Palatal Width Research Articles

Morphometric analysis of the hard palate using cone beam computed tomography in a Saudi population

Background and objectivesAnalyzing the anatomical and morphometric information of the hard palate is crucial in prosthodontics, orthodontics, maxillofacial surgery, implant dentistry, and forensic anthropology. No data exist in the literature regarding the morphometric analysis of the hard palate using 3D imaging techniques in Saudi Arabia. Therefore, this study aimed to evaluate the dimensions and types of hard palates using 3D geometric morphometrics and the existence of gender-related differences in a selected Saudi population. Material and methodsThis cross-sectional study was performed by radiological evaluation of arbitrarily collected Cone Beam computed Tomography (CBCT) images includes 130 male and 45 female individuals from our department’s archives, radiology department, Dental Hospital, Qassim University. The Galileos® Comfort Plus System (Sirona 3D, Germany) was used to obtain the CBCT images while standardizing the parameters. Images were linearly measured using Galileos software. Measurements of palatal length, palatal breadth, and palatal height, as well as the calculation of the palatine index and palatal height index, were noted and statistically analyzed. ResultsThe mean palatal length, breadth, height, palatine index, and height index were 48.8 ± 3.9 mm, 36.2 ± 3.8 mm, 11.6 ± 2.4 mm, 74.7 ± 8.9, and 32.4 ± 7.1, respectively. The mean palatal length, breadth, and height were greater in men than in women. The majority of the palatine index values corresponded to leptostaphyline (76.6%), followed by mesostaphylline (12%) and brachystaphylline (11.4%), distribution among males and females were not statistical significance (p > 0.05). Palatal height index analysis revealed that the majority were orthostaphyline (59.4%), followed by chamestaphyline (26.3%), and hypsistaphyline (14.3%) these distributions were not significant statistically among males and females(p > 0.05). ConclusionThe palatine index and palatine height index are useful in prosthodontics, orthodontics, and forensic anthropology for identifying races on the basis of the skull.

Age-dependent effects on palate volume and morphology during orthodontic RME treatment

ObjectivesRapid maxillary expansion (RME) shows different age-dependent effects. It has been shown that RME leads to a parallel expansion prior to the age of 10, while later and especially from the age of 12, a V-shaped expansion happens (transverse, anterior > posterior; horizontal, inferior > superior). However, it is not clear to what extent these effects influence palatal volume and morphology and eventually maxillary functional space. The aim of the present study was to examine possible age-related effects of treatment with a dental anchored RME appliance upon volume and width/height ratio of the anterior and posterior palate.Materials and methodsSixty children and adolescents with documented treatment histories after RME were divided into three equal groups according to age at treatment begin (PG 1, < 10 years, n=20; PG 2, 10 ≤ 12 years, n=20; PG 3, > 12 years, n=20). Maxillary dental casts before and after therapy were digitised. Changes in palatal volume were determined using 3D analyses.ResultsIn all patients, the palatal volume increases significantly after RME. Older patients experienced smaller increases in total and posterior volume in absolute and percentage terms. The anterior palate volume increases are almost equal in all patients. Since palatal width increases more markedly than palatal height, the width/height ratio always increases. Except for the posterior region in PG 3, its increase is significant in all groups, both anteriorly and posteriorly. After successful RME, the palatal morphology appears normal anteriorly in PG 1, PG 2 and PG 3 and rather steep posteriorly in PG 3.ConclusionsRME treatment with identical force application causes different, age-dependent effects upon palate volume and morphology. Width changes have a greater influence on palate volume than height changes.Clinical relevanceIt is preferable to use an RME prior to the age of 10 if homogeneous changes of the anterior and posterior palate regarding maxillary symmetry and functional space are desired.

Correlation between cleft width and dental arch symmetry in cleft lip and palate: a longitudinal study.

