Three-Dimensional Comparison in Palatal Forms Between Modified Presurgical Nasoalveolar Molding Plate and Hotz's Plate Applied to the Infants With Unilateral Cleft Lip and Palate.

The presurgical nasoalveolar molding plate appliance with stent (PNAM) extended from the palatal molding plate; to correct the nostril shape of infants with cleft lip and palate is well known. The PNAM appliance is based on the finding that a high degree of plasticity is maintained in the cartilage of infants during the first 6 weeks after birth. However, on the current PNAM protocol described by Grayson et al. the nasal stent is supposed to be an adjunct to the palatal molding plate after reducing the severity of the alveolar cleft width. We have used the modified Hotz's plate from the setup model and built up the nasal stent even before reducing the severity of the alveolar deformity. In this study we assess the effects of the modified Hotz's plate and the modified PNAM appliance for the alveolar and palatal form. The lateral deviation of the incisal point, the width of the palatal cleft, and the degree of curvature of the palatal vault were first evaluated on plaster models. The PNAM group is smaller on the lateral deviation of the incisal point than the modified Hotz's group. The decreased average width of the palatal cleft and curvature of the palate, was almost the same in both the modified Hotz's and PNAM groups. In comparison with the modified Hotz's plate, the modified PNAM appliance also improves the molding of the alveolar segments and reduces cleft width.

Relationship between the direction of mandibular growth and masseter muscle conduction velocity.

INTRODUCTION: The purpose of this study was to investigate the relationship between muscle conduction velocity (MCV) of the masseter muscle and the direction of mandibular growth. METHODS: Longitudinal cephalometric X-rays taken at the prepubertal and postpubertal periods of 16 Japanese girls were analyzed. MCV was calculated from the delay in myoelectric signals obtained by using multiple surface electrode arrays placed along the fibers of the left masseter muscle in the postpubertal period. The direction of mandibular growth was evaluated by superimposition of the lateral cephalometric X-rays at the prepubertal and postpubertal periods. The relationship between MCV and the direction of mandibular growth was analyzed statistically. RESULTS: MCV was significantly correlated with the vertical facial height at the postpubertal period and the direction of mandibular condyle growth. CONCLUSIONS: If the relationship between prepubertal and postpubertal of MCV is clarified, it might be possible to predict the direction of mandibular growth and the vertical facial proportions at the postpubertal period from MCV of the masseter muscle at the prepubertal period.

Predicting mandibular growth potential with cervical vertebral bone age.

This study assessed the possibility of using cervical vertebral bone age determined from cephalometric radiographs to predict mandibular growth potential. The subjects were 2 groups of 20 Japanese girls and young women: one group to derive a formula for predicting mandibular growth potential, the other to compare predicted values with actual values. Each group included subjects in the initial stage of the pubertal growth period and the final stage of growth in early adulthood. A formula for predicting mandibular growth potential that included cervical vertebral bone age and the actual growth of the mandible (condylion-gnathion) was determined with regression analysis. Cervical vertebral bone age, bone age on hand-wrist radiographs, and chronological age were inserted into the formula, and actual values and values predicted with these parameters of the formula for mandibular growth potential were compared. The formula found mandibular growth potential (in millimeters) = -2.76 x cervical vertebral bone age + 38.68. The average error between the value predicted by cervical vertebral bone age and the actual value (1.79 mm) was significantly less (P <.001) than that between the actual value and the value predicted by chronological age (3.48 mm) and approximately the same as that between the actual value and the value predicted by bone age (2.09 mm). The formula derived from this study might be useful for treating orthodontic patients in the growth stage.

Cervical vertebral bone age in girls.

The purpose of this study was to establish cervical vertebral bone age as a new index for objectively evaluating skeletal maturation on cephalometric radiographs. Using cephalometric radiographs of 176 girls (ages 7.0-14.9 years), we measured cervical vertebral bodies and determined a regression formula to obtain cervical vertebral bone age. Next, using cephalometric and hand-wrist radiographs of another 66 girls (ages 8.0-13.9 years), we determined the correlation between cervical vertebral bone age and bone age using the Tanner-Whitehouse 2 method. The following results were obtained: (1) a regression formula was determined to obtain cervical vertebral bone age based on ratios of measurements in the third and fourth cervical vertebral bodies; (2) the correlation coefficient for the relationship between cervical vertebral bone age and bone age (0.869) was significantly (P <.05) higher than that for the relationship between cervical vertebral bone age and chronological age (0.705); and (3) the difference (absolute value) between the cervical vertebral bone age and bone age (0.75 years) was significantly (P <.001) smaller than that between cervical vertebral bone age and chronological age (1.17 years). These results suggest that cervical vertebral bone age reflects skeletal maturity because it approximates bone age, which is considered to be the most reliable method for evaluating skeletal maturation. Using cervical vertebral bone age, it might be possible to evaluate maturity in a detailed and objective manner on cephalometric radiographs.