Midline Deviation Research Articles

Malocclusion Among 10- to 12-Year-Old Male Schoolchildren in Qassim Region of Saudi Arabia: A Retrospective Epidemiological Study.

ObjectiveTo identify the prevalence of malocclusion in late mixed dentition in Qassim region of Saudi Arabia. This will be the first epidemiological study of its kind in this region. It will be very helpful for planning effective preventive measures and therapy programs.Materials and methodsThis study was performed in Qassim region, Saudi Arabia starting from October 2018 to March 2019. The examination was performed by two well-trained general dentists after using a specially prepared clinical examination form. A total of 536 children aged between 10 and 12 and those who met the inclusion criteria have been examined for Angle’s relationship, overjet, overbite, crossbite, midline deviation and lip competent.ResultsClass I relation accounted for the highest percentage of the sample, whilst 31.3% presented with Class I ideal occlusion, and 48.9% Class I with malocclusion. This was followed by Class II malocclusion (12.5% of the sample), and Class III accounted for the lowest proportion (7.3%). Increased overjet was present in 34.4% of the sample, whereas 3.9% had edge-to-edge and 2.2% a reverse overjet. Regarding overbite, 39% reported increased overbite, whilst 3% had open bite. A total of 63 children presented with crossbite - 6.15% had anterior crossbite, 5% unilateral posterior, and 0.5% bilateral posterior. Regarding the midline, only visible and noticed deviation was recorded. The results showed that 90% had no deviation, while 10% had a deviated midline. Regarding lip competence, only 12.1% had an incompetent lip.ConclusionEarly intervention and correction of occlusal discrepancies will facilitate the treatment and eliminate possible defects in developing dental arches.

Anterior crossbite correction in early mixed dentition stage using functional jaw orthopedics principles: a case report with two-years follow-up

A five-year-old and four-month-old male patient presented with Class I malocclusion, anterior crossbite (pseudo-class III) with an overbite, midline deviation to the left (5 mm), left unilateral chewing preference, and incisors in bi-retrusion with diastemas. Initial Bimler cephalometry showed negative anterior face angle (< A), negative bone overjet (A’B’), mesoprosope biotype, negative suborbital facial index, microrhinic dysplasia, and reduced T-TM distance. Pre-treatment gnathostatic models revealed vertical asymmetry and increased left occlusal plane. After the initial assessment, we initiated the treatment with resin-composite planas direct tracks in the deciduous upper molar surface to lift the bite. The patient was oriented to perform right-side mastication movements using hyperboloid exercises. After one month, a new resin-composite lift was carried out in the lower deciduous molar occlusion surface. Planas direct tracks were built directly on the occlusal of the maxillary molars 64 and 65 to start centering the patient’s midline, which was deviated to the left, raising the bite, and increasing the vertical dimension. In the same dental appointment, we completed the right side on the occlusal of the teeth 54 and 55, to adjust the occlusion using 200 microns articulated paper. After a month, the patient returned to the dental office and resins were placed in the occlusal surface of teeth 74, 75, 84, and 85, completing the direct planas tracks and leaving the occlusal plane the most parallel to the Camper’s Plan. Direct planas tracks’ adjustments were made throughout the patient's treatment returns, with 200 microns articulated paper and selective wear. Hyperboloid (silicone-made accessory to stimulate the stomatognathic system) was used to perform chewing exercises on the right side and instructed to be performed before the main meals, for five minutes, encouraging chewing on the right side. The subsequent masticatory evaluation showed protrusive movements. To reduce this movement, planas direct tracks from canine-to-canine were prepared, correcting the anterior bite, and reducing the midline deviation to the left. Posteriorly, functional orthopedic treatment began with the Simões Network 3 (SN3) device, with Bimler’s upper dental arch not touching the incisors and an upper expander. Concomitantly, in the lower dental arch, we initiated the treatment with a Hawley dental appliance against the cervical third of lower incisors and a W-shaped lingual retainer. The SN3 device was built in a laboratory specialized in maxillary functional orthopedics, after molding the patient with alginate and wax bite registration. After 12 months of treatment, the patient presented a centralized midline, had permanent lower incisors, erupting upper central incisors, and adequate bilateral chewing. After 24 months of treatment, the patient presented physiological limits with the contact of the upper central incisors in a determined area with 2 mm overjet, centralized midline, efficient bilateral chewing, and balanced maxillomandibular growth. Post-treatment Bimler cephalometry showed a negative anterior face angle (< A), positive bone overjet (A’B’), mesoprosope biotype, increased T-TM distance. In addition, Planas’ gnathostatic models evidenced a symmetric occlusal plane. In conclusion, functional jaw orthopedics approaches can significantly contribute to the inhibitory and excitatory stimulation of the mandible to the maxilla. Furthermore, functional orthopedics might establish an appropriate development of the stomatognathic system in patients with mixed dentition.

