Maxillary bone and dento-alveolar changes in cleft lip and palate patients: Total maxillary distraction osteogenesis versus anterior maxillary segmental distraction osteogenesis.

SOCS2 deficiency drives sex-specific remodeling of mineralized tissues.

A novel sex determination method: Geometric morphometrics of maxillary bone via CT scans in Malaysia

Patients with orofacial clefts (OFCs) present with a complex bony and dental anatomy that often necessitates the use of cross-sectional imaging for orthodontic treatment and subsequent surgical cleft repair. Cinematic rendering (CR) is a recently developed photorealistic display technique that employs physically-based photorealistic volume rendering to create three-dimensional images from DICOM data. The objective of this technical report was to develop and optimize previously established CR settings for midface and dental anatomy to align with the specific requirements of three-dimensional visualization in OFCs. CR was applied for volumetric image visualization for DICOM datasets of three different types of OFCs, including right-sided cleft of the lip, alveolus, and palate (CLP), left-sided CLP and bilateral CLP. CT examination settings were individual for each patient case. In order to present the dental and bony anatomy of the upper and lower jaw in an optimal fashion, previously established custom-made rendering presets were refined for this specific issue. This technical report is the first to use cinematic rendering for the visualization of the hard palate, the cleft area and adjacent dentition in patients with OFCs. In order to achieve the most natural image impression in the context of CR, the soft kernel was employed. If the clinical context necessitates a more detailed image impression, rendering of datasets with slightly elevated doses and thinner slice thickness is recommended.

Clear aligners are widely used for their esthetic advantages, yet anchorage control in extraction cases remains challenging, often leading to the "roller-coaster effect"-characterized by anterior tipping, extrusion, and posterior mesial drift. Evidence comparing anchorage strategies to mitigate this effect is limited. This study used iterative finite element analysis to evaluate two anchorage modalities during maxillary anterior retraction with clear aligners. Three-dimensional models of maxillary teeth, periodontal ligaments, alveolar bone, and aligners were constructed from cone-beam CT data. An improved displacement-driven iterative simulation (10 iterations, 2mm total retraction post-first premolar extraction) compared three conditions: control (M1), implant anchorage (M2), and Class II elastics (M3). Tooth displacement, inclination, occlusal plane rotation, and periodontal ligament stress were analyzed. Both implant anchorage and Class II elastics effectively reduced posterior mesial movement, yet vertical control differed markedly between them. Implant anchorage minimized anterior extrusion and produced canine intrusion, whereas Class II elastics aggravated the roller-coaster effect through greater anterior extrusion and more pronounced lingual tipping. It also limited clockwise rotation of the anterior occlusal plane most effectively, while the control group exhibited the largest counterclockwise rotation of the posterior occlusal plane. Periodontal ligament stress distribution in the anterior region further highlighted these differences: it showed higher tensile stress peaks with Class II elastics but greater compressive stress at the palatal mid-root areas with implant anchorage. Implant anchorage is biomechanically preferable for hyperdivergent or deep-bite patients requiring strong vertical control. Class II elastics necessitate overcorrection to offset adverse effects. The iterative approach effectively reveals long-term biomechanical trends and supports personalized treatment planning, pending clinical validation.

Maxillary sinus augmentation is a well-established procedure to increase posterior maxillary bone volume for implant placement. Various graft materials are used, including autografts, allografts, xenografts, and alloplasts, but the clinical performance of alloplasts remains debated. A systematic review was performed following PRISMA guidelines to compare histological, histomorphometric, radiographic, and clinical outcomes of sinus lift procedures using different grafts. Electronic searches were conducted in eight databases. Eligible studies were human clinical trials (RCTs, cohorts) comparing at least two graft materials and reporting new bone formation, graft resorption, implant survival, or complications. Eighteen studies met the inclusion criteria. Risk of bias was assessed using Cochrane RoB 2.0 and ROBINS I V2 tool. Alloplastic grafts demonstrated comparatively lower new bone formation than autogenous and allogeneic grafts, and were generally inferior to xenografts in terms of regenerative potential. They exhibited higher residual graft content, suggesting slower resorption when compared with biologic grafts. In contrast, xenografts and allografts showed more favorable integration. Volumetric outcomes indicated that alloplastic grafts provided better dimensional stability than autografts but were less effective than xenografts in maintaining graft volume and space. Radiographic findings further supported superior space maintenance with xenografts compared to alloplastic grafts. Implant survival rates were high across all graft types; however, biologic grafts demonstrated relatively improved success and lower marginal bone loss compared with alloplastic grafts. Autografts demonstrated the highest effectiveness in maxillary sinus augmentation, followed by xenografts and alloplastic grafts, indicating a comparatively lower regenerative potential of alloplastic materials. Nevertheless, alloplastic grafts may still be considered a viable alternative in selected clinical scenarios, particularly where minimizing donor-site morbidity or reducing immunological and infection-related risks is a priority. High-quality, long-term randomized trials are needed to confirm these findings and optimize graft selection.

