Maxillary Width Research Articles

Comparison of aging of nonextraction treated and normal untreated occlusions: 40-year follow up

The objective of this study was to compare the aging changes of the dental arches in patients treated without extractions and untreated normal occlusion subjects after a four-decade follow-up. This retrospective study evaluated two groups: The Treated Group (Group T) comprised 16 patients (6 male; 10 female) presenting with Class I or Class II malocclusions treated orthodontically without extractions. Dental models were evaluated 3 stages: T1 (pretreatment, 13.20 years), T2 (posttreatment, 15.07 years) and T3 (long-term posttreatment, 50.32 years). The Untreated Group (Group UT) consisted of 22 untreated normal occlusion individuals. The dental casts were evaluated at the ages of 13.32 (T1), 17.82 (T2) and 60.95 years (T3). The dental casts were digitized and the irregularity index, intercanine, interpremolar and intermolar widths, overjet and overbite, arch length and perimeter were measured. Intergroup comparisons were performed with independent t tests (P < 0.05). From T1 to T2, the treated group showed maxillary and mandibular crowding and overjet decrease and a maxillary interpremolar and intermolar width increase compared to the untreated group. From T2 to T3, a greater maxillary and mandibular crowding increase and a greater arch length decrease were observed in the treated group compared to the normal occlusion subjects. Overbite increased in the treated group and decreased in the untreated group. The maturational changes of treated patients were different from untreated normal occlusion subjects. Relapse might have contributed for the greater changes observed in incisor crowding and arch length observed in orthodontically treated patients. The aging changes of untreated normal occlusions and nonextraction treated patients, after a four-decade follow-up, proved to be different, indicating that relapse of orthodontic treatment played a role in aging changes of treated patients.

Stability of unilateral posterior crossbite treatment with the Function Generating Bite appliance : Association with reduction of mandibular clockwise rotation and increased maxillary transversal width measurements.

This observational study aimed to evaluate the stability of unilateral posterior crossbite (UPXB) correction with the functional appliance function generating bite (FGB appliance) during follow-up and its effects on craniofacial growth. Atotal of 102 age- and gender-matched patients were included: 51with UPXB (male [M] = 19; female [F] = 32; mean age ± standard deviation [SD] = 7.6 ± 1.4[years.months]) and 51controls (C; M = 19; F = 32; mean age ± SD = 7.9 ± 1.3). UPXB was corrected with the FGB appliance. Study casts were collected before treatment (T0), after correction (T1), after afollow-up of 3.7 ± 1.6[years.months] (T2) and different transversal measurements were performed with calipers: intermolar (IMD), intermolar gingival (IMGD), intercanine (ICD), and intercanine gingival distances (ICGD). In treated patients, in addition, lateral cephalometric tracings were analyzed at T0 and T2. At T0, all maxillary measurements were significantly smaller in the UPXB group compared to the controls (p < 0.001). Between T0 and T1, all maxillary variables increased significantly in the UPXB group (p < 0.001; IMD +4.3 ± 2.1 mm; ICD +3.1 ± 2 mm). Between T1 and T2, maxillary IMD increased further (p < 0.05; +2.2 ± 2 mm). The mean T0-T2 increases were 6.6 ± 2.6 mm (IMD) and 4.3 ± 2.6 mm (ICD). At T0, the cephalometric analysis showed significantly stronger mandibular clockwise rotation (p < 0.01) in the UPXB group compared to the control group. Between T0 and T2, the UPXB group showed asignificant reduction of mandibular (p < 0.001; SpP-CoOr T0 = -3.47°± 4.38, T2 = -1.14°± 4.01) and occlusal plane (p < 0.01; SpP-Oc T0 = 11.37°± 3.91, T2 = 9.86°± 3.83) clockwise rotation, and of intermaxillary divergence (p < 0.01; SpP-GoGn T0 = 27.8°± 5.39, T2 = 26.65°± 5.49). Treatment of UPXB with the FGB appliance effectively increased maxillary transversal width measurements, especially in the posterior region, even after follow-up, indicating stable results. Concurrently, mandibular clockwise rotation was reduced, indicating control of the vertical dimension.

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.

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.

Predicting the Risk of Maxillary Canine Impaction Based on Maxillary Measurements Using Supervised Machine Learning.

