interdisciplinary dentofacial therapy

Juvenile idiopathic arthritis (JIA) is the most common inflammatory rheumatic disease of childhood. JIA can affect any joint and the temporomandibular joint (TMJ) is one of the joints most frequently involved. TMJ arthritis impacts mandibular growth and development and can result in skeletal deformity (convex profile and facial asymmetry), and malocclusion. Furthermore, when TMJs are affected, patients may present with pain at joint and masticatory muscles and dysfunction with crepitus and limited jaw movement...

BACKGROUND: Retinoblastoma is an intraocular cancer of infancy and childhood, which has been treated with radiation therapy and chemotherapy. Radiation on growing patients can cause deterioration in maxillofacial growth and development that leads to severe skeletal discrepancies between the maxilla and mandible, and dental problems such as crossbite, openbite, and hypodontia. CASE PRESENTATION: We present the case of a 19-year-old Korean man with chewing disability and dentofacial deformities...

BACKGROUND: The craniofacial developmental abnormality can significantly complicate the oral rehabilitation of patients with oligodontia. This case report describes an interdisciplinary approach that took 7 years to successfully treat a young patient with non-syndromic oligodontia and midface deficiency. CASE PRESENTATION: A 14-year-old patient with complex oral and maxillofacial conditions and diagnosis of oligodontia presented to our clinic. In addition to 4 retained deciduous teeth and congenitally missing 10 permanent teeth, dentofacial findings included maxillary and malar deficiency with a concave facial profile, Angle Class III malocclusion, and poor dental esthetics...

Biomimetic materials for hard and soft tissues have advanced in the fields of tissue engineering and regenerative medicine in dentistry. To examine these recent advances, we searched Medline (OVID) with the key terms "biomimetics", "biomaterials", and "biomimicry" combined with MeSH terms for "dentistry" and limited the date of publication between 2010-2020. Over 500 articles were obtained under clinical trials, randomized clinical trials, metanalysis, and systematic reviews developed in the past 10 years in three major areas of dentistry: restorative, orofacial surgery, and periodontics...

FOCUSED CLINICAL QUESTION: What are the key considerations for the Interdisciplinary Dentofacial Therapy (IDT) team in the diagnostic process to evaluate a patient for Surgically Facilitated Orthodontic Therapy (SFOT)? SUMMARY: Surgically Facilitated Orthodontic Therapy (SFOT) creates a demineralized bone matrix and augments dentoalveolar deficiencies in the management of dentofacial disharmony malocclusion. Numerous indications and contraindications exist which are essential to the periodontal surgeon for proper case selection...

Allogeneic hematopoietic stem cell transplantation (HSCT) is an established therapy and is without alternative for certain groups of patients. Successful HSCT induces both long-lasting remission and tolerance without the need for further immunosuppression. In this case, cellular repair and regenerative processes work in a physiologic manner allowing elective surgical procedures, such as the interdisciplinary correction of dentofacial anomalies. Here, we report the successful management of transverse maxillary deficiency by transpalatal distraction and subsequent orthodontic treatment in a 12-year-old boy who underwent HSCT for high-risk acute lymphoblastic leukemia at 5 years of age...

Dentofacial disharmony in patients with cerebral palsy (CP) can lead to low self-esteem and functional limitations. However, medical and behavioral challenges in patients with developmental disorders often prevent dental practitioners from offering the necessary treatment. This report describes the clinical interdisciplinary management of a 20-year-old man with CP, including orthodontic, periodontal, and orthognathic surgery therapy. The patient presented with the chief complaint of having difficulty chewing, was wheelchair dependent, had poor orofacial muscle control, and exhibited a Class III malocclusion with a skeletal anterior open bite...

Comorbidities that negatively impact orthodontic (malocclusion), periodontal (periodontitis, deficient dentoalveolar bone volume, mucogingival), and prosthetic (structural integrity compromise from caries, attrition, and erosion) conditions can affect the general health of the patient. In addition, emerging data highlights the importance of undiagnosed airway volume deficiencies and sleep-disordered breathing conditions in the adult and pediatric population. Deficiencies in dentoalveolar bone and discrepancies in skeletal relationships can impact the volume of hard- and soft-tissue structures of the periodontium and decrease oral cavity volume...

BACKGROUND: The American Academy of Periodontology (AAP) recently embarked on a Best Evidence Consensus (BEC) model of scientific inquiry to address questions of clinical importance in periodontology for which there is insufficient evidence to arrive at a definitive conclusion. This review addresses oral indications for use of cone-beam computed tomography (CBCT). METHODS: To develop the BEC, the AAP convened a panel of experts with knowledge of CBCT and substantial experience in applying CBCT to a broad range of clinical scenarios that involve critical structures in the oral cavity...

