-
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 -
Journal of Oral and Maxillofacial... Jun 2024Assessing condyle position postorthognathic surgery is pivotal for optimizing surgical accuracy, sustaining postoperative stability, and ensuring predictable treatment...
BACKGROUND
Assessing condyle position postorthognathic surgery is pivotal for optimizing surgical accuracy, sustaining postoperative stability, and ensuring predictable treatment outcomes.
PURPOSE
The aim of this study was to analyze the changes of condyle position after orthognathic surgery with different types of jaw deformity and to analyze whether the changes of condyle position are different.
STUDY DESIGN, SETTING, SAMPLE
A retrospective cohort study was designed and conducted, involving adults who underwent orthognathic surgery for jaw deformities at the affiliated Stomatological Hospital of Nanchang University between 2019 and 2022. Patients with incomplete CT data were excluded.
PREDICTOR/EXPOSURE/INDEPENDENT VARIABLE
The primary predictor variable was time (preoperative and postoperative) and types of jaw deformities (skeletal Class III, skeletal Class II, and mandibular deviation).
MAIN OUTCOME VARIABLE(S)
The main outcome variables were the three-dimensional linear and rotational positional changes of the condyle.
COVARIATES
Evaluated covariates included sex and age.
ANALYSES
MIMICS 20.0 software measured all data, and SPSS 22.0 software facilitated statistical analyses. Intragroup and intergroup correlation analyses employed paired t-tests and independent t-tests, with statistical significance set at P < .05.
RESULTS
The study sample was composed of 32 subjects with a mean age of 22.43 ± 1.6 and 9 were male. The analysis of changes of condylar position from virtual surgical planning to the immediate postoperative period showed that the maximum condylar displacement was 1.74 mm and the maximum angular change was 3.92°. The analysis of changes in condylar position from the immediate postoperative period to 1 year postoperatively showed no statistically significant changes for the same type of jaw deformity. But patients with Class II malocclusion exhibited distinct condylar displacement and rotation patterns compared to those with Class III malocclusion and mandibular deformity.
CONCLUSION AND RELEVANCE
The application of virtual surgical planning in orthognathic surgery ensures a high degree of consistency in achieving the desired condylar position. Moreover, no significant change in condylar position was observed after orthognathic surgery for the same type of jaw deformity. However, patients with Class II deformities exhibited a higher susceptibility to rotational displacement of the condyles compared to those with other types of jaw deformities.
PubMed: 38901470
DOI: 10.1016/j.joms.2024.05.013 -
American Journal of Veterinary Research Jun 2024To evaluate the dental abnormalities by visually assessing the labial and buccal photographs in dogs and cats and analyze their prevalence based on age and breed.
OBJECTIVE
To evaluate the dental abnormalities by visually assessing the labial and buccal photographs in dogs and cats and analyze their prevalence based on age and breed.
ANIMALS
1,096 client-owned dogs and 775 client-owned cats.
METHODS
Data were collected from patients who visited 26 private veterinary clinics from January to December 2022. Each animal was evaluated through dental photographs taken from the labial and buccal sides. Correlations between the prevalence of the identified dental abnormalities and age, craniofacial type, and breed, were analyzed.
RESULTS
Calculus, discoloration, epulis, fractured teeth, gingival recession, gingivitis, malocclusion, missing teeth, and persistent deciduous teeth could be identified by analyzing the dental photographs in both dogs and cats. Enamel defects in dogs and tooth resorption in cats could be identified. Brachycephalic dogs had a significantly higher prevalence of malocclusion (OR, 1.93; 95% CI, 1.36 to 2.75) and missing teeth (OR, 3.63; 95% CI, 2.71 to 4.91) compared to nonbrachycephalic dogs. Brachycephalic cats had a significantly higher prevalence of fractured teeth (OR, 1.95; 95% CI, 1.24 to 3.04) and a lower prevalence of gingival recession (OR, 0.30; 95% CI, 0.15 to 0.55) compared to nonbrachycephalic cats. Calculus, persistent deciduous teeth, and possibly gingivitis could be identified in dogs and cats by analyzing labial and buccal photographs. The assessment of some dental abnormalities such as fractured teeth, missing teeth, and tooth resorption can be limited without a complete dental examination under anesthesia.
CLINICAL RELEVANCE
Although the assessment of dental conditions may be underestimated, the data on the prevalence of the dental abnormalities evaluated through the photographs could be utilized for screening dental diseases.
