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The aim was to evaluate the distribution of congenitally missing teeth and the treatment provided for congenitally missing lower second premolars in an eleven-year cohort of patients referred to a publicly funded source of specialist care. This was a retrospective, register-based cohort study. Search for patients referred to a publicly funded source of specialist care based on ICD10 diagnosis code K00.00 (partial anodontia) and treatment codes EBA00, EBA05, EBA10, EBA12, EBB10 and EBB20 during the period 1.1.2009–27.10.2019 yielded 232 patients (151 females, 81 males), of whom 218, born in 1941–2009, were eligible. Data collected from medical files were presented in the form of descriptive statistics and analysed using Fisher's exact test. The 218 subjects possessed 876 congenitally missing teeth (males 307, females 569) (third molars excluded). The most common missing teeth were upper second premolars and lateral incisors, and lower second premolars and central incisors. No difference in laterality was found. Statistically significant associations were found between the choice of treatment and both the patient's age at referral and the patient's year of birth. Most common treatment for adult patients (age 18–56 years) was placement of an implant (67%), while autotransplantation (11%) was the preferred option for children at the mixed dentition stage (age 9–15 years). The congenitally missing teeth most commonly involved in referrals of patients to publicly funded specialist care were lower second premolars. The most frequent treatment was insertion of an implant for adults and autotransplantation at the mixed dentition stage. [ABSTRACT FROM AUTHOR]

Background: Cleft lip and palate patients often have a retruded maxilla with a severely narrowed deficient maxillary arch. This report aims to describe the management of severe maxillary retrusion and constriction in cleft lip and palate patients using distraction osteogenesis applied in serial sequence in two directions perpendicular to each other. Materials and Methods: Two adult male cleft lip and palate patients were treated with maxillary distraction osteogenesis in two stages. In the first stage, surgically assisted rapid palatal expansion with a tooth-borne device was performed to significantly expand the maxillary arch in the transverse dimension. After the teeth were orthodontically aligned, the horizontal distraction of the maxilla was made by two internal maxillary distraction devices. Results: In the first patient, the maxilla was initially widened by 11 mm and then distracted forward by 20 mm. Despite the breakage of the shaft of one of the two distractors at the end of distraction, a satisfactory occlusion was found at the time of distractor device removal. The maxillary position has remained stable through 8 years of follow-up. In the second patient, the palate was widened by 14 mm and the maxilla was distracted forward by 22 mm. The maxillary position has remained stable through 3 years of follow-up. Conclusion: Sequential serial distraction of maxilla in two planes perpendicular to each other is a safe and stable approach for the treatment of cleft lip and palate patients with severe transverse and anteroposterior discrepancies. [ABSTRACT FROM AUTHOR]

Objective. The aim of this study was to determine the incidence of cleft lip and/or cleft palate in a population uniquely from Northern Finland. Materials and methods. The records of a total of 214 cleft patients treated between 1998-2011 at the Oulu Cleft Lip and Palate Center at the University of Oulu were assessed on a retrospective basis. Data regarding cleft type, sex and side of cleft was collected and analyzed. Family history of clefting was investigated. Results. Cleft palate (68.7%) was most frequently found, followed by cleft lip and palate (18.7%) and cleft lip with or without alveolus (12.6%). Cleft palate occurred more frequently in females (63.3%) and cleft lip and palate was more frequently found in males (62.5%). The left side was more frequently affected in both male and female patients. Left-sided clefts were observed in 82% of patients compared to right-sided clefts in 18%. A family history of clefting was detected in 20.1% of patients. Conclusion. The incidence of clefts in Northern Finland is higher than the corresponding incidence in other European countries. Cleft palate was the most frequent cleft type and it was more frequent in females. In males, cleft lip and palate was more frequent. The left side was more frequently affected in both genders. One fifth of the patients had a family history of clefts. [ABSTRACT FROM AUTHOR]

Objective. The aim of this study was to examine the maxillary arch dimensions in cleft lip and/or palate infants in Northern Finland before surgery. Materials and methods. The subjects consisted of 70 Finnish cleft patients born between 1997-2004 in Northern Ostrobothnia Hospital District in Finland. The study casts were obtained before surgery at the mean age of 5.6 months (SD = 2.2). There were 42 children with cleft palate (CP) (26 girls/16 boys), 13 with unilateral cleft lip and palate (UCLP) (eight girls/five boys), eight children with cleft lip (CL)(two girls/six boys) and seven with bilateral cleft lip and palate (BCLP) (two girls/five boys). Conventionally-used landmarks were marked on study casts and cleft width, arch circumference, anterior and posterior arch width and arch length were measured with a digital sliding calliper. The statistical method was ANOVA. Results. The prevalence of CP in this study, 60% of all clefts, is higher than the average standards. There were statistically significant differences in cleft width, posterior and anterior arch width, arch length and arch circumference, when different cleft groups were compared. When differences between girls and boys were compared, boys had larger cleft size and arch dimensions generally, but the results were not statistically significant. Conclusions. The results show the large variation in the severity of cleft lip and/or palate deformity at birth and in maxillary arch dimensions between different cleft types. It also demonstrates the effect of phenotypic variability within the groups of cleft lip and/or palate. [ABSTRACT FROM AUTHOR]