Decompressive craniectomy in traumatic brain injury: the intensivist's point of view.

To perform a score with early clinical and radiological findings after a TBI that identifies the patients who in their subsequent evolution are going to undergo DC. Observational study of a retrospective cohort of patients who, after a TBI, enter the Neurocritical Section of the Intensive Care Unit of our hospital for a period of 5 years (2014-2018). Detection of clinical and radiological criteria and generation of all possible models with significant, clinically relevant and easy to detect early variables. Selection of the one with the lowest Bayesian Information Criterion and Akaike Information Criterion values for the creation of the score. Calibration and internal validation of the score using the Hosmer-Lemeshow and a bootstrapping analysis with 1,000 re-samples respectively. 37 DC were performed in 153 patients who were admitted after a TBI. The resulting final model included Cerebral Midline Deviation, GCS and Ventricular Collapse with an Area under ROC Curve: 0.84 (95% IC 0.78-0.91) and Hosmer-Lemeshow p=0.71. The developed score detected well those patients who were going to need an early DC (first 24hours) after a TBI (2.5±0.5) but not those who would need it in a later stage of their disease (1.7±0.8). However, it seems to advice us about the patients who, although not requiring an early DC are likely to need it later in their evolution (DC after 24hours vs do not require DC, 1.7±0.8 vs 1±0.7; p=0.002). We have developed a prognostic score using early clinical-radiological criteria that, in our environment, detects with good sensitivity and specificity those patients who, after a TBI, will require a DC.

Manajemen Anestesi pada Pasien dengan Tumor Regio Pineal yang Menjalani Kraniotomi Pengangkatan Tumor dengan Posisi Duduk

Incidence of pineal regio tumor is 0.4-1% of intracranial tumors. Its location which is buried between two cerebral hemispheres, close to brainstem and hypothalamus become a difficult challenge for the neurosurgeon. Surgery with supracerebellar approach in sitting position is the best method to access the lesion. Sitting position also facilitates the optimal visual field with minimal retractions. However, for anesthesiologist, sitting position is challenging since it has its own complexities during positioning the patient and the risk of complications. Venous air embolism is one of the main concern and if not detected early and treated appropriately would leads to cardiovascular collapse instantly. This is a case of a 38-year-old male with chief complaint of severe headache and blurred vision started 4 months before admission. The Magnetic Resonance Imaging showed a pineal region tumor with perifocal edema, without midline deviation. The patient underwent craniotomy tumor removal with sitting position. The procedure lasted for 10 hours and uneventful. The principle of ABCDE neuroanesthesia, sitting position and its implications, and difficult tumor location are some anesthesia considerations for this patient. A thorough preoperative evaluation, good communication and coordination between surgery and anesthesia team are needed for a smooth uneventful procedure performed in sitting position.

Management of a complete 180° rotation of bilateral maxillary canines

Background: Dental anomalies usually lead to complicated decisions having to be made in terms of the orthodontic treatment of permanent dentition; tooth rotation is the most common of these irregularities. The prevalence rate of this phenomenon is 2.1–5.1% in patients who have not received orthodontic treatment. Purpose: This case report aimed to manage the complete bilateral rotation of maxillary canines with couple force by using a Nance appliance modification. Case: A 17-year-old male patient came in wanting to straighten his teeth. He complained about his bilateral canines, which were not in a normal position. There was an impacted left maxillary second premolar and an ectopically erupted right maxillary first premolar. He also had protrusions in the upper and lower anterior teeth and crowding in the lower anterior teeth as well as upper and lower midline deviations. Case Management: A clinical examination showed a class I relationship between the dental and cephalometry measurements and highlighted a class I skeletal pattern. The upper right first premolar was extracted and the left second premolar had undergone an odontectomy to allay protrusion and correct crowding. Bilaterally rotated upper canines were derotated using a modified Nance appliance and an elastomeric chain with couple force. Conclusion: The success of the orthodontic treatment was influenced by the specific nature of the patient’s dental and medical history, extraoral and intraoral examination, diagnosis and treatment planning, which was followed by a systematic approach to treatment. The Nance appliance modification reduced the total treatment time by achieving controlled anchorage and derotation of the canines.

