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External apical root resorption (EARR) is one of the most frequently reported iatrogenic side effects of orthodontic movement. Nevertheless, no robust and unequivocal scientific evidence is yet available in the literature regarding the clinical and biological factors that trigger EARR. The purpose of the present position paper is to provide clinicians, residents, and investigators a summary of our current understanding about root resorption caused by orthodontic tooth movement, based on up-to-date available scientific evidence. Morphological, structural, biomechanical, and biological differences account for predisposing the apical third to EARR compared to other root surfaces during orthodontic treatment. In addition, a relevant number of patient and treatment-related factors increase risk of EARR. The main patient-related factors are reviewed and discussed: genetic factors, tooth anatomy, demographic factors, malocclusion factors, previous endodontic treatment, medical history, short root anomaly. Similarly, the influence of treatment-related factors are analyzed with regard to the effect of: biomechanical factors, type of orthodontic appliance, adjunctive therapies to accelerate tooth movement, early treatment, maxillary expansion, teeth extractions, the duration of treatment and the amount of apical displacement. Clinical management of EARR from pre-treatment records to the monitoring strategy as well as recommendations for the post orthodontic-treatment period are presented as a guide for the clinician. Despite years of studies, we still do not fully understand EARR, but the future is promising. True three-dimensional imaging with higher resolution and low radiation, and predictive tools towards an earlier detection without radiographs, will mark future developments in the field of EARR in orthodontics.

Intraoral fixed appliances remain in the potentially corrosive environment of the mouth for an average of two years. Over time, corrosion causes the release of metal ions, such as nickel and chromium. These metals can become allergenic and cytotoxic, causing different conditions in the human body. The aim of this study therefore is to carry out a systematic review of the available scientific evidence on the accumulation of metal ions, and the genotoxic and cytotoxic effects in oral mucosa cells deriving from short- and long-term exposure to them. The systematic review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The primary outcome (quantification of metal ion deposits and assessment of their genotoxic and/or cytotoxic effects) and secondary outcome (complementary analysis of cytotoxic and genotoxic effects) were examined. The Cochrane Collaboration tool and Toxicological data Reliability Assessment Tool (ToxRTool) were used for quality assessment. Once the search was performed, a total of seven articles met the inclusion criteria and were included in this study. Two main techniques were used to assess genotoxic effects: alkaline comet assay (6/7) and micronucleus method (1/7). Cytotoxicity was evaluated (4/7) using the trypan blue dye test. Accumulations of nickel (7/7), chromium (5/7), and other metals (zinc, cobalt, iron, manganese, molybdenum, titanium) were also quantified. The results allowed us to conclude that release of metal ions and acute cell and DNA damage in oral mucosa cells takes place in the early stages of treatment. However, more long-term studies are needed to evaluate chronic exposure to metals and DNA damage, as well as cellular capacity to recover DNA integrity.

The main aim of this study was to generate an adequate sub-phenotypic clustering model of class III skeletal malocclusion in an adult population of southern European origin. The study design was conducted in two phases, a preliminary cross-sectional study and a subsequent discriminatory evaluation by main component and cluster analysis to identify diferentiated skeletal sub-groups with diferentiated phenotypic characteristics. Radiometric data from 699 adult patients of southern European origin were analyzed in 212 selected subjects afected by class III skeletal malocclusion. The varimax rotation was used with Kaiser normalization, to prevent variables with more explanatory capacity from afecting the rotation. A total of 21,624 radiographic measurements were obtained as part of the cluster model generation, using a total set of 55 skeletal variables for the subsequent analysis of the major component and cluster analyses. Ten main axes were generated representing 92.7% of the total variation. Three main components represented 58.5%, with particular sagittal and vertical variables acting as major descriptors. Post hoc phenotypic clustering retrieved six clusters: C1:9.9%, C2:18.9%, C3:33%, C4:3.77%, C5:16%, and C6:16%. In conclusion, phenotypic variation was found in the southern European skeletal class III population, demonstrating the existence of phenotypic variations between identifed clusters in diferent ethnic groups.

Aim: To describe the particular craniofacial characteristics of Van der Woude syndrome(VWS) patients compared to patients with a non-syndromic cleft (CG1) and to a malocclusive healthy population (CG2). Material and methods: Retrospective case-control study. A sample of 110 matchedpatients was recruited (VWS (n = 7), CG1 (n = 49), CG2 (n = 49)). Subsequently, 37 radiometric variables were analysed and the dental-skeletal ages were determined. The intra/inter-observer method errors were quantified. Descriptive statistics were computed, and different inferential analysis tests were used depending on the normality of the data (Chi-square test, Fisher's exact test, paired Student's T-test, Mann–Whitney U test) (p-value < 0.05). Pairwise comparisons were corrected by Bonferroni's criteria. Results: VW-patients presented specific craniofacial characteristics and morphology. A marked tendency to the vertical growth pattern was found in VW-patients compared to CG1-CG2 (p < 0.001); at the sagittal level, skeletal class II caused by mandibular retrognathism, with a greatly increased ANB angle compared to CG1 (p = 0.042). Dental analysis showed that the lower incisor was more retruded and retroclined (p < 0.05 in all cases) and the interincisal angulation was increased (p < 0.001 (CG2)). At the profile level, an open nasolabial angle (p = 0.040; CG1) and a more protruding lower lip with respect to the Sn-Pg plane (p = 0.040 (CG1); p = 0.044 (CG2)) were observed. Conclusions: VW-patients present particular characteristics in the facial skeletal structures. There is a critical necessity to increase the evidence regarding specific clinical features and orofacial pathology of rare diseases such as VWS, which will help to these minorities to gain access in the future to a better quality of care with precise treatment and diagnostic necessities.

Personalized dental medicine requires from precise and customized genomic diagnostic. To conduct an association analysis over multiple putative loci and genes located at chromosomes 2, 4, 8, 12, 18, X, and Y, potentially implicated in an extreme type of external apical root resorption secondary to orthodontic forces (aEARR). A genome-wide association study of aEARR was conducted with 480 patients [ratio~1:3 case/control]. Genomic DNA was extracted and analyzed using the high-throughput Axiom platform with the GeneTitan&reg, MC Instrument. Up to 14,377 single nucleotide polymorphisms (SNPs) were selected at candidate regions and clinical/diagnostic data were recorded. A descriptive analysis of the data along with a backward conditional binary logistic regression was used to calculate odds ratios, with 95% confidence intervals [p &lt, 0.05]. To select the best SNP candidates, a logistic regression model was fitted assuming a log-additive genetic model using R software [p &lt, 0.0001]. In this sample the top lead genetic variants associated with aEARR were two novel putative genes located in the X chromosome, specifically, STAG 2 gene, rs151184635 and RP1-30E17.2 gene, rs55839915. These variants were found to be associated with an increased risk of aEARR, particularly restricted to men [OR: 6.09, 95%CI: 2.6&ndash, 14.23 and OR: 6.86, 95%CI: 2.65&ndash, 17.81, respectively]. Marginal associations were found at previously studied variants such as SSP1: rs11730582 [OR: 0.54, 95%CI: 0.34&ndash, 0.86, p = 0.008], P2RX7: rs1718119 [OR: 0.6, 95%CI: 0.36&ndash, 1.01, p = 0.047], and TNFRSF11A: rs8086340 [OR: 0.6, 95%CI: 0.38&ndash, 0.95, p = 0.024]), found solely in females. Multiple putative genetic variants located at chromosomes X and Y are potentially implicated in an extreme phenotype of aEARR. A gender-linked association was noted.

