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OBJECTIVES: This investigation aimed to assess the optimal timing for lip repair in children with cleft lip and palate via 3D anthropometric analysis to evaluate their maxillofacial structures. METHODS: The sample comprised 252 digitized dental models, divided into groups according to the following timing of lip repair: G1 (n = 50): 3 months; G2 (n = 50): 5 and 6 months; G3 (n = 26): 8 and 10 months. Models were evaluated at two-time points: T1: before lip repair; T2: at 5 years of age. Linear measurements, area, and Atack index were analyzed. RESULTS: At T1, the intergroup analysis revealed that G1 had statistically significant lower means of I-C', I-C, C-C', and the sum of the segment areas compared to G2 (p = 0.0140, p = 0.0082, p = 0.0004, p < 0.0001, respectively). In addition, there was a statistically significant difference when comparing the cleft area between G2 and G3 (p = 0.0346). At T2, the intergroup analysis revealed that G1 presented a statistically significant mean I-C' compared to G3 (p = 0.0461). In the I-CC' length analysis, G1 and G3 showed higher means when compared to G2 (p = 0.0039). The I-T' measurement was statistically higher in G1 than in G2 (p = 0.0251). In the intergroup growth rate analysis, G1 and G2 showed statistically significant differences in the I-C' measurement compared to G3 (p = 0.0003). In the analysis of the Atack index, there was a statistically significant difference between G1 and the other sample sets (p < 0.0001). CONCLUSION: Children who underwent surgery later showed better results in terms of the growth and development of the dental arches.
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OBJECTIVE: This study analyzed the systemic and oral abnormalities in individuals with Kabuki syndrome (KS) that might be investigated to enhance the early diagnosis and treatment by a multidisciplinary team, minimizing the consequences to the individual's health. STUDY DESIGN: Clinical examination was conducted on 15 individuals to investigate orodental alterations such as tooth abnormalities and cleft lip and/or palate, and the patient records were also reviewed to investigate systemic diseases such as cardiopathies, infectious and immunologic diseases, nephropathies, and delayed neuropsychomotor development. RESULTS: All individuals with KS presented cleft lip and/or palate, 11 (73.34%) tooth abnormalities, 5 (33.34%) congenital cardiopathies, 12 (80%) infectious or immunologic diseases, 1 (6.67%) nephropathy, and 14 (93.34%) had an intellectual disability. CONCLUSION: Individuals with KS often have dental anomalies such as hypodontia, cleft or palate, and systemic disorders such as congenital heart disease and infectious diseases. Intellectual disability is present in most cases. These alterations should be investigated as early as possible to prevent the increase in morbidity in these individuals.
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Anomalías Múltiples , Cara/anomalías , Enfermedades Vestibulares , Humanos , Femenino , Masculino , Enfermedades Vestibulares/complicaciones , Niño , Preescolar , Adolescente , Anomalías Dentarias , Adulto , Discapacidad Intelectual/complicaciones , Lactante , Fisura del Paladar/complicaciones , Enfermedades Hematológicas/complicacionesRESUMEN
The objective of this systematic review was to identify the available scientific evidence on bone substitutes (BSs) compared with autogenous bone grafts (ABGs) for regeneration of horizontal bone resorption in the anterior maxillary alveolar process, aiming at rehabilitation with endosseous implants. This review was performed according to the PRISMA guidelines (2020) and registered in the database PROSPERO (CRD: 42017070574). The databases searched were PUBMED/MEDLINE, EMBASE, SCOPUS, SCIENCE DIRECT, WEB OF SCIENCE, and CENTRAL COCHRANE, in the English language. The Australian National Health and Medical Research Council (NHMRC) and Cochrane Risk of Bias Tool were used to assess the study's quality and risk of bias. A total of 524 papers were found. After the selection process, 6 studies were selected for review. A total of 182 patients were followed for a period of 6 to 48 months. The mean age of patients was 46.46 years, and 152 implants were installed in the anterior region. Two studies achieved a reduced graft and implant failure rate, whereas the remaining 4 studies had no losses. It may be concluded that the use of ABGs and some BSs is a viable alternative for the rehabilitation with implants in individuals with anterior horizontal bone loss. However, additional randomized controlled trials are warranted due to the limited number of papers.