To predict palatally impacted maxillary canines based on maxilla measurements through supervised machine learning techniques. The maxilla images from 138 patients were analysed to investigate intermolar width, interpremolar width, interpterygoid width, maxillary length, maxillary width, nasal cavity width and nostril width, obtained through cone beam computed tomography scans. The predictive models were built using the following machine learning algorithms: Adaboost Classifier, Decision Tree, Gradient Boosting Classifier, K-Nearest Neighbours (KNN), Logistic Regression, Multilayer Perceptron Classifier (MLP), Random Forest Classifier and Support Vector Machine (SVM). A 5-fold cross-validation approach was employed to validate each model. Metrics such as area under the curve (AUC), accuracy, recall, precision and F1 Score were calculated for each model, and ROC curves were constructed. The predictive model included four variables (two dental and two skeletal measurements). The interpterygoid width and nostril width showed the largest effect sizes. The Gradient Boosting Classifier algorithm exhibited the best metrics, with AUC values ranging from 0.91 [CI95% = 0.74-0.98] for test data to 0.89 [CI95% = 0.86-0.94] for crossvalidation. The nostril width variable demonstrated the highest importance across all tested algorithms. The use of maxillary measurements, through supervised machine learning techniques, is a promising method for predicting palatally impacted maxillary canines. Among the models evaluated, both the Gradient Boosting Classifier and the Random Forest Classifier demonstrated the best performance metrics, with accuracy and AUC values exceeding 0.8, indicating strong predictive capability.

Cone-beam CT landmark detection for measuring basal bone width: a retrospective validation study

BackgroundAccurate assessment of basal bone width is essential for distinguishing individuals with normal occlusion from patients with maxillary transverse deficiency who may require maxillary expansion. Herein, we evaluated the effectiveness of a deep learning (DL) model in measuring landmarks of basal bone width and assessed the consistency of automated measurements compared to manual measurements.MethodsBased on the U-Net algorithm, a coarse-to-fine DL model was developed and trained using 80 cone-beam computed tomography (CBCT) images. The model’s prediction capabilities were validated on 10 CBCT scans and tested on an additional 34. To evaluate the performance of the DL model, its measurements were compared with those taken manually by one junior orthodontist using the concordance correlation coefficient (CCC).ResultsIt took approximately 1.5 s for the DL model to perform the measurement task in only CBCT images. This framework showed a mean radial error of 1.22 ± 1.93 mm and achieved successful detection rates of 71.34%, 81.37%, 86.77%, and 91.18% in the 2.0-, 2.5-, 3.0-, and 4.0-mm ranges, respectively. The CCCs (95% confidence interval) of the maxillary basal bone width and mandibular basal bone width distance between the DL model and manual measurement for the 34 cases were 0.96 (0.94–0.97) and 0.98 (0.97–0.99), respectively.ConclusionThe novel DL framework developed in this study improved the diagnostic accuracy of the individual assessment of maxillary width. These results emphasize the potential applicability of this framework as a computer-aided diagnostic tool in orthodontic practice.

Primary Headache Relief in Paediatric Patients Following Rapid Maxillary Expansion: a Prospective Study and Cephalometric Changes Analysis.

Primary headaches (PH) are a group of disorders greatly impairing quality of life, highly prevalent in growing population. Previous studies suggested a rhinogenic involvement in PH episodes. Modifications of nasal cavities and septum take place during rapid maxillary expansion (RME). This study aims to investigate the role of skeletal modifications due to RME on PH episodes. Sixty-eight growing patients (30/38 MF 7-12 y.o 9.2 ± 1.3 SD) were enrolled. All the selected sample patients reported at least 12 PH episodes in the previous year and were diagnosed with maxillary constriction to be treated with RME. Changes in PH episodes before and after this orthodontic procedure were analysed using paired t-tests. Correlations between age and PH episodes were assessed using Spearman correlation coefficients. Correlations between cephalometric changes and PH episodes were investigated using paired t-tests. RME produces significant modifications in maxillary and nasal width and lower nasal length and decreased monthly episodes of PH significantly. It can be supposed and inferred that RME has beneficial effects on PH in growing patients.

