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Journal of Clinical Orthodontics : JCO May 2024
Topics: Humans; Orthodontic Wires; Orthodontic Appliance Design; Female; Tooth Movement Techniques; Dental Alloys; Malocclusion; Male; Adolescent
PubMed: 38917040
DOI: No ID Found -
BMC Oral Health Jun 2024The aim of the study was to investigate the changes occurring in the mandibular condyle by using mentoplate together with rapid maxillary expansion (MP-RME) treatment in...
BACKGROUND
The aim of the study was to investigate the changes occurring in the mandibular condyle by using mentoplate together with rapid maxillary expansion (MP-RME) treatment in the correction of skeletal class III relationship, using fractal analysis (FA).
METHODS
The sample consisted of 30 individuals (8-11 years) diagnosed with skeletal Class III malocclusion who underwent MP-RME treatment. Archival records provided cone-beam computed tomography (CBCT) images taken at two intervals: before MP-RME treatment (T0) and after treatment (T1). The CBCT images were obtained using standardized settings to ensure consistency in image quality and resolution. The trabecular structures in the bilateral condyles at both T0 and T1 were analyzed using FA. The FA was performed on these condylar images using the Image J software. The region of interest (ROI) was carefully selected in the condyle to avoid overlapping with cortical bone, and the box-counting method was employed to calculate the fractal dimension (FD). Statistical analysis was conducted to compare the FD values between T0 and T1 and to evaluate gender differences. The statistical significance was determined using paired t-tests for intra-group comparisons and independent t-tests for inter-group comparisons, with a significance level set at p < 0.05.
RESULTS
The analysis revealed no statistically significant differences in the trabecular structures of the condyles between T0 and T1 (p > 0.05). However, a significant gender difference was observed in FA values, with males exhibiting higher FA values in the left condyle compared to females at both T0 and T1 (p < 0.05). Specifically, the FA values in the left condyle increased from a mean of 1.09 ± 0.09 at T0 to 1.13 ± 0.08 at T1 in males, whereas in females, the FA values remained relatively stable with a mean of 1 ± 0.09 at T0 and 1.03 ± 0.11 at T1.
CONCLUSION
The findings indicate that MP-RME therapy does not induce significant alterations in the trabecular structure of the mandibular condyle. These results suggest the treatment's safety concerning the structural integrity of the condyle, although the observed gender differences in FA values warrant further investigation.
Topics: Humans; Mandibular Condyle; Malocclusion, Angle Class III; Female; Male; Cone-Beam Computed Tomography; Child; Palatal Expansion Technique; Fractals
PubMed: 38915000
DOI: 10.1186/s12903-024-04506-0 -
BMC Oral Health Jun 2024This paper aimed to explore the prevalence of temporomandibular disorders (TMDs) signs/symptoms, and to investigate the possible link between signs/symptoms of TMDs and...
BACKGROUND
This paper aimed to explore the prevalence of temporomandibular disorders (TMDs) signs/symptoms, and to investigate the possible link between signs/symptoms of TMDs and mouth breathing (MB) by evaluating along with other risk factors, in a Turkish subpopulation of children and adolescence.
METHODS
This study was conducted with the archival data of the patients who applied with orthodontic complaints. Data on demographic characteristics, family-related factors, systemic status, occlusion, breathing patterns, oral habits, and bruxism were retrieved from the archival records.
RESULTS
Nine hundred forty-five children and adolescents with a mean age of 14.82 ± 2.06 years were included in the study. Of the participants, 66% were girls, 60.4% were delivered by C-section, 8.4% of the participants had at least one systemic disease, 9.2% of the participants had allergy, and 4.3% of the participants' parents were divorced, 18.7% have an oral habit, 6.6% have bruxism, 29.8% have malocclusion and 14.1% have MB. Eight-point-five percent of participants have signs/symptoms of TMD. Among them 2.9% have pain, 3.7% have joint sounds, 1.4% have deflection, and 3.9% have deviation. Evaluation of the risk factors revealed a significant relation between the signs/symptoms of TMD and bruxism (OR 8.07 95% CI 4.36-14.92), gender (OR 2.01 95% CI 1.13-3.59), marital status of parents (OR 2.62 95% CI 1.07-6.42), and MB (OR 3.26 95% CI 1.86-5.71).