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Aumento de la Cresta Alveolar , Sustitutos de Huesos , Implantes Dentales , Humanos , Persona de Mediana Edad , Sustitutos de Huesos/uso terapéutico , Australia , Implantación Dental Endoósea , Trasplante ÓseoRESUMEN
BACKGROUND: It is necessary to analyze and monitor the facial growth of orofacial cleft patients. The documentation should therefore begin before and after primary surgeries. Technological evolution has transformed plaster models into 3D images through scanners that allow rational storage, manipulation, and rotation without the possibility of breakage or damage. Based on this fact, this narrative review aims to provide a feature on the three-dimensional tools available for the assessment of dental arches in children with orofacial cleft and mixed dentition. MATERIAL AND METHODS: Three databases were chosen (PubMed, ScienceDirect, and Scopus) and keywords were used to select papers. RESULTS: During the database screening, 292 potentially relevant papers were found. After removing duplicates, titles, and abstracts, 32 papers presented qualifications for analysis. Through evaluating each document by reading it one by one, 24 papers fulfilled the eligibility criteria. CONCLUSIONS: It was concluded that digital tools-i.e., benchtop scanners which evaluate the dental arches of children with cleft lip, palate, and mixed dentition-are reproducible and reliable, without the use of ionizing radiation, allow storage, manipulation with sustainability, and help preserve the environment.
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STATEMENT OF PROBLEM: Reports on the impact of fixed partial denture treatments on the quality of life of patients with cleft lip and palate are lacking. PURPOSE: The purpose of this cross-sectional clinical study was to assess the impact of fixed partial dentures on the quality of life of adults with cleft lip and palate. MATERIAL AND METHODS: A total of 52 participants (23 women and 29 men) with cleft lip and palate, aged between 20 and 50 years old, and who required treatment with fixed partial dentures were enrolled in the study. They responded to the Oral Health Impact Profile (OHIP)-14 questionnaire before and 30 days after the fixed prosthodontic treatment. The final value from the OHIP-14 was generated by totaling the 14 answers, giving a range from 0 to 56, with higher values indicating a worse relationship between oral health and the quality of life. Nonparametric statistical analysis was performed with the Wilcoxon test (α=.05). RESULTS: Forty-six participants reported some negative experience before the fixed partial denture, and 48 indicated an improved quality of life 30 days after delivery. All domains assessed showed significant quality of life improvements between the periods compared (P≤.014). CONCLUSIONS: Oral treatment with fixed partial dentures improved the quality of life in adults with cleft lip and palate.
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OBJECTIVE: This study assessed the prevalence of orofacial dysfunctions (ODs) and quality of life (QoL) in adults with and without a cleft lip and palate. DESIGN: Cross sectional. SETTING: Craniofacial Center, Hospital for Rehabilitation of Craniofacial Anomalies, Bauru, São Paulo, Brazil. METHODS: The study was composed of a sample of 120 patients: 60 adults in the cleft lip and palate group (CLPG) and 60 adults in the control group with no craniofacial anomalies. Each patient underwent an interview and clinical examination, using the Nordic Orofacial Test-Screening (NOT-S) and the 36-Item Short Form Survey. Data were analyzed using Mann-Whitney U test, χ2, and the Spearman correlation coefficients. RESULTS: There was a higher prevalence of OD in CLPG (P < .001) on the NOT-S. The adults in the CLPG had higher QoL in the areas of general health (P = .003), physical function (P = .014), social function (P < .001), and vitality (P = .006). The CLPG had significant associations between higher OD and lower QoL for general health (P = .004), emotional role function (P = .028), and vitality (P = .05). CONCLUSION: Orofacial dysfunctions were more prevalent in adults with a cleft, negatively impacting their QoL in general health, emotional role function, and vitality. However, adults with a cleft also had significantly higher QoL, reflecting possible resiliency when compared to adults without a cleft.
