No abstract

Introduction: Limited studies investigated whether orthodontic movement should be performed in patients with periodontal disease and severe intrabony defects. The purpose of this study is to assess the stability of the periodontal complex combining regeneration treatment with enamel matrix derivative (EMD) and collagen bovine mineral bone, followed by early orthodontic movement. Case Series: In a prospective case series, 10 patients with radiographic vertical defects with probing depths (PDs) ≥6 mm and pathologic tooth migration were enrolled. Each patient contributed one infrabony defect treated with a combination of EMD and collagen bovine mineral bone. All patients started the alignment stage 1 month after periodontal surgery with 0.014 nickel–titanium wires, and the treatment lasted a mean time of 9 ± 3.2 months. Clinical measurements (PD, clinical attachment level [CAL], and gingival recession) were calculated from baseline to the end of orthodontic treatment. Mean PD reduction was 3.7 ± 1.77 mm, with an average residual PD of 4 ± 1.05 mm; mean CAL gain was 4.4 ± 1.71 mm, with a residual CAL of 5.5 ± 1.72 mm. Both differences are statistically significant (P <0.001). Conclusions: A reconstructive procedure that combines EMD and collagen bovine mineral bone as a periodontal preorthodontic procedure seem to provide excellent clinical results. In this clinical case series, early orthodontic movement, even if it takes place in immature bone during the healing time, has not adversely affected the maturation process of the entire periodontal apparatus.

The objective of this study was to supply quantitative information about the facial soft-tissues of a group of subjects with Down syndrome. The three-dimensional coordinates of 28 soft-tissue facial landmarks were obtained by an electromechanic digitizer in 17 male and 11 female subjects with Down syndrome aged 12-45 years, and in 429 healthy individuals of the same age, ethnicity, and sex. From the landmarks, facial areas (eyes, ears, nose, and lips) and volumes (nose and lips) were calculated according to a geometrical model of face. Data were compared to those collected in the normal subjects by computing z-scores. Male and female z-scores were not significantly different. Most of the facial volumes were significantly (Student's t, P < 0.05) smaller in subjects with Down syndrome than in their normal controls. Ear areas were significantly reduced (mean z-scores in males -2.07 right, -1.9 left; in females -2.11 right, -2.21 left), as well as nasal surface area (mean z-score -1.53 in males, -2.45 in females). In women, age and some z-scores were significantly correlated (P < 0.05): upper lip volume (r = 0.714), left and right eye area (r = 0.635, right; 0.604, left), nasal area (r = 0.603): with increasing age, the negative values of the z-scores approached the 0 value of the reference population. In the pooled sample, age and the z-score of the total lip area were significantly correlated (r = 0.423): increasing age corresponded to a larger z-score value. The method allowed a simple, low cost, fast, and noninvasive examination of the subjects, and provided a quantitative assessment of the deviation from the norm.

In conclusion, findings from the present study suggested that the Ca-P coating had no beneficial effect in improving bonding strength at the bone-implant interface either at 2, 4 and 9 weeks.

The three-dimensional coordinates of 50 selected soft tissue facial landmarks were digitized on 28 white Italian subjects with Down syndrome (17 male and 11 female subjects aged 12 to 45 years) and 429 healthy controls of comparable ages by an electromechanical instrument. From the landmarks, 16 facial dimensions were calculated. Data were compared with those collected in healthy individuals by computing z-scores. Overall, most variables were smaller in subjects with Down syndrome than in their normal controls selected for sex, age, and ethnicity (negative z-scores), even if not all of them reached statistical significance. Independently of sex, subjects with Down syndrome had faces that were significantly (P <0.05, paired Student t test) narrower (skull base and mandible), less deep (upper, middle, and lower face), and shorter (face and nose height) than the faces of normal subjects. Additionally, ear width and length were significantly reduced on both sides of the face. Only facial height was significantly different between sexes (P = 0.023, unpaired Student t test), with a female z-score that was more than two times the relevant male value. The present investigation represents the first detailed quantitative analysis of the facial soft tissue characteristics of Italian white subjects with Down syndrome.