Clinical Comparison of Diode Laser Assisted “v-Shape Frenectomy” and Conventional Surgical Method as Treatment of Ankyloglossia

(1) Background: Ankyloglossia, or tongue-tie is a condition, in which the tip of tongue cannot protrude beyond the lower incisor teeth because of short frenulum linguae, often containing scar tissue. Limitations of movement are the most important clinical symptoms of this condition, together with feeding, speech, and mechanical problems. (2) Methods: the present study included two groups of patients (group A and group B) including, respectively, 29 and 32 patients (61 patients total), aged from 8 to 12 and presenting ankyloglossia classified according to the Kotlow’s classification. The patients in group A underwent a common surgical procedure. For the patients of group B, a diode laser device (K2 mobile laser, Dentium, Korea) with a micro-pulsed wavelength of 980 ± 10 nm and power of 1.2 watts was used. The post-surgical discomfort of the patients (recording the pain perceived immediately after the end of the anesthesia and during the following week, using the Numeric Rating Scale (NRS) system) and healing characteristics (recorded using the Early Wound Healing Score or EHS) were evaluated. (3) Results: The results shows that the pain in the patients who underwent laser-assisted frenectomy is significantly reduced (p < 0.001) when compared to those who underwent conventional surgical frenectomy, both immediately after surgery (with a reduction in the average NRS of 80.6%) and after the first week (with a reduction in the average NRS of 86.58%). Additionally, in the same patients, an augmentation in the average value of the EHS of 45% was recorded, highlighting significantly (p < 0.001) better quality in the healing of the wound within the 24 h after surgery. Moreover, other advantages observed in the use of laser assisted-frenectomy are the absence of bleeding and, consequently, a clear operative field; no need to use sutures; no need to take painkillers or antibiotics after surgery; and having a faster recovery and less time needed to perform the operation. (4) Conclusions: within the limits of the present study, it seems possible to assert that the laser frenectomy performed using the v-shape technique presents a series of advantages if compared to the conventional surgical method.

Effects of Local Anesthetics With Vasoconstrictors on Dental Pulp Blood Flow and Oxygen Tension

Objective: The aim of this study was to investigate the changes in pulpal blood flow (PBF) and pulpal oxygen tension (PpulpO2) after injecting local anesthetics with vasoconstrictors. Methods: Under general anesthesia, male Japanese White rabbits were injected with 0.6 mL of 2% lidocaine with 1:80,000 epinephrine (LE) or 3% propitocaine (prilocaine) with 0.03 IU felypressin (PF) at the apical area of the lower incisor. Results: Relative to baseline, PBF and PpulpO2 significantly decreased 5 minutes after LE or PF injection as compared with saline. The decrease in PBF was significantly lower in the LE group than in the PF group. Although the LE group had a larger decrease in PpulpO2 relative to baseline than the PF group did, that difference was not significant. PBF and PpulpO2 recovered to baseline faster in the PF group than in the LE group. Conclusion: The injection of local anesthetic solutions containing vasoconstrictors (LE or PF) transiently caused significant decreases in PBF that resulted in significant decreases in PpulpO2. The recovery of PpulpO2 was faster than PBF regardless of the vasoconstrictor used.

