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Doucet K, Shaheen E, Danneels M, Dormaar T, Verdonck A, Willems G, Politis C, Jacobs R, Cadenas de Llano-Pérula M. Three-dimensional evaluation of secondary alveolar bone grafting in patients with unilateral cleft lip and palate: A 2-3 year post-operative follow-up. Orthod Craniofac Res 2024; 27 Suppl 1:100-108. [PMID: 38299981 DOI: 10.1111/ocr.12763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2024] [Indexed: 02/02/2024]
Abstract
OBJECTIVES The present study aims to quantitatively assess secondary alveolar bone graft (SABG) resorption in unilateral cleft lip, alveolus and palate (UCLAP) patients in a 2-3 year longitudinal follow-up setting by using a validated 3D protocol. Furthermore, the potential relation of SABG resorption with maxillary canine position and a number of patient-related factors was investigated. METHODS UCLAP patients who underwent SABG and had good quality CBCT images at the following timepoints were included in the study: pre-operative (T0), immediate (T1), 6 months (T2) and either 1-2 years (T3) or 2-3 years (T4) post-operative. The final bone grafted region was defined on the T1 scans and refined in the registered T0 scans. The bone graft after resorption was determined by applying threshold-based segmentation on the registered T2, T3 or T4 scans within the segmented bone graft volume. The position of the canines was determined at every timepoint at the cleft and non-cleft side. RESULTS Forty-five UCLAP patients (mean age 9.0 ± 1.3 years) were included. In the first 6 months after SABG, 43.6% bone resorption was recorded. 2-3 years post-operative, 56% bone resorption was found if the maxillary canine was not yet erupted and 42.7% if it erupted through the graft. The vertical position of the canines was significantly higher on the cleft side at T3. CONCLUSIONS The present study reports significant SABG resorption over time. However, no correlation was found between SABG resorption and canine position, nor between other patient-related factors.
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Affiliation(s)
- Kaat Doucet
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Eman Shaheen
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, University Hospitals Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Margaux Danneels
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Titiaan Dormaar
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Anna Verdonck
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Guy Willems
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Constantinus Politis
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, University Hospitals Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, University Hospitals Leuven, Leuven, Belgium
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
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De Ridder L, Decreus J, Willems G, Cadenas de Llano-Pérula M. Initial development of an 'Orthodontic Care Index' involving treatment need,-complexity and-priority. Eur J Orthod 2024; 46:cjad082. [PMID: 38195094 DOI: 10.1093/ejo/cjad082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
BACKGROUND/OBJECTIVES The aim of this study was to develop an evidence-based scoring system for prioritizing limited orthodontic resources based on orthodontic treatment need (OTN), orthodontic treatment complexity (OTC), and orthodontic treatment priority (OTP), which is not merely a scoring system for malocclusion but also a comprehensive classification of orthodontic issues incorporating patient- and treatment-related factors, called Orthodontic Care Index (OCI). MATERIALS AND METHODS The development of the OCI involved eight phases, starting with a systematic literature review to identify all possible parameters involved in determining OTN, OTC, and OTP. An eight-member orthodontic specialist panel then evaluated and scored the significance of each parameter, resulting in a parameter-score list. Subsequently, a retrospective convenience sample of 61 patients was scored with the parameter-score list, and using the same convenience sample a gold standard was established through the expert opinion of a third orthodontic panel. Linear regression analysis was used to estimate weights of importance and construct a formula to calculate index scores. Lastly, the expert opinion was compared to the index scores, to determine the index performance. RESULTS The preliminary index separately calculates OTN, OTC, and OTP for a patient as the weighted sum of his/her domain scores. The sensitivity of the index for predicting OTN, OTC, and OTP was high (98.1%, 82.9%, and 92.7% respectively), while the variability of each was relatively low (52.1%, 31.2%, and 52.6% respectively). CONCLUSIONS/IMPLICATIONS The OCI shows promise as a guideline for prioritizing orthodontic care. It will be further refined and validated to enhance its performance and usefulness.
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Affiliation(s)
- Lutgart De Ridder
- Department of Oral Health Sciences-Orthodontics, KU Leuven, University Hospitals Leuven, Kapucijnenvoer 7, Blok 1, Bus 7001, 3000 Leuven, Belgium
| | - Julie Decreus
- Department of Oral Health Sciences-Orthodontics, KU Leuven, University Hospitals Leuven, Kapucijnenvoer 7, Blok 1, Bus 7001, 3000 Leuven, Belgium
| | - Guy Willems
- Department of Oral Health Sciences-Orthodontics, KU Leuven, University Hospitals Leuven, Kapucijnenvoer 7, Blok 1, Bus 7001, 3000 Leuven, Belgium
| | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, KU Leuven, University Hospitals Leuven, Kapucijnenvoer 7, Blok 1, Bus 7001, 3000 Leuven, Belgium
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Verschueren K, Rajbhoj AA, Begnoni G, Willems G, Verdonck A, de Llano-Pérula MC. Risk factors for orthodontic fixed retention failure: A retrospective controlled study. Korean J Orthod 2023; 53:365-373. [PMID: 37649417 PMCID: PMC10663581 DOI: 10.4041/kjod23.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 06/24/2023] [Accepted: 07/11/2023] [Indexed: 09/01/2023] Open
Abstract
Objective : To investigate the potential correlation between fixed orthodontic retention failure and several patient- and treatment-related factors. Methods : Patients finishing treatment with fixed appliances between 2016 and 2017 were retrospectively included in this study. Those not showing fixed retention failure were considered as control group. Patients with fixed retention failure were considered as the experimental group. Additionally, patients with failure of fixed retainers in the period of June 2019 to March 2021 were prospectively identified and included in the experimental group. The location of the first retention failure, sex, pretreatment dental occlusion, facial characteristics, posttreatment dental occlusion, treatment approach and presence of oral habits were compared between groups before and after treatment separately by using a Fisher exact test and a Mann-Whitney U test. Results : 206 patients with fixed retention failure were included, 169 in the mandibular and 74 in the maxillary jaws. Significant correlations were observed between retention failure in the mandibular jaws and mandibular arch length discrepancy (P = 0.010), post-treatment growth pattern (P = 0.041), nail biting (P < 0.001) and abnormal tongue function (P = 0.002). Retention failure in the maxillary jaws was more frequent in patients with IPR in the mandibular jaws (P = 0.005) and abnormal tongue function (P = 0.021). Conclusions : This study suggests a correlation between fixed retention failure and parafunctional habits, such as nail biting and abnormal tongue function. Prospective studies with larger study populations could further confirm these results.
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Affiliation(s)
- Kaat Verschueren
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Amit Arvind Rajbhoj
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Giacomo Begnoni
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Guy Willems
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Anna Verdonck
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
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Farronato M, Begnoni G, Boodt LD, Thevissen P, Willems G, Cadenas de Llano-Pérula M. Are palatal rugae reliable markers for 3D superimposition and forensic human identification after palatal expansion? A systematic review. Forensic Sci Int 2023; 351:111814. [PMID: 37722313 DOI: 10.1016/j.forsciint.2023.111814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/29/2023] [Indexed: 09/20/2023]
Abstract
OBJECTIVES Palatal rugae are periodic structures situated in the palatal mucosa, often used as landmarks for human identification and superimposition of digital dental models. This review aims to collect the current evidence regarding whether orthodontic palatal expansion could affect the stability of the palatal rugae and to give preliminary guidelines. MATERIALS AND METHODS A systematic review of the literature was performed in the scientific databases Pubmed; Embase; WoS; and Cochrane. Grey Literature was also sought (clinicaltrial.gov; ICTRP; AHRQ; INAHTA). The search protocol, was registered in PROSPERO (N*208722). Data extraction comprised: year of publication, journal, sample size, characteristics of the experimental and control group, type of expander, expansion protocol, rugae classification, measurement method on casts, time between casts, method error, rugae change, morphology change and overall outcome. Risk of bias of the included articles was evaluated with the Newcastle-Ottawa Scale. RESULTS A total of 12394 manuscripts were retrieved after duplicate removal. From these, nine articles were finally included for data extraction. three studies scored as low risk of bias, two as medium and four as high. CONCLUSIONS The morphology of the palatal rugae can be modified by palatal expansion techniques, especially by rapid maxillary expansion. The first rugae is the most stable along with the points close to the palatal midline, which should be used as a reference both for manual or semi-automatic superimpositions. Human identification and serial superimpositions based on palatal rugae should not be carried immediately post expansion and be taken in consideration with caution in patients who underwent prior palatal expansion.
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Affiliation(s)
- Marco Farronato
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, Fondazione IRCCS Cà Granda, Milan 20100, Italy.
| | - Giacomo Begnoni
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000 Leuven, Belgium
| | - Laura De Boodt
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000 Leuven, Belgium
| | - Patrick Thevissen
- Department of Imaging and Pathology, Forensic Odontology, KU Leuven, Leuven, Belgium
| | - Guy Willems
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000 Leuven, Belgium
| | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000 Leuven, Belgium
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Cadenas de Llano-Pérula M, Castro AB, Danneels M, Schelfhout A, Teughels W, Willems G. Risk factors for gingival recessions after orthodontic treatment: a systematic review. Eur J Orthod 2023; 45:528-544. [PMID: 37432131 DOI: 10.1093/ejo/cjad026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
BACKGROUND/OBJECTIVES To systematically review the available evidence concerning the risk factors for gingival recessions (GR) after orthodontic treatment (OT). DATA COLLECTION AND ANALYSIS Data was obtained and collected by systematically searching 3 data bases: Pubmed, EMBASE, and Web of Science until 20 April 2023. Controlled trials, cohort, case-control or cross-sectional studies describing GR or clinical crown height (CCH) after OT were included. The risk of bias in the selected studies was evaluated with the methodological index for non-randomized studies. RESULTS Forty-eight articles were included, investigating the following six risk factors for GR: 1. OT (n = 21), 2. Type of orthodontic intervention (n = 32), 3. Patient's baseline occlusal and skeletal characteristics (n = 14), 4. Mucogingival characteristics (n = 10), 5. Oral hygiene (n = 9), and 6. Others (n = 12). Significantly higher prevalence, severity and extent of GR were found in orthodontic patients by 10/15, 4/10, and 2/2 articles respectively. 10/16 articles reported significantly more GR and increased CCH in patients where orthodontic incisor proclination was performed. The evidence surrounding maxillary expansion and orthodontic retention was too heterogeneous to allow for? definitive conclusions. Pre-treatment angle classification, ANB, overjet, overbite, arch width and mandibular divergence were found not to be associated with GR (9/14), while pre-treatment crossbite, symphysis height and width were (5/7 studies). A thin gingival biotype, presence of previous GR, baseline width of keratinized gingiva and facial gingival margin thickness were correlated with increased risk of GR after OT by nine articles, while pocket depth was not. Oral hygiene, sex, treatment duration, and oral piercings were found not to be linked with GR in orthodontic patients, while GR was reported to increase with age in orthodontic patients by 50 per cent of the articles investigating this factor. The mean risk of bias for comparative and not comparative studies was 14.17/24 and 9.12/16. LIMITATIONS The selected studies were quite heterogeneous regarding study settings, variables reported and included very limited sample sizes. CONCLUSION Although studies regarding the risk factors for GR are relatively abundant, they are very heterogeneous concerning design, studied factors, methodology and reporting, which often leads to contradictory results. Uniform reporting guidelines are urgently needed for future research. PROSPERO REGISTRATION CRD42020181661. FUNDING This research received no funding.
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Affiliation(s)
- Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven, Belgium
- Research group Orthodontics, KU Leuven, Belgium
| | - Ana Belén Castro
- Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven, Belgium
- Research group Periodontology and Oral Microbiology, KU Leuven, Belgium
| | - Margaux Danneels
- Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven, Belgium
- Research group Orthodontics, KU Leuven, Belgium
| | - Alix Schelfhout
- Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven, Belgium
- Research group Periodontology and Oral Microbiology, KU Leuven, Belgium
| | - Guy Willems
- Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven, Belgium
- Research group Orthodontics, KU Leuven, Belgium
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Willems G, Butaye C, Raes M, Zong C, Begnoni G, Cadenas de Llano-Pérula M. Early prevention of maxillary canine impaction: a randomized clinical trial. Eur J Orthod 2023; 45:359-369. [PMID: 37266982 DOI: 10.1093/ejo/cjad014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVES To investigate the effect of three interceptive measures (slow maxillary expansion (SME) with removable plates (1), extraction of both upper deciduous canines (DC) (2) and no intervention (3)) on maxillary canine (MC) position in patients with early mixed dentition (EMD) and lack of upper arch space. These three groups were additionally compared to a control group (4) with adequate upper arch space. NULL HYPOTHESIS None of the studied strategies outperforms the others regarding improvement of MC position. TRIAL DESIGN Four-arm parallel group prospective randomized controlled trial. PARTICIPANTS Patients in EMD with at least one impacted MC, non-resorbed DC, and no crossbite. INTERVENTIONS Patients with a lack of space were randomly distributed to protocols (1), (2), and (3). PRIMARY OBJECTIVE To assess the change in MC position after 18 months follow up. SECONDARY OBJECTIVES To assess canine eruption and need for orthodontic intervention within 18-60 month follow up. OUTCOME ASSESSMENT Five variables defined canine position: sector, canine-to-midline angle, canine-to-first-premolar angle, canine-cusp-to-midline distance, and canine-cusp-to-occlusal-plane distance on two panoramic radiographs at 0 (T1) and 18 months (T2). Mean differences between groups were compared with linear mixed models, corrected for age and sex. RANDOMIZATION The patient allocation sequence was generated by an electronic randomization list. BLINDING The operator taking the measurements was blinded to the groups. RESULTS Seventy-six patients were included (142 canines, mean age 9.2 years, 60.5 per cent male, mean follow up 1.9 years), 19, 17, 14, and 26 patients in groups 1-4, respectively. In absence of dental crossbite in patients with lack of space and impacted MC, SME improved the canine sector (P = 0.040), compared to no intervention (P = 0.028). Canine-to-midline angle and canine-to-occlusal-plane distance significantly decreased in all groups at T2. Extraction improved the canine-to-first-premolar angle at T2 more than other strategies in EMD (P = 0.015-0.000). CONCLUSIONS Early SME improves the canine sector and reduces the need for major orthodontic intervention in the long term. Taking a first panoramic radiograph in EMD allows timely intervention in case of MC impaction. TRIAL REGISTRATION NUMBER NCT05629312 (Clinical Trials.org). Trial status: follow up ongoing.
