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Journal of Pharmacy & Bioallied Sciences Feb 2024Orthognathic surgery is a surgical procedure performed to correct severe jaw misalignments that can affect a patient's facial aesthetics and functional occlusion. While...
BACKGROUND
Orthognathic surgery is a surgical procedure performed to correct severe jaw misalignments that can affect a patient's facial aesthetics and functional occlusion. While the primary goal of orthognathic surgery is to improve functional outcomes and facial appearance, it is essential to assess patient satisfaction as a crucial aspect of overall treatment success.
MATERIALS AND METHODS
Patient selection: We conducted a prospective study involving 50 patients who underwent orthognathic surgery. All patients had a confirmed diagnosis of severe jaw misalignment, as determined by clinical and radiographic assessments. The surgical procedures performed included maxillary advancement, mandibular setback, or a combination of both, depending on the patient's specific diagnosis. Preoperative orthodontic treatment was provided to align the teeth and prepare the patient for surgery. Patients were evaluated preoperatively and at postoperative intervals of 3 months, 6 months, and 1 year.
RESULTS
Patient satisfaction scores and functional outcomes were as follows: aesthetics of facial profile (1-year post-op): mean score = 4.6, chewing function (1-year post-op): mean score = 4.4, speech function (1-year post-op): mean score = 4.3, and overall satisfaction with surgical outcome (1-year post-op): mean score = 4.5. Objective assessments revealed a significant improvement in occlusion and facial aesthetics. The mean reduction in overjet was 4.8 mm, and the mean reduction in overbite was 3.2 mm. Additionally, the mean postoperative ANB angle improved by 3.7°, indicating a better facial balance.
CONCLUSION
Orthognathic surgery in our cohort of 50 patients resulted in high levels of patient satisfaction with both functional outcomes and facial aesthetics. Objective measurements also indicated significant improvements in occlusion and facial balance.
PubMed: 38595408
DOI: 10.4103/jpbs.jpbs_864_23 -
Journal of Pharmacy & Bioallied Sciences Feb 2024The rapid advancement of 3D printing technology has opened new avenues for patient-specific prosthodontic rehabilitation. This study aimed to explore the impact of 3D...
INTRODUCTION
The rapid advancement of 3D printing technology has opened new avenues for patient-specific prosthodontic rehabilitation. This study aimed to explore the impact of 3D printing technology on prosthodontic outcomes and patient satisfaction through a comparative analysis.
MATERIALS AND METHODS
A total of 100 patients requiring prosthodontic rehabilitation were recruited for this study. The patients were randomly divided into two groups: the experimental group, where 3D printing technology was utilized for the fabrication of patient-specific prostheses, and the control group, where conventional fabrication techniques were employed. Various parameters were assessed, including prosthesis fit, occlusion, esthetics, and patient-reported outcomes such as comfort and satisfaction. Digital measurements and subjective evaluations were conducted to compare the outcomes between the two groups. Statistical analysis was performed using appropriate tests.
RESULTS
Preliminary findings indicated that the use of 3D printing technology in prosthodontic rehabilitation resulted in superior prosthesis fit, enhanced occlusal stability, and improved esthetics compared to conventional methods. Moreover, patients in the experimental group reported higher levels of comfort and overall satisfaction. The advantages of 3D printing technology were observed across different types of prosthodontic restorations, including crowns, bridges, and dentures. These results highlight the potential of 3D printing technology to revolutionize patient-specific prosthodontic rehabilitation. By facilitating precise fabrication, customization, and improved functional outcomes, 3D printing can enhance the overall quality of prosthodontic care. Further long-term studies are warranted to validate these findings and explore the cost-effectiveness and long-term durability of 3D-printed prostheses.
CONCLUSION
In conclusion, this study demonstrates that the integration of 3D printing technology in patient-specific prosthodontic rehabilitation holds great promise for achieving optimal functional and esthetic outcomes. The findings contribute to advancing prosthodontic practices and provide valuable insights for clinicians and researchers seeking to incorporate this innovative technology into their treatment protocols.
PubMed: 38595354
DOI: 10.4103/jpbs.jpbs_643_23 -
Journal of Pharmacy & Bioallied Sciences Feb 2024Various clinical studies performed in adults have shown the relationship between craniofacial morphology and masticatory muscle function. However, the growth of the...