TROMBOSIS DE SENO VENOSO SECUNDARIO A TRAUMATISMO ENCÉFALO CRANEANO GRAVE. REPORTE DE CASO

Introduction: Cerebral venous thrombosis (CVT) is a rare type of cerebrovascular disease that can occur at any age and represents 0.5% to 1.5% of the total.1 Superior sagittal venous sinus thrombosis (SSVST) secondary to brain injury (BTI) is reported worldwide only as single cases or in small series.3,4 Headache is the most frequent symptom (90%). The most common focal signs are aphasia and hemiparesis. Papilledema occurs in 25% of cases and epilepsy in about 40%.1,4 Diagnosis is made by venous phase angiography, or by magnetic resonance imaging (MRI) with gadolinium or computed tomography (CT)1,2. Clinical Case: 23-year-old woman who suffers a traffic accident as a passenger. He presented explosive vomiting, loss of consciousness and seizures, brain CT showed multiple bifrontal contusions, midline deviation> 5mm, cisternae of the base obstructed, Glasgow Coma Scale of 6. A decompressive craniectomy was performed and then he was transferred to ICU for management of intracranial hypertension. She presented with hydrocephalus, nervous system infection (ventriculitis) and superior sagittal venous sinus thrombosis. Conclusion: SSVST post BTI is a rare cause of SSVST, but potentially dangerous if not diagnosed early. The magnitude of the trauma does not correlate with the appearance of VST. The most common symptom is headache, followed by seizures and signs of targeting, which correlate with lesions in the brain parenchyma. Keywords: Sinus Thrombosis, Intracranial, Intracranial Hypertension, Brain Injuries (Source: MeSH NLM)

Differences in third molar development and angulation in classII subdivision malocclusions.

To assess and compare the developmental stages and angulations of third molars between the classII and classI sides in classII subdivision malocclusions. This retrospective study was performed using panoramic x‑rays of 38individuals (mean age: 15.5years; 24females, 14males) with classII subdivision malocclusions, which were further divided into type1 and2 subgroups according to midline deviation, and acontrol group of 42individuals (mean age: 17.0years; 30females, 12males) with normal occlusion. Third molars were categorized using the developmental stages defined by the Demirjian method. Angles between the third molars and horizontal reference lines and also to the second molars were measured. No difference was found in developmental stages or angulations between the left and right third molars in the control group. In the classII subdivision malocclusion cases, no difference in third molar developmental stages was observed, but the angle between the long axes of the mandibular third and second molars was significantly greater on the classII side. In the type2 subgroup, developmental stage of the maxillary third molar was more advanced on the classII side. In both subgroups, the angles of the maxillary third molars' long axis to the interorbital plane differed significantly between the two sides. ClassII subdivision malocclusion may cause differences in third molar development and angulations between the two sides. Orthodontic treatment should be planned considering the third molars in this malocclusion.

The Effect of Linear and Angular Midline Deviation on Smile Attractiveness Regarding Facial Height

Introduction: The aim of the present study was to evaluate ordinary people`s perception about smile attractiveness in long face and short face subjects with linear and angular midline deviations. Methods: Frontal facial smiling images of two young Iranian females (one short face and one long face) were manipulated by Adobe Photoshop CS3 software. Four photos with different linear midline deviations to right (1mm, 2mm, 3mm and 4mm) and four photos with counter clockwise angular midline deviation (2˚, 6˚, 10˚, 14˚) were produced. Sixty Iranian individuals (30 males and 30 females) were asked to determine from which photo on, they found that the smile is unattractive. Results: Unlike angular midline deviation, there was no statistically significant difference in the acceptability limitation for linear midline deviation between long face and short face subjects. The mean of unattractive limitation for angular midline deviation was 8.44˚ and 6.56˚ in long face and short face subjects, respectively. No statistically significant differences were found in ratings between male and female examiners. Conclusion: Angular midline deviation is more acceptable in long face people. On the other hand, the attractiveness of the two facial types is similarly affected by linear midline deviation