Lower Incisor Positions in Different Malocclusions and Facial Pattern

Aims: The position of lower incisor has been of significant concern when seeking orthodontic treatment plan, it has been recognized as one of diagnostic key and play an important in the development of normal occlusion and facial pattern. This study was aimed at the determination of lower incisor position and its possible association with different sagittal malocclusions and facial patterns. Study Design: Descriptive Cross-sectional Study Place and Duration of Study: Department of Orthodontics Institute of Dentistry Liaquat University Medical and Health Sciences (LUMHS) Jamshoro between June 2019 to July 2020. Methodology: Ninety-seven pre-treatment lateral cephalometric radiographies were taken, and they were classified sagittally into skeletal class I, II and III, and vertically into normodivergent, hyperdivergent and hypodivergent facial pattern using ANB and SNMP, respectively. Lower incisor position was assessed by means of FMIA and IMPA. One way analysis of variance (ANOVA) was applied to check any association between lower incisor position and sagittal malocclusion and facial pattern. P value of 0.05 was considered statistically significant. Results: The study sample consisted of 97 patients. The mean age of the patients was 25.55 SD ±3.93. The mean SNMP value was 28.84 SD ±7.354 and mean ANB value 4.809 SD ±3.85. Mean Incisor position based on IMPA was 98.598 SD ± 9.413 and FMIA 54 SD ±9.995. Intra and interobserver reliability was assessed with intraclass correlation coefficient values ranging between 0.825 and 0.990 respectively. The ANOVA test results showed significant relationship between the sagittal malocclusion and incisor position with P value .036. The Bonferroni analysis indicated that statistically significant association existed in term of lower incisor position between Class II and Class III malocclusion with P value .047. Test results further indicated that there is no significant difference in the position of lower incisor in relation to facial pattern with P value .355. Conclusions: Statistically significant association was found between lower incisor position with respect to the sagittal malocclusion. However, no significant association was found between facial pattern and lower incisor position.

Effects of long-term use of the lower lingual arch from 8.5 years to 13.2 years

ABSTRACT Objectives To investigate the effects of long-term use of the lower lingual arch (LLA) on the sagittal and vertical positions of the permanent lower incisors and first molars. Materials and Methods The sample consisted of 98 patients who were treated with an LLA (LLA group) and 39 patients who were treated without an LLA (no-LLA group). The positional changes of the lower incisors and first molars were analyzed after performing mandibular structural superimpositions on lateral cephalometric radiographs taken before treatment (T1) and at the end of LLA therapy (T2). The mean ages at T1 and T2 were 8.5 years and 13.2 years, respectively. Study casts were analyzed to quantify arch dimensional changes. Results Mesial movement of the lower molar cusp was similar between the LLA and no-LLA groups, but the vertical position was slightly greater at T2 in the LLA group. In the LLA group, there was a molar tip-back effect, and the lower incisors were proclined 4.2° more than in the no-LLA group. Arch perimeter decreased 3.6 ± 2.6 mm without an LLA and 0.97 ± 3.7 mm with an LLA. Intercanine and intermolar widths both increased about 1 mm more with an LLA (P &lt; .0001). Conclusions The LLA does not seem to restrict mesial movement and vertical eruption of the lower incisors and molars in the long term. The LLA effectively preserves the arch perimeter at the expense of a slight lower incisor proclination.

Adaptational changes in clear aligner fit with time:

ABSTRACT Objectives To analyze adaptational changes in clear aligner fit after intraoral usage at different sets of time. Materials and Methods Eight Invisalign appliances (Align Technology, San Jose, California, USA) were collected after intraoral usage. Acrylic imprints of the lower incisor region were constructed for each appliance at T0 (unused appliance). Two appliances were then used intra-orally for each of the following defined periods of time: 3 days, 7 days, 10 days, or 15 days. Used aligners were adapted on its T0 imprint and both were sectioned buccolingually from the distal surfaces of each incisor at the attachment area. Eight surfaces were collected for each set of time (n = 32 surfaces). Microphotographs of obtained sections and micrometric measurements of aligner fit were recorded at five different levels using scanning electron microscopy (SEM). Mean values of the fit changes (gap width) and group comparisons were statistically analyzed using analysis of variance and Tukey's post hoc tests. Significance level was set at P &lt; .05. Results Highly significant differences in aligner fit were found at the different time points assessed (P &lt; .001) with the least mean gap width at 15 days (176 ± 98 μm) and the highest at 7 days (269 ± 145 μm). Significant differences in aligner fit at different attachment levels were also found (P &lt; .01) with the least mean gap width at the middle of the labial surface of the attachment (187 ± 118 μm). Conclusions The 15-day period of intraoral aligner wear might still be recommended as it showed the best adaptation and least gap width between the aligner and the attachment.

