Mm In Class Research Articles

Nasal profile changes after LeFort I osteotomy (maxillary advancement) with and without ANS reduction in class III skeletal patients: a study protocol for a randomized clinical trial

BackgroundDentofacial malformation is a common condition that affects a significant portion of the population, resulting in functional and aesthetic defects. Orthognathic surgeries, such as LeFort I osteotomy, are performed to correct these abnormalities. However, the impact of these surgeries on nasal profile changes remains unclear. Additionally, the role of anterior nasal spine (ANS) reduction in maxillary advancement surgeries of 3–5 mm range is yet to be determined. This study aims to investigate the effect of ANS reduction on soft tissue profile changes following LeFort I osteotomy with a maxillary advancement range of 3–5 mm in class III skeletal patients. The hypothesis is that the changes in nasolabial angle and upper lip length will not significantly differ between patients who undergo LeFort I osteotomy with and without ANS reduction.Method and designThis study is designed as a randomized controlled trial. A total of 26 class III skeletal patients with maxillofacial abnormalities will be recruited from the maxillofacial clinic of Bu-Ali and Farahikhtegan Hospitals in Tehran, Iran. Patients meeting the inclusion criteria will be randomly assigned to two groups: one group will undergo LeFort I osteotomy with ANS reduction, and the other group will undergo LeFort I osteotomy without ANS reduction. The soft tissue profile changes, specifically the nasolabial angle and upper lip length, will be evaluated and compared between the two groups.DiscussionAchieving facial harmony through orthognathic surgery requires careful planning and consideration of the impact on surrounding soft tissue. The primary objective is to predict and plan for the effects on the nasolabial region. LeFort I osteotomy is a common procedure used to correct dentofacial deformities, particularly in class III patients. Maxillary advancement during this surgery can lead to changes in nasal tip position, width, and rotation, potentially due to repositioning of the anterior nasal spine and soft tissue dissection. In this study, soft tissue changes will be assessed in non-growing class III patients using cephalometric radiographs. The impact of reducing the anterior nasal spine (ANS) on nasal profile changes will be investigated for maxillary advancements of 3–5 mm. Objective measurements and patient-reported outcomes will be evaluated to gain insights into the aesthetic outcomes of orthognathic surgery. The findings will provide valuable guidance for treatment decisions and alternative options based on expected nasal profile changes.Trial registrationThis project was registered at The Iranian Registry of Clinical Trials (Identifier No. IRCT20210928052625N1, Website: https://www.irct.ir/trial/59171) and Open Science Framework (OSF) (Registration https://doi.org/10.17605/OSF.IO/X3HD4). 2021-06-09.

Risk Factors of Portal Vein Thrombosis in Patients with Different Child-Pugh Classes Liver Cirrhosis

Aim: to evaluate the frequency of portal vein thrombosis (PVT) and build predictive models of the development of PVT for patients with liver cirrhosis (LC) of A and B/C classes by Child-Pugh.Materials and methods. Research design is a case-control. The Case group included 130 patients with newly diagnosed PVT not caused by invasive hepatocellular carcinoma (HCC); 29 patients were assigned to class A, 101 patients were assigned to class B/C. From the database of cirrhotic patients without PVT 60 Controls for class A and 205 for B/C were selected using sratified randomization by sex, age and etiology of cirrhosis. The Mann-Whitney U-test and Pearson's chi-squared test were used to compare the groups. Odds ratios (OR) and 95 % confidence intervals (95 % CI) were calculated. Logistic regression models are constructed with the separation of the sample into training and test (0.7; 0.3). The operational characteristics of the models were calculated on the test sample; ROC analysis was carried out, the area under the ROC curve (AUC) was calculated.Results. The overall frequency of PVT was 4.1 % (95 % CI 2.7-5.8 %) in class A and 10.4 % (95 % CI 8.5-12.5 %) class B/C. Patients with class A and B/C PVT differed from the corresponding controls by more severe portal hypertension: the frequency of bleeding / number of interventions on varices compared with the control were 41/45 % vs. 7/8 % (p < 0.001) for class A and 25.7/30.7 % vs. 16.1/16.1 % (p < 0.05) for class B/C, ascites frequency was 24 % vs. 8 % (p < 0.05) for class A and 89.1 % vs. 68.3 % (p < 0.001) for class B/C. The cutoff by the portal vein diameter was the same for both classes — 13.4 mm; the spleen length was similar and amounted 17.5 mm for class A, 17.1 mm for class B/C. Patients with PVT differed from the corresponding controls by neutrophil-to-lymphocyte ratio: class A 2.33 (1.82; 3.61) vs. 1.76 (1.37; 2.20), p < 0.01, class B/C 2.49 (1.93; 3.34) vs. 2.15 (1.49; 3.26), p < 0.05. Patients of class B/C had a higher incidence of newly diagnosed malignant tumors - 23.8% (primarily HCC that does not invade the portal vein), compared with control and cases of class A - 6.3 % and 3 % (p < 0.05), respectively. The best model for class A included variceal bleeding, ascites, portal vein diameter, absolute number of neutrophils, for class B — ascites, spleen length, portal vein diameter, malignant tumors / local factors; sensitivity, specificity, accuracy and AUC were 79.3 %, 90 %, 86.5 %, 0.897 and 73.3 %, 68.3 %, 69.9 %, 0.789, respectively.Conclusion. Independently of the Child-Pugh class of LC, the main risk factor for PVT is severe portal hypertension.

