Outcomes and Stability of Anterior Open Bite Treatment with Skeletal Anchorage in Non-Growing Patients and Adults Compared to the Results of Orthognathic Surgery Procedures: A Systematic Review

The objective of this review is to evaluate, on the basis of the available literature, if anterior open bite (AOB) can be successfully treated with the intrusion of molar teeth using skeletal anchorage in non-growing patients and adults and if this treatment modality provides comparable results to those obtained by orthognathic surgery procedures.

METHODS

A systematic review of published data in major databases from 2000 to 2021 was performed.

RESULTS

In total, 92 articles were included in title and abstract screening, and only 16 articles (11 concerning AOB correction by molar intrusion with skeletal anchorage, and five considering AOB treatment by orthognathic surgical intervention) qualified for thorough data extraction and analysis.

CONCLUSIONS

On the basis of this review, it seems to be possible to obtain successful results for AOB treatment in non-growing patients and adults by means of the intrusion of molar teeth with skeletal anchorage. However, due to the different methods of assessing treatment outcomes used by different authors, it is not possible to state conclusively whether the treatment of AOB by means of molar intrusion with skeletal anchorage provides long-term results that are comparable to orthognathic surgery procedures.

Selected toxic and essential heavy metals in impacted teeth and the surrounding mandibular bones of people exposed to heavy metals in the environment

BACKGROUND

The elemental composition of bones and teeth can allow exposure to heavy metals in the environment to be estimated. The aim of this study was to determine whether impacted mandibular teeth and the surrounding bones can be used as biomonitoring media to assess exposure to heavy metals.

METHODS

The research materials were 67 impacted lower third molars and samples of the cortical bone removed when the wisdom teeth were surgically extracted. The samples were from people living in two areas with different environmental concentrations of heavy metals. The cadmium, chromium, copper, iron, lead, manganese, and zinc concentrations in the samples were determined by atomic absorption spectrometry with flame atomization.

RESULTS

The cadmium and lead concentrations in the impacted third molars and the bones surrounding the teeth were significantly higher for people living in the relatively polluted Ruda Slaska region than for people living in Bielsko-Biala region. Significantly higher chromium, copper, manganese, and zinc concentrations were found in the bones surrounding the impacted teeth from people living in Ruda Slaska than in the bones surrounding the impacted teeth from people living in Bielsko-Biala. The cadmium concentrations in impacted teeth and the surrounding bones were significantly positively correlated.

CONCLUSION

The results indicated that impacted mandibular teeth and the surrounding mandibular bones may reflect the exposure of people to cadmium and lead in the environment. This conclusion, however, must be verified in future research projects designed to exclude the possibility of additional dietary, occupational, and other types of exposure to heavy metals.

Do the levels of selected metals differ significantly between the roots of carious and non-carious teeth?

Since the metals deposited in teeth during formation and mineralization processes are to a large extent retained, human teeth receive a considerable attention as the indicators of the heavy metal exposure. The use of permanent teeth is limited because the extraction of healthy permanent teeth just for this purpose is hardly acceptable. As the issue of the loss of elements from a carious lesion in the coronal part of a tooth remains controversial, the valuable material could only be the root of carious and fractured permanent teeth. However, to ensure the validity of the results, it should be ascertained that the levels of certain toxic and essential elements do not differ significantly between the roots of non-carious and carious teeth, and therefore this is the aim of this project. The levels of cadmium, chromium, copper, iron, manganese, lead, zinc, potassium, sodium, calcium and magnesium were determined in the roots of 344 permanent teeth (189 carious and 155 caries-free teeth) from the residents of Ruda Slaska, Poland, aged 18 to 34. No statistically significant difference between the concentration of these metals in the roots of non-carious and carious teeth was found. This finding applies to both the general population and after the grouping by donor's gender and tooth type. The concentration of lead, iron, calcium and manganese in the roots of non-carious and carious teeth exhibited dependence upon tooth type, as well as the concentration of potassium in the roots of carious teeth. Since the mineral composition of the roots of permanent teeth is similar for the non-carious, as well as the carious teeth, they can be indiscriminately selected for the tests required by a research project, as they will produce the comparable results. However, in the case of lead, iron, calcium, potassium and manganese, the comparison should be made after grouping by tooth type.

Characteristics of maxillofacial injuries resulting from road traffic accidents--a 5 year review of the case records from Department of Maxillofacial Surgery in Katowice, Poland

Background

In spite of employing numerous devices improving the safety in motor vehicles, traffic accidents are still among the main reasons of maxillofacial injuries. The maxillofacial injuries remain the serious clinical problem because of the specificity of this anatomical region. The knowledge of etiologic factors and mechanisms of injuries can be helpful in a satisfactory trauma prevention. The aim of this study was to find out the incidence and the pattern of maxillofacial injuries resulting from traffic accidents in the patients treated in the Department of Maxillofacial Surgery (Silesian Medical Academy in Katowice, Poland) from January 2001 to December 2005.

