Expansion patterns in surgically assisted rapid maxillary expansion

Abstract

Objectives

The purpose of this work was to compare the patterns of expansion resulting from a tooth-borne hyrax appliance and a bone-borne transpalatal distractor in patients treated by surgically assisted rapid maxillary expansion (SARME).

Methods

A total of 28 patients with transverse maxillary hypoplasia were treated by SARME, using a hyrax appliance in 12 and a transpalatal distractor in 16 cases. Before and after palatal expansion, an impression of each maxilla was taken. Casts fabricated on this basis were digitized with a 3D scanner. Based on the resultant virtual models, both the amounts of expansion and the angles of crown tipping from the canines through the second molars were determined and the results of the two groups were compared.

Results

Almost all measurement sites revealed significant expansion of the dental arches over the course of SARME. The sites of maximum expansion were more anterior in the distractor group, while larger total amounts of expansion were seen in the hyrax group. Both appliances involved buccal tipping of almost all canines, premolars, and molars; these findings were more pronounced in the hyrax group.

Conclusions

Either a transpalatal distractor or a hyrax appliance can be successfully used to expand a narrow maxilla by SARME. The two appliances, however, cause different amounts of dental arch expansion and buccal crown tipping. A hyrax appliance should be expected to result in a parallel expansion pattern with the largest increase in the premolar area. A transpalatal distractor is likely to cause more of a V-shaped pattern of expansion. Thus, in clinical practice, specific patterns of distraction can be selectively achieved by taking advantage of specific appliances and various options of positioning.

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Expansion patterns in surgically assisted rapid maxillary expansion

Abstract

Objectives

The purpose of this work was to compare the patterns of expansion resulting from a tooth-borne hyrax appliance and a bone-borne transpalatal distractor in patients treated by surgically assisted rapid maxillary expansion (SARME).

Methods

A total of 28 patients with transverse maxillary hypoplasia were treated by SARME, using a hyrax appliance in 12 and a transpalatal distractor in 16 cases. Before and after palatal expansion, an impression of each maxilla was taken. Casts fabricated on this basis were digitized with a 3D scanner. Based on the resultant virtual models, both the amounts of expansion and the angles of crown tipping from the canines through the second molars were determined and the results of the two groups were compared.

Results

Almost all measurement sites revealed significant expansion of the dental arches over the course of SARME. The sites of maximum expansion were more anterior in the distractor group, while larger total amounts of expansion were seen in the hyrax group. Both appliances involved buccal tipping of almost all canines, premolars, and molars; these findings were more pronounced in the hyrax group.

Conclusions

Either a transpalatal distractor or a hyrax appliance can be successfully used to expand a narrow maxilla by SARME. The two appliances, however, cause different amounts of dental arch expansion and buccal crown tipping. A hyrax appliance should be expected to result in a parallel expansion pattern with the largest increase in the premolar area. A transpalatal distractor is likely to cause more of a V-shaped pattern of expansion. Thus, in clinical practice, specific patterns of distraction can be selectively achieved by taking advantage of specific appliances and various options of positioning.

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Expansion patterns in surgically assisted rapid maxillary expansion

Abstract

Objectives

The purpose of this work was to compare the patterns of expansion resulting from a tooth-borne hyrax appliance and a bone-borne transpalatal distractor in patients treated by surgically assisted rapid maxillary expansion (SARME).

Methods

A total of 28 patients with transverse maxillary hypoplasia were treated by SARME, using a hyrax appliance in 12 and a transpalatal distractor in 16 cases. Before and after palatal expansion, an impression of each maxilla was taken. Casts fabricated on this basis were digitized with a 3D scanner. Based on the resultant virtual models, both the amounts of expansion and the angles of crown tipping from the canines through the second molars were determined and the results of the two groups were compared.

Results

Almost all measurement sites revealed significant expansion of the dental arches over the course of SARME. The sites of maximum expansion were more anterior in the distractor group, while larger total amounts of expansion were seen in the hyrax group. Both appliances involved buccal tipping of almost all canines, premolars, and molars; these findings were more pronounced in the hyrax group.

Conclusions

Either a transpalatal distractor or a hyrax appliance can be successfully used to expand a narrow maxilla by SARME. The two appliances, however, cause different amounts of dental arch expansion and buccal crown tipping. A hyrax appliance should be expected to result in a parallel expansion pattern with the largest increase in the premolar area. A transpalatal distractor is likely to cause more of a V-shaped pattern of expansion. Thus, in clinical practice, specific patterns of distraction can be selectively achieved by taking advantage of specific appliances and various options of positioning.

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The future of pediatric dentistry education and curricula: a Chilean perspective

Abstract

Background

A meeting was organised to consolidate a network of researchers and academics from Australia, Brazil, Chile, the UK and the USA, relating to Early Childhood Caries (ECC) and Dental Trauma (DT). As part of this meeting, a dedicated session was held on the future of paediatric dental education and curricula. Twenty-four paediatric dentistry (PD) academics, representing eight Chilean dental schools, and three international specialists (from Brazil and Latvia) participated in group discussions facilitated by five members of the ECC/DT International Collaborative Network. Data were collected from group discussions which followed themes developed as guides to identify key issues associated with paediatric dentistry education, training and research.

Discussion

Participants discussed current PD dental curricula in Chile, experiences in educating new cohorts of oral health care providers, and the outcomes of existing efforts in education and research in PD. They also, identified challenges, opportunities and areas in need of further development.

Summary

This paper provides an introspective analysis of the education and training of PD in Chile; describes the input provided by participants into pediatric dentistry education and curricula; and sets out some key priorities for action with suggested directions to best prepare the future dental workforce to maximise oral health outcomes for children. Immediate priorities for action in paediatric dentistry in Chile were proposed.

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Influence of different post-interventional maintenance concepts on periodontal outcomes: an evaluation of three systematic reviews

Abstract

Background

To selectively review the existing literature on post-interventional maintenance protocols in patients with periodontal disease receiving either non-surgical or surgical periodontal treatment.

Methods

Three systematic reviews with different periodontal interventions, i.e. scaling and root planing (SRP), SRP with adjunctive antibiotics or regenerative periodontal surgery were evaluated focusing on their post-interventional maintenance care. Due to the early publication of one review an additional literature search update was undertaken. The search was executed for studies published from January 2001 till March 2015 through an electronic database to ensure the inclusion of resent studies on SRP. Two reviewers guided the study selection and assessed the validity of the three reviews found.

Results

Within the group of scaling and root planing alone there have been nine studies with more than three appointments for maintenance care and five studies with more than two appointments in the first 2 months after the intervention. Chlorhexidine was the most frequently used antiseptic agent used for 2 weeks after non-surgical intervention. Scaling and root planing with adjunctive antibiotics showed a similar number of visits with professional biofilm debridement, whereas regenerative studies displayed more studies with more than three visits in the intervention group. In addition, the use of antiseptics was longer and lasted 4 to 8 weeks after the regenerative intervention. The latter studies also showed more stringent maintenance protocols.

Conclusions

With increased interventional effort there was a greater tendency to increase frequency and duration of the maintenance care program and antiseptic agents.

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Outcomes of 6.5-mm Hydrophilic Implants and Long Implants Placed with Lateral Sinus Floor Elevation in the Atrophic Posterior Maxilla: A Prospective, Randomized Controlled Clinical Comparison

Abstract

Background

Very few controlled studies have compared short and long implants placed with appropriate sinus floor elevation techniques.

Purpose

To compare the 2-year outcomes of 6.5-mm hydrophilic implants placed with osteotome sinus floor elevation (OSFE) and standard implants placed with lateral sinus floor elevation in patients with a severely atrophic posterior maxilla.

Materials and Methods

Thirty-eight patients with a residual bone height of 4–5 mm were randomized to receive one of the two above-mentioned treatments. Intra- and postoperative complications were recorded. The implant survival rate, peri-implant bone level, and periapical endosinus bone gain were assessed.