Evaluation of Closest Speaking Space in Different Angle’s Classification of Occlusion

Aim: To determine closest speaking space in different Angle’s malocclusion classes.
 Study design: Descriptive Cross Sectional.
 Place and Duration of Study: .Department of Prosthodontics, Liaquat University of medical and Health Sciences Hospital during period of July 2021 - Dec 2021.
 Methodology:Total 111 Patients from both genders with age range 18-45 with intact 1st and 2nd premolars were alginate impressions were taken. Polysiloxane Elastomeric impression material bites in 1.5cm thickness were placed bilaterally on occlusal surfaces of mandibular premolars and molar teeth in patients oral cavity. Patients were instructed to swallow and repeat the Sindhi Language word “SASSI”. The elastomeric material bite blocks were removed and thickeness was noted down for each patient at premolar region using digital vernier calliper. The measurements were recorded in millimetres.
 Results: A total of 111 patients were examined, with an average age of 35 years and a range of 18 to 45 years (Table 1). Males made up 56 % of the population, while females consists of 44 % (Figure 1). According to occlusion, the majority of patients had class I 50 (45 %), class III 29 (26.1 %), and class II div I and II 16 (14.4 %) correspondingly (Table 2). According to the mean closest speaking space, it was highest in class II div II 7.05+2.38 mm and in class II div I 4.81+3.47 mm, with 2.02+0.75 mm in class I and 1.20+1.08 mm in class III (Table 3).
 Conclusion: It was concluded that closest speaking space was significantly increased in angles class II patients whereas decreased in angles class III.

Evaluating Distance between Vibrating Line and Fovea Palatinae in Class I, Class II and Class III Soft Palate Types

Objective: The objective of this study was to evaluate the mean distance between the vibrating line and fovea palatinae in Class I, Class II and Class III Soft Palate types.
 Methodology: This study was conducted at Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences Karachi among 197patients. Duration of study was six months. All patients were examined for vibrating line clinically, assessed using phonation method. Subsequently, distance between vibrating line and fovea paltatinae was measured with uncalibrated compass in various contours of soft palate.
 Results: Out of 197 patient, the vibrating line was seen in130 (64%) anterior to fovea palatinae, whereas, 67 (34%) vibrating line was at the fovea palatinae. The mean distance of those anterior located vibrating line from fovea palatine was calculated as 2.13 (±0.82) mm in Class, 2.07 (±0.69) mm in Class II and 1.80 (±0.82) mm in Class III soft palate contours.
 Statistical analysis showed no significant between gender, while statistically significant difference among age group and mean distance of anterior located vibrating line from fovea palatinae were found.
 Conclusions: The mean distance of vibrating line which is predominately found anterior to the fovea palatinae was 2.07 (±0.77) mm.