Methods

The material consisted of 1024 case records of patients with maxillofacial injuries treated in the Maxillofacial Surgery Department of Silesian Medical Academy. The detailed analysis was carried out on the case records of 198 patients in the age of 3 to 68 with maxillofacial injuries resulting from traffic accidents. On the basis of data from a history, examination on admission, consultations and radiological examinations, patients' age and gender, we obtained the information on a pattern of injury and detailed description of an accident (the date and the time of an accident, the role of the patient in an accident).

Results

The traffic accidents were the cause of 19,93% maxillofacial injuries in the analyzed period of time. Most of the patients had injuries to the soft tissues of the face (22,21%), followed by tooth and alveolar process injuries (20,71%) and mandibular fractures (18,69%). All the types of injuries were more common in men than in women. The majority of the patients were car drivers followed by car passengers, pedestrians, cyclists and motor cyclists. The peak age of the patients was between 18 to 25 years. The prevalent number of accidents resulting in injuries to this region took place in spring, especially between noon and 4 PM.

Conclusion

Our results exhibit that road traffic accidents remain among the main reasons of maxillofacial injuries following the traumas resulting from assaults and interpersonal violence. This succession of etiologic factors is in accordance with the data from the most developed countries. The relatively high incidence of injuries resulting from traffic accidents indicates the necessity to reinforce legislation aimed to prevent road traffic crashes and thus to reduce maxillofacial injuries among children and adults.

[Effect of passive smoking on the level of selected metals in deciduous teeth]

The cigarette smoke is a significant source of heavy metals, which after being absorbed into the human organism, may be accumulated in a calcified tissue. The accumulation process may be also a result of a passive exposure to the cigarette smoke. As the hard tissues of deciduous teeth are relatively stable in chemical composition, they are widely used as the indicators of the exposure to heavy metals in children. This project is aimed to estimate the effect of passive smoke on the levels of selected toxic and essential elements in deciduous teeth. The research material consisted of 386 deciduous teeth. Out of this, 205 teeth were from the children exposed to the cigarette smoke in the apartments. The levels of cadmium, copper, iron, manganese, lead, zinc, calcium and magnesium were determined using atomic absorption spectrometer with flame atomization. It was concluded that the exposure to the cigarette smoke in children is a factor producing the changes in the levels of selected toxic and essential elements in deciduous teeth. This particularly results in the higher levels of cadmium, copper, lead and zinc, which are the permanent constituents of the cigarette smoke, and the lower levels of manganese, calcium and magnesium. Moreover, the disturbed gradient of lead levels dependent on the tooth type is observed in the children exposed to the cigarette smoke in the apartments.

[Smoking and drug use among students of selected univerities]

Smoking, drinking alcohol and drugs are still actual social and health problems in Poland and in the world as well. Conducted studies, considering health behaviours among children and youth, indicate high percentage (between 20-30%) of smokers in mentioned population, depending on age, gender and environment. Health effects caused by smoking occur usually in adulthood as smoking related diseases, despite the addiction leading to the health problem begins earlier, even in childhood. Statistics, considering drinking alcohol and drugs abuse among young people are also frightening. The aim of the study was to evaluate and compare the state of knowledge about harmful effects of smoking, drinking alcohol and drugs use among students of Silesian Medical University, Silesian University of Technology and Academy of Physical Education and to evaluate and compare health attitudes towards mentioned addictions among students of different Universities. 315 students at age between 19-24 years took part in the study and filled in the anonymous questionnaire prepared by authors. Surveyed population included 108 students of Silesian Medical University, 110 students of Silesian University of Technology and 97 students of Academy of Physical Education in Katowice. Knowledge, presented by all students, about harmful effects of smoking, drinking alcohol and drugs use is not put into practice and does not result in healthy behaviours in examined part of life style. Students of Silesian Medical University demonstrate the highest state of knowledge about drugs. Students of Academy of Physical Education in Katowice have the most improper behaviours in the area of addictions. There is a necessity of preparing and spreading efficacious prophylactic programmes in order to raise awareness about the harmfulness of smoking, drinking and drugs use.

