Background/Objectives: The relation between the orthopedic temporomandibular joint (TMJ) instability and temporomandibular disorder (TMD) most commonly remain unrecognized by orthodontists. In this study we aimed to evaluate the dentofacial characteristics and temporomandibular disorder symptomatology of patients with orthopedic instability before and after deprogramming with a stabilization splint. Methods: Sixty patients with the signs and symptoms of TMD were assessed using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and underwent stabilization splint therapy to place the condyles in a more stable musculoskeletal position. The extent of condylar displacement was evaluated using the condylar position indicator (CPI). Sixteen angular and linear hard tissue landmarks were traced and compared from lateral cephalograms taken in the maximum intercuspation (MI) position before, and in the centric relation (CR) position after, the splint therapy. Results: Following the splint therapy, the signs and symptoms of TMD were significantly reduced or completely eliminated in more than 90% of patients. Compared with the values registered before the splint therapy, a significant reduction in the mean values of condylar displacement was observed on both sides of the vertical (p < 0.001), horizontal (p < 0.05), and transverse (p < 0.001) planes of space after the splint therapy. A comparison of pre- and post-splint lateral cephalograms revealed that, following the splint therapy, the mandible moved more posteriorly and rotated in a more clockwise direction. Conclusions: In patients with orthopedic instability and the signs and symptoms of TMD, muscle deprogramming with a stabilization splint therapy is highly recommended to improve the health of the temporomandibular joint and masticatory structures and contribute to a more correct orthodontic diagnosis.

Objective. The goal of this review was to determine the effectiveness of different types of monobloc and bibloc mandibular advancement device (MAD) devices in the treatment of all forms of obstructive sleep apnea (OSA), by reviewing the available literature. Methods. A systematic literature search was performed in PubMed, ResearchGate, NCBI and Google Scholar databases. The search included articles in English, published in the inclusive time period from 2000 to 2024. Results. A total of 13 studies were analyzed that directly compared the effectiveness of monobloc and bibloc devices. The studies were published in the period from 2000 to 2024, and included crossover and parallel randomized controlled trials, as well as cross and parallel cohort studies. Out of the 13 studies, four were classified as RCT parallel studies, six were RCT crossover studies, two cohort parallel studies, and one cohort crossover study. The duration of the studies was variable, ranging from four weeks to one year, with six studies having a so-called “washout period” between the use of monobloc and bibloc MAD devices. Conclusion. Both monobloc and bibloc devices show significant success rates in the treatment of mild to moderate OSA.

Background/Aim: The aim of this study was to determine the accuracy of overall and anterior Bolton's ratio measurements obtained with an intraoral scanner compared to standard caliper measurements on plaster models. Material and Methods: This study included 33 subjects (18 female and 15 male), aged 12 to 18 years. All subjects were taken impression for the purpose of making study plaster models. In addition, all subjects underwent intraoral scanning for the purpose of creating digital models. Tooth width was measured with a caliper on plaster models, while digital models were analyzed using Cerec Ortho SW 2.0.2 software. The overall and anterior Bolton ratios were derived using both methods. Statistical data processing was performed using an independent t-test. Results: The results obtained using these two methods for measuring the anterior and overall Bolton ratio showed that there was no statistically significant difference in the measurements obtained on plaster models and the measurements obtained by intraoral scanning. For the overall Bolton ratio, T-test was 0.828 and is not statistically significant (p<0.05). The value of T-test for the anterior Bolton ratio was 0.001 and it was also not statistically significant (p<0.05). Conclusions: Determination the overall and anterior Bolton ratio using an intraoral scanner is an accurate and acceptable method for clinical work in orthodontics.