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This retrospective observational study aimed to evaluate and identify the relapse rate after orthognathic surgery for maxillary advancement (Le Fort I maxillary osteotomy) in oral cleft patients through digitized cephalograms and 3D dental models, following 2 years. Lateral cephalograms and dental casts of 17 individuals, enrolled in Orthodontics Department in Hospital of Rehabilitation of Craniofacial Anomalies, were carried out. The digital cephalometric tracings were evaluated in: T1-before surgery, T2-immediate after surgery, T3-6-month to 1-year after surgery. The dental study casts were digitized and evaluated in: F1-before surgery; F2-3-month to 1-year after surgery; F3-1 to 2 years after surgery. The analyses of the dental arches were performed directly on the scanned images. A single examiner previously trained and calibrated performed all the assessments. Repeated measures ANOVA was applied to study the variables and compare the periods, followed by Tukey test to evaluate the statistically significant differences, with level of significance of 5%. The digital cephalogram results showed that the vertical movement statistically differed from T2 to T3 (p = 0.002). The right and left premolar relationship in digitized models revealed that at F2 the individuals exhibited » Class II and Class I, in 29.4 and 23.5% of the cases, respectively; and at F3, Class I, 58.8 and 70.6% of the cases, respectively. The cephalometry showed the relapse in the vertical movement after orthognathic surgery for maxillary advancement, but no relapse in the other evaluated parameters.
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Cefalometría , Fisura del Paladar/diagnóstico por imagen , Fisura del Paladar/cirugía , Osteotomía Le Fort , Adolescente , Adulto , Femenino , Estudios de Seguimiento , Humanos , Imagenología Tridimensional , Masculino , RecurrenciaRESUMEN
BACKGROUND: There are numerous methods to measure the dimensions of the gingival tissue, but few have compared the effectiveness of one method over another. OBJECTIVE: This study aimed to describe a new method and to estimate the validity of gingival biotype assessment with the aid of computed tomography scanning (CTS). MATERIALS AND METHODS: In each patient different methods of evaluation of the gingival thickness were used: transparency of periodontal probe, transgingival, photography, and a new method of CTS). Intrarater and interrater reliability considering the categorical classification of the gingival biotype were estimated with Cohen's kappa coefficient, intraclass correlation coefficient (ICC), and ANOVA (P < .05). The criterion validity of the CTS was determined using the transgingival method as the reference standard. Sensitivity and specificity values were computed along with theirs 95% CI. RESULTS: Twelve patients were subjected to assessment of their gingival thickness. The highest agreement was found between transgingival and CTS (86.1%). The comparison between the categorical classifications of CTS and the transgingival method (reference standard) showed high specificity (94.92%) and low sensitivity (53.85%) for definition of a thin biotype. CONCLUSION: The new method of CTS assessment to classify gingival tissue thickness can be considered reliable and clinically useful to diagnose thick biotype.
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Pesos y Medidas Corporales/instrumentación , Encía/anatomía & histología , Encía/diagnóstico por imagen , Adolescente , Adulto , Anciano , Brasil , Tomografía Computarizada de Haz Cónico/métodos , Femenino , Humanos , Incisivo , Masculino , Maxilar/anatomía & histología , Persona de Mediana Edad , Bolsa Periodontal , Periodoncia/instrumentación , Fotoiniciadores Dentales , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Estadísticas no Paramétricas , Alveolo Dental/anatomía & histología , Percepción Visual , Adulto JovenRESUMEN
BACKGROUND: The concern to restore and evaluate bilateral cleft lip and palate (BCLP) patients' quality of life, after rehabilitation, is an issue that has been discussed in the literature because it is the ultimate goal of any proposed treatment. OBJECTIVE: To evaluate the overall and oral quality of life of BCLP patients who had completed their treatment with orthognathic surgery (OrSg) compared to those who completed theirs with prosthetic rehabilitation in the form of overlay prosthesis (OP). MATERIALS AND METHODS: The study comprised 40 patients, 20 in OrSg group and 20 in OP group. Epidemiological survey and application of two questionnaires (World Health Organization Quality of Life-brief [WHOQOL-bref] and Oral Health Impact Profile-14 [OHIP-14]) were done. The final results were evaluated statistically by the Mann-Whitney test. RESULTS: Regarding the comparison with the WHOQOL-bref, no significant statistical differences between groups were found. In the analysis of the OHIP-14, only in "psychological limitation" field difference could be observed, where OrSg group showed more negative impact when compared to the OP group. CONCLUSION: Both rehabilitations provide a satisfactory quality of life for patients.