A Long-term Follow-up of Mandibular Deviation Caused by Congenital Cervical Lymphangioma Treated with an Orthodontic Approach

To report a treatment case of mandibular deviation caused by congenital cervical lymphangioma with traditional orthodontic techniques, following-up by 10-year retention. Lymphangiomas, developmental anomalies, can induce various disturbances of swallowing, mastication, speech, breathing, and skeletal deformities as well as psychological stress and anxiety for the patient and their family. Lymphangiomas are benign with virtually no possibility of turning into a malignant lesion, so clinical management aims to treat the patient functionally. A girl, aged 6 years and 4 months, complained about facial asymmetry and anterior crossbite caused by congenital cervical lymphangioma. Her facial profile was the straight type with an adequate lip position. Anterior and right-side posterior crossbites were observed. On the frontal cephalogram, the menton shifted 3.0 mm to the right. A functional appliance with an expander was placed to correct her dental midline deviation and posterior crossbite. After 2-year treatment, the anterior and right-side posterior crossbites were improved. Multibracket treatment began after the growth spurt. After 44-month active treatment, a functional occlusion, including a Class I molar relationship with a proper interincisal relationship, was achieved. A functional occlusion was maintained during a 10-year retention period, while a mandibular downward growth was observed through the retention period. Conventional orthodontic techniques enable functional and stable occlusion even in patients with mandibular deviation caused by congenital cervical lymphangioma, although only using early orthodontic management by itself may have some limitations. The hybrid technique combining functional appliance and intermaxillary elastics proves to be an effective therapy for correcting occlusal cant and mandibular deviation caused by cervical lymphangioma.

Perception of dental midline deviation and smile attractiveness by eye-tracking and aesthetic ratings

Abstract Aim To evaluate the perception of smile aesthetics and midline deviation considered by orthodontists (ORT), dentists (DT), patient’s-relatives (PR), and laypersons (LP) using an eye-tracking device and survey. Methods The study invited the participation of 42 orthodontists, 51 dentists, 50 patient-relatives, and 52 laypersons. A posed smile photograph of a female was chosen as a base image. The dental midline (DML) was digitally moved 1 mm (DML1R, DML1L), 2 mm (DML2R, DML2L), 3 mm (DML3R, DML3L), and 4 mm (DML4R, DML4L) on the base image’s right (DMLR) and left (DMLL) segments. Eight modified images were subsequently obtained. The base, modified, and repeated images were randomly arranged and uploaded into the Tobii Pro Lab software program for assessment by the participants. An eye-tracking dataset included first fixation duration (FFD), total fixation duration (TFD), and visit counts (VC). The participants also evaluated the photographs on the survey forms via a Visual Analogue Scale (VAS) and a Likert scale. The intra-group relations and inter-group correlations were evaluated statistically. Results The TFD for the DML2R photograph was found to be statistically significant between the assessment groups (p = 0.026). While the longest fixation time (0.93 sec) belonged to the orthodontists, it was observed that the patient relatives had the shortest fixation time (0.51 sec). The VAS score for the DML2R image was found to be highest in laypersons (p < 0.001). In general, the survey scores of the patient relatives and laypersons were higher. Conclusion The fixation time between the participant groups increased when there was a 2 mm deviation. A 2 mm shift in the DML was noticed by all participant groups and was considered unaesthetic.