Incidence of Pocket Depth More than 3 MM in Maxillary Premolars and Molars with a Class II Restoration

Aim: To study the incidence of periodontal pocket depth more than 3mm in maxillary premolars and molarswith class 2 restorations. Introduction: A class II restoration of a tooth and its status of periodontal healthare closely related. A healthy periodontium is required for the proper functioning of all restorations whilethe functional stimulation due to dental restorations is essential for periodontal protection. Materials andMethods: It is a retrospective study in which we reviewed patient records and analysed the data of 86000patients between June 2019 and March 2020, out of these patients we collected the data of 885 patients whohad class II restoration done.The data was compiled into class II restorations with pocket depth more than 3mmm and less than 3 mm, reviewed, tabulated and exported to SPSS software for statistical analysis. Result:Incidence of pocket depth more than 3mm in Class II amalgam restorations was 3.42% out of 614 samplesand in Class II LCR restorations was 3.69% out of 271 samples. In comparison of incidence of pocket depthmore than 3 mm in both amalgam and composite class II restorations amalgam is 2.37% and composite is1.13%. Conclusion: Within the limits of study, it can be concluded that incidence of pocket depth more than3mm in maxillary premolars and molars with class II amalgam restoration was less (3.42%) compared withcomposite (3.69%). However on comparison between amalgam and composite the mean pocket depth wasmore in amalgam.

Length of the styloid process associated with different skeletal patterns in Turkish Adolescents

Aim: The purpose of this study was to investigate the length of the styloid process (SP) in different skeletal patterns and stages of skeletal maturation. Materials and Methods: Radiographs involving SP (n = 158; 77 female and 81 male, age with a mean value of 12.84 ± 1.94 years) were evaluated retrospectively. Class I group included 52 subjects (0 ≤ ANB ≤4), Class II group included 57 subjects (ANB>4), and Class III group included 49 subjects (ANB Results: Statistically significant difference in the length of the SP was found between Class I and Class II group (P ≤≤≤05). The mean length of the SP was 30.68 ± 9.69 mm in Class I group and 34.63 ± 5.87 mm in Class II group. No statistically significant difference was found in between skeletal maturation stages of the groups neither in the bilateral length of the SP between genders. Conclusion: The risk of Eagle syndrome in skeletal Class II malocclusion might be higher. In addition, when a patient is referred with pain in the temporomandibular area with skeletal Class II anomaly, SP elongation should be considered besides the joint problems.

Researching of reinforced concrete beams with damaged tensile rebar under the loading

There are defects in all reinforced concrete structures: initial (obtained during production) and operational (which arise during exploitation of the element). Operational defects arise under the influence of the environment, aggressive influences and mechanical factors. All of these damages occur under the influence of the load - starting from the weight of the structure and the above lying elements and to the design work in the exploitation stages. All defects, which arise at the action of any level of load, lead to change in the stress-strain state. Particular attention deserves investigation of damages of the tensile reinforcement in bending reinforced concrete elements. Therefore, the purpose of this article is to determine the impact on the strength of reinforced concrete bending elements damages of tensile rebar obtained under the action of the loading. To achieve researching purpose, six researching reinforced concrete beams were designed, which were divided into two series: four samples of first series and two samples of the second. All samples were identical geometric dimensions. Difference between samples consists in the diameter of the tensile rebar: the samples of the 1st series are reinforced with one rod 20 mm in diameter, class А500С, and samples of the second series - with one rod in diameter of 16 mm in the class А500С. The corrosion of the reinforcement was simulated by drilling a hole in the middle of the sample with a diameter of 5.6 mm. This diameter of the hole corresponds to the corrosion of the cross-section of the rebar with a diameter of 20 mm to a diameter of 16 mm. Damages was carried out at the initial load level of 0.7 from the bearing capacity of the control samples. Exhaustion of the bearing capacity of control samples was achieved due to the achievement of the limiting deformations with the compressed concrete zone, and for samples of the second series also the onset of yield in the tensile rebar. Damaged samples of the 2nd series were destroyed due to the rupture of tensile reinforcement and the fracture of the sample into two parts. At that time, the limiting deformations in the compressed concrete zone were not achieved. According to the results of the research, it was found that with a decrease in the cross-sectional area of the reinforcement by 35%, due to damage to the stretched armature with an aperture of 5.6 mm in diameter, under the action of the load, the bearing capacity of damaged specimens decreased by 11%. Whereas samples with an equivalent diameter of the rebar to the diameter of the damaged sample showed a carrying capacity less than 37%, which approximately corresponds to a decrease in the cross-sectional area of the stretched reinforcement.

