decreased palatal depth when compared with CG. The comparison QH/Cg vs CG demonstrated a slight transversal maxillary expansion. Conclusions: RME/BBg showed signi cant changes in the transversal and vertical dimensions with a clear maxillary expansion and a decrease of the palatal depth when compared with QH/Cg and CG. QH/Cg showed a signi cant slight maxillary expansion and no variation in vertical and sagittal planes when compared with CG.
Background: to compare the effects of two different expansion protocols in terms of bi-dimensiona... more Background: to compare the effects of two different expansion protocols in terms of bi-dimensional linear, angular measurements, and three-dimensional analysis of palatal area on digital casts in patients with mixed dentition. Methods: digital casts of 32 children treated with the RME (RG: 17 subjects), or with clear aligners (FG: 15 subjects) were collected. Linear and angular values were measured in both groups on the upper arch for each pre (T1) and post-treatment (T2) models, as well as palatal area. Unpaired t-test was used to test significant differences between groups (p<0.05). Results: the comparison of T2-T1 changes for linear measurements between groups showed significant differences in the inter-canine width (+1.5mm in FG), in the first inter-deciduous molar width (+1.5mm in FG), in the first inter-molar distal width (-1.2mm in FG), in the inter-canine transpalatal width (+1.5mm in FG) and in the first inter-deciduous molar transpalatal width (+1.4mm in FG). The analys...
Background: The objective of this retrospective study was to analyze the morphological changes of... more Background: The objective of this retrospective study was to analyze the morphological changes of the upper arch after two protocols of expansion, the Invisalign® First system and rapid maxillary expansion (RME), in mixed dentition by means of geometric morphometric analysis (GMM). Methods: Digital dental casts of 32 children treated either with RME (RME group: 17 subjects; mean age 8.1 years) or the First system (First group: subjects; mean age 8.4 years) were collected. For both the RG and FG, pre-(T1) and post-treatment(T2) digital models were created. A total of 14 landmarks were digitized and GMM was applied. Procrustes analysis and principal component analysis (PCA) were performed. Results: The PC1 resulting from the T2–T1 comparison in the RG g showed statistically significant morphological changes in the posterior region of the upper arch shape, without significant variations in the anterior region. The comparison of the T2–T1 changes in the FG showed an increase in the tran...
Con il termine Sleep disorder breathing (SDB) sintendono tutte quelle difficoltà respiratorie ch... more Con il termine Sleep disorder breathing (SDB) sintendono tutte quelle difficoltà respiratorie che si verificano durante il sonno. Si può osservare una grande variabilità nella sintomatologia dei pazienti affetti da SDB, direttamente proporzionale alla resistenza che le vie aeree superiori offrono al passaggio dellaria quando queste sono ostruite. LSDB rappresenta un ampio ventaglio di disturbi che vanno dal russamento primario fino ad arrivare alle apnee ostruttive del sonno. I bambini con problemi respiratori tendono a compensare lostruzione delle vie aeree assumendo posizioni caratteristiche, tali da garantire il mantenimento della pervietà delle vie aeree durante il sonno. Unanomalia di posizione nel sonno, durante la fase di crescita e sviluppo, si ripercuote in unalterazione dello sviluppo occlusale e in una modifica del pattern di crescita. Le principali alterazioni sono a carico del mascellare superiore, dellaltezza facciale, del tono muscolare e della posizione mandib...
Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie
Purpose The twin block (TB) is one of the most widely used functional appliances for the correcti... more Purpose The twin block (TB) is one of the most widely used functional appliances for the correction of class II malocclusions. Align Technology (San Jose, CA, USA) developed the Invisalign® mandibular advancement (MA) that replicates the mechanism of action of a functional appliance. The aim of this study was to compare the changes produced by the TB versus those by MA. Methods The records of 56 class II patients treated with the TB (TB group: n = 35) or the MA (MA group: n = 21) were compared to a control sample of 15 untreated class II subjects (UC2). Results The TB and MA groups showed a significant reduction of the ANB angle, compared to the controls (TB group: −1.5°; MA group: −1.5°; UC2 group: +0.2°). For the Co-Gn values, the TB and MA groups showed significant differences when compared with the UC2 group with an increase of 8.4 mm in TB patients and of 8.3 mm in MA patients. The increase of the distance of Pg to the true vertical line (TVL) was the only measurement where sig...
