Orthopedic Appliances Research Articles

Three-dimensional Analysis of Presurgical Nasoalveolar Molding Outcomes in Patients with Unilateral Cleft Lip and Palate: A Preliminary Study Using LED Surface Scanning Technology.

ObjectivesPresurgical infant orthopedic appliances, such as presurgical nasoalveolar molding (PNAM) devices, are used to attain optimal conditions for primary repair of the lip and nose (PRoLN) in patients with cleft lip. We aimed to analyze the three-dimensional (3D) outcomes of PNAM using an LED surface scanner. MethodsFifteen patients with unilateral cleft lip and palate (CLP) were included in this study and treated using a PNAM device. The patients’ faces were digitized pre- and post-PNAM using an Artec Space Spider scanner, and the scanned data were analyzed using 3D software (Geomagic Control X and ANSYS SpaceClaim). The columellar angle (CA), nostril curvature (NC) on the affected (NC_A) and unaffected (NC_U) sides, gap of cleft lip (GCL), alar width (AW), and nasal tip angle (NTA) were measured. ResultsCA increased significantly by 10.00° and NC_A by 0.030 mm-1 (p<0.001). GCL decreased by 4.98 mm2 on average and NC_U by 0.015 mm-1 (p=0.029 and 0.046, respectively). AW also decreased by approximately 1.22 mm pre- and post-treatment (p=0.002), and NTA, which shows a lateral profile, decreased by approximately 3.32° (p=0.002). ConclusionsThis study confirmed the orthopedic benefits of PNAMd treatment through 3D analysis using an LED surface scanner. Further studies involving a larger number of participants are warranted to study the effects of PNAM and analyze longitudinal changes in patients with CLP. Clinical SignificanceThis study shows that PNAM effectively corrects columellar deviation and nostril shape in patients with unilateral cleft lip, with 3D scanners enhancing primary lip and nose repair outcomes.

Taming the vertical growth of mandible in a growing patient with skeletal open bite: A case report

Skeletal open bite poses a significant challenge due to its association with downward and backward mandibular rotation and vertical maxillary overgrowth. Early intervention is critical, especially in patients with a hyperdivergent skeletal phenotype, as facial growth patterns are established early in development. This case report details the treatment of a 9-year-old male with a severe anterior open bite of 6 mm, vertical growth pattern, and class I skeletal relationship. Initial treatment included high-pull headgear with an intraoral transpalatal arch and tongue cribs to control the molar eruption and tongue posture. Over nine months, this approach reduced the open bite by restricting maxillary molar movement and promoting mandibular autorotation. In the second phase of treatment, temporary anchorage devices (TADs) were placed in the parasagittal region along with a transpalatal arch to achieve active molar intrusion and improve incisor exposure. The combination of orthopedic appliances and TADs successfully eliminated the open bite and corrected overjet, while improving incisor alignment, facial profile, and smile esthetics. Cephalometric analysis revealed a reduction in the mandibular plane angle, lower anterior facial height, and improved incisor extrusion. This case highlights the efficacy of early skeletal open bite correction using non-surgical methods, with TADs providing effective molar intrusion and stable long-term results. The integration of headgear and skeletal anchorage offers an effective treatment modality for young patients with severe open bites, potentially eliminating the need for more invasive surgical procedures in the future.

Contributions of jaw functional orthopedics in temporomandibular joint ankylosis (TMA) – clinical case report

Temporomandibular joint (TMJ) ankylosis is one of the most disabling pathological conditions that can occur in the maxillofacial region, often occurring at an early age, limiting growth and causing facial deformity, which significantly affects the quality of life of the individual. The objective of the study was to evaluate the contribution of Jaw Functional Orthopedics (JFO) in TMJ ankylosis after the surgical phase. The case of a 7-year-old female patient diagnosed with bilateral condylar ankylosis (fibrous ankylosis on the right side and bony ankylosis on the left side) is presented. On clinical examination, facial asymmetry, retrognathia, muscle contraction and opening limitation were observed. Treatment consisted of temporalis muscle flap rotation surgery with condylectomy and coronoidectomy, physical therapy, and functional therapy with OFM. The clinical results at 4 months of follow-up suggest significant progress in oral opening and protrusion. The patient showed a high degree of satisfaction with the results obtained. She is currently continuing with the use of orthopedic appliances to correct the sequelae of ankylosis and improve mandibular kinematics.