Results

Of the 80 inserted implants, one in the long implant group failed because of abscess formation. The peri-implant bone level change (0.35 ± 0.60 mm vs 0.40 ± 0.71 mm) was not significantly different between the two groups. The endosinus bone gain was 2.94 ± 0.81 mm and 10.19 ± 0.95 mm in the short and long implant groups, respectively. No serious adverse events related to implant surgery were recorded.

Conclusions

The results suggest that the placement of 6.5-mm short implants with OSFE is an effective alternative for the rehabilitation of a severely atrophic posterior maxilla.

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ITAC induces the melanocytic migration and hypopigmentation through destabilizing p53 via HDAC5: A possible role of ITAC in pigment-related disorders

Summary

Background

Cell migration plays a major role in the immune response and in tumorigenesis. Interferon-inducible T-cell alpha chemoattractant (ITAC) elicits a strong chemotactic response from immune cells.

Objectives

To examine the effect of ITAC on the melanocytic migration and pigmentation and its involvement in the related disorders, and to investigate potential key players in these processes.

Methods

Human melanocytes or melanoma cells were treated with ITAC and migration assay was performed. Global gene expression analysis was performed to find genes regulated by ITAC treatment. The function of key players involved in ITAC-induced cellular processes was addressed using knockdown or overexpression experiments in combination with ITAC treatment. ITAC expression in an inflammation-associated hypopigmentary disorder, vitiligo, were examined.

Results

Among CXCR3 ligands, only ITAC induces melanocyte migration. ITAC treatment up-regulated the expression of histone deacetylase 5 (HDAC5) and down-regulated that of p53, a known target of HDAC5. Through knockdown or overexpression of HDAC5 and p53, we confirmed that HDAC5 mediates ITAC-induced migration by decreasing the levels of p53 via deacetylation. In addition, ITAC treatment could decrease pigmentation in a p53- and HDAC5-dependent manner. Finally, the increased migration of human melanoma cells by ITAC treatment and the increased ITAC expression in the epidermis of vitiligo skins were verified.

Conclusions

This study provides in vitro evidences for the migratory and hypopigmentation effects of ITAC on melanocytic cells and translational insights on the roles of ITAC in pathological conditions, and suggests that HDAC5 and its substrate p53 are potent targets for regulating ITAC-induced cellular processes.

This article is protected by copyright. All rights reserved.

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Cardiorespiratory Response to Different Exercise Tests in Interstitial Lung Disease.

Introduction: The 6-minute stepper test (6MST) has been used as an alternative to the 6-minute walk test (6MWT) to assess exercise tolerance in patients with interstitial lung disease (ILD). Recent data suggest that the tests may involve different energy pathways and cardiorespiratory responses. We thus aimed to compare the cardiorespiratory responses of ILD patients during the 6MWT and the 6MST. Methods: Thirty-one patients with ILD were randomised to perform both tests in the order 6MST->6MWT (n=16) or 6MWT->6MST (n=15). Gas exchange, heart rate, and pulse O2 saturation (SpO2) were measured continuously, and dyspnoea, leg discomfort, and blood lactate concentration were assessed before and immediately after each test. Results: Oxygen uptake (VO2) was lower (p=0.002) and respiratory equivalent ratio for O2 (VE/VO2) and respiratory exchange ratios were higher (both p

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Impact of 12-s Rule on Performance and Muscle Damage of Baseball Pitchers.

Introduction: A recent US Major League Baseball (MLB) rule change requires baseball pitchers to deliver pitches within 12 sec. Purposes: To examine the effect of three, between-pitch rest intervals on throwing performance during a simulated 7-inning game and muscle damage during post-game recovery. Design: A randomized counter-balanced study. Methods: Seven intercollegiate pitchers threw 15 pitches per inning for 7 innings with rest interval trials of 8, 12, and 20 sec between pitches and 5 min between innings. Pitchers threw aimed fastballs at their best effort. Trials were separated by >=2 weeks. Results: Progressive decreases in pitching speed and accuracy below baseline (1st inning of 20-sec trial) occurred after 4th inning during the 8-sec and 12-sec trials, but not the 20-sec trial. Plasma creatine kinase (CK) elevated 48 h later for the 8-sec and 12-sec trials (+105% and +75%, P

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The Influence of Maturation on Sprint Performance in Boys over a 21-Month Period.

Purpose: This study examined how the characteristics of maximal overground sprint performance are affected by the period of peak height velocity (PHV) in boys. Methods: One hundred and eighty-nine school-aged boys completed two assessments of maximal sprint performance, separated by a 21-month period. Kinematic characteristics of sprint performance were collected during a 30 m sprint using a floor-level optical measurement system, with modelled force and stiffness characteristics also calculated. Participants were grouped according to maturation using a non-invasive predictive equation. Individuals whose maturity offset was 0.5yrs in test two were classed as 'pre-to-post-PHV' (n=39). Participants with a maturity offset between >-0.5 and

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Additive Benefits of [beta]-Alanine Supplementation and Sprint-Interval Training.

Purpose: The present study investigated the effects of [beta]-alanine supplementation only, and in combination with sprint-interval training (SIT), on training intensity, and energy provision and performance during exhaustive supramaximal-intensity cycling and a 4- and 10-km time trial (TT). Methods: Fourteen trained cyclists (VO2max = 4.5 +/- 0.6 L[middle dot]min-1) participated in this placebo-controlled, double-blind study. Subjects performed a supramaximal cycling test to exhaustion (equivalent to 120% VO2max) and a 4- and 10-km TT and 4 x 1-km sprints at three time points: before and after 28 d of supplementation loading (6.4 g[middle dot]d-1) with [beta]-alanine (n = 7) or a placebo (n = 7), and after a 5-wk supervised, SIT program performed twice weekly (repeated 1-km cycling sprints) whilst maintaining supplementation with [beta]-alanine (1.2 g[middle dot]d-1) or a placebo. Results: Following the loading period, sprint 3 and 4 of the 4 x 1-km sprint intervals were improved with [beta]-alanine supplementation (4.5 +/- 3.4% and 7.0 +/- 4.0%; P

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Persistent Muscle Inhibition after ACL Reconstruction: Role of Reflex Excitability.

Purpose: Persistent voluntary quadriceps activation deficits are common following anterior cruciate ligament reconstruction (ACLR), but the direct causes are unclear. The primary purpose of this study was to determine whether spinal reflex excitability deficits are present in individuals with a history of ACLR, and secondarily to determine if spinal reflex excitability predicts which individuals possess full voluntary quadriceps activation. Methods: One hundred and forty-seven individuals (74 Healthy and 73 ACLR) participated in this cross-sectional, case-control study. Quadriceps spinal reflex excitability was quantified using the Hoffmann reflex normalized to the maximal muscle response (H:M ratio). Voluntary quadriceps activation was evaluated with the burst superimposition technique and calculated via the central activation ratio (CAR). Separate 2x2 ANCOVAs were used to compare differences between-limbs and between-groups for H:M ratio and CAR. A receiver operating characteristic (ROC) curve was used to determine the accuracy of H:M ratio to predict if ACLR participants present with full voluntary activation (CAR>=0.95). Results: ACLR H:M ratio was not different between limbs or compared to the healthy group (P>0.05). While ACLR CAR was lower bilaterally compared to the healthy group (p

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Muscle Fatigue from the Perspective of a Single Cross-bridge.

Repeated intense stimulation of skeletal muscle rapidly decreases its force and motion generating capacity. This type of fatigue can be temporally correlated with the accumulation of metabolic by-products, including phosphate (Pi) and protons (H+). Experiments on skinned single muscle fibers demonstrate that elevated concentrations of these ions can reduce maximal isometric force, unloaded shortening velocity and peak power, providing strong evidence for a causative role in the fatigue process. This appears to be due, in part, to their direct effect on muscle's molecular motor, myosin, because in assays utilizing isolated proteins these ions directly inhibit myosin's ability to move actin. Indeed, recent work using a single molecule laser trap assay has revealed the specific steps in the cross-bridge cycle affected by these ions. In addition to their direct effects, these ions also indirectly affect myosin by decreasing the sensitivity of the myofilaments to calcium, primarily by altering the ability of the muscle regulatory proteins, troponin (Tn) and tropomyosin (Tm), to govern myosin binding to actin. This effect appears to be partially due to fatigue-dependent alterations in the structure and function of specific subunits of Tn. Parallel efforts to understand the molecular basis of muscle contraction are providing new technological approaches that will allow us to gain unprecedented molecular detail of the fatigue process. This will be crucial to fully understand this ubiquitous phenomenon and develop appropriately targeted therapies to attenuate the debilitating effects of fatigue in clinical populations. (C) 2016 American College of Sports Medicine

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PDPR Gene Expression Correlates with Exercise-Training Insulin Sensitivity Changes.