This study aimed to evaluate the influence of cleft width on dental arch symmetry of children with unilateral cleft lip and palate. Forty-one children were subjected to impression preoperatively (T1; mean age = 0.31 ± 0.07 years) and postoperatively (T2; mean age = 6 .73 ± 1.02 years). Eighty-two digitized dental casts were analyzed by stereophotogrammetry software. The cleft palate width was measured in the anterior (P-P'), middle (M-M'), and posterior (U-U') regions. Also, the following measurements were obtained: anterior intersegment (I-C') and intrasegment (I-C); total intersegment (I-T') and intrasegment (I-T); cleft-side (C'-T') and non-cleft-side (C-T) canine tuberosity. Paired t test and Pearson correlation coefficient were applied (α = 5%). Cleft width had the following means: 10.16 (± 3.46) mm for P-P', 12.45 (± 3.00) mm for M-M', and 12.57 (± 2.71) mm for U-U'. In the longitudinal analysis, I-C' had a significant reduction, while the other measurements significantly increased (p < 0.001). Asymmetry was verified in the following analyses at T1: I-C' vs. I-C and I-T' vs. I-T (p < 0.001); at T2, only in I-C' vs. I-C (p < 0.001). At T1, P-P' vs. I-C' (r = 0.722 and p < 0.001), P-P' vs. I-T' (r = 0.593 and p < 0.001), M-M' vs. I-C' (r = 0.620 and p < 0.001), and M-M' vs. I-T' (r = 0.327 and p < 0.05) showed a positive and significant correlation. At T2, there was a correlation between M-M' and I-C' (r = 0.377 and p < 0.05). In conclusion, the anterior and middle cleft widths influenced palatal asymmetry in the first months of life, while middle width influenced residual asymmetry.

The relationship between morphological changes and oral function before and after slow palate expansion

ABSTRACT Purpose Recent reports indicate that Japanese children have narrow dental arches with weakening oral functions. Therefore, this study investigated the relationship between palatal morphology and oral function after expansion treatment with a slow, removable expansion appliance. Materials and Methods We evaluated changes in the deep, middle, and shallow palatal widths of 22 children with narrow dental arches who visited our hospital. We also assessed the tongue raising force, maximum occlusal force, lip closure force, and masticatory movement patterns, representing the oral function. Changes in the hyoid and resting tongue position before and after treatment were also evaluated using lateral cephalometric radiographs. Finally, the patients were divided into two groups based on the expansion frequency (once every two weeks or once per week) for measurement comparisons. Results We found that the amount of expansion at the deep width of the palate was half that at the shallow width. Furthermore, the maximum occlusal force and tongue raising forces improved after the treatment. Additionally, multiple regression analysis indicated that the resting tongue position and maximum occlusal force before the expansion treatment were significantly associated with the amount of palate expansion. Conclusions Slow plate expand can expansion the basal palate. Moreover, oral function improves after expansion therapy.

Comparison of Dimensions of the Palate Between Individuals With and Without Nasal Septum Deviation on Cone-Beam Computed Tomography Images in an Iranian Population

Background: Nasal septum deviation might disrupt the integrity of nasal septum components, resulting in deformity. Such changes might affect the morphology of adjacent structures. The aim of the present study was to evaluate the dimensions of the palate in subjects with and without nasal septum deviation on cone-beam computed tomography (CBCT) images in an Iranian population. Methods: In the present cross-sectional study, the CBCT images of subjects with and without nasal septum deviation were evaluated in two groups (n=107) referred to the Department of Oral and Maxillofacial Radiology, Tabriz Faculty of Dentistry in 2017. The presence or absence of nasal septum deviation and its severity were evaluated in association with palatal dimensions. Data were analyzed by SPSS. Independent samples t test was used to compare the dimensions of the palate. Finally, the Mann-Whitney U test was employed to compare palatal arch depth (PAD)/palatal interalveolar length (PIL) ratios. Results: There were no significant differences between the two groups in terms of the palatal depth (P=0.967), palatal width (P=0.223), and palatal depth/palatal width ratio (P=0.644). However, the results demonstrated significant differences in palatal depth (P&lt;0.001) and palatal width (P=0.05) between male and female subjects. Conclusions: Overall, no significant differences were observed in the dimensions of the palate (depth and width) and their ratios between subjects with and without nasal septum deviation, although greater palatal dimensions (depth and width) were detected in males compared to females.