PubMed: 38901457
DOI: 10.2460/ajvr.24.03.0085 -
Journal of Oral and Maxillofacial... Jun 2024The stability of the condylar position within the first 3 months after orthognathic surgery in patients with skeletal Class III malocclusion is crucial for subsequent...
Three-Dimensional Changes of Condylar Position After Bimaxillary Surgery to Correct Skeletal III Malocclusion: Cone Beam Computed Tomography Voxel-Based Superimposition Analysis.
BACKGROUND
The stability of the condylar position within the first 3 months after orthognathic surgery in patients with skeletal Class III malocclusion is crucial for subsequent orthodontic treatment.
PURPOSE
The purpose was to compare condylar positional changes 3 months after bimaxillary surgery to correct skeletal Class III deformities, utilizing the conventional two-dimensional combined with cone beam computed tomography voxel-based superimposition analysis.
STUDY DESIGN, SETTING, SAMPLE
This retrospective cohort study included skeletal Class III patients undergoing bimaxillary orthognathic surgery at Khon Kaen University, Thailand, in 2020. Exclusion criteria were patients with temporomandibular disorder symptoms, facial asymmetry prior to the surgery, or surgical complications.
EXPOSURE VARIABLE
The exposure variable was the timing, both preoperatively and 3 months postoperatively. This 3-month postoperative time point was chosen because complete healing of the bimaxillary surgery is expected by then, without any potential influence of condylar changes resulting from subsequent orthodontic treatment.
MAIN OUTCOME VARIABLES
The outcome variables are condylar position measurement, joint space (mm), and axial condylar angle (degrees).
COVARIATES
Demographics (age, sex) and surgical details (direction and amount of movement) were collected as covariates.
ANALYSES
Statistical analysis of condylar positional changes and correlations was performed using paired t-test and linear correlation (P value < .05), respectively.
RESULTS
The sample included 11 subjects (22 condyles), with a mean age of 24 ± 5.24 years. Both two-dimensional measurements and voxel-based three-dimensional superimposition showed significant changes in condylar position 3 months after bimaxillary surgery: inferior (0.45 ± 0.26 mm, P < .001), posterior (0.46 ± 0.39 mm, P = .003), lateral (0.38 ± 0.42 mm, P = .01) displacement, and inward rotation (5.21 ± 2.54°, P < .001). No significant correlation was found between jaw movement distance and condylar changes.
CONCLUSION AND RELEVANCE
To our knowledge, this is the first study to report measures of condylar changes at 3 months, when complete healing of the osteotomies would be expected, using Le Fort I osteotomy for maxillary advancement combined with bilateral sagittal split ramus osteotomy for mandibular setback. These changes are small in magnitude and may be of little relevance to patient care.
PubMed: 38889883
DOI: 10.1016/j.joms.2024.05.014 -
Indian Journal of Otolaryngology and... Jun 2024Osteochondroma (OC) is an uncommon reason for the mandibular condyle to grow excessively. Usually unilateral, it can impact the entire mandible, the condyle and ramus,...
Osteochondroma (OC) is an uncommon reason for the mandibular condyle to grow excessively. Usually unilateral, it can impact the entire mandible, the condyle and ramus, or just the condyle. It is a bony projection covered in cartilage that protrudes from the damaged bone's exterior. Condylar OC are more prevalent as a result of endochondral ossification-related development. The most notable characteristic is the gradual asymmetry of the face over time. Clinical symptoms of the patient include pain, asymmetry, malocclusion, partial or total hearing loss, trismus, and hypomobility of the TMJ. We report a case of 40-year-old male patient complaining of reduced mouth opening since last 10 years. Clinical examination revealed gross facial asymmetry, hard swelling over right TMJ, jaw deviation towards left side, restricted mouth opening of 3 mm and deranged occlusion. An irregular radiopaque mass was seen over the right condylar region in OPG. A large, hyperdense mass that obliterated the sigmoid notch and extended medially to the right condyle was visible on CT scans. Using a pre-auricular Alkayat-Bramley technique, the mass was surgically removed. Occlusal corrections and jaw physiotherapy were then administered. On follow up, deviation was corrected and adequate mouth opening was achieved.
PubMed: 38883440
DOI: 10.1007/s12070-023-04469-8 -
Cureus May 2024Introduction In orthodontics, having a beautiful smile is very important. It is frequently the main driving force behind people's efforts to enhance their oral health...
