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The article discusses gingival phenotype and thickness through visual, probing, and ultrasound methods in orthodontic patients, finding limited agreement between probing and ultrasound measurements. Topics include the importance of gingival characteristics in dental outcomes, challenges in accurate visual assessment of phenotype by clinicians, and the need for further research to enhance diagnostic methods for gingival health.

To investigate the association between the width of keratinized gingiva (WKG), gingival phenotype (GP), and gingival thickness (GT) with craniofacial morphology in sagittal and vertical dimensions. WKG, GP, and GT of mandibular anterior teeth in 177 preorthodontic patients (mean age 18.38 ± 5.16 years) were assessed clinically using a periodontal probe, a Colorvue Biotype Probe, and ultrasound by a single examiner. Patients were grouped into skeletal Class I, II, and III and hyperdivergent, normodivergent, and hypodivergent based on ANB and SN-MP angles. Mandibular incisor inclination (L1-NB) was also measured. Clinical and cephalometric measurements were repeated to assess inter- and intraexaminer reproducibility. A significant association was found between thin GP and skeletal Classes I and III for the left mandibular central incisor (MCI; P =.0183). In skeletal Class III patients, L1-NB angle demonstrated a decreasing trend as phenotype thickness decreased. A significant association was found between thin phenotype and normodivergent and hypodivergent groups for MCIs (left: P =.0009, right: P =.00253). No significant association between WKG or GT and craniofacial morphology was found. Thin GP is associated with skeletal Class I and III for the left MCI. Thin GP is associated with hypodivergent and normodivergent skeletal patterns for the MCIs. There was no association between WKG and GT and craniofacial morphology in both skeletal and vertical dimensions. Dental compensations that exist due to different craniofacial morphology may influence the GP. [ABSTRACT FROM AUTHOR]

To identify changes in orthodontic management strategies in patients with hypodontia seen in 2000, 2010, and 2017/2018 (during a 1-year period). An assessment of the panoramic radiographs of 3701 patients from a Western Australian private practice identified 276 individuals demonstrating hypodontia. The location of missing teeth, age, sex, type of malocclusion, and the management strategies (space closure or opening) for each patient were noted. Most hypodontia involved agenesis of three or fewer teeth (90%). Maxillary lateral incisors and mandibular second premolars were the most commonly missing teeth. Female preponderance was noted. When considering treatment, the odds ratio for orthodontic space opening and prosthetic replacement in 2000 was 3.266 (P value = 7e-04; 95% confidence interval [CI], 1.464–4.633) compared with patients seen in 2010 and 1.632 (P value = 7e-04; 95% CI, 0.811–2.434) compared with patients in 2017/2018. For patients demonstrating bilateral absence of maxillary lateral incisors, the odds ratio for orthodontic space opening was 3.185 (P value = 0.0215; 95% CI, 1.182–9.243) compared with counterparts with unilateral agenesis. None of the factors investigated were significantly associated with the types of treatment planned/provided for the patients with missing mandibular second premolars. Maxillary lateral incisors and mandibular second premolars were the most commonly missing teeth. A trend away from space opening and prosthetic replacement toward orthodontic space closure was observed from 2000 to 2017/2018. This may reflect a change in attitude toward prosthetic replacement options and/or greater optimism with biomechanical strategies since the implementation of temporary anchorage devices to assist in space closure. [ABSTRACT FROM AUTHOR]

To assess changes in pulp blood flow (PBF) and pulp sensibility (PS) in teeth of patients with a history of dental trauma undergoing maxillary expansion. Twenty-five patients requiring rapid maxillary expansion (RME) had the pulp status of their maxillary anterior teeth assessed using laser Doppler flowmetry, electric pulp testing, and thermal testing (CO2 snow). Each patient was tested at T1 (prior to expansion), T2 (2 weeks after rapid expansion), and T3 (3 months after expansion). Relationships between PBF, time interval, and history of trauma were evaluated using linear mixed modelling. Within the Trauma group, PBF was significantly lower (P ≤.05) at T2 and T3 in comparison to T1 and significantly lower (P ≤.05) at T2 in comparison to T3. In the Non-trauma group, PBF at T2 was significantly lower (P ≤.05) than PBF at T1 and T3; however, no significant difference (P >.05) in PBF was observed when comparing PBF at T1 and T3. In both groups, PS was maintained in almost all teeth (>90%). RME in healthy teeth causes reduction of PBF before reestablishment of pretreatment values. RME in traumatized teeth causes reduction of PBF without PBF being reestablished to pretreatment levels. Teeth with a history of compromise may have reduced adaptive capacity under insults such as RME, which should be appreciated during the informed consent process. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the premise that skeletal anchorage with SAS miniplates are highly successful and predictable for a range of complex orthodontic movements.Materials and Methods: This retrospective cross-sectional analysis consisted of 421 bone plates placed by one clinician in 163 patients (95 female, 68 male, mean age 29.4 years 6 12.02). Simple descriptive statistics were performed for a wide range of malocclusions and desired movements to obtain success, complication, and failure rates.Results: The success rate of skeletal anchorage system miniplates was 98.6%, where approximately 40% of cases experienced mild complications. The most common complication was soft tissue inflammation, which was amenable to focused oral hygiene and antiseptic rinses. Infection occurred in approximately 15% of patients where there was a statistically significant correlation with poor oral hygiene. The most common movements were distalization and intrusion of teeth. More thana third of the cases involved complex movements in more than one plane of space.Conclusions: The success rate of skeletal anchorage system miniplates is high and predictable for a wide range of complex orthodontic movements. [ABSTRACT FROM AUTHOR]

An optimal outcome of combined surgery and orthodontics involving the maxilla is dependent on many factors. Accurate placement of the maxilla by the surgical team is ultimately of paramount importance. The aim of this retrospective study was to evaluate the accuracy of Le Fort I maxillary osteotomy with respect to the presurgical prediction. The sample comprised 42 patients (33 females, nine males) who had undergone Le Fort I osteotomy procedure alone or in combination with a mandibular osteotomy with or without genioplasty. Tracings of presurgical and immediate postsurgical lateral cephalograms and surgical predictions were digitized and compared using Quick Ceph software analysis. Vertical and horizontal measurements to various skeletal landmarks were used to assess the discrepancy between the predicted maxillary position and the actual postsurgical result. Statistically significant differences were found between the predicted and actual postsurgical maxillary molar vertical position, and significant differences were also found for the palatal plane angular measurements. Two surgical teams were compared, and surgical team 1 had significantly less variation in the surgical outcomes than did surgical team 2. When single-jaw and bimaxillary surgery were compared, no significant differences were found. Similarly, there were no statistically significant differences found when assessing the primary direction of movement (impaction vs downgraft vs advancement). Overall, 66% of the results were within two mm of prediction and 26% of the results were within one mm of prediction. A LeFort I maxillary osteotomy can be an accurate procedure with a wide range of discrepancy. [ABSTRACT FROM AUTHOR]