Purpose: Whole body insulin sensitivity (Si) typically improves following aerobic exercise training; however, individual responses can be highly variable. The purpose of this study was to use global gene expression to identify skeletal muscle genes that correlate with exercise-induced Si changes. Methods: Longitudinal cohorts from the Studies of Targeted Risk Reduction Intervention through Defined Exercise (STRRIDE) were utilized as Discovery (Affymetrix) and Confirmation (Illumina) of vastus lateralis gene expression profiles. Discovery (n=39; 21 men) and Confirmation (n=42; 19 men) cohorts were matched for age (52 +/- 8 vs. 51 +/- 10 yr), BMI (30.4 +/- 2.8 vs. 29.7 +/- 2.8 kg*m-2), and VO2max (30.4 +/- 2.8 vs. 29.7 +/- 2.8 mL/kg/min). Si was determined via intravenous glucose tolerance test pre- and post-training. Pearson product-moment correlation coefficients determined relationships between a) baseline and b) training-induced changes in gene expression and %[DELTA]Si after training. Results: Expression of 2454 (Discovery) and 1778 genes (Confirmation) at baseline were significantly (P

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Periodization Strategies in Older Adults: Impact on Physical Function and Health.

Purpose: This study compared the effect of periodized versus non-periodized (NP) resistance training (RT) on physical function and health outcomes in older adults. Methods: Forty-one apparently healthy untrained older adults (female=21, male=20; 70.9 +/- 5.1 y; 166.3 +/- 8.2 cm; 72.9 +/- 13.4 kg) were recruited and randomly stratified to a NP, block periodized (BP), or daily undulating periodized (DUP) training group. Outcome measures were assessed at baseline and following a 22-week x 3 d.wk-1 RT intervention, including; anthropometrics, body composition, blood pressure and biomarkers, maximal strength, functional capacity, balance confidence and quality of life. Results: Thirty-three subjects satisfied all study requirements and were included in analyses (female=17, male=16; 71.3 +/- 5.4 y; 166.3 +/- 8.5 cm; 72.5 +/- 13.7 kg). The main finding was that all three RT models produced significant improvements in several physical function and physiological health outcomes, including; systolic blood pressure, blood biomarkers, body composition, maximal strength, functional capacity and balance confidence, with no between-group differences. Conclusion: Periodized RT, specifically BP and DUP, and NP RT are equally effective for promoting significant improvements in physical function and health outcomes among apparently healthy untrained older adults. Therefore, periodization strategies do not appear to be necessary during the initial stages of RT in this population. Practitioners should work towards increasing RT participation in the aged via feasible and efficacious interventions targeting long-term adherence in minimally supervised settings. (C) 2016 American College of Sports Medicine

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Neuromuscular Changes and Damage after Isoload versus Isokinetic Eccentric Exercise.

Purpose: This study compared the effects of isoload (IL) and isokinetic (IK) knee extensor eccentric exercises on changes in muscle damage and neuromuscular parameters to test the hypothesis that the changes would be different after IL and IK exercises. Methods: Twenty-two young men were paired based on their strength and placed to IL (N = 11) or IK (N = 11) group. IL group performed 15 sets of 10 eccentric contractions with a 150% of pre-determined 1-RM load. IK group performed 15 sets of a number of maximal eccentric contractions matched set-by-set for the total amount of work and mean angular velocity with the IL group. Muscle damage markers (voluntary isometric peak torque, muscle soreness, creatine kinase activity: CK) and neuromuscular variables (e.g., voluntary activation, H-reflex, M-wave, evoked torque) were measured before, immediately after and 24, 48, 72 and 96 h post-exercise. Results: Voluntary isometric peak torque decreased to the same extent (p = 0.94) in both groups at immediately after (IL: -40.6 +/- 13.8% vs. IK: -42.4 +/- 10.2%) to 96 h after the exercise (IL: -21.8 +/- 28.5% vs. IK: -26.7 +/- 23.5%). Neither peak muscle soreness (IL: 48.1 +/- 28.2 mm vs. IK: 54.7 +/- 28.9 mm; p = 0.57) nor CK activity (IL: 12811 +/- 22654 U/L vs. IK: 15304 +/- 24739 U/L; p = 0.59) significantly differed between groups. H-reflex (IL: -23% vs. IK: -35%) and M wave (IL: -10% vs. IK: -17%) significantly decreased immediately post-exercise similarly between groups. Conclusion: The changes in muscle damage and neuromuscular function after the exercise are similar between IL and IK, suggesting that resistance modality has little effects on acute muscle responses. (C) 2016 American College of Sports Medicine

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Expansion patterns in surgically assisted rapid maxillary expansion

Abstract

Objectives

The purpose of this work was to compare the patterns of expansion resulting from a tooth-borne hyrax appliance and a bone-borne transpalatal distractor in patients treated by surgically assisted rapid maxillary expansion (SARME).

Methods

A total of 28 patients with transverse maxillary hypoplasia were treated by SARME, using a hyrax appliance in 12 and a transpalatal distractor in 16 cases. Before and after palatal expansion, an impression of each maxilla was taken. Casts fabricated on this basis were digitized with a 3D scanner. Based on the resultant virtual models, both the amounts of expansion and the angles of crown tipping from the canines through the second molars were determined and the results of the two groups were compared.

Results

Almost all measurement sites revealed significant expansion of the dental arches over the course of SARME. The sites of maximum expansion were more anterior in the distractor group, while larger total amounts of expansion were seen in the hyrax group. Both appliances involved buccal tipping of almost all canines, premolars, and molars; these findings were more pronounced in the hyrax group.

Conclusions

Either a transpalatal distractor or a hyrax appliance can be successfully used to expand a narrow maxilla by SARME. The two appliances, however, cause different amounts of dental arch expansion and buccal crown tipping. A hyrax appliance should be expected to result in a parallel expansion pattern with the largest increase in the premolar area. A transpalatal distractor is likely to cause more of a V-shaped pattern of expansion. Thus, in clinical practice, specific patterns of distraction can be selectively achieved by taking advantage of specific appliances and various options of positioning.

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Expansion patterns in surgically assisted rapid maxillary expansion

Abstract

Objectives

The purpose of this work was to compare the patterns of expansion resulting from a tooth-borne hyrax appliance and a bone-borne transpalatal distractor in patients treated by surgically assisted rapid maxillary expansion (SARME).

Methods

A total of 28 patients with transverse maxillary hypoplasia were treated by SARME, using a hyrax appliance in 12 and a transpalatal distractor in 16 cases. Before and after palatal expansion, an impression of each maxilla was taken. Casts fabricated on this basis were digitized with a 3D scanner. Based on the resultant virtual models, both the amounts of expansion and the angles of crown tipping from the canines through the second molars were determined and the results of the two groups were compared.

Results

Almost all measurement sites revealed significant expansion of the dental arches over the course of SARME. The sites of maximum expansion were more anterior in the distractor group, while larger total amounts of expansion were seen in the hyrax group. Both appliances involved buccal tipping of almost all canines, premolars, and molars; these findings were more pronounced in the hyrax group.

Conclusions

Either a transpalatal distractor or a hyrax appliance can be successfully used to expand a narrow maxilla by SARME. The two appliances, however, cause different amounts of dental arch expansion and buccal crown tipping. A hyrax appliance should be expected to result in a parallel expansion pattern with the largest increase in the premolar area. A transpalatal distractor is likely to cause more of a V-shaped pattern of expansion. Thus, in clinical practice, specific patterns of distraction can be selectively achieved by taking advantage of specific appliances and various options of positioning.