CONCLUSIONS
According to the study's findings, girls and those with bruxism, divorced parents, and MB behavior are more likely to have signs/symptoms of TMD. Age found to have significant effect on the occurrence of the signs/symptoms of TMD alone, but together with other factors the effect of the age is disappeared. Early screening and intervention of MB as well as the signs/symptoms of TMD can help to limit detrimental effects of these conditions on growth, and quality of life of children and adolescents.
Topics: Humans; Female; Adolescent; Male; Turkey; Cross-Sectional Studies; Temporomandibular Joint Disorders; Child; Mouth Breathing; Risk Factors; Prevalence; Bruxism; Malocclusion; Facial Pain; Hypersensitivity
PubMed: 38914975
DOI: 10.1186/s12903-024-04482-5 -
Journal of Maxillofacial and Oral... Jun 2024Facial anthropometric data vary significantly within the Indian population due to the racial, ethnic and geographic diversity. The anthropometric data of a given ethnic... (Review)
Review
OBJECTIVE
Facial anthropometric data vary significantly within the Indian population due to the racial, ethnic and geographic diversity. The anthropometric data of a given ethnic community may not match the other due to diverse ethnic variations, and hence, this study is intended to review the facial anthropometric data pertaining to the diverse Indian populace through a systematic literature survey.
MATERIALS AND METHOD
An electronic search done on Medline, Embase and Central databases was utilized to conduct a systematic review of literature. The available data were analyzed based on the various esthetic subunits of the face. The following inclusion criteria were considered: (1) studies depicting the anthropometric data of any ethnic group identified as belonging to India, (2) studies originating from Indian subcontinent, (3) studies which included data of male and female subjects separately and (4) articles in English language only. The following exclusion criteria were considered: (1) atudies conducted on participants with severe malocclusion, developmental craniofacial anomalies, post-traumatic facial deformities or with a history of previous craniofacial or cosmetic surgery, (2) studies which did not specify the anthropometric landmarks used to obtain the measurements, (3) studies in which the statistical analysis was not provided, or if data were grouped across genders and (4) editorials, commentaries, case reports, systematic reviews, meta-analyses and articles not available in English language.
RESULTS
Twenty-one articles met the inclusion criteria. Majority of the Indians, particularly men, seem to have a mesoproscopic facial phenotype. The vertical and horizontal facial dimensions of the Indian male are comparably larger than the Indian female. There is sexual dimorphism among the Indian population with regard to the upper and lower thirds of the face, with little or no gender difference as regards the middle third of the face. It was observed that the nasal dimensions of the Indian race were not compatible with that of the occidental, oriental or the western race. The overall facial structure and the upper half of the face were critical in determining facial attractiveness in Indian males while the lower half of the face and the mandibular contour were critical in determining facial attractiveness in females.
CONCLUSION
It is observed that there is a paucity of facial anthropometric data for the Indian population considering the ethnic, racial and geographic diversity. Since the prevalence of craniofacial anomalies and dentofacial deformities in India is high and thus the scope for corrective surgery, it is important to compile baseline facial anthropometric data based on the ethnic diversity of the Indian population.
PubMed: 38911415
DOI: 10.1007/s12663-024-02185-6 -
Cureus May 2024Temporomandibular joint (TMJ) ankylosis results in malocclusion, poor feeding, difficulty in maintaining oral hygiene, and facial esthetic deformity. The basic surgical...
Temporomandibular joint (TMJ) ankylosis results in malocclusion, poor feeding, difficulty in maintaining oral hygiene, and facial esthetic deformity. The basic surgical objectives in the treatment of TMJ ankylosis are to establish joint movement, prevent relapse, and achieve normal growth and development. Here, we present an operated case ofsurgical correction of mandibular hypoplasia; however, the patient came back after three years due to unsatisfactory results and underwent bilateral coronoidectomy and gap arthroplasty. Bones were osteotomized at the LeFort I level and the maxillary segment was down-fractured and mobilized to bring into occlusion with the mandible. In the present case, the lower pharyngeal airway changed from 5 mm pre-treatment to 10 mm post-treatment, and the facial angle was changed from 73 to 84 post-treatment. Assessment of the pharyngeal airway is done with a high suspicion of obstructive sleep apnea and facial deformity is mandatory in the management of TMJ ankylosis.
PubMed: 38910750
DOI: 10.7759/cureus.60857 -
Medicina Oral, Patologia Oral Y Cirugia... Jun 2024This study aimed to investigate the effectiveness of combining sevoflurane with remifentanil, esmolol, or nitroglycerin for hypotensive anesthesia and determine the...