Introduction/Objective. Deprogramming of the neuromuscular system with the use of stabilization splint might provide more precise evaluation of the centric relation (CR) - maximum intercuspation (MI) discrepancy. The study aimed to evaluate the differences between the bite registrations obtained in the CR before and after the application of the stabilization splint therapy. Methods. The sample included 48 non-deprogrammed individuals without any apparent signs and symptoms of temporomandibular disorders (TMDs). The neuromuscular system was deprogrammed by employing stabilization splint therapy. A condylar displacement evaluation was performed on vertical, horizontal and transverse planes of space, with the assistance of a condylar position indicator (CPI). Results. The mean values of condylar displacements, which were obtained after the deprogramming of the neuromuscular system, were significantly greater than those obtained before neuromuscular deprogramming for vertical condylar displacement (p < .0001). A greater degree of condylar distraction was observed on the left side of the vertical plane before (p < .01) and after neuromuscular deprogramming (p < .05). The highest level of condylar displacement occurred in the postero-inferior direction subsequent to the muscle deprogramming. Conclusion. It was observed that the level of average condylar displacements was significantly higher following the deprogramming of the neuromuscular system compared to that recorded before neuromuscular deprogramming using stabilization splint therapy. A more precise orthodontic diagnosis could have been obtained if the condyles were placed in a more exact CR position by muscle deprogramming.

Background/Aim: The aim of the research is to assess the psychosocial impact of malocclusion, to determine the relationship with the degree of need for orthodontic treatment, and to assess the influence of gender on this relationship in adolescents. Material and Methods: A total of 100 subjects, aged 12 to 18, participated in the research. The subjects had no previous orthodontic treatment. The assessment of the need for orthodontic treatment was performed using the Index of Orthodontic Treatment Need (IOTN), namely the Dental Health Component (DHC) and the Aesthetic Component (AC). The psychosocial impact of dental aesthetics was assessed using the PIDAQ questionnaire. Results: The total PIDAQ score, as well as its 4 subclasses, dental self-confidence, psychological impact, social impact and aesthetic concern have a positive correlation with the categories of the IOTN. The psychosocial impact of dental aesthetics is similar in boys and girls, except that girls showed a slightly greater aesthetic concern due to the presence of malocclusion. Conclusions: The present malocclusion has a psychological and social impact on the individual, but it also negatively affects his dental self-confidence and aesthetic concerns. The results of the PIDAQ questionnaire can guide the orthodontist to the patient's basic problem and thus provide guidelines for orthodontic treatment.

Background/Aim: The objective of this research was to evaluate the level of oral hygiene, the prevalence of caries, and the condition of the soft tissues in children and adolescents referred for their first orthodontic examination. Material and Methods: The research was conducted at the Department of Orthodontics of Sarajevo University - at the Faculty of Dentistry with the Dental Clinical Center. A total of 300 patients with mixed and permanent dentition who were referred for their first orthodontic examination were included in the study. The patients were offered to sign a Letter of Informed Consent for this study. All patients were assigned a Decayed, Missing, and Filled Teeth (dmft/DMFT) index. Periodontal indices were evaluated on all first permanent molars and all permanent central incisors. The periodontal indices included the determination of PI,CI,GI, PBI. Results: The results were processed with the application of standard statistical methods, by using the SPSS computer program for statistical analyses (SPSS-Statistical Package for Social Sciences) Version 21.0. The results of this study show a high dmft and DMFT indices in patients referred for orthodontic examination. The dmft index value in the respondents with mixed dentition was 3.0 (1.0 - 6.0). The DMFT index value in the respondents with permanent dentition was 4.0 (0.0 - 6.0), while in the respondents with mixed dentition, it was 1.0 (0.0 - 3.0). Our research also shows that out of 300 patients referred to an orthodontist for their first orthodontic examination, 250 of them (83.33%) have demonstrated an increased value of the Plaque index. Conclusions: The results of this research should be peculiarly alarming for pedodontists and general dentists, cautioning them to implement caries prevention measures more intensively and make referrals to an orthodontist only in case of those patients who have been cured previously.