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Expansion patterns in surgically assisted rapid maxillary expansion

Abstract

Objectives

The purpose of this work was to compare the patterns of expansion resulting from a tooth-borne hyrax appliance and a bone-borne transpalatal distractor in patients treated by surgically assisted rapid maxillary expansion (SARME).

Methods

A total of 28 patients with transverse maxillary hypoplasia were treated by SARME, using a hyrax appliance in 12 and a transpalatal distractor in 16 cases. Before and after palatal expansion, an impression of each maxilla was taken. Casts fabricated on this basis were digitized with a 3D scanner. Based on the resultant virtual models, both the amounts of expansion and the angles of crown tipping from the canines through the second molars were determined and the results of the two groups were compared.

Results

Almost all measurement sites revealed significant expansion of the dental arches over the course of SARME. The sites of maximum expansion were more anterior in the distractor group, while larger total amounts of expansion were seen in the hyrax group. Both appliances involved buccal tipping of almost all canines, premolars, and molars; these findings were more pronounced in the hyrax group.

Conclusions

Either a transpalatal distractor or a hyrax appliance can be successfully used to expand a narrow maxilla by SARME. The two appliances, however, cause different amounts of dental arch expansion and buccal crown tipping. A hyrax appliance should be expected to result in a parallel expansion pattern with the largest increase in the premolar area. A transpalatal distractor is likely to cause more of a V-shaped pattern of expansion. Thus, in clinical practice, specific patterns of distraction can be selectively achieved by taking advantage of specific appliances and various options of positioning.

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The future of pediatric dentistry education and curricula: a Chilean perspective

Abstract

Background

A meeting was organised to consolidate a network of researchers and academics from Australia, Brazil, Chile, the UK and the USA, relating to Early Childhood Caries (ECC) and Dental Trauma (DT). As part of this meeting, a dedicated session was held on the future of paediatric dental education and curricula. Twenty-four paediatric dentistry (PD) academics, representing eight Chilean dental schools, and three international specialists (from Brazil and Latvia) participated in group discussions facilitated by five members of the ECC/DT International Collaborative Network. Data were collected from group discussions which followed themes developed as guides to identify key issues associated with paediatric dentistry education, training and research.

Discussion

Participants discussed current PD dental curricula in Chile, experiences in educating new cohorts of oral health care providers, and the outcomes of existing efforts in education and research in PD. They also, identified challenges, opportunities and areas in need of further development.

Summary

This paper provides an introspective analysis of the education and training of PD in Chile; describes the input provided by participants into pediatric dentistry education and curricula; and sets out some key priorities for action with suggested directions to best prepare the future dental workforce to maximise oral health outcomes for children. Immediate priorities for action in paediatric dentistry in Chile were proposed.

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Influence of different post-interventional maintenance concepts on periodontal outcomes: an evaluation of three systematic reviews

Abstract

Background

To selectively review the existing literature on post-interventional maintenance protocols in patients with periodontal disease receiving either non-surgical or surgical periodontal treatment.

Methods

Three systematic reviews with different periodontal interventions, i.e. scaling and root planing (SRP), SRP with adjunctive antibiotics or regenerative periodontal surgery were evaluated focusing on their post-interventional maintenance care. Due to the early publication of one review an additional literature search update was undertaken. The search was executed for studies published from January 2001 till March 2015 through an electronic database to ensure the inclusion of resent studies on SRP. Two reviewers guided the study selection and assessed the validity of the three reviews found.

Results

Within the group of scaling and root planing alone there have been nine studies with more than three appointments for maintenance care and five studies with more than two appointments in the first 2 months after the intervention. Chlorhexidine was the most frequently used antiseptic agent used for 2 weeks after non-surgical intervention. Scaling and root planing with adjunctive antibiotics showed a similar number of visits with professional biofilm debridement, whereas regenerative studies displayed more studies with more than three visits in the intervention group. In addition, the use of antiseptics was longer and lasted 4 to 8 weeks after the regenerative intervention. The latter studies also showed more stringent maintenance protocols.

Conclusions

With increased interventional effort there was a greater tendency to increase frequency and duration of the maintenance care program and antiseptic agents.

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Outcomes of 6.5-mm Hydrophilic Implants and Long Implants Placed with Lateral Sinus Floor Elevation in the Atrophic Posterior Maxilla: A Prospective, Randomized Controlled Clinical Comparison

Abstract

Background

Very few controlled studies have compared short and long implants placed with appropriate sinus floor elevation techniques.

Purpose

To compare the 2-year outcomes of 6.5-mm hydrophilic implants placed with osteotome sinus floor elevation (OSFE) and standard implants placed with lateral sinus floor elevation in patients with a severely atrophic posterior maxilla.

Materials and Methods

Thirty-eight patients with a residual bone height of 4–5 mm were randomized to receive one of the two above-mentioned treatments. Intra- and postoperative complications were recorded. The implant survival rate, peri-implant bone level, and periapical endosinus bone gain were assessed.

Results

Of the 80 inserted implants, one in the long implant group failed because of abscess formation. The peri-implant bone level change (0.35 ± 0.60 mm vs 0.40 ± 0.71 mm) was not significantly different between the two groups. The endosinus bone gain was 2.94 ± 0.81 mm and 10.19 ± 0.95 mm in the short and long implant groups, respectively. No serious adverse events related to implant surgery were recorded.

Conclusions

The results suggest that the placement of 6.5-mm short implants with OSFE is an effective alternative for the rehabilitation of a severely atrophic posterior maxilla.

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Effect of Associated Autoimmune Diseases on Type 1 Diabetes Mellitus Incidence and Metabolic Control in Children and Adolescents

Type 1 diabetes mellitus (T1DM) is one of the most common chronic diseases developing in childhood. The incidence of the disease in children increases for unknown reasons at a rate from 3 to 5% every year worldwide. The background of T1DM is associated with the autoimmune process of pancreatic beta cell destruction, which leads to absolute insulin deficiency and organ damage. Complex interactions between environmental and genetic factors contribute to the development of T1DM in genetically predisposed patients. The T1DM-inducing autoimmune process can also affect other organs, resulting in development of additional autoimmune diseases in the patient, thereby impeding diabetes control. The most common T1DM comorbidities include autoimmune thyroid diseases, celiac disease, and autoimmune gastritis; additionally, diabetes can be a component of PAS (Polyglandular Autoimmune Syndrome). The aim of this review is to assess the prevalence of T1DM-associated autoimmune diseases in children and adolescents and their impact on the course of T1DM. We also present suggestions concerning screening tests.

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BRAF and NRAS mutations in Russian melanoma patients: results of a nationwide study.

Distribution of actionable mutations in melanoma may show considerable geographic variations. Given the importance of genetic testing for the proper use of targeted drugs, we carried out the first-in-Russia nationwide molecular epidemiological study for melanoma. Sanger sequencing analysis for BRAF (exon 15) and NRAS (exons 2-4) genes was carried out for patients with the stage IIIB or IV disease from 46 cancer centers located throughout the country. BRAF mutations were identified in 625/1034 (60.4%) melanoma samples. BRAF c.1799T>A (p.V600E) substitution was the most prevalent, being detected in 561/1034 (54.3%) tumors. Non-V600E mutations constituted about 10% of activating BRAF genetic lesions (64/625, 10.2%), with a clear prevalence of c.1798_1799GT>AA (p.V600K) variant (52 tumors) and noticeable occurrence of c.1798_1799GT>AG (p.V600R) allele (five tumors). BRAF V600E mutations were associated with younger patient age and localization of melanoma on sun-protected areas of the skin, whereas BRAF V600K substitutions were characteristic of elderly patients and occurred more often at the chronically sun-exposed regions of the body. Activating NRAS mutations were detected in 86/601 (14.3%) of samples analyzed, with 79 events affecting codon 61 and seven mutations detected in codons 12 or 13. Six types of distinct NRAS codon 61 substitutions were identified, with c.181C>A (p.Q61K), c.182A>G (p.Q61R), and c.182A>T (p.Q61L) being frequent and c.181_182CA>TT (p.Q61L), c.183A>T (p.Q61H), and c.183A>C (p.Q61H) being rare. An age-related increase in the frequency of NRAS mutations was observed. Multiplicity and clinical distribution of BRAF and NRAS mutations have to be taken into account while considering molecular testing for melanoma patients. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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BRAF and NRAS mutations in Russian melanoma patients: results of a nationwide study.

