Maxillary Arch Research Articles

Evaluation of Rate of Space Closure Between Platelet Rich Plasma (Prp) Injection and Piezocision in Bimaxillary Protrusion Cases

Aim: Reducing orthodontic treatment duration is a significant concern for both patients and clinicians, as prolonged treatments can lead to complications like dental caries, root resorption, and decreased patient compliance. This study aims to compare the effectiveness of two minimally invasive techniques—Piezocision and platelet-rich plasma (PRP) injection—in accelerating orthodontic tooth movement during space closure in patients with bimaxillary protrusion. Methods: Sixteen patients diagnosed with Angle's Class I bimaxillary protrusion requiring extraction of first premolars were randomly assigned to two groups. Group A (n = 8) underwent Piezocision-assisted orthodontic treatment, while Group B (n = 8) received submucosal PRP injections. In both groups, one side of the maxillary arch served as the experimental side, and the contralateral side served as the control. Measurements of space closure were taken at the initiation of retraction (T₀) and after 90 days (T₁). Results: Both Piezocision and PRP significantly enhanced the rate of space closure compared to their control sides. However, Piezocision demonstrated a statistically faster rate of tooth movement than PRP injection. The mean difference in space closure between the Piezocision and PRP groups at T₁ was significant (p < 0.001). Conclusion: While both Piezocision and PRP injections effectively accelerated orthodontic tooth movement, Piezocision proved to be more efficient in reducing treatment time. Clinicians may consider Piezocision as a preferred method for patients seeking expedited orthodontic treatment.

The Orientation in Space of the Maxillary Arch: New and Old Devices in the Prosthetic Digital Workflow.

In extensive prosthetic rehabilitations and in those involving the anterior area, a correct 3D spatial position is of fundamental importance for effective communication between the clinician and the dental technician. The aim of this article is to analyze the different methods used to position in space and/or in an articulator the maxillary arch in analog workflows highlighting shortcomings and difficulties in order to understand how to overcome them when employing digital workflows. Traditional mechanical devices, such as anatomical, kinematic, esthetic and postural facebows, have clear indications, but also limitations, especially in cases of skeletal asymmetries. Modern digital tools, including photography, CBCT, facial scanners and jaw recording devices, are here critically analyzed to illustrate the advantages of working in a virtual space. The adoption of digital tools in the prosthetic workflow represents a significant improvement compared to traditional techniques, as it reduces errors and artifacts of registration and transfer of the position of the maxillary arch in the articulator space. This contributes to more predictable esthetic and functional results, with a positive impact for clinicians and technicians, improving clinical-laboratory communication, operational efficiency and overall quality of work. The integration of digital tools into prosthetic workflows represents an important advancement in clinical practice since they reduce human error and facilitate communication between the clinician and the laboratory. When carrying out rehabilitations involving changes in esthetics or occlusal plane orientation, the proper and accurate positioning of the upper arch in space is particularly relevant.

Impact of early cleft lip and palate surgery on maxillary growth in 5- and 10-Year-old patients with unilateral cleft lip and palate: a cross-sectional study

ObjectivesThis study evaluated maxillary growth and dental arch relationships at 5 and 10 years of age in patients with unilateral cleft lip and palate (UCLP) who underwent early cleft lip and palate surgery.Methods28 patients with UCLP who underwent cleft lip surgery in neonatal age and cleft palate surgery at average age of 7 months without orthodontic treatment (intervention group) were measured for intercanine and intermolar distances and for dental arch length. These measurements were compared with those of 30 healthy participants in a control group. Dental arch relationships in the intervention group were evaluated by 5-YO index at 5 years and the GOSLON Yardstick score at 10 years of patients’ age.ResultsPatients in the intervention group had significantly shorter mean intercanine distance and arch length than control patients at both 5 and 10 years of age (p<.001 for all). There were no significant differences in intermolar distance at both 5 (p = .945) and 10 years (p = .105) of patients’ age. The average 5YO index increased from 2.46 to an average GOSLON 10-year score of 2.89 in intervention group.ConclusionIntercanine distance and dental arch length of patients with UCLP are significantly reduced at 5 and 10 years after early cleft lip and palate surgeries compared to the healthy population. Dental arch relationships at 5 and 10 years of patients with UCLP show comparable outcomes to those reported by other cleft centers.Clinical significanceThis study evaluates maxillary growth in UCLP patients 5 and 10 years of age who underwent early primary lip and palate surgery.

