Andrea Marinelli

Maxillary dental anomalies in children with cleft lip and palate: a controlled study

OBJECTIVE To evaluate the prevalence of dental abnormalities of the primary and permanent maxillary dentitions in children affected by unilateral (UCLP) and bilateral (BCLP) cleft of the lip and palate. METHODS One hundred and fifty-six Caucasian patients (64 females and 92 males) affected by non-syndromic UCLP or BLCP were selected. A control sample of 1000 subjects (482 males and 518 females) without CLP was selected. All comparisons were carried out by means of z-tests on proportions. RESULTS The prevalence rate for missing primary lateral incisors in UCLP subjects was 8.1% and it was 27.9% for the permanent lateral incisors. In BLCP subjects, the prevalence rates were 17% for the primary lateral incisors and 60% for the permanent lateral incisors. The second premolar was absent in 5.4% of UCLP subjects and in 8.8% in the BCLP sample. The statistical analysis revealed significant differences for the prevalence rates of all dental anomalies compared with the control group except for second premolar agenesis. CONCLUSIONS In both UCLP and BCLP subjects the most prevalent missing teeth were the lateral incisors. The dental anomalies occurred predominantly in the cleft area, thus suggesting that the effect of the cleft disturbance is more local than general on the dentition.

Class II malocclusion with maxillary protrusion from the deciduous through the mixed dentition: a longitudinal study.

The aim of this study was to analyze the skeletal characteristics of Class II malocclusion with maxillary protrusion in the deciduous dentition and to describe the growth features of this type of skeletal imbalance during the transition from the deciduous through the mixed dentition. A group of 17 subjects having skeletal Class II malocclusions in the deciduous dentition due to maxillary protrusion was compared with a control group of 30 untreated subjects with ideal occlusion at the same stage of development. Both groups were observed for the first time in the deciduous dentition (T(1)) and followed during the transition from the deciduous to the mixed dentition (T(2)). During this time no orthodontic treatment was provided. Lateral cephalograms were taken for all subjects at T(1) and T(2). A cephalometric analysis was performed based on a reference system that consisted of two perpendicular lines traced through stable basicranical structures. The results indicate that a Class II skeletal pattern due to a maxillary protrusion is established early in the deciduous dentition and remains unmodified in the transition to the mixed dentition. The maxilla appeared to be displaced forward in Class II subjects, whereas the mandibles of the Class I and Class II subjects did not show any significant differences at this stage of growth. In the passage from the deciduous through the mixed dentition, Class I and Class II subjects showed growth increments that were not significantly different from each other. Sucking habits appeared to be correlated with the skeletal maxillary protrusion.

Tooth wear in the mixed dentition: a comparative study between children born in the 1950s and the 1990s.

The aim of this study was to evaluate the degree of tooth wear in posterior deciduous teeth of 100 subjects in the second phase of mixed dentition who were born in the 1950s (50sG) and 100 subjects born in the 1990s (90sG). The degree of abrasion for each posterior deciduous tooth was scored ranging from 0 to 3. The comparison of the degree of abrasion showed significant differences between the two groups for all examined teeth (upper and lower deciduous canines and first and second primary molars) all of which appeared to be more abraded in the 50sG. The findings of the present study indicate that subjects who were born in the 1950s exhibited a significantly greater degree of tooth wear on the posterior deciduous teeth when compared with contemporary subjects, along with a well-recognized lower prevalence of malocclusions. Changes in dietary habits and a diet based on processed foods may be postulated as factors involved with a decrease of dental attrition in contemporary populations. An increase in the prevalence of mouth breathing (tested in the present study) appears to be associated with a decrease in tooth wear in the contemporary population as well.

Biometric and magnetic resonance imaging assessment of dentofacial abnormalities in a case of Klippel-Trénaunay-Weber syndrome

Klippel-Trénaunay-Weber syndrome is characterized by cutaneous hemangioma, arteriovenous fistulas or varicosities (or both), and unilateral hypertrophy of hard and soft tissues with different localization. Klippel-Trénaunay-Weber syndrome represents a syndrome of interest for those in the fields of oral and maxillofacial radiology and pathology because of the high incidence of compromise of the orofacial area in affected patients. The patient reported here presents with all of the 3 characteristic signs of the syndrome. The somatic and facial hypertrophy is contralateral to angiomata. As revealed through the use of magnetic resonance imaging, the primary component of facial hypertrophy is adipic subcutaneous tissue. Statistical analysis of the dental dimensions revealed that teeth on the hypertrophic side are significantly larger than normal.

Dental Arch Dimensions in the Mixed Dentition: A Study of Italian Children Born in the 1950s and the 1990s

The objective of this study was to compare the dental arch dimensions in the mixed dentition in two modern samples living in the same geographic area and separated by almost 35 years. A group of 83 subjects (39 boys and 44 girls) born between 1953 and 1959 (mean age: eight years and three months +/-15 months for the boys and seven years and 11 months +/-12 months for the girls) were compared with a group of 84 subjects (38 boys and 46 girls) born between 1990 and 1998 (mean age: eight years and eight months +/-12 months for the boys and eight years and four months +/-11 months for the girls). Measurements were taken on dental casts for posterior and anterior arch segments, intermolar and intercanine width, and mesiodistal size of incisors. The available anterior space in both arches and the posterior and anterior transverse dimensions were calculated. Groups were compared using a nonparametric test (Mann-Whitney U-test) for independent samples (P < .05). Results show that both boys and girls of 1990s showed significantly smaller maxillary intermolar width when compared with 1950s. Posterior transverse interarch discrepancy was significantly minor in girls of 1990s. The present population has a greater probability of developing a malocclusion as a consequence of the secular trend toward the reduction of the width of the upper arch.