Background The aim of this systematic review was to identify, evaluate, and provide a current literature about the influence of heritability on the determination of occlusal traits. Materials and methods MEDLINE, SCOPUS, Web of Science, LILACS, and Google Scholar were searched without restrictions up to March 2020. Studies with twin method were considered and the risk of bias assessment was performed using quality of genetic association studies checklist (Q-Genie). The coefficient of heritability (h2), model-fitting approaches, and coefficient correlation were used to estimate the genetic/environmental influence on occlusal traits. The GRADE tool was used to assess the quality of the evidence. Results Ten studies met the eligibility criteria. Three studies presented good quality, five moderate quality, and two poor quality. Most studies have found that the intra-arch traits, mainly the maxillary arch morphology, such as width (h2 16–100%), length (h2 42–100%), and shape (h2 42–90%), and the crowding, mainly for mandibular arch (h2 35–81%), are under potential heritability influence. The traits concerning the inter-arch relationship, as overjet, overbite, posterior crossbite, and sagittal molar relation, seem not to be genetically determined. The certainty of the evidence was graded as low for all outcomes. Conclusions Although weak, the available evidence show that the heritability factors are determinant for the intra-arch traits, namely, arch morphology and crowding. Possibly due they are functionally related, the occlusal traits concerning the maxillary and mandibular relationship seem to have environmental factors as determinants. In this scenario, early preventive approaches can offer a more effective and efficient orthodontic treatment.

The potential of human mesenchymal stromal/stem cells (MSCs) including oral stem cells (OSCs) as a cell source to derive functional neurons has been inconclusive. Here we tested a number of human OSCs for their neurogenic potential compared to non-OSCs and employed various neurogenic induction methods. OSCs including dental pulp stem cells (DPSCs), gingiva-derived mesenchymal stem cells (GMSCs), stem cells from apical papilla and non-OSCs including bone marrow MSCs (BMMSCs), foreskin fibroblasts and dermal fibroblasts using non-neurosphere-mediated or neurosphere-mediated methods to guide them toward neuronal lineages. Cells were subjected to RT-qPCR, immunocytofluorescence to detect the expression of neurogenic genes or electrophysiological analysis at final stage of maturation. We found that induced DPSCs and GMSCs overall appeared to be more neurogenic compared to other cells either morphologically or levels of neurogenic gene expression. Nonetheless, of all the neural induction methods employed, only one neurosphere-mediated method yielded electrophysiological properties of functional neurons. Under this method, cells expressed increased neural stem cell markers, nestin and SOX1, in the first phase of differentiation. Neuronal-like cells expressed βIII-tubulin, CNPase, GFAP, MAP-2, NFM, pan-Nav, GAD67, Nav1.6, NF1, NSE, PSD95, and synapsin after the second phase of differentiation to maturity. Electrophysiological experiments revealed that 8.3% of DPSC-derived neuronal cells and 21.2% of GMSC-derived neuronal cells displayed action potential, although no spontaneous excitatory/inhibitory postsynaptic action potential was observed. We conclude that DPSCs and GMSCs have the potential to become neuronal cells in vitro, therefore, these cells may be used as a source for neural regeneration.

The ability to delay gratification (ATDG) is naturally linked to key regulatory psychological traits involved in self-discipline/regulation. The aim of this study was to ascertain the normalized impact of ATDG as an early predictor of oral health, on the primary dentition.404 subjects [202 children (4-6 years old) and 202 mothers] were enrolled in a case-control study. Systematic data collection included: i) extraoral diagnostic parameters; ii) intraoral health status; iii) behavioral aspects; iv) baseline socio-demographic data. The ICC, the paired Student's t-test and kappa statistic were used to evaluate intra-observer reliability. Distributions were explored with the chi-squared test [Odds ratio;95%CI;p0.05]. Conditional logistic regression was used to evaluate associations between all clinical diagnostic data and ATDG.Overweight/obese children and those diagnosed with ADHD are more prone to lack ATDG (p0.001). Higher deft values were observed in children who lacked ATDG, who were also strongly associated with higher sugar consumption and more impulsive personalities (p0.001;OR:.107/0.031;95%CI:036-0.316/0.008-0.115). By contrast, children with responsible personality traits were associated with this skill (p0.028;OR:3.33;95%CI:1.1-9.7) and obtained the lowest deft (p0.306;OR:0.539;95%CI:0.165-0.176) and gingival index values (p0.001;OR:10.44;95%CI:2.6-40.9), which are clear indicators of better current and future oral health.These data provide insights into a novel predictor for identifying individuals at a higher risk of dental caries in early childhood.The present study offers a new hypothesis for identifying individuals with poor oral health status. Early tools to detect the most vulnerable population sectors are critically important to reduce the global burden of caries and other oral diseases.

Current phenotypic characterizations of Class III malocclusion are influenced more by gender or ethnic origin than by raw linear skeletal measurements. The aim of the present research is to develop a Class III skeletal malocclusion sub-phenotype characterization based on proportional cranial measurements using principal component analysis and cluster analysis. Radiometric data from 212 adult subjects (115 women and 96 men) of southern European origin affected by Class III skeletal malocclusion were analyzed. A total of 120 measurements were made, 26 were proportional skeletal measurements, which were used to perform principal component analysis and subsequent cluster analysis. The remaining 94 supplementary measurements were used for a greater description of the identified clusters. Principal component analysis established eight principal components that explained 85.1% of the total variance. The first three principal components explained 51.4% of the variance and described mandibular proportions, anterior facial height proportions, and posterior&ndash, anterior cranial proportions. Cluster analysis established four phenotypic subgroups, representing 18.4% (C1), 20.75% (C2), 38.68% (C3), and 22.17% (C4) of the sample. A new sub-clustering of skeletal Class III malocclusions that avoids gender influence is provided. Our results improve clinicians&rsquo, resources for Class III malocclusion and could improve the diagnostic and treatment approaches for this malocclusion.

The present systematic review aims to report and critically assess the findings of the available scientific evidence from genetic association studies examining the genetic variants underlying skeletal class III malocclusion and its sub-phenotypes. A pre-piloted protocol was registered and followed. The PubMed, Scopus, WOS, Cochrane Library, Gray Open literature, and CADTH databases were explored for genetic association studies following PICOS-based selection criteria. The research was reported in accordance with PRISMA statement and HuGE guidelines. The Q-genie tool was applied to assess the quality of genetic studies. Meta-analysis of genetic association studies was done by means of Meta-Genyo tool. A total of 8258 articles were retrieved, of which 22 were selected for in-depth analysis. Most of the studies did not differentiate between sub-phenotypes, and the cohorts were heterogeneous regarding ethnicity. Four to five principal components of class III malocclusion explained the phenotypic variation, and gene variants at MYO1H(rs10850110), BMP3(rs1390319), GHR (rs2973015,rs6184, rs2973015), FGF7(rs372127537), FGF10(rs593307), and SNAI3(rs4287555) (p

Objectives: Temporomandibular disorders (TMD) refer to a group of clinical picture affecting the masticatory muscles and temporomandibular joint that are characterized by muscular or joint pain, dysfunction (limited or altered functions) and joint noises, as well as other associated symptoms, such as tension headaches, otalgia, dizziness, tinnitus and others. Fibromyalgia (FM) is a syndrome of unknown etiology involving generalized chronic pain accompanied, in a high percentage of cases, by other symptoms such as asthenia, anxiety, depression, sleep disturbances and other less frequent symptoms, such as temporomandibular disorders (TMD). Data: data were compiled by two experienced examiners following a specific form. Sources: An electronic search was carried out in the Cochrane Central Register of Controlled Trials (CENTRAL), PUBMED, and SCOPUS electronic databases (up to April 2016, unrestricted by date or language) Study selection: comparative clinical studies with patients with both clinical pictures involving the study of pathogenic processes. Conclusions: Fibromyalgia and temporomandibular disorders with muscle pain both have profiles that affect the muscular system and therefore share many epidemiological, clinical and physiopathological symptoms. Because of this, we are led to think that there is, if not a common etiology, at least a common pathogenesis. This article revises the physiopathological processes of both clinical pictures in an attempt to determine their similarities and likenesses. This would undoubtedly help in providing a better therapeutic approach.

