Previous Orthodontic Treatment Research Articles

Pilot study for three-dimensional cephalometric Enlow's counterpart analysis: Vertical track. Two-dimensional and three-dimensional comparison.

The introduction of cone beam computed tomography (CBCT) in dentistry has given orthodontists the possibility of studying craniofacial structures in three dimensions. Despite the possibility to obtain lateral cephalograms synthesized from CBCT, this approach still does not provide a fully three-dimensional evaluation of the patient's anatomy. While there has been some success in adapting traditional two-dimensional cephalometric analyses to three dimensions, the specific application of Enlow's cephalometric analysis using CBCT remains unexplored. This pilot study aims to introduce a novel approach for performing Enlow's vertical track analysis using CBCT images. Eighteen CBCT images of skeletal Class I (ANB = 2 ± 2) subjects (12 males and 6 females, aged from 9 to 19 years) with no history of previous orthodontic treatment were selected. For each subject, 2D Enlow's vertical track analysis was performed on lateral cephalograms extracted from the CBCT images, and separately, 3D vertical track analysis was directly performed on the CBCT images. To validate the proposed method, we compared the differences between the posterior vertical counterpart (PVC) and the middle vertical counterpart (MVC), as well as between the middle vertical counterpart (MVC) and the anterior vertical counterpart (AVC), as obtained from both the two-dimensional and three-dimensional analyses. The Kolmogorov-Smirnov normality test was applied for each variable to check whether data were normally distributed and a paired Student's t-test was performed. The level of statistical significance was .05. The comparison between three-dimensional PVC-MVC (-0.43 ± 0.37 cm) and two-dimensional PVC-MVC (-0.53 ± 0.36 cm) revealed no statistical difference (P = .27). Similarly, no significant difference (P = .28) was observed between two-dimensional MVC-AVC (-0.56 ± 0.34 cm) and three-dimensional MVC-AVC (-0.47 ± 0.37 cm). The method proposed by this study to realize the vertical track analysis on 3D images is valid and superimposable on that described by Enlow on lateral cephalograms.

EMG ACTIVITY OF MUSCLES OF THE CRANIOMANDIBULAR SYSTEM IN SUBJECTS WITH NARROWING UPPER JAW AND POSTERIOR CROSSBITE

Posterior crossbite in children and adolescents has been linked to asymmetrical function and performance of the masticatory muscles. Electromyography (EMG) serves as an objective and widely applicable evidence-based method for diagnosing muscle function. The aim of our study was to analyze electromyographic (EMG) activity of muscles of the craniomandibular system in subjects with a narrowing upper jaw and unilateral posterior crossbite. Material and methods. The first (study) group consisted of 18 subjects with narrow maxilla and unilateral posterior crossbite. 20 age-matched children with normal occlusion were included in the control group. The average age of subjects in the study group was 8.4±1.4 years, in the control group – 8.8±1.6 years. The exclusion criteria of the study were as follows: previous or active orthodontic treatment, clefts, traumas in the maxillofacial region, and general diseases. EMG activity of the anterior temporal, masseter, sternocleidomastoid (SCM), orbicularis oris, and mentalis muscles on both sides (left and right) was recorded during two 30-second tests: maximum voluntary clenching and swallowing a sip of water. Maximum voluntary clenching was performed in the intercuspal position. EMG data were processed using Neurotech's Synapsis software. EMG activity for each muscle was estimated by the maximum amplitude of the muscle contractions (μV). Results. EMG activity in children with narrowing upper jaw and unilateral posterior crossbite of anterior temporal, masseter, and sternocleidomastoid muscles was asymmetrical and differed between the left and right sides. Higher bioelectrical muscle activity was found on the crossbite side for the masseter and anterior temporalis muscle, and on the opposite side – for sternocleidomastoid muscles. Values of maximum amplitude of sternocleidomastoid muscles were higher in the study group than in the control group without significant difference. There was a statistically significant difference in EMG activity of mentalis and orbicularis oris muscles between the two groups of children (p<0.05). Values of EMG activity of mentalis and orbicularis oris were higher in the study group.

3D Printer-Assisted Layered Fabrication of a Novel Appliance for Oral Myofunctional Therapy and Functional Evaluation of Its Effects on Orofacial Muscles During Wear.