Association between maxillary incisor width and craniofacial measurements: A cone beam computed tomography study

Accurate prediction of maxillary central incisor width (CIW) is essential in prosthodontics for selecting appropriately sized denture teeth. While traditional methods exist, the digital era may offer more reliable techniques for anterior tooth selection. The purpose of this study was to investigate the correlation between CIW and craniofacial measurements derived from cone beam computed tomography (CBCT) scans to identify predictors for CIW and examine possible sexual dimorphism. A retrospective analysis was conducted on 80 three-dimensional skull models (40 men, 40 women; age range: 20 to 48 years) generated from segmented CBCT scans. Measurements included CIW, interpterygoid hamulus distance, bi-orbital width, interorbital distance, and piriform aperture width. Statistical analyses comprised independent t tests, bivariate correlations, and multiple linear regression (α=.05). Significant sexual dimorphism was observed in CIW, interpterygoid hamulus distance, and bi-orbital width (P<.05). CIW positively correlated with bi-orbital width (r=.75, P<.001) and piriform aperture width (r=.49, P<.001). Multiple regression analysis revealed bi-orbital width, and interorbital distance, along with sex, as significant predictors of CIW (R²=.59, P<.001). Bony bi-orbital width, interorbital distance, and sex can be used to estimate the maxillary CIW.

Improved stability of open bite deformities: taking control of the transverse width using digital technology and robotic archwire bending

Many factors need to be considered when selecting the treatment protocol for the surgical correction of skeletal open bite deformities. In order to achieve stable long-term results, it is essential to explore the origin of the open bite, including any dysfunction of the temporomandibular joint or tongue and compromised nasal breathing, in addition to the skeletal deformity. Recurrence of a skeletal open bite is associated with relapse of the expanded transverse width. Three-dimensional virtual planning allows different treatment options to be explored and final decisions to be made together with the orthodontist who also designs the patient’s digital occlusion. This study presents a treatment protocol for predictable and stable widening of the maxillary transverse width over the long term, involving premolar extraction and rounding and shortening of the upper dental arch by advancing the molar segments. The stability of inter-canine, inter-premolar, and inter-molar distances, as well as overjet and overbite, were measured in 16 patients treated with this technique; measurements were obtained pre- and post-surgery, and the mean follow-up was 43 months. Orthodontic treatment was designed digitally and finished with robotically bent wires (SureSmile), which allowed exact planning of the overall treatment until debonding, thus making orthognathic surgery more predictable for the patient. The changes in transverse width were significant and stable over time.

Sex determination through maxillary dental arch and skeletal base measurements using machine learning

BackgroundCranial, facial, nasal, and maxillary widths have been shown to be significantly affected by the individual’s sex. The present study aims to use measurements of dental arch and maxillary skeletal base to determine sex, employing supervised machine learning.Materials and methodsMaxillary and mandibular tomographic examinations from 100 patients were analyzed to investigate the inter-premolar width, inter-molar width, maxillary width, inter-pterygoid width, nasal cavity width, nostril width, and maxillary length, obtained through Cone Beam Computed Tomography scans. The following machine learning algorithms were used to build the predictive models: Logistic Regression, Gradient Boosting Classifier, K-Nearest Neighbors (KNN), Support Vector Machine (SVM), Multi-Layer Perceptron Classifier (MLP), Decision Tree, and Random Forest Classifier. A 10-fold cross-validation approach was adopted to validate each model. Metrics such as area under the curve (AUC), accuracy, recall, precision, and F1 Score were calculated for each model, and Receiver Operating Characteristic (ROC) curves were constructed.ResultsUnivariate analysis showed statistical significance (p < 0.10) for all skeletal and dental variables. Nostril width showed greater importance in two models, while Inter-molar width stood out among dental measurements. The models achieved accuracy values ranging from 0.75 to 0.85 on the test data. Logistic Regression, Random Forest, Decision Tree, and SVM models had the highest AUC values, with SVM showing the smallest disparity between cross-validation and test data for accuracy metrics.ConclusionTransverse dental arch and maxillary skeletal base measurements exhibited strong predictive capability, achieving high accuracy with machine learning methods. Among the evaluated models, the SVM algorithm exhibited the best performance. This indicates potential usefulness in forensic sex determination.