Dimensional changes of upper airway after slow vs rapid miniscrew-supported maxillary expansion in adolescents: a cone-beam computed tomography study

BackgroundTo date, the effects of different activation rates of miniscrew-supported expanders on the airway have not been compared. Hence, the purpose of this retrospective study was to evaluate and compare the effects of slow and rapid miniscrew-supported maxillary expansion on the upper airway dimensions using cone-beam computed tomography (CBCT).MethodsData of 20 patients (Age 12 to 16 years old) treated using miniscrew-supported expanders at the Faculty of Dentistry, Alexandria University was collected. The patients were equally divided into two groups according to the activation protocol; slow maxillary expansion (SME): activation once every other day, and rapid maxillary expansion (RME): activation twice daily. CBCT scans obtained pre-expansion and 5 months post-expansion were used to evaluate the changes in the upper airway dimensions. Comparisons between the two time points within each group were done using paired samples t-test. SME and RME groups were compared using independent samples t-test. Significance level was set at p < 0.05.ResultsBoth groups showed a significant increase in anterior, middle, and posterior nasal cavity width. SME resulted in significantly greater increase of the anterior nasal cavity width than RME (Mean difference between the groups, 2.64 mm; 95% CI, 0.83, 4.45; p = 0.007). The dimensions of the retropalatal and retroglossal airways did not change significantly in either group. Both groups resulted in a significant increase of maxillary width, palatal width, and inter-molar width. RME showed a significantly larger increase of inter-molar width than SME (Mean difference between the groups, − 2.44 mm; 95% CI, − 3.88, − 1.00; p = 0.002).ConclusionsThe use of either a slow or rapid activation protocol is effective in expanding the nasomaxillary complex, with greater expansion achieved in the anterior section of the nasal cavity using the slow rate. However, the expander design employed in the current study does not affect the dimensions of the retropalatal or retroglossal airways.

Dermal Matrix Graft Effects on Facial Growth in a Veau-Wardill-Kilner Palatoplasty Model: An Experimental Study in Rats.

The primary goal of palatoplasty is the restoration of normal speech, that can be aimed by, among many procedures, lengthening the palate through the pushback technique; one of its complications is abnormal maxillary growth. The main factor affecting facial growth in CLP patients is believed by many to be the palatoplasty—due to the large scar retraction resulting from some surgical techniques. The non-crosslinked two-layer bioabsorbable collagen matrix Mucograft™ (Geistlich Pharma AG, Wolhusen, Switzerland) is a potential tool to aid in wound closure in a second-intention healing situation. The objective of this work was to test the use of an acellular dermal matrix (Mucograft®) in an experimental model of Veau–Wardill–Kilner palatoplasty, as a tool to reduce scar retraction of the denuded palatine mucosa. Twenty-four 3-week-old male Wistar rats were used. The animals were randomly divided into two groups. In the control group, an excision was made with bone exposure in the palate, simulating the defect left in the Veau–Wardill–Kilner palatoplasty. In the intervention group, the same procedure was performed, and the area of denuded palatine bone was treated with a bioabsorbable collagen matrix (Mucograft®). For data collection, 9 weeks after surgery (12 weeks of life), the animals were euthanized by excessive anesthetic dosage. Maxillary growth, macroscopic appearance of the scar, pain, and bleeding were evaluated. There were significant statistical differences between the groups for palate length growth (7.6 mm + −0.38 mm vs 5.5 mm + −0.36 mm, P = .009) and for palate width growth (1.47 mm + −0.8 mm vs −0.09 mm + −0.55 mm, P = .001), favoring dermal matrix group compared to controls. Whereas for pain and bleeding, there were no differences between the groups. The use of dermal matrix in rats with an area of bone denudation on the palate increases maxillary length and width growth patterns. Besides, it does not increase pain, bleeding, or post-operative complications.

Early Cleft Palate Repair by a Modified Technique Without Relaxing Incisions.

This study sought to evaluate a modified palatoplasty technique (MPT) concerning the postoperative outcomes and associated influencing factors. A retrospective cohort study. One hundred forty-three consecutive patients with non-syndromic cleft palate, who received MPT before one year of age within an oral and maxillofacial surgery department of a university-affiliated tertiary hospital between 2011-2017, were reviewed. The postoperative wound healing and velopharyngeal function (VPF) were the primary outcome measures. The sex, age at surgery, cleft type, cleft width, palatal width, soft palate length, pharyngeal cavity depth, and operation duration were preselected as influencing factors. Univariate and multivariate analyses were conducted. The mean age at surgery was 9 ± 1.31 months (5-11), and the average cleft width was 9.03 ± 2.41 mm (4-15). The rate of incomplete cleft palate was 84.6% while the complete cleft palate was 15.4%. Complete wound healing was reported in 96.5% while the others (3.5%) had persistent oronasal fistula. About 90.2% of cases have shown normal velopharyngeal function whereas the others (9.8%) had sustained velopharyngeal insufficiency. The wound healing appeared to be significantly impacted by cleft width and pharyngeal cavity depth (P = .015 and 0.049, respectively). However, none of the factors had a significant association with VPF. The present modified palatoplasty technique has obtained a low fistula rate and appropriate speech outcome. Therefore, this MPT could be promoted for early repairing cleft palate of different severities.