Gender-affirming facial surgery (GAFS) addresses gender dysphoria by aligning facial features with gender identity, with historical emphasis on refining the upper facial third to render patients more attractive and feminine. The GENDER-Q, a novel patient-reported outcome measure (PROM), evaluates aesthetic, functional, and psychosocial outcomes, complementing the Gender Preoccupation and Stability Questionnaire (GPSQ) to assess effects of GAFS in this study. Survey data from 86 patients was analyzed using GENDER-Q and GPSQ scores. Higher GENDER-Q scores indicated improved outcomes, whereas lower GPSQ scores reflected reduced gender dysphoria. Pre- and post-operative outcomes were compared using paired and unpaired t-tests. Spearman's correlation coefficients assessed relationships between the parameters assessed. Significant improvements in post-operative GENDER-Q scores were observed across facial features, with upper face appearance (r = 0.54, p = 0.001), jaw (r = 0.49, p = 0.001), and chin (r = 0.48, p = 0.004), showing greatest gains. GPSQ scores decreased significantly (-7.77 ± 1.61, p < 0.001). Pre- to post-operative changes of dysphoria, as measured by the GENDER-Q were associated with overall face (r = 0.62, p < 0.001), upper face (r = 0.64, p < 0.001), and chin (r = 0.51, p = 0.08) score improvement. Furthermore, increased overall facial satisfaction strongly correlated with improvement in satisfaction with the upper face (r = 0.54, p = 0.001), jaw (r = 0.49, p = 0.001), and chin (r = 0.48, p = 0.004). An individualized approach to gender-affirming facial surgery that prioritizes overall facial harmony, rather than isolated subunit changes, improves gender congruence, facial satisfaction, and alleviates gender dysphoria in transgender patients. In addition, this study advocates for the use of tailored PROMs for the transgender population to more precisely capture and quantify the impact of population-specific interventions and conditions such as gender-affirming surgery and gender dysphoria respectively.

BACKGROUND This retrospective study aimed to radiographically compare injectable platelet-rich fibrin (I-PRF)-enriched bone graft matrix (sticky bone) with conventional particulate grafting during lateral sinus lift procedures performed simultaneously with implant placement in patients exhibiting insufficient posterior maxillary residual bone height. MATERIAL AND METHODS Twenty-four systemically healthy, non-smoking patients who underwent lateral sinus lift surgery between January 2014 and June 2023 were included. Patients were retrospectively allocated into groups according to grafting material: conventional particulate bone graft (group 1, n=12) and I-PRF-enriched bone graft matrix (sticky bone) (group 2, n=12). Radiographic bone height measurements were obtained using panoramic radiographs acquired preoperatively, immediately postoperatively, and at 6 months postoperatively. Measurements were conducted using calibrated digital software. Inter- and intragroup comparisons were analyzed via paired and independent samples t-tests, using a statistical significance threshold of P<0.05. RESULTS Immediate postoperative bone gain was significantly higher in group 1 than in group 2 (11.94 mm vs 10.15 mm; P<0.05). However, bone resorption at 6 months was significantly greater in group 1 than in group 2 (2.61 mm vs 1.07 mm; P<0.05). Bone loss percentage also was significantly higher in group 1 than in group 2 (16.50% vs 7.74%; P<0.05), indicating superior bone preservation in group 2. CONCLUSIONS Although conventional grafting resulted in greater initial bone gain, I-PRF-enriched bone graft matrix demonstrated significantly reduced bone resorption at 6 months. Sticky bone may provide a clinical advantage in bone preservation after sinus lift procedures.