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Affiliation(s)
- Guy Willems
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Charlotte Butaye
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Margot Raes
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Chen Zong
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Giacomo Begnoni
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
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Van Geneugden L, Verdonck A, Willems G, Hens G, Cadenas de Llano-Pérula M. Relation between Maximum Oral Muscle Pressure and Dentoalveolar Characteristics in Patients with Cleft Lip and/or Palate: A Prospective Comparative Study. J Clin Med 2023; 12:4598. [PMID: 37510713 PMCID: PMC10380591 DOI: 10.3390/jcm12144598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 07/01/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Perioral muscle function, which influences maxillofacial growth and tooth position, can be affected in patients with oral clefts due to their inherent anatomical characteristics and the multiple surgical corrections performed. This research aims to (1) compare the maximum oral muscle pressure of subjects with and without isolated cleft palate (CP) or unilateral cleft lip and palate (UCLP), (2) investigate its influence on their dentoalveolar characteristics, and (3) investigate the influence of functional habits on the maximum oral muscle pressure in patients with and without cleft. MATERIAL AND METHODS Subjects with and without CP and UCLP seeking treatment at the Department of Orthodontics of University Hospitals Leuven between January 2021 and August 2022 were invited to participate. The Iowa Oral Performance Instrument (IOPI) was used to measure their maximum tongue, lip, and cheek pressure. An imbalance score was calculated to express the relationship between tongue and lip pressure. Upper and lower intercanine (ICD) and intermolar distance (IMD) were measured on 3D digital dental casts, and the presence of functional habits was reported by the patients. The data were analyzed with multivariable linear models, correcting for age and gender. RESULTS 44 subjects with CP or UCLP (mean age: 12.00 years) and 104 non-affected patients (mean age: 11.13 years) were included. No significant differences in maximum oral muscle pressure or imbalance score were detected between controls and clefts or between cleft types. Significantly smaller upper ICDs and larger upper and lower IMDs were found in patients with clefts. A significant difference between controls and clefts was found in the relationship between oral muscle pressure and transversal jaw width. In cleft patients, the higher the maximum tongue pressure, the wider the upper and lower IMD, the higher the lip pressure, the smaller the upper and lower ICD and IMD, and the higher the imbalance score, the larger the upper and lower IMD and lower ICD. An imbalance favoring the tongue was found in cleft patients. The influence of functional habits on the maximum oral muscle pressure was not statistically different between clefts and controls. CONCLUSION Patients with CP or UCLP did not present reduced maximum oral muscle pressure compared with patients without a cleft. In cleft patients, tongue pressure was consistently greater than lip pressure, and those who presented a larger maxillary width presented systematically higher imbalance scores (favoring the tongue) than those with narrow maxillae. Therefore, the influence of slow maxillary expansion on maximum oral muscle pressure in cleft patients should not be underestimated.
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Affiliation(s)
- Lisa Van Geneugden
- Department of Oral Health Sciences-Orthodontics, KU Leuven, University Hospitals Leuven, Kapucijnenvoer 7, Blok 1, Bus 7001, 3000 Leuven, Belgium
| | - Anna Verdonck
- Department of Oral Health Sciences-Orthodontics, KU Leuven, University Hospitals Leuven, Kapucijnenvoer 7, Blok 1, Bus 7001, 3000 Leuven, Belgium
| | - Guy Willems
- Department of Oral Health Sciences-Orthodontics, KU Leuven, University Hospitals Leuven, Kapucijnenvoer 7, Blok 1, Bus 7001, 3000 Leuven, Belgium
| | - Greet Hens
- Department of Neurosciences, KU Leuven, University Hospitals Leuven, Kapucijnenvoer 7, Blok H, Bus 7001, 3000 Leuven, Belgium
| | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, KU Leuven, University Hospitals Leuven, Kapucijnenvoer 7, Blok 1, Bus 7001, 3000 Leuven, Belgium
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Michielsens H, Decreus J, Begnoni G, Verdonck A, Jacobs R, Willems G, Cadenas de Llano-Pérula M. Performance of the Malmgren Index for Assessing Root Resorption on 2D vs. 3D Radiographs: A Pilot Study. Healthcare (Basel) 2023; 11:1860. [PMID: 37444694 DOI: 10.3390/healthcare11131860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/18/2023] [Accepted: 06/25/2023] [Indexed: 07/15/2023] Open
Abstract
OBJECTIVES To compare the performance of the Malmgren index on 2D and 3D radiographs. METHODS Patients with a panoramic radiograph and a cone beam computed tomography (CBCT) taken at an interval of <3 months and presenting root resorption (RR) on at least one incisor and/or canine were retrospectively included. RR was scored twice by two observers using the Malmgren index in both the 2D and 3D sets, and intra-class correlation coefficient (ICC) was calculated. RESULTS 155 teeth were analyzed. The ICC was the lowest in 2D, followed by overall, transversal and sagittal 3D. Malmgren scores were systematically higher in 2D, which overestimated RR, especially in the transversal plane on all incisors and canines and in the sagittal plane on the maxillary incisors. 2D respectively leads to 28.0-34.8% of false positives and negatives when discriminating between RR or not. The early stages of RR are often misdiagnosed in 2D, while later stages are more accurate. CONCLUSIONS The original Malmgren index is not suited for 3D images, especially axial, where using dichotomized values (resorption yes/no) leads to overestimation of RR. A low-dose CBCT of the upper incisors could detect RR with high diagnostic accuracy in the early stages of orthodontic treatment, especially in patients with dental trauma or familial RR history.
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Affiliation(s)
- Hanne Michielsens
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Julie Decreus
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Giacomo Begnoni
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Anna Verdonck
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS IMPATH, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven and Maxillofacial Surgery, University Hospitals Leuven, 3000 Leuven, Belgium
- Department of Dental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Guy Willems
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, 3000 Leuven, Belgium
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Zong C, Bronckaers A, Willems G, He H, Cadenas de Llano-Pérula M. Nanomaterials for Periodontal Tissue Regeneration: Progress, Challenges and Future Perspectives. J Funct Biomater 2023; 14:290. [PMID: 37367254 DOI: 10.3390/jfb14060290] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
Abstract
Bioactive nanomaterials are increasingly being applied in oral health research. Specifically, they have shown great potential for periodontal tissue regeneration and have substantially improved oral health in translational and clinical applications. However, their limitations and side effects still need to be explored and elucidated. This article aims to review the recent advancements in nanomaterials applied for periodontal tissue regeneration and to discuss future research directions in this field, especially focusing on research using nanomaterials to improve oral health. The biomimetic and physiochemical properties of nanomaterials such as metals and polymer composites are described in detail, including their effects on the regeneration of alveolar bone, periodontal ligament, cementum and gingiva. Finally, the biomedical safety issues of their application as regenerative materials are updated, with a discussion about their complications and future perspectives. Although the applications of bioactive nanomaterials in the oral cavity are still at an initial stage, and pose numerous challenges, recent research suggests that they are a promising alternative in periodontal tissue regeneration.
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Affiliation(s)
- Chen Zong
- Department of Oral Health Sciences-Orthodontics, University of Leuven (KU Leuven) and Dentistry, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Annelies Bronckaers
- Biomedical Research Institute, Faculty of Life Sciences, University of Hasselt, 3590 Diepenbeek, Belgium
| | - Guy Willems
- Department of Oral Health Sciences-Orthodontics, University of Leuven (KU Leuven) and Dentistry, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Hong He
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
- Center for Dentofacial Development and Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, University of Leuven (KU Leuven) and Dentistry, University Hospitals Leuven, 3000 Leuven, Belgium
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Butaye C, Miclotte A, Begnoni G, Zhao Z, Zong C, Willems G, Verdonck A, Jacobs R, Cadenas de Llano-Pérula M. Third molar position after completion of orthodontic treatment: a prospective follow-up. Dentomaxillofac Radiol 2023:20220432. [PMID: 37129499 DOI: 10.1259/dmfr.20220432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023] Open
Abstract
OBJECTIVES To prospectively follow up a previously reported sample, analyzing (1) changes in third molar (M3) position after completion of 2 different types of orthodontic treatment: (2) non-extraction treatment with (HG) vs without cervical headgear (non-HG) and (3) first or second premolar extractions (PM1-2) compared to a non-extraction group (NE). METHODS A total of 474 patients were prospectively followed up. Panoramic radiographs were taken pre- (T1), post-treatment (T2) and at follow-up (T3). T3 records (a mean of three years after treatment) were available for 135 (HG vs non-HG) and 134 patients (PM1-2 vs NE), respectively. Angulation, vertical position, relation with the mandibular canal and mineralization status of M3 at T2 and T3 were statistically compared. RESULTS The HG group presented more M3 with ideal vertical orientation at T3. In NE-cases, further improvement in angulation and orientation can be expected after debonding, as well as a deterioration in the relationship with the mandibular canal. Extractions accelerated upper M3 vertical eruption and PM2 extractions led to long-term larger lower retromolar spaces. CONCLUSIONS The use of cervical headgear increased upper M3 uprighting three years after debonding, while little changes in M3 position were found after orthodontic treatment with extractions. However, PM2 extractions led to larger retromolar spaces and better M3 angulation in the long term.
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Affiliation(s)
- Charlotte Butaye
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer, Leuven, Belgium
| | - Annelie Miclotte
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer, Leuven, Belgium
| | - Giacomo Begnoni
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer, Leuven, Belgium
| | - Zuodong Zhao
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer, Leuven, Belgium
| | - Chen Zong
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer, Leuven, Belgium
| | - Guy Willems
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer, Leuven, Belgium
| | - Anna Verdonck
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS IMPATH, Department of Imaging & Pathology, Faculty of Medicine, University Leuven & Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer, Leuven, Belgium
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer, Leuven, Belgium
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Zong C, Van Holm W, Bronckaers A, Zhao Z, Čokić S, Akta MK, Castro AB, Van Meerbeek B, Braem A, Willems G, de Llano-Pérula MC. Biomimetic Periodontal Ligament Transplantation Activated by Gold Nanoparticles Protects Alveolar Bone. Adv Healthc Mater 2023:e2300328. [PMID: 37114680 DOI: 10.1002/adhm.202300328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/29/2023] [Indexed: 04/29/2023]
Abstract
Stem cell therapy might be a promising method to stimulate alveolar bone regeneration, which is currently a major clinical challenge. However, its therapeutic features largely depend on pretreatment and transplantation preparation. Herein, a novel biomimetic periodontal ligament transplantation composed of human periodontal ligament stem cells (hPDLSCs) pretreated with gold nanocomplexes (AuNCs) and embedded in a type-I collagen hydrogel scaffold is developed to protect alveolar bone from resorption. AuNCs were readily absorbed by primary hPDLSCs, with limited cytotoxicity, and promoted osteogenic differentiation of hPDLSCs effectively in vitro. In addition, the AuNCs-induced hPDLSCs were encapsulated with type-I collagen hydrogel scaffold to mimic their native physiological niche, and then transplanted into a rat model of alveolar bone resorption. Both micro-computed tomography (micro-CT) and immunohistochemical assays demonstrated that alveolar bone loss was significantly prevented. Furthermore, the underlying therapeutic mechanism was elucidated, in which transplantation-activated osteogenesis was associated with autophagy, which enabled bone remodeling and regeneration. This study provides critical insight into the role of PDLSCs in bone homeostasis and proposes an innovative AuNCs-based strategy for stem cell therapy in bone regeneration. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Chen Zong
- KU Leuven (University of Leuven), Department of Oral Health Sciences, Orthodontics and UZ Leuven (University Hospitals Leuven), Dentistry, Leuven, Belgium
| | - Wannes Van Holm
- KU Leuven, Department of Oral Health Sciences, Periodontology & Oral Microbiology and UZ Leuven, Dentistry, Leuven, Belgium
| | - Annelies Bronckaers
- University of Hasselt, Faculty of Life Sciences, Biomedical Research Institute, Diepenbeek, Belgium
| | - Zuodong Zhao
- KU Leuven (University of Leuven), Department of Oral Health Sciences, Orthodontics and UZ Leuven (University Hospitals Leuven), Dentistry, Leuven, Belgium
| | - Stevan Čokić
- Department of Oral Health Sciences-BIOMAT, University of Leuven (KU Leuven) and UZ Leuven, Dentistry, Leuven, Belgium
| | - Merve Kübra Akta
- KU Leuven, Department of Materials Engineering (MTM), Biomaterials and Tissue Engineering Research Group, Leuven, Belgium
| | - Ana Belén Castro
- KU Leuven, Department of Oral Health Sciences, Periodontology & Oral Microbiology and UZ Leuven, Dentistry, Leuven, Belgium
| | - Bart Van Meerbeek
- Department of Oral Health Sciences-BIOMAT, University of Leuven (KU Leuven) and UZ Leuven, Dentistry, Leuven, Belgium
| | - Annabel Braem
- KU Leuven, Department of Materials Engineering (MTM), Biomaterials and Tissue Engineering Research Group, Leuven, Belgium
| | - Guy Willems
- KU Leuven (University of Leuven), Department of Oral Health Sciences, Orthodontics and UZ Leuven (University Hospitals Leuven), Dentistry, Leuven, Belgium
| | - Maria Cadenas de Llano-Pérula
- KU Leuven (University of Leuven), Department of Oral Health Sciences, Orthodontics and UZ Leuven (University Hospitals Leuven), Dentistry, Leuven, Belgium
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Van de Velde AS, De Boodt L, Cadenas de Llano-Pérula M, Laenen A, Willems G. Long-term effects of orthodontic interceptive expansion treatment : A retrospective study. J Orofac Orthop 2023:10.1007/s00056-023-00467-1. [PMID: 37115290 DOI: 10.1007/s00056-023-00467-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 01/24/2023] [Indexed: 04/29/2023]
Abstract
PURPOSE The aim of this retrospective cohort study was to evaluate the long-term effects of interceptive orthodontic treatment with a removable expansion plate, based on transversal, sagittal, and vertical parameters. METHODS A total of 90 patients needing interceptive treatment due to a crossbite or space deficiency were included. Records consisting of clinical photos, radiographs, and digital dental casts were collected for evaluation at two time points: the start of interceptive treatment (T0) and the start of comprehensive treatment (T1). Molar occlusion, overjet, overbite, presence and type of crossbite, mandibular shift, and transversal measurements were recorded for comparison. RESULTS After expansion with removable appliances, a significant increase in intermolar width was achieved and could be maintained over the observation period (p < 0.001). However, no significant changes regarding overjet, overbite, or molar sagittal occlusion were observed. Crossbite correction was successful in 86.9% of patients with unilateral crossbite and in 75.0% of patients with bilateral crossbite (p < 0.001). CONCLUSION Early expansion with a removable expansion plate is a successful method to correct crossbites and increase intermolar width in the early mixed dentition phase. Results remain stable until the start of comprehensive treatment in the permanent dentition.