Case Study: Facemask Protocol for Growing Patient

This case report describes the orthodontic treatment of a 9-year-old Egyptian male with a Class III incisor relationship and skeletal Class III base, characterized by a -3 mm reverse overjet, 70% reverse overbite, and masticatory difficulties. The patient exhibited full unit Class III molar relationship, unclassified canine relationship, lower and upper crowding, concave profile, acute nasolabial angle, and competent lips. Treatment involved two phases: Phase 1 utilized an orthopaedic appliance (facemask) with banded hyrax and posterior acrylic bite planes, while Phase 2 employed upper and lower fixed pre-adjusted edgewise appliances with MBT prescription and class III elastics. This comprehensive approach aimed to address the malocclusion effectively and achieve improved dental alignment and facial aesthetics.

Unified Denovo Multipurpose Analyzer

Tooth movement is affected by various factors like magnitude, direction, and the duration of the forces applied; the direction of force plays the most pivotal part. Orthopedic appliances have long been used to apply extraoral traction forces to entirely limit or redirect the growth of the maxilla and mandible. Here, we present a very simple and efficient device. The multipurpose analyzer (MPA) is used to locate the center of resistance of maxilla and maxillary dentition, giving a more accurate direction of force vector in facemask and headgear cases. It is also used as chairside device clinically to measure facial heights, nasolabial angle, mentolabial angle, and mandibular plane (MP), as well as to measure cephalometrically MP, Frankfort horizontal (FH)–MP, palatal plane (PP)–MP, occlusal plane (OP), and MP during analysis.

Treatment modalities for management of skeletal and dental Class III malocclusion – A case series

Class III malocclusion is a challenging phenomenon to comprehend. Research done to determine the cause of Class III malocclusion revealed that the deformity affects all aspects of the craniofacial system, not only the jaws. Skeletal and dentoalveolar abnormalities coexist in the majority of patients with Class III malocclusion. Orthognathic surgery, dentoalveolar compensation, and growth modification are the three main therapies available for skeletal Class III malocclusion. Until the pubertal growth spurt, growth modification needs to be started. Thereby, in order to deal with skeletal Class III malocclusion in a grownup, orthognathic surgery collectively with conventional orthodontic therapy will be required in order optimize facial esthetics as well as attain stable occlusion. The objectives of the case series are to highlight different approaches to resolving skeletal Class III malocclusion, which includes orthognathic surgery, orthopedic appliance therapy, and extractions.

Determinated area (DA) treatment goal when treating malocclusions with jaw functional orthopedics (JFO): Contribution to scientific evidence

One of the goals of malocclusion treatment with Jaw Functional Orthopedics (JFO) is to obtain touch of the inferior incisors against the superior incisors in Determinate Area (DA). It is postulated that this touch would bring better stimuli and consequently faster results. Surface electromyographic study of the muscles was performed in Masseter, Temporal and suprahyoid muscles bilaterally from 159 patients undergoing malocclusion treatment with functional orthopedic appliances (FOA). To record muscle electric activity were used a conditioning signal module from Lynx Electronics Ltda with 8 channels, model EMG1000; software AqDAnalysis 4,18 from Lynx Electronics Ltda.; Software Lynx BioInspector 1,8r; passive surface electrodes (Ag/AgCl) from Noraxon Dual Electrodes (USA); dischargeable reference electrodes Kendall Meditrace (Ag/AgCl) – Canada. Frequency calibration was 2000 Hz, with 2048 sample by channel and time 1,024 seconds, and filters regulation was 20 Hz and 1000 Hz. The results found prove that there is a better electromyographic activity (bilaterally balanced) of the studied muscles when there is touch on DA. Conclusion. Touch in DA improves the neuromuscular response of patients treated with JFO. sEMG is a trustable tool to analyze masticatory muscles function for Diagnosis, Treatment and evaluation post treatment/gained objective.