Comparación de distancias interradiculares y grosor del hueso cortical en dos sectores del maxilar inferior para colocación de mini implantes

Introducción: la colocación de mini implantes interradiculares, como alternativa para el anclaje de aparatología ortodóntica, varía acorde a la clasificación esquelética del paciente Clase I o II. Es necesario realizar la correcta identificación de la ubicación radicular y grosor cortical como parte del análisis estratégico del área a intervenir. Objetivo: comparar tomográficamente las distancias interradiculares y grosor del hueso cortical en dos sectores del maxilar inferior para colocación de mini implantes. Materiales y métodos: estudio transversal que incluyó 120 tomografías computarizadas de haz cónico, pertenecientes a pacientes Clase I (60) y Clase II (60) esquelética. Se identificó tomográficamente la distancia interradicular, el ancho bucolingual y el grosor del hueso cortical bucal, a partir de la cresta alveolar entre el segundo premolar y primer molar inferior derecho y entre el canino y lateral del mismo lado. Un análisis estadístico con prueba t Student al 95% de confianza comparó la ubicación de las estructuras anatómicas para clase I y II esquelética. Resultados: en la distancia interradicular, comparativamente entre clase I y II, se encontró significancia entre canino y lateral derecho (p=< 0.054) a los 8 mm. En este mismo sector, en el ancho bucolingual, se encontró diferencia significativa a 6mm de altura (p=<.04). En el grosor del hueso cortical no se encontraron diferencias estadísticas al comparar los valores para la Clase I y II. Conclusiones: en Clase I y II, el mayor espesor para la colocación de mini implantes se registró en el espacio interradicular a 8 mm de altura y en el ancho bucolingual a 6 mm.

Quantitation of Mandibular Symphysis Bone as Source of Bone Grafting: Description in Class I and Class III Skeletal Conditions.

The aim of this study was to quantify the cortical and cancellous bone in the mandibular symphysis and relate it to the teeth and to the skeletal class. A descriptive study was conducted using cone beam computerized tomography (CBCT). Class I and class III subjects were included, defined according to dental occlusion and cephalogram results. Linear measurements were taken on the CBCT of the mandibular canines, lateral incisors, and central incisors, where the analysis was related to the axial and apical axes considering the bone in relation to the dental area. With previous definitions, an observer took 2 measurements of the height of the mandibular symphysis, cortical bone of the buccal and lower region, and thickness of cancellous bone at different levels; the correlation coefficient between the first and second measurement was 0.99 and presented P = .001. The results were analyzed with analysis of variance and Tukey's honest significant difference test, with P < .05 being statistically significant. The symphysis height was significantly greater in class III subjects. The cortical bone was an average 1.67 ± 0.44 mm in vertical distance in the skeletal class I group and 1.74 ± 0.47 mm in the class III group. The cancellous bone had an average width of 5.03 ± 1.94 mm in the skeletal class I group and 4.74 ± 2.05 mm in the class III group. It was observed that cancellous bone was significantly thicker at the incisor level than at the canine level. There were anatomical differences between skeletal class I and class III subjects, although the clinical significance may be questionable. With the values from these analyses, it may be concluded that there are no significant differences in quantitation of the cortical and cancellous bone in the anterior mandibular symphysis.

Performance Comparison of Three Varieties of Amaranth (Amaranthus Hypochondriacus L.) at Different Harvest Time

Amaranth is one of the native plants of Africa is that in addition to the relative tolerance to drought conditions, has high potential forage production. The experimental design was a randomized complete block with factorial method, three varieties of Amaranth forage consist of Loura, Cim and Kharkovski and to harvest time before and after flowering with four replications at the Seed and Plants Improvement Research Institute of Iran in 2015. The results showed that significant difference between the tested varieties in terms of total dry and fresh forage yield, but there was not any significant difference between harvest time and interaction effects. Compare average showed a figure Loura whit 161.0 cm in cut1 had the maximum height and the Cim and Kharkovski respectively, with 155.0 and 146.9 cm stem height ranked in next categories. The maximum stem diameter over the equivalent of 20.6 mm in class a belongs to Kharkovski rather than the other two varieties with average 16.9 and 16.8 mm. Finally the Laura with 9090.3 and 13.05 total fresh and dry forage yield and relative superiority of Crude protein, Crude fat, Digestibility, Relative Forage Quality and Relative Feed Value compared to the other two varieties were superior.