Aim Balanced function of the orofacial muscles is important for normal occlusion and dentition; however, patients with malocclusion often present with myofunctional disorder (MFD). Myofunctional therapy (MFT) has received much attention as a method for reducing MFD. Moreover, prefabricated functional appliances (PFAs) have been developed as a method to eliminate abnormal muscle pressure and guide the tongue into the correct position. However, PFAs have disadvantages, such as poor intraoral retention, limited usage time due to discomfort and poor patient compliance, and changes in the axis of the mandibular anterior teeth.Therefore, this study aimed to develop a new custom-made splint-type orthodontic appliance with CAD/CAM technology. Moreover, we evaluated the characteristics of the appliance and conducted functional tests to determine the effects of the appliance on the orofacial muscles and the discomfort associated with its use. Materials and methods Twenty-five volunteers (nine females and 16 males; mean age 28.4 ± 3.4 years) with normal swallowing function were included in the study. Lip-closing strength (LCS), electromyogramduring swallowing, oxygen saturation, and pulse rate were measured and compared when the appliance was not worn and when it was worn. In addition, tongue habits were evaluated, and the maximum tongue pressure was measured when the appliance was not worn. The subjects were asked to answer a questionnaire using a numerical rating scale (NRS) regarding discomfort when wearing the appliance. The evaluation items were swallowing difficulty, speaking difficulty, and breathlessness, which were rated on an 11-point scale ranging from 0 to 10. Statistical tests were conducted using IBM SPSS version 28.0.1 (IBM, Armonk, NY, USA) with the Shapiro-Wilk and Levene's test, followed by the Wilcoxon signed rank sum test. The significance level was set at α = 0.05. The measurement error for each measurement item was evaluated using an intraclass correlation coefficient. Results A new custom-made splint-type orthodontic appliance was fabricated for each subject. The fit and retention of the appliance in the mouth were good when fitted, and a comparison of the functional test measurements of 25 subjects with and without the appliance showed that the LCS decreased significantly (p<0.05) before and after wearing the appliance. However, no statistically significant differences were found for the other items. The Mann-Whitney U test regarding the effects of sex, previous orthodontic treatment, or MFT, and oral habits did not statistically significantly influence the effects of wearing the device. In the NRS results, "difficulty swallowing" was observed in half of the subjects, "difficulty breathing" was rarely observed, and "difficulty speaking" was observed in all subjects. Conclusions A novel custom-made splint-type orthodontic appliance was designed and fabricated using digital workflow and 3D printing technology. This appliance was designed to correct oral habits and was made from a new material classified as a class II medical appliance according to the international harmonized classification.

Comparison of Soft Tissue Chin Thickness in Adult Patients With Various Mandibular Divergence Patterns.

Objective This study aimed to compare the soft tissue chin (STC) thickness at different levels in patients presenting for orthodontic treatment with different vertical facial types. Materials and methods This comparative cross-sectional study was conducted at Sharif Medical & Dental College, Lahore, Pakistan, on 195 subjects. Patients presenting for orthodontic treatment, both genders, aged from 18 to 32 years, and Pakistani nationals were included. Patients with any craniofacial deformity, syndrome, cleft lip and palate, previous orthodontic or orthognathic treatment, and multiple missing teeth and prostheses in edentulous areas were excluded. Vertical facial patterns and STC thickness were recorded from pre-treatment lateral cephalograms. One-way analysis of variance (ANOVA) was applied to compare STC among various vertical facial patterns. Post-hoc analysis was done using the Tukey test. Results There were 126 females (64.62%) and 69 males (35.38%). The mean age was 21.66 ± 3.44 years. All three soft tissue chin thickness distances significantly differed among vertical facial patterns (p<0.001). Multiple comparisons show that the distance between soft and hard tissue pogonion was insignificant between low and normal anglefacial heights (p=0.5). Similarly, no significant difference was observed for the distance between softand hard tissue menton in low and normal angle subjects (p=0.4). The rest of the multiple comparisons were statistically significant (p<0.05). Conclusion The STC thickness is significantly associated with vertical facial divergence. While planning orthognathic surgery or genioplasty of the mandible, due consideration should be given to vertical divergence of the face to avoid unwanted facial changes.