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Affiliation(s)
- Anne-Sophie Van de Velde
- Department of Oral Health Sciences-Orthodontics, Katholieke Universiteit Leuven (KU Leuven), Kapucijnenvoer 7, 3000, Leuven, Belgium
- Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Laura De Boodt
- Department of Oral Health Sciences-Orthodontics, Katholieke Universiteit Leuven (KU Leuven), Kapucijnenvoer 7, 3000, Leuven, Belgium
- Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, Katholieke Universiteit Leuven (KU Leuven), Kapucijnenvoer 7, 3000, Leuven, Belgium.
- Dentistry, University Hospitals Leuven, Leuven, Belgium.
| | - Annoushka Laenen
- Interuniversity Institute for Biostatistics and statistical Bioinformatics, KU Leuven, Leuven, Belgium
- University Hasselt, Hasselt, Belgium
| | - Guy Willems
- Department of Oral Health Sciences-Orthodontics, Katholieke Universiteit Leuven (KU Leuven), Kapucijnenvoer 7, 3000, Leuven, Belgium
- Dentistry, University Hospitals Leuven, Leuven, Belgium
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Rajbhoj AA, Stroo M, Begnoni G, Willems G, de Llano-Pérula MC. Skeletal and soft-tissue changes in humans with untreated normal occlusion throughout lifetime: a systematic review. Odontology 2023; 111:263-309. [PMID: 36350428 DOI: 10.1007/s10266-022-00757-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/09/2022] [Indexed: 11/11/2022]
Abstract
Age-related skeletal and soft-tissue changes are important in orthodontics, especially due to the increase of adult patients seeking treatment. The aim of this study is to assess the available evidence regarding age-related skeletal and soft-tissue changes in untreated Angle Class I. Articles studying skeletal and soft-tissue changes in orthodontically untreated subjects with Angle Class I and comparing them between age groups were included. Studies focusing on a single age group or in languages other than English were excluded. Risk of bias was assessed with both the MINORS and ROBINS-I tools. 50 studies were included, showing high methodological heterogeneity and a lack of information in subjects over 60 years old. In subjects with Angle Class I, the mandibular plane inclination was reported to reduce from 7 and 20 years old, while the anterior and posterior facial height continue to increase in late adult life. The anterior cranial base length increases until 20 years old, afterwards decreasing slowly until late adulthood. Nasal width increases and the nasolabial angle decreases during adolescence. Upper lip length and lower lip length increase from 6 to 18 years along with retrusion of the lips in late adulthood. Age-related skeletal and soft-tissue changes are documented in the literature from childhood until the fifth decade of life, but studies mostly focus on subjects until 20 years old. Changes after the second decade of life are studied only for the vertical and sagittal dimensions. No changes are reported in the transversal dimension beyond 15 years for neither skeletal nor soft tissues. Well-designed, long-term prospective cohort studies considering all three dimensions of skeletal and soft tissues are needed for confirmation of these findings (PROSPERO: CRD42020203206).
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Affiliation(s)
- Amit Arvind Rajbhoj
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, Blok A, Bus 7001, Leuven, 3000, Belgium.
| | - Marie Stroo
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, Blok A, Bus 7001, Leuven, 3000, Belgium
| | - Giacomo Begnoni
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, Blok A, Bus 7001, Leuven, 3000, Belgium
| | - Guy Willems
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, Blok A, Bus 7001, Leuven, 3000, Belgium
| | - María Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, Blok A, Bus 7001, Leuven, 3000, Belgium
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Rajbhoj AA, Matthews H, Doucet K, Claes P, Begnoni G, Willems G, de Llano-Pérula MC. Influence of age and diet consistency on the oral muscle pressure of orthodontically treated and untreated subjects with normal occlusion and comparison of their 3D facial shape. Clin Oral Investig 2023:10.1007/s00784-023-04977-5. [PMID: 36976359 DOI: 10.1007/s00784-023-04977-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/21/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVES (1) To investigate the effect of age and diet consistency on maximum lips, tongue and cheek pressure of orthodontically treated and untreated subjects with normal, Class I dental occlusion, (2) to find out whether there is a muscle imbalance between anterior tongue and lip pressure in the same subjects at different ages and (3) to compare the 3D facial shape of treated and untreated individuals. MATERIAL AND METHODS Subjects with normal occlusion were prospectively grouped into orthodontically treated/untreated and in children/adolescents/adults. Iowa Oral Performance Instrument was used to record the maximum muscle pressure. Two-way ANOVA and Tukey post hoc test analysed age-specific differences in muscle pressure. Two-way ANCOVA analysed the effect of diet consistency on muscle pressure. Lips and tongue imbalance was analysed using z-scores and 3D faces using a generalized Procrustes analysis. RESULTS One hundred thirty-five orthodontically untreated and 114 treated participants were included. Muscle pressure was found to increase with age in both groups, except for the tongue in treated subjects. No differences in the balance between lips and tongue muscle pressure were found, but a higher cheek pressure in untreated adults (p<0.05) was observed. 3D facial shapes showed subtle differences. Untreated subjects with soft diet consistency showed lower lip pressure (p<0.05). CONCLUSION Oral muscle pressure of orthodontically treated patients without relapse does not differ from that of untreated patients with Class-I occlusion. CLINICAL RELEVANCE This study provides normative lip, tongue and cheek muscle pressure in subjects with normal occlusion, which can be used for diagnosis, treatment planning and stability.
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Affiliation(s)
- Amit Arvind Rajbhoj
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium.
| | - Harold Matthews
- Medical Imaging Research Center, KU Leuven, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
- Department of Human Genetics, KU Leuven, Leuven, Belgium
| | - Kaat Doucet
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Peter Claes
- Medical Imaging Research Center, KU Leuven, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
- Department of Human Genetics, KU Leuven, Leuven, Belgium
- Department of Electrical Engineering, ESAT/PSI, KU Leuven, Leuven, Belgium
| | - Giacomo Begnoni
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Guy Willems
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - María Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
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Maes DM, Zong C, Begnoni G, Verdonck A, Willems G, Cadenas de Llano-Pérula M. The use of blended learning in postgraduate education in orthodontics: student versus teacher perception. Eur J Orthod 2022; 45:258-265. [PMID: 36562596 DOI: 10.1093/ejo/cjac070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To investigate the use of blended learning (BL) in Postgraduate Education in Orthodontics. METHODS A self-developed online questionnaire was sent to 244 teaching staff members of the European Orthodontic Departments. They were asked to answer it and share it with their postgraduate students. 18 questions for teaching staff and 27 for postgraduate students evaluated the use, perceptions, feedback options, learning outcomes, and teacher's role in BL. The answers of teaching staff and students were statistically compared by Fisher's Exact Test, Chi-Square Test, Unpaired t-test, and Mann-Whitney Test. RESULTS 124 completed questionnaires were received, 44 from teaching staff and 80 from postgraduate students. Teaching staff is more acquainted with BL than students (P = 0.001). Both groups found BL courses a good alternative to traditional courses (P = 0.654). The use of interactive multimedia was more appreciated by students (P = 0.015). Both groups found students' results not to change with BL, but teaching staff had a more negative perception (P = 0.012). In general, teaching staff perceived feedback and interaction as less essential than postgraduates in BL. Teaching staff felt more like coaches when using BL, while postgraduates did not perceive any changes in teachers' roles (P = 0.006). Limitations: Due to the General Data Protection Regulation it was not possible to directly contact the postgraduate students in Postgraduate Orthodontic Programs throughout Europe. Therefore, this study completely relied on the goodwill of the teaching staff being contacted. CONCLUSION The main differences in perception between teaching staff and postgraduate students were student results, teachers' role, use, and importance of feedback and interactive multimedia. Although both groups found BL courses to stimulate students' learning and to be a relevant cost-effective addition to traditional courses, they were hesitant to fully replace them with BL.
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Affiliation(s)
- Désirée Martine Maes
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Chen Zong
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Giacomo Begnoni
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Anna Verdonck
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Guy Willems
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
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Rajbhoj AA, Matthews H, Doucet K, Claes P, Willems G, Begnoni G, Cadenas de Llano-Pérula M. Age- and sex-related differences in 3D facial shape and muscle pressure in subjects with normal occlusion. Comput Biol Med 2022; 151:106325. [PMID: 36413816 DOI: 10.1016/j.compbiomed.2022.106325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/22/2022] [Accepted: 11/14/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND OBJECTIVE(S): (1) To derive descriptive statistics of three-dimensional (3D) facial shape, lip and cheek muscle pressure in subjects of European descent with normal dental occlusion. (2) To analyse the effect of age and sex on 3D-facial soft tissue morphology and muscle pressure in the same sample. (3) To assess the independent effect of muscle pressure on face shape. METHOD 129 subjects with normal occlusion were cross-sectionally recruited and divided into: children (mixed dentition), adolescents and adults (permanent dentition, < and ≥18 years respectively). Muscle pressure was recorded using the Iowa Oral Performance Instrument. MeshLab, MeVisLab and Meshmonk tool box were used to clean, annotate landmarks and generate the 3D images. Two-way analysis of variance and post-hoc tests were used to analyse age and sex differences in face shape and muscle pressure. The effect of muscle pressure on face shape was analysed by Pearson correlation and Partial Least Square regression. RESULTS Significant facial differences were observed between adults and adolescents and adults and children in both sexes, showing flattening of cheeks and lips and protrusion of nose and chin. Significant cheek protrusion and retrusion of the vertical midface were found in adult women compared to men. Lip and cheek pressure increased with age, but their effect on face shape was not significant. CONCLUSIONS This study provides 3D age- and sex-specific facial models and muscle pressure of subjects without malocclusion. These can be used as a reference for clinicians focused on facial assessment in treatment planning and follow-up.
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Affiliation(s)
- Amit Arvind Rajbhoj
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium.
| | - Harold Matthews
- Medical Imaging Research Center, KU Leuven, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium; Department of Human Genetics, KU Leuven, Leuven, Belgium
| | - Kaat Doucet
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Peter Claes
- Medical Imaging Research Center, KU Leuven, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium; Department of Human Genetics, KU Leuven, Leuven, Belgium; Department of Electrical Engineering, ESAT/PSI, KU Leuven, Leuven, Belgium
| | - Guy Willems
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Giacomo Begnoni
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
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de Llano-Perula MC, Zong C, Van Dessel J, Kuijpers-Jagtman AM, Willems G. Correction to: 3D quantification of in vivo orthodontic tooth movement in rats by means of micro‑computed tomography. Clin Oral Investig 2022; 26:3921. [PMID: 35246735 DOI: 10.1007/s00784-022-04433-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Maria Cadenas de Llano-Perula
- Department of Oral Health Sciences - Orthodontics, KU Leuven and University Hospitals Leuven, Kapucijnenvoer 7, blok A, bus 7001, 3000, Leuven, Belgium.
| | - Chen Zong
- Department of Oral Health Sciences - Orthodontics, KU Leuven and University Hospitals Leuven, Kapucijnenvoer 7, blok A, bus 7001, 3000, Leuven, Belgium
| | - Jeroen Van Dessel
- Oral and Maxillofacial Surgery, University Hospitals Leuven and OMFS‑IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Anne Marie Kuijpers-Jagtman
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine/Medical Faculty, University of Bern, Bern, Switzerland.,Department of Orthodontics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Guy Willems
- Department of Oral Health Sciences - Orthodontics, KU Leuven and University Hospitals Leuven, Kapucijnenvoer 7, blok A, bus 7001, 3000, Leuven, Belgium
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Cadenas de Llano-Pérula M, Zong C, Van Dessel J, Kuijpers-Jagtman AM, Willems G. 3D quantification of in vivo orthodontic tooth movement in rats by means of micro-computed tomography. Clin Oral Investig 2022; 26:3911-3920. [PMID: 34994861 DOI: 10.1007/s00784-021-04358-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 12/29/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE (1) To test the accuracy of split-mouth models in rats for the study of orthodontic tooth movement (OTM) and (2) to propose an improved 3D model for quantification of OTM in rats. METHODS Eleven Wistar rats were split into group 1 (dental anchorage) and group 2 (skeletal anchorage). In both groups, no orthodontic force (OF) was applied on the contralateral hemi-maxilla. In vivo micro-CT images were taken before (T0) and 31 days (T1) after OF. OTM was compared between time-points and experimental sides using conventional 2D analysis and a novel 3D model. RESULTS Using incisors as anchorage leads to their distal displacement in both OF and no OF sides. In the OF side, movement of M1 is underestimated by incisor displacement. Mesial displacement of M1 was found in the no OF side of all groups 31 days after the application of OF. CONCLUSIONS The new 3D model yielded higher sensitivity for tooth displacement in planes other than sagittal and incisor displacement was reduced by using skeletal anchorage. CLINICAL SIGNIFICANCE Studies following split-mouth designs in orthodontic research in rats might be systematically underestimating the effects of techniques and/or medication on OTM, since there is tooth displacement on the control side. 3D quantification of OTM with skeletal anchorage is more sensitive and avoids displacement of the dental units used as anchorage.