External apical root resorption during orthodontic treatment implicates specific molecular pathways that orchestrate nonphysiologic cellular activation. To date, a substantial number of in vitro and in vivo molecular, genomic, and proteomic studies have supplied data that provide new insights into root resorption. Recent mechanisms and developments reviewed here include the role of the cellular component—specifically, the balance of CD68+, iNOS+ M1- and CD68+, CD163+ M2-like macrophages associated with root resorption and root surface repair processes linked to the expression of the M1-associated proinflammatory cytokine tumor necrosis factor, inducible nitric oxide synthase, the M1 activator interferon γ, the M2 activator interleukin 4, and M2-associated anti-inflammatory interleukin 10 and arginase I. Insights into the role of mesenchymal dental pulp cells in attenuating dentin resorption in homeostasis are also reviewed. Data on recently deciphered molecular pathways are reviewed at the level of (1) clastic cell adhesion in the external apical root resorption process and the specific role of α/β integrins, osteopontin, and related extracellular matrix proteins; (2) clastic cell fusion and activation by the RANKL/RANK/OPG and ATP-P2RX7-IL1 pathways; and (3) regulatory mechanisms of root resorption repair by cementum at the proteomic and transcriptomic levels.

Objective: To determine whether orthodontic treatment with removable aligners vs fixed orthodontic appliances is associated with a different frequency of orthodontically induced external apical root resorption (OIEARR) when genetic, radiographic, and clinical factors are accounted for. Materials and Methods: Three hundred seventy-two orthodontic patients treated with removable aligners (Invisalign) or fixed appliances were genetically screened for interleukin 1B gene (IL1B) (rs1143634), interleukin 1 receptor antagonist gene (IL1RN) (rs419598), and osteopontin gene (SPP1) (rs9138/rs11730582). Twelve clinical variables, potentially associated with OIEARR, were also considered. Subjects were divided according to the presence of radiographically determined OIEARR (>2 mm). The association between OIEARR and appliance type, and radiographic, clinical and genetic factors, was assessed using backward stepwise conditional logistic regression. Odds ratios (ORs) and 95% confidence intervals (CIs) were reported. Results: Reliability of the methods was adequate. Clinical case complexity (American Board of Orthodontics [ABO] Discrepancy Index) (OR: 1.032; 95% CI: 1.005–1.061; P = .021) and extent of incisor apical displacement in the sagittal plane (OR: 1.478; 95% CI: 1.285–1.699; P = .001) were associated with an increased OIEARR risk. After adjusting for associations between clinical/radiographic/genetic factors, there were no statistically significant differences with respect to OIEARR or type of orthodontic appliance used, whether removable aligners or fixed appliances (OR: 1.662; 95% CI: 0.945–2.924; P = .078). Only subjects homozygous for the T allele of IL1RN (rs419598) were more prone to OIEARR during orthodontic treatment (OR: 3.121; CI: 1.93–5.03; P < .001). Conclusions: A similar OIEARR predisposition was identified using either removable aligners (Invisalign) or fixed appliances.

Introduction A number of biologic methods leading to decreased rates of orthodontic tooth movement (OTM) can be found in the recent literature. The aim of this systematic review was to provide an overview of biologic methods and their effects on OTM inhibition. Methods An electronic search was performed up to January 2016. Two researchers independently selected the studies (kappa index, 0.8) using the selection criteria established in the PRISMA statement. The methodologic quality of the articles was assessed objectively according to the Methodological Index for Non-Randomized Studies scale. Results We retrieved 861 articles in the initial electronic search, and 57 were finally analyzed. Three biologic techniques were identified as reducing the rate of OTM: chemical methods, low-level laser therapy, and gene therapy. When the experimental objective was to slow down OTM, pharmacologic modulation was the most frequently described method (53 articles). Rats were the most frequent model (38 of 57 articles), followed by mice (9 of 57), rabbits (4 of 57), guinea pigs (2 of 57), dogs (2 of 57), cats (1 of 57), and monkeys (1 of 57). The sample sizes seldom exceeded 25 subjects per group (6 of 57 articles). The application protocols, quality, and effectiveness of the different biologic methods in reducing OTM varied widely. Conclusions OTM inhibition was experimentally tested with various biologic methods that were notably effective at bench scale, although their clinical applicability to humans was rarely tested further. Rigorous randomized clinical trials are therefore needed to allow the orthodontist to improve the effect of translating them from bench to clinic.

Objective We aimed to systematically review articles investigating the efficiency of the clustering of skeletal class III malocclusion phenotypic subtypes of different ethnic origins as a diagnostic tool. Methods The review protocol was structured in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and registered in Prospero (CRD42016053865). A survey of articles published up to March 2018 investigating the identification of different subgroups of skeletal class III malocclusion via cluster analysis was performed using 11 electronic databases. Any type of study design that addressed the classification of subclusters of class III malocclusion was considered. The Newcastle-Ottawa scale for cohort and cross-sectional (modified) studies was used for quality assessment. Results The final selection included 7 studies that met all the criteria for eligibility (% overall agreement 0.889, free marginal kappa 0.778). All studies identified at least 3 different types of class III clusters (ranging from 3 to 14 clusters; the total variation of the prevalence of each cluster ranged from 0.2% to 36.0%). The main shared variables used to describe the more prevalent clusters in the studies included were vertical measurements (Ar-Go-Me: 117.51°-135.8°); sagittal measurements: maxilla (SNA: 75.3°-82.95°), mandible (SNB: 77.03°-85.0°). With regard to ethnicity, a mean number of 8.5 and 3.5 clusters of class III were retrieved for Asian and Caucasian population, respectively. Conclusions The total number of clusters identified varied from 3 to 14 to explain all the variability in the phenotype class III malocclusions. Although each extreme may be too simple or complex to facilitate an exhaustive but useful classification for clinical use, a classification system including 4 to 7 clusters may prove to be efficient for clinical use in conjunction with complete and meticulous subgrouping. Clinical significance The identification and description of a subclustering classification system may constitute an additional step toward more precise orthodontic/orthopedic diagnosis and treatment of skeletal class III malocclusion.