Tooth Abrasion in Unilateral Posterior Crossbite in the Deciduous Dentition

The aim of this study was to evaluate the degree of abrasion in posterior teeth of subjects with unilateral posterior crossbite in the deciduous dentition. A group of 54 untreated subjects in deciduous dentition (test group, TG) was selected from a parent sample of 1500 patients from the files of the Department of Orthodontics of the University of Florence. A sample of 20 subjects with normal occlusion in the deciduous dentition was selected as the control group (CG). As experimental units in TG, 54 crossbite sides (CB, consisting of 33 right and 21 left crossbite sides) and 54 noncrossbite sides (NCB) were used. In CG, one randomly chosen single side for each subject (NCBC) was used for comparisons. The findings of the present study indicated that subjects with unilateral crossbite in the deciduous dentition showed a significantly smaller degree of dental abrasion in the crossbite side when compared with both the opposite side and control group sides. The lack of abrasion in crossbite sides was primarily due to a significantly lesser degree of abrasion of the upper deciduous canines.

Abnormal mandibular growth after craniovertebral surgery in Morquio syndrome type A.

Morquio syndrome or MPS4A is an autosomal recessive inherited metabolic disease, due to a deficiency of N-acetil-galactosamine-6-sulfatase (OMIM 253000). Hypoplastic odontoid processes causing atlantoaxial subluxation and cervical myelopathy are usual clinical findings. Surgical intervention of craniocervical fusion is often performed to prevent this complication. Clinical and cephalometric findings in a patient affected by Morquio syndrome after craniovertebral surgery are described. Facial growth pattern in the lateral plane changed dramatically. The mandibular gonial angle (ArGoMe), the body of the mandible (GoGn), and the total length of the mandible (CoGn) increased abnormally, whereas the mandibular ramus (CoGo) exhibited normal growth. Knowledge of the possibility of abnormal mandibular growth may contribute in long-term orthodontic management of such subjects.

Oral and Craniofacial Findings of Binder Syndrome: Two Case Reports

Binder syndrome is a malformative midfacial alteration, known also as maxillonasal dysplasia or maxillonasal dysostosis. In this article, two cases of affected patients are reported, and the features of the condition are reviewed. One case presents a cleft lip. Hypotheses about etiology, pathogenesis, and classification of the syndrome are illustrated. This work provides a contribution for the delineation of a differential diagnostic procedure.

Morphometric investigation in the skulls of young adults. A comparative study between 19th century and modern Italian samples.

OBJECTIVE To test the hypothesis that there are no differences in the shape of the cranial complex between two samples from the same restricted geographical area and separated by almost 150 years. MATERIALS AND METHODS A group of 35 skulls from the 19th century were selected and compared with a modern sample composed of 43 young adult subjects by means of lateral cephalograms and using a morphometric analysis. The peculiarity of this work is the uniformity of the two samples involving adults coming from the same restricted birthplace and with homogeneity for the orthodontic classification. RESULTS Although the time spans are short, significant differences were found between the two samples. Shape changes included maxillary elongation toward the posterior region and a marked change in shape configuration in the mandibles points that shows a posterior rotation of the mandibular body. The global result of this cranial base points movements symbolizes a tiny tendency toward closure of the cranial base angle. CONCLUSIONS The hypothesis is rejected. Changes were evident, and environmental influences can be responsible for these changes.

Transverse dimensions of dental arches in subjects with Class II malocclusion in the early mixed dentition.

OBJECTIVE The purpose of this study was to analyze the transverse dentoalveolar features of subjects with Class II Division 1 malocclusion in mixed dentition when compared to subjects with normal occlusion. MATERIALS AND METHODS The study was performed on 192 randomly selected subjects in the early mixed dentition. According to sagittal skeletal and occlusal features the sample was divided into two groups: 88 subjects (53 females and 35 males) with Class II skeletal disharmony and Class II, division 1 malocclusion (Class II Group, mean age 8 years and 10 months±11 months) and 104 subjects (66 females e 38 males) with dentoskeletal Class I relationships (Class I Group, mean age 9±1 years). The Class II group was further divided into two subgroups (maxillary protrusion group and mandibular retrusion group) on the basis of the skeletal characteristics. Intermolar and intercanine distances were measured on dental casts in both arches and posterior and anterior transversal discrepancy (PTID and ATID) were calculated. RESULTS Subjects with Class II malocclusion showed a significantly greater negative PTID (-2.1 mm) which was associated with a significantly reduced maxillary width with respect to the Class I group (-2.2 mm). The Class II group showed also a significantly greater negative ATID (-1.4 mm) when compared to the Class I group. Subjects with mandibular retrusion showed a significantly greater reduction both in the maxillary intercanine width (-1.7 mm). and in the maxillary intermolar width (-2.7 mm) with respect to the Class I group. Subjects with maxillary protrusion presented with a significantly greater constriction at the maxillary intermolar width (-1.7 mm) when compared to the Class I group. CONCLUSIONS Class II malocclusion with mandibular retrusion is associated with a significant constriction of the maxillary arch with reduced intercanine and intermolar widths. When Class II malocclusion is due to a maxillary protrusion the constriction at the maxillary arch is limited to the intermolar width.