Study on the Development of a New Device with Dual Cameras for Evaluating Expiratory Nasal Flow.

BACKGROUND: Use of the Glatzel mirror for measuring expiratory nasal flow in preschool children has the disadvantage of vagueness, and the mirror may induce fear and inhibition of interest in those children. In response to these limitations, we developed a new device with dual cameras for measuring expiratory nasal flow in 2 to 6 year old children. The aim of this study is to compare the Glatzel mirror and the new device, in terms of accurate assessment of expiratory nasal flow, children's feelings, and correlation to each child's profile. METHODS: This study evaluated 20 cleft lip and palate patients and 21 healthy children aged between 2 and 6 (under 7) years. After consent was granted, a 4-week screening period was undertaken followed by inspection at weeks 8, 16, 24, and 32. Each inspection was conducted while the children were asked to pronounce various sounds and comprised three stages: i) use of the Glatzel mirror, ii) subjective visual assessment using the new device, and iii) image recording by dual cameras of the new device. Questionnaires for the new device were administered at the initial and final inspections. To contrast the results between the Glatzel mirror and the new device, the numbers that indicated values of subjective visual assessment and camera assessment greater than the assessment values of the Glatzel mirror were compared. For measuring the children's responses to the new device compared with those to the Glatzel mirror, the answers to the questionnaires were compared. For the comparison of the children's profiles (age and sex) and feelings, the numbers of subjects who could use the new device were measured. RESULTS: The camera assessment of the new device indicated significantly greater values than that of the Glatzel mirror (P < 0.05). The feelings of the subjects to the new device mostly improved as the study progressed. Subjects aged 3 years and older were generally able to use the new device from the initial inspection. For both sexes, as the inspection progressed, the number occasions of successful use increased. CONCLUSION: This study demonstrated the superiority of the new device with dual cameras to the Glatzel mirror in terms of functionality and attitude of children.

Orthodontic correction of severe Class II malocclusion in a patient with Prader-Willi syndrome.

Prader-Willi syndrome (PWS) is a complex disorder that affects multiple systems and may cause craniofacial and dentofacial abnormalities. However, there is still a lack of evidence in the literature regarding the progress of orthodontic treatment in patients with PWS. This case report describes the successful orthodontic treatment of a patient with PWS. A girl, 9 years 0 months of age, who had been diagnosed with PWS had protruding maxillary incisors and a convex profile. Her malocclusion was due to the posteriorly positioned mandible. Screening tests for sleep apnea syndrome showed that she had sleep-disordered breathing, including obstructive sleep apnea and bruxism. We also observed an excessive overjet of 10.0 mm, a deep overbite of 6.8 mm, and the congenital absence of the mandibular second premolars. The patient was diagnosed with an Angle Class II malocclusion and a skeletal Class II jaw-base relationship with a deep overbite. Functional appliance therapy with mandibular advancement, which can enlarge the upper airway and increase the upper airspace, was performed to prevent further deterioration of the patient's obstructive sleep apnea. An acceptable occlusion with a proper facial profile and functional excursion were achieved without interference after comprehensive 2-stage treatment that incorporated orthodontic therapy for the patient's excessive overjet and deep overbite. The resulting occlusion was stable, and the occlusal force and the contact area gradually increased over a 2-year retention period. These results suggest that orthodontic treatment offers the opportunity to greatly improve the health and quality of life of people with PWS.

The different effects of intraoral vertical ramus osteotomy (IVRO) and sagittal split ramus osteotomy (SSRO) on mandibular border movement.

OBJECTIVES: This study investigated the different effects of intraoral vertical ramus osteotomy (IVRO) and sagittal split ramus osteotomy (SSRO) on mandibular border movement. METHODS: The participants included 22 patients receiving IVRO and 22 patients receiving SSRO who were treated at Okayama University Hospital. Their mandibular border movement was evaluated in three dimensions with 6° of freedom using an optical recording system. RESULTS: A strong correlation between condylar and lower incisor movement was observed during maximum jaw protrusion and laterotrusion. Significant improvements in condylar and lower incisor movement were detected after orthognathic surgery during maximum jaw protrusion and laterotrusion in the IVRO group and during maximum jaw protrusion in the SSRO group. DISCUSSION: IVRO likely achieves greater improvement in jaw movement than SSRO. Therefore, the application of IVRO could be considered in the treatment of patients with jaw deformities featuring temporomandibular joint problems.

Comparative evaluation of treatment outcomes between temporary anchorage devices and Class III elastics in Class III malocclusions.

INTRODUCTION: Our objective was to elucidate the differences in treatment outcomes caused by the different mechanics of temporary anchorage devices (TADs) and Class III elastics in patients with Class III malocclusions. METHODS: Records of 23 patients with Angle Class III malocclusion were selected retrospectively. All had been treated with nonextraction comprehensive orthodontic treatment; 11 were treated with TADs and 12 with Class III elastics. Pretreatment and posttreatment lateral cephalograms were used for evaluation of the treatment outcomes. A paired t test and a Student t test were used for statistical analysis. RESULTS: In both groups, proper overjet and Class I molar relationships were achieved, and the occlusal plane was rotated counterclockwise. In the elastics group, distal tipping of the mandibular molars, extrusion of the mandibular incisors and maxillary molars, clockwise rotation of the mandibular plane angle, and increased ANB angle were observed. In the TADs group, distal tipping and intrusion of the mandibular molars, bodily movement of the mandibular incisors, and reduced mandibular plane angle were observed. CONCLUSIONS: In nonextraction treatment for Class III malocclusions, the mandibular plane angle was increased in the elastics group, whereas it was decreased in TADs group. Thus, we suggest that Class III elastics are preferred for low-angle, short-face patients, whereas TADs are preferred for high-angle, long-face patients.