Miniscrews are used as orthodontic anchorage devices in the dentistry clinical practice but the in vivo metallic release from these structures has been not previously investigated. The aim of this study was to determine the content of Al, Co, Cr, Cu, Ni, Ti and V in oral mucosa cells of control subjects, patients under orthodontic treatment and with both, orthodontic treatment and miniscrew, in order to know the contribution of these mini-implants to the total metallic content. ICP-MS measurements revealed the following ascending order: Cr

Intraoral fixed orthodontic appliances are frequently used in the clinical practice of dentistry. They are made from alloys containing different metals at various percentages. The use of these appliances leads to the long-term exposure of patients to these materials, and the potential toxic effects of this exposure raises concerns about patient safety. Thus, the biocompatibility (corrosion behaviour and toxicity) of these materials has to be evaluated prior to clinical use. In the present report, the most recent studies in the scientific literature examining metal ion release from orthodontic appliances and the toxic effects of these ions have been reviewed with a special focus on cytotoxicity and genotoxicity. Previous studies suggest that a case-by-case safety evaluation is required to take into account the increasing variability of materials, their composition and the manufacturing processes. Moreover, in vivo toxicity studies in regard to metal release, cytotoxicity and genotoxicity are still scarce. Therefore, in vitro and in vivo monitoring studies are needed to establish cause-effect relationships between metal ion release and biomarkers of cytotoxicity and genotoxicity. Further investigations could be performed to elucidate the toxic mechanisms involved in the observed effects with a special emphasis on oxidative damage.

12 pags., 4 figs., 3 tabs., Objectives: Poor oral hygiene during treatment with fixed appliances results in plaque accumulation. The presence of bacteria in the gingival crevice triggers an inflammatory reaction in the gingival tissues. The aim of this study was to compare the impact of two preventive treatments, photodynamic therapy (PDT), and ultrasonic scaler (US), on gingival health in patients under fixed orthodontic treatment. Methods: Twenty orthodontic patients were randomly allocated to two groups: PDT or US. Each group received seven sessions [days 0, 15, 30, 45, 90 (3-months follow-up), 180 (6-months follow-up), 270 (9-months follow-up)] of experimental interventions, and clinical parameters [Plaque index(PI); gingival index(GI); probing depth(PD)], periodontopathogens [Agreggatibacter actinomycetemcomitans; Porphyromonas gingivalis; Prevotella intermedia; Micromonas micros; Fusobacterium nucleatum; Tannerella forsythia; Campylobacter rectus; Eikenella corrodens; Capnocytopaga sp.] and protein markers [IL-1β;IL-1ra;IL-6;IL-10;TNF-α;FGF-2/FGF basic] were monitored at baseline and at 3, 6, and 9 months. ANOVA, Student's t-test with Bonferroni correction and ANOVA with multiple rank test were used to identify differences between groups (P < 0.05). Results: Clinical assessments [PI, GI, and PD] yielded no differences (P > 0.05) between groups, which showed a major decrease at the start of the trial. Reductions in total colony forming units (log CFU reduction) were observed with both treatments, although to a greater extent in the PDT group, but with no differences between groups (P > 0.05). Similar reductions in log CFU counts of P. gingivalis, P. intermedia, and F. nucleatum were observed in both groups (P > 0.05). The two groups also showed similar trends for inflammatory mediators with decreased levels of IL-1β, IL-10, and TNF-α, whereas IL-6 and IL-1ra levels remained stable and those of FGF-2 were increased after both interventions, with no differences (P > 0.05) between groups. Conclusion: Both PDT and US methods proved similar effectiveness for the treatment of gingival inflammation induced by fixed orthodontic appliances. Lasers Surg. Med. 51:256–267, 2019. © 2018 Wiley Periodicals, Inc.

The aim of this prospective longitudinal study was to assess and compare the microbiological and clinical parameters of patients wearing a fixed orthodontic appliance, as opposed to 10 days after the bracket had been removed following treatment.In total, 122 patients participated in this study; 61 of the subjects were assessed at baseline (wearing a fixed orthodontic appliance: T1) and 10 days after bracket removal (T2). The other 61 individuals had never worn an orthodontic appliance before and these subjects served as controls (CT). Subgingival plaque samples were assessed for bleeding on probing (GBI) and plaque index (VPI). PCR of 16s rDNA, followed by reverse species-specific hybridization for Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia and Treponema denticola were performed. A descriptive analysis was conducted; chi-squared, Student's matched and unmatched t-tests, the point biserial correlation coefficient and the McNemar test were used to test for differences between groups (p0.05).The GBI and VPI clinical parameters showed statistical differences (p0.05) between T1-T2, T1-CT and T2-CT. The prevalence of T. denticola had significantly decreased (p = 0.039) 10 days after appliance removal. At T2, a significant positive correlation was found between GBI and A. actinomycetemcomitans (p0.01) and between clinical parameters and P. intermedia. In patients without a fixed orthodontic appliance (T2 and CT), there was a significant positive correlation between T. forsythia and VPI.Local factors associated with the wearing of a fixed orthodontic appliance influence changes in subgingival plaque that leads to more inflammation and bleeding.

Introduction: Non-surgical treatment with calcium hydroxide offers a high success rate in the healing of large periapical lesions. Case Series: We present the healing of large periapical lesions with conservative, non-surgical treatment in three young patients presenting large periapical lesions and diagnosed with chronic periapical periodontitis. Non-surgical endodontic treatment was carried out involving canal preparation, irrigation with 2.5% sodium hypochlorite, filling of the canal with 75% calcium hydroxide and 25% Kri-1 iodoform paste mixed with sterile saline solution, and sealing of the cavity with composite. The filling was replaced several times, after which endodontic treatment was finally carried out. Complete apical healing was observed in all cases. Conclusion: Non-surgical treatment as a first option allows us to avoid the trauma of surgery in young individuals.

To determine whether there were differences between formocresol (FC) and white mineral trioxide aggregate (MTA) pulpotomy in terms of clinical and radiographic signs or effects upon the permanent successor over a long term.A total of 212 molars (74 treated with FC and 138 with white MTA) corresponding to 129 subjects [66 females (51.1%) and 63 males (48.8%)] were evaluated. The coronal pulp was carefully amputated up to the entrance of the root canals using a sharp spoon excavator. Post-amputation bleeding was confirmed to be bright red and was seen to subside after applying 2-3 minutes of gentle pressure with a sterile cotton pellet. One group was treated with a 1:5 dilution of formocresol (20% Buckley's formocresol solution), while a second group was treated using white MTA powder (ProRoot).There were no significant differences in clinical success rate between the two groups (89.9% in the white MTA group versus 82.5% if the FC group). However, the radiographic success rate was significantly greater for white MTA versus FC. The radiographic failure rate in the molars treated with MTA was 7.9% versus 18.9% with FC. Regarding alterations in the timing of eruption, early and delayed eruption were respectively recorded in 7.24% and 8.69% of the cases in the MTA group, versus 9.45% and 4.05% of the cases in the FC group. Thus, neither group showed relevant alterations in the timing of eruption.Mineral trioxide aggregate showed a significantly greater radiographic success rate than formocresol in pulpotomy in primary teeth over 6 to 48 months of follow-up. MTA may be indicated as a substitute of formocresol in pulpotomy treatments of temporary molars, with no pathological consequences of any kind to the permanent successor premolar.