ANALYSIS OF SURFACE QUALITY IN BASE ACRYLIC PLASTIC USING FLAW DETECTION METHOD

Before scanning the surface of the base acrylic plastic, ten samples were selected with a surface that had undergone all stages of finishing according to the proper dental protocol and ten samples that had previously been artificially damaged with scratches using sandpaper. This study addresses the assessment of the quality of removable orthopedic appliances concerning surface polishing and detection of microdefects. The research employs a comparative analysis of reference samples of base plastic and artificially damaged samples using flaw detection analysis. Prior to scanning the surface of the base acrylic plastic, ten samples underwent all stages of finishing according to dental protocol, while another ten samples were intentionally damaged with scratches using sandpaper. The macrophotographs obtained were processed using the "Image J" program, allowing for quantitative analysis of images, enabling the evaluation of surface quality through various parameters. This included evaluating the total number of defects, as well as the average area and perimeter of the defects. Statistical analysis conducted in the JUSP program enabled comparison between the two groups of samples, identifying significant quantitative differences. Based on the prominent indicators available in the Image J program, conclusions were drawn regarding the quality of the acrylic plastic surface and the factors influencing its condition through specific mechanical defects. The proposed method of light-optical flaw detection expands the clinical assessment capabilities of removable orthopedic structures (base plastic), particularly concerning potential bacterial contamination, which can serve as a significant factor in the formation of inflammation foci on the mucous membrane of the denture-supporting oral tissues. Flaw detection analysis enables a comprehensive assessment of material surface polishing quality and the detection of surface defects that may arise during production or use, thus preventing biofilm accumulation. The experiment demonstrated the effectiveness of light-optical flaw detection and highlights the potential for its further improvement and broader implementation in clinical practice.

Enhancing Presurgical Infant Orthopedic Appliances: Characterization, Mechanics, and Biofilm Inhibition of a Novel Chlorhexidine-Halloysite Nanotube-Modified PMMA.

This in vitro study aimed to develop a novel nanocomposite acrylic resin with inherent antimicrobial properties. This study evaluated its effectiveness against microbial biofilm formation, while also assessing its physical and mechanical properties. Polymethylmethacrylate (PMMA) was modified with four different concentrations of chlorhexidine halloysite nanotubes (CHX-HNTs): 1%, 1.5%, 3%, and 4.5 wt.% by weight, along with a control group (0 wt.% CHX-HNTs). The biofilm inhibition ability of the modified CHX-HNTs acrylic against Candida albicans, Staphylococcus aureus, Streptococcus pneumoniae, and Streptococcus agalactiae was assessed using microtiter biofilm test. In addition, ten samples from each group were then tested for flexural strength, surface roughness, and hardness. Statistical analysis was performed using one-way ANOVA and Tukey's test for comparison (P < 0.05). CHX-HNTs effectively reduced the adhesion of Candida albicans and bacteria to the PMMA in a dose-dependent manner. The higher the concentration of CHX-HNTs, the greater the reduction in microbial adhesion, with the highest concentration (4.5 wt.%) showing the most significant effect with inhibition rates ≥98%. The addition of CHX-HNTs at any tested concentration (1%, 1.5%, 3%, and 4.5 wt.%) did not cause any statistically significant difference in the flexural strength, surface roughness, or hardness of the PMMA compared to the control group. The novel integration of CHX-HNT fillers shows promising results as an effective biofilm inhibitor on acrylic appliances. This new approach has the potential to successfully control infectious diseases without negatively affecting the mechanical properties of the acrylic resin. Clinical Relevance. The integration of CHX-HNTs into presurgical infant orthopedic appliances should be thoroughly assessed as a promising preventive measure to mitigate microbial infections. This evaluation holds significant potential for controlling infectious diseases among infants with cleft lip and palate, thereby offering a valuable contribution to their overall well-being.