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BACKGROUND: The prosthetic treatment in cleft patients is challenging. Based on this, the aim of this study was to evaluate the longevity of prosthetic rehabilitation treatment with implant-supported overdenture (IOD) and implant-supported fixed denture (IFD) in cleft lip and palate patients in a period of 22 years. MATERIALS AND METHODS: The medical records of 72 patients were analyzed (29 males and 43 females), and the survival rate of the implants was evaluated. Moreover, the prostheses' time of use and the reason for the changing of these were also evaluated. RESULTS: Four-hundred-seventeen implants were installed, and 370 implants survive today. The mean survival time of the implants was 7.6 years. Regarding the 97 prostheses made, the time of average use was 3.28 for the IFDs and 3.92 for IODs. The reasons for the replacements of the prostheses were mainly: fracture of the acrylic base (29.6%) and loss of vertical dimension of occlusion (VDO) (18.5%) in the IFDs. Moreover, in IODs, these were accounted for the loss of VDO due to teeth damage (17.2%) and implant loss (14.6%). CONCLUSIONS: The maintenance of the prostheses was challenging because the patients had difficulties returning for periodic control, but this fact did not result in the decrease of the success rate of the implants. The longevity of implants and prostheses was satisfactory; however, the prostheses showed repetitions mainly due to the wear of the teeth, with decreased vertical dimension and fracture of acrylic base.
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OBJECTIVES: The purpose of this study was to evaluate the influence of thermal and mechanical cycling and veneering technique on the shear bond strength of Y-TZP (yttrium oxide partially stabilized tetragonal zirconia polycrystal) core-veneer interfaces. MATERIALS AND METHODS: Cylindrical Y-TZP specimens were veneered either by layering (n=20) or by pressing technique (n=20). A metal ceramic group (CoCr) was used as control (n=20). Ten specimens for each group were thermal and mechanical cycled and then all samples were subjected to shear bond strength in a universal testing machine with a 0.5mm/min crosshead speed. Mean shear bond strength (MPa) was analysed with a 2-way analysis of variance and Tukey's test (p<0.05). Failure mode was determined using stereomicroscopy and scanning electron microscopy (SEM). RESULTS: Thermal and mechanical cycling had no influence on the shear bond strength for all groups. The CoCr group presented the highest bond strength value (p<0.05) (34.72 ± 7.05 MPa). There was no significant difference between Y-TZP veneered by layering (22.46 ± 2.08 MPa) or pressing (23.58 ± 2.1 MPa) technique. Failure modes were predominantly adhesive for CoCr group, and cohesive within veneer for Y-TZP groups. CONCLUSIONS: Thermal and mechanical cycling, as well as the veneering technique does not affect Y-TZP core-veneer bond strength. CLINICAL SIGNIFICANCE: Different methods of veneering Y-TZP restorations would not influence the clinical performance of the core/veneer interfaces.