Background: Craniosynostosis compromises the cranial vault volume, severely impede growth, and may lead to increased intracranial pressure (ICP). Posterior cranial vault (PCV) distraction osteogenesis (DO) offers an excellent treatment opportunity for this condition. This article intends to describe the outcomes of PCV DO. Materials and Methods: Nine males and seven female children indicated for PCV DO were included in the study. The single vector distraction devices with quick-disconnect distraction rods, a type of miniaturized hardware, was used in all cases. Result: Seven of the 16 patients had a history of one or more prior cranioplasty. All reoperations in this series were performed for the indication of raised ICP including fi ve of the scaphocephaly patients and the syndromic patients. Clinical signs of raised ICP were present in all patients with either measured raised intracranial pressure or those with clinical signs of raised ICP preoperatively. There was substantial decrease in the ICP postoperatively. Discussion: The outcomes of this study were encouraging. Placing the distractor stems as fl at as possible against the outer layer of the cranial bone seems to be a very important maneuver. This keeps the distractor stem less proud and less likely to sustain future trauma. Removal of the distractor stems keeps the devices further away from the risk of later traumatic dislodgement. Moreover, miniaturized distractors allow precise control of the rate and the amount of distraction. [ABSTRACT FROM AUTHOR]

Background: Autogenous bone graft harvesting from the iliac crest is associated with donor site morbidity. The aim of this report is to describe the use of piezosurgery as an attempt at morbidity reduction. Materials and Methods: A piezosurgical handpiece and its selection of tips can easily be accommodated in an iliac crest wound to osteotomize and allow the harvest and delivery of autogenous bone grafts. Results: Corticocancellous blocks or cancellous strips of autogenous bone can be readily harvested using a piezosurgical technique at the anterior iliac crest. Conclusion: Piezosurgery avoids some of the traumatic aspects of harvesting bone associated with the use of conventional rotary instruments or saws. [ABSTRACT FROM AUTHOR]

Background: The harvesting of a tooth as a candidate for tooth autotransplantation requires that the delicate dental tissues around the tooth be minimally traumatized. This is especially so for the periradicular tissues of the tooth root and the follicular tissues surrounding the crown. The aim of this report is to describe the use of piezosurgery as an attempt at morbidity reduction in the harvesting of teeth for autotransplantation. Methods: A piezosurgical handpiece and its selection of tips were easily adapted to allow the harvesting and delivery of teeth for autotransplantation purposes. Results: Twenty premolar teeth were harvested using a piezosurgical device. The harvested teeth were subsequently successfully autotransplanted. All twenty teeth healed in a satisfactory manner without excessive mobility or ankyloses. Conclusions: Piezosurgery avoids some of the traumatic aspects of harvesting teeth and removing bone which are associated with thermal damage from the use of conventional rotary instruments or saws. Piezosurgery can be adapted to facilitate the predictable harvesting of teeth for autotransplantation purposes. [ABSTRACT FROM AUTHOR]

A case of sialometaplasia of the soft palate is reported in a 2-year-old girl 3 months after she had an adenoidectomy. Dental practitioners should be aware of the possible causes of intraoral swellings in both children and adults. The appearance of some conditions in children may differ from their characteristic appearance in adults. Necrotizing sialometaplasia may appear as an aggressive-looking lesion in an adult, possibly resembling squamous cell carcinoma. In the young patient reported here, frank necrosis was not evident from clinical or histological examination. Necrosis may not be part of the presentation of sialometaplasia in such young children. [ABSTRACT FROM AUTHOR]

Background: While sagittal synostosis is the most common craniosynostosis, long-term follow-up of these patients is lacking., Objective: To evaluate the results of surgical management of those patients with sagittal synostosis who attain adulthood., Methods: An outcome study of surgically treated isolated sagittal synostosis patients operated between 1977 and 1998 was conducted at the Craniofacial Center of Oulu University Hospital, Oulu, Finland with an average follow-up time of 26.5 yr. Patients' socioeconomic situation, satisfaction with their own facial appearance and attractiveness as rated by 2 independent panels was evaluated and compared to controls., Results: The self-satisfaction with the patients' own appearance scored a mean of 75 mm on a visual analog scale of 100 mm between the patients and 76 mm with the control group. The subjective satisfaction of the patients with their own appearance failed to correlate with the rating of their appearance by the panels. The panels rated the patients' appearance to be on average 6 to 7 mm out of 100 mm visual analog scale less attractive than the controls. Data on socioeconomic situation, including marital status, housing, education, employment of the patients, and controls are presented., Conclusion: Isolated sagittal synostosis patients treated surgically were as happy with their facial appearance as were individuals in an age and gender-matched control group. Two independent panels found the patients' appearance to be only somewhat less attractive. Analysis of the socioeconomic situation and general health revealed that patients equaled that of controls.

A case of sialometaplasia of the soft palate is reported in a 2-year-old girl three months after she had an adenoidectomy. Dental practitioners should be aware of the possible causes of intraoral swellings in both children and adults. The appearance of some conditions in children may differ from their characteristic appearance in adults. Necrotizing sialometaplasia may appear as an aggressive-looking lesion in an adult, possibly resembling squamous cell carcinoma. In the young patient reported here, frank necrosis was not evident from clinical or histological examination. Necrosis may not be part of the presentation of sialometaplasia in such young children.

A case of sialometaplasia of the soft palate is reported in a 2-year-old girl 3 months after she had an adenoidectomy. Dental practitioners should be aware of the possible causes of intraoral swellings in both children and adults. The appearance of some conditions in children may differ from their characteristic appearance in adults. Necrotizing sialometaplasia may appear as an aggressive-looking lesion in an adult, possibly resembling squamous cell carcinoma. In the young patient reported here, frank necrosis was not evident from clinical or histological examination. Necrosis may not be part of the presentation of sialometaplasia in such young children.