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The symptom of facial pain is one of the most common reasons for referral to a dental centre or an oralmaxillofacial treatment centre. Orofacial pain is a common symptom with many causes. However, oro-facialpain is rarely the only symptom of Chiari type 1 malformation (CM1), a disease characterized by an anatomicaldefect at the base of the skull where the cerebellum and the spinal cord herniate through the foramenmagnum into the cervical spinal canal. Approximately 20% of patients with CM1 may also experience facialhypesthesia, trigeminal or glossopharyngeal neuralgia, paralysis of the vocal cords, soft palate weakness. Inthe literature, proposed mechanisms to explain the trigeminal neuralgia and CM1 correlation are vascularcompression at the nerve root entry zone, which could be affected by hydrocephalus or anatomic factorsrelated to the CM1, demyelination, micro-ischemic changes and direct brainstem compression. However,further investigation on the mechanisms involved in orofacial pain in patients with CM1 is needed.
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The pandemic of coronavirus disease (COVID-19) resulted in an unprecedented global public healthcrisis and impacted all spheres of life, including all economic activity, travel, governance, education, surgeryand, of course, healthcare. Neurosurgery, dentistry, and maxillofacial surgery are also not spared. Surgeonsoperating near the aerodigestive tract are at particularly high risk of being infected, and consequently,they shifted their practices toward more protective personal protective equipment. In the present digitalera, surgeons use more and more web, teleconsulting, and virtual reality to effectively communicate withpatients and their relatives on treatment strategies and appointments for surgical works. The COVID-19situation also provides a novel opportunity to learn, update our knowledge, and update ourselves such thatwe continue to save lives. In conclusion, it seems appropriate to request that every healthcare institutionreceives well-researched and documented protocols for dealing with future inevitable global pandemics.
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Multidisciplinary care has been shown to improve patient outcomes, and interprofessionalcollaboration has been shown to improve one’s medical knowledge. Multidisciplinary interventionsin the field of surgery are designed to address a specific problem occurring in a particularpatient population and/or within the context of an individual hospital system. The importanceof multidisciplinarity and interdisciplinarity at all levels, including clinical oncology, craniofacialtrauma, and brain abscess caused by dental peri-implantitis, is well established. The challengefor future research is to further develop and validate medical team performance assessmentinstruments; this will help improve medical and surgical team training efforts and aid the designof clinical work systems supporting effective teamwork and safe patient care.
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Recent biotechnological advances, including three-dimensional microscopy and endoscopy, virtualreality, surgical simulation, surgical robotics, and advanced neuroimaging, have moulded the surgeoncomputerrelationship. For developing neurosurgeons and maxillofacial surgeons, such tools can reducethe learning curve, improve conceptual understanding of complex anatomy, and enhance visuospatialskills. However, current clinical trials in dental virtual reality must still be experimental.
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Genetic and environmental factors influence craniofacial growth. The presence of bad habits such as fingeror pacifier sucking, atypical swallowing, oral breathing, nail-biting and abnormal postures play an essential rolein developing malocclusions. The severity and type of malocclusion are related to the age of the patient and thefrequency, duration and intensity of the spoiled habit. The most common malocclusions are: posterior crossbite,transverse contraction of the palate, anterior open bite, and augmented overjet. Eliminating oral habits withan interceptive functional treatment allows for restoring the correct development of the bone bases and normalocclusion. Elastodontic devices represent a valid tool to correct neuromuscular dysfunctions and re-educaterespiratory, swallowing, speech and masticatory functions, performing a functional, orthopaedic action.
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Operating microscopes, navigation systems and intraoperative neurophysiological monitoring areessential in modern neurosurgical and maxillofacial procedures. Advances in surgical planning inneurosurgery and maxillofacial surgery led to the more common navigation system that helps surgeonsknow more information and ultimately do more for their patients. The benefits of a contemporarynavigation system in the complicated brain, skull-base, maxillofacial and spine surgery are undeniable.Workflow analyses and cost-benefit evaluations must be carried out to increase the efficiency of neuronavigationsystems in the next future.
