Pedro César Fernandes dos Santos

Cleft lip/palate is a congenital maxillofacial malformation which results from genetic and environmental factors. In Brazil, the prevalence is 1 in every 673 live births. Several alterations result from oral clefts and affects function, aesthetics, and social life. Due to morphofunctional changes, these patients are more susceptible to disorders of the oral cavity. This study aimed to conduct an epidemiological study about alterations of the stomatognathic complex in cleft lip/palate patients at Albert Sabin Pediatric Hospital in Fortaleza, Ceará, Brazil. Files containing medical records, imaging exams and dental models of 64 patients from 2005 to 2017 were analyzed. There was a higher prevalence of males, patients from the countryside and the left unilateral transforaminal cleft subtype. 85.9% of the patients had undergone cheiloplasty and palatoplasty. About 74% of patients had dental agenesis, 71.9% developed the precanine tooth, 26.6% presented dental shape anomalies and 65.6% presented maxillary atresia. The mean DMFT index (decayed, missing, and filled teeth) of the patients was 3.51. These results corroborate and add valuable information to the available literature on cleft lip/palate patients. Our results demonstrate that cleft patients present dental and skeletal alteration that need specialized treatment.

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Objectives: The aim of this systematic review and meta-analysis was to assess the effects of low-level laser therapy (LLLT) on the orthodontic mini-implants (OMI) stability. Materials and methods: An unrestricted electronic database search in PubMed, Science Direct, Embase, Scopus, Web of Science, Cochrane Library, LILACS, Google Scholar, and ClinicalTrials.gov and a hand search were performed up to December 2020. Randomized clinical trials (RCTs) or non-randomized clinical trials (Non-RCTs) that assessed the effects of LLLT on the OMI stability were included. Data regarding the general information, LLLT characteristics, and outcomes were extracted. The authors performed risk of bias assessment with Cochrane Collaboration’s or ROBINS-I tool. Meta-analysis was also conducted. Results: Five RCTs and one Non-RCT were included and 108 patients were evaluated. The LLLT characteristics presented different wavelength, power, energy density, irradiation time, and protocol duration. Five RCTs had a low risk of selection bias. Two RCTs had a low risk of performance and detection bias. All RCTs had a low risk of attrition bias, reporting bias and other bias. The Non-RCT presented a low risk of bias for all criteria, except for the bias in selection of participants. The meta-analysis revealed that LLLT significantly increased the OMI stability (p < 0.001, Cohen’s d = 0.67) and the highest clinical benefit was showed after 1 (p < 0.001, Cohen’s d = 0.75), 2 (p < 0.001, Cohen’s d = 1.21), and 3 (p < 0.001, Cohen’s d = 1.51) months of OMI placement. Conclusions: LLLT shows positive effects on the OMI stability.

Objective: To investigate the association between tooth loss and craniofacial factors with changes in mandibular condylar morphology. Methods: A total of 123 patients participated in this cross-sectional study. The mandibular condylar morphology was evaluated using digital panoramic radiography. The exposure variables included gender, age group, molar relationship, facial growth pattern, facial asymmetry, dental midline, posterior crossbite, presence of fixed dental prosthesis, and tooth loss. Results: Unilateral and bilateral mandibular condyle structural alterations were found in 20.3% and 28.5% of the sample, respectively. After the adjustment analysis, posterior crossbite (adjusted OR = 3.34, 95% CI = 1.23–9.06) and tooth loss (adjusted OR = 4.08, 95% CI = 1.72–9.64) were associated with the outcome. The tooth type associated with mandibular condyle structural alterations were premolars and upper molars. Conclusion: The findings suggest that posterior crossbite and tooth loss are associated with mandibular condyle structural alterations.