Background: When the incisors do not erupt at the expected time, it is crucial for the clinician ... more Background: When the incisors do not erupt at the expected time, it is crucial for the clinician to determine the etiology and formulate an appropriate treatment plan. Aim: THE AIM OF THIS REPORT IS TO PROVIDE USEFUL INFORMATION FOR IMMEDIATE DIAGNOSIS AND MANAGEMENT OF IMPACTED MAXILLARY INCISORS USING THE INTERCEPTIVE TREATMENT: removal of obstacles and rapid maxillary expansion (RME). Design: An accurate diagnosis may be obtained with clinical and radiographic exam such as panoramic radiograph, computerized tomography (CT) and cone beam computerized tomography (CBCT). It's important to know the predictive measurements of eruption evaluated on panoramic radiograph: distance from the occlusal plane, maturity, angulation and vertical position of the unerupted incisors. Early diagnosis is important and interceptive orthodontic treatment, such as removal of obstacles and orthopedic rapid maxillary expansion (RME), may correct disturbances during the eruption through recovering space for the incisors and improving the intraosseus position of delayed teeth. Results: RME treatment following the surgical removal of the obstacle to the eruption of maxillary incisors leads to an improvement of the intraosseus position of the tooth. Conclusions: The angulation and the vertical position of the delayed tooth appear to be important in trying to predict eruption. The improvement of the intraosseus position of the unerupted incisor, obtained by removal of the odontoma and rapid maxillary expansion, permits a conservative surgery and the achievement of an excellent esthetics and periodontal result.
The aim of this study was to determine the caries prevalence in urban and suburban Albanian schoo... more The aim of this study was to determine the caries prevalence in urban and suburban Albanian schools. A large sample (n= 2617) of subjects, aged 7-15, was examined by a clinical observation without radiograms. The sample comprised 1257 males and 1360 females. For each subject an anamnestic questionnaire about feeding, fluoride, dentist attendance and familiar informations was obtained. Gender and age differences were compared by Chi-square test. The total dmft index (decayed, missing and filled teeth in deciduous dentition) was 2.082; dmft in males was 2.137, in females was 2.032. The total DMFT index (Decayed, Missing and Filled Teeth in permanent dentition) was 2.327; DMFT in males was 2.253, in females was 2.396. Decayed teeth was principal component of both dmft and the DMFT index. Caries prevalence results higher in girls than boys in deciduous and in permanent teeth.
This report describes a rare case of a supplemental tooth with a morphology similar to a lateral ... more This report describes a rare case of a supplemental tooth with a morphology similar to a lateral incisor, found in the canine region of the mandible of a 6-year-old male. The purpose of this paper is to report the importance of early diagnosis and treatment during mixed dentition. The treatment was extraction of the primary mandibular left canine soon after the initial diagnosis of the condition to facilitate the spontaneous eruption of the supplemental tooth and his removal. Twenty-nine months after the removal of the supplemental tooth the mandibular left canine was fully erupted into normal position. No complication arose from the presence of this supernumerary and his early diagnosis has been very important for not disrupting the normal erupting or alignment of other teeth.