Introduction: Several experimental studies in the literature have tested different biology-based methods for inhibiting or decreasing orthodontic tooth movement (OTM) in humans. This systematic review investigated the effects of these interventions on the rate of tooth movement. Study design: Electronic [MedLine; SCOPUS; Cochrane Library; OpenGrey;Web of Science] and manual searches were conducted up to January 26th, 2016 in order to identify publications of clinical trials that compared the decreasing or inhibiting effects of different biology-based methods over OTM in humans. A primary outcome (rate of OTM deceleration/inhibition) and a number of secondary outcomes were examined (clinical applicability, orthodontic force used, possible side effects). Two reviewers selected the studies complying with the eligibility criteria (PICO format) and assessed risk of bias [Cochrane Collaboration's tool]. Data collection and analysis were performed following the Cochrane recommendations. Results: From the initial electronic search, 3726 articles were retrieved and 5 studies were finally included. Two types of biology-based techniques used to reduce the rate of OTM in humans were described: pharmacological and low-level laser therapy. In the first group, human Relaxin was compared to a placebo and administered orally. It was described as having no effect on the inhibition of OTM in humans after 32 days, while the drug tenoxicam, injected locally, inhibited the rate of OTM by up to 10% in humans after 42 days. In the second group, no statistically significant differences were reported, compared to placebo, for the rate of inhibition of OTM in humans after 90 days of observation when a 860 nm continuous wave GaAlA slow-level laser was used. Conclusions: The currently available data do not allow us to draw definitive conclusions about the use of various pharmacological substances and biology-based therapies in humans able to inhibit or decrease the OTM rate. There is an urgent need for more sound well-designed randomized clinical trials in the field.

Aims: Ectopic eruption is a change in the normal path of eruption of a tooth. The aim of this study is to determine the prevalence of ectopic eruption of the permanent maxillary first molars in a Spanish subpopulation of 505 children, its distribution as regards age and gender, unilateral and bilateral occurrence and loss of space. Methods: Periapical and panoramic X-rays were taken of the patients, with six-monthly check-ups to evaluate development. A statistical analysis of the data was performed using the chi-square test (p lessthan 0.05, 95% C.I). Results: A prevalence of 6.7% was obtained being the most common age of presentation was seven years and bilateral occurrence (67.6% of cases) with no statistically significant differences as regards to the gender. Only 14 of the 505 explored patients required treatment for ectopic eruption. Conclusion: This study provides information regarding treatment needs and prevalence regarding molar ectopic eruption in a Spanish population. It is essential for professionals to be familiar with the diagnostic factors, clinical consequences and therapeutic options for ectopic eruption of permanent molars.

The oral cavity is an ideal environment for the corrosion of fixed orthodontic appliances, leading to the release of metal ions that, eventually, could derive in adverse effects. Therefore, it is necessary to evaluate the biocompatibility of these materials for patient's safety. In vivo, oral mucosa cells are a valuable sample for this aim, however, analytical methods to quantify the liberation of metal ions are very scarce. Thus, the purpose of this work is to optimize and validate a sample preparation procedure to determine cobalt (Co), chromium (Cr), copper (Cu), and nickel (Ni) in oral mucosa cells in patients with and without orthodontic appliances, based on the extraction and digestion of the samples and quantification of the elements by inductively coupled plasma mass spectrometry (ICP-MS). The method has been suitably validated: the regression equation was calculated from standards prepared in the same matrix without oral mucosa cells and the linear range was 2.0–100.0 ng mL− 1 for all elements. Limits of detection were 0.10, 0.38, 0.49 and 0.67 ng mL− 1 and limits of quantification were 0.20, 1.13, 0.98, and 1.81 ng mL− 1 for Co, Cr, Cu, and Ni, respectively. The recovery percentages (%) obtained ranged between 104 and 109 for Co, 103–107 for Cr, 106–113 for Cu and 84–110 for Ni. Intermediate precision (RSD%) data obtained were also adequate. The present method proved to be robust for the three factors considered: heating time, volume of deionized water, and volume of PlasmaPure 65% HNO3 used to dilute the samples. Thus, the proposed method passed in a satisfactory way the validation standards considered and could be used to evaluate in vivo the metal ion release in oral mucosa cells from orthodontic patients.

The aim of this minireview was to identify and review the scientific evidence regarding regenerative endodontic protocols claiming to revascularize permanent immature teeth with apical periodontitis. The literature was identified using the PubMed/MEDLINE, Scopus, Scirus, EMBASE and Cochrane databases up to February 2013. Studies were selected independently by two different researchers (kappa index: 0.88), based on established inclusion/exclusion criteria. The methodological quality of the reviewed papers was classified as high, medium or low (HQ, MQ, LQ). The search strategy identified 285 titles. Nine studies, both human and animal based, were selected after application of the criteria (LQ:5; MQ:4). In most of these studies (seven of nine), the revascularization protocol included a triple antibiotic combination as canal disinfectant for a period of 1-4 weeks after blood clot formation (LQ:5; MQ:4), although there is no clear consensus about the treatment protocol. Two studies reported tooth discoloration after the revascularization process (LQ:2), and only three (LQ:1; MQ:2) reported a success rate of 54.9% in dogs and 73.6% and 80% in humans, respectively. Revascularization of immature permanent teeth with apical periodontitis is possible and preferable to apexification. Nevertheless, there is a widespread lack of randomized clinical trials and blinded measures. In addition, the small sample sizes that are common in these studies as well as the generally low quality of the analysed publications require the results to be viewed with caution. There is a high risk of bias, with a low quality of available information, for developing clinical guidelines for regenerative endodontic protocols; rigorous randomized clinical trials are therefore needed.

New protocols for regenerative endodontic treatment along with the parallel development of tissue engineering technologies are changing traditional knowledge and treatment possibilities for young patients with pulp-affected permanent immature teeth. The regeneration and completion of apical root development in pathological situations such as these is a clinical challenge that traditional treatments have not so far been able to resolve with complete success. In clinical terms, the decision of whether to perform apexogenesis or apexification on an immature tooth is determined by whether the pulp tissue is vital or non-vital. Recent evidence and reports in the literature have questioned the old dogmas. In this respect, the ever growing scientific literature in this field makes it essential to compile a critical reflection and summary of everything that has been written to date, in order to understand the biological basis of current clinical advances and ensuing lines of future therapy. In this paper, we wish to give scientific coverage and background to more recent clinical and molecular advances described in the field of apical regeneration using stem cell therapy and their potentially key role in the future clinical success of new pulp regenerative protocols.

Introducción: Las estrategias de razonamiento heurístico predominan en el ámbito clínico. En odontología, y en particular en la práctica clínica diaria ortodóncica, se hace esencial diagnosticar bajo condiciones de presión, lo que fomenta los errores cognitivos por parte de los alumnos. El objetivo de este estudio fue proponer y validar una checklist como herramienta para disminuir los errores cognitivos diagnósticos por parte de los alumnos. Sujetos y métodos: Treinta y seis estudiantes posgraduados realizaron dos evaluaciones clínicas de pacientes, una de la manera tradicional y otra aplicando la checklist propuesta. Resultados: Se produjo una disminución estadísticamente significativa (p < 0,05) en los errores mediante la prueba de los rangos de Wilcoxon tras el uso de la checklist. Conclusiones: La checklist propuesta ha demostrado su eficacia y ha sido evaluada positivamente por los alumnos; sin embargo, se debe prestar especial atención a los errores cognitivos de comisión porque aumenta de manera considerable su proporción.