BACKGROUND
Various clinical studies performed in adults have shown the relationship between craniofacial morphology and masticatory muscle function. However, the growth of the masticatory muscle has not received such attention, when compared with the volume of studies on the skeletal growth of face. With this background and considering the widespread use of ultrasonography (USG), the following study was undertaken to provide some insights into the relationship between muscle and bone and facial morphology.
METHODS
This was a prospective, observational study conducted over a period of three years from 2012 to 2015 to assess the correlation between the thickness of the masseter muscle in Angle's normal occlusion and the various malocclusions of the dental arch as well as the facial form. Patients with a full complement set of teeth, normal tooth morphology, Angle's normal occlusion, Angle's class I-III malocclusion, those with a history of third molar extraction, and impaction were included in the study. Those with a history of any prior orthodontic treatment, restorations, or any missing teeth (except the third molar) were exempted from the study. The greater thickness of masseter muscle in relaxed and clenched state was recorded on USG. Facial morphology was determined with the aid of facial photographs.
RESULTS
The study was conducted on 140 patients. The class I normal occlusion group had the thickest masseter muscle, while the class III malocclusion group had the thinnest masseter muscle. Facial parameters showed highly significant gender-wise differences in class I normal occlusion, class I malocclusion, and class II division II malocclusion. There was a significant negative co-relation between the thickness of masseter muscle and facial forms in all the categories of Angle's classification as indicated by a negative regression coefficient B ( < 0.05).
CONCLUSION
The masseter muscle thickness correlated directly with male gender and normal occlusion, and inversely with the degree of malocclusion and facial form.
PubMed: 38595353
DOI: 10.4103/jpbs.jpbs_1112_23 -
PloS One 2024Morphological variation in modern human dentition is still an open field of study. The understanding of dental shape and metrics is relevant for the advancement of human...
Morphological variation in modern human dentition is still an open field of study. The understanding of dental shape and metrics is relevant for the advancement of human biology and evolution and is thus of interest in the fields of dental anthropology, as well as human anatomy and medicine. Of concern is also the variation of the inner aspects of the crown which can be investigated using the tools and methods of virtual anthropology. In this study, we explored inter- and intra-population morphometric variation of modern humans' upper third and fourth premolars (P3s and P4s, respectively) considering both the inner and outer aspects of the crown, and discrete traits. We worked by means of geometric morphometrics on 3D image data from a geographically balanced sample of human populations from five continents, to analyse the shape of the dentinal crown, and the crown outline in 78 P3s and 76 P4s from 85 individuals. For the study of dental traits, we referred to the Arizona State University Dental Anthropology System integrated with more recent classification systems. The 3D shape variation of upper premolar crowns varied between short and mesio-distally broad, and tall and mesio-distally narrow. The observed shape variation was independent from the geographical origin of the populations, and resulted in extensive overlap. We noted a high pairwise correlation (r1 = 0.83) between upper P3s and P4s. We did not find any significant geographic differences in the analysed non-metric traits. Our outcomes thus suggest that geographical provenance does not play a determinant role in the shaping of the dental crown, whose genesis is under strict genetic control.
Topics: Animals; Humans; Bicuspid; Anthropology, Physical; Hominidae; Anthropology; Tooth Crown
PubMed: 38593117
DOI: 10.1371/journal.pone.0301482 -
Journal of Clinical Medicine Feb 2024Digital technologies enable the accurate replication of occlusion, which is pivotal for stability in maximum intercuspation and dynamic occlusion. CAD softwares...
Digital technologies enable the accurate replication of occlusion, which is pivotal for stability in maximum intercuspation and dynamic occlusion. CAD softwares generates standardized occlusal morphologies requiring significant adjustments. The consideration of individual mandibular movements during restoration leads to better functional integration. This pilot study evaluates the efficacy of a novel, fully digital protocol for occlusal analysis recording in prosthodontics. Patients needing single or multiple metal-free restorations were included. Teeth underwent horizontal finish line preparation, while restorations on implants were either directly screwed or used multi-unit abutments. A digital impression (Trios 3 Intraoral Scanner) captured the mouth's elements. Dynamic occlusion was recorded via Patient Specific Motion (PSM). After the placement and functionalization of temporary restorations, subsequent scans included various elements, and CAD software (Dental system) was used for the restoration design. Restorations were milled in monolithic zirconia, pressed from CAD/CAM-milled wax, and sintered. : An evaluation of 52 restorations in 37 patients indicated high accuracy in restorations manufactured via the fully digital workflow. Monolithic zirconia was predominantly used. Subtractive (17.3%) and additive (7.7%) occlusal adjustments were mainly chairside. This study underscores the efficacy of meticulous verification measures and a centric contact system in reducing the need for clinical occlusal refinements in prosthetic restorations.
