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Biomedical subjects

Paola Cozza

Publications and source records attributed to Paola Cozza.

18 recordsLinked to original sources
PubMed2006

Mandibular changes produced by functional appliances in Class II malocclusion: a systematic review.

The aim of this systematic review of the literature was to assess the scientific evidence on the efficiency of functional appliances in enhancing mandibular growth in Class II subjects. A literature survey was performed by applying the Medline database (Entrez PubMed). The survey covered the period from January 1966 to January 2005 and used the medical subject headings (MeSH). The following study types that reported data on treatment effects were included: randomized clinical trials (RCTs), and prospective and retrospective longitudinal controlled clinical trials (CCTs) with untreated Class II controls. The search strategy resulted in 704 articles. After selection according to the inclusion/exclusion criteria, 22 articles qualified for the final analysis. Four RCTs and 18 CCTs were retrieved. The quality standards of these investigations ranged from low (3 studies) to medium/high (6 studies). Two-thirds of the samples in the 22 studies reported a clinically significant supplementary elongation in total mandibular length (a change greater than 2.0 mm in the treated group compared with the untreated group) as a result of overall active treatment with functional appliances. The amount of supplementary mandibular growth appears to be significantly larger if the functional treatment is performed at the pubertal peak in skeletal maturation. None of the 4 RCTs reported a clinically significant change in mandibular length induced by functional appliances; 3 of the 4 RCTs treated subjects at a prepubertal stage of skeletal maturity. The Herbst appliance showed the highest coefficient of efficiency (0.28 mm per month) followed by the Twin-block (0.23 mm per month).

Humans↗
PubMed2006

Treatment effects of a modified quad-helix in patients with dentoskeletal open bites.

INTRODUCTION: The aim of this study was to investigate the effectiveness of a quad-helix/crib (Q-H/C) appliance in a group of growing subjects with thumb-sucking habits and both dental and skeletal open bites. METHODS: The records of 23 subjects treated with Q-H/C appliances were compared with a control group of 23 untreated subjects with similar vertical relationships. Lateral cephalograms were analyzed before treatment (T1; mean age, 8.4 +/- 1.4 years) and immediately after treatment (T2; mean age, 9.9 +/- 1.5 years). Mean duration of treatment was 1.5 +/- 7 months. The T2-T1 changes in the 2 groups were compared with a nonparametric test for independent samples (Mann-Whitney U test). RESULTS: The average increase in overbite during Q-H/C therapy (3.6 mm more than the control group) overcorrected the amount of anterior open bite at T2. However, 4 of 23 subjects did not show positive overbites at T2. Both the maxillary and mandibular incisors had significantly greater lingual inclinations (about 4.0 degrees) associated with greater extrusion (1.4 and 1.0 mm, respectively) in the Q-H/C group than in the control group. In addition, the treated group showed a greater downward rotation (1.2 degrees) of the palatal plane than did the control group. This change was associated with a greater increase in upper anterior facial height (0.7 mm) and a clinically significant reduction in the palatal plane-mandibular plane angle (-1.7 degrees) in the Q-H/C group with respect to the controls. The upper and lower lips showed significant tendencies toward retraction relative to the E-plane in the treated group (2.6 and 2.9 mm, respectively) compared with the controls. CONCLUSIONS: The Q-H/C appliance was effective in correcting the dental open bite in 90% of growing subjects with thumb-sucking habits and dentoskeletal open bites. The Q-H/C protocol produced a clinically significant improvement in the vertical skeletal relationships because of downward rotation of the palatal plane.

Cephalometry↗
PubMed2006

Shear bond strength of metal brackets on enamel.