Introduction: Obstructive sleep apnea (OSA) is characterized by the cessation of air flow during sleep due to an obstruction in the nasopharyngeal/oropharyngeal region. The consequences that untreated obstructive sleep apnoea might have on patient’s health include symptoms like sudden awakening with a sensation of suffocation, morning headache, daytime sleepiness and fatigue, lack of concentration, and it is commonly connected to hypertension, coronary artery disease, depression, obesity and other medical conditions. Aim: The purpose of this review study is to enlighten the role of an orthodontic professional in prevention and treatment of obstructive sleep apnea syndrome to the general public. Methods: Data search was determined by the following keywords: sleep apnea, orthodontic abnormalities, orthodontic prevention, sleep apnea syndrome, obstructive sleep apnea, cephalometric analysis, AHI index, BMI index and obesity. Electronic data search was performed on platforms Pubmed and Google Scholar. Results: After reading and analyses, twenty-one articles with similar procedural criteria were selected, and among them only 6 were recognized as meeting the criteria of being completely accessible, having the selected keywords in their name, using the cephalometric analysis and BMI index and discussing the obese adults sleep apnea. In all the examined studies, it is proven that craniofacial morphology is a major anatomical risk factor for OSA. Conclusion: The role of the orthodontic specialists might be crucial in prevention of the development of obstructive sleep apnea, not only considering the orthodontic devices treament options, it can be especially important when obesity appears as a factor in the sense of informing and advising the patient and cooperating with other specialists who treat and prevent obstructive sleep apnea syndrome.

AIM Research aimed to gather aepidemiological parameters of MIH from a sample of Sarajevo children born between the years 1999 and 2003. Prevalence of MIH, distribution according to severity (mild vs. moderate/severe cases) and distribution according to phenotypes (MIH vs MH) were investigated. MATERIALS AND METHODS Study design: This was a cross-sectional, observational, aepidemiological study that was conducted on a sample of 446 children aged 6 to 9 years. It was conducted as a part of regular dental screening of children attending a randomly selected primary school in the Bosnian capital city of Sarajevo. RESULTS The overall prevalence of MIH was 11.5%. MIH prevalence varied between 19.9% of examinees born in year 2002 to 8.4% among those born in 2003. Number of teeth affected varied from 1 to 7. The average number of affected teeth was 3.82 ± 1.46. Demarcated opacities were recorded on 13.89%, post-eruptive enamel breakdown on 11.28% and atypical filling on 6.2% index teeth. Mild cases of MIH were rare in our sample, 18% of subject had only demarcated opacities present. A smaller percentage of examinees (35.3%) had hypomineralisation present only on first permanent molars (MH group). Out of 64.7% of subjects in MIH group, 37.25% had one incisor affected and 21.57% had two incisors affected. CONCLUSION Over 80% of study subjects with MIH were categorised as moderate/severe case of MIH and they represent a major problem with regards to dental treatment. It is necessary to plan a multi-disciplinary approach for dental care of this population. It is necessary to educate primary care dentists to recognise this condition and provide recommended treatment to patients with mild clinical picture, while directing those with more severe problems to specialised doctors.

Abstract Objective The aim of this research was to examine the attitudes and perceptions of dentofacial aesthetics among different age groups. Materials and Methods The sample consisted of elementary-school students from the city of Sarajevo, Bosnia and Herzegovina, and their parents. This study included 314 subjects: 157 children and 157 parents. The children’s group consisted of 85 (54.14%) males and 72 (45.85%) females, aged 9 to 15 years. Statistical Analysis Descriptive statistics were used to determine frequency distribution and percentages for all variables. A chi-squared (x 2) test was used to determine the association between variables and a p-value < 0.05 was considered significant for all the differences and associations. Results For the dentofacial appearance with no teeth irregularity or with severe teeth irregularity, an analysis of variance (ANOVA) (post-hoc tests—Tukey’s HSD) indicated that the difference is not statistically significant (p = 0.06) relative to rank matching between all three subject groups. For dentofacial appearance with mild teeth irregularity, an ANOVA (post-hoc tests—Tukey’s HSD) showed statistical difference (p = 0.07) between the teenage group of subjects relative to pre-teenage group of subjects and adult group of subjects. Conclusion Attitudes about desirable and acceptable dental aesthetics differ in younger children compared with older children and parents. Ten years old children find good function with poor aesthetics more pleasing, while 14 years old children find aesthetics with bad function as more pleasing.