Temporomandibular joint asymmetry in asymptomatic skeletal class I patients

Objectives Analysis of TMJ asymmetry in a sample of asymptomatic skeletal class I patients. Patients and methods This study was performed on one hundred patients requesting CBCT scans. All patients were skeletal class I pattern. They were all free of TMD symptoms, midline deviation of teeth, open bite, cross bite, congenital craniofacial abnormalities or any systemic diseases which may affect joint morphology such as rheumatoid arthritis. TMJ was evaluated through linear and volumetric analysis. Qualitative condyle position was also evaluated. All measures were compared on the right and left sides. Results There was relative asymmetry between right and left sides regarding all measured parameters. Condyle height showed the highest asymmetry, while condyle AP dimension was the least. There was absolute asymmetry between right and left sides regarding all measured parameters. fossa roof thickness showed the highest asymmetry, while condyle ML width was the least. On Correlating the R and L measurements, all correlations were positive with medium strength and were statistically highly significant. The highest correlation was shown in condyle volume while fossa roof thickness showed the least. The distributions of cases according to condyle position were almost statistically significantly different between right and left sides with 49 % percentage of agreement. Conclusion TMJ shows relative and absolute asymmetry in skeletal class I asymptomatic patients.

Pisa Tower Concept: A New Paradigm in Crooked Nose Treatment.

The primary element of a crooked nose is a midline deviation of the nasal pyramid. To date, no surgical strategies have been described as compatible with the philosophy of dorsal preservation. The dorsal preservation technique differs from the Joseph structured rhinoplasty because it preserves both the keystone area and the continuity of the cartilaginous vault. The authors focused on the versatility of the dorsal preservation technique even for the deviated nose, introducing the "Pisa Tower concept." From January of 2015 to June of 2019, 280 patients diagnosed as having a crooked nose underwent primary septorhinoplasty with dorsal preservation through an asymmetric bony wedge resection and lowering of the bony pyramid onto the frontal process of the maxilla (the let-down osteotomy), in accordance with the Pisa Tower concept. Inclusion criteria were a preoperative computed tomography examination, nasal axis deviation, a complete photographic examination preoperatively, and at least a 1-year follow-up. The mean nasal axis deviation was 7.62 degrees preoperatively and 1.15 degrees postoperatively (p < 0.05). Of the 84 patients, 47 (55.95 percent) were very satisfied, 33 (39.28 percent) were satisfied, and four (4.76 percent) were unsatisfied with surgical results and required revision surgery. The authors' opinion is that the association of "swinging door" septoplasty with the Pisa Tower concept can be a valid alterative to other techniques when working with the structured rhinoplasty philosophy in patients with a crooked nose. Although this is only a preliminary study, the decreased use of spreaders graft and less aggressive reconstructive methods look very promising. Therapeutic, IV.

Evaluation of signs and symptoms of temporomandibular disorders and incisal relationships among 7-10-year-old Turkish children with sleep bruxism: A cross-sectional study

ABSTRACT Objective To study the signs and symptoms of temporomandibular disorders (TMDs) and incisal relationships related to sleep bruxism and parafunctional habits among children. Methods The study consisted of 106 children (53 with and 53 without bruxism) between the ages of 7 and 10. A general questionnaire and Diagnostic Criteria for Temporomandibular Disorders Axis I examination form were used for each child. Results There were significant differences between children according to pain, headache, midline deviation, opening pattern, temporomandibular joint noise, overjet, overbite, corrected deviation, and pain disorders (p < 0.05). According to the logistic regression, the higher scores of “mouth breathing” and “horizontal incisal overjet” were independent risk factors for TMDs. The lack of “bruxism” and “sleeping with open mouth” were protective factors for TMDs. Conclusion Children with bruxism showed signs and symptoms of TMDs and divergence in incisal relationships.

Effectiveness of Presurgical Nasoalveolar Molding Appliance in Infants With Complete Unilateral Cleft Lip and Palate.

To assess the effectiveness of the presurgical nasoalveolar molding appliance among infants with unilateral cleft lip and palate. In this prospective study, 95 pairs of casts of infants with unilateral cleft lip and palate treated by presurgical nasoalveolar molding were selected at the Children's Hospital 1 at Ho Chi Minh City, Vietnam. The average time of treatment was 3 months. All casts were scanned and measured using 3-dimensional technology before and after treatment. Paired t tests were applied for comparisons. There was a statistically significant increase in the nostril height in cleft side (P < .001), decrease in the nostril width and columella angle (P < .001), and decrease in cleft width and midline deviation (P < .001) after treatment with presurgical nasoalveolar molding appliance. Nasoalveolar molding appliance is effective in improving the morphology of nostril and maxillary alveolar. Understanding this helps orthodontists and surgeons in treatment outcome expectations.