Distribution of actionable mutations in melanoma may show considerable geographic variations. Given the importance of genetic testing for the proper use of targeted drugs, we carried out the first-in-Russia nationwide molecular epidemiological study for melanoma. Sanger sequencing analysis for BRAF (exon 15) and NRAS (exons 2-4) genes was carried out for patients with the stage IIIB or IV disease from 46 cancer centers located throughout the country. BRAF mutations were identified in 625/1034 (60.4%) melanoma samples. BRAF c.1799T>A (p.V600E) substitution was the most prevalent, being detected in 561/1034 (54.3%) tumors. Non-V600E mutations constituted about 10% of activating BRAF genetic lesions (64/625, 10.2%), with a clear prevalence of c.1798_1799GT>AA (p.V600K) variant (52 tumors) and noticeable occurrence of c.1798_1799GT>AG (p.V600R) allele (five tumors). BRAF V600E mutations were associated with younger patient age and localization of melanoma on sun-protected areas of the skin, whereas BRAF V600K substitutions were characteristic of elderly patients and occurred more often at the chronically sun-exposed regions of the body. Activating NRAS mutations were detected in 86/601 (14.3%) of samples analyzed, with 79 events affecting codon 61 and seven mutations detected in codons 12 or 13. Six types of distinct NRAS codon 61 substitutions were identified, with c.181C>A (p.Q61K), c.182A>G (p.Q61R), and c.182A>T (p.Q61L) being frequent and c.181_182CA>TT (p.Q61L), c.183A>T (p.Q61H), and c.183A>C (p.Q61H) being rare. An age-related increase in the frequency of NRAS mutations was observed. Multiplicity and clinical distribution of BRAF and NRAS mutations have to be taken into account while considering molecular testing for melanoma patients. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Expansion patterns in surgically assisted rapid maxillary expansion

Abstract

Objectives

The purpose of this work was to compare the patterns of expansion resulting from a tooth-borne hyrax appliance and a bone-borne transpalatal distractor in patients treated by surgically assisted rapid maxillary expansion (SARME).

Methods

A total of 28 patients with transverse maxillary hypoplasia were treated by SARME, using a hyrax appliance in 12 and a transpalatal distractor in 16 cases. Before and after palatal expansion, an impression of each maxilla was taken. Casts fabricated on this basis were digitized with a 3D scanner. Based on the resultant virtual models, both the amounts of expansion and the angles of crown tipping from the canines through the second molars were determined and the results of the two groups were compared.

Results

Almost all measurement sites revealed significant expansion of the dental arches over the course of SARME. The sites of maximum expansion were more anterior in the distractor group, while larger total amounts of expansion were seen in the hyrax group. Both appliances involved buccal tipping of almost all canines, premolars, and molars; these findings were more pronounced in the hyrax group.

Conclusions

Either a transpalatal distractor or a hyrax appliance can be successfully used to expand a narrow maxilla by SARME. The two appliances, however, cause different amounts of dental arch expansion and buccal crown tipping. A hyrax appliance should be expected to result in a parallel expansion pattern with the largest increase in the premolar area. A transpalatal distractor is likely to cause more of a V-shaped pattern of expansion. Thus, in clinical practice, specific patterns of distraction can be selectively achieved by taking advantage of specific appliances and various options of positioning.

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Expansion patterns in surgically assisted rapid maxillary expansion

Abstract

Objectives

The purpose of this work was to compare the patterns of expansion resulting from a tooth-borne hyrax appliance and a bone-borne transpalatal distractor in patients treated by surgically assisted rapid maxillary expansion (SARME).

Methods

A total of 28 patients with transverse maxillary hypoplasia were treated by SARME, using a hyrax appliance in 12 and a transpalatal distractor in 16 cases. Before and after palatal expansion, an impression of each maxilla was taken. Casts fabricated on this basis were digitized with a 3D scanner. Based on the resultant virtual models, both the amounts of expansion and the angles of crown tipping from the canines through the second molars were determined and the results of the two groups were compared.

Results

Almost all measurement sites revealed significant expansion of the dental arches over the course of SARME. The sites of maximum expansion were more anterior in the distractor group, while larger total amounts of expansion were seen in the hyrax group. Both appliances involved buccal tipping of almost all canines, premolars, and molars; these findings were more pronounced in the hyrax group.

Conclusions

Either a transpalatal distractor or a hyrax appliance can be successfully used to expand a narrow maxilla by SARME. The two appliances, however, cause different amounts of dental arch expansion and buccal crown tipping. A hyrax appliance should be expected to result in a parallel expansion pattern with the largest increase in the premolar area. A transpalatal distractor is likely to cause more of a V-shaped pattern of expansion. Thus, in clinical practice, specific patterns of distraction can be selectively achieved by taking advantage of specific appliances and various options of positioning.

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Expansion patterns in surgically assisted rapid maxillary expansion

Abstract

Objectives

The purpose of this work was to compare the patterns of expansion resulting from a tooth-borne hyrax appliance and a bone-borne transpalatal distractor in patients treated by surgically assisted rapid maxillary expansion (SARME).

Methods

A total of 28 patients with transverse maxillary hypoplasia were treated by SARME, using a hyrax appliance in 12 and a transpalatal distractor in 16 cases. Before and after palatal expansion, an impression of each maxilla was taken. Casts fabricated on this basis were digitized with a 3D scanner. Based on the resultant virtual models, both the amounts of expansion and the angles of crown tipping from the canines through the second molars were determined and the results of the two groups were compared.

Results

Almost all measurement sites revealed significant expansion of the dental arches over the course of SARME. The sites of maximum expansion were more anterior in the distractor group, while larger total amounts of expansion were seen in the hyrax group. Both appliances involved buccal tipping of almost all canines, premolars, and molars; these findings were more pronounced in the hyrax group.

Conclusions

Either a transpalatal distractor or a hyrax appliance can be successfully used to expand a narrow maxilla by SARME. The two appliances, however, cause different amounts of dental arch expansion and buccal crown tipping. A hyrax appliance should be expected to result in a parallel expansion pattern with the largest increase in the premolar area. A transpalatal distractor is likely to cause more of a V-shaped pattern of expansion. Thus, in clinical practice, specific patterns of distraction can be selectively achieved by taking advantage of specific appliances and various options of positioning.

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The future of pediatric dentistry education and curricula: a Chilean perspective

Abstract

Background

A meeting was organised to consolidate a network of researchers and academics from Australia, Brazil, Chile, the UK and the USA, relating to Early Childhood Caries (ECC) and Dental Trauma (DT). As part of this meeting, a dedicated session was held on the future of paediatric dental education and curricula. Twenty-four paediatric dentistry (PD) academics, representing eight Chilean dental schools, and three international specialists (from Brazil and Latvia) participated in group discussions facilitated by five members of the ECC/DT International Collaborative Network. Data were collected from group discussions which followed themes developed as guides to identify key issues associated with paediatric dentistry education, training and research.

Discussion

Participants discussed current PD dental curricula in Chile, experiences in educating new cohorts of oral health care providers, and the outcomes of existing efforts in education and research in PD. They also, identified challenges, opportunities and areas in need of further development.

Summary

This paper provides an introspective analysis of the education and training of PD in Chile; describes the input provided by participants into pediatric dentistry education and curricula; and sets out some key priorities for action with suggested directions to best prepare the future dental workforce to maximise oral health outcomes for children. Immediate priorities for action in paediatric dentistry in Chile were proposed.

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Influence of different post-interventional maintenance concepts on periodontal outcomes: an evaluation of three systematic reviews

Abstract

Background

To selectively review the existing literature on post-interventional maintenance protocols in patients with periodontal disease receiving either non-surgical or surgical periodontal treatment.

