Alessandro Silvestri

Sapienza University of Rome | la sapienza · Department of Oral and Maxillo-facial Sciences

Aim The aim of this retrospective study is promote a better understanding of the impaction of teeth 37 and 47 by means of clinical and statistical data from the point of view of early interceptive treatment. Materials and methods Study Design: 478 patients of the Orthodontic School of "La Sapienza" University of Rome (Italy) were studied to assess...

Objective: Our aim is to test the Nahoum Index as a support in the cephalometric study of vertical dimension and therapeutic orientation in adult patients suffering from Class II malocclusion, deep bite, or short face syndrome. Methods: Twenty-three patients with molar Class II and an overbite >4 mm were stratified into two groups: orthodontic (...

Objective: Pierre Robin Sequence (PRS) is a heterogeneous pathological condition characterized by the coexistence of micrognathia, glossoptosis, and cleft palate, resulting in upper airway tract obstruction. Among the treatment modalities, the orthodontic approach is one part of the comprehensive care of those patients and will be present in the t...

Purpose: Cone-beam computed tomography (CBCT) is widely used for 3-dimensional assessments of cranio-maxillofacial relationships, especially in patients undergoing orthognathic surgery. We have introduced, for reference in CBCT cephalometry, an anatomical mid-sagittal plane (MSP) identified by the nasion, the midpoint between the posterior clinoid...

The management of patients suffering from class III due to syndromic craniosynostosis requires a multidisciplinary team to prevent and correct the complex clinical features related to the syndrome. Among the main clinical features, the midface hypoplasia requires surgical advancement with a rigid external distraction device. The comparison of pre-...

Purpose: Facial asymmetries due to unilateral condylar hyperactivity are often a challenge both for maxillo-facial surgeons and for orthodontists; the current literature shows different opinions about aetiology, classification, treatment approach and timing. We made a retrospective study on patients suffering from unilateral condylar hyperactivity...

Aim: The aim of this retrospective study is promote a better understanding of the impaction of teeth 37 and 47 by means of clinical and statistical data from the point of view of early interceptive treatment. Materials and methods: Study design: 478 patients of the Orthodontic School of "La Sapienza" University of Rome (Italy) were studied to...

Lateral cephalometric radiograph produces a two-dimensional image with several drawbacks. Cone beam computed tomography (CBCT) allows obtaining a three-dimensional representation of the craniofacial structures and seems to overcome the problems of superimposition and magnification, providing more precision than two-dimensional methods. The aim of t...

Piezosurgery is an alternative surgical technique, now widely tested, that uses ultrasounds for bone cutting. This device uses ultrasounds to section hard tissues without harming surrounding soft tissues. The authors analyzed their experience in craniomaxillofacial procedures with piezosurgery. A comparison between operation timing and complication...

Apert syndrome is a rare congenital disorder characterized by craniosynostosis, midface hypoplasia and symmetric syndactyly of hands and feet. Abnormalities associated with Apert syndrome include premature fusion of coronal sutures system (coronal sutures and less frequently lambdoid suture) resulting in brachiturricephalic dismorphism and impaired...

Pierre Robin Sequence (PRS) is a congenital abnormality characterized by mandibular hypoplasia, glossoptosis and often secondary palate cleft. It may be an isolated or part of a most complicated syndrome. The genetic syndrome that most frequently co-occurs is Stickler syndrome characterized by skeletal abnormalities, joint pain, congenital myopia a...

Aim: Cherubism is characterised by mesenchymal alterations during the development of the jaws secondary to perivascular fibrosis. According to the ALARA (As Low As Reasonably Achievable) principle, it is important to avoid conditions where the amount of radiation used is more than that needed for the procedure, because there is no benefit from unn...

Objective The aim of this work was to compare traditional radiographic cephalometry with that based on three-dimensional computed tomography (3D CT) and to evaluate the pros and cons of two different 3D CT methods.Materials and methodsTwo adult patients were examined with traditional radiographic methods and with two different tomographic technique...

Objectives The purpose of our work was to evaluate changes in the concept of space over the years and to explore how techniques for resolving dentobasal discrepancies have evolved. The results of this assessment should allow us to choose the most appropriate operative approach and estimate the possibilities and limits of arch expansion, as well as...

Objectives Esthetics is a major consideration in the decision to undergo an orthodontic treatment. This report focuses on lingual orthodontics as a valid alternative for patients who require a truly “invisible” treatment.

Long-term results after orthopedic or surgical treatment of hemifacial microsomia (HFM) have shown a tendency toward recurrence of the facial asymmetry. However, the literature contains a number of successful case reports that show surprising changes in the morphology of the condyles. In addition, patients with similar mandibular asymmetries, treat...

Objectives To present a diagnostic and therapeutic protocol to find a physiological dental and skeletal relationship.

The paralysis of the ramus marginalis mandibulae nervus facialis may occur in Hemifacial Microsomia (HM); the combination of both HM and palsy contributes to an elongation of the mandibular body. This study explores a possible correlation between neurological deficit, muscular atony, and structural deficiency. Of 58 patients with HM who had come to...

The aim of this work is to show the orthodontic and surgical treatment of Klippel-Feil syndrome. A case of this syndrome is reported and its orthodontic-surgical treatment is described. In KFS patients, treatment must be planned taking into account any disturb associated.

Skeletal open bite is one of the most difficult malocclusion to treat for orthodontists. Some cases of open bite are borderline between orthodontic treatment only and orthodontics associated with surgery. After reviewing clinical and cephalometric characteristics of open bite malocclusion, this article shows the orthodontic edgewise technique propo...

