Background
During the first years of life, when children begin to walk and socialize, they are particularly vulnerable to traumatic injuries to the primary teeth; indeed, after dental caries, such injuries are the second most frequent cause of pediatric dental consultation. Nonetheless, the reported prevalence of trauma to the primary teeth varies depending on the literature source, type of injury, the patient's age, and the most common associated complications.
Aim
To analyze new epidemiological data and complications associated with traumatic injuries to the primary teeth of Spanish children.
Material and methods
A retrospective study was carried out in a subpopulation of 879 Spanish children in southern Europe aged between one and 7 years old, with primary and early mixed dentition. Clinical and radiological records were obtained from all pediatric patients who presented trauma to the primary teeth, with a follow‐up period of 3–5 years.
Results
A total of 21.72% of children examined had some kind of dental trauma and the most common age range for injuries to the primary teeth was 1–3 years old. The most common injuries in deciduous teeth were subluxation (47.29% of injuries affected the periodontal ligament), intrusion (23.15%), and avulsion (13.63%). On the other hand, comparatively more complications were recorded as a result of intrusion (32 of 47 intruded teeth).
Conclusions
In this Spanish subpopulation, a pediatric dental consultation as a result of traumatic dental injuries in primary dentition is most frequent in 1‐ and 2‐year‐olds, and subluxation is the commonest injury in the primary dentition. In turn, intrusion is associated with an increased frequency of complications in both the deciduous and the permanent teeth.
Objective: To determine whether orthodontic treatment with removable aligners vs fixed orthodontic appliances is associated with a different frequency of orthodontically induced external apical root resorption (OIEARR) when genetic, radiographic, and clinical factors are accounted for. Materials and Methods: Three hundred seventy-two orthodontic patients treated with removable aligners (Invisalign) or fixed appliances were genetically screened for interleukin 1B gene (IL1B) (rs1143634), interleukin 1 receptor antagonist gene (IL1RN) (rs419598), and osteopontin gene (SPP1) (rs9138/rs11730582). Twelve clinical variables, potentially associated with OIEARR, were also considered. Subjects were divided according to the presence of radiographically determined OIEARR (.2 mm). The association between OIEARR and appliance type, and radiographic, clinical and genetic factors, was assessed using backward stepwise conditional logistic regression. Odds ratios (ORs) and 95% confidence intervals (CIs) were reported. Results: Reliability of the methods was adequate. Clinical case complexity (American Board of Orthodontics [ABO] Discrepancy Index) (OR: 1.032; 95% CI: 1.005-1.061; P ¼ .021) and extent of incisor apical displacement in the sagittal plane (OR: 1.478; 95% CI: 1.285-1.699; P ¼ .001) were associated with an increased OIEARR risk. After adjusting for associations between clinical/ radiographic/genetic factors, there were no statistically significant differences with respect to OIEARR or type of orthodontic appliance used, whether removable aligners or fixed appliances (OR: 1.662; 95% CI: 0.945-2.924; P ¼ .078). Only subjects homozygous for the T allele of IL1RN (rs419598) were more prone to OIEARR during orthodontic treatment (OR: 3.121; CI: 1.93-5.03; P , .001). Conclusions: A similar OIEARR predisposition was identified using either removable aligners (Invisalign) or fixed appliances. (Angle Orthod. 2017;87:3-10)
Variations in the interleukin 1 receptor antagonist gene (rs419598) - and not only in the IL1B gene (rs1800587) - are determinants of a predisposition to postorthodontic EARR.
3D image technology provides a very effective tool for evaluating, characterising, and drawing up the surgical treatment plan for potential orthognathic surgery patients. Patients with dysmorphic syndromes or incorrect jaw positions frequently show facial asymmetry. The objective of this cross-sectional survey is to evaluate facial asymmetry by means of three-dimensional computed tomography (CT) reconstructions. Twenty one consecutive patients were diagnosed using a CT scan. 3D reconstructions of the patients' skulls were made and then measurements taken of different craniometric landmarks and of the various structures presenting asymmetry. The gonion emerged as the most asymmetrical point in all subjects, and the anterior nasal spine showed least deviation. The t test produced statistically significant differences (p < 0.05) between symmetric and asymmetric patients at all landmarks. The lateral inclination of the mandibular ramus was shown to present the greatest asymmetrical deviation, followed by the frontal inclination of the mandibular ramus. The angulation of the mandibular ramus, on both frontal and lateral planes, determines apparent facial asymmetry, as well as conditioning the surgical treatment plan for patients with craniofacial asymmetry.
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