Archive of Orofacial Data Science

Coverage of Soft Tissue Dehiscences Around Osseointegrated Implants in Aesthetic Areas - Surgical-Prosthetic Approach and Patient Satisfaction

2024-11-21T12:24:53+01:00

AIM: The aim of the study is to assess the success rate of the available methods for the treatment of soft tissue dehiscences in osseointegrated implants in the anterior area. The success rate will be determined based on the degree of coverage both short and long-term as well as clinical and aesthetic parameters.

METHODS: Clinical trials and case reports on the treatment of soft tissue dehiscences between 0.7 mm ± 0.3 mm and 3.0 mm ± 0.8 mm in anterior osseointegrated implants were analyzed. The data collection was carried out in PubMed and 17 articles were included.

RESULTS: A total of 144 osseointegrated implants in the anterior area with soft tissue dehiscences were evaluated in this bibliographic review. The possibilities of coverage in millimeters range from 0.17 mm to 3 mm. Coronally advanced flap was associated with soft tissue coverage. The use of subepithelial connective tissue graft (SCTG) results in soft tissue dehiscence reduction. Crown removal one month before surgery and chamfers or shoulders in the abutment reduction provides better healing of the soft tissue after surgery. Some authors also achieved soft tissue coverage with the use of acellular dermal matrix (ADM), but the results are still controversial.

CONCLUSION: The use of SCTG to cover STD in osseointegrated implants is a reliable method, although complete coverage is not achieved in all cases. The use of ADM seems to be a shorter and less painful alternative treatment, but the results are not yet predictable.

Comparison of Micro-Osteoperforation and Platelet-Rich Fibrin Methods in Accelerated Orthodontic Tooth Movement

2024-10-28T11:14:46+01:00

AIM: The purpose of this thesis was to compare two methods of accelerated orthodontic tooth movement (OTM) in adults: Micro-osteoperforation (MOP) and platelet-rich fibrin (PRP/PRF) regarding the speed of canine retraction and other teeth OTM in terms of patient comfort measures.

METHODS: From over 3000 searches in different sources like PubMed, Cochrane Library, and Google Scholar, 21 peer-reviewed articles from 2015 to 2022 were selected. All the studies researched healthy, non-growing humans aged 16-40, diagnosed with Class II div 1 malocclusion with first premolar extraction or molar distalization or incisors crowding.

RESULTS: Both methods accelerated orthodontic tooth movement. The MOP method was slightly faster than the PRP/PRF method but more painful. There were a few reported side effects including root resorption, anchorage loss, and canine tipping more in the MOP studies. More MOPs placed less often were more effective. Higher platelet concentration injected more often had a better result. Both methods had inflammatory markers, particularly IL-beta elevated in the gingival crevicular fluid, which persisted longer in the MOPs. Gingival and plaque indexes showed clinically insignificant differences in MOP trials and were not measured in PRP/PRF studies.

CONCLUSION: Both experimented accelerated OTM methods can help to shorten adult treatment comfortably. Nevertheless, further studies on the PRP/PRF method, are needed.

Influence of Phototherapy on the Kinetics of Orthodontic Tooth Movement: A Meta-Analysis of Randomized Controlled Trials

2024-09-05T09:16:22+02:00

AIM: This study aims to evaluate the efficacy and safety of phototherapy and the correlation between its parameters in accelerating orthodontic tooth movement.
METHODS: A comprehensive search was conducted across several databases from the study’s inception to January 25, 2019. Only randomized placebo-controlled trials examining adjunctive phototherapy during orthodontic canine retraction were included. Study quality was assessed using the Jadad score and the Cochrane risk of bias tool. Statistical analysis was performed using comprehensive meta-analysis software v. 3.
RESULTS: A total of 21 studies involving 302 patients were eligible; 11 were included in the quantitative synthesis. A meta-analysis of low-quality evidence demonstrated that adjunctive phototherapy outperformed the control group (Hedges’ g = 0.68, 95% CI [0.08-1.28], I² = 83%, p = 0.03). Subgroup analyses indicated more significant effects with a 940 nm wavelength (Hedges’ g = 2.93, 95% CI [2.20-3.65], I² = 0%, p = 0.00), 100 mW output power (Hedges’ g = 1.17, 95% CI [-0.20-2.55], I² = 91%, p = 0.10), and 5 J/cm² energy density (Hedges’ g = 0.69, 95% CI [-0.03-1.41], I² = 10%, p = 0.06). No risks were identified in the six studies that conducted safety investigations.
CONCLUSION: Phototherapy can accelerate orthodontic tooth movement without associated risks. Significant effects were observed with higher dosages. Further well designed, high-quality trials are necessary to identify the exact impact of phototherapy and its parameters.