The article is devoted to the analysis of the main clinical and radiological characteristics of the lesions of the paranasal sinuses in patients with osteonecrosis of the jaws of various origins. In the last decade, patients with atypical forms of osteomyelitis of the jaws have entered clinical practice, which, due to the peculiarities of the course, are referred to as osteonecrosis. Lesions of the middle zone of the face are almost never found in classical odontogenic and traumatic osteomyelitis. However, in patients with drug-associated osteonecrosis and covid-19-associated osteonecrosis of the jaws, this kind of pathological process becomes the leading one. Analysis of clinical and radiological data of 25 patients with osteonecrosis, conducted on the clinical basis of the N. I. Pirogov State Clinical Hospital No. 1 in Moscow, revealed similarities and differences, features of damage to the anatomical structures of bones, paranasal sinuses, and the soft-tissue component of the middle zone of the face in these diseases. The upper jaw with paranasal sinuses showed the presence of sequestration and the localization of the lesion.

Early proteomic signatures of impaired maxillary bone remodeling under mechanical stress in type 1 diabetes mellitus.

Associations of miniscrew length with long-term skeletal, dentoalveolar, and nasal airflow changes after miniscrew-assisted rapid palatal expansion: A retrospective cohort study.

To compare the percentage of new bone formation as the primary outcome of bone regeneration at 6 months after maxillary sinus floor elevation (MSFE) using platelet-rich fibrin (PRF) combined with deproteinised bovine bone mineral (DBBM) versus DBBM alone, and to explore the molecular mechanisms through which PRF modulates osteogenesis in the maxillary sinus. Forty patients undergoing MSFE were randomly allocated to two groups: DBBM alone or PRF + DBBM. Six months post MSFE, bone core samples were harvested during implant placement. Clinical outcomes included implant stability and postoperative complications. Radiographic analyses quantified graft height and volumetric changes. Bone regeneration was evaluated by micro-computed tomography (micro-CT) and histomorphometry, while osteogenic marker expression was examined using RT-qPCR and immunofluorescence. Proteomic profiling, followed by Western blot validation, was performed to identify signalling pathways associated with PRF-induced osteogenesis. The PRF + DBBM group (n = 20; 42 implants) showed significantly higher primary implant stability (71.85 ± 4.96 vs. 67.65 ± 5.19, p < 0.05). Histological analysis revealed a significantly greater amount of newly formed bone with improved quality, as indicated by higher new bone formation (28.81% ± 4.41% vs. 22.44% ± 4.40%, p < 0.001) and increased bone maturity (57.05% ± 7.76% vs. 49.17% ± 7.09%, p < 0.01) compared to the DBBM group (n = 20; 45 implants). Molecular assays showed up-regulated osteogenic gene and protein expression, with activation of TGF-β, PI3K-Akt and complement and coagulation cascade pathways. PRF combined with DBBM resulted in improved new bone formation in the maxillary sinus compared to DBBMalone and showed superior healing outcomes, potentially mediated by key growth factors and the complement proteinC1q.

Maxillary transverse deficiency in adults presents a therapeutic challenge due to fused craniofacial sutures. This study aimed to assess the changes in craniofacial sutures induced by C-expander treatment in adults. This retrospective study included 35 patients diagnosed with maxillary transverse deficiency following successful treatment with C-expander. Cone- beam computed tomography(CBCT)scans were performed and analyzed both before and after the intervention. Changes in the widths of nine craniofacial sutures were measured and compared, including the frontonasal, frontomaxillary, frontozygomatic, nasomaxillary, internasal, pterygomaxillary, zygomaticomaxillary, temporozygomatic, and midpalatal sutures. Additionally, five linear measurements in the coronal plane were quantified and analyzed. C-expander induced significant increases in the widths of the midpalatal, frontomaxillary, nasomaxillary, internasal, frontozygomatic, superior zygomaticotemporal and pterygomaxillary sutures (P < 0.05), except the zygomaticomaxillary and inferior zygomaticotemporal sutures (P > 0.05). The most pronounced increase was observed in the midpalatal suture (3.76 ± 1.63mm), followed by the frontomaxillary (1.25 ± 0.70mm) and the inferior nasomaxillary sutures (0.64 ± 0.41mm). All of the linear measurements have significant increases (P < 0.05). The largest change was at the maxillary base bone width (3.61 ± 1.34mm), followed by the inter-zygomaticomaxillary suture width (3.16 ± 1.05mm), the inter-zygomaticotemporal suture width (1.67 ± 0.49mm), the inter-frontozygomatic suture width (0.43 ± 0.26mm), and the inter-frontomaxillary suture width (0.30 ± 0.19mm). C-expander treatment achieves clinically significant midpalatal suture expansion in adults with maxillary transverse deficiency, and widens most craniofacial sutures. Suture displacement magnitude varies by suture site, the greater anterior suture expansion may drive a clinically clockwise rotation of the nasomaxillary complex.