Dynamics of changes in vascular endothelial growth factor (VEGF) expression and angiogenesis in stress-induced gastric ulceration in rats

Angiogenesis and VEGF play a major role in many repair processes such as healing of gastric ulceration. The present study was undertaken to assess the dynamics of changes in VEGF expression and angiogenesis in stress-induced gastric ulcers in rats. Acute gastric ulceration was induced using a water-immersion and restraint stress method. The VEGF expression, angiogenesis, size of area and depth of ulcers in gastric specimens were evaluated. The study shows that as early as one day after the development of ulcers there is a significant increase in both the expression of the VEGF protein and the number of newly formed microvessels, while an abrupt decrease in VEGF expression, observed on the fifth day, results in a decreased intensity of angiogenesis. Moreover, it has been demonstrated that the increase in VEGF expression and angiogenesis is accompanied by a reduction in the size of area and depth of stress-induced ulcers in rats. Six days after ulcer development both VEGF expression and angiogenesis return to normal levels.

[The effect of tobacco smoking on occurrence of precancerous lesions and cancers of oral cavity--literature reviews and own experiences]

Tobacco smoking results in many serious health problems. It exhibits also significant influence on oral health and is linked with occurrence of oral precancers and cancers. In this paper, on the basis of literature review and own experiences, we tried to prove the close relationship between tobacco smoking and occurrence of oral precancers, their malignant transformations and therapeutic effects. We pointed out on significantly higher cancer occurrence in this region among smokers. We emphasized the role of physicians, whose professional interest was focused on oral health, in prophylaxis of oral cancers and advising patients smoking cessation.

[Evaluation of knowledge and health attitude towards cigarette smoking, alcohol and drugs use among students]

Cigarette smoking, drinking alcohol and drug use are important epidemiological problems affecting state of health. Negative effects of these unhealthy behaviors are commonly known and result in many socioeconomic consequences. Despite relatively good knowledge about harm-fullness of cigarette smoking a percentage of smokers in polish population is still high, especially in young population, and hesitates between 20-30% depending on age, sex and socioeconomic conditions. Negative health attitude towards smoking, drinking alcohol and drug use among young people requires further education and promotion in this area. Aim of the study was evaluation of knowledge about harmful effects of smoking, drinking alcohol and drug use among students of Silesian University of Technology and evaluation of health attitudes towards smoking, drinking alcohol and drug abuse in examined population. 109 students of Silesian University of Technology at age between 19-24 years took part in the study and filled the anonymous questionnaire prepared by authors. The study revealed that 8% of Silesian University of Technology students smoke cigarettes regularly. 15% of students declare smoking occasionally despite most of them know negative effects of such smoking. Almost 80% do not smoke at all. In opinion of 66,7% passive model of smoking is as harmful as the active one. Relatively many (8%) of examined students admit drinking alcohol regularly. Only 15% do not drink alcohol. 35% of students declare taking a drug, at least once during entire life, and some of examined consider marihuana as not addictive. High knowledge about harmful effects of smoking among students results in a relatively low percentage of inveterate smokers. Despite knowledge about harmfulness of drinking alcohol and drug abuse proper healthy behaviors in this area are not put into practice in examined motion in order to reduce unhealthy behaviors among young people.

[Effect of cigarette smoking on coexistence of cadmium and zinc in retained wisdom teeth]

The change in coexistence pattern of elements (antagonism-synergism) in conditions of excessive level of toxic element is observed in many biological samples. The aim of this study was to establish the cadmium and zinc content in hard tissues of retained wisdom teeth of smokers and non-smokers and to find out if active exposure to cigarette smoke has an influence on coexistence of both metals in these tissues. Material consisted of 127 retained wisdom teeth (65 from smokers and 62 from non-smokers). Cadmium and zinc contents were determined by means of atomic absorption spectrometry. We found out that retained wisdom tooth from smokers exhibited higher cadmium and zinc contents compared to non-smokers' teeth. Moreover, coexistence pattern of cadmium and zinc in teeth depends on exposure to heavy metals and exhibits strong synergism in smokers.

[The assessment of food intake and declared satisfaction in medical students]

Proper nutrition is one of the basic factors of the external environment which substantially influence the assurance and upkeep of a one's good state of health until old age. For students of medicine, i.e. prospective doctors, acquisition of knowledge and clinical experience should be accompanied by raising qualifications in the field of preventive treatment so that in future they can not only cure but also promote health. The aim of the present study was to analyse students' nutrition habits and to evaluate the declared satisfaction with the way of feeding. In preparation of the present paper the author used anonymous questionnaire method employing an inquiry form. The research included 416 students of the 4th and 5th years of study of the Medicine Department and 3rd and 4th year students of the Stomatology Division in 2001-2002 years. In the female group one could observe a larger consumption of vegetables and fruit, dairy products, poultry, fish and seeds of leguminous plants. Men more often eat animal fat and red meat. The analysis of the number of meals eaten shows that majority of women eat only one hot meal a day and do not eat supper. Whereas men twice as often do not eat breakfasts, they eat two or more hot meals a day and 70% of them declare they eat supper. Every second questioned person eats sweetmeats even several times a day, and only 7.7% of the population does not have the habit of intermittent eating. Analysis of the research material allowed to draw the following conclusions: 1. There is a statistically significant interdependence between the amount and quality of consumed food and the sex. 2. Women's nutritious habits are more adequate than men's nutrition habits to the dietetic prescriptions of the Institute of Food and Nutrition]. 3. Most of the men are satisfied with their nutritious habits, and the dissatisfied group is dominated by women. 4. The obtained results point to a necessity to work out and implement pro-health education within the field of young people's nutrition.