PubMed: 38592229
DOI: 10.3390/jcm13051370 -
Cureus Mar 2024The transverse dimension, often overlooked in orthodontics, plays a crucial role in malocclusions, affecting not only occlusion in that dimension but also sagittal and...
The transverse dimension, often overlooked in orthodontics, plays a crucial role in malocclusions, affecting not only occlusion in that dimension but also sagittal and vertical dimensions. Posterior crossbites, indicative of transverse maxillary issues, are commonly addressed through palatal expansion. This case report explores the clinical insights into addressing a constricted maxillary arch in Angle's Class II malocclusion using a nickel-titanium (NiTi) expander. The NiTi expander provides constant and optimal expansion forces by incorporating a temperature-activated NiTi alloy. A 16-year-old male with irregularly placed teeth, high palatal vault, and posterior crossbite underwent treatment involving NiTi expander usage for maxillary expansion. The case presentation details the patient's journey, starting with upper arch bonding and expansion, then lower arch bonding, and concluding with complete leveling and alignment without extractions. The presented case demonstrates successful correction of a constricted maxillary arch, specifically in the canine and molar regions, utilizing the NiTi expander. The observed increase in intermolar width aligns with previous studies, showcasing the effectiveness of slow maxillary expansion. This article contributes valuable clinical insights into addressing transverse maxillary issues, emphasizing the importance of careful consideration in choosing the appropriate expansion method for optimal results.
PubMed: 38586693
DOI: 10.7759/cureus.55798 -
Cureus Mar 2024Dentin hypersensitivity (DH) involves sensitive symptoms, because of exposure of the dentinal tubules. Various materials have been utilized to occlude dentinal tubules...
Evaluation and Comparison for the Efficacy of 810 nm Diode Laser, Nano Carbonate Apatite and Their Combination Over Dentinal Tubules Occlusion: An In Vitro Scanning Electron Microscopic Study.
BACKGROUND
Dentin hypersensitivity (DH) involves sensitive symptoms, because of exposure of the dentinal tubules. Various materials have been utilized to occlude dentinal tubules for the treatment of DH. Here is a comparative evaluation of nano-carbonate apatite (n-CAP), diode laser, and their combination over the occlusion of dentinal tubules.
MATERIALS AND METHOD
Ten intact first premolars were used in this study, out of which 40 dentin disk specimens were obtained by hard tissue microtomy. Four study groups were formulated out of which one was the control group and the remaining three were test groups. Scanning electron microscopy (SEM) was done to evaluate the diameter of the dentinal tubules in each group.
RESULTS
On examining data, it was observed that the mean diameter of dentinal tubules in four study groups of control, laser, n-CAP, and n-CAP + laser was found to be 3.40, 2.00, 0.46, and 0.02 respectively. This shows the significant reduction in the diameter of dentinal tubules in the test groups when compared with the control group.
CONCLUSION
Among all the measures used to see for a reduction in the diameter of dentinal tubules, the combination group was found to be most occluding, though each of the groups also had a significant reduction in the diameter of dentinal tubules. The present study showed that combination therapy offers a promising means of treating DH in a clinical setting when compared with the treatment of DH n-CAP containing dentifrice or laser irradiation alone.
PubMed: 38586653
DOI: 10.7759/cureus.55718 -
Journal of the American Dental... May 2024Orthodontic treatment for patients with dentinogenesis imperfecta (DGI) can be risky because of the fragility of their dental hard tissue. Although the Invisalign (Align...
BACKGROUND
Orthodontic treatment for patients with dentinogenesis imperfecta (DGI) can be risky because of the fragility of their dental hard tissue. Although the Invisalign (Align Technology) clear aligner system should be a suitable orthodontic appliance for patients with DGI, to the authors' knowledge, there has been no related research.