The authors suggest a protocol for the treatment of mandibular condylar fractures classified by fracture level: the condylar head, the condylar neck and subcondylar fractures. The protocol provides a guide to individualizing intervention according to the type of fracture, the patient's age, the degree of restriction of mandible movement and the pos...

The Marfan syndrome is an autosomal dominant hereditary connective tissue disorder with variable expressivity. The incidence is estimated to be at least 1 case per 10000 individuals in most populations. The syndrome is caused by mutations in the gene coding for Fibrillin-1 (FBN1), an extracellular matrix glyco-protein. The gene responsible for the...

A case of hyperplasia of the mandibular condyle in a growing-up subject, observed at the Department of Maxillo-Facial Surgery of the University of Rome "La Sapienza", is described. Hyperplasia of the mandibular condyle is a facial asymmetry due to the unilateral overdevelopment of the mandibular bone. In this study the authors underline how bone sc...

A case of hyperplasia of the mandibular condyle in a growing-up subject, observed at the Department of Maxillo-Facial Surgery of the University of Rome "La Sapienza", is described. Hyperplasia of the mandibular condyle is a facial asymmetry due to the unilateral overdevelopment of the mandibular bone. In this study the authors underline how bone sc...

Various interpretations of clinical and cephalometric data lead to different diagnostic and surgical planning in the study of dentoskeletal malformations. Many authors have identified this discrepancy as an incorrect positioning between the skeletal structures and the Frankfurt plane (PFH)--a plane that is used routinely for the sagittal measuremen...

This study evaluates the skeletal response to functional orthodontic therapy in growing children with hemifacial microsomia (HM). A method of classification for mandibular growth subsequent to treatment is also suggested. Sixteen growing children with unilateral HM were treated. Each patient was graded according to the skeletal, auricular, tissue (...

Hemifacial microsomia (HM) is an asymmetrical congenital deformity of the head and face caused by anomalous development of the structures derived from the first and second branchial arches. This study evaluates the incidence of agenesis and dental inclusions in HM patients. Sixty-three HM patients, 27 male and 36 female, ranging from 7 to 43 years...

Heinifacial inicrosomia (HM) is an asymetrical congenital deformity of the head and face caused by anomalous development of the structures derived from the first and second branchial arches. This study evaluates the incidence of agenesis and dental inclusions in HM patients. Sixty-three HM patients, 27 male and 36 female, ranging from 7 to 43 years...

The authors make a literature review on the different interpretations of the stomatognathic apparatus and try to identify any component of it and to underline the importance of the basal skeletal structures (maxilla and mandible). In this study the authors examined three female patients affected by different pathologies (dysfunctional, malformative...

The study analyzed two samples of 10 patients with Class III dentoskeletal deformities and maxillary and mandibular involvement. Surgery was performed on both jaws at the same time, using different techniques for the stabilization of bone. In one group, osteosynthesis by wire fixation was performed (WF); and in the other group, bicortical screws we...

This study analyzes long-term findings in a group of 10 patients with Class II dentoskeletal malrelationship and who have undergone orthognathic surgical procedures. Changes in cephalometric values relative to the bony structures of the upper jaw and of the mandible are discussed in detail. Patients were reexamined on average, 5.8 years after surge...

In this study clinical diagnostic elements essential in pseudo-Class III malocclusion have been taken under consideration. First of all have been analysed the main etiopathogenetic factors which are the causes of an anomalous development of the Maxillo Facial Complex and peculiarly of mandibular pseudo prognathism. The clinical variants of the malo...

After a short clinical classification of the various open-bite types, the Authors describe from the clinical and cephalometric point of view the main structural alterations responsible for the skeletal open-bite. Then they consider the orthodontic problems in the orthodontic surgical treatment of the skeletal open-bite. Finally they describe the co...

The finding from this research is to analyse, in Class III scheletric-malocclusion patients the stability of the upper and lower incisor teeth, a few years after the surgical-orthodontic treatment. It has been pointed out the parodontal condition too.

The correction of outstanding ear is one of the most challenging problems that the plastic surgeon has to treat. The principal characteristics of this malformation are a poorly developed antihelix, an overdeveloped conchal cartilage and increased angle between the schapha and concha. Many varied methods for the correction of the protruding ear have...

The Authors define the pathology of Rhinophima in its histological clinical and aetiological components. It's important to state that the origin of the rhinophima is represented by hypertrophy of the soft tissues of the nose (glands and blood vessels) that justifies the decortication instead of the use of plastic surgical repair. The Authors afterw...

In this article the Authors take under consideration surgical techniques of segmental osteotomy of the mandible in the treatment of the maxillo-facial skeleton alterations. The anterior inferior alveolar segmental osteotomy, total subapical osteotomy, anterior subapical osteotomy, genioplasty and the midline mandibular osteotomy are presented with...

Frankel's Fr is an activator particularly suitable in malocclusions of II/1 Class in the age of growth. Such device can be also utilized in combination with the fixed multibands therapy in such a way as to connect the effects of the morphofunctional modifications, gettable with activator during the growth of the (effects) maxillary-mandibolar set,...

In the present study different types of Class II, Division 1 malocclusions have been taken under consideration. First of all, have been analysed the main etiopathogenetic factors which are the causes of an anomalous development of the Maxillo-Facial complex. It has been pointed out the clinical characteristics of these malformations, necessaries fo...

In the present article the Authors take under consideration the most important role of the presurgical orthodontic treatment from the point of view of the orthodontic techniques which aim to improve the occlusion. The authors, therefore describe the different faces, and they focalize the fact that the therapy may frequently require extractions to r...