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Recubrimiento Dental Adhesivo , Porcelana Dental , Restauración Dental Permanente/métodos , Coronas con Frente Estético , Itrio , Circonio , Análisis de Varianza , Cerámica , Aleaciones de Cromo , Cobalto , Análisis del Estrés Dental , Calor , Ensayo de Materiales , Resistencia al Corte , Itrio/administración & dosificación , Circonio/administración & dosificaciónRESUMEN
Objective. To evaluate characteristics of smile related to visibility in individuals with cleft lip, alveolus, and palate. Design. Cross-sectional. Setting. HRAC/USP, Brazil. Patients. Individuals with repaired complete unilateral cleft lip and palate (n = 45), aged 15-30 years. Interventions. Frontal facial photographs were obtained in natural and forced smiles (n = 135). Six specialists in periodontics evaluated the photographs as to the smile line, thickness, and curve of the upper lip. Main Outcome Measures. The cleft area was compared with the contralateral region. Results were expressed as percentages and means. The findings were compared between groups of periodontists. Results. Statistically significant relationship was observed in the smile line between examiners and between natural and forced smiles, regardless of the association with the cleft side. The lip was thicker at rest and thinner in the forced smile, as also evaluated by the group not experienced with cleft care. The curve of the upper lip in natural and forced smiles was considered as close to straight by both groups, regardless of the cleft. Conclusion. The smile in individuals with clefts was regarded as average for both cleft and noncleft sides. The thickness was characterized as average to thin, being thinner in forced smile and when analyzed by the group not experienced with cleft care. In the average, the curve of the upper lip was considered as straight. The present study elucidates some characteristics related to the smile in individuals with repaired unilateral cleft lip, alveolus, and palate.
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Cleft lip and palate is the most common among craniofacial malformations and causes several esthetic and functional implications that require rehabilitation. This paper aims to generally describe the several aspects related to this complex pathology and the treatment protocol used by the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC-USP) along 40 years of experience in the treatment of individuals with cleft lip and palate.
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Labio Leporino/rehabilitación , Fisura del Paladar/rehabilitación , Brasil , Labio Leporino/patología , Fisura del Paladar/patología , Estética , Hospitales Universitarios , Humanos , Resultado del TratamientoRESUMEN
OBJECTIVE: To evaluate the role of keratinized mucosa around dental implants, correlating with other clinical parameters related to the success of dental implants. DESIGN: Cross-section. SETTING: Institutional tertiary referral hospital. PATIENTS: A total of 202 dental implants fixed in the cleft area of 109 patients with cleft lip and/or palate were evaluated. Interventions: The evaluated clinical parameters were probing depth and gingival and plaque indexes on the buccal surface (three sites). MAIN OUTCOME MEASURES: All clinical parameters were correlated with the width of keratinized mucosa around the implants. RESULTS: The largest probing depths were detected when the width of keratinized mucosa was 2 mm or more, with a statistically significant difference between the means of the probing depth and keratinized mucosa width. CONCLUSION: Even though the present results suggest that peri-implant health can be observed in areas with keratinized mucosa width under 2 mm provided an adequate oral hygiene control is performed, longitudinal randomized studies are necessary to analyze the relationship between the width of keratinized mucosa and the health of peri-implant tissues.
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Labio Leporino/cirugía , Fisura del Paladar/cirugía , Implantes Dentales , Queratinas/fisiología , Mucosa Bucal/fisiología , Adolescente , Adulto , Estudios Transversales , Femenino , Homeostasis/fisiología , Humanos , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVE: To analyze the prevalence and severity of gingival recession in individuals with cleft lip and alveolus with or without cleft palate. DESIGN: Cross-sectional. SETTING: Tertiary referral hospital. PARTICIPANTS: A total of 400 individuals with cleft lip and alveolus with or without cleft palate, aged 15 to 49 years, without any previous periodontal treatment. MAIN OUTCOME MEASURES: Gingival recession was evaluated by measuring the distance from the cementoenamel junction to the most coronal point on the gingival margin, analyzing the prevalence and scoring its severity as mild (<3 mm), moderate (3 to 4 mm), or severe (4 mm). The prevalence and severity of gingival recession was compared between sextant 2 (cleft sextant) and the mean of the other sextants (1, 3, 4, 5, and 6: noncleft sextants). The relationship between gingival recession in the cleft area and gender was evaluated and data were analyzed statistically. The correlation between gingival recession and age was assessed also. RESULTS: There was no statistically significant gender difference in gingival recession. The prevalence and severity of gingival recession increased with age, and most of the affected teeth were premolars and molars. The cleft area did not present a higher prevalence and severity of gingival recession. CONCLUSIONS: Individuals with cleft lip and alveolus with or without cleft palate presented the same prevalence and severity of gingival recession compared with other populations. The area adjacent to the cleft (sextant 2) did not show greater risk of gingival recession than other areas (sextants 1, 3, 4, 5, and 6).