OBJECTIVE: To compare the shear bond strength of different metal orthodontic brackets. MATERIALS AND METHODS: Five types of orthodontic metal brackets were selected (S1, Victory Series, 3M Unitek, Monrovia, Calif; S2, Mini Dyna-Lock, 3M Unitek; S3, Mini Sprint, Forestadent, Pforzheim, Germany; S4, Topic, Dentaurum, Inspringen, Germany; and S5, equilibrium 2, Dentaurum). Brackets were bonded on enamel surfaces of bovine incisors (Transbond XT, 3M Unitek) and were tested for shear bond strength with an Instron universal testing machine (Instron Corp, Canton, Mass). Data obtained in newtons and megapascals were analyzed with descriptive statistics and with analysis of variance and Tukey honestly significant difference (HSD) tests. The adhesive fracture site was classified with the adhesive remnant index (ARI). RESULTS: All the specimens tested had shear bond strength adequate to resist orthodontic forces. S5 showed significantly greater bond strength when compared with the other samples, except for S1. S1, S3, and S5 showed a significantly greater bonding force. The ARI index demonstrated a large variability. Retentive structure of S1, S3, and S5 had equal validity. The enlargement of the retentive surface enhances adhesion but affects the adaptability to surface irregularity of the enamel, increasing the risk of fracture at the interface with the bracket. CONCLUSIONS: The results of this study suggest that probably the retentive base extension can be lower than 7 mm2 proposed in previous studies as the minimal area.

Acid Etching, Dental↗
PubMed2006

The diagnostic performance of chronologic age in the assessment of skeletal maturity.

OBJECTIVE: The aim of this study was to analyze the relationship between chronologic age the and individual skeletal maturity as assessed by means of the cervical vertebral maturation (CVM) method during the circumpubertal period. MATERIALS AND METHODS: The evaluated sample of 600 subjects consisted of 100 subjects (50 males and 50 females) for each of 6 age groups, from 9 years through 14 years of age. Individual skeletal maturity for all subjects was determined by using the CVM method. The relationship between chronologic age and the most prevalent CVM stage at each age group was evaluated statistically by means of indicators of diagnostic test performance that specify the ability of a diagnostic test to identify a condition. RESULTS: The diagnostic performance of chronologic age for the detection of the onset of the adolescent peak in skeletal maturation was very low both in males and in females. In male subjects, the chronologic age of 9 years +/- 6 months presented with strong diagnostic power for the identification of a pre-pubertal stage in skeletal maturation. In female subjects, the chronologic age of 14 years +/- 6 months corresponded with a strong probability of a postpubertal stage in skeletal maturation. CONCLUSIONS: In males, chronologic age can identify a pre-pubertal stage of skeletal development, and in females a post-pubertal stage. In both males and females, chronologic age cannot recognize the onset of the adolescent peak in skeletal maturation.

Adolescent↗
PubMed2005

Sucking habits and facial hyperdivergency as risk factors for anterior open bite in the mixed dentition.

INTRODUCTION: The aim of this study was to evaluate sucking habits and hyperdivergency as risk factors for anterior open bite in mixed-dentition subjects. METHODS: Anamnestic and pretreatment cephalometric records of 1710 mixed-dentition subjects were assessed for sucking habits, dental open bite, and facial hyperdivergency. RESULTS: The rate of anterior open bite was 17.7%. Multiple logistic regression showed that both prolonged sucking habits and hyperdivergent vertical relationships significantly increased the probability of an anterior dentoalveolar open bite, with a prevalence rate of 36.3%. This was 4 times the prevalence of sucking habits and facial hyperdivergency in subjects without anterior open bite (9.1%). CONCLUSIONS: Prolonged sucking habits and hyperdivergent facial characteristics are significant risk factors for anterior open bite in the mixed dentition.

Age Factors↗
PubMed2005

Early orthodontic treatment of skeletal open-bite malocclusion: a systematic review.

The aim of this study was a systematic review of the literature to assess the scientific evidence on the actual outcome of early treatments of open-bite malocclusions. A literature survey was done by applying the Medline database (Entrez PubMed). The survey covered the period from January 1966 to July 2004 and used the MeSH, Medical Subject Headings. The following study types that reported data on the treatment effects included: randomized clinical trials (RCT), prospective and retrospective studies with concurrent untreated as well as normal controls, and clinical trials comparing at least two treatment strategies without any untreated or normal control group involved. The search strategy resulted in 1049 articles. After selection according to the inclusionary/exclusionary criteria, seven articles qualified for the final review analysis. No RCTs of early treatment of anterior open bite have been performed. Two controlled clinical trials of early anterior open bite have been performed, and these two studies indicated the effectiveness of treatment in the mixed dentition with headgears or functional appliances (or both). Most of the studies had serious problems of lack of power because of small sample size, bias and confounding variables, lack of method error analysis, blinding in measurements, and deficient or lack of statistical methods. Thus, the quality level of the studies was not sufficient enough to draw any evidence-based conclusions.