Aim: To provide clinicians with useful information for immediate diagnosis and management of impa... more Aim: To provide clinicians with useful information for immediate diagnosis and management of impacted maxillary incisors due to trauma. Methods: We present a case of post-traumatic impaction of a central right maxillary incisor in a young patient. The treatment plan consisted in the interceptive management (surgical and orthodontic), the valuation of the necessary space to move the impacted tooth in the normal position and the biomechanical approach for anchorage, avoiding prosthetic/implants replacement. Results: THE THERAPY OF AN IMPACTED MAXILLARY INCISOR DUE TO TRAUMA REQUIRES A MULTIDISCIPLINARY APPROACH: orthodontic, surgical, endodontic and periodontal considerations are essential for successful treatment. Conclusions: SURGICAL EXPOSURE AND ORTHODONTIC TRACTION IS THE TREATMENT MOST OFTEN USED IN CASE OF POSTTRAUMATIC IMPACTED INCISOR: this technique in fact can lead to suitable results at the periodontal, occlusal and esthetics levels at an early stage and more definitively than with other treatment options.
Background: To evaluate morphologic differences between class III malocclusion success and failur... more Background: To evaluate morphologic differences between class III malocclusion success and failure treatment subjects in order to identify which variables are more predictive for long-term stability in early orthopedic treatment. In this retrospective study, 31 patients were enrolled from the Department of Orthodontics (Rome Tor Vergata). Inclusion criteria were as follows: white ancestry, class III malocclusion, mixed dentition, cervical stage (CS) 1-2, no pseudo-class III. Pre-treatment radiographic and cast records were collected. Each patient underwent rapid maxillary expansion/facial mask/bite block (RME/FM/BB) orthopedic treatment until correction. At T1 (permanent dentition, CS4), records were recollected. According to treatment stability, relapse group (RG, 19) and success group (SG, 12) were identified. Sagittal and vertical cephalometric and digital cast measurements were performed. Student's t tests were used for statistically significant differences inter and intra groups. For discriminant analysis, relapse or success status was added to each patient's T0 data. Results: At T0, RG showed larger upper anterior transversal width (p = 0.0266), while at T1 the upper anterior length was shorter than SG (p = 0.0028). Between T1 and T0, both groups showed larger upper anterior and posterior transversal widths. SG had greater upper anterior (p = 0.0066) and posterior (p = 0.449) sagittal length. RG presented larger lower anterior (p = 0.0012) and posterior (p = 0.0002) transversal widths, while there were no differences in SG lower arch. Discriminant analysis provided two predictive variables with an accuracy of 80.6%: upper anterior length and upper posterior length. A shorter and wider maxilla could be a predisposing factor for relapse and failure of the early orthopedic treatment of class III malocclusion patients. The absence of mandibular changes could be predictable for treatment success.
Aim of this report is to describe a case of a patient in mixed dentition with dento-skeletal clas... more Aim of this report is to describe a case of a patient in mixed dentition with dento-skeletal class II malocclusion, deep bite, increased overjet and gummy smile.IN THIS KIND OF CLINICAL CASE THE OBJECTIVES OF TREATMENT WERE: to correct the dento-skeletal malocclusion, to obtain a correct overbite and overjet, to control the permanent teeth in a good eruption, to improve aesthetical conditions and to maintain clinical results.Treatment plan included just Occlus-o-guide(®), the type that is indicated for mixed dentition (G type). The active phase of therapy was conducted in twelve months and the retention time was two years. Then the patient was controlled every three months and she used the appliance nighttime in alternance for one year more.Occlus-o-guide(®) was the indicated appliance to obtain all the objectives requested to solve the malocclusion. The early therapy with Occlus-o-guide(®) is easy, short and most of treated cases don't need a second phase of orthodontic therapy.