Efficacy of Augmentation Materials and Surgical Methods in Alveolar Ridge Preservation Post-Tooth Extraction

2024-09-02T16:31:43+02:00

AIM: To evaluate the clinical and radiographic outcomes of various augmentation materials and surgical techniques in alveolar ridge preservation procedures compared to natural post-extraction socket healing.

METHODS: A literature search was conducted using the PubMed/MEDLINE database, focusing on the efficacy of different augmentation materials. The initial search yielded 291 studies, which were screened to exclude duplicates and irrelevant entries. Full texts of potentially relevant articles were assessed based on predefined inclusion criteria: studies had to be randomized controlled trials or clinical studies with a minimum follow-up of two months.

RESULTS: In total, 19 studies were ultimately included into the analysis. Alveolar ridge preservation (ARP) procedures are more effective than natural healing in minimizing post-extraction bone resorption, preserving both horizontal and vertical bone dimensions. Cortico-cancellous porcine bone particles and alloplastic materials yield superior results in maintaining alveolar ridge dimensions compared to control groups. Platelet-rich fibrin also reduces bone resorption and enhances preservation. Barrier membranes in ARP procedures further improve outcomes.

CONCLUSION: Future research should refine ARP techniques and materials, focusing on long-term effectiveness and practicality. Investigations into cost-effectiveness and ease of application will promote broader adoption. By implementing tailored ARP strategies, dental professionals can enhance the long-term success of restorations, sustaining patients' health, function, and aesthetics.

The Influence of Cigarette Smoking on Dental Implant Survival Rates: A Comparative Analysis of Smokers and Non-Smokers

2024-09-05T09:51:39+02:00

AIM: The objective of this study is to determine the significant influence of smoking cigarettes on the dental implant survival-failure rate in comparison to the rate in non-smokers.
METHODS: An electronic search was conducted for studies published in English, restricted to the period between 2012 and 2022. Pub-Med and Google Scholar were used to search for articles comparing the success vs. failure rates of dental implants between smokers and non-smokers.
RESULTS: Smokers have a higher failure rate, with the duration and amount of smoking being significant factors compared to non-smokers. Moreover, osseointegration was adversely affected by smoking, and smoking accelerated marginal bone loss. Patients who quit smoking showed the same success rates as non-smokers.
CONCLUSION: Implant insertion is not an absolute contraindication for smokers, but patients should be informed about all risk factors (bone healing issues, osseointegration, and implant failure). They should be aware that consuming cigarettes during the initial healing phase after implant insertion increases the risk of failure. Advising patients to quit smoking is a viable solution that helps accelerate bone healing and increases the rates of osseointegration and implant success.

Efficacy of Platelet-Rich Fibrin in Alveolar Ridge Preservation Following Minimally Traumatic Tooth Extraction

2024-09-05T09:38:10+02:00

AIM: The application of platelet-rich fibrin (PRF) in alveolar ridge preservation (ARP) has been shown to enhance treatment outcomes. The aim of this study is to systematically review the efficacy of PRF in the preservation of alveolar ridge following minimally traumatic tooth extraction.

METHODS: A comprehensive literature search was conducted with the publication date set to the past 10 years. A total of 26 controlled clinical trials met the inclu- sion criteria and were included for review. The outcome parameters analysed included post-operational morbidity, soft tissue healing, changes of alveolar dimension, and bone formation in the socket.

RESULTS: All included studies treated the test sites with PRF, and the control sites were left for spontaneous healing. The tooth extraction procedures were kept min- imally traumatic. A pronounced post-extraction pain reduction effect was reported in the test sites, with corresponding fewer analgesic consumptions. PRF-treated sites demonstrated accelerated soft tissue healing. The applied PRF reduced bone atrophy and led to an appreciable quantity of new bone formation in the socket, thereby sus- taining the bone volume.