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Affiliation(s)
- Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences - Orthodontics, KU Leuven and University Hospitals Leuven, Kapucijnenvoer 7, blok A, bus 7001, 3000, Leuven, Belgium.
| | - Chen Zong
- Department of Oral Health Sciences - Orthodontics, KU Leuven and University Hospitals Leuven, Kapucijnenvoer 7, blok A, bus 7001, 3000, Leuven, Belgium
| | - Jeroen Van Dessel
- Oral and Maxillofacial Surgery, University Hospitals Leuven and OMFS-IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Anne Marie Kuijpers-Jagtman
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine/Medical Faculty, University of Bern, Bern, Switzerland.,Department of Orthodontics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Guy Willems
- Department of Oral Health Sciences - Orthodontics, KU Leuven and University Hospitals Leuven, Kapucijnenvoer 7, blok A, bus 7001, 3000, Leuven, Belgium
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19
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Zong C, Bronckaers A, Vande Velde G, Willems G, Cadenas de Llano‐Pérula M. In Vivo Micro-Computerized Tomography Tracking of Human Periodontal Ligament Stem Cells Labeled with Gold Nanocomplexes. Adv Healthc Mater 2022; 11:e2101133. [PMID: 34704382 DOI: 10.1002/adhm.202101133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 09/29/2021] [Indexed: 12/15/2022]
Abstract
Gold nanocomplexes have been proposed as contrast agents for computerized tomography (CT) and cell tracking, which is especially useful in stem cell therapy. However, their potential for long-term in vivo cell detection is still unknown. This study proposes an optimized approach to labeling human periodontal ligament stem cells (hPDLSCs) with gold nanocomplexes to evaluate their detection with micro-CT after transplantation at four different rat tissues. The gold nanocomplexes of 0.05 mg mL-1 do not affect cell viability nor osteogenic differentiation capacity, but render fluorescent and radiopaque hPDLSCs. Excellent linear correlation with the number of labeled cells is shown over a wide range (r = 0.99, P < 0.01), with a detection limit of ≈1.2 × 103 cells/µL. In vivo, strong, and durable detection of transplanted labeled cells within 5 days at all investigated areas is seen by micro-CT and immunohistochemical assay. This approach confirms the potential of gold nanocomplexes in longitudinal in vivo cell tracking, which may facilitate their application in CT image-guided interventions commonly used in oromaxillofacial or systemic applications of stem cell therapy.
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Affiliation(s)
- Chen Zong
- Department of Oral Health Sciences‐Orthodontics KU Leuven and Dentistry University Hospitals Leuven Leuven 3000 Belgium
| | - Annelies Bronckaers
- Biomedical Research Institute Faculty of Life Sciences University of Hasselt Diepenbeek 3590 Belgium
| | - Greetje Vande Velde
- Biomedical MRI/Molecular Small Animal Imaging Center (MoSAIC) KU Leuven Leuven 3000 Belgium
| | - Guy Willems
- Department of Oral Health Sciences‐Orthodontics KU Leuven and Dentistry University Hospitals Leuven Leuven 3000 Belgium
| | - Maria Cadenas de Llano‐Pérula
- Department of Oral Health Sciences‐Orthodontics KU Leuven and Dentistry University Hospitals Leuven Leuven 3000 Belgium
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20
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Shaheen E, Danneels M, Doucet K, Dormaar T, Verdonck A, Cadenas de Llano-Pérula M, Willems G, Politis C, Jacobs R. Validation of a 3D methodology for the evaluation and follow-up of secondary alveolar bone grafting in unilateral cleft lip and palate patients. Orthod Craniofac Res 2021; 25:377-383. [PMID: 34817927 DOI: 10.1111/ocr.12546] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 11/08/2021] [Accepted: 11/14/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of the study was to propose and validate a method for three-dimensional (3D) quantitative assessment of secondary alveolar bone grafting (SABG) and its stability in time for patients with unilateral cleft lip and palate (UCLP). SETTINGS AND SAMPLE POPULATION Ten non-syndromic UCLP patients (9 males and 1 female with a mean age of 9.5 ± 0.9 years) undergoing SABG with good quality preoperative, immediate postoperative (6 weeks) and 6 months postoperative Cone Beam Computed Tomography (CBCT) scans were selected. MATERIALS AND METHODS The preoperative and 6 months postoperative scans were registered onto the immediate postoperative scan. The bone-grafted region was defined on the immediate postoperative scan and refined on the registered preoperative scan resulting in a 3D volume. The residual bone graft was calculated by applying threshold based segmentation on the registered 6 months postoperative scan within the segmented bone graft volume of the previous step. Inter and intra observer tests using intra-class correlation coefficient (ICC) were applied comparing the volumes of the 3D models. RESULTS An excellent reliability was found for inter and intra observers with ICC ≥ 0.95. CONCLUSIONS The presented method proved to be reliable for volumetric assessment of the alveolar bone graft in UCLP patients, as well as to assess the percentage of bone resorption during follow-up.
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Affiliation(s)
- Eman Shaheen
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Margaux Danneels
- Department of Oral Health Sciences-Orthodontics, University Hospitals Leuven, KU Leuven and Dentistry, Leuven, Belgium
| | - Kaat Doucet
- Department of Oral Health Sciences-Orthodontics, University Hospitals Leuven, KU Leuven and Dentistry, Leuven, Belgium
| | - Titiaan Dormaar
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Anna Verdonck
- Department of Oral Health Sciences-Orthodontics, University Hospitals Leuven, KU Leuven and Dentistry, Leuven, Belgium
| | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, University Hospitals Leuven, KU Leuven and Dentistry, Leuven, Belgium
| | - Guy Willems
- Department of Oral Health Sciences-Orthodontics, University Hospitals Leuven, KU Leuven and Dentistry, Leuven, Belgium
| | - Constantinus Politis
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Solna, Sweden
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21
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Danneels F, Verdonck A, Indencleef K, Declerck D, Willems G, Cadenas De Llano-Pérula M. Determination of craniofacial and dental characteristics of individuals with Williams-Beuren syndrome by using 3D facial scans and radiographs. Orthod Craniofac Res 2021; 25:359-367. [PMID: 34634190 DOI: 10.1111/ocr.12541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 09/13/2021] [Accepted: 09/18/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Williams-Beuren syndrome (WBS) is caused by a microdeletion on chromosome 7q11-23 and clusters a variety of systemic affectations. AIM To investigate whether 3D facial scans can detect WBS by objectively addressing their craniofacial, skeletal and dental characteristics, compared with those of a non-affected control group. MATERIALS AND METHODS 3D facial surface scans of 17 WBS individuals and 33 normal developing patients were analysed. Additionally, cephalometric and panoramic radiographs of subjects with WBS were compared with those of non-affected individuals. RESULTS The 3D surface scans showed significant facial differences around the nose and mouth area. The cephalometric aspects of individuals with WBS differed mainly at the lower incisor region. Additionally, hypoplastic tooth morphology seems to be more often present in WBS. CONCLUSION 3D images are a non-invasive, efficient method to observe facial anomalies and facilitate an early diagnosis of WBS. Additionally, the analysis of the cephalometric and panoramic images revealed significant differences in dental characteristics. Together with early diagnosis through 3D images, these can help in the establishment of adequate medical, dental and orthodontic treatment planning.
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Affiliation(s)
- Florence Danneels
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Anna Verdonck
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Karlijne Indencleef
- Department of Electrical Engineering - Medical Imaging Research Center, KU Leuven, Leuven, Belgium
| | - Dominique Declerck
- Department of oral Health Sciences - Population Studies in Oral Health & Paediatric Dentistry and Special Dental Care, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Guy Willems
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Maria Cadenas De Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
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22
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Cadenas de Llano-Pérula M, Kihara E, Thevissen P, Nyamunga D, Fieuws S, Kanini M, Willems G. Validating dental age estimation in Kenyan black children and adolescents using the Willems method. Med Sci Law 2021; 61:180-185. [PMID: 33270504 DOI: 10.1177/0025802420977379] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE This study aimed to validate the Willems Belgian Caucasian (Willems BC) age estimation model in a Kenyan sample, to develop and validate a Kenyan-specific (Willems KB) age estimation model and to compare the age prediction performances of both models. METHODS Panoramic radiographs of 1038 (523 female, 515 male) Kenyan children without missing permanent teeth and without all permanent teeth fully developed (except third molars) were retrospectively selected. Tooth development of the seven lower-left permanent teeth was staged according to Demirjian et al. The Willems BC model, performed on a Belgian Caucasian sample and a constructed Kenyan-specific model (Willems KB) were validated on the Kenyan sample. Their age prediction performances were quantified and compared using the mean error (ME), mean absolute error (MAE) and root-mean-square error (RMSE). RESULTS The ME with Willems BC method equalled zero. Hence, there was no systematic under- or overestimation of the age. For males and females separately, the ME with Willems BC was significantly different from zero, but negligible in magnitude (-0.04 and 0.04, respectively). Willems KB was found not to outperform Willems BC, since the MAE and RMSE were comparable (0.98 vs 0.97 and 1.31 vs 1.29, respectively). Although Willems BC resulted in a higher percentage of subjects with predicted age within a one-year difference of the true age (63.3% vs 60.4%, p=0.018), this cannot be considered as clinically relevant. CONCLUSION There is no reason to use a country-specific (Willems KB) model in children from Kenya instead of the original Willems (BC) model.
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Affiliation(s)
- Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences - Orthodontics, KU Leuven and Dentistry, University Hospital Leuven, Leuven, Belgium
| | - Eunice Kihara
- Department of Oral and Maxillofacial Surgery, School of Dental Sciences, University of Nairobi, Nairobi, Kenya
| | - Patrick Thevissen
- Department of Imaging and Pathology - Forensic Odontology, KU Leuven, Leuven, Belgium
| | - Donna Nyamunga
- Forensic Odontologist, Ministry of Health - NPHLS, Nairobi, Kenya
| | - Steffen Fieuws
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics, KU Leuven and University Hasselt, Leuven, Belgium
| | | | - Guy Willems
- Department of Oral Health Sciences - Orthodontics, KU Leuven and Dentistry, University Hospital Leuven, Leuven, Belgium
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23
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Van de Velde AS, De Boodt L, Cadenas de Llano-Pérula M, Laenen A, Willems G. Short term effects of interceptive expansion treatment: a prospective study. Eur J Orthod 2021; 43:324-331. [PMID: 33830217 DOI: 10.1093/ejo/cjab006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES This prospective cohort study investigated the short term effects of interceptive orthodontic treatment with a removable expansion plate, evaluating the changes in occlusion in all its dimensions: transversal, sagittal and vertical. SUBJECTS AND METHODS A total of 226 patients treated with a removable expansion plate (slow maxillary expansion, SME) by orthodontic residents at the Department of Orthodontics, University Hospitals Leuven, Belgium were included. The patients had a mean age of 8.5 years at the start of the treatment. The mean treatment time was 6.9 months. Transversal measurements (intercanine and intermolar width) and occlusal characteristics (molar occlusion, overjet, overbite and functional shift) were collected before (T0) and after active treatment (T1). Statistical analysis was performed using the Wilcoxon signed rank test, Sign test and McNemar test for assessing changes between T0 and T1. Linear models were used to assess the associations between patient factors and the amount of expansion. RESULTS A significant increase in transversal width at different occlusal landmarks was found. Correction of unilateral, bilateral and frontal crossbites was successful in 99.0%, 95.2% and 93.6% of the cases respectively. Changes in sagittal molar occlusion were significant: 64.9% (right side) and 62.6% (left side) remained stable, 28.4% (right) and 29.3% (left) improved and 6.7% (right) and 8.1% (left) deteriorated. Overbite changes were found to be statistically significant, though clinically irrelevant. Overjet changes were non-significant. CONCLUSIONS A removable expansion plate is successful in improving the transversal dental dimensions of the maxilla. Statistically significant sagittal effects on molar occlusion were found. Long-term follow-up is needed to evaluate the long-term stability of this treatment.