A novel CAD/CAM composite occlusal splint for intraoperative verification in single-splint two-jaw orthognathic surgery

BackgroundPrevious computer-generated splints were designed and produced without modification than the traditional occlusal splints, which did not facilitate surgeon's intraoperative judgment in the single-splint two-jaw orthognathic surgery. Modifications of the digital occlusal splint can be achieved using computer-aided design and computer-aided manufacturing (CAD/CAM) software. This study reported the design, clinical application and validation of a novel CAD/CAM occlusal splint. MethodsThe maxillary and mandibular segments were fixed into the final occlusal splint and moved to the planned position according to the 3-dimensional simulation. The composite occlusal splint has 4 orthogonal bars to facilitate intraoperative assessment of the dental and skeletal midline, facial soft tissue midline, occlusal plane, upper tooth show, facial symmetry and facial bone position. To validate the surgical outcome, 5 parameters including pitch, roll and yaw rotations, midline deviation and chin position were measured on the virtual plan and the postoperative cone-beam computed tomography images to quantify the difference. ResultsThe results showed no significant differences in the 5 parameters between the simulation and postoperative images. The root-mean-square difference between the conventional splints and CAD/CAM surgical splint ranged from 0.18 to 0.31 mm by superimposition of the two image models. All patients were satisfied with the treatment outcomes. Overall, this novel occlusal splint is ideal for verification of the maxillomandibular position during surgery. ConclusionThe novel composite occlusal splint provided useful and informative check to verify the maxillomandibular complex (MMC) position and facial appearance in single-splint two-jaw orthognathic surgery.

How efficient is customized lingual orthodontics? An assessment of treatment outcome.

To assess the efficacy of lingual orthodontics by comparing setups and post-treatment casts. Thirty-two consecutive patients treated with a customized lingual orthodontic appliance were included in this retrospective study. Initial casts, post-treatment casts and setups were scanned, and the digital models produced were analysed in terms of overjet; overbite; molar and canine relationships; intercanine, interpremolar and intermolar distances; upper and lower arch lengths; midline deviation; bucco-lingual angulation of all teeth and mesio-distal angulation of anterior teeth. Comparisons between setups and post-treatment casts were performed via paired t tests. Relationships between the planned and actual correction were studied using regression analysis. Statistically significant differences in bucco-lingual torque between setups and post-treatment casts were found for all upper teeth, except for central incisors. In the lower jaw, statistically significant differences in bucco-lingual torque were found between setups and post-treatment casts for the lower incisors and molars. No statistically significant differences in mesio-distal angulation of anterior teeth were found between setups and post-treatment casts. Upper and lower arch widths did not vary significantly between setups and final casts, except upper inter-second premolar and intermolar distances. Customized lingual appliances offer efficient control of mesio-distal angulation of all anterior teeth. Significant differences in torque between setups and post-treatment casts were observed for upper lateral incisors, canines, premolars and molars, as well as lower incisors and molars. However, the torque difference was clinically significant (over three degrees) for upper second premolars and molars only.

Comparative analysis of smile esthetics between top celebrity smile and a Southern European population

Statement of problemThe analysis of different parameters involved in the esthetic perception of the smile is important for the correct planning of cosmetic dental treatments. PurposeThe purpose of this study was to analyze the differences in the main parameters of smile esthetics among celebrities identified as having the best esthetic smiles and a young Southern European population. Material and methodsThe study consisted of a control group of 144 dental students from the University of Seville (69.4% women; 30.6% men) with a mean ±standard deviation age of 23.19 ±0.5 years and photographs of 58 celebrities identified as having the best esthetic smiles (74.1% women; 25.9% men) with a mean ±standard deviation age of 42.09 ±2.25 years. Photographs of the celebrities were obtained from the Internet, and standardized photographs were made of the control group. The variables measured were smile line, smile arc, incisal edges and lower lip relationship, smile width, dental midline deviation and tilting, buccal corridor widths, and angulation discrepancy between interpupillary line and commissural line and between interpupillary line and occlusal plane. The data obtained were processed in a statistical software program for a descriptive statistical analysis and for inferential analysis parametric statistical tests by applying the Wilcoxon, chi-square, Student t, and kappa index tests (α=.05). ResultsStatistically significant differences (P<.01) were found between the groups in terms of smile width, smile arc, midline deviation and tilting, and angulation discrepancy between the interpupillary line and the commissural line. Smile arc was the only variable found to be different (P<.01) in relation to sex. ConclusionsCharacteristics of the most esthetic smiles were no deviation or tilting of the maxillary midline, showing a greater number of teeth in the smile, displaying incisal edges parallel to the lower lip (particularly in women), and displaying occlusal and commissural planes parallel to the interpupillary line.