CONCLUSION: PRF ameliorates immediate post-operational discomfort, improves soft tissue healing, and enhances bone tissue preservation and regeneration. Clini- cal application of PRF is effective and should be considered as a biomaterial for ARP following dental extractions.

An Analysis of Clinical Effectiveness of Different Types of Direct Restorative Materials in Permanent Posterior Teeth

2024-08-26T16:43:59+02:00

AIM: To compare and evaluate the effectiveness of direct restorative materials in permanent posterior teeth based on different clinical outcomes and to review how various factors influence them.

METHODS: An intensive search using the PICOS elements was conducted through PubMed and Cochrane databases. Seventeen studies were selected and analyzed using primary and secondary outcomes.

RESULTS: Amalgam restorations showed slightly better longevity compared to composite resin and glass ionomer cement restorations. However, under certain conditions, composite resins and glass ionomer cement restorations perform equally well. Failures in composite resin restorations were consistently due to secondary caries, primary caries, postoperative sensitivity, marginal defects, and marginal discoloration. Glass ionomer cement restorations failed consistently due to loss of retention and surface texture. Amalgam restorations mainly failed due to poor color match and tooth fracture. Significantly higher restoration failure rates were observed in medium or large-sized cavities with two or more surfaces involved, molars, children, teenagers, elderly patients, and those with high caries risk or poor oral hygiene.

CONCLUSION: Patient-, oral-, and dentist-related factors significantly impact the performance and longevity of direct restorative materials. No material currently meets all criteria of an ideal material, as each has its advantages, disadvantages, and preferred indications.

Dentoskeletal Effects of Modern Hybrid Fixed Functional Appliances

2024-07-03T15:47:13+02:00

AIM: This study performs an in-depth analysis of the literature to evaluate the dentoalveolar and skeletal effects of modern hybrid fixed functional appliances (HFFAs).

METHODS: An extensive literature search spanning from January 2010 to November 2023 was executed across three databases: PubMed, Cochrane Library, and Google Scholar. Additionally, a manual search was done by employing the names of relevant authors and screening the references within the included articles. The assessment for eligibility was based on the PICO approach: (P)articipants: Any patients exhibiting Class II division 1 malocclusion up to the age of 18; (I)ntervention: Treatment with HFFAs; (C)omparison: Untreated individuals; (O)utcome measures: (a) Amount of overjet reduction; (b) Changes in upper and lower incisor proclination/protrusion; (c) Skeletal maxillary/mandibular alterations (ANB, SNA, SNB values); (d) Mandibular growth (changes in mandibular length); and (e) Treatment duration.

RESULTS: Nine clinical trials were included in this study, representing a total of 584 adolescents with Class II division 1 malocclusion. Cephalometric measurements indicate pronounced dentoalveolar effects, including lower incisor proclination and upper incisor retroclination, to correct overjet and overbite. Skeletal effects, such as modest maxillary restriction and improvement in the maxillary-mandibular anteroposterior relationship, were less prominent.

CONCLUSION: Although successful at Class II dental malocclusion correction, HFFAs induce unwanted side effects such as significant lower incisor proclination and clockwise rotation of the occlusal plane. Further research, particularly focusing on HFFAs coupled with skeletal anchorage, is necessary.

Gender Links and Non-Syndrome Related Mutations Linking Isolated Cleft Palate and Ankyloglossia in the Fetal Development

2024-07-03T11:02:55+02:00

AIM: To compare the pathogenesis of ankyloglossia (tongue-tie) with isolated cleft palate only (CPO) by examining the influence of genetic and epigenetic factors.

METHODS: A comprehensive literature review encompassing the years 2012-2017, yielded a substantial body of research linking cleft palate and ankyloglossia. Inclusion criteria comprised randomized controlled clinical trials, both prospective and retrospective; with the exclusion of non-English studies.