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Affiliation(s)
- A-S Van de Velde
- Department of Oral Health Sciences-Orthodontics, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - L De Boodt
- Department of Oral Health Sciences-Orthodontics, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - M Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - A Laenen
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics, KU Leuven and University Hasselt, Belgium
| | - G Willems
- Department of Oral Health Sciences-Orthodontics, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
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24
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Aleksieva A, Begnoni G, Verdonck A, Laenen A, Willems G, Cadenas de Llano-Pérula M. Self-Esteem and Oral Health-Related Quality of Life within a Cleft Lip and/or Palate Population: A Prospective Cohort Study. Int J Environ Res Public Health 2021; 18:ijerph18116078. [PMID: 34199997 PMCID: PMC8200197 DOI: 10.3390/ijerph18116078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/21/2021] [Accepted: 05/29/2021] [Indexed: 11/16/2022]
Abstract
(1) Objective: To investigate the oral health-related quality of life (OHRQoL) and self-esteem (SE) of a population with cleft lip and/or palate (CLP) and to compare it with a non-affected control cohort. (2) Materials and methods: This study comprised 91 CLP patients and a control group of 790 individuals, seeking orthodontic treatment. OHRQoL and SE were assessed by the Child’s Perception Questionnaire (CPQ) and the Dutch adaptation of the Harter’s Self-Perception Profile for Adolescents. Treatment need and self-perception of oral aesthetic were assessed using the Index of Orthodontic Treatment Need (IOTN) and the Oral Aesthetic Subjective Impact Scale (OASIS). Patients’ expectations and motivation for treatment were also scored. Linear models were used for statistical comparisons between groups. (3) Results: The cleft group scored higher in all domains of the CPQ, OASIS, IOTN and regarding SE for the domains of scholastic competence, athletic competence, physical appearance and behavioral conduct. The cleft group was not only more motivated and expected less discomfort during treatment but also had higher expectations for the treatment outcome. (4) Conclusions: The OHRQoL of CLP patients is strongly correlated with the presence of an oral cleft, while SE remains a personal resource not influenced by the malocclusion or medical condition.
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Affiliation(s)
- Antonia Aleksieva
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, Blok A, Bus 7001, 3000 Leuven, Belgium; (A.A.); (G.B.); (A.V.); (G.W.)
| | - Giacomo Begnoni
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, Blok A, Bus 7001, 3000 Leuven, Belgium; (A.A.); (G.B.); (A.V.); (G.W.)
| | - Anna Verdonck
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, Blok A, Bus 7001, 3000 Leuven, Belgium; (A.A.); (G.B.); (A.V.); (G.W.)
| | - Annouschka Laenen
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics, KU Leuven and University Hasselt, 3000 Leuven, Belgium;
| | - Guy Willems
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, Blok A, Bus 7001, 3000 Leuven, Belgium; (A.A.); (G.B.); (A.V.); (G.W.)
| | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, Blok A, Bus 7001, 3000 Leuven, Belgium; (A.A.); (G.B.); (A.V.); (G.W.)
- Correspondence: ; Tel.: +32-16332017
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25
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Roelandt MA, Devriendt K, de Llano-Pérula MC, Raes M, Willems G, Verdonck A. Dental and Craniofacial Characteristics in Patients With 14Q22.1-Q22.2 Deletion: A Case Series. Cleft Palate Craniofac J 2020; 58:505-513. [PMID: 33063524 DOI: 10.1177/1055665620954090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This case series is a follow-up report focusing on dental and facial characteristics in patients with a rare microdeletion in chromosome 14q22.1-q22.2. Usually, these patients have severe ocular, brain, and digital abnormalities. However, this case series shows that clinical presentation can be mild. Four relatives spanning 3 generations were diagnosed with a familial autosomal dominant 2.79 Mb microdeletion in chromosome 14q22.1-q22.2. Genetic screening was done by the Bacterial Artificial Chromosome array-comparative genome hybridization and was confirmed by the fluorescence in situ hybridization technique. Dental and craniofacial data were collected from medical files, clinical examinations, clinical photos, panoramic and cephalometric radiographs, and dental casts. Written informed consent for scientific use was obtained for all family members. No larger syndrome could be identified. All cases had similar facial red flag characteristics, consisting of a long face with retrognathia and open mouth relation, associated oral clefts in varying degrees, depressed nasal bridge, delayed tooth development, hypertelorism, and low-set angular ears. The dental casts showed a distal molar occlusion and a lack of space in the dental arches. Developmental delay was noted together with limb defects such as poly- and syndactyly. Microphthalmia and hearing loss were present in the most severe cases. This rare congenital disorder, associated with facial dysmorphia, oral clefts, and tooth agenesis, can remain undiagnosed until adulthood. A family history of short stature, developmental delay, poly- or syndactyly, and micropthalmia are suggestive features. Similar reports help to raise awareness among dental practitioners, leading to an early genetic diagnosis.
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Affiliation(s)
- Marie Anne Roelandt
- Department of Oral Health Sciences-Orthodontics, 60182KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | | | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, 60182KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Margot Raes
- Department of Oral Health Sciences-Orthodontics, 60182KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Guy Willems
- Department of Oral Health Sciences-Orthodontics, 60182KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Anna Verdonck
- Department of Oral Health Sciences-Orthodontics, 60182KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium.,Multidisciplinary Cleft Lip and Palate Team, University Hospitals Leuven, Leuven, Belgium
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26
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Gaitan-Romero L, Shujaat S, Ma H, Orhan K, Shaheen E, Mulier D, Willems G, Politis C, Jacobs R. Evaluation of long-term hard tissue relapse following surgical-orthodontic treatment in skeletal class II patients: A systematic review and meta-analysis. Int J Oral Maxillofac Surg 2020; 50:477-486. [PMID: 33041167 DOI: 10.1016/j.ijom.2020.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 09/04/2020] [Accepted: 09/07/2020] [Indexed: 11/17/2022]
Abstract
This systematic review and meta-analysis was performed to evaluate the long-term hard tissue stability and relapse factors following surgical-orthodontic treatment in skeletal class II patients. A literature search was conducted using Embase, Cochrane Central, Web of Science, and PubMed, yielding 3184 articles published up to January 2019. Risk of bias was assessed following the Cochrane handbook. Ten articles met the inclusion criteria. A total of 1079 patients were followed up for 5-13 years. The qualitative findings showed a variety of extrinsic and intrinsic factors affecting long-term stability. Meta-analysis for the amount and direction of cephalometric landmark displacement in the vertical and sagittal planes showed significant angular increases of ANB and backward relapse of SNB, however within the clinically acceptable range of 4°. In relation to linear measurements, the mean differences in all landmarks were within the clinically acceptable range of 2mm except for gonion. In conclusion, this systematic review showed multiple intrinsic and extrinsic factors responsible for relapse. However, the outcomes of the meta-analysis are limited due to the heterogeneity of data, small number of studies, and inconsistent methods of evaluation. Further high-quality studies utilising standardised three-dimensional methodologies are required to improve the level of evidence.
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Affiliation(s)
- L Gaitan-Romero
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.
| | - S Shujaat
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - H Ma
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - K Orhan
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; Ankara University Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Ankara, Turkey
| | - E Shaheen
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - D Mulier
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - G Willems
- Department of Oral Health Sciences - Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - C Politis
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - R Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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27
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Van Dyck J, Begnoni G, Willems G, Laenen A, Thevissen P, Verdonck A, Cadenas de Llano-Pérula M. Dental development in patients with and without unilateral cleft lip and palate (UCLP): a case control study. Clin Oral Investig 2020; 25:2619-2631. [PMID: 32914272 DOI: 10.1007/s00784-020-03573-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 09/03/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To evaluate if the presence of unilateral cleft lip and palate (UCLP) causes delay in dental age and tooth development. MATERIALS AND METHODS Panoramic radiographs of 189 non-syndromic UCLP patients, aged from 6 to 20 years, were collected. Two measures of tooth development were examined: dental maturity scale for the seven left mandibular teeth (dental age-DA) and the degree of each tooth development (developmental score-DS). All the teeth except third molars were staged according to the Demirjian's method. The data of the cleft group were compared with a control group matched for age and gender, based on the findings observed in other 189 panoramic radiographs. RESULTS At all ages, DA was lower in the UCLP group, but not always significantly; the highest difference was - 1.411 for females at 13 years old and - 0.776 for males at 12 years old. DS of all teeth was significantly lower in the UCLP group, at all ages under 17 in females, and at all ages under 18 in males. In UCLP group, tooth development was more delayed in the maxilla compared with the mandible. No evidence of a slower development at the cleft side compared with the non-cleft side was highlighted. CONCLUSIONS Significant lower dental development was observed in UCLP patients compared with control ones by using DS and DA indexes. CLINICAL RELEVANCE These findings can help the clinicians in establishing a proper orthodontic and surgical diagnosis and treatment planning in UCLP patients and for forensic age estimation's purposes.
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Affiliation(s)
- Julie Van Dyck
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Giacomo Begnoni
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Guy Willems
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Annouschka Laenen
- Interuniversity Institute for Biostatistics and statistical Bioinformatics, KU Leuven and University Hasselt, Kapucijnenvoer 35, 3000, Leuven, Belgium
| | - Patrick Thevissen
- Department of Imaging and Pathology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Anna Verdonck
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium.
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Van Gorp G, Bormans N, Vanham I, Willems G, Declerck D. Orthodontic treatment recommendation and expected adverse reactions in patients with a history of dental trauma: A survey among general dentists, paediatric dentists, and orthodontic specialists. Int J Paediatr Dent 2020; 30:360-369. [PMID: 31803975 DOI: 10.1111/ipd.12603] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 10/21/2019] [Accepted: 12/02/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND Trauma-induced adverse reactions may trigger complications when moving teeth orthodontically. AIM The purpose of this study was to evaluate the knowledge of dental practitioners about this topic. DESIGN A questionnaire survey was organized among general dentists, paediatric dentists, and orthodontists in Flanders (Belgium). Three clinical cases describing trauma-induced tooth damage (tooth ankylosis, apical root resorption, and pulp/root canal obliteration) were presented, followed by a set of questions. RESULTS The questionnaire was completed by 121 general dentists (GD), 47 paediatric dentists (PD), and 99 orthodontic specialists (OS). In the case with ankylosis, impossibility to move the tooth orthodontically was reported as most frequent adverse reaction (82.8% of GD, 95.7% of PD, and 100.0% of OS) (P < .001). In the situation of apical root resorption, the most frequently reported adverse event was progressive apical root resorption (78.9%, 85.7%, and 88.8% respectively; P = .265). Most frequently mentioned adverse reaction in the case with pulp and root canal obliteration was tooth discoloration (64.1%, 57.1%, and 78.3%; P = .055), followed by apical root resorption (57.4%, 56.8%, and 68.7%; P = .283). Orthodontic treatment recommendation differed among specific clinical situations but also among groups of dental practitioners. CONCLUSIONS Important knowledge gaps exist regarding the orthodontic managment of traumatized teeth. This topic requires more attention in undergraduate training, specialist training, and continuing education.
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Affiliation(s)
- Gertrude Van Gorp
- Department of Oral Health Sciences, KU Leuven, Leuven, Belgium.,University Hospitals Leuven, Leuven, Belgium
| | - Naomi Bormans
- Department of Oral Health Sciences, KU Leuven, Leuven, Belgium
| | - Ingrid Vanham
- Department of Oral Health Sciences, KU Leuven, Leuven, Belgium
| | - Guy Willems
- Department of Oral Health Sciences, KU Leuven, Leuven, Belgium.,University Hospitals Leuven, Leuven, Belgium
| | - Dominique Declerck
- Department of Oral Health Sciences, KU Leuven, Leuven, Belgium.,University Hospitals Leuven, Leuven, Belgium
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Begnoni G, Cadenas de Llano-Pérula M, Dellavia C, Willems G. Cephalometric traits in children and adolescents with and without atypical swallowing: A retrospective study. Eur J Paediatr Dent 2020; 21:46-52. [PMID: 32183528 DOI: 10.23804/ejpd.2020.21.01.09] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIM It has been suggested that atypical swallowing (AS) may negatively influence the skeletal and alveolar development, but its specific effects are still unclear. The aim of this work is to compare the cephalometric characteristics of children and adolescents with and without AS. MATERIALS AND METHODS Study design: Case-control retrospective cross-sectional study. One hundred patients with (AS group) and 100 patients without AS (control group, C) were retrospectively selected. Their cephalometric data before orthodontic treatment were compared using a 3-way ANOVA variance test to detect any differences between groups considering: the type of swallowing (AS vs C); whether or not the second dentition was completed (SDC vs SDNC); and the gender (males-M and females-F). In addition, a Student-t test for unpaired data was carried out to detect differences between M and F within the AS and C groups. RESULTS When compared to the controls, AS patients showed a significantly decreased SNB angle (p<.01), increased ANB and SN^Go. Me angles (p<.0001), increased overjet and lower facial height (p<.01), decreased overbite (p<.0001), and increased proclination of the upper incisors. AS-SDC patients also showed significantly increased alveolar length. Within the AS and C groups, skeletal and alveolar measurements were larger in males, with higher significance in the C group, suggesting a different trend of growth in AS patients. CONCLUSION AS seems to affect the skeletal growth causing mandibular clockwise rotation, skeletal Class II, open bite and incisor proclination. To compensate for these effects, an increase in alveolar growth together with molar eruption seems to be induced.
