Background/Objectives: Impacted teeth are characterized by having more than three-quarters of root development completed, however failing to erupt or demonstrate imminent eruption, as evidenced both by clinical and radiographic evaluation. Canine impaction is an entity of clinical significance considering its potential to affect both oral function and facial aesthetics. If not appropriately managed, this condition may adversely impact functional occlusion and structural smile integrity. The purpose of the study was to investigate the prevalence of impacted and transmigrant canines in a Greek orthodontic cohort and identify potential sex-based differences. Methods: A total of 2594 panoramic radiographs and clinical records of consecutive patients in the mixed and permanent dentition stages, treated at the Department of Orthodontics of the Aristotle University of Thessaloniki, Greece, were retrospectively retrieved and analyzed to detect the presence of impacted and transmigrant canines. Patients lacking complete clinical records or panoramic radiograph, undergoing or had undergone orthodontic treatment, or presenting conditions affecting normal permanent dentition development, including pathological conditions, cleft lip and palate or hereditary disorders, were excluded. Results: At least one impacted canine was detected in 109 patients (67% females, 33% males), with a median age of 15 years (IQR: 13-18), documenting a 4.2% prevalence (6.97% females, 2.32% males). The frequency of maxillary canine impaction was 3.97%, while in the mandible a frequency of 0.46% was reported. The frequency of bilateral canine impaction was 1%, with it being present in 25.7% of patients with canine impaction. The prevalence of transmigrant canines was 0.11%, with detection solely in the mandible. A statistically significant sex difference was detected solely in the prevalence of impaction. Conclusions: Considering the implications of canine impaction, the epidemiological investigation of this entity may facilitate an early diagnosis and treatment.

Was to evaluate alveolar bone grafting success using the autograft from the mandibular body, own bone fragments and xenogeneic material. This study was conducted by Central Research Institute of Dentistry and Maxillofacial Surgery (Moscow, Russia) from 2013 through 2023. Consecutive 128 patients with cleft lip/palate who underwent alveolar bone grafting by one surgeon were included. The median age at alveolar bone graft was 12.7 years (range 7-23 years). Inclusion criteria were unilateral and bilateral cleft lip and alveolus and a computed tomography (CT) scan obtained >8 months (128 patients) and 2-10 years (range 3.2 years, 52 patients) after alveolar bone grafting. The success rate of surgical intervention was 92.6%. Alveolar bone graft undergoes remodeling but not lysis long-term. Alveolar bone grafting with mandibular bone proved to be effective and has demonstrated good long-term results. The bone level in the grafted area was satisfactory with no signs of resorption. Оценка эффективности костной пластики альвеолярного отростка верхней челюсти (АОВЧ) с использованием аутотрансплантата с тела нижней челюсти, собственной костной стружки и ксеногенного материала. Исследование проводилось на базе ФГБУ НМИЦ ЦНИИСиЧЛХ Минздрава России с 2013 по 2023 г. В исследование вошли 128 пациентов с одно- или двусторонней расщелиной АОВЧ в возрасте от 7 до 23 лет (средний — 12,7 года), ранее оперированных по поводу расщелины верхней губы и неба. Критерием включения являлось наличие у детей одно- или двусторонней расщелины АОВЧ и результатов КТ лицевого скелета в ближайшем (через 8 мес, 128 пациентов) и отдаленном (через 2—10 лет, в среднем 3,2 года, 52 пациента) периодах. Показатель успешности оперативного вмешательства составил 92,6%. Костный аутотрансплантат со временем подвергается ремоделированию, но не лизису. Описанная методика костной пластики АОВЧ является эффективной, обеспечивает полноценное замещение дефекта АОВЧ достаточным объемом костной ткани, которая со временем не подвергается резорбции.

Median cleft of the lower lip, midline mandibular cleft, or Tessier 30 cleft is a rare anomaly. We present a case involving the prenatal diagnosis of a median cleft of the lip and mandible associated with ankyloglossia, directly attached to the gingiva and lower lip. Postnatally, the condition was managed with a combined surgical approach of split labiaplasty and tongue-tie plasty in the stomatology department. The outcome was favorable following the transverse incision of the lower portion of the tongue-tie. The sonographer must carefully examine the craniofacial section to minimize the risk of missed diagnosis.