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Functional breastfeeding plays a key role in the correct psychophysical and neuromotor development ofa child, and it has repercussions on craniofacial complex growth and functioning. The consequences of notbreastfeeding seem to have not only aesthetic complications but can cause significant functional orthodonticrepercussions. Each study on breastfeeding has shown how breast milk protects against acute otitis media,pneumonia, syncytial virus, bronchitis, asthma, gastroenteritis, Sudden Infant Death Syndrome (SIDS),leukaemia, obesity, allergies and even constitutes a protective factor against habitual infant snoring and inreduction of the risk of obstructive apnea. By exercising his muscles, the child strengthens his zygomaticprocesses so that nasal airways have good drainage capacity and consequently a low predisposition tosinus and respiratory infections. Dentists have a fundamental role in the prevention of maternal-infantoral health, and by assisting its management, they can even implement the best development of a child’simmune system. The “primary” function of the dentist which is concretized in encouraging the planning ofthe first early visits of the interception of spoiled habits and incorrect lifestyles, together with the “internal”one of the intestinal and oral microbiota of the child together with breastfeeding have an indirect yetsignificant consequence of favoring the harmonic growth of the orofacial complex.
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SARS-CoV-2 infection can cause long-standing damage to the immune system characterized by increasedinflammatory cytokine activation. Maintaining periodontal health may reduce host susceptibility to COVID-19and prevent COVID-19 aggravation in infected patients. There is sufficient evidence in the literature towarrant an association between the presence of PDs and the development and course of respiratory illnesses.Optimum oral health, maintaining good systemic health, and elimination of smoking habits may be beneficialfor the prevention and management of COVID-19 infections. Future studies on the periodontal status ofpatients with COVID-19, including from mild to severe forms, could allow the opportune identification ofpeople at risk of severe illness and generate relevant recommendations. The connection, if any, betweenthe oral microbiome and COVID-19 complications is urgently required to establish the importance of oralhygiene and pre-existing oral disease in the severity and mortality risk of COVID-19.
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AIM: Chemical exogen acids effect can be considered in terms of the loss of hard tissue of teeth or potentialloss. When the remineralization does not antagonize the demineralization, the dissolution of hard tissuesarises. Significant among physical processes is degeneration in enamel structure due to the chemical processesof acidification and alkalinization. There are also several underlying determinants of enamel erosion. Theenamel erosion induced by chemical exogen acids causes the dissolution of the hard tissues of teeth. The aimof this study was to analyze the erosive effect of three different soft drinks on the enamel surface and thepotential remineralizing effect after applying casein phosphopeptide-amorphic calcium phosphate.MATERIALS AND METHODS: Fifteen human third molar teeth specimens were analyzed to assessthe effects of the topical cream containing 10% w/w casein phosphopeptide-amorphic calcium phosphate(CPP-ACP) nanocomplexes on enamel teeth lesions. Morphological characterization of teeth was performedusing Environmental Scanning Electron Microscope (ESEM). In addition, the surface of specimens wasexamined before and after immersion into three recipients containing three different soft drinks and after theremineralization process for comparison.RESULTS: Environmental Scanning Electron Microscopy analysis showed enamel morphology alterationsafter acidic soft drink exposure and superficially repair of teeth enamel after remineralizing treatment.CONCLUSION: This in vitro study demonstrated that the casein phosphopeptide-amorphic calciumphosphate treatment was effective in remineralizing demineralized subsurface lesion enamel in vitro afterhaving caused alterations by exogen acids.
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AIM: Periodontitis is one of the most common inflammatory and infectious diseases, significantly associatedwith circulating levels of oxidative stress biomarkers. A network of interacting molecular pathways comprisingproinflammatory mediators and reactive oxygen species (ROS) are involved in the progression of periodontitis. Theaim of the trial was to determine the effects of intensive periodontal treatment on the salivary levels of oxidativestress in patients with moderate periodontitis.MATERIALS AND METHODS: A randomized, one-blinded, controlled clinical trial was conducted with 3months of follow-up. A total of 58 patients were included in the study and randomized to receive intensive periodontaltreatment (Group Test) or conventional adult prophylaxis (Group Control). Salivary samples for determination oftotal antioxidant status (TAS), total oxidant status (TOS), nitric oxide (NO), myeloperoxidase (MPO), glutathione(GSH), malondialdehyde (MDA) levels, and 8-hydroxy-2’deoxyguanosine (X8-OHdG) concentrations werecollected from each patient prior to the periodontal treatment and at 3 months after the therapy.RESULTS: A significantly decreased NO, and MDA levels were registered in the Test Group compared to theControl Group (p<.0001), and the concentration of GSH was found to be significantly increased in the test groupcompared to the control group.CONCLUSION: Intensive periodontal treatment mitigates salivary oxidative stress in patients with moderateperiodontitis.
