Impaction of the lower second molar is not a common problem, but it is very challenging for both orthodontist and oral surgeon. Treatment options depend on the degree of tooth inclination, the position of the third molars, and the desired type of movement, which may be surgical and/or orthodontic in nature. A good treatment alternative is surgical uncovering with orthodontically-assisted eruption. A case of successful uprighting using a 0.017 ϫ 0.025-inch titanium molybdenum alloy (TMA) tip-back cantilever is presented. Different aspects of uprighting impacted second molars are discussed in light of the literature. The iatrogenic character of lower second molar impaction is emphasized.
Objectives
This retrospective cross-sectional study aimed to present a new method for secondary alveolar bone grafting (SABG) assessment and to qualitatively evaluate the SABG results in unilateral cleft lip and palate patients.
Materials and methods
Research was conducted according to the STROBE guidelines. The study group consisted of 21 patients with a mean age of 16 years. High-resolution cone-beam computed tomography (CBCT) was performed at least 1 year after grafting. The experimental side was the cleft side, and the contralateral side without a congenital cleft was the control. Measurements were performed at four levels of the maxillary central incisors’ roots according to the new scale with scores from 0 to 3. The sum of the scores provided a general assessment of bone architecture. The Wilcoxon signed-rank test was used for intergroup comparisons, and a Kappa coefficient was used for reproducibility measurements.
Results
High individual variability was found, and the bone architecture was significantly worse on the cleft side than on the noncleft side. The results showed 28.57% failure, 33.33% poor, 19.05% moderate, and 19.05% good results from the surgical procedure. Kappa coefficients produced results from 0.92 to 1.00 for intra-rater and from 0.81 to 1.00 for inter-rater reproducibility.
Conclusions
CBCT provides detailed information about alveolar bone morphology. The new assessment method is useful at every treatment stage and provides excellent repeatability. SABG did not provide good bone morphology, in most cases.
Clinical relevance
This research presents a new universal alternative for the assessment of SABG by utilizing CBCT.
Objectives
The aim of the study is to assess the skeletal age at the onset and end of the pubertal growth spurt and determine its duration in four growth type groups: (1) normodivergent skeletal Class I (I N), (2) normodivergent skeletal Class III (III N), (3) high-angle skeletal Class III (III H) and (4) high-angle skeletal Class I (I H).
Materials and methods
Two hundred thirteen subjects were selected from 2163 examined files. The cervical vertebral maturation stage was recorded by means of Baccetti’s method. The sagittal and vertical skeletal relations were evaluated according to Steiner analysis with Kaminek’s modification. The duration of the pubertal growth spurt was calculated from the difference between the means of the chronological age related to CS3 and CS4 maturation stages.
Results
The shortest lasting pubertal growth spurt was observed in group I N (1.1), followed by group III N (1.6). Major differences between arithmetic means CS4-CS3 were seen in groups I H and III H (2.3 and 2.7, respectively).
Conclusions
The following tendency was observed in the duration of the pubertal growth spurt: I N < III N < I H < III H. This tendency has statistical significance only in high-angle patients in comparison with normodivergent skeletal Class I.
Clinical relevance
Knowledge on the longer pubertal growth spurt in high-angle patients compared to patients with normal anteroposterior and vertical relationships can be useful in the selection of an appropriate therapeutic method and a treatment time.
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