The manuscript details the influence of high-temperature and high-shear processing, as well as radiation sterilization, on properties of bioresorbable and osteoconductive, patient-tailored alloplastic scaffolds for guided bone regeneration. Functionalized poly(l-lactide-co-d,l-lactide) copolymer filled with hydroxyapatite was used to produce two personalized implants for upper and lower jaw reconstruction via 3D printing. Morphology analysis (SEM, µCT), gel permeation chromatography, and thermal analysis quantified the effects of melt processing and sterilization on chain structure. Physical properties of sterilized parts, such as hardness and density, proved suitable for bone implants. Removal of the upper jaw implant after 4 months and of the lower jaw substitute after 18 months enabled monitoring of bioresorption and tissue regrowth over time. Gradual overgrowth of the implants with human tissue, initiated by the osteoconductive filler, was observed, along with time-dependent polylactide degradation, showing up to 92% molar mass reduction. The medical procedures confirmed safety, nontoxicity, non-allergenicity, and, most importantly, the tissue-forming properties of the polylactide-based formulation.

Quite often, TMD is accompanied by speech disorders, which are caused by changes in the dentognathic relationships and indicators of the functional activity of the masticatory muscles, the orbicularis oculi muscle, lips, and tongue. Aim: to determine changes in the volume of the upper airway as a result of expansion of the upper jaw during orthodontic treatment of children with dentofacial deformities accompanied by speech disorders. Material and methods. Analysis of changes in the respiratory tract was performed by comparing pre- and post-treatment tomograms. Results. The expansion of the upper jaw led to the expansion of the floor of the nasal cavity, which in turn causes the expansion of the airways, which in turn causes an increase in the flow of air inhaled through the nose. The volume of the upper airways was calculated for each patient. After treatment, the average increased by 6.80 ± 5.77 ml. The maximum increase reached 20.22 ml, the minimum—0.78 ml. One patient had a negative result. Conclusions. Using cone-beam computed tomography, an average increase in the volume of the upper airways by 6.80 ± 5.77 ml was objectively demonstrated after expansion of the upper jaw at the dentoalveolar level, thereby achieving improved results of orthodontic treatment and correction of sound pronunciation.

INTRODUCTION. Recently, the direction of dentition defects restoration on artificial supports with immediate dentoalveolar reconstruction of the alveolar process which is widely used for the bone crest and soft tissues loss develops rapidly. The main factors in the formation of destructive changes in the alveolar process are chronic foci of infection in the periapical region, localized and generalized pathologies of periodontal tissues, fractures of the bones of the facial skeleton and teeth, as well as non-carious lesions of the roots of the teeth (internal and external resorption). In this regard, when performing dental implantation, it is necessary to pay attention to the implementation of additional interventions restoring the anatomical shape of the alveolar process using various tools, materials and methods. Taking into account the above, a manual unstressed mucotome-osteotome device was developed for taking a three-layer autograft from the tubercle of the upper jaw, and the results of its practical use are presented in this research. AIM. Purpose of the research is to improve the efficiency of surgical and orthopedic stages of dental defect repair in dental implantation with dentoalveolar reconstruction by developing a special device. MATERIALS AND METHODS. The paper presents the results of our practical application of the manual unstressed mucotome-osteotome for taking a triplraft from the retromolar region of the upper jaw (tubercle) (patent application No. 2025131706 dated 14.11.2025). At the same time, a dynamic analysis of the effectiveness of our developed device for three years was carried out in 112 clinical cases in the age group from 21 to 69 years old. Statistical evaluation of the obtained results was carried out in the MS Office Excel program using standard methods. RESULTS. The combination of the main features of the developed device and its use contribute to improving the quality of graft preparation by extracting a single three-layer graft consisting of mucosal connective tissue with periosteum, cortical and spongy bone tissue from the tubercle of the upper jaw, which determine the clinical effectiveness of its use in osteoplastic operations and simultaneous dental implantation. CONCLUSIONS. The obtained clinical results of practical application of the developed manual unstressed mucotome-osteotome for sampling a three-layer autograft from the maxillary tubercle characterise its effectiveness, safety and ease of use of the given medical device.