Comparative Experimental Evaluation of Orthodontic Appliances for Maxillary Arch Expansion

Background/Objectives: The orthodontic treatment of posterior crossbite using appliances for gradual maxillary expansion is crucial to ensure proper transversal jaw relationships as much as occlusal functionality. The aim of this study was to analyze forces and torques generated by different appliances for maxillary expansion. Methods: Measurements were conducted for the Wilson® 3D® Quadhelix (WQH) and Wilson® 3D® Multi-Action Palatal Appliance (WPA) across various sizes and compared to the Remanium® Quadhelix (RQH). Activations were set to 8 mm for the WQH and RQH and 6 and 8 mm for the WPA. Rotations and root torque were simulated via an activation of 10° for arches. A total of eight test series were conducted. Results: The WPA displayed the highest force and torque values for all movements, far surpassing recommended guideline values (expansion 8.5–&gt;15.0 N/46.3–86.5 Nmm, rotation 3.1–6.1 N/40.7–61.4 Nmm, torque 3.9–5.1 N/22.4–29.7 Nmm), and the WQH displayed the lowest values (expansion 2.7–12.6 N/11.1–39.6 Nmm, rotation 0.1–1.7 N/23.0–32.2 Nmm, torque 0.9–2.9 N/3.4–10.5 Nmm). Appliances with the smallest transverse dimensions exhibited the highest force and torque maxima. Conclusions: This study underscores the importance of understanding biomechanical principles in orthodontics for minimizing unintended tooth movements, providing detailed insights into the force systems of appliances acting in the transverse plane, and establishing a foundation for future clinical investigations to validate these in vitro findings.

Predictability of Maxillary Expansion with Invisalign® First: Treatment Planning vs. Outcome

The aim of this study is to retrospectively investigate the predictability of maxillary arch expansion with Invisalign ® First in mixed dentition. In a sample of 64 treated patients, 3D digital models from the ClinCheck® software were compared with post-treatment digital models. Predicted maxillary expansion was related to the final outcome of expansion. At the cuspidal level, there was observed a predictability of 59.68% for deciduous canines, 63.77% for first deciduous molars, 66.99% for second deciduous molars, and 55.61% for first permanent molars. At the gingival level, there was observed a predictability of 49.87% for deciduous canines, 53.11% for first deciduous molars, 53.36% for second deciduous molars, and 45.16% for first permanent molars. The difference between the predicted and achieved expansion was statistically significant (p &lt; 0.05). Within the present limitations, our results suggest that, with Invisalign® First, it is possible to expand the upper arch in mixed dentition in an effective and predictable way. Clear aligners could represent a new and valid alternative for arch expansion in growing patients.

Prevalence of Edentulousness among Patient visiting a Tertiary Care Centre

Introduction: Absence of teeth i.e., edentulism is a common oral health issue worldwide and is an under evaluated disability. It is a preventable oral disability which brings major impact on overall health of individuals affecting the function, aesthetics, comfort and psychology. So, it should be identified and awareness for its management should be done so as to improve the quality of life of an individual. Objective: The purpose of this study was to collect baseline data on edentulism in the Nepalese population so that community-level awareness and educational programs could explain the importance of replacement lost teeth with prosthesis. Methods: The study was conducted in the College of Medical Sciences in the department of Oral medicine and Radiology and in the department of Prosthodontics from the patient visiting in these OPD for five months duration. Data were recorded in proforma and classified as complete / partial edentulous and further classified into Kennedy’s classification. The data were recorded and analyzed in SPSS 20. Result: Out of 301 patients, 24 (8%) had total edentulism, while 277 (92% had partial edentulism). Of the partially edentulous individuals, 90 showed just maxillary edentulism, 148 showed only mandibular edentulism, and 39 showed both maxillary and mandibular edentulism. Conclusion: Females were more likely than males to exhibit partial edentulism. Females showed more Kennedy's Class III classification than males. Both had equal complete edentulism. The mandibular arch showed more partial edentulism than the maxillary arch.

Effectiveness of 2 Lip Taping Techniques in Infants With Bilateral Cleft Lip and Palate: A Randomized Clinical Trial.