The Effectiveness of Aligners in the Treatment of Anterior Open Bite in Adult Patients: A Systematic Review and Critical Appraisal

An anterior open bite is a dental malocclusion, the diagnosis of which is fundamental for its treatment. With the evolution of artificial intelligence, it is possible to treat it through the Invisalign G4 protocol, depending on the degree of severity. The aim of this study was to perform a systematic review, based on the PICO strategy, to evaluate the effectiveness of aligners and accessory devices in adult patients with anterior open bites. The search was carried out in the following databases for publications over the last ten years: PubMed, Web of Science, Cochrane Library, and LILACS. The inclusion criteria were clinical studies evaluating adults with anterior open bites (overbites &lt; 0 mm) and orthodontic studies with aligners. The exclusion criteria were studies of cases with dentofacial deformities, previous orthodontic treatment, history of surgery/trauma, or systemic diseases that affect craniofacial growth, as well as animal studies, reviews, and clinical cases. The selection was carried out separately by two researchers. In the four databases, 108 articles were obtained. By reviewing the titles and abstracts and applying the exclusion criteria, 91 articles were eliminated. The seven resulting articles were submitted to the inclusion criteria, two of which were excluded due to their lack of patients presenting an open bite and the absence of aligner treatment. According to the PRISMA method, five studies were selected. The collected data showed an increase in overbites with the use of aligners. The bias assessment was performed with the ROBINS-I tool, indicating a moderate risk of bias. The included studies demonstrated the effectiveness of aligners in the treatment of adults with mild or moderate open bites; however, due to the lack of scientific evidence, it is necessary to carry out randomized studies with the same standardized variables.

Evaluation of Awareness and Perception of Clear Aligner Orthodontic Treatment Among Students of Hawler Medical University.

Background and Objectives: The growing emphasis on appearance has led to an increased interest in orthodontic treatment among adults, particularly those who are highly self-conscious about their looks. Clear Aligner Therapy, a nearly invisible and effective method for aligning teeth, represents the latest generation of aesthetic orthodontic treatments. This study aims to assess the awareness and perception of Clear Aligner Therapy among students at Hawler Medical University. Materials and Method: A cross-sectional study was conducted using an online questionnaire comprising four sections: demographics, general dental and orthodontic awareness, knowledge of Clear Aligner Therapy and Fixed Orthodontic Therapy, and optional comments and questions. Results: A total of 383 participants, with an average age of 20.54 years, completed the questionnaire. The majority (89.6%) were Kurds and 63.2% females. Among the participants, 68.2% had visited a dentist as needed, 72.3% had family members with malocclusions, 41% had sought orthodontic consultation. Additionally, 86.2% were familiar with Fixed Orthodontic Therapy, 63.2% had heard of Clear Aligners, 30.5% had undergone orthodontic treatment, and 8.5% individuals had received Clear Aligner Therapy. Conclusion: The knowledge level of Hawler Medical University students regarding Clear Aligner Therapy was determined to be moderate. Despite the fact that they possessed a general understanding of its characteristics and application, their involvement in the treatment and its procedures was limited. Previous orthodontic treatments recipients', satisfaction with their smile, overall concern about teeth, previous orthodontic consultation, and knowledge of Fixed Orthodontic Therapy all notably demonstrated significant associations with the awareness of Clear Aligner Therapy. Keywords: Clear Aligner, Orthodontic treatment, Esthetic treatment, Awareness, Perception, Hawler Medical University.

The association between self-esteem and aesthetic component of smile among adolescents

ObjectivesSelf-esteem plays a crucial role during adolescence in a shaping of an individual’s overall well-being and confidence. The aim of this study was to explore the relationship between the self-esteem in adolescents and their smile aesthetics, as well as to assess the alignment of opinions on this matter between adolescents and dentists.MethodsSample included 413 students in Split-Dalmatia County, aged 13 to 18 (60% females). Data on demographic issues, orthodontic history, and desire for orthodontic treatment were collected by the self-administrated questionnaire. Coopersmith's Self-Esteem Inventory was also used. Smile aesthetics was assessed by each participant and dentist independently using an Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN AC).ResultsSelf-esteem was higher in adolescents who rated their smile aesthetics equally to the dentist than in those who considered their aesthetics to be worse than the dentist (18.5 vs. 16; P = 0.011). The multiple linear regression revealed that the self-esteem of adolescents was positively related to undergone previous orthodontic treatment (β = 1.286, P = 0.020) while negatively related to the female gender (β = −2.531, P ≤ 0.001) and IOTN AC assessed by dentist (β = −0.356, P = 0.015). It was not related to educational level or desire for orthodontic treatment.ConclusionThe self-esteem in adolescence is influenced the most by gender, but the orthodontic treatment and better smile aesthetics might also contribute.

