Objectives The RASopathies are a group of syndromes that have in common germline mutations in genes that encode components of the Ras/mitogen-activated protein kinase (MAPK) pathway and have been a focus of study to understand the role of this pathway in development and disease. These syndromes include Noonan syndrome (NS); Noonan syndrome with multiple lentigines (NSML or LEOPARD syndrome); neurofibromatosis type 1 (NF1); Costello syndrome (CS); cardio-facio-cutaneous (CFC) syndrome; neurofibromatosis type 1-like syndrome (NFLS or Legius syndrome); and capillary malformation-arteriovenous malformation syndrome (CM-AVM). These disorders affect multiple systems, including the craniofacial complex. Although the craniofacial features have been well described and can aid in clinical diagnosis, the dental phenotypes have not been analyzed in detail for each of the RASopathies. In this review, we summarize the clinical features of the RASopathies, highlighting the reported craniofacial and dental findings. Methods Review of the literature. Results Each of the RASopathies reviewed, caused by mutations in genes that encode different proteins in the Ras pathway, have unique and overlapping craniofacial and dental characteristics. Conclusions Careful description of craniofacial and dental features in the RASopathies can provide information for dental clinicians treating these individuals and can also give insight into the role of Ras signaling in craniofacial development.

Objective: To fabricate orthodontic brackets from esthetic materials and determine their fracture resistance during archwire torsion. Materials and Methods: Computer-aided design/computer-aided manufacturing technology (Cerec inLab, Sirona) was used to mill brackets with a 0.018 3 0.025-inch slot. Materials used were Paradigm MZ100 and Lava Ultimate resin composite (3M ESPE), Mark II feldspathic porcelain (Vita Zahnfabrik), and In-Ceram YZ zirconia (Vita Zahnfabrik). Ten brackets of each material were subjected to torque by a 0.018 3 0.025-inch stainless steel archwire (G&H) using a specially designed apparatus. The average moments and degrees of torsion necessary to fracture the brackets were determined and compared with those of commercially available alumina brackets, Mystique MB (Dentsply GAC). Results: The YZ brackets were statistically significantly stronger than any other tested material in their resistance to torsion (P , .05). The mean torques at failure ranged from 3467 g.mm for Mark II to 11,902 g.mm for YZ. The mean torsion angles at failure ranged from 15.38 to 40.98. Conclusion: Zirconia had the highest torsional strength among the tested esthetic brackets. Resistance of MZ100 and Lava Ultimate composite resin brackets to archwire torsion was comparable to commercially available alumina ceramic brackets. (Angle Orthod. 2017;87:125-130)

Introduction The aim of this study was to evaluate three dimensionally the effect of the combined maxillary expansion and protraction treatment on oropharyngeal airway in children with non-syndromic cleft palate with or without cleft lip (CP/L). Methods CBCT data of 18 preadolescent individuals (ages, 8.4 ± 1.7 years) with CP/L, who underwent Phase I orthodontic maxillary expansion with protraction, were compared before and after treatment. The average length of treatment was 24.1± 7.6 months. The airway volume and minimal cross-sectional area (MCA) were determined using 3DMD Vultus imaging software with cross-sectional areas calculated for each 2-mm over the entire length of the airway. A control group of 8 preadolescent individuals (ages, 8.7 ± 2.6 years) with CP/L was used for comparison. Results There was a statistically significant increase in pharyngeal airway volume after phase I orthodontic treatment in both groups, however, there was no statistically significant change in minimal cross-sectional area in neither study nor control group. Conclusion The findings showed that maxillary expansion and protraction did not have a significant effect on increasing oropharyngeal volume and MCA in patients with CP/L.

Introduction Tooth agenesis is a type of dental anomaly in which individuals are missing teeth due to developmental failure as a result of genetic or environmental factors. With approximately one fourth of the population missing ≥1 third molar, tooth agenesis is considered a common dental anomaly. However, the severity of tooth agenesis can range from a missing single tooth to multiple teeth. When suffering from severe tooth agenesis, the patient's health and social relationships are often affected. Case Presentation The patient in this report congenitally lost 11 teeth and suffered from compromised esthetics and impaired chewing function. In such a severe tooth agenesis case, interdisciplinary treatments involving orthodontics, periodontics, and prosthodontics were engaged to reconstruct the ideal biology, function, and esthetics for the patient. With an interdisciplinary approach, the periodontist played an important role in the rehabilitation of the edentulous regions with implants in combination with various hard and soft tissue augmentation procedures. In addition, the patient with severe tooth agenesis presented with additional dental anomalies. The periodontist, therefore, had to collaborate with other specialists to provide early detection and intervention to avoid future complications, such as the management of infraoccluded ankylosed deciduous molars and aberrant frenum. The patient at the end of treatment had a good occlusion with improved function and esthetics. Conclusion This case report describes the interdisciplinary treatment approach used and points out the role of periodontists in the treatment of a patient with severe tooth agenesis.

