An abnormal and hypertrophied upper labial frenulum (ULF) can cause diastemas, gingival recession, eruption abnormalities, and the onset of carious and periodontal problems in the upper central ...incisors, as well as aesthetic and functional disorders of the upper lip. The goal of this investigation is to review the evidence on the surgical techniques that are currently available for treating ULF in order to identify the best approach. PubMed, Scopus, Cochrane Library, and Embase were searched for papers that matched our topic from 13 November 2012 up to 22 November 2022 using the following Boolean keywords: "frenulum" and "surgery*". A total of eight articles were selected for the purpose of the review. ULF can be surgically treated using either traditional scalpel surgery or laser surgery. The latter is the better option due to its intra- and post-operative benefits for both the patients and the clinicians, in terms of faster healing, fewer side effects and discomfort, and greater patient compliance. However, a higher learning curve is required for this technique, especially to calibrate the appropriate power of the laser. To date, it is not possible to identify which type of laser achieves the best clinical results for the treatment of ULF.
Temporomandibular disorders (TMD) are a group of musculoskeletal diseases affecting masticatory muscles and temporomandibular joints (TMJ). In this context, the chronic TMD could be considered as a ...condition with chronic primary orofacial pain, presenting as myofascial TMD pain or TMJ arthralgia. In this context, myogenous TMD may present overlapping features with other disorders, such as fibromyalgia and primary headaches, characterized by chronic primary pain related to dysfunction of the central nervous system (CNS), probably through the central sensitization. This phenomenon could be defined as an amplified response of the CNS to sensory stimuli and peripheral nociceptive, characterized by hyperexcitability in the dorsal horn neurons in the spinal cord, which ascend through the spinothalamic tract. The main objectives of the management of TMD patients are: decreasing pain, increasing TMJ function, and reducing the reflex masticatory muscle spasm/pain. The first-line treatments are physical therapy, pharmacological drugs, occlusal splints, laser therapy, extracorporeal shockwave therapy, transcutaneous electrical nerve stimulation, and oxygen–ozone therapy. Although all these therapeutic approaches were shown to have a positive impact on the central sensitization of TMD pain, there is still no agreement on this topic in the scientific literature. Thus, in this comprehensive review, we aimed at evaluating the evidence on pain management and rehabilitation for the central sensitization in TMD patients.
: Cleidocranial dysplasia (CCD) is a rare, autosomal dominant skeletal dysplasia with a prevalence of one per million births. The main causes of CCD are mutations in the core-binding factor alpha-1 ...(CBFA1) or runt-related transcription factor-2 (RUNX2), located at the 6p21 chromosomal region. RUNX2 plays important roles in osteoblast differentiation, chondrocyte proliferation and differentiation, and tooth formation. The disease is characterized by clavicular aplasia or hypoplasia, Wormian bones, delayed closure of cranial suture, brachycephalic head, maxillary deficiency, retention of primary teeth, inclusion of permanent teeth, and multiple supernumerary teeth.
: A 22-year-old girl suffering from cleidocranial dysplasia with short stature, narrow shoulders, craniofacial manifestations (short face, broad forehead, etc.) and dental anomalies (different lower dental elements under eruption, supernumerary and impacted multiple teeth, etc.) was examined at our service (Complex Operative Unit of Odontostomatology of Policlinico of Bari). RX Orthopantomography (OPG) and cone beam computed tomography (CBCT) were requested to better assess the position of the supernumerary teeth and their relationships with others and to evaluate the bone tissue.
: Under eruption was probably caused by dental interferences with supernumerary teeth; hence, extractions of supernumerary upper canines and lower premolars were performed under general anaesthesia. Surgery outcome was excellent with good tissue healing and improvements in the therapeutic possibilities with future orthodontics.
The objective of this article is to give an update about radiological, clinical, and molecular features of CCD and to alert the health team about the importance of establishing an early diagnosis and an appropriate treatment in these patients to prevent impacted teeth complications and to offer them a better quality of life.
Crown lengthening is a surgical procedure aimed at exposure of a larger tooth surface by gingivectomy alone or with cortical bone remodelling for aesthetic purposes in the anterior zone of the ...maxilla or for reconstruction of teeth affected by subgingival caries. We report two cases of crown lengthening in the anterior maxilla for aesthetic purposes by gingival and bone re-contouring performed by erbium-doped yttrium aluminium garnet (erbium:YAG) laser. As highlighted in this report, the erbium:YAG laser-assisted crown lengthening is less invasive and also leads to faster clinical outcomes in contrast to the conventional surgical technique by scalpel incision, flap elevation and osteoplastic.
Elastodontics is a specific interceptive orthodontic treatment that uses removable elastomeric appliances. They are functional appliances that produce neuromuscular, orthopedic and dental effects. ...Thus, these devices are useful in the developmental age, when skeletal structures are characterized by important plasticity and adaptation capacity, allowing to remove factors responsible for malocclusions. Elastomeric devices are generally well tolerated by patients requiring simple collaboration and management. This work can be useful to update all orthodontists already adopting these appliances or for those who want to approach them for the first time. This study aimed to describe four cases treated with new elastomeric devices called AMCOP Bio-Activators and to provide an overview of elastodontics, its evolution, indications and limits.