Orthodontic treatment demand for fixed treatment and aligners among young adults in middle Europe and South America – a questionnaire study

BackgroundPatients experiencing any malocclusion, may desire for treatment. However, there is no scientific information orthodontic treatment demand and the knowledge of young adults about orthodontic treatment. The aim of the study was to assess orthodontic treatment demand in young adults from Poland and Chile, their previous orthodontic experience and their knowledge on fixed and aligner orthodontic treatment.MethodsThe target group comprised people aged 18–30. The sample size was estimated as above 400 for each country. The survey was carried out in Polish and Spanish within 3 months and consisted of 25 questions delivered via social media. Comparisons were made between countries, age subgroups and gender.ResultsThe response rate was 1,99%, what stands for 1092 responses, 670 from Chile and 422 from Poland, respectively. The percentage of young adults who were already treated was 42,9% in Poland and 25,0% in Chile. The ones planning to have orthodontic treatment within a year counted for 11,8% in Poland and 5,3% in Chile. Most young adults who want to be treated (20,6%) rely on doctor’s recommendation on type of appliance while 14,7% of all respondents are interested solely in aligners. Most respondents have heard about aligners (58%). Direct provider-to-customer service without a doctor is not acceptable, neither in Poland (85,1%) nor in Chile (64,8%). Most young adults provided incorrect answers referring various aspects of aligner treatment.ConclusionsIn both countries, patients demand to be treated and monitored by the orthodontist. A high percentage of patients want to be treated exclusively with aligners. Direct-to-consumer orthodontics does not seem attractive to patients. Young adults do not have adequate knowledge referring to aligner treatment. Many people want to be treated despite a previous orthodontic treatment.

Assessing the immediate impact of Twin-block appliance insertion on adolescents' sleep using a wearable device.

This prospective clinical study aimed to evaluate the immediate impact of Twin-block appliance insertion on the sleep of adolescents using a wearable device. A total of 24 girls, aged 11-13 years, with Class II division 1 molar relationship, skeletal class 2 malocclusion (ANB ≥5) and overjet measuring ≥5 mm were selected. Exclusion criteria included a history of previous orthodontic treatment, systemic disease, irregular sleep pattern, obstructive sleep apnea, medical history of breathing disorders, or concurrent use of medications. Participants wore a wearable device to measure sleep parameters, including deep sleep, light sleep, minutes awake during sleep, wake-up times, bedtimes and total sleep times. The participants wore the device for 10 days prior to Twin-block insertion and sleep data were collected for another 10 days after insertion. Following the insertion of the Twin-block appliance, there was a highly statistically significant shift in bedtime and wake-up time to later hours (P < .001). All participants experienced a highly significant delay in bedtime compared to the recommended 10 pm time (P < .001). Additionally, there was a significant increase in the duration of light sleep (P < .05). However, the effect on deep sleep, minutes awake during sleep and sleep duration was not statistically significant. None of the sleep parameters tested showed statistically significant changes between the first 5 days after Twin-block insertion with the subsequent 5 days. The immediate insertion of the Twin-block appliance disrupts sleep onset, wake-up time and light sleep during the specified period of 10 days.

Associations between maxillary labial frenum Morphology, Attachment, and Patient-Related clinical factors in Saudi Arabian Adults: Cross-sectional study

ObjectiveThis study investigated the prevalence of maxillary labial frenum morphologies and attachment types and their associations with various patient-related clinical variables in a population of Saudi Arabian adults. MethodsThis study comprehensively examined 100 participants of both genders to categorize frenum types and attachment sites. The following clinical variables were recorded: probing depth, clinical attachment loss, attached gingiva width, overjet, overbite, diastema width, central incisor condition, occlusion, previous orthodontic treatment, and the incidence of gummy smile. ResultsThe mean age was 32.6 years, and the average diastema width was 0.23 mm. The study found that the simple frenum type was the most common morphology (57 %), and gingival attachment was the most frequent attachment type (54 %). Simple frenum was significantly associated with class I occlusion (p = 0.018), and frenum with nichum was significantly associated with class II occlusion (p = 0.019). Females were more likely to exhibit simple frenum with nodule frenum than males (p = 0.042). Mucosal frenum attachment was significantly correlated with the absence of previous orthodontic treatment (p = 0.042). ConclusionThe study identified a relationship between the features of the maxillary labial frenum and occlusion as well as previous orthodontic treatment. Our findings suggest that understanding each patient’s unique frenum features can lead to more effective and personalized dental care, thus improving patient satisfaction.