This trial was designed to test the efficacy of 2 lip taping methods in modifying the maxillary arch dimensions (MADs) of infants with bilateral cleft lip and palate (BCLP) before lip repair surgery. Parallel-group randomized clinical trial. The trial was conducted at 3 centers in Baghdad city. Thirty-six nonsyndromic infants with BCLP. The eligible infants were randomly assigned to either the first experimental group that received a conventional horizontal tape (3 M Steri strip-1/4 inch) or the second experimental group that received a custom-made tape made of Steri strips and orthodontic extra oral elastics. All of the included infants in both groups had rubber base impressions taken for them at the start of treatment (T1) and right before surgical lip repair (T2). A desktop scanner was used to scan each of the generated models, creating digital models that could be used for outcome evaluation. Virtual MAD measurements were performed by a blinded assessor on the generated digital models both before (T1) and after (T2) treatment. At T2, both groups showed statistically significant changes in all measured MADs, with a mean difference ranging from 1.36 to 2.95 mm for the conventional taping group and from 1.46 to 7.96 mm for the custom-made one. The comparison of the 2 groups revealed both statistically and clinically significant differences with a P value <.05. The custom-made taping demonstrated more constriction in maxillary arch in terms of changes, which could provide easier surgical manipulation for the cleft parts. Lip taping appears to be an efficient technique for modifying the MADs in infants with BCLP.

Determination of Maxillary and Mandibular Arch Width in Angle’s Class I Patients

Introduction: The transverse dimension plays a key role in smile. Maintaining the pretreatment arch form is a key to obtaining stable results. Objectives: The main aim of this study was to determine mean intercanine arch width and mean intermolar arch width in Angle’s class I patients. Methods: Seventy-six pretreatment casts were obtained from the records of patients who sought orthodontic treatment in Orthodontics and Dentofacial Orthopedics. Four parameters were used in this study namely; intercanine arch width and intermolar arch width in maxilla and mandible. Linear measurements were carried out with digital caliper. Kappa test was done for intra-observer reliability. Shapiro-Wilk test was done to determine the normal distribution of data. The Pearson Correlation test was done to assess the correlation between intercanine and intermolar arch width in maxilla and mandible. The independent t-test was used to compare between intercanine and intermolar arch width with male and female. Results: Mean intercanine arch width in maxilla and mandible were 35.41±1.47 mm and 26.85±1.59 mm respectively. Mean intermolar arch width in maxilla and mandible were 53.82±2.82 mm and 51.71±2.60 mm respectively. Statistically significant difference was found between intercanine and intermolar arch width in maxilla and mandible between male and female. The intercanine and intermolar arch width in maxilla and mandible has significantly low correlation. Conclusions: Intercanine and intermolar arch width in male and female were statistically significant and male has lager intercanine and intermolar arch width than female.

P-71732811-1392 - Fate of Tilted and Axial Implants in ALL-0n-4 Technique: A 3 year Prospective Study on Maxillary Arch

P-71732811-1392 - Fate of Tilted and Axial Implants in ALL-0n-4 Technique: A 3 year Prospective Study on Maxillary Arch

Spontaneous space closure after extraction of young first permanent molar. Retrospective cohort study.

Early compromised first-permanent-molar (FPM) extraction can adversely affect occlusion. However, the current literature does not provide sufficient support for definitive early extraction outcome. This cohort study aimed to evaluate the pattern of post-FPM extraction spontaneous space closure and its pre-extraction indicators. Patients of 7-13 years, with compromised FPM at three-tertiary-centers between 2015 and 2019 were retrospectively screened. Pre-extraction indicators were evaluated (extraction location, direction of the second permanent molar (SPM) long-axis, and SPM Demirjian development stage). Spontaneous space closure pattern was evaluated clinically and radiographically using the American Board of Orthodontics (ABO) grading system. In total, 112 FPMs (73-patients) were identified and five (4.5%) of the extraction sites showed favorable combined-ABO-scores. Distal direction of the SPM long-axis in the maxillary arch significantly decreased the relative risk (RR) of having a SPM rotation/alignment ABO score-1 (P = 0.002; RR = 0.64). For the mandibular arch, Demirjian stage D and E significantly decreased the RR of having ABO score-1 for spacing between the SPMs and second premolars (P = 0.029; RR:0.57, P = 0.004; RR:0.53, respectively) and vertical dimension (P = 0.02; RR = 0.53). The direction of the SPM long-axis and its developmental stage are key indicators of the favorable outcome pattern of spontaneous space closure after FPM early extraction.