Methods

Three systematic reviews with different periodontal interventions, i.e. scaling and root planing (SRP), SRP with adjunctive antibiotics or regenerative periodontal surgery were evaluated focusing on their post-interventional maintenance care. Due to the early publication of one review an additional literature search update was undertaken. The search was executed for studies published from January 2001 till March 2015 through an electronic database to ensure the inclusion of resent studies on SRP. Two reviewers guided the study selection and assessed the validity of the three reviews found.

Results

Within the group of scaling and root planing alone there have been nine studies with more than three appointments for maintenance care and five studies with more than two appointments in the first 2 months after the intervention. Chlorhexidine was the most frequently used antiseptic agent used for 2 weeks after non-surgical intervention. Scaling and root planing with adjunctive antibiotics showed a similar number of visits with professional biofilm debridement, whereas regenerative studies displayed more studies with more than three visits in the intervention group. In addition, the use of antiseptics was longer and lasted 4 to 8 weeks after the regenerative intervention. The latter studies also showed more stringent maintenance protocols.

Conclusions

With increased interventional effort there was a greater tendency to increase frequency and duration of the maintenance care program and antiseptic agents.

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Outcomes of 6.5-mm Hydrophilic Implants and Long Implants Placed with Lateral Sinus Floor Elevation in the Atrophic Posterior Maxilla: A Prospective, Randomized Controlled Clinical Comparison

Abstract

Background

Very few controlled studies have compared short and long implants placed with appropriate sinus floor elevation techniques.

Purpose

To compare the 2-year outcomes of 6.5-mm hydrophilic implants placed with osteotome sinus floor elevation (OSFE) and standard implants placed with lateral sinus floor elevation in patients with a severely atrophic posterior maxilla.

Materials and Methods

Thirty-eight patients with a residual bone height of 4–5 mm were randomized to receive one of the two above-mentioned treatments. Intra- and postoperative complications were recorded. The implant survival rate, peri-implant bone level, and periapical endosinus bone gain were assessed.

Results

Of the 80 inserted implants, one in the long implant group failed because of abscess formation. The peri-implant bone level change (0.35 ± 0.60 mm vs 0.40 ± 0.71 mm) was not significantly different between the two groups. The endosinus bone gain was 2.94 ± 0.81 mm and 10.19 ± 0.95 mm in the short and long implant groups, respectively. No serious adverse events related to implant surgery were recorded.

Conclusions

The results suggest that the placement of 6.5-mm short implants with OSFE is an effective alternative for the rehabilitation of a severely atrophic posterior maxilla.

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Effect of Associated Autoimmune Diseases on Type 1 Diabetes Mellitus Incidence and Metabolic Control in Children and Adolescents

Type 1 diabetes mellitus (T1DM) is one of the most common chronic diseases developing in childhood. The incidence of the disease in children increases for unknown reasons at a rate from 3 to 5% every year worldwide. The background of T1DM is associated with the autoimmune process of pancreatic beta cell destruction, which leads to absolute insulin deficiency and organ damage. Complex interactions between environmental and genetic factors contribute to the development of T1DM in genetically predisposed patients. The T1DM-inducing autoimmune process can also affect other organs, resulting in development of additional autoimmune diseases in the patient, thereby impeding diabetes control. The most common T1DM comorbidities include autoimmune thyroid diseases, celiac disease, and autoimmune gastritis; additionally, diabetes can be a component of PAS (Polyglandular Autoimmune Syndrome). The aim of this review is to assess the prevalence of T1DM-associated autoimmune diseases in children and adolescents and their impact on the course of T1DM. We also present suggestions concerning screening tests.

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BRAF and NRAS mutations in Russian melanoma patients: results of a nationwide study.

Distribution of actionable mutations in melanoma may show considerable geographic variations. Given the importance of genetic testing for the proper use of targeted drugs, we carried out the first-in-Russia nationwide molecular epidemiological study for melanoma. Sanger sequencing analysis for BRAF (exon 15) and NRAS (exons 2-4) genes was carried out for patients with the stage IIIB or IV disease from 46 cancer centers located throughout the country. BRAF mutations were identified in 625/1034 (60.4%) melanoma samples. BRAF c.1799T>A (p.V600E) substitution was the most prevalent, being detected in 561/1034 (54.3%) tumors. Non-V600E mutations constituted about 10% of activating BRAF genetic lesions (64/625, 10.2%), with a clear prevalence of c.1798_1799GT>AA (p.V600K) variant (52 tumors) and noticeable occurrence of c.1798_1799GT>AG (p.V600R) allele (five tumors). BRAF V600E mutations were associated with younger patient age and localization of melanoma on sun-protected areas of the skin, whereas BRAF V600K substitutions were characteristic of elderly patients and occurred more often at the chronically sun-exposed regions of the body. Activating NRAS mutations were detected in 86/601 (14.3%) of samples analyzed, with 79 events affecting codon 61 and seven mutations detected in codons 12 or 13. Six types of distinct NRAS codon 61 substitutions were identified, with c.181C>A (p.Q61K), c.182A>G (p.Q61R), and c.182A>T (p.Q61L) being frequent and c.181_182CA>TT (p.Q61L), c.183A>T (p.Q61H), and c.183A>C (p.Q61H) being rare. An age-related increase in the frequency of NRAS mutations was observed. Multiplicity and clinical distribution of BRAF and NRAS mutations have to be taken into account while considering molecular testing for melanoma patients. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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BRAF and NRAS mutations in Russian melanoma patients: results of a nationwide study.

Distribution of actionable mutations in melanoma may show considerable geographic variations. Given the importance of genetic testing for the proper use of targeted drugs, we carried out the first-in-Russia nationwide molecular epidemiological study for melanoma. Sanger sequencing analysis for BRAF (exon 15) and NRAS (exons 2-4) genes was carried out for patients with the stage IIIB or IV disease from 46 cancer centers located throughout the country. BRAF mutations were identified in 625/1034 (60.4%) melanoma samples. BRAF c.1799T>A (p.V600E) substitution was the most prevalent, being detected in 561/1034 (54.3%) tumors. Non-V600E mutations constituted about 10% of activating BRAF genetic lesions (64/625, 10.2%), with a clear prevalence of c.1798_1799GT>AA (p.V600K) variant (52 tumors) and noticeable occurrence of c.1798_1799GT>AG (p.V600R) allele (five tumors). BRAF V600E mutations were associated with younger patient age and localization of melanoma on sun-protected areas of the skin, whereas BRAF V600K substitutions were characteristic of elderly patients and occurred more often at the chronically sun-exposed regions of the body. Activating NRAS mutations were detected in 86/601 (14.3%) of samples analyzed, with 79 events affecting codon 61 and seven mutations detected in codons 12 or 13. Six types of distinct NRAS codon 61 substitutions were identified, with c.181C>A (p.Q61K), c.182A>G (p.Q61R), and c.182A>T (p.Q61L) being frequent and c.181_182CA>TT (p.Q61L), c.183A>T (p.Q61H), and c.183A>C (p.Q61H) being rare. An age-related increase in the frequency of NRAS mutations was observed. Multiplicity and clinical distribution of BRAF and NRAS mutations have to be taken into account while considering molecular testing for melanoma patients. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Expansion patterns in surgically assisted rapid maxillary expansion

Abstract

Objectives

The purpose of this work was to compare the patterns of expansion resulting from a tooth-borne hyrax appliance and a bone-borne transpalatal distractor in patients treated by surgically assisted rapid maxillary expansion (SARME).

Methods

A total of 28 patients with transverse maxillary hypoplasia were treated by SARME, using a hyrax appliance in 12 and a transpalatal distractor in 16 cases. Before and after palatal expansion, an impression of each maxilla was taken. Casts fabricated on this basis were digitized with a 3D scanner. Based on the resultant virtual models, both the amounts of expansion and the angles of crown tipping from the canines through the second molars were determined and the results of the two groups were compared.

Results

Almost all measurement sites revealed significant expansion of the dental arches over the course of SARME. The sites of maximum expansion were more anterior in the distractor group, while larger total amounts of expansion were seen in the hyrax group. Both appliances involved buccal tipping of almost all canines, premolars, and molars; these findings were more pronounced in the hyrax group.