Fractures of the zygomatic bone are frequently encountered in the practice of maxillofacial surgery and traumatology. The treatment of choice is surgical, involving three-dimensional repositioning to stabilise the zygomatic bone and its adjacent bones (frontal, maxillary, sphenoid and temporal bones). The purpose of this article is to present the supratarsal approach, which provides exposure of the frontozygomatic suture, allowing verification of three-dimensional positioning and producing excellent postoperative aesthetic results.

The microbiome is a dynamic system that changes throughout life. Studies have revealed the relationship between periodontal disease and the oral microbiota; however, the impact of periodontal disease on the expression of senescence markers and on the inflammaging of the oral and systemic microbiome remains unclear. We hypothesized that aging increases the periodontitis-induced changes in the oral and systemic microbiome and is accompanied by an altered inflammatory response. Experimental periodontitis was induced in 18-month-old (old) and 8-month-old (young) C57BL/6 mice by placing ligatures around the second maxillary molars. Bone morphometric analyses were conducted to assess bone loss. Senescence- and inflammatory-related gene expression in the gingiva was measured by quantitative polymerase chain reaction (qPCR). Serum inflammatory markers were evaluated via immunoassay. Oral, brain, and gut microbial content were analyzed using next-generation sequencing. Maxillary bone loss was significantly higher in the old mice with periodontal disease than in young mice. Senescence and inflammatory markers were higher in old mice than in young ones, and periodontitis increased their expression. The alpha diversity of the oral and brain microbial communities differed significantly between old and young mice. Treponema denticola, Fusobacterium nucleatum, Porphyromonas gingivalis, P. pasteri, and Prevotella nigrescens were only detected in the brains of old animals with periodontitis. Periodontopathogens and oral commensals are either only found in the brains of old animals with periodontal disease or are more prevalent in the brains of old animals, suggesting that aging and periodontitis may contribute to the dissemination of oral bacteria to the brain. Aging may increase the periodontitis-induced changes in the oral and systemic microbiome, which an altered inflammatory response may accompany. Experimental periodontitis was created in old and young mouse models. Bone loss, senescence, and inflammatory gene expression and serum inflammatory markers were assessed in each model, and oral, brain, and gut microbial content was analyzed. Senescence and inflammatory markers were higher in old mice than in young ones, and periodontitis increased their expression. Our results suggested that aging and periodontitis may contribute to the dissemination of oral bacteria to the brain.

Clinical and biomechanical determinants of immediate, early, progressive, and delayed implant loading: A comprehensive narrative review.

Digital dental implant planning using panoramic radiographs and cone beam computed tomography (CBCT) imaging is labor-intensive and prone to error due to clinician fatigue, limited digital expertise, and time constraints. Artificial intelligence (AI) offers a promising solution by automating image analysis. This study aimed to develop a deep learning system for segmenting edentulous maxillary ridges to support automated implant planning. A total of 209 CBCT scans were retrieved from the University Dental Hospital Sharjah image archive (Romexis, Planmeca), of which 77 met the inclusion criteria. Manual segmentation was performed using 3D Slicer software and reviewed by a third examiner. A convolutional neural network (CNN) based on the U-Net architecture was developed using the Medical Open Network for AI (MONAI) framework. The dataset was split into training (90%) and testing (10%) sets. Model performance was evaluated using the Dice Similarity Coefficient (DSC). Low-scoring cases (DSC <0.70) were inspected in detail to identify sources of discrepancy. The 77 cases comprised 30 unilateral and 47 bilateral edentulous spaces. Most involved posterior edentulism (n = 57), with fewer anterior (n = 5) or combined (n = 15). The model achieved a mean DSC of 76.57%. Discrepancies between manual and model segmentation mainly arose from annotators excluding narrow bone regions (<4 mm) or irregular sinus floors, and from smoothing during manual labelling. In several instances, the model provided greater anatomical precision than manual segmentation. The developed AI model segmented maxillary edentulous spaces with moderate-to-high accuracy. With larger, more balanced datasets and refined manual labelling protocols, this approach shows strong potential to streamline digital implant planning and enhance clinical outcomes.