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Affiliation(s)
- G Begnoni
- 1Phd fellow, DDS, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Italy
| | - M Cadenas de Llano-Pérula
- Associate Professor, DDS, PhD, Department of Oral Health Sciences - Orthodontics, KU Leuven and Dentistry, University Hospital Leuven, Belgium
| | - C Dellavia
- Associate Professor, DDS, PhD, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Italy
| | - G Willems
- Professor and Department Chair, DDS, PhD, Department of Oral Health Sciences - Orthodontics, KU Leuven and Dentistry, University Hospital Leuven, Belgium
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Gaitán Romero L, Mulier D, Orhan K, Shujaat S, Shaheen E, Willems G, Politis C, Jacobs R. Evaluation of long-term hard tissue remodelling after skeletal class III orthognathic surgery: a systematic review. Int J Oral Maxillofac Surg 2020; 49:51-61. [DOI: 10.1016/j.ijom.2019.02.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 02/25/2019] [Accepted: 02/28/2019] [Indexed: 12/11/2022]
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Van Dyck J, Cadenas de Llano-Pérula M, Willems G, Verdonck A. Dental development in cleft lip and palate patients: A systematic review. Forensic Sci Int 2019; 300:63-74. [DOI: 10.1016/j.forsciint.2019.04.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 02/14/2019] [Accepted: 04/09/2019] [Indexed: 11/30/2022]
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Begnoni G, Cadenas de Llano‐Pérula M, Willems G, Pellegrini G, Musto F, Dellavia C. Electromyographic analysis of the oral phase of swallowing in subjects with and without atypical swallowing: A case‐control study. J Oral Rehabil 2019; 46:927-935. [DOI: 10.1111/joor.12826] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 05/10/2019] [Accepted: 05/26/2019] [Indexed: 12/23/2022]
Affiliation(s)
- Giacomo Begnoni
- Department of Biomedical, Surgical and Dental Sciences University of Milan Milan Italy
| | | | - Guy Willems
- Department of Oral Health Sciences‐Orthodontics, KU Leuven and Dentistry University Hospital Leuven Leuven Belgium
| | - Gaia Pellegrini
- Department of Biomedical, Surgical and Dental Sciences University of Milan Milan Italy
| | - Federica Musto
- Department of Biomedical, Surgical and Dental Sciences University of Milan Milan Italy
| | - Claudia Dellavia
- Department of Biomedical, Surgical and Dental Sciences University of Milan Milan Italy
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Jaeken K, Cadenas de Llano-Pérula M, Lemiere J, Verdonck A, Fieuws S, Willems G. Reported changes in oral health-related quality of life in children and adolescents before, during, and after orthodontic treatment: a longitudinal study. Eur J Orthod 2019; 41:125-132. [PMID: 29917078 DOI: 10.1093/ejo/cjy035] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To investigate the changes in oral health-related quality of life (OHRQoL) before, during, and after orthodontic treatment, determine the relationship with the original treatment need and evaluate the influence of self-esteem (SE). MATERIALS AND METHODS OHRQoL questionnaires were used in an ongoing observational prospective cohort study at baseline (T0), 1 year after start (T1), and 1 month after the end of active orthodontic treatment (T2). Participants were 11-16-year-old at baseline and 215 complete cases were obtained from a total of 498. OHRQoL was scored by using the Child Perception Questionnaire (CPQ11-14), SE was assessed by the Dutch adaptation of the Harter's Self-Perception Profile for Adolescents and treatment need was defined by the Index of Orthodontic Treatment Need (IOTN). The Oral Aesthetic Subjective Impact Scale (OASIS) was included to score perceived treatment need. Data were analyzed with Spearman correlation, Mann-Whitney U-test and linear models for longitudinal data. RESULTS A significant decrease in IOTN and in OASIS was noted from T0-T1-T2 (P < 0.0001). CPQ results show a decrease from T0 to T2, from T1 to T2 and an increase from T0 to T1 (P < 0.0001). This was valid for the overall CPQ scores and its subdomains except for emotional well-being (EW), which decreases from T0-T1-T2. A correlation was found between baseline SE and the change of total CPQ scores between T0 and T2, also for EW (r = 0.325 and r = 0.354). CONCLUSIONS OHRQoL ameliorates after orthodontic treatment. High baseline SE works as a protective factor for OHRQoL.
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Affiliation(s)
- Katrien Jaeken
- Department of Oral Health Sciences Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Jurgen Lemiere
- Child and Adolescent Psychiatry/Pediatric Haemato-oncology, University Hospitals Leuven, Leuven, Belgium
| | - Anna Verdonck
- Department of Oral Health Sciences Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Steffen Fieuws
- Interuniversity Institute for Biostatistics and statistical Bioinformatics, KU Leuven and University Hasselt, Hasselt, Belgium
| | - Guy Willems
- Department of Oral Health Sciences Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
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Avontroodt S, Lemiere J, Cadenas de Llano-Pérula M, Verdonck A, Laenen A, Willems G. The evolution of self-esteem before, during and after orthodontic treatment in adolescents with dental malocclusion, a prospective cohort study. Eur J Orthod 2019; 42:257-262. [DOI: 10.1093/ejo/cjz048] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Summary
Objectives
This study aimed (1) to investigate the evolution of self-esteem through orthodontic treatment, and (2) to study how key demographic factors would affect these evolutions and to assess relationships between self-esteem and orthodontic treatment need.
Methods
This longitudinal prospective cohort study comprised of 326 adolescents (172 girls and 154 boys) aged 11–16 years; data were obtained from 325 adolescents at T0 and 123 at T2. Three hundred twenty-one adolescents filled in questionnaires at T0, whereas 118 at T2. They were selected in the University Hospitals Leuven, Belgium, where they all received orthodontic treatment. Self-esteem was assessed with the Dutch adaptation of the Harter’s test and treatment need was defined by the Index of Orthodontic Treatment Need (IOTN). Data were analysed with multivariate linear models and Spearman correlations.
Results
There was no evidence of a change in global self-esteem during orthodontic treatment. A significant gender by time interaction for scholastic competence (P < 0.05), a decrease in self-esteem for females, and an increase for males between T0 and T1 was observed. A significant age (at T0) by time interaction for physical appearance and global self-worth (P < 0.05) and a negative correlation between self-esteem and self-assessed IOTN aesthetic component for the subdomain of close friendship (P < 0.05) were found.
Conclusions
Global self-esteem acts as a stable construct during orthodontic treatment. The subdomains of self-esteem could be influenced by age and gender. Self-esteem and the subjective need for orthodontic treatment were found to be negatively correlated.
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Affiliation(s)
- Stephanie Avontroodt
- Department of Oral Health Sciences—Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven
| | | | | | - Anna Verdonck
- Department of Oral Health Sciences—Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven
| | - Annoushka Laenen
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics, KU Leuven and University Hasselt, Belgium
| | - Guy Willems
- Department of Oral Health Sciences—Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven
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Alqerban A, Almanea A, Alkanhal A, Aljarbou F, Almassen M, Fieuws S, Willems G. Impact of orthodontic treatment on the integrity of endodontically treated teeth. Eur J Orthod 2019; 41:238-243. [PMID: 29982467 DOI: 10.1093/ejo/cjy049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM The purpose of this study was to evaluate the periapical status of endodontically treated teeth and the integrity of endodontic treatment before and after orthodontic treatment. MATERIALS AND METHODS This retrospective study was conducted by evaluating 128 teeth with root canal treatment (RCT). The teeth were obtained from 72 patients (23 males, 49 females) who had undergone fixed orthodontic treatment. Panoramic radiographs were taken and were evaluated before the start and after the completion of orthodontic treatment. Apical periodontitis (AP) was evaluated by the periapical index (PAI) and the probability index (PRI) of periapical bone destruction. Other variables related to the quality of root canal fillings were included, such as RCT quality index, length, and homogeneity, and coronal restoration. RESULTS According to the PRI, the proportion of teeth with periapical bone destruction was significantly higher after orthodontic treatment. Overall, there was no significant change in the PAI scores after orthodontic treatment. However, the quality of the endodontic treatment moderated the change in the PAI score, as well as the change in the PRI. There was no significant increase in PAI and PRI scores after orthodontic treatment for adequately treated teeth. However, the risk for periapical lesions and bone destruction after orthodontic treatment was significantly increased for teeth receiving inadequate endodontic treatment compared with those receiving adequate endodontic treatment. CONCLUSION Increased PAI and PRI after orthodontic treatment correlated with the quality of endodontic treatment.
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Affiliation(s)
- Ali Alqerban
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | | | | | - Fahd Aljarbou
- Division of Endodontics, Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | - Steffen Fieuws
- Department of Public Health, Interuniversity Institute for Biostatistics and Statistical Bioinformatics, KU Leuven and Universiteit Hasselt, Belgium
| | - Guy Willems
- Department of Oral Health Sciences, KU Leuven Dentistry, University Hospitals Leuven, Belgium
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Van Gorp G, Bormans N, Vanham I, Willems G, Declerck D. Knowledge of orthodontic treatment approach of traumatized teeth by a group of Belgian general dentists, pediatric dentists, and orthodontists. Dent Traumatol 2019; 35:233-240. [PMID: 30963684 DOI: 10.1111/edt.12474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 04/01/2019] [Accepted: 04/02/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND/AIM Traumatized teeth are more susceptible to complications during orthodontic tooth movement. The aim of this study was to explore current practices among Belgian dental practitioners regarding orthodontic treatment of children with a history of dental trauma. MATERIAL AND METHODS A questionnaire survey was organized among general dentists, pediatric dentists, and orthodontists in Flanders (Belgium). Questionnaires were distributed at the occasions of annual meetings or symposia. They consisted of questions regarding exposure to dental trauma and orthodontic treatment approach for patients with a dental trauma history. RESULTS The questionnaire was completed by 121 general dentists, 47 pediatric dentists, and 99 orthodontists. A history of dental trauma influenced referral for orthodontic treatment by general dentists and pediatric dentists moderately (median VAS scores of 5 and 6, respectively, on a scale of 0 (not at all) to 10 (utmost)), indicating uncertainty and doubt. Additional checkups during tooth movement were usually not organized by general dentists in 33.6% and by pediatric dentists in 19.1% of cases (P = 0.006). One-third of the orthodontists (33.3%) experienced tooth loss linked to orthodontic movement of a tooth with dental trauma history in at least one patient. Only a minority of the practitioners knew of the existence of specific guidelines (7.6%, 15.6% and 22.7%, respectively, of general dentists, pediatric dentists, and orthodontists) (P = 0.007). The Dental Trauma Guide was the guideline mentioned most frequently, although this tool does not contain recommendations regarding orthodontic treatment after trauma. CONCLUSION In the group of Belgian general dental, pediatric and orthodontists surveyed, there was uncertainty regarding the orthodontic management of patients with a history of dental trauma especially among general practitioners. Further educational training is recommended.
