Medical thermography is a non-invasive technique that allows the measurement of the temperature of the human body surface, exploiting the heat emitted by the body through the skin in the form of infrared electromagnetic radiation. Recently, smartphone-based thermography (ST) has drawn considerable attention. This scoping review (SR) aims to describe its current applications and reliability based on currently available research findings, also taking into account the medico-legal implications linked to its use. A search of the sources was conducted on multiple databases (PubMed, Scopus, Cochrane, Lilacs, Google Scholar). Based on a set of eligibility criteria, all articles deemed useful were included in the SR. Collected data, processed with descriptive statistics, are then discussed. From the initial 241 results, after duplicate removal and full-text reading based on inclusion/exclusion criteria, 20 articles were classified according to the main characteristics and indications and outcomes are highlighted based on clinical evidence. The most frequently documented fields of ST are wound care management and vascular surgery. Other disciplines are less explored (dentistry, ophthalmology, otorhinolaryngology, orthopedics, etc.). Practicality, operational simplicity and affordability of mobile thermographic devices are the chief strengths of this technology. Comparative studies with traditional thermal imaging methods are poor in terms of the number of patients analyzed but this technology showed high sensitivity and accuracy in the large number of patients enrolled in observational studies, encouraging the development of further operational protocols in all medical specialties. Gaining a deeper understanding of such techniques will also help settle the medico-legal issues which may arise from the clinical implementation of ST, thus appraising its reliability and safety from that perspective as well.
Background: The treatment of mandibular second molar (MM2) impaction presents a challenge for orthodontists and requires a surgical–orthodontic approach. This study aims to compare the effectiveness of two techniques for treating impacted MM2: a traditional technique using brass wire and a technique employing skeletal anchorage. Methods: Twelve MM2 with mesio-angular impaction, with an inclination angle between 25° and 40° and an impaction depth between 4 and 10 mm, were selected and randomly divided into two treatment groups. Patients in Group A were treated using the traditional brass wire technique, while those in Group B underwent treatment with a skeletal anchoring technique that utilized a miniscrew positioned in the retromolar region and an elastic sling chain. For both groups, treatment time and the influence of the disimpaction technique on oral health-related quality of life (OHRQoL) were evaluated using the short-form Oral Health Impact Profile (OHIP-14). Results: The results indicated an average treatment time of 168.67 ± 52.32 days for Group A and 76 ± 10.17 days for Group B, with a statistically significant difference (p-value = 0.0002). Regarding the impact on the patients’ OHRQoL, Student’s t-test did not reveal a statistically significant difference between the two groups at 3 and 7 days of follow-up. Conclusions: Both techniques are considered effective for the treatment of impacted MM2 (angulation 25–40°, depth 4–10 mm). The use of skeletal anchorage significantly reduces treatment times without negatively affecting OHRQoL. The results of this study should be confirmed by further studies with larger sample sizes.
This case report of an 11-year-old subject shows the digital workflow for the management of an impacted mandibular canine using Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) technology along with Temporary Anchorage Devices (TADs). The miniscrew insertion site was planned using software, and a surgical guide was digitally designed and 3D printed. Orthodontic traction was performed using a 3D-designed and -printed device. In a single sitting, the miniscrew was inserted and the disimpaction device was also delivered. The primary objective of recovery and the repositioning of the impacted mandibular canine in the axis with its eruptive path was achieved. The space available and the subject’s early stage of mixed dentition was considered favourable to a spontaneous eruption. This case report shows how CAD/CAM digital technology, combined with 3D printing, enables the creation of a surgical guide to position the miniscrew and the customized devices used for mandibular canine disimpaction. CAD/CAM surgical guides can help clinicians to position TADs with more accuracy and predictability, ensuring high quality bone support offering primary stability. Although orthodontic traction is the most complex therapeutic choice to implement, with the aid of CAD/CAM technology it is possible to proceed with accurate and minimally invasive orthodontic traction in order to recover a mandibular canine.
19 December 2023 in Brazilian Journal of Oral Sciences
Most patients require orthodontic treatment to improve the esthetics of their smile. Orthodontists must consider how some parameters of mini-esthetics can influence the patient’s esthetic perception. Methods: A photograph of the smile of a young female was taken and some modifications were made to the buccal corridor, gingival exposure, smile arc and midline position to assess the influence of these variables on smile attractiveness. Two hundred examiners were selected from four groups: orthodontists (O), dental students (DS), orthodontic patients (OP) and surgical-orthodontic patients (SOP). Each examiner was asked to complete the questionnaire with an approval rating from 1 to 10. Significant level was set at P ≤ 0.05. Results: Only orthodontists considered buccal corridors of 4mm and midline deviation of 1mm as non-esthetic; all other examiners considered gingival exposures ≥3 mm and midline angulation as non-esthetic. All examiners assigned higher satisfaction values to the photo with the concordant smile arc and defined as non-esthetic the covered smile and the reverse smile arc. Patients perceived as non-esthetic only midline deviations of 4mm. The surgical orthodontic patients assigned lower values to the photos and showed greater attention to evaluating the esthetics of the smile than the orthodontic patients. Conclusion: Smile arc, gingival exposure and midline angulation influence smile esthetics; the role of buccal corridors and midline deviation is dependent on the type of examiner.
Objectives: Mandibular molar distalization is a complex orthodontic movement due to anatomic and biomechanical limitations. The opportunity to use a custom-made appliance with skeletal anchorage should be an advantageous alternative to traditional solutions: multiple extractions, interproximal reductions, vestibular inclination of incisal group. Methods: A 14-year-old female patient with Class II malocclusion and ectopic upper and lower canines was treated in the lower arch with a custom-made appliance anchored on a mini-screw in the right buccal-shelf where the ectopy and crowding was severe. The miniscrew was connected to a rigid arm with a rail equipped with a coil that activated promoted the distalization of first and second molars bonded with metallic bands. Results: After 8 months of treatment with activations repeated every 4 weeks, an effective distalization has been reached. Conclusions: Mandibular molars’ distalization is a challenging orthodontic result to achieve. When the need to obtain space cannot be beneficially obtained with conventional approaches, and distalization of the lower molars could be desirable, a custom distalization device with skeletal anchorage and biomechanics based on a pressed coil sliding on a rigid arm is an efficient solution.
Dynamic navigation systems can improve precision and accuracy in oral surgical procedures. Odontomas are benign lesions commonly encountered in clinical practice. When asymptomatic, they are often discovered in cases of persistence of deciduous elements, and the permanent teeth fail to erupt spontaneously. The surgical removal approach is the gold‐standard treatment, but is not without risks. This case report presents a 14‐year‐old boy with an impacted upper canine in the presence of an odontoma near the roots of the permanent central and lateral incisors. The removal of the odontoma and the recovery of the canine were performed using a dynamic navigation system. Integrating the navigation system with cone beam computed tomography (CBCT) allowed for precise planning and real‐time guided surgery, ensuring patient safety, comfort, and predictability. This approach highlights the potential of dynamic navigation systems not only for implant rehabilitation but also for advancing oral surgery procedures, paving the way for future developments in dentistry that can better leverage the clinical skills of operators.