RESULTS: The embryonic parallels between CPO and ankyloglossia suggest a phenotypic expression through neural crest cells along the anterior-posterior axis. These developmental pathways persist during palatogenesis, affecting structures such as palatal shelves and the lingual frenum. Significantly, the cranial neural crest derived connective tissue of the lingual frenum demonstrates a functional correlation with the genioglossus muscle. In the context of cleft palate (CP) models, malformation of the genioglossus muscle is associated with micrognathia in extrinsic perspectives, while intrinsic perspectives focus on causal genes affecting palatal shelves. Ankyloglossia is identified as part of an X-linked, gender-specific disease spectrum with various midline-related variations along the anterior-posterior axis.

CONCLUSION: The functional perspective has brought attention to the interplay of structures surrounding the palate in comprehending CP etiology. This approach underscores the importance of tongue position and the attachment of the lingual frenum connective tissue to the genioglossus muscle. Early intervention aimed at reducing the lingual frenum may potentially enhance the form and function of the oral cavity.

Gummy Smile - Advantages and Disadvantages of Botulinum Toxin Treatment Compared to Orthognathic Surgery

2024-03-13T14:25:36+01:00

AIM: This narrative literature review aims to evaluate the treatment of botulinum toxin compared to Le Fort I orthognathic surgery in patients with a gummy smile.

METHODS: An electronic search was conducted via PubMed/Medline and Google Scholar using keywords such as "gummy smile", "excessive gingival display", "high smile line", "botulinum toxin treatment and correction", "botox usages" and "orthognathic surgery" for studies published until January 2015. After excluding unrelated items, the initial search yielded 84 articles. Following the exclusion of irrelevant articles based on abstract and title, the full texts of 60 articles were reviewed and included in this study.

RESULTS: Botulinum toxin treatment and Le Fort I osteotomy present distinct advantages and disadvantages. Botulinum toxin serves as an adjunct for correcting excessive gingival display and is gaining popularity due to its minimally invasive nature. However, Le Fort I osteotomy remains the gold standard for correcting vertical maxillary excess in gummy smile patients.

CONCLUSIONS: Both botulinum toxin treatment and Le Fort I osteotomy are essential for correcting different types of gummy smiles. Neither can completely replace the other in the correction of gummy smiles.

Recycling Debonded Metal Orthodontic Brackets - A Comprehensive Review and Meta-Analysis

2024-03-05T18:15:16+01:00

AIM: This work provides orthodontic practitioners with an updated literature review and meta-analysis on the practicality of reusing debonded metal orthodontic brackets.
METHODS: An electronic search from January 1989 to June 2017 on MEDLINE-PubMed and EBSCOhost Research Databases yielded 63 studies after removing duplicates. Following initial screening, 47 potentially relevant articles were identified. Detailed scrutiny led to the exclusion of 19 studies. The remaining 19 studies were divided into two groups: Group I (same bracket brand and bonding agent) and Group II (different bracket brand and bonding agents). Meta-analysis and sensitivity tests were conducted using RevMan Analysis in Review Manager (version 5.3).
RESULTS: The mean shear bond strength (SBS) for debonding a new bracket was 10.16 MPa. Five chairside recycling methods were compared: erbium laser, aluminum oxide sandblasting, high-speed grinding, slow-speed grinding, and direct flaming. Average reductions in SBS were 0.65 MPa, 0.89 MPa, 2.82 MPa, 3.49 MPa, and 3.93 MPa, respectively.
CONCLUSION: Erbium laser recycling is highly efficient, though cost-prohibitive. Chairside aluminum oxide sandblasting with a microetcher offers a cost-effective alternative with comparable SBS. High-speed grinding surpasses slow-speed grinding, but both exhibit less favorable rebonding strength than sandblasting. Direct flaming yields the lowest SBS. Chairside sandblasting emerges as the most practical and economical method for recycling debonded metal orthodontic brackets.