Sixty Years of Innovation in Biomechanical Orthognathic Surgery: The State of the Art and Future Directions

Craniofacial surgery is proposed and performed for a variety of reasons, ranging from congenital or acquired malformations to emotional disorders and parafunctions of the masticatory, respiratory, auditory, and visual systems. Surgery of the mandible and its orthostatic repositioning is the most common of these corrections of craniofacial anomalies. Throughout the history of these procedures, various techniques have been proposed and perfected, but always with a high rate of minor and major complications. The recurrence rate of mandibular malposition is high, as is the temporary loss of facial sensitivity and motor skills. These outcomes are often related to the choice of surgical technique rather than the skill of the surgeon, which is considered to be one of the most important factors in the final outcome. Surgical techniques involving direct manipulation of the vascular-nervous bundles, such as bilateral sagittal split osteotomy, clearly present the possibility of major or minor complications. In this study, an orthognathic surgical technique, performed by the same team for over 40 years and now available through a 20-year postoperative patient follow-up study, is presented with a literature review relating it to biomechanical concepts and bone remodeling to analyze the evolution of orthognathic surgery since it became common practice to correct maxillofacial discrepancies. In this review, we also present a case report in which previous orthodontic treatment prepared a patient for surgical correction of mandibular bone discrepancy without the need for combined maxillary and/or genioplasty, and we describe the most commonly used techniques today, as well as their advantages and disadvantages. The combination of established concepts together promotes favorable stability of mandibular osteotomies, functional anatomical positioning of the temporomandibular joint, reduced risk of injury to the mandibular vasculo-nervous bundle, and good aesthetics with positive patient acceptance and no relapse, thus these are the objectives for proposing innovative treatments that combine the technologies available today.

Comparison of the prevalence of malocclusion and oral habits between children with cerebral palsy and healthy children

BackgroundCerebral palsy (CP) represents for children an important problem of health and affects roughly 2 per 1000 live births and is the most common pediatric developmental motor disability. Therefore, the purpose of this study was to determine the prevalence, type and severity of malocclusion and oral habits in children with Cerebral Palsy (CP) and to compare them with a control group of healthy children in Sana’a city.Materials and methodsA prospective, case–control study was made of two groups, a cerebral palsy and a control group. The study population consisted of 60 children who had CP, and a control group of 60 matched children with no physical or mental disabilities. Data were collected using a questionnaire and assessment for malocclusion was done clinically. The patients were compared with equal number of age-matched controls. The inclusion criteria were individuals aged over 6 years; absence of previous orthodontic treatment; no missing permanent first molars.ResultsResults showed an increased prevalence of malocclusion in children with cerebral palsy. Molar class II relationship was statistically higher in cerebral palsy children than healthy control (P = 0.001). Cerebral palsied children are likely to have a significantly increased protrusion of the anterior teeth (P < 0.001) when compared with normal children. Mouth breathing and Tongue thrust. Habits were significantly higher in the CP group (p = 0.0001) when compared with normal children.ConclusionThe prevalence of malocclusion was higher in children with Cerebral palsy than in normal children, and the present study concludes that in children with Cerebral Palsy, more oral Habits problems due to oral motor dysfunctions are common and problems of mouth breathing and Tongue thrust produce different malocclusion and poor oral hygiene complications in these children.

Fixed appliances orthodontic therapy as a risk factor for caries development: Systematic review.