Innovation in interceptive orthodontics: Digital space maintainers with CAD/CAM and 3D printing: Bibliographic review

Introduction: 3D and CAD/CAM technology has now been widely adopted by most dentists and pediatric orthodontics is no exception. This technology allows orthodontists to create digital dental models, thus facilitating the design and fabrication of orthopedic appliances customized to the specific needs of each patient. Objective: To gather scientific information that describes in detail the management, advantages and disadvantages of using CAD/CAM and 3D technology in the fabrication of space maintainers. Materials and methods: A search was carried out in several databases, including PubMed, Scopus, Springer link, Science Direct and Google Scholar. Fourteen articles that met the inclusion criteria were selected. Results: 10 studies used materials such as polyetheretheretherketone, polymethylmethacrylate and polymer (Trilor), milled to produce space maintainers. Another 3 studies applied titanium powder with addition 3D printing techniques for the same purpose and finally, 1 study used a zirconium block (BruxZir) to manufacture a band by milling. Conclusions: Digital space maintainers (DSM) show comparable results to conventional space maintainers (CSM), with the additional advantage of being more stable and resistant. Although their cost may represent a limitation, further studies and long-term follow-ups are recommended to take advantage of the benefits of technological innovation in the manufacture of space maintainers and improve the quality of patient care.

Testing the effect of functional orthopedic appliance Simões network 6 (SN6) through surface electromyography on rest mandibular position – a pilot study

The maintenance of the lower level of muscle contraction is fundamental for the development and health of the stomatognathic system (SS). Malocclusion leads to unbalance muscle activity, since Class II treatment is not the most prevalent malocclusion in the general population but is the more frequent to search for treatment in dental offices and the most prevalent skeletal component in the class II malocclusion is the retrognathia this pilot investigation aims to study the effect of rest electric activity of bilateral anterior temporal, masseter and suprahyoid muscle in individuals undergoing class II treatment with functional orthopedic appliance Simões Network 6 (SN6). Surface electromyography recordings of bilateral anterior temporal, masseter and suprahyoid muscle in rest position was obtained before and 8 minutes after the functional appliance insertion in mouth. Results showed improvement of electric muscle activity in rest position and balance of bilateral muscle electric activity in all muscle. Based on the preliminary results it can be conclude that jaw functional orthopedics (JFO) provides alteration of the resting records in the mandibular rest position of the studied muscles, indicating relaxation of the muscles studied and a more symmetrical electric activity. Further studies are necessary for a better understanding of the effects of functional orthopedic appliances in the electric activity of stomatognathic muscle in the mandibular rest position.

Presurgical Infant Orthopedic Videos on YouTube™: A Thematic Analysis of Caregiver Narratives.

Information regarding how caregivers cope when using presurgical infant orthopedic (PSIO) appliances is sparse. This study aimed to understand caregivers' perspectives and experiences with contemporary PSIO treatment. PSIO videos shared on the YouTube™ platform were used as the data source. Videos with caregivers were identified (n = 21) and portions with caregiver narratives were transcribed. This was followed by the application of a six-step thematic analysis as conceptualized by Braun and Clarke (2006, 2019). Two themes were identified from the caregiver narratives in the PSIO videos. The Family Journey theme included reaction to diagnosis, choice of center, burden of care, care commitment, coping, and testimonials. The Information theme included PSIO techniques and PSIO benefits. Multifaceted challenges and coping strategies were described by caregivers during the PSIO phase. Caregivers remained committed to treatment despite the burden of care, were motivated by an understanding of the benefits of PSIO, and customized care based on their individual strengths and needs. Study results can help providers gain an understanding of what caregivers experience outside the clinical environment.