CASE DESCRIPTION
A 28-year-old woman with DGI sought treatment with a 1 mm open bite, edge-to-edge occlusion of the central incisors, and a bilateral Class III cusp-to-cusp molar relationship. Invisalign was applied for her treatment, and after 3 and one-half years of orthodontic therapy, a normal overjet and overbite were achieved, accompanied by retraction of the lower lip as well as a bilateral Class I molar relationship. In addition, there was no iatrogenic injury to the patient's teeth.
PRACTICAL IMPLICATIONS
The Invisalign system may be a suitable orthodontic appliance for patients with DGI because clear aligners lessen the tensile stress to the teeth, decrease the number and area of bonds to the teeth, and offer protective effects through a full wrap of plastic that covers the crowns of the teeth.
Topics: Humans; Female; Adult; Dentinogenesis Imperfecta; Orthodontic Appliances, Removable; Tooth Movement Techniques; Orthodontics, Corrective; Orthodontic Appliance Design
PubMed: 38573273
DOI: 10.1016/j.adaj.2024.01.007 -
Heliyon Apr 2024Negative pressure pulmonary edema (NPPE), also known as post-obstructive pulmonary edema, is a rare and life-threatening condition. It occurs when a person breathes...
Negative pressure pulmonary edema (NPPE), also known as post-obstructive pulmonary edema, is a rare and life-threatening condition. It occurs when a person breathes against an obstructed glottis, causing negative thoracic pressure in the lungs. This negative pressure can lead to fluid accumulation in the lungs, resulting in pulmonary edema. The obstructed glottis might be caused by laryngospasm, which occurs when the muscles around the larynx involuntarily spasm and can lead to complete upper airway occlusion. This report shares the case of a 33-year-old woman hospitalized for periapical dental abscess, facial swelling, and shortness of breath. The patient exhibited signs of poor oral hygiene. After the exacerbation of her symptoms, she showed signs of asphyxia and decreased oxygen saturation, which led to her intubation. Imaging revealed bilateral pleural effusion and patchy ground glass opacities favoring NPPE. After three days of treatment with diuretics and other conservative measures, her condition was alleviated, and she was extubated. Laryngospasm in the presence of a dental abscess is uncommon. Identification of imaging favoring NPPE in this setting is even more rare. In cases of laryngospasm, prompt intubation is crucial. Therapy with diuretics and other conservative measures can effectively treat NPPE following laryngospasm.
PubMed: 38571620
DOI: 10.1016/j.heliyon.2024.e28470 -
Clinical Oral Investigations Apr 2024To identify predictors for long-term relapse of orthodontic therapy in patients with cleft lip and palate (CLP).
OBJECTIVES
To identify predictors for long-term relapse of orthodontic therapy in patients with cleft lip and palate (CLP).
MATERIALS AND METHODS
Patients with uni- and bilateral non-syndromal CLP were followed up at least two years after completion of their orthodontic therapy. Plaster casts of the start of treatment (T1), after completion of treatment (T2), and at follow-up (T3) were measured using the modified Huddart Bodenham Index. Characteristics of multidisciplinary therapy were taken from the patient files. Potentially influencing factors of relapse were investigated using logistic regression analyses and Spearman correlations.
RESULTS
In total 58.07% of the included 31 patients showed a stable treatment outcome at follow-up after an average of 6.9 years. Even if relapse occurred, 61.54% of these patients still showed improvement regarding their occlusion compared to baseline. Predictors for the occurrence of relapse were the severity of dysgnathia at baseline (p = 0.039) and the extent of therapeutic change (p = 0.041). The extent of therapeutic change was additionally a predictor for the extent of post-therapeutic relapse (ρ = 0.425; p = 0.019).
CONCLUSIONS
Patients with CLP benefit from their orthodontic therapy in the long term despite an increased tendency to relapse.
CLINICAL RELEVANCE
Results of this long-term study could be used to adapt the treatment concept for patients with CLP and reinforce the significance of a patient-centered orthodontic treatment concept for affected patients.
Topics: Humans; Follow-Up Studies; Cleft Lip; Cleft Palate; Dental Care; Chronic Disease
PubMed: 38568324
DOI: 10.1007/s00784-024-05632-3