Obstructive Sleep Apnea Treated with Maxillomandibular Advancement Surgery by Computer-Assisted Simulation

This 23-year-old female patient was diagnosed as a severe type of obstructive sleep apnea (OSA), skeletal Class II jaw relation with mandibular deficiency, hyper divergent facial pattern, dental Class II malocclusion, midline deviation and occlusal plane canting. By the assistance of virtual surgical simulation and maxillomandibular advancement (MMA) approaching, patient was satisfied the improvement of functional and esthetic changes after the 18-months treatment.

The Association between Occlusal Features and Temporomandibular Disorders in Northern Jordan: A Cross-sectional Study

Objective: To evaluate the possible correlation between basic occlusal features and the outcomes of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I. Materials and Methods: A convenient sample of Northern Jordanians was used in the study. Participants were examined in accordance with DC/TMD protocol. Nine occlusal features represented the independent variables; overjet, overbite, midline deviation, pain-free opening, maximum assisted opening, maximum unassisted opening, lateral excursions and protrusion, in addition to the opening pattern (classified as straight, corrected deviation and uncorrected deviation). DC/TMD diagnostic outcomes and their associated features represented the dependent variables, namely, pain-related TMD, Intra-articular Disorders (IAD), Degenerative Joint Disease (DJD), joint sounds (clicking and crepitus), joint locking and headache attributed to TMD. Binary logistic regression, multinomial logistic regression and Chi-square tests were used for statistical analyses. Results: A total of 400 participants represented the study population (mean age = 32.3±12.4 years, males=48%, females=52%). 71 subjects (18%) were diagnosed with pain-related TMD, 52 (13%) with IAD, 6 (1.5%) with DJD and 38 (10%) with headache due to TMD. Gender had a significant correlation with pain-related TMD (p= 0.014, OR= 2.16). Maximum pain free opening had a significant inverse relationship with pain related TMD (p= 0.013, OR=0.94), while midline deviation and corrected deviation mouth opening pattern had a significant correlation with IAD (p= 0.04,0.02, OR= 1.30,2.74, respectively). Overbite, midline deviation and pain free opening were significantly associated with unilateral open/close clicking (p= 0.04,0.05,0.03, OR= 0.77, 1.31, 0.94, respectively). Conclusion: There is a minimal clinical significance of the correlation between dental occlusion and TMD.

Prevalence of malocclusions in children with microcephaly associated with the Zika virus

The objectives of this study were to determine the prevalence of malocclusion among children with Zika virus-associated microcephaly (MZV) and to describe the most common malocclusion in this population. This was a cross-sectional study including patients aged between 30 and 36months diagnosed with MZV. Healthy children were randomly selected with the same sociodemographic characteristics as the control group. Information about arch-type, primate spaces, arch form, overbite, overjet, midline deviation, anterior crossbite, anterior open bite, and the posterior crossbite was recorded. The statistical analysis used descriptive analysis, Pearson chi-square test, and multivariate logistic regression. Forty children comprised the MZV group, and 40 comprised the control group. Our results demonstrated a significantly higher prevalence of malocclusions in children who had MZV than the control group (P<0.001). Patients with MZV were more likely to have late eruption (P<0.001), hypoplastic maxillary arch (P<0.001), hypoplastic mandibular arch (P<0.001), excessive overjet (P<0.001), and posterior crossbite (P=0.004). The prevalence of malocclusion was higher among children with MZV. Late eruption, hypoplastic maxillary arch, hypoplastic mandibular arch, excessive overjet, and posterior crossbite were the most common characteristics for this population.