BackgroundOne of the most controversial issues in treatment planning of class III malocclusion patients is the choice between orthodontic camouflage and orthognathic surgery. Our aim was to delineate diagnostic measures in borderline class III cases for choosing proper treatment.MethodsThe pretreatment lateral cephalograms of 65 patients exhibiting moderate skeletal class III were analyzed. The camouflage group comprised of 36 patients with the mean age of 23.5 (SD 4.8), and the surgery group comprised of 29 patients with the mean age of 24.8 years (SD 3.1). The camouflage treatment consisted of flaring of the upper incisors and retraction of the lower incisors, and the surgical group was corrected by setback of the mandible, maxillary advancement, or bimaxillary surgery. Mann-Whitney U test was used to compare the variables between the two groups. Stepwise discriminant analysis was applied to identify the dentoskeletal variables that best separate the groups.ResultsHoldaway H angle and Wits appraisal were able to differentiate between the patients suitable for orthodontic camouflage or surgical treatment. Cases with a Holdaway angle greater than 10.3° and Wits appraisal greater than − 5.8 mm would be treated successfully by camouflage, while those with a Holdaway angle of less than 10.3° and with Wits appraisal less than − 5.8 mm can be treated surgically. Based on this model, 81.5% of our patients were properly classified.ConclusionsHoldaway H angle and Wits appraisal can be used as a critical diagnostic parameter for determining the treatment modality in class III borderline cases.

JIA patients with TMJ arthritis presented higher functional disability and lower OHRQoL scores compared with JIA patients without TMJ arthritis. TMJ arthritis was strongly associated with JIA duration and activity, especially in female patients.

Background A systematic review assessing autologous versus alloplastic bone for secondary alveolar bone grafting in patients with cleft lip and palate was published in 2011 and included only one randomized controlled trial comparing traditional iliac bone graft to recombinant human bone morphogenetic protein-2 (rh-BMP2). Objectives To perform a systematic review with meta-analysis on the use of secondary alveolar bone grafting (autologous bone and rh-BMP2 graft) in order to improve bone volume and height in patients with cleft lip and palate. Data sources An electronic search was conducted via PubMed/MEDLINE, Cochrane Central Register of Controlled Trials (CONTROL) via Cochrane Library, EMBASE via Ovid, and LILAC for studies published between January 2008 and September 2018. The systematic review registration number at PROSPERO was 42018085858. Eligibility criteria Only RCTs were included. Inclusion criteria were patients with the diagnosis of unilateral cleft lip and palate older than 5 years of age, radiographic evaluation (CT and/or CBCT) of the cleft area, and at least a 6-month follow-up. Main outcome measures Bone formation and bone height by radiographic CT evaluation (preoperatively, after 6 months and after 1 year of follow-up) and length of hospital stay were assessed. Results Four studies met strict inclusion criteria. Autologous bone graft showed statistically significant higher bone formation after 6-month follow-up (MD − 14.410; 95% CI − 22.392 to − 6.428; p = 0.000). No statistically significant difference was noted after a 1-year follow-up (MD 6.227; 95% CI − 15.967 to 28.422; p = 0.582). No statistically significant difference in bone height was noted after 6-month (MD − 18.737; 95% CI − 43.560 to 6.087; p = 0.139) and 1-year follow-up (MD − 4.401; 95% CI − 30.636 to 21.834; p = 0.742). Patients who underwent rh-BMP2 graft had a statistically significant reduced hospital stay (MD − 1.146; 95% CI − 2.147 to − 0.145; p = 0.025). Limitations The main limitation is the high risk of bias among included studies. Conclusion Autologous bone and rh-BMP2 graft showed a similar effectiveness in maxillary alveolar reconstruction in patients with unilateral cleft lip and palate assessing bone graft volume and height although rh-BMP2 graft showed a relative shorter length of hospital stay (high uncertainty level). Electronic supplementary material The online version of this article (10.1186/s40510-018-0252-y) contains supplementary material, which is available to authorized users.

