Joanna Janiszewska-Olszowska

Effect of orthodontic debonding and adhesive removal on the enamel - current knowledge and future perspectives - a systematic review.

After orthodontic treatment, brackets are debonded and residual adhesive is removed, causing iatrogenic enamel damage. The aim of this study was to review the methods of orthodontic adhesive removal, find clear evidence, and provide a rationale for this procedure. A literature search was performed in PubMed, Dentistry and Oral Sciences, Scopus, Cochrane, Google, and Google Scholar using keywords: orthodontic adhesive removal, orthodontic debonding, orthodontic clean-up. Studies concerning human enamel roughness or loss from debonding and adhesive removal were considered. Forty-four full-text articles were analyzed and 3 were rejected after detailed reading; finally 41 papers were included. Fifteen qualitative studies, 13 studies based on indices of enamel surface, and 13 quantitative studies were found. No meta-analysis could be performed due to a lack of homogenous quantitative evidence. The most popular tools were tungsten carbide burs, which were faster and more effective than Sof-Lex discs, ultrasonic tools, hand instruments, rubbers, or composite burs. They remove a substantial layer of enamel and roughen its surface, but are less destructive than Arkansas stones, green stones, diamond burs, steel burs, and lasers. Multi-step Sof-Lex discs and pumice slurry are the most predictable enamel polishing tools. Arkansas stones, green stones, diamond burs, steel burs, and lasers should not be used for adhesive removal. The use of tungsten carbide bur requires multistep polishing. Further efforts should be made to find tools and methods for complete removal of adhesive remnants, minimizing enamel loss and achieving a smooth surface.

Tessier type 3 oblique facial cleft with a contralateral complete cleft lip and palate

Oblique facial clefts are extremely rare congenital deformities with a reported incidence of 0.24% of all facial clefts. This report presents a patient with a right-sided oblique cleft extending through the upper lip, the alar groove and the lower palpebra accompanied by a left-sided complete cleft lip and palate. Hypertylorism and bilateral microphthalmia as well as flexion wrist contractures were also present. Primary straight-line closure of the oblique cleft was undertaken followed by primary closure of the contralateral cleft lip. The treatment modality and 2 year follow-up results are presented.

Overall and anterior Bolton ratio in Class I, II, and III orthodontic patients

The aim of the investigation was to compare overall and anterior Bolton ratios in different malocclusion groups with Boltons standards. The material comprised 600 pre-treatment study casts (262 males and 338 females, aged 12-25 years), selected from the models of 3088 patients who had applied for orthodontic treatment based on the following criteria: permanent dentition from the first right molar to the first left molar and no interproximal caries or restorations. There were 162 Class I, 144 Class II division 1, 155 Class II division 2, and 139 Class III patients. Statistical analysis of the data was undertaken using a Students t-test. Statistically significant differences were found for the mean overall ratio when compared with the original Bolton norm for the whole study group, as well as for patients with Class I and III malocclusions when the mean anterior ratio was compared with the original Bolton norm. Significant differences were observed in all malocclusion groups for both genders. Discrepancies exceeding 2 SD were found in 31.2 per cent of the studied population for the anterior ratio when compared with Boltons norm. The highest mean values for anterior ratio were in males with Class I (79.1) and Class III (80.1) malocclusions.

The use of the transparotid approach for surgical treatment of condylar fractures – Own experience

AIM To assess the results of surgical treatment of condylar fractures using the transparotid approach. MATERIAL AND METHODS The transparotid approach was used in 38 patients with unilateral condylar fracture. In four cases a single 2.0 plate was used, in the latter - 3D plates were used. All the patients were subjected to control clinical examination including: occlusion, facial nerve function, mandibular movements, pain presence, subjective assessment of the scar aesthetics and the presence of salivary fistula or salivary cyst on the first day following surgery and after 1, 3 and 6 months. Control radiography of the mandible in at least two projections was made on the first day after surgery and after 3 months. RESULTS In 3 patients a partial paresis of the facial nerve was noticed followed by a spontaneous recovery 3 months postoperatively. In 2 patients acoustic effects, without pain in the temporomandibular joint of the fractured side were still present 6 months postoperatively. Plate fractures were found in two out of four patients operated on with single-plate technique. Loosening and displacement of a fixation screw occurred in 4 patients; in 3 cases it referred to a single 2.0 plate and in one, a Delta plate. Post-operation scar was accepted by all the patients. CONCLUSION The transparotid approach allows for direct visualisation of the fracture providing proper reduction and osteosynthesis, with a low risk of facial nerve paresis. Precise wound closure in layers, especially of the parotid capsule allows avoiding a salivary fistula.

Effect of primary correction of nasal septal deformity in complete unilateral cleft lip and palate on the craniofacial morphology

PURPOSE To assess the long-term effect of primary correction of the nasal septum during lip repair in unilateral complete cleft lip and palate on the craniofacial morphology. MATERIAL, SUBJECTS, METHODS The study material consisted of 54 lateral cephalograms made at the ages 7-22, including 28 cephalograms of patients from a study group (aged 7-14 years) after a primary correction of the nasal septum during lip closure and 26 cephalograms of patients from a control group (aged 12-22 years) operated on without septal correction. All cephalograms have been analysed with regard to skeletal, dental and soft-tissue relationships. Data distribution has been checked using Shapiro-Wilk test (α = 0.05). Student t-test was used to compare values of normal distribution and for the latter - Mann-Whitney test. RESULTS The comparison of all cephalometric values between the study and control groups revealed a statistically significant (α = 0.05) difference only for H (p = 0.0267), 1+: NB angle (p = 0.0175) and 1+: NA (mm) (p = 0.0249). Each of the three cephalometric measurements mentioned were greater in the study than in the control group. CONCLUSION No negative effect from the primary nasal septum correction on maxillary development could be found in the study group.

