1,721,062 research outputs found
Reliability of Growth Indicators and Efficiency of Functional Treatment for Skeletal Class II Malocclusion: Current Evidence and Controversies
Full text linkCurrent evidence on the reliability of growth indicators in the identification of the pubertal growth spurt and efficiency of functional treatment for skeletal Class II malocclusion, the timing of which relies on such indicators, is highly controversial. Regarding growth indicators, the hand and wrist (including the sole middle phalanx of the third finger) maturation method and the standing height recording appear to be most reliable. Other methods are subjected to controversies or were showed to be unreliable. Main sources of controversies include use of single stages instead of ossification events and diagnostic reliability conjecturally based on correlation analyses. Regarding evidence on the efficiency of functional treatment, when treated during the pubertal growth spurt, more favorable response is seen in skeletal Class II patients even though large individual responsiveness remains. Main sources of controversies include design of clinical trials, definition of Class II malocclusion, and lack of inclusion of skeletal maturity among the prognostic factors. While no growth indicator may be considered to have a full diagnostic reliability in the identification of the pubertal growth spurt, their use may still be recommended for increasing efficiency of functional treatment for skeletal Class II malocclusion
Dental maturation is not a reliable indicator of the pubertal growth spurt
No full textThe authors concluded that “As a clinical implication from our study, the association between the tooth mineralization stages and the skeletal maturation indicators allows clinicians to easily identify the pubertal growth period from the panoramic or intraoral radiographs.” The authors correctly reported that “A high correlation coefficient does not provide information about whether the dental maturation stage is satisfactory for diagnostic identification of the skeletal maturation stage.” However, in spite of that, this is a further correlation study between dental and skeletal maturation missing any diagnostic reliability analysis. Although it is a sophisticated procedure, the multiple ordinal regression analysis used by the authors remains an “association” analysis, which is unable to determine the capability of dental maturation in the identification of the different growth phases in individual subjects. The issue of the proper investigation on the diagnostic reliability of dental maturation in assessing the growth phase was raised years ago by our research team, which suggested the use of proper diagnostic performance analysis instead of correlation analyses.2 Among the diagnostic parameters we introduced was the positive likelihood ratio (LHR) that provides an estimate of how much a given dental maturation stage changes the odds of having a given growth phase.3 A threshold of ≥10 for a positive LHR is considered for assessment of satisfactory diagnostic reliability.
Posturography as a diagnostic aid in dentistry: A systematic review
No full textThe aim of this systematic review of the literature was to assess the scientific evidence for detectable correlations between the stomatognathic system and whole-body posture and to provide information on the relevance of posturography as a diagnostic aid in dentistry. A literature survey was performed using the Medline database, covering the period from January 1966 to May 2009, and using the medical subject headings. After selection, 21 articles qualified for the final analysis. Only one study was judged to be of medium/high quality, with all of the rest classified as of low quality design. Only two studies included follow-up of 28 days and 1 year. Overall, 14 of the studies reported detectable correlations between the stomatognathic system and body posture in at least one of the parameters used, although in four of these studies the authors suggested caution in the interpretation of their data. After a reappraisal of the data provided in 13 of the studies, a weak correlation that r
Diagnostic reliability of the third finger middle phalanx maturation (MPM) method in the identification of the mandibular growth peak
No full textBACKGROUND/OBJECTIVES: The use of the sole third finger middle phalanx for a maturational method has been proposed but not fully investigated. Herein, the diagnostic reliability of an improved five-stage third finger middle phalanx maturation (MPM) method in the identification of mandibular growth peak has been investigated. SUBJECTS/METHODS: From the files of the Burlington Growth Study, 35 subjects (20 males, 15 females) with at least 7 annual lateral cephalograms taken from 9 to 16 years were included. Mandibular growth was defined as annual increments in condylion-gnathion (Co-Gn) distance. Subsequently, individual annual increments in Co-Gn were arranged according to annual age intervals, with the first and last intervals defined as 9-10 years and 14/15-16 years, respectively. A full diagnostic reliability analysis (including positive likelihood ratio) was performed to establish the diagnostic reliability of the MPM stage 2 (MPS2) in the identification of the imminent mandibular growth peak.. RESULTS: The MPS2 had a satisfactory accuracy in the identification of imminent mandibular growth peak with an overall positive likelihood ratio of 10.3. However, reliability showed noteworthy variability being greater and lower for younger and older age intervals, respectively. LIMITATIONS: Secular trend, limited sample size, and annual recording in conjunction with the use of a discrete staging system. At the 15 years recording, 28 of 35 cases were missing. CONCLUSIONS/IMPLICATIONS: The MPS2 and MPS3 may be considered associated with the onset and maximum mandibular growth peak, respectively, in most of the subjects, indicating their use in planning treatment timing
Gingival Crevicular Fluid as a Source of Biomarkers of Patient Responsiveness to Orthodontic Treatment.