Credibility of Pont’s index in Egyptian population

BackgroundMany indices have been suggested to help orthodontists in predicting the ideal dental arch width. One of these was Pont’s index which was established by Pont. He suggested equations to predict the ideal maxillary dental arch width (interpremolar and intermolar) from the combined mesiodistal width of the maxillary incisors. This study aimed to test the applicability of Pont’s index as an orthodontic diagnostic tool in Egyptian population and to compare the results with those obtained from studies of different ethnic subjects.MethodsThis study was performed using dental casts of 184 Egyptian individuals (82 males and 102 females; age range, 19–24 years). The casts were divided into 46 casts with normal occlusion, 46 casts with class I, 46 casts with class II and 46 casts with class III malocclusion, according to Angle’s classification. Alginate impressions were taken for all patients and poured immediately using dental plaster. The real models were transformed into digital models using three-dimensional laser scanner to allow digital model analysis. Predicted arch widths were calculated using Pont’s equations. The predicted values were compared to the measured values.ResultsIntra class correlation coefficient (ICC) (absolute agreement) between measured and predicted arch widths was determined. Poor absolute agreement was found between measured arch width values and the corresponding values calculated according to Pont’s index.ConclusionAccording to the results of this study, Pont’s index is not a reliable method for predicting the ideal dental arch widths in Egyptian populations.

Upper airway dimensions and craniofacial morphology: A correlation study using cone beam computed tomography.

To determine the correlation between dentoskeletal parameters related to craniofacial morphology and the upper airway (UA) volume. Cone-beam computed tomography images of 106 randomly selected orthodontic patients were analyzed using NemoFab Ortho software. The dentoskeletal variables assessed were anterior facial height (AFH), posterior facial height (PFH), PFH/AFH ratio, hyoid position, maxillary width (MW), and palatal depth. The UA volume (evaluation in anatomical regions and as a whole) was also assessed using the same software. We also evaluated potential differences in UA variables between age and sex groups. The correlation between the dentoskeletal parameters and UA volume was calculated using the Pearson correlation coefficient (R). Analysis of variance and Student's t test were performed to assess differences between age and sex for UA variables. Statistical analyses were performed using SPSS software (version 26 for Windows). This study found that PFH, AFH, and MW were the dentoskeletal parameters most strongly correlated with UA volume. However, the ANB angle did not show any significant correlation with UA volume. Additionally, differences in UA volumes were observed between age groups. Sex differences were found in both the "8-12" and "≥ 16" age groups for oropharyngeal and pharyngeal volumes. In conclusion, our findings indicate a significant correlation between UA volume and dentoskeletal parameters, particularly those related to facial height and MW.

Retention efficacy and patient experience with customized clear retainer and wrap-around circumferential retainer among non-extraction orthodontic patients: A 12-month follow-up cohort study.

The aim of this study was to evaluate retention efficacy by assessing retention stability and patient perspectives according to type of circumferential retainer: the wrap-around circumferential retainer (WCR) and customized clear retainer (CCR). This cohort follow-up study involved 52 patients aged 18-62 who underwent fixed-appliance orthodontic treatment without extractions or orthognathic surgery. Following screening consenting participants were divided into WCR and CCR groups. All participants before follow-up received fixed retainers for the upper and lower anteriors and respective removable retainers within 2 weeks post-debond. Intraoral scans and lateral cephalograms were taken immediately after debonding (T0) and again 12 months later. Dentoalveolar changes in several measurements were compared to evaluate retention efficacy. Surveys were conducted at 1 month (T1) and 12 months (T2) post-debonding to assess changes in patient experiences. Outcome assessments were blinded. Paired T-tests and independent T-tests were used for intragroup and intergroup comparisons of dentoalveolar measurements, respectively. Survey responses were analysed using the Pearson Chi-Square test. The final assessment included 32 participants. Model analysis revealed no significant differences between the groups, except for maxillary intermolar width (p = .033). In the WCR group, the cephalometric analysis indicated a significant increase in the incisor mandibular plane angle (p = .002) and a decrease in the interincisal angle (p = .014), while changes in the CCR group were statistically non-significant. Patient attitude evaluation showed similar trends for wear time and overall satisfaction. However, a higher percentage of respondents in the WCR group reported irritation when wearing the retainers (p = .037) at T1 and discomfort related to speech (p = .038) at T2. CCR showed better retention efficacy in terms of lower incisor inclination. Patients experienced relatively less irritation and speech discomfort with CCRs.