Soft tissue response to titanium healing abutments treated by Er: YAG laser or plasma spray: A randomized controlled feasibility clinical study with SEM and histological analysis.

Soft tissue seal around implants ensures stable osseointegration and a long-term survival of dental implants. Different surface modification and decontamination for implant abutments were endorsed in order to improve peri-implant soft tissue healing, such as laser, plasma spray, acid etching, and steaming. The aim of this study was to evaluate the response of peri-implant soft tissue to titanium abutments treated with Erbium-doped: Yttrium-Aluminum-Garnet (Er:YAG) laser versus plasma spray. Twenty-four patients who required implant placement in the maxillary arch participated in this study. Patients were divided into three groups, abutments treated with Er:YAG laser versus cold plasma spray and untreated abutments. Fourteen days following the implant abutment insertion, soft tissue peri-implant biopsies were taken for histological, histochemical, and immunohistochemical evaluation. Scanning electron microscopy was done for the abutments; plaque index (PI) and gingival index (GI) were assessed 14 days and 3 months following final restoration. Regarding the histological results, the least mean inflammatory cell count was in the plasma group (174.09 ± 40.67), followed by the laser group (654.27 ± 85.95) and the control group (852.00 ± 117.98), with statistically significant differences between them. The mean area fraction of collagen fibers showed the highest value in the plasma group (9.73 ± 1.91), followed by the laser group (3.25 ± 0.49), while the lowest value was found in the control group (1.17 ± 0.51). The immunohistochemical expression of E-cadherin was significantly higher and uniformly distributed in the plasma group (42.4 ± 11.2%) followed by the laser group (15.4 ± 4.07%) and the control group (6.8 ± 1.7%). SEM analysis of healing abutments showed fibroblast-like cells, which were more developed with dense fibers in the plasma group; laser group fibers showed fewer and more delicate fibers than the plasma group, while no fibers were detected in the control group. Within the limitations of this feasibility study, the present data concluded that plasma spray and Erbium: YAG laser can be used for abutment surface treatment to achieve better peri-implant soft tissue healing. Clinically and histologically, plasma spray showed a better effect on the peri-implant soft tissues by reducing the inflammatory reaction, promoting collagen fiber formation, higher fibroblast-like cell attachment, and upregulating E-cadherin expression than Erbium: YAG laser and control groups.

Artificial Intelligence in Aesthetic Dentistry: Is Treatment with Aligners Clinically Realistic?

Smile aesthetics are increasingly prioritized in dental practice, with accurate orthodontic assessment and treatment planning being crucial for optimal outcomes. This study evaluates Invisalign® SmileView™ (SV), an AI-based tool that simulates post-treatment smiles, focusing on its ability to present potential orthodontic outcomes to patients. Background/Objectives: This research aims to study whether SV can simulate predictable orthodontic results and if it makes anatomical modifications to the teeth. Additionally, it will evaluate whether SV displays smiles that conform to the orthodontic criteria described in the literature. Finally, the study will analyze whether the software can align the dental with the facial midline. Methods: A total of 51 subjects were recruited in Madrid, Spain. The operator took a frontal photograph of the subjects with a social smile (T0), following the application’s instructions. Subsequently, the subjects followed the steps to modify their smile (T1), resulting in a new image of the subject with a different smile. The following variables were collected, analyzed, and compared with the standards defined in the literature: smile width, vertical exposure of the maxillary central incisor, width of the maxillary central and lateral incisors, proportion of the maxillary lateral incisor width to the central incisor, anterior gingival exposure level, position of the upper and lower dental midlines relative to the facial midline. Results: 58% of the sample showed dental expansion, with an excessive expansion (&gt;5 mm) observed in 8%. In the maxillary arch, 5.9% of incisors exceeded predictable aligner movement (&gt;1.5 mm), with 3.9% showing excessive extrusion and 2% excessive intrusion. For the lateral incisors, the mesiodistal size was reduced less than 0.5 mm in 31.4% of cases, with excessive interproximal reduction (&gt;0.5 mm) in 5.9%. Additionally, 62.7% of cases would require multidisciplinary treatment due to an increase in size. SV centered the upper midline in 77.9% of these cases. Among the sample, the upper midline was initially centered in 74.5% of subjects, and SV maintained it centered in 84.2% of these subjects. Conclusions: SV tends to generate simulations of broader smiles, which are mostly achievable through aligner treatments, from an orthodontic perspective, and showed high predictability regarding the vertical movements of the incisors that can be achieved with aligners. Moreover, it adjusted the mesiodistal size of the upper incisors in its simulations and demonstrated the ability to identify and correct deviations of the dental midlines relative to the facial midline.