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Many studies supported the clinical, anatomical and functional relationship between the cranial region, the temporomandibular joint (TMJ) and the cervical spine; however, the mechanism of this relationship remains unclear, and the relation between temporomandibular disorders (TMDs) and the head and neck posture changes are still controversial. The understanding of the complex interrelations between the stomatognathic system, cervical spine, pain and dysfunctions in other areas of the body is useful in order to be able to treat patients more efficiently and effectively at the initial stage, when painful symptoms appear, and to cure them much swifter and in a more efficient way. On the other hand, the increased severity of temporomandibular disorders also could lead to a compensatory or antalgic posture of the neck. The function of the masticatory system should be evaluated in patients with neck complaints to rule out the possible involvement of the masticatory system. In addition, to be able to make successful therapeutic interventions, dental surgeons should cooperate in an interdisciplinary fashion with neurologists, orthopedists or neurosurgeons.
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In recent years, chewing has been discussed as producing effects of maintaining and sustaining cognitiveperformance. It is reported that mastication improves cognitive function by activating cerebral corticalactivity, and it is important to demonstrate the cognitive effects of masticatory training using variousinterventions. Recent studies emphasized that chewing gum can attenuate reductions in alertness, suggestingthat chewing gum enhances worker performance. Several mechanisms have been proposed to account for thefacilitation in performance observed when the gum is chewed during cognitive testing. Chewing gum duringexposure to stress decreases plasma and salivary cortisol levels and reduces mental stress, although otherstudies report no such effect. In addition, chewing reduces stress-induced changes in central nervous systemmorphology, especially in the hippocampus and hypothalamus. However, further research on the alertingeffects of chewing gum and possible improved test performance in these situations is needed.
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AIM: The aim of the study is to evaluate the efficacy of electric or sonic toothbrushes onperiodontal inflammation.MATERIALS AND METHODS: A randomized, controlled, one-blind study was conducted. Patients inthe test group used sonic toothbrushes (Sonicare FlexCare with ProResults brush head, HX6011, PhilipsOral Healthcare Inc, Bothell, Wash), whereas those in the control group used electric toothbrushes(Oral B Professional Care Triumph 4000, Procter &recorded at baseline and 3 months. In total, 60 patients were recruited for the study at baseline. PlaqueIndex (PI) and Loe and Silness Gingival Index (GI) were used. Student’s t- test repeated was used tocompare the mean PI and GI scores obtained between the test and control groups at each time point.RESULTS: In total, 56 subjects completed the study. Significant differences were recordedbetween the two groups for periodontal parameters at 3 months. In addition, the indices of groupSonic were significantly reduced at 3 months compared to the Roto-oscillatory Group (P < .005).
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Several studies reported the association between periodontal diseases, a persistent inflammatory processand other chronic ailments such as cardiovascular diseases, diabetes mellitus, Alzheimer’s disease andcancer. Although many epidemiologic data support these associations, a cause-and-effect relationship hasnot been established. Numerous articles reporting oral bacteria in samples collected directly from brainabscesses confirmed the association between brain abscess and odontogenic infection. Dental diseases canbe treated with ambulatory care rather than hospitalization and emergency care. Older adults shouldestablish daily oral hygiene care routines during the early stages of Alzheimer’s disease.
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The potential risk of pressure changes during commercial air travel causing the expansion of trappedintracranial air in post-operative patients is known. Current studies reveal that it is safe for patientswith space-occupying brain lesions to fly various distances. Nevertheless, in patients with pre-flightsymptoms thought to be due to mass effect or cerebral oedema, the administration of dexamethasone andanticonvulsants may help minimize the risk of further brain swelling and possible seizures during air flight.Besides other oral manifestations of barometric pressure changes, such as barodontalgia, cliniciansshould be familiar with this entity, take preventive measures, and periodically examine patients who flyplanes. Clinicians should also search for occult pathologies such as leaking restorations or secondarycaries lesions. Nevertheless, pneumocephalus is not a contraindication to early post-operative flying. Moresignificant, prospective, multi-institutional studies will be necessary to validate these recent results.