Conclusions

Either a transpalatal distractor or a hyrax appliance can be successfully used to expand a narrow maxilla by SARME. The two appliances, however, cause different amounts of dental arch expansion and buccal crown tipping. A hyrax appliance should be expected to result in a parallel expansion pattern with the largest increase in the premolar area. A transpalatal distractor is likely to cause more of a V-shaped pattern of expansion. Thus, in clinical practice, specific patterns of distraction can be selectively achieved by taking advantage of specific appliances and various options of positioning.

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Expansion patterns in surgically assisted rapid maxillary expansion

Abstract

Objectives

The purpose of this work was to compare the patterns of expansion resulting from a tooth-borne hyrax appliance and a bone-borne transpalatal distractor in patients treated by surgically assisted rapid maxillary expansion (SARME).

Methods

A total of 28 patients with transverse maxillary hypoplasia were treated by SARME, using a hyrax appliance in 12 and a transpalatal distractor in 16 cases. Before and after palatal expansion, an impression of each maxilla was taken. Casts fabricated on this basis were digitized with a 3D scanner. Based on the resultant virtual models, both the amounts of expansion and the angles of crown tipping from the canines through the second molars were determined and the results of the two groups were compared.

Results

Almost all measurement sites revealed significant expansion of the dental arches over the course of SARME. The sites of maximum expansion were more anterior in the distractor group, while larger total amounts of expansion were seen in the hyrax group. Both appliances involved buccal tipping of almost all canines, premolars, and molars; these findings were more pronounced in the hyrax group.

Conclusions

Either a transpalatal distractor or a hyrax appliance can be successfully used to expand a narrow maxilla by SARME. The two appliances, however, cause different amounts of dental arch expansion and buccal crown tipping. A hyrax appliance should be expected to result in a parallel expansion pattern with the largest increase in the premolar area. A transpalatal distractor is likely to cause more of a V-shaped pattern of expansion. Thus, in clinical practice, specific patterns of distraction can be selectively achieved by taking advantage of specific appliances and various options of positioning.

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Expansion patterns in surgically assisted rapid maxillary expansion

Abstract

Objectives

The purpose of this work was to compare the patterns of expansion resulting from a tooth-borne hyrax appliance and a bone-borne transpalatal distractor in patients treated by surgically assisted rapid maxillary expansion (SARME).

Methods

A total of 28 patients with transverse maxillary hypoplasia were treated by SARME, using a hyrax appliance in 12 and a transpalatal distractor in 16 cases. Before and after palatal expansion, an impression of each maxilla was taken. Casts fabricated on this basis were digitized with a 3D scanner. Based on the resultant virtual models, both the amounts of expansion and the angles of crown tipping from the canines through the second molars were determined and the results of the two groups were compared.

Results

Almost all measurement sites revealed significant expansion of the dental arches over the course of SARME. The sites of maximum expansion were more anterior in the distractor group, while larger total amounts of expansion were seen in the hyrax group. Both appliances involved buccal tipping of almost all canines, premolars, and molars; these findings were more pronounced in the hyrax group.

Conclusions

Either a transpalatal distractor or a hyrax appliance can be successfully used to expand a narrow maxilla by SARME. The two appliances, however, cause different amounts of dental arch expansion and buccal crown tipping. A hyrax appliance should be expected to result in a parallel expansion pattern with the largest increase in the premolar area. A transpalatal distractor is likely to cause more of a V-shaped pattern of expansion. Thus, in clinical practice, specific patterns of distraction can be selectively achieved by taking advantage of specific appliances and various options of positioning.

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The future of pediatric dentistry education and curricula: a Chilean perspective

Abstract

Background

A meeting was organised to consolidate a network of researchers and academics from Australia, Brazil, Chile, the UK and the USA, relating to Early Childhood Caries (ECC) and Dental Trauma (DT). As part of this meeting, a dedicated session was held on the future of paediatric dental education and curricula. Twenty-four paediatric dentistry (PD) academics, representing eight Chilean dental schools, and three international specialists (from Brazil and Latvia) participated in group discussions facilitated by five members of the ECC/DT International Collaborative Network. Data were collected from group discussions which followed themes developed as guides to identify key issues associated with paediatric dentistry education, training and research.

Discussion

Participants discussed current PD dental curricula in Chile, experiences in educating new cohorts of oral health care providers, and the outcomes of existing efforts in education and research in PD. They also, identified challenges, opportunities and areas in need of further development.

Summary

This paper provides an introspective analysis of the education and training of PD in Chile; describes the input provided by participants into pediatric dentistry education and curricula; and sets out some key priorities for action with suggested directions to best prepare the future dental workforce to maximise oral health outcomes for children. Immediate priorities for action in paediatric dentistry in Chile were proposed.

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Influence of different post-interventional maintenance concepts on periodontal outcomes: an evaluation of three systematic reviews

Abstract

Background

To selectively review the existing literature on post-interventional maintenance protocols in patients with periodontal disease receiving either non-surgical or surgical periodontal treatment.

Methods

Three systematic reviews with different periodontal interventions, i.e. scaling and root planing (SRP), SRP with adjunctive antibiotics or regenerative periodontal surgery were evaluated focusing on their post-interventional maintenance care. Due to the early publication of one review an additional literature search update was undertaken. The search was executed for studies published from January 2001 till March 2015 through an electronic database to ensure the inclusion of resent studies on SRP. Two reviewers guided the study selection and assessed the validity of the three reviews found.

Results

Within the group of scaling and root planing alone there have been nine studies with more than three appointments for maintenance care and five studies with more than two appointments in the first 2 months after the intervention. Chlorhexidine was the most frequently used antiseptic agent used for 2 weeks after non-surgical intervention. Scaling and root planing with adjunctive antibiotics showed a similar number of visits with professional biofilm debridement, whereas regenerative studies displayed more studies with more than three visits in the intervention group. In addition, the use of antiseptics was longer and lasted 4 to 8 weeks after the regenerative intervention. The latter studies also showed more stringent maintenance protocols.

Conclusions

With increased interventional effort there was a greater tendency to increase frequency and duration of the maintenance care program and antiseptic agents.

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Outcomes of 6.5-mm Hydrophilic Implants and Long Implants Placed with Lateral Sinus Floor Elevation in the Atrophic Posterior Maxilla: A Prospective, Randomized Controlled Clinical Comparison

Abstract

Background

Very few controlled studies have compared short and long implants placed with appropriate sinus floor elevation techniques.

Purpose

To compare the 2-year outcomes of 6.5-mm hydrophilic implants placed with osteotome sinus floor elevation (OSFE) and standard implants placed with lateral sinus floor elevation in patients with a severely atrophic posterior maxilla.

Materials and Methods

Thirty-eight patients with a residual bone height of 4–5 mm were randomized to receive one of the two above-mentioned treatments. Intra- and postoperative complications were recorded. The implant survival rate, peri-implant bone level, and periapical endosinus bone gain were assessed.

Results

Of the 80 inserted implants, one in the long implant group failed because of abscess formation. The peri-implant bone level change (0.35 ± 0.60 mm vs 0.40 ± 0.71 mm) was not significantly different between the two groups. The endosinus bone gain was 2.94 ± 0.81 mm and 10.19 ± 0.95 mm in the short and long implant groups, respectively. No serious adverse events related to implant surgery were recorded.

Conclusions

The results suggest that the placement of 6.5-mm short implants with OSFE is an effective alternative for the rehabilitation of a severely atrophic posterior maxilla.

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Effect of Associated Autoimmune Diseases on Type 1 Diabetes Mellitus Incidence and Metabolic Control in Children and Adolescents

Type 1 diabetes mellitus (T1DM) is one of the most common chronic diseases developing in childhood. The incidence of the disease in children increases for unknown reasons at a rate from 3 to 5% every year worldwide. The background of T1DM is associated with the autoimmune process of pancreatic beta cell destruction, which leads to absolute insulin deficiency and organ damage. Complex interactions between environmental and genetic factors contribute to the development of T1DM in genetically predisposed patients. The T1DM-inducing autoimmune process can also affect other organs, resulting in development of additional autoimmune diseases in the patient, thereby impeding diabetes control. The most common T1DM comorbidities include autoimmune thyroid diseases, celiac disease, and autoimmune gastritis; additionally, diabetes can be a component of PAS (Polyglandular Autoimmune Syndrome). The aim of this review is to assess the prevalence of T1DM-associated autoimmune diseases in children and adolescents and their impact on the course of T1DM. We also present suggestions concerning screening tests.