Smile Asymmetry in Patients treated with combined Orthodontics and Orthognathic Surgery

2024-03-19T17:56:47+01:00

AIM: The aim of this study was to examine the relationship between lip canting and the extent of a smile, both pre- and post-operatively, in patients who were treated with combined orthodontics and orthognathic surgery.
METHODS: This study included 90 clinical photographs of 45 patients smiling, both before and after orthognathic surgery. Facial landmark points were traced to compare pre- and post-operative photographs. The data were used to measure the vertical distance of the lips when smiling – lip elevation and the extent of a smile, both before and after surgery. The correlations among canting, the type of surgery, and Angle class were evaluated by a one-way analysis of variance (ANOVA) and multiple comparisons using the Tamhane post hoc test.
RESULTS: The magnitude of the post-operative extent of a smile was not significantly correlated with lip elevation and changes in lip canting. There were no statistical differences for Angle class I and asymmetric cases, in contrast to Class II and III results regarding the extent of a smile post-operatively. Bimaxillary surgery resulted in significantly broader smiles, and bilateral sagittal split osteotomy resulted in higher lip elevation post-operatively, though not to a significant extent.
CONCLUSION: Soft tissues, particularly the smiling lip line, are affected by orthognathic surgery and skeletal malocclusion. However, further studies will be needed to better assess and study smile dynamics.

An Introduction to Publishing Research in Archive of Orofacial Data Science

2024-03-09T10:02:07+01:00

The Archive of Orofacial Data Science is committed to advancing open access publishing and disseminating high-quality research to a global audience. We believe that open access to scientific knowledge is vital for the progress of science, innovation, and societal development. This statement outlines our principles and commitment to providing free and unrestricted access to scholarly content.

TMJ and Related Skeleton Surgical Treatments: Proceedings of the 5th Sino-German Symposium 2024

2024-11-15T14:22:05+01:00

The 5th Sino-German Symposium 2024 convened leading experts in temporomandibular joint (TMJ) disorders, hosted by Duisburg-Essen University and Shanghai Jiao Tong University. The symposium aimed to enhance collaboration and knowledge exchange between scholars from Germany and China. Attendees explored a variety of topics, including anterior disc displacement, condylar resorption, and advanced surgical techniques for TMJ.

Session I addressed anterior disc displacement and condylar resorption, highlighting both surgical and conservative treatment options alongside the utility of MRI for radiological diagnoses. Session II focused on the complexities of condylar fractures and ankylosis, discussing treatment protocols and soft tissue management, with considerable dialogue surrounding the Shanghai protocol for ankylosis. Session III examined TMJ reconstruction methods, including costochondral grafts and alloplastic replacements, emphasizing the need to balance innovative approaches with established surgical practices. Finally, Session IV tackled clinical issues related to TMJ and cranio-jaw interactions, including complications from TMJ prostheses and multidisciplinary approaches to complex cases.

The symposium was co-organized by key organizations such as German Surgical Foundation, Chinese Stomatological Association, Chinese Society of Oral and Maxillofacial Surgery and the National Clinical Research Center for Oral Diseases (Shanghai), China, highlighting its collaborative nature. The proceedings aim to advance the understanding and treatment of TMJ disorders, ultimately benefiting both practitioners and patients in the field.

Growth and Maxillofacial Surgery - A Plea for a more Physiological Approach to Surgery

2024-03-05T14:39:35+01:00

The present article is the unfinished final scientific work of the late Professor Jean Delaire and offers insights into his innovative ideas during the concluding phase of his career. Right at the beginning, Delaire challenges traditional teachings by asserting that all growth sites in the skeleton share the same histological origin, namely the cephalic neural ectomesenchyme. He advocates for a comprehensive understanding of biokinetic effects and sutural physiology beyond mere union elements.
In addition, embryological, morphological, and biomechanical aspects are combined to present a comprehensive understanding of the development and evolution of maxillary and premaxillary structures in humans. Delaire argues that the development of the cranio-facial skeletal construct strictly adheres to universal laws governing harmonious and balanced states and highlights the adherence to universal mathematics in life while emphasizing that life does not accept fixity.
Case presentations are used to demonstrate how orthopedic and surgical interventions are aimed at preventing, interrupting, and healing issues related to various growth sites in the facial skeleton, such as the premaxilla, tuberosity regions, mid-palatal suture, condylar region, and bony chin. These treatments also address soft tissue involvement, including masticatory muscles, nasolabial muscles, muscles affecting the chin, and soft palate muscles.
Pioneering work by renowned anatomists accompanies and substantiates Delaire's explanations by tracing the historical development of these ideas, with the realization that the actual physiology of the sutures only became widely known in the orthodontic and maxillofacial world at a very late stage.