BACKGROUND
This study aimed to investigate the effectiveness of combining sevoflurane with remifentanil, esmolol, or nitroglycerin for hypotensive anesthesia and determine the suitable hypotensive anesthesia method for orthognathic surgery.
MATERIAL AND METHODS
This retrospective study included 60 patients who underwent orthognathic surgery for developmental malocclusion. They were divided into three groups based on the hypotensive agent preferences: Group 1 (n = 20), sevoflurane and remifentanil; Group 2 (n = 20), sevoflurane and esmolol; Group 3 (n = 20), sevoflurane and nitroglycerin. Bleeding volume, heart rate, systolic, diastolic, and mean arterial blood pressure were recorded at certain times during the perioperative period, including at stages with increased stress levels in the body, such as incision and osteotomy. The patients' blood pressure, analgesic consumption and pain level were recorded in the postoperative period.
RESULTS
Bleeding volume, surgery satisfaction related to bleeding, and total operation time did not differ significantly between groups. Intraoperatively, heart rates were significantly higher in Group 3 than in Groups 1 and 2 (p = 0.001). However, hemodynamic stability was similar in Groups 1 and 2. Postoperatively, analgesic consumption, pain levels, and blood pressure dynamics did not differ significantly between groups (p > 0.05).
CONCLUSIONS
Based on this study's results, it was concluded that infusing remifentanil, esmolol, or nitroglycerin with sevoflurane during orthognathic surgery successfully achieved the targeted hypotensive anesthesia and can be considered alternative methods. The decision on which method to use should consider the patient's overall health status and additional medical conditions.
PubMed: 38907646
DOI: 10.4317/medoral.26662 -
American Journal of Orthodontics and... Jun 2024This study aimed to analyze the comprehensive maxillofacial features of patients with skeletal Class III malocclusion and facial asymmetry to develop a classification...
INTRODUCTION
This study aimed to analyze the comprehensive maxillofacial features of patients with skeletal Class III malocclusion and facial asymmetry to develop a classification system for diagnosis and surgical planning.
METHODS
A total of 161 adult patients were included, with 121 patients in the asymmetry group (menton deviation >2 mm) and 40 patients in the symmetry group (menton deviation ≤2 mm). Twenty-eight variables were determined, including transverse translation, roll and yaw of each facial unit, transverse width, mandibular morphology, and transverse dental compensation. Principal component (PC) analysis was conducted to extract PCs, and cluster analysis was performed using these components to classify the asymmetry group. A decision tree was constructed on the basis of the clustering results.
RESULTS
Six PCs were extracted, explaining 80.622% of the data variability. The asymmetry group was classified into 4 subgroups: (1) atypical type (15.7%) showed an opposite roll direction of maxillary dentition than of menton deviation; (2) compound type (34.71%) demonstrated significant ramus height differences, maxillary roll, and mandibular roll and yaw; (3) mandibular yaw type (44.63%) showed slight mandibular yaw without mandibular morphology asymmetry; and (4) maxillary-shift type (4.96%) shared similarities with the compound type but showed significant maxillary translation. The classification and regression tree model achieved a prediction accuracy of up to 85.11%.
CONCLUSIONS
This study identified 4 distinct phenotypes using cluster analysis and proposed tailored treatment recommendations on the basis of their specific characteristics. The classification results emphasized the importance of spatial displacement features, especially mandibular yaw, in diagnosing facial asymmetry. The established classification and regression tree model enables clinicians to identify patients conveniently.