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Affiliation(s)
- Gertrude Van Gorp
- KU Leuven Department of Oral Health Sciences, Population Studies in Oral Health, Leuven, Belgium
| | | | | | - Guy Willems
- KU Leuven Department of Oral Health Sciences Orthodontics, KULeuven and Dentistry, UHLeuven, Leuven, Belgium
| | - Dominique Declerck
- KU Leuven Department of Oral Health Sciences, Population Studies in Oral Health, Leuven, Belgium
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Jaeken K, Cadenas de Llano-Pérula M, Lemiere J, Verdonck A, Fieuws S, Willems G. Difference and relation between adolescents' and their parents or caregivers' reported oral health-related quality of life related to orthodontic treatment: a prospective cohort study. Health Qual Life Outcomes 2019; 17:40. [PMID: 30808364 PMCID: PMC6390370 DOI: 10.1186/s12955-019-1094-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 01/15/2019] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Parents/caregivers play an important role in deciding whether their children will undergo orthodontic treatment or not. Their perceptions also have an influence on other choices involving orthodontic treatment. The purpose of this study was to investigate the difference and correlation between the ratings given by children and their parents or caregivers on their oral health-related quality of life (OHRQoL) before, during and after orthodontic treatment. METHODS In this ongoing observational prospective cohort study, 498 children aged 11 to 16 years-old and one of their parents/caregivers completed questionnaires before (T0), 1 year after start (T1) and 1 month after the end of orthodontic treatment (T2). OHRQoL was scored by using the Child Perception Questionnaire (CPQ11-14) and the Parental-Caregiver Perception questionnaire (P-CPQ). The self-perception of oral aesthetics was evaluated with the Oral Aesthetic Subjective Impact Scale (OASIS) in addition to the aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN). Spearman correlations, Mann-Whitney U-tests and linear models were used to analyze the longitudinal data. RESULTS At T0, the ratings of parents/caregivers were significantly lower for the total CPQ as well as for the subdomains of oral symptoms, functional limitations and emotional well-being. Parents/caregivers also scored significantly lower at T2 for the total CPQ and the subdomain of oral symptoms. The relations between the scores of children and their parents/caregivers were significant at all three time points, as were the changes in scores, but all of them were at most moderate in size. Parents/caregivers scored significantly lower for OASIS than their children at all time points and only at baseline a significant, weak correlation was found. CONCLUSION The reports of parents/caregivers should be seen as important complementary information in OHRQoL research. TRIAL REGISTRATION This study was approved by the Medical Ethical Commitee of the University Hospitals Leuven and the Katholieke Universiteit Leuven (ML5739), Leuven, Belgium, on the 12th of May of 2009, with the registration number S51642. All procedures performed are in accordance with the ethical standards of the institutional and/or national research committees and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
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Affiliation(s)
- Katrien Jaeken
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000 Leuven, Belgium
| | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000 Leuven, Belgium
| | - Jurgen Lemiere
- Child and Adolescent Psychiatry/Pediatric Haemato-oncology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Anna Verdonck
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000 Leuven, Belgium
| | - Steffen Fieuws
- Interuniversity Institute for Biostatistics and statistical Bioinformatics, KU Leuven and University Hasselt, Kapucijnenvoer 35, 3000 Leuven, Belgium
| | - Guy Willems
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000 Leuven, Belgium
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EzEldeen M, Wyatt J, Al-Rimawi A, Coucke W, Shaheen E, Lambrichts I, Willems G, Politis C, Jacobs R. Use of CBCT Guidance for Tooth Autotransplantation in Children. J Dent Res 2019; 98:406-413. [DOI: 10.1177/0022034519828701] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Tooth autotransplantation (TAT) offers a viable biological approach to tooth replacement in children and adolescents. The aim of this study was to evaluate the outcome of the cone-beam computed tomographic (CBCT)–guided TAT compared to the conventional TAT protocol and to assess the 3-dimensional (3D) patterns of healing after CBCT-guided TAT (secondary aim). This study included 100 autotransplanted teeth in 88 patients. Each experimental group consisted of 50 transplants in 44 patients (31 males and 19 females). The mean (SD) age at the time of surgery was 10.7 (1.1) y for the CBCT-guided group. This was 10.6 (1.3) y for the conventional group. The mean (SD) follow-up period was 4.5 (3.1) y (range, 1.1 to 10.4 y). Overall survival rate for the CBCT-guided TAT was 92% with a success rate of 86% compared to an 84% survival rate and a 78% success rate for the conventional group ( P > 0.005). The following measurements were extracted from the 3D analysis: root hard tissue volume (RV), root length (RL), apical foramen area (AFA), and mean and maximum dentin wall thickness (DWT). Overall, the mean (SD) percentage of tissue change was as follows: RV gain by 65.8% (34.6%), RL gain by 37.3% (31.5%), AFA reduction by 91.1% (14.9%), mean DWT increase by 107.9% (67.7%), and maximum DWT increase by 26.5% (40.1%). Principal component analysis (PCA) identified the mean DWT, RV, and maximum DWT as the parameters best describing the tissue change after TAT. Cluster analysis applied to the variables chosen by the PCA classified the CBCT group into 4 distinct clusters (C1 = 37.2%, C2 = 17.1%, C3 = 28.6%, C4 = 17.1%), revealing different patterns of tissue healing after TAT. The CBCT-guided approach increased the predictability of the treatment. The 3D analysis provided insights into the patterns of healing. CBCT-guided TAT could be adopted as an alternative for the conventional approach. (Clinical trial center and ethical board University Hospitals, KU Leuven: S55287; ClinicalTrials.gov Identifier: NCT02464202)
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Affiliation(s)
- M. EzEldeen
- OMFS IMPATH Research Group, Faculty of Medicine, Department of Imaging and Pathology, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Oral Health Sciences, KU Leuven and Paediatric Dentistry and Special Dental Care, University Hospitals Leuven, Leuven, Belgium
| | - J. Wyatt
- Department of Oral Health Sciences, KU Leuven and Paediatric Dentistry and Special Dental Care, University Hospitals Leuven, Leuven, Belgium
| | - A. Al-Rimawi
- OMFS IMPATH Research Group, Faculty of Medicine, Department of Imaging and Pathology, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - W. Coucke
- Certified Freelance Statistician, Heverlee, Heverlee, Belgium
| | - E. Shaheen
- OMFS IMPATH Research Group, Faculty of Medicine, Department of Imaging and Pathology, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - I. Lambrichts
- Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - G. Willems
- Department of Oral Health Sciences, KU Leuven and Orthodontics and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - C. Politis
- OMFS IMPATH Research Group, Faculty of Medicine, Department of Imaging and Pathology, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - R. Jacobs
- OMFS IMPATH Research Group, Faculty of Medicine, Department of Imaging and Pathology, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
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Tanaka OM, Meira TM, Batista Rodrigues AC, Willems G, Baggio GL, Couto Souza PH. Marsupialization of a Large Radicular Cyst with Extensive Maxillary Tooth Displacement: Eight-Year Follow-Up. J Dent Child (Chic) 2019; 86:64-68. [PMID: 30992104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Radicular cysts arising from primary teeth are uncommon and, when present as large lesions, may adversely affect the underlying permanent teeth. The purpose of this paper is to describe the management of a very large atypical radicular cyst involving the primary dentition of a nine-year-old boy and causing extensive tooth displacement with transposition of the permanent maxillary left canine between the bicuspids. The root apex of the canine was close to the median level of the lateral border of the nasal cavity and showed incomplete root formation and signs of dilacerations in its apical third. Marsupialization was successfully performed, followed by long-term orthodontic treatment. This interdisciplinary management facilitated the lesion resolution for repositioning of the canine into functional occlusion. (J Dent Child 2019;86(1):64-8)<br/> Received October 23, 2018; Last Revision January 10, 2019; Accepted January 11, 2019.
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Affiliation(s)
- Orlando Motohiro Tanaka
- professor, Department of Orthodontics, School of Life Sciences, Pontif í cia Universidade Católica do Paraná, Curitiba, Brazil, and is postdoctoral fellow, Center for Advanced Dental Education, Saint Louis University, St. Louis, Mo., USA
| | - Thiago Martins Meira
- PhD candidate, Department of Orthodontics, School of Life Sciences, Pontifícia Universidade Católica do Paraná
| | | | - Guy Willems
- Professor, Faculty of Medicine, and head of Orthodontics, Department of Oral Health Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Gabriela Leite Baggio
- Master's degree candidate, Department of Stomatology, School of Life Sciences, Pontifícia Universidade Católica do Paraná
| | - Paulo Henrique Couto Souza
- Professor, Department of Stomatology, School of Life Sciences, Pontifícia Universidade Católica do Paraná,
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De Mulder D, Cadenas de Llano-Pérula M, Jacobs R, Verdonck A, Willems G. Three-dimensional radiological evaluation of secondary alveolar bone grafting in cleft lip and palate patients: a systematic review. Dentomaxillofac Radiol 2019; 48:20180047. [PMID: 29947253 PMCID: PMC6398910 DOI: 10.1259/dmfr.20180047] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 06/13/2018] [Accepted: 06/19/2018] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To systematically review the existing literature on the three-dimensional (3D) radiological evaluation of secondary alveolar bone grafting (SABG) in cleft lip and palate (CLP) patients, with specific interest in 3D imaging protocols and assessment methods. METHODS A comprehensive literature search on PubMed, Embase and the Cochrane Library was conducted. Included publications concerned 3D imaging for evaluation of SABG in CLP patients while articles about primary or tertiary bone grafting or using of two-dimensional images only were excluded. Study quality was evaluated using the Methodological Index for Non-Randomized Studies or the Cochrane Collaboration tool for assessing risk of bias. RESULTS The search yielded 1735 citations, of which 38 met the inclusion criteria. We noticed a large variability in imaging protocols and bone graft evaluation methods between studies. Most articles were observational studies with medium to low methodological quality, except for the one randomised clinical trial having a low risk of bias. CONCLUSIONS There is a lack of prospective, controlled trials based on a consistent imaging protocol with a sufficiently long follow-up period. A pressing need exists for the development of a consistent optimized imaging protocol for diagnosis and follow up of SABG in CLP patients. Although 3D evaluation methods seem to be more precise than two-dimensional methods, we should be careful when comparing the outcomes arising from different 3D measuring techniques.
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Affiliation(s)
- Dries De Mulder
- Department of Oral Health Sciences - Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences - Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- Department of Imaging & Pathology, Faculty of Medicine, OMFS IMPATH, University Leuven & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anna Verdonck
- Department of Oral Health Sciences - Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Guy Willems
- Department of Oral Health Sciences - Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
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Storms AS, Miclotte A, Grosjean L, Cadenas de Llano-Pérula M, Alqerban A, Fieuws S, Sun Y, Politis C, Verdonck A, Willems G. Short-term hard and soft tissue changes after mandibular advancement surgery in Class II patients: a retrospective cephalometric study. Eur J Orthod 2018; 39:567-576. [PMID: 28204270 DOI: 10.1093/ejo/cjx003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Aim The aim of this study was to describe hard and soft tissue changes after mandibular advancement surgery and to investigate the possible differences between Class II facial patterns. Materials and methods Lateral cephalograms of 109 patients who underwent combined orthodontic treatment and bilateral sagittal split osteotomy (BSSO) were studied. Radiographs were taken within 6 weeks before surgery (T0) and at least 6 months postoperatively (T1). Patients were classified into 3 groups according to the preoperative mandibular plane angle. Hard- and soft-tissue changes were analysed with an x-y cranial base coordinate system. Measurements were evaluated statistically. Results Soft and hard tissues of the chin moved forward and downward. The position of the upper lip remained unchanged, while the lower lip moved forward and upward and decreased in thickness. The soft tissue points of the chin follow their corresponding skeletal points almost completely, while the change of the lower lip was only 76 per cent of the movement of the underlying hard tissue. The increase of SNB was more evident in the low-angle group, as well as improvement of the facial convexity. Stomium superius moved more forward in the low- and medium-angle cases. Ratios of hard and soft tissue changes showed no differences for different facial patterns. Limitations Limitations derived from the retrospective study design. Only short-term changes could be addressed. The distinction between surgical changes and changes due to skeletal relapse is difficult to assess. Also, the difficulty to reproduce a relaxed lip position during imaging may influence our results. Conclusion Class II characteristics improved after mandibular advancement. Soft tissues of the chin follow their skeletal structures almost in a 1:1 relationship, while movement of the lower lip was less predictable. The facial pattern of Class II patients should be considered in treatment planning.
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Affiliation(s)
- A S Storms
- Department of Oral Health Sciences - Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - A Miclotte
- Department of Oral Health Sciences - Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - L Grosjean
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium
| | - M Cadenas de Llano-Pérula
- Department of Oral Health Sciences - Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - A Alqerban
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - S Fieuws
- Interuniversity Institute for Biostatistics and statistical Bioinformatics, KU Leuven and University Hasselt, Belgium
| | - Y Sun
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium
| | - C Politis
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium
| | - A Verdonck
- Department of Oral Health Sciences - Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - G Willems
- Department of Oral Health Sciences - Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
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Grisar K, Vanpoecke J, Raes M, Albdour EA, Willems G, Politis C, Jacobs R. Development and validation of the autotransplanted maxillary canine radiological index. Clin Exp Dent Res 2018; 4:167-173. [PMID: 30386638 PMCID: PMC6203832 DOI: 10.1002/cre2.125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 07/06/2018] [Accepted: 07/09/2018] [Indexed: 11/11/2022] Open
Abstract
The purpose of this study was to propose and validate an index evaluating 2D and 3D radiographic variables of autotransplanted maxillary canines. Setting and sample population are from the Department of Oral and Maxillofacial Surgery at University Hospitals Leuven. Eight oral-maxillofacial surgeons rated 12 autotransplanted maxillary canines and adjacent bone using 11 rating variables. A new autotransplanted maxillary canine radiological index (AMCRI) was proposed. It consisted of 11 variables. These variables were based on 2D (intraoral) and 3D Cone Beam Computed Tomography (CBCT) radiographs. Intraclass correlation coefficient (ICC) and Fleiss's kappa statistics were performed to analyze intrarater and interrater agreement. Considering cumulative assessment of the AMCRI, the mean ICC value for the interrater agreement of the eight examiners was 0.94, representing an excellent agreement. Intrarater agreement was 0.91. The AMCRI is an objective tool in rating radiological outcome of autotransplanted canines and adjacent bone, when compared with the contralateral canine.
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Affiliation(s)
- Koenraad Grisar
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenBelgium
| | - Jasper Vanpoecke
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenBelgium
| | - Margot Raes
- Department of Oral Health SciencesUniversity of Leuven, University Hospitals LeuvenBelgium
| | - Emad Ali Albdour
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenBelgium
| | - Guy Willems
- Department of Oral Health SciencesUniversity of Leuven, University Hospitals LeuvenBelgium
| | - Constantinus Politis
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenBelgium
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenBelgium
- Department of Dental MedicineKarolinska InstitutetSweden
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De Mulder D, Cadenas de Llano‐Pérula M, Willems G, Jacobs R, Dormaar JT, Verdonck A. An optimized imaging protocol for orofacial cleft patients. Clin Exp Dent Res 2018; 4:152-157. [PMID: 30386636 PMCID: PMC6203823 DOI: 10.1002/cre2.123] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 06/14/2018] [Accepted: 06/18/2018] [Indexed: 11/09/2022] Open
Abstract
The objective was to present an optimized imaging protocol for orofacial cleft (OFC) patients, which might be used as an international recommendation for OFC care programs. The present radiological protocol has been structured by the OFC team of the University Hospitals Leuven based on a combined approach of clinical experience and scientific evidence. The development was based on careful monitoring of the existing needs for radiological diagnosis by the involved disciplines. Needs were revised by expert consensus and radiological optimization. Effective doses were converted to panoramic equivalents (professional conversion) and background radiation (patient conversion). At the age of 6, a panoramic radiograph is taken for the evaluation of dental anomalies. For the preoperative planning of secondary alveolar bone, grafting a low-resolution cone beam computer tomography (CBCT) of a limited field of the maxilla is taken at the age of 7 to 9. At the age of 10, 15, and 20, a low-resolution CBCT of both jaws with the smallest possible field is taken serving as conventional, presurgical, and end of treatment records, respectively. Two-dimensional images are reconstructed out of 3D ones. There are currently no international guidelines concerning the imaging protocol for OFC patients. It is clear that a multidisciplinary approach plays a key role in radiation hygiene. In this article, we presented an optimized imaging protocol for OFC patients based on European guidelines to accomplish the concepts of justification and optimization, which might be used as an international recommendation for OFC care programs.