Anchorage loss of the posterior teeth under different extraction patterns in maxillary and mandibular arches using clear aligner: a finite element study

BackgroundExtracting the premolars is an effective strategy for patients with bimaxillary dentoalveolar protrusion. Clear aligners (CAs) close the extraction spaces through shortening the length of aligners. The contraction force generated by the terminal of aligners makes the posterior teeth tip mesially, which is known as the roller coaster effect. This phenomenon is even worse in the 2nd premolar extraction cases. Posterior anchorage preparation is commonly used to protect the angulation of molars, taking the form of presetting distal tipping value. However, the distal tipping design aggravates the anchorage loss of anterior teeth simultaneously. This study aimed to explore the different anchorage loss of the posterior teeth when the 1st or 2nd premolars were extracted using CAs, respectively in maxillary and mandibular arches, further providing guidance for anchorage preparation design in clinical practice.MethodsTwo bimaxillary finite element models with different extraction patterns were established to simulate the anterior en-masse retraction process of the CAs. In Model 1, the maxillary and mandibular 1st premolars were extracted, while in Model 2, the 2nd premolars were extracted. Finite element analysis methods were utilized to analyze the tipping angle of the anterior and posterior teeth.ResultsCompared between two models, the anterior teeth exhibited a greater lingual inclination tendency and the posterior teeth exhibited a slighter mesial tipping tendency in Model 1 regarding individual tooth. The closer to the extraction spaces, the greater the tip, and the distal tipping tendency of the 1st premolars was more evident than the mesial tipping tendency of the 1st molars in Model 2. Compared between the maxillary and mandibular arches, the mesial tipping tendency of individual posterior tooth was more evident in the maxilla. In addition, the highest hydrostatic stress of the periodontal ligaments was concentrated on the cervical and apical parts directly adjacent to the extraction spaces, and it exhibited relatively uniform distribution in Model 1.ConclusionsThe individual posterior tooth showed the same mesial tipping direction but to different degree when the 1st or the 2nd premolars were extracted during clear aligner treatment. Presetting anchorage preparation design for the posterior teeth is essential to alleviate the roller coaster effect, especially in the 2nd premolar extraction cases. Furthermore, larger anchorage preparation value should be proposed for the maxillary posterior teeth.

Nasoalveolar Molding in Lately Presented Moderate to Severe Unilateral Cleft Lip and Palate Infants: Does it Add?

Alignment of the alveolar segments with early nasal cartilage tackling is the foundation upon which excellent surgical results are dependent. The purpose is to evaluate the short-term effect of triple combination of passive alveolar molding with early nasal molding augmented by controlled corrective power of lip tapping in lately presented moderate to severe unilateral complete cleft lip and palate infants. A prospective case series study was conducted in Plastic and Maxillofacial Surgery Department, Ain Shams University in collaboration with Orthodontics Department, from January 2021 till June 2023, 15 infants elder than 2 months till 6 months were enrolled in the study. Eight nasal anthropometric measurements ratios through 2-dimension assessment and 4 maxillary arch measurements ratios through 3-dimension assessment were recorded. Extraoral results revealed clinically and statistically decrease of nasal width, alar base width, alar base height ratios, and columellar angle, while increase of nasal height, nasal dome height, columellar length, and alar projection length ratios. Intraoral results revealed clinically and statistically decrease in cleft width with maintained posterior arch width and intercanine width. In conclusion, this triple combination helped in presurgical lessening the alveolar and nasal deformity of such elder infants in a shorter time in comparison with other conventional methods with lesser number of appointments decreasing burden of care to their families improving their compliance.