Orthodontic treatment is often mandatory to improve the patient's health condition. However, the fixed appliance can create additional plaque retention areas, which can increase the risk of caries development. Clinically, one can observe various effects of fixed appliance treatment on caries prevalence. This study aims to analyze to what extent orthodontic therapy with fixed appliances is a risk factor for developing caries in pediatric and adult patients. The keywords used in the search strategy were as follows: ("caries" AND "caries risk" AND "caries experience" AND" "orthodontic treatment" OR "fixed appliance" ") and ("caries experience" AND "orthodontic treatment").From 808 potential articles, 15 were included in the review. In individuals undergoing fixed orthodontic therapy, several factors can increase the risk of car-ies during fixed orthodontic treatment, such as salivary composition, oral dysbiosis and plaque accumulation. On the other hand, factors that reduce caries risk are, i.e., oral hygiene self-awareness and previous orthodontic treatment. In most studies which used the Decayed, Missing, and Filled Teeth (DMFT) index, there were no significant differences between the values obtained before orthodontic treatment and after the treatment. Moreover, it is easier for a patient with aligned teeth to remove plaque.In the young population, fixed orthodontic treatment appears to reduce the incidence of caries. In the adult population, fixed orthodontic treatment increases the risk of dental caries. However, education on proper oral hygiene during orthodontic treatment can reduce the risk of dental caries. The study protocol was registered in the PROSPERO database [PROSPERO CRD42022356628].

Photoanthropometric craniofacial parameters in individuals with osteogenesis imperfecta.

This study aimed to evaluate facial photoanthropometric parameters in patients with OI. We selected 20 Brazilian patients diagnosed with OI treated at the Extension Service for Minors in Need of Specialized Treatment of the Dentistry Course at the Federal University of Ceará (Fortaleza, Brazil), of both sexes, without age restriction, and able to understand and sign the informed consent form (ICF). As a control group, 38 non-syndromic Brazilian individuals, categorized as ASA I, able to understand and sign the ICF, matched by sex, age, and Legan and Burstone facial profile were selected. The exclusion criteria were: previous orthodontic treatment, craniofacial trauma and/or surgery, and the presence of any other systemic diseases. Photoanthropometric analysis of the 18 facial parameters proposed by Stengel-Rutkowski et al. (1984), previously established in the literature for craniofacial syndromes, were conducted. A single examiner digitally performed all effective and angular measurements with the CorelDRAWX7® software. Horizontally shortened ears (p<0.001) but larger in height in relation to the face (p=0.012) were shown to be alterations belonging to individuals with OI. OI patients present distinct photoanthropometric parameters inherent in this condition.

Multidimensional tooth movement boundaries in the extended aesthetic zone: a cone-beam computed tomography study

Abstract Purpose To establish tooth movement boundaries in four directions by a novel morphometric analysis of alveolar bone using conebeam computed tomography (CBCT) images. The aim was to assist clinicians in minimising the occurrence of bone fenestration and dehiscence, thereby facilitating safe and efficient orthodontic treatment. Methods CBCT images of 123 male volunteers comprising 55 individuals with hypodivergent vertical skeletal patterns and 68 individuals with normodivergent vertical skeletal patterns and normal occlusions but without a history of previous orthodontic treatment, were analysed. The mesiodistal and labiolingual alveolar bone height (ABH) as well as the labiolingual cancellous bone thickness (CBT) were measured in relation to the maxillary and mandibular anterior teeth and premolars. These parameters were subsequently compared between the different vertical skeletal patterns. Results Teeth within the extended aesthetic zone exhibited a limited range of safe movement on the labial aspect across all three root aspects, with 97.6% of the upper lateral incisors and 98.4% of the lower lateral incisors positioned against the labial cortical plate (&lt;0.5 mm). The lingual aspects had significantly more space for tooth movement compared with the labial aspects (P &lt; 0.05). The ABH was significantly greater in the hypodivergent group than the normodivergent group involving particular teeth and sites in the maxilla (P &lt; 0.05), while no significant difference was noted in the mandible. The hypodivergent group also exhibited thicker cancellous bone on most labial and some lingual aspects. Conclusions The findings provided the average tooth movement range in the horizontal and vertical directions within the extended aesthetic zone in male individuals presenting with a normal occlusion. It was concluded that a hypodivergent growth pattern may have a relatively large range of safe tooth movement in the sagittal and vertical directions.

