Effect of mesiodistal angulation of the maxillary central incisors on aesthetic perceptions of the smile in the frontal view

Yang, S., Guo, Y., Yang, X., Zhang, F., Wang, J., Qiu, J., et al.

The purpose of this study was to analyse the effect of mesiodistal angulation of the maxillary central incisors on the smiling aesthetics in young adults.

Methods
Frontal smile photographs of a young man and a young woman were digitally modified to produce 28 smile images that were grouped into four series. These images were judged using visual analogue scales by 52 orthodontists and 61 lay people. The effects of the judges’ professions, subjects’ sexes, and photograph framings on the appreciation of smile aesthetics with different mesiodistal angulations of the maxillary central incisors were evaluated. The data were analysed with paired t tests, Dunnett t tests, and independent samples t tests; statistical significance was set at p<0.05.

Results
The images were ranked less attractive as the mesiodistal angulation of the maxillary central incisors increased during smiling. No relationship was found between the judges’ professions and the aesthetic evaluations of incisal angulation, but the statistical analysis showed that both the subject’s sex and the photograph framing were significant variables (p<0.05).

Conclusions
The mesiodistal angulation of the maxillary central incisors plays an essential role in smile aesthetics in the frontal view. When formulating treatment plans, orthodontists should never underestimate the influence of mesiodistal angulation on smile attractiveness.

American Journal of Orthodontics and Dentofacial Orthopedics 2015; 148 (3): 396-404.

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Implants failures related to endodontic treatment. An observational retrospective study

López-Martínez, F., Gómez Moreno, G. Olivares-Ponce, P., Eduardo Jaramillo, D., Eduardo Maté Sánchez de Val, J., Calvo-Guirado, J.

Objective
The aim of the study was to analyse potential aetiological risk factors that constitute a complex problem in the clinical management of peri-implantitis.

Materials and methods
An observational retrospective study was conducted to describe the possible effect of lesions of pulpar origin and/or periapical success or failure of the implant. The sample consisted of review of 800 implants, of which 500 were conducted at the Faculty of Dentistry of the UANL and 300 at the private clinics of maxillofacial surgeons experienced in the placement of implants and residing in Monterrey, Mexico. A total of 580 cases were in female patients, while 220 patients were of male gender. The age of patients at the time of placing the implant ranged from 28 to 81 years.

Results
Of 800 study subjects who underwent dental implant treatments, 200 cases (25%) were detected that presented endodontic failure prior and/or adjacent to the placement of the implant. The 50.41% had peri-implantitis, recording 62 cases in the Faculty and 18 cases (23.38%) in private clinics, finding that there was a statistically significant difference between the presence and absence of peri-implantitis in terms of endodontic failure prior and/or adjacent to the placement of the implant.

Conclusions
Within the limitations of this observational retrospective study, it could be concluded that the development of inflammatory changes mediated by the presence of remnant bacteria surrounding hard tissues adjacent to implants might induce late failures of implants, and potentially trigger pathological features of apical peri-implantitis.

Clin Oral Implants Res 2015; 26 (9): 992-995.

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Oral squamous cell carcinoma presenting in a patient receiving adalimumab for rheumatoid arthritis

Beattie, A., Stassen, L.F., Ekanayake, K.

The efficacy of biologic agents in the treatment of inflammatory immune-mediated conditions has been clearly shown, but there also are numerous reports of adverse effects. Most reported adverse effects have been associated with tumour necrosis factor-α (TNF-α) inhibitors and include a possible increased risk of malignancy. There have been some reported cases of oral cancer developing in patients treated with TNF-α inhibitors. This case report describes a patient who was taking adalimumab for rheumatoid arthritis and who presented with a squamous cell carcinoma (SCC) in the mandible. Diagnosis was complicated because the clinical appearance was of a non-healing extraction socket and the patient had a history of bisphosphonate therapy. An initial diagnosis of bisphosphonate-related osteonecrosis of the ­ayed the commencement of appropriate treatment. This case highlights the importance of ruling out SCC in patients taking biological agents with unusual symptoms.

J Oral Maxillofac Surg 2015; May 22

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The evaluation of the heat generated by the implant osteotomy preparation using a modified method of the measuring temperature

Yamaba, T., Suganami, T., Ikebe, K., Sogo, M., Maeda, Y., Wada, M.

Purpose
To establish a method for measuring the heat generated when preparing an osteotomy site, and to assess for correlations of rotational speed, proceeding speed, loading value of the drill (contact pressure), motion pattern, and bone density with temperature increases.

Materials and methods
A thermocouple was placed in the internal irrigation hole of a 2mm-diameter twist drill used for measuring osteotomy site temperature. In the artificial blocks, two different densities were used to drill under varying conditions including drill proceeding, rotating speed, and motion pattern. The drilling procedure was repeated five times for each combination, and the data collected were statistically analysed using multiple regression analysis.

Results
Strong positive correlations were found among bone density, drill motion pattern and maximum temperature, and a positive correlation was found in proceeding speed (p<0.001). Rotation speed and maximum temperature were not correlated (p<0.001). Conversely, loading values of the drill increased with the lower rotation speed and higher proceeding speed, which were effective in controlling the temperature rise.

Conclusion
When preparing a simulated bone for an osteotomy with a thermocouple inserted into a twist drill with internal irrigation, the drilling motion pattern, bone density, drill speed and proceeding rate affected bone temperature, in descending order. It was also observed that bone temperature correlated positively with speed and negatively with proceeding speed, independent of density. This indicates that lower drill speed and higher proceeding speed without excessive loading values minimise the bone temperature heat.

International Journal of Oral and Maxillofacial Implants 2015; 30 (4): 820-826.