Relationship between cleft palate width and otitis media.

To investigate the relationship between cleft width and otitis media (OM) and to determine whether a wide cleft palate (CP) is a risk factor of the incidence, type, amount of middle ear effusion, and prolonged morbidity in OM. Retrospective cohort study. Children with CP who underwent palatoplasty between 2014 and 2018 were analyzed. Cleft width was measured at palatoplasty. The incidence of otitis media with effusion (OME) and acute otitis media (AOM), the type and amount of middle ear effusion, and OME duration and age at resolution were assessed in relation to cleft width. One hundred eighteen children were included. The CP types were Veau I in 16, II in 35, III in 48, and IV in 19 patients. The incidence of OME and AOM before palatoplasty was 83.1% and 49.2%, respectively. Cleft width did not differ significantly between patients with or without OME but was significantly greater in those with, than in those without, AOM (p < .001), in those with mucoid, than in those with serous, effusion (p=.012), and in those with complete, than in those with partial, effusion (p=.01). Regardless of cleft width or type, OME persisted for a median duration of 50 months. Cleft width was significantly associated with the incidence of AOM and the type and amount of middle ear effusion before palatoplasty. However, it was not significantly related to the incidence, age at resolution, or duration of OME. Regardless of cleft width or type, OM in children with CP requires long-term follow-up. Level of Evidence: 2b.

Morphometric analysis of the skull of Hamdani sheep via Three-Dimensional modelling.

The aim of the present study was to determine the craniometric characteristics of the crania of Hamdani sheep, one of local breeds of Turkey, by using computed tomography (CT). In the study, 13 (six female and seven male) skulls were used. After CT images of the skulls were taken, their three-dimensional models were created by MIMICS 20.1 (The Materialise Group, Leuven, Belgium) program. Thirty-eight craniometric measurements were taken over the models created and nine indices were calculated by using these measurements. All the characteristics examined were expressed as mean ± SE. In the study, statistically significant differences were found between females and males in terms of greatest neurocranium breadth, facial breadth, greatest palatal breadth (p < 0.05) and height of the foramen magnum (p < 0.01) parameters. No statistically significant difference was observed between the sexes in the calculated index values (p > 0.05). In conclusion, it is thought that the findings obtained from the study will contribute to the zooarchaeology and sheep taxonomy of Mesopotamian region.

Growth of the hard palate between the ages of 6 and 10 years: A longitudinal study

Several studies have found that the shape of the palate can affect articulation of speech sounds, but not much information is available characterizing the three-dimensional shape of the palate. This is especially important in children, since their speech is maturing at the same time that the palate is still growing. This study examines the longitudinal growth of the palate from 8 children between the ages of 6 and 10 years, based on high-resolution three-dimensional digitized palate impressions. Measures of palate width, height, depth, and symmetry were derived from three anatomically defined points: the marginal gingiva between the front teeth, and between the second premolar and the first molar on both sides. While palate height was most difficult to measure accurately, it was also most highly correlated with age (R2 = .42, p&amp;lt;.001), while palate depth, width, and symmetry were poorly correlated with age (R2&amp;lt;.07, p&amp;gt;.17). Age and standing height were strongly correlated (R2 = .77, p&amp;lt;.001). At the individual level, palate height appeared to grow linearly with age, while the growth of palate width and depth was nonlinear and even non-monotonic, indicating a complex interaction between growth and the ongoing structural rearrangement of dentition in this age group. [Work supported, in part, by the NSF.]