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BACKGROUND: This study evaluated retrospectively the outcomes of immediately restored singlepost-extractive implants over a period of 8–10 years. The clinical records of 62 consecutive patients (meanage 53.2 years; range 40-77 years), rehabilitated with single implants placed in fresh extraction sockets (40maxillary/22 mandibular) were analyzed. All implants were functionalized using an immediate protocol.Outcome measures were implant failure, peri-implant radiographic bone level changes, peri-implantmucosa conditions and gingival aesthetics.RESULTS: The final follow-up interval was 9.1 years (range 8-10.6 years). Three implants (4.8% oftotal) failed, one implant in mandible and two implants in maxilla. No difference in implant failures wasregistered between maxillary and mandibular implants (p=0.967). Mean marginal bone levels at implantplacement and at the last follow up were 0.02±0.04 mm and 1.23±0.43 mm, respectively. Mean marginalbone remodeling averaged 1.21±0.52 mm. Peri-implant mucosa was healthy for the most (98.3%) ofimplants. At 10 years, patients had mesial and distal papilla index scores of 2 or 3 for 84.8% and 81.4% ofimplants, respectively.CONCLUSION: The results of this retrospective long-term study proved excellent survival rate ofimmediately restored single post-extractive implants as well as favorable marginal bone response and softtissue conditions.
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The aim of this retrospective study was to report the mid-term outcome (3 years) of standard implantswith 20 to 24 mm of length in immediate function with bicortical anchorage for prosthetic rehabilitationof complete edentulous jaws with low-density bone. To this end, clinical, instrumental and 3-year outcomedata of 27 patients with complete edentulous arches and low bone density treated with long implants wereinvestigated. Follow-up examinations were performed at 10 days, 2, 4, 6 months, 1 year, 2 years, and 3years after implant placement. Marginal bone was evaluated at baseline (before surgery) and after 1, 2,and 3 years. The survival of the prosthesis was evaluated in terms of function. A prosthesis that needed tobe substituted was considered a failure. A 100% survival rate was observed. All prostheses were in functionduring the follow-up period. No patient was lost during the follow-up. Regarding the short implants, theaverage marginal bone remodelling was 0.09 ± 0.21 at the baseline time point, 0.71 ± 0.32 after 1 year and1.48 ± 0.28 at 3-year follow-up. Similarly, a constant and significant increased average marginal bonewas observed at the sites of long implants. In conclusion, the data reported improved evidence about theclinical success of using long implants (≥20 mm) in immediate function with bicortical anchorage to treatpatients with low bone density and partial or complete edentulous fixed prosthetic rehabilitation.Corresponding author:
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COVID19 is characterized by alteration of smell and taste perception. It was investigated the presence ofalteration for cold, heat, and food consistency perception in COVID-19 patients and the possible correlationwith the most commonly used biomarkers in a routine way (CRP, IL-6, IL-1, PSP, PCT) to show if the localinflammatory process may induce alteration of cold, heat, and food consistency perception in COVID-19.From March 2020 to April 2021, a survey about taste and oral tactile/thermal sensitivity dysfunction wascarried out on 1155 patients with mild or moderate COVID-19, while patients admitted to intensive care wereexcluded because they could not answer questions from health professionals. Positive RT-PCR confirmedall diagnoses. CRP, IL-6, IL-1, PSP, and PCT were detected for each patient. Taste and Smell QuestionnaireSection of the US NHANES 2011−2014 protocol (CDC 2013b) was used for gustatory function assessment.The study was approved by the Ethics committee of AOU Policlinico Consorziale di Bari (No. 6388 COVID19DOM - protocol number 0034687/12-05-2020), and written informed consent was obtained.A total of 208 patients referred only to alteration to taste (208/821). 75/208 ageusia, 71/208 ipoageusia,21/208 fantageusia, 19/208 dysgeusia, 22/208 parageusia. Significant correlations between CRP, IL-6, IL-1,PSP, PCT levels and type of dysfunctions about the perception of heat, cold and food consistency have notbeen found (P>0.05). Loss of taste can be due to the action of inflammatory mediators on gustatory buds,while alteration of cold, heat and food consistency perception may be due to direct damage of filiformpapillae, allowing virus binding through the spike protein to ACE2 receptors of filiform papillae cells.