Objecives The use of three-dimensional computed tomography (3D-CT) analyses represents a substantial improvement in planning treatment. The aim of this study is to introduce a new three-dimensional (3D) analysis of clinical value for evaluating asymmetry in cases of craniofacial syndrome. Subjects and methods Virtual 3D models were reconstructed from CT images of 62 normal subjects (35 males and 27 females), more than 18 years old. Measurements of asymmetrical skeletal and dentoalveolar relationships were evaluated and standardized data obtained. The feasibility of the new 3D craniofacial analysis was then evaluated on one patient with severe maxillomandibular asymmetry in the form of hemifacial microsomia. Results Standardized 3D data from the analysis were obtained and classified into 6 maxillary measurements, eight mandibular measurements and seven dentoalveolar process measurements. No significant differences were found between males and females (U-Mann–Whitney test, P > 0.05). Useful data of clinical value was provided for planning orthodontic and surgical treatment of asymmetries, as well as a diagnostic chart. Conclusion This method is useful for the clinical evaluation of asymmetry in craniofacial syndromes. The use of 3D analysis facilitates surgical and orthodontic treatment planning.

Anchorage is an important factor in orthodontics and must be properly managed for a successful treatment outcome. Orthodontists have historically used many devices to prevent unwanted tooth movement. The use of miniscrews as a source of skeletal anchorage has become routine in present-day orthodontic practice. Skeletal anchorage opens up alternative treatments, to borderline surgery patients for example, who can now be treated by taking advantage of the biomechanical properties of miniscrews. Because they are bone-borne and provide excellent control over tooth movement in the three spatial planes of movement, mini-implants can be used to serve many purposes in addition to anchorage. Therefore, a variety of successful mini-implant appliances are explained in relation to the three planes of movement: sagittal, vertical, and transverse. The aim of this review is to illustrate the clinical versatility of miniscrews in the three spatial planes of malocclusion in orthodontic and orthopedic management and to define clinical guidelines for the selection, application and biomechanics of mini-implants.

The need for accurate techniques of estimating age has sharply increased in line with the rise in illegal migration and the political, economic and socio-demographic problems that this poses in developed countries today. The methods routinely employed for determining chronological age are mainly based on determining skeletal maturation using radiological techniques. The objective of this study was to correlate five different methods for assessing skeletal maturation.606 radiographs of growing patients were analyzed, and each patient was classified according to two cervical vertebral-based methods, two hand-wrist-based methods and one tooth-based method. Spearman's rank-order correlation coefficient was applied to assess the relationship between chronological age and the five methods of assessing maturation, as well as correlations between the five methods (p 0.05).Spearman's rank correlation coefficients for chronological age and cervical vertebral maturation stage using both methods were 0.656/0.693 (p 0.001), respectively, for males. For females, the correlation was stronger for both methods. The correlation coefficients for chronological age against the two hand-wrist assessment methods were statistically significant only for Fishman's method, 0.722 (p 0.001) and 0.839 (p 0.001), respectively for males and females.The cervical vertebral, hand-wrist and dental maturation methods of assessment were all found to correlate strongly with each other, irrespective of gender, except for Grave and Brown's method. The results found the strongest correlation between the second molars and females, and the second premolar and males.This study sheds light on and correlates with the five radiographic methods most commonly used for assessing skeletal maturation in a Spanish population in southern Europe.

Iglesias-Linares A, Yanez-Vico RM, Ballesta S, Ortiz-Ariza E, Mendoza-Mendoza A, Perea E, Solano-Reina E. Interleukin 1 gene cluster SNPs (rs1800587, rs1143634) influences post-orthodontic root resorption in endodontic and their contralateral vital control teeth differently. International Endodontic Journal, 45, 1018–1026, 2012. Abstract Aim To investigate whether the genetic variants of the interleukin-1 gene cluster (IL1) are associated with a possible genetically induced variability in post-orthodontic external apical root resorption (EARR) in root filled teeth and their control counterparts with vital pulps. Methodology One hundred and forty-six maxillary premolars were evaluated radiographically following orthodontic treatment. Genetic screening was performed on orthodontic patients for two single-nucleotide polymorphisms (SNPs: rs1800587 and rs1143634) in the IL1 gene cluster. Subjects were divided into two groups according to the presence or absence of radiographic post-orthodontic EARR (>2 mm) in root filled teeth and their controls with vital pulps. Logistic regression analysis was performed to obtain an adjusted estimation between EARR and IL1 polymorphisms. Allelic frequencies, genotype distributions, and adjusted odds ratio (OR), at 95% confidence interval, were also calculated. Results Whilst no clear statistical association was found for gene variations in IL1A, a sound association was found in the comparative analysis of subjects homozygous [2/2(TT)] for the IL1B gene, which resulted in a two times increased risk of suffering post-orthodontic EARR in root filled teeth [OR, 2.032 (P = 0.031); CI,1.99–14.77] when compared with their controls with vital pulps. There was, however, a shared predisposition to EARR in controls with vital pulps and root filled teeth of subjects homozygous for allele 1 [OR, 5.05 (P = 0.002)] and [OR, 2.77 (P = 0.037)], respectively. Conclusions Genetic variations in the interleukin-1β gene (rs1143634) predispose root filled teeth to EARR for matched pairs secondary to orthodontic treatment in a different way from their control teeth with vital pulps in subjects homozygous for allele 2 [2/2(TT)].

Objectives: The purpose of this study was to assess cranial base and maxillary growth in patients with Class II-type I malocclusions when treated with Frankel’s functional regulator (FR-1b). Study Design: The treatment group was made up of 43 patients that were divided into two groups: prepubescent (n: 28), and pubescent (n: 15). The control group included 40 patients who did not receive any kind of treatment and were likewise divided into a prepubescent group (n: 19), and a pubescent group (n: 21). A computerized cephalometric study was carried out and superimpositions were done in order to assess the antero-posterior, vertical and rotational movement of the maxilla. Results: The results indicate that anterior cranial length is not affected by the regulator but the cranial deflection of the treatment group was diminished. Although a slight counterclockwise rotation effect on the upper jaw was observed due to treatment, no growth restriction of the maxilla in a vertical or antero-posterior direction was observed compared to other non-treated Class II-type I malocclusion patients. Conclusion: The functional regulator does not have any effect on anterior cranial length, but it does affect the angulation of the cranial base. According to our results, the appliance has demonstrated a flattening effect of the cranial base (p

Objectives: The purpose of this study was to assess mandibular growth in patients with Class II division 1 malocclusions when treated with Fränkel´s functional regulator 1b. Study Design: The treatment group was made up of 43 patients that were divided into two groups: prepubescent (n:28), and pubescent (n:15). The control group included 40 patients who did not receive any kind of treatment and were likewise divided into a prepubescent group (n:19), and a pubescent group (n:21). A computerized cephalometric study was carried out and superimpositions were done in order to assess the antero-posterior, vertical and rotational movements of the mandible. A two-way ANOVA with interaction was done to compare the changes between the control group and the treatment group, while the Student t for independent samples was used to compare each age group. Results: The Gnathion and Gonion points showed significant differences in the whole sample (p0.05). Conclusion: The results show that the FR produces vertical orthopedic growth in the mandible but not horizontal growth compared to non-treated Class II-type I malocclusion patients. No rotational changes were found in the mandible, but we did record mandibular growth along the inclination of the facial axis. Key words:Fränkel appliance, orthodontics, functional appliances, mandibular growth.