Age Factors↗
PubMed2005

Orthodontic treatment of an impacted dilacerated maxillary incisor: a case report.

Dilaceration is one of the causes of permanent maxillary incisor eruption failure. It is a developmental distortion of the form of a tooth that commonly occurs in permanent incisors as result of trauma to the primary predecessors whose apices lie close to the permanent tooth germ. We present a case of post-traumatic impaction of a dilacerated central maxillary left incisor in a young patient with a class II malocclusion.

Cephalometry↗
PubMed2004

An analysis of the corrective contribution in activator treatment.

This retrospective study (1) cephalometrically investigates the effectiveness of activator therapy, (2) evaluates the contribution of skeletal growth in the self-correction of the Class II malocclusion, and (3) analyzes separately the dental and skeletal responses to activator treatment and the differences between the incisor and molar areas. The subjects, all in the mixed dentition, were selected from a single center and were divided into a group of 40 Class II patients treated with an activator and an untreated group of 30 Class II patients. Dentoskeletal changes that occurred were compared on lateral cephalograms taken before the treatment/observation period and after 21 months (standard deviation, three months). When the activator patients were compared with the untreated control subjects, therapy promoted a combination of skeletal and dental changes that led to an improvement of the sagittal discrepancy. Other changes observed in the untreated Class II subjects did not bring about a correction of the malocclusion. An analysis of the corrective contributions in activator therapy in the posterior area showed that the orthopedic effects were greater than the dental effects in correcting the posterior occlusal relationship. In the anterior area of the arch, although both the skeletal and dental changes were favorable toward the sagittal correction, the skeletal contribution was greater than the dental contribution. In general, the skeletal contribution (140%) exceeded the dental correction (60%), and the mandibular changes (73%) exceeded the maxillary contribution (27%) both in the anterior and posterior regions.

Activator Appliances↗
PubMed2004

An orthopaedic approach to the treatment of Class III malocclusions in the early mixed dentition.

The aim of this investigation was to study cephalometrically the skeletal, dental and soft tissue modifications induced by a Delaire facemask and Bionator III appliance in a sample of 30 patients (17 boys and 13 girls), aged 4.1-9 years [mean 5.85 years, confidence interval (CI) 5.41-6.29], in the early mixed dentition with a skeletal Class III malocclusion caused by maxillary retrognathism (group 1) and compared with a control sample of 24 subjects (14 boys and 10 girls), aged 4-9 years (mean 5.97 years, CI 5.35-6.58) with untreated Class III malocclusions (group 2). For each patient a lateral cephalogram was taken before treatment (T0), after facemask removal (T1), and at the end of the retention period with a Bionator III (T2). Cephalometric analysis was carried out. The post-treatment cephalometric values in the treated group showed a forward displacement of the maxilla resulting in a statistically significant increase (P < 0.001) in the SNA angle, A-NPg (mm) and PNS-A (mm) linear values. There was a clockwise rotation of the mandible, with a decrease in the SNB angle and a satisfactory correction of the Class III relationship. The beneficial effects on the facial profile were confirmed by an increase in UL-EL distance and in NB--HL and NsPgs--HL angles, and by a decrease in the facial convexity angle. These findings indicate that the Delaire facemask and Bionator III treatment is effective for correcting skeletal Class III malocclusions caused by maxillary retrognathism in the early mixed dentition.

Activator Appliances↗
PubMed2004

Dentoskeletal effects and facial profile changes during activator therapy.