A total of four clinical cases were presented after a treatment period of 16-20 months to evaluate the clinical and radiological effects of the elastodontic therapy.
The effectiveness of Bio-Activators on clinical cases was evidenced with a significant improvement in skeletal and dentoalveolar relationship, and malocclusion correction in a limited treatment period (16-20 months).
The Bio-Activators showed clinical effectiveness to achieve therapeutic targets according to a low impact on the patient's compliance.
Background: with the emergence of technological innovations in the dental industry, one emerging trend has been the intraoral digitizing of patients by using intraoral scanning systems. Compared to ...taking conventional impressions, the use of intraoral scanners (IOS) is suitable for capturing direct optical impressions, helping to improve diagnostic efficacy, save time, reduce patient discomfort, and simplify clinical procedures. Intraoral scanning systems appear to have a high potential for providing guidance on proper standards of care. However, one main disadvantage is breathing and saliva secretion, which causes deviations, interfering with the applicability and accuracy of the optical impression. The aim of this study was to compare the validity and accuracy of three commercially available intraoral scanners, performing an analysis exploiting a wet model. Methods: an in vitro experimental study of four permanent teeth (two molars and two premolars) on the accuracy of copings obtained by subgingival preparations was performed, using an oral wet environment model. Two hundred and forty digital impressions were produced from three digital scanners using four samples. Descriptive analysis was performed using mean, standard deviation, and median. ANOVA and F-tests were performed to assess the amount of variability between the groups. For statistical analysis a 95% significance level was chosen. Results: all differences between groups were statistically significant. Conclusions: the present data implicate a huge impact of the oral biological fluids on the accuracy of digital impression to corresponding images, implying a failure of accurate impression under wetness conditions.
The number of patients undergoing a surgical resection of the maxilla for oncological reasons is constantly increasing, the most common complication of which remains the communication between oral ...and nasal cavities. On the basis of data arising from the literature regarding the treatment options of maxillary oncological post-surgical defects, obturator prosthesis remains the most used worldwide. We studied 25 patients (with at least 1-year follow up) rehabilitated by obturator prosthesis after maxillary resection leading to oro-nasal communication, providing data on the objective/subjective evaluation of such rehabilitation and mastication performance measured by a two-color chewing gum test. The type of defect was classified according to the classification system proposed by Aramany. Among the patients in our study, 72% rated a higher score for either stability and retention than for aesthetic appearance, as confirmed by the Kapur score rated by clinicians. The two-color chewing gum test shows similar results as only one patient had insufficient chewing function. Interestingly, we found no correlation between the masticatory function and residual denture, confirming that the maxillary obturator remains a predictable solution in such patients regardless of the anatomical alterations following surgery.
Crown lengthening is a surgical procedure aimed at exposure of a larger tooth surface by gingivectomy alone or with cortical bone remodelling for aesthetic purposes in the anterior zone of the ...maxilla or for reconstruction of teeth affected by subgingival caries. We report two cases of crown lengthening in the anterior maxilla for aesthetic purposes by gingival and bone re-contouring performed by erbium-doped yttrium aluminium garnet (erbium:YAG) laser. As highlighted in this report, the erbium:YAG laser-assisted crown lengthening is less invasive and also leads to faster clinical outcomes in contrast to the conventional surgical technique by scalpel incision, flap elevation and osteoplastic.
Early-stage dental demineralization, called white spots (WS), get their name from the characteristic colour that enamel takes on due to the acid attack of salivary cariogenic bacteria. They are often ...associated with fixed orthodontic therapy (FOT) and, if left untreated, evolve into caries with repercussions on oral health and dental aesthetics. This review aims to identify the most effective prophylaxis strategies to prevent WS during FOT. The search for the reviewed studies was conducted on the Pubmed, Scopus, and Web of Science databases, selecting English-only articles published in the 5 years from January 2018 to January 2023. The keywords used were "WS" and "fixed orthodontic*", using "AND" as the Boolean operator. A total of 16 studies were included for qualitative analysis. Prevention begins with maintaining proper oral hygiene; fluoride in toothpaste, mouthwashes, gels, varnishes, and sealants can be added to prophylaxis and used regularly. Using a laser in combination with fluoride helps prevent the occurrence of WS and assists in the repair processes of initial lesions. Further studies are needed to establish international guidelines for preventing WS in orthodontically treated patients.
Among all lasers with generally accepted surgical capabilities, the diode laser is most commonly used for the surgical removal of proliferating lesions and the photocoagulation of venous ...malformations of the oral cavity. The laser provides several advantages for clinicians, including an absence of intraoperative bleeding and no need for stitches. The laser benefits patients because it reduces postoperative edema and pain, with fast mucosal restoration during healing by second intention. We report a case series to highlight the capabilities of the diode laser in oral surgery procedures along with our suggestions.
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