Oral Diseases (2012) 18, 198–205 Objective: External apical root resorption (EARR) is a frequent iatrogenic effect of orthodontic treatment. Patients with genetic variants in the interleukin 1 gene have been related to an increased risk of suffering EARR. The objective of this study is to determine whether variants in the interleukin 1 receptor antagonist gene are positively/negatively associated with interleukin 1 gene polymorphisms, particularly in relation to the clinical features of EARR patients. Materials and Methods: Genetic screening of 54 orthodontic patients was performed for three polymorphisms (rs1800587, rs1143634 and rs419598) in the IL1 gene cluster. Subjects were divided according to the presence or absence of EARR of more than 2 mm. The genotype distributions and allelic frequencies were calculated by the chi-square-test. Odds ratios (OR) and 95% confidence intervals were also calculated. Results: A highly significant association was found in the comparative analysis of homozygous subjects [1/1(CC)] for the IL1B gene, resulting in an increased risk of suffering postorthodontic EARR (OR: 3.47; P = 0.027; CI: 95%). While no association was found for the IL1A gene (P = 0.097), subjects who were homozygous [1/1(TT)] for the IL1RN gene were more likely to be affected with EARR (OR: 6.75; P = 0.001; CI: 95%). Conclusion: Variations in the interleukin 1 receptor antagonist gene (rs419598) – and not only in the IL1B gene (rs1800587) – are determinants of a predisposition to postorthodontic EARR.

Purpose The aim of the present case-control study was to determine—using the 10 most recent annual listings of the most beautiful black and white people—whether any common, measurable esthetic parameter could be extracted from both groups. Materials and Methods A total of 80 women (40 white and 40 black), who had been included in the list of People magazine's 100 most beautiful people during the previous 10 years, were selected. Lateral photographs of all 80 subjects were obtained from Internet databases, oriented, and sized. A modified photogrammetric analysis was performed on the lateral view of each subject to obtain the angle and proportion measurements. Differences between the 2 groups were compared with 95% significance using the Student t test for independent samples. Results Facial similarities in the 2 ethnic groups were observed for the angle of the inferior facial third, labiomental angle, angle of facial convexity, and cervicomental angle. These results point to a similar conformation of the lower part of the face in relation to the neck that was shared by both groups of beautiful women. Additionally, both groups showed similar results for the lower lip projection. Likewise, similar proportional measurements were found for the upper lip proportion, notwithstanding differences in protrusion. Conclusions Modern society is changing the classic concept of facial beauty because of globalization and the prevalence of multiethnic communities in the developed world. Independently of ethnic origin, beautiful women tend to have similar facial features that are a mixture of both black and white features.

This study has been designed to evaluate the vertical and sagittal changes in the maxilla due to growth. A sample group was chosen of 38 individuals with normal occlusion, composed of 16 females and 22 males between the ages of 8 and 18. The total sample was divided into three groups: prepubescent (8-11 years), pubescent (12-14 years) and post-pubescent (15-18 years). A series of cephalometric angle parameters (SNA, maxillary height, slope of the palatal plane and maxillary depth) and lineal parameters (effective maxillary length, palatal plane length, middle third of the face height and convexity) were traced. Superimpositions of the initial and final cephalometries in the Ba-N plane and in the Nasion fixed point were carried out to measure growth. An analytic statistical analysis was applied using a Student t test for independent samples in order to evaluate the differences found according to sex. An analysis of variance followed by Duncan?s multiple range test was done to study the evolution of each variable throughout the duration of the experiment. In light of the results obtained, we have come to the following conclusions: sagittal growth of the maxilla is constant from the age of 8 to 18 years with an average increase of 0.2 mm/ year. Vertical growth, as well as general maxillary growth, is greater in the prepubescent group

Objective The objective of this paper was to analyse the effects of bisphosphonates and their influence on orthodontic therapy. Data/sources The literature was systematically reviewed using PubMed/Medline, Scopus, Ebsco Host, Scirus and Cochrane databases up to December 31, 2008. Study selection Articles were independently selected by two different researchers based on previously established inclusion and exclusion criteria, finding a good concordance (kappa index of 0.862). The methodological quality of the reviewed papers was assessed. The search strategy identified 205 titles. Thirteen articles were selected after application of the inclusion/exclusion criteria, and only one of these had a high methodological quality. Bisphosphonate applications in orthodontic therapy were divided between two main groups: tooth movement and skeletal relapse. Conclusions Topical or systemic application of bisphosphonates decreases orthodontic tooth movement and reduces orthodontic tooth movement relapse and skeletal relapse after maxillary expansion or mandibular distraction and similar procedures. Further longer-term studies are required to assess possible adverse effects after bisphosphonate treatment for these purposes.

Histone deacetylases (HDACs) are enzymes that are involved in the remodeling of chromatin and play a key role in the epigenetic regulation of gene expression. In addition, the activity of non-histone proteins can be regulated through HDAC-mediated hypoacetylation. In recent years, inhibition of HDACs has emerged as a potential strategy to reverse aberrant epigenetic changes associated with cancer, and several classes of HDAC inhibitors have been found to have potent and specific anti-cancer activities in preclinical studies. Many researchers have highlighted the need to determine specific HDAC isotypes related to different tumor types in order to develop selective drugs for specific isoforms and avoid side effects. We summarize recent advances in the understanding of the molecular events that underlie the epigenetic changes in different tissue carcinomas, focusing on oral squamous carcinoma. The role of epigenetics in oral squamous cancer remains poorly understood, and further descriptive studies of specific HDAC member alterations are required to form the basis for future clinical trials.

When orthodontic patients desire shorter treatment times with aesthetic results and long-term stability, it is important for the orthodontist to understand the potential limitations and problems that may arise during standard and/or technology-assisted accelerated treatment. Bone density plays an important role in facilitating orthodontic tooth movement (OTM), such that reductions in bone density can significantly increase movement velocity. Lifestyle, genetic background, environmental factors and disease status all can influence a patients’ overall health and bone density. In some individuals, these factors may create specific conditions that influence systemic-wide bone metabolism. Both genetic variation and the onset of a bone-related disease can influence systemic bone density and local bone density, such as is observed in the mandible and maxilla. These types of localized density changes can affect the rate of OTM and may also influence the risk of unwanted outcomes, i.e., the occurrence of dental external apical root resorption (EARR).

The aims of this study are to validate a new method for quantifying the predictability of expansion movement with the Invisalign® system and to determine whether there are statistically significant differences between planned expansion with ClinCheck® and actual clinical quantification using upper post-treatment model comparisons. A sample of 116 patients subjected to expansion with Invisalign® was studied. The following variables were measured at T1 and T2 on 3D models and ClinCheck®: canine gingival width, first premolar gingival width, second premolar gingival width, first molar gingival width, canine cuspid width, first premolar cuspid width, second premolar cuspid width, first molar cuspid width, canine depth, arch depth, first molar rotation, first right and left molar rotation, and first molar inclination. Measurement error was tested, showing good precision for all variables. The paired test showed non-significant differences between the 3D model and ClinCheck® at T1 for all variables except first molar cuspid width and arch depth. Statistically significant differences were found for canine gingival width, first premolar gingival width, second premolar gingival width, first molar gingival width, canine cuspid width, first premolar cuspid width, second premolar cuspid width, first molar cuspid width, and canine depth when the 3D model and ClinCheck® were compared at T2. Differences between the 3D model and ClinCheck® at T2 showed that planned expansion at the end of treatment is not predictable. This is the first in vivo human study to quantify the predictability of expansion in patients with Invisalign® Ex30 material.