Aim: The aim of this study was to assess the prevalence of oral habits in an Albanian population ... more Aim: The aim of this study was to assess the prevalence of oral habits in an Albanian population of schoolchildren. Study design: A sample of 2617 subjects, aged 7-15, was examined by clinical observation without radiograms. The sample comprised 1257 males and 1360 females, with no history of orthodontic treatment. Aestethical frontal and profile analysis, intraoral and functional analysis were performed. Statistics: Gender and age differences were compared by chi-square test. The relationship between malocclusions and oral habits was assessed by t-test and the level of significance was assessed at 0.01. Results: The findings indicated that oral habits were present in 2225 subjects (85.0%), 1103 males (87.7%) and 1121 females (82.4%); the most frequent oral habit was pacifier sucking (30%) and it was mostly present in the 7-11 years group. It was observed a significant correlation between oral habits and dental malocclusions, open bite, altered overjet and maxillary contraction. CONCLUSION The high number of oral habits observed in the studied sample suggest that prevention strategies adopted in other countries could be successfully integrated in the development of an effective national programme in Albania aimed at reducing malocclusion risk factors.
The aim of this study was to determine the caries prevalence in urban and suburban Albanian schoo... more The aim of this study was to determine the caries prevalence in urban and suburban Albanian schools. A large sample (n= 2617) of subjects, aged 7-15, was examined by a clinical observation without radiograms. The sample comprised 1257 males and 1360 females. For each subject an anamnestic questionnaire about feeding, fluoride, dentist attendance and familiar informations was obtained. Gender and age differences were compared by Chi-square test. The total dmft index (decayed, missing and filled teeth in deciduous dentition) was 2.082; dmft in males was 2.137, in females was 2.032. The total DMFT index (Decayed, Missing and Filled Teeth in permanent dentition) was 2.327; DMFT in males was 2.253, in females was 2.396. Decayed teeth was principal component of both dmft and the DMFT index. Caries prevalence results higher in girls than boys in deciduous and in permanent teeth.
International Journal of Pediatric Otorhinolaryngology, Sep 1, 2018
To evaluate the relationship between the severity degree of OSA (apnea/hypopnea index AHI > 1) an... more To evaluate the relationship between the severity degree of OSA (apnea/hypopnea index AHI > 1) and palatal area and volume, measured by 3D analysis of digital casts in Marfan children. Methods: Twenty children with a clinical diagnosis of MS were recruited from a tertiary medical center. All the subjects underwent standard nocturnal polygraphy testing. Sixteen Marfan patients (7F,9 M; mean age 8.8yy ± 1.5yy) with AHI > 1 were enrolled. Marfan Group (MG) was compared with a control group (CG) of 17 children without Marfan syndrome (9F,8 M; mean age 8.5yy ± 1.7yy) presenting with nose-breathing pattern. For each subject maxillary digital casts were taken and palatal area and volume were measured. Unpaired t-test was used to test significant differences between MG and CG for area and volume measurements. Pearson correlation coefficient (PCC) was used to measure the linear correlation between the degree of OSA (AHI index) and palatal volume and palatal area. Results: 80% of Marfan children presented an AHI > 1 and a diagnosis of OSA. MG presented statistically significant lower values of palatal surface area (662.68 mm 2 ; P < 0.0001) and palatal volume (2578.1 mm 3 ; P < 0.0001) with respect to CG (923.0 mm 2 and 3756.6 mm 3 , respectively). Correlation analysis showed that AHI index had no linear correlation with palatal area (r = -0,07) and with palatal volume (r = -0,11). Conclusion: OSA is highly prevalent in children with Marfan's syndrome (80%). Marfan children present a reduction of palatal area and volume when compared to healthy subjects. OSA in Marfan children is not linear correlated to the palatal morphology and it shows a multifactorial aetiology.