Obstructive Sleep Apnea in a 2-Year-Old Down Syndrome Child: Successful Management With Adenotonsillectomy Followed by Rapid Maxillary Expansion Treatment

Due to glossal and craniofacial skeletal abnormalities, children with Down syndrome (DS) are prone to obstructive sleep apnea (OSA), thus demanding an increased necessity for an earlier diagnosis and more strict control for OSA. Adenotonsillectomy (T&amp;A op) is an effective surgical treatment method to reduce OSA in children. Nevertheless, it should be noted that T&amp;A op in DS children might be insufficient to completely resolve OSA and that extra care is needed when performing a T&amp;A op for airway obstruction in DS during the immediate postoperative period. The objective of the present study was to report a case of a 2-year-old male DS patient with severe OSA (apnea-hypopnea index [AHI] of 61.7/hr) which was consequently reduced to moderate OSA (AHI of 7.6/hr), followed by reduction to mild OSA (AHI of 4.8/hr) with an one-year of rapid maxillary expansion (RME) device application. With a 2-year application of the RME device, the hard palate width in the 1st and 2nd molar region was increased to 5.86 mm and 5.26 mm, respectively. This is the first case report describing that a severe OSA is reduced to moderate OSA with T&amp;A op and further reduced to mild OSA with an RME device application.

Cone-beam computed tomography assessment of maxillary anterior alveolar bone remodelling in extraction and non-extraction orthodontic cases using stable extra-alveolar reference.

To explore alveolar cortical positional change in response to tooth movement in extraction and non-extraction orthodontic cases, using cone-beam computed tomography (CBCT) and stable extra-alveolar references. The pre-treatment (T1) and post-treatment (T2) CBCT scans of 25 extraction (EXT) and matched 25 non-extraction (Non-EXT) orthodontic cases were imported into Dolphin Imaging 3D, and oriented uniformly. Sagittal and axial CBCT cross-sections were traced using customized software-generated guides. The displacement of teeth and alveolar bone cortices were automatically measured using the palatal plane (PP) and the line perpendicular to PP and passing Sella as reference. Intra- and inter-group differences between T1 and T2 were analysed. Subjects were also superimposed three-dimensionally using Geomagic Control X for qualitative analysis of cortical remodelling. The EXT group showed incisor retraction, while the Non-EXT group exhibited statistically significant incisor anterior tipping (P < .05). In EXT, both the labial and palatal cortices are resorbed. Non-EXT showed labial cortex anterior modelling, and statistically significant palatal cortex resorption (P < .05). In both groups, statistically significant decrease in total and palatal alveolar widths, increase in labial widths, and palatal dehiscence were observed. Comparatively, EXT showed significantly more incisal total and palatal width decrease and palatal vertical bone loss. Labial cortical remodelling was shown to follow anterior tooth movement, but the palatal cortical response to incisor retraction and labial cortical remodelling in general remained inconclusive. Narrowing of the alveolar housing and palatal dehiscence were observed regardless of extraction following orthodontic treatment.

The Sommerlad-Furlow Modified Palatoplasty Technique: Postoperative Complications and Implicating Factors.

To explore the incidence of postoperative complications and investigate the impact of preselected factors on functional and quality of life outcomes following the Sommerlad-Furlow modified palatoplasty technique. Retrospective cohort. A total of 429 patients with cleft palate, who received Sommerlad-Furlow modified technique between 2011-2017 were enrolled. The postoperative complications including oronasal fistula (ONF), velopharyngeal insufficiency (VPI), and inadequate quality of life (QOL) were collected. Data of preselected factors including gender, age at palatoplasty, cleft type, cleft width, palatal width, pharyngeal cavity depth, and operation duration were also collected. Among 429 patients, 40.1% were males whereas 59.9% were females. The mean age at palatoplasty was 1.23 ± 0.69 (0.42-4) years, and the average cleft width was 10.15 ± 2.95 (4-27) mm. The cleft types had recorded rates of about 6.8%, 69.5%, 17.7%, and 6.1% of Veau I, II, III, and IV, respectively. The overall incidence rates of ONF, VPI, and inadequate QOL were 2.3%, 19.4%, and 31.3%, respectively. In both the univariate and multivariate analyses, the cleft type was significantly implicated in ONF formation (p= 0.023 and 0.032, respectively) whereas the velopharyngeal function was impacted by the palatoplasty age (p˂0.001). The receiver operating characteristic curve indicated that age of palatoplasty ≥1.3 years (area under the curve=0.611, p= 0.002) was the cutoff value for predicting the incidence of VPI. The Sommerlad-Furlow modified technique appears to have appropriate postoperative outcomes, even in the wide cleft palate. The older age at palatoplasty has a major impact on the overall postoperative outcomes. 4 Laryngoscope, 133:822-829, 2023.