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BRAF and NRAS mutations in Russian melanoma patients: results of a nationwide study.

Distribution of actionable mutations in melanoma may show considerable geographic variations. Given the importance of genetic testing for the proper use of targeted drugs, we carried out the first-in-Russia nationwide molecular epidemiological study for melanoma. Sanger sequencing analysis for BRAF (exon 15) and NRAS (exons 2-4) genes was carried out for patients with the stage IIIB or IV disease from 46 cancer centers located throughout the country. BRAF mutations were identified in 625/1034 (60.4%) melanoma samples. BRAF c.1799T>A (p.V600E) substitution was the most prevalent, being detected in 561/1034 (54.3%) tumors. Non-V600E mutations constituted about 10% of activating BRAF genetic lesions (64/625, 10.2%), with a clear prevalence of c.1798_1799GT>AA (p.V600K) variant (52 tumors) and noticeable occurrence of c.1798_1799GT>AG (p.V600R) allele (five tumors). BRAF V600E mutations were associated with younger patient age and localization of melanoma on sun-protected areas of the skin, whereas BRAF V600K substitutions were characteristic of elderly patients and occurred more often at the chronically sun-exposed regions of the body. Activating NRAS mutations were detected in 86/601 (14.3%) of samples analyzed, with 79 events affecting codon 61 and seven mutations detected in codons 12 or 13. Six types of distinct NRAS codon 61 substitutions were identified, with c.181C>A (p.Q61K), c.182A>G (p.Q61R), and c.182A>T (p.Q61L) being frequent and c.181_182CA>TT (p.Q61L), c.183A>T (p.Q61H), and c.183A>C (p.Q61H) being rare. An age-related increase in the frequency of NRAS mutations was observed. Multiplicity and clinical distribution of BRAF and NRAS mutations have to be taken into account while considering molecular testing for melanoma patients. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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BRAF and NRAS mutations in Russian melanoma patients: results of a nationwide study.

Distribution of actionable mutations in melanoma may show considerable geographic variations. Given the importance of genetic testing for the proper use of targeted drugs, we carried out the first-in-Russia nationwide molecular epidemiological study for melanoma. Sanger sequencing analysis for BRAF (exon 15) and NRAS (exons 2-4) genes was carried out for patients with the stage IIIB or IV disease from 46 cancer centers located throughout the country. BRAF mutations were identified in 625/1034 (60.4%) melanoma samples. BRAF c.1799T>A (p.V600E) substitution was the most prevalent, being detected in 561/1034 (54.3%) tumors. Non-V600E mutations constituted about 10% of activating BRAF genetic lesions (64/625, 10.2%), with a clear prevalence of c.1798_1799GT>AA (p.V600K) variant (52 tumors) and noticeable occurrence of c.1798_1799GT>AG (p.V600R) allele (five tumors). BRAF V600E mutations were associated with younger patient age and localization of melanoma on sun-protected areas of the skin, whereas BRAF V600K substitutions were characteristic of elderly patients and occurred more often at the chronically sun-exposed regions of the body. Activating NRAS mutations were detected in 86/601 (14.3%) of samples analyzed, with 79 events affecting codon 61 and seven mutations detected in codons 12 or 13. Six types of distinct NRAS codon 61 substitutions were identified, with c.181C>A (p.Q61K), c.182A>G (p.Q61R), and c.182A>T (p.Q61L) being frequent and c.181_182CA>TT (p.Q61L), c.183A>T (p.Q61H), and c.183A>C (p.Q61H) being rare. An age-related increase in the frequency of NRAS mutations was observed. Multiplicity and clinical distribution of BRAF and NRAS mutations have to be taken into account while considering molecular testing for melanoma patients. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Expansion patterns in surgically assisted rapid maxillary expansion

Abstract

Objectives

The purpose of this work was to compare the patterns of expansion resulting from a tooth-borne hyrax appliance and a bone-borne transpalatal distractor in patients treated by surgically assisted rapid maxillary expansion (SARME).

Methods

A total of 28 patients with transverse maxillary hypoplasia were treated by SARME, using a hyrax appliance in 12 and a transpalatal distractor in 16 cases. Before and after palatal expansion, an impression of each maxilla was taken. Casts fabricated on this basis were digitized with a 3D scanner. Based on the resultant virtual models, both the amounts of expansion and the angles of crown tipping from the canines through the second molars were determined and the results of the two groups were compared.

Results

Almost all measurement sites revealed significant expansion of the dental arches over the course of SARME. The sites of maximum expansion were more anterior in the distractor group, while larger total amounts of expansion were seen in the hyrax group. Both appliances involved buccal tipping of almost all canines, premolars, and molars; these findings were more pronounced in the hyrax group.

Conclusions

Either a transpalatal distractor or a hyrax appliance can be successfully used to expand a narrow maxilla by SARME. The two appliances, however, cause different amounts of dental arch expansion and buccal crown tipping. A hyrax appliance should be expected to result in a parallel expansion pattern with the largest increase in the premolar area. A transpalatal distractor is likely to cause more of a V-shaped pattern of expansion. Thus, in clinical practice, specific patterns of distraction can be selectively achieved by taking advantage of specific appliances and various options of positioning.

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The future of pediatric dentistry education and curricula: a Chilean perspective

Abstract

Background

A meeting was organised to consolidate a network of researchers and academics from Australia, Brazil, Chile, the UK and the USA, relating to Early Childhood Caries (ECC) and Dental Trauma (DT). As part of this meeting, a dedicated session was held on the future of paediatric dental education and curricula. Twenty-four paediatric dentistry (PD) academics, representing eight Chilean dental schools, and three international specialists (from Brazil and Latvia) participated in group discussions facilitated by five members of the ECC/DT International Collaborative Network. Data were collected from group discussions which followed themes developed as guides to identify key issues associated with paediatric dentistry education, training and research.

Discussion

Participants discussed current PD dental curricula in Chile, experiences in educating new cohorts of oral health care providers, and the outcomes of existing efforts in education and research in PD. They also, identified challenges, opportunities and areas in need of further development.

Summary

This paper provides an introspective analysis of the education and training of PD in Chile; describes the input provided by participants into pediatric dentistry education and curricula; and sets out some key priorities for action with suggested directions to best prepare the future dental workforce to maximise oral health outcomes for children. Immediate priorities for action in paediatric dentistry in Chile were proposed.

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Influence of different post-interventional maintenance concepts on periodontal outcomes: an evaluation of three systematic reviews

Abstract

Background

To selectively review the existing literature on post-interventional maintenance protocols in patients with periodontal disease receiving either non-surgical or surgical periodontal treatment.

Methods

Three systematic reviews with different periodontal interventions, i.e. scaling and root planing (SRP), SRP with adjunctive antibiotics or regenerative periodontal surgery were evaluated focusing on their post-interventional maintenance care. Due to the early publication of one review an additional literature search update was undertaken. The search was executed for studies published from January 2001 till March 2015 through an electronic database to ensure the inclusion of resent studies on SRP. Two reviewers guided the study selection and assessed the validity of the three reviews found.

Results

Within the group of scaling and root planing alone there have been nine studies with more than three appointments for maintenance care and five studies with more than two appointments in the first 2 months after the intervention. Chlorhexidine was the most frequently used antiseptic agent used for 2 weeks after non-surgical intervention. Scaling and root planing with adjunctive antibiotics showed a similar number of visits with professional biofilm debridement, whereas regenerative studies displayed more studies with more than three visits in the intervention group. In addition, the use of antiseptics was longer and lasted 4 to 8 weeks after the regenerative intervention. The latter studies also showed more stringent maintenance protocols.

Conclusions

With increased interventional effort there was a greater tendency to increase frequency and duration of the maintenance care program and antiseptic agents.

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