The purpose of this retrospective study was to evaluate the mandibular shape differences between ... more The purpose of this retrospective study was to evaluate the mandibular shape differences between a group of success and a group of failure Anterior Open Bite (AOB) malocclusion early orthodontic treatment in growing subjects, in order to identify mandibular features of relapse. Methods: Twenty three patients (7 males, 16 females, 9.3 years ±1,5 years) were enrolled from the Department of Orthodontics at the University of Rome Tor Vergata. Inclusion criteria were: white ancestry, overbite < 0 mm, mixed dentition phase, end-to-end or Class I molar relationship, first skeletal class assessed on lateral cephalograms (0° < ANB < 4°), cervical skeletal maturation CS1-CS2, no previous orthodontic treatment, no congenital diseases. Pre-treatment (T1) lateral cephalograms were acquired. Each patient underwent early orthodontic treatment with Rapid Maxillary Expander (RME) and Bite Block (BB) or Quad-Helix Crib (QHC) until open bite correction. Radiographic records were recollected at T2 (permanent dentition, skeletal cervical maturation CS3-CS4). Mean interval time T2-T1 was 4.2 years ±6 months. According to treatment stability, a Relapse Group (RG 11 patients, 3 M, 8F; 13.7 years ±8 months, 7 subjects treated with RME/BB, 4 with QH/C) and a Success Group (SG, 12 patients, 4 M, 8F; 13.4 ± 10 months, 7 subjects treated with QH/C, 5 with RME/BB) were identified. On the lateral radiographs the mandibular length (Co-Gn), the inferior gonial angle (NGo^GoMe) and the antegonial notch depth (AND) were analyzed. Then the mandibular Geometric Morphometric analysis (GMM) was applied. Intergroup statistically significant differences were found using student's t-tests. Procrustes analysis and principal component analysis (PCA) were performed for the GMM. Results: At T1 no statistically significant differences were found between RG and SG, however higher values of antegonial notch depth were found in RG. T2-T1 comparison showed in RG statistically significant increases in Co-Gn (p = 0.04), NGo^GoMe angle (p = 0.01) and antegonial notch depth (p = 0,04). PC1 confirmed the increase in the antegonial notch depth in RG when compared to SG at T2. The increased antegonial notch depth associated with the increased mandibular length and the increased gonial angle could be responsible of relapse of early orthodontic treatment in open bite growing subjects.
Background: To study the covariation between palatal and craniofacial skeletal morphology in Clas... more Background: To study the covariation between palatal and craniofacial skeletal morphology in Class III growing patients through geometric morphometric analysis (GMM). Methods: In this retrospective study, 54 Class III subjects (24F,30M;7.6±0.8yy) were enrolled following these inclusion criteria: European ancestry, Class III skeletal and dental relationship, early mixed dentition, prepubertal skeletal maturation, familiarity for Class III malocclusion, no pseudo Class III malocclusion. Each patient provided upper digital cast and cephalogram before starting the therapy. Landmarks and semilandmarks were digitized (239 on the casts;121 on the lateral radiographs) and GMM was used. Procrustes analysis and principal component analysis (PCA) were applied to show the principal components of palatal and craniofacial skeletal shape variation. Two-block partial least squares analysis (PLS) was used to assess pattern of covariation between palatal and craniofacial morphology. Results: Regarding palatal shape variation, PC with largest variance (PC1) described morphological changes in the three space dimensions, while, concerning the craniofacial complex components, PC1 revealed morphological differences along the vertical plane. A significant covariation was found between palatal and craniofacial shape. PLS1 accounted for more than 61,7% of the whole covariation, correlating the craniofacial divergence to palatal height and width. Conclusions: In Class III subjects increments of angle divergence are related to a narrow and high palate.