Checking the manufacturing of Simões Network 10 – SN10 through surface electromyography (sEMG) – Case report Study

Use of functional orthopedic appliances (FOA) in the treatment of malocclusion and Temporomandibular Disorders (TMD) has been proved to be effective but there is still questions to be answered like the muscular action of the referred appliances. The aim of this study is checking through a proven protocol of surface electromyography (sEMG) to study muscular action of FOA to check to check if it is correctly manufactured. The appliance studied is a Simões Network 10 – SN10 to treat Class II malocclusion of retrognathia. The sEMG was collected 1 patients with class II malocclusion with retrognathia who belong to a 164 volunteers with malocclusion, in two times T1 before installation of the FOA in mouth, T2 15 minutes after the FOA installation in the mouth. sEMG data of bilateral masseter, bilateral temporal and bilateral suprahyoid muscles using conditioner signals module from Lynx Electronics Ltda with 8 channels, model EMG1000; software AqDAnalysis 4,18 from Lynx Electronics Ltda.; Software Lynx BioInspector 1,8r; passive surface electrodes (Ag/AgCl) from Noraxon Dual Electrodes (USA); dischargeable reference electrodes Kendall Meditrace (Ag/AgCl) – Canada were used for the sEMG measurements. Frequency calibration was 2000 Hz, with 2048 sample by channel and time 1,024 seconds, and filters regulation was 20 Hz and 1000 Hz. With the FOA in the mouth all measurements improved with a more simetrical sEMG in T2 in rest and isometric contraction measurements. The protocol used to check the manufacturing of functional orthopedic appliances using surface EMG proved to be a valid tool in this case report study. Further investigations are needed to confirm this protocol and check if the same happens with other types of functional orthopedics appliances.

Case report – mesioclusion treated with Bimler C períod of 12 months

This study aims to present a clinical case and assess the efficacy of the Bimler C Elastic Modeler, a functional orthopedic appliance, in the early treatment of a patient diagnosed with mesiocclusion (mandibular prognathism) based on Bimler and McNamara Cephalometrics. Additionally, we aim to delineate the observed positive changes in facial expression during the course of treatment with this functional orthopedic appliance. The female patient, aged six years and nine months, manifested atypical swallowing, respiratory challenges, and allergic conditions such as rhinitis. Comprehensive examination further revealed facial asymmetry and a smile with lip asymmetry. Intra-oral examination exposed a rightward deviation of the mandible, crossbite, open bite, and mesiocclusion. The proposed intervention encompassed the application of the Bimler Elastic Modeler (BEM) functional orthopedic appliance. The documented treatment duration spanned 12 months, with ongoing monitoring every 2 or 3 months. The treatment, utilizing the BEM functional orthopedic appliance, coupled with exercises and adjustments, improved mandibular and tongue posture, enhancing overall chewing balance. The appliance effectively repositioned the mandible to a more balanced position approaching normocclusion, achieving this without causing pain or discomfort and without the necessity for elastic or constant forces. Given the crucial role of facial expression muscles in these activities, a pronounced enhancement in facial harmony was observed. These affirmative outcomes significantly contributed to heightened patient engagement throughout the treatment process and a concomitant enhancement in patient self-esteem, attributable to the documented aesthetic and functional ameliorations.

Case report – distoclusion treated with Bimler A períod of 12 months

The Bimler type A utilizes forces derived from muscles, particularly the tongue, concomitantly, it acts as a systemic, dynamic and functional treatment, Bimler appliances transmit neural excitation throughout the system. The objective of this study was to present a clinical case and demonstrate the efficacy of the functional orthopedic appliance, specifically the Bimler A elastic modeler, in the treatment of a patient diagnosed with distoclusion (prognathism of the maxilla and retrognathism of the mandible) according to Bimler and McNamara cephalometry. The case involved a 9-year and 11-month-old male patient with atypical swallowing, respiratory issues, and allergic conditions such as asthma. Clinical examination and complementary tests revealed a large overjet, a narrow maxilla and mandible, an open bite, and distoclusion (retrognathism). The proposed intervention included the installation of the Bimler Elastic Modeler (BEM), type A. The treatment duration was 12 months, with ongoing monitoring every 2 or 3 months. The comprehensive approach, combining BEM type A, chewing exercises, and occlusal adjustments, resulted in orthopedic changes improved mandibular, tongue, lip, and head posture, as well as enhanced chewing balance. Importantly, the appliance effectively repositioned the mandible into a more balanced, normoccluded position without the need for elastic or constant forces. Beyond the orthodontic changes, the active engagement of facial expression muscles during these activities contributed to an overall improvement in facial harmony, achieving lip seal and notable enhancements in breathing. These positive changes extended to the patient’s daily activities and sports performance. The observed outcomes not only increased the child’s active participation in the treatment but also positively impacted self-esteem, driven by the aesthetic, functional, and psychological improvements experienced.