Retention is a phase of orthodontic treatment devised to keep the teeth in a correct position once the orthodontic treatment has been completed. There are three main characteristics that each ideal retainer is required to have: to keep the teeth in the correct position after orthodontic therapy, to be long lasting and resistant to mechanical damage, and to have no adverse long-term effects on periodontal tissue. Through a computer-based browsing through a number of databases (such as, e.g. PubMed and Google Scholar) we have found and analysed various articles used in this research. The inclusion criteria to be met were: an overall availability of a research paper, the requirement that these research papers are published in English, that these research papers were published in the period 2007-2019, the requirement that the research papers should involve clinically randomized studies and that their titles contain one of the predefined keywords. The database browsing that is based on the said keywords and carried out within the above time frame has resulted in finding 165 relevant articles. A complete set of the inclusion criteria were met by 8 published research papers, but 7 articles were analysed in the end. The selected articles have compared different types of fixed and mobile retainers, different times of wearing the retainers, the impact that the retainers had on the periodontium, and the acceptability of different retention protocols for patients. The conclusion of this research paper is that bonded retainers prove to be most effective in stabilising the position of the incisors, particularly the lower ones, but that their disadvantages include the reopening of the extraction space and the retention of plaque due to difficulties in maintaining oral hygiene. Vacuum-formed retainers appear to be more effective than Hawley retainers in retaining the position of the incisors, and patients have indicated that they are more acceptable to wear. Hawley retainers prove to be most effective in preserving a closed extraction space, but they do now show solid results with regard to other segments. Changes in the overbite, overjet, arch length, and anterior and posterior widths did not show any significant statistical differences in the different types of retainers.   Keywords: orthodontics, retention, stability, impact

OBJECTIVE The aim of this study was to assess the prevalence of hypodontia and hyperdontia among a group of orthodontic patients. MATERIALS AND METHODS This cross sectional study was conducted using radiographs of 4256 patients (2032 males and 2224 females) who attended the Department of Orthodontics, School of Dental Medicine, University of Sarajevo. Radiographs were examined for the prevalence of hypodontia and hyperdontia in permanent dentition. Hypodontia was recorded when a tooth was absent on the panoramic radiograph and hyperdontia was recorded as an increased number of teeth above that described by normal dental formula. All data were analyzed using descriptive statistics including frequency and percentage, and differences between groups were tested using the χ2 test, or Fisher exact test. RESULTS In the sample of orthodontic patients, 4.08% subjects had a least one dental anomaly, hypodontia or hyperdontia. The observed prevalence of hypodontia was in 3.42% subjects, and it was more prevalent in females than in male subjects. The observed prevalence of hyperdontia was in 0.65% subjects and hyperdontia was more common in males than female subjects. CONCLUSIONS By early diagnosis of a reduced or increased number of teeth, various modes of therapy with a multidisciplinary approach may be performed to correct the aesthetic and functional problems caused by hypodontia or hyperdontia.

Introduction: The growth and development of the craniofacial complex are under the influence of genetic and environmental factors, which determine its morphological and functional characteristics. Twin studies provide significant insight into how many genetic and environmental factors determine dental and craniofacial characteristics. Aim: The aim of the study was to determine the genetic influence on craniofacial complex using a twin study model. Methods: The study sample comprised 52 pairs of twins who were referred to the Orthodontic Department, School of Dental medicine, University of Sarajevo. Informed consent was obtained by the parents of the children included in the study. Twenty pairs of twins were diagnosed as monozygotic while 32 pairs were diagnosed as dizygotic. Zygosity was diagnosed by physical characteristics similarity. Nineteen variables were measured: 10 dental variables, 9 cephalometric. Results: Based on the findings of this study, t-test showed significant genetic effect on the length of cranial base (p = 0.03), corpus of maxilla (p = 0.02) and mandibular length (p = 0.03), and also for B-angle (p = 0.04). Environmental factors are more involved in determining dental traits (e.g., the inclination of the incisors). Conclusion: There is a significant genetic effect on the linear cephalometric variables: the length of the cranial base, maxillary length and mandibular length.