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Affiliation(s)
- Dries De Mulder
- Department of Oral Health Sciences‐Orthodontics, KU Leuven and DentistryUniversity Hospitals LeuvenBelgium
| | | | - Guy Willems
- Department of Oral Health Sciences‐Orthodontics, KU Leuven and DentistryUniversity Hospitals LeuvenBelgium
| | - Reinhilde Jacobs
- OMFS IMPATH, Department of Imaging & Pathology, Faculty of Medicine, University Leuven and Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenBelgium
- Department of Dental MedicineKarolinska InstitutetSweden
| | - Jakob Titiaan Dormaar
- OMFS IMPATH, Department of Imaging & Pathology, Faculty of Medicine, University Leuven and Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenBelgium
| | - Anna Verdonck
- Department of Oral Health Sciences‐Orthodontics, KU Leuven and DentistryUniversity Hospitals LeuvenBelgium
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Grisar K, Claeys G, Raes M, Albdour EA, Willems G, Politis C, Jacobs R. Development and validation of the Maxillary Canine Aesthetic Index. Clin Exp Dent Res 2018; 4:216-223. [PMID: 30386643 PMCID: PMC6203826 DOI: 10.1002/cre2.133] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 08/28/2018] [Accepted: 08/30/2018] [Indexed: 11/30/2022] Open
Abstract
Aesthetic appraisal is rarely included in the objective assessment of outcome studies of impacted maxillary canines treatment. The present study aimed to validate a new index for assessing the aesthetic appearance of maxillary canines and adjacent soft tissues. The Department of Oral and Maxillofacial Surgery at University Hospitals Leuven. Four oral-maxillofacial surgeons, two orthodontists, two prosthodontists, and two lay persons rated 11 maxillary canines and adjacent soft tissues according to the new index. Each of the examiners repeated the examination three times with a 2-week interval. Twelve relevant aesthetic variables were selected on the basis of the anatomic form, color, and surface characteristics of the canine crown and on the basis of the anatomic form, color, and surface characteristics of the adjacent soft tissues. Intraclass correlation (ICC) coefficient and Fleiss' kappa statistics were performed to analyze the intrarater and interrater agreement. The index proofed to be a reliable assessment tool. Considering the cumulative assessment of the Maxillary Canine Aesthetic Index (MCAI), the mean ICC value for the interrater agreement of the 10 examiners was 0.71, representing a good agreement. Intrarater agreement ranged from 0.10 to 0.91. Interrater agreement (Fleiss' kappa statistics) calculated for each variable ranged from 0.08 to 0.98. The MCAI is a tool in rating aesthetic outcome of impacted canine treatment and adjacent soft tissues. The MCAI can be used to evaluate the aesthetic outcome after surgical exposure or transalveolar transplantation of maxillary canines.
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Affiliation(s)
- Koenraad Grisar
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of MedicineUniversity LeuvenBelgium
- Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenBelgium
| | - Gilles Claeys
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of MedicineUniversity LeuvenBelgium
- Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenBelgium
| | - Margot Raes
- Orthodontics, Department of Oral Health SciencesUniversity of Leuven, University Hospitals LeuvenBelgium
| | - Emad Ali Albdour
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of MedicineUniversity LeuvenBelgium
- Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenBelgium
| | - Guy Willems
- Orthodontics, Department of Oral Health SciencesUniversity of Leuven, University Hospitals LeuvenBelgium
| | - Constantinus Politis
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of MedicineUniversity LeuvenBelgium
- Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenBelgium
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of MedicineUniversity LeuvenBelgium
- Department of Dental MedicineKarolinska InstitutetSweden
- Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenBelgium
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Thierens LA, Lewyllie A, Temmerman L, De Roo NM, Verdonck A, Cadenas de Llano Perula M, Willems G, De Pauw GA. A retrospective intercenter comparison of two surgical protocols through the dental arch relationship of 5- to 6-year-old unilateral cleft patients. Clin Oral Investig 2018; 23:1777-1784. [PMID: 30171346 DOI: 10.1007/s00784-018-2601-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 08/22/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES The objectives of this retrospective equivalence trial were to assess the dental arch relationship of 5- to 6-year-old patients with unilateral cleft lip and palate (UCLP) treated in two specialized cleft centers with a different surgical protocol using the 5-Year-Olds' Index and the modified Huddart/Bodenham scoring system, and to determine the correlation between these two scoring indices. MATERIALS AND METHODS The dental arch relationship of seventy-three 5- to 6-year-old patients with complete UCLP was evaluated on plaster casts using the 5-Year-Olds' Index and the modified Huddart/Bodenham scoring system. The sagittal occlusion, overbite, and overjet were also recorded. Inter- and intra-examiner agreement was determined using Intraclass Correlation Coefficients. RESULTS A good to very good inter- and intra-examiner agreement was found. No significant mean difference in outcome based on the 5-Year-Olds' Index, the modified Huddart/Bodenham scoring system, overjet, or overbite was detected. For mean difference in sagittal occlusion, the hypothesis that both centers are clinically equivalent was confirmed. A strong negative correlation (rs = - 0.832) between the 5-Year-Olds' Index and the modified Huddart/Bodenham scoring system was found. CONCLUSIONS The dental arch relationship of 5- to 6-year-old unilateral cleft patients treated in two Belgian cleft centers is clinically equivalent based on sagittal occlusion, despite substantial differences in their treatment protocol. Clinical equivalence for other parameters was not confirmed. There is a strong correlation between the 5-Year-Olds' Index and the modified Huddart/Bodenham scoring system. CLINICAL RELEVANCE A well-implemented treatment protocol for cleft patients is of the utmost importance, but case load and skill of the surgeon are also important factors for the quality of the results.
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Affiliation(s)
- Laurent Am Thierens
- Oral Health Sciences, Department of Orthodontics, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium. .,Centre for Congenital Facial Anomalies, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium.
| | - Arianne Lewyllie
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Liesbeth Temmerman
- Oral Health Sciences, Department of Orthodontics, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Noëmi Mc De Roo
- Oral Health Sciences, Department of Orthodontics, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - An Verdonck
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium.,Leuven Cleft Lip and Palate Team, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Maria Cadenas de Llano Perula
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium.,Leuven Cleft Lip and Palate Team, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Guy Willems
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Guy Am De Pauw
- Oral Health Sciences, Department of Orthodontics, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium.,Centre for Congenital Facial Anomalies, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
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Kumagai A, Willems G, Franco A, Thevissen P. Age estimation combining radiographic information of two dental and four skeletal predictors in children and subadults. Int J Legal Med 2018; 132:1769-1777. [DOI: 10.1007/s00414-018-1910-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 07/31/2018] [Indexed: 11/27/2022]
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Hereman V, Cadenas De Llano-Pérula M, Willems G, Coucke W, Wyatt J, Verdonck A. Associated parameters of canine impaction in patients with unilateral cleft lip and palate after secondary alveolar bone grafting: a retrospective study. Eur J Orthod 2018; 40:575-582. [DOI: 10.1093/ejo/cjy011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Valérie Hereman
- Department of Oral Health Sciences—Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven
| | | | - Guy Willems
- Department of Oral Health Sciences—Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven
| | | | - Jan Wyatt
- Department of Oral Health Sciences—Children and Special Care Dentistry, KU Leuven and Dentistry, University Hospitals Leuven, Belgium
| | - Anna Verdonck
- Department of Oral Health Sciences—Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven
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Capitaneanu C, Willems G, Thevissen P. A systematic review of odontological sex estimation methods. J Forensic Odontostomatol 2017; 35:1-19. [PMID: 29384732 PMCID: PMC6100233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND In human identification sex estimation plays an important role in the search for ante-mortem data. AIM To systematically review studies describing and testing/validating methods of odontological sex estimation. The set research question was: What odontological sex estimation method is the most accurate? MATERIALS AND METHODS An electronic search until November 29th 2016 was performed in 5 databases: MEDLINE/PubMed, Cochrane, SciELO, LILACS and Grey literature. The PRISMA guidelines were used. Studies were assessed and included based on the reported data. In particular data criteria were set regarding the considered population, sample size, age range, sex estimation method, type of statistical analysis and study outcome. The extracted data enabled to classify the included studies. Meta-analysis was used to compare the study outcomes per obtained study group. RESULTS The established search string detected 4720 studies. 103 were considered eligible after review of title, abstract and full-text. The odontological sex estimation methods were classified based on dental metric and non-metric measurements (n=65), cephalometric analysis (n=13), frontal and maxillary sinuses (n=5), cheiloscopy (n=4), palatal features (n=3) and biochemical analysis of teeth (n=13). Teeth measurements for sex estimation were mainly performed on casts (n=34), followed by skeletal remains (n=13), medical imaging (n=5), intraoral measurements/ photography (n=4), and cascades of the above (n=4). CONCLUSION The variety of published odontological sex estimation methods highlights the importance of sex estimation in human identification. Biochemical analysis of teeth proved to be the most accurate method, but in forensic practice, a need to select the most appropriate evidence based odontological sex estimation method exists.
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Affiliation(s)
- C Capitaneanu
- Department of Oral Health Sciences, Forensic Dentistry, KU Leuven
| | - G Willems
- Department of Oral Health Sciences, Forensic Dentistry, KU Leuven
| | - P Thevissen
- Department of Oral Health Sciences, Forensic Dentistry, KU Leuven
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Lewyllie A, Cadenas De Llano-Pérula M, Verdonck A, Willems G. Three-dimensional imaging of soft and hard facial tissues in patients with craniofacial syndromes: a systematic review of methodological quality. Dentomaxillofac Radiol 2017; 47:20170154. [PMID: 29168926 DOI: 10.1259/dmfr.20170154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To systematically review the methodological quality of three-dimensional imaging studies of patients with craniofacial syndromes and to propose recommendations for future research. METHODS PubMed, Embase and Cochrane databases as well as Grey literature were electronically searched. Inclusion criteria were patients with genetic syndromes with craniofacial manifestations and three-dimensional imaging of facial soft and/or hard tissues. Exclusion criteria consisted of non-syndromic conditions or conditions owing to environmental causes, injury or trauma, facial soft and hard tissues not included in the image analysis, case reports, reviews, opinion articles. No restrictions were made for patients' ethnicity nor age, publication language or publication date. Study quality was evaluated using the Methodological Index for Non-Randomized Studies (MINORS). RESULTS The search yielded 2228 citations of which 116 were assessed in detail and 60 were eventually included in this review. Studies showed a large heterogeneity in study design, sample size and patient age. An increase was observed in the amount of studies with time, and the imaging method most often used was CT. The most studied craniofacial syndromes were Treacher Collins, Crouzon and Apert syndrome. The articles could be divided into three main groups: diagnostic studies (34/60, 57%), evaluation of surgical outcomes (21/60, 35%) and evaluation of imaging techniques (5/60, 8%). For comparative studies, the median MINORS score was 13 (12-15, 25-75th percentile), and for non-comparative studies, the median MINORS score was 8 (7-9, 25-75th percentile). CONCLUSIONS The median MINORS scores were only 50 and 54% of the maximum scores and there was a lack of prospective, controlled trials with sufficiently large study groups. To improve the quality of future studies in this domain and given the low incidence of craniofacial syndromes, more prospective multicentre controlled trials should be set up.
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Affiliation(s)
- Arianne Lewyllie
- Department of Oral Health Sciences - Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven , Leuven , Belgium
| | - Maria Cadenas De Llano-Pérula
- Department of Oral Health Sciences - Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven , Leuven , Belgium
| | - Anna Verdonck
- Department of Oral Health Sciences - Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven , Leuven , Belgium
| | - Guy Willems
- Department of Oral Health Sciences - Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven , Leuven , Belgium
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Willems G, Lee SS, Uys A, Bernitz H, Cadenas de Llano-Pérula M, Fieuws S, Thevissen P. Age estimation based on Willems method versus new country-specific method in South African black children. Int J Legal Med 2017; 132:599-607. [PMID: 28921164 DOI: 10.1007/s00414-017-1686-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 09/04/2017] [Indexed: 11/24/2022]
Abstract
AIM The aims of our study were to develop new maturity scores for dental age estimation in South African black children according to the Willems method, which was developed based on Belgian Caucasian (BC) reference data (Willems et al. J Forensic Sci 46(4):893-895, 2001), and to compare age prediction performance of both methods. SUBJECTS AND METHODS A total of 986 panoramic radiographs of healthy South African black (SAB) children (493 males and 493 females) in the age range of 4.14 to 14.99 years (mean age 10.06 years) were selected for obtaining developmental staging scores (according to Demirjian et al. Hum Biol 45(2):211-227, 1973). Willems BC methodology was applied to develop new country-specific maturity scores (Willems SAB). Age prediction performance of Willems BC and Willems SAB was compared. RESULTS On average, Willems BC renders acceptable results with an overestimation of chronological age of 0.06 years (SD 0.88 years) in SAB children. Compared to Willems SAB, the overall mean absolute error was slightly higher with Willems BC (0.62 and 0.68 years, respectively), but this was not significant in males. Also, the root mean squared error was marginally higher in Willems BC. CONCLUSION The new age prediction method developed in South African black children was found to be better compared to Willems BC, although the difference seems to be small and clinically not relevant, especially in males.
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Affiliation(s)
- Guy Willems
- Department of Oral Health Sciences - Orthodontics, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium.
| | - Sang-Seob Lee
- Medical Examiner's Office, National Forensic Service, Wonju, South Korea
| | - Andre Uys
- Department of Oral Pathology and Oral Biology, School of Dentistry, University of Pretoria, Private bag X20, Hatfield, 0028, South Africa
| | - Herman Bernitz
- Department of Oral Pathology and Oral Biology, School of Dentistry, University of Pretoria, Private bag X20, Hatfield, 0028, South Africa
| | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences - Orthodontics, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Steffen Fieuws
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics, KU Leuven and University Hasselt, Leuven, Belgium
| | - Patrick Thevissen
- Department of Oral Health Sciences - Forensic Dentistry, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
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