Role of the Growth Hormone Receptor (GHR) Gene in Skeletal Class II Malocclusion and Its Significant Influence on the Skeletal Facial Profile in Both the Sagittal and Vertical Dimensions: A Systematic Review.

This systematic review aims to determine the role of the growth hormone receptor (GHR) gene in skeletal malocclusion and its significant influence on the growth of the maxilla and the mandible in both sagittal and vertical dimensions. A search of the electronic databases of PubMed, Google Scholar, and Cochrane up to and including the year 2023 was made. In addition to this, a hand search of orthodontic and dentofacial orthopaedic journals was carried out. This search included randomized control trials. The Mesh terms used were "skeletal class II malocclusion", "mandibular retrognathism", "sagittal malocclusion", "genetic expression", "genetic factors", "genetic study", "genetic polymorphism", and "single nucleotide polymorphism". The inclusion criteria included studies such as clinical trials and orthopaedic appliances in the presurgical phase. The exclusion criteria for the study were studies not in the English language, case reports, case series, and studies with irrelevant data. It has been cited in various literature that polymorphic variations of the GHR gene could cause variations in mandibular morphogenesis affecting both the mandibular body length and ramal height. However, its effects are quite variable and are based on different population groups. Polymorphism of the GHR gene can be considered a reliable indicator predicting variations in affecting the growth of the mandible with greater significance in affecting the vertical ramal height compared to the body length of the mandible. Its effects on the maxillary skeletal base are rather limited comparatively.

Enhanced antimicrobial efficacy of chlorhexidine-encapsulated halloysite nanotubes incorporated in presurgical orthopedic appliances: an in vitro, controlled study.

Presurgical infant's orthopedic appliances (PSIOs) play an increasingly crucial role in the interdisciplinary management of neonatal CLP, aiming to improve and maintain adequate nasolabial aesthetics, followed by primary lip/nasal surgery in both unilateral and bilateral CLP cases. The use of PSIOs in cleft lip and palate patients can lead to contamination with oral microflora, acting as a potential reservoir for infectious microorganisms. Acrylic surfaces might provide retention niches for microorganisms to adhere, and inhabit, which is difficult to control in immunocompromised patients, thus predisposing them to increased infection risks. The objective of this multi-assay in vitro study was to investigate the effects of incorporating chlorhexidine-loaded halloysite nanotubes (CHX-HNTs) fillers on the morphological, cytotoxic, release, and antimicrobial characteristics of self-cured acrylic polymethyl methacrylate (PMMA) material used in pre-surgical orthopedic appliances. Disk-shaped PMMA specimens were prepared with varying proportions of CHX-HNTs. A control group without any addition served as a reference, and four experimental samples contained a range of different concentrations of CHX-HNTs (1.0, 1.5, 3, and 4.5 wt%). The antimicrobial efficacy was assessed using an agar diffusion test against common reference microorganisms: Candida albicans, Staphylococcus aureus, Streptococcus pneumoniae, and Streptococcus agalactiae. Cytotoxicity was examined using the L929 cell line (mouse fibroblasts) through a (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide, MTT) cell viability assay. The release kinetics of CHX were monitored using UV-spectral measurements. The statistical analysis used a one-way ANOVA followed by Tukey's post hoc test. The integration of CHX-HNTs in PMMA exhibited a substantial dose-dependent antifungal and antibacterial effect against microorganisms at tested mass fractions (1.0 to 4.5 wt%). CHX release was sustained for up to 60 days, supporting prolonged antimicrobial activity. Furthermore, no significant cytotoxicity was determined in the L929 fibroblast cell line (control), indicating the biocompatibility of the CHX-HNTs-enhanced PMMA. Incorporating CHX-HNTs in PMMA successfully enhanced its antimicrobial properties, providing sustained CHX release and superior antimicrobial efficacy. These findings demonstrate the potential of antimicrobial nanoparticles in dental therapies to improve therapeutic outcomes. However, rigorous further clinical trials and observational studies are warranted to validate the practical application, safety, and efficacy. This study has the potential to make a major impact on the health of infants born with cleft lip and palate by helping to reduce the prevalence of infectious illnesses. The incorporation of CHX-HNTs into PMMA-based appliances is a novel promising preventive approach to reduce microbial infections.