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There are mainly three approaches by which teeth whitening treatments can be carried out: in-office,at-home and via over-the-counter (OTC) products. There are conflicting opinions in the literature on whichtreatments are most effective and stable over time, and on which ones give greater dental sensitivity duringthe whitening treatment, this being the main adverse effect of the treatment. The objective of this reviewwas to evaluate the efficacy of post-treatment whitening (primary outcome), its stability after several weeks(secondary outcome) and the prevalence of dental sensitivity (tertiary outcome) in patients undergoingwhitening treatment, in order to evaluate which is the most effective and safest whitening approach forpatients. The following systematic review was conducted on the basis of the indications of the Prisma protocol;10 studies were identified through literature searches on the PubMed database. The various procedures relatedto the studies included in this review have shown that they can produce satisfactory post-treatmentwhitening efficacy and, albeit with less data available, also in the long term; furthermore, dental sensitivity ispresent in the first days of application, and tends to disappear after a few days, and its intensity is generallymild to moderate for all the whitening techniques tested. For a better evaluation of the stability over time withthe different techniques, it could also be useful to check the eating habits of the patients since the diet couldbe an important factor that influences the extrinsic staining of the teeth; it is necessary to undertake furtherresearch into desensitizing protocols that can further improve patient comfort.
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Salivary gland neoplasms represent less than 4% of all head and neck lesions, being 80% in theparotid gland and usually benign. Imaging plays a key role in the evaluation of parotid gland masses.Ultrasound is cheap, with an excellent resolution and a safe real time assessment making it an ideal firstevaluation option. Conversely, MRI is considered a second-line pre-surgery exam used to determine thelocation, the extension and the signal features of a parotid lesion. Both US and MRI are poorly reliablefor predicting histology, therefore a fine-needle aspiration cytology (FNAC) is usually needed.In our retrospective study, we examined 263 patients with parotid diseases and a FNAC positive for abenign neoplasm, who underwent surgery between 2010 and 2020, in the departments of Otorhinolaryngologyand Maxillofacial surgery in Verona. We compared a group of 126 patients preoperatively evaluated withultrasound and a control group of 137 patients studied through third level imaging (usually MRI).In our case series, both third level imaging and US were used in equal measure, despite the lesion size.We found the recurrence rate to be almost the same between the two diagnostic methods and we sawthat the patients studied through third level preoperative imaging had a higher complication rate and aworse facial nerve outcome.In our opinion, for patients with a FNAC positive for benign lesion the exclusive use of ultrasoundimaging provides enough information to study the neoplasm while allowing for a faster and cheaperpreoperative evaluation.
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Implant surgery was born as freehand surgery, and most protocols are still based on this way of operatingtoday. However, one of the most important trends in the implant field today is represented by guidedsurgery. There are different types of surgical guides on the market, differing in construction, materialsand characteristics. This work aims to evaluate guided surgery using the B&B Dental surgical guide tounderstand whether it can increase the accuracy and precision of implant insertion. In order to carry outthis multicenter study, each operator was assigned 15 implants to be inserted and distributed to differentpatients. In total, 6 patients were enrolled who in the first phase underwent a pre-operative CBTC (conebeam computed tomography) to then be identified for privacy reasons through a patient ID. In total, 9B&B Dental implants were placed on a number of 6 enrolled patients. 3 implants were placed in the upperarch and the remaining 6 in the lower arch. On 3 patients a single implant was inserted instead on theremaining 3, during the surgical treatment 2 implants were inserted for specific arch of interest. Analyzingthe data published in other works of the literature, it is possible to affirm that the surgical technique withthe B&B Dental protocol proposed by us is currently a valid alternative that deserves a particular interestin development and application.