[Current knowledge among students of the Silesian Medical Academy about the importance and role of medical care funds]

The purpose of this research was verification and comparison of the present state of knowledge among the students of different departments and years of study. The questions concerned the role of Medical Care Funds in the up-to-now healthcare system and the patient's rights as far as the students' future professions as doctors, dentists, healthcare managers and medical rescuers is concerned. The questionnaire included 15 questions referring to the problem of functioning of the medical care institutions after the reform of healthcare services introduced in 1999. Distinct from most of the published works of this kind, the authors adopted a uniform "assessment" method following the principles of didactic measurement. The researchers calculated: Range, Modal, Mediana, Arithmetic Average, Variance, Standard Deviation, Easiness of the Task, Difficulty of the Task, Skip Fraction, the Task's Differentiating Power, Reliability Coefficient of the Test. The calculation was conducted with the use of the Excel programme modified by the researchers to suit the needs of didactic measurement. The survey included 104 students of the 3rd year of Dental Department, 116 of the students 4th year of Dental Department, 31 students of Bachelor's Medical Rescue Studies by the Medical Department in Zabrze, 18 students of Post-Graduate Management and Administration in Healthcare by the Medical Department in Zabrze and Silesian Technical University, 151 4th year students of the Medical Department in Zabrze and 121 6th year students of the Medical Department in Zabrze. It has been proved that between the particular groups there are significant differences as far as the students' knowledge is concerned ("the healthcare managers" demonstrated quite a high knowledge ratio). And that the questions were at different difficulty levels depending on the branch and year of study represented by the respondents.

[Self-assessment of nutritinal status in medical students and objective measures of estimating somatic development]

Problem of "obesity epidemic" is still very common, but the knowledge about this is limited and it develops very slowly. Probably it even concerns medical students who are in touch with health problems every day and who will watch over society's health in the future. Available literature estimating people's health is mainly connected with negative measures of human health condition. Positive measures are rarely used, although they are simply in use and accessible (including financial accessibility). This kind of measures should be used in widest range to epidemiological investigation of obesity. The aim of the study was to estimate the level of medical student's obesity and to compare declared self-assessment expressed by BMI. In the research 416 III-VI year students of Medical University of Silesia were involved. We used a number of anonymous questionnaires to receive required information. We analyzed objective value of BMI, fat tissue capacity, student's self-assessment and student's satisfaction of their state of nutrition. Statistic analyzes were done using Epi Info v.5.01b program. Distribution of abnormal body weight among students under research was following: underweight--10.3% of the students, overweight--12% and II degree obesity--1.9% of investigated population. Among people with confirmed obesity only 100% of women realized this fact and 44.2% of men found their overweight as normal. Student's satisfaction of state of nutrition independently if it was proper or not, was significantly higher among men. It is necessary to teach students how to properly estimate the state of nutrition.

[Differentiation of students's knowledge of civilization-related diseases]

The goal of the study was to check and compare the current condition of students' knowledge on civilization-related diseases in relation to their future career as doctors, dentists, health care managers. The questionnaire consisted of 15 closed questions concerning civilization-related diseases. As opposed to majority of studies referring to this problem uniform method of assessment in accordance with the principles of didactic measurement was applied. The following test components were measured: Range, Mode, Median, Arithmetic Mean, Variance, Standard Deviation, Task Simplicity, Task Complexity, Reliability. Calculations were carried out using our own updated Excel programme. Study group consisted of 104 III year students of Division of Dentistry, 116 students of IV year Division of Dentistry, 31 students of Licentiate Faculty of Emergency Medicine in Zabrze, 18 students of Postgraduate Course in Management and Administration in Health Care Medical Faculty in Zabrze and Technical University in Gliwice, 151 IV year students of Medical Faculty in Zabrze and 121 VI year students of Medical Faculty in Zabrze. Significant differences between individual groups (surprisingly low level among future managers of health care) as well as different degree of difficulty of questions depending on the faculty and the year of study.