Background: Efforts to evaluate physicians’ awareness and attitude toward dentists’ comprehensive role in OSA management are relatively negligible. Therefore, this study aimed to assess physicians’ awareness and attitude toward the role of dentists in OSA management in Saudi Arabia. Methods: In a multi-center cross-sectional study, a total of 358 physicians in Saudi Arabia were subjected to an e-questionnaire composed of three sections: (1) physicians’ demographic data, (2) physicians’ general and specific knowledge of OSA and its management [using 29 factual statements to be responded by “True, False, or I don’t know” responses], and (3) physicians’ attitude towards dentists’ role in OSA management [using 12 attitude statements to be responded by a Likert scale of “Never, Rarely, Sometimes, Usually, Always” responses]. A scoring system was applied for both knowledge and attitude, total and percentage mean scores (PMS) were calculated, and knowledge and attitude levels were categorized accordingly. Predictors of correct knowledge and favorable attitude were identified using multiple regression analyses. Results: Physicians had an overall average knowledge level (PMS = 56% ± 19.4%), with 35.5% and 5.9% reporting good general and specific knowledge levels, respectively (χ2 = 143.0, p < 0.001). Physicians had an overall neutral attitude level (PMS = 64.4% ± 17.5%), with about one-half reporting a neutral attitude level (48.9%) and only one-fourth reporting a positive attitude level (27.7%). Higher levels of knowledge were a significant predictor of favorable attitudes (t = 5.71, p < 0.001). Higher training levels were a significant predictor of correct knowledge (t = 3.60, p < 0.001) and favorable attitude (t = 3.15, p = 0.002). Conclusions: Physicians showed insufficient knowledge about OSA and a less than favorable attitude towards dentists’ role in its management. Enhancing medical curricula and clinical protocols and guidelines on the dentists’ role in OSA management is recommended.

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STATEMENT OF PROBLEM Limited information is available on the effect of LOCATOR abutment length and luting cement type on retention to intraradicular dentin in overdentures. PURPOSE The purpose of this in vitro study was to evaluate the effect of the length of a commercially available LOCATOR abutment and cement type on retention in the root canal. MATERIAL AND METHODS Eighty LOCATOR abutments with a standard length of 6 mm were obtained. Half of them were shortened to 3 mm. Eighty recently extracted single-rooted teeth were divided into 2 groups. The post space was prepared to 6 mm in the first group and 3 mm in the second. After preparation, the LOCATOR abutments were luted with one of the following cements: dual-polymerized glass-reinforced resin cement (Parapost Paracore), dual-polymerized resin cement (Variolink II), self-adhesive resin cement (RelyX Unicem), and conventional cement (zinc phosphate). The tensile force required for the removal of the LOCATOR abutments from their corresponding roots was recorded. Data were statistically analyzed with 2-way ANOVA and the Tukey multiple comparison test. RESULTS Both the cement type (P<.001) and the length of the LOCATOR abutment (P<.001) significantly affected the mean tensile forces. Dualpolymerized glass-reinforced resin cement (Parapost Paracore) presented significantly higher mean tensile forces for the LOCATOR abutment retention among all cements (P<.05). CONCLUSIONS Regardless of the length, LOCATOR abutments luted with Parapost Paracore resin cement presented higher mean resistance to tensile forces compared with those luted with the other cements. LOCATOR abutments of 6 mm in length were more resistant to tensile forces than those of 3 mm in length in combination with all cements.

Introduction: The aim of this study was to evaluate three dimensionally the effect of the combined maxillary expansion and protraction treatment on oropharyngeal airway in children with non-syndromic cleft palate with or without cleft lip (CP/L).Methods: CBCT data of 18 preadolescent individuals (ages, 8.4 ± 1.7 years) with CP/L, who underwent Phase I orthodontic maxillary expansion with protraction, were compared before and after treatment. The average length of treatment was 24.1+ 7.6 months. The airway volume and minimal cross-sectional area (MCA) were determined using 3DMD Vultus imaging software with cross-sectional areas calculated for each 2-mm over the entire length of the airway. A control group of 9 preadolescent individuals (ages, 8.7 ± 2.6 years) with CP/L was used for comparison.