Evaluation of long-term stability of curve of Spee levelled with continuous archwires in two different retention protocol

Objectives: The objectives of the study were to assess the long-term stability of the curve of Spee leveled with continuous archwire in subjects with two different retention protocols. Materials and Methods: The study sample consisted of 20 patients (mean age 18 ± 2 years) presenting with curve of Spee depth of =/> 3 mm. For each subject, lateral cephalograms and dental casts were available before treatment (T1), at the end of orthodontic therapy (T2), and 1 year after the end of treatment (T3). All subjects were divided into two groups according to their retention protocol – fixed retainer group (Group-1) and Essix retainer group (Group-2). Cephalometric parameters were used to evaluate the dental movements after treatment. Curve of Spee depth was measured on standardized digital images of casts. Results: In multicomparison table, it shows that there was a statistically significant difference (P = 0.032) between Spee-T2 and Spee-T3 and there was no statistical difference (P = 0.159) between L1MP-T2 and L1MP-T3 in fixed retainer group. In Essix retainer group, no changes were observed from L1MP-T2 to L1MP-T3 and there was a non-significant difference found between Spee-T2 and Spee-T3. Conclusion: In Group-1 (fixed retainer), there is some amount of relapse or extrusion of lower incisor. In Group-2 (Essix retainer), there was not any change in the position of the lower incisor, which suggests that occlusal coverage of the Essix retainer does not allow any extrusion and retains the curve of Spee.

Correction of persistent crowding in the lower anterior region: A case report

Aim: This case report demonstrates the application of piezocision in correcting persistent crowding in the lower anterior region of dental arch. Methodology: A female aged 14 years and 3 months presented to the Selcuk University Department of Orthodontics due to aesthetic complaints. Clinical and radiological examination revealed crowding in the upper and lower dental arches as well as skeletal and dental Class I malocclusion. First, bonding and arch wire were applied to the patient’s upper jaw. The patient then had check-up appointments at 4-week intervals. In the second session, bonding was applied to the lower jaw. As the leveling was completed in the upper jaw, thicker arch wires were used. However, 4 months after the bonding of the lower anterior region, leveling did not occur. Consequently, piezocision was applied to the lower anterior region. Then, two applications of 0.014'' and 0.016'' NiTi wire were carried out, respectively. After the completion of the leveling, intrusion was provided with the utility arch placed on the lower incisor brackets. Orthodontic treatment was concluded with the use of NiTi and steel angle wires. Conclusion: Efficient leveling was achieved in the lower anterior region with piezocision applications. How to cite this article: Cime Akbaydogan L, Baka ZM, Uulusoy Mutluol E. Correction of persistent crowding in the lower anterior region: A case report. Int Dent Res 2021;11(Suppl.1):303-7. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.45 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Determination of Mandibular Symphysis Width in Skeletal Class I Patients with Different Vertical Patterns

Symphysis is an anatomical part of mandible that includes lower incisors and anterior chin. Mandibular symphysis is a contributing factor of facial harmony for esthetics and is a determinant for lower incisor position in orthodontic treatment planning for border line cases. This cross-sectional study was carried out in Orthodontics department, Fatima Memorial Hospital College of Medicine and Dentistry Lahore on a sample size of 90 cases using 95% confidence level. Non probability consecutive sampling technique was used. Symphyseal dimensions were measured on lateral cephalogram. Data collected was entered and analyzed in computer program SPSS version 20. Quantitative outcomes like symphysis dimensions, symphysis width, vertical pattern, and ANB were subjected to ANOVA of significance. Independent T-test was used to make the comparison between males and females on the basis of variables. Results of this study suggested thatC-C’ varies significantly between males and females, whereas the differences in symphysis width LA, and LP between males & females are statistically insignificant (P>0.05). Bone anterior to lower incisor apex varies significantly among various facial profiles with hypo divergent males exhibiting wider chin than normo divergent and hyper divergent subjects. Sexual dimorphism in symphysis width was seen among genders. Keywords: Facial harmony, lower incisor position

Anterior openbite malocclusion in adults: Treatment stability and patient satisfaction in National Dental Practice-Based Research Network patients