Gene expression profiling and regression rate of irradiated uveal melanomas.

Uveal melanoma is the most common primary intraocular cancer; however, the molecular features that predict response to therapy are poorly understood. Our objective was to determine whether gene expression profiling (GEP) is associated with rate of tumor regression after I-125 plaque brachytherapy for uveal melanoma. Retrospective review of 138 patients with posterior uveal melanoma treated with I-125 plaque brachytherapy in which GEP class and 3-month post-radiation ultrasonographic tumor thickness data were available. Statistical analysis was performed using t test and Fisher's exact test. GEP class assignment was class 1 in 83 (60.1%) and class 2 in 55 (39.9%) patients. Mean patient age was 60.9 years for class 1 and 68.1 years for class 2 tumors (P = .002). Mean initial tumor diameter was 13.0 mm for class 1 and 14.1 mm for class 2 tumors (P = .02). Mean initial tumor thickness was 5.2 mm for class 1 and 6.1 mm for class 2 tumors (P = .047). Three months after I-125 plaque radiotherapy, mean reduction in tumor thickness was 26.5% for class 1 and 16.7% for class 2 tumors (P = .03). Class 1 uveal melanoma tumors exhibit more rapid early tumor regression than class 2 tumors after I-125 plaque radiotherapy.

Intraoperative condyle positioning by sonographic monitoring in orthognathic surgery verified by MRI

ObjectiveRepositioning of the jaw in orthognathic surgery must produce precise and stable long-term results; an effective and practical method of intraoperative condyle positioning is required to achieve this. Most traditional methods, such as manual positioning or positioning plates do not permit intraoperative monitoring of the temporomandibular joint (TMJ) position. This study evaluates the results of intraoperative, sonographically-monitored joint positioning, comparing preoperative and postoperative MRI scans. Patients and methodsOf the 97 patients who were originally assessed (53 female, average age 29 ± 10.93; and 44 male, average age 28 ± 9.25), 21 had incomplete data sets and were excluded, leaving 76 evaluable patients. MRIs were performed preoperatively between 2 days and 100 weeks (median 30.5 days), and postoperatively between 12 and 96 weeks (median 150 days). Condyle positioning, intercondylar distance, and disc degeneration and dislocation were compared in preoperative and postoperative MRIs, and differentiated by Angle class on horizontal, axial and sagittal scans.Condyle to fossa distances were measured on parasagittal images from 0° (the vertical sagittal plane), 45° anteriorly and 45° posteriorly. The intercondylar distances between the condylar head midpoints were measured on axial sections. Two-sided t-tests (α < 0.05) were used for comparisons within classes; the interclass correlation was performed using univariate ANOVA and linear correlation for paired sample correlation settings. ResultsIn 27 Angle class II cases, the anterior distance of both condyles increased on average 0.3 ± 1.0 mm, the posterior position decreased 0.1 ± 1.2 mm, and the vertical position decreased 0.2 ± 1.1 mm postoperatively. In 47 Angle class III cases the anterior distance of both condyles increased on average 0.3 ± 0.8 mm, the posterior 0.1 ± 0.8 mm and the vertical distance 0.1 ± 0.8 mm postoperatively. All alterations of the condyle-fossa relation were non-significant except for the anterior distance in Angle class ІІІ (p = 0.02). Alterations of the disc position and disc degeneration were non-significant in class II. In class ІІІ, the disc degeneration deteriorated slightly on the left side (p = 0.02). Intercondylar distance increased 1 ± 5.5 mm in class ІІ and decreased by 1 ± 5.5 mm in class ІІІ postoperatively, alterations were non-significant. ConclusionSonography is a non-invasive, comfortable, fast, economical and effective intraoperative method of condyle positioning. The results of the present study support this statement because the degree of disc degeneration and luxation remained unaltered and the condyle position did not change significantly. Prospective randomized comparison to manual positioning is in preparation and will be conducted in the near future.