Aim: The aim of the present study was to compare the accuracy of the actual space obtained through interproximal enamel reduction (IPR) compared to the amount of IPR planned through the digital setup during clear aligner treatment (CAT). Materials and methods: A total of 10 clinicians were randomly recruited using the Doctor Locator by Align Technology (California). For each clinician, four consecutive patients treated with CAT and manual stripping were selected for a total of 40 subjects and 80 dental arches. For each patient, the amount of planned IPR and the amount of actual IPR performed were recorded. Each arch was considered individually. For each arch, the mesiodistal tooth measurements were obtained from second to second premolars. Results: No systematic measurement errors were identified. In 25 cases, stripping was planned and performed in both arches; in 4 cases only in the upper arch and in the remaining 7 cases only in the lower arch. The difference between planned IPR and performed IPR was on average 0.55 mm (SD, 0.67; P = 0.022) in the upper arch and 0.82 mm (SD, 0.84; P = 0.026) in the lower arch. The accuracy of IPR in the upper arch was estimated to be 44.95% for the upper arch and 37.02% for the lower arch. Conclusion: Overall, this study showed that the amount of enamel removed in vivo did not correspond with the amount of IPR planned. In most cases, the performed IPR amount was lower than planned. When considering the actual amount in millimeter, these differences may not be considered clinically relevant.

Micro-Raman Spectroscopy is an efficient method for analyzing biological specimens due to its sensitivity to subtle chemical and structural changes. The aim of this study was to use micro-Raman spectroscopy to analyze chemical and structural changes in periodontal ligament after orthodontic force application and in gingival crevicular fluid in presence of periodontal disease. The biopsy of periodontal ligament samples of premolars extracted for orthodontic reasons and the gingival crevicular fluid samples collected by using absorbent paper cones; were analyzed by micro-Raman spectroscopy. Changes of the secondary protein structure related to different times of orthodontic force application were reported; whereas an increase of carotene was revealed in patients affected by periodontal inflammation.

Elderly women had a similar in-hospital outcome and better 1-year outcome compared with men. Coronary revascularization in women was associated with lower 1-year mortality, without an increase in severe bleeding. Elderly women with NSTEACS should always be considered for early revascularization.

Objective: To evaluate short-and long-term maxillary dental arch dimensional changes in patients treated with a transpalatal arch (TPA) during mixed dentition followed by full fixed appliances in the permanent dentition compared with an untreated sample. Materials and Methods: Dental casts and lateral cephalograms obtained from 36 consecutively treated patients before TPA treatment (T 0 ), after TPA treatment (T 1 ), after fixed appliance treatment (T 2 ), and a minimum of 3 years after fixed appliance treatment (T 3 ) were analyzed. The control group was matched as closely as possible. Arch widths, perimeter, and length, as well as crowding and incisor proclination, were evaluated. Results: In the treated group, intercanine, interpremolar, and intermolar widths and arch perimeter increased significantly at T 1 . At T 2 , only the intercanine width increase was still significant. At T 3 all arch dimensions decreased, remaining larger than they were at T 0 . The arch length increased after T 1 , significantly decreased at T 2 , and slightly decreased at T 3 . The crowding decreased significantly at T 1 , was eliminated at T 2 , and increased at T 3 . At T 3, 50% of the patients showed relapse with crowding ranging from 0.5 to 2 mm. In the control group at T1, only slight changes were noted but crowding increased. At T2, crowding and upper incisor inclination increased but arch length decreased. At T3, intercuspid width, arch perimeter, and arch length continued to decrease, thereby increasing crowding. Conclusion: Maxillary dental arch dimensions changed significantly after TPA followed by treatment with fixed appliances. Relapse occurred to some extent, especially in intercanine width and arch perimeter, but most of the dental arch changes remained stable. (Angle Orthod. 2015;85:683-689.)

Purpose To evaluate differences between orthodontists and general dentists in experience with clear aligners (CA), patients’ demand and perception, types of patients, and malocclusion treated with CA and to compare the two groups of clinicians not using CA in their practice. Methods A Web-based survey was developed and sent to the 129 members of the European Aligner Society and randomly to 200 doctors of dental surgery by e-mail. They responded on demographics and to one of two different parts for clinicians using CA or not using CA. Statistical analysis was performed with SAS EGv.6.1. Results The response rate was 74%. Among the total of respondents, the majority reported utilizing CA in their practice with a greater percentage of orthodontists ( P = 0.0040). Overall, orthodontists learned more about CA during academic seminars comparing to general dentists, and they treated more class I with crowding ( P = 0.0002) and with open bite ( P = 0.0462). The majority of patients treated with CA were female and adults with a full-time employment, and the patients’ knowledge about CA treatment was mainly provided by information from external media advertising. For respondents not using CA, orthodontists were more likely to report that CA limit treatment outcomes, whereas general practitioners were reported not having enough experience to use them. Conclusions There were some significant differences between orthodontists and general dentists mainly in experience and case selection for clinicians using CA as well as in the reasons provided for not using CA in their practice. Electronic supplementary material The online version of this article (10.1186/s40510-019-0263-3) contains supplementary material, which is available to authorized users.