Primary Correction of Nasal Septal Deformity in Unilateral Clefts During Lip Repair—A Long-Term Study

Objective The aim of this study was to assess the long-term effect of primary septal correction carried out during lip closure on the nasal septum. Materials, Subjects, and Methods Before primary septal correction was introduced, specimens from the septal cartilage and the anterior nasal spine of 10 deceased newborns and infants were analyzed with the aid of a light microscope to verify the presence of any growth zone. The study group comprised 91 children with unilateral clefts who had undergone primary lip repair with septal correction. The control group comprised 29 children with unilateral clefts operated on without primary septal correction. The appearance of the nasal septum was assessed on extraoral photographs in the second week of life and then 10 to 14 years postoperatively. Results Morphologic examination revealed fibrous connective tissue with no signs of growth between the cartilaginous septum and bone. At long-term examination, the study group was found to have a nasal septum that was straight in 75 (83%), moderately deviated in 14 (15%), and severely deviated in two (2%) patients, whereas in the control group, the septum was considered straight in four (14%) children, moderately deviated in 11 (38%), and severely deviated in 14 (48%). Conclusions Primary septal correction may be considered safe because no growth zone exists between the septal cartilage and the anterior nasal spine. Careful primary nasal septal correction improves nose shape in a way that allows normal growth.

Management of temporomandibular ankylosis – compromise or individualization – a literature review

Summary Temporomandibular joint ankylosis is defined as bony or fibrous adhesion of the anatomic joint components accompanied by a limitation in opening the mouth, causing difficulties with mastication, speaking and oral hygiene as well as inadvertently influencing mandibular growth. Surgical treatment procedures include arthroplasty of the joint cavity with or without a reconstruction and a coronoidectomy, an autogenous costochondral rib graft, distraction osteogenesis and intensive mouth-opening exercise, corrective orthognathic surgery or alloplastic joint prostheses. The authors of this study would like to provide the reader with an evidence-based review of the literature in order to determine the most efficient way to manage TMJ ankylosis and re-ankylosis. The authors have concluded that in order to achieve a satisfactory and durable effective treatment, an individualized approach is necessary in each case.

Lobar Holoprosencephaly With a Median Cleft: Case Report

Holoprosencephaly is a congenital abnormality of the prosencephalon associated with median facial defects. Its frequency is 1 in 250 pregnancies and 1 in 16,000 live births. The degree of facial deformity usually correlates with the severity of brain malformation. Early mortality is prevalent in severe forms. This report presents a child with lobar holoprosencephaly accompanied by median cleft lip and palate. The treatment and 9 months’ follow-up are presented. This unique case shows that holoprosencephaly may present different manifestations of craniofacial malformations, which are not always parallel to the severity of brain abnormalities. Patients with mild to moderate brain abnormalities may survive into childhood and beyond.

Spacing in deciduous dentition of Polish children in relation to tooth size and dental arch dimensions.

AIM To assess the prevalence of primary and secondary spacing in the deciduous dentition and its correlation to tooth widths and dental arch dimensions. SUBJECTS AND METHODS Dental casts of 50 preschool children free from malocclusion, were analysed. The width of each space was measured as the smallest distance between the proximal surfaces of the neighbouring teeth, parallel to the occlusal plane. Crown width was measured as the greatest distance between the mesial and distal surfaces of the crown, parallel to the occlusal plane. Intercanine widths were measured between cusp tips of upper and lower canines. Intermolar widths were measured between the central fossae of the second molars. Arch lengths were measured from the midpoint between the central incisors to the midpoint between the distal surfaces of the deciduous second molars. RESULTS The primary spaces were present in the upper dental arch in 90% children, on the average 2.09 mm in maxilla and 1.25 mm in mandible. Their widths were dependent on upper intercanine width. Secondary spacing was present in 92% children in the upper dental arch (mean 2.86 mm) and 90% in the lower (mean 3.08 mm). Lower secondary spacing was correlated to lower intercanine width and lower arch length. Total absence of interdental spacing was found in 4% children. CONCLUSIONS Interdental spacing of the deciduous dentition is present in 96% of Polish children. Children with wider intercanine widths have wider primary spaces in maxilla and wider secondary spaces in mandible.

DD Genotype of ACE I/D Polymorphism Might Confer Protection against Dental Caries in Polish Children

The aim of the study was to examine the frequencies of the genotypes and alleles of ACE insertion/deletion (I/D) polymorphism and their association with dental caries in a sample of Polish children. The study subjects were 120 children with dental caries experience (cases) and 41 caries-free individuals (controls). The genotyping was performed using polymerase chain reaction. The genotype distributions of ACE I/D polymorphism were not statistically different between carious and control children. However, we found a borderline overrepresentation of the II + ID genotypes versus the DD genotype in the carious compared to the control group (69.2% and 51.2%, respectively, p = 0.057). Logistic regression analysis adjusted for age and sex revealed that I allele carriage was a significant predictor of dental caries susceptibility (OR = 2.14, 95% CI = 1.02-4.49, p = 0.041). In conclusion, the DD genotype of ACE I/D polymorphism might be protective against dental caries in Polish children.