Introduction: Many factors affect the growth and development of the mandible. The most common one is micrognathia; this can pose and neonatal emergency. Early recognition of mandibular and other face anomalies could provide immediate care for these infants, and presence of neonatologist or other doctors in the delivery room. The aim: Aim of this study was to develop normal ranges of the facial markers: mandibular length, jaw index and the facial angle in the fetus using 3D ultrasound. Material and methods: The research was conducted as a cross-sectional study in the second trimester of pregnancy. Fetuses (female n=23 and male n=27) from singleton pregnancy between 29-37 week of gestation were examined by ultrasound. All images were acquired transabdominally, using Voluson E16. Ultrasound was performed by an experienced operator (SM) and measured the values of head circumference, abdominal circumference, biparietal diameter, femur length, body mass. For mandibular length, inferior facial angle, and the jaw index was calculated (Jaw Index =AP mandibular diameter / BPD * 100), the profile images were used (only images in the exact midsagittal plane were used). The characteristics of the fetal profiles were determined by the Schwartz and Ricketts profile analysis using soft tissue landmarks and analysis of the profile photographs. Results: The results show that the jaw index ranged from 25.33 and 34.06 with an average of 26.00 for all examined fetuses. Conclusion: The physiological position of the mandible is retrognathic and that the average physiological length of the mandible in the third trimester is 2.31cm. There is no difference in mandibular length between genders. Corresponding Author: Samra Salga-Nefic Rosenweg 2a, 3125 Toffen, Switzerland, e-mail: samrasalaga@gmail.com A determination of the standards of morphometrics variables of the stomatognathic system of a fetus INTRODUCTION Many factors affect the growth and development of the mandible: genes, irregular cell migration, low growth potential, feeding habits, and other habits acquired by newborns.1 The most common anomalies are microgenia (weak mandible growth) and retrogenia (small mandible growth in the sagittal plane).1 Deviation of physiological mandibular growth and development may incapacitate the essential functions of the stomatognathic system. Fetuses with mandible anomalies are at risk of airway obstruction through retro-positioning of the tongue-base into posterior pharyngeal airway.2 Micrognathia is frequently seen in Pierre Robin sequence, however it can be found in many genetic syndromes.3 Antenatal diagnosis of anomalies by ultrasound is widely used nowadays. The aim of this study was to develop normal ranges of the facial marker: mandibular length, jaw index and the facial angle in the fetus using 3D ultrasound. MATERIAL AND METHODS The research was conducted as a cross-sectional study in the second trimester of pregnancy. Fetuses (female n=23 and male n=27) from singleton pregnancy between 29-37 week of gestation were examined by ultrasound. All images were acquired transabdominally, using ultrasound Voluson E16, GE Healthcare, Austria GmbH & Co OG. Salaga-Nefic S., Mehmedbasic S., Kozadra J., Zukanovic A., Tiro, A., Dzemidzic, V., Nakas E. A determination of the standards of morphometrics variables of the stomatognathic system of a fetus. South Eur J Orthod Dentofac Res. 2019;6(1):6-11. Submitted: July 30, 2018; Revised: March 7, 2019; Published: April 30, 2019 6 South Eur J Orthod Dentofac Res Salaga-Nefic S. et al. Morphometrics variables of the fetus

Introduction: Malocclusion as an oral disorder can cause negative impact on individuals oral conditions, social interactions and self-esteem. Aim: The aim of this study was to compare oral health-related quality of life (OHQoL) of patients who had received fixed orthodontic treatment and patients who had not received fixed orthodontic treatment. Materials and Methods: Data were collected from 178 participants attended at professional dental office (mean age 22.71 years) in two groups (experimental and control). The experimental group comprised of 90 subjects who were in the retention phase, after their orthodontic treatment, and the control group comprised of 88 untreated subjects. Oral Health Impact Profile (OHIP-14) was used to assess the patients oral health related quality of life (OHQoL). Results: The control group had significantly higher OHIP-14 scores than experimental group (p < 0.001). Participants with treatment need reported a significantly greater negative impact on the overall OHRQoL score. Conclusion: Subjects with no history of orthodontic treatment had more negative oral health related quality (OHRQoL), than subjects who had completed orthodontic treatment. Dental malocclusion has significant negative impact on OHRQoL.

When dealing with orthopaedic treatment of skeletal Class III malocclusion, a long-term stability of the treatment outcome is not always achievable. Although, clinical investigations1-4 have reported that orthopaedic treatments are effective to reduce skeletal Class III malocclusion avoiding surgery, there is a tendency for some patients toward re-emergence of the Class III growth pattern, especially during the pubertal growth phase.5 ABSTRACT