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Background: Chronic obstruction of the nasolacrimal duct leads to inflammation or infection of thelacrimal sac (dacryocystitis). The aim of this study was to evaluate the clinical outcomes of piezosurgerydevice vs high-speed electric drill with a diamond burr for dacryocystorhinostomies (DCR) in patientswith external dacryocystitis.Patients and Methods: Two patient with nasolacrimal duct obstruction was recruited for the study.All procedures were performed by a maxillo-facial surgeon and an ophthalmologist. The follow-uplength was 12 months.Results: Two patients, with average age of 53.2 years old, underwent to piezosurgery device vshigh speed bur for DCR. After one year from surgery, resolution of symptoms was observed. Surgicaloutcomes showed for both patients, complete resolution of the disease.Conclusions: The authors’ results, in accordance with the literature data, indicate that piezosurgerydacryocystorhinostomy is a promising surgical technique, both in terms of results and postoperativepatient’s quality life.
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Aims: The aim of this study was to evaluate the association between the facial asymmetry and the AlteredHead Position (AHP), in four patients affected by torticollis (TC).Methods and results: Three patients with diagnosis of ocular TC (OTC) and one patient with diagnosisof congenital muscular TC (MTC), aged between 6 and 15 years, were referred to University of Foggia.All patients underwent a detailed diagnostic check-up based on the collection of the following diagnosticrecords: anamnestic data; extra-oral and intra-oral clinical examination; panoramic radiograph, latero-lateral and postero-anterior teleradiographs with their cephalograms; posture-stabilometric examination;electromyographic screening. Clinically, each patient showed facial asymmetry, although in the OTCpatients the head resulted deviated to the contralateral side of the affected eye, while in the MTC patient itwas deviated to the ipsilateral side of the affected muscle. Moreover, a decreased growth of the hemimandibleon the ipsilateral side to the head deviation was found in all patients, with the prevalent involvement ofthe mandibular body. Functionally, an asymmetric jaw muscular activation was also found in all patients,both at rest and during function, as confirmed by electromyographic results.Conclusion: The clinical, radiographic and electromyographic findings of the present paper confirmedthe influence of the AHP on the development of facial asymmetry, in patients with TC.
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Aim: The aim of this study was to evaluate the Relationship between volumetric assessment of unilateralcleft lip and palate (UCLP) with age in subjects using computed tomography.Materials and methods: This retrospective study consisted of CBCT scans of 96 non-syndromic UCLPpatients 52 boys and 44 girls between 7 to 15 years old. The patients with the following criteria wereexcluded from the study: previous orthodontic treatment, alveolar grafting, orthognathic surgery, trauma,syndromes, history of tonsillectomy, and adenoidectomy. Patients were classified into 4 groups accordingto their age with approximately equal samples. Materialize Mimics innovation suite 20 software (Leuven,Belgium) was used to measure the maximum diameter of defect in the axial, coronal, sagittal plane in mm,bone defect volume in mm3, and also nasal floor deficiency area, alveolar deficiency area in mm2. KruskalWallis test was used to analyze the data.Results: The Maximum diameter of cleft in the sagittal aspect was 39.2±24.6 mm in the 7 till 8 age groupand 26.1±10.9 mm in the 13 till 15 years old age group in both genders. There was a reverse significantrelationship between age and the maximum diameter of cleft P<0001. There was not any significant relationbetween defect volume and age.Conclusions: There was not any significant relation between defect volume and age. However, CBCTimaging can be used to assess the volume of the clefts and thus evaluate the amount of bone necessary torepair the cleft area for each age.