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Labio Leporino/complicaciones , Fisura del Paladar/complicaciones , Recesión Gingival/etiología , Adolescente , Adulto , Estudios Transversales , Femenino , Recesión Gingival/diagnóstico , Recesión Gingival/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Índice de Severidad de la EnfermedadRESUMEN
OBJECTIVE: To evaluate the survival rate of dental implants placed in the cleft area. DESIGN: Retrospective study. SETTING: Hospital for Rehabilitation of Craniofacial Anomalies, Brazil. Institutional Tertiary Healthcare Center. PATIENTS: 120 patients who received dental implants in the grafted cleft area in the years 1999 to 2005. INTERVENTIONS: Clinical data were evaluated from the records of 120 patients according to the following criteria: placement grafted, cleft area, and age at surgery; age at placement of dental implants; site and dimension of implants; interval between placement of implants and the last clinical follow-up; and interval between placement and removal or indication for removal of implants. MAIN OUTCOME MEASURES: Percentage of survival rate of implants. RESULTS: Mean age at placement of the bone graft was 17.6 years and 21 years at placement of implants. A total of 123 cleft areas received secondary bone graft and bone graft to install implants (regraft). The mean survival rate was 34 months since placement of the implant to the last clinical follow-up and 26 months since placement of the prosthesis. Seven dental implants were removed. The survival rate since placement to the last clinical follow-up was 94.3%. CONCLUSION: Rehabilitation of the cleft area with dental implants is a viable and secure alternative, with good prognosis.
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Injerto de Hueso Alveolar , Aumento de la Cresta Alveolar/métodos , Fisura del Paladar/rehabilitación , Implantes Dentales , Retención de Prótesis Dentales , Prótesis Dental de Soporte Implantado , Adolescente , Trasplante Óseo , Remoción de Dispositivos , Femenino , Humanos , Masculino , Oseointegración , Estudios Retrospectivos , Adulto JovenRESUMEN
A 41-year-old man with cleft palate presented with a wide dehiscence and missing teeth. Six implants had been placed for fabrication of an overdenture, which was unsatisfactory. A bar was waxed and cast for connection to the implants; precision attachments were placed laterally for retention. A fixed partial denture was fabricated, and milled crowns were fabricated at the molar region to provide a guiding plane for insertion of a removable palatal obturator. Good swallowing and speech outcomes were achieved. This technique provided functional and esthetic benefits, enhanced oral hygiene, and improved the psychological condition of the patient.
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Anodoncia/terapia , Fisura del Paladar/terapia , Prótesis Dental de Soporte Implantado , Retención de Dentadura/instrumentación , Dentadura Parcial Fija , Obturadores Palatinos , Adulto , Anodoncia/complicaciones , Fisura del Paladar/complicaciones , Ajuste de Precisión de Prótesis , Humanos , Masculino , Masticación , Fístula Oral/complicaciones , Fístula Oral/terapia , Trastornos del Habla/etiología , Trastornos del Habla/rehabilitaciónRESUMEN
BACKGROUND: Mucogingival alterations are inherent to clefts and may be worsened by the several plastic surgeries required in these individuals. OBJECTIVE: The aim of this study was to evaluate the prevalence, severity, and some possible etiologic factors of gingival recessions in teeth adjacent to the cleft. STUDY DESIGN: A total of 641 teeth (maxillary canines and central incisors) of 193 individuals with cleft lip and/or palate were examined. A generalized linear model was used, and the Wilcoxon test was used to compare the recession with cleft types. RESULTS: Comparison among cleft types as to the presence of recession revealed a statistically significant positive relationship for the maxillary right and left central incisors only in the group with left cleft lip, alveolus, and palate (P = .034). The most frequently affected tooth was the right maxillary canine (26.16%). CONCLUSION: The prevalence of recession in teeth close to the cleft was higher, although it was not very severe.
