Cone beam computed tomography can be used in pediatric population when a tridimensional analysis of dental and maxillofacial bone structures is required. Even though CBCT is considered a low dose radiological examination, ionizing radiation is a known human carcinogenic factor. Furthermore, biological effects are more important in young patients because of their higher radiosensitivity. Orthodontic treatment is typically initiated at young ages and the most common radiographs at this age are dental. This makes it important to quantify the effects of diagnostic radiographs, in particular of CBCT, due to the fact that the radiation doses are higher compared to conventional radiological methods. So far, the carcinogenic response after low dose radiation exposure is not fully understood in the scientific literature. The aim of our review was to emphasize the main indications of CBCT in orthodontics and to evaluate the radiation doses and potential risks of CBCT irradiation of pediatric patients
Biological effects of low-dose ionizing radiation (IR) have been unclear until now. Saliva, because of the ease of collection, could be valuable in studying low-dose IR effects by means of surface-enhanced Raman spectroscopy (SERS). The objective of our study was to compare the salivary SER spectra recorded before and after low-dose IR exposure in the case of pediatric patients (PP). Unstimulated saliva was collected from ten PP before and after irradiation with a cone beam computed tomography (CBCT) machine used for diagnostic purposes. The SERS measurements have been recorded on dried saliva samples using a solid nanosilver plasmonic substrate synthesized using an original method developed in our laboratory. The experimental results showed that salivary SER spectra are dominated by three vibrational bands (441,735 and 2107 cm−1) that can be assigned to bending and stretching vibrations of salivary thiocyanate (SCN-). After exposure, an immediate increase of vibrational bands assigned to SCN- has been recorded in the case of all samples, probably as a result of IR interaction with oral cavity. This finding suggests that SCN- could be used as a valuable biomarker for the detection and identification of low-dose radiation effects.
Background/Objectives: Multiple factors may contribute to the development of open bite malocclusion, including genetics and environmental factors. Anterior open bite is usually related to the interposition of the tongue between the dental arches during swallowing or at rest. But how important is the role of the tongue in the development of anterior open bite? And how does anterior open bite malocclusion influence tongue behavior? With this study, we would like to offer a better understanding on the importance of tongue function in the context of this malocclusion. Methods: In this narrative review, a comprehensive electronic search was conducted via PubMed, Google Scholar, and ScienceDirect. The inclusion criteria were original research articles published between 2014 and 2024 with full text access. The exclusion criteria were articles older than 10 years and articles with restricted access or without full text access. Results: Out of the initial 1231 articles, 9 articles were found to be eligible for the present study. The tongue is a part of the neutral zone of the oral cavity, together with the lips and cheek musculature, forming a corridor of equilibrium. If this neuromuscular balance is altered, the teeth will move out of the neutral zone, and various malocclusions may develop. Patients with anterior open bite experience difficulties in closing the anterior portion of the oral cavity during swallowing; therefore, adaptative changes occur in an attempt to compensate by changing the dynamics of the tongue. Conclusions: The cause–effect relationship between tongue malfunction and anterior open bite remains controversial. This review article mentions the possible role of the tongue in anterior open bite etiology, but evidence is still needed on this subject, as it is yet unclear whether the influence of the tongue is a primary cause, an influencing factor, or just a consequence of an already-existing vertical occlusal pathology.
Orthodontic treatment is commonly associated with pain, leading to reduced patient compliance and treatment adherence. Non-steroidal anti-inflammatory drugs (NSAIDs) are effective in reducing this pain by inhibiting prostaglandin synthesis. However, this mechanism may also interfere with orthodontic tooth movement (OTM) by affecting bone remodeling. This narrative review investigates the existing literature published between 2004 and 2024 to assess the impact of various NSAIDs on OTM and identify those that balance pain relief with minimal impact on tooth movement. Evidence shows that NSAIDs such as aspirin, ketorolac, diclofenac, and nimesulide significantly reduce OTM. The results for ibuprofen, meloxicam, and celecoxib were inconsistent with both no influence or a reduction in OTM, depending on dosage, mode, and duration of administration. Conversely, tenoxicam, nabumetone, etoricoxib, and parecoxib appear to have no effect on OTM. Among these, etoricoxib appears particularly promising due to its favorable gastrointestinal profile, high COX-2 selectivity, and negligible influence on OTM in clinical doses. However, the limited number of human trials highlights the need for further research to develop evidence-based guidelines for pain management that preserve treatment efficiency in orthodontics.
Background/Objectives: The relationship between chronological age, dental age, and cervical vertebral maturation is critical for assessing the reliability of dental age as an indicator of skeletal age and for identifying the patient’s growth peak. This assessment facilitates the planning of appropriate orthodontic-orthopedic treatment. Methods: This retrospective observational study analyzed data from the Clinical Department of Orthodontics and Dento-Facial Orthopedics in Cluj-Napoca, Romania. The sample included 73 patients with Class II malocclusion (31 males and 42 females), with data obtained from orthopantomography and lateral cephalometric radiographs. Dental age was evaluated using both the Demirjian method and the Chronology of Eruption method. Skeletal age was determined based on Baccetti’s cervical vertebral maturation (CVM) staging method. Results: A strong and statistically significant correlation was found between cervical vertebral maturation and chronological age (r = 0.81, p < 0.001), as well as between cervical vertebral maturation and dental age assessed using the Demirjian method (rs = 0.72, p < 0.001). Additionally, a significant correlation was observed between cervical vertebral maturation and dental age assessed using the Chronology of Eruption method (rs = 0.78, p < 0.001). Conclusions: The correlation found between dental age and skeletal maturity suggests that dental age (DA) assessment might serve as a supplementary tool for estimating a patient’s growth peak in Class II malocclusion cases. Future research exploring the use of artificial intelligence (AI) in panoramic radiograph analysis could improve the accuracy and consistency of DA assessment, contributing to more reliable skeletal maturity evaluations.
A common side effect of orthodontic treatment is pain that is typically managed with acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs). However, the optimal NSAIDs choice for orthodontic pain relief, balancing efficacy and minimal impact on orthodontic tooth movement (OTM), remains unclear. This review investigates the relationship between OTM and orthodontic pain and explores how NSAIDs affect OTM based on a literature search of studies published between 2004 and 2024. Results suggest that ketorolac, nimesulide, and diclofenac may hinder OTM, while aspirin, ibuprofen, meloxicam, and celecoxib show varying effects. Tenoxicam, nabumetone, etoricoxib, and parecoxib appear to have no significant influence on OTM, with etoricoxib presenting as a potentially fa-vorable analgesic. The methodological limitations of the existing studies necessitate further rigorous clinical trials to validate the effects of NSAIDs on OTM in humans.