The purpose of this study was to evaluate whether the sequence of osteotomies influences the accuracy of maxillary positioning in patients with cleft palate with or without cleft lip undergoing bimaxillary orthognathic surgery (OGS). This was a prospective study of patients with Veau II through IV clefts who underwent bimaxillary OGS at a tertiary-care children's hospital over a 3-year period. The primary predictor variable was the sequence of osteotomies (maxilla first versus mandible first). The primary outcome of interest was the concordance between the planned and achieved maxillary position, as assessed using linear and angular measurements. Secondary study predictors were demographic and surgical variables. Differences between groups were compared using nonparametric independent samples tests for continuous measures (data reported as median and interquartile range) and chi-square tests for categorical measures. For all analyses, P ≤ 0.05 was considered significant. Participants who underwent maxilla-first ( n = 15) and mandible-first ( n = 16) operations were comparable with regard to age, sex, cleft type, skeletal classification, segmental maxillary osteotomy, and magnitude of maxillary movement ( P ≥ 0.09). The planned sagittal and vertical positions of the maxilla were similarly accurate between the 2 groups ( P ≥ 0.68). Angular accuracy was also comparable ( P ≥ 0.56) between the study groups. In patients with cleft palate with or without cleft lip undergoing bimaxillary OGS, use of mandible-first sequencing, when compared with maxilla-first sequencing, does not affect the accuracy of maxillary positioning in the immediate postoperative period in well-selected patients. Therapeutic, II.

Though it has made significant strides, Vietnam remains a resource-constrained country of 98 million people. Vietnam National Children's Hospital (VNCH) provides tertiary care to a catchment of 40 million people and is the sole national children's hospital. As such, it is one of the few referral centers in the country equipped to take care of patients diagnosed with Pierre Robin sequence (PRS) as this requires pulmonary, critical care, otolaryngology, and plastic surgery expertise. Before 2015, the only surgical options were tongue lip adhesion or tracheostomy. Only 20% of patients successfully avoided tracheostomy, mechanical ventilation, or death. From 2015 to 2019, mandibular distraction osteogenesis (MDO) was introduced by visiting international surgeons on a short-term basis. Since 2020, local surgeons at VNCH have refined their technique and widely use MDO independently. This report seeks to capitulate their experience and identify factors leading to success. A retrospective review was conducted of patients diagnosed with PRS at VNCH from 2015 to 2022. Paper records were digitized, translated, and reviewed for inclusion criteria, including demographics, indications, hospital course, and postoperative outcomes. Complete records satisfying inclusion criteria were available for 53 patients with a diagnosis of PRS who underwent MDO from 2020 to 2022. From 2015 to 2019, there were 19 cases of MDO, though records were incomplete. The median age at the time of MDO was 50 ± 43 days. Forty patients (75.5%) had isolated PRS and 13 (24.5%) were syndromic. Forty-four patients (83%) had a cleft palate. Fifty-one (96.2%) of patients required preoperative supplemental oxygen or mechanical ventilation. The active distraction and consolidation phase was 4.8 ± 1.3 months. The median days to discharge after surgery was 19.0 ± 8.3 days. Median weight at birth, at the time of surgery, and at the time of device removal were 6.8 ± 1.2, 7.7 ± 1.9, and 14.8 ± 2.8 pounds, respectively. Fifty-two patients (98.1%) had obstructive sleep apnea preoperatively with an average Apnea Hypopnea Index of 25.0 ± 10.6. Post-MDO, only 4 (7.5%) had obstructive sleep apnea and the average Apnea Hypopnea Index was 5.2 ± 0.6. No patients (0) required a tracheostomy for a 100% success rate. The tremendous success of the implementation of MDO by local surgeons in Vietnam after its introduction by visiting international surgeons illustrates a paradigm for capacity-enhancing global surgical endeavors. Mandibular distraction osteogenesis has replaced tongue lip adhesion as the surgical treatment of choice for PRS patients at VNCH. Surgical techniques can be transferred to operating environments with basic infrastructure through collaboration and resource optimization. These results demonstrate that global surgical engagement may be scalable and repeatable with direct benefits for patients in lower-middle-income countries.