Relationship Between Rate of Posterior Uveal Melanoma Flattening Following Plaque Radiotherapy and Gene Expression Profile Class of Tumor Cells

To evaluate the relationship between rate of flattening of posterior uveal melanomas (PUMs) over the first 6 months following I-125 plaque radiotherapy and gene expression profile (GEP) class of tumor cells obtained by fine needle aspiration biopsy (FNAB) prior to treatment. Retrospective analysis of relationship between GEP of PUM cells obtained by FNAB at or prior to treatment and rate of tumor flattening following I-125 plaque radiotherapy. Impact of initial tumor thickness was minimized by pairing cases so baseline tumor thickness in subgroups was matched to within ± 0.5 mm. Paired t-testing compared mean tumor thickness in GEP subgroups at 3- and 6-months post treatment assessments. Our initial group consisted of 269 patients. Seventy-seven tumors (28.6%) were GEP class 2. Twenty-seven of these were treated by I-125 plaque radiotherapy post-FNAB and returned for post treatment evaluations at 3 and 6 months. A matched GEP class 1 tumor was identified for 25 class 2 cases. Matched tumor pairs ranged in thickness from 2.5 to 11.5 mm at baseline. Mean tumor thickness at baseline in the GEP 1 subgroup was 5.8 and 5.9 mm in the GEP 2 subgroup. Three-months post plaque, mean tumor thickness was 4.5 mm in class 1 cases and 4.6 mm in class 2 cases (paired t = 0.31, P = 0.76). The 6-month post-plaque, mean tumor thickness was 4.0 mm in each subgroup (paired t = 0.25, P = 0.81). Our study showed a lack of association between the GEP class and the rate of flattening of posterior uveal melanomas following I-125 plaque radiotherapy of PUMs.

Interlabial gap behavior with time

BackgroundThe purpose of this study was to evaluate the long-term behavior of the interlabial gap in patients with Class I and Class II malocclusion after orthodontic treatment and to investigate whether interlabial gap behavior is related to treatment with or without extraction. MethodsLateral head-films at the pre- and post-treatment and long-term follow-up stages were obtained from 61 patients who initially had Class I or Class II malocclusion and with pre- and post-treatment lip incompetence, who were treated with or without extraction. Dependent and independent Student's t tests were used for the intra- and intergroup comparisons. ResultsThere were significant interlabial gap reductions of 1.64 and 1.72 mm in Class I and II, respectively, but there was no significant intergroup difference. Nonextraction patients had significantly greater interlabial gap reduction (2.7 mm) than did extraction patients (1.3 mm) in the long-term. ConclusionsIt was concluded that the interlabial gap decreases significantly and similarly in treated Class I and Class II malocclusion patients and that nonextraction treatment has greater interlabial gap reduction than does extraction treatment in the long-term post-treatment period.

Angiographic characteristics of femoropopliteal in‐stent restenosis: Association with long‐term outcomes after endovascular intervention

The purpose of this study was to identify the relationship between angiographic patterns of restenosis and outcomes after endovascular treatment of femoro-popliteal in-stent restenosis (FP-ISR). ISR is a frequent clinical problem after femoro-popliteal stenting. This was a single center study of all endovascular interventions for FP-ISR from 2006 to 2012. Class I ISR was defined as focal lesions ≤50 mm; Class II ISR as lesions > 50 mm; and Class III ISR as stent chronic total occlusion. Recurrent ISR was defined as peak systolic velocity ratio > 2.4 by duplex ultrasound. Among 75 cases of FP-ISR, 28 (37%) were Class I, 22 (29%) were Class II, and 25 (33%) were Class III. The mean lesion length was 26 mm for Class I, 135 mm for Class II, and 178 mm for Class III ISR. Patients with Class III ISR more frequently had ISR extending into both the superficial femoral and popliteal artery (48% vs. 18%, P = 0.005). Balloon angioplasty was used most frequently to treat Class I ISR, while adjunctive atherectomy and/or stenting was used for almost all cases of Class III ISR. During 2-year follow-up, rates of repeat restenosis were 39% for Class I, 67% for Class II, and 72% for Class III ISR (P = 0.04). Rates of stent occlusion were 8% for Class I, 11% for Class II, and 52% for Class III ISR (P = 0.009). Class III ISR was associated with significantly increased risk of recurrent ISR (HR 2.4, 95% CI 1.1-5.6) and recurrent occlusion (HR 5.8, 95% CI 1.8-19.0) compared to other types of ISR. Angiographic patterns of FP-ISR are important determinants of subsequent outcomes. Repeat restenosis and occlusion remain common despite currently available technologies.