The accumulation of chronic or severe acute DNA and cellular damage in oral mucosa cells is one of the main factors that help initiate a wide range of malignant lesions in the oral cavity. There has been considerable controversy in the literature about the effect of such sustained genotoxic and cytotoxic damage to oral mucosa cells.The aim of this systematic review, reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, is to investigate the effects of such interventions.Electronic and manual searches were performed (15 May 2015) for Randomized Clinical Trials/quasi-Randomized Clinical Trials that analyzed the genotoxic/cytotoxic effects of these types of oral appliances in humans. A primary outcome (cell/DNA damage) and a number of secondary outcomes were examined. Two reviewers carried out the study selection and performed a "risk of bias" assessment [Cochrane Collaboration's tool]. Wherever possible the meta-analysis was conducted on homogenous groups.From the electronic search (2797), 6 studies met the eligibility criteria. Most studies (5/6) observed significant differences in most comparisons at the short-term (1-3 months) and long-term (24-48 months) evaluations, with respect to critically acute genotoxic/cytotoxic effects. Some of the studies (2/3) concluded that the post-removable effects at DNA/cellular levels were not significant (p 0.05) with respect to the controls.Acute DNA/cellular damage in oral mucosa cells is induced by orthodontic appliances. Nevertheless, even though these effects were no longer detected after removing the appliances, more rigorous RCTs are needed to explore the extent to which acquired damage can be observed in the oral mucosa.

Objective To evaluate the extent of the association between instant gratification behavior and childhood obesity. Study design PubMed, Scopus, EMBASE, EBSCOhost, and Cochrane databases were searched for the terms delayed gratification, children, and obesity. Studies were eligible if they included a sample of at least 100 children who were made to choose between an immediate reward and a larger one later, with the authors comparing the response in different populations and observing some relationship with obesity. A specifically designed data extraction form was used, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The methodologic quality of the included studies was assessed with the methodologic index for nonrandomized studies. Results Nine articles were included after we applied the inclusion and exclusion criteria. Almost all studies conducted the test in populations of preschool children and offered food and/or nonfood rewards. The studies found a clear relationship between an inability to defer gratification and overweight and obesity. The quality assessment of the publications was ranked high in 5 studies and medium in 4. Conclusions Children with the inability to delay gratification are more likely to be overweight or obese. Observation of such trends is useful in its implications for reeducation programs. Although the methodologic quality of the eligible studies was acceptable, additional experimental controlled studies are required to associate these behaviors with other aspects.

Miniscrew implants are widely used nowadays in orthodontic treatments due to their good results in clinical practice. However, data regarding the biocompatibility of commercially available orthodontic miniscrews and temporary devices are very scarce, and their role as genotoxicity inducers has been not previously evaluated with the alkaline comet assay. The aim of this study was to investigate the DNA damage in buccal cells of patients subjected to orthodontic treatments. The alkaline comet assay has been applied in oral mucosa cells from patients treated with conventional orthodontic treatment in comparison to patients treated additionally with miniscrews, non-treated volunteers (control) and smoking volunteers (positive control). The application of orthodontic appliances and miniscrews induced significant and similar (2-fold) increases of %DNA in tail in comparison to control group. Females experienced a significant increase in %DNA in all the treatments in comparison to the control group, whereas males showed significant damage only with the combined orthodontic and miniscrew treatment. In conclusion, conventional orthodontic appliances induced genotoxicity, and the incorporation of miniscrews assayed did not imply any additional increase of DNA damage.

To determine the long-term success rate of white MTA pulpotomies in primary teeth and its influence upon eruption and calcification of the permanent successor, as well as other key clinical and radiographic parameters.A total of 138 molars from participants between 2-10 years of age were included. Clinical and radiographic parameters were monitored in the primary and/or permanent successor at 6, 12, 18, 24, 30, 36, 42, and 48 months or until eruption of the permanent successor, using the contralateral tooth as control. Chi-squared test and the Spearman correlation coefficient (r) were used to evaluate potential associations and distributions between radiographic/clinical parameters (P0.05; 95% CI).Clinical alterations were observed in 1.4% of the primary molars. Unfavorable radiographic pulp responses (furcation radiolucency, internal root resorption with perforation, or external root resorption) were observed in 6.5% of the cases. Dentin bridge formation in the roots was observed in a range as low as 71.2% to a maximum of 89.9% of the cases. The presence or absence of dentin bridge formation in any of the roots was not associated or correlated with the age of the patient (P0.05). Reparative dentin formation in any of the the root canals was recorded in 37.3 to a 68.1% of the canals (P0.05). The 50 permanent successors recorded after exfoliation of the treated molars showed no alterations in color, mineralization, structure or position, and no alterations in the timing of eruption were noted.

Statement of problem Deviation from the facial midline and inclination of the dental midline or occlusal plane has been described as extremely influential in the layperson's perceptions of the overall esthetics of the smile. Purpose The purpose of this study was to determine the prevalence of deviation from the facial midline and inclination of the dental midline or occlusal plane in a selected sample. Material and methods White participants from a European population (N=158; 93 women, 65 men) who met specific inclusion criteria were selected for the present study. Standardized 1:1 scale frontal photographs were made, and 3 variables of all participants were measured: midline deviation, midline inclination, and inclination of the occlusal plane. Software was used to measure midline deviation and inclination, taking the bipupillary line and the facial midline as references. Tests for normality of the sample were explored and descriptive statistics (means ±SD) were calculated. The chi-square test was used to evaluate differences in midline deviation, midline inclination, and occlusion plane (α=.05) Results Frequencies of midline deviation (>2 mm), midline inclination (>3.5 degrees), and occlusal plane inclination (>2 degrees) were 31.64% (mean 2.7±1.23 mm), 10.75% (mean 7.9 degrees ±3.57), and 25.9% (mean 9.07 degrees ±3.16), respectively. No statistically significant differences ( P >.05) were found between sex and any of the esthetic smile values. Conclusions The incidence of alterations with at least 1 altered parameter that affected smile esthetics was 51.9% in a population from southern Europe.

Background During the first years of life, when children begin to walk and socialize, they are particularly vulnerable to traumatic injuries to the primary teeth; indeed, after dental caries, such injuries are the second most frequent cause of pediatric dental consultation. Nonetheless, the reported prevalence of trauma to the primary teeth varies depending on the literature source, type of injury, the patient's age, and the most common associated complications. Aim To analyze new epidemiological data and complications associated with traumatic injuries to the primary teeth of Spanish children. Material and methods A retrospective study was carried out in a subpopulation of 879 Spanish children in southern Europe aged between one and 7 years old, with primary and early mixed dentition. Clinical and radiological records were obtained from all pediatric patients who presented trauma to the primary teeth, with a follow-up period of 3–5 years. Results A total of 21.72% of children examined had some kind of dental trauma and the most common age range for injuries to the primary teeth was 1–3 years old. The most common injuries in deciduous teeth were subluxation (47.29% of injuries affected the periodontal ligament), intrusion (23.15%), and avulsion (13.63%). On the other hand, comparatively more complications were recorded as a result of intrusion (32 of 47 intruded teeth). Conclusions In this Spanish subpopulation, a pediatric dental consultation as a result of traumatic dental injuries in primary dentition is most frequent in 1- and 2-year-olds, and subluxation is the commonest injury in the primary dentition. In turn, intrusion is associated with an increased frequency of complications in both the deciduous and the permanent teeth.