Diagnostic ability of the primary second molar crown‐to‐root length ratio and the corresponding underlying premolar position in estimating future expander anchoring teeth exfoliation

Abstract

Objectives The aim was to assess the diagnostic ability of the crown‐to‐root length ratio of the primary second molar and the position of the corresponding underlying premolar in estimating future anchoring teeth exfoliation during maxillary expansion. Setting and Sample Population Fifty‐four subjects (30 females, 24 males; 108 teeth) aged 8.2 ± 1.0 years that underwent palatal expansion. Methods The upper second premolar position of the corresponding expander anchoring primary molar was determined in relation to the ipsilateral first permanent molar half‐pulp chamber (HPC) line on panoramic radiographs. Subjective and objective (based on measurements) assessments of the crown‐to‐root length ratio of anchoring primary molars were performed. Exfoliation after the expansion was recorded over a retention period of 12 months. All the assessments were performed individually by three examiners at two 3‐week‐apart sessions, trained and calibrated before enrolment. The intra‐/inter‐examiner agreements were evaluated, and the diagnostic accuracy of the methods was calculated. Results All methods exhibited almost perfect intra‐ and at least substantial inter‐examiner agreement (Kappa >0.8 and ≥0.63, respectively). Good diagnostic accuracy was seen for the premolar position to the HPC line (0.7‐0.8), while the crown‐to‐root length ratio methods exhibited hardly sufficient accuracy. The diagnostic agreement of the methods was fair. Conclusions When primary molars are considered as anchoring teeth for maxillary expansion, the premolar position in relation to the HPC line appears to be the most valid and reliable method for predicting their stability. Despite high repeatability values, the crown‐to‐root length ratio needs a cut‐off point re‐definition to increase its predicting ability.

CBCT Analysis of Dento-Skeletal Changes after Rapid versus Slow Maxillary Expansion on Deciduous Teeth: A Randomized Clinical Trial

“…The protocol for this randomized clinical trial was reviewed and approved by the Ethical Committee of the University of Milan (protocol number ROS18/02) and the following procedures adhered to the World Medical Organization Declaration of Helsinki. The sample was selected according to the following inclusion criteria: (I) early mixed dentition; (II) first permanent molars erupted and non-mobile maxillary deciduous second molars in accordance with the radiographic method purposed by Primozic et al, [ 14 ]; (III) skeletal class I or II; (IV) maxillary transverse discrepancy with or without posterior crossbite evaluated by CBCT measurements of transversal dimension of basal bone at the level of upper and lower first permanent molars. Exclusion criteria were: (I) craniofacial anomalies; (II) noticeable asymmetries; (III) previous orthodontic treatment; (IV) skeletal class III.…”

The interaction between gut microbiome and bone health

“…Genomic variations, especially those per-tinting to immune-related genes, play a pivotal role in shaping an individual's response to viral infections. The genetic makeup of hosts significantly influences disease progression, and understanding these genetic nuances is paramount for personalized medicine approaches in managing COVID-19 [53][54][55][56][57][58][59][60][61][62][63]. Key interleukin genes, including interleukin (IL)1b, IL1RN, IL6, IL6R, IL10, interferon gamma (IFNg), tumor necrosis factor alpha (TNFa), Angiotensin-converting enzyme 2, Serine protease inhibitor 3, Vitamin D receptor, and Creactive protein, are integral to proinflammatory and immunomodulatory responses and are considered crucial in the progression and complications of COVID-19.…”

“…Neutrophils, T-killer cells, T-active cells, T-suppressor cells, and T-CD8 þ CD38 þ cells emerge as crucial actors in the immune response to COVID-19 and COVIDlike individuals. The intricate dance of immune cells, especially T-lymphocytes and B-lymphocytes, takes center stage in predicting the severity of COVID-19 and the potential efficacy of therapeutic interventions [63][64][65][66][67][68][69][70][71][72][73]. The systemic implications of COVID-19 are illuminated, particularly affecting the lungs, kidneys, and heart.…”