No full textDental occlusion, body posture, and temporomandibular disorders: Where we are now and where we are heading for
No full textThe aim of this investigation was to perform a review of the literature dealing with the issue of relationships between dental occlusion, body posture and temporomandibular disorders (TMD). A search of the available literature was performed to determine what the current evidence is regarding: (i) The physiology of the dental occlusion-body posture relationship, (ii) The relationship of these two topics with TMD and (iii) The validity of the available clinical and instrumental devices (surface electromyography, kinesiography and postural platforms) to measure the dental occlusion-body posture-TMD relationship. The available posturographic techniques and devices have not consistently found any association between body posture and dental occlusion. This outcome is most likely due to the many compensation mechanisms occurring within the neuromuscular system regulating body balance. Furthermore, the literature shows that TMD are not often related to specific occlusal conditions, and they also do not have any detectable relationships with head and body posture. The use of clinical and instrumental approaches for assessing body posture is not supported by the wide majority of the literature, mainly because of wide variations in the measurable variables of posture. In conclusion, there is no evidence for the existence of a predictable relationship between occlusal and postural features, and it is clear that the presence of TMD pain is not related with the existence of measurable occluso-postural abnormalities. Therefore, the use instruments and techniques aiming to measure purported occlusal, electromyographic, kinesiographic or posturographic abnormalities cannot be justified in the evidence-based TMD practice
Facial soft tissue changes during the pre-pubertal and pubertal growth phase: a mixed longitudinal laser-scanning study
Full text linkBACKGROUND/OBJECTIVES: Facial soft tissues changes during growth roughly tend to mimic the underlying hard tissues, but not completely. The aim of this mixed longitudinal study was to assess facial growth among pre-pubertal and pubertal subjects without malocclusion using a non-invasive three-dimensional laser scanning system. SUBJECTS/METHODS: Fifty-nine subjects (30 females and 29 males) aged at baseline 5.4-8.9 years with normal occlusion were clustered into the younger, older pre-pubertal, and pubertal groups according to age and the absence/presence of a standing height growth spurt. Three-dimensional facial images were obtained using laser scanners for five consecutive years. Several transversal, sagittal, and vertical parameters were assessed for between and within group comparisons. RESULTS: Significant overall changes of almost all parameters were seen within each group (P 0.05). The younger pre-pubertal group showed greater annual growth rates of lip prominence; both pre-pubertal groups showed greater rates in facial middle third height. The pubertal group showed greater annual rates in facial profile angle changes during the growth peak. LIMITATIONS: A high standing height increment (7cm) was used as the threshold for subject allocation in the pubertal group. CONCLUSIONS: Soft tissue facial growth has generally similar amounts and rates irrespective of the pubertal growth spurt. Pre-pubertal subjects show greater annual rates of facial middle third height changes while pubertal subjects show greater annual rates of chin protrusion
Gingival crevicular fluid alkaline phosphatase activity in relation to pubertal growth spurt and dental maturation: A multiple regression study
Full text linkIntroduction: The identification of the onset of the pubertal growth spurt has major clinical implications when dealing with orthodontic treatment in growing subjects.
Aim: Through multivariate methods, this study evaluated possible relationships between the gingival crevicular fluid (GCF) alkaline phosphatase (ALP) activity and pubertal growth spurt and dentition phase.
Materials and methods: One hundred healthy growing subjects (62 females, 38 males; mean age, 11.5±2.4 years) were enrolled into this doubleblind, prospective, cross-sectional-design study. Phases of skeletal maturation (pre - pubertal, pubertal, post - pubertal) was assessed using the cervical vertebral maturation method. Samples of GCF for the ALP activity determination were collected at the mesial and distal sites of the mandibular central incisors. The phases of the dentition were recorded as intermediate mixed, late mixed, or permanent. A multinomial multiple logistic regression model was used to assess relationships of the enzymatic activity to growth phases and dentition phases.
Results: The GCF ALP activity was greater in the pubertal growth phase as compared to the pre - pubertal and post - pubertal growth phases. Significant adjusted odds ratios for the GCF ALP activity for the pre - pubertal and post - pubertal subjects, in relation to the pubertal group, were 0.76 and 0.84, respectively. No significant correlations were seen for the dentition phase.
Conclusions: The GCF ALP activity is a valid candidate as a non - invasive biomarker for the identification of the pubertal growth spurt irrespective of the dentition phase
Is postural platform suited to study correlations between the masticatory system and body posture? A study of repeatability and a meta-analysis of reported variations.
No full textInfluence of sucking habits and breathing pattern on palatal constriction in unilateral posterior crossbite - a controlled study.
No full textThe aim of this study was to evaluate the influence of prolonged sucking habits and mouth breathing on palatal vault morphology in a group of subjects with unilateral functional crossbite [crossbite (CB) group] compared with a group of subjects with normal occlusion [non-crossbite (NCB) group]. A sample of 80 Caucasian subjects (51 CB and 29 NCB; aged 5.3 ± 0.8 years) in the deciduous dentition was selected. A questionnaire regarding the subject's sucking habits was answered by the parents. Any sucking habit that lasted more than 24 months was considered as a prolonged sucking habit. The breathing pattern was assessed by an experienced otorinolarygologist and was classified either mainly nose or mouth breathing. Intercanine and intermolar distances and palatal surface area and volume were recorded three dimensionally on study casts. Univariate and multivariate analyses were employed. Posterior CB was negatively correlated with all the dental and palatal parameters (P < 0.01) with the exception of the palatal surface area that did not reach the statistical significance. Only prolonged sucking habits (but not mouth breathing) was a significant risk indicator for unilateral functional CB (P < 0.001). However, the prolonged sucking habits were not significantly correlated with any of the investigated parameter, and mouth breathing was negatively correlated with the intermolar distance only. Therefore, maxillary constriction in unilateral functional CB might not be influenced by the presence or absence of prolonged sucking habits or mouth breathing
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