BACKGROUND: The aim of this systematic review is to evaluate whether cone-beam computed tomography (CBCT) imaging can be used to assess dentoalveolar anatomy critical to the periodontist when determining risk assessment for patients undergoing orthodontic therapy using fixed or removable appliances. METHODS: Both observational and interventional trials reporting on the use of CBCT imaging assessing the impact of orthodontic/dentofacial orthopedic treatment on periodontal tissues (i...

Pretreatment knowledge of crestal and radicular dentoalveolar zones and their associated thicknesses can improve risk assessment to meet esthetic and functional goals, particularly when discrepancies in anterior maxillary and mandibular arches exist and when an anterior protected articulation is to be achieved. This paper discusses a new classification of dentoalveolar bone phenotypes that differentiates the alveolar crestal zone from that of the radicular zone and classifies the thickness of facial bone at each compartment to aid in interdisciplinary dentofacial therapy risk assessment...

Long-term prophylaxis achievements, demographic changes, scientific progress, patient requirements, and political regulations through social legislation will fundamentally change the future of orthodontics, i.e., a reduction in children and adolescent therapy as well as an increase in interdisciplinary complex treatments for adult patients mostly outside the social security system. Health care research at a high evidence level needs to be intensified due to social-political reasons. In addition to well-proven appliances, modern sometimes even invisible appliances (CAD-CAM) will be used in future orthodontic therapy...

PURPOSE: To evaluate surgical results, speech, hearing, and craniofacial morphology after primary cleft repair performed from 1973 to 1979. METHODS: During the years 1972 to 1985, all primary cleft surgeries were performed by 1 plastic surgeon, using Tennison lip closure combined with a periosteoplasty on the clefted alveolus at age 3 months. By mobilizing mucoperiosteal flaps, bony bridges were induced in the alveolar process in approximately 60% of the cases. All patients had the soft palate closed at age 24 months by a pushback technique...

Restorative-driven interdisciplinary therapy frequently requires orthodontic therapy to optimally address the underlying dentofacial problems. Limitations in traditional orthodontic techniques and the length of requisite treatment times often create barriers to providers and patients' willingness to accept orthodontics as part of the overall treatment plan. Two main types of surgically facilitated orthodontic therapy (SFOT), each with its own indications and protocols, are becoming popular. They can expand significantly the limitations of orthodontics and greatly shorten treatment times...

Individuals with dentofacial deformities have masticatory muscle changes. The objective of the present study was to determine the effect of interdisciplinary treatment in patients with dentofacial deformities regarding electromyographic activity (EMG) of masticatory muscles three years after surgical correction. Thirteen patients with class III dentofacial deformities were studied, considered as group P1 (before surgery) and group P3 (3 years to 3 years and 8 months after surgery). Fifteen individuals with no changes in facial morphology or dental occlusion were studied as controls...

There is an increasing demand to improve dentofacial esthetics in the adult population. This demand usually requires a close collaboration within the various disciplines of dentistry and the patient at every stage of the therapy. The materials and techniques used by these interdisciplinary clinicians must be conservative and minimally invasive. Fiber-reinforced composite technology offers such solutions for chairside applications. This case report presents two cases where fiber-reinforced ribbon and composite complex was used in a multidisciplinary approach to improve esthetics...

The aim of the present study was to evaluate palatal morphology in Down syndrome (Ds) subjects, focusing on the effect of dental formula on the hard palate to assist clinicians when planning dental rehabilitation. Palatal landmarks were digitized with a three-dimensional (3D) computerized digitizer on the dental casts of 47 Ds subjects (23 dentate males, 9 edentulous males, and 15 dentate females) aged 20-45 years, 37 dentate reference individuals (20 males and 17 females) aged 30-39 years, and 14 edentulous reference males aged 55-72 years...

The early loss of permanent teeth following trauma or congenital aplasia and agenesia need to be corrected by orthodontic or prosthetic means, sometimes combined with implant therapy. Preprosthetic orthodontic measures are often an integral part of comprehensive oral rehabilitation. The individual aspects of treatment are aimed at optimizing dentofacial esthetics and at improving masticatory function and hygiene potential of prosthetic restorations. The orthodontic solution results usually in different anatomic, functional, and esthetic problems...

Modern dentistry, with its various disciplines, has an exciting and unmatched potential to enhance the overall quality of life for our patients. In this environment one of the greatest challenges for clinicians is to properly utilize this vast potential. It can be very difficult to consistently establish health and physiological occlusal relationships in patients with significant dental, periodontal, dentoalveolar, temporomandibular, and/or skeletal problems. This task is further complicated by ever-increasing patient and provider demands for results with optimal dentofacial aesthetics and long-term stability...

The rationale for orthodontic/surgical management of dentofacial deformities was reviewed for single and double jaw problems. Coordinated interdisciplinary work-ups and treatment modalities can produce predictable results. In well-selected cases, esthetics and functional stability are greatly enhanced by the combined technique.