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Elastodontics is a specific orthodontic treatment that uses removable elastomeric appliances. They arefunctional appliances that produce neuromuscular, orthopedic, and dental effects. Thus, these devices areuseful in the developmental age, when skeletal structures are characterized by important plasticity andadaptation capacity, allowing to remove factors responsible for malocclusions. Elastomeric devices aregenerally well tolerated by patients requiring simple collaboration and management. Neuromuscular anddental effects can perhaps be obtained, with these devices, even in adults. The authors present a case reportof elastodontic myofunctional treatment in an adult case. The patient improved functionally and evenaesthetically, solving the mostly recessions too, with a significant improvement of the aesthetic outcomes.* Corresponding
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Aim: This retrospective research was aimed to evaluate the impact of coronavirus disease 2019(COVID-19) on orthodontic emergencies and Patients’ perceptions of orthodontic patients.Material and Methods: A total of 204 patients were gathered who were not seen for nearly 5 monthsfrom the first of March 2020 to the end of July 2020 due to dental clinic closure. The mean age of thesamples was 20.2 (SD = 12.5) years consisting of 134 females (66%) and 70 males (34%). All patients hadundergone active orthodontic treatment with fixed and removable appliances before the pandemic. Thesurvey included demographics, types of orthodontic emergencies, and Patients’ perceptions of orthodontictreatment during the closure of the dental clinic. Continuous variables were analyzed by mean and standarddeviation, while categorical variables were analyzed by frequency and percentage.Results: In general, 46.5% of the patients suffered from various emergencies. The incidence ofemergencies was approximately 3 times higher than that of the normal appointment times. Debonding andpoking wire had the most frequently reported classification respectively (14.2%) (7.9%). 30.4% of patientsstated that pandemic had a significant impact on the efficacy of orthodontic treatment.Conclusions: This study showed that the COVID-19 pandemic had a negative impact on patient care due to a higher number of emergencies and in turns, it delayed the therapeutic progress of patients. 16% ofpatients with active orthodontic appliances did not continue their treatment due to pandemics. More thanhalf of the patients were willing to be seen every 8 weeks.
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There is a significant paucity of literature regarding dental prophylaxis in spine surgery patients. Apoint of controversy has remained the question of antimicrobial prophylaxis for patients with a history ofneurosurgical procedures and spinal instrumentation undergoing invasive procedures on an outpatientbasis. Invasive dental procedure does not increase the risk of postoperative spinal infection and antibioticprophylaxis before dental procedure was not effective in preventing spinal infection.
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There has long been discussion regarding the positive effects of physical exercise on brain activity.Exercising is used as a non-pharmacological treatment in many chronic diseases. Exercise has beenshown to have beneficial effects on brain functions in humans and animals and, therefore, exercise isvery important for brain rehabilitation and remodeling. Several studies have shown the beneficial effectsof aerobic and resistance exercises in adult and geriatric populations. In addition, physical activity mayimprove self-esteem and feelings of self-worth in young adults.
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OBJECTIVES: Prediction of soft tissue changes following orthogenetic surgery has always beenchallenging for orthodontists and surgeons. There is a plethora of literature on the subject of soft tissuechanges associated with orthogenetic surgery, but it has remained as a matter of controversial. The aimof this study was to evaluate soft and hard tissue changes in vertical and anterior posterior dimensionfollowing Lefort I surgery.METHODS AND MATERIALS: 15 patients (12 females and 3 males) having Cl II Div 1 malocclusionwith open bite more than 4 mm were selected. Following the arch coordination and arch decompensation,patients underwent Lefort 1 surgery. Preoperatively, the study casts, panoramic view, and lateralcephalometry were prepared.RESULTS: The angle of Go.GN/S.N and Y axis followed a significant reduction trend after the surgeryfrom 41/4 ± 7/3° to 34/4 ± 7/8° (P0/001) and from 69/4 ± 3/8 ° to 66/1 ± 4/6° (P<0/009), respectively. Inthe vertical dimension (related to the Y axis), the following parameters reduced significantly after theorthognathic surgery: L1, B, Pog, Me, PNS. Whereas, in the anterior – posterior dimension (related to theX axis), only the interval of the tip of the mesiobuccal cusp of the maxillary first molar in relative of the Xaxis modified in significant way (P<0/01).CONCLUSION: In posterior impaction of maxilla, the anterior facial height was significantly reducedand hard and soft tissue cephalometric landmarks of the mandible reduced in the vertical dimension.Lower lip length significantly reduced. Upper lip length and protrusion changed postoperatively but it wasnot statistically significant.
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Technological advances in neurosurgery and maxillofacial surgery, aided by improvements inanesthesia have resulted in surgery that is faster, simpler and safer with excellent perioperative recovery.As a result of improved outcomes, several centers are performing certain neurosurgical procedures onan outpatient basis; where patients arrive at the hospital the morning of their procedure and leave thehospital the same evening, thus avoiding an overnight stay in the hospital. Future efforts to encourageefficient cost savings should focus on practice patterns/pathways for similar conditions rather thanlimiting the use of certain implants.