The aim of this retrospective study was to investigate cephalometrically the skeletal, dental, and soft tissue modifications induced by activator treatment in patients with Class II malocclusions caused by mandibular retrognathism. The subjects, all in the mixed dentition, were selected from a single centre and were divided into two groups: 40 patients treated with an incisor double capping activator (20 girls, 20 boys with a mean age of 10 years) and a control group of 30 subjects (15 girls, 15 boys with a mean age of 10 years). The dentoskeletal and aesthetic changes that occurred were compared on lateral cephalograms taken before treatment (T0) and after 18-24 months, when the activator was removed (T1). In the control group the radiographs were obtained before (T0) and after (T1) 21 months (standard deviation +/- 3 months). Activator treatment in these growing patients resulted in a correction of the Class II relationship (ANB -2.14 degrees), a restriction of maxillary growth (SNA -0.5 degrees), an advancement of the mandibular structures (SNB +1.64 degrees, FH--NPg +3.39 degrees; OLp-B +5.17 mm, OLp-Pg +5.14 mm, OLp-Go +2.44 mm), a correction of the overjet (-5.03 mm), an improvement in overbite (-1.17 mm) and uprighting of the maxillary incisors (1--FH -5.64 degrees). The activator appliance was effective in treating growing patients with mandibular deficiency: activator therapy corrected Class II malocclusions by a combination of skeletal and dental changes and improved the soft tissue facial profile.

Activator Appliances↗
PubMed2004

A modified monobloc for the treatment of obstructive sleep apnoea in paediatric patients.

The aims of this study were to determine the differences in craniofacial morphology between children with obstructive sleep apnoea (OSA) and control subjects, and to investigate the effects of modified monobloc (MM) appliance treatment in OSA children. The treatment group consisted of 20 OSA Caucasian subjects (10 boys and 10 girls) with ages ranging from 4 to 8 years (mean 5.91 years). The control group comprised 20 healthy Caucasian subjects without OSA (10 boys and 10 girls) with ages ranging from 5 to 7 years (mean 6 years). Polysomnography was used to establish the diagnosis of OSA and to evaluate the effects of MM treatment in the test group. Cephalometric radiographs and study models were obtained for all subjects. A number of statistically significant differences were detected in craniofacial morphology between the treatment group and controls. The treatment group demonstrated a skeletal Class II pattern (P= 0.04), with a reduced mandibular length (P= 0.03) and a corresponding increase in overbite. The hyoid bone was located superiorly in the OSA group (P = 0.04). Analysis of the dental arches demonstrated a significantly smaller distance between the first and second inter-molar primary mandibular regions (P = 0.03 and P = 0.04, respectively) in OSA patients. Repeat polysomnography, with the MM in situ, after 6 months of wear, revealed a significant reduction in the apnoea-hypopnoea index in children with OSA (P= 0.0003). The MM was found to reduce daytime sleepiness and to subjectively improve assessed sleep quality. The patients and their parents reported good compliance with MM treatment.

Cephalometry↗
PubMed2004

Interceptive management of eruption disturbances: case report.

The aim of the present report is to describe a case of a patient with eruption disturbances of an ankylosed lower primary second molar, delayed development of a maxillary permanent canine associated with an odontoma and a class III dental malocclusion. In such a case the objectives of treatment are: to prevent impaction of the lower second premolar and tipping of the lower first molar; to establish correct anterior overbite and overjet and to control the development of the permanent upper canine.

Bicuspid↗
PubMedDate not supplied

Early diagnosis and treatment of supplemental mandibular tooth: report of a case.

This report describes a rare case of a supplemental tooth with a morphology similar to a lateral incisor, found in the canine region of the mandible of a 6-year-old male. The purpose of this paper is to report the importance of early diagnosis and treatment during mixed dentition. The treatment was extraction of the primary mandibular left canine soon after the initial diagnosis of the condition to facilitate the spontaneous eruption of the supplemental tooth and his removal. Twenty-nine months after the removal of the supplemental tooth the mandibular left canine was fully erupted into normal position. No complication arose from the presence of this supernumerary and his early diagnosis has been very important for not disrupting the normal erupting or alignment of other teeth.

Child↗
PubMedDate not supplied

Orthodontic treatment of a patient with an unusual impaction of a central incisor: case report.

This report documented an unusual case with impaction of a right permanent central incisor. The purpose of this work was to illustrate how the original lingual lever arm moved the impacted central incisor in the dental arch. The authors used a modified lingual arch made of .036 inch stainless steel wire soldered to bands on the second primary molars. The lingual arch caused some minor inconveniences, but the discomfort was slight. Patient compliance was not a problem because a fixed appliance was used in the primary dentition.

Child↗