Cephalometric Determination of the Vertical Dimension of Occlusion: Clinical Study

The following is a retrospective descriptive cross-sectional stud aimed at determining the vertical cephalometric standards of a Moroccan population. The values found will be used to orient the choice of the VDO during complex prosthetic rehabilitations where all dental references are absent. The study was conducted on 80 teleradiographies of subjects consulting the ODF department of the CCTD Casablanca with a skeletal class 1 dental occlusion in the absence of any previous or current orthodontic treatment. After performing the cephalometric tracings, we correlated the VDO with 7 angular measurements: ENA-Xi-Pm, GoGn/SN, Occ/SN, Occ/Fr, SGn/Fr, FMA, GoGn/GoENA. Our study led us to the following results: • For the ENA-Xi-Pm angle, we found a mean value of 47.9. • The GoGn/SN angle averaged 38.3°, it varied in 37.29.° • For the Occ/SN angle, it was found that the average value was 21.2° for the whole sample. • The Occ/Fr angle was on average 9.9.° • The SGn/Fr angle averaged 60° in the Moroccan population. • The measurement of the FMA angle showed an average of 27. • Finally, for the GoGn/GoENA angle, we found a mean value of 50. The comparison of our results with those of studies conducted on different populations showed significant differences. This can be explained by the tendency to hyperdivergence in the Moroccan population, hence the interest in using the mean values specific to each population. The comparison of the global means with the means of each group showed that the angular values in hyperdivergent cases are significantly higher than the global values and the angular values in hypodivergent cases are significantly lower than the global values, and for the normodivergent cases, we found a significant difference only for the values of the FMA angle which is lower than the global value of the sample. And thus, the determination of the VDO using cephalometric analysis represents one of the best methods to correctly restore the occlusal environment in a complex prosthetic project, given that the restauration is based on cephalometric standards of the corresponding population.

Torque changes of anchorage units in preadolescent patients treated with a digitally designed tooth-borne expander anchored to deciduous vs. permanent molars.

To compare the effects on permanent or deciduous anchorage dental units in patients treated with a digitally designed palatal expander. Inclusion criteria were the following: presence of maxillary transverse deficiency, no previous orthodontic treatment, no extractions, absence of agenesis, congenital pathologies and cranio-maxillofacial malformations. Twenty patients (11 males, 9 females, 11 ± 1.8 years) received a digitally designed and metal printed palatal expander anchored on first permanent molars and 1 activation per day for 30 days (Group 1). Twenty-one patients (12 males, 9 females, 8.6 ± 1.4 years) received a digitally designed and metal printed palatal expander anchored on second deciduous molars and 2 activations per day for 14 days (Group 2). Digital intraoral scans were taken before expansion and after device removal, and torque and the palatal transverse diameter were digitally measured. The FDI notation was used to indicate each tooth CONCLUSION: Less dental torque augmentation was produced in Group 2. Significant intragroup differences over time were found in Group 1 considering the torque of teeth 1.6, 1.4, 1.3, 2.1, 2.4, 2.5, 2.6. Significant differences between groups were found regarding the longitudinal change in torque of teeth 1.5, 2.4 and 2.5. Significant intragroup differences over time were found in both groups considering all transverse diameter parameters. No significant differences were found between groups in the transverse diameter modifications over time. Less dental torque augmentation was produced in Group 2.

Systematic Review and Meta-Analysis of the Index of Orthognathic Functional Treatment Need for Detecting Subjects with Great Need for Orthognathic Surgery.

Index of Orthognathic Functional Treatment Need (IOFTN) Identifies patients with greatest need for orthoganthic surgery. This systematic review looks into the available evidence on prevalence of patients with great treatment need (IOFTN 4&5) who had orthognathic surgery in previous studies. Literature search of the major electronic databases was carried out for articles published between 2014 and September 2023, looking for "Index of Orthognathic Functional Treatment Need","Orthognathic Surgery","IOFTN", "Epidemiology" and "Dentofacial Deformity". The prevalence of patients identified with IOFTN grades of 4&5 was calculated. A random-effect model was employed and the Forest and Galbraith plots were produced. The pooled prevalence estimate for subjects with IOFTN scores of 4&5 was calculated. The heterogeneity among studies was assessed with the I2 statistics. In total, 14 retrospective studies conducted between 2015 and 2019 in 7 countries (UK, New Zealand, Iran, Pakistan, Turkey, Malaysia, Japan) were included, reporting on 1339 orthognathic patients. The sample sizes ranged from 30 to 200. Only 7 studies reported on the subcategories of the IOFTN for grades 1, 2&3. The prevalence of orthognathic patients with IOFTN scores of 4 & 5 ranged from 79% to 100%. The heterogeneity I2 statistics was 16%. The pooled prevalence estimate for subjects with IOFTN scores of 4&5 was 92% (95% CI, 0.91-0.94%). According to this meta-analysis, IOFTN successfully identified 92% of patients who underwent orthognathic surgery with a great need for treatment (Grade 4 & 5). To enhance the identification of patients with well-compensated malocclusions, previous orthodontic treatment, or extreme occlusal deviations (e.g., proclination or retroclination of incisors), it would be advantageous to employ additional means alongside IOFTN for assessing orthognathic need in this group.