An evaluation of the Pi analysis in the assessment of anteroposterior jaw relationship

This study has investigated two new cephalometric variables, the Pi angle and Pi linear in the evaluation of anteroposterior skeletal discrepancy. Retrospective cross-sectional study. Manipal College of Dental Sciences, Manipal, India A sample of 155 subjects (mean age 19·7 years) were subdivided into skeletal class I, II and III groups based upon ANB angle. Descriptive data were calculated for each variable and group. Receiver operating characteristics curves were used to examine sensitivity and specificity of the Pi angle in the discrimination between different skeletal groups. Correlation coefficients were obtained for each of the parameters to compare their relationship with other parameters in the class I group. Coefficient of determination, regression coefficient, regression equation and standard error of estimate were also calculated from the parameters showing significant correlation with the Pi angle. Mean values for the Pi angle in skeletal class I, II and III subjects were 3·40 (±2·04), 8·94 (±3·16) and -3·57 (±1·61) degrees, respectively. For the Pi linear they were 3·40 (±2·20), 8·90 (±3·56) and -3·30 (±2·30) mm for class I, II and III subjects, respectively. Receiver operating characteristic curves showed that a Pi angle greater than 5 degrees had 89% sensitivity and 82% specificity for discriminating a skeletal class II group from class I. A Pi angle of less than 1·3 degrees had 100% sensitivity and 84% specificity in discriminating skeletal class III groups from class I. The overall accuracy for discriminating class II groups from class I was 85% and for class III from class I, 90%. Thus, a cut-off point between class I and II groups could be considered a Pi angle of approximately 5 degrees and between class I and class III, approximately 1·3 degrees. There were no statistically significant correlations found between Pi angle and ANB (0·07), Beta angle (-0·04) and WITS analysis (0·19). The highest level of correlation was obtained for the Pi angle and Pi linear (0·96). The anglar and linear components of the Pi analysis are a suitable method for assessing anteroposterior jaw discrepancy in daily clinical practice.

Dento-skeletal changes associated with treatment of deep overbite in class II malocclusion

The present study aimed to evaluate the treatment changes in class II patients with deep overbite. A total of 22 females (15-18 years) were treated with fixed orthodontic appliances divided into 2 groups; the first group comprised of 12 cases with class II division 1and the second group ten cases with class II division 2. All cases possessed over bite more than 4 mm, class II more than 4 degrees and had pre and post treatment lateral cephalometric x-ray films. Eleven angular and ten linear cephalometric measurements were recorded and analyzed before and after treatment. The differences in mean values of variables within each studied group were statistically analyzed using Wilcox on singed rank test. On the other hand the mean differences of overbite before and after intervention were compared between the two studied groups using Mann-Whitney test.Results: Bite depth improved an average of 5.6 mm in class II division1, and 2.6 mm in class II division2 with significant differences within and between the studied groups. All measurements showed changes that were statistically significant except SNB0 in both groups, ANB0, OP/MP0, U1-PP, ANS-Me in group 1, and L1-MP in group 2. Conclusion: Bite depth improved due to the changes in the axial inclination of incisor teeth that were decreased in class II division1, while increased in class II division 2, intrusion of lower incisor in class II division1, and intrusion of maxillary incisor in class II division 2 in addition to extrusion of upper and lower molars in both groups.