The Prevalence of Partial Edentulism and Associated Factors: A Cross-Sectional Study

Objective: The current study aimed to determine the prevalence of partial edentulism according to Kennedy’s classification and its association to arch, age and gender. Methods: Data were collected from 358 patients aged 18 to 80 years. Selected patients were grouped according to gender and age (&lt;45, =&gt;45). Intra oral examination for each patient was done. The pattern of partial edentulism according to Kennedy’s classification was determined. Statistical analysis was done using the SPSS V26 statistical program. Chi-square test was used to test for differences in frequency at p-value&lt;0.05. Results and Conclusion: The rate of class III pattern in maxillary arch was significantly higher than that of mandibular arch. Class I pattern in mandibular arch was significantly higher than that of maxillary arch (25.1% vs 14%, P=0.001). No differences in frequency were found between class II and IV pattern and affected arch. Class IV was the least frequent in both dental arches. Frequency of class I and class II partial edentulism increased with age, while class III was more frequent at young age. Class IV pattern was more frequent among males than females.

Dental arch shape in twins: A morphometric study of genetic influences

The objective of this study was to assess the relative contribution of genes to shape variation in the permanent dental arches in individuals of Western European descent. The dental casts from 64 monozygotic and 38 dizygotic twins, housed in the Adelaide Dental School's twin record collection, Australia, were assessed. The subjects were of Western European descent, with a mean age of 19.4 ± 5.4 years. Dental casts were scanned using a 3-dimensional scanner (3Shape E4, 3Shape, Copenhagen, Denmark), and landmarks were placed on incisal edges and cusp tips of canines, premolars, and molars. Procrustes superimposition and principal components analysis were applied to examine shape variation. Two-block partial least-squares analysis was used to assess shape covariation between arches. Structural equation modeling was utilized to decompose observed shape variation into genetic and environmental components using the normal assumptions of the twin model. The first 3 principal components (PCs) of the maxillary and mandibular arch were meaningful, accounting for 53% and 50% of the variation in shape space, respectively. The PCs represented shape variability as follows: PC1 - arch depth-width ratio, PC2 - arch taper, canine position (and first premolar rotation for the mandibular arch), and PC3 - incisor displacement and rotation. Genetic modeling indicated that a model incorporating additive genetic and unique environmental factors optimally explained the observed variation for all meaningful PCs. Within shape space, most of the variation in maxillary and mandibular arches exhibited moderate to high heritability (h2= 0.61-0.74). Maxillary and mandibular dental arches had strong and significant shape covariation, with high heritability in their reciprocal influences on shape (h2= 0.72-0.74; rpls coefficient= 0.87; P<0.05). In this cohort, dental arch shape variation was predominantly influenced by genetic factors. High covariation and heritability were observed between the maxillary and mandibular dental arches. This information may help inform decisions around orthodontic intervention.

Tooth sensitivity in different arches post in-office dental bleaching: A multicenter randomized controlled trial

ObjectiveTo compare the risk and intensity of tooth sensitivity (TS) and gingival irritation (GI), as well as bleaching efficacy (BE) in the maxillary and mandibular arches after in-office dental bleaching. Materials and Methods90 participants were randomly into two groups according to the arch (maxillary or mandibular) in which the patient will first receive a 35 % hydrogen peroxide gel (2 sessions; 1 × 30 min; 1 week apart). TS and GI were recorded immediately after, up to 1 h, 24 h and 48 h after bleaching, using the 0–10 Visual Analogue Scale (VAS). BE was assessed before bleaching and 30 days after the end of the treatment (shade guide units [ΔSGU], CIELab [ΔEab], CIEDE2000 [ΔE00], and Whiteness Index for Dentistry [WID]). TS and GI were compared using McNemar's and paired t-test. BE were compared with Wilcoxon Signed Rank Test (ΔSGU) and paired t-test (ΔEab, ΔE00, and WID) (α = 0.05). ResultsThe risk and the intensity of TS was statistically higher for the mandibular arch (p < 0.003). The risk and intensity of GI did not differ between arches (p > 0.38). Both arches demonstrated significant BE (ΔSGU, ΔEab, ΔE00 and WID), without differences between them (p > 0.08). ConclusionsIn-office dental bleaching induces higher risk and the intensity of TS in the mandibular arch when compared to maxillary arch, without significant differences in gingival irritation, or bleaching efficacy. Clinical RelevanceMost patients experience tooth sensitivity regardless of the dental arch involved. However, when performing in-office dental bleaching, clinicians should consider that the mandibular arch is more likely to experience greater sensitivity compared to the maxillary arch.