ABSTRACT Objectives To investigate stability and satisfaction in adult anterior open bite (AOB) patients at least 9 months post-treatment, as well as patient and practitioner factors that may be associated with stability and satisfaction. Materials and Methods Practitioners and their adult AOB patients were recruited through the National Dental Practice-Based Research Network. Data on patient and practitioner characteristics, treatment recommendations and factors were previously collected. Treatment stability was determined by assessing post-treatment intraoral photographs. Patient satisfaction was determined from post-treatment questionnaires. Treatment was categorized into aligners, fixed appliances, temporary anchorage devices, and orthognathic surgery. Extractions were also investigated. Retention type was categorized into vacuum-formed, Hawley-style, or bonded retainers, and regimens were classified as full-time or part-time wear. Results Retention data collected from 112 patients had a mean post-treatment time of 1.21 years. There were no statistically significant differences in stability between treatment groups. Depending on whether a qualitative index or a millimetric measure was employed, stability ranged from 65% to 89%. Extractions and less initial lower incisor proclination were associated with higher stability in patients treated with fixed appliances only. High satisfaction was reported by patients at retention. There were no clear differences in stability or satisfaction among retention types or regimens. Conclusions The stability of adult AOB orthodontic treatment was high, regardless of treatment or retainer modality. Satisfaction in adult AOB patients was high, regardless of retention type or regimen.

Constitutional Features of the Maxillofacial Area of Omsk Young Men

The aim was to determine the morphometric parameters of the maxillofacial area of Omsk young men of 18-20 years of age according to the teleroentgenography of the head (in a lateral projection), taking into account the indicators of cephalometry and anthropometry, to identify regional constitutional features of quantitative values.Material and methods. A cephalometric and somatometric examination of 26 Omsk Slavic young men of 18-20 years of age without concomitant pathology was performed, supplemented by an X-ray examination of the head (to obtain teleroentgenograms in a lateral projection). The analysis of teleroentgenograms was carried out in the online service Mave Cloud.Results. According to the results of anthropometry, the longitudinal and transverse dimensions of the young men's heads, the zygomatic diameter and the full height of the face were assessed; the indicators of body growth, body weight, chest circumference and transverse chest diameter were determined. These indicators were used to calculate the indices. The value of the facial index was 81.86 (79.31; 88.88), the value of the head index was 76.65 (74.27; 79.47), the Rees-Eisenck index corresponded to 97.58 (94.62; 107.48), the Rohrer index was 13.34 (12.07; 15.48), the Pinier index was 11.1 (-10; 22), the Quetelet II index was 23.33 (22.03; 27.71). When analyzing teleroentgenograms, it was revealed that the values of some parameters in Omsk young men of 18-20 years of age differ from the values of the «norm». Thus, the indicators of the lower jaw length (Go-Gn), the ratio of the body of the lower jaw length to the length of the anterior base of the skull (Go-Me/S-N), the length of the posterior base of the skull (S-Ar), the height of the branch of the lower jaw (Ar-Go), the ratio of the heights of the face (S-Go/N-Me), the angle between the axis of the lower incisor and the plane of the lower jaw (IM IMPA) have greater values than the «norm»; and the figures of the angles sum according to Bjork (∠SUM Bjork), mandibular angle (∠Ar-Go-Me), maxillary angle (∠N-Go-Ar), upper jaw inclination angle (∠NSL-NL), lower jaw inclination angle (∠NSL-ML), intermaxillary angle (∠NL-ML), the angle between the lower jaw plane and the Frankfurt horizontal (∠FMA), have values less than the «norm». The values of the saddle angle (∠N-S-Ar) differed in young men with euryprosopic and leptoprosopic facial forms. The quantitative values of the lower jaw angle (ArGo-Me) and the upper jaw angle (N-Go-Ar) differed only in the representatives of the dolichocephalic and mesocephalic forms of the head.Conclusion. Quantitative values of cephalometric and somatometric parameters in Omsk young men of 18-20 years of age have distinctive features. Individual parameters of the maxillofacial area (according to teleroentgenograms) differ in persons with dolichocephalic and mesocephalic forms of the head and in the representatives of euryprosopic and leptoprosopic forms of the face.