Modified Radical Hysterectomy Versus Extrafascial Hysterectomy in the Treatment of Stage I Endometrial Cancer: Results From the ILIADE Randomized Study

Five percent to 20% of stage I endometrial cancer patients undergoing total abdominal hysterectomy and bilateral salpingo-oophorectomy develop vaginal and pelvic recurrences. Adjuvant radiotherapy can improve locoregional control but not survival. This randomized trial aimed to determine whether a modified radical (Piver-Rutledge class II) hysterectomy can improve survival and locoregional control compared to the standard extrafascial (Piver-Rutledge class I) hysterectomy. Eligible patients (n = 520) with stage I endometrial cancer were randomized to class I or class II hysterectomy. Primary endpoint was overall survival. The median length of parametria and vagina removed were 15 and 5 vs. 20 mm and 15 mm for class I and class II hysterectomy, respectively (P > 0.001). Operating time and blood loss were statistically significantly higher for class II hysterectomy. At a median follow-up of 70 months, 51 patients had died. Five-year disease-free and overall survival were similar between arms (87.7 and 88.9% in the class I arm and 89.7 and 92.2% in the class II arm, respectively). The unadjusted hazard ratios for recurrence was 0.91 (95% confidence interval, 0.55-1.51, P = 0.72), and the hazard ratio for death was 0.77 (95% confidence interval, 0.44-1.33, P = 0.35). Class II hysterectomy did not improve locoregional control and survival compared to class I hysterectomy, but when an adequate vaginal cuff transection is not feasible with class I hysterectomy, a modified radical hysterectomy allows to obtain an optimal vaginal and pelvic control of disease with a minimal increase in surgical morbidity.

Sonographic evaluation of the ranges of condylar translation and of temporomandibular joint space as well as first comparison with symptomatic joints

To assess the normal ranges of condylar translation and width of the lateral temporomandibular joint (TMJ) of a healthy population by sonography and permit comparison of findings made in individual patients using this norm. Fifty non-orthodontically treated, asymptomatic volunteers (100 joints) were subdivided by Angle classes (I = 20, II = 15, III = 15) and evaluated. Reliability was assessed in 15 of those volunteers. The validity was checked in 8 more patients with temporomandibular dysfunction (TMD), all class II with disc dislocation diagnosed by means of MRI. Sonographic assessment of condylar translation from centric occlusion to maximum opening and during protrusion and mediotrusion was performed with a probe positioned parallel to the zygomatic arch. Translation during opening was 12.7+/-3.2 mm in class I, 12.9+/-3.3 mm in class II and 10.9+/-3.6 mm in class III. Protrusive translation was 7.4+/-2.5 mm/10.3+/-4.4 mm/6.8+/-2.1mm, respectively; and mediotrusive translation was 7.9+/-2.6 mm/10.8+/-3.4 mm/6.7+/-2.4 mm, respectively. Class II had longer and class III shorter condylar translations. The lateral joint space in occlusion and protrusion was wider in class II than in classes I and III. Symptomatic patients had shorter condylar translations than asymptomatic volunteers. Patients with class II had a more anteroposterior mobility, class III shorter translation. Significant sonographic differences of condylar translation from the norm did not correspond with clinical findings. This demonstrates the higher sensitivity of sonography for the evaluation of individual condylar translation. It is a sensitive tool for assessing joint function.

Cervical Headgear Treatment and Growth Patterns: Analysis by Lateral Cephalometry

Retrospective cephalometric study of changes in vertical and sagittal relations after headgear treatment depending on preexisting growth patterns. Lateral cephalograms obtained from 119 patients before and after headgear treatment were analyzed. All patients were treated with headgears exclusively. Only cases were included that showed bilateral improvement of least 4 mm in Class II occlusion after headgear treatment lasting at least 6 months. Patients were assigned to six groups based on y-axis values obtained at baseline. Almost all groups revealed substantial improvements in skeletal Class II relations, including 1.38 degrees-1.72 degrees reductions in ANB angles and 0.62-0.81 mm reductions in Wits values. SNA values fell by 0.51-1.25 degrees. SNB angle values increased by 0.21 degrees-0.95 degrees. SN-MeGo angles and mandibular angles were reduced, while y-axis values remained essentially unchanged during headgear treatment. Different results were only obtained in the group with the most pronounced horizontal growth pattern. Those patients revealed lower SNB angle values (-0.93 degrees ) and increased vertical relations (y-axis: +1.39 degrees ; SN-MeGo angle: +1.22 degrees; mandibular angle: +0.01 degrees) after headgear treatment. All groups showed a reduction in basal plane angles and maxillary retroinclination after treatment. Our results do not support the conventional recommendation that cervical headgears should not be used in the presence of vertical growth patterns.