PubMed: 38904566
DOI: 10.1016/j.ajodo.2024.05.012 -
Cureus Jun 2024This review aimed to evaluate the currently available evidence regarding the best method of correcting deep bites in growing patients. In September 2023, a search was... (Review)
Review
This review aimed to evaluate the currently available evidence regarding the best method of correcting deep bites in growing patients. In September 2023, a search was conducted electronically across the following databases: PubMed®, Web of Science™, Scopus®, Embase®, Google™ Scholar, and Cochrane Library. In this systematic review, randomized control trials (RCTs), controlled clinical trials (CCTs), and cohort studies of growing patients with deep bite malocclusion who received treatment with the primary objective of treating the deep bite were included. Risk of bias of the included studies was assessed using two different tools; one tool was applied for RCTs and the other one for the CCTs and cohort studies. One RCT, one CCT, and one cohort study were included (85 patients). The flat fixed acrylic bite plane was superior in terms of duration of treatment when compared to the inclined fixed acrylic bite plane and the utility arch with posterior intermaxillary elastics. Limited evidence indicates that the inclined fixed acrylic bite plane causes a significant increase in the lower incisor inclination and a significant increase in the angle between the mandible and the anterior cranial base (SNB). However, limited evidence indicates that the utility arch with posterior intermaxillary elastics causes a significant decrease in the angle between the maxilla and the anterior cranial base (SNA). Regarding the vertical skeletal changes, it was found that the three methods were comparable; in each case, the vertical dimension of the face increased because of a significant increase in the lower first molar height. There is a need for further studies to strengthen the evidence of the treatment efficacy of the employed methods, with more RCTs to be conducted in this regard.
PubMed: 38903977
DOI: 10.7759/cureus.62666 -
Unravelling the Complexities of Bite Force Determinants in Paediatric Patients: A Literature Review.Cureus May 2024The amount of maximum voluntary bite force (MVBF) is determined by the combined action of the jaw elevator muscles, which are altered jaw biomechanics and reflex... (Review)
Review
The amount of maximum voluntary bite force (MVBF) is determined by the combined action of the jaw elevator muscles, which are altered jaw biomechanics and reflex processes. Bite force (BF) measurements can yield valuable information on the activity and function of the jaw muscles. The accuracy of biting force measurements depends on several variables, including age, gender, malocclusion, dental caries, dental prostheses and temporomandibular joint (TMJ). This information is essential for evaluating the development and function of the masticatory system, identifying potential abnormalities or impairments and guiding appropriate treatment interventions for paediatric patients. The aim of this article is to review the literature on the factors affecting bite force and the importance of these factors in assessing dental development and guiding interventions for paediatric patients with bite force-related issues. Additionally, establishing normative values for bite force in different age groups can aid in monitoring growth and detecting any deviations from expected patterns. Measuring bite force in paediatric patients is significant in comprehensive oral health assessment and management.
PubMed: 38903313
DOI: 10.7759/cureus.60630 -
Evaluation of the soft tissue facial profile in different skeletal malocclusions in relation to age.BMC Oral Health Jun 2024The aim of the study was to assess the thickness of the soft tissue facial profile (STFP) in relation to the skeletal malocclusion, age and gender.
BACKGROUND
The aim of the study was to assess the thickness of the soft tissue facial profile (STFP) in relation to the skeletal malocclusion, age and gender.
METHODS
All patients, aged 7-35 years, who were seeking orthodontic treatment at the Department of Orthodontics, Medical University of Warsaw between 2019 and 22 were included in the study. All patients had lateral head radiographs taken before the treatment. The cephalometric analysis was performed including the STFP analysis. The patients were allocated to one of six groups based on age and skeletal relations (ANB angle). The minimum number of patients in each group was 60 with equal gender distribution. The STFP analysis included ten linear measurements.
RESULTS
A total of 300 patients were included in the study and allocated to five groups. Group 6 (growing patients with skeletal Class III malocclusion) was not included in the study as it failed to achieve the assumed group size. There were significant differences in the thickness of the STFP in relation to the skeletal malocclusions. Adults with skeletal Class III malocclusion had significantly thicker subnasal soft tissues compared to patients with skeletal Class I and Class II malocclusions. The thickness of the lower lip in patients with Class II skeletal malocclusion was significantly bigger compared to the other groups. Children and adolescents with Class II malocclusions had thicker lower lip in comparison to the group with Class I malocclusion. The majority of the STFP measurements were significantly smaller in children and adolescents compared to adults. The thickness of the STFP in males was significantly bigger in all age groups compared to females.
CONCLUSIONS
The thickness of facial soft tissues depends on the patient's age and gender. The degree of compensation of the skeletal malocclusion in the STFP may be a decisive factor during orthodontic treatment planning regarding a surgical approach or a camouflage treatment of skeletal defects.
Topics: Humans; Adolescent; Male; Female; Child; Cephalometry; Face; Adult; Age Factors; Young Adult; Malocclusion; Sex Factors; Malocclusion, Angle Class III; Malocclusion, Angle Class II
PubMed: 38902685
DOI: 10.1186/s12903-024-04486-1