Comparative Analysis of Cephalometric Parameters of Class II Malocclusion

Class II malocclusions are of immense interest to orthodontists as they constitute a significant percentage of the cases they treat. This study aimed to recognize the importance of the variations of Class II malocclusion and its implications in determining the best treatment approach. The sample of this study was collected from cases that had been reported to private clinics in Navi Mumbai and had not undergone any previous or ongoing orthodontic treatment. 58 lateral cephalograms were selected from patients having Class II malocclusion. Cephalometric tracing was performed manually. Steiner, Tweed and Jarabak analyses were done. It was seen that there is a significant difference in the maxillary and mandibular incisor angulation and position of the mandible between Class II Division 1 and 2 malocclusion cases; between cephalometric parameters of females and males in cases with Class II Division 1 and 2 cases with respect to the mandibular incisor angulation, mandibular corpus length, posterior cranial base, facial depth and posterior facial height; between the cephalometric parameters of cases with less than and more than 14 years of age in individuals with Class II Division 2 malocclusion with respect to the gonial angle, mandibular plane angle, the maxillary and mandibular incisor angulation and position, angle of convexity, ramus height, facial depth, posterior and anterior facial heights; upper and lower lip position. Thus, Class II malocclusions show a significantly diverse array of skeletal, dental and soft tissue cephalometric parameters; hence a customized orthodontic treatment plan for each case is imperative.

Effect of SEC III protocol on upper airway dimensions in growing class III patients: a retrospective study

BackgroundThe primary objective of the study was to evaluate the effects of SEC III (Splints, Class III Elastics, and Chin cup) protocol on the upper airway dimensions using lateral cephalometric radiographs. The secondary objectives were to evaluate the skeletal and dental effects of the SEC III protocol using lateral cephalometric radiographs.MethodsThe pre- and post-treatment lateral cephalometric radiographs of 24 patients treated using the SEC III protocol were used to address the aim of the study. Children in the pre-pubertal (CS-1 or CS-2) or circumpubertal (CS-3 or CS-4) skeletal maturation stage and having class III dentoskeletal malocclusion were included in the study. Patients with a history of previous orthodontic treatment, maxillofacial surgery or trauma, tonsillectomy, adenoidectomy, or craniofacial malformations were excluded. The pre-treatment and post-treatment lateral cephalometric radiographs were traced, then airway measurements, skeletal measurements, and dental measurements were performed. The results were analysed using paired samples t-test or Wilcoxon signed rank test according to the data normality.ResultsData of 6 males and 18 females were analysed (Mean age = 11.21 ± 1.02 years). Duration of active treatment was 5.75 ± 1.03 months. Treatment using SEC III protocol resulted in a significant increase in ANB angle (2.92 ± 1.50 degrees, p < 0.001) and Wits appraisal (3.31 ± 1.99 mm) (p < 0.001). The increase in the mandibular plane angle (0.75 ± 1.42 degrees, p = 0.02) and the maxillary length (2.29 ± 2.69 mm, p < 0.001) was statistically significant. Contrarily, the mandibular length did not change significantly (p = 0.10). The maxillary incisors were significantly proclined (4.38 ± 4.28 degrees; p < 0.001), while the mandibular incisors were significantly retroclined (-5.79 ± 6.21 degrees; p < 0.001) following treatment. The change in the nasopharyngeal airway and the retropalatal airway was not statistically significant. The middle and inferior pharyngeal space (retroglossal airway) significantly decreased by 1.33 ± 1.97 mm (p = 0.003) and 1.96 ± 2.48 mm (p = 0.001), respectively.ConclusionsEarly class III correction using SEC III protocol reduced the retroglossal airway dimensions but did not affect the nasopharyngeal and retropalatal airway dimensions. Correction of the class III dentoskeletal relationship was obtained through both skeletal and dental changes.