Costanza Cavallini

Dental anomalies and clinical features in patients with maxillary canine impaction.

OBJECTIVE To analyze the prevalence, distribution, clinical features, and relationship with dental anomalies of maxillary canine impaction. MATERIALS AND METHODS The complete pretreatment records of 1674 orthodontic patients were examined. Subjects with maxillary impacted canines were divided into two study groups: a palatally displaced canine (PDC) group (114 patients) and a buccally displaced canine (BDC) group (37 patients). These were compared to a control group of 151 patients who were randomly selected from the initial sample without maxillary canine impaction. The significance of associations between canine impaction and dental and clinical features and anomalies was examined with the chi-square test. RESULTS PDC patients presented with normal overjet and facial profile and a lower degree of dental arch crowding in comparison to the control patients. PDC patients showed a higher prevalence of impaction of other teeth, dental aplasia, transposition, and peg-shaped maxillary lateral incisors (odds ratios 3.3, 2.6, 8.3, and 5.8, respectively). CONCLUSION PDC was frequently the only orthodontic problem of patients. BDC group patients did not present with notable differences in clinical and dental features or dental anomalies compared to control subjects.

Lack of clinical predictors for low mineral density in children with celiac disease

Objectives: Metabolic bone disease remains a significant and common complication of celiac disease (CD). Several studies have demonstrated low bone mineral density (BMD) at the time of CD diagnosis in both children and adults. Low BMD in children and adolescents is defined as an areal BMD <2 SD below the age-adjusted mean value (z score <−2 SD). The aim of the study was to evaluate the BMD in a pediatric population with CD at diagnosis and to correlate z score value, anti–tissue transglutaminase type 2 antibody (anti-tTG2) titer, symptoms, and Marsh-Oberhuber (MO) grading. Methods: We enrolled 99 patients with celiac disease (male 35, female 64) ages 4 to 15 years at the diagnosis. All of the patients had positive test results for anti-tTG2 antibodies and histological lesions graded according to MO classification, and underwent lumbar dual-energy x-ray absorptiometry. BMD was estimated by z score. Results: Low BMD (z score ⩽−2 SD) was found in 13 (13.13%) patients; 22 (22.22%) patients with CD showed −2 < z score ⩽ −1; −1 < z score < 0 was found in 41 (41.41%) patients. z score ≥ 0 was detected only in 23 (23.23%) patients with CD. Mean BMD value in patients with CD is z score −0.68. No correlations were found between z score value and anti-tTG2 titer (Spearman &rgr; 0.13), between z score value and MO degree (Spearman &rgr; −0.17), and between z score and symptoms (Spearman &rgr; −0.10). Conclusions: BMD of patients with CD at diagnosis does not seem to correlate with MO degree, anti-tTG2 titer, and symptoms. At the moment, we do not have clinical predictors for low mineral density in children with CD.

Skeletal features in patient affected by maxillary canine impaction

Objective: To analyze the skeletal features of patients with maxillary canine impaction. Material and Methods: The complete pre-treatment records of 1674 orthodontic patients were examined. From the subjects with maxillary impacted canine 12 patients were excluded , remaining 108. The subjects with maxillary impacted canine were divided into two study groups: a palatally displaced canine group (PDCG) (77 patients) and a buccally displaced canine group (BDCG) (31 patients). The values of the skeletal features measured on the lateral cephalometric radiograph were compared with a control group (CG) of 121 subjects randomly selected from the initial sample without maxillary canine impaction. The statistical analysis of the difference between the study groups and the CG was tested using ?2 test and Fisher’s exact test. The level of significance was set at P ?0.05. Results: The CG was characterized by increased values of A point-Nasion-B point angle (ANB) and by a retro-positioned or smaller lower jaw. PDCG patients showed normal skeletal features compared to the CG, presenting mainly I class and lower rank of II and III sagittal skeletal features. PDCG subjects presented also normal values of the Steiner vertical skeletal relationship angles with normal facial divergence compared to the CG. PDCG cases were also characterized by horizontal and prognathic growth. BDCG did not present significant differences in skeletal features compared to the CG, except for an increased ANB. Conclusions: Palatally displaced canine (PDC) was frequently the only orthodontic problem of patients and was not associated whit altered skeletal features. The frequent absence of malocclusion in PDC patients explains the delayed identification of this problem. BDCG patients did not present significant differences in skeletal features with respect to the orthodontic population. The presence of both buccally displaced canine (BDC) and malocclusion makes the patient with BDC both aware of the need for, and motivated to undergo, orthodontic treatment. Key words:Canine impaction, palatal displacement, buccal displacement, skeletal features.

The effects of a common stainless steel orthodontic bracket on the diagnostic quality of cranial and cervical 3T- MR images: A prospective, case-control study

OBJECTIVES To evaluate the effect of orthodontic stainless steel brackets and two different types of archwires on the diagnostic quality of 3-T MR images. METHODS This prospective, case-control study was conducted following Strengthening the Reporting of Observational Studies in Epidemiology guidelines. The recruitment was conducted among orthodontic patients. 80 subjects, requiring MRI for the presence of temporomandibular disorders, were enrolled and divided into four groups: 20 patients using aligners (control group); 20 patients with stainless steel brackets without archwires; 20 patients with stainless steel brackets and nickel-titanium archwires; and 20 patients with stainless steel brackets and stainless steel archwires. Two experts in neuroradiology evaluated the images to determine the amount of distortion in 6 regions and 48 districts. A score was subjectively assigned according to a modified receiver operating characteristic method of distortion classification. Any disagreement was resolved through consensus seeking; when this was not possible, a third neuroradiologist was consulted. The following statistical methods were used: descriptive statistics, Cohens kappa coefficient (k), Kruskal-Wallis test, pairwise comparisons using the Dunn-Bonferroni approach. The significance was set at p ≤ 0.05. RESULTS The presence of stainless steel brackets with or without archwires negatively influenced MRI of the cervical region, paranasal sinuses, head and neck region, and cervical vertebrae but did not influence MRI of brain and temporomandibular joint regions. CONCLUSIONS Patients with a stainless steel multibracket orthodontic appliance should remove it before cervical vertebrae, cervical region, paranasal sinuses, and head and neck MRI scans. The brain and temporomandibular joint region MRI should not require the removal of such appliances.