Background: The purpose of this study was to evaluate the palatal morphological changes in Anteri... more Background: The purpose of this study was to evaluate the palatal morphological changes in Anterior Open Bite (AOB) pre-pubertal subjects treated with Rapid Maxillary Expansion and Bite-Block (RME/BB) or Quad Helix with crib (QH/C) when compared with a Control Group (CG) by using Geometric Morphometric Analysis (GMM). Methods: AOB group (AOBG) included 30 subjects (20 females, 10 males, mean age 8.1 ± 0.8ys) with dentoskeletal AOB. AOBG was divided in two subgroups according to the treatment strategy: RME/BB group (RME/BBg) included 15 subjects (10 females, 5 males, QH/C group (QH/Cg) comprised 15 subjects (10 females, 5 males). The two subgroups were compared with a CG of 15 subjects (10 females, 5 males) matched for sex, age, vertical pattern, and observation period. Digital upper dental casts were collected before treatment (T1) and at the end of the active treatment (T2). Landmarks and semilandmarks were digitized on dental casts and GMM was applied. Procrustes analysis and principal component analysis (PCA) were performed. Results: At T2, RME/BBg when compared with QH/Cg evidenced no statistically signi cant differences. Instead, RME/BBg showed an increased maxillary transverse dimension and a decreased palatal depth when compared with CG. The comparison QH/Cg vs CG demonstrated a slight transversal maxillary expansion. Conclusions: RME/BBg showed signi cant changes in the transversal and vertical dimensions with a clear maxillary expansion and a decrease of the palatal depth when compared with QH/Cg and CG. QH/Cg showed a signi cant slight maxillary expansion and no variation in vertical and sagittal planes when compared with CG.
Background: to compare the effects of two different expansion protocols in terms of bi-dimensiona... more Background: to compare the effects of two different expansion protocols in terms of bi-dimensional linear, angular measurements, and three-dimensional analysis of palatal area on digital casts in patients with mixed dentition. Methods: digital casts of 32 children treated with the RME (RG: 17 subjects), or with clear aligners (FG: 15 subjects) were collected. Linear and angular values were measured in both groups on the upper arch for each pre (T1) and post-treatment (T2) models, as well as palatal area. Unpaired t-test was used to test significant differences between groups (p<0.05). Results: the comparison of T2-T1 changes for linear measurements between groups showed significant differences in the inter-canine width (+1.5mm in FG), in the first inter-deciduous molar width (+1.5mm in FG), in the first inter-molar distal width (-1.2mm in FG), in the inter-canine transpalatal width (+1.5mm in FG) and in the first inter-deciduous molar transpalatal width (+1.4mm in FG). The analys...
Background: The objective of this retrospective study was to analyze the morphological changes of... more Background: The objective of this retrospective study was to analyze the morphological changes of the upper arch after two protocols of expansion, the Invisalign® First system and rapid maxillary expansion (RME), in mixed dentition by means of geometric morphometric analysis (GMM). Methods: Digital dental casts of 32 children treated either with RME (RME group: 17 subjects; mean age 8.1 years) or the First system (First group: subjects; mean age 8.4 years) were collected. For both the RG and FG, pre-(T1) and post-treatment(T2) digital models were created. A total of 14 landmarks were digitized and GMM was applied. Procrustes analysis and principal component analysis (PCA) were performed. Results: The PC1 resulting from the T2–T1 comparison in the RG g showed statistically significant morphological changes in the posterior region of the upper arch shape, without significant variations in the anterior region. The comparison of the T2–T1 changes in the FG showed an increase in the tran...
Con il termine Sleep disorder breathing (SDB) sintendono tutte quelle difficoltà respiratorie ch... more Con il termine Sleep disorder breathing (SDB) sintendono tutte quelle difficoltà respiratorie che si verificano durante il sonno. Si può osservare una grande variabilità nella sintomatologia dei pazienti affetti da SDB, direttamente proporzionale alla resistenza che le vie aeree superiori offrono al passaggio dellaria quando queste sono ostruite. LSDB rappresenta un ampio ventaglio di disturbi che vanno dal russamento primario fino ad arrivare alle apnee ostruttive del sonno. I bambini con problemi respiratori tendono a compensare lostruzione delle vie aeree assumendo posizioni caratteristiche, tali da garantire il mantenimento della pervietà delle vie aeree durante il sonno. Unanomalia di posizione nel sonno, durante la fase di crescita e sviluppo, si ripercuote in unalterazione dello sviluppo occlusale e in una modifica del pattern di crescita. Le principali alterazioni sono a carico del mascellare superiore, dellaltezza facciale, del tono muscolare e della posizione mandib...
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