Introduction In orthodontics, having a beautiful smile is very important. It is frequently the main driving force behind people's efforts to enhance their oral health and professional opportunities. Orthodontic and dental treatment planning might benefit greatly when evaluating the aesthetic components of a patient's smile in individuals with varying skeletal growth patterns. In order to help orthodontists achieve the best possible functional and aesthetic results for their patients, the eight elements of a balanced smile are essential to orthodontic therapy. This study aims to evaluate, in comparison to Skeletal Class I Average instances, eight balanced smile components in patients with Skeletal Class II Vertical and Horizontal growth patterns. Methodology A total of 45 patients aged 14-30 were selected from the Orthodontics and Dentofacial Orthopedics Out-Patient Department (OPD). They were divided into three groups: Skeletal Class I Average, Skeletal Class II Vertical, and Skeletal Class II Horizontal cases based on their malocclusion type. Patients were made to smile in response to a joke or social conversation and their photos were analyzed using Photopea software (Photopea Inc., Prague, Czech Republic) to determine the eight components of a balanced smile. Result Three skeletal classes' worth of smile components were examined in this study. Lip line measurements varied greatly; the highest mean measurement was found in the Skeletal Class II Vertical group (p-value < 0.01). There were no noteworthy correlations found between smile arc and upper lip curvature. Measurements of lateral negative space did not show any significant group differences. On the other hand, a significant correlation was seen in smile symmetry, where asymmetrical smiles were more prevalent in Skeletal Classes I and II Vertical groups (p-value is 0.00072). While arch symmetry suggested a potential relationship between the groups, dental midline alignment revealed possible associations. Conclusion Assessing the aesthetic components of smiles in patients with varying skeletal growth patterns, i.e., contrasting Class II Vertical and Horizontal growth patterns with Class I Average cases, provides valuable information about the connection between smile aesthetics and facial skeletal structure. The results suggest that when compared to Class I typical instances, Skeletal Class II Vertical and Horizontal growth patterns may show clear variations in certain aspects of an attractive smile. Comprehending these variations is essential for devising treatment strategies for patients, and additional investigation is needed. In order to obtain optimal aesthetic outcomes, treatment strategies should strive to optimize smile aesthetics while addressing personalized treatment plans that take into account the patient's unique facial features, smiling preferences, and functional requirements.
PubMed: 38882971
DOI: 10.7759/cureus.60399 -
Journal of Pharmacy & Bioallied Sciences Apr 2024To assess the dentist perception of efficiency, treatment outcome, and stability of the tooth movement treated with mysmartalign clear aligner therapy (MSA CAT).
AIM AND OBJECTIVE
To assess the dentist perception of efficiency, treatment outcome, and stability of the tooth movement treated with mysmartalign clear aligner therapy (MSA CAT).
MATERIALS AND METHOD
A cross-sectional web-based questionnaire survey was carried out to evaluate the dentist perception of MYSMARTALIGN (MSA). To determine the sample size, a pilot study has been carried out and the final sample arrived was 4990 subjects. The current study's inclusion criteria took into account those who had finished their BDS and MDS as well as dentists and orthodontists who had been using the MSA CAT system on their patients for the previous 7 years.
RESULTS
The result of the study showed that most research participants (3650) used MSA to treat mild to moderate malocclusion, and 3996 participants said that initial digital treatment plans have been authorised with no revisions. In view of efficiency, 3894 doctors were satisfied with the final outcome.
CONCLUSIONS
Finally concluded that recent survey showed that dentists were very satisfied with the effectiveness and treatment results of the MSA clear aligner procedure.
PubMed: 38882901
DOI: 10.4103/jpbs.jpbs_1095_23 -
Journal of Pharmacy & Bioallied Sciences Apr 2024The current purpose of the survey is to completely evaluate parents' attitudes, knowledge, and perceptions of myofunctional appliances.
AIM
The current purpose of the survey is to completely evaluate parents' attitudes, knowledge, and perceptions of myofunctional appliances.
MATERIALS AND METHODS
Parents in Chennai participated in this cross-sectional web-based questionnaire survey. Pilot study was carried out to determine the sample size, and 500 individuals were the final sample size. The 10 organized, predesigned, and validated questions are on awareness of myofunctional appliance.
RESULTS
The result of the survey showed that in 500 subjects, 79.8% were aware of skeletal problems. The proportion of parents willing to recommend the use of such treatments is about 70%, while 69% believe that myofunctional appliances are important in correcting skeletal problems.
CONCLUSION
The present study has established that most parents know about the functional appliance and have an understanding of how to distinguish between skeletal problems. In order to diagnose skeletal issues in an appropriate age range for the individual, more awareness about appliances is necessary and needs to be developed.
PubMed: 38882836
DOI: 10.4103/jpbs.jpbs_953_23