Evaluation of rapid versus slow maxillary expansion in early adolescent patients with skeletal maxillary constriction using cone-beam computed tomography: A short-term follow-up randomized controlled trial.

Maxillary expansion is one of the treatment options for the correction of the skeletal constriction of the upper jaw. However, evidence regarding the best treatment effects with the use of rapid vs. slow maxillary expansion in the early adolescence period (i.e., between the age of 12 and 16 years) is still lacking in the available literature. The aim of the present study was to investigate the effectiveness of rapid and slow maxillary expansion in treating posterior skeletal constriction, and to compare the 2 techniques in terms of skeletal and dentoalveolar changes by using cone-beam computed tomography (CBCT). The sample consisted of 34 patients (15 males and 19 females) suffering from posterior skeletal constriction. They were randomly allocated either to the rapid maxillary expansion (RME) group (17 patients aged 13.76 ±0.32 years) or to the slow maxillary expansion (SME) group (17 patients aged 14.02 ±0.28 years). The skeletal and dental landmarks, and changes in the posterior dimensions were examined using CBCT radiographs at the beginning of treatment (T1) and at the end of the observation period (T2). There were no significant differences between the 2 groups in terms of skeletal and dental changes except the amount of change in the inter-premolar width at the root apex, which was greater in the SME group (p = 0.007), as well as the amount of change in the skeletal palatal width in the molar region, which was also greater in the SME group (p = 0.008). Both maxillary expansion protocols were effective in treating posterior skeletal constriction. The average changes in the skeletal and dental widths were generally similar in both groups. Therefore, SME can be considered as an alternative to RME in patients with skeletal maxillary constriction in the early adolescence period.

Correlations of palatal surface area with anthropometric dimensions of the head and face

PurposeSaliva distribution over the palatal surface plays an important role in the perception of dry mouth. It is envisaged that non-invasive estimation of the palatal surface area by anthropometric measurements of the head and face can be useful in the assessment of oral dryness. For this purpose, the relationship between the palatal surface area and anthropometric measurements of the head and face was investigated.MethodsThe palatal surface was measured in 51 healthy volunteers using an intra-oral scanner. The distances between anthropometric landmarks of the head and face were determined using an anatomical sliding caliper. Correlations between the palatal surface area and the anthropometric landmarks were investigated.ResultsThe median palatal surface area for the total study population was found to be 2120.6 mm2. Virtually, all anthropometric measurements showed significant differences between females and males. Various head and face measurements had a significant correlation with the palatal surface area. However, these correlations disappeared when the participants were stratified based on their sex, with the exception of mandibular length and palatal width in females.ConclusionThe surface area of the palate correlates with nearly all anthropometric measurements of the head and face included in this study. Yet, the clinical applicability seems limited to females.

A Study on Various Sizes and Volumes of the Palate among the Korean Population in Mixed Dentition

The purpose of this study was to compare the palatal dimensions (volume, width, length, and height) in different malocclusions (Class I, II, and III) in mixed dentition using a three-dimensional digital scanner. The study was performed on 30 selected casts from 1400 casts that were taken at the Department of Pediatric Dentistry at Dankook University. Casts consisted of Class I, II, and III malocclusion groups in Hellman’s dental age IIIA. The mean age was 8 years and 6 months ± 11 months. Each cast was scanned by three-dimensional digital scanner, Medit T710 (Medit, Seoul, Korea), and shaped into the three-dimensional image and calculated palatal dimensions using the Plan T program (SMD solution, Seoul, Korea). The values were statistically compared and evaluated by Kruskal-Wallis followed by the Mann-Whitney test. According to our results, subjects with Class II malocclusion showed lower palatal width and longer palatal length compared to those with Class I and Class III. For palatal height, Class III malocclusion subjects in mixed dentition exhibited a larger number than Class II and Class I. Lastly, for palatal volume, compared to other malocclusions, Class III showed higher results; however, there were no significant differences. The form of the palate differs in types of malocclusions and understanding of these differences is important in clinical significance. Based on this study, the understanding of the relationship between the shape of the palate and the skeletal pattern provides useful information about orthodontic treatment plans, early diagnosis of malocclusion, and morphological integration mechanisms. Orthopedic treatment in the maxilla should be performed during early and intermediate mixed dentition to enhance treatment efficiency.