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Labio Leporino/complicaciones , Fisura del Paladar/complicaciones , Recesión Gingival/etiología , Adolescente , Adulto , Factores de Edad , Trasplante Óseo , Estudios de Casos y Controles , Diente Canino , Femenino , Recesión Gingival/patología , Humanos , Incisivo , Modelos Lineales , Masculino , Maxilar , Persona de Mediana Edad , Aparatos Ortodóncicos/efectos adversos , Estadísticas no Paramétricas , Adulto JovenRESUMEN
OBJECTIVE: To evaluate whether teeth close to the cleft area present higher prevalence and severity of periodontal disease than teeth in other regions. DESIGN: Cross-sectional. SETTING: Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo. PATIENTS: There were 400 individuals with complete unilateral or bilateral cleft lip and palate, aged 15 to 49 years, without any previous periodontal treatment. MAIN OUTCOME MEASURES: All clinical parameters were evaluated in six sites for each tooth. The arithmetic means were calculated for each sextant. RESULTS: Of the sextants, 86.75% presented means of probing depth smaller than or equal to 3 mm. No sextant exhibited means of probing depth greater than or equal to 6 mm. There was a statistically significant difference (p < .001) in probing depth according to age, types of cleft, and sextant; 95.87% of sextants presented mean attachment levels smaller than or equal to 3 mm. The sextant with cleft did not present higher means of probing depth, clinical attachment level, plaque index, and gingival index. There was gingival bleeding in 99.08% of the sample and plaque in 97.40%. The type of cleft was not an important factor influencing the prevalence of periodontal disease. Age seems to be an important factor influencing the prevalence and severity of periodontal disease for all aspects investigated. CONCLUSIONS: Periodontal disease in individuals with clefts occurred in a similar manner as observed in other populations. The presence of the cleft does not seem to increase the prevalence of the disease.
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Fisura del Paladar/epidemiología , Enfermedades Periodontales/epidemiología , Diente/patología , Adolescente , Adulto , Factores de Edad , Brasil/epidemiología , Estudios Transversales , Índice de Placa Dental , Femenino , Hemorragia Gingival/epidemiología , Gingivitis/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Pérdida de la Inserción Periodontal/epidemiología , Índice Periodontal , Bolsa Periodontal/epidemiología , Prevalencia , Factores de Riesgo , Factores Sexuales , Adulto JovenRESUMEN
Craniosynostosis syndromes are characterized by premature closure of one or more cranial sutures, associated with other malformations, the most frequent of which are the Crouzon and Apert syndromes. Few studies in the literature have addressed the oral health of these individuals. The purpose of this study was to compare the periodontal status of individuals with Apert, Crouzon, Pfeiffer and Saethre-Chotzen syndromes before toothbrushing and compare the efficiency of plaque removal before and after mechanical toothbrushing. The probing depth, plaque index (according to Löe and O'Leary), clinical attachment level, gingival index (according to Silness and Löe) and amount of keratinized mucosa were evaluated before toothbrushing, and the O'Leary plaque index was assessed before and immediately after toothbrushing, on the same day, in 27 individuals aged 11 to 36 years. There was statistically significant difference in the mean probing depth and clinical attachment level among regions (p=0.00; p=0.01, respectively). The gingival index did not reveal statistically significant differences. With regard to the plaque index, the left region exhibited higher plaque index values than the right and anterior regions. No significant results were found in the analysis of keratinized mucosa. Comparison of the O'Leary plaque index before and after toothbrushing revealed statistically significant difference for all syndromes except for the Pfeiffer syndrome (p<0.05). In conclusion, there was no difference in the periodontal status among individuals with syndromic craniosynostosis. The posterior region was more affected than the anterior region as to the presence of plaque, loss of insertion and probing depth. Individuals with Pfeiffer syndrome exhibited greater toothbrushing efficiency than individuals with the other craniosynostosis syndromes.