Comparison of the width-to-height ratio in maxillary anterior teeth in different populations: A systematic review and meta-analysis

The width-to-height (W/H) ratio values of maxillary anterior teeth are parameters used in esthetic dentistry. However, a meta-analysis of studies evaluating these parameters in individuals from different countries, taking sex into account, is lacking. The purpose of this systematic review and meta-analysis was to determine and compare the W/H ratio values seen in the maxillary anterior teeth of different populations. A systematic search was performed using the PubMed/Medline, Google Scholar, and Web of Science databases to identify English and non-English language articles reporting the golden ratio, golden percentage, tooth ratio, tooth size, W/H ratio, maxillary tooth width, maxillary tooth height, maxillary anterior tooth size, and dental esthetics. The titles, full text, and abstracts were scanned by 2 investigators independently to identify articles that fulfilled the inclusion criteria. Using a meta-analysis software program, data extracted from each selected study were statistically combined using the random-effects model, and the weighted mean differences were calculated. The search protocol resulted in a total of 987 articles, but only 15 articles fulfilling the inclusion criteria were included in the meta-analysis. While the sample size varied between 50 and 412 in the 15 analyzed studies, a total of 2304 individuals from 12 countries were evaluated. As a result of the evaluation of the general W/H means of the maxillary anterior teeth, the largest teeth were seen in Korea and Pakistan, and the general mean W/H ratios of the central, lateral, and canine teeth showed no statistically significant difference between sexes (P>.05). As a result of the meta-analyses of the W/H ratios of the maxillary central, lateral, and canine teeth, the differences between populations were found not to be statistically significant.

Comparative evaluation of transverse width indices for diagnosing maxillary transverse deficiency

ObjectivesThis study aimed to compare and evaluate different transverse width indices for diagnosing maxillary transverse deficiency (MTD), a common malocclusion characterized by uncoordinated dental arches, crossbites, and tooth crowding.Materials and methodsSixty patients aged 7–12 years were included in the study, with 20 patients diagnosed with MTD and 40 normal controls. Transverse width indices, including maxillary width at the buccal alveolar crest and lingual midroot level, as well as at the jugal process width, were measured. Differences between these indices and their corresponding mandibular indices were used as standardized transverse width indices. The reference range of these indices was determined and evaluated. Receiver operating characteristic (ROC) analysis was performed to evaluate their diagnostic ability.ResultsThe transverse width indices and standardized transverse width indices of the MTD group were significantly smaller than those of the control group, except for the jugal process width. The evaluation of the reference range and ROC analysis revealed that the difference of the maxillomandibular width at buccal alveolar crest was the most accurate diagnostic method.ConclusionsThe jugal point analysis method may not be suitable for diagnosing MTD. Instead, measuring the difference in maxillomandibular width at the buccal alveolar crest proves to be a more reliable and accurate diagnostic method for MTD.

Dental Prediction Factors of Schizophrenia: A Pilot Case-Control Study in Morocco

&amp;lt;i&amp;gt;Introduction: &amp;lt;/i&amp;gt;Schizophrenia is a severe mental illness associated with significant morbidity and mortality. This study suggests that some dental or skeletal characteristics may be potentially associated with schizophrenia. &amp;lt;i&amp;gt;Method: &amp;lt;/i&amp;gt;A case control study was conducted from 2020 to 2022 among 30 schizophrenia patients and 30 control patients. Data was collected through a clinical exam and radiographs for each patient. Different variables were assessed including teeth dimensions, maxillary and mandibular width, occlusal characteristics and cephalometric values: SNB, IMPA, and FMA. Proportions and mean with standard deviations were used as descriptive measures. Only variables with p-values &amp;lt; 0,05 were considered as statistically significant and associated with schizophrenia. &amp;lt;i&amp;gt;Results:&amp;lt;/i&amp;gt; The mean ages of schizophrenia patients and controls were 34.0 +/- 9,12 and 17,3 +/- 2.0 years respectively. The results reported a statistically significant difference, between the two groups, at maxillar and mandibular arch depth [p &amp;lt; 0,001 and p=0,036 respectively], SNB [p = 0,013], overbite [p &amp;lt; 0,001], overjet [p = 0,002] and spee curve [p = 0,006]. &amp;lt;i&amp;gt;Conclusion: &amp;lt;/i&amp;gt;According to these study findings, some dental, skeletal and occlusal characteristics may be related to schizophrenia. However, further studies with larger sample sized and long-term follow-up may be needed to confirm these findings.

Research progress in the treatment of maxillary transverse deficiency with combined orthodontic-orthognathic approach

In combined orthodontic-orthognathic treatment, the maxillary palatine suture is closed in most patients with insufficient maxillary width, and bony expansion of the maxilla cannot be achieved by dental expansion or rapid palatal expansion (RPE) which causes buccal inclination of the maxillary posterior teeth leading to unstable results. Therefore, segmental LeFort Ⅰ osteotomy and surgically assisted RPE are often used in clinical practice. In recent years, with the application of implant anchorage technology, implant anchorage assisted RPE has been gradually applied in orthognathic treatment. This article reviewed the indications, contraindications, complications, efficacy and long-term stability in different treatment approaches including segmental LeFort Ⅰ osteotomy, surgically assisted RPE and implant-supported maxillary skeletal expansion.