Comparison of polysomnographic and cephalometric parameters based on positional and rapid eye movement sleep dependency in obstructive sleep apnea

The aim of this study is to investigate the differences in polysomnographic and cephalometric features according to positional and rapid eye movement (REM) sleep dependencies in obstructive sleep apnea patients. Standard polysomnography and cephalometric analyses were performed on 133 OSA patients. The subjects were categorized into positional and non-positional, and REM-related and not-REM-related OSA groups according to positional and REM sleep dependency on severity of sleep apnea. Polysomnographic and cephalometric parameters were compared between groups. Positional and REM-related OSA patients showed significantly lower non-supine apnea–hypopnea index (AHI), non-REM (NREM) AHI and overall AHI and higher NREM oxygen saturation (SpO2) and mean SpO2 compared to non-positional and not-REM-related OSA patients, respectively. Cephalometric features between positional and non-positional OSA patients did not show any significant differences. However, REM-related OSA patients showed significantly larger inferior oral airway space and shorter perpendicular distance between mandibular plane and anterior hyoid bone and the distance between uvula and posterior nasal spine, and narrower maximum width of soft palate than not-REM-related OSA patients. Positional and REM-related OSA patients have lower severity of sleep apnea, suggesting the possibility of lower collapsibility of the upper airway. REM sleep dependency was associated with anatomical factors, while positional dependency did not show such a tendency.

P38MAPK silencing attenuates scar proliferation after cleft palate repair surgery in rats via MRTF-A/SRF pathway

Scarring is the primary factor of maxilla growth restriction among people who have undergone cleft palate repair surgery. p38 mitogen-activated protein kinase (p38MAPK) promotes fibrosis in a variety of organs. However, its role in post-surgery scarring on the hard palate has not been fully understood. This study is designed to investigate the role of p38MAPK in scar formation and maxilla growth of rats. We removed the mucosa on the hard palate of rats and applied the p38MAPK silencing adenovirus vector on it two weeks after surgery. Then the scarring tissue and maxilla growth were evaluated by histological and morphological examination. The effect of p38MAPK silencing on scarring-related genes in fibroblasts was also studied. We found that local injection of Ad-p38MAPK-1 in vivo effectively reduces the expression of p38MAPK and scarring-related proteins and weakens the impact of scarring on the width of the hard palate. Mechanistically, p38MAPK silencing inhibits the expression of α-smooth muscle actin (α-SMA) via mediating the production and nuclear localization of myocardin-related transcription factor A (MRTF-A) in fibroblasts. These results reveal a molecular pathway of scar formation involving p38MAPK/MRTF-A stimulation and support targeting p38MAPK as a potentially effective treatment for post-surgery scarring on the hard palate.

Uniformity of palatal volume and surface area in various malocclusions.

To assess palatal volume, surface area and linear dimensions across sagittal and vertical components of malocclusion. Pre-treatment cephalographs and dental casts of 178 non-growing patients (88 males, 90 females, age 25.81 ± 8.23 years) were used for classification in sagittal malocclusion groups: Class I (n= 48), Class II division 1 (n= 42), Class II division 2 (n= 40) and Class III (n= 48); and in vertical divergence groups based on the MP/SN angle: hypodivergent (n= 35), normodivergent (n= 95) and hyperdivergent (n= 48). Dental casts were scanned and palatal measurements recorded: palatal width, depth and interdental distances; palatal surface area (PSA, mm2 ) and volume (PV, mm3 ). A 3-way ANOVA was used to compare palatal dimensions across groups. Pearson product-moment correlations were employed to assess associations among variables. PSA and PV (in both sex groups) were not statistically significantly different across sagittal malocclusions and vertical patterns. Significant differences were depicted more among the vertical divergence groups than sagittal groups. Correlations between PSA and PV and palatal dimensions were low to moderate. Predictability of PSA and PV ranged between 15 and 18%. The finding of similar palatal volume and surface area, on average, across malocclusions possibly underscores the limitations of environmental influences within the inherited orofacial phenotype. The vertical facial pattern seems to be more interactive with palatal dimensions than sagittal relations. Studies of palatal changes following orthodontic and orthognathic treatments are warranted.