A Single-center, Open-label, Randomized Controlled Clinical Trial to Evaluate the Efficacy and Safety of the Indirect Bonding Technique.

Although accurate bracket placement is essential for orthodontic treatment, many practitioners apply brackets indiscriminately with direct or indirect bonding techniques. Nonetheless, there have been few prospective clinical comparisons of the 2 techniques. We will therefore conduct a single-center, randomized control trial in 100 patients aged 12 years and diagnosed with malocclusion. All patients will receive orthodontic treatment using brackets with direct or indirect bonding techniques. The primary endpoints will be the total treatment time, occlusal index, discomfort at bonding, and oral hygiene after bonding. This study will clarify whether indirect bonding can improve the efficiency of orthodontic treatment.

Antero-posterior and vertical facial type variations influence the aesthetic preference of the antero-posterior lip positions.

UNLABELLED: SummaryObjectives: The purposes of this study were to investigate whether the antero-posterior and vertical facial type variations influenced the favoured lip positions and to elucidate whether the favoured lip positions differed between orthodontists and laypersons. METHODS: An average profile was constructed from a Japanese female with Class I occlusion and a well-balanced profile, as assessed by several cephalometric analyses. Nine facial types were composed by morphing the chin antero-posteriorly and/or vertically. Thirteen morphed lip profiles were constructed by moving the lips antero-posteriorly in the nine facial types, respectively. Seventy-seven Japanese laypersons and 30 orthodontists were asked to choose the top three most-favoured lip positions for each facial type. RESULTS: The protruded lip positions were significantly favoured for all the mandibular protrusive facial types. The retruded lip positions were significantly favoured for the short facial type of the antero-posteriorly average and mandibular retrusive-short facial types. Among the mandibular protrusive facial types, the protruded lip positions were significantly favoured for the long facial type. The retruded lip positions were statistically more attractive for orthodontists than laypersons on the antero-posteriorly average-short, mandibular protrusive-short, mandibular retrusive-vertically average, antero-posteriorly average-vertically average, and mandibular retrusive-long facial types. LIMITATIONS: Our data were limited by the specific ethnic groups and variety of facial types. CONCLUSION: The favoured antero-posterior lip position was affected by not only the antero-posterior facial disproportion but also by the vertical dimensions. The favoured lip positions differed between orthodontists and laypersons. These results might be helpful in deciding between extraction and non-extraction treatment in borderline cases.

Outcome assessment of lingual and labial appliances compared with cephalometric analysis, peer assessment rating, and objective grading system in Angle Class II extraction cases.

OBJECTIVE: To validate our hypothesis that there would be significant differences in treatment outcomes, including cephalometric values, degree of root resorption, occlusal indices, and functional aspect, between cases treated with labial and lingual appliances. MATERIALS AND METHODS: Twenty-four consecutively treated Class II cases with extractions and lingual appliance were compared with 25 matched cases treated with extraction and labial appliance. Orthodontic treatment outcomes were evaluated by cephalometric analysis, peer assessment rating, and an objective grading system (OGS). Additionally, functional analysis was also performed in both groups after orthodontic treatment. Statistical comparison was performed using the Wilcoxon signed rank test within the groups, and the Mann-Whitney U-test was used to compare between the labial and lingual groups. RESULTS: The only significant difference between the groups was that the interincisal angle was larger in the lingual group than in the labial group. OGS evaluation showed that control over root angulation was significantly worse in the lingual group than in the labial group. There was no significant difference between groups in the amount of root resorption or in functional evaluation. CONCLUSIONS: Generally, lingual appliances offer comparable treatment results to those obtained with labial appliances. However, care should be taken with lingual appliances because they are more prone to produce uprighted incisors and root angulation.

The influence of craniofacial morphology on mandibular border movements.

Although they are widely used as diagnostic signs of temporomandibular disorders, mandibular border movements reflect not only condylar movement, but also other factors. In the present study, the authors investigated the effect of craniofacial morphology on three different mandibular border movements: maximum jaw opening, maximum jaw protrusion, and maximum jaw laterotrusion. One hundred female subjects were selected from outpatients visiting the orthodontic clinic of Okayama University Hospital. The mandibular border movements were measured using an optical recording system in three dimensions as six degrees of freedom. The craniofacial morphology was evaluated using lateral cephalograms. The results suggest that craniofacial morphology had different influences on each mandibular border movement. In particular, during maximum jaw laterotrusion, lower incisor movement strongly reflected condylar movement, and the influence of craniofacial morphology on mandibular border movement was minimal. Therefore, lower incisor movement during maximum jaw laterotrusion appears suitable to evaluate condylar movement.