Pont’s Index, is it Reliable and Applicable for Iraqis?

To facilitate the correct diagnosis and treatment planning, a range of diagnostic orthodontic indices have been developed. Pont’s index, as one of them, was documented to estimate the ideal maxillary dental arch widths from the sum of crown widths of maxillary incisors. This retrospective study aimed to evaluate the applicability of Pont’s index to Iraqi individuals. Fifty stone dental models for 25 females and 25 males were retrieved from the archives of the Department of Orthodontics in Baghdad College of Dentistry. The dental arch widths at the level of 1st premolar and molar areas in addition to the mesiodistal crown widths of all teeth were measured using an electronic vernier. The estimated arch widths were compared to the actual ones using paired sample t-test. The results showed highly significant differences between the actual and estimated maxillary inter-premolar and intermolar widths with over-estimated values in both genders. New formulas were developed to make Pont's index more reliable, and the newly estimated widths were non-significantly different from the actual one. The original Pont’s index is an unreliable and inapplicable method for arch width prediction. A specific modification of Pont’s index is developed and can be applied for more reliable results.

Morphological evaluation of maxillary arch in unilateral buccally and palatally impacted canines: a cone-beam computed tomography (CBCT)-based study in Northern Iran.

This study investigated the association between the maxillary impacted canines' position and the maxilla's morphological features in an Iranian population based on cone-beam computed tomography (CBCT) images. In this cross-sectional descriptive-analytical study, 47 CBCT images of unilateral buccally impacted maxillary canines and 47 CBCT images of unilateral palatally impacted maxillary canines were examined. Several morphological variables were compared between the impacted and non-impacted sides, and between the buccal and palatal impaction types. Gender and age were not significantly associated with the canine impaction type. The alveolar bone height at the impacted side was significantly greater in the buccally impacted group than in the palatally impacted group (p = 0.016). In a comparison of the impacted and non-impacted sides, all variables of alveolar bone thickness at depth of 2 mm, maxillary arch width, and palatal volume had significantly smaller values in the impacted side in both buccally and palatally impacted groups (p < 0.05). The alveolar bone was significantly thicker at the depth of 10 mm in the impacted side of the buccal group (p = 0.024). The maxillary arch perimeter was significantly smaller in the impacted side of the buccal group (p = 0.008). The palatal depth did not significantly differ between the groups. Among the studied variables, the alveolar bone thickness showed contrary results at different depths. The palatal volume and maxillary arch width were significantly smaller on the impacted side in both buccal and palatal groups, and the arch perimeter showed the same results only in the buccal group.

Presurgical Reduction of the Cleft Palate: Serendipitous Benefit of the Stanford Orthodontic Airway Plate Treatment (SOAP) for Infants with Robin Sequence.

Narrowing of the palatal cleft is often observed in infants with Robin sequence (RS) treated with the Stanford Orthodontic Airway Plate treatment (SOAP) even though SOAP is utilized primarily to establish airway patency. The current study quantified dimensional changes of the cleft palate (CP) in infants with RS treated with SOAP. A retrospective chart review. Infants with RS and CP who completed SOAP and had maxillary arch models at both pre- and post-treatment time points at a single tertiary referral hospital between September 2019 and July 2023. Maxillary arch models were measured and analyzed using Bivariate statistical analysis. Seventeen infants were included in the study. The median age (min, max) was 6.7 weeks (1.1, 21.9) at pre-treatment and 26.6 weeks (18.7, 37.0) at post-treatment. The median Obstructive Apnea Hypopnea Index was 36.2 events/hour (8.1, 103.1) at pre-treatment and 4.1 events/hour (1.9, 8.6) at post-treatment. The pre-treatment width of CP decreased by an average (± standard diviation) of 6.37 mm (± 3.55, p < 0.001) at post-treatment. The ratio of the posterior cleft width to the total maxillary arch width decreased from 40% (± 9.1) at pre-treatment to 22% (± 11) at post-treatment (p < 0.001). The dimensions of CP reduced significantly during SOAP in infants with RS and CP treated for their severe upper airway obstruction. The findings highlight a potential benefit of SOAP that may contribute favorably to the palate repair surgery.