Class III malocclusion: Insights and current perspectives

Class III malocclusion is a complex orthodontic challenge characterized by the lower front teeth being positioned ahead of the upper front teeth, often resulting in functional and social difficulties. This review explores the etiology, classification, diagnosis, and treatment options for Class III malocclusion, emphasizing the genetic inheritance and skeletal growth patterns that influence its manifestation. Orthopedic appliances and orthognathic surgery are key treatment approaches, with early intervention favored to optimize outcomes. This article also discusses the role of temporary anchorage devices in treatment, retention protocols, and the importance of long-term follow-up to ensure stability and patient satisfaction. Advances in orthodontic technology and ongoing research into the genetic basis of Class III malocclusion promise continued improvements in treatment strategies, offering more predictable and patient-centered care.

Speech therapy in adaptation of dentomaxillary and functional orthopedic appliances

The mouth, along with the throat, nostrils and facial spaces, acts as an amplifier and shaper of sounds, while the lips, teeth and tongue are essential in the formation of vowels. Oral structure and dental or orthodontic problems can influence the way we speak. A recent study focused on dentists' perception of the usefulness of speech therapy during the adaptation of dentomaxillary and functional orthopedics, with the aim of laying the foundation for a doctoral thesis. A cross-sectional study was conducted using a validated questionnaire, administered through Google Forms. The sample consisted of 47 dentists, including teachers and students of orthodontics and pediatric dentistry at the San Gregorio de Portoviejo University, selected for their experience in dentomaxillary orthopedics in pediatric patients. The results revealed that 85% of professionals observed changes in speech when adapting devices, and 93% considered the creation of a guide to assist patients with speech irregularities after adapting these devices crucial. This study provides a foundation for future research on the impact of braces on speech function

Diagnosis, etiology, and management strategies of open bite malocclusions

Open bite malocclusion is a condition where the upper and lower incisors do not overlap vertically. It involves factors like structure, dental issues and functional challenges. This review offers an overview of diagnosing, understanding the causes and managing bite malocclusions. The condition is noticeable by the gap between incisors, difficulties in biting and speech and habits like tongue thrusting. In children thumb sucking is often associated with this issue underscoring the importance of intervention. Diagnosis relies on assessments, cephalometric analysis and categorization based on dental or skeletal elements. The causes can be attributed to factors, environmental influences or behavioral habits. Various management strategies are available with treatments playing a role using methods like fixed appliances clear aligners, and innovative temporary anchorage devices (TADs). Surgical interventions such as surgery address discrepancies when necessary. Considering that open bites are age conditions, behavioral modifications along with intervention using orthopedic appliances are crucial for effective treatment. Advanced diagnostic tools like cone beam computed tomography (CBCT) contribute to treatment planning. The retention phase ensures stability of results while patient cooperation remains essential throughout the process. Collaboration between orthodontist’s maxillofacial surgeons and other specialists is vital for care. The field of orthodontics is continuously advancing and with research we can expect improvements in our understanding and treatment of open bite malocclusions.