Directly printed aligner therapy: A 12-month evaluation of application and effectiveness

Directly printed aligners (DPAs) are gaining in popularity, potentially streamlining manufacturing, decreasing environmental waste, and offering enhanced adaptation and tailoring. This transition has been facilitated by advances in materials, software, and production. Although DPAs may have enhanced versatility and application in the management of more complex malocclusions, there is little research evaluating their effectiveness. A total of 54 patients undergoing treatment with DPAs were evaluated for occlusal improvement, overall treatment duration, and adverse effects. Regression models were fit to evaluate the association between the need for refinement, final peer assessment rating (PAR) score, and independent variables, including the total number of aligners and treatment indications. The mean number of aligners in the initial plan was 7.1 ± 2.9 and 5.1 ± 4.3 in maxillary and mandibular arches. Refinement was required in 40.8% (n= 20). The pretreatment PAR score of 17.01 ± 7.93 showed a significant improvement (86.6%), with a final PAR score of 2.25 ± 1.15. Minor complications were noted in 3 participants. The need for refinement was unrelated to the total number of aligners (odds ratio, 1.05; 95% confidence interval, 0.94-1.18; P= 0.36). There was weak evidence of an association between the final PAR score and the total number of aligners (odds ratio, -0.03; 95% confidence interval, -0.07 to 0.003, P= 0.07). On the basis of this preliminary retrospective evaluation, DPAs may be used to manage mild-moderate malocclusion, producing a significant reduction in PAR score. Nevertheless, additional prospective research is required to confirm these findings and compare the relative merits of DPAs to alternatives.

Transverse dentoalveolar development in Chinese children and adolescents: A cross-sectional study using revised Andrews’ Element III analysis

This study investigated the prevalence of maxillary transverse deficiency (MTD) in Chinese children and adolescents using revised Andrews' Element III analysis and studied transverse developmental characteristics of the maxillomandibular complex. Plaster or digital casts of 794 participants aged 7-18 years were evaluated. MTD was diagnosed when the maxilla-mandible width difference, represented by the decompensated maxillary and mandibular first molars, exceeded 4 mm. The average prevalence of MTD among patients aged 7-18 years was 31.1%. Patients with MTD exhibited narrower maxillary and/or wider mandibular arches. Strikingly, 32.3% of participants with posterior crossbite because of local crowding or mandibular deviation were not diagnosed with MTD. Dental compensation, such as a greater buccolingual inclination of the first molars, was common in patients with MTD. Transverse growth of the maxillomandibular complex was completed by 17 years old, with the maxilla undergoing greater transverse growth than the mandible. The physiological buccolingual inclination of first molars was observed in patients without MTD. The 95% reference value of the palatal arch width was 31.9-42.3 mm. The prevalence of MTD is 31.1% among Chinese children and adolescents. However, it is often camouflaged by dental compensation and sagittal discrepancy. The etiology of MTD is uncoordinated width in the maxillomandibular complex, which is not solely attributed to a narrow maxilla but also to an excessively wide mandible. To enhance diagnostic accuracy, individualized measurements of the maxillomandibular complex and a revised dental decompensation formula, rather than posterior crossbite alone, are recommended for transverse diagnosis. A potential presence of MTD is indicated when the palatal arch width is<31.9 mm.

Assessment of Residual Ridge Morphology among Edentulous Patients at A Tertiary Care Center of Nepal

Background The morphology of the residual ridge is one of the predominant factors influencing denture retention, stability, support and the masticatory function in edentulous patients thereby affecting both the planning and treatment prognosis. This study was aimed to assess the different types of maxillary and mandibular residual ridge in the group of edentulous population in Chitwan, Nepal. MethodsA descriptive cross-sectional study was conducted in total of 107 completely edentulous patients within the age of 55-85 years’ in Prosthodontic department of Chitwan Medical College. The type of maxillary and mandibular residual alveolar ridge in both male and female patients were noted in a predesigned proforma according to American College of Prosthodontists (ACP) classification system. The collected data was entered into Microsoft Excel and later transferred into SPSS version 26 and analyzed for descriptive statistics.ResultsIn this study, 107 completely edentulous patients both male 63 (58.9%) and female 44 (41.1%) participated in the study. In the maxillary arch, Type B was most prevalent residual ridge type 55 (51.4%) whereas Type C in mandibular arch around 35 (32.7%). In male patients, Type B was most common 36 (57.1%) whereas Type A in female 20 (45.5%). Conclusions From this study it can be concluded that there is variation in the residual ridge. In maxillary arch, type B residual ridge was most prevalent followed by type A while in the mandibular arch type C was prevalent followed by type B.